bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiotensin‐converting enzyme open for business: structural insights into the subdomain dynamics
Authors: Cozier Gyles E. , Lubbe Lizelle , Sturrock Edward D. , Acharya K. Ravi
Published: October 2020

Angiotensin‐1‐converting enzyme (ACE) is a key enzyme in the renin–angiotensin–aldosterone and kinin systems where it cleaves angiotensin I and bradykinin peptides, respectively. However, ACE also participates in numerous other physiological functions, can hydrolyse many peptide substrates and has various exo‐ and endopeptidase activities. ACE achieves this complexity by containing two homologous catalytic domains (N‐ and C‐domains), which exhibit different substrate specificities. Here, we present the first open conformation structures of ACE N‐domain and a unique closed C‐domain structure (2.0 Å) where the C terminus of a symmetry‐related molecule is observed inserted into the active‐site cavity and binding to the zinc ion. The open native N‐domain structure (1.85 Å) enables comparison with ACE2, a homologue previously observed in open and closed states. An open S2_S′‐mutant N‐domain structure (2.80 Å) includes mutated residues in the S2 and S′ subsites that effect ligand binding, but are distal to the binding site. Analysis of these structures provides important insights into how structural features of the ACE domains are able to accommodate the wide variety of substrates and allow different peptidase activities.

Database

The atomic coordinates and structure factors for Open nACE, Open S2_S′‐nACE and Native G13‐cACE structures have been deposited with codes 6ZPQ, 6ZPT and 6ZPU, respectively, in the RCSB Protein Data Bank, www.pdb.org
The lysosomal membrane—export of metabolites and beyond
Authors: Rudnik Sönke , Damme Markus
Published: October 2020

Lysosomes are degradative organelles in eukaryotic cells mediating the hydrolytic catabolism of various macromolecules to small basic building blocks. These low‐molecular‐weight metabolites are transported across the lysosomal membrane and reused in the cytoplasm and other organelles for biosynthetic pathways. Even though in the past 20 years our understanding of the lysosomal membrane regarding various transporters, other integral and peripheral membrane proteins, the lipid composition, but also its turnover has dramatically improved, there are still many unresolved questions concerning key aspects of the function of the lysosomal membrane. These include a possible function of lysosomes as a cellular storage compartment, yet unidentified transporters mediating the export such as various amino acids, mechanisms mediating the transport of lysosomal membrane proteins from the Golgi apparatus to lysosomes, and the turnover of lysosomal membrane proteins. Here, we review the current knowledge about the lysosomal membrane and identify some of the open questions that need to be solved in the future for a comprehensive and complete understanding of how lysosomes communicate with other organelles, cellular processes, and pathways.
Living phosphatic stromatolites in a low‐phosphorus environment: Implications for the use of phosphorus as a proxy for phosphate levels in paleo‐systems
Authors: Büttner Steffen H. , Isemonger Eric W. , Isaacs Michelle , van Niekerk Deon , Sipler Rachel E. , Dorrington Rosemary A.
Published: October 2020

In the geological record, fossil phosphatic stromatolites date back to the Great Oxidation Event in the Paleoproterozoic, but living phosphatic stromatolites have not been described previously. Here, we report on cyanobacterial stromatolites in a supratidal freshwater environment at Cape Recife, South African southern coast, precipitating Ca carbonate alternating with episodes of Ca phosphate deposition. In their structure and composition, the living stromatolites from Cape Recife closely resemble their fossilized analogues, showing phosphatic zonation, microbial casts, tunnel structures and phosphatic crusts of biogenic origin. The microbial communities appear to be also similar to those proposed to have formed fossil phosphatic stromatolites. Phosphatic domains in the material from Cape Recife are spatially and texturally associated with carbonate precipitates, but form distinct entities separated by sharp boundaries. Electron Probe Micro‐Analysis shows that Ca/P ratios and the overall chemical compositions of phosphatic precipitates are in the range of octacalcium phosphate, amorphous tricalcium phosphate and apatite. The coincidence in time of the emergence of phosphatic stromatolites in the fossil record with a major episode of atmospheric oxidation led to the assumption that at times of increased oxygen release the underlying increased biological production may have been linked to elevated phosphorus availability. The stromatolites at Cape Recife, however, form in an environment where ambient phosphorus concentrations do not exceed 0.28 μM, one to two orders of magnitude below the previously predicted minimum threshold of >5 μM for biogenic phosphate precipitation in paleo‐systems. Accordingly, we contest the previously proposed suitability of phosphatic stromatolites as a proxy for high ambient phosphate concentrations in supratidal to shallow ocean settings in earth history.
Climate change facilitates a parasite’s host exploitation via temperature‐mediated immunometabolic processes
Authors: Scharsack Jörn P. , Wieczorek Bartholomäus , Schmidt‐Drewello Alexander , Büscher Janine , Franke Frederik , Moore Andrew , Branca Antoine , Witten Anika , Stoll Monika , Bornberg‐Bauer Erich , Wicke Susann , Kurtz Joachim
Published: October 2020

Global climate change can influence organismic interactions like those between hosts and parasites. Rising temperatures may exacerbate the exploitation of hosts by parasites, especially in ectothermic systems. The metabolic activity of ectotherms is strongly linked to temperature and generally increases when temperatures rise. We hypothesized that temperature change in combination with parasite infection interferes with the host's immunometabolism. We used a parasite, the avian cestode Schistocephalus solidus, which taps most of its resources from the metabolism of an ectothermic intermediate host, the three‐spined stickleback. We experimentally exposed sticklebacks to this parasite, and studied liver transcriptomes 50 days after infection at 13°C and 24°C, to assess their immunometabolic responses. Furthermore, we monitored fitness parameters of the parasite and examined immunity and body condition of the sticklebacks at 13°C, 18°C and 24°C after 36, 50 and 64 days of infection. At low temperatures (13°C), S. solidus growth was constrained, presumably also by the more active stickleback's immune system, thus delaying its infectivity for the final host to 64 days. Warmer temperature (18°C and 24°C) enhanced S. solidus growth, and it became infective to the final host already after 36 days. Overall, S. solidus produced many more viable offspring after development at elevated temperatures. In contrast, stickleback hosts had lower body conditions, and their immune system was less active at warm temperature. The stickleback's liver transcriptome revealed that mainly metabolic processes were differentially regulated between temperatures, whereas immune genes were not strongly affected. Temperature effects on gene expression were strongly enhanced in infected sticklebacks, and even in exposed‐but‐not‐infected hosts. These data suggest that the parasite exposure in concert with rising temperature, as to be expected with global climate change, shifted the host's immunometabolism, thus providing nutrients for the enormous growth of the parasite and, at the same time suppressing immune defence.
A role for differential Rubisco activase isoform expression in C4 bioenergy grasses at high temperature
Authors: Kim Sang Yeol , Slattery Rebecca A. , Ort Donald R.
Published: October 2020

Rubisco activase (Rca) facilitates the release of sugar‐phosphate inhibitors at Rubisco catalytic sites during CO2 fixation. Most plant species express two Rca isoforms, the larger Rca‐α and the shorter Rca‐β, either by alternative splicing from a single gene or expression from separate genes. The mechanism of Rubisco activation by Rca isoforms has been intensively studied in C3 plants. However, the functional role of Rca in C4 plants where Rubisco and Rca are located in a much higher [CO2] compartment is less clear. In this study, we selected four C4 bioenergy grasses and the model C4 grass setaria (Setaria viridis) to investigate the role of Rca in C4 photosynthesis. All five C4 grass species contained two Rca genes, one encoding Rca‐α and the other Rca‐β, which were positioned closely together in the genomes. A variety of abiotic stress‐related motifs were identified in the Rca‐α promoter of each grass, and while the Rca‐β gene was constantly highly expressed at ambient temperature, Rca‐α isoforms were expressed only at high temperature but never surpassed 30% of Rca‐β content. The pattern of Rca‐α induction on transition to high temperature and reduction on return to ambient temperature was the same in all five C4 grasses. In sorghum (Sorghum bicolor), sugarcane (Saccharum officinarum), and setaria, the induction rate of Rca‐α was similar to the recovery rate of photosynthesis and Rubisco activation at high temperature. This association between Rca‐α isoform expression and maintenance of Rubisco activation at high temperature suggests that Rca‐α has a functional thermo‐protective role in carbon fixation in C4 grasses by sustaining Rubisco activation at high temperature.
A Synthetic Haematite Reference Material for LA‐ICP‐MS U‐Pb Geochronology and Application to Iron Oxide‐Cu‐Au Systems
Authors: Courtney‐Davies Liam , Gilbert Sarah E. , Ciobanu Cristiana L. , Tapster Simon R. , Richardson Marcus W. , Cook Nigel J. , Wade Benjamin P. , Verdugo‐Ihl Max R. , Ehrig Kathy , Condon Daniel J.
Published: October 2020

In both nature and synthetic experiments, the common iron oxide haematite (α‐Fe2O3) can incorporate significant amounts of U into its crystal structure and retain radiogenic Pb over geological time. Haematite is a ubiquitous component of many ore deposit types and, therefore, represents a valuable hydrothermal mineral geochronometer, allowing direct constraints to be placed on the timing of ore formation and upgrading. However, to date, no suitable natural haematite reference material has been identified. Here, a synthetic haematite U‐Pb reference material (MR‐HFO) is characterised using LA‐ICP‐MS and ID‐TIMS. Centimetre‐scale ‘chips’ of synthesised α‐Fe2O3 were randomly microsampled via laser ablation‐extraction and analysed using ID‐TIMS. Reproducible U/Pb and Pb/Pb measurements were obtained across four separate chips (n = 13). Subsequently, an evaluation of the suitability MR‐HFO in constraining U‐Pb data via LA‐ICP‐MS is presented using a selection of natural samples ranging from Cenozoic to Proterozoic in age. The MR‐HFO normalised U‐Pb ratios are more concordant and ages more accurate versus the same LA‐ICP‐MS spot analyses normalised to zircon reference material, when compared with independently acquired ID‐TIMS data from the same natural haematite grains. Results establish MR‐HFO as a suitable reference material for LA‐ICP‐MS haematite U‐Pb geochronology.
Universities as orchestrators of the development of regional innovation ecosystems in emerging economies
Authors: Thomas Elisa , Faccin Kadigia , Asheim Bjørn Terje
Published: October 2020

This paper analyses the role of universities as orchestrators of the development of a regional ecosystem that is conducive to innovation and entrepreneurship. We argue that universities in emerging economies, due to many social challenges, must go beyond their missions of teaching, research, and collaboration with industry for innovation. We present a unique case study of an alliance of three universities in Porto Alegre, Brazil that, in addition to being competitors in the above‐mentioned missions, are orchestrating a network of stakeholders in this region to develop an ecosystem for innovation and entrepreneurship. We demonstrate that universities perform several orchestration processes that are consistent with the literature, such as fostering knowledge mobility, managing innovation appropriability, and increasing network stability. Furthermore, we found differences in how innovation ecosystems are orchestrated as compared to firm networks. In the case of innovation ecosystems, appropriability reaches the broader region, and the benefits are not limited to participant stakeholders. Such orchestration processes emerge when universities take on leadership positions in the region; they can influence the beginning of collective actions and projects as well as transfer responsibility, delegating power to other actors in the network.
Bone marrow haemophagocytosis indicates severe infection with severe acute respiratory syndrome coronavirus 2
Authors: Swoboda Julia , Wittschieber Daniel , Sanft Juliane , Kleemann Sandra , Elschner Stefan , Ihle Hannah , Hubig Michael , Pletz Mathias W , Mall Gita , Gassler Nikolaus
Published: October 2020

Aims

Haemophagocytosis in the bone marrow of patients who have succumbed to coronavirus disease 19 (COVID‐19) has not been widely studied. The aims of the present study were to perform morphological analyses and morphometry of haemophagocytosis in the bone marrow of patients with severe COVID‐19, and to correlate the findings with the clinical course of the disease.

Methods and results

In this single‐centre study performed at the University Hospital Jena, bone marrow specimens of 15 deceased patients who had experienced a severe course of COVID‐19 were sampled from the vertebral column during autopsy. Slides of the bone marrow were stained with routine stains or immunohistochemically, and further examined for haemophagocytosis by the use of light microscopy. To substantiate the morphological findings, additional slides were stained for CD163 and morphometry was performed. In all bone marrow samples, an increase in cellularity was found. Haemophagocytes with erythrophagocytosis were detected in 67% of the deceased patients. In tissues with low numbers of haemophagocytes or ill‐defined haemophagocytes, an increase in iron deposits was frequently seen. Morphological findings were then correlated with several important clinical data, and the HScore (probability of having a reactive hemophagocytic syndrome) was calculated to posthumously confirm the diagnosis of secondary haemophagocytic lymphohistiocytosis. The median duration of disease and the hospitalisation time were lower in patients with haemophagocytosis (n = 10) than in patients without haemophagocytosis (n = 5). In addition, patients with haemophagocytes showed increased inflammatory parameters 2–5 days prior to death, in contrast to patients without haemophagocytes.

Conclusions

Haemophagocytosis is a common finding in the bone marrow of deceased individuals with severe COVID‐19, and may indicate fatal severe acute respiratory syndrome coronavirus 2 infections.
Hornbill abundance and breeding incidence in relation to habitat modification and fig fruit availability
Authors: Pawar Pooja Yashwant , Mudappa Divya , Raman T. R. Shankar
Published: October 2020

Asian hornbills are known to forage and breed in fragmented rainforests and agroforestry plantations in human‐modified landscapes adjoining contiguous protected forests. However, the factors influencing year‐round hornbill abundance, demography and tracking of key food resources such as wild figFicusfruits in modified habitats and protected forests remain poorly understood. We carried out monthly surveys of two species of high conservation concern, the Vulnerable Great Hornbill (GH,Buceros bicornis) and the endemic Malabar Grey Hornbill (MGH,Ocyceros griseus) for 15 months and monitored ripe fig fruit availability for 12 months along 11 line transects (total length 24 km) in shade‐coffee plantations and adjoining continuous rainforests in a protected area (PA) in the Anamalai Hills, Western Ghats, India. Both hornbill species used plantations and the PA year‐round but distance sampling density estimates were higher in the PA in both nesting (GH by 57%; MGH by 50%) and non‐nesting (GH by 53%; MGH by 144%) seasons. Relative to estimates from 2004 to 2005, mean GH density appeared stable or increasing, whereas MGH had declined by 39% in the PA and by 56% in plantations. Monthly encounter rate of both hornbills tended to be higher in the PA and that of MGH was also positively related to the density of fig trees with ripe fruit. Sex ratios of observed adult birds in the non‐nesting season were relatively even (GH) or slightly female‐biased (MGH), but became male‐biased in both species during the nesting season when females were confined in tree‐cavity nests. We used change in the adult sex ratio of observed birds from the non‐nesting to nesting season to estimate an index of the proportion of adult pairs breeding at any point within the season, providing the first such estimates for any hornbill species. The proportion of breeding pairs was higher in the PA (GH – 56%, MGH – 64%) than in the plantations (GH – 33%, MGH – 30%). Although hornbills use shade‐coffee plantations year‐round, partly due to fig fruit availability, differences in hornbill density and breeding incidence, as assessed from the sex ratios of observed adult birds, indicate that plantations are a sub‐optimal habitat for both species.
Non‐random sampling along rural–urban gradients may reduce reliability of multi‐species farmland bird indicators and their trends
Authors: Husby Magne , Hoset Katrine S. , Butler Simon
Published: October 2020

The continued global biodiversity crisis necessitates the continuation and development of new well‐designed monitoring strategies and action plans with particular focus on under‐represented countries and regions. However, limited resources in terms of budget and availability of qualified field personnel can restrict the geographical coverage of monitoring efforts. Focusing monitoring efforts on a representative subset of species and locations can improve cost‐efficiency. Optimal performance of multi‐species indicators derived from such an approach requires objective methods for species selection and a sampling design that reduces inherent sampling bias caused by regional differences in habitat availability or accessibility. To explore the performance of a multi‐species indicator across different regions within a nation, we developed a multi‐species indicator (MSI) for farmland birds in Norway using objective niche‐based selection of species. We compare the performance of this indicator at national and regional scales (Central and East regions) in Norway, and between urban and rural sites within regions. The seven‐species indicator obtained from the species selection provided similar indicator values and trends for Norway and the Central and East regions, as well as for rural sites within the combined Central + East region. All trends were defined as showing moderate decline from 2007–2016. Urban sites within the combined Central + East region provided trend estimates that showed stronger decline than rural areas in the same region during the time span. Our results emphasize the need to control for sampling bias when structuring monitoring programmes such as a Breeding Bird Survey (BBS). This is especially important if limited resources restrict the geographical coverage of the monitoring scheme. We recommend that monitoring schemes follow a stratified random sampling design that represents both the availability of different land cover types and their distribution with regard to proximity to highly populated areas. If that is not possible, statistically weighting data from different regions or landscapes is likely to be necessary.
In vitro antihypertensive activity of bioactive peptides derived from porcine blood corpuscle and plasma proteins
Authors: Aiemratchanee Panida , Panyawechamontri Kulachatr , Phaophu Phutthaphorn , Reamtong Onrapak , Panbangred Watanalai
Published: October 2020

New bioactive peptides with antihypertensive property from red blood corpuscle (RBC) and plasma (PL) hydrolysate fractions of porcine blood were identified. Three peptides with the highest Angiotensin‐converting enzyme (ACE) inhibitory activity from RBC, including RBC7 (TPYPCV), RBC15 (VVYPWR) and RBC9 (FLCT), showed IC50 values of 2.58 ± 0.87, 5.22 ± 2.56 and 6.53 ± 0.34 µm, respectively. By comparison, PL1 (YTFPFH), PL2 (WGHGNPHV) and PL7 (VPLW) from PL displayed higher IC50 values at 24.12 ± 2.44, 15.33 ± 0.44 and 32.80 ± 38.96 µm, respectively. Molecular docking was employed to simulate the interactions of RBC7 and RBC15 with the catalytic site of the ACE receptor. RBC7 and RBC15 interacted with residues in the ACE receptor that normally coordinated with Zn(II), and RBC7 also interacted extensively with residues within S1, S2 and S’1 active sites. Taken together, these results illustrate that porcine blood is an excellent source of antihypertensive peptides and could be of great benefits to people with high blood pressure.
Identification of critical versus robust processing unit operations determining the physical and biochemical properties of cassava‐based semolina (gari)
Authors: Escobar Andrés , Rondet Eric , Dahdouh Layal , Ricci Julien , Akissoé Noël , Dufour Dominique , Tran Thierry , Cuq Bernard , Delalonde Michèle
Published: October 2020

The gari‐making process involves several unit operations (U.O.), some of which strongly influence the quality of the end product. Two contrasting process scales (laboratory‐scale vs conventional) were compared in order to identify which U.O. were affected by the change of scale. U.O. that changed end‐product characteristics depending on process scale were deemed critical; whereas U.O. that resulted in similar characteristics were deemed robust. The classification depended on quality attributes considered: rasping and roasting were critical for physical properties, in particular particle size which ranged from 0.44 to 0.89 mm between the two process scales; and robust for biochemical properties. In contrast, fermentation and pressing were critical for biochemical properties such as lactic acid content (0.93–1.88 g/100 g dry matter after pressing), which influences the perception of flavour, and robust for physical properties. This classification between critical and robust operations help quality control of gari, by pinpointing which U.O. control specific quality characteristics.
Conceptual Design, Sin and the Affordances of Doctrine
Authors: Reichel Hanna
Published: October 2020

Systematic Theology harnesses the best modern reason has to offer for a coherent and rational presentation of Christian faith. Constructive Theologies point to the contextual nature of all theology, and criticize systematicity’s unexamined bias and complicity in structural injustice and oppression. Moving beyond epistemic incommensurability and mutual imputations, this article presents one Systematic Theologian’s attempt to understand such criticism as pointing to the insurmountable implication of theology in epistemological sin. Drawing on the architectural metaphor in construction and system‐building, it proposes a new understanding of theological work as conceptual design, responsibly ordering and structuring given materials for a purpose. It thus has to account for the actual use, material effects and fit with environmental requirements of its doctrinal design. Aspiring to a more realistic adaequatio ad rem thus necessitates an expansion of theology’s critical standards to encompass not only cognitive and logical criteria, but also the practical effects and uses of doctrine in an ethic of affordances. Finally, ‘queer use’ effectively expresses how both the lives of real human beings and the reality of God will never fit into conceptual logics nor be exhausted by whatever current use we attribute to them.
The state of mixed methods research in nursing: A focused mapping review and synthesis
Authors: Irvine Fiona E. , Clark Maria T. , Efstathiou Nikolaos , Herber Oliver R. , Howroyd Fiona , Gratrix Lesley , Sammut Dana , Trumm Aile , Hanssen Tove A. , Taylor Julie , Bradbury‐Jones Caroline
Published: October 2020

Aims

To consider the scope and quality of mixed methods research in nursing.

Design

Focused mapping review and synthesis (FMRS).

Data sources

Five purposively selected journals: International Journal of Nursing Studies, Journal of Nursing Scholarship, Journal of Advanced Nursing, Worldviews on Evidence‐Based Nursing, and Journal of Mixed Methods Research.

Review methods

In the target journals, titles and abstracts from papers published between 2015–2018 were searched for the words or derivative words ‘mixed methods’. Additional keyword searches were undertaken using each journal's search tool. We included studies that investigated nursing and reported to use a mixed methods approach. Articles that met the inclusion criteria were read in full and information was extracted onto a predetermined pro forma. Findings across journals were then synthesized to illustrate the current state of mixed methods research in nursing.

Results

We located 34 articles that reported on mixed methods research, conducted across 18 countries. Articles differed significantly both within and across journals in terms of conformity to a mixed methods approach. We assessed the studies for the quality of their reporting as regard the use of mixed methods. Nineteen studies were rated as satisfactory or good, with 15 rated as poorly described. Primarily, a poor rating was due to the absence of stating an underpinning methodological approach to the study and/or limited detail of a crucial integration phase.

Conclusions

Our FMRS revealed a paucity of published mixed methods research in the journals selected. When they are published, there are limitations in the detail given to the underpinning methodological approach and theoretical explanation.
Internet‐based support program on parenting outcomes for Chinese primiparous women: Study protocol for a randomized controlled trial
Authors: Zheng Xujuan , Huang Lingling , Fang Qiyu , Zhang Yan , Zhang Yao , Li Xilin , Ye Ziwen , Wang Qun
Published: October 2020

Aim

To evaluate the effects of internet‐based support program for primiparous women in terms of improving the levels of maternal self‐efficacy, social support, and satisfaction; and reducing their postpartum depression symptoms.

Design

A single‐blinded, multicentre, randomized, controlled, parallel‐group pre‐test and repeated post‐test design.

Methods

Based on the self‐efficacy theory and the social exchange theory, the internet‐based support program has five modules: (a) learning forum of parenting knowledge and skills; (b) communication forum; (c) ask‐the‐expert forum; (d) baby home forum; and (e) reminder forum. Primiparous women will be recruited in the obstetric wards of two university‐affiliated hospitals in China. The participants (N = 258) will be randomly allocated to the intervention group that receive routine care and access to the internet‐based support program and the control group that receive routine care during the 3 months postpartum. Maternal self‐efficacy, social support, and postpartum depression symptoms will be measured at baseline, immediately after the intervention (post‐test 1) and 3 months after the intervention (post‐test 2). The study was funded in January 2018 and was ethically approved in May 2020.

Discussion

If the internet‐based support program has positive outcomes, it will contribute to the scientific and practical knowledge of nursing interventions to support primiparous women on parenting; and could become the routine health care for health professionals to enhance parenting ability and mental well‐being of new mothers.

Impact

As the first RCT study on parenting outcomes using a rigorous research design and a theoretical framework in China, this research will contribute to evidence on the effectiveness of using internet platform to support women after childbirth. The results could help to advance research about the use of internet‐based intervention methods to improve women's maternal self‐efficacy, social support, satisfaction, and to alleviate depression symptoms.

Chinese Clinical Trial Registry: ChiCTR2000033154
Developing and testing of an integrative theoretical model to predict positive aspects of caregiving among family caregivers of persons with dementia: A study protocol
Authors: Yu Doris S. F. , Cheng Sheung‐Tak , Kwok Timothy
Published: October 2020

Aims

The aim is to develop and test an integrative model based on the stress and coping paradigm and the existential paradigm, to explain positive aspects of caregiving among family caregivers of persons with dementia.

Design

A mixed method research, comprises a longitudinal exploratory study and a descriptive qualitative study.

Methods

A total of 370 family caregivers will be recruited from community elderly centres. Questionnaires on positive aspects of caregiving and its predictors (including active dementia management strategies, meaning‐focused coping, and self‐efficacy) and contextual factors (including social support, religiosity, continuous good dyadic relationship quality, and intrinsic motivation towards caregiving) will be administered. Positive aspects of caregiving will be reassessed six months later. Path analysis will be used to test the hypothesized model. A subsample of 30 family caregivers will be interviewed individually to explore how positive aspects of caregiving develop from the caregiving experience. Inductive thematic analysis will be used to for the qualitative data analysis. The funding was approved in January 2018.

Discussion

Positive aspects of caregiving represents the extent to which the caregiving experience is seen as enriching an individual's life space and resulted in health protective effects. With the increasing evidence to indicate its associating factors, it is imperative to identify the theoretical model to comprehensively elucidate the process for its development.

Impact

Theoretically, this study will advance the knowledge of dementia caregiving by generating a comprehensive theory‐driven predictive model to explain how positive aspects of caregiving is developed among the family caregivers. In terms of nursing practice, the findings can inform the development of intervention to improve positive aspects of caregiving and thereby acts as a catalyst to promote the paradigm shift from ‘reducing limitations’ to ‘optimizing strengths’ in family caregivers support services.
Measuring nurses' health policy participation: WSPPIR instrument development and psychometric evaluation
Authors: Waddell Ashley
Published: October 2020

Aim

To measure nurses' health policy participation by developing and psychometrically testing the Waddell Spectrum for Policy Participation Influence and Research (WSPPIR) Instrument.

Design

Instrument development; based on a nursing conceptual framework.

Methods

This four‐phase study was conducted in 2018 to estimate content validity, construct validity, and internal consistency reliability of the WSPPIR instrument. Phase 1– item generation for the multi‐dimensional concept of health policy participation as described in WSPPIR theory. Phase 2– a content validity index was calculated based on ratings by seven experts. Phase 3– cognitive interviews of five nurses. Phase 4– 306 Registered Nurses completed the WSPPIR instrument. Exploratory factor analysis was used to identify and to estimate construct validity, Cronbach's alpha was calculated to estimate internal consistency reliability.

Results

The 38‐item WSPPIR Instrument consists of five subscales (Professional Nursing Organizations; Health Care Delivery Systems: Organizations that Deliver Health Care Services; Governance Levels: City/Town, State, National, Global; Valuing Health and Policy; Influence Skills) and exhibits adequate estimates of reliability and content and construct validity, as a measure nurses' health policy participation.

Conclusion

As efforts to enhance nurses' health policy participation continue globally, the WSPPIR instrument should be useful in measuring individual nurses' health policy participation and benchmarking health policy participation for the nursing profession at large.

Impact

The WSPPIR instrument will be useful to individual nurses, educators, and the profession as we work to systematically and strategically increase nurses' participation in and influence on health policy.
Knowledge mobilization in bridging patient‐practitioner‐researcher boundaries: A systematic integrative review
Authors: Appleby Ben , Cowdell Fiona , Booth Andrew
Published: October 2020

Aim

To review when, how, and in what context knowledge mobilization (KMb) has crossed patient‐practitioner‐researcher boundaries.

Background

KMb is essential in contemporary health care, yet little is known about how patients are engaged.

Design

Integrative review.

Data sources

Ten academic databases and grey literature.

Review methods

We followed integrative review methodology to identify publications from 2006–2019 which contributed to understanding of cross‐boundary KMb. We extracted data using a bespoke spreadsheet and the Template for Intervention Description and Replication (TIDieR) framework. We used meta‐summary to organize key findings.

Results

Thirty‐three papers collectively provide new insights into ‘when’ and ‘how’ KMb has crossed patient‐researcher‐practitioner boundaries and the impact this has achieved. Knowledge is mobilized to improve care, promote health, or prevent ill health. Most studies focus on creating or re‐shaping knowledge to make it more useful. Knowledge is mobilized in small community groups, in larger networks, and intervention studies. Finding the right people to engage in activities is crucial, as activities can be demanding and time‐consuming. Devolving power to communities and using local people to move knowledge can be effective. Few studies report definitive outcomes of KMb.

Conclusion

Cross‐boundary KMb can and does produce new and shared knowledge for health care. Positive outcomes can be achieved using diverse public engagement strategies. KMb process and theory is an emerging discipline, further research is needed on effective cross‐boundary working and on measuring the impact of KMb.

Impact

This review provides new and nuanced understandings of how KMb theory has been used to bridge patient‐researcher‐practitioner boundaries. We have assessed ‘how’, ‘when’, and in what context patients, practitioners and researchers have attempted to mobilize knowledge and identified impact. We have developed a knowledge base about good practice and what can and potentially should be avoided in cross‐boundary KMb.
Effects of family nursing conversations on families in home health care: A controlled before‐and‐after study
Authors: Broekema Susanne , Paans Wolter , Roodbol Petrie F. , Luttik Marie Louise A.
Published: October 2020

Aim

To assess the effects of family nursing conversations on family caregiver burden, patients’ quality of life, family functioning and the amount of professional home health care.

Design

A controlled before‐and‐after design.

Methods

Intervention group families participated in two family nursing conversations incorporated in home health care; control group families received usual home health care. Patients and family members completed a set of questionnaires on entering the study and 6 months later to assess family caregiver burden, family functioning and patients’ quality of life. The amount of home health care was extracted from patient files. Data were collected between January 2018–June 2019.

Results

Data of 51 patients (mean age 80; 47% male) and 61 family members (mean age 67; 38% male) were included in the results. Family caregiver burden remained stable in the intervention group whereas it increased in the control group. Family functioning improved significantly compared with the control group for patients and family members in the intervention group. No significant effects on patients’ quality of life emerged. The amount of professional home health care decreased significantly in the intervention group whereas it remained equal in the control group.

Conclusion

Family nursing conversations prevented family caregiver burden, improved family functioning, but did not affect patients’ quality of life. In addition, the amount of home health care decreased following the family nursing conversations.

Impact

Countries with ageing populations seek to reduce professional and residential care and therefore encourage family caregiving. Intensive family caregiving, however, places families at risk for caregiver burden which may lead to increased professional care and admission into residential care. This study demonstrates that family nursing conversations help nurses to prevent family caregiver burden and improve family functioning while decreasing the amount of home health care.
MR‐guided pulsed focused ultrasound improves mesenchymal stromal cell homing to the myocardium
Authors: Jang Kee W. , Tu Tsang‐Wei , Rosenblatt Robert B. , Burks Scott R. , Frank Joseph A.
Published: October 2020

Image‐guided pulsed focused ultrasound (pFUS) is a non‐invasive technique that can increase tropism of intravenously (IV)‐infused mesenchymal stromal cells (MSC) to sonicated tissues. MSC have shown promise for cardiac regenerative medicine strategies but can be hampered by inefficient homing to the myocardium. This study sonicated the left ventricles (LV) in rats with magnetic resonance imaging (MRI)‐guided pFUS and examined both proteomic responses and subsequent MSC tropism to treated myocardium. T2‐weighted MRI was used for pFUS targeting of the entire LV. pFUS increased numerous pro‐ and anti‐inflammatory cytokines, chemokines, and trophic factors and cell adhesion molecules in the myocardial microenvironment for up to 48 hours post‐sonication. Cardiac troponin I and N‐terminal pro‐B‐type natriuretic peptide were elevated in the serum and myocardium. Immunohistochemistry revealed transient hypoxia and immune cell infiltration in pFUS‐targeted regions. Myocardial tropism of IV‐infused human MSC following pFUS increased twofold‐threefold compared with controls. Proteomic and histological changes in myocardium following pFUS suggested a reversible inflammatory and hypoxic response leading to increased tropism of MSC. MR‐guided pFUS could represent a non‐invasive modality to improve MSC therapies for cardiac regenerative medicine approaches.
Post‐extraction dimensional changes: A systematic review and meta‐analysis
Authors: Couso‐Queiruga Emilio , Stuhr Sandra , Tattan Mustafa , Chambrone Leandro , Avila‐Ortiz Gustavo
Published: October 2020

Aim

To analyse the evidence pertaining to post‐extraction dimensional changes in the alveolar ridge after unassisted socket healing.

Materials and Methods

The protocol of this PRISMA‐compliant systematic review (SRs) was registered in PROSPERO (CRD42020178857). A literature search to identify studies that fulfilled the eligibility criteria was conducted. Data of interest were extracted. Qualitative and random‐effects meta‐analyses were performed if at least two studies with comparable features and variables reported the same outcome of interest.

Results

Twenty‐eight articles were selected, of which 20 could be utilized for the conduction of quantitative analyses by method of assessment (i.e. clinical vs radiographic measurements) and location (i.e. non‐molar vs molar sites). Pooled estimates revealed that mean horizontal, vertical mid‐facial and mid‐lingual ridge reduction assessed clinically in non‐molar sites was 2.73 mm (95% CI: 2.36–3.11), 1.71 mm (95% CI: 1.30–2.12) and 1.44 mm (95% CI: 0.78–2.10), respectively. Mean horizontal, vertical mid‐facial and mid‐lingual ridge reduction assessed radiographically in non‐molar sites was 2.54 mm (95% CI: 1.97–3.11), 1.65 mm (95% CI: 0.42–2.88) and 0.87 mm (95% CI: 0.36–1.38), respectively. Mean horizontal, vertical mid‐facial and mid‐lingual ridge reduction assessed radiographically in molar sites was 3.61 mm (95% CI: 3.24–3.98), 1.46 mm (95% CI: 0.73–2.20) and 1.20 mm (95% CI: 0.56–1.83), respectively.

Conclusion

A variable amount of alveolar bone resorption occurs after unassisted socket healing depending on tooth type.
Potential biomarker in serum for predicting susceptibility to type 2 diabetes mellitus: Free fatty acid 22:6
Authors: Ma Yinghua , Xiong Jianyu , Zhang Xueting , Qiu Tongtong , Pang Huai , Li Xue , Zhu Jiaojiao , Wang Jingzhou , Pan Chongge , Yang Xin , Chu Xiaolong , Yang Bingqi , Wang Cuizhe , Zhang Jun
Published: October 2020

Aims/Introduction

Type 2 diabetes mellitus is closely linked to increased levels of free fatty acids (FFAs) in obese individuals, although which FFA is most associated with type 2 diabetes mellitus is unclear. This study aimed to identify the specific FFAs that best predict the occurrence of type 2 diabetes mellitus in obese individuals, and assess their potential application value.

Materials and Methods

Participants were divided into three groups: a normal weight group (n = 20), an obese group (n = 10) and a type 2 diabetes mellitus group (n = 10). FFAs in serum samples were determined by ultra‐high‐pressure liquid chromatography–mass spectrometry, and orthogonal partial least squares discriminant analysis models were used to study the FFA profile among the three groups.

Results

Compared with the normal weight group, 14 FFAs (C8:0/10:0/14:0/16:1/18:1/20:2/ 20:3 /20:4/ 20:5/ 22:6/7:0/9:0/11:0 and C13:0) were significantly increased in the obese group, and nine FFAs (C14:0, C18:1, C20:1, C 18:2, C20:2, C20:3, C18:3, C20:5 and C22:6) were significantly increased in the type 2 diabetes mellitus group. Subsequently, the Venn diagram results showed that six FFAs (C14:0, C18:1, C20:2, C20:3, C20:5 and C22:6) were significantly increased in both the obese and type 2 diabetes mellitus groups. Among these six, C22:6 was finally identified as an independent risk factor for type 2 diabetes mellitus, and had a great potential to predict the susceptibility to type 2 diabetes mellitus (area under the curve 0.803).

Conclusions

C22:6 can be an independent risk factor for type 2 diabetes mellitus, and it has a great potential to predict the susceptibility to type 2 diabetes mellitus.
Rapid and sustained control of itch and reduction in Th2 bias by dupilumab in a patient with Sézary syndrome
Authors: Steck O. , Bertschi N.L. , Luther F. , van den Berg J. , Winkel D.J. , Holbro A. , Schlapbach C.
Published: October 2020

Background

Sézary syndrome is a leukaemic variant of cutaneous T‐cell lymphoma with poor prognosis. With the exception of stem cell transplantation, current treatments for SS are not curative. Rather, they aim at reducing disease burden and improving quality of life. Yet, pruritus – the major cause for impaired quality of life in these patients – is notoriously difficult to treat. Thus, supportive treatments addressing agonizing pruritus are urgently needed.

Objectives

To explore the clinical and immunological effects of type 2 cytokine blockade with dupilumab as supportive treatment in Sézary syndrome.

Methods

A Sézary syndrome patient with stable disease but intractable pruritus was treated with dupilumab in combination with continued extracorporeal photopheresis. Close clinical and immunological monitoring on blood and skin samples from the patient was performed over 44 weeks. In vitro assays with patient's lymphoma cells were performed to address effects of dupilumab on Sézary cell's response to Th2 cytokines.

Results

Clinically, dupilumab treatment induced rapid and sustained reduction in itch and improvement of skin and lymph node involvement. In both blood and skin, a reduction in Th2 bias was observed. Intriguingly, lymphocyte counts and Sézary cells in blood increased and later stabilized under dupilumab treatment. In vitro, dupilumab abrogated the anti‐apoptotic and activating effects of Th2 cytokines on Sézary cells.

Conclusions

In this Sézary patient, inhibition of IL‐4 and IL‐13 signalling was associated with striking clinical benefit in terms of quality of life, pruritus and use of topical corticosteroids. While safety remains an important concern, our data support the future exploration of Th2 modulation for supportive care in Sézary Syndrome.
Development of a Piscirickettsia salmonis immersion challenge model to investigate the comparative susceptibility of three salmon species
Authors: Long Amy , Goodall Aidan , Jones Simon R.M.
Published: October 2020

Piscirickettsia salmonis, the aetiological agent of salmonid rickettsial septicaemia (SRS), is a global pathogen of wild and cultured marine salmonids. Here, we describe the development and application of a reproducible, standardized immersion challenge model to induce clinical SRS in juvenile pink (Oncorhynchus gorbuscha), Atlantic (Salmo salar) and sockeye salmon (O. nerka). Following a 1‐hr immersion in 105 colony‐forming units/ml, cumulative mortality in Atlantic salmon was 63.2% while mortality in sockeye salmon was 10%. Prevalence and levels of the bacterium in kidney prior to onset of mortality were lower in sockeye compared with Atlantic or pink salmon. The timing and magnitude of bacterial shedding were estimated from water samples collected during the exposure trials. Shedding was estimated to be 82‐fold higher in Atlantic salmon as compared to sockeye salmon and peaked in the Atlantic salmon trial at 36 d post‐immersion. These data suggest sockeye salmon are less susceptible to P. salmonis than Atlantic or pink salmon. Finally, skin lesions were observed on infected fish during all trials, often in the absence of detectable infection in kidney. As a result, we hypothesize that skin is the primary point of entry for P. salmonis during the immersion challenge.
Preliminary Validation of a Patient‐Reported Measure of the Age‐Friendliness of Health Care
Authors: Wright Melanie C. , Fulmer Terry , Boult Chad
Published: October 2020

BACKGROUND/OBJECTIVE

To evaluate the validity and reliability of a patient‐reported measure of the “age‐friendliness” of health care.

DESIGN

Based on four essential domains of high‐quality health care for older outpatients (Medications, Mobility, Mentation and “what Matters,” i.e., the 4 M's), we drafted a five‐item questionnaire for older outpatients to rate the age‐friendliness of their health care. One question addressed each of the 4 M's; the fifth addressed the overall age‐friendliness of their care. After feedback from healthcare professionals, quality improvement experts, and a patient‐caregiver focus group, we revised the items to create the Age‐Friendliness Questionnaire (AFQ).

SETTING

We tested the AFQ by appending it to two surveys.

PARTICIPANTS

Older outpatients in Idaho during July to October 2019: Survey 1, with 23 other items, was sent to 1,257 older patients who were medically complex; Survey 2, with 35 other items, was sent to 2,873 older patients who visited outpatient primary care providers (PCPs) during the specified time period.

MEASUREMENTS

Respondents rated their providers’ performance using a 1 to 5 (“never” to “always”) scale for each of the five items (possible AFQ scores = 5–25).

RESULTS

The response rates were 41.4% and 33.3%, respectively. In Survey 1, the mean AFQ score from patients who had received care from a geriatrics consult clinic was higher than that from patients who had received their care from PCPs (19.3 vs 15.6; P < .001), and AFQ scores correlated with other quality‐of‐care scores. In Survey 2, AFQ scores predicted respondents’ likelihood of recommending their providers to others (P < .001). The AFQ exhibited high internal reliability (interitem correlations = .49–.77; Cronbach's α = .89).

CONCLUSION

The AFQ appears to be a valid and reliable measure of the age‐friendliness of outpatient care for older patients, and it predicts the likelihood that they will recommend their providers to others.