bluuebunny/crossref_metadata_2025 huggingface dataset:
The sequences encoded by immunoglobulin diversity (DH) gene segments play key roles in controlling B‐cell development, antigen‐binding site diversity, and antibody production
Authors: Khass Mohamed , Vale Andre M. , Burrows Peter D. , Schroeder Harry W.
Published: June 2018

Although at first glance the diversity of the immunoglobulin repertoire appears random, there are a number of mechanisms that act to constrain diversity. For example, key mechanisms controlling the diversity of the third complementarity determining region of the immunoglobulin heavy chain (CDR‐H3) include natural selection of germline diversity (DH) gene segment sequence and somatic selection upon passage through successive B‐cell developmental checkpoints. To test the role of DH gene segment sequence, we generated a panel of mice limited to the use of a single germline or frameshifted DH gene segment. Specific individual amino acids within core DH gene segment sequence heavily influenced the absolute numbers of developing and mature B‐cell subsets, antibody production, epitope recognition, protection against pathogen challenge, and susceptibility to the production of autoreactive antibodies. At the tip of the antigen‐binding loop (PDB position 101) in CDR‐H3, both natural (germline) and somatic selection favored tyrosine while disfavoring the presence of hydrophobic amino acids. Enrichment for arginine in CDR‐H3 appeared to broaden recognition of epitopes of varying hydrophobicity, but led to diminished binding intensity and an increased likelihood of generating potentially pathogenic dsDNA‐binding autoreactive antibodies. The phenotype of altering the sequence of the DH was recessive for T‐independent antibody production, but dominant for T‐cell‐dependent responses. Our work suggests that the antibody repertoire is structured, with the sequence of individual DH selected by evolution to preferentially generate an apparently preferred category of antigen‐binding sites. The result of this structured approach appears to be a repertoire that has been adapted, or optimized, to produce protective antibodies for a wide range of pathogen epitopes while reducing the likelihood of generating autoreactive specificities.
A bundled phosphate control intervention (4Ds) for adults with end‐stage kidney disease receiving haemodialysis: A cluster randomized controlled trial protocol
Authors: Milazi Molly , Douglas Clint , Bonner Ann
Published: June 2018

Aim

To evaluate the effectiveness of a bundled self‐management intervention (Taking control of your phosphate with the 4Ds) to improve phosphate control among adults receiving haemodialysis.

Background

Hyperphosphataemia occurs in end‐stage kidney disease and is associated with increased morbidity and mortality. While hyperphosphataemia can be managed through four methods (food, drinks, drugs and dialysis) adherence to these methods is challenging for patients. Studies also tend to focus on one method of phosphate control rather than bundling all methods together into a theoretically driven intervention.

Design

A multisite cluster randomized controlled trial with repeated measures.

Methods

Adults receiving haemodialysis with high serum phosphate levels (>1.6 millimoles per litre for at least 3 months) will be cluster randomized to standard care or intervention according to haemodialysis treatment shift. Informed by social cognitive theory, the intervention focuses on improving self‐efficacy and incorporates the “teach‐back” method of patient education. The intervention brings together essential phosphate control strategies of diet, drinks, drugs (phosphate binders) and dialysis prescription in a 12‐week self‐management education programme. The primary outcome is serum phosphate level. Secondary outcomes are knowledge of and adherence to phosphate control strategies and self‐efficacy for managing kidney disease.

Discussion

Efforts to improve phosphate control have been undertaken although the optimal approach remains unclear. This study will make an important contribution to building an evidence base of phosphate control nursing intervention that can be delivered during routine haemodialysis.

Trial registration: Australian and New Zealand Clinical Trials Registry Number ACTRN12617000703303
Development and initial testing of the self‐care of chronic illness inventory
Authors: Riegel Barbara , Barbaranelli Claudio , Sethares Kristen A. , Daus Marguerite , Moser Debra K. , Miller Jennifer L. , Haedtke Christine A. , Feinberg Jodi L. , Lee Solim , Stromberg Anna , Jaarsma Tiny
Published: June 2018

Aim

The aim was to develop and psychometrically test the self‐care of chronic illness Inventory, a generic measure of self‐care.

Background

Existing measures of self‐care are disease‐specific or behaviour‐specific; no generic measure of self‐care exists.

Design

Cross‐sectional survey.

Methods

We developed a 20‐item self‐report instrument based on the Middle Range Theory of Self‐Care of Chronic Illness, with three separate scales measuring Self‐Care Maintenance, Self‐Care Monitoring, and Self‐Care Management. Each of the three scales is scored separately and standardized 0–100 with higher scores indicating better self‐care. After demonstrating content validity, psychometric testing was conducted in a convenience sample of 407 adults (enrolled from inpatient and outpatient settings at five sites in the United States and ResearchMatch.org). Dimensionality testing with confirmatory factor analysis preceded reliability testing.

Results

The Self‐Care Maintenance scale (eight items, two dimensions: illness‐related and health‐promoting behaviour) fit well when tested with a two‐factor confirmatory model. The Self‐Care Monitoring scale (five items, single factor) fitted well. The Self‐Care Management scale (seven items, two factors: autonomous and consulting behaviour), when tested with a two‐factor confirmatory model, fitted adequately. A simultaneous confirmatory factor analysis on the combined set of items supported the more general model.

Conclusion

The self‐care of chronic illness inventory is adequate in reliability and validity. We suggest further testing in diverse populations of patients with chronic illnesses.
The impact of burnout on self‐efficacy, outcome expectations, career interest and nurse turnover
Authors: Chang Hao‐Yuan , Friesner Daniel , Chu Tsung‐Lan , Huang Tzu‐Ling , Liao Yen‐Ni , Teng Ching‐I
Published: June 2018

Aims

To examine the impact of burnout on self‐efficacy, outcome expectations, career interest and on nurses’ intentions to leave the profession and to leave the organization.

Background

Burnout is associated with nurse turnover. Research clarifying the underlying mechanism may provide a novel means to mitigate the impact of burnout on nurse turnover.

Design

This study uses a cross‐sectional design and proportionate stratified sampling.

Methods

Data were collected from a sample of nurses in one medical centre in northern Taiwan during February ‐ March 2017. This study included nurses employed full‐time at the medical centre. Burnout was measured using Maslach Burnout Inventory—Human Service Survey. Self‐efficacy, outcome expectations and career interest were measured using the scale of Cunningham et al. Intentions to leave were measured using the scales of Teng et al. Structural equation modelling was used to assess the proposed framework.

Results

Burnout was negatively related to self‐efficacy and outcome expectations. Self‐efficacy was positively related to outcome expectations. Outcome expectations were also positively related to career interest. However, self‐efficacy was not related to career interest. Career interest was negatively related to the intention to leave the organization, which was further related to the intention to leave the profession. The model fitted the data acceptably.

Conclusions

When nurses leave the profession, patient outcomes may be affected. Policy makers should evaluate whether the healthcare system can instil expectations for satisfaction, power and adequate compensation in the profession and thus retain nurses.
Refining nursing assessment and management with a new postanaesthetic care discharge tool to minimize surgical patient risk
Authors: Street Maryann , Phillips Nicole M. , Haesler Emily , Kent Bridie
Published: June 2018

Aims

To evaluate use of an evidence‐based discharge tool, the Post‐Anaesthetic Care Tool and its impact on nursing assessment, communication, and management of patients in the postanaesthetic care unit.

Background

Postanaesthetic care unit nurses manage patients immediately after surgery and make clinical decisions on discharge readiness. There is a lack of evidence‐based guidance on assessing, documenting, and communicating the patient's postoperative experience. The Post‐Anaesthetic Care Tool, which includes instructions for assessing discharge readiness and incorporates theISOBARacronym, was developed following a comprehensive systematic review and expert consultation.

Design and Methods

This quasiexperimental, multicentre, nonrandomized study was conducted in three postanaesthetic care units in Australia. Participants were nurses providing care to adults postgeneral anaesthesia. Episodes of care were observed before (N = 723) and after (N = 694) introduction of the evidence‐based tool. Statistical methods (Chi‐Square and Mann–WhitneyU‐Tests) were undertaken to analyse nursing assessment, communication, and management outcomes before and after implementation of the Post‐Anaesthetic Care Tool.

Results

The Post‐Anaesthetic Care Tool was associated with statistically significant improvements in the frequency of nursing assessment and responsiveness to complications including pain, nausea/vomiting and hypothermia. After the tool's introduction, nurses requested more medical reviews. This was associated with increased recognition of clinical deterioration and significant improvements in clarity of handover from the postanaesthetic care unit to the ward.

Conclusions

The structured discharge tool, Post‐Anaesthetic Care Tool, was associated with improved nursing management of patients in the postanaesthetic care unit and enabled early identification and response to clinical concerns.
Adherence, knowledge, and perception about oral anticoagulants in patients with atrial fibrillation at high risk for thromboembolic events after radiofrequency ablation
Authors: Smet Lily , Heggermont Ward A. , Goossens Eva , Eeckloo Kristof , Vander Stichele Robert , De Potter Tom , De Backer Tine
Published: June 2018

Aims

This study aimed to: (a) determine adherence rates to oral anticoagulants in atrial fibrillation patients with a high risk for thromboembolic events postradiofrequency ablation; (b) evaluate patients’ knowledge and perceptions towards oral anticoagulants; and (c) explore the impact of patients’ knowledge and perceptions on treatment adherence.

Background

Atrial fibrillation is a common arrhythmia associated with an increased risk of developing thromboembolic events such as stroke. Although adherence to oral anticoagulants is crucial to prevent such complications, the relationship between adherence, knowledge and patient perceptions is poorly understood in patients with atrial fibrillation at high risk for thromboembolic events after radiofrequency ablation.

Design

A cross‐sectional observational survey study was performed in a single centre.

Methods

The levels of adherence, knowledge, and perception towards oral anticoagulants were assessed using the 8‐item Morisky Medication Adherence Scale, Knowledge of Oral Anticoagulation Tool, Perception of Anticoagulant Treatment Questionnaire and Benefit‐Risk Perception Tool, respectively. Results from these self‐reported tools were analysed descriptively. A multivariable binary logistic regression model was used to identify factors associated with levels of adequate adherence.

Results

Adequate treatment adherence was found in three‐quarters of patients. The total mean knowledge score was low. Participants expressed high ease of use and low burden of treatment. Higher total knowledge and satisfaction scores were significant factors associated with higher levels of adherence.

Conclusion

There remains a huge unmet need to follow‐up and educate patients with atrial fibrillation, focusing on good knowledge and correct perception of the advantages and disadvantages of oral anticoagulants. Our results suggest that increased knowledge and satisfaction rates might have a positive impact on adherence to oral anticoagulants.
Divergent parasite infections in sympatric cichlid species in Lake Victoria
Authors: Karvonen Anssi , Wagner Catherine E. , Selz Oliver M. , Seehausen Ole
Published: June 2018

Parasitism has been proposed as a factor in host speciation, as an agent affecting coexistence of host species in species‐rich communities and as a driver of post‐speciation diversification. Young adaptive radiations of closely related host species of varying ecological and genomic differentiation provide interesting opportunities to explore interactions between patterns of parasitism, divergence and coexistence of sympatric host species. Here, we explored patterns in ectoparasitism in a community of 16 fully sympatric cichlid species at Makobe Island in Lake Victoria, a model system of vertebrate adaptive radiation. We asked whether host niche, host abundance or host genetic differentiation explains variation in infection patterns. We found significant differences in infections, the magnitude of which was weakly correlated with the extent of genomic divergence between the host species, but more strongly with the main ecological gradient, water depth. These effects were most evident with infections of Cichlidogyrus monogeneans, whereas the only host species with a strictly crevice‐dwelling niche, Pundamilia pundamilia, deviated from the general negative relationship between depth and parasitism. In accordance with the Janzen–Connell hypothesis, we also found that host abundance tended to be positively associated with infections in some parasite taxa. Data on the Pundamilia sister species pairs from three other islands with variable degrees of habitat (crevice) specialization suggested that the lower parasite abundance of P. pundamilia at Makobe could result from both habitat specialization and the evolution of specific resistance. Our results support influences of host genetic differentiation and host ecology in determining infections in this diverse community of sympatric cichlid species.
The challenge of acquiring a satisfactory EBSD result of CWSR Zircaloy‐4 cladding tube
Authors: LAN K.‐C. , ZHONG W. , MOUCHE P.A. , TUNG H.‐M. , LEE H. , HEUSER B.J. , STUBBINS J.F.
Published: June 2018

This work presents a methodology combining SEM, EDS, conventional EBSD, and transmission‐EBSD to analyse a recrystallised Zircaloy‐4 sheet and cold‐worked stress‐relieved (CWSR) Zircaloy‐4 cladding in unprecedented detail. Second‐phase precipitates (SPPs) in Zircaloy‐4 specimens were revealed after chemical polishing using a solution containing hydrofluoric acid (HF). Pitting corrosion of Zircaloy‐4 specimens was revealed after electropolishing using an electrolyte containing HClO4. A zirconium coupon without SPPs was used to confirm the chemical response of SPPs on surface morphology. Intrinsic features of cold‐worked Zircaloy‐4 such as relatively small grain sizes, high dislocation density, and complex microstructure make it significantly more difficult to collect excellent EBSD results compared to recrystallised Zircaloy‐4. The fine hydride structure of as‐hydrided CWSR Zircaloy‐4 cladding further increases the level of challenge on EBSD analysis.

Lay description

We present a methodology combining multiple microscopic methods to analyse a recrystallised Zircaloy‐4 sheet and cold‐worked stress‐relieved (CWSR) Zircaloy‐4 cladding, important alloys of structural materials widely used in nuclear application, and emphasis on the challenge of acquiring a satisfactory electron backscatter diffraction (EBSD) result of CWSR Zircaloy‐4 cladding material in great details. EBSD is a powerful technique to characterise the crystallographic distribution and lattice type of conductive crystalline materials, especially for a highly textured material like CWSR Zircaloy‐4 alloy. However, zirconium alloys are known to be one of the most difficult materials to prepare for EBSD characterisation. We point out that the configuration of the microstructure of the specimen cause the challenge in the EBSD sample preparations. Moreover, the occurrence of tiny zirconium hydride precipitates in Zircaloy‐4 increases the difficulty. We believe that the information of the EBSD sample preparation related results in this paper can provide researchers and scientists in this community a useful reference to speed up the EBSD sample preparation of CWSR Zircaloy‐4 cladding material and to expect the corresponding EBSD results.
Using vignettes to understand heart failure self‐care
Authors: Xu Jiayun , Arruda Sofia , Gallo Joseph J , Wenzel Jennifer , Nolan Marie T , Flowers Deirdre , Szanton Sarah L , Dennison Himmelfarb Cheryl , Han Hae‐Ra
Published: June 2018

Aims and objectives

To explore hospitalised heart failure (HF) patients' self‐care decisions.

Background

Heart failure self‐care is integral to maintain and manage health, and may prevent unnecessary HF hospitalisations. Nevertheless, self‐care remains challenging for patients, and using vignettes offer a new perspective to understand patient HF self‐care decision‐making.

Design

This qualitative descriptive analysis was conducted as part of a mixed methods study.

Methods

We conducted semi‐structured interviews (N = 20) to elicit patient decisions about self‐care in responses to three vignettes, which varied in symptom severity. Content analysis was used to extract quotes describing participant responses.

Results

Participants were on average 60 years old, primarily male, African American, unemployed and highly symptomatic (NYHA Class III or IV). Overall, participants were able to identify when symptoms required a decision to seek urgent medical attention, but had difficulty identifying the appropriate decision to make in response to less acute symptoms such as swelling.

Conclusions

Symptoms other than shortness of breath were challenging for patients to interpret and manage appropriately. Understanding how to apply HF knowledge to alleviate symptoms was also difficult.

Relevance to clinical practice

Vignettes may be a helpful tool to prompt patient–healthcare provider communication about self‐care management and prompt discussions about appropriate self‐care decisions in response to varying levels of symptom severity.
Occurrence of oral health problems and planned measures in dependent older people in nursing care
Authors: Rantzow Veronica , Andersson Pia , Lindmark Ulrika
Published: June 2018

Aims and objective

To describe oral health problems and planned measures in older people receiving nursing care.

Background

Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities.

Methods

Data were obtained from the web‐based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014–June 2015 were included. The Revised Oral Assessment Guide—the Jönköping (ROAG‐J) was used routinely by nursing staff in nursing care facilities to measure oral health status.

Results

Oral assessments were made on 2,567 individuals (65.7% women). The most common oral health problem was related to “Teeth” (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were “Moistening of the mouth” (16.6%), followed by “Brushing – assistance or complete help” (13.5%).

Conclusion

Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care.

Relevance to clinical practice

The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.
Preconception care for infertile couples: Nurses’ and midwives’ roles in promoting better maternal and birth outcomes
Authors: Allan Helen T , Mounce Ginny , Crespo Esther , Shawe Jill
Published: June 2018

Introduction

Preconception care promotes better maternal outcomes, may assist in preventing birth defects and improves fertility awareness among healthy childbearing couples. Yet, the significance of preconception care for infertile couples is undeveloped area of practice in Europe.

Aims and objectives

To discuss the importance of nurses and midwives in providing preconception care to infertile couples in the United Kingdom and Spain.

Design

Discursive paper.

Method

A comparison of different midwifery and nursing approaches to preconception care for infertile couples in two European countries.

Findings

At present, infertile couples’ needs for preconception care are not routinely identified or understood. There is an opportunity for these needs to be considered and identified by nurses at the time of investigation for infertility or when planning pregnancy with assisted conception.

Conclusions

We argue that, by providing preconception care, nurses and midwives have an opportunity to deliver important advice to infertile couples in both primary care and specialist infertility services.
Prevalence of physical restraint among ventilated intensive care unit patients
Authors: Suliman Mohammad
Published: June 2018

Aims and objectives

To investigate the prevalence of physical restraint among mechanically ventilated intensive care unit patients in Jordan and to identify predicting factors and consequences.

Background

Physical restraint has been widely used among intensive care unit patients in many countries. Despite the benefits it offers in protecting patients from disrupting their medical treatment, it has been reported that restraint has many physical and psychological adverse effects.

Method

A cross‐sectional and observational study was conducted during a period of 3 months (April–June 2017). A sample of 321 intensive care unit patients was selected from five governmental and one university‐affiliated hospital in the north and middle of Jordan. The Restraint Prevalence Tool was used to collect data from the patients.

Results

The study found that the prevalence of physical restraint use on intensive care unit patients in Jordan was 35.8%. This prevalence rate varied across the units, ranging from 33.3%–57.1%. The factors that predicted physical restraint use were younger age (odds ratio = 0.96), large intensive care unit (odds ratio = 6.14), the surgical intensive care unit (odds ratio = 10.36), the night shift (odds ratio = 3.57), a conscious patient (odds ratio = 2.24) and longer hospital stay (odds ratio = 1.07). However, hospital type, gender and being on chemical restraint were not significantly associated with physical restraint. Many patients were observed to have physical complications from restraint use, such as redness, bruising and oedema.

Conclusion

Physical restraint is a common practice in Jordan. Not following standard restraint practices may lead to many physical complications among intensive care unit patients.

Relevance to clinical practice

This study recommends implementing more policies/guidelines inside Jordanian hospitals. In addition, nursing education programs on the safe use of physical restraint should be implemented.
Mating type and sensitivity of Phytophthora nicotianae from tobacco to metalaxyl and dimethomorph in Henan province, China
Authors: Cui Linkai , Gao Pengfei , Guo Jinli , Kang Yebin , Hu Yanhong
Published: June 2018

Phytophthora nicotianae causes black shank, one of the most important diseases of tobacco worldwide. Metalaxyl and dimethomorph are two fungicides which have been used widely for control of this disease in Henan province, China. A study was conducted to determine the level of metalaxyl and dimethomorph sensitivity in isolates of P. nicotianae from tobacco in Henan province and mating type structure of the pathogen population. A total of 32 isolates were isolated from 11 cities in Henan province. Sensitivity of all isolates to metalaxyl and dimethomorph was tested in vitro, and mating types of all isolates were determined by pairing known A1 and A2 testers. For metalaxyl, EC50 values of 32 P. nicotianae isolates ranged from 0.08 to 2.82 mg/L. Sixteen isolates were sensitive, and the rest were intermediate to metalaxyl. None were classified as resistant isolates. For dimethomorph, EC50 values of 32 P. nicotianae isolates ranged from 0.07 to 0.59 mg/L. All isolates were sensitive to dimethomorph. Thirty‐one isolates were A2 mating type, and one isolate was A0 mating type. No isolate was identified as A1 mating type. These results suggested that the P. nicotianae population in Henan province has already exhibited intermediate resistance to metalaxyl and was still sensitive to dimethomorph, and asexual reproduction was the major form of reproduction for the P. nicotianae population.
Conventional farming impairsRhizoctonia solanidisease suppression by disrupting soil food web
Authors: Bonanomi Giuliano , Cesarano Gaspare , Antignani Vincenzo , Di Maio Claudio , De Filippis Francesca , Scala Felice
Published: June 2018

Intensive farming in agriculture raises questions in relation to environmental sustainability and the widespread use of agrochemicals. In the present work, we compare the impact of organic and intensive farming, in connection to the soil suppressiveness against the soilborne pathogenRhizoctonia solani. Three farms were considered in the study: two practicing organic cultivation (for 10 and 20 years, respectively), and one applying conventional cultivation. Soil suppressiveness was assessed in a greenhouse bioassay with lettuce (Lactuca sativa). Soil microbiome was characterized by combining BIOLOG EcoPlates™with high‐throughput sequencing of bacterial and eukaryotic rRNA gene markers. Suppressiveness towardsR. solaniwas higher in organic than in conventional farming soil, but this property was lost after soil sterilization. Functional biodiversity was significantly higher in the two organic soils, and this parameter was predictive of the suppressiveness towardsR. solani. According to our analyses, the overall microbial taxonomic diversity was unlinked to suppressiveness. A correlation analysis, carried out at the genus level for the most abundant bacterial and eukaryotic microbialtaxa, showed that 58.7% of the genera had a statistically significant correlation with suppressiveness. In particular, the generaFlavisolibacter,Massilia,Pseudomonas,Ramlibacter,Rhizophusand the oligochaete worms belonging to the Enchytraeidae family positively correlated with the disease suppression.
Co-administrating apigenin in a high-cholesterol diet prevents hypercholesterolaemia in golden hamsters
Authors: Wong Tsz Yan , Tan Yan Qin , Lin Shu-mei , Leung Lai K
Published: June 2018

Objectives

Hypercholesterolaemia is a major risk factor for developing atherosclerosis. Increased consumption of fruits and vegetables is recommended to hypercholesterolaemic patients. In this study, the hypocholesterolaemic effect of apigenin and luteolin was evaluated in a hamster model.

Methods

Hamsters were put on a high-cholesterol diet for 9 weeks, and apigenin or luteolin was administered in the diet at 60 and 300 ppm.

Key findings

Both apigenin and luteolin supplementations could attenuate the aorta plaque formation by 30% and 20%, respectively. Apigenin-fed hamsters at both dosages displayed a 1.5-fold increase in hepatic Ldlr expression and a 40% reduction in non-HDL cholesterol level as compared with those in the control fed a high-cholesterol (HC) diet. Besides, faecal elimination of cholesterol was facilitated by 20% in the hamsters with high apigenin consumption. Suppressing the expression of the cholesterol transporter ncp1l1 in the intestinal mucosa could block the cholesterol absorption and promote its elimination. The differential regulations of ncp1l1 and Ldlr appeared to be the underlying hypocholesterolaemic mechanism of apigenin in this model system. Luteolin supplementation, on the other hand, had no effect on the blood cholesterol.

Conclusions

This study illustrated that dietary administration of apigenin attenuated HC feeding-induced hypercholesterolemia in hamsters.
The influence of selective A1 and A2A receptor antagonists on the antidepressant-like activity of moclobemide, venlafaxine and bupropion in mice
Authors: Bogatko Karolina , Poleszak Ewa , Szopa Aleksandra , Wyska Elżbieta , Wlaź Piotr , Świąder Katarzyna , Wlaź Aleksandra , Doboszewska Urszula , Rojek Karol , Serefko Anna
Published: June 2018

Objective

The main goal of our study was to investigate whether a selective antagonism of the adenosine A1 or A2A receptors is able to enhance the antidepressant activity of commonly prescribed drugs.

Materials and methods

All experiments were carried out on male Albino Swiss mice. The forced swim test and the tail suspension test were used to evaluate the antidepressant-like potential. Drug concentrations in animals’ serum and brains were measured by high-performance liquid chromatography.

Key findings

The antidepressant potential of moclobemide (1.5 mg/kg), venlafaxine (1 mg/kg) and bupropion (10 mg/kg) was enhanced by a co-administration with 3,7-dimethyl-1-propargylxanthine (DMPX; an antagonist of adenosine A2A receptors; 3 mg/kg) or 8-cyclopentyl-1,3-dipropylxanthine (an antagonist of adenosine A1 receptors; 1 mg/kg). However, significant interactions between the tested substances were detected only in the experiments with DMPX. The nature of the observed interplays is rather pharmacodynamic than pharmacokinetic, because neither serum nor brain concentrations of the used drugs were significantly increased.

Conclusions

Blockage of the adenosine receptors (particularly the A2A subtypes) could be considered in future as a novel, promising part of the combined antidepressant therapy. However, further studies on this subject are needed.
Cardiac effects of acute administration of a protonophore in a rat model
Authors: Minanimo-Muta Eri , Kato Takao , Shioi Tetsuo , Tanada Yohei , Kimura Takeshi
Published: June 2018

Objectives

Excessive use of uncoupling agents, previously used as weight loss agents, has led to the increase in body temperature and death. The aim of the present study was to evaluate the acute cardiac effects of mitochondrial protonophore in a rat model at a high dose, and its specific influence on cardiac substrate uptake.

Methods

Eight-week-old male Sprague–Dawley rats were intraperitoneally injected with the protonophore carbonyl cyanide m-chloro phenyl hydrazone (CCCP; 4 mg/kg) or vehicle (dimethyl sulfoxide). Blood pressure, heart rate (HR) and systolic function were recorded. Substrate uptake was monitored by radioactive tracers.

Key findings

Compared to the control group, the respiratory rate and body temperature increased, the left ventricle was dilated, and systolic function transiently deteriorated in the CCCP group. There was no difference in blood pressure and HR between the two groups. In cardiac substrate uptake, glucose uptake showed a 95% increase (P < 0.05), and fatty acid uptake showed a 52% decrease (P < 0.05) in CCCP-administered group.

Conclusions

The deleterious effects on cardiac function and the changes in substrate uptake were observed when administered with the protonophore at a high dose.
Pharmacokinetic/pharmacodynamic relationship of enrofloxacin against Aeromonas hydrophila in crucian carp (Carassius auratus gibelio)
Authors: Shan Qi , Wang Jingxin , Wang Jing , Ma Lisha , Yang Fenghua , Yin Yi , Huang Ren , Liu Shugui , Li Lichun , Zheng Guangming
Published: June 2018

The pharmacokinetic (PK) properties of enrofloxacin (ENR) and its metabolite ciprofloxacin (CIP) were investigated in crucian carp following oral administration at different dose levels (5, 10, 20, 40 mg/kg body weight). The disposition kinetics of ENR was found to be linear over the dose range studied. Serum half‐lives ranged from 64.56 to 72.68 hr. The in vitro and ex vivo activities of ENR in serum against a pathogenic strain of Aeromonas hydrophila were determined. In vitro and ex vivo bactericidal activity of ENR was concentration dependent. Dosing of 10 mg/kg resulted in an AUC/minimum inhibitory concentration (MIC) ratio of 368.92 hr and a Cmax/MIC ratio of 7.23, respectively, against A. hydrophila 147 (MIC = 0.48 μg/ml), indicating a likely high level of effectiveness in clinical infections caused by A. hydrophila with MIC value ≤ 0.48 μg/ml. Modeling of ex vivo growth inhibition data to the sigmoid Emax equation provided the values of AUC24 hr/MIC required to produce bacteriostasis, bactericidal activity, and elimination of bacteria, these values were 21.70, 53.01, and 125.21 hr, respectively. These findings in conjunction with MIC90 data suggested that ENR at the dose of 7.81 mg/kg predicted a positive clinical outcome and minimize the risk of emergence of resistance.
Pharmacokinetic profiles of metamizole (dipyrone) active metabolites in goats and its residues in milk
Authors: Kim Tae Won , Łebkowska‐Wieruszewska Beata , Sitovs Andrejs , Poapolathep Amnart , Owen Helen , Lisowski Andrzej , Abilova Zulkyya , Giorgi Mario
Published: June 2018

Metamizole (dipyrone, MET) is a nonopioid analgesic drug commonly used in human and veterinary medicine. The aim of this study was to assess two major active metabolites of MET, 4‐methylaminoantipyrin (MAA) and 4‐aminoantipyrin (AA), in goat plasma after intravenous (IV) and intramuscular (IM) administration. In addition, metabolite concentration in milk was monitored after IM injection. Six healthy female goats received MET at a dose of 25 mg/kg by IV and IM routes in a crossover design study. The blood and milk samples were analyzed using HPLC coupled with ultraviolet detector and the plasma vs concentration curves analyzed by a noncompartmental model. In the goat, the MET rapidly converted into MAA and the mean maximum concentration was 183.97 μg/ml (at 0.08 hr) and 51.94 μg/ml (at 0.70 hr) after IV and IM administration, respectively. The area under the curve and mean residual time values were higher in the IM than the IV administered goats. The average concentration of AA was lower than MAA in both groups. Over 1 μg/ml of MAA was found in the milk (at 48 hr) after MET IM administration. In conclusion, IM is considered to be a better administration route in terms of its complete absorption with long persistence in the plasma. However, this therapeutic option should be considered in light of the likelihood of there being milk residue.
When I say … sociocultural learning theory
Authors: Kahlke Renate , Bates Joanna , Nimmon Laura
Published: June 2018

Kahlke et al. illuminate key concepts underpinning Sociocultural learning theory as a way of explaining how it offers a lens through which health professional educators might reconsider routine interactions.
EQUAL Aspergillosis Score 2018: An ECMM score derived from current guidelines to measure QUALity of the clinical management of invasive pulmonary aspergillosis
Authors: Cornely Oliver A. , Koehler Philipp , Arenz Dorothee , C. Mellinghoff Sibylle
Published: June 2018

Invasive pulmonary aspergillosis is a serious threat to immunocompromised and critical care patients. Recent detailed guidelines and treatment algorithms lead microbiologists and clinicians in diagnosis and treatment of invasive aspergillosis. Currently, there is no tool available that allows to measure guideline adherence. To develop such a tool, we reviewed current guidelines provided by five scientific societies (European Society for Clinical Microbiology and Infectious Diseases, European Confederation of Medical Mycology, European Respiratory Society, Infectious Diseases Society of America (IDSA), and Infectious Diseases Working Party of the German Society for Hematology and Medical Oncology) and selected the strongest recommendations for management as key components for our scoring tool. We integrated diagnostic measures (chest computed tomography, bronchoalveolar lavage with galactomannan, fungal culture, fungal polymerase chain reaction analysis, species identification, susceptibility testing, histology with silver stain, Periodic acid‐Schiff staining, and molecular diagnostics), treatment (antifungal choice and therapeutic drug monitoring), and follow‐up computed tomography. The EQUAL Aspergillosis Score 2018 aggregates and weighs the components and provides a tool to support antifungal stewardship and to quantify guideline adherence.
Bone regeneration by freeze‐dried composite of octacalcium phosphate collagen and teriparatide
Authors: Iwai Atsushi , Kajii Fumihiko , Tanaka Hidenori , Sasaki Kazuo , Matsui Keiko , Kawai Tadashi , Kamakura Shinji
Published: June 2018

Objective

Octacalcium phosphate (OCP) and collagen (col) composite (OCPcol) demonstrated superior bone regeneration properties, and its commercialization appears to be forthcoming. As a practical medical material for new combination products, we developed a freeze‐dried composite with OCPcol and teriparatide (TPTD) (OCPcolTPTDf), and investigated its bone regenerative properties.

Materials and Methods

A disk of OCPcol was made by mixing OCP granules and atelocollagen for medical use. Then, OCPcolTPTDf was prepared by impregnation of the OCPcol disk with 1.0 or 0.1 µg of TPTD solution (OCPcolTPTDf 1.0 and OCPcolTPTDf 0.1, respectively) followed by lyophilization. In vitro release profiles of TPTD from OCPcolTPTDf were determined using an enzyme‐linked immunosorbent assay. Implantation of OCPcolTPTDf or OCPcol was carried out for a rat critical‐sized calvarial defect. And five defects in each group were collected after 12 weeks of implantation.

Results

The retention–release profiles of TPTD from OCPcolTPTDf supported a higher degree of retention of TPTD. Radiographic, histological, and histomorphometric examinations indicated that regenerated bone was filled in most of the defects of the OCPcolTPTDf. Additionally, the OCPcolTPTDf groups showed significantly enhanced bone regeneration compared with the OCPcol group.

Conclusions

These results suggested that this newly developed bone regenerative composite could be a practical medical material.
Gene action controlling yield and yield‐related traits among tef (Eragrostis tef [Zucc.] Trotter) populations under drought‐stressed and nonstressed conditions
Authors: Abraha Mizan Tesfay , Shimelis Hussien , Laing Mark , Assefa Kebebew
Published: June 2018

This study was aimed to determine gene action for grain yield and yield‐related traits of newly developed tef populations under drought‐stressed and nonstressed conditions to improve drought tolerance. Ten crosses, along with the parents, were evaluated in the F2 generation under drought‐stressed conditions at Hastebo and Adigdad sites in 2015 and Dura site in 2016 and under nonstressed conditions at Dura site in 2016. Additive gene action predominantly controlled the inheritance of the grain yield and majority of the yield‐related traits under drought‐stressed and nonstressed conditions. Under both test conditions, the genotypes DZ‐Cr‐387 and 9415 were the best general combiners for increased grain yield and morphological traits. Conversely, genotype 222076 was the best general combiner for reduced maturity period only. The selected parents are novel genetic materials for tef breeding programmes to improve grain yield and morphological traits with reduced days to maturity for drought tolerance breeding. The family of the cross DZ‐Cr‐387 × 222076 was selected for high grain yield and early maturity in both the drought‐stressed and nonstressed environments.
Multiple Spitz nevi after allogeneic hematopoietic stem cell transplantation
Authors: Song Yu Mee , Kim Yoon Seob , Seo Hyun‐Min , Bang Chul Hwan , Lee Ji Hyun , Park Young Min , Lee Jun Young
Published: June 2018

Spitz nevus commonly appears as a solitary lesion. A 12‐year‐old male patient presented with a 6‐month history of several pigmented lesions on his trunk and lower extremities. He had undergone chemoradiotherapy and unrelated umbilical cord blood transplantation against recurring acute lymphoblastic leukemia for 6 years. After that, several pigmented lesions abruptly developed on his trunk and lower extremities, and the number of those increased significantly. Pathologically, the diagnosis of multiple Spitz nevi was made. In a clinical correlation, we diagnosed multiple Spitz nevi resulting from such an immunocompromised condition. This is the first description of clinical, dermoscopic, and histopathologic features of multiple Spitz nevi in the hematopoietic cell transplantation (HSCT) recipient child.
Methotrexate for severe nummular eczema in children: Efficacy and tolerability in a retrospective study of 28 patients
Authors: Knöpfel Nicole , Noguera‐Morel Lucero , Hernández‐Martín Angela , Torrelo Antonio
Published: June 2018

Background/Objectives

Nummular eczema in children is a chronic condition characterized by pruritic coin‐shaped eczematous lesions that affect any part of the body and often become exudative. Mid‐ to high‐potency topical corticosteroids are considered the mainstay treatment, but there are limited data on the use of systemic therapy for nummular eczema in children. The objective of the current study was to evaluate the efficacy and safety of methotrexate in children with severe nummular eczema.

Methods

A retrospective review was undertaken of children with nummular eczema treated with methotrexate between January 2007 and May 2017.

Results

The records of 28 patients (24 male, 4 female) with a mean age at the beginning of treatment of 7.8 ± 1.6 years (95% confidence interval (CI) = 6.1‐9.4 years) were reviewed. The median duration of treatment was 12.6 ± 3.3 months (95% CI = 9.2‐16 months), and 14 patients were still undergoing methotrexate therapy at the time of last review. Ten patients (35.7%) had complete or almost complete clearance of eczema (> 90% improvement), 13 (46.4%) had marked improvement (50%‐89%), four had mild improvement (< 50%), and one failed methotrexate therapy. Gastrointestinal intolerance (21.4%) and a nonsignificant increase in liver enzymes (17.9%) were the most frequent side effects. No serious adverse events were noted.

Conclusion

Methotrexate is an effective, well‐tolerated treatment in children with moderate to severe nummular eczema that has failed to respond to conventional topical therapy.
Cutaneous manifestations in Egyptian children with beta‐thalassemia major: Relationship with serum ferritin, thyroid profile, and treatment modalities
Authors: El‐Dash Hanaa , Adel Shereen
Published: June 2018

Background

Cutaneous manifestations can be found in many patients with hematologic disorders, including thalassemia.

Methods

Patients with beta‐thalassemia major attending the pediatric department of Fayoum University Hospital from April 2016 to October 2016 (n = 100) were compared with controls (n = 100). Both groups underwent detailed history evaluation, clinical examination, and laboratory investigations, including complete blood count, liver and kidney function, serum ferritin, and thyroid profile. A single dermatologist conducted a clinical dermatologic examination for all participants.

Results

Children with thalassemia had a greater prevalence of xerosis (72%), pruritus (52%), idiopathic guttate hypomelanosis (22%), urticaria (16%), ephelides (freckles; 13%), and scars (13%) than controls (P ≤ .001). We detected a significant relationship between serum ferritin and pruritus, xerosis, ephelides, idiopathic guttate hypomelanosis, urticaria, and age of patients with thalassemia (P < .05). Children without thyroid abnormalities were more likely to have xerosis, pruritus, idiopathic guttate hypomelanosis, urticaria, and ephelides (86%) than controls (P < .05). Although there was no significant difference in skin findings between patients who did and did not receive chelating agents (P > .05), a significant association was found between xerosis and the use of deferoxamine and deferiprone, whereas ephelides and urticaria were more common in patients receiving deferasirox.

Conclusion

Because cutaneous manifestations are common in Egyptian patients with beta thalassemia major, regular dermatologic follow‐up is recommended for early management.
Pediatric “pet consort dermatitis”—Allergic contact dermatitis from transfer of bronopol from a pet cat
Authors: Hamann Dathan , Ridpath Alyson , Fernandez Faith Esteban
Published: June 2018

Consort dermatitis refers to an allergic contact dermatitis caused by transfer from an intimate contact to a sensitized patient. Although close contact with other humans most commonly provokes consort dermatitis, pets have been the source in a minority of cases. We present a unique case of transfer dermatitis from a patient's cat litter to her forearms. Pediatric dermatologists should be aware of the possibility of consort or “transfer” allergic contact dermatitis from pets.
Dermatoscopic features of lichen nitidus
Authors: Jakhar Deepak , Grover Chander , Kaur Ishmeet , Sharma Sonal
Published: June 2018

Dermatoscopy is a noninvasive, painless, and easily repeatable technique that reveals interesting and characteristic features associated with various cutaneous conditions. Lichen nitidus is a rare dermatosis of childhood. We describe the dermatoscopic features in 8 cases of lichen nitidus, which can aid noninvasive diagnosis. The report serves to emphasize the need for examining these lesions using both polarized and nonpolarized modes.
Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes
Authors: Lin Shang‐Yi , Tu Hung‐Pin , Lu Po‐Liang , Chen Tun‐Chieh , Wang Wen‐Hung , Chong Inn‐Wen , Chen Yen‐Hsu
Published: June 2018

Background and objective

Metformin is an oral anti‐diabetic therapy (ADT) to manage type 2 diabetes mellitus (T2DM), and has been reported to have potential anti‐tuberculosis (TB) effects. This study investigates the risk of active TB among persons with T2DM who were treated with various ADT and insulin therapies.

Methods

We conducted a nationwide population‐based cohort study using the Taiwan Longitudinal Health Insurance Database, including 49 028 T2DM patients who were metformin users (n = 44 002) or non‐users (n = 5026). A total of 5026 propensity score‐matched pairs of metformin users and non‐users with T2DM were evaluated from 1998 to 2010. The data were analysed using Cox proportional hazard models.

Results

Patients with T2DM had a significantly higher rate of incident TB than did the control subjects (adjusted hazard ratio: 2.01; 95% confidence interval (95% CI): 1.80–2.25). After adjusting for comorbidities, diabetes complications, ADT type and statin use, metformin use was an independent factor for predicting a reduced risk of active TB (adjusted relative risk (aRR): 0.24; 95% CI: 0.18–0.32). The association between metformin use and active TB risk was also consistent in most subgroup analyses, except for patients with metabolic disorders (aRR: 0.46; 95% CI: 0.11–1.87). This protective effect of metformin was dose‐dependent but diminished gradually in the elderly population.

Conclusion

Among all types of ADT and insulin therapies, metformin is the only agent with a decreased risk of active TB in the T2DM population. However, this effect was diminished in the elderly population and was not observed in patients with metabolic disorders.
Targeting dyspnoea in patients with very severe COPD: Practical precision medicine
Authors: Celli Bartolome R.
Published: June 2018

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