bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of interpersonal style in aggression and its containment in a forensic mental health setting: A correlational and pseudoprospective study of patients and nursing staff
Authors: Jalil Rahul , Huber Jorg W. , Sixsmith Judith , Dickens Geoffrey L.
Published: December 2019

Inpatient aggression on mental health wards is common and staff–patient interactions are frequently reported antecedents to aggression. However, relatively little is known about the precise relationship between aggression and these interactions, or their relationships with aggression and staff containment responses such as restraint and seclusion. This study aimed to determine the roles of anger and interpersonal style among mental health nurses and between nurses and patients in the occurrence of aggression and its containment. A correlational, pseudoprospective study design was employed. n = 85 inpatients and n = 65 nurses were recruited from adult, low‐ and medium‐secure wards of a secure forensic mental health service. Participants completed validated self‐report anger and transactional interpersonal style measures. Inpatient aggression and containment incident data for a 3‐month follow‐up period were extracted from clinical records. Dyadic nurse–patient relationships were anticomplementary. Patients' self‐reported anger and staff‐rated hostile interpersonal style were significantly positively correlated; staff self‐reported anger and patient‐rated dominant interpersonal style were also positively correlated. Patient anger predicted aggression and their interpersonal style predicted being subject to containment in the form of restraint and seclusion. There were no statistically significant differences identified on measures between staff who were and were not involved in containment. More targeted intervention for patients' anger may have a positive impact on interpersonal style and lead to the reduction of incidents. Staff education and skills training programmes should emphasize the importance of interpersonal styles which could help to promote and enhance positive interactions.
The effect of employee share ownership on employee commitment and turnover: comparing the cases in Britain and South Korea and the role of the economy
Authors: Yoon Yeongjoon , Sengupta Sukanya
Published: December 2019

Despite the consensus in the employee share ownership (ESO) literature for the need to explore contexts that influence ESO outcomes, studies examining two important factors, national context and status of the economy, are limited. In this study, the authors compare the outcomes of ESOs in Britain and South Korea during economic expansion and downturn. The results demonstrate that, during an economic expansion, the effect of ESOs in increasing employee commitment is stronger in South Korea, while their effect in decreasing employee turnover is stronger in Britain. However, during an economic downturn, the authors find no evidence for these effects in both societies. The findings lend support to the contingency perspective in managing ESOs and provide meaningful implications and guidance to the literature.
Platelet sonicates activate hair follicle stem cells and mediate enhanced hair follicle regeneration
Authors: Zhu Meishu , Kong Deqiang , Tian Ruiyun , Pang Mengru , Mo Miaohua , Chen Yu , Yang Guang , Liu Cheng Hanghang , Lei Xiaoxuan , Fang Kunwu , Cheng Biao , Wu Yaojiong
Published: December 2019

An increasing number of studies show that platelet‐rich plasma (PRP) is effective for androgenic alopecia (AGA). However, the underlying cellular and molecular mechanisms along with its effect on hair follicle stem cells are poorly understood. In this study, we designed to induce platelets in PRP to release factors by calcium chloride (PC) or by sonication where platelet lysates (PS) or the supernatants of platelet lysate (PSS) were used to evaluate their effect on the hair follicle activation and regeneration. We found that PSS and PS exhibited a superior effect in activating telogen hair follicles than PC. In addition, PSS injection into the skin activated quiescent hair follicles and induced K15+ hair follicle stem cell proliferation in K14‐H2B‐GFP mice. Moreover, PSS promoted skin‐derived precursor (SKP) survival in vitro and enhanced hair follicle formation in vivo. In consistence, protein array analysis of different PRP preparations revealed that PSS contained higher levels of 16 growth factors (out of 41 factors analysed) than PC, many of them have been known to promote hair follicle regeneration. Thus, our data indicate that sonicated PRP promotes hair follicle stem cell activation and de novo hair follicle regeneration.
Assessment of occupational exposure and spectrum of contact sensitization in metalworkers with occupational dermatitis: results of a cohort study within the OCCUDERM project
Authors: Schubert S. , Brans R. , Reich A. , Hansen A. , Buhl T. , Skudlik C. , Mempel M. , Schön M.P. , John S.M. , Geier J.
Published: December 2019

Background

Metalworkers occupationally exposed to metals, tools, metalworking fluids (MWFs), technical oils, gloves, skin care products etc. frequently suffer from occupational dermatitis (OD).

Objectives

To investigate occupational exposure and to identify relevant occupational sensitizers in metalworkers with OD, and to evaluate suitability of current German patch test recommendations for this occupational group.

Patients and methods

As part of the OCCUDERM project, occupational exposure of 230 metalworkers with suspected OD patch tested in the departments of dermatology in Göttingen and Osnabrück (both Lower Saxony, Germany) in 2012–2017 was recorded by questionnaire. These data, as well as results, of patch testing with standardized allergens and with workplace material were analysed.

Results

Metalworking fluids and skin care products were the most important exposures. Among MWF allergens, most frequently sensitizations to formaldehyde and formaldehyde releasers, colophony/abietic acid and monoethanolamine were observed. Sensitization to methylisothiazolinone (MI) was frequent, probably as part of the general European epidemic of contact allergy to MI in leave‐on cosmetics. Sensitization to glove ingredients only played a minor role.

Conclusions

The known occupational allergen spectrum could largely be confirmed. In order not to miss relevant sensitizations, patch testing with material from the patients’ workplaces in parallel to baseline and MWF series is recommended. Sensitizations diagnosed could not always be linked to particular occupational exposures.
ERCC2 mutations in two siblings with a severe trichothiodystrophy phenotype
Authors: Leemans G. , De Raeve L. , Keymolen K.
Published: December 2019

Background

Trichothiodystrophy (TTD) describes a group of rare genetic disorders of DNA repair, characterized by sulphur‐deficient hair, skin anomalies and systemic complications like preterm delivery, neurological impairment, haematological and ophthalmological abnormalities and life‐threatening infections.

Objectives

The aim of this case report was to investigate the contribution of the gene mutation to the phenotype.

Methods

We describe the clinical and molecular characteristics of a family with two TTD‐affected siblings who died before the age of 2 years.

Results

The causal mutated gene is the ERCC2 gene, and one of the identified mutations is the c.2164C>T (p.Arg722Trp) variant. The association of this mutation with a severe TTD phenotype was suggested earlier in literature, and the present family adds further evidence to this hypothesis.

Conclusion

Accurate identification of the underlying genetic defect can guide the clinical follow‐up and counselling of patients and their families.
Target‐controlled propofol infusion with or without bispectral index monitoring of sedation during advanced gastrointestinal endoscopy
Authors: Lin Yueh‐Juh , Wang Yi‐Chia , Huang Hui‐Hsun , Huang Chi‐Hsiang , Liao Min‐Xiu , Lin Pei‐Lin
Published: December 2019

Background and Aim

Target‐controlled infusion (TCI) uses averaged pharmacokinetic datasets derived from population samples to automatically control the infusion rate. Bispectral index (BIS) technology non‐invasively measures levels of consciousness during surgical procedures. We compared the efficacy and safety of propofol TCI with or without BIS monitoring for sedation during advanced gastrointestinal endoscopy.

Methods

This prospective study enrolled 200 patients who were premedicated with midazolam 2 mg and alfentanil 0.4 mg before undergoing advanced gastrointestinal endoscopy. The initial target blood concentration of propofol was set at 1.0 μg/mL, and adjustments of 0.2 μg/mL were made as necessary to maintain moderate‐to‐deep sedation. Patients were randomized to either the BIS‐blind group and evaluated for depth of anesthesia by monitoring scores of 1–2 on the Modified Observer's Assessment of Alertness/Sedation scale (n = 100) or to the BIS‐open group and monitored by BIS scores of 60–80 (n = 100). The primary outcome was the total amount of propofol required to maintain anesthesia. Secondary outcomes were sedation‐induced adverse events, recovery, and quality of sedation (endoscopist and patient satisfaction).

Results

The mean propofol infusion rate was significantly higher in patients not monitored by BIS scores than in those who were (5.44 ± 2.12 vs 4.76 ± 1.84 mg/kg/h; P = 0.016). Levels of satisfaction were higher for endoscopists who used BIS monitoring than in those who did not.

Conclusions

Mean infusion rates were higher in propofol TCI without BIS monitoring compared with propofol TCI with BIS during advanced gastrointestinal endoscopy. Endoscopists expressed satisfaction with BIS monitoring.
Service Regulations, Input Prices and Export Volumes: Evidence from a Panel of Manufacturing Firms
Authors: Correa‐López Mónica , Doménech Rafael
Published: December 2019

Using a panel of firm‐level data from Spanish manufacturers, this study shows that better service regulation reduces the price of intermediate inputs paid by downstream firms. The beneficial cost effects of services reforms extend to both large and small‐to‐medium sized corporations (SME’s), but the former tend to enjoy greater gains. This feature also manifests itself in international markets. We find evidence of an input cost channel through which service regulations affect the volume of exports of large manufacturers, while the evidence of such a channel is weaker for SME’s. Our estimates indicate that, from 1991 to 2007, large firms increased their volume of exports by an average of 20 per cent as a result of the direct input cost effect of services reforms, such that the firms that benefited the most typically belonged to industries more dependent on service inputs. Furthermore, convergence to the ‘best practice’ regulatory framework in services would have raised exports at least by an additional nine per cent. We conclude that firm size is relevant for the connection between services reforms, intermediate input prices and export volumes.
Plagues, Pagans, and Christians: Differential Survival, Social Networks, and the Rise of Christianity
Authors: Everton Sean F. , Schroeder Robert
Published: December 2019

In his book, The Rise of Christianity, Rodney Stark argues that the early Christian church indirectly benefitted from the plagues that struck the early Roman Empire in the 2nd and 3rd centuries of the Common Era. In particular, he argues that the early church's doctrines concerning love, charity, and social service would have led Christians to enjoy higher survival rates than pagans, which would have left the social networks of the former relatively intact, while those of the latter in disarray. Moreover, since recruitment to new religious movements occurs largely through social ties, the probability that an average pagan would have converted to Christianity would have been greater after the plagues than before. In this article, we use computer modeling to test Stark's hypothesis. Not only do we find support for his hypothesis, we also show that higher survival rates for either group not only would have benefitted their respective social networks but also would have benefitted their competitor's social networks, highlighting how network effects often flow in multiple and unexpected ways. We conclude with suggestions for future research, in particular how scholars can build upon our analyses and explore alternative assumptions.
Identification with Religion: Cross‐National Evidence from a Social Psychological Perspective
Authors: Curtis K. Amber , Olson Laura R.
Published: December 2019

Why is religion a more central social identity for some people than for others? Previous studies focus on explaining individual differences in religious affiliation and religiosity, often using the term “identification” in reference to these concepts. Yet, few scholars operationalize—let alone attempt to explain—identification with religion in social psychological terms, i.e., as a construct that captures the subjective psychological centrality of one's religious identity. After underscoring the benefits of exploring religious identification using cross‐national data, we employ an original data set composed of nationally representative surveys in three European countries to model religious identification in two ways: importance (independent strength of attachment) and prominence (prioritization of one's religious identity relative to the others one holds). We document substantial variation in the degree to which individuals define themselves on the basis of their religious identity. We then test predictions drawn from existing theories to model these two measures. Our results extend current understandings of what shapes psychological attachment to religion and raise new questions for future theorization and analysis.
The phosphatase Ptc6 is involved in virulence and MAPK signalling in Fusarium oxysporum
Authors: Nunez‐Rodriguez Juan Carlos , Ruiz‐Roldán Carmen , Lemos Pedro , Membrives Sergio , Hera Concepcion
Published: December 2019

Mitogen‐activated kinase (MAPK) signalling pathways are involved in several important processes related to the development and virulence of Fusarium oxysporum. Reversible phosphorylation of the protein members of these pathways is a major regulator of essential biological processes. Among the phosphatases involved in dephosphorylation of MAPKs, type 2C protein phosphatases (PP2Cs) play important roles regulating many developmental strategies and stress responses in yeasts. Nevertheless, the PP2C family is poorly known in filamentous fungi. The F. oxysporum PP2C family includes seven proteins, but only Ptc1 has been studied so far. Here we show the involvement of Ptc6 in the stress response and virulence of F. oxysporum. Expression analysis revealed increased expression of ptc6 in response to cell wall and oxidative stresses. Additionally, targeted inactivation of ptc6 entailed enhanced susceptibility to cell wall stresses caused by Calcofluor White (CFW). We also demonstrate that the lack of Ptc6 deregulates both the Mpk1 phosphorylation induced by CFW and, more importantly, the Fmk1 dephosphorylation induced by pH acidification of the extracellular medium, indicating that Ptc6 is involved in the regulation of these MAPKs. Finally, we showed, for the first time, the involvement of a phosphatase in the invasive growth and virulence of F. oxysporum.
FHL1‐mutated reducing body myopathy
Authors: Lim Ka Young , Kim Hyun Hee , Sung Jung‐Joon , Oh Byung‐Mo , Kim Keewon , Park Sung‐Hye
Published: December 2019

Here, we report about reducing body myopathy, associated with a mutation in the four and a half LIM domain 1 gene (FHL1), identified in a 40‐year‐old woman who was suffering from subtle muscle weakness since the age of six and a limping gait since the age of 22 years. In addition to her elevated muscle enzyme level and magnetic resonance imaging, myopathy was highly suspected considering progression of symptoms. Nerve conduction studies and electromyogram suggested myopathy. The muscle biopsy revealed severe dystrophic features with many reducing bodies on hematoxylin and eosin, nicotinomide adenine dinucleotide dehydrogenase‐tetrazolium reductase (NADH‐TR), and modified Gomori stains and ubiquitin immunohistochemistry. Whole‐exome sequencing revealed Xq26.3 encoding FHL1 missense mutations (NM_001159704) in exon 4: p.C150R, c.T448C. FHL1‐mutated “reducing body myopathy” is worth reporting based on its rarity and unique clinicopathologic features including ultrastructure. The confirmative diagnosis is still very difficult before gene analysis because clinical and pathological features of this disease overlap with other myofibrillar myopathies. We stress the importance of genotype‐phenotype correlation to obtain a precise diagnosis.
Open‐label pilot study: Non‐invasive vagal nerve stimulation improves symptoms and gastric emptying in patients with idiopathic gastroparesis
Authors: Gottfried‐Blackmore Andres , Adler Emerald P. , Fernandez‐Becker Nielsen , Clarke John , Habtezion Aida , Nguyen Linda
Published: December 2019

Background

Gastroparesis, a chronic motility disorder characterized by delayed gastric emptying, abdominal pain, nausea, and vomiting, remains largely unexplained. Medical therapy is limited, reflecting the complex physiology of gastric sensorimotor function. Vagus nerve stimulation is an attractive therapeutic modality for gastroparesis, but prior methods required invasive surgery. In this open‐label pilot study, we aimed to assess the benefit of non‐invasive vagal nerve stimulation in patients with mild to moderate idiopathic gastroparesis.

Methods

Patients self‐administered the gammaCore vagal nerve stimulator for 4 weeks. The gastroparesis cardinal symptom index daily diary (GCSI‐dd) was assessed during a two‐week run‐in period, ≥4 weeks of therapy, and 4 weeks after therapy was completed. Gastric emptying and autonomic function testing were also performed. The primary endpoint was an absolute reduction in CGSI‐dd of 0.75 after nVNS.

Results

There was a total improvement in symptom scores (2.56 ± 0.76 to 1.87 ± 1.05; P = .01), with 6/15 (40%) participants meeting our primary endpoint. Therapy was associated with a reduction in gastric emptying (T1/2 155 vs 129 minutes; P = .053, CI −0.4 to 45). Therapy did not correct autonomic function abnormalities, but was associated with modulation of reflex parasympathetic activity.

Conclusions

Short‐term non‐invasive vagal nerve stimulation led to improved cardinal symptoms and accelerated gastric emptying in a subset of patients with idiopathic gastroparesis. Responders had more severe gastric delay at baseline and clinical improvement correlated with duration of therapy, but not with improvements in gastric emptying. Larger randomized sham‐controlled trials of greater duration are needed to confirm the results of this pilot study.
Nematode communities, plant nutrient economy and life‐cycle characteristics jointly determine plant monoculture performance over 12 years
Authors: Dietrich Peter , Roeder Anna , Cesarz Simone , Eisenhauer Nico , Ebeling Anne , Schmid Bernhard , Schulze Ernst‐Detlef , Wagg Cameron , Weigelt Alexandra , Roscher Christiane
Published: December 2019

Knowledge from agriculture and ecological field studies suggests that plant monocultures lose productivity over time, but the drivers underlying the long‐term performance of monocultures of grassland species are not completely understood. We examined the performance of 60 grassland species growing in monoculture for 12 years in a biodiversity experiment (Jena Experiment) and studied three groups of biotic drivers potentially affecting plant performance in monocultures over time: 1) soil biota (nematode communities, arbuscular mycorrhizal fungi), 2) leaf traits related to leaf economics spectrum, and 3) plant life‐cycle characteristics related to buffered population growth (viable seeds in topsoil, seedling density, seed survival). Monocultures of 15 out of 60 species increased productivity, while monocultures of the remaining 45 species showed slight to strong losses of productivity over time, resulting in zero biomass in 15 species. All three biotic drivers were related to the varying long‐term performance of monocultures. Their combined influence on monoculture performance could be interpreted as a tradeoff between ‘fast’ versus ‘slow’ life strategies. ‘Fast’ species showed rapid resource use and little buffering of population growth through a viable seed bank, which led to high biomass production in young monocultures but a consecutive loss of biomass production over time. ‘Slow’ species were characterized by positive nematode effects (high abundance of predatory nematodes), conservative use of resources, and a viable seed bank with high recruitment success resulting in gradually increasing productivity over time. In summary, our study highlights the importance of studying long‐term field monocultures to investigate the complex role of different biotic drivers responsible for productivity changes over time. These insights provide an essential baseline for estimating biodiversity effects on productivity as well as to understand and predict long‐term performance of plant populations.
Relationships Between Disc Degeneration and Autophagy Expression in Human Nucleus Pulposus
Authors: Quan Meiling , Hong Myoung‐Wha , Ko Myung‐Sup , Kim Young‐Yul
Published: December 2019

Objectives

To elaborate on the relationship between degeneration grade and autophagy expression in human nucleus pulposus obtained from surgical procedures.

Methods

For the 16 patients included in the present study, we determined the Pfirrmann classifications of degenerative lesions by MRI. Western blot analysis, LC3, LAMP2, and p62 protein expressions were quantified in different degeneration grades of disc nucleus pulposus. Double immunofluorescence staining was used to show co‐localization of LC3 and LAMP2, and immunohistochemistry to show LC3 and p62 in the nucleus pulposus.

Results

In the western blot analysis, LC3‐II was highly expressed in grade III and decreased progressively from grade IV to V. In addition, LC3‐II expression in grade III was significantly higher than in grade II, IV, and V (P < 0.05). LAMP2 expression in grade V was significantly higher than that in grade II, III, and IV (P < 0.05). P62 increased with decreasing autophagy expression up through grade V. In the double staining, the LC3 level was highly expressed in grade III and decreased progressively from grades IV to V, as in the western blot analysis. LAMP2 rose with increasing disc degeneration grade through grade V. In the quantitative analysis of colocalization, grade III is significantly higher than grade II and V (P < 0.05). Immunohistochemical staining showed that LC3 was highly expressed in grade III but weakly expressed in other grades, with few positive areas around the nucleus pulposus. However, p62 increased progressively with increasing disc degeneration grade.

Conclusion

Pfirrmann grade III disc degeneration showed that autophagosomes were formed, which led to the reversible decomposition of degenerative substances. Thus, by analyzing the effect of autophagy on degenerative discs, we showed the possibility of reversing degenerative changes, but only in grades III and lower.
Unique preservation of siliceous dinoflagellate motile cells from the Oligocene fossil Lagerstätte of Sieblos, Germany
Authors: Harding Ian C.
Published: December 2019

The Triassic to Recent fossil record of the dinoflagellates is represented overwhelmingly by geologically resistant, organic‐walled, non‐motile resting cysts; such cysts are formed following the sexual phase in the life cycle. Very few confirmed records exist of the motile stage being preserved in the fossil record. This paper reports the occurrence of two very unusual dinoflagellate taphofacies, one developed in bituminous shales and the other in micrites, from the Oligocene fossil Lagerstätte at Sieblos, Hesse, Germany. A new dinoflagellate taxon, Sieblososphaera martini sp. nov. has been identified through analysis of dissociated skeletal elements in the bituminous shales and external moulds and casts in the micrites. The unique preservation of these fossils confirms them not only as primary biogenically silicified motile thecate cells, but also indicates that there was a much greater range of tabulation present within the subfamily Lithoperidiniaceae than has hitherto been recognized.
Review of empirical and emerging breeding methods and tools for yam (Dioscorea spp.) improvement: Status and prospects
Authors: Darkwa Kwabena , Olasanmi Bunmi , Asiedu Robert , Asfaw Asrat
Published: December 2019

Yam (Dioscorea spp.) is an important tuber crop with tremendous potential as a functional food in the tropics and subtropics. However, the crop has not shown progressive productivity gain over decades due to various production constraints. This paper reviews the progress achieved in empirical breeding endeavours and the development, status and application of emerging breeding tools and technologies to translate genetic gains in yam improvement. Significant progress has been made in yam genetic improvement over the years which has led to the identification and development of several improved clones and sources of variability for various economically important traits. Substantial efforts have also been made to develop diverse molecular markers, transcriptome and metabolome profiles of crucial traits, trait mapping and generate reference genome sequences of the key species. However, there seems to be a slow translation of research improvements into widespread applications. These advances and the integration of empirical and emerging methods and technologies into the breeding process will enhance yam breeding efforts and ensure the quick delivery of improved varieties that possess superior agronomic and quality traits.
Delineating Genotype × Environment interactions towards durable resistance in mungbean against Cercospora leaf spot (Cercospora canescens) using GGE biplot
Authors: Das Arpita , Gupta Sanjeev , Parihar Ashok K. , Singh Deepak , Chand Ramesh , Pratap Aditya , Singha Kansam Dayamoy , Kushwaha Kailash Pati Singh
Published: December 2019

Cercospora leaf spot (Cercospora canescens) is a major fungal disease which impedes mungbean production worldwide. Presence of wider host range with existence of pathogenic variability creates intricacy towards host‐pathogen dynamics. Moreover, environmental factors having crucial role in augmenting severity of this disease further complicate disease management. An attempt has been made for unfolding genotype x environment interactions towards identifying and validating durable resistant genotypes against cercospora leaf spot in multi‐environment testing. Preliminary screening with 246 genotypes under artificial epiphytotic condition was conducted to extract out a subset of 22 mungbean genotypes for further evaluation in field testing across six environments consecutively for two years. GGE biplot analysis detected significant environmental influence towards genotypic response and confirmed the presence of non‐crossover interaction with incoherent genotypic response, thus advocating the urgency for multi‐location testing. GGE biplot aptly identified “LGG 460” and “COGG 912” as “ideal” and “desirable” genotypes, respectively having durable resistance and genetic homeostasis and thus suggested for their utilization in future resistance breeding programme in mungbean against cercospora leaf spot.
The effect of elevated CO2 on the production and respiration of a Sargassum thunbergii community: A mesocosm study
Authors: Punchai Peeraporn , Ishimatsu Atsushi , Nishihara Gregory N.
Published: December 2019

Approximately one‐third of anthropogenic carbon dioxide is absorbed into the ocean and causes it to become more acidic. The Intergovernmental Panel on Climate Change (IPCC) suggested that the surface ocean pH, by the year 2100, would drop by a further 0.3 and 0.4 pH units under RCP (Representative Concentration Pathway) 6.0 and 8.5 climate scenarios. The macroalgae communities that consisted of Sargassum thunbergii and naturally attached epibionts were exposed to fluctuations of ambient and manipulated pH (0.3–0.4 units below ambient pH). The production and respiration in S. thunbergii communities were calculated from dissolved oxygen time‐series recorded with optical dissolved oxygen sensors. The pH, irradiance, and dissolved oxygen occurred in parallel with diurnal (day/night) patterns. According to net mesocosm production – photosynthetically active radiation (PAR) model, the saturation and compensation PAR, the mean maximum gross mesocosm production (GMP), and daily mesocosm respiration were higher in the CO2 enrichment, than in the ambient condition, while the mean of photosynthetic coefficient was similar. In conclusion, elevated CO2 stimulated oxygen production and consumption of S. thunbergii communities in the mesocosm. Furthermore, the sensitivity of the GMP of the S. thunbergii community to irradiance was reduced, and achieved maximum production rate at higher PAR. These positive responses to CO2 enrichment suggest that S. thunbergii communities may thrive in under high CO2 conditions.
Elder abuse and associated factors in eastern romania
Authors: Alexa Ioana Dana , Ilie Adina Carmen , Pislaru Anca Iuliana , Dronic Aliona , Gavrilovici Ovidiu , Alexa‐Stratulat Teodora , Stefaniu Ramona , Sandu Ioana , Nuta Catalina , Herghelegiu Anna Marie
Published: December 2019

Background

This article explores elder abuse in a hospitalised population. We wanted to identify details related to psychological and emotional abuse in the older population in our region and to determine the importance of the Elderly Abuse Suspicion Index (EASI©) in comprehensive geriatric assessments.

Methods

This cross‐sectional study conducted between March 2015 and May 2016 included 386 consecutive hospitalised patients over 65 years of age. All patients underwent a geriatric assessment, data were collected about their medical history, and the EASI© was administered to each. The main outcome was identifying the presence, the type of abuse and the factors associated with abuse.

Results

There were 21.5% of patients who suffered any form of abuse. Women were more frequently abused than men. Emotional abuse was the most common (60.2%) followed by neglect (53%) and physical abuse (22.91%); sexual abuse was absent in our study group. The abused patients had an impaired cognitive function (P = 0.034). They were also malnourished (P ≤ 0.001) and depressed (P = 0.001). The presence of peripheral artery disease, stroke, pneumonia, chronic kidney disease, musculoskeletal diseases and anxiety correlated with the presence of abuse. No statistically significant correlation was found between the degree of independence in instrumental activities of daily living and the presence of abuse (r = 0.105, P = 0.051).

Conclusions

EASI is a tool for detecting elder abuse and should be included in the standard geriatric assessment to prevent ageism. The number of abused elderly patients is significant, and the multiple factors associated with abuse are diverse.
Validation of Pain Assessment Checklist for Seniors with Limited Ability to Communicate‐II (PACSLAC‐II) in Iranian older adults with dementia living in nursing homes
Authors: Haghi Marjan , Fadayevatan Reza , Alizadeh‐khoei Mahtab , Kaboudi Bijan , Foroughan Mahshid , Mahdavi Behrouz
Published: December 2019

Background

Some dementia patients can self‐report pain although the reports are not valid in severe dementia. Observational scales have been developed for pain assessment in these patients. This study aimed to assess the psychometric properties of the Persian version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate‐II (PACSLAC‐II).

Methods

This validation study was conducted on 138 older adults with dementia suffering from chronic pain who lived in nursing homes. The PACSLAC‐II Persian version was applied through observations during activity and rest. Reliability of the PACSLAC‐II was evaluated by Cronbach's alpha and intra‐class correlation coefficients. Construct validity was determined by confirmatory factor analysis, divergent and convergent validity. The Spearman's rank correlation between PACSLAC‐II scores and Faces Pain Scale was calculated for concurrent validity. Known‐group validity during activity and rest was calculated by Wilcoxon signed ranks test.

Results

Cronbach's alpha coefficient for facial expression (0.82), verbalisation (0.72), and body movement (0.84) subscales indicated good internal consistency. The intra‐class correlation coefficients between two raters was 0.76 and in three times evaluation, the value was 0.76. Convergent validity with Iranian Brief Pain Inventory and divergent validity with 15‐item Geriatric Depression Scale confirmed the construct validity of PACSLAC‐II. Three factors structure of PACSLAC‐II was approved, and most of the variance was explained by facial expressions. The PACSLAC‐II can discriminate between pain and non‐pain events and has a moderate correlation with Faces Pain Scale (r = 0.33).

Conclusions

PACSLAC‐II Persian version is a valid and reliable scale for pain assessment in older adults with dementia.
Leading and Learning through Dynamic Performance Management in Government
Authors: Munteanu Ioana , Newcomer Kathryn
Published: December 2019

Performance management in government is at a crossroads. The advent of big data and advances in technological and analytical tools have provided opportunities to measure and track a wider variety of internal and external indicators on a more timely basis. Public leaders require new vision and capacity to design and manage knowledge‐building systems. This article provides two tools: (1) a more comprehensive open systems performance management framework and (2) a model of leadership needed to orchestrate such systems—knowledge brokers who orchestrate the demand for and supply of evidence. This article recommends that public agencies strategically build evidence to better track measures of the effects of governmental actions on public value and their intended and unintended consequences on the ecosystem; articulate, measure, and test the assumptions built into their operating models; and learn from routine monitoring of the dynamic environment in which their organizations strive to achieve their missions.
Membrane stability and mitochondrial activity of bovine sperm frozen with low‐density lipoproteins and trehalose
Authors: Varela Elizabeth , Rojas Mauricio , Restrepo Giovanni
Published: December 2019

Cryopreservation results in the destabilization of the sperm plasma membrane, leading to negative side effects such as premature cryocapacitation, apoptosis and the low mitochondrial activity of bovine spermatozoa. Low‐density lipoproteins (LDL) and trehalose have been used in seminal freezing to protect the integrity and stability of sperm membranes. Likewise, trehalose can increase the mitochondrial activity of sperm. The objective of this study was to evaluate the membrane stability and mitochondrial activity of bovine sperm after being frozen and treated with LDL sources and trehalose. Ten ejaculates from five bulls were cryopreserved under the treatments, CEY: chicken egg yolk (20% v/v); CCEY: centrifuged CEY (20% v/v); LDL: LDL (8% v/v); T: trehalose (100 mM); and TLDL: T (100 mM) plus LDL (8% v/v). After thawing, membrane stability and mitochondrial membrane potential (ΔΨM) were assessed by flow cytometry through the M‐540/Yopro‐1 and DiOC6/PI probes. The structural membrane integrity (SMI) was evaluated by fluorescence microscopy using SYBR14/PI dyes. A generalized linear model was adjusted, and the means were compared using the Tukey test. Centrifuged chicken egg yolk and LDL had a higher proportion of non‐cryocapacitated non‐apoptotic sperm (M−Y−), while CEY and T had the largest populations of cryocapacitated non‐apoptotic sperm (M+Y−) and cryocapacitated apoptotic sperm (M+Y+). Centrifuged chicken egg yolk also showed a higher proportion of sperm with high‐ΔΨM. Treatments that included egg yolk or purified LDL had a positive effect on SMI. Centrifuged chicken egg yolk has a superior cryoprotective effect on membrane stability and mitochondrial activity of bovine semen over the conventional use of CEY or the individual or simultaneous use of LDL and trehalose.
Comparison of different intracellular cryoprotectants on the solid surface vitrification of red‐rumped agouti (Dasyprocta Leporina Lichtenstein, 1823) ovarian tissue
Authors: Praxedes Érica Camila G. , Lima Gabriela L. , da Silva Andréia M. , Campos Lívia B. , de Souza Carla Michelle P. , Moreira Samara Sandy J. , de Oliveira Moacir F. , Silva Alexandre R.
Published: December 2019

In contributing to the conservation of wild rodents, the aim of this study was to evaluate the use of distinct cryoprotectants, separately or in combination, for solid surface vitrification (SSV) of red‐rumped agouti ovarian tissue. Ovarian cortex from nine females was recovered and fragmented. Fresh fragments (control) were used to analyse the pre‐antral follicle (PF) morphology using a histologic procedure, viability using the Trypan blue test, cell proliferation by counting the argyrophilic nucleolar organizing regions (Ag‐NORs technique) and DNA integrity using the TUNEL assay. The remaining fragments were vitrified using SSV method with 3 M or 6 M ethylene glycol (EG) or dimethyl sulfoxide (DMSO), or in combination (3 M EG/3 M DMSO), and further evaluated as reported for the fresh samples. All cryoprotectants were effective at preserving PFs morphology compared to the control group (80.7 ± 5.21%), except 6 M EG and 3 M DMSO that provoked a significant (p < .05) decrease on the values of morphologically normal primary (60.0 ± 19.0%) and primordial (44 ± 4.5%) follicles, respectively. Regarding viability, all cryoprotectants provided values similar to that verified for the control group (79.0%), but a significant decrease (p < .05) was observed with EG/DMSO combination (59%). Using Ag‐NORs technique, the highest (p < .05) cell proliferative capacity was detected when using EG at each tested concentration. The TUNEL proved the preservation of DNA integrity regardless of the cryoprotectant. In summary, we suggest the use of 3 M EG for the solid surface vitrification of red‐rumped agouti ovarian tissue.
Technological Advances and the Future of Suicide Prevention: Ethical, Legal, and Empirical Challenges
Authors: Berman Alan L. , Carter Gregory
Published: December 2019

Technological advancements have brought multiple and diverse benefits to our human existence. In suicide prevention, new technologies have spurred great interest in and reports of the applicability to assessing, monitoring, and intervening in various community and clinical populations. We argue in this article that we need to better understand the complexities of implementation of technological advances; especially the accuracy, effectiveness, safety, ethical, and legal issues, even as implementation occurs at individual, clinical, and population levels, in order to achieve that measure of public health impact we all desire (i.e., greater benefit than harm).
Unfavourable treatment outcomes in tuberculosis patients with different vitamin D status and blood glucose levels in a programme setting in China
Authors: Lin Yan , Bai Yunlong , Zhang Tiejuan , Kang Wanli , Kang Demei , Miao Qiang , Wang Yunlong , Shao Hongshan , Li Xiangwen , Brigden Grania , Dlodlo Riitta A. , Harries Anthony D.
Published: December 2019

Objective

Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO.

Method

Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi‐squared test and multivariate logistic regression.

Results

Of the 306 recruited TB patients, 96 (31.4%) had smear‐positive pulmonary TB, 187 (61.1%) had smear‐negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow‐up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear‐negative pulmonary TB (P = 0.009), EPTB (P < 0.001) and DM (P = 0.007).

Conclusion

The proportion of TB patients with UTO increased with smear‐negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.
Red blood cell transfusion results in adhesion of neutrophils in human endotoxemia and in critically ill patients with sepsis
Authors: van Hezel Maike E. , Boshuizen Margit , Peters Anna L. , Straat M. , Vlaar Alexander P. , Spoelstra ‐ de Man Angelique M.E. , Tanck Michael W.T. , Tool Anton T.J. , Beuger Boukje M. , Kuijpers Taco W. , Juffermans Nicole P. , van Bruggen Robin
Published: December 2019

BACKGROUND

Red blood cell (RBC) transfusion is associated with adverse effects, which may involve activation of the host immune response. The effect of RBC transfusion on neutrophil Reactive Oxygen Species (ROS) production and adhesion ex vivo was investigated in endotoxemic volunteers and in critically ill patients that received a RBC transfusion. We hypothesized that RBC transfusion would cause neutrophil activation, the extent of which depends on the storage time and the inflammatory status of the recipient.

STUDY DESIGN AND METHODS

Volunteers were injected with lipopolysaccharide (LPS) and transfused with either saline, fresh, or stored autologous RBCs. In addition, 47 critically ill patients with and without sepsis receiving either fresh (<8 days) or standard stored RBC (2‐35 days) were included. Neutrophils from healthy volunteers were incubated with the plasma samples from the endotoxemic volunteers and from the critically ill patients, after which priming of neutrophil ROS production and adhesion were assessed.

RESULTS

In the endotoxemia model, ex vivo neutrophil adhesion, but not ROS production, was increased after transfusion, which was not affected by RBC storage duration. In the critically ill, ex vivo neutrophil ROS production was already increased prior to transfusion and was not increased following transfusion. Neutrophil adhesion was increased following transfusion, which was more notable in the septic patients than in non‐septic patients. Transfusion of fresh RBCs, but not standard issued RBCs, resulted in enhanced ROS production in neutrophils.

CONCLUSION

RBC transfusion was associated with increased neutrophil adhesion in a model of human endotoxemia as well as in critically ill patients with sepsis.
Prevalence of serologic markers of transfusion and sexually transmitted infections and their correlation with clinical features in a large cohort of Brazilian patients with sickle cell disease
Authors: Blatyta Paula F. , Kelly Shannon , Sabino Ester , Preiss Liliana , Mendes Franciane , Carneiro‐Proietti Anna B. , Werneck Rodrigues Daniela de Oliveira , Mota Rosimere , Loureiro Paula , Maximo Claudia , Park Miriam , Mendrone‐Jr Alfredo , Gonçalez Thelma T. , de Almeida Neto Cesar , Custer Brian ,   for the National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study III (REDS‐III) International Component, Brazil
Published: December 2019

BACKGROUND

Patients with sickle cell disease (SCD) often require red blood cell (RBC) transfusion for clinical complications, so may be exposed to transfusion‐transmitted infections (TTIs). The prevalence of markers for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and B (HBV), human T‐cell lymphotropic virus (HTLV‐1/2), Chagas disease, and syphilis in an SCD cohort in Brazil were studied.

STUDY DESIGN AND METHODS

Clinical history, interview data, blood samples, and medical chart review data were collected during cohort enrollment from November 2013 to May 2015. Serologic markers of infection were assessed. Standard measures of statistical association were calculated, and multivariable models were developed for the most prevalent infections to identify associated factors.

RESULTS

Infection markers were evident in 5.2% (144/2779) of the enrolled cohort. Anti‐HCV was detected in 69 (2.5%), syphilis antibodies in 34 (1.2%), anti‐HTLV‐1/2 in 17 (0.6%), HBV surface antigen in 13 (0.5%), Chagas disease antibodies in 13 (0.5%), and anti‐HIV in 8 (0.3%) of participants. Factors associated with increased odds of being anti‐HCV reactive were older age, illegal drug use, increasing number of RBCs, more than three pain crises in the previous year, and geographic location. Syphilis was associated with older age, females, and smoking history.

CONCLUSION

HCV infection was more common in older patients who may have received RBCs before testing was performed on donations, suggesting possible historic transfusion transmission. The cohort showed decreasing rates of infections and a reduction in transfusion transmission markers in younger patients compared to historical literature except for syphilis, indicating contemporary reduced risk of TTI.
Introducing the Interdisciplinary Nature of Health Care Through Case Study Models
Authors: Newton Kathryn T. , Ashley Aaron
Published: December 2019

Interprofessional education (IPE) is a critical area needed to improve the quality of healthcare. Stereotypes of other disciplines persist by healthcare workers, limiting the ability to work as a team. Knowledge of roles of healthcare professions is a key competency of IPE. An online, 12-week course was developed to introduce students to the interdisciplinary nature of healthcare through case study models. Through built-in links, students explore medical terminology, diagnostic testing, pathophysiology, treatment, and health professionals who work as a team to diagnose and treat the patient. A 24-question survey was administered to a convenience sample of 582 high school students. Results of paired-samples t-tests showed significant increases pre-training to post-training in: 1) knowledge of the different roles of health professionals, (n = 338, M = .71, SEM = .01) to post-training (M = .82, SEM = .01), t(337) = 11.08, p<.001, pη2 = .203, 2) and self-reported knowledge of roles of different health professions, pre-training (n = 338, M = 2.73, SEM = .30) to post-training (M = 3.60, SEM = .039), t(337) = 20.02, p < .001, pη2 = .543. Interestingly, students’ likelihood in a career in healthcare professions decreased significantly pre-training (n = 338, M = 4.30, SEM = .043) to post-training (M = 4.20, SEM = .06), t(337) = 2.21, p = .028, pη2 = .016. Introducing knowledge of health professions to this population may be critical in avoiding stereotypes before a student enters a chosen career path, increasing the likelihood of participation in interdisciplinary teams.