bluuebunny/crossref_metadata_2025 huggingface dataset:
Stigma in visible skin diseases – a literature review and development of a conceptual model
Authors: Germain N. , Augustin M. , François C. , Legau K. , Bogoeva N. , Desroches M. , Toumi M. , Sommer R.
Published: January 2021

The burden of visible skin diseases (VSDs) includes not only physical symptoms but also psychosocial consequences such as depression, anxiety, impaired quality of life and low self‐esteem. Stigmatization was shown to play a major role in people with skin diseases. The aim of the study was to review the evidence for the components, drivers and impacts of (self‐)stigma, and to organize the data into a series of conceptual models. A targeted literature search was conducted to identify studies on (self‐)stigma in relation to VSD. Conceptual models of stigma in VSDs were developed from existing generic conceptual models for VSD and of generic conceptual models of stigma and were refined after discussion with a board of experts, patient advocacy groups, clinicians and researchers. A total of 580 references were identified, of which 56 references were analysed and summarized. Two conceptual models of stigma were identified: one with external stigma and self‐stigma dimensions, the other for self‐stigma in mental health. These models were adapted to allow a complete description of stigma in VSDs. For this, a distinction was made between ‘discrimination’ and ‘impact’. Finally, five models were developed: macro‐overview; stigma, impact and socio‐demographics; stigma, impact and disease characteristics; stigma, impact and quality of life; and stigma, impact and coping. Gaps were identified in available quantitative evidence. To our knowledge, this is the first conceptual model of stigma in VSDs. The model will help to standardize evaluation of stigma and to enhance empirical evaluation of anti‐stigma interventions in VSDs. Further research should be conducted to develop a more complete model in stigma due to significant gaps in existing evidence, particularly including the stigma in others (external stigma) and also to cover a broader range of VSDs as their impact on particular dimensions of stigma differs.
Differentially expressed proteins identified by TMT proteomics analysis in children with verrucous epidermal naevi
Authors: Yuan T. , Cai M.‐l. , Sheng Y.‐m. , Ding X. , Shen T.‐t. , Li W.‐r. , Huang H. , Liang B. , Zhang X.‐j. , Zhu Q.‐x.
Published: January 2021

Background

Verrucous epidermal naevi (VEN) are benign skin tumours, considered keratinocytic epidermal naevi, that appear at birth or early childhood. VEN may display a range of appearances, depending on patient age. Although the number of studies regarding VEN is increasing, the exact mechanism of VEN is still unknown.

Objectives

The aim of this study was to analyse the changes in the expression of protein factors in lesions of VEN children by TMT labelling‐based quantitative proteomics.

Methods

A total of 8 children with VEN (5 for experiment and 3 for validation) and 8 healthy children (5 for experiment and 3 for validation) presented to the Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Boao Super Hospital, between January 2019 and November 2019. The lesions and lesion‐adjacent tissues from children with VEN and naevus‐adjacent normal skin tissues from children with pigmented naevi were defined as the VEN group, VENC group and C group, respectively. We performed a proteomics analysis to screen for differentially expressed proteins in the lesions of these individuals. We further performed Western blotting to validate the relative expression levels of nine targeted proteins in the validation group.

Results

According to the proteomics results, a total of 4970 proteins were identified, and 4770 proteins were quantified. Among these proteins, 586 proteins were up‐ or downregulated at least 1.3‐fold with a P‐value < 0.05 (upregulated: 399, downregulated: 187) in lesions between the VEN group and the C group. These proteins played important roles in multiple biological functions, such as cornification, epidermal cell differentiation and neutrophil activation, and formed a complicated protein–protein interaction network. Of the 586 up‐ or downregulated proteins, nine were selected for further validation. According to Western blotting analysis results, the relative expression levels of Involucrin, NDUFA4, Loricrin, Keratin type II cytoskeletal 6A (Cytokeratin 6A), BRAF, Filaggrin, S100A7 and Desmocollin‐3 were significantly upregulated in VEN children and may be associated with skin barrier dysfunction, epidermal cell overgrowth and differentiation, inflammation and immune and oxidative phosphorylation, which are involved in the pathogenesis of VEN.

Conclusions

According to TMT‐based proteomics and Western blotting results, we identified eight noteworthy proteins, Involucrin, NDUFA4, Loricrin, Keratin type II cytoskeletal 6A, BRAF, Filaggrin, S100A7 and Desmocollin‐3, that were upregulated in the lesions of VEN children and may be associated with the pathogenesis of VEN. Our findings provide new starting points for identifying precise pathogenic mechanisms or therapeutic targets for VEN.
Long‐term safety and efficacy of a fixed‐combination halobetasol propionate 0.01%/tazarotene 0.045% lotion in moderate‐to‐severe plaque psoriasis: phase 3 open‐label study
Authors: Lebwohl M.G. , Stein Gold L. , Papp K. , Han G. , Pariser D.M. , Lin T. , Harris S. , Jacobson A.
Published: January 2021

Background

The topical corticosteroid halobetasol propionate (HP) and the retinoid tazarotene (TAZ) are effective in psoriasis treatment. To mitigate adverse cutaneous reactions observed with monotherapy, a fixed‐ combination HP 0.01%/TAZ 0.045% lotion has been developed for the treatment of plaque psoriasis in adults.

Objectives

To investigate the long‐term safety, efficacy and maintenance of response with HP/TAZ lotion.

Methods

This was a 1‐year, multicentre, open‐label study in 555 adults with psoriasis [Investigator's Global Assessment (IGA) score of 3 (‘moderate’) or 4 (‘severe’) and body surface area (BSA) of 3–12% at baseline]. HP/TAZ was administered once daily for 8 weeks and then intermittently as needed in 4‐week intervals for up to 1 year based on achievement of treatment success [IGA score of 0 (‘clear’) or 1 (‘almost clear’)]. Maximum continuous exposure was 24 weeks.

Results

Of 550 participants with postbaseline safety data, 318 (57.8%) achieved treatment success during the study. Of those, 54.4% achieved treatment success within the first 8 weeks; retreatment was not required for >4 weeks in over half (55.3%), and 6.6% did not require any retreatment. Among participants enrolled for the full 52 weeks, 77.5% maintained BSA ≤5% on treatment. There were marked improvements in severity of itching, dryness and burning/stinging over the study course. The most common treatment‐related adverse events were application site reactions of dermatitis, pruritus, pain and irritation.

Conclusions

Fixed‐combination HP/TAZ lotion provided maintained efficacy with a favourable tolerability and safety profile, supporting its use for the long‐term treatment and management of moderate‐to‐severe plaque psoriasis.
Does natural vegetation from olive groves benefit the olive moth, Prays oleae?
Authors: Nave Anabela , Gonçalves Fátima , Oliveira Irene , Campos Mercedes , Torres Laura
Published: January 2021

Conservation biological control aims to enhance the efficacy of biological control agents, such as predators and parasitoids, by providing them access to key requisites, for example floral or other alternative food resources. However, the occurrence of floral resources in agricultural systems may have positive effects not only on natural enemies but also on the pests themselves. For this reason, we have studied in laboratory common Mediterranean plants as potential food resources for an important lepidopteran olive pest, the olive moth, Prays oleae. The effects of 15 wild flowering plants from olive grove ecosystems, and four sugars present in floral nectars, on key biological parameters of P. oleae (i.e. longevity, pre‐oviposition and oviposition periods, fertility and fecundity) were evaluated. The three pest generations were analysed. Only few of the plants tested increased some reproductive parameters of the insect individuals compared to the water‐fed controls, while sugars generally improved them. This could be due to a higher concentration of sugars provided by individual sugars than by flower nectar. These results indicate that, in general, P. oleae will not benefit from the availability of the floral resources tested.
Impact of emergency short‐stay unit opening on in‐hospital global and cardiology indicators
Authors: Cirillo Willian , Freitas Lidia R. C. , Kitaka Edson L. , Matos‐Souza José R. , Silva Marcos R. , Coelho Otávio R. , Coelho‐Filho Otávio R. , Sposito Andrei C. , Nadruz Wilson
Published: January 2021

Rationale, aims and objectives

Emergency short‐stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in‐hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated whether SSU opening differentially modified in‐hospital indicators at a whole general hospital and at its cardiology division (CARD).

Methods

We retrospectively analysed indicators based on 859 686 ED visits, and 171 547 hospital admissions, including 12 110 CARD admissions, from 2007 to 2018 at a general tertiary hospital, and compared global ED indicators and in‐hospital indicators at the hospital and CARD before (2007‐2011) and after (2011‐2018) SSU opening.

Results

After SSU opening, monthly ED bed occupancy rate decreased (mean ± SD 200 ± 18% vs 187 ± 22%; P < .001) and in‐hospital admissions from ED increased at the hospital (median [interquartile range] 460 [81] vs 524 [41], P < .001) and CARD (50 [12] vs 54 [12], P = .004). In parallel, monthly in‐hospital elective admissions decreased at CARD (34 [18] vs 28 [17], P = .019), but not at the hospital (712 [73] vs 700 [104], P = .54). Average length of stay (LOS) increased at both hospital (8.5 ± 0.3 vs 8.7 ± 0.4 days, P < .001) and CARD (9.2 ± 1.5 vs 10.3 ± 2.3 days, P = .002) after SSU opening, but percent admissions at SSU showed a direct relationship with LOS solely at CARD. Furthermore, cardiology patients admitted at SSU had greater LOS, prevalence of coronary heart disease and age than those admitted at the conventional cardiology ward.

Conclusions

SSU opening improved ED crowding, but was associated with changes in in‐hospital indicators, particularly at CARD, and in the characteristics of hospitalized cardiology patients. These findings suggest that in‐hospital cardiology services may need re‐evaluation following SSU opening at a general hospital.
Taste preferences and feeding behaviour in the facultative herbivorous fish, Nile tilapia Oreochromis niloticus
Authors: Levina Aleksandra D. , Mikhailova Elena S. , Kasumyan Alexander O.
Published: January 2021

Taste preferences in fishes are known mainly for carnivorous species, whereas herbivorous consumers were rarely used in such studies. The main goal of the present study was to evaluate the taste preferences in the herbivorous African cichlid fish, Nile tilapia Oreochromis niloticus. In laboratory settings, the palatability of widely used taste substances (four taste substances that are considered to be sweet, sour, bitter and salty for humans – sucrose, citric acid, calcium chloride and sodium chloride; 21 free L‐amino acids; 12 sugars and artificial sweetener Na‐saccharin; 0.1–0.0001 M) was evaluated. In each trial, a standard agar pellet flavoured with a substance was offered for fish individually. The consumption of pellet, the number of grasps and the retention time before the pellet was finally ingested or rejected were registered. Overall, 21 of 38 substances were palatable, whereas other substances did not shift consumption of pellets in relation to blank pellets. Pellets containing citric acid, L‐cysteine, L‐norvaline, L‐isoleucine, L‐valine, Na‐saccharin and D‐sorbitol were consumed in >85% of trials. Taste attractiveness of amino acids was highly species‐specific and was not associated with the trophic category of the 19 species compared. Moreover, it did not correlate with dietary quantitative requirements of Nile tilapia (rs = 0.27; P > 0.05). Palatability of sugars for O. niloticus and their sweetness for humans did not correlate as well (rs = 0.21; P > 0.05); nonetheless, Na‐saccharin has the most attractive taste for both O. niloticus and humans. The most palatable amino acids lost their effect if the concentration was lowered to 0.01 M for L‐cysteine and 0.001 M for L‐norvaline (lower than 242.3 μg and 23.4 μg per a pellet, respectively). Single pellet grasp was characteristic of O. niloticus feeding behaviour (>95% of trials), and this pattern may be related to the social lifestyle of this species. Fish spent 4–8 s on average for orosensory evaluation of pellet edibility. The retention time correlated with the palatability of substances and was significantly longer in trials that ended up with pellet swallowing. It is suggested that prolonged orosensory evaluation of food before swallowing provides a reliable and accurate sensory evaluation, which, in turn, can reduce the probability that inadequate food will be consumed.
Physical properties of barley grains at hydration and drying conditions of malt production
Authors: Carvalho Gisandro Reis , Polachini Tiago Carregari , Augusto Pedro Esteves Duarte , Telis‐Romero Javier , Bon José
Published: January 2021

Barley has shown several applications in food formulation, mainly after the malting process (hydration, germination, and drying). Because barley is steeped prior the malting, the aim of this work was to determine the physical properties of the grains and their bed as functions of a wide range of moisture content (12.68–80.28% d.b.). Such influences were evaluated and described through mathematical expressions. Length, width, thickness, different diameters, sphericity, and surface area of the barley grains increased with increasing moisture content, up to ~60%. Volume of thousand grains behaved similarly to these properties while their mass was increased continuously with increasing the moisture content. Bulk and true density tended to decrease during hydration while the bed porosity accompanied the density and volume variations. Specific surface area of the grains and bed decreased at higher moisture content due to the grain tri‐dimensional expansion during hydration. Polynomial equations could be obtained to predict the studied properties as a function of the moisture content. Both experimental data and resulting models can be used to accurately design equipment and processes involving heat and mass transfer during malting as well as for determining parameters as water diffusion coefficients.

Practical applications

Barley is an important cereal food and beverages applications, mainly to malt production. This study evaluated barley properties in a wide range of moisture contents, in order to understand its behavior under hydration and drying conditions. This data will provide important information needed to design different aspects of barley processing and storage.

Moisture dependence of physical properties were determined for barley, considering a wide moisture range (12–80%d.b.).

Barley achieved an expansion limit in moistures about 60–70% (d.b.).

Simple polynomial equations were proposed to represent the physical properties.

All physical properties were satisfactorily modeled.
Nanoencapsulation of clove oil and study of physicochemical properties, cytotoxic, hemolytic, and antioxidant activities
Authors: Nagaraju Pramod G. , Sengupta Parineeta , Chicgovinda Poornima Priyadarshini , Rao Pooja J.
Published: January 2021

The therapeutic properties of clove oil are well known, however, the pungent nature, chemical instability, and low water solubility impose limitations in harnessing its potential. Nanoemulsion of clove oil (CON) was prepared to overcome the above constraints. The non‐ionic surfactants Tween 20, 40, and 80 with hydrophile lipophile balance (HLB) of 16.7, 15.6, and 15, respectively, were used to stabilize CON. The creaming index of CON prepared with Tween 20, 40, and 80 was 22.75, 17.5, and 1.5%, respectively, after 8 days of storage at room temperature. Tween 20 and 40 produced particles >300 nm while Tween 80 produced ~150 nm. Transmission electron microscopic image of spray‐dried CON (with Tween 80) showed particles in the range of 150–190 nm. The in vitro release studies showed 76 and 42% cumulative release of CON and native clove oil (NC), respectively, at pH 7.4. The cellular toxicity of CON was significantly reduced by fourfold compared to NC at a concentration of 60 μg/ml when tested on CaCO2 cells. Similarly, hemolytic activity on red blood cells revealed less than 10% hemolysis. In addition, CON also exhibited higher in‐vitro antioxidant compared to NC as shown by 1, 1‐diphenylpicrylhydrazyl and 2,2′‐azino‐di‐[3‐ethylbenzthiazoline sulfonate (6)] (ABTS) radical scavenging activity.

Practical application

The study highlights the development of clove oil nanoemulsion using cost‐effective, commercially important polysaccharide (maltodextrin) and surfactant for increased bioactivity. The spray‐dried nanoparticle showed high retention (95%) of oil and small particle size even after 1 month of storage at room temperature. The biological studies signify the compatibility of nanoparticle for its nutraceutical applications because of its low cytotoxicity (fourfold reduction), hemolytic activity, and high anti‐oxidant property. The clove oil nanoparticles can replace the clove oil/microencapsulated particles in food product development due to their high water dispersibility and loading content (25% on dry weight basis).
Thermophysical properties of frozen parsley: A state diagram representation
Authors: Iaccheri Eleonora , Cevoli Chiara , Dalla Rosa Marco , Fabbri Angelo
Published: January 2021

Sorption behavior and glass transition of frozen parsley were investigated in order to study the physical modifications, represented as state diagram to figure out information about product behavior for storage and supply chain handling. Frozen products may be located in the state diagram in all the possible freezing temperatures to understand the structure state and study feasible corrective actions mainly focused on temperature and solid content. Parsley was totally dehydrated and equilibrated at selected relative humidity. Sorption behavior was evaluated by saturated salt slurry method and sorption isotherm fitting, while solid components in terms of mass fraction were investigated by using differential scanning calorimetry. Brunauer–Emmet–Teller (BET) model well fitted with moisture and water activity data (R2 = 0.995, p‐level < 0.05). The characteristic ranges of stability, in terms of system mobility and physical modification, are the monolayer values (0.240 water activity; 0.052 kg/kg dry basis) and the critical water activity range (0.424 water activity; 0.078 kg/kg dry basis). Glass transition and melting temperature were used to define parsley state diagram. Different zones figure out a specific physical behavior: depending on solid content and temperature. Unfrozen water was estimated as monolayer BET value 0.84 kg/kg wet basis and extrapolated from state diagram 0.984 kg/kg wet basis.

Practical applications

Frozen high‐quality product and energy efficiency can be obtained by a correct temperature management. Thermophysical properties of parsley represented in a state diagram are reported in the typical solute and temperature range of freezing process and storage. These data can relate physical structure and temperature, allowing different possible conditions management.
Muscle Mass and Direct Oral Anticoagulant Activity in Older Adults With Atrial Fibrillation
Authors: Bendayan Melissa , Mardigyan Vartan , Williamson David , Chen‐Tournoux Annabel , Eintracht Shaun , Rudski Lawrence , MacNamara Elizabeth , Blostein Mark , Afilalo Marc , Afilalo Jonathan
Published: January 2021

Background

Direct oral anticoagulants (DOAC) are hydrophilic drugs with plasma levels inversely proportional to lean body mass. Sarcopenic patients with low muscle mass may be at risk for supra‐therapeutic DOAC levels and bleeding complications. We therefore sought to examine the influence of lean body mass on DOAC levels in older adults with atrial fibrillation (AF).

Methods

A prospective cohort study was conducted with patients 65 years of age or more receiving rivaroxaban or apixaban for AF. Appendicular lean mass (ALM) was measured using a bioimpedance device and a dual X‐ray absorptiometry scanner. DOAC levels were measured using a standardized anti‐Xa assay 4 hours after (peak) and 1 hour before (trough) ingestion.

Results

The cohort consisted of 62 patients (47% female, 77.0 ± 6.1 years). The prescribed DOACs were apixaban 2.5 mg (21%), apixaban 5 mg (53%), and rivaroxaban 20 mg (26%). Overall, 16% had supra‐therapeutic DOAC levels at trough and 25% at peak. In the multivariable logistic regression model, lower ALM was independently associated with supra‐therapeutic DOAC levels at trough (odds ratio per ↓ 1‐kg 1.23, 95% confidence interval 1.02 to 1.49) and peak (odds ratio per ↓ 1‐kg 1.18, 95% confidence interval 1.02 to 1.37). Addition of ALM to a model consisting of age, total body weight, and renal function resulted in improved discrimination for supra‐therapeutic DOAC levels.

Conclusion

Our proof‐of‐concept study has identified an association between ALM and DOAC levels in older adults with AF. Further research is needed to determine the impact of ALM on bleeding complications and the potential role of ALM‐guided dosing for sarcopenic patients.
Defining a good death for people with dementia: A scoping review
Authors: Takahashi Zaiya , Yamakawa Miyae , Nakanishi Miharu , Fukahori Hiroki , Igarashi Naoko , Aoyama Maho , Sato Kazuki , Sakai Shima , Nagae Hiroko , Miyashita Mitsunori
Published: January 2021

Aim

End‐of‐life care for people with dementia is becoming increasingly important as the global population ages. However, there is no agreed definition of a good death for people with dementia. The current review examined previous literature to establish the current state of knowledge on this issue.

Methods

We conducted a scoping review using a standard methodological framework. Relevant studies were identified from four databases. Studies were included if they were in English, discussed palliative or end‐of‐life care for dementia, and defined or explained a good death. The definitions or explanations of a good death were categorized into subthemes, and grouped into broader themes.

Results

We identified 11 articles discussing or explaining a good death in dementia, which were published between 2009 and 2017. Most of these studies drew on the views of healthcare professionals and/or family members of people with dementia, and only one considered the views of people with dementia themselves. Ten themes were identified, including pain‐free status, peaceful/comfort, dignity, family presence, surrounded by familiar things and people, person‐centered communication, spirituality, life completion, treatment preferences, and other.

Conclusions

The characteristics of a good death in dementia showed similarities with those identified more generally. However, there were some themes that were specific to end‐of‐life care in dementia, notably “surrounded by familiar things and people” and “person‐centered communication”. To obtain a fuller picture of the nature of a good death in dementia, researchers need to examine the views of people living with dementia.
Effectiveness of nursing care provided for fall prevention: Survival analysis of nursing records in a tertiary hospital
Authors: Suh Minhee , Cho Insook
Published: January 2021

Aim

This study was carried out to analyze nursing care provided to patients on high and low fall‐risk days and to evaluate the effectiveness of nursing care in terms of preventing falls.

Methods

A retrospective review of medical records was conducted for patients admitted to a tertiary hospital in Korea. General and clinical information, fall occurrences, Hendrich II Fall Risk Model (HFRM II) fall‐risk assessment scores, nursing care related to fall prevention, and medications administered were extracted.

Results

Data from 43,267 days of records for 11,718 patients were analyzed. Nursing assessment, intervention, and administration of medication were provided more frequently on high fall‐risk days than on low fall‐risk days. Analysis performed on the entire cohort days showed fall occurrence was significantly associated with infrequent mobility assessment and greater usage of anti‐anxiety agents. On high fall‐risk days, fall occurrence was related to less restraint assessment and greater usage of vessel dilatators.

Conclusions

The implementation of risk‐targeted interventions for fall prevention based on fall‐risk assessment is needed. For general fall prevention, assessment of patients' mobility should be strengthened. For high fall‐risk patients, it may be more effective for nurses to focus on assessing restraints, evaluating medication records, and withdrawing medications related to falls.
Garnet as a monitor for melt–rock interaction: Textural, mineralogical, and compositional evidence of partial melting and melt‐driven metasomatism
Authors: Goncalves Philippe , Raimondo Tom , Paquette Jean‐Louis , Santos de Souza de Oliveira Jailma
Published: January 2021

In this study, we focus on a partially melted garnet‐bearing granulite from the Salvador–Esplanade Belt (Salvador da Bahia, Brazil), and examine the behaviour of major and trace elements during partial melting and melt‐driven metasomatism. Phase equilibria modelling and U–Th–Pb geochronology show that the sample underwent partial melting during the heating segment of the decompression path from ~1.2 GPa and 675–700°C to ~0.8 GPa and 790°C at c. 2.06 Ga. During the final stage of decompression, from 0.8 to ~0.5 GPa, physical segregation of melt resulted in the establishment of chemical potential gradients and mass transfer between the host granulite and the leucosome. Modelling shows that H2O, CaO, K2O, and Na2O diffused from the melt into the host residue, whereas SiO2 was transferred from the host granulite into the adjacent leucosome. Opposed senses of diffusional transfer resulted in the formation of a quartz‐rich anhydrous leucosome and a quartz‐depleted selvedge in the host granulite. Compositional maps show that garnet exhibit contrasting major and trace element distributions depending on their textural position. The largest garnet located in the quartz‐depleted selvedge preserve their original Ca and trace element growth zoning. A transition from bell‐shaped profiles for Y and heavy rare earth elements to bowl‐shaped profiles for light rare earth elements is consistent with a typical Rayleigh fractionation model, fast intergranular element mobility, and rock‐wide equilibrium during prograde partial melting. In contrast, smaller garnet away from the leucosome show prograde growth zoning modified by intragranular diffusion, as evidenced by a network of open channels and healed cracks that act as connecting pathways between the matrix and garnet core. This results in either subtle modification of both major and trace elements adjacent to the inner core inclusions, or a complete re‐equilibration. Recognition that the original Ca growth zoning was later modified by intragranular diffusion implies that misleading thermobarometric results and tectonic interpretations would be obtained if the core composition was used to fingerprint the early garnet nucleation stage. This study demonstrates that at high temperature (>750°C) and in the presence of melt, REE are not less vulnerable to diffusive resetting than divalent cations like Ca2+.
Site‐specific angular dependent determination of inelastic mean free path of 300 keV electrons in GaN nanorods
Authors: Ghatak Jay , Chatterjee Abhijit , Shivaprasad S. M.
Published: January 2021

Inelastic mean free path (IMFP) of the electron is a very important parameter for quantitative analysis of several electron spectroscopies and transport properties. In spite of being a fundamental material property, its experimental determination is not trivial due to complexity of the various electron scattering processes in matter. In this report, we demonstrate a procedure to determine the IMFP of 300 keV electrons in GaN, using the log‐ratio technique where the local specimen thickness needs to be accurately known. The GaN nanorod morphology of the sample used here allows the accurate measurement of thickness by ‘thickness map’ under EFTEM measurements which enable the site specific determination of IMFP. IMFP for different collection semi angles have also been measured to validate the angular dependence. Our experimental results estimates the IMFP of GaN for 300 keV electrons to be 143 ± 11 nm at no‐aperture condition and exhibit a strong inverse angular dependence at smaller collection semi angles (β < 20 mrad) and a near angular independence at larger collection semi angles (β > 30 mrad). We discuss these results in the light of three different theoretical models prevalent in the literature.
A historical perspective on the interactions of insulin at the blood‐brain barrier
Authors: Rhea Elizabeth M. , Banks William A.
Published: January 2021

Subsequent to the discovery of insulin in 1921, the role of insulin in the brain has been investigated throughly. The ability of insulin to act within the brain to regulate peripheral glucose levels helped evolve the research surrounding the ability of insulin to be transported into the brain. Investigations aiming to determine the transport of insulin into the brain from the circulation soon followed. Once it was established that insulin could enter the brain, the ability of insulin to bind brain microvessels and regulators of this process were determined. As technology advanced, quantitative measurements to specify the transport rate of insulin across the blood‐brain barrier (BBB) and the impact of physiological conditions and diseases were the logical next steps. Lastly, with the advent of genetic mouse models and high‐specificity antagonists, the specific role of the insulin receptor in mediating insulin transport could begin to be explored. In this review, we summarise the main findings throughout the decades regarding the interactions of insulin at the BBB.
Predicting nurses' intentions in allowing family presence during resuscitation: A cross‐sectional survey
Authors: Park Ju Young , Ha Jiyeon
Published: January 2021

Aims and Objectives

This study examined nurses' intention to allow family presence during resuscitation (FPDR) by applying the theory of planned behaviour with an extended concept.

Background

Medical institutions, including nurses and other medical professionals working in emergency and intensive care units, are reluctant to allow FPDR. However, this practice reduces the family's anxiety and stress while fostering well‐being and minimises their feelings of helplessness and distress by making them believe that they have helped the patient.

Design

A cross‐sectional descriptive design was used in this study.

Methods

The participants were 252 nurses who had been working for at least 3 months in a general hospital in South Korea. Data were collected using self‐report questionnaires in April 2020 and were analysed using descriptive statistics, Pearson's correlation analysis and multiple regression analysis. The instruments were intention to allow FPDR (five constructs: intention to allow FPDR, positive attitude, negative attitude, subjective norm and perceived behavioural control), perception of FPDR and self‐confidence. The STROBE checklist was used for reporting this study.

Results

The mean score for the intention to allow FPDR was 3.47 out of 5. The regression analysis results indicated that perception of FPDR, positive attitude and negative attitude predicted the intention to allow FPDR.

Conclusions

It is necessary to develop educational programmes to change the perceptions of and attitudes towards FPDR. Additionally, written policies and protocols for FPDR in South Korea are needed to develop systematic care for patients’ families during cardiopulmonary resuscitation.

Relevance to clinical practice

The findings of this study provide baseline data for developing FPDR policies and guidelines that could minimise the family's distress and allow them to feel that they have helped the patient.
Pathways of diabetes distress, decisional balance, self‐efficacy and resilience to quality of life in insulin‐treated patients with type 2 diabetes: A 9‐month prospective study
Authors: Hsu Hui‐Chun , Chen Shi‐Yu , Lee Yau‐Jiunn , Chen Wan‐Yi , Wang Ruey‐Hsia
Published: January 2021

Aims and Objectives

To construct a path model addressing influences of diabetes distress, self‐efficacy of injecting insulin, resilience and decisional balance of injecting insulin to quality of life (QoL) in insulin‐treated patients with type 2 diabetes (T2DM).

Background

Insulin regimens more negatively impact QoL than oral medication treatments in patients with T2DM. Understanding the factors and influencing pathways associated with subsequent QoL will help nurses design timely interventions to improve QoL of insulin‐treated T2DM patients.

Design

A 9‐month prospective design was employed in this study.

Methods

Self‐reported questionnaires were used to collect data from 185 insulin‐treated T2DM patients. At baseline, diabetes distress and self‐efficacy of injecting insulin were collected, while QoL, resilience and decisional balance of injecting insulin were collected 9 months later. Data were collected from February 2017 to February 2018. Structural equation modelling was used for analysis. This study was conducted based on the STROBE.

Results

Low baseline diabetes distress and high 9‐month decisional balance of injecting insulin directly associated with high 9‐month QoL. High baseline self‐efficacy of injecting insulin and high 9‐month resilience directly associated with high 9‐month decisional balance of insulin injection and indirectly associated with high 9‐month QoL. High baseline diabetes distress directly and indirectly associated with poor 9‐month QoL.

Conclusions

Diabetes distress, self‐efficacy of injecting insulin, resilience and decisional balance of injecting insulin play different roles in associating with QoL in insulin‐treated T2DM patients.

Relevance to clinical practice

Nurses could provide educational programs focusing on enhancing decisional balance of injecting insulin to improve QoL in insulin‐treated patients. Improving self‐efficacy of injecting insulin and resilience could be promising strategies to improve the decisional balance of injecting insulin. More timely assessment of diabetes distress and intervention might be powerful strategies to improve subsequent QoL in these patients.
Application of serum markers in diagnosis and staging of ovarian endometriosis
Authors: Tang Ting , Lai Huichao , Huang Xuemei , Gu Liqin , Shi Haiying
Published: January 2021

Aims

Laparoscopic surgery is widely used for diagnosing ovarian endometriosis but it has medical risks. This study explored the application of blood indicators in diagnosis and staging of ovarian endometriosis, aiming to develop a noninvasive diagnostic method.

Methods

A total of 190 ovarian endometriosis patients were included in observation group, among these participants, 77 patients among them were stages I–II, and the rest 113 patients were stages III–IV, and a total of 103 healthy women as control group. Serum biochemical indexes, tumor markers, and cytokines levels in two groups were used for the diagnosis and staging of the disease. Area under the receiver operating characteristic (ROC) curve (AUC) predicted the value of individual and joint tests for indicators.

Results

Biochemical indexes, namely, alkaline phosphatase (ALP), total protein (TP), and glucose (Glu) could distinguish patients from normal women; and that ALP and Glu could indicate disease staging. In tumor markers, alpha fetoprotein (AFP), carcinoembryonic antigen (CA) 125, CA199 and human epididymis protein 4 (HE4) helped to diagnose endometriosis; CA125, HE4, and cytokeratin 19 fragment (CYFRA21‐1) could differentiate stages. In cytokines, vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF)‐α, interleukin (IL)‐6, soluble fms‐like tyrosine kinase receptor 1 (sflt‐1), monocyte chemoattractant protein (MCP)‐1 therefore, have values to diagnose endometriosis; VEGF, TNF‐α, IL‐6, and sflt‐1 helped to differentiate disease staging.

Conclusion

Serological indicators in ovarian endometriosis patients were different from healthy women, which were of certain differential values in diagnosis and disease staging. The current study provided a novel strategy for endometriosis diagnosis.
Postpartum endometritis after uterine cleaning versus no cleaning in cesarean sections: Randomized clinical trial
Authors: Hamdy Mostafa A. , Taha Omima T. , Elprince Mohamed
Published: January 2021

Aim

The aim of the study was to compare the rates of postpartum endometritis due to uterine cleaning and no cleaning in patients delivered by elective cesarean section.

Methods

This was a randomized clinical trial conducted at the Obstetrics and Gynecology Department, Suez Canal University Hospital, Ismailia, from June 2019 to November 2019. We recruited patients undergoing cesarean delivery aged 18–45 years with singleton pregnancy, intact membranes, either first or repeated delivery, without labor pains. Patients were allocated into two groups, uterine cleaning (336 patients) and no cleaning (312 patients). The main outcome measure was the occurrence of postpartum endometritis.

Results

Both groups were matched in their demographic characters. Twelve patients (3.6%) developed endometritis in the cleaning group versus one patient (0.3%) in the other one. Estimated blood loss was 754.35 ± 247.13 and 730.36 ± 232.77 for the cleaning and no cleaning groups, respectively, with a P value of 0.201. Septic wound infection (21 patients, 6.3%) was predominant in the cleaning group.

Conclusion

Uterine cleaning after delivery of the placenta during CS can be omitted as a surgical step during the operation. It was associated with increased rates of postpartum endometritis and blood loss.
Inflammatory bowel disease in Hermansky–Pudlak syndrome: a retrospective single‐centre cohort study
Authors: O’Brien K. J. , Parisi X. , Shelman N. R. , Merideth M. A. , Introne W. J. , Heller T. , Gahl W. A. , Malicdan M. C. V. , Gochuico B. R.
Published: January 2021

Background

Knowledge about inflammatory bowel disease (IBD) in patients with Hermansky–Pudlak syndrome (HPS), a rare autosomal recessive disorder characterized by defective biogenesis of lysosome‐related organelles, could provide insights into IBD in general.

Objective

To expand the understanding of IBD in patients with HPS.

Methods

Retrospective review of records from patients with HPS evaluated at the National Institutes of Health Clinical Center from 1995 to 2019 was conducted. Clinical features of IBD, genotyping results and histologic findings of colectomy specimens were analysed.

Results

IBD affected 37 (14.2%; 12 male, 25 female) of 261 patients with HPS. Median age of onset was 17 years; range was 1 to 52 years. The most common symptoms of HPS IBD were hematochezia, abdominal pain and loose stools. Fistulae or extra‐intestinal manifestations developed in 30% or 22%, respectively. Genotyping showed that patients with biallelic variants in HPS1, HPS3, HPS4 or HPS6 were diagnosed with IBD. Six children had very early‐onset IBD. Patients with HPS‐3 had mild manifestations of IBD. Medical therapy and bowel resection were utilized to treat 73% and 35% of patients with HPS IBD, respectively; 7 of 13 patients receiving anti‐tumor necrosis factor alpha therapy had prolonged clinical responses. Active cryptitis, chronic inflammatory changes, granulomas and ceroid lipofuscinosis were histopathologic findings in three colectomy specimens.

Conclusions

IBD resembling Crohn’s disease affects some patients with HPS; genetic heterogeneity is a feature of HPS IBD. HPS3 is a new gene associated with human IBD. Very early‐onset IBD can develop in HPS.
Telehealth mitigates COPD disease progression compared to standard of care: a randomized controlled crossover trial
Authors: Rassouli F. , Germann A. , Baty F. , Kohler M. , Stolz D. , Thurnheer R. , Brack T. , Kähler C. , Widmer S. , Tschirren U. , Sievi N. A. , Tamm M. , Brutsche M. H.
Published: January 2021

Background

We showed excellent adherence and satisfaction with our telehealth care (TC) approach for COPD. Here, the results of a consecutive randomized controlled trial are presented.

Methods

Patients were randomly assigned to TC or standard care (SC). During TC, patients answered six daily questions online, and focused on the early recognition of exacerbations, in addition to SC.

Results

The mean increase in COPD assessment test (CAT) was 1.8 vs. 3.6 points/year in the TC and SC groups, respectively (P = 0.0015). Satisfaction with care (VAS) at baseline was 8.2; at the end of SC, 8.5 (P = 0.062); and after TC, 8.8 (P < 0.001). We detected significantly more moderate exacerbations during TC.

Conclusion

Whilst receiving TC, the slope of the CAT increase – an indicator of the naturally progressive course of COPD – was reduced by 50%. Satisfaction with care increased with TC. The higher number of detected moderate exacerbations probably indicates a higher diagnostic sensitivity than without TC.
Post‐Separation Parenting Time Schedules in Joint Physical Custody Arrangements
Authors: Steinbach Anja , Augustijn Lara
Published: January 2021

Objective

The objective of the study was to examine patterns of parenting time schedules in joint physical custody (JPC) arrangements.

Background

Although the importance of contact with the non‐residential parent for children's well‐being after family dissolution is well‐documented, the measures used in surveys are often crude and do not capture the two dimensions of post‐separation parenting time schedules: the proportion of time children spend with each parent and the number of transitions children make between parental homes.

Method

The analyses are based on the Family Models in Germany study, a German sample of families with children aged 0–14 that was conducted in 2019. As this study includes a residential calendar capturing the children's stays with each parent over 4 weeks, it was possible to calculate both dimensions of post‐separation parenting time schedules for 463 JPC families.

Results

The results revealed that 55.5% of JPC families practiced an asymmetric (at least 30% with one parent) and 44.5% practiced a symmetric care arrangement (50% with each parent). The mean number of transitions children experienced was 9.5 within a month. The factors that were found to be positively associated with practicing symmetric JPC were working hours of the responding parent and parents' relationship quality. However, working hours of the responding parent and the distance between the parents' homes reduced the number of transitions between the parents' homes, whereas a good parental relationship increased them.

Conclusion

Empirical investigations of children in post‐separation families should take the two dimensions of physical custody into account.
The Ideal Job‐Seeker Norm: Unemployment and Marital Privileges in the Professional Middle‐Class
Authors: Rao Aliya Hamid
Published: January 2021

Objective

To understand how heterosexual US married parents interpret and respond to a spouse's unemployment and subsequent job‐searching.

Background

The pervasiveness of employment uncertainty, and unemployment, may propel families to embrace gender egalitarian norms. Quantitative research finds that this possibility is not borne out. Qualitative research has sought to illuminate mechanisms as to how gender norms persist even during a time that is optimal for dismantling them, but these mechanisms remain unclear.

Method

Seventy‐two in‐depth interviews were conducted with a nonrandom sample of heterosexual, professional, dual‐earner, married, unemployed women, men, and their spouses in the United States. Follow‐up interviews were conducted with 35 participants. Intensive family observations were conducted with four families, two of unemployed men, and two of unemployed women.

Results

Unemployed women, men, and spouses acknowledge that a set of time‐intensive activities are key for reemployment (the ideal job‐seeker norm). Couples with unemployed men direct resources such as time, space, and even money to facilitate unemployed men's compliance with the ideal job‐seeker norm. Couples downplay the importance of women's reemployment and do not direct similar resources to help unemployed women job‐search.

Conclusion

Couples preserve a traditional gender status quo, often in defiance of material realities, by actively maintaining men's position at the helm of paid work and women's at unpaid work.

Implications

Linking unemployment and job‐seeking with the institution of heterosexual marriage reveals novel insights into social and marital processes shaping job‐seeking.
Association between declines in objective masticatory performance and salivary stress markers: The Suita study
Authors: Kosaka Takayuki , Ono Takahiro , Kida Momoyo , Fushida Shuri , Nokubi Takashi , Kokubo Yoshihiro , Watanabe Makoto , Higashiyama Aya , Miyamoto Yoshihiro , Ikebe Kazunori
Published: January 2021

Dentists often encounter patients suffering from psychological and social stress due to declines in masticatory performance, making this a critical issue to manage. We aimed to clarify the relationships between salivary stress markers as objective indices of chronic stress and objective masticatory performance in a general urban Japanese population. Data from 880 participants (mean age, 65.8 years) in the Suita study were used. Salivary interleukin (IL)‐6 and cortisol concentrations were measured by enzyme‐linked immunosorbent assay. Objective masticatory performance was determined by measuring the increase in surface area test gummy jelly after 30 times chewing. Participants were divided into two groups based on masticatory performance: a decreased group (lowest quartile) and a non‐decreased group (second to fourth quartiles). Odds ratios (ORs) of higher salivary levels of stress markers (highest quartile) according to masticatory performance were estimated using logistic regression analysis adjusting for age, sex, periodontal status, salivary flow rate and smoking habit. Salivary IL‐6 level was significantly higher in the decreased group than in the non‐decreased group. Logistic regression analysis showed the adjusted OR for higher salivary IL‐6 was significantly higher in the decreased group than in the non‐decreased group (OR = 1.92; 95% confidence interval = 1.33‐2.76; P < .001). No significant associations were found between salivary cortisol and decreased masticatory performance in any analyses. Declines in objective masticatory performance may correlate with higher salivary IL‐6 level as an objective index of chronic stress.