bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetics and selected pharmacodynamics of morphine and its active metabolites in horses after intravenous administration of four doses
Authors: Hamamoto‐Hardman Briana D. , Steffey Eugene P. , Weiner Daniel , McKemie Daniel S. , Kass Philip , Knych Heather K.
Published: March 2019

The objective of the current study was to describe and characterize the pharmacokinetics and selected pharmacodynamic effects of morphine and its two major metabolites in horses following several doses of morphine. A total of ten horses were administered a single intravenous dose of morphine: 0.05, 0.1, 0.2, or 0.5 mg/kg, or saline control. Blood samples were collected up to 72 hr, analyzed for morphine, and metabolites by LC/MS/MS, and pharmacokinetic parameters were determined. Step count, heart rate and rhythm, gastrointestinal borborygmi, fecal output, packed cell volume, and total protein were also assessed. Morphine‐3 glucuronide (M3G) was the predominant metabolite detected, with concentrations exceeding those of morphine‐6 glucuronide (M6G) at all time points. Maximal concentrations of M3G and M6G ranged from 55.1 to 504 and 6.2 to 28.4 ng/ml, respectively, across dose groups. The initial assessment of morphine pharmacokinetics was done using noncompartmental analysis (NCA). The volume of distribution at steady‐state and systemic clearance ranged from 9.40 to 16.9 L/kg and 23.3 to 32.4 ml min−1 kg−1, respectively. Adverse effects included signs of decreased gastrointestinal motility and increased central nervous excitation. There was a correlation between increasing doses of morphine, increases in M3G concentrations, and adverse effects. Findings from this study support direct administration of purified M3G and M6G to horses to better characterize the pharmacokinetics of morphine and its metabolites and to assess pharmacodynamic activity of these metabolites.
Comparative efficacy of long‐term antibiotic treatments in the primary prophylaxis of spontaneous bacterial peritonitis
Authors: Facciorusso Antonio , Papagiouvanni Ioanna , Cela Marina , Buccino Vincenzo R. , Sacco Rodolfo
Published: March 2019

Background & Aims

Several antibiotic treatments aiming to prevent spontaneous bacterial peritonitis (SBP) in cirrhotic patients with low‐protein content in ascitic fluid have been tested; however, there are limited data on the comparative efficacy of these regimens. We assessed their comparative efficacy through a network meta‐analysis and using GRADE criteria to appraise quality of evidence.

Methods

Through literature review through October 2018, we identified 10 randomized controlled trials comparing antibiotic treatments (norfloxacin, ciprofloxacin, trimethoprim/sulfamethoxazole and rifaximin) with each other or placebo. Primary outcome was SBP occurrence, with mortality rate and rate of other infections as secondary outcomes.

Results

In comparison with placebo, moderate quality evidence supports the use of norfloxacin and ciprofloxacin in primary prophylaxis of SBP (risk ratio 0.23; 95% CI, 0.09‐0.56; P = 0.001 and 0.23; 0.07‐0.79; P = 0.02 respectively) while only low quality evidence suggests superiority of rifaximin (risk ratio 0.15; 0.05‐0.42). When antimicrobial agents were compared to each other, no significant difference was found. With regard to mortality, moderate quality supports the superiority of norfloxacin over placebo (risk ratio, 0.68; 95% CI, 0.47‐0.99; P = 0.04), while ciprofloxacin and rifaximin showed only a non‐significant benefit and no significant difference was found in the other comparisons. None of the tested antibiotics proved to significantly decrease the rate of other infections.

Conclusions

Norfloxacin appears to have significant benefit both in terms of SBP prevention and mortality; ciprofloxacin represents a valuable option although without a clear survival benefit. Rifaximin shows interesting results but needs to be tested in further trials.
The role of toll‐like receptor 4 and mast cell in the ameliorating effect of electroacupuncture on visceral hypersensitivity in rats
Authors: Yang Juan , Shang Boxin , Shi Haitao , Zhu Shanshan , Lu Guolong , Dai Fei
Published: March 2019

Background

Visceral hypersensitivity is one of the main pathogenesis of irritable bowel syndrome (IBS) and mast cell activation is closely related to visceral hypersensitivity. As a critical molecule of the innate immune system, toll‐like receptor 4 (TLR4) may modulate the activation of mast cell. Alleviating effect of electroacupuncture (EA) on visceral hypersensitivity has been proved, whereas, whether the TLR4 and mast cell is involved in this process remains unclear.

Methods

Forty Sprague‐Dawley rats were randomly divided into five groups: control group, model group, EA group, sham EA group, and mast cell stabilizer (MCS) group. Visceral sensitivity during colorectal distension was assessed by the measurement of visceral motor reflex (VMR). TLR4 mRNA and protein expression were assessed by real‐time PCR and immunohistochemistry, respectively. Mast cell number and mast cell tryptase (MCT) expression were detected. The level of inflammatory cytokine in serum was detected with ELISA.

Key Results

Visceral sensitivity was significantly higher in the model group than in the control group. EA and MCS significantly reduced VMR score at 0.8 mL and 1.2 mL distention pressures. Compared with model group, TLR4 mRNA expression, the protein expression of TLR4 and MCT, and the number of mast cells with degranulation in the colonic tissue, serum concentration of IL‐1β and IL‐8 were all significantly decreased in EA and MCS group.

Conclusions & Inferences

Electroacupuncture ameliorated visceral hypersensitivity in colon‐sensitized model probably via decreasing the level of pro‐inflammatory cytokines released by mast cell which were decreased when the TLR4 expression in the colonic tissue was downregulated by EA.
DNA methylation in Marchantia polymorpha
Authors: Aguilar‐Cruz Adolfo , Grimanelli Daniel , Haseloff Jim , Arteaga‐Vázquez Mario Alberto
Published: March 2019

Methylation of DNA is an epigenetic mechanism for the control of gene expression. Alterations in the regulatory pathways involved in the establishment, perpetuation and removal of DNA methylation can lead to severe developmental alterations. Our understanding of the mechanistic aspects and relevance of DNA methylation comes from remarkable studies in well‐established angiosperm plant models including maize and Arabidopsis. The study of plant models positioned at basal lineages opens exciting opportunities to expand our knowledge on the function and evolution of the components of DNA methylation. In this Tansley Insight, we summarize current progress in our understanding of the molecular basis and relevance of DNA methylation in the liverwort Marchantia polymorpha.
DNA methylation repatterning accompanying hybridization, whole genome doubling and homoeolog exchange in nascent segmental rice allotetraploids
Authors: Li Ning , Xu Chunming , Zhang Ai , Lv Ruili , Meng Xinchao , Lin Xiuyun , Gong Lei , Wendel Jonathan F. , Liu Bao
Published: March 2019

Allopolyploidization, which entails interspecific hybridization and whole genome duplication (WGD), is associated with emergent genetic and epigenetic instabilities that are thought to contribute to adaptation and evolution. One frequent genomic consequence of nascent allopolyploidization is homoeologous exchange (HE), which arises from compromised meiotic fidelity and generates genetically and phenotypically variable progenies.

Here, we used a genetically tractable synthetic rice segmental allotetraploid system to interrogate genome‐wide DNA methylation and gene expression responses and outcomes to the separate and combined effects of hybridization, WGD and HEs.

Progenies of the tetraploid rice were genomically diverse due to genome‐wide HEs that affected all chromosomes, yet they exhibited overall methylome stability. Nonetheless, regional variation of cytosine methylation states was widespread in the tetraploids. Transcriptome profiling revealed genome‐wide alteration of gene expression, which at least in part associates with changes in DNA methylation. Intriguingly, changes of DNA methylation and gene expression could be decoupled from hybridity and sustained and amplified by HEs.

Our results suggest that HEs, a prominent genetic consequence of nascent allopolyploidy, can exacerbate, diversify and perpetuate the effects of allopolyploidization on epigenetic and gene expression variation, and hence may contribute to allopolyploid evolution.
Characteristics of symptomatic recurrent tachyarrhythmia after thoracoscopic ablation for persistent atrial fibrillation
Authors: Gwag Hye Bin , Jeong Dong Seop , Hwang Jin Kyung , Park Seung‐Jung , On Young Keun , Kim June Soo , Park Kyoung‐Min
Published: March 2019

Background

Recurrent atrial tachyarrhythmia (ATa) is a challenge in all ablation procedures for atrial fibrillation (AF). However, data on ATa after totally thoracoscopic ablation (TTA) is lacking. This study aimed to investigate the mechanisms and outcomes of recurrent ATa after TTA.

Methods

Eligible patients for the present study were those who underwent electrophysiologic study and catheter‐based radiofrequency ablation (RFA) at least 3 months after TTA for symptomatic recurrent ATa that was refractory to antiarrhythmic drugs and/or cardioversion. Follow‐up outcomes included recurrent ATa after first or repeated RFA.

Results

A consecutive 154 TTA patients were evaluated. A total of 24 patients showed symptomatic recurrent ATa after TTA, and 22 underwent RFA. Half of the patients (11/22, 50%) had AF as a form of recurrent ATa. Nonpulmonary vein (PV)‐related mechanisms of ATa were noted in half of patients. PV gaps showed a characteristic distribution: most gaps in right PVs were located at the posterior ridge (71.4%) with the posterior ridge of left PVs saved in all patients. Post‐RFA recurrence rate was 27.3% during a median follow‐up of 9.1 months, with all recurrences except for one occurring within 3 months after first RFA.

Conclusions

During a median of 17.8 months after TTA, 24 patients (24/154, 15.6%) developed symptomatic recurrent ATa, and 22 patients underwent RFA. Post‐RFA recurrence rate was 27.3%, which mostly occurred within 3 months after RFA. Catheter‐based ablation of recurrent arrhythmias may be effective, but challenging.
Drug reaction with eosinophilia and systemic symptoms in a cohort of Asian children
Authors: Han Xiuhui D. , Koh Mark J.‐A. , Wong Sharon M.Y.
Published: March 2019

Background/objectives

Drug reaction with eosinophilia and systemic symptoms (DRESS) is rare but potentially fatal in children. Fever and rash, which are salient features of DRESS, may mimic other commonly encountered pediatric conditions. We profiled the DRESS cases in a tertiary children's hospital in Singapore.

Methods

The medical records of all pediatric DRESS patients diagnosed from 2006 to 2016. Data on epidemiology, inciting drugs, clinical, pathologic manifestations, and treatment were assessed.

Results

Ten patients aged 4‐16 years old were diagnosed with DRESS within the 10‐year period. Drugs implicated were antibiotics, such as trimethoprim‐sulfamethoxazole, and anticonvulsants, such as carbamazepine, phenobarbitone, and levetiracetam. All patients had fever and pruritic exanthems. Desquamation, purpura, and oral mucositis were also observed. Lymphadenopathy, hepatomegaly, and facial edema occurred frequently. There was liver involvement in all cases, but none progressed to liver failure. Seven patients had eosinophilia, and nine had atypical lymphocytosis. Other laboratory abnormalities included low hemoglobin, thrombocytosis, and prolonged coagulation times. All patients received systemic corticosteroids of varying durations and dosages. Systemic steroids were weaned after 19 days to 4 months. Disease resolution, with liver enzyme levels returning to normal, occurred within 28‐90 days. One patient developed TSH‐receptor‐antibody‐positive hyperthyroidism 6 months after the onset of DRESS, while another patient developed chronic urticaria 4 months after resolution of DRESS.

Conclusion

Early recognition of DRESS is important to ensure that the inciting drug is discontinued, and supportive treatment started expediently. Liver involvement was very common but responded well to systemic steroids.
Use of dried urine spots for screening of inborn errors of bile acid synthesis
Authors: Naritaka Nakayuki , Suzuki Mitsuyoshi , Takei Hajime , Chen Huey‐Ling , Oh Seek‐hi , Kaewplang Pinyada , Zhang Chunhua , Murai Tsuyoshi , Kurosawa Takao , Kimura Akihiko , Shimizu Toshiaki , Nittono Hiroshi
Published: March 2019

Background

In pediatric patients with cholestasis of unknown cause, inborn errors of bile acid (BA) synthesis (IEBAS) may be considered. For the initial screening for IEBAS, clarification of the urine BA profile is essential. The transportation of urine in a frozen state via air delivery, however, is laborious and costly. This study assessed the feasibility of using dried urine spots (DUS) to establish a more convenient and affordable method of IEBAS screening.

Methods

We created DUS using urine samples from patients with 3β‐hydroxy‐Δ5‐C27‐steroid dehydrogenase/isomerase deficiency (3β‐HSD) and Δ4‐3‐oxo‐steroid 5β‐reductase deficiency as standard preparations. We started accepting DUS specimens by regular mail.

Results

The ratio of unusual to usual BA is essential for the initial detection of IEBAS, and the recovery rates of abnormal BA were acceptable. The recovery rate of Δ4‐BA on day 28 decreased to 31.8% at 25°C, and to 19.6% at 37°C. Therefore, the sending of DUS should be avoided under conditions of high temperature. Of a total of 49 children with cholestasis, eight new patients were diagnosed with IEBAS using this screening method.

Conclusion

The mailing screening system is expected to facilitate the shipment, from regions outside of Japan, of samples for IEBAS screening.
Commitment in relationships: An updated meta‐analysis of the Investment Model
Authors: Tran Peter , Judge Madeline , Kashima Yoshihisa
Published: March 2019

This article provides a systematic review and updated meta‐analysis of the extant literature on Rusbult's Investment Model of Commitment. This meta‐analysis aimed to determine the strength of the associations between commitment and its antecedents and to investigate potential moderators of these associations. This meta‐analysis included 50,427 participants from 202 independent samples (collected between 1980 and early 2016) that had examined the intercorrelations between satisfaction, investment size, quality of alternatives, and commitment. Across all studies, satisfaction had the largest aggregate association with commitment (r = 0.65), followed by investments (r = 0.53) and quality of alternatives (r = −0.43). Several significant moderators of the relationships between the antecedents and commitment were also identified. Implications and future research directions are discussed.
Love as story, love as storytelling
Authors: Dunlop William L.
Published: March 2019

Across three studies, individual differences in the degree to which (a) participants enjoyed autobiographical storytelling with their romantic partners (storytelling enjoyment [SE]) and (b) thought about these relationships in narrative terms (narrative mindset [NM]) were examined in relation to psychological functioning and romantic relationship narratives. Drawing data from over 1,650 participants, relationship satisfaction, certain positive personality traits, and a dimension of secure attachment corresponded with both SE and NM. SE and NM also related to features of participants' relationship narratives. Storytelling and applying a NM to one's love life may carry implications for functioning within the romantic domain.
Trichodysplasia spinulosa mimicking lichen nitidus in a renal transplant patient
Authors: Barone Hope , Brockman Ross , Johnson Luke , Al‐Uzri Amira , Wright Mary , Mengden‐Koon Stephanie , Funk Tracy
Published: March 2019

Trichodysplasia spinulosa (TS) is a rare cutaneous condition associated with the TSPyV and characterized by skin‐colored, folliculocentric papules with keratin spicule formation. TS is seen almost exclusively in immunosuppressed individuals, often presenting in patients with a history of solid organ transplantation or chemotherapy for a lymphoreticular malignancy. We report a case of widespread TS in a 9‐year‐old girl with a history of renal transplantation complicated by BK viremia, which is also caused by a polyomavirus, BKPyV. The clinical presentation of TS in this case morphologically resembled the more common, harmless skin condition known as “lichen nitidus,” and was more extensive than expected for TS, creating a diagnostic challenge. This case illustrates an important presentation of severe TS of which transplant teams, oncologists, primary care providers, and dermatologists should be aware.
The Presentational Use of Descriptions
Authors: Hicks Michael R
Published: March 2019

Discussing Keith Donnellan's distinction between attributive and referential uses of descriptions, Gareth Evans considered a speaker he found it natural to describe as having “given expression to” a singular thought, though he insisted she was not referring to the person she has in mind. On accounts otherwise similar to Evans's, to express a singular thought just is to refer. Thus, as he does not explain why this speaker might speak this way, it is tempting to ignore this as a slip. On the contrary, I shall argue, Evans has good reason to deny that picture of reference. My interest, though, is in the case itself. It turns out it is apresentationaluse of descriptions: it provides its audience a cognitive ability they would otherwise lack. This characterization raises deep theoretical questions which I only begin to address here. My goal is to show that weoughtto address those questions, for there is no better way of understanding examples like Evans's than to see them as presentational.
Does smoking during pregnancy mediate educational disparities in preterm delivery? Findings from three large birth cohorts
Authors: Poulsen Gry , Andersen Anne‐Marie Nybo , Jaddoe Vincent W. V. , Magnus Per , Raat Hein , Stoltenberg Camilla , Osler Merete , Mortensen Laust Hvas
Published: March 2019

Background

Socio‐economic disparities in preterm delivery have often been attributed to socially patterned smoking habits. However, most existing studies have used methods that potentially give biased estimates of the mediating effect of smoking. We used a contemporary mediation approach to study to which extent smoking during pregnancy mediates educational disparities in preterm delivery.

Methods

We performed a comparative analysis of data from three large birth cohort studies: the Danish National Birth Cohort (DNBC), the Dutch Generation R Study, and the Norwegian Mother and Child Cohort Study (MoBa). Risk of preterm delivery by maternal education is reported as risk differences and decomposed into a part explained by smoking and a part explained by other pathways.

Results

Proportions of preterm singleton deliveries were 4.8%‐4.9% in all three cohorts. Total effects of maternal education were 2.0 (95% confidence interval [CI] 1.4, 2.5), 3.2 (95% CI 0.8, 5.2) and 2.0 (95% CI 0.9, 3.0) excess preterm deliveries per 100 singleton deliveries in DNBC, Generation R and MoBa when comparing primary/lower secondary education to an academic degree or equivalent. Smoking mediated, respectively, 22%, 10% and 19% of the excess risk in the DNBC, Generation R and MoBa cohorts. Adjustment for potential misclassification of smoking only increased mediated proportions slightly.

Conclusions

Smoking during pregnancy explains part of educational disparities in preterm delivery, but the mediated proportion depends on the educational gradient in smoking, emphasising that educational disparities in preterm birth may be mediated by different risk factors in different countries.
Metre‐scale cycles in shallow water carbonate successions: Milankovitch and stochastic origins
Authors: Kemp David B. , Van Manen Saskia M.
Published: March 2019

Metre‐scale cycles are a common feature in Precambrian and Phanerozoic shallow water carbonate successions, and astronomically forced changes in sea‐level (Milankovitch cycles) may have been an important driver controlling their deposition. Nevertheless, the degree to which potentially low amplitude astronomically paced sea‐level oscillations may have controlled carbonate accumulation in deep time is unclear. In this study, a stochastic model of carbonate accumulation demonstrates how metre‐scale exposure‐bound sequences can be generated under conditions of random sea‐level change. These sequences have characteristic durations close to Milankovitch cycles, despite the absence of any astronomical control on their formation. Metre‐scale sequences with sub‐Milankovitch (millennial‐scale) durations can also be generated by the model, potentially shedding light on the origin of sub‐Milankovitch sequences such as those recorded on the Middle Triassic Latemar platform of Northern Italy. Sensitivity tests demonstrate how shallow water carbonates may be very sensitive to weak (i.e. low amplitude) astronomically forced sea‐level oscillations. Notably, strong statistical evidence (P < 0·01) for astronomical cycles can be preserved in modelled successions even when astronomical forcing contributes <1% of the sea‐level variance on million year timescales. Taken together, metre‐scale cycles with Milankovitch‐scale durations in ancient carbonate successions may reveal very little about the amplitude, or even the existence, of astronomical forcing as a sea‐level driver.
Circulating CD137+CD8+ T cells accumulate along with increased functional regulatory T cells and thoracic tumour burden in lung cancer patients
Authors: Nong Jingying , Wang Jinghui , Gao Xin , Zhang Qi , Yang Bin , Yan Zhuohong , Wang Xiaojue , Yi Ling , Wang Qunhui , Gao Yuan , Hu Aimin , Qin Na , Wei Panjian , Zhang Hongtao , Zhang Shucai
Published: March 2019

CD137 is a promising target for immunostimulation strategies against cancer. Previous studies showed that CD137+CD8+ T cells are enriched in antitumour effector T cells in both preclinical tumour models and cancer patients, but to date, such T cells in the blood of lung cancer patients have not been sufficiently investigated. In this study, circulating antigen‐activated CD8+ T cell subsets, identified as CD137+CD8+ or PD‐1+ (programmed cell death protein 1) CD8+, and regulatory T cells (Treg), identified as CD4+CD25+CD127low/−, in 40 untreated lung cancer patients and in 49 age‐ and sex‐matched healthy controls (HCs) were assessed by flow cytometry. Results were evaluated for associations with lung cancer patient clinical characteristics. Correlations between antigen‐activated CD8+ T cells and effector Treg (CTLA‐4+ [cytotoxic T‐lymphocyte antigen 4] CD4+CD25+CD127low/−) were also investigated. Higher percentages of PD‐1+, CD137+ and PD‐1+CD137+ amongst CD8+ T cells were observed in lung cancer patients compared with HCs. The percentages of CD137+CD8+ and PD‐1+CD137+CD8+ T cell subsets amongst CD8+ T cells were positively correlated with thoracic tumour burden and were strongly positively correlated with the percentage of effector Treg subset. Smoking patients harboured higher percentages of the PD‐1+CD8+ T cell subset compared with non‐smoking patients. This study demonstrated that circulating antigen‐activated CD8+ T cells accumulated in lung cancer patients along with increased effector Treg and thoracic tumour burden. These findings aid a better understanding of immune‐host interactions in lung cancer patients using peripheral blood, and further support immunotherapeutic intervention strategies using combination therapy for differential control of Treg and activation of tumour‐specific effector T cells.
Why self‐regulation success is not the opposite of failure
Authors: Kroese Floor M.
Published: March 2019

Inspired by some of current Western societies' most pressing problems, much research attention has been devoted to understanding self‐regulation failure. While this has yielded some very valuable insights, the current paper underlines that understanding self‐regulation failure does not mean that we also understand self‐regulation success. Whereas failure and success are semantic antonyms, in terms of self‐regulation research, they should not be regarded as mere opposites. First, on the process level, self‐regulation success versus failure is not simply a matter of inverse explanatory factors (e.g., the capacity to inhibit impulses vs. a lack thereof). Second, on the outcome level, self‐regulation success versus failure is not strictly a matter of inverse behavioral action (e.g., abstaining from versus indulging in immediate gratification). This has significant implications, the most important one being that to understand self‐regulation success, researchers need to take a more holistic perspective rather than mainly considering single instances when studying self‐regulation.
The narrative identity approach and romantic relationships
Authors: Bühler Janina Larissa , Dunlop William L.
Published: March 2019

Narrative identity is an internal and evolving life story in which the narrator integrates conceptions of the personal past, present, and presumed future within a coherent story‐based framework. Carrying a number of personal and social implications, this construct represents a psychological resource. We contend that, like life itself, one's history within the romantic domain as well as one's current romantic relationship(s) are often viewed using story‐based frameworks. As such, we argue that the greater adoption of the narrative identity approach within the close relationships literature would complement and extend current assessment paradigms used to study romantic relationships. In this article, we outline the conceptual and methodological background of the narrative identity approach. This is followed by a brief review of extant research using narrative methodologies in the study of romantic relationships. Finally, a series of current and future research directions are presented that rest at the nexus between the narrative identity approach and the study of romantic relationships. We conclude that the more extensive integration of the narrative identity approach within the close relationships literature would contribute to the understanding of such relationships. This is a story worth telling.
Decolonising The Geographical Tradition
Authors: Craggs Ruth
Published: March 2019

The Geographical Tradition played a key role in highlighting geography's imperialism in the 19th and early 20th centuries and prompted a wave of necessary research into the discipline's colonial and racist past. However, both the book itself and the scholarship it subsequently inspired have overlooked the role of geographers from the Global South almost entirely, reinforcing geography's exclusionary traditions. More inclusive disciplinary histories that embrace the contributions of scholars from the post‐colonial world in their contents and reference lists, and that tackle directly not only the history of ideas, but also broader, crucial, questions about academic labour, might be better able to contribute to the challenge of “decolonising” the discipline today.
Statistics do sweat: Situated messiness and spatial science
Authors: van Meeteren Michiel
Published: March 2019

David Livingstone's The Geographical Tradition remains a landmark in geographic historiography. This commentary argues that Livingstone contravened his own methodology when discussing geography's spatial science era. After situating the book in its own spatiotemporal context, I suggest elements that could enrich a contemporary account of the spatial science era sensitive to Livingstone's methodological approach.
Effects of Implementing a Health Team Communication Redesign on Hospital Readmissions Within 30 Days
Authors: Opper Kristi , Beiler Joseph , Yakusheva Olga , Weiss Marianne
Published: March 2019

Background and Rationale

Poor communication between health team members can interfere with timely, coordinated preparation for hospital discharge. Research on daily bedside interprofessional health team rounds and nursing bedside shift handoff reports provides evidence that these strategies can improve communication.

Aims

To improve health team communication and collaboration about hospital discharge; improve patient experience of discharge measured by patient‐reported quality of discharge teaching, readiness for discharge, and postdischarge coping difficulty; and reduce readmissions and emergency department (ED) visits postdischarge.

Methods

A two‐sample pre‐ and postintervention design provided baseline data for redesign of health team communication processes and comparison data for evaluation of the new process’ impact. Health team members (n = 105 [pre], n = 95 [post]) from two surgical units of an academic medical center in the midwestern United States provided data on discharge‐related communication and collaboration. Patients (n = 413 [pre], n = 191 [post]) provided data on their discharge experience (quality of discharge teaching, readiness for discharge, postdischarge coping difficulty) and outcomes (readmissions, ED visits). Chi‐square and t tests were used for unadjusted pre‐ and postintervention comparisons. Logistic regression of readmissions with a matched pre‐ and postintervention sample included adjustments for patient characteristics and hospitalization factors.

Results

Readmissions decreased from 18% to 12% (p < .001); ED visits decreased from 4.4% to 1.5% (p < .001). Changes in health team communication and collaboration and patients’ experience of discharge were minimal.

Discussion

The targeted outcomes of readmission and ED visits improved after the health team communication process redesign. The process indicators did not improve; potential explanations include unmeasured hospital and unit discharge, and other care process changes during the study timeframe.

Linking Evidence to Practice

Evidence from daily interprofessional team bedside rounding and bedside shift report studies was translated into a redesign of health team communication for discharge. These strategies support readmission reduction efforts.
Nonpharmacological Interventions for Cancer‐Related Fatigue: A Systematic Review and Bayesian Network Meta‐Analysis
Authors: Wu Chunxiao , Zheng Yan , Duan Yuting , Lai Xin , Cui Shaoyang , Xu Nenggui , Tang Chunzhi , Lu Liming
Published: March 2019

Background

Nonpharmacological interventions are the first recommendation for cancer‐related fatigue, according to current guidelines. There are many forms of nonpharmacological interventions for addressing cancer‐related fatigue, but the preferred means remain controversial and are not stated in the guidelines. Therefore, we evaluated the comparative effects and ranks of all major nonpharmacological interventions, according to different assessment methods, in cancer patients with fatigue.

Methods

Medline, Embase, Cochrane Library, and Allied and Complementary Medicine Database were searched for randomized controlled trials on nonpharmacological treatments for cancer‐related fatigue. We assessed the trials’ methodological quality using the Cochrane Risk of Bias tool. A Bayesian network meta‐analysis and a comparative effects ranking were performed with Aggregate Data Drug Information System software.

Results

A total of 16,675 items were obtained from the databases, and 182 studies comprising 18,491 participants were included in the analysis. Based on the ranking probabilities, multimodal therapy and qigong ranked best with a Brief Fatigue Inventory; for a Functional Assessment of Cancer Therapy‐fatigue scale, combined psychosocial therapies and bright white light therapy ranked best; for the Piper Fatigue Scale, resistance exercise and mindfulness‐based stress reduction ranked best; for a multidimensional fatigue inventory, multimodal therapy and cognitive behavioral therapy (CBT) ranked best; for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30), acupuncture and CBT ranked best; and for the Profile of Mood States Fatigue Subscale, multimodal therapy, qigong, aerobic exercise, and CBT ranked best. Comprehensive analysis of the results indicated that multimodal therapy, CBT, and qigong might be the optimum selections for reducing cancer‐related fatigue. Most of the included studies had low risk of methodological quality problems; however, 59 studies had low methodological quality.

Linking Evidence to Action

Different interventions have their own sets of advantages for addressing cancer‐related fatigue. These results can be utilized as evidence‐based interventions for healthcare workers and patients to manage cancer‐related fatigue.
Patient, Nurse, and Organizational Factors That Influence Evidence‐Based Fall Prevention for Hospitalized Oncology Patients: An Exploratory Study
Authors: Tucker Sharon , Sheikholeslami Deborah , Farrington Michele , Picone Debra , Johnson Janis , Matthews Grace , Evans Rhonda , Gould Renee , Bohlken Deborah , Comried Lynn , Petrulevich Kelly , Perkhounkova Elena , Cullen Laura
Published: March 2019

Background

Hospital falls remain common despite decades of studies and guidelines to reduce their rate. Research evidence alone is insufficient, and integration of patient values and preferences, clinician expertise and experiences, and organizational culture is needed to ensure sustainable practice changes. Little is known about the best strategies for integrating these constructs to sustain effective fall prevention programs.

Aims

Guided by the Comprehensive Framework for Implementation Research (CFIR), this study aimed to identify patient, nursing staff, and organizational‐level factors that influence effective and sustainable fall prevention strategies with the goal of identifying variables amenable to targeted interventions.

Methods

A descriptive research design engaged four oncology units in a Midwestern academic medical center and included patients (N = 39) and nursing staff (N = 70). Questionnaire data were collected from patients with interview assistance, and nursing staff completed a demographic form and two standardized instruments adapted for the study. Data were analyzed using descriptive statistics and narrative summaries.

Results

Findings indicated two‐thirds of patients did not see themselves at risk for falling, despite nearly half having a fall history. Nursing staff indicated knowledge gaps related to specific known risks and interventions, and confidence in fall prevention management was lowest for team communication about patient risks and engaging patients and families in preventing falls.

Linking Evidence to Action

Engagement of patients in fall risk assessment and management, clear and routine communication among team members, and creating a culture of true engagement with appropriate leadership and resources can potentially improve the sustainability of successful fall prevention programs. The CFIR can guide the planning of fall prevention and other evidence‐based practice changes to become hardwired and sustainable over time even with the ongoing introduction of new initiatives.
5‐HT2A receptor activation enhances NMDA receptor‐mediated glutamate responses through Src kinase in the dendrites of rat jaw‐closing motoneurons
Authors: Dantsuji Masanori , Nakamura Shiro , Nakayama Kiyomi , Mochizuki Ayako , Park Sook Kyung , Bae Yong Chul , Ozeki Masahiko , Inoue Tomio
Published: March 2019

Key points

5‐HT increases the excitability of brainstem and spinal motoneurons, including the jaw‐closing motoneurons, by depolarizing the membrane potential and decreasing the medium‐duration afterhyperpolarization.

In this study, we focused on how 5‐HT enhances postsynaptic glutamatergic responses in the dendrites of the jaw‐closing motoneurons.

We demonstrate that 5‐HT augments glutamatergic signalling by enhancing the function of the GluN2A‐containing NMDA receptor (NMDAR) through the activation of 5‐HT2A receptors (5‐HT2ARs) and Src kinase.

To enhance glutamatergic responses, activation of the 5‐HT2ARs must occur within ∼60 μm of the location of the glutamate responses.

5‐HT inputs to the jaw‐closing motoneurons can significantly vary their input–output relationship, which may contribute to wide‐range regulation of contractile forces of the jaw‐closing muscles.

Various motor behaviours are modulated by 5‐HT. Although the masseter (jaw‐closing) motoneurons receive both glutamatergic and serotonergic inputs, it remains unclear how 5‐HT affects the glutamatergic inputs to the motoneuronal dendrites. We examined the effects of 5‐HT on postsynaptic responses evoked by single‐ or two‐photon uncaging of caged glutamate (glutamate responses) to the dendrites of masseter motoneurons in postnatal day 2–5 rats of either sex. Application of 5‐HT induced membrane depolarization and enhanced the glutamate‐response amplitude. This enhancement was mimicked by the 5‐HT2A receptor (5‐HT2AR) agonist and was blocked by the 5‐HT2A/2CR antagonist. However, neither the 5‐HT2BR nor the 5‐HT2CR agonists altered glutamate responses. Blockade of the NMDA receptors (NMDARs), but not AMPA receptors, abolished the 5‐HT‐induced enhancement. Furthermore, the selective antagonist for the GluN2A subunit abolished the 5‐HT‐induced enhancement. 5‐HT increased GluN2A phosphorylation, while the Src kinase inhibitor reduced the 5‐HT‐induced enhancement and GluN2A phosphorylation. When exposure to the 5‐HT2AR agonist was targeted to the dendrites, the enhancement of glutamate responses was restricted to the loci of the dendrites near the puff loci. Electron microscopic immunohistochemistry revealed that both the NMDARs and the 5‐HT2ARs were close to each other in the same dendrite. These results suggest that activation of dendritic 5‐HT2ARs enhances the function of local GluN2A‐containing NMDARs through Src kinase. Such enhancement of the glutamate responses by 5‐HT may contribute to wide‐range regulation of contractile forces of the jaw‐closing muscles.
Basal forebrain GABAergic innervation of olfactory bulb periglomerular interneurons
Authors: Sanz Diez Alvaro , Najac Marion , De Saint Jan Didier
Published: March 2019

Key points

Basal forebrain long‐range projections to the olfactory bulb are important for olfactory sensitivity and odour discrimination.

Using optogenetics, it was confirmed that basal forebrain afferents mediate IPSCs on granule and deep short axon cells. It was also shown that they selectively innervate specific subtypes of periglomerular (PG) cells.

Three different subtypes of type 2 PG cells receive GABAergic IPSCs from the basal forebrain but not from other PG cells.

Type 1 PG cells, in contrast, do not receive inputs from the basal forebrain but do receive inhibition from other PG cells.

These results shed new light on the complexity and specificity of glomerular inhibitory circuits, as well as on their modulation by the basal forebrain.

Olfactory bulb circuits are dominated by multiple inhibitory pathways that finely tune the activity of mitral and tufted cells, the principal neurons, and regulate odour discrimination. Granule cells mediate interglomerular lateral inhibition between mitral and tufted cells’ lateral dendrites whereas diverse subtypes of periglomerular (PG) cells mediate intraglomerular lateral inhibition between their apical dendrites. Deep short axon cells form broad intrabulbar inhibitory circuits that regulate both populations of interneurons. Little is known about the extrabulbar GABAergic circuits that control the activity of these various interneurons. We examined this question using patch‐clamp recordings and optogenetics in olfactory bulb slices from transgenic mice. We showed that axonal projections emanating from diverse basal forebrain GABAergic neurons densely project in all layers of the olfactory bulb. These long‐range GABAergic projections provide a prominent synaptic input on granule and short axon cells in deep layers as well as on selective subtypes of PG cells. Specifically, three different subclasses of type 2 PG cells receive robust and target‐specific basal forebrain inputs but have little local interactions with other PG cells. In contrast, type 1 PG cells are not innervated by basal forebrain fibres but do interact with other PG cells. Thus, attention‐regulated basal forebrain inputs regulate inhibition in all layers of the olfactory bulb with a previously overlooked synaptic complexity that further defines interneuron subclasses.
Tensor Train Accelerated Solvers for Nonsmooth Rigid Body Dynamics
Authors: Corona Eduardo , Gorsich David , Jayakumar Paramsothy , Veerapaneni Shravan
Published: March 2019

In the last two decades, increased need for high-fidelity simulations of the time evolution and propagation of forces in granular media has spurred a renewed interest in the discrete element method (DEM) modeling of frictional contact. Force penalty methods, while economic and widely accessible, introduce artificial stiffness, requiring small time steps to retain numerical stability. Optimization-based methods, which enforce contacts geometrically through complementarity constraints leading to a differential variational inequality problem (DVI), allow for the use of larger time steps at the expense of solving a nonlinear complementarity problem (NCP) each time-step. We review the latest efforts to produce solvers for this NCP, focusing on its relaxation to a cone complementarity problem (CCP) and solution via an equivalent quadratic optimization problem with conic constraints. We distinguish between first-order methods, which use only gradient information and are thus linearly convergent and second-order methods, which rely on a Newton type step to gain quadratic convergence and are typically more robust and problem-independent. However, they require the approximate solution of large sparse linear systems, thus losing their competitive advantages in large scale problems due to computational cost. In this work, we propose a novel acceleration for the solution of Newton step linear systems in second-order methods using low-rank compression based fast direct solvers, leveraging on recent direct solver techniques for structured linear systems arising from differential and integral equations. We employ the quantized tensor train (QTT) decomposition to produce efficient approximate representations of the system matrix and its inverse. This provides a versatile and robust framework to accelerate its solution using this inverse in a direct or a preconditioned iterative method. We demonstrate compressibility of the Newton step matrices in primal dual interior point (PDIP) methods as applied to the multibody dynamics problem. Using a number of numerical tests, we demonstrate that this approach displays sublinear scaling of precomputation costs, may be efficiently updated across Newton iterations as well as across simulation time steps, and leads to a fast, optimal complexity solution of the Newton step. This allows our method to gain an order of magnitude speedups over state-of-the-art preconditioning techniques for moderate to large-scale systems, hence mitigating the computational bottleneck of second-order methods.
Clinical and sonographic characteristics of Warthin-like variant papillary thyroid carcinomas
Authors: Ning Chunping , Koo Ja Seung , Kim Eun-Kyung , Lee Suji
Published: March 2019

Aim: To summarize the clinical, ultrasonographic (US) and pathological characteristics of Warthin-like variant papillary thyroid carcinomas (WVPTC).Material and methods: Medical records and US images of 32 cases of WVPTCs diagnosed between December, 2006 and September, 2018 were reviewed. Clinical, pathological and US characteristics of these cases were collected and summarized. ACR TI-RADS was followed during the analysis of the US features of the lesions. Results: Totally, 32 patients with 33 WVPTC nodules were reviewed. WVPTC was more often seen in female patients (27/32,84.4%) with a relatively high age (mean age, 51.0±10.8 years old). Hyperthyroidism was observed in 14 patients; 2 patients were diagnosed as subclinical hyperthyroidism and 1 patient as subclinical hypothyroidism. Abnormal thyroglobulin antibody was detected in 22 patients. Mean size of the nodule was 1.2±0.5 cm (range, 0.5~2.99 cm) on US. Pathologically, tumor margin of 63.6% carcinomas were infiltrative but most (72.9%) of the enrolled carcinomas were intra-thyroidal. Lymphocytic thyroiditis was detected in 87.5% (28/32) patients. On US, most WVPTCs were solid or almost complete solid (32/33, 97.0%) and very hypoechoic (26/33, 78.8%). Taller-than-wide shape (6/33, 18.2%) and punctate echogenic foci (9/33, 27.3%) were not popular. All the nodules were scored higher than 5 points according to the ACR TI-RADS, including 9 nodules that were classified into TR4 and 24 nodules as TR5. Follow-up information was available in 31 patients and no recurrence or distal metastasis was detected.Conclusions: WVPTC is a rare variant of PTCs with favorable outcomes. Very hypoechoic echogenicity, solid or almost complete solid composition are the vital indicators for biopsy, even though the nodule may be wider-than-tall and have a lack of punctuate echoic foci.
One-pot synthesis of hierarchical Ag mesoparticles with tunable morphology for ultrasensitive surface-enhanced Raman scattering activity
Authors: Ji Shangdong , Wang Minqiang , Qiu Hengwei , Guo Jun , Li Le , Cao Minghui , Yang Zhi
Published: March 2019

Surface-enhanced Raman scattering (SERS) has shown inspiring prospects owing to its high sensitivity, convenience, and reliable results in molecular detection. Therefore, the fabrication of a sensitive, reproducible, and economical SERS material has attracted great interest. Herein, a facile one-pot synthetic system is presented to fabricate various hierarchical Ag mesoparticles (AgMPs) with well-tuned shapes to systematically study the morphology-related SERS activity. Of the morphologies produced herein, multibranched AgMPs exhibited the highest SERS sensitivity as particle-array substrates for rhodamine B detection, reaching a detection limit of 10−13M and an enhancement factor of >108. To investigate their practical effectiveness, multibranched AgMPs were used for in situ detection of a widely used growth regulator (forchlorfenuron) on an apple, showing legible Raman peaks at a low concentration of 0.01 ppm. This work provides a facile, robust, and low-cost route for the synthesis of uniform, shape-controlled Ag mesoparticles with high SERS performance.
Tracking cryptic animals using acoustic multilateration: A system for long-range wolf detection
Authors: Kershenbaum Arik , Owens Jessica L. , Waller Sara
Published: March 2019

The study of animal behavior in the wild requires the ability to locate and observe animals with the minimum disturbance to their natural behavior. This can be challenging for animals that avoid humans, are difficult to detect, or range widely between sightings. Global Positioning System (GPS) collars provide one solution but limited battery life, and the disturbance to the animal caused by capture and collaring can make this impractical in many applications. Wild wolves Canis lupus are an example of a species that is difficult to study in the wild, yet are of considerable conservation and management importance. This manuscript presents a system for accurately locating wolves using differences in the time of arrival of howl vocalizations at multiple recorders (multilateration), synchronized via GPS. This system has been deployed in Yellowstone National Park for two years and has recorded over 1200 instances of howling behavior. As most instances of howling occur at night, or when human observers are not physically present, the system provides location information that would otherwise be unavailable to researchers. The location of a vocalizing animal can, under some circumstances, be determined to within an error of approximately 20 m and at ranges up to 7 km.