bluuebunny/crossref_metadata_2025 huggingface dataset:
Mismatch of cognition and neural networks in asymptomatic middle cerebral artery steno‐occlusive disease
Authors: Liu C.‐Y. , Yan S. , Hou B. , Li M.‐L. , Gao S. , Li A. , Liu B. , Xu W.‐H.
Published: March 2020

Background and purpose

The role of intracranial steno‐occlusive disease in cognitive impairment and dementia is unclear and has not been well studied.

Methods

A total of 32 consecutive patients (13 males, aged 54 ± 12 years) with asymptomatic steno‐occlusive middle cerebral artery (MCA) disease, defined as >70% stenosis on maximum intensity projection images or a complete signal loss of MCA trunk on magnetic resonance angiography, and 20 age‐ and education‐matched normal controls (12 males, 60 ± 8 years old) were compared for neuropsychological performance, gray matter volume and neural network analysis.

Results

The patient group did not show a significant decrease in gray matter volume or cognitive tests except for their performance on the grooved pegboard test. However, graph analysis of resting‐state functional magnetic resonance imaging showed significant decreases in network strength, global efficiency and the clustering coefficient, as well as a longer characteristic path length (P < 0.05). The diffusive decrease pattern was particularly located in interhemispheric connectivity and there was no compensatory hyperconnectivity in any brain regions.

Conclusion

In asymptomatic steno‐occlusive MCA disease, cognition and neural network changes are mismatched and have underlying pathophysiological mechanisms that are different from those of neurodegenerative disease.
Selectivity metrics for fisheries management and advice
Authors: Vasilakopoulos Paraskevas , Jardim Ernesto , Konrad Christoph , Rihan Dominic , Mannini Alessandro , Pinto Cecilia , Casey John , Mosqueira Iago , O’Neill Finbarr G.
Published: March 2020

Fisheries management typically aims at controlling exploitation rate (e.g., Fbar) to ensure sustainable levels of stock size in accordance with established reference points (e.g., FMSY, BMSY). Population selectivity (“selectivity” hereafter), that is the distribution of fishing mortality over the different demographic components of an exploited fish stock, is also important because it affects both Maximum Sustainable Yield (MSY) and FMSY, as well as stock resilience to overfishing. The development of an appropriate metric could make selectivity operational as an additional lever for fisheries managers to achieve desirable outcomes. Additionally, such a selectivity metric could inform managers on the uptake by fleets and effects on stocks of various technical measures. Here, we introduce three criteria for selectivity metrics: (a) sensitivity to selectivity changes, (b) robustness to recruitment variability and (c) robustness to changes in Fbar. Subsequently, we test a range of different selectivity metrics against these three criteria to identify the optimal metric. First, we simulate changes in selectivity, recruitment and Fbar on a virtual fish stock to study the metrics under controlled conditions. We then apply two shortlisted selectivity metrics to six European fish stocks with a known history of technical measures to explore the metrics’ response in real‐world situations. This process identified the ratio of F of the first recruited age–class to Fbar (Frec/Fbar) as an informative selectivity metric for fisheries management and advice.
Effects of seasonal and decadal warming on soil enzymatic activity in a P‐deficient Mediterranean shrubland
Authors: Zuccarini Paolo , Asensio Dolores , Ogaya Romà , Sardans Jordi , Peñuelas Josep
Published: March 2020

Soil enzymes are central in the response of terrestrial ecosystems to climate change, and their study can be crucial for the models’ implementation. We investigated for 1 year the effects of warming and seasonality on the potential activities of five soil extracellular enzymes and their relationships with soil moisture, phosphorus (P) concentration, and other soil parameters in a P‐limited Mediterranean semiarid shrubland. The site was continuously subjected to warming since 1999, and we compared data from this study to analogous data from 2004. Warming uniformly increased all enzymes activities, but only when a sufficient amount of soil water was available. Seasonality unevenly altered enzyme activities, thus affecting enzymatic stoichiometry. P deficiency affected enzymatic stoichiometry, favoring the activities of the phosphatases. The effect of warming was stronger in 2014 than 2004, excluding the hypothesis of acclimation of rhizospheric responses to higher temperatures and suggesting that further increases in extracellular enzymatic activities are to be expected if sufficient water is available. Climatic warming will likely generally stimulate soil enzymatic activities and accelerate nutrient mineralization and similar ecological processes such as the production and degradation of biomass and changes in community composition, but which will be limited by water availability, especially in Mediterranean soils in summer. Winters in such ecosystems will benefit from a general increase in activity and production, but biological activity could even decrease in summer, potentially leading to a negative overall balance of nutrient mineralization. This study suggests that a general increase in activity due to warming could lead to faster mineralization of soil organic matter and water consumption in colder climates, until one of these factors in turn becomes limiting. Such trade‐offs between water and temperature in relation with enzyme activity should be considered in biogeochemical models.
Introduction to the special issue: after trust
Authors: MARSDEN MAGNUS , ANDERSON PAUL
Published: March 2020

‘Trust’ has long been seen as critical to the success and durability of trading networks, and conceptualized as a positive moral sentiment that is embedded in shared kinship, ethnicity or friendship, or in shared frameworks of morality. Other recent studies of business communities suggest that the ability to work in settings characterized by pervasive mistrust is a key factor in the development of commercial acumen and a determinant of success. Here, the authors argue that a focus on trust and mistrust, and an underlying concern with ethics and morality, can obscure equally critical factors that inform the durability of trading networks. They offer ethnographic accounts of different inter‐Asian trading networks active in the city of Yiwu, which is one of China's most dynamic and diverse ‘international trade cities’. Yiwu is home to the largest wholesale market of small commodities in the world, and attracts traders and merchants from across the planet; more than 12,000 foreign traders are also resident in the city. The authors of the articles presented here analyse the durability of these networks in relation to broader geopolitical processes and contexts. They argue that success often depends on the ability to negotiate geopolitical shifts and the fault lines of political identity. They trace traders’ efforts to create institutions that allow them to withstand geopolitical transformations. They also document the ability of trading networks to operate flexibly across different social fields, showing that resilience often depends on the ability to navigate and profit from shifting relations between economic, political and familial domains.
Introduction to the special theme: theorizing transnational labour markets
Authors: MENSE‐PETERMANN URSULA
Published: March 2020

In this introduction to the special themed section, ‘Theorizing transnational labour markets: economic‐sociological approaches’, I introduce the reader to the topic and give an overview of the four contributions. The terms ‘global labour market’ and ‘transnational labour market’ are broadly used to account for contemporary social phenomena as diverse as the ever‐closer integration of China or India, with their huge labour forces, into the world economy, the off‐shoring of specific operations of MNCs to countries with cheap labour, or cross‐border labour migration. In most of these cases, the existence of global or transnational labour markets is taken for granted by the media, consulting agencies and other economic actors. However, scholars in labour market research and cross‐border migration alike have largely ignored the categories of global or transnational labour markets. Thus far, it remains unclear what these terms really mean and how we should address them theoretically. The aim of this themed section, therefore, is to view cross‐border labour migration through an economic‐sociological lens and thus bring into dialogue migration and labour market scholarship. By introducing a transnational perspective into labour market research, we hope to make a useful contribution towards theorizing on cross‐border labour markets and thereby overcome the methodological nationalism that seems to have crept into this area of scholarship.
Emicizumab improves the stability and structure of fibrin clot derived from factor VIII‐deficient plasma, similar to the addition of factor VIII
Authors: Shimonishi Naruto , Nogami Keiji , Ogiwara Kenichi , Matsumoto Tomoko , Nakazawa Fumie , Soeda Tetsuhiro , Hirata Michinori , Arai Nobuo , Shima Midori
Published: March 2020

Introduction

Emicizumab is an antifactor (F)IXa/FX bispecific antibody, mimicking FVIIIa cofactor function. Emi prophylaxis effectively reduces bleeding events in patients with haemophilia A. The physical properties of emicizumab‐induced fibrin clots remain to be investigated, however.

Aim

We have investigated the stability and structure of emicizumab‐induced fibrin clots.

Methods

Coagulation was initiated by activated partial thromboplastin time (aPTT) trigger and prothrombin time (PT)/aPTT‐mixed trigger in FVIII‐deficient plasma with various concentrations of emicizumab or recombinant FVIII. The turbidity and stability of fibrin clots were assessed by clot waveform and clot‐fibrinolysis waveform analyses, respectively. The resulting fibrin was analysed by scanning electron microscopy (SEM).

Results

Using an aPTT trigger, the turbidity was decreased and the fibrinolysis times were prolonged in the presence of emicizumab dose‐dependently. Scanning electron microscopy imaging demonstrated that emicizumab improved the structure of fibrin network with thinner fibres than in its absence. Although emicizumab shortened the aPTT dramatically, the nature of emicizumab‐induced fibrin clots did not reflect the hypercoagulable state. Similarly, using a PT/aPTT‐mixed trigger that could evaluate potential emicizumab activity, emicizumab improved the stability and structure of fibrin clot in a series of experiments. In this circumstance, fibrin clot properties with emicizumab at 50 and 100 µg/mL appeared to be comparable to those with FVIII at ~12 and ~24‐32 IU/dL, respectively.

Conclusion

Emicizumab effectively improved fibrin clot stability and structure in FVIII‐deficient plasma, and the physical properties of emicizumab‐induced fibrin clots were similar to those with FVIII.
The role of integrins in melanoma: a review
Authors: Arias‐Mejias Suzette M. , Warda Katerina Y. , Quattrocchi Enrica , Alonso‐Quinones Hector , Sominidi‐Damodaran Sindhuja , Meves Alexander
Published: March 2020

Integrins are the major family of cell adhesion receptors in humans and essential for a wide range of normal physiology, including formation and maintenance of tissue structure integrity, cell migration, proliferation, and differentiation. Integrins also play a prominent role in tumor growth and metastasis. Translational research has tried to define the contribution of integrins to the phenotypic aggressiveness of melanoma because such knowledge is clinically useful. For example, differential expression of integrins in primary cutaneous melanoma can be used to distinguish indolent from aggressive, prometastatic melanoma. Recent studies have shown that gene expression–based testing of patient‐derived melanoma tissue is feasible, and molecular tests may fully replace interventional surgical methods such as sentinel lymph node biopsies in the future. Because of their central role in mediating invasion and metastasis, integrins are likely to be useful biomarkers. Integrins are also attractive candidate targets for interventional therapy. This article focuses on the role of integrins in melanoma and highlights recent advances in the field of translational research.
Postoperative renal impairment and longitudinal change in renal function after adrenalectomy in patients with Cushing's syndrome
Authors: Nakamura Yuki , Yokoyama Minato , Yoshida Soichiro , Tanaka Hajime , Kijima Toshiki , Ishioka Junichiro , Matsuoka Yoh , Saito Kazutaka , Minami Isao , Yoshimoto Takanobu , Naito Shotaro , Ogawa Yoshihiro , Yamada Tetsuya , Uchida Shinichi , Fujii Yasuhisa
Published: March 2020

Objectives

To evaluate the renal function after adrenalectomy in patients with Cushing's syndrome in comparison with that in patients with primary aldosteronism.

Methods

This retrospective study included 35 patients with Cushing's syndrome and 51 patients with primary aldosteronism who underwent unilateral adrenalectomy and were followed up for >6 months. The renal function was analyzed before and after adrenalectomy using the estimated glomerular filtration rate. Postoperative renal impairment was defined as a >25% reduction in the estimated glomerular filtration rate from baseline at 1 month after adrenalectomy. Multivariate logistic regression analyses were carried out to examine whether the differences between Cushing's syndrome and primary aldosteronism increased the risk of postoperative renal impairment. Longitudinal changes were calculated starting 1 month after adrenalectomy using the linear mixed model.

Results

The mean estimated glomerular filtration rate in both groups significantly decreased at 1 month after adrenalectomy from baseline. Postoperative renal impairment was observed in four (11%) and 12 (24%) patients in the Cushing's syndrome and primary aldosteronism groups, respectively. Multivariate analysis showed that preoperative systolic blood pressure was independently associated with postoperative renal impairment, but not with the type of the disease. There was no significant increase or decrease in postoperative estimated glomerular filtration rate observed after the initial decrease after adrenalectomy in either group.

Conclusions

Patients with Cushing's syndrome show the same persistent renal impairment after adrenalectomy as that reported in patients with primary aldosteronism. Attention should be given to possible masked renal damage in clinical practice for the management of Cushing's syndrome.
Obesity and CD8 T cell metabolism: Implications for anti‐tumor immunity and cancer immunotherapy outcomes
Authors: Turbitt William J. , Buchta Rosean Claire , Weber K. Scott , Norian Lyse A.
Published: March 2020

Obesity is an established risk factor for many cancers and has recently been found to alter the efficacy of T cell–based immunotherapies. Currently, however, the effects of obesity on immunometabolism remain unclear. Understanding these associations is critical, given the fact that T cell metabolism is tightly linked to effector function. Thus, any obesity‐associated changes in T cell bioenergetics are likely to drive functional changes at the cellular level, alter the metabolome and cytokine/chemokine milieu, and impact cancer immunotherapy outcomes. Here, we provide a brief overview of T cell metabolism in the presence and absence of solid tumor growth and summarize current literature regarding obesity‐associated changes in T cell function and bioenergetics. We also discuss recent findings related to the impact of host obesity on cancer immunotherapy outcomes and present potential mechanisms by which T cell metabolism may influence therapeutic efficacy. Finally, we describe promising pharmaceutical therapies that are being investigated for their ability to improve CD8 T cell metabolism and enhance cancer immunotherapy outcomes in patients, regardless of their obesity status.
An empirical study on using virtual reality for enhancing the youth's intercultural sensitivity in Hong Kong
Authors: Li Chen , Ip Horace H. S. , Wong Yuen M. , Lam Wing S.
Published: March 2020

According to the census data published by the government in 2016, 92% of the Hong Kong Special Administrative Region population is ethnic Chinese, while the number of ethnic minorities increased significantly by around 70% over the past decade. Enhancing the youth’s intercultural sensitivity is becoming critical. Although many of the schools start to provide intercultural sensitivity training as extra‐curriculum activities, students often find them unattractive while teachers question their effectiveness. In this paper, we present a virtual reality enabled approach for enhancing the youth’s intercultural sensitivity. The objective is to design and develop an approach that can benefit from using virtual reality to deliver the instructional materials, making the learning more effective. A total number of three different virtual reality learning scenarios have been created, covering topics such as views of marriage and family, religious beliefs, and language barrier. The empirical study found significantly increase of intercultural sensitivity among the 67 qualified participants after joining the session. The calculated linear regression model also suggested that the participants’ perceived motivation from the virtual reality learning content positively contributed to the intercultural sensitivity increase, while interestingly the perceived enjoyment during the virtual reality exposure may negatively affected the learning outcomes.
Maresin Conjugates in Tissue Regeneration 1 improves alveolar fluid clearance by up‐regulating alveolar ENaC, Na, K‐ATPase in lipopolysaccharide‐induced acute lung injury
Authors: Han Jun , Li Hui , Bhandari Suwas , Cao Fei , Wang Xin‐Yang , Tian Chao , Li Xin‐Yu , Zhang Pu‐Hong , Liu Yong‐Jian , Wu Cheng‐Hua , Smith Fang Gao , Jin Sheng‐Wei , Hao Yu
Published: March 2020

Maresin Conjugates in Tissue Regeneration 1 (MCTR1) is a newly identified macrophage‐derived sulfido‐conjugated mediator that stimulates the resolution of inflammation. This study assessed the role of MCTR1 in alveolar fluid clearance (AFC) in a rat model of acute lung injury (ALI) induced by lipopolysaccharide (LPS). Rats were intravenously injected with MCTR1 at a dose of 200 ng/rat, 8 hours after administration of 14 mg/kg LPS. The level of AFC was then determined in live rats. Primary rat ATII (Alveolar Type II) epithelial cells were also treated with MCTR1 (100 nmol/L) in a culture medium containing LPS for 8 hours. MCTR1 treatment improved AFC (18.85 ± 2.07 vs 10.11 ± 1.08, P < .0001) and ameliorated ALI in rats. MCTR1 also significantly promoted AFC by up‐regulating epithelial sodium channel (ENaC) and Na+‐K+‐adenosine triphosphatase (Na, K‐ATPase) expressions in vivo. MCTR1 also activated Na, K‐ATPase and elevated phosphorylated‐Akt (P‐Akt) by up‐regulating the expression of phosphorylated Nedd4‐2 (P‐Nedd4‐2) in vivo and in vitro. However, BOC‐2 (ALX inhibitor), KH7 (cAMP inhibitor) and LY294002 (PI3K inhibitor) abrogated the improved AFC induced by MCTR1. Based on the findings of this study, MCTR1 may be a novel therapeutic approach to improve reabsorption of pulmonary oedema during ALI/acute respiratory distress syndrome (ARDS).
LncRNA ADAMTS9‐AS2 suppresses the proliferation of gastric cancer cells and the tumorigenicity of cancer stem cells through regulating SPOP
Authors: Wang Feiran , Tang Chong , Xu Dong , Tang Yijie , Jiang Yasu , Gao Xuesong , Xu Junfei
Published: March 2020

Nowadays, research on CSCs is still in an initial stage, and there are few studies reporting the successful isolation and identification of CSCs. In the present study, we attempted to isolate CSCs through cultivating the cell line MKN45 in defined serum‐free medium and study the expression of stem cell markers or related proteins (Oct3/4, Sox2, Nanog and CD44) in CSCs. Moreover, immunofluorescence staining was performed to validate the stem cell markers of spheroid body‐forming cells. Further experiments were used to evaluate the SPOP expression in tumorsphere cells. In addition, ADAMTS9‐AS2 is a lncRNA that contributes to the genesis and development of many cancers, including gastric cancer (GC). We found ADAMTS9‐AS2 functioned as an anti‐oncogene and positively correlated with the expression of SPOP in GC tissues by combining bioinformatics analyses. Furthermore, we reported that ADAMTS9‐AS2 regulated the expression of SPOP in GC cells and tumorsphere cells to inhibit GC progression. Together, our results demonstrated that SPOP and ADAMTS9‐AS2 can be potential targets for GC treatment.
Moderate‐to‐vigorous physical activity and processing speed: predicting adaptive change in ADHD levels and related impairments in preschoolers
Authors: Hoza Betsy , Shoulberg Erin K. , Tompkins Connie L. , Martin Caroline P. , Krasner Allison , Dennis Marissa , Meyer Lori E. , Cook Hannah
Published: March 2020

Background

Preschool ADHD symptoms have predictive utility for later presence of ADHD diagnoses (Harvey, Youngwirth, Thakar, & Errazuriz, 2009, Journal of Consulting and Clinical Psychology, 77, 349; Lahey et al., 2004, American Journal of Psychiatry, 161(11), 2014), yet some level of inattention, hyperactivity, and impulsivity are present even in typically developing preschoolers. Physical activity (PA) is known to have a broad spectrum of positive effects on the brain in school‐age typically developing children (Centers for Disease Control and Prevention, 2010, The association between school based physical activity, including physical education, and academic performance. Atlanta, GA: U.S. Department of Health and Human Services), including functions impaired by ADHD (Halperin, Berwid, & O'Neill, 2014, Child and Adolescent Psychiatric Clinics of North America, 23, 899), yet links between PA and ADHD levels and impairments have rarely been studied in either typically developing or at‐risk preschool children. Importantly, impaired processing speed (PS), though not a symptom of ADHD, is a robust neuropsychological correlate (Willcutt & Bidwell, 2011, Treating attention deficit hyperactivity disorder: Assessment and intervention in developmental context. Kingston, NJ: Civic Research Institute) that may indicate additional risk for ADHD. Hence, we examined whether baseline PS moderates the association between preschoolers' PA, specifically moderate‐to‐vigorous PA (MVPA), and changes in ADHD levels and related behaviors.

Method

Eighty‐five preschoolers (49.4% female; Mage = 4.14, SDage = .64) were drawn from a larger study of the effects of the Kiddie Children and Teachers (CATs) on the Move PA program on school readiness. The sample was largely Head Start eligible (68.2%) and ethnically diverse. Hierarchical regressions were utilized to examine links between MVPA, averaged over a school year, and changes in inattention (IA), hyperactivity/impulsivity (HI), oppositional behaviors, moodiness, and peer functioning, and whether these associations varied based on baseline PS.

Results

Results indicated that for IA, HI, and peer functioning, higher amounts of MVPA were associated with greater adaptive change for those with lower (but not higher) levels of PS.

Conclusions

Preschool MVPA may be a viable method of reducing ADHD levels and impairments for those with lower PS.
The encapsulation of curcumin by whey protein: Assessment of the stability and bioactivity
Authors: Solghi Saber , Emam‐Djomeh Zahra , Fathi Morteza , Farahani Farzaneh
Published: March 2020

Aims

The aims of the present work were to encapsulate curcumin in denaturated whey protein isolate and investigate the physicochemical and morphological properties of whey protein isolate‐based nanoparticles (WPI‐NPs).

Methods

Scanning electron microscopy (SEM) was used to investigate the morphological properties of WPI‐NPs. The crystalline structure of the developed NPs was evaluated by using an X‐ray diffraction technique. Antiradical activity of pure and loaded curcumin was also tested. in vitro release of curcumin into the simulated stomach and small intestine was evaluated. The stability of pure and encapsulated curcumin against pH and oxidation was compared.

Results

WPI‐NPs had a spherical shape‐like structure with smooth surface. The encapsulation efficiency of curcumin in WPI‐NPs was found to be 93.1%, demonstrating that the encapsulation system used in the present work was effective to entrap curcumin molecules. WPI‐NPs showed more stability at pH 7, indicating that the developed system is suitable for application of beverages with neutral pH. Furthermore, the encapsulation of curcumin into nanoparticles led to improvement of the oxidation stability of curcumin from 10% to 70%. The developed nanoparticles improved the release of curcumin in the simulated gastrointestinal tract. The release of curcumin in simulated gastric medium was low, but in the intestine, most of the curcumins were released in the early hours. The release of curcumin followed non‐Fickian mechanism in the intestine and stomach environment.

Conclusion

The developed encapsulation system can be introduced as a viable strategy to improve the bioavailability of curcumin.

Practical Applications

Considering the diverse biological activity of curcumin and high oxidation stability of WPI‐NPs, the developed nanoparticles can be used as a valuable additive compound in food and pharmaceutical systems, especially in beverages with neutral pH.
Older Adults Can Successfully Monitor Symptoms Using an Inclusively Designed Mobile Application
Authors: Reading Turchioe Meghan , Grossman Lisa V. , Baik Dawon , Lee Christopher S. , Maurer Mathew S. , Goyal Parag , Safford Monika M. , Masterson Creber Ruth M.
Published: March 2020

OBJECTIVES

Patient‐Reported Outcomes Measurement Information System (PROMIS) measures can monitor patients with chronic illnesses outside of healthcare settings. Unfortunately, few applications that collect electronic PROMIS measures are designed using inclusive design principles that ensure wide accessibility and usability, thus limiting use by older adults with chronic illnesses. Our aim was to establish the feasibility of using an inclusively designed mobile application tailored to older adults to report PROMIS measures by examining (1) PROMIS scores collected with the application, (2) patient‐reported usability of the application, and (3) differences in usability by age.

DESIGN

Cross‐sectional feasibility study.

SETTING

Inpatient and outpatient cardiac units at an urban academic medical center.

PARTICIPANTS

A total of 168 English‐ and Spanish‐speaking older adults with heart failure.

INTERVENTION

Participants used an inclusively designed mobile application to self‐report PROMIS measures.

MEASUREMENTS

Eleven PROMIS Short‐Form questionnaires (Anxiety, Ability to Participate in Social Roles and Activities, Applied Cognition‐Abilities, Depression, Emotional Distress‐Anger, Fatigue, Global Mental Health, Global Physical Health; Pain Interference, Physical Function, Sleep Disturbance), and a validated health technology usability survey measuring Perceived Ease‐of‐Use and Usefulness of the application.

RESULTS

Overall, 27% of participants were between 65 and 74 years of age, 10% were 75 years or older, 63% were male, 32% were white, and 96% had two or more medical conditions. There was no missing PROMIS data, and mean PROMIS scores showed the greatest burden of pain, fatigue, and physical function in the sample. Usability scores were high and not associated with age (Perceived Ease‐of‐Use P = .77; Perceived Usefulness P = .91).

CONCLUSION

It is feasible for older adults to use an inclusively designed application to report complete PROMIS data with high perceived usability. To ensure data completeness and the opportunity to study multiple domains of physical, mental, and social health, future work should use inclusive design principles for applications collecting PROMIS measures among older adults. J Am Geriatr Soc 68:1313–1318, 2020.
Empowering Older Adults to Discuss Advance Care Planning During Clinical Visits: The PREPARE Randomized Trial
Authors: Freytag Jennifer , Street Richard L. , Barnes Deborah E. , Shi Ying , Volow Aiesha M. , Shim Janet K. , Alexander Stewart C. , Sudore Rebecca L.
Published: March 2020

BACKGROUND/OBJECTIVES

A patient‐directed, online program (PREPARE for Your Care [PREPARE]; prepareforyourcare.org) has been shown to increase advance care planning (ACP) documentation. However, the mechanisms underlying PREPARE are unknown. Our objectives were to compare the efficacy of PREPARE plus an easy‐to‐read advance directive (AD) vs an AD alone to increase active patient participation in ACP discussions during clinic visits and to examine effects of active patient participation on ACP documentation.

DESIGN

Audio recordings of postintervention primary care visits from two randomized trials (2013‐2016).

SETTING

Seven primary care clinics at a veterans affair and safety‐net hospital in San Francisco, CA.

PARTICIPANTS

English‐ and Spanish‐speaking adults, aged 55 years and older, with two or more chronic/serious conditions.

INTERVENTION

PREPARE plus an easy‐to‐read AD or an AD alone.

MEASUREMENTS

The primary outcome was the number of active patient participation utterances about ACP (eg, asking questions, stating preferences) measured by the validated Active Patient Participation Coding Scheme. We examined differences in utterances by study arm using mixed effects negative binomial models and utterances as a mediator of PREPARE's effect on documentation using adjusted logistic regression. Models were adjusted for health literacy, prior care planning, and clinician.

RESULTS

Among 393 participants, the mean (SD) age was 66 (8.1) years, 120 (30.5%) had limited health literacy, and 99 (25.2%) were Spanish speaking. PREPARE plus the AD resulted in 41% more active patient participation in ACP discussions compared with the AD alone (mean [SD] = 10.1 [16.8] vs 6.6 [13.4] utterances; incidence rate ratio = 1.41; 95% confidence interval = 1.00‐1.98). For every additional utterance, participants had 15% higher odds of ACP documentation, and active patient participation accounted for 16% of PREPARE's effect on documentation.

CONCLUSIONS

The PREPARE program and easy‐to‐read AD empowered patients to actively participate in ACP discussions during clinical visits more than the AD alone. Increased activation was associated with increased ACP documentation. Therefore, PREPARE may mitigate barriers to ACP among English‐ and Spanish‐speaking older adults.

TRIAL REGISTRATION

ClinicalTrials.gov identifiers: “Improving Advance Care Planning by Preparing Diverse Seniors for Decision Making (PREPARE)” NCT01990235 and “Preparing Spanish‐Speaking Older Adults for Advance Care Planning and Medical Decision Making (PREPARE)” NCT02072941. J Am Geriatr Soc 68:1210–1217, 2020.
Improving sexual healthcare delivery for men in prison: A nurse‐led initiative
Authors: Kelly Carmel , Templeton Michelle , Allen Karen , Lohan Maria
Published: March 2020

Aims and objectives

The study aim was to develop and evaluate a nurse‐led sexual health service and health promotion intervention for men in prison.

Background

Men in prison are particularly marginalised members of our society, negatively impacting on their ability to making healthy choices. In relation to sexual health, prison provides an opportunity for curative and preventive care, for an otherwise often hard‐to‐reach, priority population.

Design

Practice development, audit and evaluation.

Methods

Employing a practice development and participatory methodology, we empowered prison nursing staff to provide robust asymptomatic testing for sexually transmitted infections, including the management of chlamydia, with appropriate treatment and partner notification. Collaboratively with young men and nursing staff, a short animation video to promote the service was developed. A case note audit of 172 patients seen in the service during the 6‐month period 1 July 2018–31 December 2018 was undertaken. The Standards for Quality Improvement Reporting Excellence (SQUIRE, see Supplementary Material) checklist was followed.

Results

National outcome measures were exceeded for some clinical outcomes. During the 6‐month period, there were 12 chlamydia‐positive (7% positivity rate) and 3 gonorrhoea‐positive results. In addition, two new cases of syphilis were detected and a further two cases of known HIV were highlighted. There were seven cases of hepatitis C (3 previously diagnosed) and three cases of hepatitis B. A short animation Dick Loves Doot was developed.

Conclusion

Successful partnerships between sexual health and prison healthcare services, in partnership with service users, can achieve well‐coordinated services and health promotion interventions.

Relevance to clinical practice

This nurse‐led model of care increased detection and early treatment of asymptomatic STIs among men in prison, impacting positively the men, their partner (s) and the public health of the society to which they return.
Needling therapies in the management of myofascial pain of the masticatory muscles: A network meta‐analysis of randomised clinical trials
Authors: Al‐Moraissi Essam Ahmed , Alradom Jabr , Aladashi Omar , Goddard Greg , Christidis Nikolaos
Published: March 2020

Objective

A network meta‐analysis (NMA) of randomised clinical trials (RCTs) was performed aiming to compare the treatment outcome of dry needling, acupuncture or wet needling using different substances in managing myofascial pain of the masticatory muscles (TMD‐M).

Method

An electronic search was undertaken to identify RCTs published until September 2019, comparing dry needling, acupuncture or wet needling using local anaesthesia (LA), botulinum toxin‐A (BTX‐A), granisetron, platelet‐rich plasma (PRP) or passive placebo versus real active placebo in patients with TMD‐M. RCTs meeting the inclusion criteria were stratified according to the follow‐up time: immediate post‐treatment to 3 weeks, and 1 to 6 months post‐treatment. Outcome variables were post‐treatment pain intensity, increased mouth opening (MMO) and pressure threshold pain (PPT). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Mean difference (MD) was used to analysed via frequentist NMA using Stata software.

Results

Twenty‐one RCTs involving 959 patients were included. The quality of evidence of the included studies was low or very low. There was significant pain decrease after PRP when compared to an active/passive placebo and acupuncture. There was a significant improvement of MMO after LA (MD = 3.65; CI: 1.18‐6.1) and dry needling therapy (MD = 2.37; CI: 0.66‐4) versus placebo. The three highest ranked treatments for short‐term post‐treatment pain reduction in TMD‐M (1‐20 days) were PRP (95.8%), followed by LA (62.5%) and dry needling (57.1%), whereas the three highest ranked treatments at intermediate‐term follow‐up (1‐6 months) were LA (90.2%), dry needling (66.1%) and BTX‐A (52.1%) (all very low‐quality evidence). LA (96.4%) was the most effective treatment regarding the increase in MMO followed by dry needling (72.4%).

Conclusion

Based on this NMA, one can conclude that the effectiveness of needling therapy did not depend on needling type (dry or wet) or needling substance. The outcome of this NMA suggests that LA, BTX‐A, granisetron and PRP hold some promise as injection therapies, but no definite conclusions can be drawn due to the low quality of evidence of the included studies. This NMA did not provide enough support for any of the needling therapies for TMD‐M.
The association between mental health nurse to registered nurse ratio and patient outcomes in psychiatric inpatient wards: Protocol for a systematic review
Authors: Moyo Nompilo , Jones Martin , Gilbert Sue , Romero Lorena , Gray Richard
Published: March 2020

Accessible summary

What is known on the subject?

Nursing skill mix research has primarily focused on medical and surgical patients.

The association between nursing skill mix and clinical outcomes for psychiatric inpatients has not been adequately explored.

No systematic reviews have been reported that have examined the association between the ratio of mental health to registered nurses and patient outcomes.

What this paper adds to existing knowledge?

Our protocol sets out, in detail, the methods we intend to follow to ensure that this review is conducted and reported to the highest possible standards.

What are the implications for practice?

The review will summarize evidence about safe staffing in mental health inpatient units internationally.

The review will inform health policy and planning of health services.

Aim

To assess the association between mental health nurse to comprehensive/general nurse ratio and relapse—determined by hospital admission—in adult psychiatric inpatients.

Background information

There is considerable variation in psychiatric inpatient nursing skill mix internationally. In most countries, wards are typically staffed by a mix of mental health and comprehensive/general nurses. To date, there have been no systematic reviews that have examined the association between the ratio of mental health to registered nurses and patient outcomes.

Method

We will systematically search five databases. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool. A meta‐analysis will be undertaken if there are at least two similar studies.

Results

For included studies, we will produce table summarizing risk of bias and extracted data. If we are able to undertake a meta‐analysis, this will be reported as a forest plot.

Discussion

This paper sets out a detailed plan for a systematic review of mental health nurse skill mix research.

Implications for practice

High‐quality evidence about the association between nursing skill mix and patient outcomes is important to inform the planning of mental health services internationally.
Response to Preuss and Zuccarello (2020): biological definitions that can be unambiguously applied for red algal parasites
Authors: Salomaki Eric D. , Lane Christopher E.
Published: March 2020

In response to a comment in this issue on our proposal of new terminology to distinguish red algal parasites, we clarify a few key issues. The terms adelphoparasite and alloparasite were previously used to identify parasites that infected close or distant relatives. However, most red algal parasites have only been studied morphologically, and molecular tools have shown that these binary terms do a poor job at representing the range of parasite–host relationships. We recognize the need to clarify inferred misconceptions that appear to be drawing from historical terminology to contaminate our new definitions. We did not intend to replace the term adelphoparasite with neoplastic parasites and the term alloparasites with archaeplastic parasites. Rather, we seek to establish new terms for discussing red algal parasites, based on the retention of a native plastid, a binary biological trait that is relatively easy to identify using modern methods and has biological implications for the interactions between a parasite and its host. The new terminology can better account for the spectrum of relationships and developmental patterns found among the many independently evolved red algal parasites, and it is intended to inspire new research, particularly the role of plastids in the survival and evolution of red algal parasites.
Comparing experimental and field‐measured traits and their variability in Central European grassland species
Authors: Dostál Petr , Fischer Markus , Prati Daniel
Published: March 2020

Questions

What are the relative effects of intra‐ and interspecific differences on variation in five functional traits measured in a garden pot experiment? Are species rankings based on trait means and intraspecific trait variability (ITV) stable across the garden experiment and field measurements?

Location

Experimental garden and two grassland systems in Central Europe.

Methods

We measured five functional traits (plant height, leaf dry matter content [LDMC], leaf greenness, leaf thickness and specific leaf area SLA]) in 105 grassland species grown in a garden experiment subjected to fertilization, shading and waterlogging, complemented by a control. We also measured plant height, LDMC and SLA across grasslands in Germany, and used published values of the same traits from a field study in the Czech Republic. We then correlated speciesʼ trait means from different treatments in the experiment. We also compared garden‐ and field‐measured trait means and ITV in SLA, LDMC and plant height.

Results

Most variation in the experiment‐measured trait data was explained by interspecific differences, except for leaf greenness (where species explained less than 50% of the variance), and the treatments had little effect on close associations of trait means. Species rankings based on SLA and LDMC, but not plant height, were stable across garden and field measurements. Though garden and field‐measured ITV were positively associated with each other, the associations were not significant.

Conclusions

Our study indicates that species can be stably ranked based on SLA and LDMC means across different datasets (experimental and field‐based). To what extent species vary in their functional traits under field conditions can be, however, less well predicted from experimentally measured ITV. Garden‐measured differences in ITV should be thus used with caution when associated with species’ performance and distribution patterns explored in the field.
The absurd as method: The Chinese absurdist hero, enchanted power, and the alienated poor in Yan Lianke's military literature
Authors: Xie Haiyan
Published: March 2020

As one of the most prolific and outspoken of contemporary Chinese writers, Yan Lianke has won international recognition for his writing from the margins. However, while his novels have been extensively studied, Yan's military literature has received much less scholarly attention. This paper explores Yan's adaptation of the absurd in Western literature to Chinese military literature, investigates how he constructs Chinese absurdist heroes, and reconstructs the concepts of “the poor” and “power” in his narratives. Focusing in particular on his 2009 collection of military novellas Sihao jinqu (Prohibited Area Number Four), this paper argues that the absurd in Yan's military texts serves not only as a formal experiment for exploring the alternative imagination of the alienated and marginalized peasant soldiers in contemporary China but also as an implicit means of articulating Yan's own socio‐political commentary, one which cannot allow itself to be explicitly political.
Functional colour genes and signals of selection in colour‐polymorphic salamanders
Authors: Burgon James D. , Vieites David R. , Jacobs Arne , Weidt Stefan K. , Gunter Helen M. , Steinfartz Sebastian , Burgess Karl , Mable Barbara K. , Elmer Kathryn R.
Published: March 2020

Coloration has been associated with multiple biologically relevant traits that drive adaptation and diversification in many taxa. However, despite the great diversity of colour patterns present in amphibians the underlying molecular basis is largely unknown. Here, we use insight from a highly colour‐variable lineage of the European fire salamander (Salamandra salamandra bernardezi) to identify functional associations with striking variation in colour morph and pattern. The three focal colour morphs—ancestral black‐yellow striped, fully yellow and fully brown—differed in pattern, visible coloration and cellular composition. From population genomic analyses of up to 4,702 loci, we found no correlations of neutral population genetic structure with colour morph. However, we identified 21 loci with genotype–phenotype associations, several of which relate to known colour genes. Furthermore, we inferred response to selection at up to 142 loci between the colour morphs, again including several that relate to coloration genes. By transcriptomic analysis across all different combinations, we found 196 differentially expressed genes between yellow, brown and black skin, 63 of which are candidate genes involved in animal coloration. The concordance across different statistical approaches and ‘omic data sets provide several lines of evidence for loci linked to functional differences between colour morphs, including TYR, CAMK1 and PMEL. We found little association between colour morph and the metabolomic profile of its toxic compounds from the skin secretions. Our research suggests that current ecological and evolutionary hypotheses for the origins and maintenance of these striking colour morphs may need to be revisited.
The bifurcated trajectory of nation formation in Kurdistan: Democratic confederalism, nationalism, and the crisis of capitalist modernity
Authors: Sunca Yasin
Published: March 2020

Two different sociopolitical projects of nation formation seem to be in praxis in Kurdistan simultaneously: The Kurdistan Region of Iraq aspires to be an independent nation‐state, while the movement led by the Kurdistan Workers' Party advocates a democratic confederal project. How did this bifurcation arise? By putting Abdullah Öcalan's interpretation of nationalism and capitalist modernity in dialogue with existing theories of nationalism, I argue that this bifurcation resulted from a difference in scaling the root causes of the Kurdish question: The former project imagines emancipation through state formation within capitalist modernity, while the latter problematises capitalist modernity itself. The modular and hegemonic expansion of nationalism and the nation‐state along with capitalist modernity has been countered in Mesopotamia by politico‐social multiplicity. This has given rise to the particular structural dynamics that underlie a “recurring failure” in state formation. The bifurcation in question here has emerged interactively against this background.