bluuebunny/crossref_metadata_2025 huggingface dataset:
Topography of behavior problems among children with neurodevelopmental conditions: Profile differences and overlaps
Authors: Gardiner Emily , Miller Anton R. , Lach Lucyna M.
Published: November 2019

Background

This exploratory proof of principle study examined the extent to which behavior problems represent a functional characteristic that crosses diagnostic boundaries.

Methods

This cross‐sectional study pertains to 179 caregivers of children, aged 4–13 years (M = 8.27) with cerebral palsy (n = 77), autism spectrum disorder (n = 58), and global developmental delay/intellectual disability (n = 44). Caregivers completed the Strengths and Difficulties Questionnaire, which provides a measure of conduct problems, emotional symptoms, hyperactivity‐inattention, peer problems, as well as total difficulties.

Results

Behavior problem severity differed across diagnostic groups (p < .001). Visual examination of box plots indicated substantial overlap within Strengths and Difficulties Questionnaire subscales across children with autism spectrum disorder, cerebral palsy, and global developmental delay/intellectual disability. Children within each condition demonstrated matching profile topographies, such that hyperactivity‐inattention difficulties were most severe. Repeated measures analysis of variances confirmed that children within each group received significantly higher ratings on the hyperactivity‐inattention subscale (all p < .001).

Conclusions

The approach adopted to examine the data and findings have the potential to inform how we conceptualize and study behavior problems among children with neurodevelopmental conditions. Importantly, children with particular conditions did not demonstrate unique constellations of difficulties. Clinicians must therefore be attuned to the possibility of commonality in behavior problems across children with disparate diagnoses, irrespective of syndrome‐specific expectations.
Efficacy and safety of prenatal dexamethasone treatment in offspring at risk for congenital adrenal hyperplasia due to 21‐hydroxylase deficiency: A systematic review and meta‐analysis
Authors: Xu Lizhen , Lin Wei , Cai Liangchun , Huang Huibin , Liang Jixing , Li Liantao , Zong Liyao , Wang Nengying , Wen Junping , Chen Gang
Published: November 2019

Objective

To assess the efficacy and safety of prenatal dexamethasone treatment in offspring at risk for congenital adrenal hyperplasia.

Methods

MEDLINE, EMBASE, the Cochrane Library, the clinicaltrials.gov website databases were systematically searched from inception through March 2019. WMD and SMD with 95%CIs were calculated using random or fixed effects models.

Results

There was a significant reduction in virilization in the DEX‐treated group (WMD: −2.39, 95%CI: −3.31,‐1.47). No significant differences were found in newborn physical outcomes for birth weight (WMD: 0.09, 95%CI: −0.09, 0.27) and birth length (WMD = 0.27, 95%CI: −0.68, 1.21). Concerning cognitive functions, no significant differences in the domains of psychometric intelligence (SMD: 0.05, 95%CI: −0.74, 0.83), verbal memory (SMD: −0.17, 95%CI: −0.58, 0.23), visual memory (SMD: 0.10, 95%CI: −0.14, 0.34), learning (SMD: −0.02, 95%CI: −0.27, 0.22) and verbal processing (SMD: −0.38, 95%CI: −0.93, 0.17). Regarding behavioural problems, no significant differences in the domains of internalizing problems (SMD: 0.16, 95%CI: −0.49, 0.81), externalizing problems (SMD: 0.07, 95%CI: −0.30, 0.43) and total problems (SMD: 0.14, 95%CI: −0.23, 0.51). With respect to temperament, no significant differences in the domains of emotionality (SMD: 0.13, 95%CI: −0.79, 1.05), activity (SMD: 0.04, 95%CI: −0.32, 0.39), shyness (SMD: 0.25, 95%CI: −0.70, 1.20) and sociability (SMD: −0.23, 95%CI: −0.90, 0.44).

Conclusions

Prenatal DEX treatment reduced virilization with no significant differences in newborn physical outcomes, cognitive functions, behavioural problems and temperament. The results need to be interpreted cautiously due to the existence of limitations.
Distortion of inferences and undue exaggeration of study limitations: Response to Shrotriya et al.
Authors: Majgaonkar Iravatee , Vaidyanathan Srinivas , Srivathsa Arjun , Shivakumar Shweta , Limaye Sunil , Athreya Vidya
Published: November 2019

Our study titled “Land sharing potential of large carnivores in human‐modified landscapes of western India” used an occupancy framework to provide baseline information on patterns and determinants of large carnivore presence in human‐use landscapes. In their letter, Shrotriya et al. raise concerns about our survey design, distort our inferences, and present unwarranted exaggeration of our study limitations. Here, we provide detailed responses to key the issues raised by the authors while reiterating the accurate interpretations of our findings.
Long‐term outcome of vein of Galen malformation
Authors: Taffin Hélène , Maurey Hélène , Ozanne Augustin , Durand Philippe , Husson Béatrice , Knebel Jean‐François , Adamsbaum Catherine , Deiva Kumaran , Saliou Guillaume
Published: November 2019

Aim

To describe the long‐term outcomes of children by the time they reached school age with vein of Galen aneurysmal malformation (VGAM).

Method

This was a retrospective observational study on a consecutive cohort of patients with VGAM. We included patients with at least one Francophone parent, aged between 6 and 11 years at the time of long‐term evaluation. The neurological outcome was assessed with the King’s Outcome Scale for Childhood Injury score and eight neurological and behavioural items from the Rivermead Postconcussion Symptoms questionnaire.

Results

All 52 patients (17 females, 32 males [data missing for n=3]) with at least one Francophone parent (5 fetuses and 47 children) were included. At the long‐term evaluation time‐point, 33 patients were alive and 19 patients had died. Risk of postnatal death was associated with severe neonatal cardiac failure (p=0.007) or isosystemic or suprasystemic pulmonary hypertension (p=0.014). Among survivors, 19 had a good outcome with normal schooling and 14 had a poor outcome. Moreover, among the good outcome patients, a large proportion had neurodevelopmental alterations.

Interpretation

Long‐term outcome of patients with VGAM appears to be less favourable than outcome described at the short‐ and medium‐term, even in the absence of encephalomalacia at birth. Even patients with good outcome often have neuropsychological disorders that may have repercussions on learning and requiring appropriate rehabilitation or medical management.

What this paper adds

Long‐term outcome appears to be less favourable than described at short‐ and medium‐term follow‐up.

Even patients with good outcome at these time‐points often have minor neuropsychological disorders.
Treatment of refractory and superrefractory status epilepticus with topiramate: A cohort study of 106 patients and a review of the literature
Authors: Fechner Anne , Hubert Kristina , Jahnke Kolja , Knake Susanne , Konczalla Jürgen , Menzler Katja , Ronellenfitsch Michael W. , Rosenow Felix , Strzelczyk Adam
Published: November 2019

Objective

Novel treatments are needed to control treatment‐resistant status epilepticus (SE). We present a summary of clinical cases where oral topiramate (TPM) was used in refractory SE (RSE) and superrefractory SE (SRSE).

Methods

A review of medical records was carried out to detect TPM administration in SE patients treated in Frankfurt and Marburg between 2011 and 2016. The primary outcome question concerned SE resolution after TPM initiation.

Results

In total, TPM was used in 106 of 854 patients having a mean age of 67.4 ± 18.1 years, 61 of whom were female (57.5%). The median latency from SE onset to TPM initiation was 8.5 days. Patients with SE had previously failed a median of five other antiepileptic drugs. The median initial TPM dose was 100 mg/d, which was uptitrated to a median maintenance dose of 400 mg/d. Treatment with TPM was continued for a median time of 12 days. TPM was the last drug provided to 42 of 106 (39.6%) patients, with a resultant response attributed to TPM observed in 29 of 106 (27.4%) patients. A response was attributed to TPM in 21 (31.8%) of 66 RSE cases and eight (20%) of 40 SRSE cases. Treatment‐emergent adverse events were attributed to TPM usage in two patients, one each with pancreatitis and hyperchloremic acidosis, and in 38 patients (35.8%), hyperammonemia was seen. Thirty‐four of these patients received a combination of TPM and valproate and/or phenobarbital. The intrahospital mortality rate was 22.6% (n = 24).

Significance

The rate of SE cessation attributed to TPM treatment (27.4%) represents a relevant response given the late treatment position of TPM and the treatment latency of more than 8 days. Based on these results and in line with the findings of other case series, TPM can be considered an alternative option for treating RSE and SRSE.
Direct regulation of Chk1 protein stability by E3 ubiquitin ligase HUWE1
Authors: Cassidy Katelyn B. , Bang Scott , Kurokawa Manabu , Gerber Scott A.
Published: November 2019

The HECT E3 ubiquitin ligase HUWE1 is required for a wide array of important functions in cell biology. Although HUWE1 is known to play a role in DNA damage signaling, the mechanism(s) that underlie this function remain elusive. HUWE1 regulates effectors of DNA replication and genotoxic stress tolerance. However, the loss of HUWE1 can also result in the accrual of significant endogenous DNA damage due to insufficient remediation of replication stress induced by an overabundance of key substrates. We discovered that HUWE1 depletion leads to a significant increase in levels of the single‐strand break effector kinase Chk1, independent of the DNA damage response, activation of apical DNA damage repair (DDR) signaling kinases (ATM and ATR), and the tumor suppressor p53. We also identified multiple lysine residues on Chk1 that are polyubiquitinated by HUWE1 in vitro, many of which are within the kinase domain. HUWE1 knockdown also markedly prolonged the protein half‐life of Chk1 in steady‐state conditions and resulted in greater stabilization of Chk1 protein than depletion of Cul4A, an E3 ubiquitin ligase previously described to control Chk1 abundance. Moreover, prolonged replication stress induced by hydroxyurea or camptothecin resulted in a reduction of Chk1 protein levels, which was rescued by HUWE1 knockdown. Our study indicates that HUWE1 plays a significant role in the regulation of the DDR signaling pathway by directly modulating the abundance of Chk1 protein.
PLAG enhances macrophage mobility for efferocytosis of apoptotic neutrophils via membrane redistribution of P2Y2
Authors: Kim Guen Tae , Hahn Kyu Woong , Sohn Ki‐Young , Yoon Sun Young , Kim Jae Wha
Published: November 2019

Neutrophil activity, including trapping of damage‐associated molecular patterns by neutrophil extracellular traps (NETs), is an important response to microbial infection. Most activated neutrophils commit to apoptosis and are removed by activated macrophages in the process of efferocytosis. Improper clearance of apoptotic neutrophils often causes an unnecessary and exaggerated immune response and subsequent chronic inflammation. Effective macrophage mobility toward activated neutrophils, which is triggered by binding of ‘find‐me’ signals to receptors such as P2Y2, is a crucial step for the timely clearance of apoptotic neutrophils. In this paper, we investigated the effect of 1‐palmitoyl‐2‐linoleoyl‐3‐acetyl‐rac‐glycerol (PLAG) on efferocytosis and the underlying molecular mechanisms. In a coculture of apoptotic neutrophils with macrophages, PLAG treatment increased levels of efferocytosis of apoptotic neutrophils. PLAG induced faster translocation of P2Y2 from lipid rafts to nonlipid raft plasma membrane domains in macrophages. This repositioning of P2Y2 enables the polarization of the cytoskeleton by association of the receptor with cytoskeletal proteins such as α‐tubulin and actin to improve the mobility of macrophages. The formation of vesicular, chylomicron‐like structures by PLAG was a prerequisite for the induction of this macrophage activity, as none of these effects was seen when the vesicle receptor GPIHBP1 was absent. Taken together, these data showed that PLAG is a powerful immune resolvent that triggers the prompt clearance of apoptotic neutrophils by enhanced efferocytosis activity. PLAG could therefore be an effective lipid‐based efferocytosis enhancer for use as a therapeutic drug to prevent inflammatory disease caused by uncontrolled immune responses.
A global test of the subsidized island biogeography hypothesis
Authors: Menegotto André , Rangel Thiago Fernando , Schrader Julian , Weigelt Patrick , Kreft Holger
Published: November 2019

Aim

The decreasing capacity of area to predict species richness on small islands (the small‐island effect; SIE) seems to be one of the few exceptions of the species–area relationship. While most studies have focused on how to detect the SIE, the underlying ecological factors determining this pattern remain largely unexplored. Here, we evaluate one of the few mechanisms proposed to explain the SIE, the subsidized island biogeography hypothesis, which posits that marine productivity around small islands may alter their expected species richness.

Location

Seven hundred and ninety islands worldwide, including 420 islands < 1 km2.

Time period

Present.

Major taxa studied

Angiosperms.

Methods

We applied iterative partial regression to determine the effects of island area and marine productivity on plant species richness for islands of varying sizes. We also employed geographically weighted regression to account for non‐stationarity in the marine productivity effects. Lastly, we used estimates of ammonia emissions based on nutrient excretion by seabird colonies from a subset of 66 islands to evaluate the effects of marine resources deposition on angiosperm species richness.

Results

We found no effect of marine productivity on insular species richness, at both regional and global scales. In all models, area emerged as the only predictor of plant species richness. A weak contribution of marine productivity was only detectable in models with a low number of islands, but this effect was independent of island size. Although nutrient deposition significantly contributes to explaining plant diversity, this effect was also independent of island size.

Main conclusions

Our study demonstrates that marine productivity has no general effect on plant species richness of small islands worldwide. Although marine‐derived resources may still contribute to species richness variation, this effect does not seem to be restricted to small islands. Overall, our results do not provide support for the subsidized island biogeography hypothesis.
Role of strontium substitution in spray drying of hydroxyapatite: A comparative study on physical properties
Authors: Bastan Fatih E. , Erdogan Garip , Ustel Fatih
Published: November 2019

Spray drying (SD) has the ability to tailor granule size and morphology, thus, it is used for producing hydroxyapatite (HA) granules. Recently, Sr functionalized HA (SrHA) has been recommended owing to its improved biological properties. The aim of this article was to produce SrHA granules with the combination of nanoparticle synthesis and spray‐drying. The effects of substitution on the physical properties of SrHA nanoparticles and spray‐dried granules were investigated. TEM analyzes revealed that Sr substitution reduced the mean size of HA nanoparticles from 4.59 nm to 2.31 nm. Besides, Sr substitution increased the viscosity of the prepared slurry for spray drying, which may be attributed to the smaller nanoparticle sizes. The reduced nanoparticle size caused to the agglomeration of the SrHA more than the pure HA nanoparticles. Moreover the 16 mol % Sr substituted HA (16SrHA) slurry were quickly hardened, which hampered the feeding of the slurry to the SD system; eventually the atomizer was blocked. The increase in the viscosity increased the mean granule size of HA from 41.53 µm to 49.18 µm. HA and 8SrHA granules presented HA phase dominantly after the heat treatment at 1000°C, while, 16SrHA decomposed to TCP according to RAMAN and XRD investigations.
Systematic review and narrative synthesis of pharmacist provided medicines optimisation services in care homes for older people to inform the development of a generic training or accreditation process
Authors: Wright David John , Maskrey Vivienne , Blyth Annie , Norris Nigel , Alldred David P , Bond Christine M , Desborough James , Hughes Carmel M , Holland Richard Charles
Published: November 2019

Objectives

To develop a training programme to enable pharmacists with prescribing rights to assume responsibility for the provision of pharmaceutical care within care homes, a systematic review and narrative synthesis was undertaken to identify reported approaches to training pharmacists and use this literature to identify potential knowledge requirements.

Methods

A PROSPERO-registered systematic review was performed using key search terms for care homes, pharmacist, education, training and pharmaceutical care. Papers reporting primary research focussed on care of the older person within the care home setting were included. No restrictions were placed on methodology. Two researchers independently reviewed titles, abstracts and papers. Agreement on inclusion was reached through consensus. Data on titles, training and activities undertaken were extracted and knowledge requirements identified. Findings were synthesised and reported narratively.

Key findings

Fifty-nine papers were included, most of which were uncontrolled service evaluations. Four papers reported an accreditation process for the pharmacist. Thirteen papers reported providing tools or specific training on a single topic to pharmacists. The main clinical and therapeutic areas of activity (requiring codified knowledge) were dementia, pain, antipsychotic and cardiovascular medication. Provision of pharmaceutical care, effective multidisciplinary working and care home staff training represented the main areas of practical knowledge.

Conclusions

Information regarding training and accreditation processes for care home pharmacists is limited. This study provides insight into potential codified and practical knowledge requirements for pharmacists assuming responsibility for the provision of pharmaceutical care within care homes. Further work involving stakeholders is required to identify the cultural knowledge requirements and to develop a training and accreditation process.
Assessment of agreement and time in therapeutic range of capillary versus venous international normalised ratio in frail elderly people in a nursing home
Authors: Sikirdji Chloé , Costa David , Alonso Sandrine , Clape Jean‐François , Amouyal Michel , de Waziere Benoît , Fabbro‐Peray Pascale
Published: November 2019

Vitamin K antagonists are widely used, yet have a slim therapeutic margin and high iatrogenicity. Patients are monitored through international normalised ratio (INR) by venipuncture, but coagulometers could measure INR by capillary puncture. This prospective study evaluated the clinical concordance of capillary INR versus venous INR in 31 nursing home patients. Concordance was good and mean time in therapeutic range (TTR) markedly increased. Capillary INR is thus reliable, could improve TTR and decrease iatrogenicity.
Are external management consultancies effective in healthcare improvement, do they reflect value for money and what are the alternative models?
Authors: Skouteris Helen , Kirkpatrick Ian , Currie Graeme , Braithwaite Jeffrey , Teede Helena
Published: November 2019

Despite the increasing use and costs associated with external management consultancy for healthcare improvement, there is a paucity of formal evaluations examining impact. This paper aims to: (i) discuss the potential benefits and disadvantages of external consultancies in addressing complex healthcare challenges and delivering healthcare improvement in Australia; and (ii) explore potential alternative models, including internal consultancy and hybrid models delivered through platforms of collaborative expertise. We propose that the substantive reliance on high cost external management consultancies without demonstrating value or benefit, is unsustainable. An integrative approach that embeds research and capacity building within healthcare services may be of value.
The significance of anti‐granulocyte‐macrophage colony‐stimulating factor antibodies in cryptococcal infection: case series and review of antibody testing
Authors: Stevenson Brittany , Bundell Christine , Mulrennan Siobhain , McLean‐Tooke Andrew , Murray Ronan , Brusch Anna
Published: November 2019

We report two cases of cryptococcosis, associated with anti‐granulocyte‐macrophage colony‐stimulating factor antibodies. We review this recently identified acquired form of autoimmune immune deficiency and discuss the potential applications of granulocyte‐macrophage colony‐stimulating factor antibody testing by enzyme‐linked immunosorbent assay.
Translation, cross‐cultural adaptation and validation of the “Cardiff wound impact schedule,” a wound‐specific quality of life instrument, to the native Spanish of Mexican patients
Authors: Lozano‐Platonoff Adriana , Contreras‐Ruiz Jose , Dominguez‐Cherit Judith , Cardenas‐Sanchez Andrea , Alvarez‐Rivero Valeria , Martínez‐Regalado Joel A.
Published: November 2019

The aim of this study was to translate into Mexican Spanish, cross‐culturally adapt and validate the wound‐specific quality of life (QoL) instrument Cardiff wound impact schedule (CWIS) for Mexican patients. This instrument went through the full linguistic translation process based on the guidelines of Beaton et al (Beaton DE, Bombardier C, Guillemin F, Ferraz MB, Guidelines for the process of cross‐cultural adaptation of self‐report measures, Spine Phila Pa, 1976, 2000, 318‐391). We included a total of 500 patients with chronic leg ulcers. The expert committee evaluated the Face validity and they agreed unanimously that the instrument was adequate to assess the QoL of these patients, covering all relevant areas presented by them. The content validity index obtained was of 0.95. The construct validity demonstrated moderately significant correlations between related sub‐scales of CWIS and SF‐36 (P = .010 to P < .001). The instrument was able to discriminate between healed and unhealed ulcers. The instrument obtained an overall Cronbach's alpha of .952, corresponding to an excellent internal consistency (.903‐.771 alpha range for domains). The CWIS can be appropriately used to assess the health‐related QoL of Mexican patients with chronic leg ulcers.
Atmospheric humidity and genotype are key determinants of the diurnal stomatal conductance pattern
Authors: Zhang Xinying , Wang Yajing , Huang Guirong , Feng Fu , Liu Xiaoying , Guo Rui , Gu Fengxue , Hu Xin , Yang Ziguang , Zhong Xiuli , Mei Xurong
Published: November 2019

Great understanding of the genotypic difference in diurnal stomatal conductance (gs) pattern and the key determinants of the pattern is important for saving water by adopting cultivars appropriately. Fifteen wheat genotypes were studied under different soil conditions and various meteorological conditions with pot cultivation in rain shelter for two years. Genotype and air humidity were found to be key determinants of diurnal gs pattern. All genotypes under low relative humidity (LRH) and most genotypes under high relative humidity (HRH) displayed a gradual decline pattern from morning through the afternoon. Under moderate relative humidity (MRH), all genotypes present a single‐peak curve pattern, but they differed in peak time, which may lead to unreliable gs comparison between genotypes and get ostensible contrasting materials. The stomatal conductance was significantly different among genotypes under LRH and the increased gs magnitude is also significantly different when it was compared between LRH and HRH. The present results provide new thinking for selecting and adopting appropriate cultivars with specific stomata traits for the area with various meteorological conditions.
The concept of effective population size loses its meaning in the context of optimal management of diversity using molecular markers
Authors: Toro Miguel A. , Villanueva Beatriz , Fernández Jesús
Published: November 2019

Effective population size is a key parameter in conservation genetics. In the management of conservation programs using pedigree information, there is a consensus that the optimal method for maximizing effective population size is to calculate the contribution of each potential parent (the number of offspring that each individual leaves to the next generation) by minimizing the global pedigree‐based coancestry between potential parents weighted by their contributions. When using molecular data, the optimal method for managing genetic diversity will remain the same but now the molecular coancestry calculated from markers will replace the pedigree‐based coancestry. However, in this situation, the concept of effective population size loses its meaning because with optimal molecular management, genetic diversity increases in early generations and therefore effective population size takes negative values. Furthermore, in the long term, the molecular effective population size does not attain an asymptotic value but it shows an unpredictable behaviour.
Climate change and biogeographic connectivity across the Brazilian cerrado
Authors: De Oliveira Paulo E. , Raczka Marco , McMichael Crystal N. H. , Pinaya Jorge L. D. , Bush Mark B.
Published: November 2019

Aim

To investigate cerrado responses to glacial–interglacial climate change and the potential for connective rain forest corridors between the Atlantic Coastal Forest and Amazonian rain forest.

Location

The crater lake of Serra Negra (18 °S, 46 °W) in Minas Gerais, Brazil.

Taxon

117 fossil pollen types, 22 non‐pollen palynomorphs were documented.

Methods

We recovered 7.82 m of sediment from the lake, and analysed fossil pollen at 62 depth intervals throughout the core. We derived a chronology based on radiocarbon dating with simple rate extrapolation to the base of the core.

Results

The c. 90,000‐year fossil record showed a trend towards cooler climates at the Last Glacial Maximum (LGM), but interstadial warming coupled with reduced evaporative stress allowed the expansion of woodlands under cool, moist conditions. Cool‐adapted trees were most abundant between c. 67,000 and 48,000 years ago. A cool cerrado‐like environment marked full glacial conditions between c. 48,000 and 34,000 years ago. The peak of the LGM between c. 34,000 and 17,000 years ago is inferred to have been dry as no sediment accumulated in the system.

Main conclusions

Expanded ranges of cold‐tolerant forest taxa led to establishment of a series of assemblages without modern analogue. A system characteristic of modern cerrado was rare in the history of this site. Multiple forest expansions were observed, each differing in composition. The periods of forest abundance at Serra Negra were not temporally aligned with forest expansion in the Atlantic Coastal Forest, and did not provide a continuous corridor of similar forest that connected the cerrado to the Atlantic Coastal Forest.
The role of Persian‐language word exercise games in improving spelling of students with dyslexia: Word exercise games in improving spelling
Authors: Zare Mahbobe , Amani Malahat , Sadoughi Majid
Published: November 2019

Children with dyslexia have reduced sensitivity to phonological sounds and words, and this deficiency in lexical processing causes many problems for them. Word exercise games based on phonological awareness have emphasized the mistakes of students with dyslexia, attempting to help children avoid these mistakes. This study was conducted to investigate the effect of Persian‐language word exercise games on the spelling of students with dyslexia. The design of the present study was quasi‐experimental, with a pretest and posttest of an experimental group and a control group. Participants were 30 students with dyslexia from second grade to fifth grade in elementary schools in Bojnord, who completed the spelling test as a pretest and posttest. The experimental group played eleven 40‐min sessions of word exercise games. The results showed that the word exercise programme improved the spelling of the children with dyslexia. This suggests that basing training on the phonological mistakes of students with dyslexia and using the word exercise games can improve their spelling.
Live interactive teledermatology compared to in‐person care – a systematic review
Authors: Andrees V. , Klein T.M. , Augustin M. , Otten M.
Published: November 2019

Teledermatology is a rapidly developing field of dermatological care, giving the opportunity to deliver more efficient healthcare to patients in remote areas. Live interactive (LI) teledermatology uses videoconferencing and, hence, allows for direct communication. A current overview on effectiveness, costs, feasibility and accuracy of LI applications compared to standard care is missing. The present systematic review provides this overview on LI teledermatology. Two databases were searched until April 2019, followed by title, abstract and full‐text screening. Additionally, reference lists of the detected eligible articles were screened for further eligible studies. Studies comparing LI applications with standard care were included. Data on study design, sample size, country, objectives, main findings and characteristics of LI applications were extracted. Results on time effectiveness, costs, accuracy and feasibility of LI applications were synthesized. Additionally, the quality of included studies was assessed. Twenty‐three publications were included in the final analysis: seventeen case–control studies and six randomized controlled trials. Included studies were published between 1997 and 2017. Study quality differed across studies. The studies were carried out in eight different countries. Eleven studies focused on patient consultation, three on patient organization and nine on combined applications of the aforementioned. Nine studies investigated applications facilitating patient–provider interaction. Fourteen studies evaluated applications combining patient–provider and provider–provider interaction, meaning the patient sits next to one provider while using LI applications to interact with another provider. This review reveals that LI applications can be a time effective substitute of or supplement to standard dermatological care. Results demonstrated that LI and standard care are comparable with regard to feasibility and accuracy. No clear tendencies can be reported with regard to costs. However, there is a lack of current comparative studies.
The distribution and density of monocarboxylate transporter 2 in cerebral cortex, hippocampus and cerebellum of wild‐type mice
Authors: Pang Ruiqi , Wang Xiaofan , Du Zhiqiang , Pei Feifei , Li Zhiyue , Sun Libing , Wang Shuying , Peng Yingnan , Lu Xupeng , Gao Xiaoqun , Chang Cheng
Published: November 2019

Monocarboxylates cannot cross the blood‐brain barrier freely to participate in brain energy metabolism. Specific monocarboxylate transporters (MCTs) are needed to cross cellular membranes. Monocarboxylate transporter 2 (MCT2) is a major monocarboxylate transporter encoded by the SLC16A7 gene. Recent studies reported that neurodegenerative diseases of the CNS, such as Alzheimer's disease (AD) and Parkinson's disease (PD), were related to energy metabolic impairment. MCT2 also plays an important role in energy metabolism in the CNS. To provide experimental evidence for future research on the role of MCT2 in the pathological process of CNS degenerative diseases, the distribution and density of MCT2 in different subregions of wild‐type mouse brain was examined using immunohistochemistry, western blot and immunogold post‐embedding electron microscopic techniques. The amount of MCT2 was higher in cerebellum than in cortex and hippocampus on western blots, and there was no statistical difference between cortex and hippocampus. Immunohistochemistry assay revealed the highest density of MCT2 in the CA3 of the hippocampus. The granular cell layer of the cerebellum contained more MCT2 than the molecular layer. The MCT2 density on the end feet of astrocytes of molecular layer was lower than in hippocampus, but the postsynaptic densities (PSDs) of asymmetric synapses in the molecular layer exhibited a high density using immunogold post‐embedding electron microscopic techniques.
The psychological processes voiced by nursing students when caring for suicidal patients during their psychiatric clinical practicum: A qualitative study
Authors: Sun Fan‐Ko , Long Ann , Chiang Chun‐Ying , Wu Ming‐Kung , Yao YuChun
Published: November 2019

Aims and objectives

This study was designed to explore the psychological processes experienced by nursing students caring for suicidal patients during their first psychiatric clinical practicum.

Background

Nursing students expressed fear when caring for patients who presented with suicidal behaviours. Yet, there is a lack of research exploring nursing students' feelings and thoughts when caring for suicidal patients.

Design

A grounded theory study.

Methods

A theoretical sample of 22 undergraduate nursing students who had cared for suicidal patients for at least 5 days during their psychiatric clinical practicum. Data were collected from 2016–2017, in three universities in Taiwan, using a semi‐structured interview and constant comparative analysis. COREQ reporting guidelines were utilised.

Results

Four categories emerged depicting the psychological processes and revealing that the student nurses navigated four phases when caring for patients exhibiting suicidal behaviours. The phases were as follows: (a) apprehension and fear: involving students being frightened about patients attempting suicide; (b) frustration and powerlessness: concerning students finding it challenging to focus on changing patients' suicidal ideations; (c) support and catharsis: covering the students having to ask for psychological support from other people and explore their painful emotions; (d) confidence and empathy: meaning that the students incorporated enhanced confidence and cultivated advanced empathy, leading to the integration of competent care competencies towards suicidal patients.

Conclusions

Findings could help nursing teachers to understand students' psychological processes when caring for suicidal patients. Teachers could provide appropriate support to help reduce students' negative thoughts and feelings and increase their care competencies when nursing suicidal patients during their psychiatric clinical practicum.

Relevance to clinical practice

Clinical nurse teachers could support and facilitate students to develop their competencies and confidence as they negotiate the four phases and, actually, complete their internship goals on their clinical practicums.
A case study of frontline nurse leadership informed by complex responsive processes of relating
Authors: Phillips Natasha , Norman Karen
Published: November 2019

Aims and objectives

To understand the social construction of frontline nurse leadership and how power operates at this level.

Background

It is argued that frontline nurse leaders are central to the negotiation of care. Evidence suggests they feel ill‐equipped to lead and lack confidence in their ability to do so. Disempowerment has been proposed as a barrier to effective ward leadership. There is a lack of studies about daily frontline leadership practice.

Design

Single instrumental case study with embedded cases.

Methods

A purposive sample of one acute National Health Service Trust, with a convenience sample of embedded cases, was selected. Multiple methods of data collection were used including semi‐structured interviews, nonparticipant observations, field notes and documentary evidence. Thematic analysis using constant comparison and categorisation of data within, between and across cases was used to generate a theory of ward leadership in its organisational context. COREQ Checklist compliant.

Results

These findings suggest the frontline nurse leaders' power is a dynamic and situation‐dependent phenomenon that shapes and is shaped by ongoing interactions between stakeholders in the NHS. In these interactions, power ebbs and flows. These leaders, like all actors involved, were paradoxically both powerful and powerless at the same time.

Conclusion

This study offers a new contribution to the discussion about the power of ward leaders and problematises the theoretical assumptions that perpetuate calls for increased power.

Relevance to practice

In their efforts to resolve the spontaneous dilemmas that arise in practice, frontline nurse leaders would benefit from regularly participating in communities of reflexive practice.
Nurse management of vasoactive medications in intensive care: A systematic review
Authors: Hunter Stephanie , Considine Julie , Manias Elizabeth
Published: November 2019

Aim and objective

To investigate how intensive care nurses prepare, initiate, administer, titrate, and wean vasoactive medications.

Background

The management of vasoactive medications is core business for intensive care nurses, but little is known on how nurses manage these ubiquitous and potentially harmful medications.

Design

A systematic review of the literature with narrative synthesis of data.

Methods

The databases CINAHL Complete, Medline Complete and EMBASE were searched from 1965 to January 2019 with keywords under five concept headings and in a variety of configurations. This systematic review was conducted according to the PRISMA guidelines. Studies were assessed for quality and bias, and a modified narrative synthesis was used to analyse data, investigate findings and explore relationships within and between studies.

Results

The review identified 13 studies: two observational studies, two pre and post intervention studies, four survey studies, two quasi‐experimental studies, one longitudinal time series, one prospective controlled trial, and one interview incorporating content analysis. Four studies on preparing and initiating vasoactive medications described a lack of standardisation in infusion preparation and inconsistencies in dosing units and patient weights. Five of six studies on vasoactive medication administration examined nurses’ use of syringe changeovers to reduce patient haemodynamic compromise and there were three studies on titration and weaning.

Conclusion

Further research on nurse management of vasoactive medications is needed to develop an evidence base for specialist education and standardised practices aimed at reducing risk for patient harm.

Relevance to clinical practice

Nurses working in intensive care units in many parts of the world are responsible for the management of vasoactive medications. There is great variation in practices that include preparation, initiation, administration, titration and weaning of vasoactive medications, which increases the risk for medication errors and adverse events in a vulnerable population of critically ill patients.
Education, income and occupation and their influence on the uptake of cervical cancer prevention strategies: A systematic review
Authors: Murfin Jessica , Irvine Fiona , Meechan‐Rogers Ronnie , Swift Amelia
Published: November 2019

Aims

To report a systematic review of the literature exploring how education, income and occupation influence the uptake of cervical screening and HPV vaccination among eligible women in developed countries, including the United Kingdom, United States, Spain, Germany and Norway.

Background

Cervical cancer remains a highly prevalent disease despite it being largely preventable through cervical screening and HPV vaccination. Incidence and mortality of cervical cancer are unequally distributed among socioeconomic groups, warranting research into how individual socioeconomic factors contribute to this unbalanced uptake of prevention strategies.

Design

Systematic review and narrative synthesis.

Methods

The PRISMA guidelines (PLoS Medicine, 6, 2009, e1000097) guided the selection of papers. MEDLINE, CINHAL, PsychINFO, Science Citation Index and HMIC were searched. Ten articles were suitable. Key findings were then extracted, and a narrative synthesis was completed, using suitable guidance and the AXIS tool.

Results

Obtaining high school or college education is associated with uptake of both cervical screening and HPV vaccination. Total household income and income in respect of the countries' poverty line was measured less frequently than education, but associated with screening and vaccination in some studies. Occupation was infrequently measured in comparison to education and income, limiting conclusions of its association to uptake.

Conclusion

Education and income have an association with uptake of cervical screening and HPV vaccination among women. However, evidence is insufficient to affirm a relationship between occupation and uptake of screening and vaccination. Further research would be advised to strengthen these findings.

Relevance to clinical practice

Interventions to promote cervical cancer prevention strategies should be targeted at women and girls with lower education levels and lower income. However, differences are displayed in the relationships between the individual socioeconomic factors and uptake of preventative strategies between countries and populations and so they should be considered separately. Nurses play a considerable role in people's perceptions and experiences of cervical screening and HPV vaccination. The review findings offer new insight that can inform future policy and nursing practice on targeting interventions to promote uptake among women who are underusing cervical cancer prevention programmes.
One Village, Two Sign Languages: Qualia, Intergenerational Relationships and the Language Ideological Assemblage in Adamorobe, Ghana
Authors: Kusters Annelies
Published: November 2019

“Adamorobe signing is sweet,” “The signing in Adamorobe is hard,” “Adamorobe’s deaf people should sign in an eye‐hard way.” These are discourses about signing in Adamorobe Sign Language (AdaSL), a sign language used in Adamorobe, an Akan farmer village in southern Ghana distinguished by a history of hereditary deafness. By calling AdaSL sweet, hard and so on, deaf people in Adamorobe attribute qualia (sensuous qualities which can include hardness, lightness, dryness, and so on) to different forms of signing. Based on fieldwork stints in Adamorobe spread over a period of 10 years, I analyze how qualic evaluations of AdaSL are expressed differently by deaf people from different generations who have had different rates of exposure to Ghanaian Sign Language in addition to AdaSL. Qualic evaluations of AdaSL are related to qualic evaluations of behavior (Gal 2013; Harkness 2015): there are parallels in discourses about AdaSL being hard and deaf people being hard of character and being hardworking strong farmers. Qualic evaluations of language and social relationships permeate discourses about intergenerational differences, constituting a recurrent theme in the language ideological assemblage (i.e., clusters of language ideologies and other ideologies that impact on language) (Kroskrity 2018).
Ultrasound Criteria for Assessment of Vertebral Artery Origins
Authors: Rice Cory J. , Cho Sung‐Min , Strohm Tamara , Raber Larry , Katzan Irene L. , Hussain M. Shazam , Uchino Ken
Published: November 2019

BACKGROUND AND PURPOSE

We sought to validate ultrasound as a reliable means of assessing vessel stenosis of vertebral artery origins.

METHODS

We reviewed 1,135 patient charts with ultrasound of the posterior circulation performed in 2008‐2015 in a single hospital. Inclusion criteria for native vessels consisted of ultrasound and digital subtraction angiography (DSA) performed within 3 months. Patients with indwelling stents were analyzed separately from native vessels. Using DSA as the gold standard, we determined sensitivity and specificity of ultrasound in detecting occlusion at vertebral artery origin. All patients with nonoccluded native vertebral artery origins were evaluated for degree of stenosis on DSA, and compared to mean flow velocity (MFV), peak systolic velocity (PSV), and end‐diastolic velocity (EDV) on ultrasound.

RESULTS

Among 218 vertebral artery origins in 139 patients evaluated, ultrasound showed sensitivity of 85.7% (95% confidence interval (CI): 69.7‐95.2%) for occlusion and specificity of 99.5% (95%CI: 96.9‐99.9%). Among 126 arteries without occlusion, <50% stenosis had average MFV (39 ± 19 cm/s), 50‐69% stenosis had average MFV (68 ± 35 cm/s), and severe (70‐99%) stenosis had average MFV (120 ± 93 cm/s) (P < .001). MFV cutoff value of 44 cm/s corresponded to 77% sensitivity and 70% specificity to detect vertebral artery origin stenosis >50% (C‐statistic: .81). PSV value of 97 cm/s corresponded with 72% sensitivity and 70% specificity to detect >50% stenosis (C‐statistic: .77). MFV cutoff value of 60 cm/s corresponded with 70% sensitivity and 82% specificity to predict 70‐99% stenosis (C‐statistic: .83). PSV cutoff value of 110 cm/s corresponded with 80% sensitivity and 72% specificity to predict 70‐99% stenosis (C‐statistic: .84).

CONCLUSION

Ultrasound has good sensitivity and excellent specificity for detecting vertebral origin occlusion. Flow velocity can be used to screen for severe stenosis of vertebral artery at origin.
Effects of γ‐polyglutamic acid on the gelling properties and non‐covalent interactions of fish gelatin
Authors: Hu Zi‐Zi , Sha Xiao‐Mei , Ye Yun‐Hua , Xiao Wan‐Rong , Tu Zong‐Cai
Published: November 2019

The effects of γ‐polyglutamic aid (γ‐PGA) on the gelling properties and non‐covalent interactions of fish gelatin were investigated. The gel strength and melting temperature of fish gelatin gradually increased, with increasing γ‐PGA concentration, although there was no significant change when the γ‐PGA concentration was greater than 0.04%. As the concentration of γ‐PGA increased, the electrostatic interaction of fish gelatin increased and the hydrophobic interaction between gelatin molecules decreased. The fish gelatin system was comprised of γ‐PGA concentrations of 0.04 and 0.06% showing a strong hydrogen bond. When the γ‐PGA concentration increased from 0 to 0.04%, more phenolic hydroxyl groups in the tyrosine residue tended to form hydrogen bonds with the protein. However, an additional increase in γ‐PGA concentration to 0.1% led to enhanced hydrogen bonding with water molecules. The results of this study showed that hydrogen bonds played an important role in improving the gelling properties of gelatin by γ‐PGA.
Dietary protein reduction for Nile tilapia fingerlings reared in biofloc technology
Authors: Hisano Hamilton , Parisi Jéssica , Cardoso Israel L. , Ferri Giovanni H. , Ferreira Pollyanna M. F.
Published: November 2019

The objective of this study was to evaluate the growth performance of Nile tilapia fed diets with 28, 32, and 36% crude protein (CP) in biofloc technology (BFT) and to verify its influence on water quality and hematological parameters. The experimental design was completely randomized with three treatments (28, 32, and 36% CP) and six replicates. Nile tilapia (n = 270, 6.31 ± 0.40 g) were randomly distributed in 18 aquaria—200 L (15 fish/aquarium), over a period of 60 days. No differences (p > .05) were observed among the treatments for the growth performance and hematological parameters. The volumes of nitrite and sedimentable solids showed higher values with 36% CP, which differed (p < .05) in comparison to 28% CP. Different levels of dietary CP content (36, 32 and 28% CP) do not influence the growth performance and health of Nile tilapia (6–25 g) reared in BFT. Thus, an 8% reduction in dietary protein (28% CP) can generate savings in terms of the costs of production and can decrease the environmental impact of excess dietary protein.