bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrastructure of sensilla on the maxillary and labial palps of three species (Coleoptera: Staphylinidae: Staphylininae)
Authors: Liu Zhiping , Yu Wei , Wu Xuan
Published: August 2019

Most species of Staphylinidae are predators in an agroecosystem. They acquire prey information from their environment through receptors. In this study, the sensilla on maxillary and labial palps of Philonthus kailiensis, Philonthus lewisius and Quedius robustus were examined with scanning electron microscopy to identify and analyse the external morphology and distribution of the sensilla to enhance our knowledge of the sensilla of Staphylinidae and provide a rationale of taxonomical studies on the two genus. Results showed that the sensilla are classified into six types: Böhm bristles, sensilla chaetica, sensilla furcate, sensilla coeloconica, sensilla placodea and sensilla basiconica. No sexual dimorphism exists among the three species. The relationships and functions of sensilla on maxillary and labial palps were also speculated. There may be a certain correlation between the sensilla on maxillary and labial palps of the staphylinid and its habitat.
Time to onset of gastrointestinal bleeding in the SUP‐ICU trial: A pre‐planned substudy
Authors: Granholm Anders , Lange Theis , Anthon Carl Thomas , Marker Søren , Krag Mette , Meyhoff Tine Sylvest , Wise Matt P. , Borthwick Mark , Bendel Stepani , Keus Frederik , Guttormsen Anne Berit , Schefold Joerg C. , Wetterslev Jørn , Perner Anders , Møller Morten Hylander
Published: August 2019

Background

The aetiology and risk factors for clinically important gastrointestinal bleeding (CIB) in adult ICU patients may differ according to the onset of CIB, which could affect the balance between benefits and harms of stress ulcer prophylaxis (SUP).

Methods

We assessed the time to CIB in the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP‐ICU) trial. We assessed if associations between baseline characteristics including allocation to SUP and CIB changed during time in the ICU, specifically in the later (after day 2) compared to the earlier (first 2 days) period, using Cox models adjusted for SAPS II and allocation to SUP. Additionally, we described baseline characteristics and CIB episodes stratified by earlier/later/no CIB and 90‐day mortality status.

Results

Clinically important gastrointestinal bleeding occurred in 110/3291 (3.3%) patients after a median of 6 (interquartile range 2‐13) days; 25.5% of the episodes occurred early. Higher SAPS II was consistently associated with increased risk of CIB (hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.01‐1.05 in the earlier period vs HR 1.02, 95% CI 1.01‐1.03 in the later period; P = .37); university hospital admission was associated with decreased risk of earlier CIB (HR 0.30, 95% CI 0.14‐0.63); this significantly increased in the later period (to HR 0.85, 95% CI 0.53‐1.37; P = .02). Patients with later compared to earlier CIB received more transfusions and had more diagnostic/therapeutic procedures for CIB.

Conclusions

Clinically important gastrointestinal bleeding mostly occurred more than 2 days after randomization. University hospital admission was associated with significantly decreased risk of CIB in the earlier period only.
Impacts of the timing of the discovery of a subsequent event on the auditors’ approach to subsequent events
Authors: Phang Soon‐Yeow
Published: August 2019

This study investigates the underlying causes affecting auditors’ approaches to subsequent events. As auditors are required to perform the majority of subsequent events procedures near the due date of the audit report, I examine whether auditors are less likely to make adjustments or disclosures regarding subsequent events that occur after the audit completion, but before issuing the audit report. Results indicate that auditors were less likely to adjust Type I events that occurred after audit completion when the risk was low, but not when the risk was high. This was not the case for Type II events, which only require disclosure.
Loss of β‐arrestin2 in D2 cells alters neuronal excitability in the nucleus accumbens and behavioral responses to psychostimulants and opioids
Authors: Porter‐Stransky Kirsten A. , Petko Alyssa K. , Karne Saumya L. , Liles L. Cameron , Urs Nikhil M. , Caron Marc G. , Paladini Carlos A. , Weinshenker David
Published: August 2019

Psychostimulants and opioids increase dopamine (DA) neurotransmission, activating D1 and D2 G protein‐coupled receptors. β‐arrestin2 (βarr2) desensitizes and internalizes these receptors and initiates G protein‐independent signaling. Previous work revealed that mice with a global or cell‐specific knockout of βarr2 have altered responses to certain drugs; however, the effects of βarr2 on the excitability of medium spiny neurons (MSNs), and its role in mediating the rewarding effects of drugs of abuse are unknown. D1‐Cre and D2‐Cre transgenic mice were crossed with floxed βarr2 mice to eliminate βarr2 specifically in cells containing either D1 (D1βarr2‐KO) or D2 (D2βarr2‐KO) receptors. We used slice electrophysiology to characterize the role of βarr2 in modulating D1 and D2 nucleus accumbens MSN intrinsic excitability in response to DA and tested the locomotor‐activating and rewarding effects of cocaine and morphine in these mice. Eliminating βarr2 attenuated the ability of DA to inhibit D2‐MSNs and altered the DA‐induced maximum firing rate in D1‐MSNs. While D1βarr2‐KO mice had mostly normal drug responses, D2βarr2‐KO mice showed dose‐dependent reductions in acute locomotor responses to cocaine and morphine, attenuated locomotor sensitization to cocaine, and blunted cocaine reward measured with conditioned place preference. Both D2βarr2‐KO and D1βarr2‐KO mice displayed an enhanced conditioned place preference for the highest dose of morphine. These results indicate that D1‐ and D2‐derived βarr2 functionally contribute to DA‐induced changes in MSN intrinsic excitability and behavioral responses to psychostimulants and opioids dose‐dependently.
Myokines in skeletal muscle physiology and metabolism: Recent advances and future perspectives
Authors: Das Dibash K. , Graham Zachary A. , Cardozo Christopher P.
Published: August 2019

Myokines are molecules produced and secreted by skeletal muscle to act in an auto‐, para‐ and endocrine manner to alter physiological function of target tissues. The growing number of effects of myokines on metabolism of distant tissues provides a compelling case for crosstalk between skeletal muscle and other tissues and organs to regulate metabolic homoeostasis. In this review, we summarize and discuss the current knowledge regarding the impact on metabolism of several canonical and recently identified myokines. We focus specifically on myostatin, β‐aminoisobutyric acid, interleukin‐15, meteorin‐like and myonectin, and discuss how these myokines are induced and regulated as well as their overall function. We also review how these myokines may serve as potential prognostic biomarkers that reflect whole‐body metabolism and how they may be attractive therapeutic targets for treating muscle and metabolic diseases.
Histochemical and ultrastructural investigations on the renal parenchyma of the Egyptian Nile Monitor Lizard (Varanus niloticus)
Authors: Awad Mahmoud , Mohamadain Dalia
Published: August 2019

Varanus niloticus (Linnaeus, 1766), the Nile monitor lizard, is considered the largest lizard in Africa and one of the most widespread. The Egyptian Nile monitor lizard exists in variable habitats, from grasslands to rainforests. This study pointed to investigate the light and ultrastructural features of the renal tissue of this lizard. Microscopically, the lizard nephron deprived from loop of henle and no demarcation could be detected between the cortical and medullary tissues. The renal corpuscles were small, but complex structures. The proximal convoluted tubules were lined by acidophilic cuboidal cells with hemosiderin pigment in their apical cytoplasm. The cytoplasm of the distal convoluted tubular cells reacted strongly with alcian blue stain. The sexual segment of the lizard kidney was lined with high columnar cells with massive periodic acid–Schiff‐positive/alcian blue‐negative supra‐nuclear granules. Ultrastructurally, the basal infoldings of the proximal convoluted cells were evident. Supra‐nuclear electron‐dense vesicles were detected in the cytoplasm of the sexual segment cells. In summary, the kidney of the Egyptian Nile monitor lizard shares many histochemical features with other reptiles. However, they own several structural specializations in order to adapt to their harsh environments. Future studies focusing on the histochemical components of the sexual segment secretion would be required.
The importance of the neuro‐immuno‐cutaneous system on human skin equivalent design
Authors: Vidal Yucha Sarah E. , Tamamoto Kasey A. , Kaplan David L.
Published: August 2019

The skin is a highly complex organ, responsible for sensation, protection against the environment (pollutants, foreign proteins, infection) and thereby linked to the immune and sensory systems in the neuro‐immuno‐cutaneous (NIC) system. Cutaneous innervation is a key part of the peripheral nervous system; therefore, the skin should be considered a sensory organ and an important part of the central nervous system, an ‘active interface’ and the first connection of the body to the outside world. Peripheral nerves are a complex class of neurons within these systems, subsets of functions are conducted, including mechanoreception, nociception and thermoception. Epidermal and dermal cells produce signalling factors (such as cytokines or growth factors), neurites influence skin cells (such as via neuropeptides), and peripheral nerves have a role in both early and late stages of the inflammatory response. One way this is achieved, specifically in the cutaneous system, is through neuropeptide release and signalling, especially via substance P (SP), neuropeptide Y (NPY) and nerve growth factor (NGF). Cutaneous, neuronal and immune cells play a central role in many conditions, including psoriasis, atopic dermatitis, vitiligo, UV‐induced immunosuppression, herpes and lymphomas. Therefore, it is critical to understand the connections and interplay between the peripheral nervous system and the skin and immune systems, the NIC system. Relevant in vitro tissue models based on human skin equivalents can be used to gain insight and to address impact across research and clinical needs.
A review of the use of transient elastography in the assessment of fibrosis and steatosis in the post–liver transplant patient
Authors: Winters Adam C. , Mittal Rasham , Schiano Thomas D.
Published: August 2019

Liver biopsy is considered the gold standard method for diagnosing and staging liver disease, particularly in the post‐liver transplant setting. Given the invasive nature of biopsy, alternate means for accurately assessing liver fibrosis and steatosis are preferred especially as the number of patients with fatty liver disease is increasing. Transient elastography has been validated as a useful tool for evaluation of liver fibrosis, as has controlled attenuation parameter index as a tool for assessing steatosis. It is a non‐invasive, rapid, and highly reproducible approach to demonstrate the presence of fibrosis among non‐transplant patients with chronic liver disease of various etiologies. However, it has not yet found wide acceptance in liver transplant recipients. There are few published studies evaluating the merits and applicability of transient elastography to assess allografts after liver transplantation. We review the published data on the use of transient elastography with concurrent controlled attenuation parameter in liver transplant recipients and recommend its greater use to follow allograft function over time.
Concurrent cutaneous localization of Langerhans cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma in a patient with a history of chronic lymphocytic leukemia/small lymphocytic lymphoma
Authors: Papoudou‐Bai Alexandra , Vassou Amalia , Marinos Leonidas , Papathanasiou Konstantina , Kapsali Eleni , Kanavaros Panagiotis
Published: August 2019

The phenomenon of histiocytic/dendritic cell sarcomas arising through transformation of a pre‐existed lymphoproliferative disease is called transdifferentiation. Langerhans cell sarcoma transdifferentiating from chronic lymphocytic leukemia/small lymphocytic lymphoma is extremely rare and all the reported cases were localized in lymph nodes. We present a case of concurrent cutaneous localization of Langerhans cell sarcoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, in which the chronic lymphocytic leukemia/small lymphocytic lymphoma preceded the development of the Langerhans cell sarcoma. A cutaneous lesion from a 63‐year‐old patient with a history of chronic lymphocytic leukemia/small lymphocytic lymphoma was biopsied. The histologic examination revealed a mixture of two cell populations infiltrating diffusely the dermis. The first was composed of small lymphoid cells with somewhat monotonous appearance and mild nuclear atypia positive for PAX5, CD79a, CD20, CD23, CD5, and LEF1. The second was composed of large cells with abundant cytoplasm and pleomorphic nuclei. These cells were positive for CD1a, CD207, and S100 protein and exhibited a high mitotic rate and a high MIB‐1 immunostaining index. Therefore, two different entities, chronic lymphocytic leukemia/small lymphocytic lymphoma and Langerhans cell sarcoma, were detected in the same skin fragment. The patient died 3 years after initial diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma.
Addressing gaps in transversal educational contents in undergraduate dental education. The audio‐visual ‘pill of knowledge’ approach
Authors: Vázquez‐Rodríguez Inés , Rodríguez‐López Melina , Blanco‐Hortas Andrés , Da Silva‐Domínguez José Luis , Mora‐Bermúdez María Jesús , Varela‐Centelles Pablo , Santana‐Mora Urbano
Published: August 2019

Introduction

Training on impression disinfection is often limited to brief explanations in the clinic. This investigation assessed knowledge on this topic amongst clinical students in our university, produced a pill of knowledge to suit their needs, and evaluated its impact and acceptance.

Material and Methods

A pre‐post study was designed to identify knowledge gaps using an anonymous, voluntary self‐applied questionnaire before and after watching an audio‐visual clip (pill of knowledge). All 136 students in the school were invited to enter the study (estimated sample size: 116).

Results

Participants: 109 (26.6% in 3rd year; 37.6% in 4th year and 39.4% in 5th year). Participation dropped 10.29% (n = 95) in the post‐intervention survey. Knowledge improvement was higher for those impression materials included in the pill. Most students (68.4%) reported to know more about impression disinfection after the pill and 70.5% felt more able to achieve correct disinfection. The pill was particularly well received (86.3%). All students would recommend it to their peers, and 93.5% are willing to receive pills on other topics.

Discussion

Our results disclosed an important gap in knowledge, which can be filled by a single, brief and concise pill adapted to the intended audience. Once made readily available through digital repositories, it may help solve this problem, given the ubiquitous presence of mobile devices.

Conclusions

Our results found pills of knowledge as a useful approach to facilitating undergraduates’ learning process. This method, using suitable information and communication technologies, has the potential to improve the performance on certain clinical tasks.
The case of Tudmīr: archaeological evidence for the introduction of irrigation systems in al‐Andalus
Authors: Gutiérrez Lloret Sonia
Published: August 2019

With a focus on the detail of the archaeological evidence for the introduction of irrigation systems into Tudmīr in south‐east Spain in the eighth and ninth centuries, this paper explores the archaeological contribution to our understanding of the process by which planned irrigation was established in al‐Andalus in the early Middle Ages.
Centennial decline in North Sea water clarity causes strong delay in phytoplankton bloom timing
Authors: Opdal Anders Frugård , Lindemann Christian , Aksnes Dag L.
Published: August 2019

With climate warming, a widespread expectation is that events in spring, such as flowering, bird migrations, and insect bursts, will occur earlier because of increasing temperature. At high latitudes, increased ocean temperature is suggested to advance the spring phytoplankton bloom due to earlier stabilization of the water column. However, climate warming is also expected to cause browning in lakes and rivers due to increases in terrestrial greening, ultimately reducing water clarity in coastal areas where freshwater drain. In shallow areas, decreased retention of sediments on the seabed will add to this effect. Both browning and resuspension of sediments imply a reduction of the euphotic zone and Sverdrup's critical depth leading to a delay in the spring bloom, counteracting the effect of increasing temperature. Here, we provide evidence that such a transparency reduction has already taken place in both the deep and shallow areas of the North Sea during the 20th century. A sensitivity analysis using a water column model suggests that the reduced transparency might have caused up to 3 weeks delay in the spring bloom over the last century. This delay stands in contrast to the earlier bloom onset expected from global warming, thus highlighting the importance of including changing water transparency in analyses of phytoplankton phenology and primary production. This appears to be of particular relevance for coastal waters, where increased concentrations of absorbing and scattering substances (sediments, dissolved organic matter) have been suggested to lead to coastal darkening.
Synthesis and characterization of BiOCl‐CoWO4 nanocomposites with improved photocatalytic activity
Authors: Paul Chowdhury Arpita , Shambharkar Baban H.
Published: August 2019

We have synthesized novel BiOCl‐CoWO4 heterostructured nanocomposites through chemical precipitation route with different amount of CoWO4 using KCl as Cl source at a temperature of 100°C, 4 hours. X‐ray diffraction, transmission electron microscopy, UV‐visible NIR spectroscopy, photoluminescence spectroscopy, N2 adsorption‐desorption isotherms, and electrochemical impedance spectroscopy were performed to gain the crystal structure, morphology, optical properties, surface area, and charge separation of the prepared photocatalysts. BiOCl‐CoWO4 composites demonstrated the diffraction peaks of both monoclinic CoWO4 nanoparticles and tetragonal BiOCl indicating the formation of the nanocomposite. TEM observations have shown that CoWO4 nanoparticles were deposited on the BiOCl surface. Photoluminescence, fluorescence lifetime study, and Electrochemical impedance spectroscopy responses of materials indicated a good separation efficiency of charge carriers in BiOCl‐CoWO4‐1. The photodegradation efficiency of the prepared materials was assessed by the decomposition of rhodamine B (RhB) dye solution under sunlight irradiation. Among the synthesized materials, the BiOCl‐CoWO4‐1 composite photocatalyst exhibited maximum photocatalytic activity. Thus the resulting heterostructure favored the efficient charge and energy transfer between BiOCl and CoWO4 nanoparticles across the interface. The investigations from the radical scavenger tests showed that photogenerated h+, O2∙−, and •OH radicals were involved in the photodegradation of RhB.
A universal HF‐free synthetic method to highly efficient narrow‐band red‐emitting A2XF6:Mn4+ (A = K, Na, Rb, Cs; X = Si, Ge, Ti) phosphors
Authors: Luo Xuefang , Hou Ziyang , Zhou Tianliang , Xie Rong‐Jun
Published: August 2019

Mn4+‐activated fluoride red‐emitting narrow‐band phosphors have been successfully used in wide color‐gamut white LEDs for liquid crystal display (LCD) backlights. However, highly concentrated and toxic HF is usually used in their synthesis, causing environment and safety issues. In this work, we proposed a HF‐free green method, that is, using NH4F/HCl instead of HF, to synthesize a series of A2XF6:Mn4+ (A = K, Na, Rb, Cs; X = Si, Ge, Ti) phosphors. The microstructure, photoluminescence (PL) properties, thermal quenching, and applications of the synthesized phosphors were investigated. Using the proposed approach, the phosphors generally showed a pure phase, a particle size ranging from 5 to 45 μm, and some characteristic sharp emission lines of Mn4+ in the red spectral range. The internal quantum efficiency was varied in a broad range of 69%‐94% under the 460 nm excitation, depending on the composition of the fluoride host. Among these compositions, K2XF6:Mn4+ (X = Ge and Ti) phosphors even had a similar external quantum efficiency (>60%) with commercial ones. By combining K2GeF6:Mn4+ (narrow‐band red) and β‐sialon:Eu2+ (narrow‐band green) with a blue LED, a white light‐emitting diode (wLED) backlight with a color gamut of 87.7% National Television System Committee Standard, color temperature of 8423 K, and a luminous efficacy of 110.8 lm/W was demonstrated. These results indicate that the synthetic method proposed in this work is universal for preparing highly efficient fluoride phosphors used in wLEDs.
Involving caregivers in self‐management interventions for patients with heart failure and chronic obstructive pulmonary disease. A systematic review and meta‐analysis
Authors: Noonan Miriam C. , Wingham Jennifer , Dalal Hasnain M. , Taylor Rod S.
Published: August 2019

Aim

To quantify the impact of involving caregivers in self‐management interventions on health‐related quality of life of patients with heart failure or chronic obstructive pulmonary disease.

Design

Systematic review, meta‐analysis.

Data sources

Searched: Medline Ebsco, PsycINFO, CINAHL, Embase, Web of Science, The British Library and ProQuest. Search time frame; January 1990–March 2018.

Review Methods

Randomized controlled trials involving caregivers in self‐management interventions (≥2 components) compared with usual care for patients with heart failure or chronic obstructive pulmonary disease. A matched sample based on publication year, geographic location and inclusion of an exercise intervention of studies not involving caregivers were identified. Primary outcome of analysis was patient health‐related quality of life.

Results

Thirteen randomized controlled trials (1,701 participants: 1,439 heart failure; 262 chronic obstructive pulmonary disease) involving caregivers (mean age 59; 58% female) were identified. Reported patient health‐related quality of life measures included; Minnesota Living with Heart Failure questionnaire, St. George's respiratory questionnaire and Short‐Form‐36. Compared with usual care, there was similar magnitude in mean improvement in patient health‐related quality of life with self‐management interventions in trials involving caregivers (SMD: 0.23, 95% confidence interval: −0.15–0.61) compared with trials without caregivers (SMD: 0.27, 0.08–0.46).

Conclusion

Within the methodological constraints of this study, our results indicate that involving caregivers in self‐management interventions does not result in additional improvement in patient health‐related quality of life in heart failure or chronic obstructive pulmonary disease. However, involvement of caregivers in intervention delivery remains an important consideration and key area of research.

Impact

Greater understanding and awareness is needed of the methodology of caregiver engagement in intervention development and delivery and its impact on patient outcomes.
Reasons for choosing or refusing care from a nurse practitioner: Results from a national population‐based survey
Authors: Craswell Alison , Dwyer Trudy
Published: August 2019

Aim

To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services.

Design

This cross‐sectional, population‐based survey study used computer assisted telephone interviewing to elicit public opinions on the topic.

Methods

Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open‐ended responses.

Results

Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life‐threatening condition.

Conclusion

Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role.

Impact

This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners.

Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.
What is important for advance care planning in the palliative phase of people with intellectual disabilities? A multi‐perspective interview study
Authors: Voss Hille , Vogel Anique , Wagemans Annemieke M. A. , Francke Anneke L. , Metsemakers Job F. M. , Courtens Annemie M. , de Veer Anke J. E.
Published: August 2019

Background

Advance care planning (ACP) is the process of discussing and documenting wishes and preferences for future care. Research about ACP for people with intellectual disabilities (ID) is limited. This study describes what is important for ACP in the palliative phase of people with intellectual disabilities.

Method

In‐depth interviews were conducted with people with intellectual disabilities (n = 5), relatives (n = 7) and professional caregivers (n = 8). Qualitative data were analysed inductively, using the principles of thematic analysis.

Results

Important themes in ACP were as follows: tailoring care, working as a team and taking and giving time. The perceived role of people with intellectual disabilities in ACP was to express their wishes. Relatives had a signalling, representing and contributing role. Professionals felt their role was to inform, collaborate and coordinate.

Conclusions

A staff training programme about ACP should cover how to build and maintain close relationships, provide a safe environment and address ACP as an integral part of care.
Outcomes from a community‐based Positive Behavioural Support team for children and adults with developmental disabilities
Authors: Bowring Darren L. , Totsika Vasiliki , Hastings Richard P. , Toogood Sandy
Published: August 2019

Background

Previous evaluations of community PBS teams have not investigated whether behaviour change is both statistically reliable and clinically significant. Few previous studies have reported quality of life (QoL) and social validity outcomes.

Method

The present authors collected data on 85 people referred to a specialist PBS team. The present authors used a unique set of multiple measures and statistical change metrics to evaluate outcome.

Results

Statistically significant improvements in QoL and health‐related QoL (HRQoL), with medium to large effect sizes, were demonstrated following PBS input. Mean Behaviour Problems Inventory‐Short Form scores reduced from 37.74 (SD = 30.54) at baseline to 12.12 (SD = 12.24) at follow‐up, with a large effect size (d = 0.84). Stakeholders reported valuing the process and outcomes of PBS, findings which support the social validity of PBS for people with developmental disabilities.

Conclusion

This study demonstrates successful PBS outcomes in QoL, HRQoL, challenging behaviour and social validity in a community setting.
Life after release from prison: The experience of ex‐offenders with intellectual disabilities
Authors: Chiu Pak , Triantafyllopoulou Paraskevi , Murphy Glynis
Published: August 2019

Background

In the UK, little is known about the experience of ex‐prisoners with intellectual disabilities.

Method

A qualitative study was therefore conducted to investigate what life is like for ten men with intellectual disabilities who left prison at least 9 months previously. Semi‐structured interviews were employed to explore the men's views of post‐prison life, including opportunities/challenges and support received from services.

Results

Through interpretative phenomenological analysis, four over‐arching themes were constructed: the nature of support and services, the difficulty of staying out of trouble, the importance of family and the need to act the “tough guy”. The participants reported being extremely under‐supported. They were often hostile about staff who they felt were too focused on their previous crime.

Conclusions

In general, men were very under‐supported and the upheavals of post‐prison lives appeared to be “normalized” by them. Better understanding of their lives within their social context would benefit their community re‐entry.
A step in the global effort to control hypertension: Fixed dose combination antihypertensive drugs
Authors: Campbell Norm R. C.
Published: August 2019

Several fixed dose combinations (FDCs) of antihypertensive drugs have recently been added to the World Health Organization model list of essential medications. FDCs have advantages in the management of hypertension compared to single drug tablets including improved adherence, greater blood pressure lowering and are associated with reduced cardiovascular complications. FDCs can also reduce ethnic, and age‐related variation in blood pressure lowering and have similar or reduced adverse effects relative to single‐drug therapy. Best hypertension control practices from the World Health Organization HEARTS program advocates the use of FDC in simple directive treatment protocols. FDC in simple directive protocols was viewed as a key success factor in the control of chronic infections (eg, tuberculosis, HIV). Unfortunately, implementing simple directive protocols with FDC has had substantial opposition from hypertension experts. Hypertension organizations and experts need to familiarize themselves with best practices in hypertension control, their supporting evidence and to become advocates.
Atopic dermatitis is associated with increased use of social benefits: a register‐based cohort study
Authors: Slagor R.M. , Nørreslet L.B. , Ebbehøj N.E. , Bonde J.P. , Thomsen S.F. , Agner T.
Published: August 2019

Background

The comprehensive consequences of atopic dermatitis (AD) include a negative influence on work life. However, data regarding use of social benefits in patients with AD are sparse.

Objective

To examine the association between AD and use of social benefits, with a specific focus on paid sick leave and disability pension.

Methods

The study cohort comprises citizens born in the period 1964–1999 with a diagnosis of AD registered in the Danish National Patient Registry (DNPR) and a 20‐fold match control group from the background population. Cross‐linkage of data from 1964 up to 2015 by four national registers (the DNPR; the Central Person Register; the Register of Medicinal Product Statistics; and the Danish Register for Evaluation of Marginalisation) enabled the comparison of AD patients and controls with respect to social benefits. Prescription of systemic medication served as a proxy for AD severity. Social benefits were analysed as a function of AD status using Cox regression.

Results

A total of 28 156 AD patients were registered in the DNPR, and the control group comprised 473 836 individuals not registered with AD in the DNPR. AD was found to be associated with increased risk of receiving social benefits, paid sick leave in particular, and most pronounced for younger patients with severe AD (OR = 1.37, 95% CI: 1.25–1.52). The use of disability pension was increased for all groups of AD patients compared to controls and most pronounced for older patients with severe AD [HR 1.67 (95% CI: 1.45–1.93)].

Conclusion

Our data emphasize that AD significantly impacts work life negatively for the patients and is a financial burden for the society.
Sun‐protection and sun‐exposure habits among sailors: results of the 2018 world's largest sailing race Barcolana’ skin cancer prevention campaign
Authors: Zalaudek I. , Conforti C. , Corneli P. , Jurakic Toncic R. , di Meo N. , Pizzichetta M.A. , Fadel M. , Mitija G. , Curiel‐Lewandrowski C.
Published: August 2019

Background

Epidemiologic data suggest an increased risk of melanoma (MM) and non‐melanoma skin cancer (NMSC) in persons with intense recreational sun‐exposure such as marathon runners or surfers. Up to data little is known about the sun‐exposure habits, sun‐protection behaviours and risk factors for MM and NMSC among sailors.

Objective

The objective of this prospective, cross‐sectional study was to investigate the sun‐exposure and sun‐protective habits and risk factors for skin cancer among sailors attending the 50° edition of Barcolana, the largest sailing race in of the world, which took place in October 2018 in Trieste, Italy as an integrative component of a public sun‐prevention campaign.

Methods

The study consisted of 2 parts: (i) a self‐administered questionnaire focusing on sun‐exposure and protective habits and (ii) a free skin examination carried out by volunteer dermatologists. Participation was optional and anonymous, and open to visitors and sailors attending the event.

Results

Overall, 431 (52.4%) sailors and 391 (47.6%) visitors responded to the questionnaire, while a total of 437 individuals including 189 (43.3%) sailors and 248 (56.6%) visitors participated in the skin examination group. The majority of sailors reported a past history of severe sunburns (20.2%), applied sunscreen never (14.4%) to sometimes (45.7%) or only once daily (59%) on the face (55%) and shoulders (26%). Moreover, 14% of sailors had a personal history of non‐melanoma skin cancer (NMSC). During the dermatological examination, suspicious lesions for skin cancer (including MM and NMSC) were identified in 37% of the sailors.

Conclusion

Our findings support the need to develop and promote primary and secondary prevention strategies to improve the sun‐exposure and sun‐protective habits among sailors.
Evaluation of moisturizing and irritation potential of sacha inchi oil
Authors: Soimee Wichuda , Nakyai Wongnapa , Charoensit Pensri , Grandmottet Francois , Worasakwutiphong Saran , Phimnuan Preeyawass , Viyoch Jarupa
Published: August 2019

Objective

The moisturizing and irritation effects of sacha inchi oil were evaluated.

Study Design

The moisturizing effect on the skin was clinically assessed using a regression study design. Sacha inchi oil or olive oil (benchmark) was applied on the left or right lower leg of the subjects for 14 days followed by application discontinuation for 2 days. The TEWL, skin moisture content and dryness appearance were observed.

Methods

The fatty acid composition and characteristics of cold‐pressed sacha inchi seed oil were determined. Skin tissues cultured ex vivo were used to assess primary irritation induced by the oil by examining keratin 1 expression and TNF‐α and IL‐1α release from the oil‐applied tissues.

Results

The sacha inchi oil contained 42.3% linolenic acid and 39.5% linoleic acid. This oil's saponification, iodine, acid and peroxide values were 168.58 ± 1.55 mg KOH/g, 203.00 ± 0.04 g I2/100 g, 1.68 ± 0.03 mg KOH/g, and 1.95 ± 0.26 mEq peroxide/kg, respectively. Compared with nontreated skin tissues, induced secretion of TNF‐α and IL‐1α and disruption of keratin 1 integrity in the stratum corneum layer were not found in the sacha inchi oil‐treated tissues. In a clinical study with 13 volunteers, the improvement in moisture content and skin dryness appearance at the sacha inchi oil‐applied site was comparable with that observed at the olive oil‐applied site.

Conclusions

The sacha inchi oil was mild to the skin and benefited dry skin.
Chronic eyelid edema and xerophthalmia secondary to periorbital hyaluronic acid filler injection
Authors: Khalil Krystina , Arnold Nichelle , Seiger Eric
Published: August 2019

Background

Hyaluronic acid (HA) is a popular, nonsurgical, temporary technique that is commonly used in the periocular region to restore volume in areas that have undergone volume loss, as well as adjusting the height and contour of the eyebrow.

Aims

Due to the location of glands, nerves, and vasculature, the facial anatomy should be well understood to avoid injections into areas that may result in complications.

Patient/Methods

A 54‐year‐old woman presented for a cosmetic consultation to address "puffy eyelids". She states she had HA filler injected along the orbital ridge inferior to the eyebrow and medially at the glabellar crease two years prior. Two months after her injection, she began to notice upper eyelid edema, xerophthalmia, and dryness of her nasal mucous membranes. Extensive evaluation and imaging were done by physicians of different specialties with a negative workup.

Results

A total of 60 units of hyaluronidase were injected into the areas of previous filler placement over a three‐week period. This resulted in complete resolution of the patient's presenting symptoms.

Conclusion

Familiarity with potential adverse events is arguably the most important aspect of treating patients with HA filler. The anatomy of the orbit and lacrimal system are important to keep in mind when evaluating symptoms related to possible long‐term complications of retained filler injections. Reporting this case should raise awareness about this potential adverse event and further explain the delicate anatomy of the periorbital area.
Functional characterization of 27 CYP3A4 variants on macitentan metabolism in vitro
Authors: Li Ying-hui , Lu Xiang-ran , Lin Qian-meng , Huang Huan-le , Liang Xiao-long , Cai Jian-ping , Cui Ju , Hu Guo-xin
Published: August 2019

Objective

Macitentan is a new choice for pulmonary hypertension treatment which is converted to active metabolite ACT132577 by human cytochrome P450 3A4. Human cytochrome P450 3A4 often occurred gene mutations. Gene polymorphism might cause a variety of changes of protein expression and thus give rise to metabolic difference. The aim of this study was to investigate the catalytic characteristics of 27 CYP3A4 protein variants on the metabolism of macitentan in vitro.

Method

The incubation mixtures (final volume of 200 μl in 1 m PBS) consisted of 1 pmol wild-type CYP3A4.1 or other CYP3A4 protein variants, 2.38 pmol CYP b5 and macitentan (10–600 μm) with 1 mm NADPH. All specimens were processed using same approach with acetonitrile precipitation. The metabolite of macitentan was analysed by ultra performance liquid chromatography–tandem mass spectrometry.

Key finding

Most CYP3A4 protein variants (CYP3A4.9, .11, .12, .13, .17, .20, .23, .24, .28, .29, .33, .34) exhibited a sharp decrease, meanwhile nearly one in five variants (CYP3A4.3, .4, .5, .10, .15, .16) showed a significant rise in intrinsic clearance. The relative clearance of CYP3A4 protein variants was ranged from 5.53 to 501.00%.

Conclusion

Twenty-seven CYP3A4 protein variants displayed different catalytic characteristics towards macitentan in vitro, especially CYP3A4.5, .17, .20, .23. It is important to pay more attention to the dosage of macitentan in order to get better treatment for pulmonary arterial hypertension.
Optimizing a determination of chewing efficiency using a solid test food
Authors: van der Glas Hilbert W. , Liu Ting , Zhang Yifan , Wang Xinmiao , Chen Jianshe
Published: August 2019

A test using a solid food is relevant to measure chewing ability (CA) as (a) it includes an integrated functioning of all oral structures involved, (b) an impairment of chewing a solid food causes inevitably diet restrictions, and (c) chewing efficiency (CE) can easily be defined. CE is the number of chewing cycles, N(1/2‐Xo), needed to attain a particular chewing outcome (a median particle size, X
50, which is half the initial particle size Xo) whereas chewing performance (CP) is a state of chewing outcome (X
50) at an arbitrary number of chewing cycles. The use of CE is preferable for CA because inter‐subject ratios are constant regardless of the initial conditions of the test food. Furthermore, the inter‐subject variation is two times larger for CE values than for CP ones, yielding a better inter‐subject differentiation of CA. However, a determination of CP needs only one N‐value, and that of CE at least two N‐values for enabling an interpolation of N(1/2‐Xo). Using samples of only two half‐cubes (9.6 x 9.6 x 4.8 mm; limiting test load) of Optosil (an artificial test food), and detailed previous information on log(X
50)‐log(N) relationships (Liu et al., Archives of Oral Biology, 2018, 91, 63–77) as a “gold standard,” a short procedure has been developed for a priori choosing two appropriate N‐numbers, and the subsequent determination of a subject's CE. This procedure has been developed using results from 20 young adults (23.7 years, SD 1.1) and was validated in 10 middle‐aged and older adults (52.3 years, SD 10.1), where impairments in the dentition were reflected in the CE‐values. Our short procedure to determine CE will improve studies on relationships between CA and food preference, or between CA and dental factors and/or physiological factors. The first type of relationship may be of interest for food industry whereas the second type may be of interest for population studies in rapidly aging societies and for clinical studies in dentistry. Results can be compared between subjects and studies without bias by using CE rather than CP as a measure of CA.
Urban lifestyle supports larger red foxes in Australia: an investigation into the morphology of an invasive predator
Authors: Stepkovitch B. , Martin J. M. , Dickman C. R. , Welbergen J. A.
Published: August 2019

Adult body size, mass and condition predict reproductive success and survival, and hence fitness, in mammals and many other animals. Here, we assessed morphological variation and body condition in populations of the red fox (Vulpes vulpes) along an urban to natural land use gradient in the Sydney region, Australia. The red fox was introduced into Australia in the mid‐19th century and is a recent but successful urban adapter as well as a highly effective predator of naïve native species. As the red fox has successfully invaded urban environments in many parts of the world where it readily exploits anthropogenic sources of food, we hypothesized that individuals should be larger and in better condition in urban than in natural habitats. We found that individuals (N = 135) of both sexes had larger body mass and skeletal measurements in urban than in more natural habitats; body condition, by contrast, showed no consistent variation. Thus, the urban environment of Sydney provides conditions that favour an increase in size in red foxes so that individuals are now larger than, but in similar body condition as, their non‐urban counterparts. Increased body size and mass may enable red foxes to hunt a broader array of prey species, and as such would be of added concern for the management of native wildlife in Australia's urban environments, a possibility that warrants further investigation.
Evolutionary responses to global change in species‐rich communities
Authors: Lau Jennifer A. , terHorst Casey P.
Published: August 2019

Evolution in nature occurs in the proverbial tangled bank. The species interactions characterizing this tangled bank can be strongly affected by global change and can also influence the fitness and selective effects of a global change on a focal population. As a result, species interactions can influence which traits will promote adaptation and the magnitude or direction of evolutionary responses to the global change. First, we provide a framework describing how species interactions may influence evolutionary responses to global change. Then, we highlight case studies that have explicitly manipulated both a global change and the presence or abundance of interacting species and used either experimental evolution or quantitative genetics approaches to test for the effects of species interactions on evolutionary responses to global change. Although still not frequently considered, we argue that species interactions commonly modulate the effects of global change on the evolution of plant and animal populations. As a result, predicting the evolutionary effects of the multitude of global changes facing natural populations requires both community ecology and evolutionary perspectives.
The feasibility of implementing education on older person care to practice on medical units: Nurses’ perceptions and the influence of practice context
Authors: Hunter Kathleen F. , Dahlke Sherry , Negrin Kelly , Kalogirou Maya Reshef , Fox Mary , Antonio Natasha , Buckborough Neena , Morgan Angela , Wagg Adrian
Published: August 2019

Aim

As part of a larger primary study on evidence‐informed practice with hospitalised older people, we aimed to (a) examine nursing staffs’ perceptions of the interactive geriatric educational intervention and to explore how perceptions of their work context may influence their ability to enact the evidence‐informed assessment and care approaches discussed during the educational sessions and (b) compare differences in perceptions of context between RNs, LPNs and HCAs.

Method

A survey‐based evaluation that used both closed and open‐ended questions was conducted as part of an interactive educational intervention on cognitive impairment and managing responsive behaviours. Data were gathered on participants’ perceptions of the education intervention and organisational context.

Results

Findings from this study suggest when education is tailored to nurses’ articulated educational needs, it is well received; however, barriers to implementation exist. Assessment of the context by using a standardised survey tool to get the nursing staffs’ perceptions of organisational context revealed strengths in leadership support and day‐to‐day interactions with other nurses and healthcare professionals, but potential barriers related to lack of facilitation to transfer new knowledge into practice existed.

Conclusion

Providing evidence‐based education related to care of older patients and evaluating nursing staffs’ perceptions of the education and their context has laid the groundwork for a long‐term relationship with the managers and nursing staff on the participating medical units. Further investigation about how best to incorporate the facilitator role into the medical units to support evidence‐based practices with older patients is warranted. 

Implications for practice

While nurses are receptive to new knowledge, the unpredictable workload of acute care creates challenges to implementing this new knowledge. Assessment of contextual factors that influence evidence‐informed practice facilitates planning for implementation of new knowledge and support practice change.