bluuebunny/crossref_metadata_2025 huggingface dataset:
“When my worse fear happened”: Mental health nurses’ responses to the death of a client through suicide
Authors: Morrissey Jean , Higgins Agnes
Published: May 2021

Accessible Summary

What is known on the subject?

The death of a client to suicide evokes a range of grief responses for mental health nurses (MHNs), which vary in intensity according to the nature of the therapeutic relationship with the deceased client.

There are limited qualitative studies on the experiences of nurses working in the community and the personal or professional strategies used by nurses to cope with the death of a client by suicide.

What this paper adds to existing knowledge?

Following a client suicide, MHNs were often left to carry the burden of grief alone and to care for themselves with the support of their family and colleagues.

While all participants perceived the need for support following the death of a client by suicide, they were offered minimal support beyond the debriefing meetings, with their grief experience being largely unacknowledged and disenfranchised.

What are the implications for practice?

MHNs and services need to establish and promote a culture of openness in which suicide is anticipated as a possible outcome, even with excellent standards of care and wherein all staff are supported and encouraged to discuss and reflect on their concerns and fears during the aftermath of a client suicide.

As MHNs are often left to carry the burden of grief alone, services need to recognize the emotional cost of embodied engagement with clients and families and provide the necessary supports.

Introduction

Experiencing a client's death through suicide is complex and challenging, yet limited research exists on how MHNs might deal with its aftermath.

Aim

This study aimed to explore the impact and responses of MHNs to a client suicide.

Method

The study design is a secondary analysis of an existing data set involving semi‐structured interview with 33 MHNs that were analysed using the principles of grounded theory. To answer the secondary question on the impact and responses of MHNs to the death of a client by suicide a subset of the data from 10 participants who experienced the death of a client by suicide were re‐analysed using thematic analysis. Ethical approval was granted by the university ethics committee.

Findings

The findings identified five themes: “Hearing the news,” “Experiencing the impact of grief,” “Grieving privately” “Searching for meaning” and “Questioning practice.”

Discussion

Findings highlighted that although participants perceived the need for support, they were offered minimal support beyond the debriefing meetings, with their grief experience being largely unacknowledged and disenfranchised.

Implications for practice

MHN services need to promote a culture of openness wherein all MHNs are supported and encouraged to discuss their concerns and fears during the aftermath of a client suicide.
Tetramethylpyrazine supplementation improves performance, digestion, blood and immune state of broilers exposure to oxidative stress
Authors: Shi Hanyi , Luo Yiran , Li Yufa , Zhang Feike , Liu Ning
Published: May 2021

This study aimed to investigate the effect of dietary tetramethylpyrazine (TMP) on the growth performance, nutrient digestion, blood parameters and immunity of broilers under oxidative stress. Five treatments included negative control, positive control with lipopolysaccharide induction and TMP addition at 50, 100 and 150 mg/kg of diet using 600 male Arbor Acres broiler chicks. Results showed that during 1–14 days of age, body weight gain and feed efficiency in the positive control were worsened (p < .05) compared with the negative control, while with incremental TMP doses from 0 to 150 mg/kg there were linear and quadratic increases (p < .001) in body weight gain and a linear decrease in feed/gain (p = .001). During 12–14 days of age, with incremental TMP doses, crude protein digestibility was linearly increased (p = .001), and gross energy utilization was linearly and quadratically changed (p < .001). At 14 days of age, the TMP beneficially regulated digestive enzymes, blood parameters and immunoglobulins, showing linear and quadratic responses (p ≤ .008) on trypsin, lipase, glutamic pyruvic transaminase, glucose, lipoproteins, albumin, immunoglobulins (M, Y), interleukin 6 and interferon α, and only linear changes (p ≤ .030) on amylase, glutamic oxaloacetic transaminase, immunoglobulin A and interleukin 2. Most parameters in TMP groups reached to the levels of negative control and the effects of TMP at 100 or 150 mg/kg were more pronounced on body weight gain, crude protein digestibility, trypsin and glutamic pyruvic transaminase. It is concluded that TMP can be used as a feed additive capable of improving growth, blood parameter and immunity of broiler chicks under oxidative stress.
Rural and racial disparities in colorectal cancer incidence and mortality in South Carolina, 1996 – 2016
Authors: Adams Swann Arp , Zahnd Whitney E. , Ranganathan Radhika , Hung Peiyin , Brown Monique J. , Truman Samantha , Biesecker Claire , Kirksey Victor C. , Eberth Jan M.
Published: May 2021

Purpose

Colorectal cancer (CRC) is the third leading cause of cancer mortality among men and women in the United States and South Carolina (SC). Since SC has one of the highest proportions of Black (27.9%) and rural residents (33.7%), the purpose of this investigation was to describe the burden of CRC on racial disparities in rural populations.

Methods

Count data from 2012 to 2016 were obtained from the state central cancer registry using an online data retrieval system. Rural‐urban status was determined using Urban Influence Codes (1‐2 = urban; 3‐12 = rural). Chi‐square tests were calculated to examine differences in CRC stage by rurality and race. Annual percent change and annual average percent change (AAPC) were calculated to examine trends in incidence and mortality rates across rural‐urban and racial groups between 1996 and 2016.

Results

Areas with high mortality‐to‐incidence ratios tended to be in rural counties. Furthermore, rural residents had higher proportions of distant stage CRC compared to urban residents, and Black populations had higher proportions of distant stage CRC compared to White populations (22.7% vs. 26.3% and 29.3% vs. 23.7%, respectively; P value < 0.05). From 1996 to 2016, Black and White urban‐dwelling residents experienced a significant decline in incidence. Urban White, urban Black, and rural White populations experienced significant declines in mortality (AAPC = −2.6% vs −2.4% vs −1.6% vs −0.9%, respectively).

Conclusions

Despite improvements in CRC screening in recent decades, focused evidenced‐based interventions for lowering incidence and mortality among rural and Black populations in South Carolina are necessary.
Denominational Differences in Obesity Among Black Christian Adults: Why Gender and Life Stage Matter
Authors: Bentley‐Edwards Keisha L. , Robbins Paul A. , Blackman Carr Loneke T. , Smith Imari Z. , Conde Eugenia , Darity William A.
Published: May 2021

Religiosity is a potential social determinant of obesity risk among black Americans, a group that tends to be highly religious and disproportionately suffers from this disease. Although religious engagement differs within this group, researchers often classify black Protestants into broad categories, making it challenging to determine which subgroups experience the worst outcomes. Using data from the National Survey of American Life, this study investigated whether black adults from various Christian denominations had comparable odds of having obesity and if these findings were consistent across life stage (i.e., young, middle, and late adulthood). Results suggest that for middle‐aged Pentecostal women, and men and women who attend church most frequently, the odds of having obesity were comparably higher than their respective counterparts. These findings indicate that, even when denominational consolidation is appropriate in other religious research contexts, researchers should consider diaggregating black Christians by denomination when examining the relationship between religion and health.
On the Relationship between Uhlig Extended and beta‐Bartlett Processes
Authors: Peña Víctor , Irie Kaoru
Published: May 2021

Stochastic volatility processes are used in multi‐variate time series analysis to track time‐varying patterns in covariance matrices. Uhlig extended (UE) and beta‐Bartlett (BB) processes are especially convenient for analyzing high‐dimensional time series because they are conjugate with Wishart likelihoods. In this article, we show that UE and BB are closely related, but not equivalent: their hyperparameters can be matched so that they have the same forward‐filtered posteriors and one‐step ahead forecasts, but different joint (smoothed) posterior distributions. Under this circumstance, Bayes factors cannot discriminate the models and alternative approaches to model comparison are needed. We illustrate these issues in a retrospective analysis of volatilities of returns of foreign exchange rates. Additionally, we provide a backward sampling algorithm for the BB process, for which retrospective analysis had not been developed.
Partitioned beta diversity patterns of plants across sharp and distinct boundaries of quartz habitat islands
Authors: Eibes Pia Maria , Oldeland Jens , Irl Severin David Howard , Twerski Alina , Kühne Nicole , Schmiedel Ute
Published: May 2021

Questions

Habitat islands are often characterized by the presence of more or less sharp boundaries to adjacent matrix habitats. However, knowledge on boundaries of natural habitat islands is scarce, especially regarding patterns of beta diversity and its two underlying components: species turnover and nestedness. We therefore aim to quantify the effects of fine‐scaled and sharp boundaries of quartz islands (quartz gravel‐covered soils) on the different components of plant beta diversity and how they are linked to different soil environmental drivers.

Location

Knersvlakte, Western Cape, South Africa.

Methods

We sampled plant species richness in 56 fine‐scale transects of 6 m × 1 m plots across eight different boundary types (four quartz island to matrix, four between habitats on quartz islands). Soil depth and chemistry (pH, electrical conductivity) were analyzed for each 1 m2 plot. Differences in the two beta diversity components (turnover and nestedness) for each boundary type were tested by t tests. We used linear models to test relationships between species and environmental dissimilarity.

Results

All boundary types showed high beta diversity. Species turnover was the prevailing component for six boundary types, the nestedness component was only important for two boundary types. We found a significant linear increase of species dissimilarity with increasing dissimilarity in soil pH and distinct plant communities for the habitat types, but no significant increase for electrical conductivity or soil depth.

Conclusions

The spatial distinctiveness of the quartz islands leads to sharp boundaries, which result in high beta diversity, mainly through species turnover. This reflects the high levels of diversification and adaptation of the local plant communities. Nestedness occurred at two boundaries to the matrix, indicating that the latter does not necessarily represent an impermeable boundary for all species of the respective ecosystem. Studying diversity patterns across boundaries contributes to the question of applicability of island biogeography theory to habitat islands.
Chronic hepatic involvement in the clinical spectrum of A20 haploinsufficiency
Authors: Deshayes Samuel , Bazille Céline , El Khouri Elma , Kone‐Paut Isabelle , Giurgea Irina , Georgin‐Lavialle Sophie , Martin Silva Nicolas , Dumont Anaël , Ollivier Isabelle , Amselem Serge , de Boysson Hubert , Aouba Achille
Published: May 2021

Background & Aims

Secondary to tumour necrosis factor‐alpha induced protein 3 (TNFAIP3) mutations, A20 haploinsufficiency (HA20) is a recently described autoinflammatory disease with clinical features similar to those of Behçet's and Crohn's diseases but with a constantly expanding clinical spectrum. Here, we describe HA20 liver involvement in three new patients from the same family.

Methods

We retrospectively assessed clinical, biological and/or histological findings for eight patients over three generations of the same family with heterozygous mutations in the TNFAIP3 gene (c.259C > T, p.Arg87*).

Results

The eight patients exhibited the following: aphthous ulcers (8/8, bipolar in 7), autoimmune features (6/8, including 5 with definitive autoimmune disease diagnoses, ie, type I diabetes, Hashimoto thyroiditis, pernicious anaemia, and/or 5 with antinuclear antibodies ≥320), pustulosis/folliculitis (5/8), abdominal pain (4/8), arthralgia (3/8), enlarged cervical lymph nodes (3/8) and pericarditis (1/8). In addition, three patients (twin sisters and their grandmother aged 23 and 70 years, respectively) exhibited persistent mild hepatic cytolysis associated with splenomegaly (n = 3), hepatomegaly (n = 1) and/or liver atrophy (n = 1) on echography. We could not detect any other causes of chronic liver diseases. Liver biopsies from three patients displayed hepatic fibrosis, hepatocyte injury and/or CD4+/CD8+ T lymphocyte infiltration, and patterns of inflammatory cells and NLRP3 or NF‐κB immunostaining differed from the predominant neutrophil infiltration observed in skin or some digestive tract biopsies.

Conclusions

This study reinforces the dual involvement of innate and adaptive immunity in HA20 according to both acute and chronic injury and the organ involved and widens its clinical spectrum to include chronic hepatic involvement.
Glecaprevir/pibrentasvir for 8 weeks in patients with compensated cirrhosis: Safety and effectiveness data from the German Hepatitis C‐Registry
Authors: Klinker Hartwig , Naumann Uwe , Rössle Martin , Berg Thomas , Bondin Mark , Lohmann Kristina , Koenig Bettina , Zeuzem Stefan , Cornberg Markus
Published: May 2021

Glecaprevir/pibrentasvir, a pangenotypic, direct‐acting antiviral combination approved for chronic hepatitis C virus treatment, has limited real‐world evidence supporting 8‐week therapy in compensated cirrhosis. We investigated effectiveness and safety of 187 hepatitis C virus‐infected, treatment‐naïve, patients with compensated cirrhosis receiving 8‐week glecaprevir/pibrentasvir therapy in the German Hepatitis C‐Registry between 2 August 2017 and 1 January 2020. Sustained virologic response was 98.4% (127/129) in the per‐protocol analysis (excluding patients lost to follow‐up or who discontinued treatment due to compliance) and was 85.8% (127/148) in patients with data available in an intention‐to‐treat analysis. Nineteen patients were lost to follow‐up; nine genotype 3 patients, nine nongenotype 3 patients and one mixed genotype patient. One patient relapsed, and one died, unrelated to treatment. Adverse events (>5%) were fatigue and headache. Two serious adverse events occurred; no adverse events resulted in drug discontinuation. An 8‐week glecaprevir/pibrentasvir therapy was effective and well‐tolerated in this real‐world analysis.
Hepatic macrophages: Key players in the development and progression of liver fibrosis
Authors: Cheng Da , Chai Jin , Wang Huiwen , Fu Lei , Peng Shifang , Ni Xin
Published: May 2021

Hepatic fibrosis is a common pathological process involving persistent liver injury with various etiologies and subsequent inflammatory responses that occur in chronic liver diseases. If left untreated, liver fibrosis can progress to liver cirrhosis, hepatocellular carcinoma and eventually, liver failure. Unfortunately, to date, there is no effective treatment for liver fibrosis, with the exception of liver transplantation. Although the pathophysiology of liver fibrosis is multifactorial and includes the activation of hepatic stellate cells, which are known to drive liver fibrogenesis, hepatic macrophages have emerged as central players in the development of liver fibrosis and regression. Hepatic macrophages, which consist of resident macrophages (Kupffer cells) and monocyte‐derived macrophages, have been shown to play an intricate role in the initiation of inflammatory responses to liver injury, progression of fibrosis, and promotion of fibrosis resolution. These features have made hepatic macrophages uniquely attractive therapeutic targets in the fight against hepatic fibrosis. In this review, we synthesised the literature to highlight the functions and regulation of heterogeneity in hepatic macrophages. Furthermore, using the existing findings, we attempt to offer insights into the molecular mechanisms underlying the phenotypic switch from fibrogenic macrophages to restorative macrophages, the regulation of heterogeneity, and modes of action for hepatic macrophages. A better understanding of these mechanisms may guide the development of novel anti‐fibrotic therapies (eg macrophage subset‐targeted treatments) to combat liver fibrosis in the future.
Evaluation of cardiovascular events in patients with hepatocellular carcinoma treated with sorafenib in the clinical practice. The CARDIO‐SOR study
Authors: Carballo‐Folgoso Lorena , Álvarez‐Velasco Rut , Lorca Rebeca , Castaño‐García Andrés , Cuevas Javier , González‐Diéguez María Luisa , Martín María , Álvarez‐Navascués Carmen , Cadahía Valle , Morís César , Rodríguez Manuel , Varela María
Published: May 2021

Background and Aims

The effectiveness of systemic treatment in advanced hepatocellular carcinoma (HCC) depends on the selection of patients, management of cirrhosis complications and expertise to treat adverse events. The aims of the study are to assess the frequency and management of cardiovascular events in HCC patients treated with sorafenib (SOR) and to create a scale to predict the onset of major adverse cardiovascular events (MACE).

Method

Observational retrospective study with consecutive HCC patients treated with SOR between 2007 and 2019 in a western centre. In order to classify cardiovascular risk pre‐SOR, we designed the CARDIOSOR scale with age, hypertension, diabetes, dyslipidaemia and peripheral vascular disease. Other adverse events, dosing and outcome data were collected during a homogeneous protocolled follow‐up.

Results

Two hundred ninety‐nine patients were included (219 BCLC‐C). The median overall survival was 11.1 months (IQR 5.6‐20.5), and duration of treatment was 7.4 months (IQR 3.3‐14.7). Seventeen patients (6%) stopped SOR due to cardiovascular event. Thirty‐three patients suffered MACE (7 heart failure, 11 acute coronary syndrome, 12 cerebrovascular accident and 8 peripheral vascular ischemia); 99 had a minor cardiovascular event, mainly hypertension (n = 81). Age was the only independent factor associated to MACE (HR 1.07; 95% CI 1.03‐1.12; P = .002). The CARDIOSOR scale allows to identify the group of patients with higher risk of MACE (sHR 3.4; 95% CI 1.4‐6.7; P = .04).

Conclusion

The incidence of cardiovascular events in HCC patients treated with SOR is higher than expected. Multidisciplinary approach and clinical tools like CARDIOSOR scale could be helpful to manage these patients.
Experimental liver models: From cell culture techniques to microfluidic organs‐on‐chip
Authors: Polidoro Michela Anna , Ferrari Erika , Marzorati Simona , Lleo Ana , Rasponi Marco
Published: May 2021

The liver is one of the most studied organs of the human body owing to its central role in xenobiotic and drug metabolism. In recent decades, extensive research has aimed at developing in vitro liver models able to mimic liver functions to study pathophysiological clues in high‐throughput and reproducible environments. Two‐dimensional (2D) models have been widely used in screening potential toxic compounds but have failed to accurately reproduce the three‐dimensionality (3D) of the liver milieu. To overcome these limitations, improved 3D culture techniques have been developed to recapitulate the hepatic native microenvironment. These models focus on reproducing the liver architecture, representing both parenchymal and nonparenchymal cells, as well as cell interactions. More recently, Liver‐on‐Chip (LoC) models have been developed with the aim of providing physiological fluid flow and thus achieving essential hepatic functions. Given their unprecedented ability to recapitulate critical features of the liver cellular environments, LoC have been extensively adopted in pathophysiological modelling and currently represent a promising tool for tissue engineering and drug screening applications. In this review, we discuss the evolution of experimental liver models, from the ancient 2D hepatocyte models, widely used for liver toxicity screening, to 3D and LoC culture strategies adopted for mirroring a more physiological microenvironment for the study of liver diseases.
Extensive pollen‐mediated gene flow across intensively managed landscapes in an insect‐pollinated shrub native to semiarid habitats
Authors: González‐Robles Ana , García Cristina , Salido Teresa , Manzaneda Antonio J. , Rey Pedro J.
Published: May 2021

Our knowledge of the impact of landscape fragmentation on gene flow patterns is mainly drawn from tropical and temperate ecosystems, where landscape features, such as the distance of a tree to the forest edge, drive connectivity and mating patterns. Yet, the structure of arid and semiarid plant communities – with open canopies and a scattered distribution of trees – differs greatly from those that are well‐characterized in the literature. As a result, we ignore whether the documented consequences of landscape fragmentation on plant mating and gene flow patterns also hold for native plant communities in arid and semiarid regions. We investigated the relative contribution of plant traits, pollinator activity, and individual neighbourhood in explaining variation in mating and gene flow patterns of an insect‐pollinated semiarid arborescent shrub, Ziziphus lotus, at three sites embedded in highly altered agriculture landscapes. We used 14 SSRs, seed paternity analyses, and individual mixed effect mating models (MEMMi) to estimate the individual mating variables and the pollen dispersal kernel at each site. Individual spatial location, flower density, and floral visitation rate explained most of the variation of mating variables. Unexpectedly, individual correlated paternity was very low and shrubs surrounded by the most degraded matrix exhibited an increased fraction of pollen immigration and a high effective number of pollen donors per mother shrub. Overall, our results reveal that an active pollinator assemblage ensures highly efficient mating, and maintains pollen‐mediated gene flow and notable connectivity levels, even in highly altered landscapes, potentially halting genetic isolation within and between distant sites.
On Physics, Metaphysics, and Metametaphysics
Authors: Arenhart Jonas R. Becker , Arroyo Raoni Wohnrath
Published: May 2021

Nonrelativistic quantum mechanics (QM) works perfectly well for all practical purposes. Once one admits, however, that a successful scientific theory is supposed not only to make predictions but also to tell us a story about the world in which we live, a philosophical problem emerges: in the specific case of QM, it is not possible to associate with the theory a unique scientific image of the world; there are several images. The fact that the theory may be compatible with distinct ontologies, and that those ontologies may themselves be associated with a plurality of metaphysical approaches, gives rise to the problem of metaphysical underdetermination. This paper concludes that the available metametaphysical criteria fail to deliver objectivity in theory choice, and it puts forward its own criterion based on a tension between two methods of metaphysical inquiry: one that is closely related to science and another that is not.
A Perturbed Markovian process with state‐dependent increments and measurement uncertainty in degradation modeling
Authors: Oumouni M. , Schoefs F.
Published: May 2021

In structural reliability, the Markovian cumulative damage approaches such as Gamma process seem promising to model a nonreversible deterioration that involves gradually over time with small time increments. However, in many degradation phenomena, its evolution depends on the level of the degradation rather than the increments of time. Further, the measured data are usually collected with random error whose dispersion depends on the current degradation level. Therefore, the deterioration model should take in consideration such dependency and uncertainty for more accurate prediction. In this paper, a new statistical, data‐driven state‐dependent and perturbed model is proposed to model the state dependence (hidden level‐degradation) both in temporal increments and measurement uncertainty. The construction of the degradation model will be discussed within an application to the pitting corrosion and synthetic data. Numerical experiments will later be conducted to identify preliminary properties of the model in terms of statistical inferences. Algorithm and estimates are proposed to compute the parameters of the model, the hidden state, and failure  probabilities.
High‐performance vibration isolation technique using passive negative stiffness and semiactive damping
Authors: Shi Xiang , Zhao Fulei , Yan Zhidan , Zhu Songye , Li Jin‐Yang
Published: May 2021

Among active, semiactive, and passive vibration isolation methods, active control can provide the best isolation performances. However, high‐energy consumption hinders its wide applications in civil engineering field. This paper proposes a novel vibration isolation technique based on a passive negative stiffness spring (NSS) and a semiactive device (SAD), aiming to achieve an active isolation performance by using a low‐power semiactive technique. Due to its nature of negative potential energy, an NSS enables the semiactive isolation system to provide negative transient power flow that injects power into the structure and avoids the clipping phenomenon of semiactive control forces. Consequently, the combined NSS and SAD isolation system can perfectly generate the theoretical control forces calculated by an active control algorithm and achieve a considerably improved semiactive isolation performance. The prospects and performance advantages of the proposed NSS and SAD isolation system are validated through a series of numerical simulations of single‐degree‐of‐freedom and multi‐degree‐of‐freedom structures excited by various types of ground motions and a benchmark building model excited by seismic ground motions.
A Gaussian sampling heuristic estimation model for developing synthetic trip sets
Authors: Batista S. F. A. , Cantelmo Guido , Menéndez Mónica , Antoniou Constantinos
Published: May 2021

In this paper, we develop a heuristic model based on Gaussian processes to determine synthetic sets of trips in urban networks, considering only supply‐related information. This is an alternative to the benchmark method used in the literature, which consists of repeating several trials of Monte Carlo simulations and therefore requiring a complex calibration task and large computational resources. The developed heuristic model explicitly leverages the probabilistic nature of Gaussian processes and exploits their properties to iteratively select origin–destination (od) pairs of nodes in the city network. The model then determines the shortest trip in distance for the selected od pairs and appends it to the synthetic set. We discuss the implementation and performance of both the benchmark method and the developed heuristic model on two city networks. We show that the presented model is more robust and computationally efficient than the benchmark method. This is evidenced by its ability to determine synthetic sets with much smaller sizes, naturally reducing the computational burden, when compared to the benchmark method. We also discuss how the choice of the kernel function and calibration of the hyperparameters influence the performance of the presented heuristic model.
The global regulator Hfq exhibits far more extensive and intensive regulation than Crc in Pseudomonas protegens H78
Authors: Wang Zheng , Huang Xianqing , Jan Malik , Kong Deyu , Pan Jingwen , Zhang Xuehong
Published: May 2021

The biocontrol rhizobacterium Pseudomonas protegens H78 can produce a large array of antimicrobial secondary metabolites, including pyoluteorin (Plt), 2,4‐diacetylphloroglucinol (DAPG), and pyrrolnitrin (Prn). Our preliminary study showed that the biosynthesis of antibiotics including Plt is activated by the RNA chaperone Hfq in P. protegens H78. This prompted us to explore the global regulatory mechanism of Hfq, as well as the catabolite repression control (Crc) protein in H78. The antimicrobial capacity of H78 was positively controlled by Hfq while slightly down‐regulated by knockout of crc. Similarly, cell growth of H78 was significantly impaired by deletion of hfq and slightly inhibited by knockout of crc. Transcriptomic profiling revealed that hfq mutation resulted in significant down‐regulation of 688 genes and up‐regulation of 683 genes. However, only 113 genes were significantly down‐regulated and 105 genes up‐regulated by the crc mutation in H78. Hfq positively regulated the expression of gene clusters involved in secondary metabolism (plt, prn, phl, hcn, and pvd), the type VI secretion system, and aromatic compound degradation. However, Crc only positively regulated the biosynthesis of Plt but not other antibiotics. Hfq also regulated expression of genes involved in oxidative phosphorylation and flagellar biogenesis. In addition, Hfq and Crc activated transcription of crcY/Z sRNAs by feedback. In summary, Hfq processes far more extensive and intensive regulatory capacity than Crc and shows small cross‐regulation with Crc in H78. This study lays the foundation for clarifying the Hfq and/or Crc‐dependent global regulatory network and improving antibiotic production by genetic engineering in P. protegens.
The role of oxidative stress in onychomycosis: Thiol/disulphide homeostasis
Authors: Metin Mahmut Sami , Elmas Ömer Faruk , Demirbaş Abdullah , Erel Özcan , Atasoy Mustafa , Türsen Ümit , Lotti Torello
Published: May 2021

Objectives

Onychomycosis is the general term to define fungal nail infections that arise from dermatophytes, non‐dermatophytic moulds and yeasts. Thiol/disulphide homeostasis is a new indicator of oxidative stress. In this study, we aimed to investigate the role of thiol/disulphide balance in the pathogenesis of onychomycosis.

Methods

This cross‐sectional study included adult patients with onychomycosis who were admitted to the dermatology department and healthy adult volunteers without any dermatologic or systemic condition. The patients and controls were evaluated in terms of native thiol, total thiol, and disulphide levels, and disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios. The possible association between these parameters and clinical subtypes of onychomycosis and demographic characteristics was also investigated.

Results

A total of 52 patients with onychomycosis and 50 healthy subjects were enrolled in the study. The patient group showed lower levels of total thiol, native thiol and native thiol/total thiol ratio, and higher ratios of disulphide/native thiol and disulphide/total thiol. No statistically significant relationship was found between the parameters, clinical subtypes of onychomycosis and demographic characteristics (p > .05).

Conclusion

Patients with onychomycosis showed a shifted thiol/disulphide homeostasis towards oxidative stress with a reduction in thiols and an increase in disulphide/native thiol, and disulphide/total thiol ratios. These findings may indicate the role of oxidative stress in the pathogenesis of onychomycosis.
Concomitant use of isavuconazole and CYP3A4/5 inducers: Where pharmacogenetics meets pharmacokinetics
Authors: Van Daele Ruth , Debaveye Yves , Vos Robin , Van Bleyenbergh Pascal , Brüggemann Roger J. , Dreesen Erwin , Elkayal Omar , Guchelaar Henk‐Jan , Vermeersch Pieter , Lagrou Katrien , Spriet Isabel
Published: May 2021

Background

Isavuconazole is a triazole antifungal drug, approved for the treatment of invasive aspergillosis and mucormycosis. Isavuconazole is metabolised by CYP3A4 and CYP3A5, and it has been shown that the CYP3A inducer rifampin reduces isavuconazole exposure. By extrapolation, the concomitant use of isavuconazole with moderate and strong CYP450 inducers is contraindicated, although it is known that some CYP450 inducers are less potent in comparison with rifampin.

Objectives

We aim to document exposure to isavuconazole in patients concomitantly treated with a CYP450 inducer that is less potent compared to rifampin. Moreover, although it is well known that CYP3A enzymes are important for the metabolism of isavuconazole, this induction effect has never been studied in combination with the patient's CYP3A genotype.

Patients

We report three patients treated with both isavuconazole and a CYP3A inducer that is less potent compared to rifampin (rifabutin or phenobarbital), in whom we determined isavuconazole concentrations.

Results

These cases suggest that the CYP3A4/5 genotype is an important determinant for isavuconazole exposure and that it might also influence the CYP450 induction interaction.

Conclusions

CYP3A inducers that are less potent compared to rifampin, may be combined with isavuconazole in patients with loss of CYP3A5 activity (CYP3A5*3/*3). Therapeutic drug monitoring is recommended during this combination. However, low‐isavuconazole exposure was observed in the extensive metaboliser with CYP3A4*1/*1 and CYP3A5*1/*3 alleles.
Hypothermia‐induced triphasic waves
Authors: Shiraishi Wataru , Ogoshi Takaaki
Published: May 2021

A 79‐year‐old Japanese woman was admitted to our hospital with consciousness disturbance and difficulty in moving. On admission, her core temperature was 28°C. Electroencephalography showed slow waves and frontal‐dominant triphasic waves. After rewarming, her symptoms and electroencephalography abnormality disappeared. Triphasic waves and their resembling appear in numerous cerebral diseases, for example, metabolic encephalopathy, antibiotic encephalopathy, and stroke; however, there are only a few case reports of hypothermia‐associated triphasic waves.
Ways of walking, speaking and listening: Nursing practices and professional identities among Polish nurses in Norway
Authors: Pawlak Marek
Published: May 2021

This article explores the lived experiences of Polish nurses’ transition into the Norwegian healthcare system and analyses the emerging differences in nursing practices and professional identities between Poland and Norway. It draws on ethnographic findings and argues that nursing is a complex practice, which involves not only nursing knowledge, but also less obvious and often taken for granted nursing imaginaries and actions. In doing so, the article looks at different ways of walking, speaking and listening, which are not merely nurses’ daily habits, but also the embodiments of hierarchical relations, agency and empowerment in healthcare settings. This kind of analytical perspective of the existing differences in nursing practices and professional identities between Poland and Norway raises crucial questions about transitional contexts of nurse migration and shows that nursing is not static, but rather a dynamic and processual way of conduct.
Fol‐milR1, a pathogenicity factor of Fusarium oxysporum, confers tomato wilt disease resistance by impairing host immune responses
Authors: Ji Hui‐Min , Mao Hui‐Ying , Li Si‐Jian , Feng Tao , Zhang Zhao‐Yang , Cheng Lu , Luo Shu‐Jie , Borkovich Katherine A. , Ouyang Shou‐Qiang
Published: May 2021

Although it is well known that miRNAs play crucial roles in multiple biological processes, there is currently no evidence indicating that milRNAs from Fusarium oxysporum f. sp. lycopersici (Fol) interfere with tomato resistance during infection.

Here, using sRNA‐seq, we demonstrate that Fol‐milR1, a trans‐kingdom small RNA, is exported into tomato cells after infection.

The knockout strain ∆Fol‐milR1 displays attenuated pathogenicity to the susceptible tomato cultivar ‘Moneymaker’. On the other hand, Fol‐milR1 overexpression strains exhibit enhanced virulence against the resistant cultivar ‘Motelle’. Several tomato mRNAs are predicted targets of Fol‐milR1. Among these genes, Solyc06g007430 (encoding the CBL‐interacting protein kinase, SlyFRG4) is regulated at the posttranscriptional level by Fol‐milR1. Furthermore, SlyFRG4 loss‐of‐function alleles created using CRISPR/Cas9 in tomato (‘Motelle’) exhibit enhanced disease susceptibility to Fol, further supporting the idea that SlyFRG4 is essential for tomato wilt disease resistance. Notably, our results using immunoprecipitation with specific antiserum suggest that Fol‐milR1 interferes with the host immunity machinery by binding to tomato ARGONAUTE 4a (SlyAGO4a). Furthermore, virus‐induced gene silenced (VIGS) knock‐down SlyAGO4a plants exhibit reduced susceptibility to Fol.

Together, our findings support a model in which Fol‐milR1 is an sRNA fungal effector that suppresses host immunity by silencing a disease resistance gene, thus providing a novel virulence strategy to achieve infection.
Evolution of crassulacean acid metabolism (CAM) as an escape from ecological niche conservatism in MalagasyBulbophyllum(Orchidaceae)
Authors: Gamisch Alexander , Winter Klaus , Fischer Gunter A. , Comes Hans Peter
Published: May 2021

Despite growing evidence that niche shifts are more common in flowering plants than previously thought, little is known of whether such shifts are promoted by changes in photosynthetic pathways.

Here we combine the most complete phylogeny for epiphytic MalagasyBulbophyllumorchids (c. 210 spp.) with climatic niche and carbon isotope ratios to infer the group’s spatial‐temporal history, and the role of strongly expressed crassulacean acid metabolism (CAM) in facilitating niche shifts and diversification.

We find that most extant species still retain niche (Central Highland) and photosynthesis (C3) states as present in the single mid‐Miocene (c. 12.70 million yr ago (Ma)) ancestor colonizing Madagascar. However, we also infer a major transition to CAM, linked to a late Miocene (c. 7.36 Ma) invasion of species from the sub‐humid highland first into the island’s humid eastern coastal, and then into the seasonally dry ‘Northwest Sambirano’ rainforests, yet without significant effect on diversification rates.

These findings indicate that CAM in tropical epiphytes may be selectively advantageous even in high rainfall habitats, rather than presenting a mere adaptation to dry environments or epiphytismper se. Overall, our study qualifies CAM as an evolutionary ‘gateway’ trait that considerably widened the spatial‐ecological amplitude of Madagascar’s most species‐rich orchid genus.
The bacterial effector HopZ1a acetylates MKK7 to suppress plant immunity
Authors: Rufián José S. , Rueda‐Blanco Javier , López‐Márquez Diego , Macho Alberto P. , Beuzón Carmen R. , Ruiz‐Albert Javier
Published: May 2021

The Pseudomonas syringae type III secretion system translocates effector proteins into the host cell cytosol to suppress plant basal immunity. Effector HopZ1a suppresses local and systemic immunity triggered by pathogen‐associated molecular patterns (PAMPs) and effectors, through target acetylation. HopZ1a has been shown to target several plant proteins, but none fully substantiates HopZ1a‐associated immune suppression. Here, we investigate Arabidopsis thaliana mitogen‐activated protein kinase kinases (MKKs) as potential targets, focusing on AtMKK7, a positive regulator of local and systemic immunity.

We analyse HopZ1a interference with AtMKK7 by translocation of HopZ1a from bacteria inoculated into Arabidopsis expressing MKK7 from an inducible promoter. Reciprocal phenotypes are analysed on plants expressing a construct quenching MKK7 native expression. We analyse HopZ1a–MKK7 interaction by three independent methods, and the relevance of acetylation by in vitro kinase and in planta functional assays.

We demonstrate the AtMKK7 contribution to immune signalling showing MKK7‐dependent flg22‐induced reactive oxygen species (ROS) burst, MAP kinas (MAPK) activation and callose deposition, plus AvrRpt2‐triggered MKK7‐dependent signalling. Furthermore, we demonstrate HopZ1a suppression of all MKK7‐dependent responses, HopZ1a–MKK7 interaction in planta and HopZ1a acetylation of MKK7 with a lysine required for full kinase activity.

We demonstrate that HopZ1a targets AtMKK7 to suppress local and systemic plant immunity.
Soil biotic and abiotic effects on seedling growth exhibit context‐dependent interactions: evidence from a multi‐country experiment on Pinus contorta invasion
Authors: Nuske Susan J. , Fajardo Alex , Nuñez Martin A. , Pauchard Aníbal , Wardle David A. , Nilsson Marie‐Charlotte , Kardol Paul , Smith Jane E. , Peltzer Duane A. , Moyano Jaime , Gundale Michael J.
Published: May 2021

The success of invasive plants is influenced by many interacting factors, but evaluating multiple possible mechanisms of invasion success and elucidating the relative importance of abiotic and biotic drivers is challenging, and therefore rarely achieved.

We used live, sterile or inoculated soil from different soil origins (native range and introduced range plantation; and invaded plots spanning three different countries) in a fully factorial design to simultaneously examine the influence of soil origin and soil abiotic and biotic factors on the growth of invasive Pinus contorta.

Our results displayed significant context dependency in that certain soil abiotic conditions in the introduced ranges (soil nitrogen, phosphorus or carbon content) influenced responses to inoculation treatments.

Our findings do not support the enemy release hypothesis or the enhanced mutualism hypothesis, as biota from native and plantation ranges promoted growth similarly. Instead, our results support the missed mutualism hypothesis, as biota from invasive ranges were the least beneficial for seedling growth. Our study provides a novel perspective on how variation in soil abiotic factors can influence plant–soil feedbacks for an invasive tree across broad biogeographical contexts.
A randomized controlled trial of manual versus powered tooth brushing during haematopoietic stem cell transplantation
Authors: Potting Carin M.J. , van Leeuwen Stephanie J.M. , Kurstjens Marie‐Helene , Bronkhorst Ewald M. , Thomas Renske Z. , Blijlevens Nicole M.A. , Huysmans Marie‐Charlotte D.N.J.M.
Published: May 2021

Aim

To compare manual and powered tooth brushing (MT and PT) with respect to patient compliance to brushing frequency advice, plaque removal and severity of oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT) after high‐dose chemotherapy.

Materials & methods

A randomized controlled trial was conducted. Forty‐six patients scheduled to receive myeloablative conditioning regimen before autologous HSCT were included and randomly assigned to control (MT, n = 23) or test (PT, n = 23) groups. Starting at day 1 (day of hospital admission for HSCT), brushing frequency (patient recorded diary), plaque scores (Plaque Control Index) and oral mucositis (Oral Mucositis Nursing Index) were recorded daily. Data for days 1 to 17 were analysed using regression analysis and general linear models.

Results

Few patients maintained 4 times per day brushing, but most brushed at least 2 times per day throughout the study. In PT, overall plaque scores were lower by 6.98% (p = .006) as compared to MT. No differences were seen in OM scores between the groups (p = .968). A small but significant positive correlation was found between plaque scores and OM severity: R2=0.15 (p < .01).

Conclusions

Powered tooth brushing resulted in lower plaque scores, but was not associated with reduced OM severity. Individual plaque scores were positively related to OM severity.
Haematoma of the buccal space in an edentulous patient – a case report
Authors: Maciver Rory , Ali Sarah , Mackenzie Fiona R. , Henderson Neil
Published: May 2021

Background

Oral swellings can be attributed to various causes, both odontogenic and non‐odontogenic in nature. This paper will discuss a buccal swelling caused by a haematoma.

Case presentation

A 76‐year‐old edentulous male patient presented to a dental student outreach clinic with a three‐day history of a right‐sided facial swelling. No dental cause could be confirmed and so the patient was referred to the local secondary oral surgery department. The patient was examined, and an ultrasound of the swelling was arranged on the same day. The swelling was aspirated, and a haematoma was deemed the likely cause. After aspiration and a course of antibiotics, the swelling reduced rapidly. Blood tests were undertaken, and no underlying cause could be identified.

Conclusions

Although uncommon, haematoma should be considered within differential diagnoses when dental pathology has been ruled out. A course of antibiotics is indicated where symptoms appear consistent with a systemic infection and timely referral to local dental hospital services is recommended. Blood tests should be requested to identify any undiagnosed coagulopathies or platelet abnormalities and liaison with local haematology services if resolution is not achieved would be appropriate.
Clinical Efficacy of Minimally Invasive Elastic Stable Intramedullary Nailing for Limb Long Bone Fractures in Children
Authors: Dong Liangchao , Wang Yichen , Jiao Qin , Wang Sun
Published: May 2021

Objective

The aim of the present paper was to investigate the clinical efficacy of minimally invasive elastic stable intramedullary nailing (ESIN) for long bone fractures in children.

Methods

A total of 350 children with limb fractures from June 2012 to June 2018 were recruited and randomized into two groups: an ESIN group (n = 175) treated with elastic stable intramedullary nailing, and an MPIF group (n = 175), treated with metal plate internal fixation. Both groups received the same physical examination and routine medication. Operation related indexes, clinical efficacy, complications, and postoperative quality of life scores were analyzed and compared.

Results

The operation time, intraoperative blood loss, hospitalization time, and fracture healing time in the ESIN group were 43.74 ± 4.96 min, 8.14 ± 1.34 mL, 5.97 ± 1.88 days, and 55.89 ± 5.61 days, respectively, which were all significantly less than those in the MPIF group (all P < 0.001). In terms of common complications after limb fracture treatment, there were 6 cases of osteomyelitis, 5 cases of skin irritation response, and 7 cases of inflammatory granuloma in the MPIF group. There were 2 cases of skin irritation response and 5 cases of inflammatory granuloma in the ESIN group. The incidence of postoperative complications in the ESIN group was 4.00%, which was significantly lower than that in MPIF group (10.29%) (P < 0.05). The effective rate for recovery condition in the ESIN group (93.71%) was significantly higher than that in the MPIF group (P < 0.001). The quality of life scores after treatment in both groups were improved, while the score in the ESIN group was significantly higher than that in the MPIF group (79.43%) (P < 0.001). The postoperative satisfaction rate in the ESIN group (94.29%) was significantly higher than that in the MPIF group (86.29%) (P < 0.05). The quality of life scores after treatment in both groups were improved, while the score in the ESIN group was significantly higher than that in the MPIF group (P < 0.001). The postoperative satisfaction rate and the acceptance rate for adjacent joint function in the ESIN group (100%) were significantly higher than those in the MPIF group (92.00%) (P < 0.0001).

Conclusion

Elastic stable intramedullary nailing is a minimally invasive procedure for long bone fractures in children. It can effectively improve the operation‐related indicators and postoperative quality of life and reduce the incidence of complications.