bluuebunny/crossref_metadata_2025 huggingface dataset:
Subthreshold nitric oxide synthase inhibition improves synergistic effects of subthreshold MMP‐2/MLCK‐mediated cardiomyocyte protection from hypoxic injury
Authors: Bil‐Lula Iwona , Lin Han‐Bin , Biały Dariusz , Wawrzyńska Magdalena , Diebel Lucas , Sawicka Jolanta , Woźniak Mieczyslaw , Sawicki Grzegorz
Published: March 2016

Injury of myocardium during ischaemia/reperfusion (I/R) is a complex and multifactorial process involving uncontrolled protein phosphorylation, nitration/nitrosylation by increased production of nitric oxide and accelerated contractile protein degradation by matrix metalloproteinase‐2 (MMP‐2). It has been shown that simultaneous inhibition of MMP‐2 with doxycycline (Doxy) and myosin light chain kinase (MLCK) with ML‐7 at subthreshold concentrations protects the heart from contractile dysfunction triggered by I/R in a synergistic manner. In this study, we showed that additional co‐administration of nitric oxide synthase (NOS) inhibitor (1400W or L‐NAME) in subthreshold concentrations improves this synergistic protection in the model of hypoxia–reoxygenation (H‐R)‐induced contractile dysfunction of cardiomyocytes. Isolated cardiomyocytes were subjected to 3 min. of hypoxia and 20 min. of reoxygenation in the presence or absence of the inhibitor cocktails. Contractility of cardiomyocytes was expressed as myocyte peak shortening. Inhibition of MMP‐2 by Doxy (25–100 μM), MLCK by ML‐7 (0.5–5 μM) and NOS by L‐NAME (25–100 μM) or 1400W (25–100 μM) protected myocyte contractility after H‐R in a concentration‐dependent manner. Inhibition of these activities resulted in full recovery of cardiomyocyte contractility after H‐R at the level of highest single‐drug concentration. The combination of subthreshold concentrations of NOS, MMP‐2 and MLCK inhibitors fully protected cardiomyocyte contractility and MLC1 from degradation by MMP‐2. The observed protection with addition of L‐NAME or 1400W was better than previously reported combination of ML‐7 and Doxy. The results of this study suggest that addition of NOS inhibitor to the mixture of inhibitors is better strategy for protecting cardiomyocyte contractility.
Sphingosine 1‐phosphate and its carrier apolipoprotein M in human sepsis and in Escherichia coli sepsis in baboons
Authors: Frej Cecilia , Linder Adam , Happonen Kaisa E. , Taylor Fletcher B. , Lupu Florea , Dahlbäck Björn
Published: March 2016

Sphingosine 1‐phosphate (S1P) is an important regulator of vascular integrity and immune cell migration, carried in plasma by high‐density lipoprotein (HDL)‐associated apolipoprotein M (apoM) and by albumin. In sepsis, the protein and lipid composition of HDL changes dramatically. The aim of this study was to evaluate changes in S1P and its carrier protein apoM during sepsis. For this purpose, plasma samples from both human sepsis patients and from an experimental Escherichia coli sepsis model in baboons were used. In the human sepsis cohort, previously studied for apoM, plasma demonstrated disease‐severity correlated decreased S1P levels, the profile mimicking that of plasma apoM. In the baboons, a similar disease‐severity dependent decrease in plasma levels of S1P and apoM was observed. In the lethal E. coli baboon sepsis, S1P decreased already within 6–8 hrs, whereas the apoM decrease was seen later at 12–24 hrs. Gel filtration chromatography of plasma from severe human or baboon sepsis on Superose 6 demonstrated an almost complete loss of S1P and apoM in the HDL fractions. S1P plasma concentrations correlated with the platelet count but not with erythrocytes or white blood cells. The liver mRNA levels of apoM and apoA1 decreased strongly upon sepsis induction and after 12 hr both were almost completely lost. In conclusion, during septic challenge, the plasma levels of S1P drop to very low levels. Moreover, the liver synthesis of apoM decreases severely and the plasma levels of apoM are reduced. Possibly, the decrease in S1P contributes to the decreased endothelial barrier function observed in sepsis.
Longitudinal effects of prenatal exposure to air pollutants on self‐regulatory capacities and social competence
Authors: Margolis Amy E. , Herbstman Julie B. , Davis Katie S. , Thomas Valerie K. , Tang Deliang , Wang Ya , Wang Shuang , Perera Frederica P. , Peterson Bradley S. , Rauh Virginia A.
Published: March 2016

Background

We evaluated the influence of prenatal exposure to widespread urban air pollutants on the development of self‐regulation and social competence in a longitudinal prospective cohort of children born to nonsmoking minority women in New York City.

Methods

Air pollutant exposure was estimated categorically by level of polycyclic aromatic hydrocarbon (PAH)‐DNA adducts in maternal blood collected at delivery, providing a biomarker of maternal exposure to PAH over a 2‐ to 3‐month period. Deficient emotional self‐regulation (DESR) was defined as moderate elevations on three specific scales of the child behavior checklist (anxious/depressed, aggressive behavior, and attention problems). We used generalized estimating equations to assess the influence of prenatal exposure to PAH on DESR in children at 3–5, 7, 9, and 11 years of age, adjusted for gender and race/ethnicity. Next, we assessed the association of prenatal exposure to PAH with social competence, as measured by the social responsiveness scale (SRS), the association of impaired self‐regulation with social competence, and whether impairment in self‐regulation mediated the association of prenatal exposure to PAH with social competence.

Results

We detected a significant interaction (at p = .05) of exposure with time, in which the developmental trajectory of self‐regulatory capacity was delayed in the exposed children. Multiple linear regression revealed a positive association between presence of PAH‐DNA adducts and problems with social competence (p < .04), level of dysregulation and problems with social competence (p < .0001), and evidence that self‐regulation mediates the association of prenatal exposure to PAH with social competence (p < .0007).

Conclusions

These data suggest that prenatal exposure to PAH produces long‐lasting effects on self‐regulatory capacities across early and middle childhood, and that these deficits point to emerging social problems with real‐world consequences for high‐risk adolescent behaviors in this minority urban cohort.
Is GLP‐1 a hormone: Whether and When?
Authors: D'Alessio David
Published: March 2016

Glucagon‐like peptide‐1 (GLP‐1) is a product of proglucagon cleavage synthesized in L cells in the intestinal mucosa, α‐cells in the pancreatic islet, and neurons in the nucleus of the solitary tract. GLP‐1 is essential for normal glucose tolerance and acts through a specific GLP‐1 receptor that is expressed by islet β‐cells as well as other cell types. Because plasma concentrations of GLP‐1 increase following meal ingestion it has been generally presumed that GLP‐1 acts as a hormone, communicating information from the intestine to the endocrine pancreas through the circulation. However, there are a number of problems with this model including low circulating concentrations of GLP‐1 in plasma, limited changes after meal ingestion and rapid metabolism in the plasma. Moreover, antagonism of systemic GLP‐1 action impairs insulin secretion in the fasting state, suggesting that the GLP‐1r is active even when plasma GLP‐1 levels are low and unchanging. Consistent with these observations, deletion of the GLP‐1r from islet β‐cells causes intolerance after IP or IV glucose, challenges that do not induce GLP‐1 secretion. Taken together, these data support a model whereby GLP‐1 acts through neural or paracrine mechanisms to regulate physiologic insulin secretion. In contrast, bariatric surgery seems to be a condition in which circulating GLP‐1 could have an endocrine effect. Both gastric bypass and sleeve gastrectomy are associated with substantial increases in postprandial GLP‐1 release and in these conditions interference with GLP‐1r signaling has a significant impact on glucose regulation after eating. Thus, with either bariatric surgery or treatment with long‐acting GLP‐1r agonists, circulating peptide mediates insulinotropic activity. Overall, a case can be made that physiologic actions of GLP‐1 are not hormonal, but that an endocrine mechanism of GLP‐1r activation can be co‐opted for therapeutics.
Discovery of gastric inhibitory polypeptide and its subsequent fate: Personal reflections
Authors: Pederson Raymond A , McIntosh Christopher HS
Published: March 2016

The present review focuses initially on experimental studies that were designed to identify acid inhibitory factors, referred to as ‘enterogastrones,’ that ultimately led to the isolation of gastric inhibitory polypeptide (GIP), a 42‐amino acid polypeptide. GIP was shown to inhibit acid secretion in animal models, as well as stimulating gastric somatostatin secretion. However, its role in human gastric physiology is unclear. Further studies showed that GIP strongly stimulated the secretion of insulin, in the presence of elevated glucose, and this ‘incretin’ action is now considered to be its most important; an alternative for the GIP acronym, glucose‐dependent insulinotropic polypeptide, was therefore introduced. In the 1970s, GIP purified by conventional chromatography was shown by high‐performance liquid chromatography to consist largely of GIP1‐42 and GIP3‐42. It was later shown that dipeptidyl peptidase 4 was a physiologically relevant enzyme responsible for this conversion, as well as the similar metabolism of the second incretin, glucagon‐like peptide‐1. Dipeptidyl peptidase‐4 inhibitors are currently in use as type 2 diabetes therapeutics, and studies on islet transplantation in rodent models of type 1 diabetes have shown that dipeptidyl peptidase‐4 inhibitor treatment reduces graft rejection. Additional studies on C‐terminally shortened forms of GIP have shown that GIP1‐30 and a dipeptidyl peptidase‐4‐resistant form (D‐Ala2GIP1‐30) are equipotent to the intact polypeptide in vitro, and administration of D‐Ala2GIP1‐30 to diabetic rodents greatly improved glucose tolerance and reduced apoptotic cell death in islet β‐cells. There are probably therefore further clinically useful effects of GIP that require investigation.
Hidden suppression of sex ratio distortion suggests Red queen dynamics between Wolbachia and its dwarf spider host
Authors: Vanthournout B. , Hendrickx F.
Published: March 2016

Genetic conflict theory predicts strong selection for host nuclear factors suppressing endosymbiont effects on reproduction; however, evidence of these suppressors is currently scarce. This can either be caused by a low suppressor evolution rate, or if suppressors originate frequently, by rapid spread and concurrent masking of their activity by silencing the endosymbiont effect. To explore this, we use two populations of a dwarf spider with a similar female bias, caused by a Wolbachia infection. Using inter‐ and intrapopulation crosses, we determine that one of these populations demonstrates a higher suppressing capability towards Wolbachia despite having a similar population sex ratio. This suggests that spider and endosymbiont are locked in so‐called red queen dynamics where, despite continuous coevolution, average fitness remains the same, hence hiding the presence of the suppressor. Finding different suppressor activity in populations that even lack phenotypic differentiation (i.e. similar sex ratio) further supports the hypothesis that suppressors originate often, but are often hidden by their own mode of action by countering endosymbiont effects.
Using AGREE II to evaluate the quality of traditional medicine clinical practice guidelines in China
Authors: Deng Wei , Li Le , Wang Zixia , Chang Xiaonan , Li Rui , Fang Ziye , Wei Dang , Yao Liang , Wang Xiaoqin , Wang Qi , An Guanghui , Chen Yaolong
Published: March 2016

Objective

To evaluate/assess the quality of the clinical practice guidelines (CPGs) of traditional medicine in China.

Methods

We systematically searched the literature databases WanFang Data, VIP, CNKI, and CBM for studies published between 1978 and 2012 to identify and select CPGs of traditional medicine. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate these guidelines.

Results

A total of 75 guidelines were included, of which 46 guidelines (62%) were on Traditional Chinese Medicine, 19 (25%) on Chinese Integrated Medicine, and 10 (13%) on Uyghur Medicine. Most traditional medicine CPGs published in domestic journals scored <20% (range: 0% to 63%). Eleven (14%) CPGs were developed following the methodology of evidence‐based medicine. In each domain of AGREE II, traditional medicine CPGs performed clearly better than international CPGs. The same trend was seen in guidelines of modern medicine.

Conclusions

An increasing amount of CPGs are being published, but their quality is low. Referring to the key points of international guidelines development, supervision through AGREE II, cooperating with international groups and exploring the strategy of guideline development could improve the quality of CPGs on traditional medicine.
The use of GRADE approach in systematic reviews of animal studies
Authors: Wei Dang , Tang Kun , Wang Qi , Estill Janne , Yao Liang , Wang Xiaoqin , Chen Yaolong , Yang Kehu
Published: March 2016

Objective

The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) in systematic review (SR) of animal studies can promote the translation from bench to bedside. We aim to explore the use of GRADE in SRs of animal studies.

Methods

We used a theoretical analysis method to explore the use of GRADE in SR of animal studies and applied in an SR of animal studies. Meanwhile, we presented and discussed our results in two international conferences.

Results

Five downgrade factors were considered as follows in SRs of animal studies: (1) Risk of bias: the SYRCLE tool can be used for assessing the risk of bias of animal studies. (2) Indirectness: we can assess indirectness in SRs of animal studies from the PICO. (3) Inconsistency: similarity of point estimates, extent of overlap of confidence intervals (CIs), and statistical heterogeneity are also suitable to evaluate inconsistency of evidence from animal studies. (4) Imprecision: optimal information size and 95% CIs are also suitable for SRs of animal studies, like those of clinical trials. (5) Publication bias: we need to consider publication bias comprehensively through the qualitative and quantitative methods.

Conclusions

The methods about the use of GRADE in SR of animal studies are explicit. However, the principle about GRADE in developing the policy based on the evidence from animal studies when there is an emergency of public health.
Development of Lemon Marmalade Formulated with New Sweeteners (Isomaltulose and Tagatose): Effect on Antioxidant, Rheological and Optical Properties
Authors: Rubio‐Arraez Susana , Ferrer Carlos , Capella Juan Vicente , Ortolá María Dolores , Castelló María Luisa
Published: March 2016

The aim of this study was to make lemon marmalades in which sucrose is replaced by sweeteners such as tagatose and isomaltulose. Analyses of ºBrix, pH, moisture, water activity, antioxidant capacity, optical and rheological properties were carried out on marmalades on their first day of storage, and after 60 days of storage. Microbiological analyses were also performed. Moreover, a sensory evaluation was performed to assess its consumer acceptance as compared to marmalade made with sucrose. The results showed that the antioxidant capacity of the new formulations was lower than in marmalade with sucrose. Moreover, marmalades made with healthy sweeteners showed lower consistency than those made with sucrose. Lemon marmalades formulated with a higher proportion of isomaltulose initially had high luminosity compared to the other samples, but browned over time. All marmalades were microbiologically stable, and the marmalades made with healthy sweeteners were scored better than those made with sucrose.

Practical Applications

The development of new healthier marmalades offer new alternatives to the conventional ones not only to prevent caries and obesity but also to provide functional features associated with the use of tagatose and isomaltulose as sweeteners. However, not always it is possible to replace traditional components by others and that is why is so important to assess their technological influence. In this study, the viability of the use of both sweeteners to prepare lemon marmalades has been checked.
Effect of Ultrasound on Alkali Extraction Protein from Rice Dreg Flour
Authors: Li Kexin , Ma Haile , Li Shujun , Zhang Cunsheng , Dai Chunhua
Published: March 2016

In this study, Counter‐current ultrasound‐assisted alkali was employed to extract rice dreg protein (RDP) from rice dreg flour (RDF). The results indicated that extraction yield of RDP reached a maximum value at 0.08 mol/L alkali concentrate. It was only 43.20% in absence of ultrasound, whereas it reached up to 88.44% under ultrasonic condition. Amino acid composition, scanning electron microscopy, atomic force microscopy and fourier transform infrared spectra were used to determine amino acid composition, morphology, aggregates and microstructure of RDP. Ultrasound treatment could result in improving of hydrophobic amino acids content and changing of RDF and RDP microstructure, showing enhancement in the porosity of RDF particle, variation of RDP particle size. Thus, the acceleration of protein extraction was related to the changes of RDF and RDP microstructure caused by ultrasound. Counter‐current ultrasound‐assisted alkali extraction, as a modified method, was proved to be helpful in industrial manufacture of RDP from RDF.

Practical Applications

Low‐frequency high‐intensity ultrasound has been used in many aspects in laboratory, such as extraction of components, pretreatment. Counter‐current ultrasound‐assisted extraction was proved to be helpful in industrial manufacture of protein because it can dramatically improve extraction rate of rice dreg protein, and Counter‐current ultrasound method can achieve continuous production of industrialization.
Mathematical Modeling of Low Temperature High Velocity (LTHV) Drying in Foods
Authors: Kilic Aydin
Published: March 2016

The main purpose of this study is the mathematical modeling of low temperature and high velocity (LTHV) drying method with different temperatures and its comprehensive evaluations in fish. For this purpose, 200 g of trout (Oncorhynchus mykiss) was dried with a single layer dryer by using 7 m/s air velocity and ∼40–50% relative humidity at 4, 10, 15 and 20°C. Based on the experiments, weight loss (percentage), final moisture content and drying times were determined. Twenty‐three different mathematical models were applied to the observed data to perform a nonlinear regression analysis and the result was comprehensively evaluated by using 14 evaluation criteria. Moreover, the exponential forms of thin‐layer drying curves of fish samples were derived. Consequently, the most suitable mathematical models were selected for the LTHV drying conditions considering evaluation criteria. In this regard, the most suitable six models (Logarithmic, Midilli‐Kucuk, Demir et al., Hii et al., Balbay‐Şahin and Alibas) were selected for the LTHV drying at 4°C that is the most suitable drying temperature for food quality. After comprehensive evaluations, it was understood that some of the evaluation criteria give same results in similar drying conditions as the residual sum of squares (RSS), total sum of squares (SST) and sum of squares (SSE).

Practical Applications

LTHV drying method is a cold drying process that performed at very low temperatures (≤20°C) and high velocities (≤7 m/s). LTHV drying refers an indoor thin‐layer drying of food products, which is entirely exposed to the cold drying air moving throughout the food product. In the open literature, this new drying method has some preservative effects on food quality especially at 4°C. In addition, it is well known that the drying equations can easily be applied to industrial drying applications. In this regard, thin‐layer LTHV drying equations can contribute to the drying characteristics of perishable and semidried food. This study allows researchers to select the suitable drying equations and provide which of them should be preferred. The study also provides a comprehensive evaluation of mathematical models for specific products.© 2016 Wiley Periodicals, Inc
Acute‐on‐chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience
Authors:   Shalimar, Saraswat Vivek , Singh Shivaram P , Duseja Ajay , Shukla Akash , Eapen Chundamannil E , Kumar Dharmendra , Pandey Gaurav , Venkataraman Jayanti , Puri Pankaj , Narayanswami Krishnasamy , Dhiman Radha K , Thareja Sandeep , Nijhawan Sandeep , Bhatia Shobna , Zachariah Uday , Sonika Ujjwal , Varghese Thomas , Acharya Subrat K
Published: March 2016

Background and Aim

The aim of this study was to analyze etiologies and frequency of hepatic and extrahepatic organ failures (OFs) and outcome of acute‐on‐chronic liver failure (ACLF) at 10 tertiary centers in India.

Methods

In this retrospective study (2011–2014), patients satisfying Asian Pacific Association for the Study of the Liver definition of ACLF were included. Etiology of acute precipitating insult and chronic liver disease and outcomes were assessed. Occurrence and severity of OF were assessed by chronic liver failure‐sequential organ failure assessment score.

Results

The mean (±SD) age of 1049 consecutive ACLF patients was 44.7 ± 12.2 years; Eighty‐two percent were men. Etiology of acute precipitants included alcohol 35.7%, hepatitis viruses (hepatitis A, hepatitis B, and hepatitis E) 21.4%, sepsis 16.6%, variceal bleeding 8.4%, drugs 5.7%, and cryptogenic 9.9%. Among causes of chronic liver disease, alcohol was commonest 56.7%, followed by cryptogenic and hepatitis viruses. Predictors of survival were analyzed for a subset of 381 ACLF patients; OF's liver, renal, coagulation, cerebral, respiratory, and failure were seen in 68%, 32%, 31.5%, 22.6%, 14.5%, and 15%, respectively. Fifty‐seven patients had no OF, whereas 1, 2, 3, 4, and 5 OFs were recorded in 126, 86, 72, 28, and 12 patients, respectively. The mortality increased progressively with increasing number of OFs (12.3% with no OF, 83.3% with five OFs). During a median hospital stay of 8 days, 42.6% (447/1049) of patients died. On multivariate analysis by Cox proportional hazard model, elevated serum creatinine (hazard ratio [HR] 1.176), advanced hepatic encephalopathy (HR 2.698), and requirement of ventilator support (HR 2.484) were independent predictors of mortality.

Conclusions

Alcohol was the commonest etiology of ACLF. Within a mean hospital stay of 8 days, 42% patients died. OFs independently predicted survival.
The intravesicular cocktail and its role in the regulation of exocytosis
Authors: Estévez‐Herrera Judith , González‐Santana Ayoze , Baz‐Dávila Rebeca , Machado José D. , Borges Ricardo
Published: March 2016

The accumulation of neurotransmitters within secretory vesicles (SVs) far exceeds the theoretical tonic concentrations in the cytosol, a phenomenon that has captivated the attention of scientists for decades. For instance, chromaffin granules can accumulate close to molar concentrations of catecholamines, along with many other products like ATP, calcium, peptides, chromogranins, ascorbate, and other nucleotides. In this short review, we will summarize the interactions that are currently believed to occur between the elements that make up the vesicular cocktail in the acidic environment of SVs, and how they permit the accumulation of such high concentrations of certain components. In addition, we will examine how the vesicular cocktail regulates the exocytosis of neurotransmitters.

image

In this review, we have highlighted the mechanisms that permit the storage of neurotransmitters and hormones inside secretory vesicles. We also have proposed a novel model based in the intravesicular interactions of the main components of this inner cocktail – catecholamines, ATP, and chromogranins – to allow the accumulation of near molar concentrations of transmitters in secretory vesicles.

This article is part of a mini review series on Chromaffin cells (ISCCB Meeting, 2015).
Loss of collapsin response mediator protein 4 suppresses dopaminergic neuron death in an 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine‐induced mouse model of Parkinson's disease
Authors: Tonouchi Aine , Nagai Jun , Togashi Kentaro , Goshima Yoshio , Ohshima Toshio
Published: March 2016

Parkinson's disease (PD) is a progressive neurodegenerative disorder that is characterized by the selective loss of dopaminergic neurons in the substantia nigra pars compacta (SNc). Several lines of evidence suggest that neurodegeneration in PD is accelerated by a vicious cycle in which apoptosis in dopaminergic neurons triggers the activation of microglia and harmful inflammatory processes that further amplify neuronal death. Recently, we demonstrated that the deletion of collapsin response mediator protein 4 (CRMP4) suppresses inflammatory responses and cell death in a mouse model of spinal cord injury, leading to improved functional recovery. We thus hypothesized that Crmp4−/− mice may have limited inflammatory responses and a decrease in the loss of SNc dopaminergic neurons in an 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP)‐induced PD mouse model. We observed CRMP4 expression in neurons, astrocytes, and microglia/macrophages following the injection of 25 mg/kg MPTP. We compared the number of dopaminergic neurons and the inflammatory response in SNc between Crmp4+/+ and Crmp4−/− mice after MPTP injection. Limited loss of SNc dopaminergic neurons and decreased activations of microglia and astrocytes were observed in Crmp4−/− mice. These results suggest that CRMP4 is a novel therapeutic target in the treatment of PD patients.

image

We demonstrated that genetic CRMP4 deletion delays a vicious cycle of inflammation and neurodegeneration in a Parkinson's disease mouse model. MPTP (1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine) injection to wild‐type mice induces collapsin response mediator protein 4 (CRMP4) up‐regulation in neurons, astrocytes, and microglia. CRMP4‐deficient mice show reduced inflammation and suppressed dopaminergic neuronal death after MPTP injection. These findings suggest that CRMP4 deletion may be a new therapeutic strategy against Parkinson's diseases.
A qualitative exploration of intentional nursing round models in the emergency department setting: investigating the barriers to their use and success
Authors: Kirk Kate , Kane Ros
Published: March 2016

Aims and objectives

This research aimed to investigate the use of intentional rounding within in the emergency department setting through exploration of the staff nurse experience. The focus was its implementation at a large teaching hospital in England.

Background

Research into the use of intentional rounding in any area of practice is minimal in the UK; however, a broader evidence base comes from America. The majority of this research supports the notion of intentional rounding for improved patient care and outcomes. Research from the UK is generally more contested. There is less literature on using intentional rounding specifically in the emergency department setting.

Design

Qualitative methodological approach.

Methods

Semi‐structured interviews (n = 5) were completed with staff nurses working within an emergency department. A purposive sampling technique was used for recruitment. The data was then analysed using ‘Framework Method of Qualitative Analysis’ (Spencer et al. 2014).

Results

The findings were categorised into four headings: (1) Improved patient experience, (2) Current unmanageability, (3) Adapting for the emergency department, (4) Benefits on achieving quality indicators and targets.

Conclusion

The findings show that although staff felt the introduction of intentional rounding techniques could lead to improvements in patient safety and overall care experience, they also identified a range of difficulties and adaptations needed to ensure its success within this acute care environment.

Relevance to clinical practice

The research offers an insight into the staff's perceptions of using intentional rounding and also explains the practical difficulties faced by the nursing staff with potential suggestions that may help to address these problems. Benefits include more open communication between staff and patients and potentially more timely response to patient need, which positively impacts levels of safety and satisfaction. Barriers include lack of staff engagement, and the environmental factors and pressures, within the ED setting.
Accuracy of EASI 12‐lead ECGs in monitoring ST‐segment and J‐point by nurses in the Coronary Care Units
Authors: Loreto Lancia , Andrea Toccaceli , Lucia Dignani , Carla Lucertini , Cristina Petrucci , Silvio Romano
Published: March 2016

Aims and objectives

To confirm the accuracy of the EASI system compared to the standard 12‐lead electrocardiogram, which is the gold standard, in monitoring the two major parameters used in the Coronary Care Units to detect myocardial ischaemia: ST‐segment and J‐point.

Background

Continuous electrocardiograph monitoring is used in the Coronary Care Units to detect cardiac conduction abnormalities and to show the morphology of electrocardiographic waves and tracts. Its accuracy is essential for efficient nursing vigilance, particularly for monitoring the ST segment and the J‐point, in which alterations may indicate the onset of myocardial ischaemia.

Design

An observational study was conducted.

Methods

The enrolled patients (n = 253) simultaneously underwent standard electrocardiogram (10 electrodes) and EASI electrocardiogram (five electrodes). Data were collected by the Coronary Care Units nurses. Tests to compare differences in means and medians between the two sets of measurements were performed, and the Bland‐Altman plots were used to illustrate their agreement.

Results

All 6·072 electrocardiographic leads (3·036 standard and 3·036 EASI) were recorded and analysed. Between the two measurement methods, very small statistically significant differences were found in some leads which are not clinically relevant for both the ST‐segment or the J‐point.

Conclusions

This study confirms that the accuracy of the EASI 12‐leadelectrocardiogram, compared to the standard 12‐leadelectrocardiogram, which is the gold standard, is acceptable for clinical practice to monitor the two major parameters used in the Coronary Care Units for detecting myocardial ischaemia: ST‐segment and J‐point.

Relevance to clinical practice

The EASI system ensures: (1) ease of use and comfort for patients admitted to Coronary Care Units because it only requires five electrodes; (2) increased efficacy of nursing vigilance in the early detection of changes in ST‐segment and J‐ point measurements.
Mutuality in health care: review, concept analysis and ways forward
Authors: Brown Brian J
Published: March 2016

Aims and objectives

This paper aims to critically investigate the notion of mutuality in nursing, and explore how to resolve the tension between individualised accounts of mutuality and institutional and political factors.

Background

The concept of mutuality underlies many theories and models of nursing yet this does not capture the power relations in health care or institutional constraints on mutuality.

Design

This is a position paper informed by a narrative literature review.

Methods

A search of the Scopus, PubMed, Web of Knowledge and CINAHL databases for the terms mutual, mutuality and nursing was conducted, to capture English language literature published from 1990 to mid‐2015.

Results

There is a large literature discussing the nature and value of mutual exchange and mutuality. There is acknowledgement of institutional and professional constraints which limit the potential of mutuality. Yet there is often a reluctance to engage with critical thinking which emphasises the inequalities of power in health care situations. Accordingly, the notion of social capital is introduced, which emphasises the role of social relationships which individuals and groups can deploy to their advantage. Finally the paper explores how new thinking about mutuality and social capital can make health care more effective.

Conclusions

Mutuality and social capital can be enhanced in a variety of ways and may improve client and practitioner outcomes via training, educational and organisational design, and initiatives involving patients and service users, as well as practitioners and service leaders.

Relevance to clinical practice

The sociologically nuanced account of mutuality advanced here sensitises us to questions of power and domination, as well as enabling us to see mutuality in terms of networks of relationships instead of merely an interpersonal phenomenon. This enables practitioners to enhance clients' and their own capacity for mutuality and develop effective resources to increase resilience and recovery.
The Huddling Programme: effects on empowerment, organisational commitment and ego‐resilience in clinical nurses – a randomised trial
Authors: Im Sook Bin , Cho Mi‐Kyoung , Kim Se Young , Heo Myoung Lyun
Published: March 2016

Aim and objective

To identify effects of the huddling programme as a strategy for retention of clinical nurses.

Background

In Korea, new nurses leave hospitals more than experienced nurses for many reasons. Hospitals with a high nurse turnover require larger budgets and longer periods of time to train large numbers of newly recruited nurses until they can perform as well as those who have left. Furthermore, the remaining nurses have an additional workload associated with both the shortage of manpower and the need to train the incoming nurses. This means that reducing nurse turnover intention requires preventive measures that promote empowerment and organisational commitment among nurses in Korea.

Design

Randomised controlled trial.

Methods

This research used a pretest–post‐test experimental‐group–control‐group design to investigate the effect of the huddling programme. The participants were 49 clinical nurses working at two general hospitals with more than 500 beds that are located in D city and S city of Korea. The experimental group participated in the huddling programme that comprised a full‐day retreat and after‐work social networking services during January and February 2013. Self‐reported questionnaires were used to assess empowerment, organisational commitment and ego‐resilience. The data were analysed by descriptive analysis using the t‐test.

Results

The mean scores for normative commitment and impact of empowerment were higher in the experimental group, but ego‐resilience did not differ significantly between the two groups.

Conclusion

The huddling program positively increased nurses' perception of organisational commitment and empowerment who participated in huddling programme. The huddling programme could be a useful strategy for improving the retention of clinical nurses.

Relevance to clinical practice

This study is both significant and relevant to nursing science and practice given that it demonstrated the effectiveness of an empowerment programme in increasing organisational commitment and decreasing actual turnover rates of clinical nurses.
Undergraduate nursing students’ attitudes and use of research and evidence‐based practice – an integrative literature review
Authors: Ryan Elizabeth Jo
Published: March 2016

Aims and objectives

This integrative review of the literature addresses undergraduate nursing students’ attitudes towards and use of research and evidence‐based practice, and factors influencing this. Current use of research and evidence within practice, and the influences and perceptions of students in using these tools in the clinical setting are explored.

Background

Evidence‐based practice is an increasingly critical aspect of quality health care delivery, with nurses requiring skills in sourcing relevant information to guide the care they provide. Yet, barriers to engaging in evidence‐based practice remain. To increase nurses’ use of evidence‐based practice within healthcare settings, the concepts and skills required must be introduced early in their career. To date, however, there is little evidence to show if and how this inclusion makes a difference.

Design

Integrative literature review.

Methods

ProQuest, Summon, Science Direct, Ovid, CIAP, Google scholar and SAGE databases were searched, and Snowball search strategies used. One hundred and eighty‐one articles were reviewed. Articles were then discarded for irrelevance. Nine articles discussed student attitudes and utilisation of research and evidence‐based practice.

Results

Factors surrounding the attitudes and use of research and evidence‐based practice were identified, and included the students’ capability beliefs, the students’ attitudes, and the attitudes and support capabilities of wards/preceptors.

Conclusions

Undergraduate nursing students are generally positive toward using research for evidence‐based practice, but experience a lack of support and opportunity. These students face cultural and attitudinal disadvantage, and lack confidence to practice independently. Further research and collaboration between educational facilities and clinical settings may improve utilisation.

Relevance to clinical practice

This paper adds further discussion to the topic from the perspective of and including influences surrounding undergraduate students and new graduate nurses.
Alzheimer's disease with cerebrovascular disease: current status in the Asia–Pacific region
Authors: Chen C. , Homma A. , Mok V. C. T. , Krishnamoorthy E. , Alladi S. , Meguro K. , Abe K. , Dominguez J. , Marasigan S. , Kandiah N. , Kim S.Y. , Lee D. Y. , De Silva H. A. , Yang Y.‐H. , Pai M.‐C. , Senanarong V. , Dash A.
Published: March 2016

Background

There is growing awareness of the coexistence of Alzheimer's disease and cerebrovascular disease (AD+CVD), however, due to lack of well‐defined criteria and treatment guidelines AD+CVD may be underdiagnosed in Asia.

Methods

Sixteen dementia specialists from nine Asia Pacific countries completed a survey in September 2014 and met in November 2014 to review the epidemiology, diagnosis and treatment of AD+CVD in Asia. A consensus was reached by discussion, with evidence provided by published studies when available.

Results

AD accounts for up to 60% and AD+CVD accounts for 10‐20% of all dementia cases in Asia. The reasons for underdiagnosis of AD+CVD include lack of awareness as a result of a lack of diagnostic criteria, misdiagnosis as vascular dementia or AD, lack of diagnostic facilities, resource constraints and cost of investigations. There is variability in the tools used to diagnose AD+CVD in clinical practice. Diagnosis of AD+CVD should be performed in a stepwise manner of clinical evaluation followed by neuroimaging. Dementia patients should be assessed for cognition, behavioural and psychological symptoms, functional staging and instrumental activities of daily living. Neuroimaging should be performed using computed tomography or magnetic resonance imaging. The treatment goals are to stabilize or slow progression as well as to reduce behavioural and psychological symptoms, improve quality of life and reduce disease burden. First‐line therapy is usually an acetylcholinesterase inhibitor such as donepezil.

Conclusion

AD+CVD is likely to be under‐recognised in Asia. Further research is needed to establish the true prevalence of this treatable and potentially preventable disease.
Could the PI3K canonical pathway be a common link between chronic inflammatory conditions and oral carcinogenesis?
Authors: Sonis Stephen T. , Amaral Mendes Rui
Published: March 2016

The association between chronic inflammatory disorders and oral carcinogenesis has been both a source of interest and contention. Based upon its central importance in oral carcinogenesis, the finding that the PI3k/Akt/mTOR pathway is activated in oral lichen planus, chronic graft‐versus‐host disease, and chronic oral candidiasis suggests that it may provide a link between benign and malignant oral conditions. Here, we discuss a possible mechanistic rationale that addresses the activation of this important signaling pathway and its downstream events, while correlating it with the carcinogenic potential of chronic oral disorders.
Optimization of Fracture Resistance and Stiffness of Heat‐Polymerized High Impact Acrylic Resin with Localized E‐Glass FiBER FORCE® Reinforcement at Different Stress Points
Authors: Agha Haitham , Flinton Robert , Vaidyanathan Tritala
Published: March 2016

Purpose

Dentures are subject to fracture through flexural stresses during masticatory function. Distribution of stresses under flexural loading varies from compressive to tensile stress along the thickness of the denture cross section. The goal of this investigation was to evaluate the effect of reinforcing compressive, tensile, and no stress regions of flexurally loaded rectangular bars of heat‐cured denture base acrylic resin reinforced with tough E‐Glass FiBER FORCE (GFF) on their fracture resistance under flexural loading.

Materials and Methods

Forty rectangular specimens (65 mm long × 10 mm wide × 2.5 mm thick) were prepared and divided into four groups (n = 10). Group FN had no fiber reinforcement, group FM had fiber in the middle at the no‐stress neutral axis, group FC had fiber close to the surface on the compressive stress side, and group FT had the fiber close to the surface on the tensile stress side. The effect of GFF reinforcement on flexural strength (FS), flexural toughness (TG), and flexural modulus of elasticity (MOE) was evaluated.

Results

The mean and (SD) of the FS, TG, and MOE varied as follows. FS (MPa): group FN: 91.49 (7.88); group FM: 102.83 (13.5); group FC: 107.68 (11.21); group FT: 141.46 (14.77). TG (mJ/mm3): group FN: 0.171 (0.026); group FM: 0.236 (0.033); group FC: 0.156 (0.032); group FT: 0.347 (0.010). MOE (MPa): group FN: 2682 (761); group FM: 2601 (417); group FC: 4188 (1012); group FT: 4215 (674). Statistical analysis showed that reinforcement on the tensile side of the neutral axis yielded improvement in all properties evaluated.

Conclusions

Placement of the GFF close to the tensile stress side surface of the bar increased the resistance to elastic deformation (i.e., higher MOE or stiffness) and the stress level needed for flexural fracture (i.e., higher FS). In addition, more energy was absorbed by reinforced specimens before fracture occurred (i.e., higher toughness). Localized reinforcement targeting tensile stress centers is thus a practical way to improve clinical durability of dentures against intra‐ and extraoral fracture.
Private, Social, and Self‐Insurance for Long‐Term Care in the Presence of Family Help
Authors: DONDER PH. DE , PESTIEAU P.
Published: March 2016

We study the political determination of the level of social long‐term care insurance when voters can top up with private insurance, saving and family help. Agents differ in income, probability of becoming dependent and of receiving family help, and amount of family help received. Social insurance redistributes across income and risk levels, while private insurance is actuarially fair. The income‐to‐dependency probability ratio of agents determines whether they prefer social or private insurance. Family support crowds out the demand for both social and, especially, private insurance, as strong prospects of family help drive the demand for private insurance to zero. The availability of private insurance decreases the demand for social insurance but need not decrease its majority‐chosen level. A majority of voters would oppose banning private insurance.
Melatonin pretreatment enhances the therapeutic effects of exogenous mitochondria against hepatic ischemia–reperfusion injury in rats through suppression of mitochondrial permeability transition
Authors: Chen Hong‐Hwa , Chen Yen‐Ta , Yang Chih‐Chao , Chen Kuan‐Hung , Sung Pei‐Hsun , Chiang Hsin‐Ju , Chen Chih‐Hung , Chua Sarah , Chung Sheng‐Ying , Chen Yi‐Ling , Huang Tien‐Hung , Kao Gour‐Shenq , Chen Sheng‐Yi , Lee Mel S. , Yip Hon‐Kan
Published: March 2016

We tested the hypothesis that melatonin (Mel) enhances exogenous mitochondria (Mito) treatment against rodent hepatic ischemia–reperfusion (IR) injury. In vitro study utilized three groups of hepatocytes (i.e. nontreatment, menadione, and menadione–melatonin treatment, 4.0 × 105 each), while in vivo study used adult male Sprague Dawley rats (n = 40) equally divided into sham‐control (SC), IR (60‐min left‐lobe ischemia + 72‐hr reperfusion), IR‐Mel (melatonin at 30 min/6/8 hr after reperfusion), IR‐Mito (mitochondria 15,000 μg/rat 30 min after reperfusion), and IR‐Mel‐Mito. Following menadione treatment in vitro, oxidative stress (NOX‐1/NOX‐2/oxidized protein), apoptotic (cleaved caspase‐3/PARP), DNA damage (γ‐H2AX/CD90/XRCC1), mitochondria damage (cytosolic cytochrome c) biomarkers, and mitochondrial permeability transition were found to be lower, whereas mitochondrial cytochrome c were found to be higher in hepatocytes with melatonin treatment compared to those without (all P < 0.001). In vivo study demonstrated highest liver injury score and serum AST in IR group, but lowest in SC group and higher in IR‐Mito group than that in groups IR‐Mel and IR‐Mel‐Mito, and higher in IR‐Mel group than that in IR‐Mel‐Mito group after 72‐hr reperfusion (all P < 0.003). Protein expressions of inflammatory (TNF‐α/NF‐κB/IL‐1β/MMP‐9), oxidative stress (NOX‐1/NOX‐2/oxidized protein), apoptotic (caspase‐3/PARP/Bax), and mitochondria damage (cytosolic cytochrome c) biomarkers displayed an identical pattern, whereas mitochondria integrity marker (mitochondrial cytochrome c) showed an opposite pattern compared to that of liver injury score (all P < 0.001) among five groups. Microscopically, expressions of apoptotic nuclei, inflammatory (MPO+/CD68+/CD14+ cells), and DNA damage (γ‐H2AX+ cells) biomarkers exhibited an identical pattern compared to that of liver injury score (all P < 0.001) among five groups. Melatonin‐supported mitochondria treatment offered an additional benefit of alleviating hepatic IR injury.
Differential responses of tetrasporophytes and gametophytes of Mazzaella laminarioides (Gigartinales, Rhodophyta) under solar UV radiation
Authors: Navarro Nelso P. , Figueroa Félix L. , Korbee Nathalie , Mansilla Andrés , Plastino Estela M.
Published: March 2016

The effects of solar UV radiation on mycosporine‐like amino acids (MAAs), growth, photosynthetic pigments (Chl a, phycobiliproteins), soluble proteins (SP), and C and N content of Mazzaella laminarioides tetrasporophytes and gametophytes were investigated. Apical segments of tetrasporophytes and gametophytes were exposed to solar radiation under three treatments (PAR [P], PAR+UVA [PA], and PAR+UVA+UVB [PAB]) during 18 d in spring 2009, Punta Arenas, Chile. Samples were taken after 2, 6, 12, and 18 d of solar radiation exposure. Most of the parameters assessed on M. laminarioides were significantly influenced by the radiation treatment, and both gametophytes and tetrasporophytes seemed to respond differently when exposed to high UV radiation. The two main effects promoted by UV radiation were: (i) higher synthesis of MAAs in gametophytes than tetrasporophytes at 2 d, and (ii) a decrease in phycoerythrin, phycocyanin, and SPs, but an increase in MAA content in tetrasporophytes at 6 and 12 d of culture. Despite some changes that were observed in biochemical parameters in both tetrasporophytes and gametophytes of M. laminarioides when exposed to UVB radiation, these changes did not promote deleterious effects that might interfere with the growth in the long term (18 d). The tolerance and resistance of M. laminarioides to higher UV irradiance were expected, as this intertidal species is exposed to variation in solar radiation, especially during low tide.