bluuebunny/crossref_metadata_2025 huggingface dataset:
Risking vulnerability: Enacting moral agency in the is/ought gap in mental health care
Authors: Musto Lynn , Schreiber Rita , Rodney Patricia (Paddy)
Published: February 2021

Aim

To explore how healthcare providers in acute care mental health settings navigate ethically challenging situations, enact moral agency, practice in congruence with ethical standards and mitigate moral distress (MD).

Design

Grounded theory, a qualitative methodology.

Methods

Over 18 months between 2015 and 2017, we reviewed documents, conducted observations and interviewed multidisciplinary participants (N = 27) from inpatient and emergency departments. Participants either provided direct care (N = 14) or were in leadership positions (N = 13). Data were analysed iteratively using constant comparison, coding, memoing and theorizing, which continued until saturation was reached in July 2016.

Findings

The basic social process of how healthcare professionals enacted moral agency, Risking Vulnerability, occurred in the context of Systemic Inhumanity, a constant source of MD. Participants Risked Vulnerability, balancing professional obligations, clinical expertise and organizational processes with their own vulnerability in the system as they strove to practice ethically. Risking Vulnerability was composed of Pushing Back, Working Through Team Relationships and Struggling with Inhumanity.

Conclusion

Healthcare professionals’ moral agency occurred at the nexus of structure (organizational constraints) and agency (persons). Given this, interventions for MD should be directed at all levels of healthcare to support moral agency, promote ethical practice and improve care.

Impact

Sociopolitical elements such as austerity measures undermined ethical practice at the level of direct care. Enactment of moral agency is dynamic, influencing experiences of MD: participants supported by leadership or colleagues to enact moral agency noted that they were not stuck in MD. Interventions supporting moral agency throughout the healthcare system are necessary to mitigate experiences of MD. Findings enhance our understanding of the role of action in the experience of MD.
Virtual reality and distraction cards to reduce pain during intramuscular benzathine penicillin injection procedure in adults: A randomized controlled trial
Authors: Basak Tulay , Demirtas Ayla , Yorubulut Sevde Melike
Published: February 2021

Aim

The aim of this study was to determine the effect of using three‐dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures on patients’ pain and satisfaction levels during intramuscular benzathine penicillin injection.

Design

A randomized controlled trial.

Method

The study population consisted of 91 patients who were prescribed intramuscular benzathine penicillin medication. The participants were stratified by gender and assigned to three groups (control, virtual reality and distraction cards groups). The visual analogue scale was used to assess pain and patient satisfaction. A one‐way analysis of variance and Dunnett's post hoc tests were used to compare the pain and satisfaction levels by group.

Results

The mean pain was 6.67 (2.17) in the control group, 4.4 (2.71) in the distraction cards group and 4.93 (3.07) in the virtual reality group and the difference was statistically significant (F = 5.84, p ˂ .01). The average of the satisfaction levels in the groups was 3.57 (2.23) in the control group, 7.13 (2.86) in the distraction cards group and 8.07 (2.55) in the virtual reality group. The difference between the satisfaction levels was statistically significant (F = 25.77, p ˂ .01).

Conclusion

The three‐dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures were effective in reducing pain associated with intramuscular benzathine penicillin injection and increasing patient satisfaction.

Impact

The results of this study will contribute to evidence‐based nursing practices for the pain associated with intramuscular benzathine penicillin injection.

Clinical Trial Registry

NCT04420559.
Examining nurses' role in Adult Protective Services related to safeguarding older people
Authors: Liu Pi‐Ju , Hernandez Chilatra Jessica Andrea , Phelan Amanda
Published: February 2021

Aim

To examine the role of Adult Protective Services' (APS's) nurses in helping abused, neglected and exploited older people, this study investigated how nurses' contribution differs from social workers. Though the majority of APS' workforce is staffed by social workers, some programmes also employ nurses.

Design

Secondary data analysis using convergent parallel mixed‐method design was conducted.

Methods

Using survey data from the National Adult Protective Services Association, 99 nurses' responses between October 2014 and August 2015 were analysed to examine their agency characteristics, training and qualities, job responsibilities and interprofessional collaboration.

Results

The majority of nurses work with social workers or other professionals using a multidisciplinary team (MDT) approach. Among those carrying a caseload, 69% (49 out of 71) of nurses work in conjunction with social workers. Out of all nurses, 64% (63 out of 99) indicated participation in at least one MDT. While the responsibilities nurses provided were similar to social workers, nurses were also able to provide healthcare related services, in their professional competencies, without referral.

Conclusion

Nurses in APS are in a privileged position to investigate mistreatment and provide/coordinate direct care for victims.

Impact

Not much was known about nurses who directly investigate elder mistreatment and provide services to victims. This study was the first to highlight the nursing workforce in APS, and described the nurses' unique contribution to the field. Nurses functioned as both social workers and healthcare professionals in APS. Since victims of elder mistreatment often suffer from negative physical, psychological and social consequences, having nurses in APS benefits victims to receive and the programmes in providing better care and services.
Managing and keeping control: A qualitative synthesis of nursing and care staff strategies to prevent older people from falling
Authors: De La Cuesta‐Benjumea Carmen , Lidón‐Cerezuela Beatriz , Abad‐Corpa Eva , Meseguer‐Liza Cristóbal , Arredondo‐González Claudia P.
Published: February 2021

Aim

To better understand formal care providers’ role in fall prevention.

Design

Qualitative synthesis as part of an integrative review.

Data sources

Fifteen electronic databases were consulted with the time limit being December 2017. Studies included were qualitative primary studies on formal care providers and fall prevention of people over 65 years of age in health care facilities. 17 studies were included.

Review Methods

Qualitative researchers carried out a critical appraisal and abstraction of the studies retained. Primary studies were imported into Nvivo 12 software; grounded theory procedures of constant comparison, microanalysis, coding, development of memos and diagrams were completed concurrently in a continuous growing process of data conceptualization. Analysis was iterative; it started with open coding and ended with the development of an integrative memo.

Findings

Primary studies were synthesized with the emerging core category of “Managing and keeping control” and described by the emerging strategies of risk management, risk control and articulation work. These three categories account for the formal care providers’ role in fall prevention in health care facilities.

Conclusion

Fall prevention is not given by a series of means and instruments; it is rather built in the interactions between formal care providers and the material and social world. The interactive character of prevention implies that outcomes cannot always be anticipated.

Impact:

Although falls are one of the most researched clinical problems in nursing, the role played by nursing and care staff is dispersed and scantily documented.

Formal care providers alternate risk management with risk control strategies to prevent older people from falling in health care facilities, they also resort to the articulation of the health care team as a complementary strategy.

This review shows the dynamic character of fall prevention, which is something that has tended to go unnoticed in the literature and in policy.
What gets measured gets noticed. Tracking surgical site infection post caesarean section through community surveillance: A post intervention study protocol
Authors: Ohr Se Ok , Giles Michelle , Munnoch Sally , Hunter Mandy , Bolte Michelle , Ferguson John , Deane Jeffrey , Cashman Patrick , Foureur Maralyn
Published: February 2021

Aim

This study aims to evaluate the effectiveness of HealthTracker, a surgical site infection surveillance system that aims to improve the notification of surgical site infection for women after giving birth by caesarean section.

Design

This protocol is an intervention study to evaluate the effectiveness of the surveillance system called “HealthTracker” in monitoring surgical site infections post caesarean section.

Methods

This study will use a mobile web application to automatically send a text message inviting all women who give birth to a live baby by caesarean section over six months during 2020–2021, at an Australian tertiary referral hospital. The text message invites women to complete a web‐based validated Wound Healing Questionnaire. The estimated number of eligible women in six months is 700 (caesarean section rate: 34% of 4,000 births annually). Intervention: the proposed “HealthTracker” surveillance system facilitates active patient‐reported surgical site infection identification through an automated mobile text message linking women to an individualized online Wound Healing Questionnaire.

Discussion

This project aims to provide a consistent, reliable and cost effective surgical site infection surveillance tool to improve post caesarean section surgical site infection reporting, can be scaled for broader utilization and will provide valuable information to decision makers regarding surgical site infection prevention.

Impact

Study findings will provide insights into whether HealthTracker is an efficient and cost effective platform for a systematic and consistent approach to surgical site infection surveillance that can be adopted more broadly, across the local health organization, the State and across other surgical specialty areas. This information will equip hospitals and clinicians with knowledge to better identify patient outcomes related to SSI post discharge from hospital and inform decision making related to preventative strategies, providing the necessary momentum to introduce practice change initiatives aimed at reducing surgical site infection rates.

Trial Registration: ACTRN12620001233910.
Blood pressure and long‐term subclinical cardiovascular outcomes in low‐risk young adults: Insights from Hanzhong adolescent hypertension cohort
Authors: Yan Yu , Ma Qiong , Liao Yueyuan , Chen Chen , Hu Jiawen , Zheng Wenling , Chu Chao , Wang Keke , Sun Yue , Zou Ting , Wang Yang , Mu Jianjun
Published: February 2021

Stage 1 hypertension, newly defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guideline, has been the subject of significant interest globally. This study aims to assess the impact of the new blood pressure (BP) stratum on subsequent subclinical cardiovascular outcomes in low‐risk young adults. This longitudinal study consisted of 1020 young adults (47.7% female; ages 18–23 years) free of cardiovascular disease from the Hanzhong Adolescent Hypertension Cohort with up to 25‐year follow‐up since 1992–1995. Outcomes were available through June 2017. Young adults with stage 1 hypertension accounted for 23.7% of the cohort. When it comes to middle adulthood, subjects with early life stage 1 hypertension were more likely to experience BP progression, and they had a 1.61‐fold increased risk of high‐risk brachial‐ankle pulse wave velocity (baPWV) and a 2.92‐fold risk of left ventricular hypertrophy (LVH) comparing with their normotensive counterparts. Among participants without any active treatment in midlife, the risk associated with stage 1 hypertension for BP progression was 2.25 (95% confidence interval [CI] = 1.41–3.59), high‐risk baPWV was 1.58 (95% CI = 1.09–2.79), LVH was 2.75 (95% CI = 1.16–6.48), and subclinical renal damage (SRD) was 1.69 (95% CI = 1.02–2.82) compared with the normal BP group. Overall, young adults with stage 1 hypertension had significantly higher risks for midlife subclinical cardiovascular outcomes than normotensive subjects. BP management targeting low‐risk young adults is of importance from both clinical and public health perspectives.
Sertoli cell‐derived exosomal MicroRNA‐486‐5p regulates differentiation of spermatogonial stem cell through PTEN in mice
Authors: Li Quan , Li Hanhao , Liang Jinlian , Mei Jiaxin , Cao Zhen , Zhang Lei , Luo Jiao , Tang Yan , Huang Rufei , Xia Huan , Zhang Qihao , Xiang Qi , Yang Yan , Huang Yadong
Published: February 2021

Self‐renewal and differentiation of spermatogonial stem cell (SSC) are critical for male fertility and reproduction, both of which are highly regulated by testicular microenvironment. Exosomal miRNAs have emerged as new components in intercellular communication. However, their roles in the differentiation of SSC remain unclear. Here, we observed miR‐486‐5p enriched in Sertoli cell and Sertoli cell‐derived exosomes. The exosomes mediate the transfer of miR‐486‐5p from Sertoli cells to SSCs. Exosomes release miR‐486‐5p, thus up‐regulate expression of Stra8 (stimulated by retinoic acid 8) and promote differentiation of SSC. And PTEN was identified as a target of miR‐486‐5p. Overexpression of miR‐486‐5p in SSCs down‐regulates PTEN expression, which up‐regulates the expression of STRA8 and SYCP3, promotes SSCs differentiation. In addition, blocking the exosome‐mediated transfer of miR‐486‐5p inhibits differentiation of SSC. Our findings demonstrate that miR‐486‐5p acts as a communication molecule between Sertoli cells and SSCs in modulating differentiation of SSCs. This provides a new insight on molecular mechanisms that regulates SSC differentiation and a basis for the diagnosis, treatment, and prevention of male infertility.
1ɑ,25‐Dihydroxyvitamin D3 promotes osteogenesis by down‐regulating FGF23 in diabetic mice
Authors: Luo Wenqiong , Jiang Yixuan , Yi Zumu , Wu Yingying , Gong Ping , Xiong Yi
Published: February 2021

1ɑ,25‐dihydroxyvitamin D3 (1,25D) and fibroblast growth factor 23 (FGF23) play important roles in bone metabolism through mutual regulation. However, the underlying mechanism between 1,25D and FGF23 in diabetes‐induced bone metabolism disorders has not yet been elucidated. In this study, we investigated the effect of 1,25D on FGF23 under diabetic condition both in vitro and in vivo. The results showed that 1,25D down‐regulated the expression of FGF23 in osteoblast significantly though a dose‐dependent manner in vitro within high glucose environment. Western blot and immunofluorescence analysis indicated that 1,25D activated PI3K/Akt signalling through binding to vitamin D receptor (VDR), which inhibited the phosphorylation of the transcription factor Forkhead Box O1 (FOXO1). Decreased phosphorylation of FOXO1 down‐regulated the expression Dickkopf‐1 (DKK1), a well‐known inhibitor of Wnt signalling. In addition, we observed that 1,25D remarkably ameliorated osteogenic phenotypic markers such as Ocn and Runx2 and rescued diabetes‐induced bone loss in vivo. Our results suggested that 1,25D could promote osteogenesis though down‐regulating FOXO1/FGF23 in diabetes.
STAT1 is a key gene in a gene regulatory network related to immune phenotypes in bladder cancer: An integrative analysis of multi‐omics data
Authors: Weng Hong , Yuan Shuai , Huang Qiao , Zeng Xian‐Tao , Wang Xing‐Huan
Published: February 2021

The immunophenotype of bladder cancer plays a pivotal role in the prognosis of cancer, but the effect of different epigenetic factors on different immunophenotypes in bladder tumours remains unclear. This study used multi‐omics data analysis to provide molecular basis support for different immune phenotypes. Unsupervised cluster analysis revealed distinct subclusters with higher (subcluster B2) or lower cytotoxic immune phenotypes (subcluster A1) related to PD‐L1 and IFNG expression. Mutational landscape analyses showed that the mutation level of TP53 in subcluster B1 was highest than other subclusters, and subcluster B1 had a lower frequency of concurrent mutation than subcluster A2. A total of 2364 differentially expressed genes were identified between subclusters A2 and B1, and the main functions of the up‐regulated genes in subcluster B1 were enriched in the activation of T cells and other related pathways. We found that STAT1 was a key gene in a gene regulatory network related to immune phenotypes in bladder cancer. Finally, we constructed a prognostic prediction model by LASSO Cox regression which could distinguish high‐risk and low‐risk cases significantly. In conclusion, the present study addressed a field synopsis between genetic and epigenetic events in immune phenotypes of bladder cancer.
Serum Helicobacter pylori antibody reactivity in seven Asian countries using an automated latex aggregation turbidity assay
Authors: Akada Junko , Tshibangu‐Kabamba Evariste , Tuan Vo Phuoc , Kurogi Shusaku , Matsuo Yuichi , Ansari Shamshul , Doohan Dalla , Phuc Bui Hoang , Subsomwong Phawinee , Waskito Langgeng Agung , Binh Tran Thanh , Nguyen Lam Tung , Khien Vu Van , Dung Ho Dang Quy , Miftahussurur Muhammad , Syam Ari Fahrial , Tshering Lotay , Vilaichone Ratha‐korn , Mahachai Varocha , Ratanachu‐ek Thawee , Shrestha Pradeep Krishna , Yee Than Than , Htet Kyaw , Aftab Hafeza , Matsuhisa Takeshi , Uchida Tomohisa , Okimoto Tadayoshi , Mizukami Kazuhiro , Kodama Masaaki , Murakami Kazunari , Takahashi Naohiko , Yamaoka Yoshio
Published: February 2021

Background and Aim

To determine the application range of diagnostic kits utilizing anti‐Helicobacter pylori antibody, we tested a newly developed latex aggregation turbidity assay (latex) and a conventional enzyme‐linked immunosorbent assay (E‐plate), both containing Japanese H. pylori protein lysates as antigens, using sera from seven Asian countries.

Methods

Serum samples (1797) were obtained, and standard H. pylori infection status and atrophy status were determined by culture and histology (immunohistochemistry) using gastric biopsy samples from the same individuals. The two tests (enzyme‐linked immunosorbent assay and latex) were applied, and receiver operating characteristics analysis was performed.

Results

Area under the curve (AUC) from the receiver operating characteristic of E‐plate and latex curves were almost the same and the highest in Vietnam. The latex AUC was slightly lower than the E‐plate AUC in other countries, and the difference became statistically significant in Myanmar and then Bangladesh as the lowest. To consider past infection cases, atrophy was additionally evaluated. Most of the AUCs decreased using this atrophy‐evaluated status; however, the difference between the two kits was not significant in each country, but the latex AUC was better using all samples. Practical cut‐off values were 3.0 U/mL in the E‐test and 3.5 U/mL in the latex test, to avoid missing gastric cancer patients to the greatest extent possible.

Conclusions

The kits were applicable in all countries, but new kits using regional H. pylori strains are recommended for Myanmar and Bangladesh. Use of a cut‐off value lower than the best cut‐off value is essential for screening gastric cancer patients.
Networked lives
Authors: Vacchiano Mattia , Spini Dario
Published: February 2021

Social network analysis has grown tremendously across a wide range of disciplines and is now regarded as a road‐map in strengthening links with the life‐course perspective. ‘Linked lives’ is often cited as a key principle of life‐course theory, but there is still much to be learned about the significance of these links for the life course. Network theory refines our understanding of the properties of these links, their emergence as structures in daily life, and the mechanisms underlying the inequalities that arise from social relationships. This paper clarifies why networks can be conceptualised as meso‐level structures that bridge the micro‐macro gap. It thus addresses four processes of particular interest for the integration of life‐course and network research: (a) the problem of tie formation; (b) the activation of ties as social capital; (c) their resilience through segments of a life course; and finally, (d) the problem of their loss. In so doing, we highlight innovative approaches for each of these issues in order to propose a research agenda we call ‘Networked Lives’, which emphasises promising avenues for advancing the integration of these two important fields in the social sciences.
Soybean anthracnose caused by Colletotrichum species: Current status and future prospects
Authors: Boufleur Thais R. , Ciampi‐Guillardi Maisa , Tikami Ísis , Rogério Flávia , Thon Michael R. , Sukno Serenella A. , Massola Júnior Nelson S. , Baroncelli Riccardo
Published: February 2021

Soybean (Glycine max) is one of the most important cultivated plants worldwide as a source of protein‐rich foods and animal feeds. Anthracnose, caused by different lineages of the hemibiotrophic fungus Colletotrichum, is one of the main limiting factors to soybean production. Losses due to anthracnose have been neglected, but their impact may threaten up to 50% of the grain production.

Taxonomy

While C. truncatum is considered the main species associated with soybean anthracnose, recently other species have been reported as pathogenic on this host. Until now, it has not been clear whether the association of new Colletotrichum species with the disease is related to emerging species or whether it is due to the undergoing changes in the taxonomy of the genus.

Disease symptoms

Typical anthracnose symptoms are pre‐ and postemergence damping‐off; dark, depressed, and irregular spots on cotyledons, stems, petioles, and pods; and necrotic laminar veins on leaves that can result in premature defoliation. Symptoms may evolve to pod rot, immature opening of pods, and premature germination of grains.

Challenges

As accurate species identification of the causal agent is decisive for disease control and prevention, in this work we review the taxonomic designation of Colletotrichum isolated from soybean to understand which lineages are pathogenic on this host. We also present a comprehensive literature review of soybean anthracnose, focusing on distribution, symptomatology, epidemiology, disease management, identification, and diagnosis. We consider the knowledge emerging from population studies and comparative genomics of Colletotrichum spp. associated with soybean providing future perspectives in the identification of molecular factors involved in the pathogenicity process.

Useful website

Updates on Colletotrichum can be found at http://www.colletotrichum.org/.

All available Colletotrichum genomes on GenBank can be viewed at http://www.colletotrichum.org/genomics/.
UK food and nutrition security during and after the COVID‐19 pandemic
Authors: Rivington M. , King R. , Duckett D. , Iannetta P. , Benton T. G. , Burgess P.J. , Hawes C. , Wellesley L. , Polhill J. G. , Aitkenhead M. , Lozada‐Ellison L.‐M. , Begg G. , Williams A. G. , Newton A. , Lorenzo‐Arribas A. , Neilson R. , Watts C. , Harris J. , Loades K. , Stewart D. , Wardell‐Johnson D. , Gandossi G. , Udugbezi E. , Hannam J.A. , Keay C.
Published: February 2021

The COVID‐19 pandemic is a major shock to society in terms of health and economy that is affecting both UK and global food and nutrition security. It is adding to the ‘perfect storm’ of threats to society from climate change, biodiversity loss and ecosystem degradation, at a time of considerable change, rising nationalism and breakdown in international collaboration. In the UK, the situation is further complicated due to Brexit. The UK COVID‐19 Food and Nutrition Security project, lasting one year, is funded by the Economic and Social Research Council and is assessing the ongoing impact of COVID‐19 on the four pillars of food and nutrition security: access, availability, utilisation and stability. It examines the food system, how it is responding, and potential knock on effects on the UK’s food and nutrition security, both in terms of the cascading risks from the pandemic and other threats. The study provides an opportunity to place the initial lessons being learnt from the on‐going responses to the pandemic in respect of food and nutrition security in the context of other long‐term challenges such as climate change and biodiversity loss.
Effect of plantation of genetically modified trees on the control of atmospheric carbon dioxide: A modeling study
Authors: Verma Maitri , Verma Alok Kumar
Published: February 2021

The increase in carbon dioxide (CO2) gas concentration in the atmosphere is primarily responsible for the threat of global warming. Forest is one of the prime sinks of CO2. The reduction in the global forest cover due to human activities has contributed significantly to the increase in CO2 levels. Reforestation and afforestation are avenues to control the atmospheric CO2 level; however, several demographic, ecological, and economic constraints exist in the large‐scale plantations. In this scenario, the plantation of genetically modified trees, which absorb more CO2 from the atmosphere, may aid in attaining the CO2 mitigation target. In this study, a mathematical model is proposed to investigate the effect of the plantation of genetically modified trees on the control of the atmospheric CO2 level. A comprehensive qualitative analysis of the model is carried out. The model is calibrated to fit the actual data of global CO2 concentration, population, and forest area. Numerical simulations are carried out to show the effect of key parameters on the dynamics of forest cover and atmospheric CO2 gas. The optimal strategies for the reduction in CO2 concentration while minimizing the implementation cost of plantation programs are also investigated by proposing the optimal control problem.

Recommendations for Resource Managers

The enhanced concentration of is primarily responsible for anthropogenic global warming. Declination in global forest cover is contributing to the increase in the concentration.

Plantation of trees is an avenue to combat global warming by reducing the atmospheric level. However, plantation activities are constrained by land availability and other constraints. In this scenario, the use of genetically modified trees may aid in achieving mitigation targets.

Forest plantation using genetically modified trees brings more reduction in concentration in comparison to when planted trees are not genetically modified.

The forest management policies should focus on the development and plantation of genetically modified trees having more sequestration capacity, so that the carbon stock per unit forest area can be increased. Such policies are also found to be helpful in attaining the target reduction in concentration under economic constraints.
Land use optimization through bridging multiobjective optimization and multicriteria decision‐making models (case study: Tilabad Watershed, Golestan Province, Iran)
Authors: Sheikh Vahedberdi , Salmani Hossein , Salman Mahiny Abdolrassoul , Ownegh Majid , Fathabadi Abolhasan
Published: February 2021

This study aims to present an efficient methodology for land use optimization based on minimization of runoff and sediment and maximization of economic benefits, occupational opportunities, and land use suitability in the Tilabad watershed in northeast of Iran. The land use map of the area was prepared using the Landsat satellite images and field surveys. The amounts of runoff and sediment were estimated via SWAT model. The TOPSIS multicriteria decision‐making (MCDM) approach was applied on the results of the multiobjective optimization (MOO) based on non‐dominated sorting genetic algorithm II (NSGA II) to choose the final optimal solution among the Pareto solutions front generated by MOO. The results indicated that the area of agriculture and rangelands should decrease, and the area of forests should increase to achieve the defined objectives. Overall, results indicated that integration of MOO and MCDM provides an efficient procedure for land use optimization in a complex watershed.

Recommendations for Resource Managers

The optimization of land use allocation across a complex watershed requires the combined application of several models and techniques to achieve a sustainable decision‐making process.

By optimization of land use patterns according to the final solution, the surface runoff and sediment load of the watershed will decline, while the economic profit and land use suitability will improve.

Despite using a maximization objective function, the land‐based job opportunities might decrease across a watershed by optimization of land use allocation, but this can be considered as an opportunity for provision of manpower to other socioeconomic sectors.
Enhancing cardiac arrest survival with extracorporeal cardiopulmonary resuscitation: insights into the process of death
Authors: Aufderheide Tom P. , Kalra Rajat , Kosmopoulos Marinos , Bartos Jason A. , Yannopoulos Demetris
Published: February 2021

Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging method of cardiopulmonary resuscitation to improve outcomes from cardiac arrest. This approach targets patients with out‐of‐hospital cardiac arrest previously unresponsive and refractory to standard treatment, combining approximately 1 h of standard CPR followed by venoarterial extracorporeal membrane oxygenation (VA‐ECMO) and coronary artery revascularization. Despite its relatively new emergence for the treatment of cardiac arrest, the approach is grounded in a vast body of preclinical and clinical data that demonstrate significantly improved survival and neurological outcomes despite unprecedented, prolonged periods of CPR. In this review, we detail the principles behind VA‐ECMO–facilitated resuscitation, contemporary clinical approaches with outcomes, and address the emerging new understanding of the process of death and capability for neurological recovery.
Factors influencing the prescribing behaviour of independent prescriber optometrists: a qualitative study using the Theoretical Domains Framework
Authors: Spillane Daniel , Courtenay Molly , Chater Angel , Family Hannah , Whitaker Angela , Acton Jennifer H
Published: February 2021

Purpose

Whilst the number of independent prescriber (IP) optometrists in the United Kingdom is increasing, there is limited evidence describing the experiences of these individuals. The Theoretical Domains Framework (TDF) provides an evidence‐based approach to understand determinants of behaviour. This conceptual framework can enable mapping to the COM‐B behaviour change model and the wider Behaviour Change Wheel to develop interventions to optimise behaviour‐change and healthcare processes more systematically. The study aimed to use the TDF to identify the factors that influence independent prescribing behaviour, and to map these findings to the COM‐B system to elucidate the relevant intervention functions, in order to identify the support required by optometrist prescribers.

Methods

Using a qualitative design, semi‐structured interviews based on the TDF were undertaken with independent prescriber optometrists. Thematic analysis was used to identify themes inductively, which were then deductively mapped to the TDF and linked to the COM‐B.

Results

Sixteen participants (9 male, 7 female; median age 45 years, range 28–65 years), based in community (n = 10) and hospital (n = 6) settings, were interviewed. Eleven of the TDF domains were found to influence prescribing behaviour. Findings highlighted the need for good communication with patients (TDF domain: Skills, COM‐B: Capability); confidence (TDF domain: Beliefs about capabilities, COM‐B: Motivation); good networks and relationships with other healthcare professionals, e.g., general practitioners (TDF domain: Social influences, COM‐B: Opportunity; TDF domain: Social/professional role and identity, COM‐B: Motivation); the need for appropriate structure for remuneration (TDF domain: Reinforcement, COM‐B: Motivation; TDF domain: Social/professional role and identity, COM‐B: Motivation) and the provision of professional guidelines (TDF domain: Knowledge, COM‐B: Capability; TDF domain: Environmental context and resources, COM‐B Opportunity).

Conclusions

Having identified theory‐derived influencers on prescribing decisions by optometrists, the findings can be used to develop a structured intervention, such as a support package to help optimise prescribing by optometrists, with the ultimate goal of eye care quality improvement.
Harnessing Shared Identities to Mobilize Resilient Responses to the COVID‐19 Pandemic
Authors: Vignoles Vivian L. , Jaser Zahira , Taylor Frankiebo , Ntontis Evangelos
Published: February 2021

Shared social identifications (family, community, nation, humanity) predict normative actions and psychological well‐being and can be invoked discursively by leaders to mobilize their followers. We illustrate the potential for harnessing shared identities to mobilize resilient public responses against COVID‐19. Study 1 explored which patterns of social identification predicted protective behaviors (personal hygiene, physical distancing), prosocial actions (helping proximal and distal others), and psychological well‐being (mental well‐being, depressive symptoms, anxiety) among 560 U.K. adults surveyed during lockdown. Study 2 contrasted Prime Minister Ardern's use of identity‐based rhetoric to mobilize New Zealanders, with Prime Minister Johnson's use of individualistic appeals to the U.K. public. Our findings suggest how political leaders might beneficially use social identities in communications about extreme events.

Highlights

Political leaders seeking to mobilize cooperative, resilient public responses to the COVID‐19 pandemic should portray themselves and their followers as sharing multiple group identities.

They should attribute collective agency and norms of solidarity to these groups.

They should portray desired public behaviors as morally necessary acts of mutual helping, stemming from the “character” of the invoked group identities.

They should show they have a personal stake in the political choices they make, as members of the groups affected.
Comparative physiological and metabolic analyzes of two Italian ryegrass (Lolium multiflorum) cultivars with contrasting salinity tolerance
Authors: Feng Qijia , Song Shurui , Yang Yong , Amee Maurice , Chen Liang , Xie Yan
Published: February 2021

Italian ryegrass (Lolium multiflorum) is a widely cultivated forage with high nutritional value and good palatability. Salinity, however, is a negative factor to lessen output and quality in Italian ryegrass. The aim of this study was to elucidate the salt tolerance mechanism of two Italian ryegrass cultivars, ‘Abundant’ and ‘Angus’. Under hydroponic conditions, two cultivars of Italian ryegrass with different salt tolerance were exposed to 0 and 300 mM NaCl solution for 1 week, respectively. The results showed that salt stress decreased relative growth rate and relative water content, especially in salt‐sensitive ‘Angus’. The salt‐tolerant ‘Abundant’ cultivar alleviated reactive oxygen species (ROS) induced burst and cell damage. However, ‘Angus’ exhibited a greater activity of superoxide dismutase (SOD) and peroxidase (POD) than ‘Abundant’. Additionally, ‘Abundant’ exhibited higher photosynthetic efficiency than ‘Angus’ under salt stress condition. Salt treatment significantly increased the Na/K, Na/Mg, and Na/Ca ratios in the leaves and roots of both cultivars, with a pronounced effect in salt‐sensitive ‘Angus’. The metabolite analysis of leaf polar extracts revealed 41 salt responsive metabolites in both cultivars, mainly consisting of amino acids, organic acids, fatty acids, and sugars. Following exposure to salt conditions, salt‐sensitive ‘Angus’ had a higher level of metabolites and more uniquely upregulated metabolites were detected. Based on these findings, we conclude that the ‘Abundant’ cultivar emerged as a favorite in saline‐alkali soil, while the ‘Angus’ cultivar is suitable for planting in normal soil. It appears that the high salt tolerance of ‘Abundant’ is partly to prevent the plant from ionic homeostasis disruption.
Organic aquaponics in the European Union: towards sustainable farming practices in the framework of the new EU regulation
Authors: Fruscella Lorenzo , Kotzen Benz , Milliken Sarah
Published: February 2021

Under the new Commission Regulation (EU) 2018/848 which will enter into law in January 2022, aquaponic produce cannot be certified as organic in the European Union. Given the multiple components of an aquaponic system, which involve growing plants in hydroponic conditions, recycling of fish waste and raising fish in artificial conditions, the achievement of organic certification for aquaponic produce is a complex matter dictated by many parameters. Although in theory and in practice aquaponics fulfils nearly all organic farming principles, rules such as the need for crops to be cultivated in soil and the ban on using recirculating aquaculture systems currently prevent aquaponic produce from achieving organic certification. This review examines these rules in the new regulation on horticulture and aquaculture. The rules are evaluated, their foundations discussed, and suggestions are made on the type of system modifications that could potentially make it possible for aquaponic produce to be certified as organic. Suggested modifications include the use of soil in the hydroponic section and the implementation of environmental enrichment for improving the fish welfare in the aquaculture section. Several EU policies and strategies that support the development of aquaponics are also discussed, and potential policies for the development of organic aquaponics are formulated.
Are serum biomarkers useful in the management of systemic sclerosis‐associated interstitial lung disease?
Authors: Proudman Susanna M. , Corte Tamera J.
Published: February 2021

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When life gives you no choice: Context of decision‐making when offered an oncology clinical trial
Authors: Gregersen Trine A. , Birkelund Regner , Wolderslund Maiken , Steffensen Karina Dahl , Ammentorp Jette
Published: February 2021

Background

Patients with advanced cancer are faced with a wide variety of challenges and difficult treatment decisions made while in a vulnerable life‐threatening situation, including decisions about clinical trial participation. Internationally, there is a great focus on shared decision‐making as a way to help patients and healthcare professionals to make informed decisions together; nevertheless, research focusing on patient experiences shows that information about clinical trials is insufficient in supporting patients to make trial decisions in the context of their course of disease and managing life with advanced cancer.

Aim

To explore where and how decisions about participation in oncology clinical trials are made and the role of the patients and healthcare professionals.

Methods

Participant observation was used as a qualitative research method to gain knowledge about decision‐making in different clinical situations. Data were analysed using thematic analysis.

Results

Four themes were developed: (a) preformed decisions, (b) dissimilar perceptions of successful treatment, (c) cues and concerns stated by patients and (d) creating common ground.

Conclusion

There are underexposed aspects to be aware of in the decision‐making process for clinical trial participation. Preformed decisions made by the physicians before the encounter with patients seemed to narrow down the patients’ options and could have benefited from including the patients’ views. Cues and concerns stated by patients were often neglected. However, when physicians talked with the patients about truly difficult issues such as treatment expectations, hope and death, it led to another kind of conversation about treatment decisions involving the patients’ preferences.

Implications for practice

Awareness of preformed decisions and an increased focus on picking up cues and concerns about existential issues in the clinical encounter may improve the quality of the decisions and increase shared decision‐making.
Splenic abscess diagnosed following relapsing sterile peritonitis in a peritoneal dialysis patient: A case report with literature review
Authors: Masaki Chiaki , Matsushita Kenta , Inoue Tomoko , Shima Hisato , Chikakiyo Motoya , Yamada Mayumi , Shirono Ryozo , Tashiro Manabu , Tada Hiroaki , Takamatsu Norimichi , Wariishi Seiichiro , Okada Kazuyoshi , Minakuchi Jun
Published: February 2021

Peritoneal dialysis (PD)‐related peritonitis is sometimes complicated with other infections; however, few cases of splenic abscess have been reported. We present the case of a 64‐year‐old PD patient with complicated splenic abscesses diagnosed following relapsing sterile peritonitis. After PD induction, he presented with turbid peritoneal fluid and was diagnosed with PD‐related peritonitis. A plain abdominal computed tomography (CT) did not reveal any intra‐abdominal focus of infection. After empiric intravenous antibiotics, the peritoneal dialysate was initially cleared, with a decrease in dialysate white blood cells (WBC) to 20/µL. However, WBC and C‐reactive protein (CRP) levels remained elevated. A contrast‐enhanced abdominal CT showed two areas of low‐density fluid with no enhancement in a mildly enlarged spleen, making it difficult to distinguish abscesses from cysts. Due to relapsing sterile peritonitis, we performed an abdominal ultrasonography, and suspected splenic abscesses due to rapid increase in size. Repeated imaging tests were useful in establishing a diagnosis of splenic abscesses. Considering the persistent elevation of WBC and CRP levels, imaging findings, and episodes of relapsing peritonitis, we comprehensively formed the diagnosis, and performed a splenectomy as a rescue therapy. We should consider the possibility of other infectious foci with persistent inflammation after resolving PD‐related peritonitis.
Complications and challenges of home hemodialysis: A historical review
Authors: Gupta Ankur , Zimmerman Deborah
Published: February 2021

Home hemodialysis (HHD) has evolved as a preferred and safe kidney replacement modality over the past six decades. Despite advances in technological aspects of HHD, potential complications still pose a challenge to health care givers, patients, and their families. In this narrative review, we describe vascular access and cannulation, anticoagulation, nutritional, residual kidney function, psychosocial, technique failure, and machine/procedural‐related complications. Addressing these problems is essential for favorable patient outcomes.
Primary conjunctival sporotrichosis in three cats from Northeastern Brazil
Authors: Spinelli Taciana P. , Bezerra Leticia M. , de Souza Bruno O.F. , Rocha Angelica , Neto Joaquim E. , Sá Fabrício B.
Published: February 2021

Introduction

Classically, sporotrichosis occurs as a chronic granulomatous lymphocutaneous infection. The extracutaneous form is uncommon and may affect the eye without cutaneous involvement. The most frequent form of ocular sporotrichosis reported in humans is a granulomatous conjunctivitis. There are no previous reports on primary ocular sporotrichosis in cats.

Procedures

Three mixed breed cats rescued from shelters were referred by the veterinarian for ophthalmic evaluation with a complaint of conjunctivitis nonresponsive to treatment with no evidence of skin disease or systemic disease. Complete ophthalmic examination, conjunctival cytology, and microbiological analysis were performed.

Results

Ophthalmic examinations revealed epiphora, purulent ocular discharge, conjunctival hyperemia, and a mass in the palpebral conjunctiva. Conjunctival cytology revealed segmented and degenerated neutrophils, conjunctival epithelial cells, and an abundant number of round and oval cells compatible with Sporothrix spp. Microbiological culture was performed and confirmed the presence of fungi from the Sporothrix schenckii complex. All animals were treated with oral itraconazole; two animals received topical itraconazole in association with oral treatment. Case 1 was refractory to treatment, and iodate potassium was combined with itraconazole therapy without resolution at the time of this publication. Cases 2 and 3 had complete resolution of conjunctival lesions with four months of oral and topical itraconazole therapy.

Conclusion

Conjunctival sporotrichosis should be considered as a differential diagnosis of conjunctivitis in cats from endemic regions. Conjunctival cytology is an important tool that can aid early diagnosis.
Virtual ACM UMAP 2020
Authors: Burke Robin , Gena Cristina , Kuflik Tsvi , Torre Ilaria
Published: February 2021

This year, the 28th (and the first virtual) ACM International Conference on User Modeling, Adaptation, and Personalization (UMAP 2020, virtually in Genoa, Italy, July 12-18, 2020) was held virtually due to Covid-19 pandemic. UMAP is the premier international conference for researchers and practitioners working on systems that adapt to individual users or to groups of users. The conference spans a wide scope of topics related to user modeling, adaptation, and personalization.
Interview with Beat Signer
Authors: Atzenbeck Claus
Published: February 2021

Beat Signer is Professor of Computer Science at the Vrije Universiteit Brussel (VUB) and co-director of the Web & Information Systems Engineering (WISE) research lab. He received a PhD in Computer Science from ETH Zurich where he has also been leading the Interactive Paper lab as a senior researcher for four years. He is an internationally distinguished expert in cross-media technologies and interactive paper solutions. His further research interests include human-information interaction, document engineering, data physicalisation, mixed reality as well as multimodal interaction. He has published more than 100 papers on these topics at international conferences and journals, and received multiple best paper awards.

Beat has 20 years of experience in research on cross-media information management and multimodal user interfaces. As part of his PhD research, he investigated the use of paper as an interactive user interface and developed the resource-selector-link (RSL) hypermedia metamodel. With the interactive paper platform (iPaper), he strongly contributed to the interdisciplinary European Paper++ and PaperWorks research projects and the seminal research on paper-digital user interfaces led to innovative cross-media publishing solutions and novel forms of paper-based human-computer interaction. The RSL hypermedia metamodel is nowadays widely applied in his research lab and has, for example, been used for cross-media personal information management, an extensible cross-document link service, the MindXpres presentation platform as well as in a framework for cross-device and Internet of Things applications. For more details, please visit https://beatsigner.com.