bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses' and nursing assistants' emotional skills: A major determinant of motivation for patient education
Authors: Lelorain Sophie , Bachelet Adeline , Goncalves Virginie , Wortel Erica , Billes Marine , Seillier Mélanie , Bertin Nicole , Bourgoin Maryline
Published: April 2019

Aims

To explore professionals' (i.e. nurses and nursing assistants) motivation for Patient Education according to their emotional skills.

Design

A cross‐sectional study using a convenience sample of professionals completing self‐reported questionnaires assessing their general emotional skills and their Patient‐Education‐related sense of competence, autonomy and relatedness, according to the theory of basic psychological needs.

Methods

Professionals from 27 French hospitals working in various departments completed paper and web‐based questionnaires between January 2015 ‐ May 2017. Mediation analyses were performed controlling for the already known variables associated with motivation for patient education.

Results

Usable questionnaires (N = 185) were analysed. Professionals' emotional skills were associated with their motivation for Therapeutic Patient Education both directly and indirectly (i.e. partial mediation) via a higher sense of competence in Patient Education. Among the covariates, professionals who had received a high‐level training in Patient Education, those with a high recognition of their work in patient education and nurses (compared with nursing assistants) were the most motivated.

Conclusion

Professionals' emotional skills are the mainstay of their motivation for Patient Education. Training should aim to develop these skills so that professionals can manage their own emotions better (e.g. frustration when faced with non‐motivated patients) and those of patients (e.g. discouragement) and thus effectively support patient self‐management.

Impact

The study addressed nurses' and nursing assistants' motivation for patient education. Their emotional skills were directly and indirectly – via a higher sense of patient‐education‐related competence – associated with higher motivation. Training for professionals should therefore develop their emotional skills.
Mental health patients’ experiences of softer coercion and its effects on their interactions with practitioners: A qualitative evidence synthesis
Authors: Allison Rob , Flemming Kate
Published: April 2019

Aims

To synthesize qualitative evidence of mental health patients’ treatment‐related experiences of softer coercion and its effect on their interactions with practitioners.

Background

Coercion is controversial but global in mental health care. It ranges from softer to harder forms, but less attention is given in the literature to softer coercion.

Design

Qualitative thematic synthesis examining patients’ experiences of softer coercion.

Data Sources

Electronic databases searched from inception to September 2015 and further updated January 2018.

Review Methods

Thematic synthesis of 11 UK/Irish articles, quality appraised using the Critical Appraisal Skills Programme tool.

Results

Three analytic themes were developed: Losing a sense of self, Less than therapeutic relationship, and Journey through treatment.

Conclusion

Softer coercion is experienced across mental health care in a context of broader coercion.
Association between pulse pressure at discharge and clinical outcomes in patients with acute myocardial infarction: From the KAMIR‐Korean‐NIH registry
Authors: Park Hyun Woong , Kang Min Gyu , Kim Kyehwan , Koh Jin‐Sin , Park Jeong Rang , Hwang Seok‐Jae , Kim Hye Ree , Jeong Young‐Hoon , Ahn Jong Hwa , Jang Jeong Yoon , Kwak Choong Hwan , Park Yongwhi , Hwang Jin‐Yong , Jeong Myung Ho , Kim Hyo‐Soo , Yoon Chang‐Hwan , Kim Doo‐Il ,   the KAMIR‐Korean‐NIH registry
Published: April 2019

Pulse pressure (PP) is affected by arterial stiffness and is a predictor of cardiovascular events. However, value and utility of PP assessment in patients with acute myocardial infarction (AMI) remain less clear. We aimed to evaluate the association between PP and cardiovascular events in surviving patients with AMI at discharge. A total of 11 944 surviving patients with AMI at discharge from a Korean nationwide registry were included. Blood pressure was checked just before discharge. Noncardiac death and major adverse cardiovascular events (MACEs) including cardiac death, AMI, and stroke after discharge were analyzed. The median follow‐up duration was 368 (IQR 339, 388) days. The rate of MACEs and cardiac death was higher in groups with the lowest PP (PP < 20 mm Hg) and highest PP (PP ≥ 71 mm Hg) and lowest in the group with PP of 31‐40 mm Hg. With PP of 31‐40 mm Hg as reference, univariate analysis showed a U‐shaped association between the risk of MACEs (PP ≤ 20 mm Hg: hazard ratio [HR] 2.3; PP ≥ 71 mm Hg: HR 2.7) or cardiac death (PP ≤ 20 mm Hg: HR 2.6; PP ≥ 71 mm Hg: HR 3.1) and PP. In multivariate analysis, the curve changed from being U‐shaped to J‐shaped, and HR for PP ≥ 71 mm Hg (1.2 for MACEs and 1.4 cardiac death) decreased and HR for PP < 20 (2.1 for MACEs and 2.4 for cardiac death) did not significantly decrease after adjustment for cardiovascular risk factors. Our findings indicate that PP is a strong independent prognostic factor of MACEs and cardiac death in surviving patients with AMI. Low PP is a more significant independent predictor of MACEs and cardiac death than high PP in surviving patients after AMI.
Potential vector species of carp edema virus (CEV)
Authors: Matras Marek , Stachnik Magdalena , Borzym Ewa , Maj‐Paluch Joanna , Reichert Michal
Published: April 2019

During a PCR‐based CEV survey in Poland in 2015–2017, the virus was detected in many farms both in clinical and asymptomatic cases and in common as well as in koi carp (Cyprinus carpio). In order to evaluate the potential carrier role of fish species that share the same habitats with carp, an experimental trial was performed. Investigations carried out on specimens of bleak (Alburnus alburnus), crucian carp (Carassius carassius), European perch (Perca fluviatilis), Prussian carp (Carassius gibelio), roach (Rutilus rutilus) and tench (Tinca tinca) cohabited with CEV‐infected carp yielded positive results. These species of fish were experimentally cohabited with CEV‐infected common carp at a temperature of 16°C ± 1. Material from the brain, gills, spleen, kidneys, intestine and skin was investigated for the presence of CEV DNA. Similar investigations were performed with uninfected fish designated controls. Samples were tested for CEV by qPCR.
The field and microstructural signatures of deformation‐assisted melt transfer: Insights from magmatic arc lower crust, New Zealand
Authors: Meek Uvana , Piazolo Sandra , Daczko Nathan R.
Published: April 2019

Melt must transfer through the lower crust, yet the field signatures and mechanisms involved in such transfer zones (excluding dykes) are still poorly understood. We report field and microstructural evidence of a deformation‐assisted melt transfer zone that developed in the lower crustal magmatic arc environment of Fiordland, New Zealand. A 30–40 m wide hornblende‐rich body comprising hornblende ± clinozoisite and/or garnet exhibits 'igneous‐like' features and is hosted within a metamorphic, two‐pyroxene–pargasite gabbroic gneiss (GG). Previous studies have interpreted the hornblende‐rich body as an igneous cumulate or a mass transfer zone. We present field and microstructural characteristics supporting the later and indicating the body has formed by deformation‐assisted, channelized, reactive porous melt flow. The host granulite facies GG contains distinctive rectilinear dykes and garnet reaction zones (GRZ) from earlier in the geological history; these form important reaction and strain markers. Field observations show that the mineral assemblages and microstructures of the GG and GRZ are progressively modified with proximity to the hornblende‐rich body. At the same time, GRZ bend systematically into the hornblende‐rich body on each side of the unit, showing apparent sinistral shearing. Within the hornblende‐rich body itself, microstructures and electron back‐scatter diffraction mapping show evidence of the former presence of melt including observations consistent with melt crystallization within pore spaces, elongate pseudomorphs of melt films along grain boundaries, minerals with low dihedral angles as small as <10° and up to <60°, and interconnected 3D melt pseudomorph networks. Reaction microstructures with highly irregular contact boundaries are observed at the field and thin‐section scale in remnant islands of original rock and replaced grains, respectively. We infer that the hornblende‐rich body was formed by modification of the host GG in situ due to reaction between an externally derived, reactive, hydrous gabbroic to intermediate melt percolating via porous melt flow through an actively deforming zone. Extensive melt–rock interaction and metasomatism occurred via coupled dissolution–precipitation, triggered by chemical disequilibrium between the host rock and the fluxing melt. As a result, the host plagioclase and pyroxene became unstable and were reacted and dissolved into the melt, while hornblende and to a lesser extent clinozoisite and garnet grew replacing the unstable phases. Our study shows that hornblendite rocks commonly observed within deep crustal sections, and attributed to cumulate fractionation processes, may instead delineate areas of deformation‐assisted, channelized reactive porous melt flow formed by melt‐mediated coupled dissolution–precipitation replacement reactions.
Surgical nurses' perceptions and experiences of a medications and oral restrictions policy change: A focus group study
Authors: To The‐Phung , Dunnachie Gillian , Brien Jo‐anne , Story David A.
Published: April 2019

Aims and objectives

To explore the perceptions and experiences of surgical nurses before and after introducing the Medications and Oral Restrictions Policy (the Policy).

Background

The Policy was developed following extensive consultation, and evidence‐based strategies were considered for its implementation. However, it is possible uptake did not meet expectations.

Design

Focus group interviews.

Methods

Three focus groups were conducted in November 2015 around ‘what worked, what didn't and why, before and after hospital‐wide implementation of the Policy.’ Data were coded and analysed using an inductive–deductive thematic analysis approach. The COREQ checklist guided reporting.

Results

The three groups consisted of 16, 14 and six surgical nurses. Before the Policy, there was confusion, lack of clarity and guidance, and lack of experience and confidence in managing medications when patients had oral restrictions. After the Policy rollout, there was a sense of ‘knowing what to do’ because of improved clarity and decision support; but there were also problems with: not everyone knowing about the policy, particularly due to staff movement and turnover; and, individual interpretation of the policy including use of its signs outside of context, and decision‐making processes.

Conclusion

Exploration of nurses' perceptions of a medication‐related policy change found that while the Policy provided clarity and decision support for some, it made little difference for others. Limited reach of the policy was an issue despite an effort to address this at the outset, as well as variations in interpretation of the policy and subsequent decision‐making.

Relevance to clinical practice

How individuals interpret information and their understanding of the context behind the policy or guideline may affect implementation and should be considered alongside other barriers when implementing medication‐related initiatives. Furthermore, implementation strategies that are independent of ongoing resources and/or key champions to sustain should be prioritised for all initiatives.
Domestic violence and suicide attempts among married women: A case–control study
Authors: Rahmani Farzad , Salmasi Shiva , Rahmani Farnaz , Bird Jamie , Asghari Elnaz , Robai Navide , Asghari Jafarabadi Mohammad , Gholizadeh Leila
Published: April 2019

Aims and objectives

To investigate the impact of domestic violence‐related factors on suicide attempt in married women.

Background

Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women.

Design

A retrospective case–control design was adopted.

Methods

Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of Iran, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence‐related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, and simple and multivariate logistic regression analysis were used to analyse the data. Odds ratios (OR) of domestic violence‐related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study.

Results

The mean age of participants in the case and control groups was 28.4 and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08–326. 63, p < 0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54–118.67, p < 0.001), jealousy of husband (OR 23.46, 95%CI 11.63–47.30, p < 0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91–46.31, p < 0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father‐in‐law (p < 0.001).

Conclusions

To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals.

Relevance to clinical practice

Recognising risk, assessment and referral of victims of domestic violence should be an integral part of healthcare systems.
Strigolactone represses the synthesis of melatonin, thereby inducing floral transition in Arabidopsis thaliana in an FLC‐dependent manner
Authors: Zhang Zixin , Hu Qian , Liu Yanan , Cheng Peilei , Cheng Hua , Liu Weixin , Xing Xiaojuan , Guan Zhiyong , Fang Weimin , Chen Sumei , Jiang Jiafu , Chen Fadi
Published: April 2019

The transition from vegetative to reproductive growth is a key developmental event in a plant's life cycle. The process is mediated by a combination of phytohormones, including melatonin (MT) and strigolactone (SL). Here, the Arabidopsis mutants, d14‐1 and max4‐1, which are compromised with respect to either SL synthesis or signaling, were shown to flower earlier than wild types. The tissue MT content in both mutants was higher than in wild types, as a result of the up‐regulation of various genes encoding enzymes involved in MT synthesis. The abundance in the mutants of transcripts derived from each of the genes SPLs, AP1, and SOC1 was reduced with exogenously supplied MT, while FLC was induced. Plants exposed to a high concentration of MT did not flower earlier than wild types. The tissue MT content of a mutant unable to synthesize caffeic acid O‐methyltransferase was less than that of wild type and flowered earlier than did wild types. The suggestion is that the flowering time of Arabidopsis is altered if the tissue content of MT is either higher than ~ 8 ng/g F.W, or lower than ~ 0.9 ng/g. Within this range, SL acts to determine flowering time by its regulation of SPL genes. The application of exogenous SL reduces tissue MT content. The flowering time of the flc‐3 mutant was unaffected by exogenously supplying either MT or/and SL. It is proposed that MT acts downstream of SL to activate FLC, inducing a delay to flowering if its concentration lies outside a certain range.
The Association Between Telemedicine and Emergency Department (ED) Disposition: A Stepped Wedge Design of an ED‐Based Telemedicine Program in Critical Access Hospitals
Authors: Natafgi Nabil , Mohr Nicholas M. , Wittrock Amy , Bell Amanda , Ward Marcia M.
Published: April 2019

Purpose

To study the relationship between the availability and activation of emergency department‐based telemedicine (teleED) and patient disposition in Critical Access Hospitals (CAHs).

Methods

A non randomized stepped wedge design examined 133,396 ED visits in 15 CAHs that subscribe to a single teleED provider. Data were available for at least 12 months prior to teleED implementation and at least 12 months of post‐implementation. Primary analyses were conducted using multinomial logistic regression models with teleED availability (indicator of post‐teleED implementation period) and activation (indicator of utilization of teleED service) predicting discharge disposition adjusting for age, sex, and clinical diagnosis.

Results

Patients for whom teleED was activated were more likely to be transferred [adjusted odds ratio (aOR) = 12.04; 95% confidence interval (CI), 10.97‐13.21] and more likely to be admitted to the local hospital (aOR = 3.23; 95% CI, 2.84‐3.67) than to be routinely discharged. This pattern was confirmed for patients presenting with chest pain, mental illness, and injury/poisoning. However, in the period following teleED implementation, patients presenting to EDs after telemedicine was available, but not necessarily utilized, were less likely to be admitted to the local hospital (aOR = 0.79; 95% CI, 0.76‐0.82) than to be routinely discharged.

Conclusions

Telemedicine availability in CAH EDs is associated with a higher likelihood of routine discharges from the ED possibly due to changes in care associated with teleED implementation. The relationship between teleED use and disposition may be related to selection in activating teleED for cases more likely to require hospital inpatient care.
Bed and rise times during the Age of Enlightenment: A case report
Authors: van Egmond Lieve , Ekman Martin , Benedict Christian
Published: April 2019

Studies have shown that our modern electrical lighting environment reduces naturally occurring seasonal variations in sleep–wake rhythms, such as longer sleep during the winter versus summer. However, less is known about how timing and duration of sleep were affected by the seasons in the premodern era, before the invention of electrical lighting. The Swedish researcher Olof Hiorter collected and documented geophysical data every hour during wakefulness in Uppsala, Sweden, between December 1746 and November 1747. In this way, his bed and rise times could be approximated. The data revealed that Hiorter's rise times occurred around 1 hr before sunrise in winter versus 1 hr after sunrise in summer. No such association was observed between the time of sunset and Hiorter's bedtimes. Finally, the time in bed was about 3.5–4 hr shorter in summer compared to winter. This 273‐year‐old case report suggests that time in bed and rise times of people from the premodern era exhibited seasonal variations.
Real‐world effectiveness of sofosbuvir/velpatasvir/voxilaprevir in 573 direct‐acting antiviral experienced hepatitis C patients
Authors: Belperio Pamela S. , Shahoumian Troy A. , Loomis Timothy P. , Backus Lisa I.
Published: April 2019

Sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) provides a needed hepatitis C virus (HCV) antiviral option for direct‐acting antiviral (DAA)‐experienced patients. We evaluated the effectiveness of SOF/VEL/VOX for 12 weeks in DAA‐experienced patients with genotype 1‐4 treated in clinical practice. In this observational cohort analysis from the Veterans Affairs’ Clinical Case Registry, 573 DAA‐experienced patients initiating SOF/VEL/VOX were included: 490 genotype 1, 20 genotype 2, 51 genotype 3 and 12 genotype 4. Rates of cirrhosis were 32.7%, 30.0%, 49.0% and 58.3%; rates of prior NS5A‐experience were 100.0%, 95.0%, 90.2% and 100.0% for genotypes 1‐4, respectively. Overall SVR rates were 90.7% (429/473), 90.0% (18/20), 91.3% (42/46) and 100.0% (12/12) for genotypes 1‐4, respectively, and were 91.3% (274/300), 88.9% (16/18), 90.2% (37/41) and 100.0% (11/11) for those with prior NS5A + NS5B experience. For genotype 1, SVR rates were similar in patients with prior regimens of ledipasvir/SOF (90.6%, 298/329), elbasvir/grazoprevir (91.2%, 73/80) and ombitasvir/paritaprevir/ritonavir/dasabuvir (90.9%, 70/77). SVR rates in genotype 1, 2 and 3 patients with prior SOF/VEL experience were 78.9% (15/19), 86.7% (13/15) and 84.6% (11/13). In genotype 1‐4 patients completing 12 weeks of SOF/VEL/VOX, overall SVR rates were 95.1% (409/430), 89.5% (17/19), 93.3% (42/45) and 100% (12/12). In this diverse real‐world cohort of heavily NS5A pretreated patients, SOF/VEL/VOX SVR rates in DAA‐experienced patients were high across all genotypes. Genotype 1 patients who had prior experience with the most commonly prescribed NS5A regimens achieved similarly high SVR rates when retreated with SOF/VEL/VOX. For genotypes 1, 2 and 3, patients with prior SOF/VEL experience had lower SVR rates.
Encouraging interviewees to say more and deception: The ghostwriter method
Authors: Leal Sharon , Vrij Aldert , Deeb Haneen , Kamermans Kevin
Published: April 2019

Background

We examined a new method to encourage interviewees to say more, the ghostwriter method, and examined its effect on eliciting information and cues to deceit.

Method

A total of 150 truth tellers and liars either told the truth about a trip they made in the last 12 months or pretended to have made such a trip. They were allocated to a Control condition, a ‘Be detailed’ condition in which they were encouraged to report even small details and a ghostwriter condition in which they were told to imagine talking to a ghostwriter. The dependent variables were details, complications, common knowledge details, self‐handicapping strategies, proportion of complications, plausibility, and verifiable sources.

Results

The ghostwriter condition elicited more details and revealed in plausibility a stronger cue to deceit than the other two conditions.

Conclusion

The ghostwriter method appears to be a promising tool for eliciting information and cues to deceit.
Landscape genomic signatures indicate reduced gene flow and forest‐associated adaptive divergence in an endangered neotropical turtle
Authors: Gallego‐García Natalia , Forero‐Medina Germán , Vargas‐Ramírez Mario , Caballero Susana , Shaffer Howard Bradley
Published: April 2019

Human‐induced transformations of ecosystems usually result in fragmented populations subject to increased extinction risk. Fragmentation is also often associated with novel environmental heterogeneity, which in combination with restricted gene flow may increase the opportunity for local adaptation. To manage at‐risk populations in these landscapes, it is important to understand how gene flow is changing, and how populations respond to habitat loss. We conducted a landscape genomics analysis using Restriction‐site Associated DNA sequencing to investigate the evolutionary response of the critically endangered Dahl's Toad‐headed turtle (Mesoclemmys dahli) to severe habitat modification. The species has lost almost all of its natural habitat in the southwestern part of its range and about 70% in the northeast. Based on least cost path analysis across different resistance surfaces for 3,211 SNPs, we found that the landscape matrix is restricting gene flow, causing the fragmentation of the species into at least six populations. Genome scans and allele‐environment association analyses indicate that the population fragments in the deforested grasslands of the southwest are adaptively different from those in the more forested northeast. Populations in areas with no forest had low levels of adaptive genetic diversity and the fixation of ancestrally‐polymorphic SNPs, consistent with directional selection in this novel environment. Our results suggest that this forest‐stream specialist is adapting to pond‐grassland conditions, but it is also suffering from negative consequences of habitat loss, including genetic erosion, isolation, small effective population sizes, and inbreeding. We recommend gene flow restoration via genetic rescue to counteract these threats, and provide guidance for this strategy.
Beyond the struggles: a scoping review on the transition to undergraduate clinical training
Authors: Atherley Anique , Dolmans Diana , Hu Wendy , Hegazi Iman , Alexander Sonita , Teunissen Pim W
Published: April 2019

Context

The transition to clinical training within medical school is often seen as a struggle and students remain in distress despite numerous efforts to minimise threats. Efforts to change this may be misdirected if they are based on narrow conceptualisations of transitions. The authors conducted a scoping review to explore existing conceptual perspectives regarding the transition within medical school from pre‐clinical training to clinical training to suggest a research agenda and practical implications.

Methods

Between October 2017 and February 2018 the authors searched PubMed, MEDLINE, ERIC, PsycINFO, Web of Science and CINAHL for English language literature with no date limits and retrieved 1582 articles; 46 were included in this review. Two reviewers independently screened articles and extracted data. Data were then charted, analysed and discussed with the research team.

Results

The transition to clinical training was often described negatively as ‘difficult’, ‘a problem’ and ‘a struggle’. Our analysis found that researchers in medical education conducted studies on the transition to clinical training from three conceptual perspectives: educational; social, and developmental. Most research approached the transition to clinical training as a problem to be addressed from an educational perspective through transition to clerkship courses and curriculum innovations. Some research was conducted from a social perspective, focusing on building relationships. Regarding development, authors found a few articles highlighting opportunities for personal and professional development by nurturing transferrable learning strategies and reflection.

Conclusions

This review provides an empirical base on which future research can be built to better understand and support medical students’ ability to navigate change. Finding new perspectives to approach the transition to clinical training could allow researchers to look beyond preparing students for struggles.
Commelina littoralis (Commelinaceae), a new species from India
Authors: Nandikar Mayur D. , Naik Mudavath Chennakesavulu
Published: April 2019

The present article accounts for a previously overlooked, new species of Commelina from Andaman and Nicobar Islands, India. The new species, here described as Commelina littoralis can be distinguished e.g. by its white antherodes, and appendaged seeds. It is compared with the similar, cosmopolitan species C. diffusa and C. caroliniana and provided with a description, illustration, photographs and distribution.
School‐level factors associated with obesity: A systematic review of longitudinal studies
Authors: Gray Heewon L. , Buro Acadia W. , Barrera Ikan Janelle , Wang Wei , Stern Marilyn
Published: April 2019

Although school has been an important intervention venue for obesity prevention, the role of school‐level factors in obesity development or prevention has not been well‐documented. This study aimed to systematically examine the current evidence on school‐level factors associated with obesity outcomes in longitudinal studies. The literature search was performed in PubMed, EMBASE, CINHAL, and PsycINFO. Peer‐reviewed articles using longitudinal study designs and published in English from 1991 to 2018 were eligible. Twelve articles met eligibility criteria for final systematic review. Nine studies reported significant long‐term associations between school‐level factors and obesity outcomes. Higher parental education, longer minutes of recess, meeting recommended recess and physical education time, higher socio‐economic status, suburban compared with rural area, higher parental involvement in school, and healthful school food environment were significantly associated with lower rates of obesity or obesity trajectory. However, due to the small number of studies and heterogeneity of measures and variables used in their analytic models, the overall level of evidence from this review suggests the importance of further, systematic study. Empirically rigorous research is needed to identify additional aspects of the school context and environment that may contribute to the risk of obesity throughout the life course.
Dental management of lymphangiomatosis: case report
Authors: Charrette D. , Mulvihill C. , Brady P.
Published: April 2019

Lymphangiomatosis is a rare type of diffuse tumour, which develops from an aberrant growth of the lymphatic vessels, and can produce progressive osteolysis of bone in multiple organ systems. In this article, we illustrate a rare case of a 14‐year‐old female patient with lymphangiomatosis affecting the maxillofacial bones. The patient showed a marked deviation from normal maxillofacial growth patterns resulting in significant malocclusion and oral complications. The present study examines and considers the multidisciplinary management of the case with a brief review of the literature.
Success of chemotherapy and a liver transplant in a pediatric patient with hepatic angiosarcoma: A case report
Authors: Pilbeam Kristy , Eidenschink Ben , Sulciner Megan , Luquette Mark , Neglia Joseph , Chinnakotla Srinath
Published: April 2019

Hepatic angiosarcoma is an extremely rare diagnosis in children, with fewer than 50 pediatric cases reported in the literature worldwide. This aggressive vascular sarcoma carries a very dismal prognosis and is known to be resistant to radiation, chemotherapy, and other vascular‐targeted agents. Complete surgical resection is felt to provide the best chance for long‐term survival. In patients with tumors not amenable to resection, a liver transplant can be considered. However, very few such transplants have been reported, given that they remain controversial due to high cancer recurrence and mortality post‐transplant. Herein, we report the unique case of a 2‐year‐old child with localized hepatic angiosarcoma not amendable to resection who successfully underwent a liver transplant and received chemotherapy with six cycles of doxorubicin, docetaxel, and ifosfamide.
Hepatic artery reconstruction with interposition of donor’s right gastroepiploic artery graft in pediatric living donor liver transplantation for metabolic disease
Authors: Chen Xiaojie , Wei Lin , Zhu Zhijun , Sun Liying , Qu Wei , Zeng Zhigui
Published: April 2019

Objective

We introduce the indications, technique, results of our experience using donor's RGEA as interposition vessel to solve hepatic artery reconstruction problems in P‐LDLT.

Methods

A retrospective analysis of P‐LDLT for children with metabolic diseases from June 2013 to November 2018 in our center was carried out. The arterial conditions, reconstruction methods, and prognosis were analyzed.

Results

A total of 73 children with metabolic diseases underwent P‐LDLT during the period. The LLF was the main graft, accounting for 71.2%. The donor's RGEA was utilized in five cases. There were three children with OTCD and two children with deficiency of CPS1 and MSUD, respectively. In three cases, the grafts’ left hepatic arteries were anastomosed with the recipients’ PHA using donors’ RGEA as interposition vessel. In other two cases, the donors’ RGEA was interposed between graft's MHA and the recipient's bifurcation of PHA and GDA. The average follow‐up time was 19.7 ± 15.9 month. There were two cases of artery thrombosis or occlusion, and the incidence was 2.7%. No arterial complications occurred in children using RGEA (follow‐up time 5.0 ± 3.4 months).

Conclusion

In P‐LDLT for patients with metabolic diseases, the application of RGEA as an interposition vessel can solve caliber mismatch and short arteries problem and achieve good results. Compared with traditional arterial anastomosis, it may reduce the incidence of arterial complications.
Low‐dose azacitidine for relapse prevention after allogeneic hematopoietic cell transplantation in children with myeloid malignancies
Authors: Oshrine Benjamin R. , Shyr David , Hale Gregory , Petrovic Aleksandra
Published: April 2019

Background

The prognosis of children who relapse after allogeneic hematopoietic cell transplant (alloHCT) for myeloid malignancies remains poor.

Procedure

To describe the safety and feasibility of post‐transplant azacitidine for relapse prevention, we retrospectively reviewed the charts of 18 children undergoing alloHCT for myeloid malignancies.

Results

There were 15 evaluable patients since three patients did not receive planned azacitidine due to early relapse or TRM. Azacitidine (32 mg/m2/dose for 5 days, in 28‐day cycles as tolerated up to 1 year post‐transplant) was started at a median of 66 days post‐transplant (range 42‐118). Two‐thirds (10/15) of patients received eight or more cycles. Five patients stopped therapy early, only one attributable to toxicity. Mild myelosuppression was the most common reason for cycle delays. Dose modifications were made in three patients. There were three relapses, two of which occurred in patients in CR2 and one in CR1, with a median follow‐up of 20 months (range 12.5‐28), and no TRM in patients who received azacitidine.

Conclusions

Post‐transplant azacitidine in children is safe and feasible, with most patients successfully receiving all planned cycles. Despite the limitations of a small cohort, low relapse incidence suggests a potential benefit in disease control that warrants further investigation.
SrfC of Pseudomonas cichorii JBC1 affects its attachment to the host surface and host tissue infection
Authors: Nagendran R. , Lee Y. H.
Published: April 2019

Plant pathogenic Pseudomonas species produce effectors, toxins and cyclic lipopeptides to infect various host plants. Despite many studies aiming to understand the underlying mechanisms of virulence in Pseudomonas spp., the function of genes in the srf gene cluster including srfC, which was formerly known as HopL1, remains undetermined. To investigate the roles of srf genes in the virulence of the bacterial pathogen, each srfA, srfB, srfC and srfD gene from the srf cluster of Pseudomonas cichorii JBC1 was knocked out. When tomato seedlings were infected with the knockout mutants by flood inoculation, disease incidence was suppressed only in srfC‐defective mutants (∆srfC) compared to wildtype. Interestingly, when the ∆srfC strain was inoculated directly into the apoplast of tomato leaves by vacuum infiltration, disease developed similar to that of the wildtype. In addition, the ∆srfC strain showed defective swarming motility and biofilm formation, and the attachment of ∆srfC cells on the leaf surface was significantly reduced compared to wildtype. Furthermore, droplets of the ∆srfC culture supernatant did not spread on a hydrophobic surface, unlike the wildtype. The results indicate that the SrfC protein plays important roles in swarming motility, biofilm formation and attachment/colonization on host surfaces; thus, it is beneficial for the pathogen's dispersion and entry into host tissues and consequently contributes to disease development. This study elucidates for the first time the functional role of srfC in P. cichorii virulence. The results will broaden understanding of plant and bacterial pathogen interactions.
The Intimate Link Between Income Levels and Life Expectancy: Global Evidence from 213 Years*
Authors: Jetter Michael , Laudage Sabine , Stadelmann David
Published: April 2019

Objectives

What is the main driver of life expectancy across societies and over time? This study aims to document a systematic and quantitatively sizeable relationship between income levels and life expectancy.

Method

A panel data set of 197 countries over 213 years is analyzed with different regression methods. Robustness tests are provided.

Results

By itself, GDP per capita explains more than 64 percent of the variation in life expectancy. The Preston curve prevails even when accounting for country‐ and time‐fixed effects, country‐specific time trends, and alternative explanatory variables such as health‐care expenditure, malaria prevalence, or political institutions. If anything, this link has become stronger over recent decades when data quality has improved. Results from instrumental variable estimations suggest this finding to be largely unaffected by reverse causality. Quantile regression results suggest the relationship between income and life expectancy to be persistent across different levels of life expectancy.

Conclusion

Income matters for life expectancy. If policymakers want to prolong people's lives, economic growth appears to be the predominant medicine.
Reflections on Grant Evans’ The Politics of Ritual and Remembrance: Laos since 1975
Authors: Cohen Paul T.
Published: April 2019

In this article I reflect on Grant Evans’ landmark and influential The Politics of Ritual and Remembrance: Laos since 1975, the way in which this book relates to the transformation from socialism to post‐socialism in the Lao People's Democratic Republic (LPDR), to the crisis of legitimacy of the communist regime, and to issues of social memory, Buddhism, nationalism, iconography, and ethnic minorities. I also consider how other scholars have engaged with The Politics of Ritual and Remembrance both critically and supportively since the publication of the monograph in 1998. I include in my analysis some observations on Evans’ quite radical change in political views over his career as a student, journalist and academic, culminating in his critique of socialism in general and the LPDR in particular and his controversial sympathy for the Lao monarchy.
Effectiveness of blood donor screening by HIV, HCV, HBV‐NAT assays, as well as HBsAg and anti‐HBc immunoassays in Germany (2008–2015)
Authors: Fiedler Sarah A. , Oberle Doris , Chudy Michael , Scheiblauer Heinrich , Henseler Olaf , Halbauer Jochen , Heiden Margarethe , Funk Markus
Published: April 2019

Background and Objectives

In Germany, in addition to standard blood donor screening, further mandatory tests were introduced for HCV‐RNA, HIV‐1‐RNA and for anti‐HBc. Screening for HBV‐DNA is optional. This study investigates the benefits of these additional tests for the detection of HIV, HCV, and HBV infections among German blood donors.

Materials and Methods

From 2008 to 2015 we collected data on blood donations exclusively testing NAT positive (NAT yield) or reactive in only one of the screening assays. Assuming a Poisson distribution, we calculated NAT yield/reactive only rates on a per donation basis (number of yield/reactive only cases divided by the number of donations tested in the period under review) with 95% confidence intervals.

Results

Responding establishments covered 95% of the donations. We identified 20 HIV‐1‐NAT, 61 HCV‐NAT and 29 HBV‐NAT yield cases among approximately 46 million blood donations tested corresponding to 0·43 HIV‐1 NAT, 1·32 HCV‐NAT, and 0·64 HBV‐NAT yield cases per million blood donations tested. For one HBsAg reactive only case and 23 anti‐HBc reactive only cases in repeat donors, infection was confirmed by ID‐NAT which translates into 0·02 and 0·55 cases per million donations tested. During the 8‐year‐observation period, one HIV‐1, no HCV and four HBV transmissions associated with donations in the viremic pre‐seroconversion window period were reported.

Conclusion

Annually, NAT screening alone detected 2·5 HIV‐1, 7·6 HCV, and 3·6 HBV infectious donations; anti‐HBc screening alone identified 2·9 infectious donations of repeat donors with occult HBV infection. Overall, the survey results support that the currently practiced donor HIV/HCV/HBV screening strategy in Germany does ensure a high standard of blood safety.
Prolonged survival after craniectomy with skull reconstruction and adjuvant definitive radiation therapy in three dogs with multilobular osteochondrosarcoma
Authors: Holmes Molly E. , Keyerleber Michele A. , Faissler Dominik
Published: April 2019

Multilobular osteochondrosarcoma is an uncommon canine tumor but presents a treatment challenge when arising on the skull. This retrospective case series study aimed to describe outcome of a multimodality treatment approach involving aggressive surgical resection and adjuvant definitive radiation therapy in a group of dogs with multilobular osteochondrosarcoma of the calvarium. Clinical, imaging, treatment, and outcome data were collected from retrospective review of medical records. Three dogs met inclusion criteria. The presenting clinical complaint was the presence of a mass effect of the skull in all three dogs and concurrent neurologic abnormalities in one dog. Advanced imaging revealed aggressive lytic and proliferative tumors arising from the calvarium in all three dogs. All dogs were treated surgically with a modified craniectomy, repaired with a titanium mesh—polymethyl methacrylate bone cement implant or a low prolife titanium mesh plate and followed by adjuvant definitive radiation therapy with 2.5 Gy per fraction for 22 daily fractions. There were no major immediate surgical complications and radiation was well tolerated overall. Neurologic improvement was seen in the patient that presented with neurologic disease. Survival times from surgery were 387, 422, and 730 days and from the time of radiation were 358, 397, and 677 days. Findings in this sample of three dogs supported the use of aggressive therapy with a combination of surgical craniectomy and cranioplasty utilizing a titanium mesh implant and high dose definitive radiation therapy for local control and prolonged survival times in dogs with multilobular osteochondrosarcoma of the skull.
Improving Provider Readiness for Intimate Partner Violence Screening
Authors: Lee Amy S. D. , McDonald Lynn R. , Will Susan , Wahab Maybel , Lee Judy , Coleman Jenell S.
Published: April 2019

Background

Intimate partner violence (IPV) is a significant public health issue. Healthcare providers (e.g., nurses, advanced practice nurses, physicians, social workers) have a unique opportunity to prevent and reduce IPV through screening and referral. The objective of this project was to determine the impact of education and a brief screening tool integrated into the electronic medical record (EMR) on readiness to screen for IPV.

Methods

An intervention was implemented that included the EMR integration of a screening tool, creation of an automated resource telephone system and healthcare provider IPV screening and response education. Readiness for screening was evaluated pre‐ and postintervention using the Domestic Violence Health Care Provider Survey Scale (DVHCPSS), which is scored cumulatively and by each of six domains. An unpaired Student's t test was performed.

Results

Mean age (31–40 years of age) and years of clinical practice (11–15 years) was the same for pre‐ (n = 96) and postintervention (n = 83) survey respondents. There was an overall significant increase in screening readiness (p = .003) with significant improvement in “professional role resistance/fear of offending the patient” (p < .0001), “blame victim items” (p = .0029), “perceived self‐efficacy” (p = .0064), and “victim/provider safety” (p = .003).

Linking Evidence to Action

Adopting and integrating a validated IPV screening tool into the EMR combined with education was associated with an improvement in overall readiness for IPV screening. Reducing and preventing IPV through universal screening and referral can be accomplished by embedding a standardized readily accessible validated IPV screening tool in the EMR.
Analysis of boride layer thickness of borided AISI 430 by response surface methodology
Authors: Turkoglu Turker , Ay Irfan
Published: April 2019

The boriding process is a thermochemical surface treatment which can be applied to many iron and non-ferrous materials and improves the properties of the material such as hardness, wear resistance. In the present study, the layer thickness values of the boronized AISI 430 material were optimized using the Response Surface Methodology. Mathematical model was constructed using parameters such as temperature and time and the results were analyzed comparatively. As a result of the analysis, the optimum layer thickness value for AISI 430 material was obtained as 39.0183 µm for 1000 ºC and 5.9h and it was determined that the boriding temperature and time are effective on the boride layer formation process of AISI 430 material. Finally, the Response Surface Methodology and Face Centered Central Composite Design have been effectively applied to the boriding process.
A Machine Learning Approach to Aircraft Sensor Error Detection and Correction
Authors: Swischuk Renee , Allaire Douglas
Published: April 2019

Sensors are crucial to modern mechanical systems. The location of these sensors can often make them vulnerable to outside interferences and failures, and the use of sensors over a lifetime can cause degradation and lead to failure. If a system has access to redundant sensor output, it can be trained to autonomously recognize errors in faulty sensors and learn to correct them. In this work, we develop a novel data-driven approach to detect sensor failures and predict the corrected sensor data using machine learning methods in an offline/online paradigm. Autocorrelation is shown to provide a global feature of failure data capable of accurately classifying the state of a sensor to determine if a failure is occurring. Feature selection of the redundant sensor data in combination with k-nearest neighbors regression is used to predict the corrected sensor data rapidly, while the system is operational. We demonstrate our methodology on flight data from a four-engine commercial jet that contains failures in the pitot static system resulting in inaccurate airspeed measurements.
Tracing the origin and evolution of pseudokinases across the tree of life
Authors: Kwon Annie , Scott Steven , Taujale Rahil , Yeung Wayland , Kochut Krys J. , Eyers Patrick A. , Kannan Natarajan
Published: April 2019

Pseudokinases are prevalent across species and contribute diverse, noncatalytic signaling functions.
Bacterial and Fungal Endophytic Microbiomes ofSalicornia europaea
Authors: Furtado Bliss Ursula , Gołębiewski Marcin , Skorupa Monika , Hulisz Piotr , Hrynkiewicz Katarzyna
Published: April 2019

Endophytes are particularly fascinating because of their multifaceted lifestyle, i.e., they may exist as either free-living soil microbes or saprobic ones or pathogens. Endophytic communities of halophytes may be different than those in other plants because salinity acts as an environmental filter. At the same time, they may contribute to the host’s adaptation to adverse environmental conditions, which may be of importance in agriculture.
Simple semi-permanent blockade against rigid varus foot in a case with spasticity: possible practical benefits in ambulatory adults
Authors: Yahata Tetsutaro , Maruta Takahiro , Nakanami Aki
Published: April 2019

A 55-year-old ambulatory woman with hemiplegia and varus foot deformity had several problems in her daily life, including load pain and stance instability in the affected foot, easy fatigue of the non-paralysed leg, low back pain, neck stiffness and rapid shoe-rubber wear on the deformed side. We began repeated focal blockades using botulinum toxin to the tibialis posterior muscle to control varus spasticity. Distant influences presenting in the whole body were relieved soon after the first blockade, and shoe wear also stopped. Although, neither the deformed appearance nor foot contact pattern on walking changed in the initial period after beginning the blockade, the foot contact pattern revealed gradual improvement over several years. Generally, surgical correction is indicated for the treatment of deformed feet. The present case suggests that, in case of varus-deformed foot with some spastic elements, trial of focal blockade for varus spasticity may be worthwhile.