bluuebunny/crossref_metadata_2025 huggingface dataset:
The nexus of nursing leadership and a culture of safer patient care
Authors: Murray Melanie , Sundin Deborah , Cope Vicki
Published: August 2017

Aims and objectives

To explore the connection between +6 nursing leadership and enhanced patient safety.

Background

Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices.

Design

The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care.

Conclusions

Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership.

Relevance to practice

Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes.
There is more to perinatal mental health care than depression: Public health nurses reported engagement and competence in perinatal mental health care
Authors: Higgins Agnes , Downes Carmel , Carroll Margaret , Gill Ailish , Monahan Mark
Published: August 2017

Aims and objectives

To explore public health nurses’ engagement, competence and education needs in relation to perinatal mental health care in Ireland.

Background

It is estimated that 15%–25% of women will experience a mental health problem during or postpregnancy, either as a new problem or a reoccurrence of a pre‐existing problem. Public health nurses, or their equivalent, are ideally positioned to support women's mental health and improve health outcomes for the woman and baby, yet little is known about their role and engagement with mental health issues, other than with postnatal depression. The objectives of the study were to identify public health nurses’ knowledge, skills and current practices in perinatal mental health and establish their education needs.

Design

The research used a descriptive design.

Method

A total of 186 public health nurses completed an anonymous, online survey, designed by the research team.

Results

While public health nurses are positive about their role in supporting women's mental health, they lack the knowledge and skills to address all aspects of mental health, including opening a discussion with women on more sensitive or complex issues, such as trauma and psychosis and providing information to women. Those who received education reported statistically significant higher knowledge and confidence scores than those without.

Conclusion

Public health nurses lack the knowledge and skills required to provide comprehensive perinatal mental health care to women. Future education programmes need to move beyond postnatal depression and address the range of mental health problems that may impact on women in the perinatal period.

Relevance to clinical practice

Without knowledge and skill among nurses in all aspects of perinatal mental health, women with significant mental health needs may be left to cope alone and lack the necessary prompt evidence‐based interventions and supports.
Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses
Authors: Endacott Ruth , O'Connor Margaret , Williams Allison , Wood Pamela , McKenna Lisa , Griffiths Debra , Moss Cheryle , Della Phillip , Cross Wendy
Published: August 2017

Aims and objectives

To determine, from the perspectives of enrolled nurses and registered nurses, the current scope of enrolled nurse practice and to identify the activities that most enrolled nurses frequently performed in their workplace.

Background

Enrolled nurse scope of practice in Australia has evolved and expanded over the past decade. However, the unclear role, function and competency differentiation between enrolled nurse and registered nurse leads to role confusion and ongoing professional debate.

Design

Exploratory Descriptive Study.

Methods

A cross‐sectional online survey of enrolled nurses and registered nurses across Australia was conducted examining their levels of agreement on statements related to the scope of practice and the clinical and nonclinical activities that enrolled nurses were required to perform in their workplace.

Results

Valid responses were received from 892 enrolled nurses and 1,198 registered nurses. Enrolled nurses mostly agreed that they understood their scope of practice; did not undertake roles for which they were unprepared; sometimes undertook activities other than direct patient care; and believed that they operated equally to many registered nurses. The majority of enrolled nurses reported that they performed tasks mostly related to basic patient care in their workplace. There were a number of significant differences between perspectives of registered nurses and enrolled nurses.

Conclusions

Clarifying the roles and scope of practice between the registered nurse and the enrolled nurse is important, and explicit differences in responsibility and accountability between their roles must be clearly articulated to harmonise perceptions about role and capability. Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned.

Relevance to clinical practice

Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned.
Does pre‐exposure prophylaxis for HIV prevention in men who have sex with men change risk behaviour? A systematic review
Authors: Freeborn Kellie , Portillo Carmen J.
Published: August 2017

Aims and Objectives

To review the literature regarding PrEP and sexual behaviour change in MSM.

Background

Pre‐exposure prophylaxis for HIV has been available since 2012. Even so, pre‐exposure prophylaxis has not been widely accepted among healthcare providers and men who have sex with men some of whom are convinced that pre‐exposure prophylaxis decreases condom use and increases sexually transmitted infections.

Design

A systematic review of the state of the evidence regarding the association of pre‐exposure prophylaxis with condom use, sexually transmitted infection incidence and change in sexual risk behaviours in men who have sex with men. A structured search of databases resulted in 142 potential citations, but only 10 publications met inclusion criteria and underwent data abstraction and critical appraisal.

Methods

An adapted Cochrane Collaboration domain‐based assessment tool was used to critically appraise the methodological components of each quantitative study, and the Mixed Methods Appraisal Tool was used to critically appraise qualitative and mixed‐methods studies.

Results

Condom use in men who have sex with men using pre‐exposure prophylaxis is influenced by multiple factors. Studies indicate rates of sexually transmitted infections in treatment and placebo groups were high. Pre‐exposure prophylaxis did not significantly change sexually transmitted infection rates between baseline and follow‐up. Reporting of sexual risk improved when questionnaires were completed in private by clients. Our review found that pre‐exposure prophylaxis may provide an opportunity for men who have sex with men to access sexual health care, testing, treatment and counselling services. We did not find any conclusive evidence that pre‐exposure prophylaxis users increase sexual risk behaviours.

Conclusion

The perception among healthcare providers that pre‐exposure prophylaxis leads to increased sexual risk behaviours has yet to be confirmed. In order to provide effective sexual health services, clinicians need to be knowledgeable about pre‐exposure prophylaxis as an HIV prevention tool.

Relevance to clinical practice

In an era where HIV prevention methods are rapidly improving, strategies for sexually transmitted infection testing, treatment, counselling and prevention remain vital to improve health. All healthcare providers are uniquely positioned to promote sexual health through the dissemination of accurate information.
An Evaluation of the Effect of Periodontal Biotype on Inter‐Dental Papilla Proportions, Distances Between Facial and Palatal Papillae in the Maxillary Anterior Dentition
Authors: Ahmed Arshia Jameel , Nichani Ashish S. , Venugopal Ranganath
Published: August 2017

Purpose

Gingival esthetics are an essential segment of facial beauty. The aim of the present study was to clinically assess the impact of periodontal biotype (PB), the length between the base of interproximal contact area and the interproximal bone crest (CP‐BC), the distance between the facial and palatal papillae (DFPP), and papillary proportions (PP) on the presence of interdental papillae (PIP).

Materials and Methods

80 patients aged 18 to 60 years were recruited for study. PB and CP‐BC were evaluated clinically. Alginate impressions of maxillary arches were made, and DFPPs were measured using a digital Vernier caliper. The impressions were later poured in dental stone, and PP were calculated.

Results

Descriptive statistics and ANOVA were used for statistical analysis for correlation among the variables. A greater proportion of individuals who had a thick PB (77.7%) had significantly higher amounts of PIP than did patients with thin PB (60.7%) (p < 0.01). A strong significant positive correlation was found between PIP in thick PB patients and DFPP (p < 0.01, r = 0.56); DFPP and PP (p < 0.01, r = 0.61). A strong negative correlation was seen between PIP in thin PB and DFPP (p < 0.01, r = –0.67).

Conclusion

According to the results of this study, PB affected the heights and presence of maxillary interdental papillae by affecting papilla proportion and distances between the facial and palatal papillae.
Alternative Method to Evaluate the Adaptation of Implant‐Supported Multi‐Unit Prosthetic Frameworks
Authors: Zhou Ying , Li Yong , Ma Xiao , Huang Yiqing , Wang Jiawei
Published: August 2017

Purpose

Various methods to evaluate the adaptation of dental prostheses are available; however, only a few of these methods assess the adaptation of the framework as a whole. This study aimed to propose an alternative method to evaluate the adaptation of implant‐supported multi‐unit Co–Cr alloy frameworks.

Materials and Methods

A four‐unit framework supported by two implants was designed using a computer. Six dots with a diameter of 0.2 mm were designed randomly using 3Shape software on the abutment surface of the framework for measurement. Then, Co–Cr frameworks were fabricated via the milled and selective laser melting (SLM) techniques (n = 10 for each technique). They were subsequently scanned and exported as files in stereolithography format. The distances between two dots roughly along 3D directions were measured in both the designed framework and fabricated frameworks. The differences in distances were calculated. The adaptation of the frameworks was also evaluated using the impression replica method. The data were compared and statistically analyzed via t‐test.

Results

The average difference of the distances between the designed and milled frameworks was 0.046 ± 0.057 mm when evaluated using the new method. This result was significantly different from that between the designed and SLM frameworks (0.073 ± 0.048 mm, p < 0.05). The average marginal gap width of the milled frameworks was 44.44 ± 8.61 μm when evaluated using the impression replica method. This result was also significantly different from that of the SLM frameworks (57.31 ± 7.97 μm, p < 0.05).

Conclusions

The new method can evaluate the adaptation of implant‐supported multi‐unit frameworks, thereby making assessments more effective and comprehensive when it is combined with the traditional impression replica technique.
Mental health of health professionals
Authors: Nunn Kenneth
Published: August 2017

Helping medical colleagues with depression and suicidal thoughts and feelings can be more difficult than helping those who are not in the caring professions. The current systems of notification of impairment and supporting troubled doctors, especially in the public sector, are not working well and can make help seeking and help accepting harder. Accessing effective psychiatric help confidentially and in a timely way is difficult unless it is anticipated, facilitated, tenacious and resistant to initial rebuff. When suicide occurs, it is frequently associated with unhelpful generalisations on the value of psychiatric intervention among colleagues that makes others less likely to seek help or believe that the ‘the help will help’. The needs of the children of those who take their lives are often overlooked.
Unilateral nipple plaque in a male boy
Authors: Pereira Ana Sousa , Machado Susana , Selores Manuela
Published: August 2017

See Answer
Lactobacillus plantarum BS22 promotes gut microbial homeostasis in broiler chickens exposed to aflatoxin B1
Authors: Zeng Y. , Zeng D. , Zhang Y. , Ni X. Q. , Wang J. , Jian P. , Zhou Y. , Li Y. , Yin Z. Q. , Pan K. C. , Jing B.
Published: August 2017

Probiotics promote the health of the host by maintaining intestinal microbial homeostasis. This study aimed to investigate the benefits of Lactobacillus plantarum BS22 (LP) in the gastrointestinal tract (GIT) microbial homeostasis of broiler chickens exposed to aflatoxin B1 using the PCR‐DGGE, viable count and real‐time PCR. The toxin adsorption experiment demonstrated that treatment R5 (1.0 × 108 CFU/g LP) exhibited good absorptive effect in adsorbing the aflatoxin B1 (AFB1) in vitro. DGGE showed that the composition and structure of gut microbiota were more similar in the mucosa than in the content of all the samples. In addition, higher diversity of the microbiota was observed in the caecum and glandular stomach than in other segments. Lactobacillus, Enterococcus and Enterobacteriaceae were more abundant in the ileum than in the other segments. Enterobacteriaceae in groups I (basal diet) and II (basal diet+50 μg/kg AFB1) showed a significant difference in group III (basal diet + 50 μg/kg AFB1 + 1 × 108 CFU/g LP) in the crop content and duodenum mucosa (p < .05). This investigation indicates that the L. plantarum BS22 promotes GIT microbial homeostasis in broiler chickens exposed to AFB1, particularly for the intestine mucosa microbiota. Thus, L. plantarum BS22 is a possible candidate for degrading AFB1.
The role of external carbonic anhydrase in photosynthesis during growth of the marine diatom Chaetoceros muelleri
Authors: Smith‐Harding Tamsyne Jade , Beardall John , Mitchell James Gordon
Published: August 2017

Carbon dioxide concentrating mechanisms (CCMs) act to improve the supply of CO2 at the active site of ribulose‐1,5‐bisphosphate carboxylase/oxygenase. There is substantial evidence that in some microalgal species CCMs involve an external carbonic anhydrase (CAext) and that CAext activity is induced by low CO2 concentrations in the growth medium. However, much of this work has been conducted on cells adapted to air‐equilibrium concentrations of CO2, rather than to changing CO2 conditions caused by growing microalgal populations. We investigated the role of CAext in inorganic carbon (Ci) acquisition and photosynthesis at three sampling points during the growth cycle of the cosmopolitan marine diatom Chaetoceros muelleri. We observed that CAext activity increased with decreasing Ci, particularly CO2, concentration, supporting the idea that CAext is modulated by external CO2 concentration. Additionally, we found that the contribution of CAext activity to carbon acquisition for photosynthesis varies over time, increasing between the first and second sampling points before decreasing at the last sampling point, where external pH was high. Lastly, decreases in maximum quantum yield of photosystem II (Fv/Fm), chlorophyll, maximum relative electron transport rate, light harvesting efficiency (α) and maximum rates of Ci‐ saturated photosynthesis (Vmax) were observed over time. Despite this decrease in photosynthetic capacity an up‐regulation of CCM activity, indicated by a decreasing half‐saturation constant for CO2 (K0.5CO2), occurred over time. The flexibility of the CCM during the course of growth in C. muelleri may contribute to the reported dominance and persistence of this species in phytoplankton blooms.
Parental management of adrenal crisis in children with congenital adrenal hyperplasia
Authors: Fleming Louise , Knafl Kathleen , Knafl George , Van Riper Marcia
Published: August 2017

Purpose

Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents’ perceptions of the consequences of having a child with a life‐threatening condition; and to examine a relationship between parents’ perceived management ability and the impact CAH has on the family.

Methods

In Phase 1 of this mixed‐methods, cross‐sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi‐structured interviews were conducted to elicit detailed descriptions of parents’ experiences in managing crises.

Results

There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p < .001). From birth to age 5, parents reported more frequent crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers.

Practice Implications

Provider support is needed for these parents throughout childhood, but especially in the first 5 years of life when parents are adjusting to having a child with a life‐threatening condition. Identifying gaps in parent education by healthcare providers is necessary to promote positive family outcomes.
Predictors of insomnia symptoms and nightmares among individuals with post‐traumatic stress disorder: an ecological momentary assessment study
Authors: Short Nicole A. , Allan Nicholas P. , Stentz Lauren , Portero Amberly K. , Schmidt Norman B.
Published: August 2017

Despite the high levels of comorbidity between post‐traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD‐specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia‐specific (i.e. dysfunctional beliefs about sleep, insomnia‐related safety behaviours and daily stressors) predictors of sleep quality, efficiency and nightmares in a sample of 30 individuals with PTSD. Participants participated in ecological momentary assessment to determine how daily changes in PTSD‐ and insomnia‐related factors lead to changes in sleep. Multi‐level modelling analyses indicated that, after accounting for baseline PTSD symptom severity, PTSD‐specific factors were associated with insomnia symptoms, but insomnia‐specific factors were not. Only daytime PTSD symptoms and fear of sleep predicted nightmares. Both sleep‐ and PTSD‐related factors play a role in maintaining insomnia among those with PTSD, while nightmares seem to be linked more closely with only PTSD‐related factors.
Claudin‐1, miR‐122 and apolipoprotein E transductions improve the permissivity of SNU‐182, SNU‐398 and SNU‐449 hepatoma cells to hepatitis C virus
Authors: Fournier C. , Hoffmann T. W. , Morel V. , Descamps V. , Dubuisson J. , Brochot E. , Francois C. , Duverlie G. , Castelain S. , Helle F.
Published: August 2017

Hepatitis C virus (HCV) is a human hepatotropic virus, but many hepatoma cell lines are not permissive to this virus. In a previous study, we observed that SNU‐182, SNU‐398 and SNU‐449 hepatoma cell lines were nonpermissive to HCV. To understand the nonpermissivity, we evaluated the ability of each cell line to support the different steps of HCV life cycle (entry, replication and production of infectious particles). Using retroviral pseudoparticles pseudotyped with HCV envelope proteins and recombinant HCV produced in cell culture, we observed that low level or absence of claudin‐1 (CLDN1) expression limited the viral entry process in SNU‐182 and SNU‐398 cells, respectively. Our results also showed that supplementation of the three cell lines with miR‐122 partly restored the replication of a JFH1 HCV replicon. Finally, we observed that expression of apolipoprotein E (ApoE) was very low or undetectable in the three cell lines and that its ectopic expression permits the production of infectious viral particles in SNU‐182 and SNU‐398 cells but not in SNU‐449 cells. Nevertheless, the supplementation of SNU‐182, SNU‐398 and SNU‐449 cells with CLDN1, miR‐122 and ApoE was not sufficient to render these cells as permissive as HuH‐7 cells. Thus, these cell lines could serve as cell culture models for functional studies on the role of CLDN1, miR‐122 and ApoE in HCV life cycle but also for the identification of new restriction and/or dependency host factors essential for HCV infection.
Acute liver failure induced by idiosyncratic reaction to drugs: Challenges in diagnosis and therapy
Authors: Tujios Shannan R. , Lee William M.
Published: August 2017

Acute liver failure (ALF) requires urgent attention to identify etiology and determine prognosis, in order to assess likelihood of survival or need for transplantation. Identifying idiosyncratic drug‐induced liver injury (iDILI) may be particularly difficult, but the illness generally follows a subacute course, allowing time to assess outcome and find a liver graft if needed. Not all drugs that cause iDILI lead to ALF; the most common are antibiotics including anti‐tuberculous medications, non‐steroidal anti‐inflammatory agents and herbal and dietary supplements (HDS). Determining causality remains challenging particularly if altered mentation is present; identifying the causative agent depends in part on knowing the propensity of the drugs that have been taken in the proper time interval, plus excluding other causes. In general, iDILI that reaches the threshold of ALF will more often than not require transplantation, since survival without transplant is around 25%. Treatment consists of withdrawal of the presumed offending medication, consideration of N‐acetylcysteine (NAC), as well as intensive care. Corticosteroids have not proven useful except perhaps in instances of apparent autoimmune hepatitis caused by a limited number of agents. Recently developed prognostic scoring systems may also aid in predicting outcome in this setting.
ITS1 metabarcoding highlights low specificity of lichen mycobiomes at a local scale
Authors: Fernández‐Mendoza Fernando , Fleischhacker Antonia , Kopun Theodora , Grube Martin , Muggia Lucia
Published: August 2017

As self‐supporting and long‐living symbiotic structures, lichens provide a habitat for many other organisms beside the traditionally considered lichen symbionts—the myco‐ and the photobionts. The lichen‐inhabiting fungi either develop diagnostic phenotypes or occur asymptomatically. Because the degree of specificity towards the lichen host is poorly known, we studied the diversity of these fungi among neighbouring lichens on rocks in an alpine habitat. Using a sequencing metabarcoding approach, we show that lichen mycobiomes clearly reflect the overlap of multiple ecological sets of taxa, which differ in their trophic association with lichen thalli. The lack of specificity to the lichen mycobiome is further supported by the lack of community structure observed using clustering and ordination methods. The communities encountered across samples largely result from the subsampling of a shared species pool, in which we identify three major ecological components: (i) a generalist environmental pool, (ii) a lichenicolous/endolichenic pool and (iii) a pool of transient species. These taxa majorly belong to the fungal classes Dothideomycetes, Eurotiomycetes and Tremellomycetes with close relatives in adjacent ecological niches. We found no significant evidence that the phenotypically recognized lichenicolous fungi influence the occurrence of the other asymptomatic fungi in the host thalli. We claim that lichens work as suboptimal habitats or as a complex spore and mycelium bank, which modulate and allow the regeneration of local fungal communities. By performing an approach that minimizes ambiguities in the taxonomic assignments of fungi, we present how lichen mycobiomes are also suitable targets for improving bioinformatic analyses of fungal metabarcoding.
The evolutionary ecology of roots
Authors: Maherali Hafiz
Published: August 2017

This article is a Commentary on Valverde‐Barrantes et al., 215: 1562–1573.
Winning Iran's Election Is Just The Beginning Of Rouhani's Political Struggles
Authors: Mousavian Seyed Hossein
Published: August 2017

Iran's president may have been re‐elected, but he'll need to win the supreme leader's support and get foreign powers to engage with Tehran to be successful.
China's “One Belt, One Road” Plan Marks The Next Phase Of Globalization
Authors: Bijian Zheng
Published: August 2017

The developing world is the new engine of growth that will drive shared prosperity in the future.
It's A Problem That America Is Still Unable To Admit It Will Become #2 To China
Authors: Mahbubani Kishore
Published: August 2017

This is partially why Trump happened, says Kishore Mahbubani.
Low Paid Employment in Britain: Estimating State‐Dependence and Stepping Stone Effects
Authors: Cai Lixin , Mavromaras Kostas , Sloane Peter
Published: August 2017

Using 18 waves of the British Household Panel Study, this paper examines state‐dependence and stepping stone effects of low pay. The results show that both state‐dependence and stepping stone effects of low pay are present. However, there is no evidence to support a low‐pay no‐pay cycle. The introduction of the national minimum wage does not appear to have affected state‐dependence and stepping stone effects of low pay.
Mineral features of connective dental hard tissues in hypoplastic amelogenesis imperfecta
Authors: Kammoun R , Behets C , Mansour L , Ghoul‐Mazgar S
Published: August 2017

Objective

To explore the mineral features of dentin and cementum in hypoplastic Amelogenesis imperfecta AI teeth.

Materials and methods

Forty‐four (44) teeth cleaned and free of caries were used: 20 control and 24 affected by hypoplastic amelogenesis imperfecta. Thirty‐two teeth were studied by pQCT, cut in sections, and analyzed under microradiography, polarized light microscopy, and confocal Raman spectroscopy. Eight teeth were observed under scanning electron microscope. Four teeth were used for an X‐ray diffraction. The mineral density data were analyzed statistically with the Mann–Whitney U test, using GraphPad InStat software.

Results

Both coronal dentin and radicular dentin were less mineralized in AI teeth when compared to control (respectively 6.2% and 6.8%; p < .001). Root dentinal walls were thin and irregular, while the cellular cementum layers were thick, reaching sometimes the cervical region of the tooth. Regular dentinal tubules and sclerotic dentin areas were noticed. Partially tubular or cellular dysplastic dentin and hyper‐, normo‐, or hypomineralized areas were noticed in the inter‐radicular areas of hypoplastic AI teeth. The main mineral component was carbonate hydroxyapatite as explored by Raman spectroscopy and X‐ray diffraction.

Conclusions

Dentin and cementum in hypoplastic AI teeth are (i) hypomineralized, (ii) constituted of carbonate hydroxyapatite, and (iii) of non‐homogenous structure.
Brain molecular changes and behavioral alterations induced by propofol anesthesia exposure in peripubertal rats
Authors: Pavković Željko , Smiljanić Kosara , Kanazir Selma , Milanović Desanka , Pešić Vesna , Ruždijić Sabera
Published: August 2017

Background

Propofol is commonly used in modern anesthesiology. Some findings suggest that it is highly addictive.

Aim

In this study it was examined whether propofol anesthesia exposure was able to induce behavioral alterations and brain molecular changes already described in addictive drug usage in peripubertal rats, during the onset of mid/periadolescence as a developmental period with increasing vulnerability to drug addiction.

Methods

The expression of D1 dopamine receptor, a dopamine, and cAMP‐regulated phosphoprotein with a Mr 32 000; Ca2+/calmodulin‐dependent protein kinase IIα; and Finkel‐Biskis‐Jinkins murine osteosarcoma viral oncogene homolog‐B was examined in peripubertal rats 4, 24, and 48 hour after propofol anesthesia exposure by Western blot and immunohistochemistry. Brain regions of interest were the medial prefrontal cortex, the striatum, and the thalamus. Anxiety and behavioral cross‐sensitization to d‐amphetamine were examined as well.

Results

Significant increase in the expression of dopamine and cAMP‐regulated phosphoprotein with a Mr 32 000 phosphorylated at threonine 34, a postsynaptic marker of dopaminergic neurotransmission, and Finkel‐Biskis‐Jinkins murine osteosarcoma viral oncogene homolog‐B, a marker of neuronal activity, was detected in the thalamus of experimental animals 4‐24 hour after the treatment, with the accent on the paraventricular thalamic nucleus. Significant increase in the expression of Ca2+/calmodulin‐dependent protein kinase IIα phosphorylated at threonine 286, a sensor of synaptic activity, was observed in the prefrontal cortex and the striatum 24 hour after propofol anesthesia exposure. It was accompanied by a significant decrease in Finkel‐Biskis‐Jinkins murine osteosarcoma viral oncogene homolog‐B expression in the striatum. Decreased behavioral inhibition in aversive environment and increased motor response to d‐amphetamine in a context‐independent manner were observed as well.

Conclusion

In peripubertal rats, propofol anesthesia exposure induces transient molecular and behavioral response that share similarities with those reported previously for addictive drugs. In the absence of additional pharmacological manipulation, all detected effects receded within 48 hour after the treatment.
HISTONE DEACETYLASE 6 represses pathogen defence responses in Arabidopsis thaliana
Authors: Wang Yizhong , Hu Qin , Wu Zhenjiang , Wang Hui , Han Shiming , Jin Ye , Zhou Jin , Zhang Zhengfeng , Jiang Jiafu , Shen Yun , Shi Huazhong , Yang Wannian
Published: August 2017

Plant defence mechanisms are suppressed in the absence of pathogen attack to prevent wasted energy and growth inhibition. However, how defence responses are repressed is not well understood. Histone deacetylase 6 (HDA6) is a negative regulator of gene expression, and its role in pathogen defence response in plants is not known. In this study, a novel allele of hda6 (designated as shi5) with spontaneous defence response was isolated from a forward genetics screening in Arabidopsis. The shi5 mutant exhibited increased resistance to hemibiotrophic bacterial pathogen Pst DC3000, constitutively activated expression of pathogen‐responsive genes including PR1, PR2, etc. and increased histone acetylation levels at the promoters of most tested genes that were upregulated in shi5. In both wild type and shi5 plants, the expression and histone acetylation of these genes were upregulated by pathogen infection. HDA6 was found to bind to the promoters of these genes under both normal growth conditions and pathogen infection. Our research suggests that HDA6 is a general repressor of pathogen defence response and plays important roles in inhibiting and modulating the expression of pathogen‐responsive genes in Arabidopsis.
Transcriptome analysis of terpene chemotypes of Melaleuca alternifolia across different tissues
Authors: Bustos‐Segura Carlos , Padovan Amanda , Kainer David , Foley William J. , Külheim Carsten
Published: August 2017

Plant chemotypes or chemical polymorphisms are defined by discrete variation in secondary metabolites within a species. This variation can have consequences for ecological interactions or the human use of plants. Understanding the molecular basis of chemotypic variation can help to explain how variation of plant secondary metabolites is controlled. We explored the transcriptomes of the 3 cardinal terpene chemotypes of Melaleuca alternifolia in young leaves, mature leaves, and stem and compared transcript abundance to variation in the constitutive profile of terpenes. Leaves from chemotype 1 plants (dominated by terpinen‐4‐ol) show a similar pattern of gene expression when compared to chemotype 5 plants (dominated by 1,8‐cineole). Only terpene synthases in young leaves were differentially expressed between these chemotypes, supporting the idea that terpenes are mainly synthetized in young tissue. Chemotype 2 plants (dominated by terpinolene) show a greater degree of differential gene expression compared to the other chemotypes, which might be related to the isolation of plant populations that exhibit this chemotype and the possibility that the terpinolene synthase gene in M. alternifolia was derived by introgression from a closely related species, Melaleuca trichostachya. By using multivariate analyses, we were able to associate terpenes with candidate terpene synthases.
Tuberous Sclerosis Complex in 29 Children: Clinical and Genetic Analysis and Facial Angiofibroma Responses to Topical Sirolimus
Authors: Wang Senfen , Liu Yuanxiang , Wei Jinghai , Zhang Jian , Wang Zhaoyang , Xu Zigang
Published: August 2017

Background/Objectives

Tuberous sclerosis complex (TSC) is a genetic disorder and facial angiofibromas are disfiguring facial lesions. The aim of this study was to analyze the clinical and genetic features of TSC and to assess the treatment of facial angiofibromas using topical sirolimus in Chinese children.

Methods

Information was collected on 29 patients with TSC. Genetic analyses were performed in 12 children and their parents. Children were treated with 0.1% sirolimus ointment for 36 weeks. Clinical efficacy and plasma sirolimus concentrations were evaluated at baseline and 12, 24, and 36 weeks.

Results

Twenty‐seven (93%) of the 29 patients had hypomelanotic macules and 15 (52%) had shagreen patch; 11 of the 12 (92%) who underwent genetic analysis had gene mutations in the TSC1 or TSC2 gene. Twenty‐four children completed 36 weeks of treatment with topical sirolimus; facial angiofibromas were clinically undetectable in four (17%). The mean decrease in the Facial Angiofibroma Severity Index (FASI) score at 36 weeks was 47.6 ± 30.4%. There was no significant difference in the FASI score between weeks 24 and 36 (F = 1.00, p = 0.33). There was no detectable systemic absorption of sirolimus.

Conclusion

Hypomelanotic macules are often the first sign of TSC. Genetic testing has a high detection rate in patients with a clinical diagnosis of TSC. Topical sirolimus appears to be both effective and well‐tolerated as a treatment of facial angiofibromas in children with TSC. The response typically plateaus after 12 to 24 weeks of treatment.
Idiopathic Calcinosis Cutis Universalis Treated Successfully with Oral Diltiazem—A Case Report
Authors: Singh Jayanti , Paliwal Vijay K. , Bhargava Puneet , Mathur Deepak K.
Published: August 2017

Idiopathic calcinosis cutis is very rare and difficult to treat. Various medical modalities of treatment described with inconsistent results include chelating agents, colchicine, and probenecid. Calcium channel blockers are known to work by inhibiting intracellular entry of calcium. We successfully treated a case of idiopathic calcinosis cutis using oral diltiazem.
Fludarabine, cytarabine, granulocyte colony‐stimulating factor and idarubicin for relapsed childhood acute myeloid leukemia
Authors: Nakayama Hideki , Tomizawa Daisuke , Tanaka Shiro , Iwamoto Shotaro , Shimada Akira , Saito Akiko M , Yamashita Yuka , Moritake Hiroshi , Terui Kiminori , Taga Takashi , Matsuo Hidemasa , Kosaka Yoshiyuki , Koh Katsuyoshi , Hosoi Hajime , Kurosawa Hidemitsu , Isoyama Keiichi , Horibe Keizo , Mizutani Shuki , Adachi Souichi
Published: August 2017

Background

The combination of fludarabine (Flu), high‐dose cytarabine (Ara‐C) and granulocyte colony‐stimulating factor (G‐CSF; FLAG), with anthracyclines has become standard chemotherapy for refractory acute myeloid leukemia (AML) in European children and adults. To clarify the efficacy and the safety of FLAG‐idarubicin (IDA) for children prospectively, we planned a multicenter phase II study (AML‐R11) by the Japanese Pediatric Leukemia/Lymphoma Study Group.

Methods

Patients with AML aged between 2 and 20 years old, who had the first bone marrow (BM) relapse or induction failure, were enrolled. The FLAG‐IDA regimen consisted of Flu 30 mg/m2 for 5 days, Ara‐C 2 g/m2 for 5 days, G‐CSF (lenograstim) 5 μg/kg for 6 days and IDA 10 mg/m2 for 3 days. The primary endpoint was remission rate after therapy.

Results

Due to drug supply issues, the trial was suspended after the inclusion of seven eligible patients. There were six cases of early relapse within 1 year of the first remission. All seven patients completed the therapy and no early death was observed. Hematological toxicity was common, and one patient developed grade 4 non‐hematological toxicity of bacterial meningitis. Although only one patient with late relapse achieved complete remission, minimal residual disease was positive on both flow cytometry and Wilms’ tumor 1 mRNA. Two patients were alive in remission following hematopoietic stem cell transplantation, whereas the other five patients died of either the disease or treatment‐related causes.

Conclusion

FLAG‐IDA might be tolerable for children with refractory AML although the efficacy should be further investigated.
Visiting nurses’ posthospital medication management in home health care: an ethnographic study
Authors: Kollerup Mette Geil , Curtis Tine , Schantz Laursen Birgitte
Published: August 2017

Background

Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care.

Aim

The aim of this study was to explore visiting nurses’ medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety.

Method

Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients’ homes, medication lists and medical records. Field notes were analysed in four steps.

Findings

The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients’ actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home.

Conclusion

The nurse–patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses’ medication management in patients’ homes after hospital discharge. The implications for practice were the following: to ensure nurses’ opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients’ needs and the adjustment of care and treatment; to clarify expectations to nurses’ responsibility and patients’ privacy.
Lifetime stress exposure and health: A review of contemporary assessment methods and biological mechanisms
Authors: Shields Grant S. , Slavich George M.
Published: August 2017

Life stress is a central construct in health research because it is associated with increased risk for a variety of serious mental and physical health problems, including anxiety disorders, depression, cardiovascular disease, autoimmune disorders, Alzheimer's disease, certain cancers, and other diseases of aging. In this review, we examine how lifetime stress exposure contributes to elevated disease risk and explore ongoing measurement and scientific issues related to this topic. To accomplish these goals, we first review existing instruments that have been developed for assessing perceived stress, self‐reported life events, interviewer‐assessed life stressors, and lifetime stress exposure. Next, we describe laboratory‐based tasks that have been used for characterizing individual differences in psychological and biological stress reactivity. These methods have yielded an enormous amount of data showing how life stress influences the activity of the hypothalamic–pituitary–adrenal axis, hypothalamic–pituitary–gonadal axis, sympathetic–adrenal–medullary axis, and immune system, and how such processes can in turn cause allostatic load and biological embedding of the stress effect at the level of the human brain and genome. At the same time, many critical measurement and scientific issues remain unresolved, and we discuss these topics last while describing some pressing issues and opportunities for future research on stress and health.
Four meanings of “categorization”: A conceptual analysis of research on person perception
Authors: Klapper Andre , Dotsch Ron , van Rooij Iris , Wigboldus Daniel
Published: August 2017

It is widely assumed that people tend to “categorize” other people. However, the term “categorization” has been used with qualitatively different underlying definitions in the person perception literature. We present a conceptual analysis in which we disentangle four existing definitions: (a) categorization as representing, (b) categorization as dichotomizing, (c) categorization as organizing, and (d) categorization as grouping. Subsequently, we show that seemingly antagonistic viewpoints in the literature may be reconciled by disentangling these definitions. Furthermore, we argue that disentangling these definitions is vital for theoretical interpretations of (past and future) empirical findings. Overall, our work aims to contribute to the clarity of person perception theories, provide novel perspectives on existing debates, and serve as a stepping stone for more differentiated models of person perception.
Skin collagen can be accurately quantified through noninvasive optical method: Validation on a swine study
Authors: Tzeng S.‐Y. , Kuo T.‐Y. , Hu S.‐B. , Chen Y.‐W. , Lin Y.‐L. , Chu K.‐Y. , Tseng S.‐H.
Published: August 2017

Background/purpose

Diffuse reflectance spectroscopy (DRS) is a noninvasive optical technology characterized by relatively low system cost and high efficiency. In our previous study, we quantified the relative concentration of collagen for the individual keloid patient. However, no actual value of collagen concentration can prove the reliability of collagen detection by our DRS system.

Methods

Skin‐mimicking phantoms were prepared using different collagen and coffee concentrations, and their chromophore concentrations were quantified using the DRS system to analyze the influence of collagen and other chromophores. Moreover, we used the animal study to compare the DRS system with the collagen evaluation of biopsy section by second‐harmonic generation (SHG) microscopy at four different skin parts.

Results

In the phantom study, the result showed that coffee chromophore did not severely interfere with collagen concentration recovery. In the animal study, a positive correlation (r=.902) between the DRS system and collagen evaluation with SHG microscopy was found.

Conclusions

We have demonstrated that the DRS system can quantify the actual values of collagen concentration and excluded the interference of other chromophores in skin‐mimicking phantoms. Furthermore, a high positive correlation was found in the animal study with SHG microscopy. We consider that the DRS is a potential technique and can evaluate skin condition objectively.
Detection of IgE‐reactive proteins in hydrolysed dog foods
Authors: Roitel Olivier , Bonnard Lionel , Stella Alexandre , Schiltz Odile , Maurice Delphine , Douchin Gaël , Jacquenet Sandrine , Favrot Claude , Bihain Bernard E. , Couturier Nicolas
Published: August 2017

Background

Commercial hydrolysed diets are used for the diagnosis of food allergy in dogs. The cleaved parent proteins are presumed to be too small to elicit an allergic response by reacting with allergen‐specific immunoglobin E (IgE).

Objectives

To evaluate three commercial hydrolysed dog diets for proteins.

Animals

Sera were collected from dogs with suspected food allergy.

Methods

Two batches of each hydrolysed diet were examined by electrophoresis and visualized by Coomassie blue, silver nitrate staining and IgE immunoblotting.

Results

From two to five proteins, ranging from 21 to 67 kDa, were detected in all three diets evaluated. Circulating IgE antibodies targeting these proteins were detected by immunoblotting of dog sera. Six different carbohydrate proteins were identified by mass spectrometry; maize/potato granule‐bound starch synthase‐1, soybean glycinin, soybean β‐conglycinin α chain, potato aspartic protease inhibitor, rice glutelin type B1 and soybean sucrose‐binding protein. Four of these proteins have been described as allergens in humans.

Conclusions

Some commercial hydrolysed diets contain carbohydrate proteins. Some dogs have circulating IgE antibodies targeting these proteins. The clinical significance of these findings is unknown.