bluuebunny/crossref_metadata_2025 huggingface dataset:
Unreplicable state‐dependent effects on start‐box emergence latency in wild‐origin sticklebacks
Authors: Näslund Joacim
Published: May 2021

Animals are predicted to adjust their behaviour in relation to their bodily energetic state. Adjustment can be driven by either positive feedbacks (e.g. increased risk‐taking with higher energetic status; “state‐dependent safety”) or negative feedbacks (e.g. reduced risk‐taking with higher status; “asset protection”). This study investigated effects of food restriction and subsequent refeeding on boldness‐like behaviour in three‐spined sticklebacks (Gasterosteus aculeatus) and nine‐spined sticklebacks (Pungitius pungitius). The same experimental design was run in 2 consecutive years, using a start‐box emergence test to score behaviour, aiming for an exact replication in the second year. Results indicate that the results from the original and the replicated experiment did not match. Both years there was support for treatment effects, but the effects were qualitatively and quantitatively different. In 2012, the fish on a continuous high ration had longer emergence times than restricted‐refed fish (suggesting asset protection as the feedback mechanism), while in 2013, this pattern is reversed (suggesting state‐dependent safety as the feedback mechanism). In 2013, the general emergence time was also generally shorter than in 2012. These effects suggest that the methodology used may not be particularly robust. Subject fish were wild‐caught, and differences in the populations across years, or in the individuals' prior experience, may have influenced the results. Alternatively, the start‐box emergence test could be sensitive to minor (unperceived) alterations in procedures. Regardless, the present study suggests that the robustness of the start‐box emergence test, which is a commonly used test (e.g. to score “boldness” in animal personality experiments) needs further investigation. In addition to the behavioural experiment, fish going through the refeeding protocol were shown to have higher body water content than fish on a continuously high food ration in both species. Food restriction also decreased relative liver mass in the short term, but it was restored during refeeding.
Expanding the Traumatic Stress Framework to Incorporate a Socioecological Family Systems Perspective
Authors: Kelley Amber N. , Curtis Michael G. , Wieling Elizabeth
Published: May 2021

Over the past few decades, there has been a growing interest among systemic researchers and clinicians to address issues related to psychological traumatic stress. Yet, research in this area has largely focused on intrapersonal and physiological processes in conceptualizing traumatic stress and its various outcomes. Despite the usefulness of intrapersonally focused models of traumatic stress, this approach has its limitations. Emerging evidence indicates that both proximal contexts, such as family, and distal socioecological contexts, such as political and environmental systems, can have a profound effect on traumatic stress risk, presentation, and recovery. In the present article, we review and synthesize emerging research on traumatic stress and integrate findings from intrapersonally and systemically focused models of traumatic stress. We propose and present evidence for what we term the dynamic socioecological framework of traumatic stress, a heuristic framework for conceptualizing the interactions between different forms of traumatic stress. This framework puts forward the dimensions of traumatic stress typology, severity, and timing, underscoring how traumatic stress risk, presentation, and recovery are highly dependent upon the systems in which people are embedded. We conclude with a discussion of the research and clinical implications of this conceptual framework.
Role of Mcpip1 in obesity‐induced hepatic steatosis as determined by myeloid and liver‐specific conditional knockouts
Authors: Pydyn Natalia , Żurawek Dariusz , Kozieł Joanna , Kus Edyta , Wojnar‐Lason Kamila , Jasztal Agnieszka , Fu Mingui , Jura Jolanta , Kotlinowski Jerzy
Published: May 2021

Monocyte chemoattractant protein‐induced protein 1 (MCPIP1, alias Regnase 1) is a negative regulator of inflammation, acting through cleavage of transcripts coding for proinflammatory cytokines and by inhibition of NFκB activity. Moreover, it was demonstrated that MCPIP1 regulates lipid metabolism both in adipose tissue and in hepatocytes. In this study, we investigated the effects of tissue‐specific Mcpip1 deletion on the regulation of hepatic metabolism and development of nonalcoholic fatty liver disease (NAFLD). We used control Mcpip1fl/fl mice and animals with deletion of Mcpip1 in myeloid leukocytes (Mcpip1fl/flLysMCre) and in hepatocytes (Mcpip1fl/flAlbCre), which were fed chow or a high‐fat diet (HFD) for 12 weeks. Mcpip1fl/flLysMCre mice fed a chow diet were characterized by a significantly reduced hepatic expression of genes regulating lipid and glucose metabolism, which subsequently resulted in low plasma glucose level and dyslipidemia. These animals also displayed systemic inflammation, demonstrated by increased concentrations of cytokines in the plasma and high Tnfa, Il6, IL1b mRNA levels in the liver and brown adipose tissue (BAT). Proinflammatory leukocyte infiltration into BAT, together with low expression of Ucp1 and Ppargc1a, resulted in hypothermia of 22‐week‐old Mcpip1fl/flLysMCre mice. On the other hand, there were no significant changes in phenotype in Mcpip1fl/flAlbCre mice. Although we detected a reduced hepatic expression of genes regulating glucose metabolism and β‐oxidation in these mice, they remained asymptomatic. Upon feeding with a HFD, Mcpip1fl/flLysMCre mice did not develop obesity, glucose intolerance, nor hepatic steatosis, but were characterized by low plasma glucose level and dyslipidemia, along with proinflammatory phenotype. Mcpip1fl/flAlbCre animals, following a HFD, became hypercholesterolemic, but accumulated lipids in the liver at the same level as Mcpip1fl/fl mice, and no changes in the level of soluble factors tested in the plasma were detected. We have demonstrated that Mcpip1 protein plays an important role in the liver homeostasis. Depletion of Mcpip1 in myeloid leukocytes, followed by systemic inflammation, has a more pronounced effect on controlling liver metabolism and homeostasis than the depletion of Mcpip1 in hepatocytes.
High plasticity in germination and establishment success in the dominant forest tree Fagus sylvatica across Europe
Authors: Muffler Lena , Schmeddes Jonas , Weigel Robert , Barbeta Adrià , Beil Ilka , Bolte Andreas , Buhk Constanze , Holm Stefanie , Klein Geoffrey , Klisz Marcin , Löf Magnus , Peñuelas Josep , Schneider Léonard , Vitasse Yann , Kreyling Juergen
Published: May 2021

Aim

Distribution ranges of temperate tree species are shifting poleward and upslope into cooler environments due to global warming. Successful regeneration is crucial for population persistence and range expansion. Thus, we aimed to identify environmental variables that affect germination and seedling establishment of Europe's dominant forest tree, to compare the importance of plasticity and genetic variation for regeneration, and to evaluate the regeneration potential at and beyond the southern and northern distribution margins.

Location

Europe.

Time period

2016–2018.

Major taxa studied

European beech (Fagus sylvatica (L.)).

Methods

We investigated how germination, establishment and juvenile survival change across a reciprocal transplantation experiment using over 9,000 seeds of beech from 7 populations from its southern to its northern distribution range margins.

Results

Germination and establishment at the seedling stage were highly plastic in response to environmental conditions. Germination success increased with warmer and declined with colder air temperature, whereas establishment and survival were hampered under warmer and drier conditions. Germination differed among populations and was positively influenced by seed weight. However, there was no evidence of local adaptation in any trait.

Main conclusions

The high plasticity in the early life‐history traits found irrespective of seed origin may allow for short‐term acclimatization. However, our results also indicate that this plasticity might not be sufficient to ensure the regeneration of beech in the future due to the low survival found under dry and hot conditions. The future climatic conditions in parts of the distribution centre and at the rear edge might thus become limiting for natural regeneration, as the likelihood of extreme heat and drought events will increase. By contrast, at the cold distribution margin, the high plasticity in the early life‐history traits may allow for increasing germination success with increasing temperatures and may thus facilitate natural regeneration in the future.
Reduced handgrip strength predicts poorer survival in chronic liver diseases: A large multicenter study in Japan
Authors: Nishikawa Hiroki , Shiraki Makoto , Hiramatsu Akira , Hara Nagisa , Moriya Kyoji , Hino Keisuke , Koike Kazuhiko
Published: May 2021

Aim

Sarcopenia has a high prevalence and can be an adverse predictor in patients with chronic liver diseases (CLDs). We sought to assess the prevalence of sarcopenia and its prognostic significance in patients with CLDs at multiple centers in Japan.

Methods

In this retrospective study, we collated the data of 1624 patients with CLDs (976 men). The diagnosis of sarcopenia was determined by the sarcopenia assessment criteria of the Japan Society of Hepatology. Predictors of mortality were identified using univariate and multivariate analyses.

Results

Muscle weakness and skeletal muscle loss occurred in 33.5% and 29.3% of all subjects, respectively, while sarcopenia occurred in 13.9% of all patients. Patients with sarcopenia had a poorer prognosis among all patients, patients with hepatocellular carcinoma (HCC), and those without HCC by log‐rank test. The multivariate Cox proportional hazards model identified female gender (hazard ratio [HR], 0.59; p = 0.03), alcoholic liver disease (HR, 4.25; p < 0.01), presence of HCC (HR, 6.77; p < 0.01), Child–Pugh classes A (HR, 1.42; p < 0.05), B (HR, 2.70; p < 0.01), and C (HR, 6.30; p < 0.01), and muscle weakness (HR, 2.24; p < 0.01) as significant adverse predictors. The cut‐off values of handgrip strength (HGS) for prognosis determined by maximally selected rank statistics were calculated as 27.8 kg for men and 18.8 kg for women.

Conclusion

Reduced HGS in patients with CLD was an independent adverse predictor of mortality, with cut‐off values of 27.8 kg for men and 18.8 kg for women.
Association between PDCD1 gene polymorphisms and psoriasis susceptibility in the Chinese population
Authors: Hua Shengyuan , Fan Bin , Mao Weiwei , Xu Rong , Wang Yifei , Kuai Le , Ding Xiaojie , Li Bin , Chen Jie , Miao Xiao
Published: May 2021

Background

As an immune regulator expressed on the surface of activated T cells, programmed cell death 1 (PDCD1) plays an important role in psoriasis. However, whether PDCD1 genetic polymorphism is associated with psoriasis has yet to be explored.

Objective

To study the association between polymorphisms of the immune‐related gene PDCD1 and psoriasis susceptibility in the Chinese population, to illustrate the genetic mechanism of psoriasis and provide new research ideas for the diagnosis and treatment of psoriasis (PS).

Methods

Overall, 128 psoriasis patients and 88 healthy controls were included in this study. Using polymerase chain reaction (PCR)‐Sanger sequencing analysis, six PDCD1 single nucleotide polymorphisms (SNPs) were sequenced: PD1.1, PD1.3, PD1.4, PD1.5, PD1.6, and PD1.9.

Results

Among the six tested SNPs, PD1.6 showed a significant association with psoriasis in genotype and allele frequency distribution. The G allele of PD1.6 increased the risk of psoriasis (P = 0.03). In contrast, the other five SNPs failed to show association with psoriasis. Further analysis within the patient group showed that the frequency of the PD1.6 G allele was relatively high in severe psoriasis, but the difference was nonsignificant.

Conclusion

PDCD1 gene polymorphism is associated with psoriasis. The population carrying PD1.6 allele G are at a higher risk of developing psoriasis, though the severity of psoriasis does not correlate with PD1.6 polymorphism.
The region matters—for whom? The regional actor network for vocational education and training in tourism of Cancún (Mexico)
Authors: Röhrer Natascha , Vogelsang Beke , Fuchs Martina
Published: May 2021

Actor networks are relevant to provide vocational education and training. Many studies have focused on such networks without a clear regional focus. Suggesting a conceptual approach of regional actor networks based on contributions of business education and economic geography, this study analyses the regional actor network in the tourism sector in Cancún (Mexico). Methodologically, the study follows an exploratory qualitative approach. The results illustrate that there are two dominant axes within the regional network, which comprise on the one hand hotels cooperating with applied universities, and on the other hand hotels cooperating with vocational schools. This local actor network has impacts on the practical relevance that vocational education and training provides to the learners, and generates a particular, and rather vulnerable, way of regional development.
Non‐structural protein 1‐specific antibodies directed against Zika virus in humans mediate antibody‐dependent cellular cytotoxicity
Authors: Sanchez Vargas Luis A. , Adam Awadalkareem , Masterson Mary , Smith Madison , Lyski Zoe L. , Dowd Kimberly A. , Pierson Theodore C. , Messer William B. , Currier Jeffrey R. , Mathew Anuja
Published: May 2021

There is growing interest in understanding antibody (Ab) function beyond neutralization. The non‐structural protein 1 (NS1) of Zika virus (ZIKV) is an attractive candidate for an effective vaccine as Abs against NS1, unlike the envelope or premembrane, do not carry the risk of mediating antibody‐dependent enhancement. Our aim was to evaluate whether ZIKV NS1 Abs elicited following natural infection in humans can mediate antibody‐dependent cellular cytotoxicity (ADCC). We evaluated the isotype specificity of ZIKV‐specific Abs in immune sera and supernatants from stimulated immune PBMC and found that Abs against ZIKV NS1 and virus‐like particles were predominantly of the IgG1 isotype. Using a recently developed FluoroSpot assay, we found robust frequencies of NS1‐specific Ab‐secreting cells in PBMC of individuals who were naturally infected with ZIKV. We developed assays to measure both natural killer cell activation by flow cytometry and target cell lysis of ZIKV NS1‐expressing cells using an image cytometry assay in the presence of ZIKV NS1 Abs. Our data indicate efficient opsonization of ZIKV NS1‐expressing CEM‐NKR cell lines using ZIKV‐immune but not ZIKV‐naïve sera, a prerequisite of ADCC. Furthermore, sera from immune donors were able to induce both NK cell degranulation and lysis of ZIKV NS1 CEM‐NKR cells in vitro. Our data suggest that ADCC is a possible mechanism for ZIKV NS1 Abs to eliminate virally infected target cells.
Immigrant children in Turkey a descriptive study: Determining the depression levels of children who have been exposed to forced migratıon
Authors: Öztürk Ceyda , Güleç Keskin Serap
Published: May 2021

Purpose

The aim of this study was to determine the level of depression in children aged 6–17 years who had been subject to forced migration.

Design and Method

This study was a descriptive design. The sample included comprised 200 children aged 6–17 years who had experienced forced migration.

Findings

About 69.5% of the children who participated in the research migrated from Syria due to war. Participants’ mean Children's Depression Inventory (CDI) score was 13.65 ± 8.58; a CDI score of 19 and higher is considered to indicate depression.

Conclusion

It was found that the depression levels of the migrant children were low.

Practice Implications

Psychiatric nurses should understand risk factors for depression when providing care to immigrant children.
The effect of preventive psychosocial interventions directed towards mothers and children on children's knowledge about protection from sexual abuse
Authors: Orak Oya Sevcan , Okanli Ayşe
Published: May 2021

Problem

Sexual abuse is a multidimensional public health problem that concerns all communities. Primary‐level preventive approaches in the fight against sexual abuse have an important place. However, research involving parents in sexual abuse prevention interventions with children is limited. The aim of this study is to determine the effect of preventive psychosocial interventions directed towards mothers and their children on children's knowledge about protection from sexual abuse.

Methods

The study has a quasi‐experimental, comparative design with a control group and a pretest/posttest. The participants were assigned into four groups; namely, control, mother psychoeducation, child psychoeducation and mother–child psychoeducation.

Findings

Significant difference was determined within and between the groups in the mean scores of the Good Touch Bad Touch Curriculum test (p < 0.001).

Conclusion

The preventive psychosocial intervention simplemented to mothers and their children increase children's knowledge about protection from sexual abuse.
The P300/XBP1s/Herpud1 axis promotes macrophage M2 polarization and the development of choroidal neovascularization
Authors: Li Wendie , Wang Ying , Zhu Linling , Du Shu , Mao Jinghai , Wang Yanyan , Wang Sangsang , Bo Qingyun , Tu Yuanyuan , Yi QuanYong
Published: May 2021

Neovascular age‐related macular degeneration (AMD), which is characterized by choroidal neovascularization (CNV), leads to vision loss. M2 macrophages produce vascular endothelial growth factor (VEGF), which aggravates CNV formation. The histone acetyltransferase p300 enhances the stability of spliced X‐box binding protein 1 (XBP1s) and promotes the transcriptional activity of the XBP1s target gene homocysteine inducible endoplasmic reticulum protein with ubiquitin‐like domain 1 (Herpud1). Herpud1 promotes the M2 polarization of macrophages. This study aimed to explore the roles of the p300/XBP1s/Herpud1 axis in the polarization of macrophages and the pathogenesis of CNV. Hypoxia‐induced p300 interacted with XBP1s to acetylate XBP1s in RAW264.7 cells. Additionally, hypoxia‐induced p300 enhanced the XBP‐1s‐mediated unfolded protein response (UPR), alleviated the proteasome‐dependent degradation of XBP1s and enhanced the transcriptional activity of XBP1s for Herpud1. The hypoxia‐induced p300/XBP1s/Herpud1 axis facilitated RAW264.7 cell M2 polarization. Knockdown of the p300/XBP1s/Herpud1 axis in RAW264.7 cells inhibited the proliferation, migration and tube formation of mouse choroidal endothelial cells (MCECs). The p300/XBP1s/Herpud1 axis increased in infiltrating M2‐type macrophages in mouse laser‐induced CNV lesions. Blockade of the p300/XBP1s/Herpud1 axis inhibited macrophage M2 polarization and alleviated CNV lesions. Our study demonstrated that the p300/XBP1s/Herpud1 axis in infiltrating macrophages increased the M2 polarization of macrophages and the development of CNV.
Commentary response: Smartphone use and parenting: re‐stratifying the multiverse for families of young children
Authors: Modecki Kathryn L. , Low‐Choy Samantha , Vasco Daniela , Vernon Lynette , Uink Bep
Published: May 2021

Concerns have been raised that smartphones may harm children and families. Arguably, risk‐driven discourses are not always evidence‐based. This is a problem, because blanket assumptions of risk drowns out nuanced empirical questions of what constitutes “good” parenting when it comes to smartphone use, and for whom. Here we outline three logical missteps which have contributed to the deficit zeitgeist—ignoring context, misinterpreting effect, and conflation. Further, we speak to questions about parents of young children, by refocusing our multiverse analysis on 800+ parents. We ask– where are the links between parental phone use and parenting? Are these robust versus frail or positive versus negative? After re‐examining our 84 analytic choices (adopting existing measures), patterns revealed fragility in this case. The few findings that did emerge implicated technoference, not smartphone use, in relation to negative parenting. We encourage continued rigorous and scientific dialogue, to accrue good evidence for families and children.
Hepatitis B core‐related antigen predicts disease progression and hepatocellular carcinoma in hepatitis B e antigen‐negative chronic hepatitis B patients
Authors: Kaneko Shun , Kurosaki Masayuki , Inada Kento , Kirino Sakura , Hayakawa Yuka , Yamashita Koji , Osawa Leona , Sekiguchi Shuhei , Higuchi Mayu , Takaura Kenta , Maeyashiki Chiaki , Tamaki Nobuharu , Yasui Yutaka , Itakura Jun , Takahashi Yuka , Tsuchiya Kaoru , Nakanishi Hiroyuki , Izumi Namiki
Published: May 2021

Background and Aim

The serum hepatitis B core‐related antigen (HBcrAg) is considered a surrogate marker of the amount and activity of intrahepatic covalently closed circular DNA. This study aims to investigate the virological characteristics of HBcrAg in chronic hepatitis B (CHB) patients and to reveal the hepatocellular carcinoma (HCC) risk factors of hepatitis B e antigen (HBeAg)‐negative patients.

Methods

Hepatitis B core‐related antigen was measured in 245 naive CHB patients before receiving nucleoside/nucleotide analog (NA) therapy. All patients were receiving NA (entecavir, tenofovir disoproxil fumarate, and tenofovir alafenamide) continuously for more than 1 year until the end of follow‐up, and they did not have a history of HCC. Hepatitis B viral status was compared between 106 HBeAg‐positive and 139 HBeAg‐negative patients.

Results

Median HBcrAg levels were significantly higher in HBeAg‐positive patients than in HBeAg‐negative patients (> 6.8 vs 3.7 log U/mL, P < 0.01). In HBeAg‐negative patients, higher HBcrAg levels were associated with cirrhosis (119 chronic hepatitis/20 cirrhosis = 3.5/4.7 log U/mL, P = 0.03) and higher serum hepatitis B virus DNA. During a median follow‐up of 5.28 (1.03–12.0) years, the 5‐year cumulative HCC incidence rate was 5.4% in the HBeAg‐negative cohort. In the multivariate Cox regression analysis, higher HBcrAg levels at 1 year were independent predictive factors for HCC development in HBeAg‐negative patients who received NA therapy (cutoff value, 4.1 log U/mL; hazard ratio, 6.749; 95% confidence interval, 1.334–34.15, P < 0.01) and even in non‐cirrhosis patients.

Conclusion

Hepatitis B core‐related antigen was useful for understanding disease progression in CHB patients and for stratifying the risk for carcinogenesis in HBeAg‐negative patients receiving NA therapy.
Nursing and the Sustainable Development Goals: A Scoping Review
Authors: Fields Lorraine , Perkiss Stephanie , Dean Bonnie Amelia , Moroney Tracey
Published: May 2021

Purpose

In 2015, all member states that comprise the United Nations unanimously adopted the Sustainable Development Goals (SDGs), a set of ambitious and inclusive targets toward global economic, social, and environmental betterment. Nurses have a key role to play in the achievement of the SDGs. The aim of this article was to conduct a scoping review to synthesize the literature related to nursing and the SDGs.

Methods

This scoping review utilized Arksey and O’Malley’s five‐stage framework. Several electronic databases were searched for literature published from 2015 to 2020 using the key words “nurse OR nurses OR nursing” and “Sustainable Development Goals OR SDGs”.

Findings

A total of 447 articles were identified through the databases searches, of which 35 articles were deemed relevant and included for final review and content analysis. Analysis of relevant literature on nursing and the SDGs revealed two distinct, yet connected, perspectives: the nurse and the profession.

Conclusions

Individual nurses may feel disconnected from the SDGs and struggle to relate the goals to their clinical role, calling for an increase in awareness and education on the goals. The wider profession could also increase both research and policy with relation to the SDGs, strengthening nursing’s position to have a voice in and contribute towards achievement of the goals.

Clinical Relevance

Individual nurses and the wider nursing profession have opportunities to more meaningfully contribute to the SDGs, beginning with an increased awareness through education and a commitment to research and participation in local and global decision making.
The effects of online consumer credit on household consumption level and structure: Evidence from China
Authors: Li Jie , Song Quanyun , Wu Yu , Huang Bihong
Published: May 2021

Using data from the China Household Finance Survey (CHFS) in 2017, this paper examines the association between access to online consumer credit and household consumption. We find that online consumer credit has a significantly positive relationship with household consumption. Heterogeneity analysis shows that the relationship between online consumer credit and household consumption is more obvious among poorer households and households resided in less developed areas, which partially reflects the inclusiveness of online consumer credit. Further analysis shows that online consumer credit mainly increases the expenditures of large‐sum and non‐daily items, which suggests that online consumer credit has promoted consumption upgrading of households.
‘A picture is worth a thousand words’—A photovoice study exploring health professionals’ experiences during the COVID‐19 pandemic
Authors: Badanta Bárbara , Acevedo‐Aguilera Rosa , Lucchetti Giancarlo , de Diego‐Cordero Rocío
Published: May 2021

Aim

To elicit the experiences and perspectives of health professionals working on the frontline in the COVID‐19 pandemic.

Background

Although some qualitative studies have been carried out in health professionals during COVID‐19 pandemic, to our knowledge, no study has used the Photovoice method.

Design

A qualitative descriptive study using Photovoice was carried out between March and June 2020.

Methods

A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID‐19 pandemic. Following the Photovoice method, audio‐recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used.

Results/Findings

Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID‐19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals.

Conclusion

These findings highlight the essential role of health professionals in the COVID‐19 pandemic and the tireless work they are carrying out to provided highly skilled care.

Relevance to clinical practice

These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well‐being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.
Understanding the decision‐making of critical care nurses when restraining a patient with psychomotor agitation secondary to hyperactive delirium: A ‘Think Aloud’ study.
Authors: Teece Angela , Baker John , Smith Helen
Published: May 2021

Aims & Objectives

This study aimed to explore the decision‐making processes undertaken by critical care nurses when considering restraint to manage a patient with psychomotor agitation secondary to hyperactive delirium.

Background

Psychomotor agitation is frequently cited as clinical rationale for initiating chemical or physical restraint. Despite the presence of clinical guidance for restraint in critical care, wide variations in nursing and prescribing practice are evident. Nurses are the primary decision makers when initiating restraint, but little is known about this process and influencing factors.

Design

A pragmatic qualitative approach was used to explore critical care nurses’ decision‐making processes.

Methods

A ‘think aloud’ approach was undertaken. Audio‐visual vignettes featuring simulated patients were used as stimulus to elicit decision‐making processes from thirty critical care nurses and practitioners. The COREQ checklist was followed.

Results

Five themes relating to restraint were identified: Intrinsic beliefs and aptitudes; Handover and labelling; Failure to maintain a consistent approach; Restraint might be used to replace vigilance; The tyranny of the now.

Conclusions

Restraint was more frequent when staffing ratios were reduced below 1:1 and opportunities for vigilance reduced. Participants described physical and psychological exhaustion when caring for a patient with delirium and how this might lead to restraint to create ‘space’ for respite. Variations in practice were evident and restraint use appears rooted in custom and culture rather than objective assessment.

Relevance to clinical practice

The lack of pre‐emptive management for hyperactive delirium and reduced staffing ratios lead to the decision to restrain to preserve safety in acute agitation. The struggle to manage agitated behaviour is associated with nurse burnout and reduced engagement with therapeutic management methods, suggesting the need for psychological and educational support for clinical staff. Delirium is an important and debilitating form of organ dysfunction which should be collaboratively managed by the multi‐disciplinary team.
Developing a theory to help guide End‐Stage Renal Disease Patients to adapt to Peritoneal Dialysis: A grounded theory study
Authors: Chen Shui‐Tao , Yao YuChun , Tseng Yun Shan , Sun Fan‐Ko
Published: May 2021

Aim and objectives

The aim of this study was to develop a theory to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis.

Background

Taiwan ranks first worldwide in end‐stage renal disease incidence and dialysis prevalence. Many patients cannot accept long‐term dialysis treatment and thus face several physical and psychological suffering. No theory has yet been developed to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis.

Design

A grounded theory approach was used in this study.

Methods

A theoretical sampling was performed after interviewing 25 patients who had adapted to peritoneal dialysis at a medical centre in Taiwan from January 2018 to September 2018; data saturation was achieved. Data were analysed using open, axial and selective coding and while using the constant comparison technique. COREQ reporting guidelines were utilised.

Results

A substantive theory was developed to help guide patients with end‐stage renal disease to adapt to peritoneal dialysis. The core category that emerged from the data collected was ‘Confronting peritoneal dialysis to live and co‐exist with peritoneal dialysis’. Other key categories linked to and embraced in this core category were as follows: positive self‐regulation, regulation of daily life and the process of adaptation to dialysis method.

Conclusion

The results could help healthcare professionals to better understand the process of end‐stage renal disease patients’ adaptation to peritoneal dialysis, thereby facilitating patients’ adaptation to dialysis in their daily life, enhancing their quality of life and improving the quality of medical care.

Relevance to clinical practice

Healthcare professionals could use this theory as reference when providing care for peritoneal dialysis patients to assist them in adapting to life with peritoneal dialysis as soon as possible through positive self‐regulation, daily life adjustments and the process of adapting to the dialysis method.
Pharmacokinetics and pharmacodynamics of doxycycline in aStreptococcusequisubsp.zooepidemicusinfection model in horses
Authors: Chapuis Ronan J. J. , Smith Joe S. , Uehlinger Fabienne D. , Meachem Melissa , Johnson Ron , Dowling Patricia M.
Published: May 2021

The objectives of this study were to investigate the pharmacokinetics (PK), pharmacodynamics (PD), and the efficacy of oral administration of doxycycline (DXC) in horses withStreptococcus zooepidemicustissue infections. Tissue chambers (TC) were implanted subcutaneously in the cervical region of 7 horses and inoculated with a singleS. zooepidemicusisolate with a minimum inhibitory concentration (MIC) of 0.25 µg/ml, determined by agar dilution. Doxycycline hyclate (10 mg/kg, orally, q 12 h, for 5 days) mixed with poloxamer gel was started following inoculation. The TC fluid was sampled prior to and following inoculation for cytology analysis, quantitative culture, and DXC determination. Plasma DXC concentrations were measured over 48 h following the last dose of DXC administered. The mean plasma peak concentration (Cmax) of DXC was 0.32 µg/ml, and concentrations above the MIC were only reached in 3 TC samples. In plasma, meanT > MIC was 2.4 h, meanCmax/MIC was 1.30, and mean AUClast/MIC was 11.63 h. These PK/PD indices did not reach the suggested targets for DXC treatments of infections, and the TC abscessed in all horses. This is the first study to evaluate the recommended dose of DXC in horse in an infection model.
Mortality in critically ill patients with coronavirus disease 2019‐associated pulmonary aspergillosis: A systematic review and meta‐analysis
Authors: Singh Shreya , Verma Nipun , Kanaujia Rimjhim , Chakrabarti Arunaloke , Rudramurthy Shivaprakash M.
Published: May 2021

Reports of COVID‐19 associated pulmonary aspergillosis (CAPA) are rising, but the associated mortality and factors affecting it are not well‐characterised. We performed a systematic review including 20 peer‐reviewed English language studies reporting mortality in CAPA published till 18 February 2021from PubMed, Ovid SP, Web of Science, Embase and CINHAL. The pooled mortality in CAPA was 51.2% (95% CI: 43.1–61.1, I2 = 38%). The leave one out sensitivity analysis and influential case diagnostics revealed one outlier and its exclusion resulted in a mortality estimate of 54% (95% CI: 45–62). Higher odds of mortality: 2.83 (95% CI: 1.8–4.5) were seen in CAPA compared to controls. No significant difference in various subgroups according to the country of study, the continent of study, income category of country and quality of the included study was seen. None of the host risk factors, mycological test results, therapy for COVID‐19 and antifungal therapy affected mortality. Thus, patients with CAPA have a high probability of mortality and early diagnosis with prompt therapy must be ensured to optimally manage these patients. However, more prospective studies with global and multi‐centre coordination may help to address CAPA in a better way.
GAB1 overexpression identifies hedgehog‐activated anterior skull base meningiomas
Authors: Boetto Julien , Lerond Julie , Peyre Matthieu , Tran Suzanne , Marijon Pauline , Kalamarides Michel , Bielle Franck
Published: May 2021

Aims

Mutations activating the hedgehog (Hh) signalling pathway have been described in anterior skull base meningiomas, raising hope for the use of targeted therapies. However, identification of Hh‐activated tumours is hampered by the lack of a reliable immunohistochemical marker. We report the evaluation of GAB1, an immunohistochemical marker used to detect Hh pathway activation in medulloblastoma, as a potential marker of Hh‐activated meningiomas.

Methods

GAB1 staining was compared to SMO mutation detection with Sanger and NGS techniques as well as Hh pathway activation study through mRNA expression level analyses in a discovery set of 110 anterior skull base meningiomas and in a prospective validation set of 21 meningiomas.

Results

Using an expression score ranging from 0 to 400, we show that a cut‐off score of 250 lead to excellent detection of Hh pathway mutations (sensitivity 100%, specificity 86%). The prospective validation set confirmed the excellent negative predictive value of GAB1 to exclude Hh‐independent meningiomas. We describe a large series of 32 SMO‐mutant meningiomas and define multiple ways of Hh activation, either through somatic mutations or associated with mutually co‐exclusive sonic hedgehog (SHH) or Indian hedgehog (IHH) overexpression independent of the mutations.

Conclusion

The assessment of GAB1 expression by an immunohistochemical score is a fast and cost‐efficient tool to screen anterior skull base meningiomas for activation of the Hh pathway. It could facilitate the identification of selected cases amenable to sequencing for Hh pathway genes as predictive markers for targeted therapy.
A novel BLOC1S5‐related HPS‐11 patient and zebrafish with bloc1s5 disruption
Authors: Zhong Zilin , Wu Zhuanbin , Zhang Jun , Chen Jianjun
Published: May 2021

Hermansky–Pudlak Syndrome (HPS) cases present with a variable degree of OCA and bleeding tendency. HPS is categorized into eleven types based on eleven causative genes, and disease severity varies among different types. By whole‐exome sequencing performed on a family trio and Sanger sequencing of candidate variants, we identified a novel homozygous variant (NM_201280.3: c.181delC, p.Val61*) in BLOC1S5 in the patient who presents OCA and mild bleeding diathesis, and his healthy parents are heterozygous carriers. The variant can be considered pathogenic based on the guideline American College of Medical Genetics and Genomics, and the patient is proposed to be affected with HPS‐11. In this study, we also explored bloc1s5 in zebrafish. bloc1s5 mRNA can be detected during early development of zebrafish. bloc1s5 knockdown zebrafish present with retinal hypopigmentation, thrombocytes loss and pericardial edema, and dll4/notch1 signaling and vascular integrity signaling are down‐regulated at mRNA level in bloc1s5 morphants. The data from the first HPS‐11 patient in Chinese population expand phenotypic and genotypic spectrum of HPS‐11. Disruption of bloc1s5 in zebrafish recapitulates HPS‐11‐like phenotypes, and the potential signaling pathways associated with bloc1s5 are proposed. Altogether, this study may facilitate genetic counseling of HPS and investigation about BLOC1S5.
Granulosa cells affect in vitro maturation and subsequent parthenogenetic development of buffalo (Bubalus bubalis) oocytes
Authors: Zhang Jun , Wang Haoxin , Lu Jiaka , Yu Qing , Fu Penghui , Li Zhengda , Feng Yun , Wang Yanxin , Deng Yanfei , Shi Deshun , Lu Fenghua
Published: May 2021

Granulosa cells (GCs) play a crucial role in follicular development and atresia. Previous studies have showed that GCs in the form of monolayer influenced in vitro maturation (IVM) of oocytes. However, the effects of GCs in the form of conditioned medium and monolayer on IVM and development competence of buffalo oocytes remain unclear. In the present study, we examined the impacts of GC‐conditioned medium (GCCM) and monolayer GC on maturation efficiency and embryo development of buffalo oocytes after parthenogenetic activation (PA). Our results showed that GCCM that was collected on day 2 and added to IVM medium at a 20% proportional level (2 days and 20%) exerted significant negative effects on IVM rate (41.6% vs. 44.5%), but significantly enhanced embryo development (oocyte cleavage, 81.3% vs. 69.3%; blastocyst formation, 36.3% vs. 29.3%) of buffalo oocytes after PA compared with the control group. Furthermore, monolayer GC significantly reduced both maturation efficiency (40.2% vs. 44.5%) and embryo development (oocyte cleavage, 60.6% vs. 69.3%; blastocyst formation, 20.6% vs. 29.3%) of buffalo oocytes after PA compared to the control group. Our study indicated that GCs in the form of GCCM (2 days and 20%) and monolayer GC had different effects on IVM and subsequent parthenogenetic development of buffalo oocytes.
Changing Jerome’s Bible: Biblical quotations in the patristic translations of Lampugnino Birago (1390–1472) and George of Trebizond (1396–1472/3)☆
Authors: den Haan Annet
Published: May 2021

The fifteenth‐century Italian humanists applied their ideas on translation and textual scholarship not only to classical texts, but also to Scripture. One problem they encountered was the rendering of biblical passages in their patristic translations. The Church Fathers had occasionally based their exegesis on variant readings or interpretations that clashed with ‘Jerome’s translation’, the Latin translation in common use in the fifteenth century and traditionally ascribed to Jerome. When the patristic source text demanded it, changing Jerome’s translation was therefore surely justified – but perhaps it was justified in other cases too. This article analyses how humanist translators treated biblical quotations in patristic texts, focusing on the Latin translations of Basil’s Hexaemeron by Lampugnino Birago (1390–1472) and Cyril’s Commentary on John by George of Trebizond (1396–1472/3), and explores what their practice can tell us about humanist approaches to translation and the biblical text.
Revisiting time as a trade barrier: Evidence from a panel structural gravity model
Authors: Oberhofer Harald , Pfaffermayr Michael , Sellner Richard
Published: May 2021

In this paper, we revisit the evidence on the effects of time spent on border‐crossing procedures for international trade using a theory‐consistent structural gravity model. We exploit a rich panel dataset including domestic trade flows and employ a recent econometric estimator that exhibits favorable asymptotic properties for inference. The results indicate a significant negative effect of the time required for border procedures that is driven by the time needed for document preparation. We find that an additional day spent on those procedures corresponds to an ad valorem tariff equivalent of 0.4 percentage points. The parameters of our structural model are used to simulate three counterfactual scenarios, quantifying the effect of past and potential future trade facilitation efforts for middle‐, low‐, and high‐income countries. Full endowment general equilibrium effects suggest that in times of stagnating multilateral and bilateral trade liberalization efforts, unilateral implementation of trade facilitation carries the potential to induce an alternative stimulus for trade and welfare, especially for low‐ and middle‐income countries.
Curved wedges in the long‐time asymptotics for the integrable nonlocal nonlinear Schrödinger equation
Authors: Rybalko Yan , Shepelsky Dmitry
Published: May 2021

We consider the Cauchy problem for the integrable nonlocal nonlinear Schrödinger equation , with a step‐like boundary values: as and as for all , where is a constant. In a recent paper, we presented the long‐time asymptotics of the solution of this problem along the rays , where is a constant. In the present paper, we extend the asymptotics into a region that is asymptotically closer to the ray than any of these rays. We specify a one‐parameter family of wedges in the ‐plane, with curved boundaries, characterized by qualitatively different asymptotic behavior of , and present the main asymptotic terms for each wedge. Particularly, for wedges within , we show that the solution decays as with depending on the wedge. For wedges within , we show that the asymptotics has an oscillatory nature, with the phase functions specific for each wedge and depending on a slow variable parameterizing the wedges.
Caries experience in caregiver‐intellectual deficient pair: Influence of caregiver's psychological morbidity
Authors: Baumgarten Alexandre , Hilgert Juliana Balbinot , Rech Rafaela Soares , Cunha‐Cruz Joana , de Goulart Bárbara Niegia Garcia
Published: May 2021

Objective

Evaluate how determinants of psychological morbidity were associated with dental caries experience in the caregiver‐intellectual deficient pair.

Methods

A cross‐sectional study with 299 pair, who had their oral health status assessed using the DMFT index (decayed, missing and filled teeth). Symptoms of anxiety, depression, stress, quality of sleep, and socioeconomic variables were measured in caregivers. Adjusted prevalence ratios were estimated using Poisson regression with the caregiver and children's caries index as outcome.

Results

The average prevalence of DMFT/dmft was 7.48 (SD ± 3.9) for students with ID and DMFT was 14.7 (SD ± 8.1) for their caregivers. For the caregiver's oral health, the following psychic comorbidities were associated with worse oral health condition: anxiety (PR = 1.48; 95%CI 1.07‐2.06), depression (PR = 1.39; 95%CI 1.05‐1.85), high level of stress (PR = 1.58; 95%CI 1.17‐2.13) and sleep disorders (PR = 1.59; 95%CI 1.18‐2.14). For people with ID, the caregiver's psychic comorbidities also showed association with a worse oral health condition, including anxiety (PR = 1.31; 95%CI 1.03‐1.74), depression (PR = 1.28; 95%CI 1.01‐1.67) and high level of stress (PR = 1.63; 95%CI 1.14‐2.32), as well as mother's high level of DMFT (PR = 1.96; 95%CI 1.28‐3.03).

Conclusion

Symptoms of depression, anxiety and stress were associated with higher levels of dental caries experience for caregivers and for people with intellectual disabilities.
Differential diagnosis of primary immunodeficiency in patients with BCGitis and BCGosis: A single‐centre study
Authors: Soyak Aytekin Elif , Keskin Armagan , Tan Cagman , Yalçın Ebru , Dogru Deniz , Ozcelik Ugur , Kiper Nural , Tezcan Ilhan , Cagdas Deniz
Published: May 2021

BCG infections occur more frequently in patients with underlying primary immunodeficiency disease (PIDD). In this study, we aimed to evaluate the ratio of PIDD in the patients with BCG infections. Patients with BCG infections were analyzed in a tertiary referral centre in the 2015‐2020 period. Forty‐seven patients with BCGitis/BCGosis were evaluated; thirty‐four (72.3%) had BCGitis, and 13 (27.7%) had BCGosis. Common tissue and organs affected are lymph nodes (57.4%), skin and subcutaneous tissue (48.9%), lungs (23.4%) and liver (17%). PIDD was shown in 26 patients (55.3%), including 92.3% of patients with BCGosis and 41.2% of patients with BCGitis. Ten patients had Mendelian susceptibility to Mycobacterial disease (MSMD) (21.2%), six had predominantly antibody deficiency (PAD) (12.7%), five had severe combined immunodeficiency (SCID) (10.6%), three had CGD (6.3%), and two had CID (4.2%). Mortality was reported in two patients (4.2%) with CID (ZAP70 deficiency (n = 1) and PIK3R1 deficiency (n = 1)). Parental consanguinity (84%), axillary lymphadenopathy (65%), mycobacterial lung disease (42%), hepatomegaly (30%) and growth retardation (19%) were significantly high in patients with PIDD diagnosis. Isolated vaccination site infection was also recorded in patients with PIDD (CID (n = 1), SCID (n = 1), PAD (n = 5)). BCG vaccination should be planned with caution for the cases with suspected PIDD. This study indicates that almost all patients (92.3%) with BCGosis and one in every two patients (41.2%) with BCGitis have an underlying PIDD. Parental consanguinity, axillary lymphadenopathy, mycobacterial lung disease, hepatomegaly and growth retardation (19%) are important clinical features in the differential diagnosis of PIDD.