bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and enablers to diabetic eye screening attendance: An interview study with young adults with type 1 diabetes
Authors: Prothero Louise , Lawrenson John G. , Cartwright Martin , Crosby‐Nwaobi Roxanne , Burr Jennifer M. , Gardner Philip , Anderson John , Presseau Justin , Ivers Noah , Grimshaw Jeremy M. , Lorencatto Fabiana ,   for the EROS Study Investigators
Published: November 2021

Aim

The aim of this study was to identify barriers and enablers of diabetic eye screening (DES) attendance amongst young adults with diabetes living in the United Kingdom.

Methods

Semistructured qualitative interviews with adults aged 18–34 years with diabetes. Participants were purposively sampled to aim for representation across gender, geographical locations, diabetes type, years since diabetes diagnosis and patterns of attendance (i.e. regular attenders, occasional non‐attenders, regular non‐attenders). Data were collected and analysed using the Theoretical Domains Framework (TDF) to explore potential individual, sociocultural and environmental influences on attendance. Data were analysed using a combined deductive and inductive thematic analysis approach. Barriers/enablers were mapped to behaviour change techniques (BCTs) to identify potential strategies to increase attendance.

Results

Key barriers to attendance reported by the sample of 29 study participants with type 1 diabetes, fell within the TDF domains: [Knowledge] (e.g. not understanding reasons for attending DES or treatments available if diabetic retinopathy is detected), [Social Influences] (e.g. lack of support following DES results), [Social role and Identity] (e.g. not knowing other people their age with diabetes, feeling ‘isolated’ and being reluctant to disclose their diabetes) and [Environmental Context and Resources] (e.g. lack of appointment flexibility and options for rescheduling). Enablers included: [Social Influences] (e.g. support of family/diabetes team), [Goals] (e.g. DES regarded as ‘high priority’). Many of the reported barriers/enablers were consistent across groups. Potential BCTs to support attendance includeInstructions on how to perform the behaviour;Information about health consequences;Social support (practical)andSocial comparison.

Conclusions

Attendance to diabetic eye screening in young adults is influenced by a complex set of interacting factors. Identification of potentially modifiable target behaviours provides a basis for designing more effective, tailored interventions to help young adults regularly attend eye screening and prevent avoidable vision loss.
Oxidized phospholipids and lipoprotein(a): An update
Authors: Koutsogianni Amalia Despoina , Liberopoulos Evangelos , Tellis Konstantinos , Tselepis Alexandros D.
Published: November 2021

Over the past few years, there has been an undiminished interest in lipoprotein(a) [Lp(a)] and oxidized phospholipids (OxPLs), mainly carried on this lipoprotein. Elevated Lp(a) has been established as an independent causal risk factor for cardiovascular disease. OxPLs play an important role in atherosclerosis. The main questions that remain to be answered, however, is to what extent OxPLs contribute to the atherogenicity of Lp(a), what effect hypolipidaemic medications may have on their levels and the potential clinical benefit of their reduction. This narrative review aimed to summarize currently available data on OxPLs and cardiovascular risk, as well as the effect of established and emerging hypolipidaemic medications on Lp(a)‐OxPLs.
Anti‐SARS‐CoV‐2 mRNA vaccines as inducers of humoral response against apolipoprotein A‐1?
Authors: Vuilleumier Nicolas , Pagano Sabrina , Ludewig Burkhard , Schmiedeberg Kristin , Haller Christoph , von Kempis Johannes , Rubbert‐Roth Andrea
Published: November 2021

Background

COVID‐19 and some anti‐SARS‐CoV‐2 vaccines trigger a humoral autoimmune response against a broad range of endogenous components, which may affect recipients’ prognosis in predisposed individuals. Autoantibodies directed against apolipoprotein A‐1 (AAA1 IgG) the major protein fraction of High Density Lipoprotein have been shown to be raised in COVID‐19 and in rheumatoid arthritis (RA) patients and other populations where they have been associated with poorer outcomes. We wanted to assess the impact of anti‐SARS‐CoV‐2 mRNA‐based vaccination on AAA1 autoimmune biomarkers in RA patients.

Methods

20 healthy controls and 77 RA mRNA‐based vaccinated patients were collected at baseline, 3 weeks after the first vaccination, 2 and 8 weeks after the second vaccination. AAA1 and SARS‐CoV‐2 serologies were measured by immunoassays. Systemic and local symptoms occurring during the vaccination protocol were recorded.

Results

mRNA‐based vaccination induced a significant increase in median AAA1 IgG levels in both healthy controls and RA patients overtime. However, in both populations, these medians trend did not translate into significant increase in AAA1 IgG seropositivity rates despite evolving from 5 to 10% in healthy controls, and from 9 to 12.9% in RA patients. No associations were retrieved between AAA1 IgG and symptoms of any kind during the vaccination protocol.

Conclusions

mRNA‐based vaccination seems to induce a light AAA1 IgG response in immunocompetent individuals within 2 months after the last injection. Although we did not observe any warning signs, the formal demonstration of the harmlessness of such biological warrants further studies.
The neural determinants of beauty
Authors: Yang Taoxi , Formuli Arusu , Paolini Marco , Zeki Semir
Published: November 2021

The perception of faces correlates with activity in a number of brain areas, but only when a face is perceived as beautiful is the medial orbitofrontal cortex (mOFC) also engaged. Here, we enquire whether it is the emergence of a particular pattern of neural activity in face perceptive areas during the experience of a face as beautiful that determines whether there is, as a correlate, activity in mOFC. Seventeen subjects of both genders viewed and rated facial stimuli according to how beautiful they perceived them to be while the activity in their brains was imaged with functional magnetic resonance imaging. A univariate analysis revealed parametrically scaled activity within several areas, including the occipital face area (OFA), fusiform face area (FFA) and the cuneus; the strength of activity in these areas correlated with the declared intensity of the aesthetic experience of faces; multivariate analyses showed strong patterns of activation in the FFA and the cuneus and weaker patterns in the OFA and the posterior superior temporal sulcus (pSTS). The mOFC was only engaged when specific patterns of activity emerged in these areas. A psychophysiological interaction analysis with mOFC as the seed area revealed the involvement of the right FFA and the right OFA. We conjecture that it is the collective specific pattern‐based activity in these face perceptive areas, with activity in the mOFC as a correlate, that constitutes the neural basis for the experience of facial beauty, bringing us a step closer to understanding the neural determinants of aesthetic experience.
Influences on the trajectory and subsequent outcomes in CDKL5 deficiency disorder
Authors: Leonard Helen , Junaid Mohammed , Wong Kingsley , Aimetti Alex A. , Pestana Knight Elia , Downs Jenny
Published: November 2021

Objective

The study investigated the effect of seizure and medication burden at initial contact with the International CDKL5 Disorder Database on subsequent development and clinical severity and compared quality of life among those whose development progressed, remained stable, or regressed between baseline and follow‐up.

Methods

The effects of seizure and medication burden at baseline (high or low) on the CDKL5 Disorder Severity Scores and CDKL5 Developmental Score (CDS) at follow‐up were assessed using linear and negative binomial regressions, respectively, with adjustment for age at baseline, gender, and follow‐up duration with and without genotype. Seizure and medication burden were defined by average daily seizure count (high, ≥5/day; low, <5/day) and number of antiseizure medications (high, ≥3/day; low, <3/day), respectively. The effects of change in CDS over time (improved, stable, or deteriorated) on Quality of Life Inventory–Disability (QI‐Disability) total and domain scores at follow‐up were assessed in those aged at least 3 years at follow‐up using linear regression models with adjustment for baseline CDS, gender, and follow‐up duration.

Results

The expected follow‐up CDS was lower for individuals with high compared to low seizure burden at baseline (β = −.49, 95% confidence interval [CI] = −.84 to −.13). The average total QI‐Disability score was 5.6 (95% CI = −.2 to 11.5) points higher among those with improved compared with stable or deteriorating CDS and 8.5 (95% CI = 3.1–13.8) points lower for those with deteriorating compared to stable or improved CDS.

Significance

Our finding that later development showed slight improvement in those with better earlier seizure control even after adjustment for genotype suggests that the trajectory for an individual child is not necessarily predetermined and could possibly be influenced by optimal seizure management. This has implications for children's quality of life.
ESIMD: Epileptic seizure identification using metaheuristic deep learning technique
Authors: Satyender  , Dhull Sanjeev , Singh Krishna Kant
Published: November 2021

The identification of epileptic seizure from electroencephalogram (EEG) segments is significant for seizure identification and classification. In epilepsy, the patients develop epileptic seizures. These lead to neurological disorders and abnormal brain activities. The manual identification of seizures is not very efficient. As the manual analysis of EEG data requires expert neurologists it is prone to inaccuracies. Therefore, automated methods for seizure identification are required. Deep learning methods have shown efficiency in the seizure classification problem. Many challenges are faced by the existing methods owing to the properties of the EEG signals like transiency, non‐stationary behaviour and presence of noise. Therefore, to overcome these challenges and design a highly efficient method an automated method based on deep learning and spotted hyena optimization (SHO) algorithm is proposed. The SHO algorithm is used to initialize the network as it avoids the local minima problem. Epileptic seizure identification using metaheuristic deep learning (ESIMD) is proposed in this paper which is a hybridization of spotted hyena and deep convolution network. The convolutional neural network used has two blocks, the first block is used for feature extraction and the second block for seizure classification. ESIMD is used for seizure detection and classification. The proposed algorithm can handle the complex and large number of features in EEG signals. The performance of the proposed is evaluated by applying it on EEG Bonn Dataset. The results are compared with 13 other conventional methods. The comparative study shows that ESIMD gives higher accuracy than the existing methods.
Relative bioavailability and pharmacokinetic comparison of a fixed‐dose combination tablet of mosapride, pancreatin, and simethicone relative to single‐component mosapride tablets in healthy Mexican subjects
Authors: Camarillo Cárdenas Karen Paola , García González Jessica , Argüelles Tello Federico Alberto , Ocampo Ramírez Jorge Arturo , Moreno Hernández José Belisario , Pendela Murali Mohan
Published: November 2021

Abbott Laboratories de México S.A. de C.V. developed a new fixed‐dose combination of mosapride 5 mg, pancreatin 170 mg, and simethicone 125 mg as an alternative to the mosapride monotherapy to improve overall satisfaction and adequate relief of gastrointestinal disorders symptoms and to reduce multiple pill burden. As a part of the fixed‐dose combination registration process in Mexico, a pharmacokinetic and relative bioavailability study was carried out to demonstrate nonexistence of pharmacokinetic interaction when mosapride is administered alone or in combination with pancreatin and simethicone using DOSIER® (mosapride) 5‐mg tablets as a reference product. Tolerability of the fixed‐dose combination tablet was assessed. In this open‐label, randomized, oral single‐dose, two‐way crossover study, 65 healthy male and female subjects received either the fixed‐dose combination tablet or the reference product during each study period. The two study periods were separated by a 7‐day washout period. Mosapride concentrations in plasma samples were determined using a validated ultra‐performance liquid chromatography coupled with tandem mass spectrometry (UPLC‐MS/MS) method. Blood samples were collected for up to 16 h post dose. The primary evaluation criteria were Cmax and AUC0–t for mosapride. The 90% confidence intervals for the ratio of geometric means for Cmax (96.12% to 110.90%) and AUC0–t (99.07% to 108.06%) were within the defined acceptance limits of 75% to 133% and 80% to 125% for Cmax and AUC0–t, respectively, indicating bioequivalence between the two products. Both products were safe and well tolerated. Therefore, mosapride in combination with pancreatin and simethicone tablet is bioequivalent to mosapride alone, and no new safety signals emerged.
Vertebrate population trends are influenced by interactions between land use, climatic position, habitat loss and climate change
Authors: Williams Jessica J. , Freeman Robin , Spooner Fiona , Newbold Tim
Published: November 2021

Rapid human‐driven environmental changes are impacting animal populations around the world. Currently, land‐use and climate change are two of the biggest pressures facing biodiversity. However, studies investigating the impacts of these pressures on population trends often do not consider potential interactions between climate and land‐use change. Further, a population's climatic position (how close the ambient temperature and precipitation conditions are to the species’ climatic tolerance limits) is known to influence responses to climate change but has yet to be investigated with regard to its influence on land‐use change responses over time. Consequently, important variations across species’ ranges in responses to environmental changes may be being overlooked. Here, we combine data from the Living Planet and BioTIME databases to carry out a global analysis exploring the impacts of land use, habitat loss, climatic position, climate change and the interactions between these variables, on vertebrate population trends. By bringing these datasets together, we analyse over 7,000 populations across 42 countries. We find that land‐use change is interacting with climate change and a population's climatic position to influence rates of population change. Moreover, features of a population's local landscape (such as surrounding land cover) play important roles in these interactions. For example, populations in agricultural land uses where maximum temperatures were closer to their hot thermal limit, declined at faster rates when there had also been rapid losses in surrounding semi‐natural habitat. The complex interactions between these variables on populations highlight the importance of taking intraspecific variation and interactions between local and global pressures into account. Understanding how drivers of change are interacting and impacting populations, and how this varies spatially, is critical if we are to identify populations at risk, predict species’ responses to future environmental changes and produce suitable conservation strategies.
(Un)doing gender in female breadwinner households: Gender relations and structural change
Authors: Sánchez‐Mira Núria
Published: November 2021

The paper explores working class couples' experiences of female‐breadwinning during the Great Recession in Spain. It examines the extent to which couples' adaptations to these gender‐atypical work‐family arrangements have led to processes of (un)doing gender. The study is based on the analysis of 24 semi‐structured biographical interviews and life history calendars with men and women in 12 heterosexual couples who have gone through different breadwinning statuses during their trajectory. Findings show that men whose partners were primary breadwinners for a period make the greatest effort to preserve the male‐breadwinner illusion. In contrast, female breadwinners identify with a co‐breadwinner model and do not understate their own economic contribution. Men's insufficient participation in housework and child care is experienced by women with disapproval, which turns into open conflict when the women perform the bulk of such work. The paper concludes that adaptation to unconventional arrangements can constitute a catalyst for processes that undo gender, but more qualitative longitudinal research is needed to determine how economistic and normative factors interact dynamically across different countries and social groups in shaping these processes.
Changes in the content and antioxidative activity of β‐carotene and its metabolite vitamin A during gastrointestinal digestion and absorption and optimisation of HPLC‐based detection
Authors: Zhuang Shanshan , Zheng Wenxiong , Na Yunong , Chen Naiyi , Gong Fan , Huang Bingxuan , Charles Stephen Brennan , Liu Congyi , Cheng Jian , Ma Lukai , Liu Huifan
Published: November 2021

The β‐Carotene (BC), an important precursor of vitamin A (VA), possesses antioxidant activity but is fat‐soluble and has low bioavailability. In previous in‐vitro assays evaluating antioxidant and 2,2′‐azobis(2‐amidinopropane) dihydrochloride (AAPH) free radical scavenging, both BC and VA showed a strong ability to scavenge radicals and protected cells from oxidative stress. Here, we used artificially simulated gastrointestinal digestion and Caco‐2 cell absorption models to evaluate the bioavailability of the BC during gastrointestinal digestion and absorption using high‐performance liquid chromatography (HPLC) analysis. We observed high absorptive and transfer rates of BC and detected retinol metabolites (Vitamin A). Therefore, BC can be detected in the acidic gastrointestinal environment using HPLC. Optimised method provided better separation of BC and VA in the column, improving the accuracy of the test results.
The Syrian refugee crisis through the lenses of Turkish political discourses: An analysis of deliberations in the Turkish Parliament
Authors: Apaydın Samet , Müftüler‐Baç Meltem
Published: November 2021

Migration has become highly contentious. Turkey is no exception. Turkey faces even further challenges as the host to the world's largest refugee population, with Syrians as the majority. Fear about loss of control over borders, and its subsequent political, economic, social and cultural repercussions lies at the heart of migration debates. Parliamentary deliberations provide a public venue for airing these concerns. The paper focuses on Turkish Parliamentary deliberations on the Syrians to assess its issue salience. To do so, an extensive coding of the Parliamentary debates from 2015 to 2019 is conducted. The paper's rigorous analysis of the Turkish Parliamentary debates on the Syrians reveals multiple findings, uncovering a divide among the five political parties in the Parliament—the AKP, CHP, MHP, Iyi Party and the HDP emphasizing different dimensions. The paper captures the commonalities and differences among these political parties with a systematic empirical study of Turkish Parliamentary debates.
NSW Cannabis Medicines Advisory Service preliminary survey results: enquirer perceptions and patient outcomes
Authors: Graham Myfanwy , Bird Sonia , Howard Zachary , Dobson Michelle , Palazzi Kerrin , Lucas Catherine J. , Schneider Jennifer , Eagar Kathy , Martin Jennifer H.
Published: November 2021

Background

In 2018, an innovative, State government‐funded cannabis medicines drug information service was established for health professionals in New South Wales (NSW). The NSW Cannabis Medicines Advisory Service (CMAS) provides expert clinical guidance and support to medical practitioners considering prescribing a cannabis medicine to their patient(s).

Aims

This research examines quality assurance and patient outcomes related to enquirers' experience with NSW CMAS.

Methods

Data collection involved an online, anonymous survey with two components. Following a health professional enquiry, quality assurance data were collected about the enquirers' experience with NSW CMAS. The second survey focussed on patient outcomes and provides real‐world observational data about cannabis medicines safety and effectiveness across a wide range of indications.

Results

Data collection occurred between January 2020 and June 2021. Preliminary analyses were based on 68 quality assurance and 50 patient outcomes survey responses. General practitioners represented the highest proportion of survey responses (n = 33; 49%). The most common enquiry involved ‘patient‐specific advice’ (n = 50; 74%). Patient‐specific information provided by the service was mainly used for prescribing decision support (n = 45; 90%).

Conclusions

Preliminary findings highlight the impact of an innovative cannabis medicines drug information service in supporting health professional clinical practice in an area of rapid knowledge translation. Quality assurance data indicate that the service is perceived well by the majority of enquirers. Patient outcomes data across a wide range of indications suggest some effectiveness and a reasonable safety profile for prescribed cannabis medicines for most patients.
Conflict resolution in the era of cognitive multicriteria decision‐making: an AHP‐retributive approach
Authors: Vargas Luis G. , Moreno‐Loscertales Cristina , Moreno‐Jiménez José María
Published: November 2021

This paper puts forth the foundation for a different type of negotiation that reflects in a more realistic way the behavior of human beings when making complex decisions, aligned with the cognitive process involved. The positive and the negative aspects of decisions reflect two components in the human brain: the nucleus accumbens and the amygdala. The first component deals with behavior related to rewards or potential gains, and the other with behavior related to risk aversion or potential losses. Negotiations require communication, learning, accommodation of positions, and development of alternatives and modification of constraints. Negotiation support systems help and advice negotiators; structure and analyze the problem; elicit preferences to construct a preference function; visualize different aspects of the problem and the process; and facilitate communication and learning. The methodology used is based on the Analytic Hierarchy Process previously employed in a retributive conflict in which each party calculates the incremental benefits it gets and the costs to its opponent. The Israeli–Palestinian conflict is used to show the viability of the approach and the type of inputs we need to study conflicts with this approach. The negotiation platform that we describe here help the actors to start and engage a negotiation from noncooperative parties. It can also be used in human– negotiations to expedite reaching an agreement if one exists. However, we are not seeking automated negotiations. Advantages and risks of Artificial Intelligence contribution in negotiation support systems for cognitive and retributive conflict resolution based on AHP (CRCR‐AHP) are also discussed.
Effect of an mHealth self‐help intervention on readmission after adult cardiac surgery: Protocol for a pilot randomized controlled trial
Authors: Wynne Rochelle , Nolte Joanne , Matthews Stacey , Angel Jennifer , Le Ann , Moore Andrew , Campbell Tina , Ferguson Caleb
Published: November 2021

Aim

To describe a protocol for the pilot phase of a trial designed to test the effect of an mHealth intervention on representation and readmission after adult cardiac surgery.

Design

A multisite, parallel group, pilot randomized controlled trial (ethics approval: HREC2020.331‐RMH69278).

Methods

Adult patients scheduled to undergo elective cardiac surgery (coronary artery bypass grafting, valve surgery, or a combination of bypass grafting and valve surgery or aortic surgery) will be recruited from three metropolitan tertiary teaching hospitals. Patients allocated to the control group with receive usual care that is comprised of in‐patient discharge education and local paper‐based written discharge materials. Patients in the intervention group will be provided access to tailored ‘GoShare’ mHealth bundles preoperatively, in a week of hospital discharge and 30 days after surgery. The mHealth bundles are comprised of patient narrative videos, animations and links to reputable resources. Bundles can be accessed via a smartphone, tablet or computer. Bundles are evidence‐based and designed to improve patient self‐efficacy and self‐management behaviours, and to empower people to have a more active role in their healthcare. Computer‐generated permuted block randomization with an allocation ratio of 1:1 will be generated for each site. At the time of consent, and 30, 60 and 90 days after surgery quality of life and level of patient activation will be measured. In addition, rates of representation and readmission to hospital will be tracked and verified via data linkage 1 year after the date of surgery.

Discussion

Interventions using mHealth technologies have proven effectiveness for a range of cardiovascular conditions with limited testing in cardiac surgical populations.

Impact

This study provides an opportunity to improve patient outcome and experience for adults undergoing cardiac surgery by empowering patients as end‐users with strategies for self‐help.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000082808.
Promoting Attachment Through Healing (PATH): Results of a retrospective feasibility study providing trauma‐and‐violence‐informed care to pregnant women
Authors: Mantler Tara , Jackson Kimberley T. , Walsh Edmund J. , Jackson Brianna , Baer Jessi R. , Davidson Cara A. , Shillington Katie J. , Parkinson Sarah
Published: November 2021

Aim

To evaluate the impact of a trauma and violence‐informed cognitive behavioural therapy (TVICBT) intervention, compared with standard care on mental health, coping, bonding and maternal‐infant attachment among pregnant women with a history of intimate partner violence and who displayed symptomatology consistent with anxiety, depression or post‐traumatic stress disorder (PTSD).

Design

A mixed‐methods case study design was employed, where women either received standard perinatal care or were referred to a specialized TVICBT program.

Methods

Data were collected through a retrospective obstetric medical chart audit in 2017 at an Ontario hospital in a large urban centre. Multiple choice and ‘yes/no’ questions were analysed using measures of central tendency and dispersion, in addition to frequency counts. Qualitative data from clinical notes were subjected to an inductive content analysis approach to identify key concepts.

Results

In total, 69 women participated (intervention group = 37, standard care group = 32). Prevalence of mental illness between groups was consistent, apart from the TVICBT group having a significant increase in PTSD. In the TVICBT group, 83.8% of women (n = 31) expressed perinatal concerns, compared with only 37.5% (n = 12) of the standard care group. More women in the intervention group (94.6%, n = 35) coped successfully in the intrapartum period than the standard care group (78.1%, n = 25). However, more women in the standard care group (97.0%, n = 31) exhibited appropriate bonding behaviours than the TVICBT group (88.6%, n = 31).

Conclusion

The TVICBT intervention was effective in assisting women to identify triggers during their pregnancy journey, develop appropriate coping strategies and advocate for their needs to best cope.

Impact

TVICBT offers an effective, individualized, trauma and violence‐informed approach to optimize the health outcomes of perinatal women and their infants by promoting positive coping and maternal‐infant bonding, thus filling an existing practice gap of a lack of individualized, trauma‐informed care.
Ambivalence in nurses’ use of the early warning score: A focussed ethnography in a hospital setting
Authors: Mølgaard Rikke R. , Jørgensen Lone , Christensen Erika F. , Grønkjær Mette , Voldbjerg Siri L.
Published: November 2021

Aim

This study describes and explores the influences in registered nurses’ use of early warning scores to support clinical decisions in a hospital setting.

Design

A focussed ethnography allowed for the investigation of registered nurses’ clinical practices in two wards in a Danish University Hospital. The study adhered to the ‘Standards for Reporting Qualitative Research’.

Methods

Participant observation and ethnographic interviews were conducted from March 2019 to August 2019. Ten registered nurses were observed and interviewed, and four physicians were interviewed. Data were analysed using LeCompte and Schensul's ethnographic analysis.

Findings

The findings show the registered nurses’ ambivalence towards the early warning score as a decision support system. Early warning score monitoring created a space for registered nurses to identify and initiate optimized care. However, when early warning scores contradicted registered nurses’ clinical judgments, the latter were given priority in decisions even though elevated scores were not always accounted for in the situation. Moreover, we found unspoken expectations in the collaboration between physicians and registered nurses, which influenced the registered nurses’ workloads and decisions regarding early warning scores.

Conclusion

Registered nurses’ clinical judgment is essential to clinical decisions on the care and safety of patients if used combined with the early warning score. Interprofessional collaboration between registered nurses and physicians about the early warning score is challenged. Future research may address this challenge to explore how it should be operated as a collaboration tool.

Impact

The study adds knowledge to the evidence base of registered nurses’ use of early warning score and the advantages and challenges associated with the use of these scoring systems. The study may provide valuable knowledge for the future development of policies or implementation strategies.
Reduced rank analysis of morphometric and functional traits in Campolina horses
Authors: de Oliveira Bussiman Fernando , Carvalho Rachel Santos Bueno , e Silva Fabyano Fonseca , Ventura Ricardo Vieira , Ferraz José Bento Sterman , Mattos Elisângela Chicaroni , Eler Joanir Pereira , Balieiro Júlio Cesar de Carvalho
Published: November 2021

Multitrait models can increase the accuracy of breeding value prediction and reduce bias due to selection by using traits measured before and after it has occurred. However, as the number of traits grows, a similar trend is expected for the number of parameters to be estimated, which directly affects the computing power and the amount of data required. The aim of the present study was to apply reduced rank (principal components model—PCM) and factor analytical models (FAM), to estimate (co)variance components for nineteen traits, jointly evaluated in a single analysis in Campolina horses. A total of 18 morphometric traits (MT) and one gait visual score (GtS), along with genealogical records of 48,806 horses, were analysed under a restricted maximum likelihood framework. Nine PCM, nine FAM and one standard multitrait model (MTM) were fitted to the data and compared to find the best suitable model. Based on Bayesian information criterion, the best model was the FAM option, considering five common factors (FAM5). After performing an intraclass analysis, none of MT were genetically negatively correlated, whereas GtS was negatively related to all MT, except for the genetic correlations among GtS and BLL, and between GtS and BLLBL (0.01 and 0.10 respectively). From all MT, two traits were derived computing ratios involving other traits, those had negative correlations with others MT, but all favourable for selection. Similar patterns were observed between the genetic parameters obtained from MTM and FAM5 respectively. The heritability estimates ranged from 0.09 (head width) to 0.47 (height at withers). Our results indicated that FAM was efficient to reduce the multitrait analysis dimensionality, and therefore, traits can be combined based on the first three eigenvectors from the additive genetic (co)variance matrix. In addition, there was sufficient genetic variation for selection, benefiting its potential implementation in a breeding program.
Single‐step genomic evaluation of Russian dairy cattle using internal and external information
Authors: Kudinov Andrei A. , Mäntysaari Esa A. , Pitkänen Timo J. , Saksa Ekaterina I. , Aamand Gert P. , Uimari Pekka , Strandén Ismo
Published: November 2021

Genomic data are widely used in predicting the breeding values of dairy cattle. The accuracy of genomic prediction depends on the size of the reference population and how related the candidate animals are to it. For populations with limited numbers of progeny‐tested bulls, the reference populations must include cows and data from external populations. The aim of this study was to implement state‐of‐the‐art single‐step genomic evaluations for milk and fat yield in Holstein and Russian Black & White cattle in the Leningrad region (LR, Russia), using only a limited number of genotyped animals. We complemented internal information with external pseudo‐phenotypic and genotypic data of bulls from the neighbouring Danish, Finnish and Swedish Holstein (DFS) population. Three data scenarios were used to perform single‐step GBLUP predictions in the LR dairy cattle population. The first scenario was based on the original LR reference population, which constituted 1,080 genotyped cows and 427 genotyped bulls. In the second scenario, the genotypes of 414 bulls related to the LR from the DFS population were added to the reference population. In the third scenario, LR data were further augmented with pseudo‐phenotypic data from the DFS population. The inclusion of foreign information increased the validation reliability of the milk yield by up to 30%. Suboptimal data recording practices hindered the improvement of fat yield. We confirmed that the single‐step model is suitable for populations with a low number of genotyped animals, especially when external information is integrated into the evaluations. Genomic prediction in populations with a low number of progeny‐tested bulls can be based on data from genotyped cows and on the inclusion of genotypes and pseudo‐phenotypes from the external population. This approach increased the validation reliability of the implemented single‐step model in the milk yield, but shortcomings in the LR data recording scheme prevented improvements in fat yield.
Setting up a diagram process for the elaboration of a new plant‐based beverage from Pinus halepensis seeds: Selection of unit operations and their conditions
Authors: Abbou Amina , Kadri Nabil , Servent Adrien , Ricci Julien , Madani Khodir , Dornier Manuel , Collignan Antoine , Achir Nawel
Published: November 2021

Aleppo pine seeds are a potential candidate for the production of nondairy milk due to their high protein (26%) and lipid (37%) content and their availability. For the first time, this study presents the implementation of a manufacturing scheme from seeds to final product, including pre‐extraction, extraction, and post‐extraction (physical and microbiological stabilization), using a 2(7‐4) fractional factorial screening design. The seven factors were seed soaking time, grinding time, temperature and seed/water ratio during extraction, xanthan gum concentration, homogenization pressure, and pasteurization temperature. Beverage quality analysis consisted of measurements of chemical composition, color, stability, and rheological behavior. The results of experimental design showed that the dry matter as well as the lipid and protein contents increased significantly by increasing the ratio (grain/water) and the grinding time. On the other hand, the extraction temperature led to a better extraction of lipids but a lower extraction of proteins. Regarding stability, xanthan gum had a negative effect, while homogenization pressure and pasteurization temperature showed their effectiveness in decreasing the particle size and increasing the physical stability of the product.

Practical applications

Plant‐based drinks, also called plant milks, are interesting alternatives to animal milk. They have similar organoleptic properties but are more sustainable and offer very different nutritional composition depending on the plant used. As the consumers demand is constantly increasing, setting up fabrication processes from new plant sources is relevant. Aleppo pine seeds are a potential matrix for the production of vegetable beverages because they are very nutritious and available in the entire Mediterranean area. This study presents the setting up of a fabrication diagram of a plant‐based beverage made from Aleppo pine seeds. Seven production parameters were tested, including pre‐extraction (seed conditioning), extraction, and post‐extraction (physical and microbiological stabilization), thanks to a fractional factorial 2(7‐4) screening design. The best conditions enabled the production of a final beverage comparable to other commercialized plant‐based beverages in terms of nutritional and organoleptic quality.
Clinician knowledge and behaviors related to the 4Ms framework of Age‐Friendly Health Systems
Authors: Lesser Sarah , Zakharkin Stanislav , Louie Christina , Escobedo Marcus R. , Whyte John , Fulmer Terry
Published: November 2021

Background

The Age‐Friendly Health Systems (AFHS) aims to improve the experience of care for adults aged 65 years and older through the 4Ms framework, an evidence‐based approach to care planning that emphasizes what matters most to the older person, mentation, mobility, and medication. The aim of this study was to examine clinicians' attitudes, knowledge, and practices concerning AFHS and the 4Ms.

Methods

We surveyed U.S.‐based health care providers randomly identified from the Medscape database. The sample was weighted based on sex, U.S. Census region, and ethnic diversity of health occupations. We examined the differences between cohorts using proportions tests and logistic regression models.

Results

More than 90% of clinicians (n = 1684) agreed that “older patients require a different approach to care than younger patients.” Fifty percent of clinicians “always” take the age of their patient into consideration when determining care. A majority of clinicians said they discuss each of the 4Ms with older patients and/or their family caregivers. Screening for depression and review of high‐risk medication use are among the leading types of age‐friendly care that clinicians provide to older patients. A minority of clinicians are asking older adults about and aligning the care plan with What Matters.

Conclusions

A majority of clinicians acknowledged the benefits of providing care via AFHS but reported limited knowledge of the specificities of the 4Ms framework and are not necessarily taking the age of their patients into consideration when determining the best form of care. Health care settings that have implemented the 4Ms framework appear to be doing so in an incomplete way. Our study reinforces the case for training primary care providers on how to adopt the evidence‐based 4Ms framework in clinical practice effectively and consistently.
Interaction of brassinosteroid and cytokinin promotes ovule initiation and increases seed number per silique in Arabidopsis
Authors: Zu Song‐Hao , Jiang Yu‐Tong , Chang Jin‐Hui , Zhang Yan‐Jie , Xue Hong‐Wei , Lin Wen‐Hui
Published: November 2021

Ovule initiation is a key step that strongly influences ovule number and seed yield. Notably, mutants with enhanced brassinosteroid (BR) and cytokinin (CK) signaling produce more ovules and have a higher seed number per silique (SNS) than wild‐type plants. Here, we crossed BR‐ and CK‐related mutants to test whether these phytohormones function together in ovule initiation. We determined that simultaneously enhancing BR and CK contents led to higher ovule and seed numbers than enhancing BR or CK separately, and BR and CK enhanced each other. Further, the BR‐response transcription factor BZR1 directly interacted with the CK‐response transcription factor ARABIDOPSIS RESPONSE REGULATOR1 (ARR1). Treatments with BR or BR plus CK strengthened this interaction and subsequent ARR1 targeting and induction of downstream genes to promote ovule initiation. Enhanced CK signaling partially rescued the reduced SNS phenotype of BR‐deficient/insensitive mutants whereas enhanced BR signaling failed to rescue the low SNS of CK‐deficient mutants, suggesting that BR regulates ovule initiation and SNS through CK‐mediated and ‐independent pathways. Our study thus reveals that interaction between BR and CK promotes ovule initiation and increases seed number, providing important clues for increasing the seed yield of dicot crops.
Serum biochemistry panel of free‐living red‐handed howler monkeys (Alouatta belzebul) in the Eastern Amazon
Authors: Guimarães Victor Yunes , Justo André Augusto , Santos Bruna dos , Ramos Marcos Montanha , Takahira Regina Kiomi
Published: November 2021

Background

The red‐handed howler monkey (Alouatta belzebul) is one of 116 imperiled Brazilian primate species. We aimed to determine the serum biochemical profile of free‐ranging red‐handed howler monkeys in a highly disturbed area of the eastern Amazon.

Methods

We obtained serum samples from 26 monkeys, in which we analyzed 20 biochemical variables.

Results and Conclusions

Calcium concentration was significantly lower in adult males (1.82 ± 0.25 mmol/L) than in adult females (2.10 ± 0.50 mmol/L). Both adults (males = 89 ± 85 UI/L, females = 62 ± 23 UI/L) had lower alkaline phosphatase serum activity than juvenile females (178 ± 120 UI/L). Adult male had higher levels of the direct bilirubin (13.9 ± 8.2 µmol/L) and creatinine (74.3 ± 19.4 µmol/L) than juvenile females (5.1 ± 1.4 µmol/L and 38.9 ± 15.0 µmol/L, respectively). This detailed biochemical profile may be useful for the management of red‐handed howler monkeys in the wild and to support further studies at ex situ facilities.
TBC1Domain Family Member 25 deficiency aggravates cerebral ischemia‐reperfusion injury via TAK1‐JNK/p38 pathway
Authors: Zhang Zongyong , Ma Tengfei , Fu Zhengyi , Feng Yu , Wang Zhen , Tian Song , Liu Zhen , Wei Wei , Li Xiang , Chen Jincao , Zhao Wenyuan
Published: November 2021

TBC1Domain Family Member 25 (TBC1D25) is a protein that contains a TBC/RAB‐GTPase activating protein (GAP) domain, which was shown to participate in autophagy in previous studies. However, the role of TBC1D25 in cerebral ischemia‐reperfusion (I/R) injury remains unknown. In this study, we found that the mRNA and protein expression levels of TBC1D25 decreased in mouse brain after I/R injury and primary cortical neurons treated with oxygen and glucose deprivation/reoxygenation (OGD/R). Then TBC1D25 knockout (KO) mice were applied to demonstrate that TBC1D25 ablation aggravated cerebral I/R‐induced neuronal loss and infarct size. In addition, neuronal apoptosis and inflammation were significantly potentiated in the TBC1D25‐KO group. In in vitro OGD/R model, TBC1D25 knockdown can attenuate neuronal cell viability and aggravate the process of inflammation and apoptosis. Conversely, over‐expression of TBC1D25 in primary neurons ameliorated the aforementioned processes. Mechanistically, RNA‐sequencing (RNA‐seq) analysis revealed mitogen‐activated protein kinase (MAPK) signaling pathway was the most significant pathway that contributed to TBC1D25‐mediated brain I/R injury process. Through experimental verification, TBC1D25 deficiency increased the phosphorylation of the transforming growth factor‐β‐activated kinase 1 (TAK1)‐c‐Jun N‐terminal kinase (JNK)/p38 axis in neurons during the brain I/R injury. Furthermore, we found that TAK1 blockade abrogated the apoptosis and inflammatory response produced by TBC1D25 knockdown in vitro. In conclusion, this study is the first to demonstrate the functional significance of TBC1D25 in the pathophysiology of brain I/R injury, and the protective mechanism of TBC1D25 is dependent on the TAK1‐JNK/p38 pathway.

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The efficacy of psychological interventions for depressed primary caregivers of patients with Alzheimer's disease: A systematic review and meta‐analysis
Authors: Liu Xiaofeng , Wang Yanan , Wang Shen
Published: November 2021

Objectives

To systematically evaluate the effectiveness of psychological intervention durations and different psychological interventions on treating depression in primary caregivers of Alzheimer's disease (AD) patients.

Methods

A computerized search of PubMed, Cochrane Library, Embase, Ebsco, Web of Science, CNKI, CSBD, and CSTJ databases on randomized controlled trials (RCTs) of psychological interventions for depressed primary caregivers of AD patients was performed. Depression scores were derived from the Self‐rated Depression Scale (SDS) and the Centre for Epidemiological Studies Depression Scale (CES‐D). The results were analyzed using Revman 5.3 utilizing Trial Sequential Analysis (TSA) software for data analysis.

Results

Eight RCTs involving 857 depressed primary caregivers of AD patients were included in the study. Of the four psychological interventions studied, only three (i.e., cognitive‐behavioral psychological, integrated psychological, and psychological interview intervention) were shown to significantly reduce depression levels in primary caregivers of AD patients after 2‐months, 10‐weeks, and 6‐months of treatment (p ≤ 0.05). It is uncertain that a supportive psychological intervention or a 3‐months psychological intervention reduced the level of depression. Sequential and sensitivity analyses confirmed the reliability of the outcome measures.

Conclusion

Cognitive‐behavioral psychological, integrated psychological, and psychological interview interventions were able to significantly reduce depression levels in primary caregivers of AD patients. These findings reveal that psychological interventions may be a promising means for depressed primary caregivers of patients with AD.

Clinical relevance

For the primary caregivers of AD patients, effective interventions can help reduce psycho‐depressive symptoms and improve the quality of life for the caregivers and the patients. Medical staff may want to use this information to help to provide a more effective guide for primary caregivers in an effort to reduce possible levels of depression.