bluuebunny/crossref_metadata_2025 huggingface dataset:
Sibling Adjustment to Childhood Chronic Illness: An Integrative Review
Authors: Lummer-Aikey Shannon , Goldstein Sara
Published: December 2020

Siblings of children with a chronic illness are among the close family members impacted by childhood chronic illness. Family roles, routines, and functioning are adjusted to fit the needs of the child and family throughout the course of the illness. Empirical articles regarding adjustment of healthy siblings of children with chronic illnesses ages 0 to 17 years, published in 2000 to 2019 were searched on PsycInfo, PubMed, and Medline using the keywords “sibling adjustment,” “sibling chronic,” and “sibling illness.” Through thematic synthesis, four broad topics emerged concerning sibling adjustment to chronic illness: (a) experiences, (b) psychosocial adjustment, (c) coping, and (d) communication. Implications for family nursing and family health practitioners and future research directions are presented.
Multimodal Analysis in Qualitative Research: Extending Grounded Theory Through the Lens of Social Semiotics
Authors: Sommer Vivien
Published: December 2020

Digital technology has made it easier for researchers to conduct and produce multimodal data. In terms of a social semiotic understanding, multimodal means that data are produced from different sign resources, such as field protocols combined with visual recordings or document analysis consisting of audiovisual material. The increase in multimodal data brings the challenge of developing analytical tools not only to collect data but also to examine them. In this article, I introduce a research approach for how to integrate multimodal data within the framework of grounded theory by extending the coding process with a social semiotic understanding of data as a combination of different sign modes. This approach makes it possible not only to analyze data based on different modes separately but also to analyze their combination, for example, the interweaving of text and image.
Examined
Authors: Rogalska Elżbieta
Published: December 2020

They learn and prepare. Then they pass the exam. What are the preparations for the Grand Exam?
The Course of ADHD during Pregnancy
Authors: Baker Allison S. , Wales Rebecca , Noe Olivia , Gaccione Peter , Freeman Marlene P. , Cohen Lee S.
Published: December 2020

Objective

The aim of this study was to characterize the course of ADHD during pregnancy.

Method

Women ages 18 to 45 were followed prospectively at <20 weeks, 24 weeks, and 36 weeks pregnant. Three groups emerged: women who discontinued, maintained, or adjusted their ADHD medications. ADHD symptoms were recorded using the AISRS. Anxiety, depression, stress, and functional impairment were monitored.

Results

A total of 25 women with ADHD were eligible for analysis. No significant difference observed between three groups in AISRS scores. Significant differences found between medication discontinuers vs adjusters for both mood and family functioning (EPDS, 5.3, p < .0001; WFIRS, 3.3, p = .0309). Significant differences also found between discontinuers vs maintainers for mood and family functioning (EPDS, 4.98, p = .0009; WFIRS, 3.09, p = .0197).

Conclusion

This preliminary study provides novel insight into the course of ADHD during pregnancy, underscoring mood and family functioning as critical domains that may contribute to growing use of psychostimulants during pregnancy.
Measuring Cumulative Stressfulness: Psychometric Properties of the COVID-19 Stressors Scale
Authors: Tambling Rachel R. , Russell Beth S. , Park Crystal L. , Fendrich Michael , Hutchinson Morica , Horton Abagail L. , Tomkunas Alexandria J.
Published: December 2020

Scales assessing stressor exposure often fail to demonstrate adequate psychometric qualities, demonstrating low interitem reliability or complex factor structures, as would be expected, given that the majority of stressors are independent events. However, in large-scale mass crisis events, the stressors may be highly interrelated, indicating shared experience. Furthermore, few stressor exposure scales also measure appraised stressfulness of those stressors. Development of a psychometrically sound measure of both stressor exposure and appraisal advances the study of highly stressful events such as community-wide crises, especially in providing a useful measure of its cumulative stressfulness. The coronavirus disease 2019 (COVID-19) pandemic is an enduring, worldwide stressor with an indefinite timeline. The COVID-19 Stressor Scale is a 23-item measure of stressor exposure and appraisal related to the pandemic developed within the first weeks of widespread shelter-in-place practices in the Unites States. We present initial psychometric results of the COVID-19 Stressor Scale. Results of a principal components analysis indicate that the measure is unidimensional and has strong internal consistency. Evidence of convergent and discriminant validity were demonstrated. The COVID-19 Stressor Scale is a useful measure for studying the ongoing stressors associated with the pandemic and presents a model for measuring other massive, ongoing crises.
Gender asymmetries in Portuguese trade unions: The case of the CGTP-IN
Authors: Santos Maria Helena , Cerqueira Carla , Cruz Rui Vieira
Published: December 2020

Gender imbalances persist throughout the world, particularly at leadership level, and equally also visible in the case of trade unions. This article focuses on CGTP-IN, the largest Portuguese trade union confederation, and sets out analysis incorporating both figures from this organisation and accounts by female members of CGTP-IN unions. Results confirm the existence of gender asymmetries, especially at the highest leadership levels. Analysis of the discourses of these women leaders reveals some awareness of the influence of gender on professional relations, placing women at a disadvantage, especially where leadership is concerned. Furthermore, four reasons driving the persistence of these gender asymmetries in trade union leadership/decision-making roles were identified: family responsibilities, gendered professional segregation, masculine trade union cultures and traditional gender stereotypes. Nevertheless, the interviewees resist to means of affirmative action such as gender quotas, and instead prefer to prioritise education and raising awareness around gender equality.
The case for treating violence against women as a form of sex discrimination in India
Authors: Agarwal Ayushi
Published: December 2020

Violence against women (VAW) is rampant in India, and rising every year. However, Indian laws are geared towards punishing individual instances of such violence, instead of attempting to eradicate the problem itself. This is owed in part to the incomplete understanding of the causes and effects of such violence. Here, I advance a feminist understanding of VAW, wherein it is seen as a result of gendered prejudices designed to keep women in subordination. I show that international human rights law now endorses this feminist understanding, and trace the evolving understanding of equality in Indian courts to argue that given its current understanding as substantive equality, VAW can and should be seen as a form of sex discrimination due the cycle of disadvantage it creates for women. I critically analyse several decisions by Indian courts that show a move towards acceptance of VAW as a form of sex discrimination, and point to the limitations of these decisions. Finally, I propose various ways in which envisaging VAW as a form of sex discrimination would lead to a better framework of laws for not only countering such violence, but also eradicating it.
Assessment of 30-Day Adverse Events in Single-Event, Multilevel Upper Extremity Surgery in Adult Patients with Upper Motor Neuron Syndrome
Authors: Patel Raahil , Rhee Peter C.
Published: December 2020

Background:

Upper motor neuron (UMN) syndrome consists of muscle spasticity, weakness, and dyssynergy due to a brain or spinal cord injury. The purpose of this study is to describe the perioperative adverse events for adult patients undergoing single-event, multilevel upper extremity surgery (SEMLS) due to UMN syndrome.

Methods:

A retrospective case series was performed for 12 consecutive adult patients who underwent SEMLS to correct upper extremity dysfunction or deformity secondary to UMN syndrome. The evaluation consisted of primary outcome measures to identify readmission rates and classify adverse events that occurred within 30 days after surgery.

Results:

All 12 patients were functionally dependent with 50% (n = 6) men and 50% (n = 6) women at a mean age of 43.6 years (range: 21-73) with a mean of 5.92 (range: 0-16) comorbid diagnoses at the time of surgery. There were no intraoperative complications, hospital readmissions, or deaths among the 12 patients. Five patients experienced 5 minor postoperative complications that consisted of cast- or orthosis-related skin breakdown remote from the incision (n = 3), incidental surgical site hematoma that required no surveillance or intervention (n = 1), and contact dermatitis attributed to the surgical dressing that resolved with topical corticosteroids (n = 1).

Conclusions:

With an appropriate multidisciplinary approach, there is minimal risk for developing perioperative and 30-day postoperative adverse events for adults undergoing SEMLS to correct upper extremity deformities secondary to UMN syndrome.

Level of Evidence:

Level IV
Synthesis and Antimicrobial Characterization of Luotonin Derivatives
Authors: Zhu Rui , Guo Rui , Han Ke , Xi Wenying , Zheng Shaojun , Zhang Jiwen
Published: December 2020

Twenty-one novel luotonin derivatives were synthesized from 2-aminobenzamide in excellent yields. The prepared compounds, when tested against 8 strains of bacteria and many plant pathogen fungi showed diverse and promising antimicrobial activities. Notably, compounds a5, a9, b4, and b5 demonstrated good activities and might be potential lead compounds for further development as antifungal agents. The relationship between structure and biological activity is also discussed.
Much Louder Than I Am: A Musical Collaborative Autoethnography
Authors: Carless David , Douglas Kitrina
Published: December 2020

One challenge of performative research is that a performance is a one-time unique event. It cannot be preserved or returned to in its own form. Here, we offer a more durable artifact to preserve some aspects of the collaborative performance autoethnography we performed at the International Congress of Qualitative Inquiry (ICQI) in 2018. We write to communicate not only what we performed during the session but also our sentiments concerning singing and playing music as autoethnography. Because so often in our work we use songs, songwriting, music, and performance; we propose rhythm, melody, and harmony as alternative acts of autoethnographic collaboration. In this way of doing autoethnography, it may be that no words are spoken. But the burden of work is shared. This is the kind of collaboration we seek … in the here and now.
Evaluation of microvasculopathy using dual‐energy computed tomography in patients with chronic thromboembolic pulmonary hypertension
Authors: Onishi Hiroyuki , Taniguchi Yu , Matsuoka Yoichiro , Yanaka Kenichi , Izawa Yu , Tsuboi Yasunori , Mori Shumpei , Kono Atsushi , Nakayama Kazuhiko , Emoto Noriaki , Hirata Ken‐ichi
Published: December 2020

The existence of microvasculopathy in patients with chronic thromboembolic pulmonary hypertension has been suggested. Recently, dual‐energy computed tomography has been used to produce a sensitive iodine distribution map in lung fields to indicate microvasculopathy according to poor subpleural perfusion. Our aim was to evaluate the impact of microvasculopathy on pathophysiology in chronic thromboembolic pulmonary hypertension. According to the extent of poor subpleural perfusion, ninety‐three interventional treatment‐naïve patients were divided into poorly perfused (n = 49) or normally perfused group (n = 44). We assessed cardiopulmonary exercise test, right heart catheterization, and dual‐energy computed tomography parameters for quantitative evaluation of lung perfusion of blood volume score. Lung perfusion of blood volume score in normally perfused group was significantly inversely correlated with pulmonary vascular resistance (pulmonary vascular resistance = 6816.1 × lung perfusion of blood volume score−0.793, R2 = 0.225, p < 0.01), but lung perfusion of blood volume score in poorly perfused group was not. Poorly perfused group had higher pulmonary vascular resistance (879 ± 409 dynes‐s/cm5 vs. 574 ± 279 dynes‐s/cm5, p < 0.01) and lower lung perfusion of blood volume score (22.1 ± 5.4 vs. 26.4 ± 6.6, p < 0.01) and % diffusing capacity for carbon monoxide divided by the alveolar volume (59.9 ± 15.4% vs. 78.8 ± 14.2%, p < 0.01). Perfusion of blood volume score in the normally perfused group showed an inverse correlation with pulmonary vascular resistance; however, that in poorly perfused group did not. Microvasculopathy might contribute to severe hemodynamics, apart from pulmonary vascular obstruction. In our experience, more than half of treatment‐naïve chronic thromboembolic pulmonary hypertension patients have microvasculopathy.
Rapid dynamic bedside assessment of pulmonary perfusion defect by electrical impedance tomography in a patient with acute massive pulmonary embolism
Authors: Yuan Siyi , He Huaiwu , Long Yun , Chi Yi , Frerichs Inéz , Zhao Zhanqi
Published: December 2020

Several animal studies have shown that regional lung perfusion could be effectively estimated by the hypertonic saline contrast electrical impedance tomography method. Here, we reported an application of this method to dynamically assess regional pulmonary perfusion defect in a patient with acute massive pulmonary embolism. A 68‐year‐old man experienced sudden dyspnea and cardiac arrest during out‐of‐bed physical activity on the first day after partial mediastinal tumor resection. Acute pulmonary embolism was suspected due to acute enlargement of right heart and fixed inferior venous cava measured with bedside ultrasound. The computed tomography pulmonary angiography further confirmed large embolism in both left and right main pulmonary arteries and branches. The regional time impedance curves, which were obtained by a bolus of 10 ml 10% NaCl through the central venous catheter, were then analyzed to quantitatively assess regional perfusion. Normal ventilation distribution with massive defects in regional perfusion in both lungs was observed, leading to a ventilation–perfusion mismatch and low oxygenation index (PaO2/FiO2 = 86 mmHg) at the first day of pulmonary embolism. The anticoagulation was performed with heparin, and the patient’s condition (such as shock, dyspnea, hypoxemia, etc.), regional lung perfusion defect, and ventilation–perfusion mismatch continuously improved in the following days. In conclusion, this case implies that electrical impedance tomography might have the potential to assess and monitor regional perfusion for rapid diagnosis of fatal pulmonary embolism in clinical practice.
Promoting and Hindering Health and Well-Being in Firefighter Discourse
Authors: Jacobsson Ann , Backteman Erlanson Susann , Brulin Christine , Egan Sjolander Annika
Published: December 2020

The aim of this critical discourse analysis is to identify and discuss dominant and recurrent themes in firefighter discourse that promote and hinder firefighters’ health and well-being. Using critical discourse analysis, the focus is directed toward routine work culture at the station, as well as how firefighters deal with extraordinary events. The empirical material was collected from rescue services in Sweden representing different geographical areas. In total, 28 firefighters participated in focus group discussions or individual interviews. We identified dominant themes in the discourse that promoted firefighters’ health and well-being. We also identified recurrent themes that may serve as hindrances to health and well-being. We note that themes in the latter category also relate to changes in the profession and work culture, expressing external pressures on the rescue service. One reason for resistance toward change might be the health benefits that the current order of firefighter discourse brings.
The Effect of Organizational Climate on Faculty Burnout at State and Private Universities: A Comparative Analysis
Authors: Dinibutun Sait Revda , Kuzey Cemil , Dinc Muhammet Sait
Published: December 2020

Organizational climate, that is, the atmosphere surrounding an organization, unites features with individual, organizational, and environmental characteristics that affect the behaviors of individuals within the organization. Burnout is accepted as a syndrome that often occurs in people who work together with others. Faculty members in universities are potential burnout candidates due to their relationships with many students, employees, and administrators. To reduce burnout of the faculty members, it is crucial to maintain a healthy organizational climate. It is also projected that discrepancies in organizational climate can manifest differently between public and private universities. So, the purpose of this study is to examine the effect of organizational climate on the burnout of faculty members at both state and private universities. By using the survey method, 984 responses were collected from faculty members. A covariance-based structural equation modeling was constructed to test the reliability and validity of both the measurement and the structural model. The results of the study supported the hypotheses mostly and indicated that all dimensions of organizational climate negatively influenced faculty members’ emotional exhaustion. While the balanced workload, clarity of task, cohesion, and the ethical dimensions within the organizational climate produced a negative effect on the depersonalization of faculty members, the lack of clarity of task and ethical dimensions contributed negatively to the diminished personal accomplishment. In addition, the study demonstrated that state university faculty members having cohesion dimension of organizational climate were less likely to be exhausted emotionally, whereas cohesion among private university faculty members negatively influenced the depersonalization. Theoretical and practical implications regarding organizational climate dimensions and burnout levels of faculty members were discussed.
Embracing Change: A Mindful Medical Center Meets COVID-19
Authors: Klatt Maryanna D , Bawa Rani , Gabram Olivia , Blake Amanda , Steinberg Beth , Westrick Alexis , Holliday Scott
Published: December 2020

Background

Healthcare professional (HCP) burnout transcends clinician job title and role, thus creating a need for interprofessional strategies to address burnout. The organizational framework of offering employer-sponsored mindfulness programming to HCPs sets the stage for an orchestrated, mindful response to COVID-19.

Objective

This single arm pre-post interventional research tested changes in measures of burnout, resilience, perceived stress and work engagement for interprofessional HCP faculty and students participating in Mindfulness in Motion (MIM), a novel eight-week multimodal evidenced–based onsite intervention.

Methods

A Graduate Medical Education (GME) pilot of MIM was expanded to target inter-professional resiliency within an academic health center. MIM is the core offering of the Gabbe Health and Wellness program for students, staff, faculty, and residents and is embedded across the entire medical center.

Results

The faculty/student role demographic categories (n = 267) included resident physicians, resident chaplains, attending physicians, medical center faculty, and hospital administrative/managerial clinical staff. These cohorts demonstrated significant 27% reduction in participants meeting burnout criteria. Total burnout was determined by scores on subscales of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) of the Maslach Burnout Inventory (MBI). There was a highly significant pre/post decrease in the in the emotional exhaustion (p < 0.00001) and depersonalization scores (p < 0.001), with highly significant increase in the personal accomplishment (p < 0.00001) scores. Resilience, as measured by the Connor Davidson Resiliency Scale (CDRS), significantly increased (p < 0.00001), alongside a significant increase (p < 0.00001) in the total Utrecht Work Engagement Score (UWES) and a significant decrease in scores on the Perceived Stress Scale (PSS) (p < 0.00001).

Conclusion

MIM significantly reduced burnout and perceived stress, for interprofessional (HCP) faculty and staff, while increasing resilience and work engagement in a large healthcare system. These results paved the way for an organizational response that utilized mindfulness to empower HCPs to navigate through the novel challenges presented by COVID-19.
Can the Open Stance Forehand Increase the Risk of Hip Injuries in Tennis Players?
Authors: Martin Caroline , Sorel Anthony , Touzard Pierre , Bideau Benoit , Gaborit Ronan , DeGroot Hugo , Kulpa Richard
Published: December 2020

Background:

The open stance forehand has been hypothesized by tennis experts (coaches, scientists, and clinicians) to be more traumatic than the neutral stance forehand as regards hip injuries in tennis. However, the influence of the forehand stance (open or neutral) on hip kinematics and loading has not been assessed.

Purpose:

To compare the kinematics and kinetics at the hip joint during 3 common forehand stances (attacking neutral stance [ANS], attacking open stance [AOS], defensive open stance [DOS]) in advanced tennis players to determine whether the open stance forehand induces higher hip loading.

Study Design:

Descriptive laboratory study.

Methods:

The ANS, AOS, and DOS forehand strokes of 8 advanced right-handed tennis players were recorded with an optoelectronic motion capture system. The flexion-extension, abduction-adduction, and external-internal rotation angles as well as intersegmental forces and torques of the right hip were calculated using inverse dynamics.

Results:

The DOS demonstrated significantly higher values than both the ANS and AOS for anterior ( P < .001), medial ( P < .001), and distractive ( P < .001) forces as well as extension ( P = .004), abduction ( P < .001), and external rotation ( P < .001) torques. The AOS showed higher distractive forces than the ANS ( P = .048). The DOS showed more extreme angles of hip flexion ( P < .001), abduction ( P < .001), and external rotation ( P = .010).

Conclusion:

The findings of this study imply that the DOS increased hip joint angles and loading, thus potentially increasing the risk of hip overuse injuries. The DOS-induced hip motion could put players at a higher risk of posterior-superior hip impingement compared with the ANS and AOS.

Clinical Relevance:

Coaches and clinicians with players who have experienced hip pain or sustained injuries should encourage them to use a more neutral stance and develop a more aggressive playing style to avoid the DOS, during which hip motion and loading are more extreme.
Anterior Cruciate Ligament Tears: The Impact of Increased Time From Injury to Surgery on Intra-articular Lesions
Authors: Chavez Audrie , Jimenez Andrew E. , Riepen Dietrich , Schell Benjamin , Khazzam Michael , Coyner Katherine J.
Published: December 2020

Background:

Previous research has shown that meniscal and articular cartilage lesions increase with time in the anterior cruciate ligament (ACL)–deficient knee.

Purpose:

To analyze the association between increased time from ACL injury to reconstruction and the presence of intra-articular lesions.

Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A retrospective chart review was performed for patients who sustained an ACL injury and underwent reconstruction from January 1, 2009, to May 14, 2015. Factors analyzed included age, sex, and body mass index, as well as time from injury to surgery, the presence of meniscal tears, and the presence of cartilage lesions. The data were evaluated to quantify the association between time from ACL injury to reconstruction and presence of intra-articular lesions.

Results:

Overall, 405 patients were included in this study. Regarding time from injury, 27.3% patients were treated at <3 months, 23.6% at 3 to <6 months, 18% at 6 to <12 months, 13.6% at 12 to <24 months, 10.6% at 24 to <60 months, and 6.9% at ≥60 months. When compared with the group treated <3 months from injury, a significant increase in the rate of medial meniscal tears was seen in the groups treated at 6 to <12 months (odds ratio [OR], 2.2), 12 to <24 months (OR, 3.5), 24 to <60 months (OR, 7.0), and ≥60 months (OR, 6.3). A similar trend was seen with medial femoral condyle lesions in the groups treated at 6 to <12 months (OR, 2.5), 12 to <24 months (OR, 2.6), 24 to <60 months (OR, 2.6), and ≥60 months (OR, 6.9). The prevalence of lateral tibial plateau and lateral femoral condyle lesions also significantly increased with increased time between ACL injury and reconstruction, but this association was not seen until 24 to <60 months (ORs, 5.1 and 11.5, respectively).

Conclusion:

For patients undergoing ACL reconstruction, an interval >6 months between injury and surgery was associated with an increased prevalence of medial meniscal tears and medial compartment chondral lesions at the time of surgery. An interval >24 months between injury and surgery was associated with an increased prevalence of lateral compartment chondral lesions at the time of surgery.
Sonographically Guided Anchor Placement in Anterior Talofibular Ligament Repair Is Anatomic and Accurate
Authors: Hattori Soichi , Onishi Kentaro , Yano Yuji , Kato Yuki , Ohuchi Hiroshi , Hogan MaCalus V. , Kumai Tsukasa
Published: December 2020

Background:

Arthroscopic repair is a widely accepted surgical treatment for chronic ankle instability; however, recent studies have shown that arthroscopic repair is nonanatomic in its anchor placement and resultant biomechanics. Ultrasound may improve the accuracy of the anchor placement.

Hypothesis:

Our hypothesis was that the accuracy of anchor placement in sonographically guided anterior talofibular ligament (ATFL) repair will be comparable with that in open ATFL repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The study included 26 patients who received surgical treatment between April 2012 and October 2019 for chronic ankle instability. Fifteen patients underwent open modified Broström repair and 11 underwent sonographically guided ATFL repair. The distance between the anchor hole and the fibular obscure tubercle was measured using 3-dimensional computed tomography and was compared between the operative procedures. For comparison, a noninferiority trial was employed, with open modified Broström repair as the reference surgery. The noninferiority margin was defined as 5 mm.

Results:

The mean ± SD distance between the anchor and fibular obscure tubercle was 6.0 ± 2.7 mm in open repair and 5.6 ± 3.3 mm in sonographically guided repair. The mean difference in distance between the techniques ( open repair – sonographically guided repair) was 0.37 mm (95% CI, –2.1 to 2.9 mm). The lower margin of the confidence interval was within the noninferiority margin (–5 to 5 mm).

Conclusion:

Anchor placement under sonographically guided ATFL repair was equivalent to that of open ATFL repair and can be considered anatomic and accurate.
Optimization and validation of a highly sensitive method for determining glyphosate in human urine by solid-phase extraction and liquid chromatography with tandem mass spectrometry: a methodological study
Authors: Nomura Hiroshi , Hamada Risa , Saito Isao , Nakane Kunihiko , Sawa Ritsuko , Ukai Miwa , Shibata Eiji , Sato Mitsuo , Kamijima Michihiro , Ueyama Jun
Published: December 2020

Background

Glyphosate and its salt formulations are nonselective herbicides that have been extensively used worldwide, both for residential and agricultural purposes. The possible carcinogenicity and teratogenicity of glyphosate remain to be elucidated. We developed a sensitive and high-throughput analytical method for urinary glyphosate using liquid chromatography-tandem mass spectrometry with the aim of contributing to glyphosate exposure assessment in epidemiological studies.

Methods

After urine dilution (creatinine matching dilution to 0.05 g creatinine/L), glyphosate was extracted using two types of solid phase extraction columns (SCX and NH2) with automated sample preparation instruments. The eluate was dried and dissolved in the mobile phase, followed by liquid chromatography-tandem mass spectrometry analysis. The optimized method was applied to urine samples obtained from 54 Japanese adults and children.

Results

The results from the validation study demonstrated good recoveries (91.0-99.6%), within- and between-run precisions (< 15%), low detection limits (0.1 μg/L), and lower limit of quantification (0.3 μg/L). The detection frequency and median concentration of the urinary glyphosate in Japanese subjects were 59% and 0.25 μg/L (0.34 μg/g creatinine).

Conclusions

Our reliable determination method was successful in measuring urinary glyphosate concentration. Moreover, this is the first biomonitoring report of urinary glyphosate levels in the Japanese general population.
Study protocol for the randomized controlled EVA (early vascular adjustments) trial: tailored treatment of mild hypertension in pregnancy to prevent severe hypertension and preeclampsia
Authors: Mulder Eva , Ghossein-Doha Chahinda , Appelman Evine , van Kuijk Sander , Smits Luc , van der Zanden Rogier , van Drongelen Joris , Spaanderman Marc
Published: December 2020

Background

In contrast to severe gestational hypertension, it is questioned whether antihypertensive medication for mild to moderate gestational hypertension prevents adverse maternal and offspring outcomes. Hypertensive drugs halve the risk of severe hypertension, but do not seem to prevent progression to preeclampsia or reduce the risk of complications in offspring. In fact, beta-blockers, a first line therapy option, are suspected to impair foetal growth. Disappointing effects of antihypertensive medication can be anticipated when the pharmacological mode of action does not match the underlying haemodynamic imbalance. Hypertension may result from 1) high cardiac output, low vascular resistance state, in which beta blockade is expected to be most effective, or 2) low cardiac output, high vascular resistance state where dihydropyridine calcium channel blockers or central-acting alpha agonists might be the best corrective medication. In the latter, beta-blockade might be maternally ineffective and even contribute to impaired foetal growth by keeping cardiac output low. We propose a randomized controlled trial to determine whether correcting the haemodynamic imbalance in women with mild to moderate hypertension reduces the development of severe hypertension and/or preeclampsia more than non-pharmacological treatment does, without alleged negative effects on foetal growth.

Methods

Women diagnosed with mild to moderate hypertension without proteinuria or signs of other organ damage before 37 weeks of pregnancy are invited to participate in this randomized controlled trial. Women randomized to the intervention group will be prescribed tailored antihypertensive medication, using a simple diagnostic and treatment algorithm based on the mean arterial pressure/heart rate ratio, which serves as an easy-to-determine proxy for maternal circulatory state. Women randomized to the control group will receive non-pharmacological standard care according to national and international guidelines. In total, 208 women will be randomized in a 1:1 ratio. The primary outcome is progression to severe hypertension and preeclampsia and the secondary outcomes are adverse maternal and neonatal outcomes.

Discussion

This trial will provide evidence of whether tailoring treatment of mild to moderate gestational hypertension to the individual haemodynamic profile prevents maternal disease progression.

Trial registration

NCT02531490, registered on 24 August 2015.
Facilitators and challenges in delivering a peer-support physical activity intervention for older adults: a qualitative study with multiple stakeholders
Authors: Crozier Anthony , Porcellato Lorna , Buckley Benjamin J. R. , Watson Paula M.
Published: December 2020

Background

Involving peer volunteers in intervention delivery can provide social support and improve adherence. Whilst such interventions have the potential to reduce physical activity (PA) intervention costs, little is known about the process of delivering them in practice. This qualitative study explored the facilitators and challenges of delivering a peer-support PA intervention for older adults, with a view to making recommendations for the delivery of future interventions.

Methods

Data were collected via (7) semi-structured interviews and a focus group with stakeholders involved in a peer-support PA intervention for older adults in a large city in the North-West of England. Participants included local authority staff (n = 3), peer volunteers (n = 2) and service users (n = 7). Audio data were transcribed verbatim and thematically coded to identify perceived facilitators and challenges.

Results

Facilitators to delivery included social interaction, community referral pathways, suitable facilities, peer volunteers and high-quality instructors. Challenges surrounded inconsistent practice, staff capacity, safety and accountability, and awareness raising.

Conclusions

Peer volunteers can provide an additional support mechanism alongside qualified instructors for increasing social interaction within PA interventions. For optimal intervention delivery, consideration needs to be given to equipment and space, safety and accountability and consistency of practice.
The dysregulation of the hypothalamic–pituitary–adrenal axis in diet-induced prediabetic male Sprague Dawley rats
Authors: Mosili Palesa , Mkhize Bongeka Cassandra , Ngubane Phikelelani , Sibiya Ntethelelo , Khathi Andile
Published: December 2020

Background

Altered function of the hypothalamic–pituitary–adrenal (HPA) axis in type 2 diabetic patients, a condition preceded by pre-diabetes, has been shown to increase the risk of depression as well as cause downstream effects resulting in upregulation of gluconeogenesis and dyslipidemia. In addition, stress, either psychological from managing diabetes or lifestyle related, further activates the HPA axis causing an exaggerated stress response. This study investigated the activity of the HPA axis in selected markers of glucose handling, and the stress response relative to components of the HPA axis in a diet-induced pre-diabetic rat model.

Methods

Sprague Dawley Rats were randomly divided into non-pre-diabetic group (NPD) and pre-diabetic group (PD) (n = 6, per group) over a 20-week induction period and a further 12-week experimental period to get 32 weeks. At the end of the 20 and 32-week periods, glucose handling using the Homeostasis Model Assessment indices, adrenocorticotropic (ACTH) and corticosterone (CORT) concentrations were measured. Stress was induced and the forced swim test were performed in the 12-week experimental week. At the end of 32 weeks glucocorticoid and mineralocorticoid hippocampal receptors were also measured.

Results

Impaired glucose handling in the PD group as well as increase in corticosterone was observed at the end of both 20 and 32-week periods by comparison to NPD groups. No changes were observed in ACTH concentration at week 20 while, at week 32, a decrease in plasma ACTH concentration was observed in the PD group by comparison to the NPD group. The stressed-induced animals were stressed using the forced swim test: the behaviour observed showed an increase in immobility time in the PD stressed group by comparison to the NPD group. This was followed by the observation of a decrease in ACTH and CORT concentration in the PD stressed group by comparison to the NPD stressed group. Mineralocorticoid and glucocorticoid receptors gene expression were elevated in the stressed PD group relative to the stressed NPD group.

Conclusion

These observations, together, suggest that diet-induced pre-diabetes is associated with impaired HPA axis activity and deteriorating response to stress.
Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and metaanalysis
Authors: Lailulo Yishak , Kitenge Marcel , Jaffer Shahista , Aluko Omololu , Nyasulu Peter Suwirakwenda
Published: December 2020

Background

Despite the increase in the number of people accessing antiretroviral therapy (ART), there is limited data regarding treatment failure and its related factors among HIV-positive individuals enrolled in HIV care in resource-poor settings. This review aimed to identify factors associated with antiretroviral treatment failure among individuals living with HIV on ART in resource-poor settings.

Methods

We conducted a comprehensive search on MEDLINE (PubMed), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization’s (WHO’s) library database, and Latin American and Caribbean Health Sciences Literature (LILACS). We included observational studies (cohort, case-control, and cross-sectional studies) where adolescents and adults living with HIV were on antiretroviral treatment regardless of the ART regimen. The primary outcomes of interest were immunological, virological, and clinical failure. Some of the secondary outcomes were mm3opportunistic infections, WHO clinical stage, and socio-demographic factors. We screened titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements were resolved by consensus. We analyzed the data by doing a meta-analysis to pool the results for each outcome of interest.

Results

Antiretroviral failure was nearly 6 times higher among patients who had poor adherence to treatment as compared to patients with a good treatment adherence (OR = 5.90, 95% CI 3.50, 9.94, moderate strength of evidence). The likelihood of the treatment failure was almost 5 times higher among patients with CD4 < 200 cells/mm3compared to those with CD4 ≥ 200 CD4 cells/mm3(OR = 4.82, 95% CI 2.44, 9.52, low strength of evidence). This result shows that poor adherence and CD4 count below < 200 cells/mm3are significantly associated with treatment failure among HIV-positive patients on ART in a resource-limited setting.

Conclusion

This review highlights that low CD4 counts and poor adherence to ART were associated to ART treatment failure. There is a need for healthcare workers and HIV program implementers to focus on patients who have these characteristics in order to prevent ART treatment failure.

Systematic review registration

The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number: 2019 CRD42019136538.
The influence of acute exercise on bone biomarkers: protocol for a systematic review with meta-analysis
Authors: Dolan E. , Dumas A. , Keane K. M. , Bestetti G. , Freitas L. H. M. , Gualano B. , Kohrt W. , Kelley G. A. , Pereira R. M. R. , Sale C. , Swinton P.
Published: December 2020

Background

Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics.

Methods

This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Discussion

A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research.

Systematic review registration

This protocol was prospectively registered in the Open Science Framework Registry (https://osf.io/6f8dz)
A brief review of the biological potential of indole derivatives
Authors: Kumar Sunil , Ritika
Published: December 2020

Background

Various bioactive aromatic compounds containing the indole nucleus showed clinical and biological applications. Indole scaffold has been found in many of the important synthetic drug molecules which gave a valuable idea for treatment and binds with high affinity to the multiple receptors helpful in developing new useful derivatives.

Main text

Indole derivatives possess various biological activities, i.e., antiviral, anti-inflammatory, anticancer, anti-HIV, antioxidant, antimicrobial, antitubercular, antidiabetic, antimalarial, anticholinesterase activities, etc. which created interest among researchers to synthesize a variety of indole derivatives.

Conclusion

From the literature, it is revealed that indole derivatives have diverse biological activities and also have an immeasurable potential to be explored for newer therapeutic possibilities.
Simulated annealing velocity analysis: Automating the picking process
Authors: Velis Danilo
Published: December 2020

We have developed an automated method for velocity picking that allows us to estimate appropriate velocity functions for the normal moveout correction of common-depth-point (CDP) gathers, valid for either hyperbolic or nonhyperbolic trajectories. In the hyperbolic velocity analysis case, the process involves the simultaneous search (picking) of a certain number of time-velocity pairs in which the semblance, or any other coherence measure, is high. In the nonhyperbolic velocity analysis case, a third parameter, usually associated with the layering and/or the anisotropy, is added to the searching process. Our technique relies on a simple but effective search of a piecewise linear curve defined by a certain number of nodes in a 2D or 3D space that follows the semblance maxima. The search is carried out efficiently using a constrained very fast simulated annealing algorithm. The constraints consist of static and dynamic bounding restrictions, which are viewed as a means to incorporate prior information about the picking process. This allows us to avoid those maxima that correspond to multiples, spurious events, and other meaningless events. Results using synthetic and field data indicate that our technique permits automatically obtaining accurate and consistent velocity picks that lead to flattened events, in agreement with the manual picks. As an algorithm, the method is very flexible for accommodating additional constraints (e.g., preselected events) and depends on a limited number of parameters. These parameters are easily tuned according to data requirements, available prior information, and the user’s needs. The computational costs are relatively low, ranging from a fraction of a second to, at most, 1–2 s per CDP gather, using a standard PC with a single processor.
Rare health conditions 41: Childhood interstitial lung disease or ChILD, Neuroblastoma and Ehlers-Danlos syndromes
Authors: Barber Chris
Published: December 2020

The purpose of this series is to highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually less than 1 person in every 2000 and many healthcare assistants and nurses will encounter some of these conditions, given the high number of them.

This 41st article will explore three of these conditions: childhood interstitial lung disease or ChILD, neuroblastoma and Ehlers-Danlos syndromes.
The public health role of maternity support workers
Authors: Lindsay Pat , Linay Denise
Published: December 2020

Most of the work of midwives and obstetricians is directed at improving pregnancy outcomes. Part of this work is built on the public health strategy developed by the national health services around the UK. Pregnancy and early parenthood are times when expectant and new parents are receptive to public health information.

Midwives and maternity support workers work together to convey public health messages. The positive outcomes of this work include reductions in rates of stillbirth, preterm birth and low-birthweight babies.

Other outcomes are increased parental satisfaction, stronger family bonds and better family health. Specialist and consultant midwives' views on the role of maternity support workers in public health are included in this paper.
Understanding the nursing process
Authors: Stonehouse David
Published: December 2020

Support staff work closely with their patients and members of the multidisciplinary team to deliver high-quality care. Often this care will have been planned by a nurse using ‘the nursing process’. It is therefore important for the support worker to understand how the patient has been assessed and that the care they are providing has been planned.

Within this article, the author will be discussing the nursing process, explaining the different stages and how these are used to deliver quality care. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted.

Support workers have a clear and important role in making sure the nursing process is successful and patients receive the best quality care.