bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of hydrolysed diets for vomiting and/or diarrhoea in cats in primary veterinary practice
Authors: Kathrani A. , Church D. B. , Brodbelt D. C. , Pegram C. , O'Neill D. G.
Published: September 2020

Objective

To describe responses of cats prescribed a hydrolysed diet with or without concurrent medication for chronic vomiting and/or diarrhoea of undetermined aetiology.

Materials and Methods

Anonymised records of 512,213 cats under UK veterinary care in 2016 from the VetCompass database were searched using relevant terms for hydrolysed diets. The records of 5000 (90%) of 5569 cats with evidence of receiving a hydrolysed diet were randomly reviewed for gastrointestinal indication, prior and concurrent medication and response after hydrolysed dietary intervention. A poor response was defined as evidence of receiving antibiotic or glucocorticoid treatment for vomiting/diarrhoea at visits after the onset of the diet or death from gastrointestinal signs for at least 6 months follow‐up.

Results

Of 977 cats prescribed a hydrolysed diet for chronic vomiting/diarrhoea, 697 (71%) were first prescribed the diet without concurrent antibiotics or glucocorticoids while 280 (29%) first received the diet with these medications. Thirty‐four per cent of cats in the former group and 61% in the latter had a poor response. Cats older than 6 years and cats prescribed antibiotic and/or glucocorticoid for vomiting/diarrhoea before and concurrently with the diet had higher odds of poor response.

Clinical Significance

Although variations in our observations may reflect severity of signs or prescribing habits of primary‐care veterinary surgeons, our study suggests there is merit in trialling a hydrolysed diet first as a sole therapy in cats with chronic vomiting/diarrhoea when diagnostic investigations do not reveal a cause, before resorting to antibiotic and/or glucocorticoid therapy for cases that respond poorly.
A theory of “popular political legitimation”: A dual‐process model approach to legitimation and political socialization
Authors: Vila‐Henninger Luis Antonio
Published: September 2020

How do everyday people—or actors who do not occupy positions of political authority—legitimate political systems? Responding to this question, I use work from sociology, political science, and cognitive science to build a theory of “Popular Political Legitimation” (PPL)—defined as everyday people's legitimation of a political system. To answer how PPL happens, we must answer two sub‐questions that address legitimacy as a normative phenomenon: 1) What are the processes of socialization through which individuals learn the norms, widely held beliefs, and values that legitimate a political system? 2) How do individuals subsequently use these norms, widely held beliefs, and/or values in their own legitimations of a political system? Thus, we see that a model of socialization is central to understanding how PPL happens. I proceed in four steps. First, I review the literature on political legitimation. Next, I review the literature on political socialization. Third, to address gaps in the two aforementioned literatures concerning a model of socialization that explains legitimation, I turn to neuroscience (for reviews see Greene, 2017; Cushman, 2020) and psychology to review models of socialization and rationalization. Finally, I synthesize these literatures to develop a theory of political socialization and how it generates PPL.
Maintained virological suppression and renal function with reduced dose tenofovir disoproxil fumarate in renally impaired chronic hepatitis B patients
Authors: Liem Kin Seng , Wong David K. , Fung Scott , Zahirieh Alireza , Yim Colina , Zanjir Wayel R. , Feld Jordan J. , Hansen Bettina E. , Janssen Harry L. A.
Published: September 2020

Tenofovir disoproxil fumarate (TDF) effectively suppresses viral replication in chronic hepatitis B (CHB), but occasionally leads to renal impairment. We evaluated the prevalence of viral and biochemical breakthrough and renal function kinetics in renally impaired patients with CHB on reduced and on full‐dose TDF. This clinic‐based longitudinal cohort study included patients receiving full and reduced dose TDF (due to eGFR [Cockcroft‐Gault] <60 mL/min/1.73 m2). Viral and biochemical breakthroughs were assessed 1 month after starting full and reduced TDF dose until the end‐of‐follow‐up. Breakthroughs were studied in full and reduced dose TDF, and renal function (MDRD) longitudinally before and after dose reduction within patients starting on full‐dose TDF. Of 750 patients on TDF, 78 (10%) had reduced dose and 672 (90%) full dose. At the time of dose reduction, 36 (46%) patients had chronic kidney disease stage G3B. A viral breakthrough occurred in one cirrhotic dialysis‐dependent patient (dosed 300 mg weekly) which resolved without signs of decompensation, and in one patient on full dose which resolved spontaneously. One biochemical breakthrough occurred during dose reduction and resolved naturally without viral breakthrough. The MDRD improved within the first year of dose reduction (+3.0 [2.5] mL/min per year; P < .005) and remained stable thereafter. Fifty‐three (79%) patients reached an MDRD >50 mL/min during dose reduction. Low dose TDF maintains renal function and viral suppression in most renally impaired patients with CHB, even in those with advanced liver disease. This useful, yet simple strategy could be particularly viable in resource‐constrained settings.
Impact of a nurse‐led enhanced monitoring, management and contact tracing intervention for chronic hepatitis B in England, 2015‐2017
Authors: Beebeejaun Kazim , Amin‐Chowdhury Zahin , Letley Louise , Kara Edna , Mahange Beauty , Harrington Kate , Checkley Jacqui , Salimee Sultan , Poole Kristina , Ijaz Samreen , Alexander Graeme , Ramsay Mary , Mandal Sema , Edelstein Michael
Published: September 2020

Around 200,000 people live with chronic hepatitis B in England. Despite national guidance on identification and management of cases and their close contacts, testing rates of close contacts is as low as 43% in high prevalence areas of London. Our study aimed to determine whether a nurse‐led enhanced management and contact tracing of chronically infected individuals improved testing uptake, vaccination and onward referral of close contacts. The study was conducted across Greater Manchester and East of England regions between October 2015 and July 2017. All HBV chronically infected individuals registered with a GP and their close contacts were eligible for recruitment. The proportion of contacts who were tested, vaccinated and referred where appropriate were compared before and after the nurse‐led intervention. Baseline and outcome information was collected using questionnaires. The intervention improved case referral rates by an additional 14% (from 86% (88/102 cases) to 99.7%; 648/650 cases). The proportion of contacts tested increased from 34% to 72%‐94% with 18 new cases of HBV diagnosed. Amongst close contacts tested, vaccination rates of at least three doses increased from 77% (43/56) to 93% (452/491) during the study. Our study has shown that nurse‐led enhanced management greatly improves identification, testing and vaccination of close contacts. The identification of new acute and chronic cases is likely to make the intervention cost effective and local health commissioners should consider providing a nurse‐led service as part of hepatitis B care pathways.
Epidemiological and clinical characteristics of 70 cases of coronavirus disease and concomitant hepatitis B virus infection: A multicentre descriptive study
Authors: Wu Jian , Yu Jiong , Shi Xiaowei , Li Wei , Song Shu , Zhao Liangping , Zhao Xinguo , Liu Jun , Wang Dawei , Liu Chengyuan , Huang Biao , Meng Yiling , Jiang Bin , Deng Yijun , Cao Hongcui , Li Lanjuan
Published: September 2020

The interaction between existing chronic liver diseases caused by hepatitis B virus (HBV) infection and COVID‐19 has not been studied. We analysed 70 COVID‐19 cases combined with HBV infection (CHI) to determine the epidemiological, clinical characteristics, treatment and outcome. We investigated clinical presentation, imaging and laboratory parameters of COVID‐19 patients of seven hospitals from Jan 20 to March 20, 2020. Multivariate analysis was used to analyse risk factors for progression of patients with COVID‐19 combined with HBV infection. Compared with COVID‐19 without HBV infection (WHI) group, patients with dual infection had a higher proportion of severe/critically ill disease (32.86% vs. 15.27%,P = .000), higher levels of alanine aminotransferase (ALT), aspartate transaminase (AST) and activated partial thromboplastin (APTT) [50(28‐69)vs 21(14‐30),P = .000; 40(25‐54) vs 23(18‐30),P = .000; 34.0(27.2‐38.7) vs 37.2(31.1‐41.4),P = .031]. The utilization rates of Arbidol and immunoglobulin were significantly higher than those in the co‐infected group [48.57% vs. 35.64%,P < .05; 21.43% vs. 8.18%,P < .001], while the utilization rate of chloroquine phosphate was lower (1.43% vs 14.00%,P < .05) in the co‐infected patients group. Age and c‐reactive protein (CRP) level were independent risk factors for recovery of patients with COVID‐19 combined with HBV infection. The original characteristics of COVID‐19 cases combined with HBV infection were higher rate of liver injury, coagulation disorders, severe/critical tendency and increased susceptibility. The elderly and patients with higher level of CRP were more likely to experience a severe outcome of COVID‐19.
Surface distribution of pyrethroids following topical application to veterinary species: Implications for lateral transport
Authors: Bäumer Wolfgang , Baynes Ronald
Published: September 2020

Pyrethroids like permethrin have been used as topical formulations for their ectoparasiticidal effects since the 1970s. There are numerous efficacy studies in dogs and livestock animals that indicate a fast spread of pyrethroids after topical administration onto rather confined areas of the skin. Some studies correlate the efficacy against ticks, fleas or lice with concentrations of pyrethroids in hair and, less frequently, stratum corneum samples. It is often stated that lateral transport is responsible for the distribution of the pyrethroids over the body surface. With this review, we attempt to demonstrate evidence for lateral transport of pyrethroids after topical administration in dogs, cattle and sheep and to present data gaps that should be addressed in follow‐up studies.
Determinants of tree seedling establishment in alpine tundra
Authors: Marsman Floor , Nystuen Kristin O. , Opedal Øystein H. , Foest Jessie J. , Sørensen Mia Vedel , De Frenne Pieter , Graae Bente Jessen , Limpens Juul
Published: September 2020

Questions

Changes in climate and herbivory pressure affect northern alpine ecosystems through woody plant encroachment, altering their composition, structure and functioning. The encroachment often occurs at unequal rates across heterogeneous landscapes, hinting at the importance of habitat‐specific drivers that either hamper or facilitate woody plant establishment. Here, we assess: (1) the invasibility of three distinct alpine plant community types (heath, meadow and Salix shrubland) by Pinus sylvestris (Scots pine); and (2) the relative importance of biotic (above‐ground interactions with current vegetation, herbivory and shrub encroachment) and microclimate‐related abiotic (soil temperature, moisture and light availability) drivers of pine seedling establishment success.

Location

Dovrefjell, Central Norway.

Methods

We conducted a pine seed sowing experiment, testing how factorial combinations of above‐ground removal of co‐occurring vegetation, herbivore exclusion and willow transplantation (simulated shrub encroachment) affect pine emergence, survival and performance (new stem growth, stem height and fraction of healthy needles) in three plant communities, characteristic of alpine tundra, over a period of five years.

Results

Pine seedling emergence and survival were similar across plant community types. Herbivore exclusion and vegetation removal generally increased pine seedling establishment and seedling performance. Within our study, microclimate had minimal effects on pine seedling establishment and performance. These results illustrate the importance of biotic resistance to seedling establishment.

Conclusion

Pine seedlings can easily establish in alpine tundra, and biotic factors (above‐ground plant interactions and herbivory) are more important drivers of pine establishment in alpine tundra than abiotic, microclimate‐related, factors. Studies aiming to predict future vegetation changes should thus consider local‐scale biotic interactions in addition to abiotic factors.
Soil nutrients, canopy gaps and topography affect liana distribution in a tropical seasonal rain forest in southwestern China
Authors: Liu Qi , Sterck Frank J. , Medina‐Vega José A. , Sha Li‐Qing , Cao Min , Bongers Frans , Zhang Jiao‐Lin , Poorter Lourens
Published: September 2020

Questions

Lianas are a conspicuous element of tropical forests but have largely been ignored in species‐level vegetation surveys. As a result, there is limited understanding of how environmental factors structure liana communities.

Location

A 20‐ha forest dynamics plot in Xishuangbanna National Nature Reserve, southwestern China.

Methods

We evaluated the distribution of the 50 most abundant liana species, comprising >18,000 individuals, in the 20‐ha forest plot. Ordination analysis and generalized linear mixed models were used to evaluate how species distribution and abundance are associated with soil pH, soil phosphorus (P), soil nitrogen (N), and soil potassium (K), canopy gaps and topography. We calculated the average weighted distribution as a proxy for the optimum resource condition for each species.

Results

The first two axes of a canonical correspondence analysis explained 65% of the variation in liana species composition, with pH and P being the strongest drivers and highly correlated with each other. We modelled the responses of liana species to soil nutrients, and found a negative, unimodal or positive response of liana abundance with increasing soil nutrient concentrations. Forty‐six of the 50 species occurred under significantly higher or lower soil nutrient conditions than expected at random. Lianas mainly separated along the P gradient, whereas for N and K most liana species tended to occupy locations with high nutrient concentrations.

Conclusions

Although lianas are thought to be notoriously light‐demanding, soil conditions were stronger drivers of liana species distribution than gaps. Species differences in distributions were mainly driven by soil gradients in pH and P, highlighting the importance of soil nutrient status for liana niche partitioning in wet tropical forests on highly weathered soils. Most liana species had high resource requirements for N, K and light, which come along with their fast growth and acquisitive resource use strategy. Hence, below‐ground resource availability plays an important role in shaping the assembly of liana communities.
Reconsidering the Electoral Connection of Speeches: The Impact of Electoral Vulnerability on Legislative Speechmaking in a Preferential Voting System
Authors: Poyet Corentin , Raunio Tapio
Published: September 2020

Recent literature highlights the incentives emanating from the electoral system and intraparty politics to explain unequal access to the plenary floor. This article contributes to the literature by investigating the effect of electoral vulnerability on the likelihood to deliver speeches in a preferential voting system. Drawing on data from Finland, it argues that intraparty vulnerability has a negative impact on the likelihood to deliver speeches, whereas the opposite effect is expected regarding interparty vulnerability. The findings show that intraparty vulnerability is negatively correlated with the number of speeches and that this effect is even larger when intraparty competition is tougher. The article underlines the importance of individual electoral goals when exploring legislative speechmaking. It also shows the need to distinguish the two forms of vulnerability and to consider factors that mediate the electoral connection.
Limited genetic parallelism underlies recent, repeated incipient speciation in geographically proximate populations of an Arctic fish (Salvelinus alpinus)
Authors: Salisbury Sarah J. , McCracken Gregory R. , Perry Robert , Keefe Donald , Layton Kara K.S. , Kess Tony , Nugent Cameron M. , Leong Jong S. , Bradbury Ian R. , Koop Ben F. , Ferguson Moira M. , Ruzzante Daniel E.
Published: September 2020

The genetic underpinnings of incipient speciation, including the genomic mechanisms which contribute to morphological and ecological differentiation and reproductive isolation, remain poorly understood. The repeated evolution of consistently, phenotypically distinct morphs of Arctic Charr (Salvelinus alpinus) within the Quaternary period offer an ideal model to study the repeatability of evolution at the genomic level. Sympatric morphs of Arctic Charr are found across this species' circumpolar distribution. However, the specific genetic mechanisms driving this morph differentiation are largely unknown despite the cultural and economic importance of the anadromous morph. We used a newly designed 87k SNP chip to investigate the character and consistency of the genomic differences among sympatric morphs within three recently deglaciated and geographically proximate lakes in Labrador, Canada. We found genetically distinct small and large morph Arctic Charr in all three lakes consistent with resident and anadromous morphs, respectively. A degree of reproductive isolation among sympatric morphs is likely given genome‐wide distributions of outlier SNPs and high genome‐wide FSTs. Across all lakes, outlier SNPs were largely nonoverlapping suggesting a lack of genetic parallelism driving morph differentiation. Alternatively, several genes and paralogous copies of the same gene consistently differentiated morphs across multiple lakes suggesting their importance to the manifestation of morphs. Our results confirm the utility of Arctic Charr as a model for investigating the predictability of evolution and support the importance of both genetic parallelism and nonparallelism to the incipient speciation of Arctic Charr morphs.
MonitoringPlasmodium falciparumandPlasmodium vivaxusing microsatellite markers indicates limited changes in population structure after substantial transmission decline in Papua New Guinea
Authors: Kattenberg Johanna Helena , Razook Zahra , Keo Raksmei , Koepfli Cristian , Jennison Charlie , Lautu‐Gumal Dulcie , Fola Abebe A. , Ome‐Kaius Maria , Barnadas Céline , Siba Peter , Felger Ingrid , Kazura James , Mueller Ivo , Robinson Leanne J. , Barry Alyssa E.
Published: September 2020

Monitoring the genetic structure of pathogen populations may be an economical and sensitive approach to quantify the impact of control on transmission dynamics, highlighting the need for a better understanding of changes in population genetic parameters as transmission declines. Here we describe the first population genetic analysis of two major human malaria parasites,Plasmodium falciparum(Pf) andPlasmodium vivax(Pv), following nationwide distribution of long‐lasting insecticide‐treated nets (LLINs) in Papua New Guinea (PNG). Parasite isolates from pre‐ (2005–2006) and post‐LLIN (2010–2014) were genotyped using microsatellite markers. Despite parasite prevalence declining substantially (East Sepik Province:Pf = 54.9%–8.5%,Pv = 35.7%–5.6%, Madang Province:Pf = 38.0%–9.0%,Pv: 31.8%–19.7%), genetically diverse and intermixing parasite populations remained.Pfdiversity declined modestly post‐LLIN relative to pre‐LLIN (East Sepik:Rs = 7.1–6.4,HE = 0.77–0.71; Madang:Rs = 8.2–6.1,HE = 0.79–0.71). Unexpectedly, population structure present in pre‐LLIN populations was lost post‐LLIN, suggesting that more frequent human movement between provinces may have contributed to higher gene flow.Pvprevalence initially declined but increased again in one province, yet diversity remained high throughout the study period (East Sepik:Rs = 11.4–9.3,HE = 0.83–0.80; Madang:Rs = 12.2–14.5,HE = 0.85–0.88). Although genetic differentiation values increased between provinces over time, no significant population structure was observed at any time point. For both species, a decline in multiple infections and increasing clonal transmission and significant multilocus linkage disequilibrium post‐LLIN were positive indicators of impact on the parasite population using microsatellite markers. These parameters may be useful adjuncts to traditional epidemiological tools in the early stages of transmission reduction.
A complex network of additive and epistatic quantitative trait loci underlies natural variation of Arabidopsis thaliana quantitative disease resistance to Ralstonia solanacearum under heat stress
Authors: Aoun Nathalie , Desaint Henri , Boyrie Léa , Bonhomme Maxime , Deslandes Laurent , Berthomé Richard , Roux Fabrice
Published: September 2020

Plant immunity is often negatively impacted by heat stress. However, the underlying molecular mechanisms remain poorly characterized. Based on a genome‐wide association mapping approach, this study aims to identify in Arabidopsis thaliana the genetic bases of robust resistance mechanisms to the devastating pathogen Ralstonia solanacearum under heat stress. A local mapping population was phenotyped against the R. solanacearum GMI1000 strain at 27 and 30 °C. To obtain a precise description of the genetic architecture underlying natural variation of quantitative disease resistance (QDR), we applied a genome‐wide local score analysis. Alongside an extensive genetic variation found in this local population at both temperatures, we observed a playful dynamics of quantitative trait loci along the infection stages. In addition, a complex genetic network of interacting loci could be detected at 30 °C. As a first step to investigate the underlying molecular mechanisms, the atypical meiotic cyclin SOLO DANCERS gene was validated by a reverse genetic approach as involved in QDR to R. solanacearum at 30 °C. In the context of climate change, the complex genetic architecture underlying QDR under heat stress in a local mapping population revealed candidate genes with diverse molecular functions.
Heterozygous CAPN3 missense variants causing autosomal‐dominant calpainopathy in seven unrelated families
Authors: González‐Mera L. , Ravenscroft G. , Cabrera‐Serrano M. , Ermolova N. , Domínguez‐González C. , Arteche‐López A. , Soltanzadeh P. , Evesson F. , Navas C. , Mavillard F. , Clayton J. , Rodrigo P. , Servián‐Morilla E. , Cooper S. T , Waddell L. , Reardon K. , Corbett A. , Hernandez‐Laín A. , Sanchez A. , Esteban Perez J. , Paradas‐Lopez C. , Rivas‐Infante E. , Spencer M. , Laing N. , Olivé M.
Published: September 2020

Aims

Recessive variants in CAPN3 gene are the cause of the commonest form of autosomal recessive limb girdle muscle dystrophy. However, two distinct in‐frame deletions in CAPN3 (NM_000070.3:c.643_663del21 and c.598_621del15) and more recently, Gly445Arg and Arg572Pro substitutions have been linked to autosomal dominant (AD) forms of calpainopathy. We report 21 affected individuals from seven unrelated families presenting with an autosomal dominant form of muscular dystrophy associated with five different heterozygous missense variants in CAPN.

Methods

We have used massively parallel gene sequencing (MPS) to determine the genetic basis of a dominant form of limb girdle muscular dystrophy in affected individuals from seven unrelated families.

Results

The c.700G> A, [p.(Gly234Arg)], c.1327T> C [p.(Ser443Pro], c.1333G> A [p.(Gly445Arg)], c.1661A> C [p.(Tyr554Ser)] and c.1706T> C [p.(Phe569Ser)] CAPN3 variants were identified. Affected individuals presented in young adulthood with progressive proximal and axial weakness, waddling walking and scapular winging or with isolated hyperCKaemia. Muscle imaging showed fatty replacement of paraspinal muscles, variable degrees of involvement of the gluteal muscles, and the posterior compartment of the thigh and minor changes at the mid‐leg level. Muscle biopsies revealed mild myopathic changes. Western blot analysis revealed a clear reduction in calpain 3 in skeletal muscle relative to controls. Protein modelling of these variants on the predicted structure of calpain 3 revealed that all variants are located in proximity to the calmodulin‐binding site and are predicted to interfere with proteolytic activation.

Conclusions

We expand the genotypic spectrum of CAPN3‐associated muscular dystrophy due to autosomal dominant missense variants.
Impact of pre‐transplant biopsy on 5‐year outcomes of expanded criteria donor kidney transplantation
Authors: Yap Yun Ting , Ho Quan Yao , Kee Terence , Ng Chee Yong , Chionh Chang Yin
Published: September 2020

Aim

Compared to Standard Criteria Donors (SCD), Expanded Criteria Donor (ECD) kidneys are associated with poorer outcomes, although pre‐transplant biopsy may mitigate risks. This study assessed 5‐year outcomes of deceased‐donor kidney transplant recipients, comparing recipients of ECD allografts evaluated histologically to recipients of SCD and ECD kidneys assessed clinically.

Methods

This is a single‐centre retrospective study. From November 2005 to December 2009 (Era 1), donors were assessed clinically for suitability for kidney donation. From December 2009 to October 2017 (Era 2), kidneys from ECDs and diabetics underwent pre‐transplant biopsy and were allocated based on Remuzzi score. Outcomes of Era 1 and 2 recipients were compared.

Results

ECD kidney transplantation increased from 30.4% to 40.0% from Era 1 to 2. Univariable Cox regression, stratified by transplant era, found that 5‐year graft loss was highest with Era 1 ECD (HR 2.5, 95% CI 1.1‐5.5, P = .027) while graft loss for Era 2 ECD recipients was similar to SCD recipients. There was no difference in 5‐year recipient survival. Amongst Era 1 ECD recipients, 51.2% experienced rejection compared to 30.8‐41.5% for other subgroups. Five‐year eGFR was higher with Era 2 ECD at 48.4 (33.3‐60.7) ml/min/1.73 m2 compared to 42.2 (35.8‐57.3) ml/min/1.73 m2 for Era 1 ECD. However, these differences were not statistically significant.

Conclusion

Introduction of pre‐transplant biopsy assessment may be associated with improved outcomes of ECD kidney recipients such that they are now comparable to SCD kidney recipients, with benefits persisting over 5 years.
Inpatient Suicide Second Victim Experience and Support Tool: Psychometric properties of a scale for nurses who experienced inpatient suicide at Chinese general hospitals
Authors: Tan Rong , Luo Kaiyan , Hu Deying , Zhao Yue , Han Yanhong , Xu Ke
Published: September 2020

This study describes a psychometric scale, the Inpatient Suicide Second Victim Experience and Support Tool, for evaluating physical and psychological distress with a focus on resources for supporting the needs of nursing professionals. Our study defines “second victim” as a nurse who experiences inpatient suicide while on shift. We conducted a cross‐sectional study among non‐psychiatric nurses to examine the psychometrics of the scale. A total of 731 participants were recruited from eight Chinese general hospitals for this research. Data were analyzed by exploratory factor analysis and confirmatory factor analysis to examine the reliability and validity of the scale. The results indicated adequate indices resulting in 21 items. The final structure for the scale was categorized into five domains: psychosomatic distress, support from family and friends, work‐related support, organizational support, and professional self‐efficacy. The total variance explained was 69.06%. Cronbach's alpha was 0.869 overall, and ranged from 0.626 to 0.914 for the five dimensions. The test–retest reliability of 0.792 for the entire scale was also acceptable. The scale shows promise for use by healthcare organizations to identify second victims and promote necessary organizational support interventions in Chinese hospitals.
Effect of Melatonin on Postoperative Pain and Perioperative Opioid Use: A Meta‐analysis and Trial Sequential Analysis
Authors: Wang Zhaoqi , Li Yan , Lin Duomao , Ma Jun
Published: September 2020

Objectives

We performed this meta‐analysis in order to assess the effect of melatonin on postoperative pain and perioperative opioid consumption.

Methods

We systematically searched PubMed, EMBASE, and the Cochrane Library until October 2019 for studies concerning the effect of melatonin vs. placebo on postoperative pain. We also searched for grey literature in ClnicalTrials.gov and grey literature databases, including OpenGrey and Grey Literature Report. We performed a meta‐analysis of postoperative pain scores, perioperative opioid use, the number of patients with analgesic requirements, the time to the first analgesic requirement, length of hospital stay, and common reported adverse events of melatonin.

Results

According to the inclusion and exclusion criteria, 15 studies with a total of 1,102 patients were included in the final analysis. Melatonin was significantly associated with decreased VAS score (24 hours postoperatively) compared to placebo (trial sequential analysis = conclusive; mean difference [MD] −0.86; 95% confidence interval [CI] −1.38, −0.34; P = 0.001). Patients randomly assigned to melatonin were administered less postoperative opioids than patients in the control groups (trial sequential analysis = inconclusive; MD −3.33 mg; 95% CI −5.28, −1.38; P = 0.0008). The need for analgesic requirements was significantly decreased in the melatonin group. Patients who received melatonin had a significantly longer time to the first analgesic requirement. Compared to the placebo group, there were no significant differences in terms of length of hospital stay, dizziness, headache, paresthesia, and nausea.

Conclusions

Given the low quality of evidence, minor degree of VAS score reduction, and inconclusive trial sequential analysis of postoperative opioid consumption, this meta‐analysis neither supports nor opposes the effect of melatonin on postoperative pain.
Using the word “Healthy” in an emergency food pantry: An unexpected response
Authors: Oliver Tracy L. , Dowdell Elizabeth Burgess
Published: September 2020

The word “healthy” holds significant value when discussing health and nutrition; however, the word was identified as having a negative and confusing connotation at an Emergency Food Pantry (EFP). The sample of 11 women, ages 40–70 years, who are patrons at an EFP in Southeastern Pennsylvania shared that “healthy” is a misunderstood term, frequently perceived as expensive and tasteless. Identification of the word “healthy” as a barrier was unexpected for the interprofessional team of health educators. Understanding the perspectives of individuals who utilize EFPs can benefit anyone working in public health and community settings since “healthy” and “healthy eating” are common words. When planning nutrition and health education classes, barriers must be recognized in order to promote health by using words that resonate with EFP patrons and their community. It is crucial for nurses and providers to communicate with patients using the most effective and impactful terminology.
Hepatitis C virus infections among people aged 15–44, United States, 2009–2018
Authors: Watts Theresa , Lauver Diane , Sethi Ajay K. , Snedden Traci , Zahner Susan
Published: September 2020

Objectives

To estimate the prevalence, characteristics, and gender differences among people aged 15–44 years who are living with current HCV infections in the United States.

Design and sample

We conducted a cross‐sectional, secondary data analysis using data from people who participated in National Health and Nutrition Examination Survey (NHANES) cycles in 2009–2018.

Measurements

Sociodemographic, social behavior, and clinical factors that had been identified as related to having HCV, barriers to receiving HCV screening, care, or treatment, and health conditions that increase the risks of developing HCV‐related complications were studied. A weighted‐data analysis approach was used to generate descriptive statistics.

Results

The estimated, weighted prevalence of current HCV infections was 0.3% (95% CI, 0.2–0.4), representing approximately 363,161 people (95% CI, 301,402–424, 920). Females were more likely than males to have an unknown risk factor and reported worse overall health. Males were more likely to have comorbidities such as obesity or diabetes that put them at risk for developing life‐threatening complications.

Conclusions

Increased public health attention with gender‐specific actions are needed to address the health needs of the thousands of people aged 15–44 years who are living with current HCV infections across the United States.
New insights into the genetic diversity of Xanthomonas campestris pv. campestris isolates from winter oilseed rape in Serbia
Authors: Jelušić Aleksandra , Berić Tanja , Mitrović Petar , Dimkić Ivica , Stanković Slaviša , Marjanović‐Jeromela Ana , Popović Tatjana
Published: September 2020

Winter oilseed rape has recently been described as a new host for the phytopathogenic bacterium Xanthomonas campestris pv. campestris (Xcc) in Serbia. In order to provide information about the genetic structure of this bacterium's population and its pathogenic features on this crop, a collection of 65 winter oilseed rape Xcc isolates obtained over a 5‐year period (2014–2018) from different Serbian localities was examined. The presence of intrapathovar diversity within the tested isolates was confirmed by repetitive element PCR (rep‐PCR), revealing 14, 10, and 4 different profiles for BOX, ERIC, and REP primers, respectively. A multilocus sequence typing (MLST) approach separated the isolates into seven groups on a phylogenetic tree. The PubMLST non‐redundant database was used to compare sequences of four housekeeping genes from isolates with 75 strains of Xanthomonas spp. to determine nucleotide changes caused by host–pathogen coevolution. Five allelic profile combinations (ST3, ST5, ST9, ST26, and ST47) were determined, with ST47 being the most frequent. Pathogenicity and host range tests showed higher virulence of the tested isolates on winter oilseed rape than on other Brassica oleracea hosts (broccoli, cabbage, cauliflower, collard greens, kale, and kohlrabi). The most aggressive isolates were NCPPB4679, NCPPB4680, and Xc361, belonging to genotype ST26. Fifty oilseed rape lines, cultivars, and hybrids showed susceptibility to the three Xcc isolates tested (of high, low, and moderate virulence), indicating that there was no resistance to the bacterium. The results provide significant information about diversification of Xcc isolates and their evolution toward specialization for winter oilseed rape.
Self‐deception and pragmatic encroachment: A dilemma for epistemic rationality
Authors: Gao Jie
Published: September 2020

Self‐deception is typically considered epistemically irrational, for it involves holding certain doxastic attitudes against strong counter‐evidence. Pragmatic encroachment about epistemic rationality says that whether it is epistemically rational to believe, withhold belief or disbelieve something can depend on perceived practical factors of one's situation. In this paper I argue that some cases of self‐deception satisfy what pragmatic encroachment considers sufficient conditions for epistemic rationality. As a result, we face the following dilemma: either we revise the received view about self‐deception or we deny pragmatic encroachment on epistemic rationality. I suggest that the dilemma can be solved if we pay close attention to the distinction between ideal and bounded rationality. I argue that the problematic cases fail to meet standards of ideal rationality but exemplify bounded rationality. The solution preserves pragmatic encroachment on bounded rationality, but denies it on ideal rationality.
Barriers to optimal peritoneal dialysis
Authors: Finkelstein Fredric O.
Published: September 2020

Peritoneal dialysis in the United States is underutilized when compared to the experience in other developed countries. The reasons for this are multifactorial and include government regulatory issues, the priority of dialysis facilities, and education and training of nephrology trainees and patients. The challenges to expanding PD in the United States are discussed and strategies to overcome the barriers are outlined.
Multivariate substrate characterization: The case of shellfish harvesting areas in the Rías Altas (north‐west Iberian Peninsula)
Authors: Cerdeira‐Arias JosÉ Daniel , Otero Jaime , Álvarez‐Salgado XosÉ AntÓn , Mena RodrÍguez Anxo , Nombela Miguel Ángel
Published: September 2020

The productivity of intertidal shellfish banks is affected by a wide variety of environmental parameters. In this study, a battery of multivariate analyses including generalized linear mixed models, hierarchical cluster analysis and principal component analysis were performed to define the spatial organization of sandbanks and to identify the variables driving the grouping. Grain‐size distribution and calcium carbonate, organic matter, Si and Al oxides, and trace metals content were the variables used to characterize the intertidal sediments. Field data were collected through the upper 50 cm in 57 sites located in shellfish sandbanks from five coastal inlets of the western Cantabrian coast (Rías Altas, north‐west Iberian Peninsula). Generalized linear mixed models showed that hardly any variable differed with core depth, and the hierarchical cluster analysis and principal component analysis revealed that the banks organized around four clusters. This grouping was dictated by the influence of the imprint of the Cabo Ortegal complex material (with high levels of MgO, Mn, Cr, Ni, V and Fe2O3) or by the imprint of the Ollo de Sapo and Manto de Mondoñedo (high levels of SiO2, Rb, K2O and Ba). The multivariate analysis also separated the sandbanks with higher terrestrial influence in the inner part of the inlets (high levels of Al2O3, Zn, Ba and TiO2) from those with higher marine influence, which were located in the outer part (high levels of Sr, CaO and CaCO3). Furthermore, it was observed that both axes of main ordination were related to the annual average concentration of chlorophyll‐a and inorganic nitrogen in the water column above those sediments, highlighting the interdependence between chemical composition of the overlying water and sediments’ characteristics. This approach, combining parametric models and multivariate analyses of textural and geochemical sediment composition data, proved to be useful for characterizing intertidal substrates where shellfish species live.
Human leukocyte antigen associations with renal function among ethnic minorities in the United Kingdom
Authors: Lowe Marcus , Payton Antony , Verma Arpana , Gemmell Isla , Worthington Judith , Hamilton Patrick , Ollier William , Augustine Titus , Poulton Kay
Published: September 2020

Human leukocyte antigens (HLA) have been associated with renal function, but previous studies report contradictory findings. There has been a lack of research into how HLA affects renal function in Black, Asian and Minority Ethnic (BAME) people in the UK, despite BAME people being disproportionately affected by renal dysfunction. This study included >27 000 UK Biobank subjects of six ethnicities (>12 100 Irish, >5400 Indian, >4000 Black Caribbean, >3000 Black African, >1600 Pakistani, and >1400 Chinese) aged 39 to 73. Subjects' high‐resolution HLA genotypes were imputed using HLA*IMP:02 software. Regression analysis was used to compare 108 imputed HLA alleles with two measures of estimated glomerular filtration rate (eGFR): one based on serum creatinine; one based on serum cystatin. Secondary analysis compared CKD stage 2 subjects to healthy controls. Nine imputed HLA alleles were associated with eGFR (adjusted P < .05). Six associations were based on creatinine in Black African subjects: HLA‐B*53:01 (beta = −2.628, adjusted P = 4.69 × 10−4); C*04:01 (beta = −1.667, adjusted P = .0269); DPA1*02:01 (beta = −1.569, adjusted P = .0182); and DPA1*02:02 (beta = −1.716, adjusted P = .0251) were linked to decreased renal function, while DRB1*03:01 (beta = 3.200, adjusted P = 3.99 × 10−3) and DPA1*01:03 (beta = 2.276, adjusted P = 2.31 × 10−5) were linked to increased renal function. Two of these (HLA‐B*53:01 and C*04:01) are commonly inherited together. In Irish subjects, HLA‐DRB1*04:01 (beta = 1.075, adjusted P = .0138) was linked to increased eGFR (based on cystatin); in Indian subjects, HLA‐DRB1*03:01 (beta = −1.72, adjusted P = 4.78 × 10−3) and DQB1*02:01 (beta = −1.755, adjusted P = 2.26 × 10−3)were associated with decreased eGFR (based on cystatin). No associations were found in the other three ethnic groups. Nine HLA alleles appear to be associated with kidney function in BAME people in the UK. This could have applications for the diagnosis and treatment of renal disease and could help reduce health inequalities in the UK.
Clinical and laboratory predictors of 30‐day mortality in severe acute malnourished children with severe pneumonia
Authors: Shahrin Lubaba , Chisti Mohammod J. , Brintz Benjamin , Islam Zahidul , Shahid Abu S.M.S.B. , Hassan Md. Zakiul , Leung Daniel T. , Chowdhury Fahmida
Published: September 2020

Objective

To determine the predictors of mortality within 30 days of hospital admission in a diarrhoeal disease hospital in Bangladesh.

Methods

Cohort study of hospitalised children aged 0–59 months with severe acute malnutrition (SAM) and severe pneumonia in Dhaka Hospital, icddr,b, Bangladesh from April 2015 to March 2017. Those discharged were followed up, and survival status at 30 days from admission was determined. Children who died were compared with the survivors in terms of clinical and laboratory biomarkers. Multivariable logistic regression analysis was used for calculating adjusted odds ratio for death within 30 days of hospital admission.

Results

We enrolled 191 children. Mortality within 30 days of admission was 6% (14/191). After adjusting for potential confounders (hypoxia, CRP and haematocrit) in logistic regression analysis, independent factors associated with death were female sex (aOR = 5.80, 95% CI: 1.34–25.19), LAZ <−4 (aOR = 6.51, 95% CI: 1.49–28.44) and Polymorphonuclear Leucocytes (PMNL) (>6.0 × 109/L) (aOR = 1.06, 95% CI: 1.01–1.11). Using sex, Z‐score for length for age (LAZ), and PMNL percentage, we used random forest and linear regression models to achieve a cross‐validated AUC of 0.83 (95% CI: 0.82, 0.84) for prediction of 30‐day mortality.

Conclusions

The results of our data suggest that female sex, severe malnutrition (<−4 LAZ) and higher PMNL percentage were prone to be associated with 30‐day mortality in children with severe pneumonia. Association of these factors may be used in clinical decision support for prompt identification and appropriate management for prevention of mortality in this population.
The cytologic features of biliary diseases: A retrospective study
Authors: Masserdotti Carlo
Published: September 2020

Background

Histologic examination, together with clinical data and instrument support, contributes to the recognition of biliary diseases. Although quantitative and qualitative changes in hepatic and biliary cells can occur, descriptions of cytologic samples from the liver affected by cholangiopathies are rare.

Objectives

This study aimed to describe the quantitative and qualitative changes in cholangiocytes, hepatocytes, and inflammatory cells in cytologic samples from dogs and cats affected by histologically confirmed cholangiopathies.

Methods

Cytologic samples from the liver with histologically confirmed cholangiopathies were reviewed and compared to describe the changes seen on cytology. The samples were obtained from the Archive of Clinica Veterinaria Sant'Antonio and the Laboratorio Veterinario Bresciano. Statistical analysis was not performed.

Results

A total of 196 cytologic samples retrieved from the database fit the selection criteria, 88 from dogs, and 108 from cats. A total of eight categories of cholangiopathies have been identified and described, while histology is often required to achieve a definitive diagnosis, six categories of cholangiopathy in dogs and seven in cats provide cytologic information.

Conclusions

Cytologic examination, together with clinical and ultrasonographic data, can be useful for identifying hepatic abnormalities in acute and chronic cholestasis, chronic cholangitis, feline lymphoplasmacytic cholangitis, and cholangiocellular neoplasms.
Serum concentrations of IL‐31 in dogs with nonpruritic mast cell tumours or lymphoma
Authors: Ignatenko Nataliia , Gonzales Andrea J. , Messamore James E. , Hirschberger Johannes , Udraite‐Vovk Laura , Boehm Teresa M.S.A. , Troedson Karin , Fejos Csilla , Mueller Ralf S.
Published: September 2020

Background

The aim of this study was to compare serum interleukin (IL)‐31 concentrations in dogs with lymphoma and mast cell tumours (MCT) without pruritus to those of healthy dogs.

Hypothesis/Objectives

To determine if IL‐31 plays a role in tumour pathogenesis and if IL‐31 could be a biological marker for disease progression.

Animals

Forty‐eight healthy dogs and 36 dogs with neoplasia [multicentric lymphoma (14), MCT (15) and cutaneous lymphoma (7)] were included in the study.

Methods and materials

Dogs with neoplasia were assigned to three different groups. Group 1 consisted of patients with multicentric lymphoma, which were diagnosed by cytological, histopathological and clonality investigations. Thoracic radiographs, ultrasound examination of the abdominal cavity, and fine‐needle aspirates from liver and spleen were used to determine the lymphoma stage Patients with cutaneous lymphoma, diagnosed by cytological and histopathological findings, were included in Group 2. Patients with MCT, diagnosed by cytological and histopathological findings, were included in Group 3. Serum was frozen at –80ºC before measuring the concentration of IL‐31 via a Simoa ultra‐sensitive, fully automated two‐step immunoassay.

Results

Serum concentrations of IL‐31, regardless of the disease and its staging, were within the normal range in all patients; there was no difference between any of the different tumour groups and healthy dogs.

Conclusions and clinical importance

IL‐31 is not likely to be involved in the pathogenesis of canine MCT or lymphoma without pruritus.
Development of an updated assay for prekallikrein activator in albumin and immunoglobulin therapeutics
Authors: Roberts Graham , Fox Bernard , Longstaff Colin
Published: September 2020

Background

Prekallikrein activator (PKA) is a contaminating enzyme found in therapeutic albumin and immunoglobulin products. The level is commonly measured using methods such as that defined by the European Pharmacopoeia (Ph Eur) with traceability to the WHO International Standard for PKA. This method generally works well, but problems are sometimes observed.

Materials and methods

A simplified one‐step method has been developed to replace the existing Ph Eur two‐step method which consists of kallikrein generation followed by kallikrein measurement using a chromogenic substrate. Analysis of data from the one‐stage method is simplified by the use of a dedicated online app.

Results

The one‐stage method was validated against the current Ph Eur method using batches of albumin and immunoglobulins. Problem batches of immunoglobulins were investigated using the one‐stage method. Improved methodology using true initial rate determinations and use of acid‐treated prekallikrein substrate (PKS) helped understand and reduce artefactual results.

Conclusions

The one‐stage method and associated app streamline real‐time determination of PKA and promote good principles of enzyme assays to limit substrate depletion, while also conserving expensive PKS. Blanking steps and reproducibility are simplified.