bluuebunny/crossref_metadata_2025 huggingface dataset:
Abatacept suppresses the telomerase activity of lymphocytes in patients with rheumatoid arthritis
Authors: Otani Kazuhiro , Kurosaka Daitaro
Published: April 2019

Aim

Telomere is a component of chromosomes that protects their ends from various stresses. The telomeres shorten during cell division, and their length is maintained by telomerase. The telomerase activity of lymphocytes was shown to be upregulated on lymphocyte activation, and abatacept was found to suppress the activation of T lymphocytes involved in pathogenesis of rheumatoid arthritis. Therefore, we investigated the effect of abatacept on lymphocyte telomerase activity in patients with rheumatoid arthritis.

Method

This study included 11 patients diagnosed with rheumatoid arthritis based on American College of Rheumatology 2010 criteria, who received abatacept treatment from August 2012 to August 2013. We collected their clinical data and obtained peripheral blood samples before starting abatacept, and 1, 3, 6, and 12 months after treatment. Peripheral blood mononuclear cells were extracted using Ficoll density gradient centrifugation, and T and B lymphocytes were sorted by magnetic beads. The telomerase activity of lymphocytes was determined using the telomeric repeat amplification protocol.

Results

The telomerase activity of T lymphocytes declined from 0.357 to 0.161 (P < 0.01) at 12 months after abatacept treatment, and that of B lymphocytes declined from 0.554 to 0.202 (P < 0.01). The telomerase activity of B lymphocytes, but not that of T lymphocytes, was also significantly downregulated 1 month after treatment.

Conclusion

Abatacept suppressed the telomerase activity of both T and B lymphocytes, although that of B lymphocytes was downregulated before T lymphocytes. These findings imply that the clinical efficacy of abatacept during the early phase depends on the suppression of B lymphocytes.
Factors associated with patient‐physician discordance in a prospective cohort of patients with psoriatic arthritis: An Asian perspective
Authors: Wang Charmaine Tze May , Kwan Yu Heng , Fong Warren , Xiong Shu Qin , Leung Ying Ying
Published: April 2019

Objectives

To evaluate factors associated with patient‐physician discordance in a multiethnic Asian cohort of psoriatic arthritis (PsA) patients.

Methods

We used data from a prospective cohort of consecutive patients with PsA fulfilling the Classification Criteria for Psoriatic Arthritis, recruited from a single center in Singapore. Sociodemographic, clinical data and patient‐reported outcomes were collected using a standardized protocol at baseline, 4 months, 8 months, 1 year, 2 years and 5 years. patient‐physician discordance was defined as patient global assessment minus physician global assessment (PGA‐PhGA). We evaluated variables associated with patient‐physician discordance using generalized linear regression to control for within‐subject effect.

Results

One hundred and fortytwo patients (51.4% male, 66.2% Chinese, mean [SD] age and duration of illness 51.1 [13.8] years and 27.5 [98.3] months) were recruited at baseline. Paired results for PGA and PhGA were available for 291 visits with median (interquartile range) follow‐up time of 11.6 (17) months. In univariable analysis, duration of illness, fatigue, pain, tender and swollen joint count, dactylitis count, and health‐related quality of life (Short Form‐36) domains were significantly correlated with patient‐physician discordance. In multivariable analysis, age, fatigue level, pain score were positively associated with patient‐physician discordance, while swollen joint count and mental health were negatively associated with patient physician discordance.

Conclusions

Increased age, higher fatigue levels, higher pain score  and poorer mental health may explain underestimation of disease activity by physicians. Physicians’ overestimation of disease activity may be explained by higher swollen joint counts.
Venovenous extracorporeal membrane oxygenation treatment in a low‐volume and geographically isolated cardiothoracic centre
Authors: Ingvarsdottir Inga L. , Vidarsdottir Halla , Valsson Felix , Simonardottir Liney , Sigurdsson Martin I. , Myrdal Gunnar , Geirsson Arnar , Gudbjartsson Tomas
Published: April 2019

Background

Extracorporeal membrane oxygenation (ECMO) treatment is generally offered in large tertiary cardiothoracic referral centres. Here we present the indications and outcome of venovenous‐ECMO (VV‐ECMO) treatment in a low‐volume, geographically isolated single‐centre in Iceland, a country of 350 000 inhabitants. Our hypothesis was that patient survival in such a centre can be similar to that at high‐volume centres.

Methods

A retrospective study that included all patients treated with VV‐ECMO in Iceland from 1991‐2016 (n = 17). Information on demographics, indications and in‐hospital survival was collected from patient charts and APACHE II and Murray scores were calculated. Information on long‐term survival was collected from a centralized registry.

Results

Seventeen patients were treated with VV‐ECMO (nine males, median age 33 years, range 14‐74), the indication for 16 patients was severe acute respiratory distress syndrome, most often following pneumonia (n = 6), H1N1‐infection (n = 3) or drowning (n = 2). Median APACHE‐II and Murray‐scores were 20 and 3.5, respectively, and median duration of VV‐ECMO treatment was 9 days (range 2‐40 days). In total 11 patients (64,7%) survived the treatment, with 10 patients (58,8%) surviving hospital discharge, all of who were still alive at long‐term follow‐up, with a median follow‐up time of 9 years (August 15th, 2017).

Conclusion

Venovenous‐ECMO service can be provided in a low‐volume and geographically isolated centre, like Iceland, with short‐ and long‐term outcomes comparable to larger centres.
Hyperadrenocorticism of calorie restriction contributes to its anti‐inflammatory action in mice
Authors: Allen Brian D. , Liao Chen‐Yu , Shu Jianhua , Muglia Louis J. , Majzoub Joseph A. , Diaz Vivian , Nelson James F.
Published: April 2019

Calorie restriction (CR), which lengthens lifespan in many species, is associated with moderate hyperadrenocorticism and attenuated inflammation. Given the anti‐inflammatory action of glucocorticoids, we tested the hypothesis that the hyperadrenocorticism of CR contributes to its attenuated inflammatory response. We used a corticotropin‐releasing‐hormone knockout (CRHKO) mouse, which is glucocorticoid insufficient. There were four controls groups: CRHKO mice and wild‐type (WT) littermates fed either ad libitum (AL) or CR (60% of AL food intake), and three experimental groups: (a) AL‐fed CRHKO mice given corticosterone (CORT) in their drinking water titrated to match the integrated 24‐hr plasma CORT levels of AL‐fed WT mice, (b) CR‐fed CRHKO mice given CORT to match the 24‐hr CORT levels of AL‐fed WT mice, and (c) CR‐fed CHRKO mice given CORT to match the 24‐hr CORT levels of CR‐fed WT mice. Inflammation was measured volumetrically as footpad edema induced by carrageenan injection. As previously observed, CR attenuated footpad edema in WT mice. This attenuation was significantly blocked in CORT‐deficient CR‐fed CRHKO mice. Replacement of CORT in CR‐fed CRHKO mice to the elevated levels observed in CR‐fed WT mice, but not to the levels observed in AL‐fed WT mice, restored the anti‐inflammatory effect of CR. These results indicate that the hyperadrenocorticism of CR contributes to the anti‐inflammatory action of CR, which may in turn contribute to its life‐extending actions.
Effect of short‐term fasting on electrocardiographic parameters
Authors: van der Stuijt Willeke , Gal Pim , Kemme Michiel J. B. , Burggraaf Jacobus
Published: April 2019

Introduction

During early drug development trials, electrocardiograms (ECGs) in healthy volunteers who are in a fasting state are evaluated to screen for possible adverse cardiac effects. However, the effect of the duration of fasting on electrocardiographic parameters is largely unknown. We compared the effects of fasting on standard 12‐lead electrocardiographic recordings.

Methods

Electrocardiograms were available for 432 healthy subjects (mean age 28.5 ± 12.5; 88.9% male) who participated in early drug development studies after 4‐ and 10‐hr fasting. All ECGs were automatically analyzed for conduction intervals and wave amplitudes with the Marquette 12SL algorithm and compared among fasting duration. Mixed model analyses were used to identify confounding variables.

Results

After 10 hr of fasting, compared to after 4 hr of fasting, mean P‐wave duration and amplitude were reduced by 1.95 ± 1.48 ms and 2.18 ± 2.75 μV, mean R wave and S wave amplitude were decreased by 25.83 ± 31.16 μV and 55.39 ± 78.72 μV, mean QRS duration was decreased by 1.84 ± 6.61 ms, and mean T‐wave duration and amplitude were decreased by 2.06 ± 0.72 ms and 9.36 ± 17.21 μV (lead II). The mean PR interval was prolonged by 4.26 ± 17.67 ms, the ventricular rate was reduced by 3.64 ± 8.61 min, and QTcF was reduced by 3.87 ± 14.50 ms. These observations persisted after correction for demographics, electrolytes, blood pressure, heart rate variability, and diurnal variation.

Conclusion

The present analysis showed that 10‐hr fasting compared to 4‐hr fasting resulted in changes to the surface ECG, consisting of a reduced wave amplitude and duration and increased isoelectric interval duration.
A study on the school violence experience of children with attention‐deficit hyperactivity disorder in the context of bullying
Authors: Huh Sung‐Young , Kim Sung‐Gon , Lee Jin‐Sung , Jung Woo‐Young , Choi Bum‐Sung , Kim Ji‐Hoon
Published: April 2019

Introduction

School violence causes harmful effects to victims. Harmful effects are likely to persist into adulthood. There are many studies about the relationship between attention‐deficit hyperactivity disorder (ADHD) and school violence. But, there are few comparative studies dividing groups by the context of bullying and by the school grade. Therefore, this study will identify the differences between general students and patients with ADHD under treatment, creating two groups (one with experience of the perpetration of violence and one with victimization).

Methods

This study was conducted by questionnaires that dealt with experiences of being a bully and being bulled at school in the past year as six items each. A 5‐point Likert scale was used. The ADHD group was 49, and the general students group was 245. The data were compared using the chi‐squared test. Statistical analysis was performed using SPSS version 24, with statistical significance at P < 0.05.

Results

The ADHD group was significantly high who reported severely beating other people than the general group. Likewise, ADHD group who reported threatening other people was significantly higher than in the general group. However, for the remaining items, there was no significant difference between the ADHD group and the general student group.

Discussion

Previous studies suggested that ADHD symptoms are major causes of both bullying and being the victim of bullying. However, in this study, ADHD patients have more being the victim of bullying experiences than general students. Further, a well‐designed study will be needed to accurately evaluate the relationship between school violence and ADHD.
New therapies in development for the management of non‐infectious uveitis: A review
Authors: Hassan Muhammad , Karkhur Samendra , Bae Jeong H. , Halim Muhammad S. , Ormaechea Maria S. , Onghanseng Neil , Nguyen Nam V. , Afridi Rubbia , Sepah Yasir J. , Do Diana V. , Nguyen Quan D.
Published: April 2019

Uveitis is a spectrum of inflammatory disorders characterized by ocular inflammation and is one of the leading causes of preventable visual loss. The main aim of the treatment of uveitis is to control the inflammation, prevent recurrences of the disease and preserve vision while minimizing the adverse effects associated with the therapeutic agents. Initial management of uveitis relies heavily on the use of corticosteroids. However, monotherapy with high‐dose corticosteroids is associated with side effects and cannot be maintained long term. Therefore, steroid‐sparing agents are needed to decrease the burden of steroid therapy. Currently, the therapeutic approach for non‐infectious uveitis (NIU) consists of a step‐ladder strategy with the first‐line option being corticosteroids in various formulations followed by the use of first‐, second‐ and third‐line agents in cases with suboptimal steroid response. Unfortunately, the agents currently at our disposal have limitations such as having a narrow therapeutic window along with their own individual potential side‐effect profiles. Therefore, research has been targeted to identify newer drugs as well as new uses for older drugs that target specific pathways in the inflammatory response. Such efforts are made in order to provide targeted and safer therapy with reduced side effects and greater efficacy. Several specially designed molecular antibodies are currently in various phases of investigations that can potentially halt the inflammation in patients with NIU. In the review, we have provided a comprehensive overview of the current and upcoming therapeutic options for patients with NIU.
Noninvasive ventilation and renal replacement therapy in do‐not‐intubate order critically ill patients: A brief report
Authors: Catalanotti Vito , Pisani Lara , Betti Sara , Bensai Serena , Prediletto Irene , Fasano Luca , Nava Stefano
Published: April 2019

Introduction

Multiple organ failure has been considered a contraindication for noninvasive ventilation (NIV).

Materials and methods

We described the outcome of Do‐not‐Intubate (DNI) patients with acute respiratory failure, treated with NIV and, subsequently, necessitating renal replacement therapy (RRT).

Results and discussion

Seven patients admitted to our Respiratory Intensive Care Unit, developed Acute Kidney Injury (AKI) during NIV treatment and received RRT for 12.8 ± 8 days together with NIV. All the patients but one, discontinued renal support because they regained a satisfactory urinary output; nevertheless mortality rate was high (71%).

Conclusion

Our data suggest that RRT could be feasible together with NIV. RRT was associated with an acute improvement in renal function but did not modify the mortality rate.
Determining the optimal fasting glucose target for patients with type 2 diabetes: Results of the multicentre, open‐label, randomized‐controlled FPG GOAL trial
Authors: Yang Wenying , Ma Jianhua , Yuan Guoyue , Li Ling , Zhang Min , Lu Yibing , Ye Xinhua , Song Weihong , Liu Ming , Wu Jun , Chen Riqiu , Li Yunguang , Zhang Xia , Cui Nan , Yang Jinkui
Published: April 2019

The optimal fasting blood glucose (FBG) target of achieving HbA1c less than 7.0% in type 2 diabetes (T2D) patients remains controversial. This open‐label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) who were using one to three oral antidiabetic drugs to achieve an FBG target of 3.9 < FBG ≤5.6 mmol/L (Group 1), 3.9 < FBG ≤6.1 mmol/L (Group 2) or of 3.9 < FBG ≤7.0 mmol/L (Group 3). Targets were achieved using a pre‐defined insulin glargine 100 U/mL titration scheme. The primary endpoint was proportion of patients achieving HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1% and 37.7% of patients achieved HbA1c <7.0% in Groups 1, 2 and 3, respectively (P = 0.017; Group 2 vs Group 3). Alert hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 than in Group 3 (38.9 vs 23.3%; P < 0.001) but was not in Group 2 vs Group 3 (27.5% vs 23.3%; P = 0.177). Clinically important hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3, respectively. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9‐6.1 mmol/L.
Cardiovascular safety of linagliptin compared with other oral glucose‐lowering agents in patients with type 2 diabetes: A sequential monitoring programme in routine care
Authors: Patorno Elisabetta , Gopalakrishnan Chandrasekar , Brodovicz Kimberly G. , Meyers Andrea , Bartels Dorothee B. , Liu Jun , Kulldorff Martin , Schneeweiss Sebastian
Published: April 2019

Aim

To evaluate the safety of linagliptin versus other glucose‐lowering medications in a multi‐year monitoring programme using insurance claims data.

Methods

In two commercial US claims databases, we identified three pairwise 1:1 propensity‐score (PS)‐matched cohorts of patients with type 2 diabetes (T2D) aged ≥18 years initiating linagliptin or a comparator (other dipeptidyl peptidase‐4 [DPP‐4] inhibitors [n = 31 492 pairs], pioglitazone [n = 23 316 pairs], or second‐generation sulphonylureas [n = 19 731 pairs]) between May 2011 and December 2015. The primary endpoint was the risk of a composite cardiovascular (CV) outcome (hospitalization for myocardial infarction, stroke, unstable angina, or coronary revascularization). We estimated pooled hazard ratios (HRs) and 95% confidence intervals (CIs), controlling for >100 baseline characteristics.

Results

Patient characteristics were well balanced after PS‐matching. The mean age was 55 years and mean follow‐up was 0.8 years. Linagliptin conferred a similar risk of the composite CV outcome compared to other DPP‐4 inhibitors (HR 0.91, 95% CI 0.79‐1.05) and pioglitazone (HR 0.98, 95% CI 0.84‐1.15), and showed a reduced risk of CV outcomes compared to second‐generation sulphonylureas (HR 0.76, 95% CI 0.64‐‐0.92). Key findings were signalled at the first interim analysis in June 2013 and solidified during ongoing monitoring until 2015.

Conclusion

Analyses from a large monitoring programme in routine care of patients with T2D, showed that linagliptin had similar CV safety compared to other DPP‐4 inhibitors and pioglitazone, and a reduced CV risk compared to sulphonylureas.
Critical Literacy and Transformative Social Practice: An Ethical Grounding
Authors: Hearfield Colin , Boughton Bob
Published: April 2019

Colin Hearfield and Bob Boughton contend that, over roughly the past seventy‐five years, a number of writers have attempted to underwrite the relationship between critical literacy and transformative social practice with an ethics of freedom and social justice. The first two such writers they address, Frantz Fanon and Paulo Freire, draw on a humanist ethics of social freedom, whereas the latter two, Amartya Sen and Jack Mezirow, turn respectively to Immanuel Kant's moral theory of individual freedom and Jürgen Habermas's ethics of communicative interaction. Hearfield and Boughton begin by discussing various shortcomings of the approach each of these writers takes, and then argue that a more adequate grounding can be found in Axel Honneth's ethics of recognition, where the idea of social freedom again comes to prominence. Unlike the others, Honneth, a contemporary German philosopher and former research assistant of Habermas, does not address explicitly the issue of critical literacy, but he does speak of the right to education as an already significant aspect of the modern ethics of recognition. The driving motivation for Hearfield and Boughton's discussion in this article is the situation of many Indigenous Australians who remain unable to read or write Standard Australian English (SAE) and thus cannot participate, or have an effective voice, in deliberations concerning their own and their people's situation in the political landscape of modern Australia.
Sor Juana Inés de la Cruz and the Demands of Education
Authors: Hansen David T.
Published: April 2019

Sor Juana Inés de la Cruz (1648–1695) is a legend in her native Mexico and elsewhere in Latin America. She is esteemed for the artistic and intellectual quality of her wide‐ranging poetry, plays, and prose writings. She is renowned for her defense of the right of women to study, to publish their scholarship, and to teach, all controversial claims in her era of Catholic patriarchy. In recent decades, Sor Juana's work has finally become known to English‐speaking audiences. To date, however, no thorough analysis of her conception of education has been published in any field of educational research. In this essay, David Hansen addresses that oversight by examining several of her key works in order to illuminate her philosophy of education. For Sor Juana, education is an endlessly demanding ethical undertaking, in the sense of making serious claims on the person's commitments and sense of direction. At the same time, education positions the person to articulate serious, public demands for justice in society.
Dispelling the Burden of Agency: Receptive Learning During Political Crisis
Authors: Wahl Rachel
Published: April 2019

In response to a fractured and vitriolic public culture, many civic educators hope to cultivate students' ability to learn from people who are different from themselves. In this article Rachel Wahl illuminates how college students' conceptions of moral order shape their willingness to learn during deliberative dialogue from people whose political views they reject. While openness to difference is common to liberal conceptions of a good society, this inquiry suggests that the secular liberal emphasis on political change driven by individuals can, for principled reasons, constrain students' receptivity to their political opponents. Conversely, the evangelical belief that God is the source of transformation can, in surprising ways, form the basis for an ethics of receptivity. Drawing on Charles Taylor's conception of the primacy of moral identity and his assertion that ideals can be best understood through the study of how people enact them, Wahl argues here that some aspects of the secular liberal imaginary can hinder noninstrumental engagement, but that such engagement may be precisely what is needed to bridge the deepest divides.
Comparative and Individual Perspectives on Mother–Infant Interactions with People and Objects among South Koreans, Korean Americans, and European Americans
Authors: Bornstein Marc H. , Cote Linda R. , Kwak Keumjoo
Published: April 2019

Comparative and individual acculturation of mother and infant person‐directed and object‐directed behaviors and interactions were investigated among 183 South Korean, Korean American, and European American mothers and their 5½‐month‐old infants. We analyzed and compared mean levels in mothers’ and infants’ person‐ and object‐directed behaviors and partner responsiveness and initiation of these behaviors in dyads in the three cultural groups. Among Korean American dyads, we also analyzed individual‐level variation in the acculturation of these behaviors and interactions. This study reveals how contrasting South Korean and European American cultural values are embedded and manifested in early mother–infant interactions and how cultural values from South Korean origin and European American destination cultures are interwoven in Korean American mother–infant interactions.
Regulatory Dualism as an Alternative Trust‐Enhancing Mechanism for Dividends and Debt: Evidence from Brazil*
Authors: Lozano María Belén , López‐Iturriaga Félix J. , Braz‐Bezerra Victor Hugo
Published: April 2019

We test whether a market‐level corporate governance reform in Brazil influences the behavior of firms. To do so, we first verify whether the Novo Mercado (NM)—the segment applying more stringent corporate governance practices—impacts specific firms’ financial characteristics. We also investigate if it impacts firms’ dividends and leverage, two well‐known mechanisms for mitigating agency problems. Results show the NM impacts many firms’ characteristics and reduces firms’ dividends and leverage. We thus claim that market‐level reform may be an effective trust‐enhancing mechanism and may improve minority investor protection, thus providing evidence that a country's institutional setting can evolve over time.
New insights into the habitat use and husbandry of crocodile lizards (Reptilia: Shinisauridae) including the conception of new facilities for Vietnamese crocodile lizards Shinisaurus crocodilurus vietnamensis in Vietnam and Germany
Authors: Ziegler T. , Van Schingen M. , Rauhaus A. , Dang P. H. , Pham D. T. K. , Pham C. T. , Nguyen T. Q.
Published: April 2019

The Crocodile lizard Shinisaurus crocodilurus is a popular reptile species in the pet trade and has been regularly kept in terrariums by hobbyists since the 1980s. Recent integrative taxonomic research revealed the Chinese representatives to be morphologically, genetically and ecologically distinct from Vietnamese populations, which occur in alarmingly low population sizes. All extant populations are threatened by habitat destruction and poaching for the pet trade. Thus, it will be crucial to manage the Vietnamese and Chinese subspecies separately as different conservation units, both to maintain their genetic integrity and to adjust appropriate husbandry conditions in the frame of ex situ conservation programmes. For this reason, we provide a topical review of microhabitat use of the newly described subspecies from Vietnam – the Vietnamese crocodile lizard Shinisaurus crocodilurus vietnamensis – based on recent field work as well as husbandry experiences at the Me Linh Station for Biodiversity in North Vietnam. We further compare our new findings with the data available for the nominate subspecies from China. Based on our current knowledge, we update existing minimum husbandry requirements in Germany and elaborate different husbandry parameters for both subspecies. Furthermore, we introduce new husbandry protocols and facility designs for the Vietnamese subspecies both at Me Linh Station for Biodiversity and at Cologne Zoo, Germany.
Understanding the integration of family caregivers in delirium prevention care for hospitalized older adults: A case study protocol
Authors: Cohen Christine , Pereira Filipa , Kampel Thomas , Bélanger Louise
Published: April 2019

Aim

To understand family caregiver involvement in delirium prevention care for older adults hospitalized for orthopaedic surgery hospitals and family caregiver integration by nurses.

Design

Multiple‐case study.

Methods

The model of Care Partner Engagement was selected as theoretical framework. Eight cases will comprise an older adult hospitalized a family caregiver and a ward nurse. They will be recruited with a non‐probability sampling on two orthopaedic surgery wards in two hospitals. Semi‐structured interviews with participants will be audiotaped. Sociodemographic data will be collected. These data, researcher field notes and interview transcripts will be subjected to within‐ and across‐case thematic analysis. Regional ethics committee approved the study protocol in August 2018.

Discussion

The study will allow surgical nursing teams to gain a better understanding of the issues and possibilities regarding family caregiver integration in delirium prevention care for older adults.
Translation and validation of the Clinical Trial Nursing Questionnaire in Swedish—A first step to clarify the clinical research nurse role in Sweden
Authors: Backman Lönn Beatrice , Olofsson Niclas , Jong Mats
Published: April 2019

Aim and objectives

To translate the Clinical Trial Nursing Questionnaire (CTNQ) into Swedish and test it for face and content validity as well as internal consistency and reproducibility using test–retest procedures.

Introduction/Background

In many countries, as in Sweden, a registered nurse can be involved in research by becoming a clinical research nurse. The clinical research nurse plays a pivotal role in clinical studies as a part of the research team. Scales have been developed and used with the objective to clarify the role of clinical research nurses: one of them is the CTNQ.

Methods

A quantitative cross‐sectional design with a test–retest procedure was applied to validate the translated questionnaire. By using a snowball sampling method, relevant participants were identified and 49 registered nurses working in the field of research as clinical research nurses answered the questionnaire on two occasions. An expert panel of three clinical research nurses evaluated the questionnaire for face and content validity. The STROBE checklist for observational research has been followed for presenting the research (see File S1).

Results

Face and content validity was agreed upon in the expert panel group. Tests for internal consistency of the CTNQ was calculated and showed a high Cronbach's alpha for both the frequency and importance subscales. The test–retest correlation analysis (reproducibility) also revealed a high correlation coefficient for both subscales.

Conclusion

The CTNQ‐SWE is a valid and robust instrument in a Swedish version. The instrument can be of importance in assessing the role of clinical research nurses in Sweden in future studies.

Relevance to clinical practice

Use of the CTNQ‐SWE in future research can be of value for clarification and professional development of the clinical research nurse role in Sweden. The further use of the CTNQ in Sweden can be of value in understanding the process where licensed nurses make a transition into becoming a clinical research nurse, and to identify needs for customised education.
Family needs during critical illness in the Emergency Department: A retrospective factor analysis of data from three countries
Authors: Redley Bernice , Phiri Lesego M. , Heyns Tanya , Wang Wei , Han Chin‐Yen
Published: April 2019

Aims and objectives

To examine underlying factor structure of the Critical Care Family Needs Inventory—Emergency Department across three countries to identify similarities and differences.

Background

Understanding family needs assists nurses to provide family‐centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments.

Design

Retrospective secondary analyses of data collected in three cross‐sectional surveys.

Methods

Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item‐matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist.

Results

The factor structure of the 40‐item Critical Care Family Needs Inventory—Emergency Department differed between countries. Analyses of the Australian data revealed a four‐factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four‐factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two‐factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1).

Conclusions

The findings suggest family members from different countries responded to Critical Care Family Needs Inventory—Emergency Department items in different ways. Consistent with concepts of family‐centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED.

Relevance to clinical practice

Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory—Emergency Department has limited utility. Participation and communication needs emerged as common family needs.
Symptom description in patients with chest pain—A qualitative analysis of emergency medical calls involving high‐risk conditions
Authors: Wibring Kristoffer , Herlitz Johan , Lingman Markus , Bång Angela
Published: April 2019

Aims and objectives

To explore the symptoms descriptions and situational information provided by patients during ongoing chest pain events caused by a high‐risk condition.

Background

Chest pain is a common symptom in patients contacting emergency dispatch centres. Only 15% of these patients are later classified as suffering from a high‐risk condition. Prehospital personnel are largely dependent on symptom characteristics when trying to identify these patients.

Design

Qualitative descriptive.

Methods

Manifest content analysis of 56 emergency medical calls involving patients with chest pain was carried out. A stratified purposive sampling was used to obtain calls concerning patients with high‐risk conditions. These calls were then listened to and transcribed. Thereafter, meaning units were identified and coded and finally categorised. Consolidated criteria for reporting qualitative studies guidelines have been applied.

Results

A wide range of situational information and symptoms descriptions was found. Pain and affected breathing were dominating aspects, but other situational information and several other symptoms were also reported. The situational information and these symptoms were classified into seven categories: Pain narrative, Affected breathing, Bodily reactions, Time, Bodily whereabouts, Fear and concern and Situation management. The seven categories consisted of 17 subcategories.

Conclusions

Patients with chest pain caused by a high‐risk condition present a wide range of symptoms which are described in a variety of ways. They describe different kinds of chest pain accompanied by pain from other parts of the body. Breathing difficulties and bodily reactions such as muscle weakness are also reported. The variety of symptoms and the absence of a typical symptomatology make risk stratification on the basis of symptoms alone difficult.

Relevance to clinical practice

This study highlights the importance of an open mind when assessing patients with chest pain and the requirement of a decision support tool in order to improve risk stratification in these patients.
Dissent, Legitimacy, and Public Support for Court Decisions: Evidence from a Survey-Based Experiment
Authors: Bentsen Henrik Litleré
Published: April 2019

Scholars often argue that whereas unanimous rulings should boost public support for court decisions, dissents should fuel public opposition. Previous studies on public responses to U.S. Supreme Court decisions suggest that unanimity does in fact bolster support. However, a recent study has also found that dissents may increase support among opponents of a court decision by suggesting evidence of procedural justice. By examining how individuals react to dissents from the Supreme Court of Norway, this article is the first study outside the U.S. context of the public's reaction to unanimity and dissent. Breaking with the common notion of the negative effects of dissent on public support, the article shows that when the Supreme Court handles cases of higher political salience, the formulation of dissenting opinions can be a meaningful way of securing greater support for its policy outputs by suggesting evidence of procedural justice. Contrary to recent studies, however, this positive influence of dissent is irrespective of individuals' ex ante policy views.
High frequency of H3K27M immunopositivity in adult thalamic glioblastoma
Authors: Rao Shilpa , Kanuri Nandaki N. , Nimbalkar Vidya , Arivazhagan Arimappamagan , Santosh Vani
Published: April 2019

Adult thalamic glioblastomas (GBM) are uncommon tumors with limited available molecular data. One of the reported molecular alterations in these tumors is the H3K27M mutation. It has been documented that H3K27M mutation is found in a high proportion of pediatric thalamic gliomas. In this study, we have analyzed the molecular alterations exclusive to adult thalamic GBM. This is a 6 years retrospective study of adult thalamic GBM patients who underwent surgical decompression of the tumor. Clinical data were obtained from the case records. Immunohistochemistry (IHC) was performed on the tumors using antibodies directed against the gene products of R132H mutant isocitrate dehydrogenase 1 (IDH1), alpha‐thalassemia/mental retardation X‐linked (ATRX), p53, H3K27M, H3K27me3, and V600E mutant BRAF. Molecular analyses were carried out to detect other IDH1 and IDH2 mutations, O6‐methylguanine‐DNA‐methyltransferase gene (MGMT) promoter methylation, and epidermal growth factor gene (EGFR) and telomerase reverse transcriptase gene (TERT) promoter mutations. A total of 42 cases of adult thalamic GBM were studied. The mean age of presentation was 42 years with age range of 19–58 years. Male predominance was noted. All the tumors were IDH wild‐type, BRAF (V600E)‐immunonegative and unmethylated for MGMT promoter. H3K27M immunopositivity was noted in 60% of tumors. Of these 33.3% were from older adults above the age of 50 years. Of the H3K27M‐immunopositive cases, ATRX loss of expression was seen in 32%, p53 immunopositivity in 24% and EGFR amplification in 12%. Higher frequency of TERT promoter mutations was noted in H3K27M‐immunonegative cases (58.8%) compared to immunopositive cases (20%). Ours is one of the few studies elucidating the molecular alterations exclusive to adult thalamic GBM. We show a high frequency of H3K27M immunopositivity, suggestive of its mutational status in these tumors, including in older adults.
Moving beyond noninformative priors: why and how to choose weakly informative priors in Bayesian analyses
Authors: Lemoine Nathan P.
Published: April 2019

Throughout the last two decades, Bayesian statistical methods have proliferated throughout ecology and evolution. Numerous previous references established both philosophical and computational guidelines for implementing Bayesian methods. However, protocols for incorporating prior information, the defining characteristic of Bayesian philosophy, are nearly nonexistent in the ecological literature. Here, I hope to encourage the use of weakly informative priors in ecology and evolution by providing a ‘consumer's guide’ to weakly informative priors. The first section outlines three reasons why ecologists should abandon noninformative priors: 1) common flat priors are not always noninformative, 2) noninformative priors provide the same result as simpler frequentist methods, and 3) noninformative priors suffer from the same high type I and type M error rates as frequentist methods. The second section provides a guide for implementing informative priors, wherein I detail convenient ‘reference’ prior distributions for common statistical models (i.e. regression, ANOVA, hierarchical models). I then use simulations to visually demonstrate how informative priors influence posterior parameter estimates. With the guidelines provided here, I hope to encourage the use of weakly informative priors for Bayesian analyses in ecology. Ecologists can and should debate the appropriate form of prior information, but should consider weakly informative priors as the new ‘default’ prior for any Bayesian model.
Estimating Braking Performance in Osteoarthritis of the Knee or Hip with a Reaction Timer
Authors: von Bernstorff Maximilian , Rapp Jennifer , Bausenhart Felix , Feierabend Martina , Ipach Ingmar , Hofmann Ulf K
Published: April 2019

Objective

To investigate if testing in a brake simulator can be replaced by a simple reaction timer setup imitating the ergonomic conditions of emergency braking when evaluating the ability to drive in patients with musculoskeletal problems of the lower extremities.

Methods

A cross‐sectional survey was performed in the Department of Orthopaedic Surgery in our University Hospital from October 2014 until May 2015. Patients attending our department with either osteoarthritis or arthroplasty of the knee or hip were asked to participate in the study if they had a valid driving license. The age limit was from 18 to 85 years. Both women and men were included. Registered demographic data were patient age, height, sex, body weight, and body mass index. Braking performance (brake response time [BRT]) was evaluated in a brake simulator that was embedded into a real car cabin (10 measurements). The values obtained were compared with those registered when simply testing (5 measurements) those patients with a normal reaction timer setup that imitated the sitting position in a car. Kendall's tau correlation coefficient was calculated between the values obtained from the brake simulator with those from the reaction timer setup.

Results

Altogether, 137 patients (median age 67 years [range, 24–89 years]) with either osteoarthritis of the knee (n = 55) or hip (n = 82) were tested. Age was comparable in both collectives (P = 0.807). The mean body height was 1.70 m in both groups. Knee patients presented with a higher body weight of approximately 5 kg (P = 0.014) and consequently also had a higher body mass index (P = 0.023). The median BRT in the brake simulator was 628 ms (range, 390–1444 ms) for all subjects: 592 ms (range, 418–1146 ms) in the hip group and 696 ms (range, 390–1444 ms) in the knee group. Measurement values obtained by the reaction timer were significantly (P < 0.001) higher by approximately 15% (SD, 22%) than those measured in the brake simulator. A moderate correlation was found between the reaction timer and the brake simulator, with a Kendall's tau of 0.449 (P < 0.001) for all patients. Interestingly, hip patients showed a higher correlation (τ = 0.471) than knee patients (τ = 0.263).

Conclusion

Even though the measured correlations do not allow us to make a definite statement concerning braking performance, especially in knee patients, a simple reaction timer test can provide a low‐cost first estimate of BRT for patients and their treating physicians. For forensic statements, the brake simulator will, however, remain the gold standard.
Potassium mediates coordination of leaf photosynthesis and hydraulic conductance by modifications of leaf anatomy
Authors: Lu Zhifeng , Xie Kailiu , Pan Yonghui , Ren Tao , Lu Jianwei , Wang Min , Shen Qirong , Guo Shiwei
Published: April 2019

Typical symptoms of potassium deficiency, characterized as chlorosis or withered necrosis, occur concomitantly with downregulated photosynthesis and impaired leaf water transport. However, the prominent limitations and mechanisms underlying the concerted decreases of leaf photosynthesis and hydraulic conductance are poorly understood. Monocots and dicots were investigated based on responses of photosynthesis and hydraulic conductance and their components and the correlated anatomical determinants to potassium deficiency. We found a conserved pattern in which leaf photosynthesis and hydraulic conductance concurrently decreased under potassium starvation. However, monocots and dicots showed two different hydraulic‐redesign strategies: Dicots tended to show a decreased minor vein density, whereas monocots reduced the size of the bundle sheath and its extensions, rather than the minor vein density; both of these strategies may restrain xylem and outside‐xylem hydraulic conductance. Additionally, potassium‐deprived leaves developed with fewer mesophyll cell‐to‐cell connections, leading to a reduced area being available for liquid‐phase flow. Further quantitative analysis revealed that mesophyll conductance to CO2 and outside‐xylem hydraulic resistance were the major contributors to photosynthetic limitation and increased hydraulic resistance, at more than 50% and 60%, respectively. These results emphasize the importance of potassium in the coordinated regulation of leaf photosynthesis and hydraulic conductance through modifications of leaf anatomy.
Nudging the Neoliberal Agenda: Administrative Opportunities in the Deregulated State
Authors: Kasdan David Oliver
Published: April 2019

The current climate of neoliberalism in the executive branch is attended by active deregulation and distrust of the administrative state. As protections are rolled back, there is concern that individuals may be susceptible to information asymmetries that will influence their decision making, leading to detrimental outcomes for both their own and the general welfare. Behavioral public administration—the bureaucratic conception of “nudge” theory—offers ways to counter the pitfalls that come with greater freedom of choice, as promoted by the neoliberal agenda. Public administrators may employ alternative mechanisms, such as choice architecture, to help people make better decisions in the absence of explicitly protective regulations. After laying out the argument for a behavioral approach, this article analyzes several neoliberal agenda issues with potential nudge responses for practical implementation, as well as a justifiable call for action to protect the public welfare in the absence of policy guidance.
Coverage versus generosity: Comparing eligibility and need assessment in six cash‐for‐care programmes
Authors: Ranci Costanzo , Österle August , Arlotti Marco , Parma Andrea
Published: April 2019

This paper investigates the potential trade‐offs between extension of coverage and adequate generosity in cash‐for‐care (CfC) programmes in six European countries (Austria, Germany, France, Great Britain, Italy, and Spain), which are characterised by different configurations of CfC programmes. Building on an empirical analysis of the eligibility rules, of the regulation applied to classify beneficiaries according to their level of dependency, and the ways CfC benefits are distributed among them, it becomes clear that these programmes differ substantially in terms of coverage and generosity. Such differences reflect the variety of ways by which universalism, selectivity, and adequacy are built up together throughout Europe.
Characterization of the novel HLA‐DQB1*03:353 allele by sequencing‐based typing
Authors: Elsermans Vincent , Visentin Jonathan , Top Isabelle , Varlet Pauline , Labalette Myriam
Published: April 2019

HLA‐DQB1*03:353 differs from HLA‐DQB1*03:01:01:01 by one nucleotide substitution in codon 46 in exon 2.
A dynamic analysis of the impacts of export taxes: The case of Argentinean soy and beef markets
Authors: Devadoss Stephen , Luckstead Jeff , Ridley William
Published: April 2019

Argentina plays an important role in the global soy market as one of the world's leading exporters of soy products. In an effort to shift its agricultural sector's focus to value‐added exports and to raise revenue, Argentina's government has maintained a regime of differential export taxes on soy products. In addition to soy products, Argentina is a major producer, consumer and exporter of beef. However, over the last decade it has relinquished much of its world market share as its beef exports have fallen because the government has periodically imposed a ban on exports of beef along with maintaining an export tax. As the soy and livestock sectors are inextricably linked, owing to both industries’ intensive land use and the utilisation of soymeal as a feed supplement for cattle, trade policies in one sector have pronounced cross‐sectoral impacts. This study develops a theoretical model of these different sectors and trade policies, incorporating the dynamic decisions of cattle stock management. The model is calibrated to real‐world data on the Argentinean economy, and the impacts of trade liberalisation are quantified. Key results show modelling the various intersectoral linkages and the dynamic implications of cattle stock is essential for obtaining accurate estimates.
Optimization of alum recovery from water treatment sludge‐case study: Samannoud water treatment plant, Egypt
Authors: Ramadan Hassan , El Sayed Abd El Aziz
Published: April 2019

Alum recovery from water treatment sludge is a promising technique applied for reducing the virgin coagulant demand and the sludge volume and safe disposal of the sludge. The aim of the current study is to optimize alum recovery process from alum sludge in Samannoud water treatment plant, Egypt by acidification technique using sulphuric acid and evaluate the effect of total solids (TS) content in the sludge on alum recovery process. Results showed that the optimal mixing time for alum recovery was 60 min for clariflocculator sludge, whereas 15 min for thickener sludge. Optimum pH value was 1.50 for alum recovery from different sludge types. At optimum conditions, acidification experiments showed that alum recovery percent and sludge volume reduction for clariflocculator sludge were 83 and 91.2%, respectively, versus 35.9 and 45%, respectively, for thickener sludge. Besides, alum recovery and sludge reduction decreased with the increase in TS content in the sludge.