bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a hand massage with a warm hand bath on sleep and relaxation in elderly women with disturbance of sleep: A crossover trial
Authors: Kudo Yukiko , Sasaki Makiko
Published: February 2020

Aim

The purpose of the present study was to clarify the effects of a hand massage with a warm hand bath on sleep, autonomic nervous activity, subjective sleep quality, and relaxation in elderly women with sleep disturbance.

Methods

A crossover design was used. Participants were assigned to two groups: a structured control first and intervention second condition, or an intervention first and control second condition. The sleep index as assessed by actigraphy, autonomic nervous activity, subjective sleep quality, and relaxation was then recorded.

Results

The mean age of the participants was 77.8 ± 6.8 years (n = 28). According to the actigraph, the intervention day showed significantly improved sleep efficiency (p = .048) and sleep onset latency (p = .015). Regarding autonomic nervous activity, heart rate decreased significantly after the intervention (p = .001), but no significant differences were seen in the other indexes. Subjective sleep quality, which was investigated using the middle‐age and aged version of the Oguri–Shirakawa–Azumi sleep questionnaire, was significantly higher after the intervention for four out of five factors. Subjective comfort and relaxation were significantly higher after the intervention for all items.

Conclusions

A hand massage with a warm hand bath in the evening improved sleep efficiency and sleep onset latency in elderly women with sleep disturbance. These results suggest that a hand bath and massage may improve subjective sleep quality and relaxation.
Scratches and grazes: a detailed microscopic analysis of trampling phenomena
Authors: COURTENAY L.A. , HUGUET R. , YRAVEDRA J.
Published: February 2020

Sedimentary abrasion and postdepositional damage to fossil remains are of great interest if considering the possible distortion they could produce in the archaeological and paleontological record. Since their discovery, natural agents such as trampling phenomena have been a topic of great taphonomic interest. Nevertheless, the majority of investigation into these traces has focused almost exclusively on their differentiation from other anthropic agents such as cut marks. In recent years, advances into bone surface modification analysis via geometric morphometrics have proven useful for in‐depth characterization of different taphonomic traces; including cut, tooth and percussion marks. Through this, a preliminary study of trampling marks using advanced 3D digital microscopy was able to detect differences between what have since been known as scratch and graze marks. The present study expands from this, developing a more detailed analysis of these traces. Here, we use advanced data science techniques to provide a means of understanding trampling mark variations, contributing to our knowledge of site formation processes. Our results show how scratch and graze marks are a product of progressional decay and changes in cortical hardness, providing a new means of understanding taphonomic processes.

Lay Description

The study of microscopic bone surface modifications in archaeology and palaeontology is of great importance, allowing for a detailed reconstruction of the formation of a site and providing a means of interpreting the fossil register. The damage that sedimentary abrasion can produce, however, is likely to distort and influence these studies, thus requiring a detailed understanding of the different traces that can be found on different materials. Here, we use advanced 3D digital microscopy and pattern recognition algorithms to analyse the different marks produced in different sedimentological contexts, also controlling for other variables such as the state of the bone when buried, the type of bone and the time exposed to these types of damages. Through this detailed microscopic analysis of these types of damages, we are able to conclude that morphological variations in trampling marks are product of the state of decay when the bones are buried.
Comparative analysis of the body surface area calculation method used in vitiligo extent score vs the hand unit method used in vitiligo area severity index
Authors: Mogawer Rania M. , Mostafa Wedad Z. , Elmasry Maha Fathy
Published: February 2020

Background

Vitiligo Area and Severity Index (VASI) is standing on the top of the cited and implemented scoring tools for vitiligo. However, an easily applicable and time‐saving tool has been a need.

Aim

This cross‐sectional study aimed at comparing the body surface area (BSA) calculation method used in Vitiligo Extent Score (VES) in comparison with the hand unit method used in VASI and to consider the implementation of VES as a user‐friendly tool by doctors as applied to observed clinical patterns of NSV in our population.

Methods

For each patient with NSV, vitiligo was assessed using both VES and VASI as well as vitiligo disease extent by hand units.

Results

Vitiligo extent score and VASI scores showed a strong significant correlation. Both scores were found reliable in spite of the presence of unrepresented areas in the VES with tendency of the values for the BSA by the VES to be lower than that by hand units.

Conclusion

In comparison with VASI, VES has proven to be a clear, user‐friendly score for vitiligo assessment. However, special concern is to be given for required modification for pediatric population. A slight modification may be required regarding the pediatric population.
Effectiveness of horticultural therapy in people with dementia: A quantitative systematic review
Authors: Zhao Yajie , Liu Yang , Wang Zhiwen
Published: February 2020

Aims and objectives

To evaluate the effectiveness of horticultural therapy on cognitive function, agitation, positive emotion and engagement in people with dementia.

Background

The number of people with dementia is increasing rapidly, and nonpharmacological interventions such as horticultural therapy have been recommended as the first choice for these patients. Horticultural therapy involves participatory and ornamental horticultural therapy. Many original studies have examined the effectiveness of horticultural therapy in the last two decades. However, these studies vary in types of interventions, outcomes and measurement.

Design

A quantitative systematic review and meta‐analysis.

Methods

This systematic review was conducted under PRISMA guidelines. Randomised controlled trials (RCTs) and quasi‐experimental studies involving horticultural therapy for people with dementia were included. Risk of bias was assessed by the Cochrane's and Joanna Briggs Institute's tool. Reference lists and a relevant journal were searched. Meta‐analyses were conducted using RevMan 5.3. PubMed, CINAHL, Embase, BIOSIS Previews, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang, SinoMed, Cochrane Library and ProQuest Health & Medical Complete were searched. Studies from database inception to 1 July 2019 were included.

Results

This systematic review included 14 studies (4 RCTs and 10 quasi‐experimental studies) involving 411 people with dementia. The results of meta‐analyses indicated that significant differences were found in the effectiveness of participatory horticultural therapy on total score of cognitive function, agitation, positive emotion and engagement, but not in the effectiveness of ornamental horticultural activities on agitation and positive emotion.

Conclusions

The existing evidence supports the effectiveness of participatory horticultural therapy on cognitive function, agitation, positive emotion and engagement. Future high‐quality original studies are needed to draw more robust conclusions.

Relevance to clinical practice

The results support the use of participatory horticultural therapy for improving cognitive function, agitation, positive emotion and engagement of people with dementia.
Standardization Alliance Networks, Standard‐Setting Influence, and New Product Outcomes*
Authors: Wen Jinyan , Qualls William J. , Zeng Deming
Published: February 2020

Standardization alliances evolve through collaborations among firms for developing and implementing industry technical standards. Cooperative standard setting can help allied firms to gain access to external knowledge and technologies, but it is unclear how the configuration of a standardization alliance can result in improving a firm’s performance in new product development. This study examines how standardization alliance network‐based resource advantages vary across a firm’s network position and the firm’s ability to influence industry standard setting and new product outcomes. Empirical analyses, based on archival data from 170 Chinese automobile manufacturers from 1999 to 2013, indicate that firms that span structural holes in standardization alliance networks gain an advantage when focusing on early new product introductions but suffer a disadvantage when aiming at more innovative products. In contrast, taking a central position in standardization alliance networks is negatively related to a firm’s speed in bringing new products to market but positively related to the firm’s new product introduction rate. Further, standard‐setting influence significantly mediates the effect of network position on a firm’s new product speed to market. Increasing centrality and structural holes can lead to the improvement of a firm’s standard‐setting influence, and this, in turn, positively affects speed to market.
Comparison of 2 assays for measuring serum total thyroxine concentration in dogs and cats
Authors: Wolff Ewan D. S. , Bilbrough Graham , Moore George , Guptill Lynn , Scott‐Moncrieff J. Catharine
Published: February 2020

Background

No gold standard assay for serum total thyroxine (TT4) concentration in small animals exists. The Microgenics DRI TT4 (MTT4) assay is used by most reference laboratories.

Hypothesis/Objectives

IDEXX Catalyst Total T4 (CTT4) and Immulite 2000 TT4 (ITT4) results will agree with MTT4 results.

Animals

Residual small animal sera were randomized before reanalysis (dogs, CTT4 versus MTT4: n = 176, ITT4 versus MTT4: n = 74; cats, CTT4 versus MTT4: n = 319, ITT4 versus MTT4: n = 79).

Methods

Validation and method comparison study. Serum TT4 concentration was measured on all analyzers. Pairwise Pearson correlation, cumulative sum linearity test, regression, and Bland‐Altman method were performed.

Results

CTT4 versus MTT4 in dogs: constant bias (y‐intercept) was 0.10 μg/dL (95% confidence interval [CI], 0.05‐0.15), proportional bias (slope) was 0.86 μg/dL (95% CI, 0.83‐0.89); in cats, constant bias was 0.13 μg/dL (95% CI, 0.08‐0.20) and proportional bias was 1.01 μg/dL (95% CI, 0.98‐1.03), but the test for linearity failed. Bland‐Altman plots identified increasing disagreement with increasing serum TT4 concentrations.

ITT4 versus MTT4 in dogs, constant bias was 0.14 μg/dL (95% CI, 0.04‐0.22) and 0.22 μg/dL (95% CI, 0.09‐0.33) for cats; proportional bias was 0.76 (95% CI, 0.72‐0.80) for dogs and 0.71 (95% CI, 0.69‐0.74) for cats.

Conclusions and Clinical Importance

Differences in CTT4 and MTT4 results affect interpretation at higher serum TT4 concentrations. The ITT4 proportional bias will underestimate serum TT4 concentrations in dogs and cats, compared to MTT4. Serial TT4 measurements should be done using the same assay.
The effects of ulimorelin, a ghrelin agonist, on liquid gastric emptying and colonic transit in humans
Authors: James Joyce , Mair Stuart , Doll Walter , Sandefer Erik , Wurtman David , Maurer Alan , Deane Adam M , Harris M. Scott
Published: February 2020

Background

Ulimorelin, a small molecule ghrelin agonist and prokinetic agent, was effective in animal models of gastroparesis and delayed transit. However, employing once daily administration, it failed in clinical trials of postoperative ileus (POI), a condition in which colonic motility recovers last. The aim of this study was to evaluate drug dosing and regional differences in drug activity between stomach and colon.

Methods

Gastric emptying was assessed by scintigraphy in healthy adults at single doses of 600‐1200 µg kg−1 and multiple doses of 80‐600 µg kg−1 Q8H for 7 days. Colonic motility was assessed by 7‐region scintigraphic analysis at a dose of 600 µg kg−1 for 2 days. The primary endpoints were percent change in time to 50% (∆t50) liquid gastric emptying on Days 1, 4, and 6 and the geometric mean center of colonic transit at 24 hours (GC24). Plasma concentrations of free and total ulimorelin were measured for pharmacokinetic and exposure‐response modeling.

Key Results

Ulimorelin 150‐600 µg kg−1 every 8 hours resulted in statistically significant improvements (∆t50 = 23% to 46% (P < .05)) in gastric emptying from baseline that were sustained through Day 6. However, no effects on GC24 were observed. Pharmacokinetic analyses suggested that the free concentrations of ulimorelin achieved in POI trials and dosing frequency may have been inadequate.

Conclusions and Inferences

Ulimorelin is a potent gastric prokinetic but lacks evidence of activity in the human colon, pointing to the stomach as the predominant site of action of ghrelin in humans; ClinicalTrials.gov NCT02993055.
Comparison of antegrade continence enema treatment and sacral nerve stimulation for children with severe functional constipation and fecal incontinence
Authors: Vriesman Mana H. , Wang Lyon , Park Candice , Diefenbach Karen A. , Levitt Marc A. , Wood Richard J. , Alpert Seth A. , Benninga Marc A. , Vaz Karla , Yacob Desale , Di Lorenzo Carlo , Lu Peter L.
Published: February 2020

Background

To compare antegrade continence enema (ACE) treatment and sacral nerve stimulation (SNS) in children with intractable functional constipation (FC) and fecal incontinence (FI).

Methods

We performed a retrospective review of children 6‐18 years old with FC and FI treated with either ACE or SNS at our institution. We recorded symptoms at baseline, 6 months, 12 months, 24 months, and their most recent visit after starting treatment. We compared improvement in FI, bowel movement (BM) frequency, abdominal pain, laxative use, and complications. Patients were contacted to evaluate perceived benefit using the Glasgow Children's Benefit Inventory.

Key Results

We included 23 patients treated with ACE (52% female, median age 10 years) and 19 patients treated with SNS (74% female, median age 10 years). Improvement in FI was greater with SNS than ACE at 12 months (92.9% vs 57.1%, P = .03) and 24 months (100% vs 57.1%, P = .02). Improvement in BM frequency was greater with ACE, and children were more likely to discontinue laxatives at all follow‐up time points (all P < .05). Improvement in abdominal pain was greater with ACE at the most recent visit (P < .05). Rate of complications requiring surgery was similar between groups (26.3% vs 21.7%). Benefit was reported in 83.3% and 100% of ACE and SNS groups, respectively (NS).

Conclusions and Inferences

Although both ACE and SNS can lead to durable improvement in children with FC and FI, SNS appears more effective for FI and ACE more effective in improving BM frequency and abdominal pain and in discontinuation of laxatives.
Rising prevalence of BMI ≥40 kg/m2: A high‐demand epidemic needing better documentation
Authors: Williamson Kath , Nimegeer Amy , Lean Michael
Published: February 2020

Whilst previously rare, some surveys indicate substantial increases in the population with body mass index (BMI) ≥40 kg/m2 since the 1980s. Clinicians report emerging care challenges for this population, often with high resource demands. Accurate prevalence data, gathered using reliable methods, are needed to inform health care practice, planning, and research. We searched digitally for English language sources with measured prevalence data on adult BMI ≥40 collected since 2010. The search strategy included sources identified from recent work by NCD‐RisC (2017), grey sources, a literature search to find current sources, and digital snowball searching. Eighteen countries, across five continents, reported BMI ≥40 prevalence data in surveys since 2010: 12% of eligible national surveys examined. Prevalence of BMI ≥40 ranged from 1.3% (Spain) to 7.7% (USA) for all adults, 0.7% (Serbia) to 5.6% (USA) for men, and 1.8% (Poland) to 9.7% (USA) for women. Limited trend data covering recent decades support significant growth of BMI ≥40 population. Methodological limitations include small samples and data collection methods likely to exclude people with very high BMIs. BMI ≥40 data are not routinely reported in international surveys. Lack of data impairs surveillance of population trends, understanding of causation, and societal provision for individuals living with higher weights.
Milestones in the fight to eliminate trachoma
Authors: West Sheila K
Published: February 2020

Purpose

Trachoma, a chronic conjunctivitis that can result in vision loss from trichiasis, is targeted for global elimination by 2020. Several milestones in the long process towards elimination are noteworthy for the impact they have had on changing or accelerating progress. The purpose of this review is to describe the milestones and the impact they have had both for trachoma elimination and beyond.

Findings

Eight milestones are presented. They are discovery of the causative agent; development of a clinical grading scheme; establishment of the World Health Organization Alliance for the Global Elimination of Trachoma by 2020; setting targets that define elimination; building an evidence base for trichiasis surgery; azithromycin donation programme; use of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvement); and The Global Trachoma Mapping Project.

These milestones have significantly pushed the progress towards elimination. Despite challenges to achieving the goal of elimination by 2020, there is continued commitment into the future to ensure that this preventable cause of blindness is no longer a threat.
New perspectives in gene therapy for inherited disorders
Authors: Cicalese Maria Pia , Aiuti Alessandro
Published: February 2020

Gene therapy has become promising in many fields of medicine, as a single treatment could allow long‐lasting and curative benefits. New medicines based on cell gene correction are expected to occur in upcoming years and will be hopefully part of the therapeutic armamentarium for inherited and acquired diseases. Issues related to the costs of these new therapies and access to care for all patients, and procedures and expertise needed to facilitate their application worldwide require to be addressed, together with long‐term safety and efficacy monitoring.
Eosinophilic esophagitis and other eosinophilic disorders of the gastrointestinal tract
Authors: Cianferoni Antonella
Published: February 2020

Eosinophilic disorders of the gastrointestinal tract (EGID) are a group of diseases characterized by an eosinophilic inflammation limited to the GI tract. EoE is by far the most common EGID and is an atopic chronic/relapsing eosinophilic inflammation of the esophagus. It is now recognized as an increasingly common cause of esophageal dysfunction, fibrosis, stricture, and food impaction in children and adults. There are globally accepted guidelines for its treatment that are based on the use of proton pump inhibitors (PPI), corticosteroids, and diet. Many clinical trials have been published on the use of biologics in this disease. Non‐EoE‐EGID is a rare, more severe disease. No globally accepted guidelines exist for their treatment and diagnosis. Corticosteroids are at the moment the most effective treatment of those diseases.
Macrophage activation syndrome in pediatrics
Authors: Alongi Alessandra , Naddei Roberta , De Miglio Laura , Natoli Valentina , Ravelli Angelo
Published: February 2020

Macrophage activation syndrome (MAS) is a serious, potentially life‐threatening, hyperinflammatory condition, which belongs to the spectrum of hemophagocytic lymphohistiocytosis (HLH) and can complicate several immunologic and rheumatic disorders. MAS is characterized by a dysfunctional immune response that is similar to that seen in other forms of HLH. Because MAS may pursue a rapidly fatal course, prompt recognition of its clinical and laboratory features and immediate therapeutic intervention are fundamental. Recently, a set of classification criteria for MAS complicating sJIA has been developed through a multinational collaborative effort. High‐dose parenteral corticosteroids remain the mainstay of treatment of MAS.
Photoreactive DNA as a Tool to Study Replication Protein A Functioning in DNA Replication and Repair
Authors: Rechkunova Nadejda I. , Lavrik Olga I.
Published: February 2020

Replication protein A (RPA), eukaryotic single‐stranded DNA‐binding protein, is a key player in multiple processes of DNA metabolism including DNA replication, recombination and DNA repair. Human RPA composed of subunits of 70‐, 32‐ and 14‐kDa binds ssDNA with high affinity and interacts specifically with multiple proteins. The RPA heterotrimer binds ssDNA in several modes, with occlusion lengths of 8–10, 13–22 and 30 nucleotides corresponding to global, transitional and elongated conformations of protein. Varying the structure of photoreactive DNA, the intermediates of different stages of DNA replication or DNA repair were designed and applied to identify positioning of the RPA subunits on the specific DNA structures. Using this approach, RPA interactions with various types of DNA structures attributed to replication and DNA repair intermediates were examined. This review is dedicated to blessed memory of Prof. Alain Favre who contributed to the development of photoreactive nucleotide derivatives and their application for the study of protein–nucleic acids interactions.
Growth and growth constraints in craft industry clusters: The batik industries of Central Java
Authors: Phelps Nicholas A. , Wijaya Holi Bina
Published: February 2020

We investigate the constraints on and forms of business change and how these shape collective dynamics in batik‐producing districts in Indonesia. Conceptually, this paper argues the need to incorporate insights regarding the constraints on, forms of change and segmentation of small businesses with those relating to the collective dynamics of industry agglomerations and the possibilities for policy to effect joint action. We examined 89 batik businesses surveyed across four districts in Surakarta and Pekalongan, Central Java. Overall, the picture we find is one of constraint, modest forms of change and weariness of the effects that policy can have on collective dynamics. In the face of much diminished batik industry agglomerations in both cities, we find little evidence of differences in growth patterns and constraints according to location or industry segment.
Gangs, identity, and cultural performance
Authors: Lauger Timothy R.
Published: February 2020

Although the notion of identity has received substantial attention from sociologists and psychologists, it has not been well developed in the gang literature. Identity accounts for a person's sense of self, which is based on meaningful social interactions and group participation, and becomes a source for publicly performing social roles. Gang membership is one such role that merits significant attention, and existing theories about identity and role performance can help explain variations in criminal behavior among members. This article applies multiple perspectives on social, personal, and collective identity to gangs and gang members. It offers principles to explain how gang identities fuel social performances that mimic, induce, or involve criminal behavior.
Environmental and anthropogenic factors associated with increased malaria incidence in South‐Kivu Province, Democratic Republic of the Congo
Authors: Bigirinama R. N. , Ntaongo J. A. , Batumbo D. , Sam‐Agudu N. A. , Katoto P. D. M. C. , Byamungu L. N. , Karume K. , Nachega J. B. , Bompangue D. N.
Published: February 2020

Objective

To examine environmental and human factors that affect the spatial and temporal dynamism of malaria in DRC’s South‐Kivu province.

Methods

In a cross‐sectional study conducted between 1 January 2010 and 31 December 2015, spatial distribution was determined through thematic maps of malaria attack rate. SatScan ™ software and Monte Carlo test were used to identify spatial risk clusters. Temporal evolutions were analysed using the Cleveland algorithm. Generalized Additive Models for Location Scale and Shape and negative binomial regression were used to assess the independent human and environmental factors associated with incident malaria.

Results

The cumulative annual incidence of malaria increased from 10 968/100 000 in 2013 to 15 501/100 000 in 2015 (P for trend ˂0.001); malaria lethality increased from 0.1% in 2013 to 0.3% in 2015 (P for trend = 0.62). Between 2010 and 2015, 18 of 34 health zones consistently reported the highest attack rates, which ranged from 25 000 to 50 000/100 000. Four risk clusters areas were identified, with relative risk (RR) of 1.2 to 3.0, from which malaria was reported continuously during each year. Factors significantly associated with malaria cases were agro‐pisciculture practices (Incidence Risk Ratio [IRR]: 1.96; 95% CI: 1.23–3.13) and the presence of a lake in the health zone (IRR: 2.48, 95% CI: 1.51–4.42).

Conclusions

Malaria control in this setting must be intensified in peri‐lacustrine areas and those in which the population is intensively engaged in standing water‐associated activities.
Sustainability and Outcomes of a Suicide Prevention Program for Nurses
Authors: Davidson Judy E. , Accardi Rachael , Sanchez Courtney , Zisook Sidney , Hoffman Laura A.
Published: February 2020

Background

We now know that nurses are at greater risk for suicide than others in the general population. It is known that job stressors are prevalent in nurses who die by suicide. Yet, little is known about targeted suicide prevention for nurses. The first nurse‐centric Healer Education Assessment and Referral (HEAR) suicide prevention program was piloted for 6 months in 2016. The HEAR program was effective in identifying at‐risk nurses.

Aim

The purpose of this paper is to report the 3‐year sustainability and outcomes of this nurse suicide prevention program.

Methods

Descriptive statistics are provided of program outcomes over the course of 3 years.

Results

Over the 3 years, 527 nurses have taken advantage of the screening portion of the program. Of these, 254 (48%) were Tier 1 high risk, and 270 (51.2%) were Tier 2 moderate risk. A startling 48 (9%) had expressed thoughts of taking their own life, 51 (9.7%) had a previous suicide attempt, whereas only 79 (15%) were receiving counseling or therapy. One hundred seventy‐six nurses received support from therapists electronically, over the phone, or in person; 98 nurses accepted referral for treatment. The number of group emotional debriefs rose from eight in 2016 to 15 in 2017 to 38 in fiscal year 2019. Many of the debriefs are now requested (vs. offered), demonstrating the development of a culture open to reaching out for mental health treatment.

Linking Evidence to Action

The initial success of this pilot program has been sustained. A nurse suicide prevention program of education, assessment, and referral is feasible, well‐received, proactively identifies nurses with reported suicidality and facilitates referral for care. The HEAR program has provided service to physicians and residents for 10 years and now supports effectiveness in nurses. The HEAR program is portable and ready for replication at other institutions.
Authentic Connections Groups: A Pilot Test of an Intervention Aimed at Enhancing Resilience Among Nurse Leader Mothers
Authors: Chesak Sherry S. , Bhagra Anjali , Cutshall Susanne , Ingram Alexandra , Benoit Renee , Medina‐Inojosa Jose R. , Hayes Sharonne N. , Carolan Bridget J. , Luthar Suniya
Published: February 2020

Background

Nurse leaders who are mothers are at significant risk for experiencing stress, burnout, and occupational fatigue. Authentic Connections (AC) Groups is an intervention shown to be effective for fostering resilience among at‐risk moms, including physicians; however, it has not previously been tested with nurse leaders.

Aims

Our aims were to test the feasibility and acceptability of the AC Groups intervention with nurse leader mothers and examine its effects on participant resilience, as measured by increased self‐compassion and decreased distress, depression, perceived stress, and burnout.

Methods

A randomized controlled trial design was employed for this pilot study, with 36 nurse leaders at Mayo Clinic. AC participants attended group sessions for an hour per week for 12 weeks. Control group members were provided 1 hr per week of free time over 12 weeks. Multiple self‐report psychological measures were completed at baseline, post‐intervention, and 3‐month follow‐up.

Results

The AC Groups intervention was feasible and well‐received by nurse leaders. Session attendance rates averaged 92%. Despite the small n’s, repeated measures of Analysis of Variance showed significantly greater improvements (p < .05) for participants in the AC Groups than control condition for depression, self‐compassion, and perceived stress, with large effect sizes ( 0.18–0.22). In addition, effect sizes for anxiety and feeling loved approximated the moderate range ( 0.05 and .07).

Linking Evidence to Action

The AC intervention shows promise as a feasible intervention for mitigating nurse leader mothers’ stress by positively impacting indices of well‐being, including depression, self‐compassion, and perceived stress. Given, the prevalence of stress and burnout among nurse leaders, the effectiveness of the AC intervention in fostering resilience in this population has significant implications for research and practice. Further research is warranted with larger numbers from multiple sites, longer follow‐up periods, and biomarker measures of stress.
Vortex Tube Operational Temperature Regime
Authors: Bargiel Paweł , Skorek Janusz , Usón Sergio , Klimanek Adam , Kostowski Wojciech
Published: February 2020

New temperature limits model of the Ranque–Hilsch vortex tube has been proposed within the presented paper. The model originates from the local compression/expansion and inner friction hypothesis anticipated to be responsible for the Ranque–Hilsch effect. The model in a presented form provides a fair estimation of the temperature limits at each outlet, hence enabling its application on new thermodynamic cycles studies that include vortex tube in the process. The drawback of the proposed model is its simplification by neglecting the impact of kinetic energy on the anticipated temperature values at each outlet.
Flame Stability in Inverse Coaxial Injector Using Repetitive Nanosecond Pulsed Plasma
Authors: Zare Saeid , Lo Hao Wei , Askari Omid
Published: February 2020

Recently, methane has been investigated as a feasible fuel for propulsion systems. The higher boiling point and higher density of methane, compared with hydrogen, makes its storage tank lighter, cheaper, and smaller to launch. Methane is abundant in the outer solar system and can be harvested on Mars, Titan, Jupiter, and many other planets and therefore, it can be used in reusable rocket engines. However, there are still some technological challenges in the methane engines development path. For example, ignition reliability and flame stability are of great importance. These challenges can be addressed by integrating low-temperature plasma (LTP) through repetitive nanosecond pulsed (RNP) discharge to the injector design. This research focuses on air/CH4 jet flames in a single-element coaxial shear injector coupled with RNP plasma discharge to study the influence of LTP on ignition characteristics and flame stability using advanced diagnostic techniques. The experiments have been performed for different fuel composition, jet velocities, discharge voltages, and frequencies at atmospheric conditions. The transient flame behavior including flame oscillation is studied using direct photography by CMOS high-speed camera. The effect of plasma discharge location on flame stability is also investigated. To demonstrate the effectiveness of RNP discharge on liftoff and blowout/blowoff velocities, the jet velocity at the critical conditions is measured and the enhancements of flame stability are then evaluated. The collected experimental data have shown that the RNP discharge can significantly extend the stability by reducing the liftoff height and increasing the velocity of blowout/blowoff phenomena.
Intra- and inter-muscular differences in the cross-sectional area of the quadriceps muscles assessed by extended field-of-view ultrasonography
Authors: Sahinis Chrysostomos , Kellis Eleftherios , Galanis Nikiforos , Dafkou Konstantinos , Ellinoudis Athanasios
Published: February 2020

Aim: Τo examine the inter- and intra-muscular differences in the anatomical cross-sectional area (CSA) of the quadricep muscles, using extended - field of view (EFOV) ultrasonography (US).Material and methods: Panoramic transverse US images of the thigh were acquired from 10 young participants at five different locations across the thigh, in two sessions, spaced a week apart. The CSA of the vastus medialis (VM), rectus femoris (RF), vastus intermedius (VI), vastus lateralis (VL) and tensor vastus intermedius (TVI) was quantified.Results: The intraclass correlation coefficients ranged from 0.75 to 0.97 and the standard error of measurement ranged from 0.78% to 6.61%, indicating high test-retest reliability. Analysis of the variance indicated that among the 5 quadriceps muscles the VL and the RF displayed the greater CSA proximally, the VI medially and the VM distally across the thigh (p <0.05). No differences in the quadriceps CSA measured with and without including the TVI were found (p >0.05).Conclusions: The EFOV US technique provides transverse scans of the quadriceps muscle in vivo and allowed a reliable and non-invasive determination of CSA at a low cost. Evaluation of CSA along the thigh largely depends on the measurement site. Future studies that examine the quadriceps CSA using EFOV after any form of intervention should consider changes of at least 6.5% as meaningful.
Magnetic resonance imaging and ultrasound for assessing parametrial infiltration in cervical cancer. A systematic review and meta-analysis
Authors: Alcazar Juan Luis , García Encarnación , Machuca Marcela , Quintana Raquel , Escrig Julia , Chacón Enrique , Mínguez José Angel , Chiva Luis
Published: February 2020

Aims: To provide information on the current evidence regarding the diagnostic performance of ultrasound and MRI for assessing parametrial involvement in cervical cancer using the histological report as the reference standard.Material and methods: Meta-analysis. An extensive search of papers comparing ultrasound and MRI in assessing parametrial infiltration in cervical cancer using pathologic analysis as a reference standard was performed in Medline (Pubmed) and Web of Science from January 1990 to September 2019. Quality was assessed using the QUADAS-2 tool.Results: Our extended search identified 205 citations but after exclusions we finally included 9 articles in the meta-analysis. The risk of bias for most studies was low for four domains were assessed in QUADAS-2. Overall, for ultrasound pooled estimated sensitivity and specificity for diagnosing parametrial infiltration was 78% (95% confidence interval [CI]:48%–93%) and 96% (95% CI=89%–99%), respectively. For MRI these figures were 68% (95% CI=54%–80%) and 91% (95% CI=84%–95%), respectively. No statistical differences were found when comparing both methods (p=0.548). Heterogeneity was low/moderate for MRI and high for ultrasound.Conclusion: Ultrasound and MRI have similar diagnostic performance for detecting parametrial infiltration in women with cervical cancer. This might have relevance from the clinical point of view, since ultrasound is cheaper than MRI
Neutral Processes Dominate Microbial Community Assembly in Atlantic Salmon,
Salmo salar
Authors: Heys C. , Cheaib B. , Busetti A. , Kazlauskaite R. , Maier L. , Sloan W. T. , Ijaz U. Z. , Kaufmann J. , McGinnity P. , Llewellyn M. S.
Published: February 2020

A growing number of studies have examined variation in the microbiome to determine the role in modulating host health, physiology, and ecology. However, the ecology of host microbial colonization is not fully understood and rarely tested. The continued increase in production of farmed Atlantic salmon, coupled with increased farmed-wild salmon interactions, has accentuated the need to unravel the potential adaptive function of the microbiome and to distinguish resident from transient gut microbes. Between gut compartments in a farmed system, we found a majority of operational taxonomic units (OTUs) that fit the neutral model, with
Mycoplasma
species among the key exceptions. In wild fish, deterministic processes account for more OTU differences across life stages than those observed across gut compartments. Unlike previous studies, our results make detailed comparisons between fish from wild and farmed environments, while also providing insight into the ecological processes underpinning microbial community assembly in this ecologically and economically important species.
The Blood Stage Antigen RBP2-P1 of Plasmodium vivax Binds Reticulocytes and Is a Target of Naturally Acquired Immunity
Authors: Chim-Ong Anongruk , Surit Thitiporn , Chainarin Sittinont , Roobsoong Wanlapa , Sattabongkot Jetsumon , Cui Liwang , Nguitragool Wang
Published: February 2020

The interactions between
Plasmodium
parasites and human erythrocytes are prime targets of blood stage malaria vaccine development. The reticulocyte binding protein 2-P1 (RBP2-P1) of
Plasmodium vivax
, a member of the reticulocyte binding protein family, has recently been shown to be highly antigenic in several settings endemic for malaria. Yet, its functional characteristics and the relevance of its antibody response in human malaria have not been examined. In this study, the potential function of RBP2-P1 as an invasion ligand of
P. vivax
was evaluated.
Novel Tat-Dependent Protein Secretion
Authors: Braun Volkmar , Hantke Klaus
Published: February 2020

The transcription initiation signal elicited by the binding of ferric citrate to the outer membrane FecA protein is transmitted by the FecR protein across the cytoplasmic membrane to the FecI extracytoplasmic function (ECF) sigma factor. In this issue of
Journal of Bacteriology
, I. J. Passmore, J. M. Dow, F. Coll, J. Cuccui, et al. (J Bacteriol 202:e00541-19, 2020,
https://doi.org/10.1128/JB.00541-19
) report that the FecR sequence contains both the twin-arginine signal motif and the secretory (Sec) avoidance motif typical of proteins secreted by the twin-arginine translocation (TAT) system.
Human T-Cell Lymphotropic Virus Type 1 Transactivator Tax Exploits the XPB Subunit of TFIIH during Viral Transcription
Authors: Martella Christophe , Tollenaere Armelle Inge , Waast Laetitia , Lacombe Benoit , Groussaud Damien , Margottin-Goguet Florence , Ramirez Bertha Cecilia , Pique Claudine
Published: February 2020

HTLV-1 is considered the most potent human oncovirus and is also responsible for severe inflammatory disorders. HTLV-1 transcription is undertaken by RNA polymerase II and is controlled by the viral oncoprotein Tax. Tax transactivates the viral promoter first via the recruitment of CREB and its cofactors to the long terminal repeat (LTR). However, how Tax controls subsequent steps of the transcription process remains unclear. In this study, we explore the link between Tax and the XPB subunit of TFIIH that governs, via its ATPase activity, the promoter-opening step of transcription. We demonstrate that XPB is a novel physical and functional partner of Tax, recruited on HTLV-1 LTR, and required for viral transcription. These findings extend the mechanism of Tax transactivation to the recruitment of TFIIH and reinforce the link between XPB and transactivator-induced viral transcription.
Herpes Simplex Virus Glycoprotein C Regulates Low-pH Entry
Authors: Komala Sari Tri , Gianopulos Katrina A. , Weed Darin J. , Schneider Seth M. , Pritchard Suzanne M. , Nicola Anthony V.
Published: February 2020

Herpesviruses are ubiquitous pathogens that cause lifelong latent infections and that are characterized by multiple entry pathways. We propose that herpes simplex virus (HSV) gC plays a selective role in modulating HSV entry, such as entry into epithelial cells, by a low-pH pathway. gC facilitates a conformational change of the main fusogen gB, a class III fusion protein. We propose a model whereby gC functions with gB, gD, and gH/gL to allow low-pH entry. In the absence of gC, HSV entry occurs at a lower pH, coincident with trafficking to a lower pH compartment where gB changes occur at more acidic pHs. This report identifies a new function for gC and provides novel insight into the complex mechanism of HSV entry and fusion.
A Nonfunctional Opsonic Antibody Response Frequently Occurs after Pneumococcal Pneumonia and Is Associated with Invasive Disease
Authors: Uddén Fabian , Ahl Jonas , Littorin Nils , Strålin Kristoffer , Athlin Simon , Riesbeck Kristian
Published: February 2020

Numerous reports on the dynamics of antipneumococcal immunity in relation to immunization with pneumococcal vaccines and on the prevalence of naturally acquired immunity in various populations have been published. In contrast, studies on the dynamics of the humoral immune response triggered by pneumococcal infection are scarce. This study provides valuable information that will contribute to fill this knowledge gap. Our main results indicate that a functional immune response frequently fails to occur after CAP, predominantly among patients with simultaneous bacteremia.
Geometry-Aware Cell Detection with Deep Learning
Authors: Jiang Hao , Li Sen , Liu Weihuang , Zheng Hongjin , Liu Jinghao , Zhang Yang
Published: February 2020

Automated diagnostic microscopy powered by deep learning is useful, particularly in rural areas. However, there is no general method for object detection of different cells. In this study, we developed GFS-ExtremeNet, a geometry-aware deep-learning method which is based on the detection of four extreme key points for each object (topmost, bottommost, rightmost, and leftmost) and its center point. A postprocessing step, namely, adjacency spectrum, was employed to measure whether the distances between the key points were below a certain threshold for a particular cell candidate. Our newly proposed geometry-aware deep-learning method outperformed other conventional object detection methods and could be applied to any type of cell with a certain geometrical order. Our GFS-ExtremeNet approach opens a new window for the development of an automated cell detection system.
Provider perspectives of the introduction and implementation of care for drug-resistant tuberculosis patients in district-level facilities in South Africa: a qualitative study
Authors: Vanleeuw Lieve , Atkins Salla , Zembe-Mkabile Wanga , Loveday Marian
Published: February 2020

Objectives

Drug-resistant tuberculosis (DR-TB) is a growing concern in many low-income and middle-income countries. Facing rising numbers of DR-TB patients, South Africa (SA) introduced a decentralised model of care for DR-TB in 2011. We aimed to document the introduction and implementation of the new models of care for patients with DR-TB in four provinces (Northern Cape, KwaZulu-Natal, Eastern Cape and Gauteng) in 2015 using mixed methods, including interviews, register reviews and clinical audits. This paper reports on the qualitative component of the study.

Design

This is a qualitative interview study.

Setting

Data were collected in 22 decentralised DR-TB sites, primary healthcare facilities and district hospitals and one provincial central DR-TB hospital.

Participants

58 healthcare workers (HCWs), facility staff and provincial and district TB coordinators were included in qualitative interviews.

Results

HCWs felt that the introduction of DR-TB care in their facility came with little warning or engagement, creating fear and anxiety. They expressed a need for support from the district and province to guide them through the changes but this support was often lacking. In addition, many respondents expressed feeling isolated and not supported by other healthcare providers which they feel impacts on the quality of the care they provide.

Conclusion

Introduction of a new service such as DR-TB care can be difficult and does not always result in the intended outcomes. Improved engagement with front-line providers and addressing the fear and anxiety that may be raised by changes in daily practices should be addressed to ensure successful implementation and prevent negative consequences that can hamper quality of care for patients. Attention should be paid to how the decentralised DR-TB unit can be supported by district management and other healthcare providers.
Challenges in the acute identification of mild traumatic brain injuries: results from an emergency department surveillance study
Authors: Pozzato Ilaria , Meares Susanne , Kifley Annette , Craig Ashley , Gillett Mark , Vu Kim Van , Liang Anthony , Cameron Ian , Gopinath Bamini
Published: February 2020

Objectives

To establish the proportion of mild traumatic brain injury (mTBI) diagnosis among people presenting to an emergency department (ED), to determine the accuracy of recorded ED diagnoses. We also aimed to describe challenges in mTBI case identification and its acute hospital management.

Design and setting

A retrospective chart review of all ED attendances to a major trauma hospital, over a 9-month period (June 2015–February 2016).

Participants

Adults aged 18–65 years consecutively presenting to an ED.

Primary outcome measures

Proportion of mTBI diagnosis among ED attendances (ie, confirmed mTBI based on the WHO criteria or indeterminate mTBI based on secondary criteria), and proportion of accurately recorded mTBI diagnosis by ED clinicians (ie, ‘mTBI’, ‘concussion’).

Results

Of 30 479 ED attendances, 351 (1.15%) confirmed mTBI diagnosis and 180 (0.6%) indeterminate diagnosis were identified. Only 81 (23.1%) individuals with a confirmed mTBI had a ‘mTBI diagnosis’ clearly recorded in the medical notes. Of the allocated discharge diagnosis codes to the two identified cohorts, 89.8% were not indicative of mTBI. Intracranial injuries were found in 31 (8.5%) confirmed cases. Glasgow Coma Scale scores were consistently assessed in the ED but identified only 117 (33.3%) confirmed mTBI cases. Post-traumatic amnesia (PTA) testing was able to confirm acute cognitive impairment in 113 (62.1%) of those who were tested (182, 51.3%).

Conclusions

mTBI is a common, but an under-recognised cause for ED attendance. Despite challenges, the use of an operational definition such as the WHO diagnostic criteria can improve accuracy in mTBI identification. Acute management may be enhanced by rapid assessment of PTA.