bluuebunny/crossref_metadata_2025 huggingface dataset:
The value of screening biopsies in light‐chain (AL) and transthyretin (ATTR) amyloidosis
Authors: Cohen Oliver C. , Sharpley Faye , Gilbertson Janet A. , Wechalekar Ashutosh D. , Sachchithanantham Sajitha , Mahmood Shameem , Whelan Carol J. , Martinez‐Naharro Ana , Fontana Marianna , Lachmann Helen J. , Hawkins Philip N. , Gillmore Julian D.
Published: June 2020

Introduction

Systemic amyloidosis is a histological diagnosis, often achieved via critical organ biopsy. Screening biopsies represent a low‐risk approach to diagnosis.

Objectives and Methods

All patients with systemic AL and ATTR amyloidosis who underwent abdominal fat aspiration (AFA) and either a bone marrow (BM) or gastrointestinal (GI) biopsy at the UK National Amyloidosis Centre (2006‐2019) were identified. We sought to determine diagnostic sensitivity in relation to whole body amyloid burden, amyloid type and organ involvement.

Results

Diagnostic sensitivity established in 471 patients with AL (n = 321) and ATTR (n = 150) amyloidosis, respectively, was 73.2% and 27.3% for AFA (P< .001), 59.7% and 42.2% for BM (P< .001), and 74.6% and 44.6% for GI biopsy (P< .001). ATTR amyloid deposits were detected in 35.4% BMs and 33.3% of GI biopsies when AFA did not demonstrate amyloid. In AL amyloidosis, sensitivity of combined AFA and BM biopsy in AL amyloidosis was 82.9%. There was a strong association between whole body amyloid burden and sensitivity of each screening biopsy method. The diagnostic sensitivity of screening biopsies ranged from 80.0% to 90.5% for patients with a large amyloid load on 123I‐SAP scintigraphy in comparison with 53.9%‐79.0% in those with no visceral amyloid visible on imaging.

Conclusion

Performing both AFA and BM biopsy should be considered in suspected AL amyloidosis to substantially reduce the clinical risk associated with critical organ biopsy. The sensitivity of screening biopsies in ATTR amyloidosis is poor.
Perioperative management for patients with von Willebrand disease: Defining the optimal approach
Authors: Miesbach Wolfgang
Published: June 2020

von Willebrand disease (VWD) is the most common inherited bleeding disorder characterised by a quantitative or qualitative deficiency in von Willebrand factor (VWF). During invasive surgical procedures, patients with VWD require additional treatment to maintain haemostasis; however, due to the complexity of VWD, there is a lack of consensus on the optimal management. In the perioperative period, patients are usually treated with VWF and factor FVIII (FVIII)‐containing concentrates to provide an immediate haemostatic response to prevent excessive bleeding during both elective and emergency surgery. With the introduction of recombinant VWF (rVWF), there is a need for guidance on the use of the various VWF products in the perioperative period for all types of patients and surgeries. This review provides an overview of the current evidence for the surgical management of patients with VWD and, summarises the optimal treatment approach during the perioperative period, and highlights key unanswered questions and the research needed to address the evidence gaps.
P. F. Strawson was neither an externalist nor an internalist about moral responsibility
Authors: De Mesel Benjamin
Published: June 2020

Internalism about moral responsibility is the view that moral responsibility is determined primarily by an agent's mental states; externalism is the view that moral responsibility is determined primarily by an agent's overt behaviour and by circumstances external to the agent. In a series of papers, Michelle Ciurria has argued that most if not all current accounts of moral responsibility, including Strawsonian ones, are internalist. Ciurria defends externalism against these accounts, and she argues that, in contrast to his contemporary followers, P.F. Strawson himself was an externalist. I believe that Ciurria's reading of Strawson is problematic. The aim of this paper is to elucidate Strawson's position with regard to the internalism‐externalism issue against the background of Ciurria's reading of him. I conclude that Strawson was neither an internalist nor an externalist about moral responsibility. I draw extensively upon the whole body of Strawson's work, much of which is sadly neglected in discussions of ‘Freedom and Resentment’, although it illuminates many of the issues discussed there.
Signal quality and patient experience with wearable devices for epilepsy management
Authors: Nasseri Mona , Nurse Ewan , Glasstetter Martin , Böttcher Sebastian , Gregg Nicholas M. , Laks Nandakumar Aiswarya , Joseph Boney , Pal Attia Tal , Viana Pedro F. , Bruno Elisa , Biondi Andrea , Cook Mark , Worrell Gregory A. , Schulze‐Bonhage Andreas , Dümpelmann Matthias , Freestone Dean R. , Richardson Mark P. , Brinkmann Benjamin H.
Published: June 2020

Noninvasive wearable devices have great potential to aid the management of epilepsy, but these devices must have robust signal quality, and patients must be willing to wear them for long periods of time. Automated machine learning classification of wearable biosensor signals requires quantitative measures of signal quality to automatically reject poor‐quality or corrupt data segments. In this study, commercially available wearable sensors were placed on patients with epilepsy undergoing in‐hospital or in‐home electroencephalographic (EEG) monitoring, and healthy volunteers. Empatica E4 and Biovotion Everion were used to record accelerometry (ACC), photoplethysmography (PPG), and electrodermal activity (EDA). Byteflies Sensor Dots were used to record ACC and PPG, the Activinsights GENEActiv watch to record ACC, and Epitel Epilog to record EEG data. PPG and EDA signals were recorded for multiple days, then epochs of high‐quality, marginal‐quality, or poor‐quality data were visually identified by reviewers, and reviewer annotations were compared to automated signal quality measures. For ACC, the ratio of spectral power from 0.8 to 5 Hz to broadband power was used to separate good‐quality signals from noise. For EDA, the rate of amplitude change and prevalence of sharp peaks significantly differentiated between good‐quality data and noise. Spectral entropy was used to assess PPG and showed significant differences between good‐, marginal‐, and poor‐quality signals. EEG data were evaluated using methods to identify a spectral noise cutoff frequency. Patients were asked to rate the usability and comfort of each device in several categories. Patients showed a significant preference for the wrist‐worn devices, and the Empatica E4 device was preferred most often. Current wearable devices can provide high‐quality data and are acceptable for routine use, but continued development is needed to improve data quality, consistency, and management, as well as acceptability to patients.
First report of the defoliator moth, Spoladea recurvalis (Fabricius, 1775) (Lepidoptera: Crambidae), in Tunisia
Authors: Ehsine M. , Aoun F.
Published: June 2020

In October 2019, Spoladea recurvalis (Fabricius, 1775) (Lepidoptera: Crambidae) was identified for the first time in Tunisia, in the geothermal site of Saaidan and the geothermal site of El Mansoura (Kebili, south western region of Tunisia). Damage was observed on melon, chard, beet and weeds. This is the first record of S. recurvalis in Tunisia.
Ultrasonographic guided block of the median nerve
Authors: Beaumont A. , Bertoni L. , Denoix J‐M.
Published: June 2020

Median nerve anaesthesia is sometimes indicated in the diagnosis of forelimb lameness in the horse in conjunction with the ulnar nerve block, but the localisation of the nerve to perform a precise deposition of the anaesthetic solution around and close to the nerve is difficult to achieve using the conventional blind technique. The objectives of this paper are to describe the ultrasonographic anatomy of the median nerve and the technique for performing an ultrasound‐guided anaesthetic block of the nerve. The median nerve is imaged using a microconvex (or linear) probe in transverse section performed proximally to the chestnut on the medial aspect of the forearm. Distribution of the anaesthetic solution around the nerve is done by initially inserting the needle caudally and then cranially to the nerve and injecting 4–6 mL at each site. Control of the needle penetration avoids erroneous intravascular or intramuscular injections or sudden horse reaction. Ultrasound‐guided injection has the potential to safely and accurately block the median nerve.
Safety and efficacy of subcutaneous alpha‐tocopherol in healthy adult horses
Authors: Donnelly C. G. , Burns E. , Easton‐Jones C. A. , Katzman S. , Stuart R. , Cook S. E. , Finno C. J.
Published: June 2020

Vitamin E is essential for neuromuscular function. The primary treatment, oral supplementation with natural (‘RRR’) α‐tocopherol, is not effective in all horses. The objectives of this pilot study were to evaluate the safety and efficacy of a subcutaneously administered RRR‐α‐tocopherol preparation. Horses were randomly assigned in a cross‐over design to initially receive RRR‐α‐tocopherol (5000 IU/450 kg of 600 IU/mL) subcutaneously (n = 3) or orally (n = 3) or were untreated sentinels (n = 2). Tissue reactions following injection in Phase I of the study necessitated adjustment of the preparation with reduction of the RRR‐α‐tocopherol concentration to 500 IU/mL in Phase 2. Following an 8‐week washout period, horses received the reciprocal treatment route with the new preparation (5000 IU/450 kg of 500 IU/mL). Serum, CSF and muscle α‐tocopherol concentrations were determined by high‐performance liquid chromatography over a 14‐day period during each phase. Serum and CSF α‐tocopherol concentrations increased significantly postinjection only when the 500 IU/mL product was administered (P<0.0001). There was no significant difference in the muscle concentration of α‐tocopherol following either treatment. All eight horses had marked tissue reaction to subcutaneous injection, regardless of product concentration. Whilst we have demonstrated that this route may be a useful alternative to oral supplementation, the marked tissue reaction makes use of such products limited at this time to only the most refractory of cases.
Effects of antiretroviral therapy on proprotein convertase subtilisin/kexin 9: focus on lipids, inflammation and immunovirological parameters
Authors: Bianconi V , Schiaroli E , Pirro M , Cardaci S , Busti C , Mannarino MR , Baldelli F , Francisci D
Published: June 2020

Objectives

Plasma levels of proprotein convertase subtilisin/kexin type 9 (PCSK9), a major regulator of cholesterol metabolism, have been reported to have an increasing trend in people living with HIV (PLWH) compared with controls. We assessed the impact of different antiretroviral (ARV) regimens on plasma PCSK9 levels as well as plasma lipids, systemic inflammation and immunovirological parameters.

Methods

Eighty HIV‐positive ARV therapy (ART)‐naïve PLWH and 40 uninfected controls were retrospectively enrolled. At baseline and 3, 6 and 12 months after ART initiation, plasma PCSK9 levels, lipids, high‐sensitivity C‐reactive protein (hs‐CRP), HIV‐1 RNA levels and CD4 T‐cell count were measured.

Results

Baseline PCSK9 levels were significantly more elevated in PLWH and were associated with HIV‐1 RNA levels (P < 0.001), CD4 T‐cell counts (P < 0.001), triglycerides (P < 0.001) and high‐density lipoprotein (HDL) cholesterol (P < 0.001), but not with total cholesterol, low‐density lipoprotein (LDL) cholesterol and lipoprotein(a) levels. The prescription of ART was paralleled by significant decreases in plasma PCSK9 and hs‐CRP levels, and increases in total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and lipoprotein(a), independent of regimen.

Conclusions

PCSK9 levels, along with systemic inflammation, were progressively reduced following the initiation of an effective ART. However, at the end of the study PCSK9 levels remained higher than in controls and did not correlate with any of the lipid variables.
Association of Abl interactor 2, ABI2, with platelet/lymphocyte ratio in patients with renal cell carcinoma: A pilot study
Authors: Ergun Sercan , Gunes Sezgin , Buyukalpelli Recep , Aydin Oguz
Published: June 2020

There are many unknown aspects of the pathogenesis of renal cell carcinoma (RCC). The aim of the current study was to define new RCC‐related genes and measure their associations with RCC and clinical parameters, especially platelet/lymphocyte ratio which may be an independent predictor of prognosis in patients with RCC and other forms of cancer. Via in silico analysis upon RCC‐specific deleted genes in chromosome 3, four possible ceRNAs (ATXN3, ABI2, GOLGB1 and SMAD2) were identified. Then, the expression levels of these genes in tumour and adjacent healthy kidney tissues of 19 RCC patients were determined by real‐time PCR. ATXN3 and GOLGB1 gene expression levels increased but ABI2 gene expression level decreased in tumour kidney tissues when compared to normal ones. ATXN3, ABI2 and GOLGB1 gene expression levels were significantly higher in Fuhrman grade 4 than other grades (P < .001). ABI2 gene expression levels were significantly associated with higher platelet/lymphocyte ratio of the patients with RCC (P < .05). ATXN3, ABI2 and GOLGB1 may predict higher RCC grades. Also, ABI2 may regulate platelet/lymphocyte ratio which may be an independent predictor of RCC and other forms of cancer.
Coronavirus disease 2019 (COVID‐19): strengthening our resolve to achieve universal palliative care
Authors: Rosa William E. , Davidson Patricia M.
Published: June 2020

In this paper, we strongly advocate for universal palliative care access during the COVID‐19 pandemic. The delivery of universal palliative care services has been called for by leading global health organizations and experts. Nurses are critical to realizing this goal. COVID‐19 diagnoses and fatalities continue to rise, underscoring the importance of palliative care, particularly in the context of scant resources. To inform the writing of this paper, we undertook a review of the COVID‐19 and palliative care literature and drew on our experiences. It is very clear that investment in nurses is needed to ensure appropriate palliative care services now and into the future. Avoiding futile interventions and alleviating suffering is an ethical imperative for nurses regardless of the setting. Multi‐level practices and policies to foster the delivery of safe, high‐quality palliative care for all are urgently needed.
Systematic review and network meta‐analysis of atrial fibrillation percutaneous catheter ablation technologies using randomized controlled trials
Authors: Kukendrarajah Kishore , Papageorgiou Nikolaos , Jewell Paul , Hunter Ross J. , Ang Richard , Schilling Richard , Providencia Rui
Published: June 2020

Aims

We sought out to make comparisons between all atrial fibrillation (AF) catheter ablation technologies using randomized controlled trial data. Our comparisons were freedom from AF, procedural duration, and fluoroscopy duration.

Methods

Searches were made of EMBASE, MEDLINE, and CENTRAL databases, and studies were selected which had cryoballoon, conventional radiofrequency (RF), multipolar RF catheters, and laser technology as an arm in the study and were identified as randomized controlled trials (RCTs). These studies were analyzed for direct comparisons using conventional meta‐analysis and a combination of indirect and direct comparisons via a network meta‐analysis (NMA).

Results

With respect to freedom from AF both direct comparisons and NMA did not demonstrate any significant difference. However in analysis of procedural and fluoroscopy duration (minutes) for the pulmonary vein ablation catheter (PVAC), both conventional analysis and NMA revealed significantly shorter procedure times, RF vs PVAC (conventional: 61.99 [38.03‐85.94], P <.00001; NMA: 54.76 [36.64‐72.88], P < .0001) and fluoroscopy times, RF vs PVAC (conventional: 12.96 [6.40‐19.53], P = .0001; NMA: 8.89 [3.27‐14.51], P < .01). The procedural duration was also shorter for the cryoballoon with NMA, RF vs CRYO (20.56 [3.47‐37.65], P = .02).

Discussion

Our analysis demonstrated that while there was no difference in the efficacy of the individual catheter technologies, there are significant differences in the procedural duration for the PVAC and the cryoballoon. While they may seem an attractive solution for high‐volume centers, further RCTs of next‐generation technologies should be examined.
Cryoballoon pulmonary vein isolation in treating atrial fibrillation using different freeze protocols: The “ICE‐T 4 minutes vs 3 minutes” propensity‐matched study (Frankfurt ICE‐T 4 vs. 3)
Authors: Chen Shaojie , Schmidt Boris , Bordignon Stefano , Tohoku Shota , Urbanek Lukas , Plank Karin , Willems Franziska , Throm Christina , Konstantinou Athanasios , Hilbert Max , Zanchi Simone , Bianchini Lorenzo , Bologna Fabrizio , Tsianakas Nikolaos , Kreuzer Claudia , Nagase Takahiko , Perrotta Laura , Last Jana , Chun K. R. Julian
Published: June 2020

Background

Time‐to‐isolation (TTI) guided second‐generation cryoballoon (CB2) ablation has been shown to be effective for pulmonary vein isolation (PVI).

Objective

The objective of this paper is to compare the safety and clinical outcome of CB2 PVI using the TTI guided 4 minutes vs 3 minutes freeze protocol.

Methods

This was a propensity‐matched study based on an institutional database. Symptomatic atrial fibrillation (AF) patients who underwent CB2 PVI and systematic follow‐up were consecutively included.

Results

A total of 573 patients were identified, of them 214 (107 matched‐pairs) symptomatic AF (paroxysmal AF: 61%, persistent AF: 39%) patients (age: 67.7 ± 11.2 years) were analyzed. The baseline characteristics were comparable between the two groups. Procedural time was significantly longer in the 4 minutes group compared to 3 minutes group (67.2 ± 21.8 vs 55.9 ± 16.9 minutes, P < .0001). During a mean follow‐up of 2 years, the 4 minutes group was associated with a significantly higher rate of freedom from arrhythmia recurrence compared with the 3 minutes group (66.4% vs 56.1%, P = .009), which was mainly driven by patients with persistent AF. The multivariate regression showed that the 4 minutes freeze was the independent predictor of freedom from arrhythmia recurrence. During the repeat procedure, the 4 minutes group was associated with a significantly higher rate of durable PVI. There was no difference regarding procedural adverse events between the two groups.

Conclusion

As compared with the 3 minutes freeze, the TTI guided 4 minutes freeze is associated with a significantly higher rate of arrhythmia‐free and durable PVI without compromising the safety profile, patients with persistent AF may benefit from the TTI guided 4 minutes freeze more pronouncedly.
Analysis of the nanoscale phase characteristics of bitumen and bitumen in mastics and mixtures via AFM
Authors: XING C. , LIU L. , LI M.
Published: June 2020

A peak force quantitative nanomechanical mode (PF‐QNM) can be used to simultaneously measure the topographical and nanomechanical property maps of samples. Currently, few studies used this mode to investigate the phase characteristics of bitumen in mastics and mixtures. The present study adopted hot‐bitumen‐pouring methods to prepare base bitumen surface samples and further used frozen‐storage and low‐temperature‐cutting methods to prepare the internal samples of base bitumen in mastics and mixtures. Then, the atomic force microscopy (AFM) PF‐QNM mode was used to collect data on the topographical and nanomechanical properties of bitumen and bitumen in mastics and mixtures. The results indicated that a typical bee structure only appeared on the bitumen surface. In contrast to the bitumen surface, the bitumen interior showed two phases, A‐ and B‐phase, which were close in some properties to the periphase and paraphase of the bitumen surface, respectively. Furthermore, the addition of mineral aggregates affected the phase characteristics of the free bitumen interior. With an increase in the mineral aggregate surface area, the proportion of A‐phase decreased and that of B‐phase increased in the free bitumen interior.

Lay Description

Bitumen is a complex mixture of hydrocarbons primarily applied for pavement materials. In the pavement industry, the bituminous mixture is a multilevel system, in which bitumen acts as a binder binding the aggregates and fillers to form bituminous mixture. Currently, atomic force microscopy (AFM), which is an advanced microscopy technology, has been used to investigate bitumen surface phase characteristics at the nanoscale. However, few studies have directly explored the nanoscale phase characteristics of bitumen in mastics or mixtures. Recently, with the progress of technology, a peak‐force‐quantitative‐nanomechanical mode (PF‐QNM) can be used to simultaneously measure the topographical and nanomechanical property maps of samples. Relying on this advanced mode, this study analyzed the nanoscale phase characteristics of the bitumen surface and interior, and further explored the effect of mineral aggregates on bitumen interior phase characteristics. In detail, we used hot‐bitumen‐pouring methods to prepare bitumen surface samples and adopted frozen‐storage and low‐temperature‐cutting methods to prepare the internal samples of bitumen in mastics and mixtures. Subsequently, AFM PF‐QNM mode was used to collect topographical and nanomechanical property maps of bitumen and bitumen in mastics and mixtures. The results indicated that the bitumen interior only consisted of two phases, where the A‐phase presented low adhesion, deformation, and dissipation, while the B‐phase presented high adhesion, deformation, and dissipation. A‐phase and B‐phase of the bitumen interior were close to the periphase and paraphase of the bitumen surface, respectively. Furthermore, the addition of mineral aggregates significantly affected the bitumen interior phase characteristics.
Light microscopy of the endoplasmic reticulum–membrane contact sites in plants
Authors: ZANG J. , ZHANG T. , HUSSEY P.J. , WANG P.
Published: June 2020

The existence of membrane contact sites (MCS) has been reported in different systems in the past decade, and their importance has been recognised by the cell biology community. Amongst all endomembrane structures, the endoplasmic reticulum (ER) plays vital roles in organising the organelle interaction network with the plasma membrane (PM), Golgi bodies, mitochondria, plastids, endosomes and autophagosomes. A number of methods have been used to study the establishment and functions of these interactions, among them, light microscopy appears to be one of the most effective approaches. Here, we present an overview of the discovery of ER–PM contact sites, and highlight the latest developments in light microscopical‐based techniques that can be used for their study.
Validation of Consumer Styles Inventory for consumer decision making styles
Authors: Eom Hyo Jin , Youn Nara , Lee Myoung‐Jin
Published: June 2020

The Consumer Styles Inventory (CSI) developed by Sproles and Kendall, Journal of Consumer Affairs, 1986, 20: 267–279, is one of the most widely used instruments to classify consumers by their decision making styles. With changes in consumption culture attributable to the coexistence of global and local consumer culture in the past few decades, it is essential to reaffirm that the CSI measurement instrument is valid for contemporary consumers and can be applied in various contexts. This study, therefore, aimed to present a set of CSI validation procedures using contemporaneous participants and targeting two groups of participants in the United States. Two sets of exploratory factor analysis using the main data set (n = 390) were performed and confirmatory factor analysis was applied to the main data set and the cross‐validation data set (n = 172). Results from both the exploratory factor and confirmatory factor analyses seem to validate the eight underlying consumer characteristics of CSI.
Exploring pairing of new graduate nurses with mentors: An interpretive descriptive study
Authors: Devey Burry Robin , Stacey Dawn , Backman Chantal , Donia Magda B.L. , Lalonde Michelle
Published: June 2020

Aims and Objectives

To explore mentorship pairing practices for new graduate nurses in a tertiary care hospital.

Background

Many organisations have implemented mentorship transition programmes to decrease new nursing graduate turnover in the first two years of practice. Little is known about mentorship pairing processes.

Design

An interpretive descriptive qualitative study was conducted in a multicampus academic health science centre in Ontario, Canada. The COREQ reporting guideline was used.

Methods

Thirty‐one semistructured interviews were conducted from July 2018–July 2019 in a multicampus academic health science centre with new nursing graduates, experienced nurses and nurse leaders who participated in the New Graduate Guarantee programme or were involved in the mentor–mentee pairing process in 2016 or 2017. Data collected were analysed using thematic analysis within the groups and triangulated across groups.

Results

Neither the new graduates nor the mentors were aware of the pairing processes. Nursing leaders relied on their knowledge of the participants to pair new graduates and mentors with many stating participants’ personalities were considered. New graduates and mentors described making an initial connection and socialisation as important themes related to facilitating the pairing process. Organisational influences on pairing included taking breaks together, the location of the final student placement, and the management of workload and scheduling.

Conclusions

Increased awareness and transparency regarding nursing mentorship pairing processes is required. Pairing processes suggested by participants warrant further investigation to determine efficacy.

Relevance

Findings reinforce the need to discuss and research nursing specific mentorship pairing processes.
Aggressive behaviour of persons with dementia towards professional caregivers in the home care setting—A scoping review
Authors: Schnelli Angela , Karrer Melanie , Mayer Hanna , Zeller Adelheid
Published: June 2020

Aims and objectives

To outline and to examine the current research and grey literature on aggressive incidents of persons with dementia towards professional caregivers in the home care setting. We intended to identify evidence and research gaps in this field.

Background

Worldwide, around fifty million people are living with dementia. Current research indicates that aggressive behaviour of persons with dementia towards professional caregivers occurs frequently in inpatient settings. However, there has been little research on this phenomenon in the home care setting.

Design

The design entails a scoping review using the methodological framework of Arksey and O’Malley and PRISMA‐ScR.

Methods

A systematic literature search in five databases and a web search in Google Scholar was conducted. Title and abstract screening and a full‐text screening were conducted by two independent authors. A free web search for grey literature was conducted in Google.

Results

The search yielded 1,376 hits. A total of seven journal articles met the inclusion criteria. In the free web search, six references were identified for inclusion, resulting in a total of 13 references. We identified the following four themes: (1) aggressive behaviour in the context of dementia, (2) triggering factors of aggressive behaviour in persons with dementia, (3) skills and educational needs and (4) hindrances to solving the problem of aggressive behaviour.

Conclusions

There is a lack of literature on aggressive behaviour of persons with dementia in the home care setting, and various hindrances to solving this problematic behaviour have been identified.

Relevance to clinical practice

For home caregivers, specific education concerning communication skills and responding to aggressive behaviour may help to deal with the situation. A further approach may involve specific training aimed to improve caregivers’ confidence.
Fostering team innovation and learning by means of team‐centric transformational leadership: The role of teamwork quality
Authors: Klaic Anamarija , Burtscher Michael Josef , Jonas Klaus
Published: June 2020

Team innovation is an important factor for organizational effectiveness. However, fostering innovation in teams remains a major challenge for team leaders. In particular, we still have an incomplete understanding of (1) the effects of team‐centric leadership and (2) the role of teamwork for the relationship between leadership and innovation and learning. Integrating team‐centric transformational leadership and the teamwork quality (TWQ) model with frameworks for team innovation, the current study addresses this issue. Specifically, we investigated TWQ as a team‐level mediator of the relationship between team‐centric transformational leadership, team innovation, and individual members’ learning. We tested our hypotheses using lagged, multi‐source data from a sample of 79 scientific teams. Our findings show that team‐centric transformational leadership is positively related to both team innovation and individual members' learning. Furthermore, the positive relationship between team‐centric transformational leadership and learning is mediated by specific aspects of TWQ. Our study helps to clarify the processes underlying the effects of team‐centric leadership on innovation and learning.

Practitioner points

Innovation and learning are crucial drivers of success in organizations in knowledge‐intensive industries such as science. Transformational leadership is a key factor for enhancing innovation and learning in scientific teams.

By engaging in team‐centric transformational leadership behaviours including emphasizing group identity, communicating a group vision, and fostering team‐building, scientific team leaders can improve innovation and learning

However, leaders of scientific teams should also be aware of potential negative effects of high team cohesion on team innovation, because it may undermine divergent thinking and critical discussions in teams.
Pooled analysis of the efficacy and safety of intraoperative dexmedetomidine on postoperative catheter‐related bladder discomfort
Authors: Shi Hongbin , Zhang Huaping , Pan Weizhong , Lu Youyi , Zhang Yong , Chen Linjing , Wei Chunxiao , Cui Yuanshan
Published: June 2020

Objectives

The goal of the pooled analysis was to demonstrate the efficacy and safety of intraoperative dexmedetomidine in postoperative catheter‐related bladder discomfort (CRBD).

Methods

MEDLINE, the Cochrane Central Register of Controlled Trials, and the Excerpta Medica Database (Embase) were used to pick out randomized controlled trials (RCTs) that used intraoperative dexmedetomidine in postoperative CRBD. This study was carried out using the preferred reporting items for systematic reviews and pooled analysis. We used RevMan version 5.3.0. to analyze the data.

Results

Seven RCTs involving 607 patients were brought into in the analysis. The incidence of CRBD and the incidence of moderate to severe CRBD were assessed at 0 hours, 0.5 or 1 hour, 2 or 3 hours, 6 hours, and 12 or 24 hours postoperatively. The analysis proved that both the incidence of CRBD (P < .00001) and the incidence of moderate to severe CRBD had a statistically significant reduction at 0 hours, 0.5 or 1 hours, 2 or 3 hours, and 6 hours postoperatively (P < .00001, P <.00001, P <.00001, P = .003, respectively). The postoperative pain score was lower in the dexmedetomidine group at 0 hours (P < .00001) and 1 hour (P = .002). Safety assessments indicated that there were no statistical differences between dexmedetomidine and control for side effects, mainly including dry mouth (P = .99) and postoperative vomiting and nausea (P = .77).

Conclusions

The pooled analysis demonstrates that intraoperative dexmedetomidine administration decreases the rate and severity of early postoperative CRBD without causing significant side effects.
Patterns of environmental variability influence coral‐associated bacterial and algal communities on the Mesoamerican Barrier Reef
Authors: Speare Lauren , Davies Sarah W. , Balmonte John P. , Baumann Justin , Castillo Karl D.
Published: June 2020

A coral's capacity to alter its microbial symbionts may enhance its fitness in the face of climate change. Recent work predicts exposure to high environmental variability may increase coral resilience and adaptability to future climate conditions. However, how this heightened environmental variability impacts coral‐associated microbial communities remains largely unexplored. Here, we examined the bacterial and algal symbionts associated with two coral species of the genus Siderastrea with distinct life history strategies from three reef sites on the Belize Mesoamerican Barrier Reef System with low or high environmental variability. Our results reveal bacterial community structure, as well as alpha‐ and beta‐diversity patterns, vary by host species. Differences in bacterial communities between host species were partially explained by high abundance of Deltaproteobacteria and Rhodospirillales and high bacterial diversity in Siderastrea radians. Our findings also suggest Siderastrea spp. have dynamic core bacterial communities that likely drive differences observed in the entire bacterial community, which may play a critical role in rapid acclimatization to environmental change. Unlike the bacterial community, Symbiodiniaceae composition was only distinct between host species at high thermal variability sites, suggesting that different factors shape bacterial versus algal communities within the coral holobiont. Our findings shed light on how domain‐specific shifts in dynamic microbiomes may allow for unique methods of enhanced host fitness.
N‐terminal heterogeneity of parenchymal and vascular amyloid‐β deposits in Alzheimer’s disease
Authors: Zampar S. , Klafki H. W. , Sritharen K. , Bayer T. A. , Wiltfang J. , Rostagno A. , Ghiso J. , Miles L. A. , Wirths O.
Published: June 2020

Aims

The deposition of amyloid‐β (Aβ) peptides in the form of extracellular plaques in the brain represents one of the classical hallmarks of Alzheimer’s disease (AD). In addition to ‘full‐length’ Aβ starting with aspartic acid (Asp‐1), considerable amounts of various shorter, N‐terminally truncated Aβ peptides have been identified by mass spectrometry in autopsy samples from individuals with AD.

Methods

Selectivity of several antibodies detecting full‐length, total or N‐terminally truncated Aβ species has been characterized with capillary isoelectric focusing assays using a set of synthetic Aβ peptides comprising different N‐termini. We further assessed the N‐terminal heterogeneity of extracellular and vascular Aβ peptide deposits in the human brain by performing immunohistochemical analyses using sporadic AD cases with antibodies targeting different N‐terminal residues, including the biosimilar antibodies Bapineuzumab and Crenezumab.

Results

While antibodies selectively recognizing Aβ1–x showed a much weaker staining of extracellular plaques and tended to accentuate cerebrovascular amyloid deposits, antibodies detecting Aβ starting with phenylalanine at position 4 of the Aβ sequence showed abundant amyloid plaque immunoreactivity in the brain parenchyma. The biosimilar antibody Bapineuzumab recognized Aβ starting at Asp‐1 and demonstrated abundant immunoreactivity in AD brains.

Discussion

In contrast to other studied Aβ1–x‐specific antibodies, Bapineuzumab displayed stronger immunoreactivity on fixed tissue samples than with sodium dodecyl sulfate‐denatured samples on Western blots. This suggests conformational preferences of this antibody. The diverse composition of plaques and vascular deposits stresses the importance of understanding the roles of various Aβ variants during disease development and progression in order to generate appropriate target‐developed therapies.
Health state utilities for economic evaluation of bariatric surgery: A comprehensive systematic review and meta‐analysis
Authors: Xia Qing , Campbell Julie A. , Ahmad Hasnat , Si Lei , de Graaff Barbara , Otahal Petr , Palmer Andrew J.
Published: June 2020

Health state utilities (HSUs) are health economic metrics that capture and assess health‐related quality of life (HRQoL). They are essential in health‐economic evaluations when calculating quality‐adjusted life years. We investigated published studies reporting bariatric surgery‐related HSUs elicited through direct or indirect (multiattribute utility instrument [MAUI]) patient‐reported methods (PROSPERO registration number: CRD42019131725). Mean HSUs for different time points and HSU changes over time (where feasible) were meta‐analysed using random‐effects models. Of the 950 potentially relevant identified studies,n= 28 (2004–2018) qualified for data extraction, withn= 85 unique HSUs elicited mainly from the EQ‐5D (88%). Most (75%) studies were published after 2013. The follow‐up duration varied between studies and was often limited to 12 months. The pooled mean HSU was 0.72 (0.67–0.76) at baseline/presurgery (n= 18) and 0.84 (0.79–0.89) one‐year postsurgery (n= 11), indicating a 0.11 (0.09–0.14) utility unit increment. EQ‐5D showed the similar results. This positive difference can be partially explained by BMI and/or co‐morbidities status improvement. This study provides a valuable summary of HSUs to future bariatric surgery‐related cost‐utility models. However, more well‐designed higher‐quality bariatric‐related HSU studies are expected for future reviews to improve the available evidence. We suggest that researchers select an MAUI that is preferentially sensitive to the study population.
Cup‐Cage Solution for Massive Acetabular Defects: A Systematic Review and Meta‐Analysis
Authors: Wang Chao‐xin , Huang Zi‐da , Wu Bai‐jian , Li Wen‐bo , Fang Xin‐yu , Zhang Wen‐ming
Published: June 2020

Our systematic review compiled multiple studies and evaluated survivorship and clinical outcomes of cup‐cage construct usage in the management of massive acetabular bone defects. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Various combinations of “acetabular”, “pelvis”, “cup cage” and their corresponding synonyms were used to search relevant articles in the Cochrane, EMBASE, and PubMed databases. Basic information of the functional scores, implant revision rate, and complication rate were selected as outcomes for analysis. Finally, a total of 11 articles published between 1999 and 2019 were selected, which include 232 patients with an average age of 68.5 years (range, 30–90). The mean follow‐up period was 48.85 months (range, 1–140). Our study shows that the cup‐cage construct has a good clinical outcome with a low revision rate and a low complication rate. Improved clinical outcomes of cup‐cage constructs were seen with a revision rate of 8% and an all‐cause complication rate of 20%. The most commonly reported complication was dislocation, followed by aseptic loosening, infection, and nerve injuries. In summary, it is a promising method for managing large acetabular bone defects in total hip revision.
Natural variation of photosynthetic efficiency in Arabidopsis thaliana accessions under low temperature conditions
Authors: Prinzenberg Aina E. , Campos‐Dominguez Lucia , Kruijer Willem , Harbinson Jeremy , Aarts Mark G. M.
Published: June 2020

Low, but non‐freezing, temperatures have negative effects on plant growth and development. Despite some molecular signalling pathways being known, the mechanisms causing different responses among genotypes are still poorly understood. Photosynthesis is one of the processes that are affected by low temperatures. Using an automated phenotyping platform for chlorophyll fluorescence imaging the steady state quantum yield of photosystem II (PSII) electron transport (ΦPSII) was measured and used to quantify the effect of moderately low temperature on a population of Arabidopsis thaliana natural accessions. Observations were made over the course of several weeks in standard and low temperature conditions and a strong decrease in ΦPSII upon the cold treatment was found. A genome wide association study identified several quantitative trait loci (QTLs) that are associated with changes in ΦPSII in low temperature. One candidate for a cold specific QTL was validated with a mutant analysis to be one of the genes that is likely involved in the PSII response to the cold treatment. The gene encodes the PSII associated protein PSB27 which has already been implicated in the adaptation to fluctuating light.
Acute kidney injury and chronic kidney disease after non‐kidney solid organ transplantation
Authors: Menon Shina , Pollack Ari H. , Sullivan Erin , Murphy Tasha , Smith Jodi
Published: June 2020

Background

SOT is the treatment of choice for end‐stage organ disease. Improved long‐term survival after NKSOT has uncovered chronic morbidity including CKD. AKI is common after NKSOT and may be associated with long‐term CKD.

Methods

We performed a retrospective cohort study looking at AKI and CKD after pediatric heart (n = 109) or liver (n = 112) transplant. AKI was defined using KDIGO creatinine‐based criteria. pAKI was AKI ≤ 7 days post‐transplant; CKD3‐5 was eGFR < 60 mL/min/1.73 m2 by modified Schwartz formula for > 3 months. We looked at the incidence of CKD3‐5 and the effect of perioperative pAKI on the slope of eGFR post‐transplant.

Results

pAKI was seen in 63% (n = 69) after heart and 38% (n = 43) after liver transplant. pAKI was associated with longer ICU and hospital stays. Cumulative incidence (95% CI) of CKD3‐5 at 60 months post‐heart transplant was 40.9% (27.9%‐57.1%) in patients with AKI vs 35.8% (17.1%‐64.8%) in those without (P = NS). Post‐liver transplant, the cumulative incidence of CKD3‐5 at 60 months was 0% in those without pAKI vs 10% (3.2%‐29.3%) in those with (P = .01). Patients with pAKI had lower eGFR at last follow‐up.

Conclusion

pAKI and CKD are common after NKSOT. Incidence of CKD is higher in those with pAKI. AKI episodes are associated with a drop in eGFR during follow‐up. Identifying patients who have had AKI is an important first step in identifying those at risk of repeated AKI episodes. These patients would benefit from closer monitoring for CKD, lower nephrotoxic drug use, and follow‐up with nephrology.
LGBT youth in foster care and the critical advocacy role of Public Health Nurses
Authors: Carabez Rebecca , Kim Jung Eun
Published: June 2020

Aims and Objectives

The purpose of this study was to describe the role of public health nurses working with lesbian, gay, bisexual, and transgender (LGBT) children in foster care in the San Francisco Bay Area.

Background

LGBT youth are disproportionately represented in foster care and experience poor health and education outcomes. Foster care public health nurses (FCPHN) are in a unique position to address disparities with timely and appropriate referrals and advocate for policy changes.

Design

An online survey was developed to describe FCPHN responsibilities in case managing LGBT children.

Method

In all, 39 FCPHNs completed the survey.

Results

Most FCPHN did not know the number of LGBT youth in their caseload and reported that there was no systematic method of collecting this data. Few FCPHN had received training in LGBT health issues.

Conclusion

This study confirms reports from other studies regarding lack of systematic data collection to deliver appropriate services to LGBT youth. It reports FCPHN lack of training as well as their assessment of the most important needs of this population.

Relevance to clinical practice

FCPHNs are in a unique position to advocate by promoting gender inclusive forms in child welfare agencies and addressing disparities in access to care.
CRISPR/Cas9 gene drive technology to control transmission of vector‐borne parasitic infections
Authors: Nateghi Rostami Mahmoud
Published: June 2020

Gene drive is the process of copying of an endonuclease‐containing cassette that leads to increased frequency of inheritance of the desired traits in a targeted population. CRISPR/Cas9 technology is advancing genetic manipulation of insects in the field of gene drive experiments. The CRISPR/Cas9 drive could be engineered for genetic manipulation of parasites and/or vectors for disease control. A number of promising CRISPR/Cas9‐based gene drive strategies that interfere with parasite development or impairs the reproductive capability of the insect vector have been proposed in the laboratory for blocking transmission of malaria and leishmaniasis. Still several technical and ethical challenges remain to be addressed, and none appear insuperable in this field.
Cyber Security Responsibilization: An Evaluation of the Intervention Approaches Adopted by the Five Eyes Countries and China
Authors: Renaud Karen , Orgeron Craig , Warkentin Merrill , French P. Edward
Published: June 2020

Governments can intervene to a greater or lesser extent in managing the risks that citizens face. They can adopt a maximal intervention approach (e.g., COVID‐19) or a hands‐off approach (e.g., unemployment), effectively “responsibilizing” their citizens. To manage the cyber risk, governments publish cyber‐related policies. This article examines the intervention stances the governments adopt in supporting individual citizens managing their personal cyber risk. The authors pinpoint the cyber‐related responsibilities that several governments espouse, applying a “responsibilization” analysis. Those applying to citizens are identified, thereby revealing the governments' cyber‐related intervention stances. The analysis reveals that most governments adopt a minimal cyber‐related intervention stance in supporting their citizens. Given the increasing number of successful cyber attacks on individuals, it seems time for the consequences of this stance to be acknowledged and reconsidered. The authors argue that governments should support individual citizens more effectively in dealing with cyber threats.
Tonsillar Kaposi sarcoma in a renal transplant patient
Authors: Howard John H. , Darrow Morgan , Chen Ling‐Xin , Alnimri Muna , Jen Kuang‐Yu
Published: June 2020

Kaposi sarcoma (KS) is a vascular neoplasm caused by human herpesvirus‐8 (HHV‐8) infection. KS is most often seen in individuals with acquired immunodeficiency syndrome but can occur in patients who are on immunosuppressive therapy. While the skin and oral mucosa are the typical sites for KS, lesions of the tonsil are quite rare with only a few reported cases. Here, we present a case of tonsillar KS occurring in a renal transplant patient. He presented with dysphagia, odynophagia, and weight loss. Oral examination revealed tonsillar hypertrophy with purple discoloration. Imaging revealed diffuse enlargement of Waldeyer's ring with enlarged right cervical lymph nodes, worrisome for post‐transplant lymphoproliferative disorder. Microscopic examination of the tonsillectomy specimen showed a vascular proliferation positive for HHV‐8, consistent with KS. The patient was subsequently treated with immunosuppression reduction and the addition of sirolimus, which resulted in complete resolution of oropharyngeal and cervical lesions.