bluuebunny/crossref_metadata_2025 huggingface dataset:
ADMM for Penalized Quantile Regression in Big Data
Authors: Yu Liqun , Lin Nan
Published: August 2017

Traditional linear programming algorithms for quantile regression, for example, the simplex method and the interior point method, work well for data of small to moderate sizes. However, these methods are difficult to generalize to high‐dimensional big data for which penalization is usually necessary. Further, the massive size of contemporary big data calls for the development of large‐scale algorithms on distributed computing platforms. The traditional linear programming algorithms are intrinsically sequential and not suitable for such frameworks. In this paper, we discuss how to use the popular ADMM algorithm to solve large‐scale penalized quantile regression problems. The ADMM algorithm can be easily parallelized and implemented in modern distributed frameworks. Simulation results demonstrate that the ADMM is as accurate as traditional LP algorithms while faster even in the nonparallel case.
Balancing competing needs mediates the association of caregiving demand with caregiver role strain and depressive symptoms of dementia caregivers: A cross‐sectional study
Authors: Liu Hsin‐Yun , Yang Ching‐Tzu , Wang Yu‐Nu , Hsu Wen‐Chuin , Huang Tzu‐Hsin , Lin Yueh‐E , Liu Chin‐Yi , Shyu Yea‐Ing L.
Published: August 2017

Aims

To examine the role of balancing competing needs in the relationship between caregiving demand and caregiving outcomes (caregivers’ role strain and depressive symptoms).

Background

Caregivers who do not balance competing needs are more likely to experience negative caregiving outcomes, suggesting that balance mediates between caregiving demand and caregiving outcomes. Identifying a mediator of negative caregiving effects may help in developing tailored interventions for family caregivers of persons with dementia.

Design

A cross‐sectional, correlational design.

Methods

Data were collected from family caregivers’ self‐completed questionnaires between March 2013 ‐ April 2014. A convenience sample of 120 family caregivers and care receivers with dementia was enrolled. We examined whether balance mediated the relationship between caregiving demand and caregiving outcomes (caregivers’ role strain and depressive symptoms) by multiple regression analysis. To evaluate the significance of the indirect effect of caregiver balance, we used the Sobel test and Monte Carlo method, an alternative approach to testing mediation.

Results

Balancing competing needs completely mediated the association of caregiving demand with depressive symptoms and partially mediated the association of caregiving demand with role strain.

Conclusion

Assessing caregivers’ self‐perceived sense of balance may help to identify caregivers at high risk for role strain and depressive symptoms. Interventions to enhance caregivers’ perceived sense of balance between competing needs may provide a strategy for reducing the negative effects of caregiving.
Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review
Authors: Lavoie Patrick , Michaud Cécile , Bélisle Marilou , Boyer Louise , Gosselin Émilie , Grondin Myrian , Larue Caroline , Lavoie Stéphan , Pepin Jacinthe
Published: August 2017

Aim

To identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students.

Background

Nurse educators face the challenge of making explicit the outcomes of competency‐based education, especially when competencies are conceptualized as holistic and context dependent.

Design

Theoretical review.

Data Sources

Research papers (N = 182) published between 1999–2015 describing simulation in nursing education.

Review Methods

Two members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools.

Results

Some papers (N = 79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self‐efficacy. Students’ perceptions of simulation, knowledge and self‐confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach.

Conclusion

This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context‐dependent constructs.
Prediction of energy expenditure during walking in adults with down syndrome
Authors: Agiovlasitis Stamatis , Mendonca Goncalo V. , McCubbin Jeffrey A. , Fernhall Bo
Published: August 2017

Background

When developing walking programmes for improving health in adults with Down syndrome (DS), physical activity professionals are in need of an equation for predicting energy expenditure. We therefore developed and cross‐validated an equation for predicting the rate of oxygen uptake (VO2; an index of energy expenditure) for adults with and without DS.

Method

A total of 469 VO2 observations during walking across different speeds were available from 54 adults with DS and 61 adults without DS.

Results

Significant predictors of VO2 were speed, speed square, group and group‐by‐speed interaction. Separate models for each group showed that speed and its square significantly predicted VO2. Absolute per cent error was small and did not differ between groups.

Conclusion

Adults with DS have different VO2 response to walking speed from persons without DS. VO2 is predicted from speed with acceptable accuracy for persons with DS.
Archipelagic genetics in a widespread Caribbean anole
Authors: Reynolds R. Graham , Strickland Tanner R. , Kolbe Jason J. , Falk Bryan G. , Perry Gad , Revell Liam J. , Losos Jonathan B.
Published: August 2017

Aim

We examine the influence of fluctuating sea levels in a land‐bridge archipelago on the apportioning of intraspecific genetic diversity and divergence in the widespread Puerto Rican crested anole (Anolis cristatellus). We compare three alternative scenarios for genetic diversification in an archipelagic species that contrast the relative influences of periodic isolation versus island connectedness driven by fluctuating sea levels. Our approach combines information from geography and population genetics to assess the influence of island size, island isolation, island historical geography, and population genetic processes such as drift on the contemporary distribution of genetic variation within and among islands.

Location

The Puerto Rico Bank in the Caribbean focusing primarily on the Spanish, British and U.S. Virgin Islands.

Methods

We used nuclear and mitochondrial DNA sequences and microsatellite genotypes sampled from A. cristatellus populations to investigate: (1) the broad‐scale pattern of phylogeographical divergence across Puerto Rico Bank islands and (2) diversification within the Virgin Islands archipelago. For the first component, we used sequence data to reconstruct the relationships among 542 samples from across the species range. For the second component, we examined the relative influences of island size, isolation, and population genetic processes on the distribution of genetic diversity across the Virgin Islands.

Results

In the Virgin Islands, A. cristatellus is represented by a monophyletic clade except on the island of Vieques, where two divergent clades coexist. We found evidence for non‐equilibrium dynamics in the Virgin Islands, suggesting spatial population expansion during intraglacial periods of low sea level.

Main conclusions

We found limited evidence that periods of island isolation affected patterns of genetic diversity and differentiation. Instead, we found that the patterns of genetic diversity and divergence in A. cristatellus in the Virgin Islands archipelago are likely shaped by long‐term persistence in the region and periods of population spatial expansion.
CD155 knockdown promotes apoptosis via AKT/Bcl‐2/Bax in colon cancer cells
Authors: Zheng Qianqian , Wang Biao , Gao Jian , Xin Na , Wang Wei , Song Xiaowen , Shao Yue , Zhao Chenghai
Published: August 2017

CD155, one of the nectin‐like molecule family members, is involved in cell adhesion and motility. CD155 is overexpressed in several human cancers, but its role in proliferation and apoptosis of colorectal cancer remains unclear. We found that CD155 was up‐regulated in colorectal cancer tissues. CD155 knockdown via shRNA lentiviruses inhibited colon cancers cell migration and invasion, with a reduction in the expression of FAK, Src and MMP‐2. CD155 down‐regulation also suppressed colon cancer cell proliferation, accompanied by changing expressions of some molecules related to cell cycle. Finally, CD155 knockdown increased the expression ratio between Bax and Bcl‐2, resulting in a significant increase in colon cancer cell apoptosis. Taken together, these results demonstrate that CD155 is involved in not only migration and invasion but also proliferation and survival abilities of colon cancer cells, suggesting that CD155 is one of key molecules promoting the growth and metastasis of colorectal cancer.
When Normative and Market Power Interact: The European Union and Global Biofuels Governance
Authors: Renckens Stefan , Skogstad Grace , Mondou Matthieu
Published: August 2017

Drawing on the literature on the market and normative power of the EU, we document and explain the limited success of the EU in transferring its environmental standards with respect to sustainable biofuels governance to the world's two largest biofuels producers – the US and Brazil – and to two international standard setting organizations, the International Organization for Standardization (ISO) and the Global Bioenergy Partnership (GBEP). Our explanation highlights four factors: first, the extent to which EU strategies to strengthen its market power can undermine its normative power; second, the limits to EU policy influence posed by other actors' use of their own market and normative power resources; third, the diminished influence of a late policy‐mover; and fourth, the difficulty of establishing normative leadership in a policy field subject to epistemic contestation.
Simultaneous lateral bone augmentation and implant placement using a particulated synthetic bone substitute around chronic peri‐implant dehiscence defects in dogs
Authors: Jung Ui‐Won , Cha Jae‐Kook , Vignoletti Fabio , Nuñez Javier , Sanz Javier , Sanz Mariano
Published: August 2017

Aim

To determine the histological outcomes when using a highly porous synthetic bone substitute and a cross‐linked collagen membrane for lateral bone augmentation of peri‐implant dehiscence defects.

Methods

In eight dogs, three treatment groups were randomly allocated at each peri‐implant dehiscence defect (mean height × depth = 3 × 1 mm) as follows: (i) synthetic bone substitute covered by a cross‐linked collagen membrane (test group), (ii) deproteinized bovine bone mineral covered by a natural collagen membrane (positive control), and (iii) no treatment (negative control). Two healing periods (8 and 16 weeks) were applied.

Results

The differences in healing outcomes between the test and positive control groups were not significant at 8 weeks. Horizontal bone augmentation 2 mm below the implant shoulder was significantly greater in the test group (1.22 ± 0.53 mm) than in the positive and negative controls (0.42 ± 0.51 and 0.36 ± 0.50 mm, respectively) at 16 weeks. Similarly, the augmented tissue thickness at 0, 1, and 2 mm apical to the implant shoulder was significantly greater in the test group than in the positive control group.

Conclusion

The test group showed significantly better histological outcomes for lateral bone augmentation and tissue thickness at 16 weeks compared to both the positive and negative control groups.
Langerhans cell: exciting developments in health and disease
Authors: Atmatzidis D.H. , Lambert W.C. , Lambert M.W.
Published: August 2017

Langerhans cells (LCs) have been the subject of much research since their discovery in 1868. LCs belong to the subset of leucocytes called dendritic cells. They are present in the epidermis and the pilosebaceous apparatus and monitor the cutaneous environment for changes in homeostasis. During embryogenesis, a wave of yolk sac macrophages seed the fetal skin. Then, fetal liver monocytes largely replace the yolk sac macrophages and comprise the majority of adult LCs. In the presence of skin irritation, LCs process antigen and travel to regional lymph nodes to present antigen to reactive T lymphocytes. Changes in LCs' surface markers during the journey occur under the influence of cytokines. The difference in expression of surface markers and the ability to resist radiation have allowed researchers to differentiate LCs from the murine Langerin‐positive dermal dendritic cells. Exciting discoveries have been made recently regarding their role in inflammatory skin diseases, cancer and HIV. New research has shown that antibodies blocking CD1a appear to mitigate inflammation in contact hypersensitivity reactions and psoriasis. While it has been established that LCs have the potential to induce effector cells of the adaptive immune system to counter oncogenesis, recent studies have demonstrated that LCs coordinate with natural killer cells to impair development of squamous cell carcinoma caused by chemical carcinogens. However, LCs may also physiologically suppress T cells and permit keratinocyte transformation and tumorigenesis. Although long known to play a primary role in the progression of HIV infection, it is now understood that LCs also possess the ability to restrict the progression of the disease. There is a pressing need to discover more about how these cells affect various aspects of health and disease; new information gathered thus far seems promising and exciting.
Topical ionic contra‐viral therapy comprised of digoxin and furosemide as a potential novel treatment approach for common warts
Authors: van der Kolk T. , Dillingh M.R. , Rijneveld R. , Klaassen E.S. , de Koning M.N.C. , Kouwenhoven S.T.P. , Genders R.E. , Bouwes Bavinck J. N. , Feiss G. , Rissmann R. , Burggraaf J.
Published: August 2017

Background

DNA viruses such as HPV rely on K+ influx for replication. Both digoxin and furosemide inhibit the K+ influx by interacting with cell membrane ion co‐transporters (Na+/K+‐ATPase and Na+‐K+‐2Cl− co‐transporter‐1, respectively). We therefore hypothesized that these two compounds in a topical formulation may be valuable in the treatment of HPV‐induced warts. This new approach is called Ionic Contra‐Viral Therapy (ICVT).

Objective

To evaluate systemic exposure, safety and tolerability of ICVT with a combination of furosemide and digoxin after repeated topical application in subjects with common warts. Furthermore, we aimed to evaluate pharmacodynamics effects of ICVT.

Methods

Twelve healthy subjects with at least four common warts on their hands were included in the study and treated with a fixed dose of 980 mg topical gel containing 0.125% (w/w) digoxin and 0.125% (w/w) furosemide for 7 consecutive days on their lower back to assess safety and systemic exposure. Two warts were treated with 10 mg each and two served as negative controls to obtain preliminary evidence of treatment effect.

Results

ICVT was well tolerated topically, and there was no evidence of systemic exposure of digoxin or furosemide. There were no clinical relevant safety findings and no serious adverse events (SAEs). A rapid and statistically significant reduction in diameter, height and volume of the warts was already observed at day 14.

Conclusion

ICVT was found to be safe for administration to humans and 7 days of active treatment showed a statistical significant wart reduction compared to untreated control lesions, clearly indicating pharmacological activity.
Societal and Family Lifetime Cost of Dementia: Implications for Policy
Authors: Jutkowitz Eric , Kane Robert L. , Gaugler Joseph E. , MacLehose Richard F. , Dowd Bryan , Kuntz Karen M.
Published: August 2017

Objectives

To estimate the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia.

Design

We developed an evidence‐based mathematical model to simulate disease progression for newly diagnosed individuals with dementia. Data‐driven trajectories of cognition, function, and behavioral and psychological symptoms were used to model disease progression and predict costs. Using modeling, we evaluated lifetime and annual costs of individuals with dementia, compared costs of those with and without clinical features of dementia, and evaluated the effect of reducing functional decline or behavioral and psychological symptoms by 10% for 12 months (implemented when Mini‐Mental State Examination score ≤21).

Setting

Mathematical model.

Participants

Representative simulated U.S. incident dementia cases.

Measurements

Value of informal care, out‐of‐pocket expenditures, Medicaid expenditures, and Medicare expenditures.

Results

From time of diagnosis (mean age 83), discounted total lifetime cost of care for a person with dementia was $321,780 (2015 dollars). Families incurred 70% of the total cost burden ($225,140), Medicaid accounted for 14% ($44,090), and Medicare accounted for 16% ($52,540). Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia. Total annual cost peaked at $89,000, and net cost peaked at $72,400. Reducing functional decline or behavioral and psychological symptoms by 10% resulted in $3,880 and $680 lower lifetime costs than natural disease progression.

Conclusion

Dementia substantially increases lifetime costs of care. Long‐lasting, effective interventions are needed to support families because they incur the most dementia cost.
Arabidopsis EXO70A1 recruits Patellin3 to the cell membrane independent of its role as an exocyst subunit
Authors: Wu Chengyun , Tan Lu , van Hooren Max , Tan Xiaoyun , Liu Feng , Li Yan , Zhao Yanxue , Li Bingxuan , Rui Qingchen , Munnik Teun , Bao Yiqun
Published: August 2017

The exocyst is a well‐known complex which tethers vesicles at the cell membrane before fusion. Whether an individual subunit can execute a unique function is largely unknown. Using yeast‐two‐hybrid (Y2H) analysis, we found that EXO70A1 interacted with the GOLD domain of Patellin3 (PATL3). The direct EXO70A1‐PATL3 interaction was supported by in vitro and in vivo experiments. In Arabidopsis, PATL3‐GFP colocalized with EXO70A1 predominantly at the cell membrane, and PATL3 localization was insensitive to BFA and TryA23. Remarkably, in the exo70a1 mutant, PATL3 proteins accumulated as punctate structures within the cytosol, which did not colocalize with several endomembrane compartment markers, and was insensitive to BFA. Furthermore, PATL3 localization was not changed in the exo70e2, PRsec6 or exo84b mutants. These data suggested that EXO70A1, but not other exocyst subunits, was responsible for PATL3 localization, which is independent of its role in secretory/recycling vesicle‐tethering/fusion. Both EXO70A1 and PATL3 were shown to bind PI4P and PI(4,5)P2 in vitro. Evidence was obtained that the other four members of the PATL family bound to EXO70A1 as well, and shared a similar localization pattern as PATL3. These findings offered new insights into exocyst subunit‐specific function, and provided data and tools for further characterization of PATL family proteins.
Enhanced EDX images by fusion of multimodal SEM images using pansharpening techniques
Authors: FRANCHI G. , ANGULO J. , MOREAUD M. , SORBIER L.
Published: August 2017

The goal of this paper is to explore the potential interest of image fusion in the context of multimodal scanning electron microscope (SEM) imaging. In particular, we aim at merging the backscattered electron images that usually have a high spatial resolution but do not provide enough discriminative information to physically classify the nature of the sample, with energy‐dispersive X‐ray spectroscopy (EDX) images that have discriminative information but a lower spatial resolution. The produced images are named enhanced EDX. To achieve this goal, we have compared the results obtained with classical pansharpening techniques for image fusion with an original approach tailored for multimodal SEM fusion of information. Quantitative assessment is obtained by means of two SEM images and a simulated dataset produced by a software based on PENELOPE.
Phase imaging quality improvement by modification of AFM probes’ cantilever
Authors: SKIBINSKI J. , REBIS J. , KACZMAREK L. , WEJRZANOWSKI T. , PLOCINSKI T. , ROZNIATOWSKI K.
Published: August 2017

Imaging of the surface of materials by atomic force microscopy under tapping and phase imaging mode, with use of modified probes is addressed. In this study, the circularly shaped holes located in varying distance from the probe base, were cut out by focused ion beam. Such modification was a consequence of the results of the previous experiments (probe tip sharpening and cantilever thinning) where significant improvement of image quality in tapping and phase imaging mode has been revealed. The solution proposed herein gives similar results, but is much simpler from the technological point of view. Shorter exposition time of the tip onto gallium ions during FIB processing allows to reduce material degradation. The aim of this modification was to change harmonic oscillators’ properties in the simplest and fastest way, to obtain stronger signal for higher resonant frequencies, which can be advantageous for improving the quality of imaging in PI mode. Probes shaped in that way were used for AFM investigations with Bruker AFM nanoscope 8. As a testing material, titanium roughness standard sample, supplied by Bruker, was used. The results have shown that the modifications performed within these studies influence the oscillation of the probes, which in some cases may result in deterioration of the imaging quality under tapping mode for one or both self‐resonant frequencies. However, phase imaging results obtained using modified probes are of higher quality. The numerical simulations performed by application of finite element method were used to explain the results obtained experimentally. Phenomenon described within this study allows to apply developed modelling methodology for prediction of effects of various modifications on the probes' tip, and as a result, to predict how proposed modifications will affect AFM imaging quality.
Beveled posteromedial corner of the radial head: a three‐dimensional micro‐computed tomography modeling study
Authors: Adikrishna Arnold , Shin Young‐ho , Zulkarnain Rizki F. , Hong Hanpyo , Sun Yucheng , Jeon In‐Ho
Published: August 2017

The posteromedial quadrant of the radial head is known to be different from the other quadrants. However, the explanation of this unique anatomical feature remains elusive. Hence, this study was designed to address this unique anatomical variance using three‐dimensional μCT (micro‐computed tomography) analysis. Nine fresh cadaveric radial heads were scanned using μCT. Three‐dimensional subchondral bone and cartilage models were rendered. Both models were separated into the four quadrants at both the periphery (rim) and the articulating dish (fovea): anteromedial (AM), posteromedial (PM), posterolateral (PL), and anterolateral (AL). Each quadrant was analyzed in terms of (1) subchondral bone porosity (SBP), (2) mean subchondral bone thickness (MSBT), and (3) mean cartilage thickness (MCT). There was a significant difference between the fovea and the rim in terms of its microarchitectural features. Although within the fovea, the PM quadrant did not differ significantly from the other quadrants, a significant difference was found within the rim. In terms of SBP, PM, AM, PL and AL were calculated as 33, 37, 36 and 35%, respectively. In terms of MSBT, PM, AM, PL and AL were calculated as 0.11, 0.10, 0.09, and 0.09 mm, respectively. In terms of MCT, PM, AM, PL and AL were calculated 1.09, 0.81, 0.84 and 0.83 mm, respectively. The PM corner of the radial head between the 8 and 9 o'clock positions, was beveled. This might explain why the PM quadrant of the rim differed significantly from the other quadrants in terms of its microarchitectural features.
Examining the social construction of surveillance: A critical issue for health visitors and public health nurses working with mothers and children
Authors: Peckover Sue , Aston Megan
Published: August 2017

Aims and objectives

To critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada.

Background

The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs.

Design

We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings.

Methods

Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance.

Results

Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power.

Conclusions

Healthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice.

Relevance to clinical practice

Healthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families.
“My mentor didn't speak to me for the first four weeks”: Perceived Unfairness experienced by nursing students in clinical practice settings
Authors: Jack Kirsten , Hamshire Claire , Harris W. Edwin , Langan Mark , Barrett Neil , Wibberley Christopher
Published: August 2017

Aims and objectives

To explore the perceived unfairness experienced by student nurses during their undergraduate clinical placements.

Background

It is important that student nurses feel supported by practice staff during their clinical placement education experiences. However, it has been reported that learners can feel ignored, unsupported and bullied by others in the clinical environment and this has a detrimental effect on their learning. It is important to understand the student nurse perspective and explore ways in which their feelings of belongingness might be enhanced in the clinical area.

Design

A descriptive narrative approach was used to explore the qualitative data generated by the survey and interviews. Limited closed‐question survey data were acquired to explore a selection of quantified survey responses about placements and mentorship.

Methods

A survey was conducted with 1,425 student nurses from adult and mental health degree nursing pathways, across nine institutions in the North West of England, UK. Unstructured interviews were undertaken with 22 student nurses from across these nine institutions. The data generated from both methods (free‐text survey responses and interview) were thematically analysed.

Results

There were times when student nurses felt that they had been treated unfairly by various members of the healthcare team during their clinical placements. Unfairness was related to being ignored and unsupported or being used as an “extra pair of hands” and having their supernumerary status ignored. Student nurses want to have feelings of belongingness in the clinical area and value enthusiasm for teaching from mentors. Certain positive mentor qualities were identified through the data in this study. These have been used to inform a tiered model of mentorship, to inform future thinking about student nurse education.

Conclusion

Student nurses can feel like they are being treated unfairly in the clinical area in numerous ways. Identifying ways in which mentorship practice can be developed to adequately support education is important. This can lead to satisfaction and development on both sides of the student/educator relationship.

Relevance to practice

Exploring student nurse perceptions of their learning is important when attempting to enhance educational practice in the clinical setting.
New graduate nurses’ preparation for recognition and prevention of failure to rescue: A qualitative study
Authors: Herron Elizabeth K.
Published: August 2017

Aim and Objective

To explore new graduate nurses’ experiences with recognition and prevention of failure to rescue.

Background

Failure to rescue is recognised as a quality–of‐care indicator, a core measure of nursing care in hospitals, and a determinant for staffing in acute care facilities. Clinical reasoning is an essential component in preventing failure to rescue and should be emphasised in nursing education and new graduate orientation. Many nurses graduate without the ability to use clinical reasoning in providing patient care which can lead to adverse patient outcomes.

Design

A descriptive phenomenological design was used.

Methods

A purposive sample of 14 new graduate nurses from a nursing programme in the south‐eastern USA, in practice for no more than eighteen months, was recruited. Individual one‐on‐one interviews were conducted from January–June 2016 and audio‐recorded for accuracy. Data were evaluated using the consolidated criteria for reporting qualitative research (COREQ) guidelines. Recordings were professionally transcribed and reviewed.

Results

Using Giorgi's methods for data analysis, five main themes were discerned in the data: clinical preparation in school; experience with emergent situations; development of clinical reasoning; low confidence as a new graduate; and responding to emergencies. Within each theme, subthemes emerged.

Conclusion

The words of the participants provided rich detail into the preparation of new graduate nurses and how nurse educators, managers and preceptors can better focus learning opportunities to prepare them for practice. Experiential learning combined with collaboration among education stakeholders will lead to a better prepared and more confident nursing work force.

Relevance to clinical practice

Better preparation and continued support of new graduate nurses lead to positive patient outcomes and more satisfaction with their choice of nursing as a profession.
Stuck in tradition‐A qualitative study on barriers for implementation of evidence‐based nutritional care perceived by nursing staff
Authors: O′Connell Malene Barfod , Jensen Pia Søe , Andersen Signe Lindgård , Fernbrant Cecilia , Nørholm Vibeke , Petersen Helle Vendel
Published: August 2017

Aims and objectives

To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopaedic ward, aiming to implement evidence‐based nutritional care.

Background

Previous studies indicate that nurses recognise nutritional care as important, but interventions are often lacking. These studies show that a range of barriers influence the attempt to optimise nutritional care. Before the implementation of evidence‐based nutritional care, we examined barriers for nutritional care among the nursing staff.

Design

Qualitative study.

Methods

Four focus groups with thirteen members of the nursing staff were interviewed between October 2013–June 2014. The interview guide was designed according to the Theoretical Domains Framework. The interviews were analysed using qualitative content analysis.

Results

Three main categories emerged: lacking common practice, failing to initiate treatment and struggling with existing resources. The nursing staff was lacking both knowledge and common practice regarding nutritional care. They felt they protected patient autonomy by accepting patient′s reluctance to eat or getting a feeding tube. The lack of nutritional focus from doctors decreased the nursing staffs focus leading to nonoptimal nutritional treatment. Competing priorities, physical setting and limited nutritional supplements were believed to hinder nutritional care.

Conclusion

The results suggest that nutritional care is in a transitional state from experience‐ to evidence‐based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence‐based nutritional care.

Relevance to clinical practice

This study contributes with valuable knowledge before the implementation of evidence‐based nutritional care. The study provides an understanding of barriers for nutritional care and presents explanations to why nutritional care has failed to become an integrated part of the daily treatment and care.
Attitudes toward pessary use among Thai women with pelvic organ prolapse
Authors: Mungpooklang Treewijit , Bunyavejchevin Suvit
Published: August 2017

Aim

This study was conducted to investigate attitudes toward pessary use in Thai women with pelvic organ prolapse (POP).

Methods

Ninety Thai women with symptomatic POP without any history of previous prolapse treatment were recruited. Participants completed a questionnaire about attitudes toward pessary use in Thai language. Patient characteristics and decision‐making factors were identified.

Results

Forty eight women (53.3%) decided to use a pessary. Most respondents felt that pessary use would improve emotional status (56.2%), pain (52.0%) and quality of life (75%). The opinions of family members and post‐application bleeding, discharge, irritation and pain were important factors in decision‐making.

Conclusion

Many Thai women with POP prefer a pessary. Their decision is influenced by opinions of family members and complications of pessary use. Counseling about the advantages and uncommon complications of pessary use should be provided to both patients and family members to improve higher pessary acceptance.
Expressions of programmed death (PD)‐1 and PD‐1 ligand (PD‐L1) in cervical intraepithelial neoplasia and cervical squamous cell carcinomas are of prognostic value and associated with human papillomavirus status
Authors: Yang Wen , Lu Yan‐Ping , Yang Yi‐Zhou , Kang Jia‐Rui , Jin Yi‐Duo , Wang Hong‐Wei
Published: August 2017

Aim

The programmed death 1/programmed death 1 ligand (PD‐1/PD‐L1) pathway can decrease the immune clearance effects of antigen‐presenting cells and T lymphocytes to promote immune evasion of cervical cancer cells. However, the effects of this pathway on cervical intraepithelial neoplasia (CIN) progression and squamous cell carcinoma (SCC) metastasis are not clear. We herein investigated whether human papillomavirus infection could affect PD‐1 and PD‐L1 expression in CIN, and whether their expression is associated with CIN progression and SCC metastasis.

Methods

We collected paraffin‐embedded samples from two cohorts of patients: (i) CIN samples from cohort I (40 women who tested positive or negative for high‐risk human papillomavirus [HR‐HPV] with grades 0, I, and II–III CIN); and (ii) paired primary and metastatic tumor samples from cohort II (20 SCC patients with or without metastasis). Immunohistochemistry was used to detect expressions of PD‐L1 in tumor cells and PD‐1 in tumor‐associated macrophages and tumor‐infiltrating lymphocytes. We also measured P16INK4a expression and interferon‐γ levels in the cervical tissues.

Results

The most common HPV type seen in both cohorts of patients was HPV16, followed by HPV18. Increase in PD‐L1 and PD‐1 expression was positively correlated with HPV‐positivity, increase in CIN grade, and tumor metastasis. Furthermore, upregulation of the PD‐1/PD‐L1 pathway was associated with decreased expression of the pro‐inflammatory cytokine, interferon‐γ and increased expression of P16INK4a.

Conclusion

Expression of PD‐L1 and PD‐1 could be used as clinical prognostic biomarkers for evaluating CIN and cervical cancer because of its positive correlation with CIN progression and tumor metastasis.
Predictors of distant relapse in patients with FIGO stage IIB–IVA cervical cancer treated with definitive radiotherapy
Authors: Okazawa‐Sakai Mika , Mabuchi Seiji , Isohashi Fumiaki , Kawashima Atsushi , Yokoi Eriko , Ogawa Kazuhiko , Kimura Tadashi
Published: August 2017

Aim

To investigate the predictors of distant relapse in International Federation of Gynecology and Obstetrics (FIGO) stage IIB–IVA cervical cancer patients treated with definitive radiotherapy (RT).

Methods

The clinical data of 219 patients with FIGO stage IIB–IVA cervical cancer treated with definitive RT between January 1997 and December 2011 were retrospectively reviewed. The cumulative distant relapse, progression‐free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan–Meier method and compared using the log‐rank test. A Cox proportional hazards regression model was used to investigate the predictors of distant relapse in patients.

Results

Following treatment with definitive RT, 61 of the 219 (27.9%) patients developed distant relapse with median PFS and OS rates of 9.9 and 32.8 months, and estimated five‐year PFS and OS rates of 4.9% and 21.3%, respectively. Multivariate analysis revealed that pelvic node metastasis, pretreatment leukocytosis and pretreatment neutrophilia were significant predictors of distant relapse. The risk of developing distant relapse was found to be associated with the number of predictors that the patients displayed: the estimated five‐year distant relapse rates of the patients with no predictors, one predictor and two predictors were 20.3%, 35.5% and 88.9%, respectively.

Conclusions

Roughly 28% of patients with FIGO stage IIB–IVA cervical cancer developed distant relapse after definitive RT. Pelvic lymph node metastasis and pretreatment leukocytosis/neutrophilia are independent predictors of distant relapse.
Clinical indications for hysteroscopic removal of uterine masses: Time, age at diagnosis, and mass size
Authors: Cho Hyun‐Woong , Koo Yu‐Jin , Hong Jin‐Hwa , Lee Jae‐Kwan
Published: August 2017

Aim

The aim of this study was to investigate clinical factors associated with abnormal pathologies of uterine masses resected via hysteroscopy.

Methods

Women who underwent hysteroscopic surgery for presumptive diagnoses of abnormal endometrial or endocervical masses, such as polyps or leiomyomas on ultrasonography, between January 2012 and April 2015, were enrolled. Clinical and pathologic data were retrospectively reviewed.

Results

Among 189 patients, pathologic diagnoses of the uterine mass were abnormal in 172 (91.0%) cases, including polyps in 119 (63.0%), leiomyomas in 49 (26.0%), endometrial hyperplasia in two (1.0%), and endometrial cancer in two (1.0%). Seventeen (9.0%) women who underwent hysteroscopic removal showed unremarkable results on pathology, and the most common finding among them was the proliferative phase of the normal endometrium. Women aged over 40 years with uterine masses and a time since last menstrual period of over 15 days are four times more likely to be diagnosed with neoplastic masses than others (odds ratio [OR], 4.39, 95% confidence interval [CI], 1.33–14.48 and OR, 4.22, 95%CI, 1.35–13.21, respectively); those with masses over 1.5 cm in size are three times more likely to be neoplastic than others (OR, 3.08, 95%CI, 1.04–9.12).

Conclusion

Large mass size, longer time after last menstrual period, and older age are risk factors for abnormal histologies of uterine masses resected via hysteroscopy. Clinicians should take particular care when contemplating hysteroscopic removal for women younger than 40 years, and those with masses of <1.5 cm in size in the proliferative phase of the endometrium to avoid an unnecessary surgery.
Motivational interviewing to enhance treatment attendance in mental health settings: A systematic review and meta‐analysis
Authors: Lawrence P. , Fulbrook P. , Somerset S. , Schulz P.
Published: August 2017

Accessible summary

What is known on the subject?

Despite differences between samples, some literature reviews have suggested that MI is effective in enhancing treatment attendance for individuals with mental health issues.

Little is known regarding the effects of MI as a pre‐treatment on individuals who are not seeking treatment for mental health issues.

What this paper adds to existing knowledge?

This systematic review of the literature and meta‐analysis demonstrates that MI is most beneficial for individuals who are not seeking mental health treatment.

MI represents an opportunity for health promotion when patients are unmotivated but may otherwise be amenable to an intervention.

MI is effective as a pre‐treatment intervention to motivate individuals to attend further post‐MI treatment and counselling.

What are the implications for practice?

MI is a process and a useful tool for clinicians in all therapeutic interactions, to motivate their patients to seek further assistance for mental heath issues.

Health promotion and encouragement to attend further treatment sessions can be facilitated through telephone contact.

Introduction

The stages of change model suggests that individuals seeking treatment are in the “preparation” or the “action” stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems.

Aim

This study examined the published research on MI as a pre‐treatment to enhance attendance among individuals treatment‐seeking and non‐treatment‐seeking for mental health issues.

Methods

Fourteen randomized controlled trials were identified, and MI efficacy was examined dichotomously: attendance or non‐attendance for post‐MI therapy. Subgroup analysis investigated treatment‐seeking and non‐treatment‐seeking groups.

Results

Despite wide variations in sample sizes, blinding and monitoring, intervention fidelity was absent in the majority of published studies. Meta‐analysis revealed that MI pre‐treatment improved attendance relative to comparison groups.

Conclusions

Individuals not seeking treatment for mental health issues benefited the most from MI. Despite differences in MI treatment intensity, short interventions were as effective as longer interventions, whereas two MI sessions for as little as 15 min were effective in enhancing treatment attendance.

Implications for Practice

Motivational interviewing is a useful tool for clinicians in all therapeutic interactions to help motivate patients to seek assistance for mental health issues.
Differential effects of changes in spectral irradiance on photoacclimation, primary productivity and growth in Rhodomonas salina (Cryptophyceae) and Skeletonema costatum (Bacillariophyceae) in simulated blackwater environments
Authors: Lawrenz Evelyn , Richardson Tammi L.
Published: August 2017

The underwater light field in blackwater environments is strongly skewed toward the red end of the electromagnetic spectrum due to blue light absorption by colored dissolved organic matter (CDOM). Exposure of phytoplankton to full spectrum irradiance occurs only when cells are mixed up to the surface. We studied the potential effects of mixing‐induced changes in spectral irradiance on photoacclimation, primary productivity and growth in cultures of the cryptophyte Rhodomonas salina and the diatom Skeletonema costatum. We found that these taxa have very different photoacclimation strategies. While S. costatum showed classical complementary chromatic adaption, R. salina showed inverse chromatic adaptation, a strategy previously unknown in the cryptophytes. Transfer of R. salina to periodic full spectrum light (PFSL) significantly enhanced growth rate (μ) by 1.8 times and primary productivity from 0.88 to 1.35 mg C · (mg Chl−1) · h−1. Overall, R. salina was less dependent on PFSL than was S. costatum, showing higher μ and net primary productivity rates. In the high‐CDOM simulation, carbon metabolism of the diatom was impaired, leading to suppression of growth rate, short‐term 14C uptake and net primary production. Upon transfer to PFSL, μ of the diatom increased by up to 3‐fold and carbon fixation from 2.4 to 6.0 mg C · (mg Chl−1) · h−1. Thus, a lack of PFSL differentially impairs primarily CO2‐fixation and/or carbon metabolism, which, in turn, may determine which phytoplankton dominate the community in blackwater habitats and may therefore influence the structure and function of these ecosystems.
Crystal structure of the Melampsora lini effector AvrP reveals insights into a possible nuclear function and recognition by the flax disease resistance protein P
Authors: Zhang Xiaoxiao , Farah Nadya , Rolston Laura , Ericsson Daniel J. , Catanzariti Ann‐Maree , Bernoux Maud , Ve Thomas , Bendak Katerina , Chen Chunhong , Mackay Joel P. , Lawrence Gregory J. , Hardham Adrienne , Ellis Jeffrey G. , Williams Simon J. , Dodds Peter N. , Jones David A. , Kobe Bostjan
Published: August 2017

The effector protein AvrP is secreted by the flax rust fungal pathogen (Melampsora lini) and recognized specifically by the flax (Linum usitatissimum) P disease resistance protein, leading to effector‐triggered immunity. To investigate the biological function of this effector and the mechanisms of specific recognition by the P resistance protein, we determined the crystal structure of AvrP. The structure reveals an elongated zinc‐finger‐like structure with a novel interleaved zinc‐binding topology. The residues responsible for zinc binding are conserved in AvrP effector variants and mutations of these motifs result in a loss of P‐mediated recognition. The first zinc‐coordinating region of the structure displays a positively charged surface and shows some limited similarities to nucleic acid‐binding and chromatin‐associated proteins. We show that the majority of the AvrP protein accumulates in the plant nucleus when transiently expressed in Nicotiana benthamiana cells, suggesting a nuclear pathogenic function. Polymorphic residues in AvrP and its allelic variants map to the protein surface and could be associated with differences in recognition specificity. Several point mutations of residues on the non‐conserved surface patch result in a loss of recognition by P, suggesting that these residues are required for recognition.
Association of left ventricular systolic dysfunction with mortality in incident peritoneal dialysis patients
Authors: Wang Yating , Xiong Liping , Xu Qingdong , Li Wei , Peng Xuan , Shen Jiani , Qiu Yagui , Yu Xueqing , Mao Haiping
Published: August 2017

Summary at a Glance

This study showed that there was a trend for a stepwise increase in the risk of both all‐cause and cardiovascular mortality with a reduced LVEF in CAPD patients, suggesting lower level of LVEF is an independent predictor for clinical outcomes in this population.