bluuebunny/crossref_metadata_2025 huggingface dataset:
Contribution of Hepatic Retinaldehyde Dehydrogenase Induction to Impairment of Glucose Metabolism by High‐Fat‐Diet Feeding in C57BL/6J Mice
Authors: Xu Jiong , Zhang Mian , Zhang Xiangping , Yang Hanyu , Sun Binbin , Wang Zhongjian , Zhou Yaqian , Wang Shuting , Liu Xiaodong , Liu Li
Published: May 2018

Obesity and insulin resistance are associated with overexpression of retinaldehyde dehydrogenase 1 (RALDH1). We aimed to investigate the roles of hepatic RALDH1 induction in glucose metabolism impairment using mice fed with high‐fat‐diet (HFD). Mice were fed with HFD for 8 weeks and treated with RALDH inhibitor citral for another 4 weeks. Oral glucose tolerance test (OGTT), pyruvate tolerance test (PTT) and insulin tolerance test were performed. Expressions of phosphoenolpyruvate carboxykinase 1 (PCK1), glucokinase (GCK) and RALDH1 were measured. Therapeutic effects of citral were also documented in diabetic rats. Effects of retinaldehyde on PCK1 and GCK expressions were examined in rat primary hepatocytes and HepG2 cells. The results showed that HFD mice were characterized by hyperlipidaemia and insulin resistance, accompanied by significantly increased RALDH1 activity and expression. Citral (10 and 50 mg/kg) ameliorated HFD‐induced hyperlipidaemia and insulin resistance, as demonstrated by the improved fasting glucose, insulin levels and lipid profiles. OGTT and PTT demonstrated that citral reversed HFD‐induced glucose disposal impairment and glucose production enhancement. Citral also reversed the increased PCK1 expression and decreased GCK expression by HFD. Citral therapeutic effects were reconfirmed in diabetic rats. In vitro data indicated that retinaldehyde had the strongest PCK1 induction in primary hepatocytes of diabetic rats compared with HFD rats and control rats, in line with the increased RALDH1 expression. Citral reversed the retinaldehyde‐induced PCK1 expression in primary rat hepatocytes and HepG2 cells. In conclusion, RALDH1 induction impaired glucose metabolism partly via modulating PCK1 and GCK expressions. Citral improved glucose metabolism through inhibiting RALDH activity.
Src‐type tyrosine kinase p56lck is critical for thymic stromal lymphopoietin‐induced allergic rhinitis
Authors: Nam S.‐Y. , Kim H.‐Y. , Han N.‐R. , Moon P.‐D. , Cho J.‐S. , Kim H.‐M. , Jeong H.‐J.
Published: May 2018

Background

Thymic stromal lymphopoietin (TSLP) is a regulator of mast cell‐mediated allergic inflammatory reactions, but the manner in which TSLP contributes to allergic rhinitis (AR) remains unclear.

Objective

Here, we sought to determine that TSLP plays a crucial role in AR by interacting with Src‐type tyrosine kinase p56lck and STAT6 and promoting mast cells degranulation.

Methods

The effects of TSLP on mast cell degranulation and AR were analysed in human mast cell line (HMC‐1 cells), ovalbumin (OVA)‐induced AR animal model, and human subjects. Small interfering RNA experiments were performed in HMC‐1 cells and OVA‐induced AR model. Immune responses were analysed by enzyme‐linked immunosorbent assay, Western blotting, immunoprecipitation, and histological studies.

Results

Thymic stromal lymphopoietin levels and mast cell‐derived p56lck activation were elevated in human subjects with AR, and in AR mice, exogenous TSLP accelerated TH2‐allergic inflammatory reactions by up‐regulating p56lck and STAT6. On the other hand, depletion of TSLP, p56lck, and STAT6 ameliorated clinical symptoms in AR mice. The selective inhibitor of p56lck, damnacanthal, inhibits AR reactions.

Conclusion

Collectively, these observations suggest a role for TSLP/p56lck/STAT6 in AR and offer insight into potential therapeutic strategies.
Anti‐resorptive effect of pamidronate on extraction socket wall in dogs
Authors: Cha Jae‐Kook , Sun Yoo‐Kyung , Kim Myong Ji , Sanz Mariano , Jung Ui‐Won
Published: May 2018

Aim

The aim of this experimental in vivo investigation was to assess the anti‐resorptive effect of low concentration pamidronate on the buccal plate in fresh extraction sockets.

Materials and methods

The distal roots of the third premolars were extracted bilaterally in six dogs. A collagen matrix loaded with either pamidronate (test group) or saline (control group) was positioned on the outer surface of buccal bone immediately after tooth extraction and subsequently covered with a coronally advanced flap. Histological and histomorphometric outcomes were evaluated 12 weeks later.

Results

The mean vertical distance between the buccal and lingual bone crest differed significantly between the test and control groups (0.52 ± 0.43 and 2.21 ± 1.15 mm, respectively; p = .037). The width of the buccal bone 1 mm below the crest was significantly wider in the test group than the control group (4.68 ± 0.68 vs. 3.44 ± 0.60 mm, p < .001).

Conclusions

Local application of pamidronate onto a collagen matrix may reduce the dimensional changes of the buccal bone plate both vertically and horizontally.
Genetic and clinical features of Chinese patients with mitochondrial ataxia identified by targeted next‐generation sequencing
Authors: Dong Hai‐Lin , Ma Yin , Li Quan‐Fu , Du Yi‐Chu , Yang Lu , Chen Sheng , Wu Zhi‐Ying
Published: May 2018

Aim

To characterize the mutations in mitochondrial DNA (mtDNA) and mitochondrion‐related nuclear genes (nDNA), and clinical features in Chinese patients with mitochondrial ataxia.

Methods

Targeted next‐generation sequencing (NGS) technology was performed to screen the whole mtDNA sequence and nDNA genes in a cohort of 33 unrelated ataxia patients.

Results

A total of 5 pedigrees were finally genetically diagnosed as mitochondrial ataxia, with 3 pathogenic mutations (m.8344A>G, m.9176T>C, and m.9185T>C), one likely pathogenic mutation (m.3995A>G) in mtDNA, and one pathogenic mutation (c.1159_1162dupAAGT, p.Ser388Terfs) in PDHA1. The prevalence of mitochondrial ataxia in our patient cohort is 15.2%. In addition, all 4 patients with mtDNA mutations experienced symptoms of ataxia with age at onset ranging from 12 to 39 years (21 ± 12.2) and developed extrapyramidal symptoms during the disease course. One male patient with pyruvate dehydrogenase deficiency showed an acute intermittent ataxia phenotype.

Conclusions

Our results implicate that mitochondrial ataxia might not be as rare in Chinese as previously assumed. This study firstly defines the mutations of mitochondrial ataxia in a Chinese population by targeted NGS, which broadens the clinical spectrum of mtDNA mutations and highlights the importance of screening mtDNA and nDNA mutations among undefined ataxia patients.
Examining conservation compliance with randomized response technique analyses
Authors: Chang Charlotte H. , Cruyff Maarten J. L. F. , Giam Xingli
Published: May 2018

Understanding violations of laws or social norms designed to protect natural resources from overexploitation is a priority for conservation research and management. Because direct questioning about stigmatized behaviors can produce biased responses, researchers have adopted more complex, indirect questioning techniques. The randomized response technique (RRT) is one of the most powerful indirect survey methods, yet analyses of these data require sophisticated statistical models. To date, there has been limited user‐friendly software to analyze RRT data, particularly for models that combine information from multiple RRT questions. We developed an R package, zapstRR (ZoologicAl Package for RRT) that provides functions for 3 RRT models that can be applied to single or multiple RRT questions. With these functions, researchers can estimate the prevalence of conservation noncompliance, determine the number of violations by individuals, perform regressions for univariate and multivariate RRT data, and correct prevalence estimates for evasive‐response bias. We illustrate the use of these estimators for RRT data through an examination of 2 case studies: illegal bird hunting where the interview consisted of a standard RRT question design and a novel implementation designed to offer further anonymity to respondents and reveal the impact of educational interventions on illegal bushmeat consumption. The case studies demonstrate how the models can work in tandem to uncover distinct patterns within RRT data sets. The case studies also show how several assumptions are central to the application of the multivariate models.
Shift in predation regime mediates diversification of foraging behaviour in a dragonfly genus
Authors: Jiang Bin , Mikolajewski Dirk J.
Published: May 2018

1. Behavioural adaptations to avoid and evade predators are common. Many studies have investigated population divergence in response to changes in predation regime within species, but studies exploring interspecific patterns are scant. Studies on interspecific divergence can infer common outcomes from evolutionary processes and highlight the role of environmental constraints in shaping species traits.

2. Species of the dragonfly genusLeucorrhiniaunderwent well‐studied shifts from habitats being dominated by predatory fish (fish lakes) to habitat being dominated by predatory invertebrates (dragonfly lakes). This change in top predators resulted in a set of adaptive trait modifications in response to the different hunting styles of both predator types: whereas predatory fish actively search and pursue prey, invertebrate predator follow a sit‐and‐wait strategy, not pursuing prey.

3. Here it is shown that the habitat shift‐related change in selection regime on larvalLeucorrhiniacaused species in dragonfly lakes to evolve increased larval foraging and activity, and results suggest that they lost the ability to recognise predatory fish.

4. The results of the present study highlight the impact of predators on behavioural trait diversification with habitat‐specific predation regimes selecting for distinct behavioural expression.
Enhanced neural and behavioural processing of a nonnative phonemic contrast in professional musicians
Authors: Dittinger Eva , D'Imperio Mariapaola , Besson Mireille
Published: May 2018

Based on growing evidence suggesting that professional music training facilitates foreign language perception and learning, we examined the impact of musical expertise on the categorisation of syllables including phonemes that did (/p/, /b/) or did not (/ph/) belong to the French repertoire by analysing both behaviour (error rates and reaction times) and Event‐Related brain Potentials (N200 and P300 components). Professional musicians and nonmusicians categorised syllables either as /ba/ or /pa/ (voicing task), or as /pa/ or /pha/ with /ph/ being a nonnative phoneme for French speakers (aspiration task). In line with our hypotheses, results showed that musicians outperformed nonmusicians in the aspiration task but not in the voicing task. Moreover, the difference between the native (/p/) and the nonnative phoneme (/ph/), as reflected in N200 and P300 amplitudes, was larger in musicians than in nonmusicians in the aspiration task but not in the voicing task. These results show that behaviour and brain activity associated to nonnative phoneme perception are influenced by musical expertise and that these effects are task‐dependent. The implications of these findings for current models of phoneme perception and for understanding the qualitative and quantitative differences found on the N200 and P300 components are discussed.
Varying the rate of intravenous cocaine infusion influences the temporal dynamics of both drug and dopamine concentrations in the striatum
Authors: Minogianis Ellie‐Anna , Shams Waqqas M. , Mabrouk Omar S. , Wong Jenny‐Marie T. , Brake Wayne G. , Kennedy Robert T. , du Souich Patrick , Samaha Anne‐Noël
Published: May 2018

The faster drugs of abuse reach the brain, the greater is the risk of addiction. Even small differences in the rate of drug delivery can influence outcome. Infusing cocaine intravenously over 5 vs. 90–100 s promotes sensitization to the psychomotor and incentive motivational effects of the drug and preferentially recruits mesocorticolimbic regions. It remains unclear whether these effects are due to differences in how fast and/or how much drug reaches the brain. Here, we predicted that varying the rate of intravenous cocaine infusion between 5 and 90 s produces different rates of rise of brain drug concentrations, while producing similar peak concentrations. Freely moving male Wistar rats received acute intravenous cocaine infusions (2.0 mg/kg/infusion) over 5, 45 and 90 s. We measured cocaine concentrations in the dorsal striatum using rapid‐sampling microdialysis (1 sample/min) and high‐performance liquid chromatography‐tandem mass spectrometry. We also measured extracellular concentrations of dopamine and other neurochemicals. Regardless of infusion rate, acute cocaine did not change concentrations of non‐dopaminergic neurochemicals. Infusion rate did not significantly influence peak concentrations of cocaine or dopamine, but concentrations increased faster following 5‐s infusions. We also assessed psychomotor activity as a function of cocaine infusion rate. Infusion rate did not significantly influence total locomotion, but locomotion increased earlier following 5‐s infusions. Thus, small differences in the rate of cocaine delivery influence both the rate of rise of drug and dopamine concentrations, and psychomotor activity. A faster rate of rise of drug and dopamine concentrations might be an important issue in making rapidly delivered cocaine more addictive.
Ex vivo effects of insulin on the structural integrity of equine digital lamellae
Authors: Sandow C. , Fugler L. A. , Leise B. , Riggs L. , Monroe W. T. , Totaro N. , Belknap J. , Eades S.
Published: May 2018

Background

Laminitis has a considerable impact on the equine industry. Endocrinopathic laminitis is the most common form and affected horses often have hyperinsulinaemia due to an underlying metabolic disorder.

Objectives

The aim of this study was to determine if insulin weakens the structural integrity of digital lamellae and to develop an ex vivo model for the study of hyperinsulinaemia‐induced lamellar failure.

Study design

Ex vivo experiment.

Methods

Biomechanical testing was used to assess the structural integrity of lamellar explants exposed to either medium alone (control) or medium supplemented with insulin. Lamellar explants comprised of hoof wall, lamellar tissue and distal phalanx were harvested from four adult horses with no evidence of inflammatory disease or pre‐existing disease of the digit. Following an equilibration period, explants were incubated in medium or medium supplemented with insulin (2.5 μg/ml) for 8 h prior to biomechanical testing to obtain load (N), stress (MPa), elongation to failure (mm), and Young's modulus (MPa) for each explant. Significant differences were assessed using a mixed linear model with horses as a random factor and control or insulin‐treated group as a fixed factor.

Results

Lamellar explants incubated in medium supplemented with insulin failed at significantly lower load (P = 0.0001) and lower stress (P = 0.001) and had greater elongation to failure (P = 0.02).

Main limitations

In addition to the ex vivo nature of the study, location‐dependent variability in explant structural integrity and variable diffusion of nutrients due to explant size may have been limitations. However, the study design attempted to account for these limitations through random assignment of explants to treatment groups independent of location and by evaluating stress to failure.

Conclusions

Insulin weakens the structural integrity of equine lamellar explants and an ex vivo model for evaluation of hyperinsulinaemia‐induced lamellar failure was established.

The summary is available in Spanish – see Supporting Information.
Fluoxetine uses in nociceptive pain management: a promising adjuvant to opioid analgesics
Authors: Hamdy Mostafa M. , Elbadr Mohamed M. , Barakat Ahmed
Published: May 2018

Fluoxetine, a commonly prescribed antidepressant, use in nociceptive pain management represents one of the unsettled issues of fluoxetine therapeutics. By reviewing the literature about fluoxetine's possible roles in this setting, those could be solitary antinociceptive effect, enhancement of acute morphine analgesia, blocking morphine tolerance development, and blocking dependence development and associated abstinence syndrome. In this study, we examined those four alleged roles of fluoxetine. Moreover, as effective alleviation of morphine tolerance, dependence, and abstinence syndrome represents one of the most challenging medical needs, we biochemically analyzed fluoxetine effect on these phenomena. Fluoxetine (10 mg/kg, IP) was examined in hot plate test for assessment of possible analgesic activity and enhancement of morphine acute analgesia (1 and 5 mg/kg, SC). Repeated morphine (5 mg/kg, SC) administration for 9 days developed tolerance and dependence; fluoxetine was co‐administered to evaluate its potential to modulate these processes. We also determined concomitant changes in neurotransmitters (glutamate and noradrenaline), inflammatory status, and prooxidant–antioxidant balance. Our results indicated that fluoxetine did not possess significant analgesia solely and did not enhance acute morphine analgesia. However, fluoxetine administration with morphine significantly attenuated tolerance and dependence development and abstinence syndrome with corresponding suppression of morphine‐induced changes in neurotransmitters (glutamate and noradrenaline), inflammatory status, and prooxidant–antioxidant balance. These biochemical results may reflect both direct and indirect effects of fluoxetine. Our conclusion is that despite fluoxetine possesses low – if any – analgesic activity, it significantly adds to opioids not via enhancing analgesic activity but through modulation of tolerance and dependence development.
Application of finitized power series distributions to accelerated variate generation. Part II: the case of the logarithmic distribution
Authors: Kirtland James Andrew , Levy Martin S. , Cochran James J. , Golnabi Saeed
Published: May 2018

The method of aliasing vastly expands the palette of discrete random variate generation methodologies while providing excellent speed. However, its application is limited to finitely supported distributions. We demonstrate that an application of moment preserving finitization called the Negative Taylor Series Finitization (NTSF) method for the power series family of discrete distributions, when coupled with the method of aliasing, can greatly improve infinitely supported discrete random variate generation speed with certain limitations. We illustrate this with the logarithmic power series distribution, and we compare four published algorithms designed to generate random variates from a logarithmic distribution to the aliasing method of random variate generation from anNTSFversion of the same distribution. We compare the accuracy and speed (user‐time) of these various methods for generating variates from a logarithmic distribution.
Treatment of class III multiple gingival recessions: Prognostic factors for achieving a complete root coverage
Authors: Aroca Sofia , Barbieri Antoine , Clementini Marco , Renouard Franck , de Sanctis Massimo
Published: May 2018

Background

This report is intended to present a supplemental analysis of data from a prior report (Aroca et al., ) to investigate factors associated with a complete root coverage at 1 year. The purpose of the prior report was to investigate at 1 year the adjunction effect of EMD for the treatment of Miller’s class III recession defects using a coronally advanced modified tunnel/CTG technique with (test group) or without (control group). The purpose of this report was to investigate additional factors associated with root coverage in the same data set.

Materials and methods

On the 138 observations collected from 20 patients, a regression model was used to highlight the relationship between the percentages of root coverage (RC) and three following covariates: the distance from the tip of the papilla and the contact point (DCP) at baseline, the group membership (control vs. test) and tooth position in the mouth (maxillary vs. mandibular).

Results

The statistical analysis showed that there was a significant effect of the DCP at baseline (p = 0.01) and of the tooth type (p < .001) on the percentage of RC at 1 year, whereas no significant difference between the two techniques (group membership effect) was shown (p = 0.69).

Conclusion

The probability to obtain a complete root coverage decreases when the DCP at baseline increases. Moreover, maxillary teeth are more likely to give better RC than mandibular teeth. However, in this analysis similar to the last, there was no group effect.
Diversity and Hidden Host Specificity of Chytrids Infecting Colonial Volvocacean Algae
Authors: Van den Wyngaert Silke , Rojas‐Jimenez Keilor , Seto Kensuke , Kagami Maiko , Grossart Hans‐Peter
Published: May 2018

Chytrids are zoosporic fungi that play an important, but yet understudied, ecological role in aquatic ecosystems. Many chytrid species have been morphologically described as parasites on phytoplankton. However, the majority of them have rarely been isolated and lackDNAsequence data. In this study we isolated and cultivated three parasitic chytrids, infecting a common volvocacean host species,Yamagishiella unicocca. To identify the chytrids, we characterized morphology and life cycle, and analyzed phylogenetic relationships based on 18S and 28SrDNAgenes. Host range and specificity of the chytrids was determined by cross‐infection assays with host strains, characterized byrbcL andITSmarkers. We were able to confirm the identity of two chytrid strains asEndocoenobium eudorinaeIngold andDangeardia mamillataSchröder and described the third chytrid strain asAlgomyces stechlinensisgen. et sp. nov. The three chytrids were assigned to novel and phylogenetically distant clades within the phylum Chytridiomycota, each exhibiting different host specificities. By integrating morphological and molecular data of both the parasitic chytrids and their respective host species, we unveiled cryptic host‐parasite associations. This study highlights that a high prevalence of (pseudo)cryptic diversity requires molecular characterization of both phytoplankton host and parasitic chytrid to accurately identify and compare host range and specificity, and to study phytoplankton‐chytrid interactions in general.
Identifying sagittal otoliths of Mediterranean Sea gobies: variability among phylogenetic lineages
Authors: Lombarte A. , Miletić M. , Kovačić M. , Otero‐Ferrer J. L. , Tuset V. M.
Published: May 2018

In this study, we describe and analyse the morphology of the sagitta, the largest otolith, of 25 species of Gobiidae inhabiting the Adriatic and north‐western Mediterranean seas. Our goal was to test the usefulness and efficiency of sagittal otoliths for species identification. Our analysis of otolith contours was based on mathematical descriptors called wavelets, which are related to multi‐scale decompositions of contours. Two methods of classification were used: an iterative system based on 10 wavelets that searches the Anàlisi de Formes d'Otòlits (AFORO) database and a discriminant method based only on the fifth wavelet. With the exception of paedomorphic species, the results showed that otolith anatomy and morphometry can be used as diagnostic characters distinguishing the three Mediterranean phylogenetic goby lineages (Pomatoschistus or sand‐goby lineage, Aphia lineage and Gobius lineage). The main anatomical differences were related to overall shape (square to rhomboid), the development and shape of the postero‐dorsal and antero‐ventral lobes and the degree of convexity of dorsal and ventral margins. Iterative classifications and discriminant analysis of otolith contour provided very similar results. In both cases, more than 70% of specimens were correctly classified to species and more than 80% to genus. Iterations in the larger AFORO database (including 216 families of teleosts) attained a 100% correct classification at the family level.
Reactive oral lesions associated with dental implants. A systematic review
Authors: Atarbashi‐Moghadam Fazele , Atarbashi‐Moghadam Saede , Namdari Mahshid , Shahrabi‐Farahani Shokoufeh
Published: May 2018

Reactive lesion formation around dental implants a complication that has been given much consideration. These lesions can lead to marginal bone loss, and consequently, implant failure. In the present systematic review, all reported reactive lesions associated with dental implants in the literature were assessed. An electronic search was performed using PubMed Central, Scopus, Google Scholar, and Science Direct. The search strategy was limited to human studies (case reports and case series), full‐text English language articles, published until May 2017. A total of 19 articles reporting 27 lesions in 25 cases were included. Peripheral giant cell granuloma and pyogenic granuloma were the most reactive lesions found around dental implants. The mean age of the patients was 51.28 ± 14.48 years, with a slight female predilection. Posterior mandibular gingiva was the most common location for these lesions. The recurrence rate of lesions was 33.33%, and the chance of implant removal was 29.62%. Due to the clinical significance of these lesions, early histopathologic examination is recommended to exclude the presence of such pathological lesions.
It’s like balancing on a slackline—A description of how adults with congenital heart disease describe themselves in relation to physical activity
Authors: Bay Annika , Lämås Kristina , Berghammer Malin , Sandberg Camilla , Johansson Bengt
Published: May 2018

Aims and objectives

To illuminate how adults with congenital heart disease (CHD) describe themselves in relation to physical activity.

Background

Several studies have shown that adults with CHD have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

Design

Qualitative study with semistructured interviews analysed with qualitative content analysis.

Methods

Semistructured interviews were individually performed with 14 adults (women = 7, age 19–68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow‐up and diagnosis.

Results

The overall theme, It′s like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (a) Being an adventurer—enjoying the challenges of physical activity; (b) Being a realist—adapting to physical ability; (c) Being a non‐doer—lacking prerequisites for physical activity; and (d) Being an outsider—feeling excluded depending on physical ability.

Conclusions

Adults with CHD seem to have a diverse relationship with physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active to get a deeper understanding of how to support adults with CHD to be physically active.

Relevance to clinical practice

Given the diverse relationship with physical activity, nurses have to further investigate the patients’ relationship with physical activity, to support a healthy lifestyle. Nurses and allied health professionals should offer individualised exercise prescriptions and education about suitable physical activities in relation to physical ability.
Using qualitative data to enhance our understanding of the reasons young people decline Structured Diabetes Education programmes
Authors: Coates Vivien , Horigan Geraldine , Carey Marian , Davies Mark
Published: May 2018

Aim

To explore the reasons young people with type 1 diabetes decline Structured Diabetes Education from the perspectives of the young people themselves, their parents and diabetes educators.

Background

Structured Diabetes Education programmes that are evidence based and quality assured are a key component to empowering people with diabetes to self‐manage effectively. However, research reveals that uptake of structured education programmes is disappointingly low.

Design

Qualitative cross‐sectional study involving participants from Northern Ireland and England.

Methods

Twenty young people with type 1 diabetes (13–22 years) who had declined Structured Diabetes Education within the past 2 years, 17 parents of a young person with type 1 diabetes and 16 diabetes educators participated in semistructured interviews and focus groups.

Results

Three main themes emerged from across all three groups: timing, access and communication issues. In addition, a lack of understanding by the referrer was cited by some young people and their parents. Diabetes educators were sympathetic and understood many of the reasons why Structured Diabetes Education was declined. Solutions were proposed to overcome expressed barriers.

Conclusions

Although the expressed reasons for declining might suggest that the young people simply did not prioritise education, this study adds a more nuanced scenario to the debate. The interviews revealed the tensions that exist between people's daily commitments and their need to self‐manage their diabetes. The young people and their parents must be given a much stronger sense of the importance of Structured Diabetes Education and ways to accommodate attendance must be sought. Diabetes educators must be able to better promote the importance of Structured Diabetes Education.

Relevance to clinical practice

As optimal glycaemic control is so vital for long‐term health, there is an urgent need to understand how to respond more fully to the needs of young people who have type 1 diabetes.
Role‐modelling and the hidden curriculum: New graduate nurses’ professional socialisation
Authors: Hunter Kiri , Cook Catherine
Published: May 2018

Aims and objectives

To explore new graduate nurses’ experiences of professional socialisation by registered nurses in hospital‐based practice settings, and identify strategies that support professional identity development.

Background

Professionalism is reinforced and stabilised in the clinical environment through the “hidden curriculum”, with major learning coming from practice role‐models. New graduates observe attitudes, behaviours, decision‐making and skills, and gain feedback from registered nurses, which they translate into their own practice. Professional socialisation occurs through encounters with desirable and undesirable role‐modelling; both are significant in professional identity formation.

Design

Qualitative descriptive design.

Method

Data collection was undertaken through semistructured interviews with five new graduate nurse participants. A general inductive approach guided analysis. The meaningful descriptions gained provided insight into their experiences.

Results

Three main themes identified from the data include: “Lessons from the wilderness”; “Life in the wild”; and “Belonging to a wolf pack”. The data set highlighted the major transitional process from student identity to registered nurse.

Conclusions

New graduates’ rethinking of beliefs and professional nursing identities were influenced by organisational pressures and experienced nurses’ role‐modelling practices contrary to professional values. Despite encountering a range of professional behaviours, attitudes and dilemmas, new graduates were capable of moral agency and critical thinking. However, they rapidly acculturated and described compromises to cope. To promote high morale and a sense of belonging, a concerted effort is required by all nurses to facilitate the socialisation process to encourage self‐authorship.

Relevance to clinical practice

A well‐developed professional identity enhances nursing as a profession, contributing towards better healthcare delivery and outcomes. It is critically important how professional values are learnt within the culture of nursing. Tensions in clinical practice need to be understood better to avoid moral distress caused by dissonance between expectation and experience. It is advantageous to increase early positive socialisation.
Documentation of psychotropic pro re nata medication administration: An evaluation of electronic health records compared with paper charts and verbal reports
Authors: Martin Krystle , Ham Elke , Hilton N Zoe
Published: May 2018

Aims and objectives

To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process.

Background

The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131).

Design

The project was a mixed‐method, two‐phase study that collected data from two sites.

Methods

In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice.

Results

Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration.

Conclusions

We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation.

Relevance to clinical practice

Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases.
Exploring family members’ experiences during a death process in the emergency department: A grounded theory study
Authors: Berbís‐Morelló Carme , Mora‐López Gerard , Berenguer‐Poblet Marta , Raigal‐Aran Laia , Montesó‐Curto Pilar , Ferré‐Grau Carme
Published: May 2018

Aims and objectives

To identify which are the needs arised from feelings, perceptions and experiences of the family members during any time within the death process in an emergency service of an acute care hospital, with regard to the assistance received.

Background

The publications refer to the needs expressed by bereaved families, who explain the support they received right after the death of a relative in an emergency service, and during the months after the tragedy.

Design

Qualitative study drawing on grounded theory based on Charmaz (2006).

Methods

Ten interviews were conducted to a member of each family, who had been in an emergency service with a relative during any of the stages of the dying process. Data were collected from September 2015–June 2016. The analysis was made while data were being collected. Three types of codification were carried out: open, axial and selective. Theoretical saturation was achieved after data collection and analysis.

Results

Three thematic categories emerged: the power of information/communication (a), decisions taken by professionals within the dimension of caring (b) and the humanisation of death in emergency services (c).

Conclusions

The quality of the information given to families in the process of death in an emergency service affects to their satisfaction. Family support must be essential in a situation of death. Institutions must guarantee standards of practice, which include orientation on the care of people in bereavement, and the commitment to provide specialised attention those families.

Relevance to clinical practice

Research findings reveal the need to create changes within clinical practice, regarding how to take care of the family involved in a death process in an emergency service. From the needs detected by the participants, it could be possible to implement an interventional programme, which offers the relatives the emotional support they may need.
Perspectives on oral squamous cell carcinoma prevention—proliferation, position, progression and prediction
Authors: Thomson P. J.
Published: May 2018

Squamous cell carcinoma arising from oral mucosal epithelium remains a lethal and deforming disease due to tumour invasion, oro‐facial destruction, cervical lymph node metastasis and ultimate blood‐borne dissemination. Worldwide, 300 000 new cases are seen each year, with a recent and significant rise in incidence affecting particularly the young. To rationalize perspectives on preventive strategies in oral cancer management, this study addresses a number of fundamental questions regarding carcinogenesis: proliferation—what epithelial cell changes precede tumour development? Position—why are certain oral sites so predisposed to cancer? Progression—why do some precursor lesions progress to invasive carcinoma and others do not? Prediction—how can we predict individual patient and/or lesion behaviour to prevent disease progression? By improving our understanding of oral carcinogenesis, can we thereby facilitate more effective primary, secondary and tertiary preventive strategies and ultimately reduce the global burden of oral squamous cell carcinoma (OSCC)?
Evaluation of a hepatitis C clinical care coordination programme’s effect on treatment initiation and cure: A surveillance‐based propensity score matching approach
Authors: Deming R. , Ford M. M. , Moore M. S. , Lim S. , Perumalswami P. , Weiss J. , Wyatt B. , Shukla S. , Litwin A. , Reynoso S. , Laraque F.
Published: May 2018

Hepatitis C (HCV) is a viral infection that if left untreated can severely damage the liver. ProjectINSPIREwas a 3 yearHCVcare coordination programme in New York City (NYC) that aimed to address barriers to treatment initiation and cure by providing patients with supportive services and health promotion. We examined whether enrolment in ProjectINSPIREwas associated with differences inHCVtreatment and cure compared with a demographically similar group not enrolled in the programme.INSPIREparticipants in 2015 were matched with a cohort ofHCV‐infected persons identified in theNYCsurveillance registry, using full optimal matching on propensity scores and stratified byINSPIREenrolment status. Conditional logistic regression was used to assess group differences in the two treatment outcomes. Two follow‐up sensitivity analyses using individual pair‐matched sets and the full unadjusted cohort were also conducted. Treatment was initiated by 72% (790/1130) ofINSPIREparticipants and 36% (11 960/32 819) of study‐eligible controls. Among initiators, 65% (514/790) ofINSPIREparticipants compared with 47% (5641/11 960) of controls achieved cure. In the matched analysis, enrolment inINSPIREincreased the odds of treatment initiation (OR: 5.25, 95%CI: 4.47‐6.17) and cure (OR: 2.52, 95%CI: 2.00‐3.16). Results from the sensitivity analyses showed agreement with the results from the full optimal match. Participation in theHCVcare coordination programme significantly increased the probability of treatment initiation and cure, demonstrating that care coordination forHCV‐infected individuals improves treatment outcomes.
Novel and emerging therapies for cholestatic liver diseases
Authors: Goldstein Jordan , Levy Cynthia
Published: May 2018

While bile acids are important for both digestion and signalling, hydrophobic bile acids can be harmful, especially when in high concentrations. Mechanisms for the protection of cholangiocytes against bile acid cytotoxicity include negative feedback loops via farnesoid X nuclear receptor (FXR) activation, the bicarbonate umbrella, cholehepatic shunting and anti‐inflammatory signalling, among others. By altering or overwhelming these defence mechanisms, cholestatic diseases such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) can further progress to biliary cirrhosis, end‐stage liver disease and death or liver transplantation. While PBC is currently treated with ursodeoxycholic acid (UDCA) and obeticholic acid (OCA), many fail treatment, and we have yet to find an effective therapy for PSC. Novel therapies under evaluation target nuclear and surface receptors including FXR, transmembrane G‐protein–coupled receptor 5 (TGR5), peroxisome proliferator‐activated receptor (PPAR) and pregnane X receptor (PXR). Modulation of these receptors leads to altered bile composition, decreased cytotoxicity, decreased inflammation and improved metabolism. This review summarizes our current understanding of the role of bile acids in the pathophysiology of cholestatic liver diseases, presents the rationale for already approved medical therapies and discusses novel pharmacologic therapies under investigation.
Inflammation in psychiatric disorders: what comes first?
Authors: Bauer Moisés E. , Teixeira Antonio L.
Published: May 2018

Neuropsychiatric disorders (i.e., mood disorders and schizophrenia) and inflammation are closely intertwined, and possibly powering each other in a bidirectional loop. Depression facilitates inflammatory reactions and inflammation promotes depression and other neuropsychiatric disorders. Patients with neuropsychiatric disorders exhibit all cardinal features of inflammation, including increased circulating levels of inflammatory inducers, activated sensors, and inflammatory mediators targeting all tissues. Inflammation may contribute to the pathophysiology and clinical progression of these disorders. Of note, proinflammatory cytokines modulate mood behavior and cognition by reducing brain monoamine levels, activating neuroendocrine responses, promoting excitotoxicity (increased glutamate levels), and impairing brain plasticity. What are the sources of this chronic inflammation? Increasing evidence indicates that changes in neuroendocrine regulation, metabolism, diet/microbiota, and negative health behaviors are important triggers of inflammation. Finally, recent data indicate that early‐life stress is associated with overt inflammation prior to the development of neuropsychiatric disorders.
Scale‐dependent foraging tradeoff allows competitive coexistence
Authors: Bolin Arvid , Smith Henrik G. , Lonsdorf Eric V. , Olsson Ola
Published: May 2018

In spatially heterogeneous environments, coexistence between competing species can be facilitated by spatially mediated tradeoffs. In this paper we develop a mechanistic model to investigate under which circumstances interspecific differences in the tradeoff between foraging efficiency and travel costs can allow two central place foraging species to coexist in spite of considerable overlap in resource use. One species (Flyer) has a high basal metabolic rate, but a low relative cost of travelling such that it can use patches at a greater distance from its central place while the minimum patch quality it can economically use is high. The other species (Forager), by contrast, has a lower basal metabolic rate, but higher relative cost of travelling, and can therefore be a more efficient forager and able to use foraging patches of low quality, as long as they are not too far from the nest. We demonstrate that the coexistence of these two species critically depends on landscape composition and structure, with the Flyer outcompeting the Forager in structurally simple, coarse‐grained, landscapes with abundant high‐quality forage and the Forager outcompeting the Flyer in fine‐grained highly diverse landscapes. Coexistence between the two species is possible when the landscape is structurally and compositionally complex, fine‐grained, and has both high and low quality forage. Our results demonstrate that exploitative competition between two contrasting life histories can produce very different community dynamics depending on landscape composition and structure.
A healthy measure of monitoring fundamentals!
Authors: Wallin Mats , Lönnqvist Per‐Arne
Published: May 2018

Monitoring represents a seminal part of modern anesthesia but it is imperative that clinicians and health care staff understand the fundamentals of measurements to correctly understand, apply, and at times discard various monitoring options. The world of measurements is a very precise science that needs to be fully acknowledged. This communication aims at highlighting certain issues relevant to everyday clinical monitoring.
Enhanced recovery after surgery in children: Promising, evidence‐based multidisciplinary care
Authors: Rove Kyle O. , Edney John C. , Brockel Megan A.
Published: May 2018

Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children.
Perioperative factors associated with persistent opioid use after extensive abdominal surgery in children and adolescents: A retrospective cohort study
Authors: Owusu‐Agyemang Pascal , Cata Juan P. , Meter Antoinette Van , Kapoor Ravish , Zavala Acsa M. , Williams Uduak U. , Tsai January , Rebello Elizabeth , Feng Lei , Hayes‐Jordan Andrea
Published: May 2018

Background

In adults, preoperative opioid use and higher perioperative opioid consumption have been associated with higher odds of persistent opioid use after surgery. There are limited data on the prevalence and factors associated with persistent opioid use after major oncologic surgery in children.

Aims

In this study, we sought to determine the prevalence and factors associated with the development of persistent opioid use in a group of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Methods

A retrospective study of patients ≤19 years of age was performed. Univariable logistic regression was used to assess factors associated with a postdischarge persistent opioid use of up to 6 months.

Results

Eighty‐six children were identified. The median age was 12 years, and 43% were female. The proportion of patients with persistent opioid use over the immediate 3, 6, 12 and 24 postdischarge months was 54/77 (70%), 18/51 (35%), 13/45 (29%), and 3/24 (13%), respectively. The daily average in‐patient pain scores were higher in the group of children who subsequently developed persistent opioid use of up to 6 months (estimated difference 0.5, 95% confidence interval [CI]: 0.3, 0.8, P < .01). Furthermore, higher postoperative opioid consumption was associated with greater odds of a subsequent persistent opioid use of up to 6 months (odds ratio 1.03, 95% CI: 1.00, 1.07, P = .05).

Conclusion

In this retrospective study of children and adolescents who had undergone a major oncologic surgery, higher in‐patient pain scores and higher postoperative opioid consumption were associated with a persistent opioid use of up to 6 months.