bluuebunny/crossref_metadata_2025 huggingface dataset:
AT1‐R is involved in the development of long‐lasting, region‐dependent and oxidative stress‐independent astrocyte morphological alterations induced by Ketamine
Authors: Occhieppo Victoria B. , Basmadjian Osvaldo M. , Marchese Natalia A. , Silvero C M. Jazmin , Rodríguez Anahí , Armonelli Samanta , Becerra María C. , Baiardi Gustavo , Bregonzio Claudia
Published: April 2020

Astrocytes play an essential role in the genesis, maturation and regulation of the neurovascular unit. Multiple evidence support that astrocyte reactivity has a close relationship to neurovascular unit dysfunction, oxidative stress and inflammation, providing a suitable scenario for the development of mental disorders. Ketamine has been proposed as a single‐use antidepressant treatment in major depression, and its antidepressant effects have been associated with anti‐inflammatory properties. However, Ketamine long‐lasting effects over the neurovascular unit components remain unclear. Angiotensin II AT1 receptor (AT1‐R) blockers have anti‐inflammatory, antioxidant and neuroprotective effects. The present work aims to distinguish the acute and long‐term Ketamine effects over astrocytes response extended to other neurovascular unit components, and the involvement of AT1‐R, in prefrontal cortex and ventral tegmental area. Male Wistar rats were administered with AT1‐R antagonist Candesartan/Vehicle (days 1–10) and Ketamine/Saline (days 6–10). After 14 days drug‐free, at basal conditions or after Ketamine Challenge, the brains were processed for oxidative stress analysis, cresyl violet staining and immunohistochemistry for glial, neuronal activation and vascular markers. Repeated Ketamine administration induced long‐lasting region‐dependent astrocyte reactivity and morphological alterations, and neuroadaptative changes observed as exacerbated oxidative stress and neuronal activation, prevented by the AT1‐R blockade. Ketamine Challenge decreased microglial and astrocyte reactivity and augmented cellular apoptosis, independently of previous treatment. Overall, AT1‐R is involved in the development of neuroadaptative changes induced by repeated Ketamine administration but does not interfere with the acute effects supporting the potential use of AT1‐R blockers as a Ketamine complementary therapy in mental disorders.
Phenomenology and the stratification of reality
Authors: Kinkaid James
Published: April 2020

Phenomenologists have no taste for desert landscapes. The early phenomenologists—Edmund Husserl, Max Scheler, and Roman Ingarden—adopt stratified views of reality on which spiritual objects like artifacts and persons are distinct from their underlying matter. Call this view “pluralism.” After describing Scheler, Ingarden, and Husserl's pluralism about goods, literary artworks, and images, respectively, I reconstruct a phenomenological case for pluralism from Husserl's work and defend it against an objection. The phenomenological method reveals a special subset of objects' essential properties: modes of givenness. On Husserl's view, there are necessary correlations between types of objects and the types of intentional acts through which they are given. Spiritual objects, unlike their matter, can only be given in acts belonging to the “personalistic attitude,” which has a motivational and expressive structure. My broader claim is that Husserl's phenomenology is a sophisticated metametaphysical view about the methodology of first‐order metaphysical inquiry.
Partial aneurysmectomy and autologous patch venoplasty in a horse diagnosed with pseudoaneurysm of the jugular vein
Authors: De Clercq E. , Martens A. , Matthys H. , Wiemer P. , Ugahary F. , van Loon G.
Published: April 2020

Experience with vascular pathology and vascular surgery, especially with the use of grafts, is limited in horses. Only one case of a venous aneurysm has been described in the horse, but without successful surgical correction. This case report describes the treatment of a 3‐year‐old female pony presented with an intermittent localised swelling of the left jugular vein after a previous thrombophlebitis. Ultrasonographic examination revealed a large jugular vein pseudoaneurysm. Treatment consisted of a partial aneurysmectomy preserving the healthy medial wall of the jugular vein. An autologous saphenous vein patch technique was used to reconstruct the vein with the largest possible lumen to minimise thrombus formation. Anticoagulants, antimicrobial and anti‐inflammatory drugs were administered pre‐ and post‐operatively. Follow‐up ultrasound examinations initially showed local narrowing of the graft. At 2 and 8 months post‐operatively, no external deformation of the jugular vein was visible and ultrasonography revealed patent blood flow with only a slight difference in lumen diameter. The patch venoplasty proved a viable surgical technique for jugular vein reconstruction resulting in a sufficient lumen, no thrombus formation and a good cosmetic and functional outcome.
Intracellular cathepsin C levels determine sensitivity of cells to leucyl‐leucine methyl ester‐triggered apoptosis
Authors: Kavčič Nežka , Butinar Miha , Sobotič Barbara , Hafner Česen Maruša , Petelin Ana , Bojić Lea , Zavašnik Bergant Tina , Bratovš Andreja , Reinheckel Thomas , Turk Boris
Published: April 2020

L‐leucyl‐leucine methyl ester (LLOMe) is a lysosomotropic detergent, which was evaluated in clinical trials in graft‐vs‐host disease because it very efficiently killed monocytic cell lines. It was also shown to efficiently trigger apoptosis in cancer cells, suggesting that the drug might have potential in anticancer therapy. Using U‐937 and THP‐1 promonocytes as models for monocytic cells, U‐87‐MG and HeLa cells as models for cancer cells, and noncancerous HEK293 cells, we show that the drug triggers rapid cathepsin C‐dependent lysosomal membrane permeabilization, followed by the release of other cysteine cathepsins into the cytosol and subsequent apoptosis. However, monocytes were found to be far more sensitive to the drug than the cancer and noncancer cells, which is most likely a consequence of the much higher intracellular levels of cathepsin C—the most upstream molecule in the pathway—in monocytic cell lines as compared to cancer cells. Overexpression of cathepsin C in HEK293 cells substantially enhances their sensitivity to the drug, consistent with the crucial role of cathepsin C. Major involvement of cysteine cathepsins B, S, and L in the downstream signaling pathway to mitochondrial cell death was confirmed in two gene ablation models, including the ablation of the major cytosolic inhibitor of cysteine cathepsins, stefin B, in primary mouse cancer cells, and simultaneous ablation of two major cathepsins, B and L, in mouse embryonic fibroblasts (MEFs). Deletion of stefin B resulted in sensitizing primary murine breast cancer cells to cell death without affecting the release of cathepsins, whereas simultaneous ablation of cathepsins B and L largely protected MEFs against cell death. However, due to the extreme sensitivity of monocytes to LLOMe, it appears that the drug may not be suitable for anticancer therapy due to risk of systemic toxicity.
Early vigour in wheat: Could it lead to more severe terminal drought stress under elevated atmospheric [CO2] and semi‐arid conditions?
Authors: Bourgault Maryse , Webber Heidi A. , Chenu Karine , O’Leary Garry J. , Gaiser Thomas , Siebert Stefan , Dreccer Fernanda , Huth Neil , Fitzgerald Glenn J. , Tausz Michael , Ewert Frank
Published: April 2020

Early vigour in wheat is a trait that has received attention for its benefits reducing evaporation from the soil surface early in the season. However, with the growth enhancement common to crops grown under elevated atmospheric CO2 concentrations (e[CO2]), there is a risk that too much early growth might deplete soil water and lead to more severe terminal drought stress in environments where production relies on stored soil water content. If this is the case, the incorporation of such a trait in wheat breeding programmes might have unintended negative consequences in the future, especially in dry years. We used selected data from cultivars with proven expression of high and low early vigour from the Australian Grains Free Air CO2 Enrichment (AGFACE) facility, and complemented this analysis with simulation results from two crop growth models which differ in the modelling of leaf area development and crop water use. Grain yield responses to e[CO2] were lower in the high early vigour group compared to the low early vigour group, and although these differences were not significant, they were corroborated by simulation model results. However, the simulated lower response with high early vigour lines was not caused by an earlier or greater depletion of soil water under e[CO2] and the mechanisms responsible appear to be related to an earlier saturation of the radiation intercepted. Whether this is the case in the field needs to be further investigated. In addition, there was some evidence that the timing of the drought stress during crop growth influenced the effect of e[CO2] regardless of the early vigour trait. There is a need for FACE investigations of the value of traits for drought adaptation to be conducted under more severe drought conditions and variable timing of drought stress, a risky but necessary endeavour.
Digital Therapeutic Self‐Management Intervention in Adolescents With Migraine: Feasibility and Preliminary Efficacy of “Migraine Manager”
Authors: Hommel Kevin A. , Carmody Julia , Hershey Andrew D. , Holbein Christina , Kabbouche‐Samaha Marielle , Peugh James , Powers Scott
Published: April 2020

Objective

The objective of this study was to design, code, and pilot test the feasibility and preliminary efficacy of a self‐management digital therapeutic tool for adolescents with migraine.

Background

Self‐management of migraine in adolescents is complex and has important implications for health outcomes. A comprehensive and accessible approach to self‐management is needed for youth with migraine, their parents, and clinicians.

Methods

An iterative co‐design process was used to develop and optimize the Migraine Manager's digital therapeutic self‐management tool. Subsequently, 40 adolescents, age 11‐18 years, were enrolled in an 8‐week single‐arm open label trial (N = 36 analyzed). The primary outcome was headache days.

Results

Usage data for Migraine Manager were similar to other health app usage data and feedback from participants was uniformly positive, indicating acceptable feasibility. Preliminary efficacy was demonstrated by a reduction in headache days from 17.2 ± 8.5 at baseline to 7.9 ± 7.2 at 8 weeks (95% CI, −13.0 to −7.8;P < .001). There was also statistically significant improvement in patient physical functioning quality of life reported by both patients (baseline = 55.7 ± 20.4; 8 weeks = 69.7 ± 21.9,P = .005) and parents (baseline = 58.5 ± 22.8; 8 weeks = 74.3 ± 18.1,P = .002), and in parent‐reported ingestion issues subscale of the adherence barriers scale from baseline to 8 weeks (baseline = 6.0 ± 2.6; 8 weeks = 5.2 ± 3.0,P = .020).

Conclusions

A self‐management digital therapeutic tool for adolescents with migraine can offer care to patients who might not otherwise receive such services. Migraine Manager demonstrated the feasibility and preliminary efficacy in this pilot trial, highlighting the potential beneficial impact of this tool. Larger controlled trials with long‐term follow‐up are needed to definitively determine the clinical efficacy of Migraine Manager.
Children's rights as law in Sweden–every health‐care encounter needs to meet the child's needs
Authors: Sahlberg Sofia , Karlsson Katarina , Darcy Laura
Published: April 2020

Background

In 2020, the United Nations Convention on the Rights of the Child (UNCRC) became law in Sweden. This puts extra demands on Swedish health care for children in need. This study aimed to investigate children's experiences and paediatric nurses' experiences of caring in accordance with the UNCRC.

Methods

Interviews were conducted in 2019 with 10 children and 13 nurses at a paediatric clinic in western Sweden. Child and nurse data were analysed separately with qualitative content analysis. The results are presented as a synthesis of the combined analysis of both data sets.

Results

Children did not always meet health‐care professionals with the necessary competence to care for them, and they were not always cared for in a child‐friendly environment. Even though nurses in paediatric care had the competence necessary to meet children's rights in health care, organizational issues made it challenging. Providing health care in accordance with the UNCRC principles required time and competence. Sufficient time to help children participate in their care and ensure that they feel secure was considered necessary—regardless of the health‐care context.

Conclusion

Health‐care encounters without the necessary time or competence can affect children and future encounters negatively. Instruments to safeguard children's rights in health care need to be developed and implemented, such as a documentation system to make children's rights visible and/or UNCRC certification. Implementation of UNCRC principles in all health‐care situations for children as standardized care requires competence, involvement, strong leadership and economic support. Children's voices in research can assist in guiding care.
The future of work: Meeting the global challenges of demographic change and automation
Authors: ABELIANSKY Ana L. , ALGUR Eda , BLOOM David E. , PRETTNER Klaus
Published: April 2020

This article explores future job creation needs under conditions of demographic, economic and technological change. The authors first estimate the implications for job creation during 2020–30 of population growth, changes in labour force participation and the achievement of target unemployment rates, by age and sex. Second, they analyse the job creation needs by country income group and, lastly, examine the effects of accelerated automation. Projections indicate that shifting demographics will account for a far greater share of the estimated global need for 340 million jobs over 2020–30 than automation.
Regreso al futuro. Continuidad del diálogo sobre el trabajo y la tecnología en la OIT
Authors: CHERRY Miriam A.
Published: April 2020

La preocupación por el desempleo tecnológico no es nueva. Los debates que tuvieron lugar en el decenio de 1960 sobre la automatización reflejaban tanto optimismo como preocupación por la potencial destrucción de empleo causada por la tecnología. Al estudiar los archivos de la OIT, y en particular la información recopilada por su ṢOficina de Automatizaciónṣ, se observa que muchas propuestas actuales se debatieron durante aquel periodo, aunque nunca se tradujeron en políticas de reglamentación. La autora reabre este antiguo debate, como un buen punto de partida para abordar los problemas actuales en consonancia con el mundo del trabajo que aspiramos a construir.
Evaluación del Índice de Progreso Real para medir lo que importa y orientar las políticas
Authors: BERIK Günseli
Published: April 2020

Se examina el Índice de Progreso Real (IPR), un indicador monetario que, a diferencia del PIB, es idóneo para medir el desempeño económico, evaluar los efectos de las políticas y responder a las preocupaciones contemporáneas sobre el bienestar. Presenta funcionalidades de análisis evolutivo de variables, como el método del panel de control, pero la comparación entre países solo será posible cuando se resuelvan ciertos problemas de datos y se uniformice su metodología mediante la definición del IPR 2.0. Actualmente, los principales obstáculos que impiden su uso generalizado son la falta de voluntad política y de apoyo institucional.
Geografías laborales en la economía de plataformas. Entender las estrategias de representación colectiva en el contexto del trabajo digital
Authors: JOHNSTON Hannah
Published: April 2020

Se examina la influencia de los aspectos geográficos y espaciales en las estrategias de representación colectiva de los trabajadores de plataformas, según estas ofrezcan servicios localizados en una ubicación precisa o distribuyan en línea trabajo «deslocalizado» en régimen de externalización abierta. Tomando como ejemplos de diálogo social los comités de empresa, la negociación colectiva y los acuerdos multiempresariales, se analizan los factores que determinan la elección de estas estrategias solidarias según el tipo de plataforma y los marcos normativos aplicables, así como su efectividad para mejorar las condiciones de trabajo en las plataformas digitales.
Immunometabolism: From basic mechanisms to translation
Authors: Makowski Liza , Chaib Mehdi , Rathmell Jeffrey C.
Published: April 2020

Immunometabolism has emerged as a major mechanism central to adaptive and innate immune regulation. From early observations that inflammatory cytokines were induced in obese adipose tissue and that these cytokines contributed to metabolic disease, it was clear that metabolism and the immunological state are inextricably linked. With a second research wave arising from studies in cancer metabolism to also study the intrinsic metabolic pathways of immune cells themselves and how those pathways influence cell fate and function, immunometabolism is a rapidly maturing area of research. Several key themes and goals drive the field. There is abundant evidence that metabolic pathways are closely tied to cell signaling and differentiation which leads different subsets of immune cells to adopt unique metabolic programs specific to their state and environment. In this way, metabolic signaling drives cell fate. It is also apparent that microenvironment greatly influences cell metabolism. Immune cells adopt programs specific for the tissues where they infiltrate and reside. Ultimately, a central goal of the field is to apply immunometabolism findings to the discovery of novel therapeutic strategies in a wide range of diseases, including cancer, autoimmunity, and metabolic syndrome. This review summarizes these facets of immunometabolism and highlights opportunities for clinical translation.
A novel approach to the rapid synthesis of high‐entropy carbide nanoparticles
Authors: Zhao Qinglong , Mei Jie , Jin Wei , Jiang Qichuan
Published: April 2020

A novel strategy for the rapid synthesis of high‐entropy carbide particles is proposed that involves the transformation of multicomponent intermetallic intermediates to multicomponent carbides (high‐entropy carbide precursors). (Ti0.25V0.25Nb0.25Ta0.25)C nanoparticles with a uniform solute distribution were successfully synthesized in an Al matrix by heating Al‐Ti‐V‐Nb‐Ta‐C powder mixtures at 1500°C for 10 minutes. The multicomponent aluminide intermediates led to the rapid formation of multicomponent carbides during heating to 1100°C, which transformed into a high‐entropy solid solution during heating to 1500°C. We developed a new rapid approach for the synthesis of high‐entropy ceramic particles.
Garnet stability in the Al–Ca–Mg–Si–Y–O system with implications for reactions between TBCs, EBCs, and silicate deposits
Authors: Godbole Eeshani , Karthikeyan Nikhil , Poerschke David
Published: April 2020

This work expands the understanding of the garnet solid solution field in the yttria‐calcia‐magnesia‐alumina‐silica system. The crystal chemistry was used to define the theoretical extent of the garnet homogeneity range based on site‐specific substitution rules and charge neutrality constraints. Compositions lying within this range were equilibrated at 1400°C. The resulting phase assemblages were analyzed to determine the identity and compositions of the equilibrium phases. Quantitative chemical analysis was used to infer that Mg2+ preferentially partitions into the intermediate‐sized octahedral site compared to the larger dodecahedral site, that Ca2+ has a higher solubility in the dodecahedral site than Mg2+, and that the presence of Mg2+increases the total Si4+ solubility in the garnet structure. The results were also used to map the extent of the garnet solid solution phase field at 1400°C. The findings are discussed in the context of efforts to understand the interactions between Y‐containing thermal and environmental barrier coatings and silicate deposits.
Singing behaviour of ruby‐crowned kinglets Regulus calendula in relation to time‐of‐day, time‐of‐year and social context
Authors: Fahmy Mohammad , Wilson David R.
Published: April 2020

Observational field studies provide insight on the multifunctional nature of birdsong. For example, if song production were limited to pre‐fertilization, then that would suggest a mate attraction function. If it were used throughout the breeding season and in response to intruding males, then that would suggest a territorial defence function. In the present study, we determined the daily and seasonal singing patterns of male ruby‐crowned kinglets Regulus calendula in Labrador, Canada, using microphone arrays in two breeding seasons. Using a playback experiment, we simulated a territorial intrusion to compare the structure of songs produced while defending a territory to the structure of songs produced during solo and contest singing. Singing peaked in the early part of the breeding season and then declined continuously for the remainder of the season, which suggests that the songs function in mate attraction. Singing peaked 2–3 h after dawn, and then declined steadily until it stopped at 10 pm. Some nocturnal singing was observed, but no dawn singing was observed. A high probability of signal overlap by heterospecific songs at dawn would hinder signal recognition and explain the observed delay in peak singing activity. Vocal responses to playback suggested a function in territory defence. However, there were no significant differences in the duty cycle, frequency modulation and bandwidth of songs in relation to the context of song production, though songs were shorter in the intrusion context than during solo singing. Overall, the study provides the first quantitative description of the effects of time of day, time of year and social context on singing behaviour in this understudied species.
Klotho protein contributes to cardioprotection during ischaemia/reperfusion injury
Authors: Olejnik Agnieszka , Krzywonos‐Zawadzka Anna , Banaszkiewicz Marta , Bil‐Lula Iwona
Published: April 2020

Restoration of blood flow to ischaemic heart inflicts ischaemia/reperfusion (I/R) injury, which manifests in metabolic and morphological disorders. Klotho is a protein with antioxidative and antiapoptotic activity, and is involved in the regulation of inflammation and fibrosis. The aim of the current research was to determine the role of Klotho in the heart subjected to I/R injury, as well as to study Klotho as a potential cardioprotective agent. Human cardiomyocytes and Wistar rat hearts perfused using Langendorff method subjected to I/R have been used. Hemodynamic parameters of heart function, markers of I/R injury, and gene and protein expression of Klotho were measured. Human cardiomyocytes were also incubated in the presence of recombinant Klotho protein, and the viability of cells was measured. There was a higher expression of Klotho gene and protein synthesis in the cardiomyocytes subjected to I/R injury. The compensatory production and release of Klotho protein from cardiac tissue during I/R were also shown. The treatment of cardiomyocytes subjected to I/R with Klotho protein resulted in increased viability and metabolic activity of cells. Thus, Klotho contributes to compensatory mechanism during I/R, and could be used as a marker of injury and as a potential cardiopreventive/cardioprotective agent.
Dermatologists and SARS‐CoV‐2: the impact of the pandemic on daily practice
Authors: Gisondi P. , Piaserico S. , Conti A. , Naldi L.
Published: April 2020

Since the first case of ‘pneumonia of unknown aetiology’ was diagnosed at the Wuhan Jinyintan Hospital in China on 30 December 2019, what was recognized thereafter as ‘severe acute respiratory syndrome coronavirus 2’ (SARS‐CoV‐2) has spread over the four continents, causing the respiratory manifestations of coronavirus disease‐19 (COVID‐19) and satisfying the epidemiological criteria for a label of ‘pandemic’. The ongoing SARS‐CoV‐2 pandemic is having a huge impact on dermatological practice including the marked reduction of face‐to‐face consultations in favour of teledermatology, the uncertainties concerning the outcome of COVID‐19 infection in patients with common inflammatory disorders such as psoriasis or atopic dermatitis receiving immunosuppressive/immunomodulating systemic therapies; the direct involvement of dermatologists in COVID‐19 care for patient assistance and new research needs to be addressed. It is not known yet if skin lesions and derangement of the skin barrier could make it easier for SARS‐CoV‐2 to transmit via indirect contact; it remains to be defined if specific mucosal or skin lesions are associated with SARS‐CoV‐2 infection, although some unpublished observations indicate the occurrence of a transient varicelliform exanthema during the early phase of the infection. SARS‐CoV‐2 is a new pathogen for humans that is highly contagious, can spread quickly, and is capable of causing enormous health, economic and societal impacts in any setting. The consequences may continue long after the pandemic resolves, and new management modalities for dermatology may originate from the COVID‐19 disaster. Learning from experience may help to cope with future major societal changes.
Zigzag longitudinal melanonychia: a peculiar dermoscopic pattern
Authors: Sahin S. , Aydingoz I.E. , Ersoy Evans S. , Demircioglu Duman D. , Di Chiacchio N.G. , Haneke E.
Published: April 2020

Background

Longitudinal melanonychia (LM) can present a diagnostic challenge and dermoscopy is of utmost importance for its evaluation and differential diagnosis of LM.

Objective

This report aimed to describe an unusual dermoscopic pattern in a group of patients that presented with LM.

Methods

The clinical course and features of five LM patients that presented with an unusual ‘zigzag’ dermoscopic pattern were analyzed retrospectively.

Results

In all, four of the five patients were children (age range: 10–13years). In all five patients, the thumb nail was affected. A nail matrix biopsy was available for only one patient and was reported as lentigo. In two (one child and one adult) out of the five patients, spontaneous total regression of the LM was observed.

Conclusions

The peculiar ‘zigzag’ dermoscopic pattern of LM described herein seems to occur primarily in children. Although this pattern is a benign in nature, it is not clear if it is related to trauma. Further investigation is warranted to clarify the association between the histopathological findings and the zigzag pattern observed via dermoscopy.
Perspectives on an amended law addressing pharmacists' availability in community pharmacies
Authors: Qadeer Gohar , Amin Mohamed Ezzat Khamis
Published: April 2020

Rationale, aims, and objectives

Little attention has been given to perceptions of pharmacist availability and role in the community setting following policy changes. The Pakistani model is particularly interesting as it encompasses three different pharmacy practice licensure types with major differences in credentials, training, and role. Guided by the theory of planned behaviour (TPB), this study examined factors associated with the availability of pharmacists in the community setting in Pakistan following the implementation of a new policy regulating pharmacist presence in community pharmacies.

Methods

Fifteen participants were interviewed in three Pakistani cities (Islamabad, Lahore, and Peshawar). Those included pharmacy licence holders (types A, B, and C), non‐pharmacist owners and a pharmacist inspector who were purposively sampled to assure variance in education, gender, time in practice, and geographic location. Directed content analysis was performed based on the TPB framework. Description of themes came after discussions among the two authors.

Results

Findings indicated a discrepancy between participants about the value of having a pharmacist present with pharmacists showing more appreciation of the value they would provide. Participants felt that the new policy is attempting to change a norm that has existed for a long time. They also pointed to logistical challenges in making a pharmacist available including the feasibility of having a pharmacist present, the financial burden of hiring a pharmacist, and difficulty in enforcing the law uniformly across different geographical areas. Participants were concerned that some type A licence holders sensed that practicing in the community setting and the act of selling medications was beneath their social status as pharmacists.

Conclusion

A set of factors contribute to the availability of pharmacists in community pharmacies in Pakistan. The change in law should be supplemented with other interventions that contribute to making well‐trained pharmacy personnel available for serving patrons.
Gut microbiota regulate cognitive deficits and amyloid deposition in a model of Alzheimer’s disease
Authors: Li Zhuo , Zhu Hua , Guo Yaxi , Du Xiaopeng , Qin Chuan
Published: April 2020

Gut microbiota, comprising a vast number of microorganism species with complex metagenome, are known to be associated with Alzheimer's disease (AD) and amyloid deposition. However, studies related to gut microbiota have been mostly restricted to comparisons of amyloid deposits, while investigations on neurobehavioral changes and the pathogenesis of AD are limited. Therefore, we aimed to identify the relationship between changes in the intestinal microbiome and the pathogenesis of AD. APPswe/PS1ΔE9 (PAP) transgenic mice and wild‐type (WT) mice of different age groups were used. The composition of intestinal bacterial communities in the mice was determined by 16S ribosomal RNA sequencing (16S rRNA Seq), and the Y maze was used to measure cognitive function. Transcriptome sequencing (RNA Seq) and Gene Expression Omnibus (GEO) database (GSE 36980) were used to filter differentially expressed genes (DEGs) between specific pathogen‐free (SPF) and germ‐free (GF) mice. Quantitative reverse‐transcriptase PCR (qRT‐PCR) and western blot (WB) were used to verify the results. We found that the intestinal microbiota was significantly different between 5‐month‐old PAP and WT mice and the cognition of SPF PAP mice was diminished compared to GF PAP and SPF WT mice. DEGs in 5‐month‐old SPF and GF mice were enriched in the MAPK signalling pathway, and expression of amyloid precursor protein and amyloid deposition increased in 5‐month‐old SPF PAP mice. Results from this study showed that changes in intestinal microbiota were correlated with impairment of cognitive function and might promote amyloid deposition by stimulating the MAPK signalling pathway in the brain.

image
Psycho‐social and educational interventions for enhancing adherence to dialysis in adults with end‐stage renal disease: A meta‐analysis
Authors: Tao Wei‐Wei , Tao Xiao‐Mei , Wang Yue , Bi Shu‐Hong
Published: April 2020

Aims and objectives

To examine the influence of psycho‐social and educational interventions on improving adherence to dialysis for patients with end‐stage renal disease.

Background

Adherence to the complex regimen is poor, contributing to avoidable hospitalisation and morbidity. Psycho‐social and educational interventions may be beneficial coping strategies.

Design

Systematic literature review and meta‐analysis were conducted.

Methods

We conducted a systematic search of 8 databases from their inceptions to 16 January 2019 to identify relevant articles. Only randomised controlled trials (RCTs) were included in the analysis. The PRISMA checklist was used.

Results

A total of forty RCTs were included to evaluate the effect. The aggregated results of the studies showed that psycho‐social and educational interventions elevated adherence rate in both peritoneal dialysis (PD) and haemodialysis (HD) patients. For physiological and biochemical indicators, meta‐analysis revealed that significant post‐treatment effects were evident for interdialytic weight gain (IDWG), IDWG/dry weight, serum potassium, phosphate, creatinine and blood urea nitrogen (BUN), except for albumin. In particular, subgroup analysis indicated that only the interventions carried out individually exerted significant combined effect for lowering IDWG. As for subjective measures, meta‐analysis also revealed small but significant combined effects.

Conclusions

The results of this meta‐analysis suggest that psycho‐social and educational interventions were associated with significant effects on adherence in patients receiving dialysis regimen.

Relevance to clinical practice

The analysis suggests that psycho‐social and educational interventions should be considered as effective strategies for enhancing adherence to dialysis in adults with end‐stage renal disease. The potential utility of these interventions should focus on how best to promote individually implementation in clinical practice.
Does breastfeeding self‐efficacy theory apply to mothers of moderate and late preterm infants? A qualitative exploration
Authors: Brockway Meredith , Benzies Karen M. , Carr Eloise , Aziz Khalid
Published: April 2020

Background

Breastmilk feeding reduces morbidities and improves outcomes related to prematurity. However, breastmilk feeding rates in preterm infants are substantially lower than those in term infants. Breastfeeding self‐efficacy theory is a social change theory, which is predictive of exclusive breastmilk feeding at 2 months postpartum in mothers of full‐term infants. However, this theory has not been well explored in mothers of moderate and late preterm infants.

Aims and Objectives

To explore maternal experiences with feeding moderate (320/7 – 336/7 weeks’ gestational age) and late preterm infants (340/7 – 366/7 weeks’ GA) in neonatal intensive care units and assess applicability of breastfeeding self‐efficacy theory.

Methods

We conducted a qualitative descriptive exploration of maternal experiences with infant feeding in neonatal intensive care units. Using purposive, maximum variation sampling, we selected mothers of preterm infants born at 320/7 – 346/7 weeks, who experienced high mean differences in their BSE scores between admission and discharge. Fourteen mothers participated in semi‐structured telephone interviews. Data were examined using thematic analysis. To explore and describe breastfeeding self‐efficacy within the context of neonatal intensive care units, we super‐imposed the four sources of information from breastfeeding self‐efficacy theory onto the defined themes.

Results

Three main themes emerged: (a) institutional influences, (b) relationship with the pump and (c) establishing breastfeeding, with an emphasis on the importance of direct breastfeeding at discharge. Overlaying the four sources of information from breastfeeding self‐efficacy highlighted the presence of three sources of information: verbal persuasion, performance accomplishment and physiologic/affective responses. Vicarious experience was not identified in maternal experiences with infant feeding.

Conclusion

Our findings indicate that breastfeeding self‐efficacy is an applicable theory for mothers of preterm infants.

Relevance to Clinical Practice

Healthcare providers need to be aware of the influence that institutional culture and policies may have on maternal breastfeeding self‐efficacy and breastfeeding outcomes.
Prevalence, characteristics and mortality outcomes of obese, nonobese and lean NAFLD in the United States, 1999–2016
Authors: Zou B. , Yeo Y. H. , Nguyen V. H. , Cheung R. , Ingelsson E. , Nguyen M. H.
Published: April 2020

Background

Updated prevalence and outcome data for nonobese NAFLD for the multi‐ethnic US population is limited.

Objectives

We aimed to investigate the prevalence, clinical characteristics and mortality of obese and nonobese individuals with NAFLD in the United Sates.

Methods

A retrospective study was conducted using the 1999–2016 NHANES databases. We determined hazard ratio stratified by obesity status in NAFLD individuals using Cox regression and log‐rank test.

Results

Overall NAFLD prevalence was 32.3%: 22.7% were obese and 9.6% were nonobese, with increasing trend over time for obese NAFLD, but not nonobese NAFLD. Amongst those with NAFLD, 29.7% (95% CI: 27.8%‐31.7%) were nonobese, of which 13.6% had lean NAFLD. Nonobese NAFLD was more common in older (40.9% if ≥ 65 vs. 24.2% if < 65 years), male (34.0% vs. 24.2%) and foreign‐born Asian people (39.8% vs. 11.4%) and uncommon in black (11.5% vs 30–35% in other ethnicities, P < 0.001). Metabolic comorbidities were common in nonobese NAFLD individuals who also had more advanced fibrosis. Nonobese NAFLD individuals had higher 15‐year cumulative all‐cause mortality (51.7%) than obese NAFLD (27.2%) and non‐NAFLD (20.7%) (P < 0.001). However, DM and fibrosis, but neither obese nor nonobese NAFLD compared to non‐NAFLD was independently associated with higher mortality.

Conclusion

Nonobese NAFLD makes up about one‐third of the NAFLD in the United States (even higher in older, male and foreign‐born individuals) and carries higher mortality than obese NAFLD. Screening for NAFLD should be considered in high‐risk groups even in the absence of obesity.
Tax Fraud and Selective Law Enforcement
Authors: de la Feria Rita
Published: April 2020

This article presents a new conceptual framework for research into tax fraud and law enforcement. Informed by research approaches from across tax law, public economics, criminology, criminal justice, economics of crime, and regulatory theory, it assesses the effectiveness, and the legitimacy, of current approaches to combating tax fraud, bringing new dimensions to previously identified trends in crime control. It argues that, whilst the last decade has witnessed a significant intensification of measures that purportedly target tax fraud, preference has been consistently given to enforcement measures that maximize revenue gains rather than combat the fraud itself, even where the effect is to aggravate the non‐revenue costs of tax fraud. These developments demonstrate a significant shift from tax fraud suppression to tax fraud management. The article concludes that this shift not only undermines tax equity and overall tax compliance, but also leads to selective tax enforcement, thus representing a significant risk to the rule of law.
Managing Excessive Gingival Display Using a Digital Workflow
Authors: Ahmed Walaa Magdy , Hans Amandeep , Verhaeghe Tyler V. , Nguyen Caroline
Published: April 2020

This technique article describes an approach to managing excessive gingival display by lengthening of the clinical crowns using a digital workflow. An intraoral scanner was used to obtain a template to be used for the crown lengthening surgical procedure considering the patient‐desired diagnostic setups while fully seating the template on the patient's teeth during surgery. Using a digital approach for lengthening the clinical crowns decreased the likelihood of the need for postsurgical modifications, thus shortening the treatment duration. After the crown lengthening healed for 12 weeks, full‐mouth reconstruction proceeded. Maxillary and mandibular preparation reduction guides were digitally designed and printed to facilitate conservative crown preparations. An intraoral scanner was used to make full‐arch scans and interocclusal records for the fabrication of provisional and final crowns. Fully guided implant planning and placement were also executed.
Educational or behavioural interventions for symptoms and health‐related quality of life in adults receiving haemodialysis: A systematic review
Authors: Sharma Sita , Green Theresa , Alexander Kimberly E. , Bonner Ann
Published: April 2020

Background

People with end‐stage kidney disease (ESKD) suffer from multiple symptoms, which have a negative impact on their health‐related quality of life (HRQoL). Educational and behavioural interventions are being developed for this population; however, the effect of these interventions is unclear.

Aim

To evaluate the effectiveness of educational or behavioural interventions compared with standard care or alternative strategies on reducing symptoms and improving HRQoL in adults with ESKD receiving haemodialysis (HD).

Methods

An effectiveness systematic review using Joanna Briggs Institute (JBI) procedures was conducted on experimental studies [randomised controlled trials (RCTs), pseudo‐RCTs and quasi‐experimental designs] published in English between January 2009 and July 2019. Studies were retrieved from CINAHL, PubMed, MEDLINE, Embase, PsycINFO, Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trial) and JBI databases. Effect size at 95% confidence interval was calculated where possible.

Results

Eighteen studies involving 791 participants were included in this review. All studies involved behavioural interventions with the majority of studies (n = 11) targeting psychological symptoms. Interventions were categorised as either active or passive. Active interventions seemed to improve some physical symptoms, although there was very little evidence of improvements to HRQoL. Passive interventions tended to have a large effect on psychological symptoms and the mental health components of HRQoL.

Conclusion

Due to great heterogeneity between studies, meta‐analyses could not be conducted further limiting the evidence to inform practice. In addition, further research on educational interventions to teach self‐management strategies for symptom management and to improve HRQoL in people with ESKD receiving HD are needed.
Mothers' experiences of exclusive breastfeeding in a postdischarge home setting
Authors: Van Ryneveld Manya , Mwangome Martha , Kahindi Jane , Jones Caroline
Published: April 2020

Re‐establishment and maintenance of exclusive breastfeeding (EBF) is recommended by the World Health Organization for the nutritional rehabilitation of malnourished infants under 6 months; however, there is no explicit guidance on how this should be achieved. The IBAMI study—a pilot study conducted in Kilifi, Kenya—implemented these recommendations using an intervention for hospitalized infants and their mothers that included ward‐based breastfeeding peer supporters. This paper explores how the challenges of maintaining EBF are recontextualized after infant hospitalization for malnutrition. Four weeks after discharge, semistructured interviews on experiences of trying to maintain EBF in a postdischarge home setting were conducted with a total of 20 mothers. Although most stated the aspiration of maintaining EBF for 6 months, a range of challenges were reported and not all had successfully maintained EBF post discharge. Reported challenges include the stress of household chores, food insecurity, technical difficulties and social stigma of expressing breast milk, pressure from neighbours and family members to introduce mixed feeding, and needing more community‐based awareness and support. Most of these challenges were specific to the home setting and were not easily surmountable, despite the breastfeeding practices mothers had learned in the ward. Indeed, in some cases, challenges were exacerbated by the overmedicalized nature of the breastfeeding practices taught in the ward. In order to aid the transition from ward to home, there may be a need to further translate ward‐based education and promotional messaging for EBF into a community setting, targeting other caregivers as well.
Proton pump inhibitors enhance intestinal permeability via dysbiosis of gut microbiota under stressed conditions in mice
Authors: Takashima Shingo , Tanaka Fumio , Kawaguchi Yunosuke , Usui Yuki , Fujimoto Kosuke , Nadatani Yuji , Otani Koji , Hosomi Shuhei , Nagami Yasuaki , Kamata Noriko , Taira Koichi , Tanigawa Tetsuya , Watanabe Toshio , Imoto Seiya , Uematsu Satoshi , Fujiwara Yasuhiro
Published: April 2020

Background

Intestinal permeability and psychological stress are considered the key mechanism(s) in functional dyspepsia (FD). Although proton pump inhibitors (PPIs) are commonly used for the treatment of FD, the effect of PPIs on intestinal permeability has not been elucidated. This study investigated the effect of PPI on intestinal permeability under stressed conditions.

Methods

C57BL/6J mice were subjected to water avoidance stress (WAS) and administered rabeprazole (40 mg/kg) or vehicle treatment (VT). We then evaluated intestinal permeability both in vivo and ex vivo using plasma fluorescein isothiocyanate‐dextran and by assessing the paracellular permeability and transepithelial electrical resistance (TEER) in an Ussing chamber, respectively. Furthermore, we evaluated the effect of PPI‐treated fecal microbiota transplant (FMT) on intestinal permeability in vivo. Microbiota profiles of donor feces were assessed by 16S rRNA gene analysis using MiSeq and QIIME2.

Key Results

In the WAS treatment, PPI significantly enhanced intestinal permeability in vivo compared to that in VT. Moreover, PPI significantly increased paracellular permeability and decreased TEER in the duodenum and jejunum, respectively, compared to those in VT under stressed conditions. Moreover, both vasoactive intestinal peptide (VIP) receptor antagonist and ketotifen significantly reversed the effect of PPI on intestinal permeability. Furthermore, PPI‐treated FMT significantly increased the intestinal permeability in vivo compared to that in vehicle‐treated FMT. Proton pump inhibitors treatment altered the gut microbiota composition, indicating that PPI induced dysbiosis.

Conclusions and Inferences

Under stressed conditions, PPI enhances intestinal permeability via dysbiosis of gut microbiota. Vasoactive intestinal peptide and mast cells are also implicated in the underlying mechanisms.
Perioperative aspiration events in children: A report from the Wake Up Safe Collaborative
Authors: Pfaff Kayla E. , Tumin Dmitry , Miller Rebecca , Beltran Ralph J. , Tobias Joseph D. , Uffman Joshua C.
Published: April 2020

Background

Perioperative aspiration, while rare, is a serious complication of anesthetic care. Consequences of aspiration may include physical obstruction, wheezing, and pneumonia, resulting in mild to severe hypoxemia and even death.

Aim

We used a multi‐institutional registry of pediatric patients to identify factors that influence the rate and resulting harm of perioperative pulmonary aspiration.

Methods

The Wake Up Safe registry was queried for all severe adverse events reported from 29 institutions from 2010 to 2017. Aspiration events were identified through the “respiratory adverse event” data entry form or through free text search. Multivariable regression was used to predict aspiration events, and contributory factors were identified by reviewing free text case comments.

Results

Analysis included 2 440 810 anesthetics administered involving patients ≤18 years of age. There were 135 pulmonary aspiration events, for an incidence of 0.006%. Within these 135 cases, 110 cases (82%) resulted in escalation of care and 51 (38%) resulted in patient harm, including 2 deaths (1.5%). In multivariable analysis, patients undergoing emergency surgery (OR 2.0 [1.2‐3.5]) or with higher ASA status were more likely to experience aspiration (ASA 3 (OR 5.0 [2.6‐9.1]); ASA ≥ 4 (OR 5.5 [3.8‐16.8])). Noted causes of aspiration included gastrointestinal comorbid conditions (19%), postcoughing event or laryngospasm (14%), nil per os (NPO) violation (11%), blood or secretions in the airway following or during the procedure (6%), and oral premedication reaction (3%).

Conclusion

Although infrequent, death was reported as a consequence of perioperative aspiration in two patients. The frequency with which NPO violations were identified as a potential cause of aspiration highlights the struggles institutions face with adherence to NPO regulations, as these cases may be preventable. Furthermore, preventive measures may be needed to address other common causes of aspiration, such as gastrointestinal comorbid conditions.