bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial and Ethnic Disparities in COVID‐19 Infections and Deaths Across U.S. Nursing Homes
Authors: Li Yue , Cen Xi , Cai Xueya , Temkin‐Greener Helena
Published: September 2020

BACKGROUND/OBJECTIVES

To determine racial/ethnic disparities in weekly counts of new COVID‐19 cases and deaths among nursing home residents or staff.

DESIGN

Cross‐sectional analysis of national nursing home COVID‐19 reports linked to other data. Multivariable two‐part models modeled disparities in count of cases or deaths, and logistic regressions modeled disparities in self‐reported shortages in staff and personal protective equipment (PPE), across nursing home groups with varying proportions of racial/ethnic minority residents, defined as low‐, medium‐, medium‐high–, and high‐proportion groups.

SETTING

A total of 12,576 nursing homes nationally.

PARTICIPANTS

None.

INTERVENTION

None.

MEASUREMENTS

Numbers of incident COVID‐19 confirmed cases among residents and staff, and incident COVID‐19 related deaths among residents (primary outcomes); and nursing home reported shortages in staff and PPE (secondary outcomes). All outcomes were reported for the week of May 25, 2020.

RESULTS

The number of weekly new COVID‐19 confirmed cases among residents ranged from an average of 0.4 cases per facility (standard deviation (SD) = 2.5) for the low‐proportion group (93.0% had zero new cases) to 1.5 cases per facility (SD = 6.3) for the high‐proportion group (78.9% had zero new cases). Multivariable regression estimated that compared with the low‐proportion group, the likelihood of having at least one new resident case was 76% higher (odds ratio = 1.76; 95% confidence interval = 1.38–2.25; P = .000) for the high‐proportion group. Similar across‐facility disparities were found for the weekly count of new COVID‐19 deaths among residents (ranging from 0.1 deaths per facility (SD = 1.1) for the low‐proportion group to 0.4 deaths (SD = 2.0) for the high‐proportion group) and in the weekly count of new COVID‐19 confirmed cases among staff (ranging from 0.3 cases (SD = 1.4] to 1.3 cases (SD = 4.4) per facility). No substantial disparities in self‐reported shortages of staff or PPE were found.

CONCLUSION

Nursing homes caring for disproportionately more racial/ethnic minority residents reported more weekly new COVID‐19 confirmed cases and/or deaths. Immediate actions are needed to address these system‐level disparities.
A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement
Authors: Shin Hwayeon Danielle , Price Sheri , Aston Megan
Published: September 2020

Aims and objectives

To use a poststructuralist framework to critique historical, social and institutional constructions of emergency nursing and examine conflicting discourses surrounding suicide prevention. The aim is to also demonstrate practical guidance for enhancing emergency nursing practice and research with regard to suicide prevention.

Background

Emergency departments have been historically constructed as places for treating life‐threatening physical crises, thereby constructing other "nonurgent" health needs as less of a priority. Physical needs take priority over psychological needs, such as suicide‐related thoughts and behaviours, negatively impacting the quality of care that certain groups of patients receive.

Design

A theoretical analysis of the published literature on the topic of emergency nursing and suicide prevention was conducted and analysed using a poststructuralist framework.

Methods

Relevant literature on the topic of emergency nursing related to suicide prevention was analysed for a poststructuralist construct of power, language, subjectivity and discourse. Implications to practice and research were identified, as well as expanding emergency nursing using a poststructuralist framework. SQUIRE guidelines were used (see Supporting Information).

Discussion

The emergency department is a critical point of intervention for patients with urgent and life‐threatening needs. However, the biomedical model and historical, social, and institutional expectations that influence emergency nurses' beliefs and values do not effectively respond to the needs of suicidal patients. One step to address this issue is to deconstruct the current understanding of emergency nursing as a treatment for only life‐threatening physical crises in order to become inclusive of psychological crises such as suicide‐related thoughts and behaviours.

Relevance to clinical practice

How a poststructural framework can be used to expand emergency care is discussed. Examples include empowering nurses to challenge the "taken‐for‐granted" emergency nursing and recognizing the health needs that fall outside of the dominant discourse of emergency care.
Nursing students' engagement with social media as an extracurricular activity: An integrative review
Authors: Alharbi Muna , Kuhn Lisa , Morphet Julia
Published: September 2020

Objective

To explore primary research evidence reporting the reason for undergraduate nursing students' engagement with social media as an extracurricular activity.

Background

The formal integration of social media into nursing education has been discussed extensively in previous research. The influence of social media on nursing students' learning and class engagement has also been explored. However, despite the growing volume of literature examining the formal use of social media by undergraduate nursing students, a broader perspective on how and why nursing students engage with social media as an extracurricular activity has not yet been explored.

Design

An integrative review.

Methods

A systematic search was performed to find articles published between 2007–2019 using Ovid MEDLINE, Embase, Ovid Emcare and CINAHL Plus databases and the Google Scholar search engine. The review process is reported according to PRISMA.

Results

Twelve papers met the inclusion criteria, revealing that undergraduate nursing students engaged with social media for many reasons external to their formal curricula. They engaged with social media to keep in touch with others and to entertain themselves, promote learning, find social support, develop a professional nursing identity, share their experiences as nursing students and locate job opportunities.

Conclusion

Undergraduate nursing students engaged with social media for numerous reasons. It supported students in their academic and personal lives by keeping them in touch with people around them. The students used social media to identify with the nursing profession; however, its influence on their professional identity development is yet to be fully explored.

Relevance to clinical practice

Nursing schools should consider the myriad of reasons students engage with social media in order to optimise their professional development. Understanding how nursing students' professional identity develops via social media may be used to help sustain nursing students and support their transition into practice.
Prioritisation of diabetes‐related footcare amongst primary care healthcare professionals
Authors: Mullan Leanne , Wynter Karen , Driscoll Andrea , Rasmussen Bodil
Published: September 2020

Aims and objectives

To assess primary healthcare professionals’ priority for managing diabetic foot disease (DFD) over the progressive course of the condition compared to other aspects of diabetes care.

Background

DFD affects up to 60 million people globally. Evidence suggests that comprehensive preventative footcare may reduce serious complications of DFD, such as amputation.

Design

A cross‐sectional quantitative study reported according to STROBE statement.

Methods

General Practitioners (GPs) and Credentialled Diabetes Educators (CDEs) working within Australian primary care were invited to complete an online survey, to obtain information about preventative and early intervention footcare priorities and practices. Ten GPs and 84 CDEs completed the survey.

Results

On diagnosis of type 2 diabetes, haemoglobin A1c (HbA1c) review was identified to be one of the top three priorities of care by 57 (61%) of participants whilst at 20‐year history of diabetes 73 (78%) participants indicated its priority. Foot assessments became a priority for 78% (n = 73) of participants and podiatry referrals a priority for 53% (n = 50) of participants only when a “foot concern” was raised. Referrals to specialist high‐risk foot podiatrists or services were a first priority for 56% (n = 53), when the person had significant amputation risk factors.

Conclusion

Diabetes‐related preventative footcare assessments and management remain a low priority amongst primary healthcare professionals. Preventative care for asymptomatic complications, such as DFD, may be overlooked in favour of monitoring HbA1c or medication management. Limited prioritisation of footcare in primary care is concerning given the risks for amputation associated with DFD.

Relevance to clinical practice

This study reveals the need for primary healthcare decision makers and clinicians to ensure preventative footcare is a focused priority earlier in the diabetes care continuum. Collaborative and widespread promotion of the importance of proactive rather than reactive footcare practices is required to support prevention of foot ulcers and amputation.
Prevention and practice during the COVID‐19 emergency declaration period in Japanese obstetrical/gynecological facilities
Authors: Komatsu Hiroaki , Banno Kouji , Yanaihara Nozomu , Kimura Tadashi ,   Board Members of Japan Society of Obstetrics and Gynecology
Published: September 2020

Aim

A nationwide questionnaire survey was performed to evaluate how Japanese Society of Obstetrics and Gynecology (JSOG) members dealt with the coronavirus disease (COVID‐19) pandemic during the declared nationwide emergency.

Methods

We sent questionnaires to members of JSOG via official email. Participants answered anonymously using Google forms.

Results

Two (0.08%) JSOG members had contracted COVID‐19. There was a clear decrease in the number of patients scheduled for operation, not only for malignant but also for benign diseases. A decrease in the number of outpatients for infertility treatment was also observed. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was available in 20.4% of the facilities. Inpatients and outpatients were requested to wear masks, limit the number of contacts and check body temperature when visiting hospitals/clinics. During parturition care, caregivers and physicians wore gloves, masks (other than N‐95), face shields and gowns. About 66% and 80% of the facilities decided to transfer pregnant women if they had asymptomatic and symptomatic infection, respectively. Cesarean section was typically chosen as delivery mode in infected women.

Conclusion

The COVID‐19 pandemic provoked significant changes in obstetrics and gynecology practices in Japan. Apparently, nosocomial infections were largely prevented due to these changes, although some of them might not have been necessary.
Neurocognitive, neuropsychiatric, and neurological outcomes associated with phenylalanine hydroxylase deficiency: Assessment considerations for nurse practitioners
Authors: Lowe Tracy B. , DeLuca Jane , Arnold Georgianne
Published: September 2020

Purpose

The purpose of this article is to review literature for neurocognitive, neuropsychiatric, neurological complications associated with phenylalanine hydroxylase (PAH) deficiency. The goal is to familiarize nurse practitioners with treatment and monitoring guidelines for persons living with the disorder.

Conclusions

Appropriate treatment can maximize neurocognitive and neuropsychiatric outcomes.

Practice Implications

Nurse practitioners can help persons with PAH deficiency through education and providing appropriate referrals and by supporting disease‐specific treatment.
Mixtures of Nonlinear Poisson Autoregressions
Authors: Doukhan Paul , Fokianos Konstantinos , Rynkiewicz Joseph
Published: September 2020

We study nonlinear infinite order Markov switching integer‐valued ARCH models for count time series data. Markov switching models take into account complex dynamics and can deal with several stylistic facts of count data including proper modelling of nonlinearities, overdispersion and outliers. We study structural properties of those models. Under mild conditions, we prove consistency and asymptotic normality of the maximum likelihood estimator for the case of finite order autoregression. In addition, we give conditions which imply that the marginal likelihood ratio test, for testing the number of regimes, converges to a Gaussian process. This result enables us to prove that the BIC provides a consistent estimator for selecting the true number of regimes. A real data example illustrates the methodology and compares this approach with alternative methods.
Toxicosis with grapes or raisins causing acute kidney injury and neurological signs in dogs
Authors: Schweighauser Ariane , Henke Diana , Oevermann Anna , Gurtner Corinne , Francey Thierry
Published: September 2020

Background

The ingestion of grapes or raisins has been reported to cause acute kidney injury (AKI) in dogs, with a clinical picture dominated by early gastrointestinal signs and rapidly developing uremia. Ataxia is mentioned in a few reports, but not further characterized.

Objectives

To evaluate the clinical, laboratory, and pathological features of dogs diagnosed with grape or raisin toxicosis (GRT) with emphasis on renal and neurological manifestations, compared to a control group of dogs with AKI from other causes.

Animals

Fifteen client‐owned dogs with GRT and 74 control dogs.

Methods

Retrospective study over 17 months.

Results

All dogs with GRT were presented with severe AKI (grade 4, n = 5; grade 5, n = 10). Eleven dogs (73%) had marked forebrain, cerebellar, or vestibular signs. These manifestations dominated the clinical picture in some dogs, but were not associated with the severity of azotemia or the presence of systemic hypertension. Eight dogs (53%) survived, and 5 dogs experienced a complete neurological recovery. Causes of death were unrelated to the neurological manifestations. Neuropathological examination of 4 dogs did not identify any structural central nervous system abnormality. Only 2 control dogs (3%) displayed neurological signs with seizures unrelated to the AKI; 42 control dogs (57%) survived.

Conclusions and Clinical Importance

Severe forebrain, cerebellar, or vestibular signs may be an important feature of GRT and dominate the early clinical picture. The described features suggest a reversible functional brain injury specific to GRT and unrelated to uremia.
Early sulfur‐rich magmatism on the ungrouped achondrite Northwest Africa 7325 differentiated parent body
Authors: Yang Jing , Lin Yangting , Changela Hitesh , Xie Liewen , Chen Bin , Yang Jinhui
Published: September 2020

The ungrouped achondrite Northwest Africa (NWA) 7325 parent body underwent a severe impact after primary crystallization, which completely melted plagioclase and partially melted pyroxene, followed by Mg diffusion into the adjacent plagioclase‐melt. The 26Al‐26Mg system was therefore modified, forming a pseudoisochron with an initial δ26Mg* of 0.094 ± 0.005‰ and an age of 4563.12 ± 0.33 Ma between the primary crystallization and subsequent impact event(s). The positive initial δ26Mg* can be interpreted by a model age of ~1.77 Ma after CAIs when a chondritic composition differentiated into a magma/rock with the Al/Mg ratio equivalent to that of NWA 7325 (~1.52). The LREE enrichments and a positive Eu anomaly suggest that the NWA 7325 parent magma formed by the melting of a plagioclase‐rich crustal lithology, which crystallized from a magma ocean. Differentiation of the magma ocean was prior to 1.77 Ma after CAIs. NWA 7325 is also unique by containing many rounded voids (5–6 vol%) interstitial to or enclosed in silicates, suggested to have formed by the leaching/vaporization of pre‐existing Fe‐Ca‐Mg‐Mn sulfides. This is supported by the similar morphology between voids and Cr‐bearing troilites, the discovery of relict oldhamite, and the highly reducing conditions of NWA 7325. The loss of pre‐existing sulfides could explain the unusual subchondritic Mn/Mg ratio of the bulk sample. Furthermore, the enrichment of moderately volatile elements (K/Th ratio ~2600–10,000) in the NWA 7325 parent body may result from the bonding with S2‐ in silicate melts under highly reducing conditions. NWA 7325 therefore provides evidence of sulfur‐rich magmatism in the early solar system.
Convergent and distinctive functions of transcription factors VdYap1, VdAtf1, and VdSkn7 in the regulation of nitrosative stress resistance, microsclerotia formation, and virulence in Verticillium dahliae
Authors: Tang Chen , Jin Xianjiang , Klosterman Steven J. , Wang Yonglin
Published: September 2020

Reactive oxygen/nitrogen species (ROS/RNS) play a fundamental role in plant–fungal interactions. How pathogenic fungi manipulate plant‐derived ROS/RNS is of importance to the outcomes of these interactions. In this study, we explored the individual and combined contributions of three transcription factors, VdAtf1, VdYap1, and VdSkn7, in the response to ROS/RNS, microsclerotia formation, and virulence in the plant wilt pathogen Verticillium dahliae. We showed that VdYap1 is essential for ROS response. Additionally, mutants lacking any combination of the three genes shared significant hypersensitivity to nitro‐oxidative stress like sodium nitroprusside dehydrate and double deletions lacking VdYap1 and VdAtf1 resulted in further increased sensitivity to ROS. Double deletion of VdAtf1 and VdSkn7 reduced melanin production and virulence while simultaneous lack of VdSkn7 and VdYap1 disrupted nitrogen metabolism and ROS resistance. Finally, comparison of transcriptional profiles of the respective single or double mutants in response to nitro‐oxidative stress revealed that the three transcription factors are involved in denitrification of nitrated alkanes and lipids to protect against nitro‐oxidative stress. Taken together, our results demonstrate convergent and distinctive functions of VdYap1, VdAtf1, and VdSkn7 in V. dahliae, and provide new data on their roles in response to ROS/RNS in fungi.
Nursing workload in intensive care units and the influence of patient and nurse characteristics
Authors: Moghadam Kolsoom Nasirizad , Chehrzad Minoo Mitra , Masouleh Shademan Reza , Mardani Abbas , Maleki Maryam , Akhlaghi Elham , Harding Celia
Published: September 2020

Background

Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics.

Aims and objectives

This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics.

Design

A cross‐sectional design was conducted.

Methods

All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t‐test, one‐way analysis of variance, and multivariable linear regression analysis.

Results

The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score.

Conclusion

This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics.

Relevance to clinical practice

The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.
The effects of environmental stressors in intensive care unit on anxiety and depression
Authors: Gezginci Elif , Goktas Sonay , Orhan Busra Nur
Published: September 2020

Background

Physical and emotional conditions of patients treated in an intensive care unit (ICU) may be adversely affected by environmental stressors.

Aims and objectives

The aim of this study was to investigate the relationship between patients' anxiety and depression levels and environmental stressors in the ICU.

Design

This was a descriptive cross‐sectional study.

Methods

The study was conducted between June 2018 and April 2019 with 150 patients treated in the ICUs of a training and research hospital. Patient information form and ICU environmental stressors and hospital anxiety and depression scales were used for data collection. Descriptive statistics, t‐test, one‐way analysis of variance, and Pearson's correlation coefficient were used to evaluate the data.

Results

The mean hospital anxiety score of the patients in ICUs was 11.1 ± 2.7, and 77.3% of patients were at risk for anxiety (10‐point cut‐off). The mean hospital depression score was 10.6 ± 3.3, and 94% of patients were at risk for depression (7‐point cut‐off). The mean score of environmental stressors was 123.9 ± 13.1. A moderate positive correlation between hospital anxiety and hospital depression (r = .63, P < .001) and a weak negative correlation between environmental stressors and hospital anxiety (r = −.24, P = .003) were found. However, no significant correlation between environmental stressors and hospital depression was found (r = −.13, P = .12).

Conclusion

According to this study, the environmental stressors in the ICU were high, and the patients were at risk of anxiety and depression. The depression levels of the patients increased along with their anxiety levels. As environmental stressors increased, hospital anxiety levels of the patients decreased. However, there was no significant relationship between environmental stressors and patients' hospital depression levels.

Relevance to clinical practice

Environmental stressors in ICUs are high, and the patients in the ICUs are at risk of anxiety and depression.
The relationship between obesity and nursing care problems in intensive care patients in Austria
Authors: Großschädl Franziska , Bauer Silvia
Published: September 2020

Objectives

To describe the characteristics and nursing care problems of intensive care patients in Austria stratified by obesity.

Background

Obese people in intensive care units (ICUs) present nurses with special challenges. Therefore, nurses need to receive education and training regarding how to treat obese patients to provide them with the best care. Most studies on obesity in ICU patients have not specifically addressed the problems and challenges from the nurses' perspective. This may be because nursing science programmes in Europe rarely introduce the topic of obesity.

Design

This was a secondary data analysis of a longitudinal study.

Methodology

The “Nursing Quality Measurement 2.0” is the Austrian version of the “International Prevalence Measurement of Care problems”. It is an annual cross‐sectional study, which has been carried out since 2009. Data from all ICU patients for 2009 to 2018 were extracted and combined into one file (n = 460). The main outcome measures were obesity and various nursing care problems, including care dependency.

Results

Of the ICU patients. 25% were obese. Obese ICU patients suffered significantly more often from diabetes mellitus and endocrine, nutritional, or metabolic diseases than non‐obese patients. About 30% of the ICU patients were totally care dependent, and 85.6% of the ICU patients were at risk of developing pressure ulcers, whereas the risk was higher for non‐obese than obese patients. ICU patients with a risk of pressure ulcer (measured with the Braden Scale) had a reduced risk of being obese (OR = 0.544).

Conclusion

Overall, the prevalence of nursing care problems found in this study was high. No significant differences in the prevalence of nursing care problems between obese and non‐obese patients were found. However, because of the increase in the number of obese patients in all nursing settings, a stronger focus on obesity research in the area of nursing science is recommended.
The ethics of refusing to care for patients during the coronavirus pandemic: A Chinese perspective
Authors: Zhu Junhong , Stone Teresa , Petrini Marcia
Published: September 2020

As a result of the coronavirus (COVID‐19) pandemic, health professionals are faced with situations they have not previously encountered and are being forced to make difficult ethical decisions. As the first group to experience challenges of caring for patients with coronavirus, Chinese nurses endure heartbreak and face stressful moral dilemmas. In this opinion piece, we examine three related critical questions: Whether society has the right to require health professionals to risk their lives caring for patients; whether health professionals have the right to refuse to care for patients during the coronavirus pandemic; and what obligations there are to protect health professionals? Value of care, community expectations, legal obligations, professional and codes of practice may compel health professionals to put themselves at risks in emergency situations. The bioethical principles of autonomy, justice, beneficence and non‐maleficence, as well as public health ethics, guide nurses to justify their decisions as to whether they are entitled to refuse to treat COVID‐19 patients during the pandemic. We hope that the open discussion would support the international society in addressing similar ethical challenges in their respective situations during this public health crisis.
Characterization of hydrogen sulfide toxicity to human corneal stromal fibroblasts
Authors: Balne Praveen K. , Sinha Nishant R. , Hofmann Alexandria C. , Martin Lynn M. , Mohan Rajiv R.
Published: September 2020

Hydrogen sulfide gas (H2S) is a chemical weapon and a common environmental pollutant. H2S intoxication is lethal to humans and animals. H2S contact to the eye can cause vision loss. However, the molecular mechanisms associated with H2S toxicity to the cornea remain unclear, and no specific therapy exists to mitigate ocular damage from H2S. Here, we report H2S‐induced cytotoxicity and the parameters contributing to the molecular mechanisms associated with corneal toxicity using primary human corneal stromal fibroblasts (hCSFs) in vitro. Sodium hydrosulfide (NaSH) was used as a source of H2S, and the cytotoxicity of H2S was determined by treating hCSF cells with varying concentrations of NaSH (0–10 mM) for 0–72 hours. Changes in cell proliferation, oxidative stress factors, and the expression of inflammatory and fibrotic genes were studied using standard commercial kits and qRT‐PCR. NaSH exposure to hCSFs showed dose‐ and time‐dependent cytotoxicity. The IC50 of NaSH was determined to be 5.35 mM. NaSH 5.35 mM exposure led to significantly decreased cytochrome c oxidase activity, increased ROS production, and increased expression of inflammatory and fibrotic genes in hCSF cells. H2S/NaSH exposure alters normal mitochondrial function, oxidative stress, and inflammatory and fibrotic gene responses in corneal stromal fibroblasts in vitro.
Same same, but different? Cycling and e‐scootering in a rapidly changing urban transport landscape
Authors: Curl Angela , Fitt Helen
Published: September 2020

The introduction of e‐scooters into the urban transport landscape has led to speculation regarding their potential to support transitions to healthy, sustainable and equitable urban mobility. This paper explores similarities between e‐scooter use and cycling in terms of user demographics and competencies required. We draw on data from a 2019 survey of users and non‐users of e‐scooters. Cycling experience is not strongly related to e‐scooter use or self‐reported competence. E‐scooters seem to appeal to a broader demographic than cycling. E‐scooter users are more likely to be young, able or male, raising questions surrounding equity of this emerging mode.
Overexpression of a plasma membrane protein generated broad‐spectrum immunity in soybean
Authors: Ngaki Micheline N. , Sahoo Dipak K. , Wang Bing , Bhattacharyya Madan K.
Published: September 2020

Plants fight‐off pathogens and pests by manifesting an array of defence responses using their innate immunity mechanisms. Here we report the identification of a novel soybean gene encoding a plasma membrane protein, transcription of which is suppressed following infection with the fungal pathogen, Fusarium virguliforme. Overexpression of the protein led to enhanced resistance against not only against F. virguliforme, but also against spider mites (Tetranychus urticae, Koch), soybean aphids (Aphis glycines, Matsumura) and soybean cyst nematode (Heterodera glycines). We, therefore, name this protein as Glycine max disease resistance 1 (GmDR1; Glyma.10g094800). The homologues of GmDR1 have been detected only in legumes, cocoa, jute and cotton. The deduced GmDR1 protein contains 73 amino acids. GmDR1 is predicted to contain an ecto‐ and two transmembrane domains. Transient expression of the green fluorescent protein fused GmDR1 protein in soybean leaves showed that it is a plasma membrane protein. We investigated if chitin, a pathogen‐associated molecular pattern (PAMP), common to all pathogen and pests considered in this study, can significantly enhance defence pathways among the GmDR1‐overexpressed transgenic soybean lines. Chitin induces marker genes of the salicylic‐ and jasmonic acid‐mediated defence pathways, but suppresses the defence pathway regulated by ethylene. Chitin induced SA‐ and JA‐regulated defence pathways may be one of the mechanisms involved in generating broad‐spectrum resistance among the GmDR1‐overexpressed transgenic soybean lines against two serious pathogens and two pests including spider mites, against which no known resistance genes have been identified in soybean and among the most other crop species.
The alternative breeding approaches for improving yield gains and stress response in pigeonpea (Cajanus cajan)
Authors: Saxena Kulbhushan , Bohra Abhishek , Choudhary Arbind K. , Sultana Rafat , Sharma Mamta , Pazhamala Lekha T. , Saxena Rachit K.
Published: September 2020

Pigeonpea is an important food legume crop of semi‐arid tropical regions. Plateauing of pigeonpea yield has been worrying breeders for the past 6–7 decades. Serious breeding efforts made during this period resulted in various high‐yielding and disease resistant cultivars. However, the gains in pigeonpea productivity have been modest. The authors, while reviewing this situation, conclude that long generation turnover, complexity of biological traits, low selection response and overreliance upon pedigree breeding present the key bottlenecks for this situation. In this paper, some alternative breeding approaches and technologies are suggested for the genetic enhancement of yield stability and stress response of pigeonpea.
Defence priming in tomato by the green leaf volatile (Z)‐3‐hexenol reduces whitefly transmission of a plant virus
Authors: Su Qi , Yang Fengbo , Zhang Qinghe , Tong Hong , Hu Yuan , Zhang Xinyi , Xie Wen , Wang Shaoli , Wu Qingjun , Zhang Youjun
Published: September 2020

Green leaf volatiles (GLVs) can induce defence priming, that is, can enable plants to respond faster or more strongly to future stress. The effects of priming by GLVs on defence against insect herbivores and pathogens have been investigated, but little is known about the potential of GLVs to prime crops against virus transmission by vector insects. Here, we tested the hypothesis that exposure to the GLV Z‐3‐hexenol (Z‐3‐HOL) can prime tomato (Solanum lycopersicum) for an enhanced defence against subsequent Tomato yellow leaf curl virus (TYLCV) transmission by the whitefly Bemisia tabaci. Bioassays showed that Z‐3‐HOL priming reduced subsequent plant susceptibility to TYLCV transmission by whiteflies. Z‐3‐HOL treatment increased transcripts of jasmonic acid (JA) biosynthetic genes and increased whitefly‐induced transcripts of salicylic acid (SA) biosynthetic genes in plants. Using chemical inducers, transgenics and mutants, we demonstrated that induction of JA reduced whitefly settling and successful whitefly inoculation, while induction of SA reduced TYLCV transmission by whiteflies. Defence gene transcripts and flavonoid levels were enhanced when whiteflies fed on Z‐3‐HOL‐treated plants. Moreover, Z‐3‐HOL treatment reduced the negative impact of whitefly infestation on tomato growth. These findings suggest that Z‐3‐HOL priming may be a valuable tool for improving management of insect‐transmitted plant viruses.
Lung ultrasound compared to chest X‐ray for the diagnosis of CAP in children
Authors: Bloise Silvia , La Regina Domenico Paolo , Pepino Daniela , Iovine Elio , Laudisa Marco , Di Mattia Greta , Nicolai Ambra , Nenna Raffaella , Petrarca Laura , Mancino Enrica , Frassanito Antonella , Midulla Fabio
Published: September 2020

Background

Community‐acquired pneumonia (CAP) represents one of the most common infectious diseases among children. Diagnosis of CAP is mainly clinical. Chest X‐ray (CXR) remains the gold standard for the diagnosis in severe or controversial conditions. Recently, some authors have focused on the application of ultrasound in lung diseases but the role of lung ultrasound (LUS) in the diagnosis of CAP is still debated. We aimed to study the concordance between LUS and CXR in evaluating specific signs of CAP. As a secondary aim, we sought to determine the sensitivity and specificity of LUS in CAP diagnosis compared with CXR. Finally, we evaluated the role of LUS during the follow up.

Methods

We enrolled 68 children (<16 years old) hospitalized from October 2018 to September 2019 with a clinical and radiological diagnosis of CAP (cases: N = 41), or with no respiratory diseases (controls: N = 27), in whom a CXR was performed for clinical indications. All the children underwent LUS during hospitalization. The average time needed to perform LUS was 5–10 min for each child, and 19/41 cases were re‐evaluated by LUS and CXR 30 days after discharge.

Results

Lung ultrasound confirmed CAP diagnosis in 40/41 patients. Concordance between the two techniques was K = 0.88 for the right lung and K = 0.70 for the left lung. Lung ultrasound showed a sensitivity of 97% and a specificity of 96% compared with CXR. At the follow up, sensitivity increased to 100% while specificity was 94%.

Conclusions

Our study showed a potential benefit of LUS compared with CXR in the diagnosis and the follow up of CAP.
A novel lineage in the Fusarium incarnatum‐equiseti species complex is one of the causal agents of fusarium rot on melon fruits in Northeast Brazil
Authors: Lima Eveline N. , Oster Andréia H. , Bordallo Patricia N. , Araújo Antonio A. C. , Silva Diene E. M. , Lima Cristiano S.
Published: September 2020

Fusarium rot on melon fruits is a postharvest disease and its importance in Brazil is increasing since its first report in 1999. Initially this disease was attributed to the fungus Fusarium semitectum based on pathogen morphology. However, there is controversy regarding the aetiology of this disease because, in the current species concept based on phylogenetic analysis, F. semitectum is regarded as a synonym to different Fusarium species. With the objective of elucidating the disease aetiology in Northeast Brazil, Fusarium isolates were obtained from melon fruits showing rot symptoms in the main producing areas of the country. From the phylogenetic analyses of TEF1 and RPB2 gene sequences, the isolates were identified as belonging to two phylogenetic species of the Fusarium incarnatum‐equiseti species complex (FIESC), one in the Incarnatum clade (Fusarium sulawense) and the other in the Equiseti clade, which corresponds to a new lineage. The newly identified lineage is close to Fusarium lacertarum. Isolates from the two species showed morphological characteristics typical of the Incarnatum and Equiseti clades, agreeing with the molecular identification, and were pathogenic when inoculated on melon fruits. This is the first report of F. sulawense on melon fruits. The data generated in this study are potentially useful for a better management of the fusarium rot on melon.
Factors influencing biological traits and aggressiveness of Colletotrichum species associated with cashew anthracnose in Brazil
Authors: Veloso Josiene S. , Lima Waléria G. , Reis Ailton , Doyle Vinson P. , Michereff Sami J. , Câmara Marcos P. S.
Published: September 2020

Anthracnose is the main fungal disease on cashew orchards in Brazil, occurring on both vegetative and reproductive organs of cultivated and noncultivated host plants. Understanding the effect of physical and chemical exogenous factors on the biological traits of Colletotrichum spp. and determining their host range are key to developing appropriate anthracnose control measures. The present study aimed to estimate the optimum temperatures for mycelial growth, sporulation, and conidial germination of seven Colletotrichum species (C. chrysophilum, C. fragariae, C. fructicola, C. gloeosporioides, C. queenslandicum, C. siamense, and C. tropicale) associated with cashew anthracnose in Brazil. Their aggressiveness on cashew leaves and six alternative host fruits, and their sensitivity to three fungicides were also investigated. The optimum temperatures for mycelial growth, sporulation, and conidial germination ranged from about 25 to about 33°C. All Colletotrichum species induced anthracnose symptoms on wounded cashew leaves, but none of them caused lesions on intact leaf surfaces. The Colletotrichum species, except for C. fragariae and C. fructicola, were pathogenic to wounded fruits of avocado, banana, guava, mango, and papaya, and some isolates also produced lesions on nonwounded fruit tissues. No symptoms were observed on passion fruits, regardless of the inoculation method. Mycelial growth, sporulation, conidial germination, and/or appressorial formation of the seven Colletotrichum species were inhibited by azoxystrobin, difenoconazole, and thiophanate‐methyl to varying degrees. The present study will contribute to the development of forecasting models based on prevailing weather of cashew cropping zones and improve cashew anthracnose management in Brazil.
Early Miocene metallogenic event formed the Bosawa low‐sulfidation epithermal gold deposit, Northeast Japan arc
Authors: Suzuki Teruhiro , Satori Shota , Fujimaki Yuho , Watanabe Yasushi
Published: September 2020

There are a number of epithermal Au‐Ag deposits in the Tohoku region of the Northeast Japan arc; however, these deposits have undergone limited exploration for over the past seven decades. This reconnaissance research study of the Bosawa deposit in Akita Prefecture was conducted to support future gold exploration in the Tohoku region. The Bosawa deposit is a vein‐type Au‐Ag deposit, with a production of 42,486 t of ore at 7.01 g/t Au and 14.9 g/t Ag recorded for the period from 1936 to 1957; mining started in the 18th century. The deposit consists of the Ohgiri vein system, which is hosted in felsic volcanic rocks of the Early Miocene Katsurabuchi Formation. The study included geological prospecting, ore description, K‐Ar dating, and fire assay analyses. The deposit is characterized by (a) strongly silicified host lapilli tuff fringed by pyrite‐adularia‐illite alteration; (b) presence of sulfide‐poor banded quartz veins with adularia; (c) abundance of bladed quartz in veins, pseudomorphs after bladed calcite; (d) presence of colloform opal texture in veins; and (e) simple ore mineralogy consisting of gold and argentite. These characteristics are typical of low‐sulfidation epithermal Au deposits. The K‐Ar age of adularia (19.33 ± 0.45 Ma) indicates that mineralization at Bosawa is distinctly older than the ages of other epithermal deposits in the Tohoku region but similar to the age of the initial mineralization episode of the Sado and Tsurushi deposits (24.4–22.1 Ma), Japan's second largest gold producer. This mineralization age coincides with the start of rifting of the Northeast Japan arc and separation from the Asian continent. As the felsic rocks related to this rifting event are widespread in the arc, and some are associated with epithermal gold deposits, the confirmation of typical low‐sulfidation style of mineralization in the Early Miocene provides evidence for a previously unrecognized metallogenic event in the Tohoku region.
Feasibility and early effectiveness of the Tell‐us Card communication tool to increase in‐hospital patient participation: a cluster randomised controlled pilot study
Authors: van Belle Elise , Huisman‐De Waal Getty , Vermeulen Hester , Heinen Maud
Published: September 2020

Background

Patient participation is fundamental to nursing care and has beneficial effects on patient outcomes. However, it is not well embedded yet and little is known on how nurses could effectively stimulate patient participation in hospital care. The Tell‐us Card is a communication tool for inviting patients to talk about their preferences and needs, and to increase patient participation in daily care.

Objectives

To assess feasibility and early effectiveness of the Tell‐us Card communication tool for enhanced patient participation during hospitalisation.

Design and method

A pilot cluster randomised controlled study design was used including four nursing wards. Effectiveness was measured with the Individualized Care Scale (ICS) and the Quality from the Patients’ Perspective (QPP) questionnaire. Linear mixed model analysis was used for analysis. Feasibility was assessed with an evaluative questionnaire for patients and nurses and by reviewing the content of Tell‐us Cards using the Fundamentals of Care Framework (FOCF) for analysis. Ethical approval was attained.

Results

Data of 265 patients showed a significant increase at one intervention ward on the ICS (effect size 0.61, p = 0.02) and most ICS subscales. No effect was visible on the QPP. The majority of patients regarded the intervention as beneficial; nurses however experienced barriers with incorporating the Tell‐us Card into daily care. Analysis of the Tell‐us Card content showed many elements of the FOCF being mentioned, with most patients indicating psychosocial needs like being involved and informed.

Conclusions

This pilot study showed a positive early effect of the Tell‐us Card communication tool on patient participation, although integration in daily nursing care appeared to be complex and an optimal fit has not yet been reached. Patients were positive about the intervention and wrote meaningful issues on the Tell‐us Cards. More research is needed on how to incorporate patient participation effectively in complex hospital care.
Artificial intelligence enabled applications in kidney disease
Authors: Chaudhuri Sheetal , Long Andrew , Zhang Hanjie , Monaghan Caitlin , Larkin John W. , Kotanko Peter , Kalaskar Shashi , Kooman Jeroen P. , van der Sande Frank M. , Maddux Franklin W. , Usvyat Len A.
Published: September 2020

Artificial intelligence (AI) is considered as the next natural progression of traditional statistical techniques. Advances in analytical methods and infrastructure enable AI to be applied in health care. While AI applications are relatively common in fields like ophthalmology and cardiology, its use is scarcely reported in nephrology. We present the current status of AI in research toward kidney disease and discuss future pathways for AI. The clinical applications of AI in progression to end‐stage kidney disease and dialysis can be broadly subdivided into three main topics: (a) predicting events in the future such as mortality and hospitalization; (b) providing treatment and decision aids such as automating drug prescription; and (c) identifying patterns such as phenotypical clusters and arteriovenous fistula aneurysm. At present, the use of prediction models in treating patients with kidney disease is still in its infancy and further evidence is needed to identify its relative value. Policies and regulations need to be addressed before implementing AI solutions at the point of care in clinics. AI is not anticipated to replace the nephrologists’ medical decision‐making, but instead assist them in providing optimal personalized care for their patients.
Contralateral effects of eccentric resistance training on immobilized arm
Authors: Valdes Omar , Ramirez Carlos , Perez Felipe , Garcia‐Vicencio Sebastian , Nosaka Kazunori , Penailillo Luis
Published: September 2020

This study compared the effects of contralateral eccentric‐only (ECC) and concentric‐/eccentric‐coupled resistance training (CON‐ECC) of the elbow flexors on immobilized arm. Thirty healthy participants (18‐34 y) were randomly allocated to immobilization only (CTRL; n = 10), immobilization and ECC (n = 10), or immobilization and CON‐ECC group (n = 10). The non‐dominant arms of all participants were immobilized (8 h·day−1) for 4 weeks, during which ECC and CON‐ECC were performed by the dominant (non‐immobilized) arm 3 times a week (3‐6 sets of 10 repetitions per session) with an 80%‐120% and 60%‐90% of one concentric repetition maximum (1‐RM) load, respectively, matching the total training volume. Arm circumference, 1‐RM and maximal voluntary isometric contraction (MVIC) strength, biceps brachii surface electromyogram amplitude (sEMGRMS), rate of force development (RFD), and joint position sense (JPS) were measured for both arms before and after immobilization. CTRL showed decreases (P < .05) in MVIC (−21.7%), sEMGRMS (−35.2%), RFD (−26.0%), 1‐RM (−14.4%), JPS (−87.4%), and arm circumference (−5.1%) of the immobilized arm. These deficits were attenuated or eliminated by ECC and CON‐ECC, with greater effect sizes for ECC than CON‐ECC in MVIC (0.29: +12.1%, vs −0.18: −0.1%) and sEMGRMS (0.31:17.5% vs −0.15: −5.9%). For the trained arm, ECC showed greater effect size for MVIC than CON‐ECC (0.47 vs 0.29), and increased arm circumference (+2.9%), sEMGRMS (+77.9%), and RDF (+31.8%) greater (P < .05) than CON‐ECC (+0.6%, +15.1%, and + 15.8%, respectively). The eccentric‐only resistance training of the contralateral arm was more effective to counteract the negative immobilization effects than the concentric‐eccentric training.
Recognition of an HLA‐C*03:04:01:01 variant, HLA‐C*03:04:37, in a Taiwanese individual
Authors: Yang Kuo‐Liang , Li Chi‐Cheng , Lin Py‐Yu
Published: September 2020

One nucleotide substitution in codon 81 of HLA‐C*03:04:01:01 results in a novel allele, HLA‐C*03:04:37.
Viscoelastic testing in cardiac surgery
Authors: Agarwal Seema , Abdelmotieleb Mohamed
Published: September 2020

Bleeding complications are common in cardiac surgery and lead to an increase in morbidity and mortality. This is multifactorial in aetiology including the effects of cardiopulmonary bypass, the drugs given to manipulate the coagulation system and the vascular nature of the surgery itself. Viscoelastic tests provide a point of care, rapid assessment of coagulation which offer the advantage of faster turnaround times and a nuanced view of the elements of the coagulation system allowing targeted therapy to be delivered quickly. Both thomboelastography (TEG)and thromboelastometry (ROTEM) have been recommended for use in cardiac surgery, both have shown a reduction in transfusion and bleeding when used as part of a testing algorithm. They are particularly useful in assessing residual heparinisation and fibrinogen levels. Additionally, TEG allows the evaluation of the effects of anti‐platelet agents on platelet function. This review discusses the mechanisms by which bleeding occurs in cardiac surgery and explores three uses of viscoelastic testing in cardiac surgery: to predict bleeding, to assess platelet function and peri‐operative testing to reduce transfusion