bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study
Authors: Jackson Haley , Baker John , Berzins Kathyrn
Published: June 2019

Aim

This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion.

Background

Seclusion should only be used as a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals' decision to seclude. Little is known about factors professionals consider when releasing service users.

Design

A qualitative study was undertaken to explore factors which influence decision‐making of mental health professionals when terminating episodes of seclusion.

Methods

Semi‐structured face‐to‐face interviews with 21 professionals were undertaken between May 2017–January 2018. Framework analysis was used to systematically manage, analyse, and identify themes, while maintaining links to primary data and providing a transparent audit trail.

Results

Six themes were identified where professionals looked for service users to demonstrate cooperation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol.

Conclusion

Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involves in decisions regarding seclusion should be explored.

Impact

Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded.
Impact of including information from bulls and their daughters in the training population of multiple‐step genomic evaluations in dairy cattle: A simulation study
Authors: de Oliveira Hinayah Rojas , Brito Luiz Fernando , Sargolzaei Mehdi , e Silva Fabyano Fonseca , Jamrozik Janusz , Lourenco Daniela Andressa Lino , Schenkel Flavio Schramm
Published: June 2019

The objective of this study was to investigate the impact of accounting for parent average (PA) and genotyped daughters’ average (GDA) on the estimation of deregressed estimated breeding values (dEBVs) used as pseudo‐phenotypes in multiple‐step genomic evaluations. Genomic estimated breeding values (GEBVs) were predicted, in eight different simulated scenarios, using dEBVs calculated based on four methods. These methods included PA and GDA in the dEBV (VR) or only GDA (VRpa) and excluded both PA and GDA from the dEBV with either all information or only information from PA and GDA (JA and NEW, respectively). In general, VR and NEW showed the lowest and highest GEBV reliabilities across scenarios, respectively. Among all deregression methods, VRpa and NEW provided the most consistent bias estimates across the majority of scenarios, and they significantly yielded the least biased GEBVs. Our results indicate that removing PA and GDA information from dEBVs used in multiple‐step genomic evaluations can increase the reliability of GEBVs, when both bulls and their daughters are included in the training population.
Transplantation of mesenchymal stem cells overexpressing interleukin‐10 induces autophagy response and promotes neuroprotection in a rat model of TBI
Authors: Maiti Panchanan , Peruzzaro Sarah , Kolli Nivya , Andrews Melissa , Al‐Gharaibeh Abeer , Rossignol Julien , Dunbar Gary L.
Published: June 2019

Autophagy, including mitophagy, is critical for neuroprotection in traumatic brain injury (TBI). Transplantation of mesenchymal stem cells (MSCs) provides neuroprotection and induces autophagy by increasing anti‐inflammatory cytokines, such as interleukin‐10 (IL‐10). To evaluate these effects of IL10 that are released by MSCs, we genetically engineered MSCs to overexpress IL10 and compared their effects to unaltered MSCs following transplantation near the site of induced TBIs in rats. Adult, male Sprague‐Dawley rats were divided into four groups: Sham + vehicle, TBI + vehicle, TBI + MSCs‐IL‐10 and TBI + MSCs‐GFP. Thirty‐six hours post‐TBI, the first two groups received vehicle (Hanks balance salt solution), whereas last two groups were transplanted with MSCs‐IL‐10 or MSCs‐GFP. Three weeks after transplantation, biomarkers for neurodegenerative changes, autophagy, mitophagy, cell death and survival markers were measured. We observed a significant increase in the number of dead cells in the cortex and hippocampus in TBI rats, whereas transplantation of MSCs‐IL‐10 significantly reduced their numbers in comparison to MSCs alone. MSCs‐IL‐10 rats had increased autophagy, mitophagy and cell survival markers, along with decreased markers for cell death and neuroinflammation. These results suggest that transplantation of MSCs‐IL‐10 may be an effective strategy to protect against TBI‐induced neuronal damage.
Evaluation of effectiveness of treatment paradigm for newly diagnosed type 2 diabetes patients in Chin: A nationwide prospective cohort study
Authors: Cai Xiaoling , Hu Dayi , Pan Changyu , Li Guangwei , Lu Juming , Ji Qiuhe , Su Benli , Tian Haoming , Qu Shen , Weng Jianping , Zhang Danyi , Xu Jie , Ji Linong
Published: June 2019

Aims/Introduction

Data of nationwide glycemic control and hypoglycemic treatment patterns in newly diagnosed type 2 diabetes patients in China are absent. The aim of this study was to assess the evolution of treatment patterns for newly diagnosed type 2 diabetes patients and the clinical outcomes during 12‐month follow up.

Materials and Methods

This is an observational prospective cohort study with 12 months of follow up. Patients with a diagnosis of type 2 diabetes for <6 months were enrolled. Glycated hemoglobin A1c (HbA1c) levels and hypoglycemic treatment patterns were collected at baseline and at every 3 months of follow up.

Results

A total of 79 hospitals were recruited, consisting of 5,770 participants. The mean HbA1c was 8.4 ± 2.5% at baseline, and decreased to 6.7 ± 1.2% at 12 months with 68.5% of patients achieving HbA1c <7%. At baseline, 44.6% of the patients were without hypoglycemic medications, 37.7% had oral hypoglycemic agents and 17.7% received insulin treatment. Determinants of change in HbA1c were treatment patterns, comorbidities, baseline characteristics such as obesity and smoking, regions, and tiers of hospitals. Associated factors with treatment alterations were time of follow up, treatment patterns, patient‐reported reasons such as the economic factors and poor efficacy.

Conclusions

In newly diagnosed type 2 diabetes patients, compared with patients without medications, patients with one oral hypoglycemic agent had higher possibilities of reaching glycemic control, whereas patients using insulin had lower possibilities of reaching the target. Factors associated with change in HbA1c and treatment alterations were also revealed.
The influences of socio‐individual determinants and health information seeking on health‐promoting behaviors among migrant women: A cross‐sectional study
Authors: Ahn Jung‐ae , Chae Duckhee
Published: June 2019

Aim

This study aimed to examine the effects of socio‐individual and health information‐seeking variables on health‐promoting behaviors among migrant women living in Korea.

Methods

A descriptive, cross‐sectional design was used. A convenience sample comprising 190 Filipino marriage‐migrant women from G City and J province, South Korea, were recruited between November and December 2015. Participants completed self‐report surveys examining health‐promoting behaviors, health information seeking, and socio‐individual determinants.

Results

The most popular health information sources were healthcare professionals (39.0%), family or friends (31.6%), and the Internet (28.9%). Most respondents (90.5%) possessed smart devices; 55.8% used them to seek health information, while 9.5% used health‐related applications. The health information that migrant women searched for online mainly concerned their health, diet/nutrition, and physical activity. Education (β = .15, p = .008), health status (β = −.10, p = .038), and smart device possession (β = .20, p = .032) were factors influencing health‐promoting behaviors.

Conclusions

Considering the high use of smart devices among migrant women in Korea, these findings suggest the need for an accessible, reliable, and easily understandable Internet‐based health information source to facilitate their health‐promoting behaviors.
Factors related to perioperative nurses' job satisfaction and intention to leave
Authors: Lee Seung Eun , MacPhee Maura , Dahinten V. Susan
Published: June 2019

Aim

This study investigated factors associated with perioperative nurses' job satisfaction and their intention to leave. Recruitment and retention of nurses are particularly important in a specialist environment such as the perioperative setting where it is especially difficult to attract and retain nurses due to its unique environment.

Methods

Cross‐sectional data were drawn from a larger study on nurses' work environments, conducted in one province of Canada. An e‐survey tool, consisting of validated scales, was administered by the provincial nurses' union to a stratified random sample of registered nurses. The study sample consisted of 113 perioperative nurses working in acute‐care hospitals. This study included two outcome variables (job satisfaction and intention to leave) and five predictor variables (three aspects of work environment, workload, and emotional exhaustion). Data were analyzed using multivariate linear and logistic regressions.

Results

A multivariate linear regression model explained 49% (adjusted R2) of variance in nurses' job satisfaction, and a multivariate logistic regression explained 19% (McFadden's R2) of the variance in their intent to leave. After controlling for work status and other predictors, nurse‐physician relationship was significantly related to nurses' job satisfaction, and emotional exhaustion was the key predictor for both outcome variables.

Conclusions

This study demonstrated that higher emotional exhaustion is associated with decreased job satisfaction and increased intention to leave among perioperative nurses. The findings suggest that nurse managers should create an empowering and open work environment that fosters perioperative nurses' job satisfaction and reduces their intention to leave.
Characteristics, outcome and factors associated with success of quitting smoking in 77 people living with HIV/AIDS who received smoking cessation therapy in Japan
Authors: Taniguchi Chie , Hashiba Chieko , Saka Hideo , Tanaka Hideo
Published: June 2019

Aim

Smokers with HIV/AIDS have lower success of quitting smoking than smokers with other chronic diseases. However, there have been no studies investigating characteristics and outcomes of success of quitting smoking among people living with HIV compared to HIV‐negative people who received smoking cessation therapy. In addition, there have been no studies that investigated factors associated with success of quitting smoking among people living with HIV in Japan. The aim of this study was to elucidate characteristics, outcomes and factors associated with the success of quitting smoking in people living with HIV.

Methods

We previously conducted a prospective cohort study on patients who received Japanese smoking cessation therapy (SCT), which consists of smoking cessation intervention five times with nurses' counseling over a 12‐week period. Among them, we compared 77 HIV‐positive male individuals and 323 HIV‐negative male individuals with complications.

Results

Smokers with HIV had a larger number of cigarettes smoked per day, and higher scores of nicotine dependence and depression compared with the HIV‐negative group. The HIV‐positive group had a significantly lower success rate of quitting smoking than the HIV‐negative group (35.1 vs. 47.7%, p = .046). The subjects living with HIV who had higher self‐efficacy showed a significantly higher quit rate compared with those who had lower self‐efficacy (odds ratio 9.99, p < .01).

Conclusion

Smokers with HIV had characteristics that made it difficult for them to quit smoking. Increasing their self‐efficacy of quitting smoking through nurses' counseling will lead to success of quitting smoking in HIV‐positive smokers receiving the SCT.
The effects of bladder training on bladder functions after transurethral resection of prostate
Authors: Büyükyilmaz Funda , Culha Yeliz , Zümreler Hande , Özer Murat , Culha Mehmet Gokhan , Ötünçtemur Alper
Published: June 2019

Aim and Objectives

The aim of this was to examine the effect of bladder training on bladder functions.

Background

Urinary catheterization is frequently performed in order to evaluate the outcomes of the surgical procedures and to monitor the urine output after urology operations.

Design and Methods

This quasi‐experimental study was conducted in the urology clinic in Istanbul, Turkey in which 50 males were nonrandomly assigned to either a bladder training (n = 28) or a control group (n =22). In the bladder training groups, the urinary catheters of the patients were clamped at 4‐hr intervals and then were left open for 5 min on the second postoperative day. This study was created in accordance with TREND Statement Checklist.

Results

The first urgency time and the first voiding time were longer, and the prevoiding and the voiding volumes were higher following the removal of the catheter in the training group (p = 0.001). In addition, the evaluation of the patient bladder diaries in the first three days after the discharge period revealed that the daily frequencies of micturition and nocturia were lower (p = 0.04), the mean duration of intervals between the micturition was longer (p = 0.006), and the mean voided urinary volume was higher (p = 0.024) in the training group.

Conclusion

At the end of the study, it is observed that bladder training performed by clamping the catheter on postoperative day 2 after Transurethral Resection of Prostate (TUR‐P) operation is a significant positive effect on the storage symptoms of the patients.

Relevance to clinical practice

Before removing the urinary catheter, bladder training programme affects positively to patients, especially prevoiding and the voiding volumes, the daily frequencies of micturition and nocturia on postoperative periods.
Facilitating holistic continuity of care for older patients: Home care nurses’ experiences using checklists
Authors: Nilsen Elin R. , Söderhamn Ulrika , Dale Bjørg
Published: June 2019

Aims and objectives

To explore home care nurses’ experiences of implementation and use of checklists developed for improving continuity of care for older patients (65+ years).

Background

The Norwegian Coordination Reform was implemented to improve coordination between hospitals and communities and facilitate a quicker return to home community after hospital discharge. To follow‐up, national learning networks were initialised to improve pathways for chronically ill older patients, including the development and use of standardised checklists.

Design

An explorative qualitative design was chosen.

Methods

Three focus group interviews were conducted, including 18 registered nurses from eight municipalities in southern Norway. Systematic text condensation was used to analyse the interview texts. The COREQ checklist was followed.

Results

Three categories emerged from the analysis. (a) “The implementation process” included the experiences of a chaotic beginning, the importance of involvement, the leaders’ role and resource allocation. (b) “Pros and cons of checklists in use” included the informants’ experiences of checklists’ usefulness for nurses and the patients. (c) “Competence needed” included the need for a comprehensive set of formal, experiential and social competences.

Conclusion and relevance to clinical practice

The leaders’ role, support and engagement are decisive for a successful implementation. To succeed and establish solid routines, allocating resources when implementing new laborious routines, such as checklists, is important. To improve holistic continuity of care to chronically ill older patients, checklists should be customisable to each patient's needs, be comprehensive enough to grasp the essence in what to be done at several time points, but at the same time brief enough to be operational. Checklists can be a useful tool for home care nurses, if customised to the individual municipality and the staffs’ working routines. It is important that the staff have versatile and extensive competencies enabling them to use the checklists appropriately.
Overseas qualified nurses’ communication with other nurses and health professionals: An observational study
Authors: Philip Susan , Woodward‐Kron Robyn , Manias Elizabeth
Published: June 2019

Aims and objectives

To understand the interprofessional and intraprofessional communication patterns of overseas qualified nurses as they coordinate care for patients in Australian hospitals.

Background

Numerous studies have informed the transitioning experiences of overseas qualified nurses with non‐English‐speaking backgrounds working in English‐speaking workplaces. Only a few observational studies have involved examining the intercultural communication experiences of overseas qualified nurses, and none have considered their intra‐ and interprofessional communication patterns.

Design

A qualitative design was adopted, using participant observation and discourse analysis.

Methods

This study was from January 2017 to March 2017. Thirteen overseas qualified nurses working in acute, subacute and interventional cardiology settings in a Melbourne metropolitan hospital were shadowed over a period of 12 weeks to collect data that inform their communication patterns. The COREQ checklist was used.

Results

This observational study informed by genre analysis revealed that intra‐ and interprofessional communication occurred more commonly under the clinical communication goals ofcoordinating careand less commonly underfacilitating intervention. Communication strategies ranged from structured interactions with use of communication tools to unstructured ad hoc interactions. Analysis of the discourse patterns demonstrated that effectiveness of interactions was affected by hesitancy, lack of assertion and few strategies to manage inadequate or aggressive communication by other team members. Poor clinical communication with peers was not always caused by the nurses from non‐English‐speaking backgrounds. Positive interpersonal interactions with laughter, language‐switching and small talk were evident in interactions with nurses from similar cultural backgrounds but were rare with local colleagues.

Conclusion

The linguistic evidence from this study shows variations in communication competency between participants, which emphasises the importance of not viewing overseas qualified nurses’ communication training needs as homogenous. With the growing multicultural nature of healthcare teams, this study underscores the need for intercultural communication training for team integration and patient safety.

Relevance to clinical practice

Continuous professional development should incorporate intercultural communication training to ensure team effectiveness within nursing teams as well as interprofessional teams.
Australian parents' experiences when discussing their child's overweight and obesity with the Maternal and Child Health nurse: A qualitative study
Authors: Hardy Kelly , Hooker Leesa , Ridgway Lael , Edvardsson Kristina
Published: June 2019

Aims and objectives

To explore parents' experiences when discussing child overweight issues with the Maternal and Child Health nurse.

Background

Community‐based child and family health nurses are in a unique position to discuss child overweight and obesity with parents. However, studies of parents' experiences in this context are lacking.

Method

Ten mothers of children identified as overweight or obese from regional Victoria, Australia, were interviewed in 2017. Data were analysed using an inductive qualitative thematic approach. The COREQ guidelines were used to ensure study rigour.

Results

In summary, the analysis revealed experiences of Maternal and Child Health nurses “brushing over” the topic, with a lack of information provided about how to tackle the problem at home. The interpersonal relationship aspect of continuity of care was described as facilitating awareness of the child's overweight, although mothers expressed confusion about what constituted a “healthy weight range.” While some mothers perceived the nurse's role was to offer evidence‐based information and support, others saw the family doctor as the appropriate health professional to address the problem.

Conclusion

The findings of this study indicate that parents are often left unsure how to manage their child's weight despite the child being identified as overweight or obese by their Maternal and Child Health nurse.

Relevance to clinical practice

Discussions about overweight and obesity may be facilitated by continuity of care where established relationships serve as a facilitator for effective communication. The findings further indicate a need for more structured support of Maternal and Child Health nurses working with parents of young children identified as overweight or obese, including ongoing education, skill development and improved understanding of parental health literacy and its links to childhood obesity.
Managerial Political Behavior in Innovation Portfolio Management: A Sensegiving and Sensebreaking Process
Authors: Röth Tobias , Spieth Patrick , Lange Donald
Published: June 2019

By applying formalized innovation portfolio management systems, firms seek to ensure an alignment of their goals and strategy with their employees' different abilities, actions, and outcomes. However, research indicates that nonrational, political behavior also determines formalized innovation portfolio management decision‐making processes. Research on political behavior in respect of innovation portfolio management usually conceptualizes political behavior as a set of self‐serving activities, such as negotiation, bargaining, coalition building, and acquiring power, aimed at protecting, maintaining, or promoting an actor's self‐interest and power. Consequently, extant research tends to focus on political behavior's dysfunctional impacts on decision‐making processes and their subsequent outcomes. This paper challenges this negativity bias by exploring a novel, neutral specification of political behavior and its relation to innovation portfolio management decision‐making processes. By conducting an automotive industry case study focusing on the innovation portfolio management decision‐making processes, the paper analyzed the data from 43 interviewees. The conceptual model shows that managers' political capabilities determine their ability to behave politically. According to the results, political behavior comprises the activities that prepare the stage and orchestrate others in order to form a political coalition. Furthermore, results show that political behavior functions as a sensegiving and a sensebreaking process, with managers seeking to shape an innovation project's understanding according to their interests and to influence portfolio decisions. The resulting novel specification of political behavior extends the construct's scope and validity by investigating their functional and dysfunctional aspects, and by indicating that a political sensemaking process complements formalized innovation portfolio management decision‐making processes.
Pharmacokinetics of the amoxicillin–clavulanic acid combination after intravenous and oral administration in cats
Authors: Yang Fan , Yang Fang , Wang Guoyong , Xi Wenyuan , Zhang Chaoshuo , Wang Han
Published: June 2019

The pharmacokinetic properties of amoxicillin (AMX) and clavulanic acid (CLV) were studied in healthy cats following single intravenous and oral dosage of 10 mg/kg of AMX and 2.5 mg/kg of CLV. The drug concentrations in plasma were determined by a high‐performance liquid chromatographic–tandem mass spectrometry (LC‐MS‐MS) method validated for canine plasma and further subjected to noncompartmental analysis. After intravenous injection, no significant difference (p > 0.05) was found in the volume of distribution of these two compounds. In addition, AMX and CLV were both rapidly eliminated from plasma with a clearance of 0.453 and 0.921 L hr−1 kg−1, respectively; however, a quicker elimination was observed for CLV (p < 0.01). After oral administration, both drugs were characterized by rapid absorption with an absorption half‐life of 1.10 and 0.70 hr for AMX and CLV, respectively. Significant differences were observed between their absorption rates (p < 0.05). However, the oral bioavailabilities of AMX and CLV (75.57% and 98.15%, respectively) were not statistically different (p > 0.05). A total intravenous or oral dose at 12.5 mg/kg of AMX and CLV (4:1) is predicted to be effective for treating those bacterial species isolated from cats with a minimum inhibitory concentration (MIC) of ≤0.25 μg/ml for 12 hr, based on a time above the MIC (T > MIC) of 40%.
Determinants of spatial patterns of canopy tree species in a tropical evergreen forest in Gabon
Authors: Engone Obiang Nestor Laurier , Kenfack David , Picard Nicolas , Lutz James A. , Bissiengou Pulchérie , Memiaghe Hervé R. , Alonso Alfonso
Published: June 2019

Questions

We examined the spatial patterns of dominant canopy species in a tropical forest to investigate: (a) what is the niche occupancy of canopy species with respect to topographic gradients; (b) what are the dominant ecological processes that explain their distribution; (c) what are the interactions among the most prevalent canopy species; and (d) what are the interactions between canopy species adults and juveniles trees?

Location

Rabi permanent CTFS‐ForestGEO plot, Gabon.

Methods

We selected the four most abundant canopy species and one timber species. We used Berman's test to determine the effect of three topographic variables on the distribution of each species and univariate analysis to model the spatial pattern of each species using either an inhomogeneous Poisson process or an inhomogeneous Cox process. We also used a bivariate form of the pair correlation function (PCF) to determine the spatial interaction between species and the correlation among conspecific adult and juvenile trees.

Results

Four of the five species had aggregated spatial patterns whileLophira alatashowed spatial randomness. Most of the variance in the local tree density was explained by within‐population dispersal processes rather than environmental factors. Bivariate PCF tests showed significant segregation between species associations. Two species exhibited aggregation at small distances between young and adult trees, while others showed either complete spatial randomness at small inter‐tree distances or segregation at large distances.

Conclusions

This study showed that the spatial pattern in the majority of canopy species was aggregation. Seed dispersal limitation mainly explained the observed aggregation pattern. Habitat filtering, as evidenced by the influence of topographic variables on niche occupancy, marginally, yet significantly, explained this pattern. The different spatial patterns of the principal species permit their coexistence. Spatial segregation among adult and juvenile trees reveals a strong pattern of either species‐specific seed predation or pathogens.
Optimal Export Policy With Upstream Price Competition
Authors: Mizuno Tomomichi , Takauchi Kazuhiro
Published: June 2019

We present a third‐market model with a vertical trading structure, in which upstream input suppliers engage in homogeneous price competition. We show that, under downstream Bertrand competition, a non‐monotonic export policy may result. Specifically, the optimal policy of the exporting country can turn into a tax–subsidy–tax as the degree of product substitutability rises. We also confirm the conventional result for which the optimal policy is an export subsidy (tax) if there is Cournot (Bertrand) competition downstream, provided that the number of domestic suppliers is at an intermediate level. We further discuss bilateral policy interventions when both exporting countries offer a subsidy/tax to their domestic downstream firms. We show that a non‐monotonic export policy (tax–subsidy–tax) can arise even in this extended setting.
Trehalose protects Escherichia coli against carbon stress manifested by protein acetylation and aggregation
Authors: Moruno Algara María , Kuczyńska‐Wiśnik Dorota , Dębski Janusz , Stojowska‐Swędrzyńska Karolina , Sominka Hanna , Bukrejewska Małgorzata , Laskowska Ewa
Published: June 2019

The disaccharide trehalose is widely distributed in nature and can serve as a carbon reservoir, a signaling molecule for controlling glucose metabolism and a stress protectant. We demonstrated that in Escherichia coli ΔotsA cells, which are unable to synthesize trehalose, the aggregation of endogenous proteins during the stationary phase was increased in comparison to wild‐type cells. The lack of trehalose synthesis boosted Nε‐lysine acetylation of proteins, which in turn enhanced their hydrophobicity and aggregation. This increased Nε‐lysine acetylation could result from carbon overflow and the accumulation of acetyl phosphate caused by the ΔotsA mutation. These findings provide a better understanding of the previously reported protective functions of trehalose in protein stabilization and the prevention of protein aggregation. Our results indicate that trehalose may participate in proteostasis not only as a chemical chaperone but also as a metabolite that indirectly counteracts detrimental protein acetylation. We propose that trehalose protects E. coli against carbon stress – the synthesis and storage of trehalose can prevent carbon overflow, which otherwise is manifested by protein acetylation and aggregation.
Failure to report poor care as a breach of moral and professional expectation
Authors: Ion Robin , Olivier Stephen , Darbyshire Philip
Published: June 2019

Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients, the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here, we build on this work but specifically foreground the responsibilities of registrants and students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and, sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when “real‐world” cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations.
PTCH1 alterations are frequent but other genetic alterations are rare in sporadic odontogenic keratocysts
Authors: Qu Jiafei , Zhang Jianyun , Zhang Heyu , Li Xuefen , Hong Yingying , Zhai Jiemei , Wang Yanjin , Chen Feng , Li Tiejun
Published: June 2019

Objective

Odontogenic keratocysts (OKCs) are benign jaw lesions with high growth potential and propensity for recurrence. Our previous study revealed that PTCH1 mutations, which were frequently detected in sporadic OKCs, might be underestimated due to the masking effect of the stromal components within the tested tissues. We aimed to confirm these results in larger scale and further present the unbiased view of the genomic basis of sporadic OKCs except PTCH1.

Materials and methods

We analyzed PTCH1 mutations in additional 19 samples. Using whole‐exome sequencing (WES), we further characterized the mutational landscape of five sporadic OKC samples lacking PTCH1 mutation and loss of heterozygosity (LOH).

Results

Combined with our previously reported 19 cases, thirty of 38 (79%) cases harbored PTCH1 mutations. Through whole‐exome sequencing and integrative analysis, 22 novel mutations were confirmed among five PTCH1‐negative samples. No recurrent mutations were identified in the WES samples and validation cohort of 10 OKCs.

Conclusions

Our data further confirmed the frequent PTCH1 mutation and other rare genetic alterations in sporadic OKCs, highlighting the central role of SHH signaling pathway. In PTCH1‐negative cases, other rare mutations scattered in a subset of OKCs were independent of the SHH pathway. These results suggested that an SHH inhibitor may be effective to treat the majority of OKCs.
LINE‐1 methylation in cleft lip tissues: Influence of infant MTHFR c.677C>T genotype
Authors: Khan Mohammad Faisal J. , Little Julian , Aleotti Valentina , Mossey Peter A. , Steegers‐Theunissen Régine P. M. , Autelitano Luca , Meazzini Maria C. , Ravaei Amin , Rubini Michele
Published: June 2019

Objective

To investigate the influence of MTHFR c.677C>T genotype on LINE‐1 methylation in lateral and medial tissues from cleft lip (CL).

Methods

Forty‐five consecutive non‐syndromic cleft lip with or without cleft palate (nsCL/P) cases were included in the study. Genomic DNA was extracted from tissues at both sides of cleft lip, and LINE‐1 methylation was detected by bisulfite conversion and pyrosequencing. MTHFR c.677C>T genotyping was carried out using the TaqMan genotyping assay.

Results

LINE‐1 methylation level was significantly higher on medial side of cleft lip compared with lateral side (p = 0.001). This difference was not significantly influenced by the case's sex or cleft type. However, MTHFR c.677C>T genotyping revealed that the difference in LINE‐1 methylation across cleft lip was restricted to carriers of C allele of MTHFR c.677C>T and was not apparent in TT homozygous cases (p = 0.027).

Conclusion

This integrated analysis supports the previous finding of differences in DNA methylation across the two sides of cleft lip and further suggests a possible role of MTHFR c.677C>T genotype in establishing this difference.
Modeling of Distributed Generators Resilience Considering Lifeline Dependencies During Extreme Events
Authors: Krishnamurthy Vaidyanathan , Kwasinski Alexis
Published: June 2019

This article derives distributed generators resilience models considering lifeline dependencies during extreme events. The effects on power resilience of storage capacity, fuel delays, and fuel order placements are analyzed. Results indicate that storage capacity has an important role in improving overall power supply resilience as seen by loads. In addition, the presented models provide a quantifiable approach in evaluating fuel delivery resilience. The models facilitate studying fuel scheduling policies and local fuel storage sizing for specified resilience requirements. It is observed that tank autonomy greatly affects the flexibility in employing scheduling policies supplying fuel to generators. Resilience dependence on buffer autonomy is high during the first few days of extreme events, and this could have considerable effects on managing evacuations and rescue operations.
The Influence of General Strikes against Government on Stock Market Behavior
Authors: Wisniewski Tomasz Piotr , Lambe Brendan John , Dias Alexandra
Published: June 2019

Using a sample of 76 countries, this paper examines the impact of major strikes against government and its policies on stock market behavior. An occurrence of a general strike is detrimental to the value of equities, as documented by the ceteris paribus 6.11% fall in dollar‐denominated stock market indices of the affected countries. This event is also accompanied by a statistically significant increase in risk, as measured by the standard deviation of returns and Value‐at‐Risk metrics. Taken together, these results imply that general strikes have serious ramifications for stock market investors.
Threatening Places or Diverse Spaces: Divergent Constructions of Florida Puerto Ricans across Twitter and Newspaper Articles
Authors: Dhuman Giron Stephanie A. , Vargas Nicholas
Published: June 2019

This study examines constructions of Puerto Ricans across two different media forms: newspaper articles and Twitter. We use Poinciana, Florida, a Central Florida Puerto Rican enclave, as a means to examine these constructions. Because of the high concentration of Puerto Rican residents and unprecedented migration to the area, Poinciana is an ideal community to examine media constructions of a migrant group. Utilizing constructivist grounded theory, we analyze all published newspaper articles (1995–2016) and public Twitter posts (2009–2016) about Puerto Ricans in the region (N = 174). We find newspaper articles construct mostly benign views of Puerto Ricans, reflecting “Happy Talk” diversity discourse, while Twitter constructions present more negative portrayals, generally relating to population size, and often reflecting a racist ideology reminiscent of the Latino Threat Narrative. We conclude by detailing the significance of divergent constructions across media forms during a period of heightened migration, and how the type of media consumed by Puerto Ricans in this community known as “Little Puerto Rico” is likely to influence their perceived level of societal acceptance.
The Evolution of Attitudes on Same‐Sex Marriage in the United States, 1988–2014
Authors: Daniels R. Steven
Published: June 2019

Objective

This article assesses the evolution of U.S. opinion on same‐sex marriage.

Methods

The analysis used multinomial regression on same‐sex marriage questions from eight surveys with more than 34,000 respondents by the Pew Research Center and the National Opinion Research Center (NORC) between 1988 and 2014. Multinomial logistic regression analysis tested five hypotheses about the effects of ideology, partisanship, religious intensity, contact with gays and lesbians, and education on support or opposition to same‐sex marriage over three separate periods (1988, 2003–2013, 2013–2014).

Results

Religious intensity, ideology, partisanship, contact with gays or lesbians, the Millennial generation, and being born again influenced opinion on same‐sex marriage. Differences by region and religious affiliation declined in relative influence, whereas differences by religious and political values increased between 1988 and 2014. Support increased steadily from 1988.

Conclusion

Opinion on same‐sex marriage has shifted across all groups, but the increased gap in opinion presages continuing conflict.
Interval decline in hemoglobin A is associated with annual clinical event rate in sickle cell anemia patients receiving maintenance apheresis RBC exchange
Authors: Kamyszek Reed W. , Raval Jay S. , Srinivasan Amudan J. , Ansari Andrea K. , Evans Brooke A. , Rollins‐Raval Marian A. , Poisson Jessica L. , Shah Nirmish R. , Welsby Ian J.
Published: June 2019

BACKGROUND

Apheresis red blood cell (RBC) exchange (RCE) is a standard intervention for patients with sickle cell anemia (SCA) who have had previous thromboembolic stroke or intractable chronic pain. Replacing sickling cells with those containing hemoglobin A (HbA) minimizes microvascular pathophysiology that produces clinical crises. Limited data exist regarding the interval changes in HbA between transfusions. We sought to describe the HbA decrement between RCE procedures and its relationship to clinical status.

STUDY DESIGN AND METHODS

SCA patients (all hemoglobin SS disease) treated with maintenance RCE (n = 21) over a 15‐month period at two neighboring institutions were retrospectively reviewed. Time‐normalized daily HbA decrement was calculated to reflect loss of transfused RBCs, and annual events of either emergency department or hospital admissions for SCA complications were noted. Associations between HbA decrement and laboratory measures were calculated using mixed linear regression models and unpaired t test was used to compare HbA decrement between high and low event rate groups.

RESULTS

A total of 31 events were recorded, and mean HbA decrement per day was 0.77 ± 0.16%. The mean interval between RCEs was 36 ± 12 days. Patients with more annual events exhibited a significantly greater daily HbA decrement (p = 0.007). No significant association between RBC unit age and HbA decrement or annual event rate was observed.

CONCLUSIONS

Patients exhibiting greater daily HbA decrement were more likely to have multiple emergency department visits or admissions for sickling crises. Modulating HbA decrement may merit study as an intermediate metric for interventions to improve outcomes in hemoglobin SS disease.
Structured phonetic variation facilitates talker identification
Authors: Ganugapati Divya , Theodore Rachel M.
Published: June 2019

Listeners use talker-specific phonetic structure to facilitate language comprehension. This study tests whether sensitivity to talker-specific phonetic variation also facilitates talker identification. During training, two listener groups learned to associate talkers' voices with cartoon pseudo-faces. For one group, each talker produced characteristically different voice-onset-time values; for the other group, no talker-specific phonetic structure was present. After training, listeners were tested on talker identification for trained and novel words, which was improved for those who heard structured phonetic variation compared to those who did not. These findings suggest an additive benefit of talker-specific phonetic variation for talker identification beyond traditional indexical cues.
Role of Massed Versus Distributed Practice in Learning Novel Foreign Language Utterances
Authors: Kaipa Ramesh , Howard Bethany , Kaipa Roha , Turcat Eric , Prema Laurielle
Published: June 2019

The current study compared the role of massed versus distributed practice in learning novel foreign language utterances. Fifty healthy native English-speaking participants were randomly assigned to either massed or distributed practice groups. All participants practiced eight novel French utterances 25 times each for a total of 200 times, with the spacing of practice sessions differing between the two groups. Both the groups completed an immediate retention as well as a delayed retention test. Participants’ learning was evaluated based on phonetic accuracy and naturalness of the French utterances. The findings revealed that participants involved in distributed practice demonstrated better learning over participants involved in massed practice. Future research should aim to extrapolate these findings in treating speech disorders.
Cancer and the death domain
Authors: Wong Wei
Published: June 2019

Inclusion of a death domain in an alternatively spliced isoform of the kinase IRAK4 increases leukemic burden.
Screening Mycobacterium tuberculosis Secreted Proteins Identifies Mpt64 as a Eukaryotic Membrane-Binding Bacterial Effector
Authors: Stamm Chelsea E. , Pasko Breanna L. , Chaisavaneeyakorn Sujittra , Franco Luis H. , Nair Vidhya R. , Weigele Bethany A. , Alto Neal M. , Shiloh Michael U.
Published: June 2019

Advances have been made to identify secreted proteins of
Mycobacterium tuberculosis
during animal infections. These data, combined with transposon screens identifying genes important for
M. tuberculosis
virulence, have generated a vast resource of potential
M. tuberculosis
virulence proteins. However, the function of many of these proteins in
M. tuberculosis
pathogenesis remains elusive. We have integrated three cell biological screens to characterize nearly 200
M. tuberculosis
secreted proteins for eukaryotic membrane binding, host subcellular localization, and interactions with host vesicular trafficking. In addition, we observed the localization of one secreted protein, Mpt64, to the endoplasmic reticulum (ER) during
M. tuberculosis
infection of macrophages. Interestingly, although Mpt64 is exported by the Sec pathway, its delivery into host cells was dependent upon the action of the type VII secretion system. Finally, we observed that Mpt64 impairs the ER-mediated unfolded protein response in macrophages.
Methylotetracoccus oryzae
Strain C50C1 Is a Novel Type Ib Gammaproteobacterial Methanotroph Adapted to Freshwater Environments
Authors: Ghashghavi Mohammad , Belova Svetlana E. , Bodelier Paul L. E. , Dedysh Svetlana N. , Kox Martine A. R. , Speth Daan R. , Frenzel Peter , Jetten Mike S. M. , Lücker Sebastian , Lüke Claudia
Published: June 2019

Most of the methane produced on our planet gets naturally oxidized by a group of methanotrophic microorganisms before it reaches the atmosphere. These microorganisms are able to oxidize methane, both aerobically and anaerobically, and use it as their sole energy source. Although methanotrophs have been studied for more than a century, there are still many unknown and uncultivated groups prevalent in various ecosystems. This study focused on the diversity and adaptation of aerobic methane-oxidizing bacteria in different environments by comparing their phenotypic and genotypic properties. We used lab-scale microcosms to create a countergradient of oxygen and methane for preenrichment, followed by classical isolation techniques to obtain methane-oxidizing bacteria from a freshwater environment. This resulted in the discovery and isolation of a novel methanotroph with interesting physiological and genomic properties that could possibly make this bacterium able to cope with fluctuating environmental conditions.
Fossil collections and mapping the Silurian: An example from Scandinavia
Authors: Diemer John A.
Published: June 2019

From 1840 to 1845, Roderick Murchison (1792–1871), an accomplished geologist who was instrumental in developing the Paleozoic portion of the geologic time scale, traveled in Europe, Scandinavia, and Russia, where he documented the occurrence and extent of the Silurian, Devonian, and Permian Systems. A key component of his fieldwork methodology was to examine fossils in both private collections and public museums to assess the types of fossils that occur in a region, in order to guide and expedite his mapping efforts. While working in Scandinavia, he examined fossil collections in Copenhagen, Oslo, Stockholm, Upsala, and Visby, and those collections clearly influenced his choice of travel routes and, ultimately, the geologic map (plate VI) in The Geology of Russia (Murchison et al., 1845). Furthermore, he was able to compare the Scandinavian fossils to British collections, thereby confirming the age of the strata he was mapping. The results of Murchison’s work appeared in numerous papers as well as two major books, The Geology of Russia (Murchison et al., 1845) and Siluria (Murchison, 1854), thereby advancing knowledge of Scandinavian stratigraphy. Not only were the fossil collections in the museums of his day essential to Murchison’s scientific research, but collections of documents in modern archives are invaluable in reconstructing his movements, observations, and discoveries more than 170 years ago, thereby demonstrating the utility of collections and museums to the construction of knowledge.