bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ Attitudes Toward the Families Caring Process Regarding the Childbirth and the Immediate Postpartum Period / Atitudes de Enfermeiros nos Cuidados com Famílias no Contexto do Parto e Puerpério Imediato.
Authors: Ribeiro Jéssica Sâmia Silva Tôrres , Sousa Francisca Georgina Macêdo de , Santos Giuliane Ferreira Lopes dos , Silva Andrea Cristina Oliveira , Sousa Benylda Araújo Pinheiro de
Published: July 2018

Objetivo: Identificar atitudes de enfermeiros sobre a importância das famílias no processo de cuidado no contexto do parto e puerpério segundo as dimensões da Escala IFCE – AE; Descrever as atitudes que contribuem e/ou implicam para a valorização das famílias nas práticas de cuidados dos enfermeiros. Métodos: Estudo transversal, descritivo realizado com 76 enfermeiros dos Serviços de Alojamento Conjunto e Centro Obstétrico de duas instituições de saúde. Resultados: Os enfermeiros detinham atitudes de suporte para com as famílias, com média da escala total de 78,4 pontos e nas dimensões Família: parceiro dialogante e recurso de coping (35,6 pontos), Família: recurso nos cuidados de enfermagem (30,8 pontos), Família: Fardo (11,9 pontos). Conclusão: A maior parte dos enfermeiros não têm o curso de enfermagem e famílias, evidenciando a necessidade de investimento em formação continuada voltadas para as práticas de cuidado de famílias e em mudanças nas estruturas curriculares das universidades.Descritores: Enfermagem, Cuidado centrado na família, Enfermagem Familiar.
Caregiver Women’s Coping Strategies Toward Schizophrenia Bearing People / Estratégias de Enfrentamento de Mulheres Cuidadoras de Pessoas com Esquizofrenia
Authors: Félix Magalhães Josiléia , Evangelista Lopes Roberlandia , Nobrega-Therrien Silvia Maria , Bastos Vasconcelos Suyanne
Published: July 2018

Objetivo: Conhecer as estratégias de enfrentamento utilizadas por mulheres cuidadoras de pacientes com esquizofrenia. Método: Estudo de natureza exploratório-descritivo, com abordagem qualitativa, realizado no Centro de Atenção Psicossocial Geral de Sobral-CE, com 15 mulheres cuidadoras de pacientes com esquizofrenia, nos períodos de julho de 2015 a junho de 2016, a partir de entrevistas. Resultados: Os fatores desencadeantes de estresse relatados pelas mulheres foram: o desgaste físico e psicológico pelo cuidado diário com o portador de esquizofrenia; a dificuldade de lidar com a doença, sua aceitação e medo de morrer e; deixar o seu ente sozinho. As estratégias de enfrentamento apresentadas por elas foram: busca de apoio espiritual e religioso, expressão de sentimentos para alívio do estresse, uso de medicações psicotrópicas e participação em atividades grupais. Conclusão: É importante que as instituições de saúde, em especial aquelas que prestam cuidados à pessoa com transtorno mental, ofertem apoio ao cuidador.
Incontinence-Associated Dermatitis in Hospitalized Elderly Patients: Nurses’ Self-Reported Knowledge / Dermatite Associada à Incontinência em Idosos Hospitalizados: Conhecimento Autorreferido de Enfermeiros
Authors: Riechel Strehlow Bruna , Lucia Fortunato Fortes Vera , Vieira do Amarante Michael
Published: July 2018

Objetivo: Identificar o conhecimento autorreferido dos enfermeiros em relação a prevenção, diagnóstico e tratamento da dermatite associada a incontinência (DAI) em idosos hospitalizados e propor a construção de um protocolo de cuidados de enfermagem a partir de fluxograma. Métodos: Pesquisa exploratória descritiva, qualitativa, através de entrevista semiestruturada com enfermeiros de unidades de um hospital, no segundo semestre de 2016. Os dados das entrevistas foram analisados mediante análise temática. Resultados: Apresentados em três categorias: Admissão do idoso e prevenção da DAI: A maioria da clientela é idosa, na qual a adoção de medidas de higiene e aplicação de barreira consistem na prevenção; Diagnóstico da DAI no idoso: Desconhecem o estadiamento da DAI; Tratamento da DAI: Inclui dispositivos que evitam o contato das eliminações com a pele existindo dificuldades em diferenciar as categorias da lesão. Conclusão: Ausência de uniformização entre os enfermeiros acerca dos produtos que tratam a pele com DAI.DESCRITORES: Dermatite das Fraldas, Assistência a Idosos, Incontinência fecal, Incontinência urinária.
Caregivers’ Perception When Facing the Care Humanization in The Immediate Postoperative Period From a Cardiac Surgery Procedure / Percepção dos Cuidadores Frente à Humanização da Assistência no Pós- Operatório Imediato de Cirurgia Cardíaca
Authors: Milani Patrícia , Lanferdini Isabel Zamarchi , Alves Valentina Bernardi
Published: July 2018

Objetivo: Analisar a percepção dos cuidadores de pacientes submetidos à cirurgia cardíaca frente à humanização da assistência, em uma Unidade de Terapia Intensiva. Métodos: Estudo do tipo exploratório e descritivo, com abordagem qualitativa, através de entrevista semiestruturada aplicada a cuidadores de pacientes em pós-operatório imediato de cirurgia cardíaca, com posterior análise de conteúdo de Bardin. Resultados: Os cuidadores perceberam positivamente o trabalho realizado pela equipe multiprofissional, sendo estes os detentores das informações e possibilitadores do cuidado. Identificaram que as orientações recebidas em todo o processo de tratamento foram essenciais para o preparo psicológico e emocional do paciente, assim como dos familiares. E os sentimentos vivenciados foram de dualidade entre a esperança e o medo, com destaque para a angústia e ansiedade. Conclusão: Prestar uma assistência de qualidade aos pacientes e seus cuidadores através de escuta qualificada e valorização dos sentimentos, se faz imprescindível para o processo de humanização do cuidado.
The Nurses’ Viewpoint Regarding the Use of the braden Scale With the Elderly Patient / A Visão de Enfermeiros Quanto a Aplicação da Escala de Braden no Paciente Idoso
Authors: Debon Raquel , Fortunato Fortes Vera Lucia , Roman Rós Ana Cláudia , Scaratti Maira
Published: July 2018

Objetivo: Identificar se os enfermeiros têm conhecimento e fazem uso correto em seu cuidado diário da escala de Braden em idosos, instrumento consolidado na prevenção das Lesões por Pressão. Método: Trata-se de uma pesquisa qualitativa, exploratória, descritiva, realizada em um hospital ao Norte do RS. Os dados foram coletados por meio de entrevistas semi-estruturadas com quatorze enfermeiros e analisados mediante análise temática. Resultados: A maioria dos enfermeiros realizam a escala, tem conhecimento da mesma, porém encontram dificuldades como falta de tempo para que seja realmente efetivado os cuidados que aparecem no escore de risco. Conclusão: A Escala de Braden é um indicador de saúde que avalia o risco de formação de lesão, onde o enfermeiro tem papel primordial no seu desempenho, apesar de considerá-la importante, muitas vezes realiza-a apenas para preencher protocolos institucionais.
Assessment of The Waste Management in Basic Health Units From a South Brazilian City / Avaliação da Gestão dos Resíduos em Unidades Básicas de Saúde de um Município Sul-Brasileiro
Authors: Teixeira Matheus Veber , Echevarría-Guanilo Maria Elena , Knuth Franco  Goulart , Ceolin Teila
Published: July 2018

Objetivo: analisar a gestão dos resíduos de serviços de saúde e, o conhecimento dos profissionais de enfermagem acerca da legislação vigente. Método: pesquisa quantitativa, de caráter descritivo-exploratório, desenvolvida em três Unidades Básicas de Saúde de área urbana, de Pelotas, Rio Grande do Sul. Participaram profissionais da equipe de enfermagem de Estratégia de Saúde da Família. Foi aplicado questionário para identificar a gestão de Resíduos Sólidos de Saúde e estrutura das unidades, entre outubro a novembro de 2014. Foram realizadas análises descritivas. Resultados: dos 19 profissionais, 57,8% relataram não conhecer a legislação sobre Resíduos Sólidos de Saúde; 89,5% realizar a segregação desses materiais, porém 73,7% afirmaram não conhecer sua classificação e 36,8% desconheciam os cuidados específicos para cada tipo de resíduo. Observou-se ausência de plano de gestão. Conclusão: as unidades apresentam importantes fragilidades no processo de gerenciamento dos Resíduos Sólidos de Saúde.
Life Quality: The Night Shift Work Challenge To Nursing Team / Qualidade de Vida: O Desafio do Trabalho Noturno Para a Equipe de Enfermagem
Authors: Sena Alexia Gonçalves , Lopes de Figueiredo Mirela , Campos Mota Écila , Marques da Costa Fernanda , Fernandes do Prado Patrícia , De Almeida Lima Cássio
Published: July 2018

Objetivo: Avaliar a qualidade de vida e sua associação com as características sociodemográficas dos trabalhadores da enfermagem do período noturno. Métodos: Pesquisa do tipo analítico, com abordagem quantitativa, com 145 trabalhadores, realizada em 2014 em uma instituição hospitalar de Montes Claros, Minas Gerais-Brasil. Foram aplicados um questionário sociodemográfico e o Instrumento Abreviado de Avaliação da Qualidade de Vida, em agosto de 2014. Realizou-se a análise descritiva e o teste t student para verificação de associações. Resultados: Predominaram trabalhadores do sexo feminino, com idade de até 35 anos, com companheiro(a) e filhos. Os domínios meio ambiente e físico apresentaram piores escores. Na comparação dos escores médios nos quatro domínios, as covariáveis mais significativas foram: sexo, atividade física, outro vínculo, estado civil e tempo de trabalho. Conclusão: Os trabalhadores demandam maior atenção nas dimensões ambientais e físicas, e nas características sociodemográficas que interferiram na qualidade de vida.
The Experiences of Pregnant Adolescents’ Relatives Regarding The Early Pregnancy in Montes Claros/MG Municipality / Experiência de Familiares de Adolescentes Grávidas Quanto a Gestação Precoce no Município de Montes Claros/MG
Authors: Mata Jozimara Rodrigues da , Durães Fernanda Pereira , Souza Meriele Santos , Teles Mariza Alves Barbosa , Amaral Edilene Oliveira
Published: July 2018

Objetivo: Conhecer as experiências de familiares de adolescentes grávidas assistidas pelas ESF do município de Montes Claros/MG, acerca da gestação precoce. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa, no qual foram entrevistados 10 familiares de adolescentes grávidas. Resultados: Percebe-se com a pesquisa que os familiares referem a sexualidade como ato sexual somente. Os entrevistados relacionam a gestação precoce à vários fatores. A aceitação da gravidez é referida como positiva, mesmo quando inesperada. Conclusão: As condutas adotadas transitam desde o aconselhamento até a oferta de apoio familiar, mas quase sempre designando a responsabilidade para as adolescentes. O sentimento predominante é o de conformismo, devido à precocidade da gestação.
Meanings of Health Care Assigned by Quilombola Women / Significados Atribuídos por Mulheres Quilombolas ao Cuidado à Saúde
Authors: Prates Lisie Alende , Possati Andrêssa Batista , Timm Marcella Simões , Cremonese Luiza , Oliveira Gabriela , Ressel Lúcia Beatriz
Published: July 2018

Objetivo: conhecer os significados atribuídos por mulheres de uma comunidade quilombola ao cuidado à saúde. Método: estudo qualitativo descritivo, com vertente antropológica, realizado com mulheres quilombolas. Os dados foram produzidos por meio da técnica de grupo focal, analisados conforme a análise de conteúdo temática da proposta operativa e interpretados sob o prisma da antropologia interpretativa. Resultados: os significados atribuídos pelas mulheres ao cuidado à saúde estão condicionados ao trabalho, alimentação, higiene, atividade física e ações de prevenção de agravos à saúde, a partir da realização de exames preventivos e da prática de sexo seguro. Conclusões: os significados atrelados pelas mulheres quilombolas sobre o cuidado à saúde são considerados produtos culturais, que devem ser apreendidos dentro do contexto em que foram construídos e observados sob uma perspectiva cultural.
The Partner’s Involvement in the Prenatal Routine Through the Pregnant Women Perspective / A Participação do Parceiro na Rotina Pré-Natal Sob a Perspectiva da Mulher Gestante
Authors: Pereira Silva Cardoso Vanessa Erika , Da Silva Junior Aristides José , Bonatti Angélica Fátima , Soares dos Santos Gefferson Wandelles , Nascimento Ribeiro Thomaz Ademar
Published: July 2018

Objetivo: Analisar como a gestante percebe a participação do parceiro na rotina pré-natal. Método: Estudo descritivo exploratório de abordagem qualitativa. Coleta de dados entre março e junho de 2016, por meio de entrevista semiestruturada, com 11 gestantes, a partir da 28ª semana de gestação, sendo estes submetidos à análise de conteúdo na modalidade temática. Resultados: Das participantes do estudo, apenas uma teve acompanhamento integral do parceiro, outras cinco relataram a presença apenas na realização da ultrassonografia obstétrica. Daquelas que relataram ausência, o trabalho foi apontado como principal fator, também se observou que questões de gênero influenciam nesta ausência, pois a gestação é vista como momento exclusivo da mulher. Considerações finais: É imprescindível que os serviços de saúde estejam sensíveis à inserção do parceiro nesta rotina, e que hajam parcerias intersetoriais entre a saúde, o setor jurídico e a educação que possam estimular esta mudança.
The Nursing Care Actions Toward the Pregnant women: Challenging the Primary Health Care / As Ações de Enfermagem no Cuidado à Gestante: Um Desafio à Atenção Primária de Saúde
Authors: Garcia Estefania Santos Gonçalves Félix , Bonelli Marina Cortez Pereira , Oliveira Aline Neves , Clapis Maria José , Leite Eliana Peres Rocha Carvalho
Published: July 2018

Objetivo: verificar as ações desenvolvidas pelos profissionais de enfermagem na assistência às gestantes em unidades de atenção primária à saúde. Métodos: estudo descritivo e transversal realizado em um município do Sul de Minas Gerais, que acompanhou 134 gestantes. O levantamento das ações desempenhadas pelos nove profissionais ocorreu por meio da observação sistemática e utilizou-se um instrumento que abordava as melhores evidências científicas da prática obstétrica. A análise foi apresentada por meio de tabelas de contingência, frequência absoluta e percentual. Resultados: dentre as ações realizadas na pré-consulta a aferição da pressão arterial foi de 97,7%. Quanto às orientações realizadas pelos profissionais sobre o aleitamento materno e teste do pezinho constatou-se uma percentagem de 30,59% e 74,35%, respectivamente. Conclusão: constata-se que os profissionais desenvolvem a consulta de pré-natal de forma incompleta. Ressalta-se que a educação permanente voltada para as competências essenciais em obstetrícia pode ofertar uma assistência integral e de qualidade.
Factors Associated to the Unplanned Pregnancy Type in the Family Health Strategy Project / Fatores Associados ao Tipo de Gestação não Planejada na Estratégia de Saúde da Família
Authors: Bonatti Angélica Fatima , Wandelles Soares Dos Santos Gefferson , Nascimento Ribeiro Thomaz Ademar , Da Silva Santos Débora Aparecida , Alves de Olinda Ricardo , De Souza Oliveira Jânia Cristiane
Published: July 2018

Objetivo: Identificar fatores associados à ocorrência de gravidez não planejada em duas Estratégias de Saúde da Família. Método: Estudo transversal, realizado nos meses de agosto/2015 a outubro/2016, com amostra de 89 gestantes e 51 puérperas. Foi realizada coleta de dados secundários no SISPRENATAL WEB. As diferenças entre as proporções foram verificadas, mediante uso dos Testes Qui-quadrado de Pearson e o Exato de Fischer ao nível de 5% de significância estatística e a magnitude das associações entre as variáveis foram avaliadas por meio da razão de prevalência. As análises foram realizadas com o auxílio do software estatístico R. Resultados: Observou-se prevalência de 75% de gestação não planejada. Verificou-se associação estatisticamente significante entre intercorrência durante a gestação atual e o tipo de gravidez não planejada. Conclusão: A elevada ocorrência de gravidez não planejada, sobretudo entre aquelas que apresentaram intercorrência indica a necessidade de estabelecerem estratégias de saúde à atenção desta população. Descritores: Gravidez não planejada; Planejamento familiar; Saúde da mulher.
Social Iniquity and Mortality Related to Breast and Cervical Cancers: an Integrative Review / Iniquidade Social e Mortalidade por Câncer de Mama e Colo do Útero: Uma Revisão Integrativa
Authors: Pereira Duarte Daniela de Almeida , Bustamante-Teixeira Maria Teresa
Published: July 2018

Objetivos: Identificar as principais publicações relacionadas à iniquidade social e mortalidade por câncer de mama (CAM) e/ou colo do útero (CCU) e investigar o tipo de associação existente entre fator e desfecho. Método: Revisão Integrativa de Literatura a partir da busca de artigos nas bases Medline, Lilacs, PubMed e Scielo. Obteve-se 3.439 estudos, destes apenas 85 atendiam aos critérios de inclusão. Resultados: A maioria dos estudos encontrou associação entre alto nível socioeconômico e mortalidade CAM e entre baixo nível socioeconômico e mortalidade por CCU. Educação, renda/pobreza e mercado de trabalho foram os principais indicadores utilizados para avaliação dessas associações. Conclusão: Áreas com grande desigualdade social apresentam maior mortalidade por CCU enquanto aquelas com melhor nível socioeconômico exibem altas taxas de mortalidade por CAM. Estes fenômenos possuem várias explicações: estilo de vida dos indivíduos, oferta e acessibilidade aos serviços de rastreamento e/ou tratamento, estratificação social baseada no modelo econômico do país.
Stress and Burnout Syndrome Among Nursing Professinals Working in Nephrology: an Integrative Review / Estresse e Síndrome de Burnout em Profissionais de Enfermagem que Atuam na Nefrologia: Uma Revisão Integrativa
Authors: Ruback Sabrina Pinto , Tavares Joyce Martins Arimatea Branco , Lins Silvia Maria de Sá Basílio , Campos Tatiane da Silva , Rocha Ronilson Gonçalves , Caetano Débora Andrade
Published: July 2018

O estresse ocupacional crônico pode ocasionar o desenvolvimento da síndrome de burnout. Enfermeiros atuantes na nefrologia também estão predispostos à ocorrência do estresse e burnout. Objetivos: Identificar a produção científica relacionada à burnout e estresse em trabalhadores de enfermagem da nefrologia; discutir os fatores de risco e os fatores relacionados ao burnout e ao estresse em trabalhadores de enfermagem que atuam na nefrologia. Método: Trata-se de uma revisão integrativa. A amostra foi composta por 5253 artigos e após refinamento, foram obtidos 13 artigos completos. Resultados: Deste número, oito apesentaram altos níveis de estresse e/ou burnout entre enfermeiros da hemodiálise e cinco apontaram o burnout abaixo da média dos países de origem ou comparados a outros setores de cuidado em saúde. Conclusão: Com este resultado, espera-se ampliar a visão sobre o estresse e burnout em enfermeiros que atuam em nefrologia identificando os fatores que podem influenciar na assistência.
MicroRNA‐9 inhibits growth and invasion of head and neck cancer cells and is a predictive biomarker of response to plerixafor, an inhibitor of its target CXCR4
Authors: Hersi Hersi Mohamed , Raulf Nina , Gaken Joop , Folarin Najeem'deen , Tavassoli Mahvash
Published: June 2018

Head and neck squamous cell carcinomas (HNSCC) are associated with poor morbidity and mortality. Current treatment strategies are highly toxic and do not benefit over 50% of patients. There is therefore a crucial need for predictive and/or prognostic biomarkers to allow treatment stratification for individual patients. One class of biomarkers that has recently gained importance are microRNA (miRNA). MiRNA are small, noncoding molecules which regulate gene expression post‐transcriptionally. We performed miRNA expression profiling of a cohort of head and neck tumours with known clinical outcomes. The results showed miR‐9 to be significantly downregulated in patients with poor treatment outcome, indicating its role as a potential biomarker in HNSCC. Overexpression of miR‐9 in HNSCC cell lines significantly decreased cellular proliferation and inhibited colony formation in soft agar. Conversely, miR‐9 knockdown significantly increased both these features. Importantly, endogenous CXCR4 expression levels, a known target of miR‐9, inversely correlated with miR‐9 expression in a panel of HNSCC cell lines tested. Induced overexpression of CXCR4 in low expressing cells increased proliferation, colony formation and cell cycle progression. Moreover, CXCR4‐specific ligand, CXCL12, enhanced cellular proliferation, migration, colony formation and invasion in CXCR4‐overexpressing and similarly in miR‐9 knockdown cells. CXCR4‐specific inhibitor plerixafor abrogated the oncogenic phenotype of CXCR4 overexpression as well as miR‐9 knockdown. Our data demonstrate a clear role for miR‐9 as a tumour suppressor microRNA in HNSCC, and its role seems to be mediated through CXCR4 suppression. MiR‐9 knockdown, similar to CXCR4 overexpression, significantly promoted aggressive HNSCC tumour cell characteristics. Our results suggest CXCR4‐specific inhibitor plerixafor as a potential therapeutic agent, and miR‐9 as a possible predictive biomarker of treatment response in HNSCC.
Agility MLC transmission optimization in the Monaco treatment planning system
Authors: Roche Michael , Crane Robert , Powers Marcus , Crabtree Timothy
Published: June 2018

The Monaco Monte Carlo treatment planning system uses three‐beam model components to achieve accuracy in dose calculation. These components include a virtual source model (VSM), transmission probability filters (TPFs), and an x‐ray voxel Monte Carlo (XVMC) engine to calculate the dose in the patient. The aim of this study was to assess the TPF component of the Monaco TPS and optimize the TPF parameters using measurements from an Elekta linear accelerator with an Agility™ multileaf collimator (MLC). The optimization began with all TPF parameters set to their default value. The function of each TPF parameter was characterized and a value was selected that best replicated measurements with the Agility™ MLC. Both vendor provided fields and a set of additional test fields were used to create a rigorous systematic process, which can be used to optimize the TPF parameters. It was found that adjustment of the TPF parameters based on this process resulted in improved point dose measurements and improved 3D gamma analysis pass rates with Octavius 4D. All plans calculated with the optimized beam model had a gamma pass rate of > 95% using criteria of 2% global dose/2 mm distance‐to‐agreement, while some plans calculated with the default beam model had pass rates as low as 88.4%. For measured point doses, the improvement was particularly noticeable in the low‐dose regions of the clinical plans. In these regions, the average difference from the planned dose reduced from 4.4 ± 4.5% to 0.9 ± 2.7% with a coverage factor (k = 2) using the optimized beam model. A step‐by‐step optimization guide is provided at the end of this study to assist in the optimization of the TPF parameters in the Monaco TPS. Although it is possible to achieve good clinical results by randomly selecting TPF parameter values, it is recommended that the optimization process outlined in this study is followed so that the transmission through the TPF is characterized appropriately.
Palladium‐Catalyzed Carbonylative Cyclization of Terminal Alkynes and Anilines to 3‐Substituted Maleimides
Authors: Xu Jian‐Xing , Wu Xiao‐Feng
Published: June 2018

Herein, we describe an interesting palladium‐catalyzed protocol for the carbonylative synthesis of 3‐substituted maleimides. By annulation of simple anilines with terminal alkynes under carbon monoxide pressure, the desired 3‐substituted maleimides can be obtained in 50–85% yields. Additionally, with the addition of phosphine ligand, maleic acid isoimide can be obtained from the same substrates as well. With the presence of K2S2O8, the obtained maleic acid isoimide can be completely transformed to the corresponding maleimide.

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A Light‐Up Probe with Aggregation‐Induced Emission for Real‐Time Bio‐orthogonal Tumor Labeling and Image‐Guided Photodynamic Therapy
Authors: Hu Fang , Mao Duo , Kenry  , Cai Xiaolei , Wu Wenbo , Kong Deling , Liu Bin
Published: June 2018

Bio‐orthogonal tumor labeling is more effective in delivering imaging agents or drugs to a tumor site than active targeting strategy owing to covalent ligation. However, to date, tumor‐specific imaging through bio‐orthogonal labeling largely relies on body clearance to differentiate target from the intrinsic probe signal owing to the lack of light‐up probes for in vivo bio‐orthogonal labeling. Now the first light‐up probe based on a fluorogen with aggregation‐induced emission for in vivo bio‐orthogonal fluorescence turn‐on tumor labeling is presented. The probe has low background fluorescence in aqueous media, showing negligible non‐specific interaction with normal tissues. Once it reacts with azide groups introduced to tumor cells through metabolic engineering, the probe fluorescence is lightened up very quickly, enabling rapid tumor‐specific imaging. The photosensitizing ability was also used to realize effective image‐guided photodynamic tumor therapy.
Design and modularized optimization of one‐step production of N‐acetylneuraminic acid from chitin in Serratia marcescens
Authors: Yan Qiang , Fong Stephen S.
Published: June 2018

Chitin is an abundant, biorenewable, nitrogen‐rich biomass feedstock that can be potentially developed for biochemical production; however, efficient bioprocesses have yet to be established. Here, we demonstrate an engineered bioprocess to produce N‐acetylneuraminic acid (Neu5Ac) directly from chitin using the chitinolytic bacterium, Serratia marcescens by selecting and characterizing promoters, characterization of heterologous enzyme activity, and optimization of pathway fluxes. By generating RNASeq data for S. marcescens growth in different carbon‐limited conditions (glucose, N‐acetylglucosamine, and glycerol), 12 promoters with varying strength were identified and characterized to implement for transcriptional control. Neu5Ac production was initially engineered into S. marcescens through heterologous expression of N‐acetylglucosamine 2‐epimerase (slr1975) and N‐acetylneuraminic acid aldolase (nanA). The activity of both genes was characterized in vitro for kinetics and in vivo expression using promoters identified in this study. Optimization of Neu5Ac production was accomplished by balancing pathways fluxes through promoter swapping and replacing the reversible nanA with the irreversible gene neuB. The optimized recombinant strain P
T5‐slr1975‐P
rplJ‐neuB was able to produce 0.48 g/L Neu5Ac from 20 g/L N‐acetylglucosamine, and 0.30 g/L Neu5Ac from 5 g/L crystal chitin. These results represent the first demonstration of direct conversion of crystal chitin to N‐acetylneuraminic acid.
Outline‐etching image segmentation reveals enhanced cell chirality through intercellular alignment
Authors: Huang Yaozhun , Bao Yuanye , Kwong Hoi Kwan , Chen Ting‐Hsuan , Lam Miu Ling
Published: June 2018

Cells cultured on micropatterns exhibit a chiral orientation, which may underlie the development of left–right asymmetry in tissue microarchitectures. To investigate this phenomenon, fluorescence staining of nuclei has been used to reveal such orientation. However, for images with high cell density, analysis is difficult because of the overlapping nuclei. Here, we report an image processing method that can acquire cell orientations within dense cell populations. After initial separation based on Boolean addition of binarized images using global and adaptive thresholds, the overlapping nucleus contours in the binarized images were segmented by iteratively etching the outlines of nuclei, which allowed the orientations of each cell to be extracted from densely packed cell clusters. In applying this technique to cultured C2C12 myoblasts in micropatterned stripes on different substrates, we found an enhanced chiral orientation on glass substrate. More important, this enhanced chirality was consistently observed with increased intercellular alignment and independent of cell–cell distance or cell density, suggesting that intercellular alignment plays a role in determining the chiral orientation. By segmenting single cells with intact orientation, this technique offers an automated method for quantitative analysis with improved accuracy, providing an essential tool for studying left–right asymmetry and other morphogenic dynamics in tissue formation.
River response to large‐dam removal in a Mediterranean hydroclimatic setting: Carmel River, California, USA
Authors: Harrison Lee R. , East Amy E. , Smith Douglas P. , Logan Joshua B. , Bond Rosealea M. , Nicol Colin L. , Williams Thomas H. , Boughton David A. , Chow Kaitlyn , Luna Lauren
Published: June 2018

Dam removal provides a valuable opportunity to measure the fluvial response to changes in both sediment supply and the processes that shape channel morphology. We present the first study of river response to the removal of a large (32‐m‐high) dam in a Mediterranean hydroclimatic setting, on the Carmel River, coastal California, USA. This before‐after/control‐impact study measured changes in channel topography, grain size, and salmonid spawning habitat throughout dam removal and subsequent major floods. During dam removal, the river course was re‐routed in order to leave most of the impounded sediment sequestered in the former reservoir and thus prevent major channel and floodplain aggradation downstream. However, a substantial sediment pulse occurred in response to base‐level fall, knickpoint migration, and channel avulsion through sediment in the former reservoir above the newly re‐routed channel. The sediment pulse advanced ~3.5 km in the first wet season after dam removal, resulting in decreased riverbed grain size downstream of the dam site. In the second wet season after dam removal, high flows (including a 30‐year flood and two 10‐year floods) transported sediment > 30 km downstream, filling pools and reducing cross‐channel relief. Deposition of gravel in the second wet season after dam removal enhanced salmonid spawning habitat downstream of the dam site. We infer that in dam removals where most reservoir sediment remains impounded and where high flows follow soon after dam removal, flow sequencing becomes a more important driver of geomorphic and fish‐habitat change than the dam removal alone. © 2018 John Wiley & Sons, Ltd.
Evaluating competing activities to enhance functional communication training during reinforcement schedule thinning
Authors: Fuhrman Ashley M. , Greer Brian D. , Zangrillo Amanda N. , Fisher Wayne W.
Published: June 2018

Arranging periods in which requests for reinforcement are denied in a multiple schedule may result in increased destructive behavior during these periods for individuals who receive functional communication training (FCT) as treatment for severe destructive behavior. Providing access to competing activities during periods of reinforcer unavailability has been shown to minimize destructive behavior. We evaluated methods to identify effective competing activities for use when thinning reinforcement availability in a multiple schedule and compared competing activities embedded within the multiple schedule using an alternating‐treatments design. Results suggested at least one competing activity facilitated favorable treatment outcomes for each participant. We discuss building on this empirical approach to identify effective competing activities for use during reinforcement schedule thinning.
Cover Image, Volume 93, Issue 8
Authors: Delgove Marie AF , Elford Matthew T , Bernaerts Katrien V , De Wildeman Stefaan MA
Published: July 2018

The cover image, by Marie AF Delgove et al., is based on the Research Article Application of a thermostable Baeyer–Villiger monooxygenase for the synthesis of branched polyester precursors, DOI: 10.1002/jctb.5623.

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Greater Nutrient Intake Is Associated With Lower Mortality in Western and Eastern Critically Ill Patients With Low BMI: A Multicenter, Multinational Observational Study
Authors: Compher Charlene , Chittams Jesse , Sammarco Therese , Higashibeppu Naoki , Higashiguchi Takashi , Heyland Daren K.
Published: June 2018

Background: Little is known about the impact of feeding adequacy by NUTrition Risk in the Critically Ill (NUTRIC) groups in critically ill patients with body mass index (BMI) <20. Our purpose was to assess whether adequacy of protein/energy intake impacts mortality in patients with BMI <20 in Western/Eastern intensive care units (ICUs) and high/low NUTRIC groups.Methods: Data from the International Nutrition Survey 2013–2014 were dichotomized into Western/Eastern ICU settings; BMI <20 or ≥20; and high (≥5)/low (<5) NUTRIC groups. Association of BMI <20 with 60‐day mortality was compared in unadjusted and adjusted (Western/Eastern, age, medical/surgical admission, high/low NUTRIC group) logistic regression models. The impact of adequacy of protein/energy on 60‐day mortality relationship was tested using general estimating equations in high/low NUTRIC groups, in unadjusted and adjusted models.Results: Western (n = 4274) patients had higher mean BMI (27.9 ± 7.7 versus (vs) 23.4 ± 4.9,P< 0.0001) than Eastern (n = 1375), respectively. BMI <20 was associated with greater mortality (adjusted odds ratio [OR] 1.30, 95% confidence interval [CI] 1.07–1.57), with no interaction between BMI group and Western/Eastern ICU site. Among patients with BMI <20 and high NUTRIC score, 10% greater protein and energy adequacy was associated with 5.7% and 5.5% reduction in 60‐day mortality, respectively. Results were not significantly different between Western and Eastern ICUs.Conclusions: The benefit of greater protein/energy intake in high‐NUTRIC patients was observed regardless of geographic origin or low BMI, suggesting a consistent response to nutrition support in this group. Clinical guidelines and research projects focused on improving care in high‐risk critically ill patients can be applied across geographic boundaries.
Enteral Protein Supplementation in Critically Ill Children: A Randomized Controlled Pilot and Feasibility Study
Authors: Hauschild Daniela B. , Oliveira Luna D. A. , Farias Mirelle S. , Barbosa Eliana , Bresolin Nilzete L. , Mehta Nilesh M. , Moreno Yara M. F.
Published: June 2018

Background

Loss of muscle mass in critically ill children can negatively impact outcomes. The aims of this study were to conduct a pilot randomized control trial (RCT) to examine the difference in protein delivery and nitrogen balance in critically ill children with enteral protein supplementation vs controls. We also aimed to assess the feasibility, safety, and tolerance of the pilot trial.

Methods

This is a 3‐arm RCT in critically ill children eligible for enteral nutrition (EN) therapy. Patients were randomized to 1 of the 3 groups: (1) control (routine EN), (2) polymeric protein module added to EN to reach protein goal by day 4, or (3) oligomeric protein supplementation. Demographics, clinical characteristics, nutrition status, and daily nutrition intake variables were recorded. Protein delivery, nitrogen balance, feasibility variables, and rate of adverse events were the outcomes.

Results

After screening 286 consecutive patients admitted to the pediatric intensive care unit over 11 months, we enrolled and randomized 25 patients. Twenty‐two patients (88% of the enrolled) completed the study procedures. Significantly higher protein prescription and actual protein intake within the first 5 days was achieved in the intervention groups, compared with the control group. Nitrogen balance was obtained in 15 patients. There was no significant difference between the groups for the rate of adverse effects and clinical outcomes.

Conclusion

In our pilot trial, protein supplementation was safe and well tolerated. Our preliminary results suggest that a larger RCT is potentially feasible, with some modifications of the entry criteria. Trial enrollment was low, likely due to restrictive entry criteria.
Correction of severe beam‐hardening artifacts via a high‐order linearization function using a prior‐image‐based parameter selection method
Authors: Oh Daejoong , Kim Sewon , Park Doohyun , Choi Seungwon , Song Hundong , Choi Yunsu , Moon Seunghyuk , Baek Jongduk , Hwang Dosik
Published: June 2018

Purpose

Polychromatic x‐rays are used in most computed tomography scanners. In this case, a beam‐hardening effect occurs, which degrades the image quality and distorts the shapes of objects in the reconstructed images. When the beam‐hardening artifact is not severe, conventional correction methods can reduce the artifact reasonably well. However, highly dense materials, such as iron and titanium, can produce more severe beam‐hardening artifacts, which often cannot be corrected by conventional methods. Moreover, when the size of the metal is large, severe darks bands due to photon starvation as well as beam‐hardening are generated. The purpose of our study was to develop a new method for correcting severe beam‐hardening artifacts and severe dark bands using a high‐order polynomial correction function and a prior‐image‐based linearization method.

Methods

The initial estimate of an image free of beam‐hardening (a prior image) was constructed from the initial reconstruction of the original projection data. Its corresponding beam‐hardening‐free projection data (a prior projection) were calculated by a projection operator onto the prior image. A new beam‐hardening correction function G(praw) with many high‐order terms was effectively determined via a simple minimization process applied to the difference between the original projection data and the prior projection data. Using the determined correction function G(praw), a corrected linearized sinogram pcorr can be obtained, which became effectively linear for the line integrals of the object. Final beam‐hardening corrected images can be reconstructed from the linearized sinogram. The proposed method was evaluated in both simulation and real experimental studies.

Results

All investigated cases in both simulations and real experiments showed that the proposed method effectively removed not only streaks for moderate beam‐hardening artifacts but also dark bands for severe beam‐hardening artifacts without causing structural and contrast distortion.

Conclusions

The prior‐image‐based linearization method exhibited better correction performance than conventional methods. Because the proposed method did not require time‐consuming iterative reconstruction processes to obtain the optimal correction function, it can expedite the correction procedure and incorporate more high‐order terms in the linearization correction function in comparison to the conventional methods.
Performance characterization of an integrated cone‐beam CT system for dedicated gamma radiosurgery
Authors: Sarfehnia Arman , Ruschin Mark , Chugh Brige , Yeboah Collins , Becker Nathan , Cho Young‐Bin , Lee Young
Published: June 2018

Purpose

This work describes the performance characterization of a cone‐beam CT‐guided radiosurgery device, the Gamma Knife® Icon™.

Methods

The performance tests have been categorized into: (a) image quality and mechanical integrity; (b) image coregistration fidelity; (c) adaptive treatment delivery quality; (d) high definition motion management performance characterization; (e) software communication performance testing of the integrated cone‐beam CT (CBCT) system.

Results

All image quality performance characterization satisfied or exceeded manufacturer specifications. The image quality and mechanical stability of the CBCT system over a 3‐month period was within tolerance with negligible (<0.1°) detector tilt angle. The CBCT definition of the stereotactic space had a measured average discrepancy of 0.15–0.16 mm in x, y, and z directions. On average, the high definition motion management system performance was within 0.05 mm with a residual offset of 0.15 mm when large displacements in a given direction were taken. The adaptive treatment delivery component as measured with CBCT coregistration of daily setups against reference setup images was accurate to within 0.2°. Comprehensive end‐to‐end testing showed a total uncertainty of better than 0.2 mm in positioning and 0.4% in dosimetry for treatment of centrally located lesions.

Conclusions

A set of system performance characterization tests spanning all aspects of the Gamma Knife Icon are presented. Overall, the system performance was in line with manufacturer specifications.
Comparison of Two Methods for Estimating the Tip Position of a Nasogastric Feeding Tube: A Randomized Controlled Trial
Authors: Torsy Tim , Saman Renée , Boeykens Kurt , Duysburgh Ivo , Van Damme Nele , Beeckman Dimitri
Published: June 2018

Background

Several studies have shown that the nose‐earlobe‐xiphoid distance (NEX) is inadequate to estimate the insertion length of nasogastric tubes. An alternative approach tested in these studies, which leads to > 90% well‐placed nasogastric tubes, used a corrected calculation of the NEX: (NEX × 0.38696) + 30.37. The primary aim of this study was to determine whether using the corrected NEX was more successful than the NEX in determining the insertion length. The secondary aim was to investigate the likelihood to successfully obtain gastric aspirate.

Methods

Adult patients in a general hospital (N = 215) needing a nasogastric tube were randomized to the control (NEX) or intervention group (corrected NEX). Tip positioning was verified using X‐ray. Correct tip positioning was defined as between 3 and 10 cm under the lower esophageal sphincter (LES).

Results

In >20% of all patients, both methods underestimated the required tube length for correct positioning. The NEX showed an overestimation (17.2%) of the insertion length (>10 cm under the LES) compared with the corrected NEX (4.8%). There was no difference (P = 0.938) between the 2 groups in obtaining gastric aspirate (55.6% vs 56%). However, correct tip positioning resulted in a fourfold increase of obtaining gastric aspirate.

Conclusions

Both methods resulted in a high risk of incorrectly placed tubes due to malposition of the tip near the LES or distal esophagus. This may increase the risk of reflux and pulmonary aspiration. Based on these results, the development of more reliable methods requires consideration.
Reward‐enhancing effect of methylphenidate is abolished in dopamine transporter knockout mice: A model of attention‐deficit/hyperactivity disorder
Authors: Ide Soichiro , Ikekubo Yuiko , Hua Jennifer , Takamatsu Yukio , Uhl George R. , Sora Ichiro , Ikeda Kazutaka
Published: June 2018

Aim

Attention‐deficit/hyperactivity disorder is a heterogeneous neurobiological disorder that is characterized by inattention, impulsivity, and an increase in motor activity. Although methylphenidate has been used as a medication for decades, unknown is whether methylphenidate treatment can cause drug dependence in patients with attention‐deficit/hyperactivity disorder. This study investigated the reward‐enhancing effects of methylphenidate using intracranial self‐stimulation in an animal model of attention‐deficit/hyperactivity disorder, dopamine transporter knockout mice.

Methods

For the intracranial self‐stimulation procedures, the mice were trained to nosepoke to receive direct electrical stimulation via an electrode that was implanted in the lateral hypothalamus. After the acquisition of nosepoke responding for intracranial self‐stimulation, the effects of methylphenidate on intracranial self‐stimulation were investigated.

Results

In the progressive‐ratio procedure, dopamine transporter knockout mice exhibited an increase in intracranial self‐stimulation compared with wild‐type mice. Treatment with 5 and 10 mg/kg methylphenidate increased intracranial self‐stimulation responding in wild‐type mice. Methylphenidate at the same doses did not affect intracranial self‐stimulation responding in dopamine transporter knockout mice. We then investigated the effects of high‐dose methylphenidate (60 mg/kg) in a rate‐frequency procedure. High‐dose methylphenidate significantly decreased intracranial self‐stimulation responding in both wild‐type and dopamine transporter knockout mice.

Conclusions

These results suggest that low‐dose methylphenidate alters the reward system (ie, increases intracranial self‐stimulation responding) in wild‐type mice via dopamine transporter inhibition, whereas dopamine transporter knockout mice do not exhibit such alterations. High‐dose methylphenidate appears to suppress intracranial self‐stimulation responding not through dopamine transporter inhibition but rather through other mechanisms. These results support the possibility that methylphenidate treatment for attention‐deficit/hyperactivity disorder does not increase the risk of drug dependence, in attention‐deficit/hyperactivity disorder patients with dopamine transporter dysfunction.
Health literacy and the health status of men with prostate cancer
Authors: Goodwin Belinda C. , March Sonja , Zajdlewicz Leah , Osborne Richard H. , Dunn Jeff , Chambers Suzanne K.
Published: June 2018

Objective

To test the Health Literacy Questionnaire (HLQ) in a sample of men with prostate cancer and examine the components of health literacy that are most strongly associated with mental and physical health‐related quality of life in men with prostate cancer.

Method

Members (N = 565) of a state‐wide prostate cancer support network in Queensland, Australia (Mage = 71.14, SD = 8.68) completed the HLQ along with the Medical Outcomes Study, 36‐item short‐form health survey (SF‐36). Confirmatory factor analysis was employed to assess the internal structure of the HLQ. The effects (bs) of each of the nine health literacy factors on mental and physical health status were graphed and compared using Fishers exact test for comparing parameter estimates.

Results

Fit indices including RMSEA (0.069, CI = 0.066‐0.072), CFI (.853), and TLI (.839), alongside item loadings and internal consistency (Cronbach alphas >0.80) for the nine‐factor model, supported the robustness of the HLQ for use in this prostate cancer sample. Health literacy factors reflecting social and health provider support, navigating health systems, finding and understanding health information, and active engagement with providers shared small to moderate associations with mental health status and little to no association with physical health status.

Conclusion

Findings provide support for the use of the HLQ as a valid and reliable measure of health literacy in men with prostate cancer. Although further research is required to establish causality, interventions that aim to improve skills in connecting and effectively communicating with health care services and providers might lead to better mental health related quality of life for men with prostate cancer.