bluuebunny/crossref_metadata_2025_split huggingface dataset:
Travel arrangements in chronic hemodialysis patients: A qualitative study
Authors: Wongboonsin Janewit , Merighi Joseph R. , Walker Patricia F. , Drawz Paul E. 
Published: October 2020

AbstractIntroductionFor patients on renal replacement therapy (RRT), “travel” and “independence” are rated as 2 of the top 5 factors that inform their choice of treatment modality. While home dialysis modalities offer patients a high degree of independence, the most common RRT in the United States is in‐center hemodialysis (IHD). The limits imposed by IHD treatment can present a variety of challenges for patients who wish to travel. This study explored how IHD patients managed their travel and the role of dialysis social workers in executing travel arrangements for patients.MethodsWe performed a qualitative descriptive investigation using semi‐structured interviews with adults receiving IHD (n = 16) and renal social workers (n = 8) from Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin. Data were analyzed using a constant comparative method.FindingsThree themes emerged from the interviews: travel process, travel‐related barriers, and travel‐related facilitators. The travel process entailed transient dialysis unit challenges and the need for multiple preparations and precautions. Barriers included comorbidities and not having a relationship with transient dialysis unit staff. Facilitators focused on the importance of travel and staff professionalism at transient dialysis units. Overall, there was lack of uniform protocols to guide the travel process at the patient and the dialysis unit levels.DiscussionThis study identified multiple perspectives regarding travel arrangements in chronic IHD patients. There is limited research on travel issues for IHD patients and this investigation is among the first to articulate barriers and facilitators associated with travel from the perspective of patients and social workers. Supporting travel for IHD patients can increase their sense of autonomy and provide opportunities to improve their quality of life.
Comparison of the impact of childhood psoriasis on mothers’ and fathers’ quality of life – does gender of a caregiver play a role?
Authors: Żychowska M. , Reich A. , Maj J. , Jankowska‐Konsur A. , Szepietowski J. C. 
Published: October 2020

AbstractBackgroundPsoriasis is a chronic skin condition that in one third of cases starts in the first two decades of life. The disease might impact the quality of life (QoL) of the affected children and their caregivers. The issue of gender differences in the assessment of psychological burden of dermatological conditions has been the subject of few studies with contradictory results.ObjectivesThe aim of this study was to investigate the differences in the impact of childhood psoriasis on mothers’ and fathers’ well‐being using Family Dermatology Life Quality Index (FDLQI).MethodsForty‐five children with psoriasis (31 girls and 14 boys; mean age ± standard deviation (SD) 10.53 ± 3.44 years) and their parents (45 mothers and 45 fathers) were included in the study. Both parents of each child were asked to separately fill in the validated Polish version of the FDLQI questionnaire.ResultsComparing the FDLQI scores, the QoL of mothers was significantly more impaired than the QoL of fathers (13.44 ± 6.46 versus 9.53 ± 6.12 points; P < 0.0001). In mothers, childhood psoriasis had a significantly greater impact in the areas of emotional distress (P = 0.007), dealing with other people’s reactions (P < 0.0001), social life (P = 0.02), amount of time spent caring for the child’s skin (P = 0.0001) and extra housework (P = 0.0005), compared to fathers. The FDLQI scores of both mothers and fathers were independent of the impairment of children’s QoL or the severity of psoriasis, except for positive correlation between mothers’ FDLQI scores and children’s BSA (R = 0.31; P = 0.03).ConclusionsDifferences in the impact of childhood skin diseases on mothers’ and fathers’ well‐being should be taken into consideration while developing educational programmes for patients and their families. There is a need for further, multi‐centre research that would take into account geographical and cultural differences, in order to reliably assess the impact of childhood psoriasis on various aspects of caregivers’ QoL.
Factors influencing management of agitation in aged care facilities: A qualitative study of staff perceptions
Authors: Watson Karen , Hatcher Deborah 
Published: October 2020

AbstractBackgroundAgitation in older people is commonly associated with cognitive decline, complex medical diagnoses and polypharmacy. Impaired communication and comprehension within a dementia trajectory adds complexity to assessment and management. Despite high prevalence, agitated behaviours remain challenging to manage in residential aged care settings.AimTo explore staff perceptions of agitation in residents of aged care facilities, including the influence of dementia, when selecting management strategies to reduce agitated behaviour.DesignQualitative descriptive.MethodsSemi‐structured interviews with 11 aged care staff were conducted at two aged care sites. Transcripts were examined using content analysis to identify common issues and categories. The study complied with COREQ guidelines (see. Appendix S1).ResultsParticipants reported managing resident agitation at least once per shift; most frequently manifesting as wandering, restlessness or aggression. Management strategies included distraction, providing space, knowing the resident, identifying causative factors, spending individual time and if necessary medication administration. Agitation management was more challenging for residents with dementia due to impaired communication or comprehension of instruction.ConclusionsWhile participants strived to deliver individualized person‐centred care, this was difficult given time and resource constraints. Contemporary management of agitation therefore remains variable in everyday practice, with resident preference used when causative factors were known. Conversely, for residents with impaired communication and/or comprehension, distraction and chemical restraint were commonly used. Nuanced education for assessment and management is recommended to better address this unmet need for some residents.Relevance to clinical practiceFor optimal care, appropriate allocation of time and resources is necessary to identify causative and contextual factors for individual residents. Recommendations are for additional staff training in communication and attitude, and collaborating with frontline staff to develop a practical guide for management of agitation in aged care. These simple initiatives may help to improve consistency of care delivery and resident outcomes.
Prevalence of xerostomia with or without overactive bladder symptoms
Authors: Ito Kayoko , Inoue Makoto , Nishii Hisae , Matsumoto Tetsuro 
Published: October 2020

AbstractOveractive bladder (OAB) occurs idiopathic or secondary to a neurological cause. In addition, OAB may also occur due to xerostomia, because it causes excessive drinking of water. If xerostomia is one of the causes of OAB, treating xerostomia may be effective. This study aimed to investigate the prevalence of xerostomia with or without overactive bladder symptoms. A web‐based questionnaire was administered to investigate the prevalence of xerostomia with or without overactive bladder symptoms. The survey included questions concerning age, gender, medical history, medications, OAB symptoms by the Overactive Bladder Symptom Score (OABSS), and xerostomia by the Dry Mouth Scale (DMS). From the analysis, a total of 21 (13.0%) participants were identified as having OAB. The prevalence of xerostomia was six (28.6%) in the OAB group and 14 (10.0%) in the non‐OAB group. OABSS and DMS were significantly higher in the OAB group than in the non‐OAB group. Urgency score and urgency incontinence score of OABSS were substantially higher in xerostomia participants than non‐xerostomia participants. The adjusted odds ratio of OAB showed DMS total score, xerostomia symptoms, accompanying symptoms, and other symptoms that were all significantly associated with OAB. These results suggested that OAB subjects, even untreated subjects, had xerostomia. It may be beneficial for clinicians to perform dry mouth management in parallel with careful choice pharmacotherapy for the wellness of OAB patients.
Health literacy profiles of adults with multiple chronic diseases: A cross‐sectional study using the Health Literacy Questionnaire
Authors: Dinh Ha T.T. , Nguyen Nguyet T. , Bonner Ann 
Published: October 2020

AbstractHealth literacy is multidimensional, comprising functional, communicative, and critical thinking dimensions. Understanding health literacy is crucial for clinicians to develop effective health education strategies. In this study, we examined the multiple dimensions of health literacy in Vietnamese adults with chronic comorbidities. A cross‐sectional sample of 600 patients, aged ≥18 years with a diagnosis of at least two chronic diseases (cardiovascular conditions, chronic kidney disease, or diabetes), completed the Health Literacy Questionnaire, an instrument assessing nine distinct domains. Descriptive and parametric tests were performed to analyze the health literacy levels for various demographic characteristics. Generalized linear models using backward modelling explored factors associated with higher health literacy. The lowest scoring domains were “Healthcare provider support” and “Appraisal of health information.” In multivariate models greater health literacy was associated with those <65 years, having a postsecondary degree or higher level of education, greater income, urban residence, being cared for by spouses/children, and having fewer comorbidities. To improve health literacy, clinicians in primary and acute healthcare settings should build supportive relationships with patients and assist them with understanding and appraising health information.
MEDIATOR16 orchestrates local and systemic responses to phosphate scarcity in Arabidopsis roots
Authors: Raya‐González Javier , Ojeda‐Rivera Jonathan Odilón , Mora‐Macias Javier , Oropeza‐Aburto Araceli , Ruiz‐Herrera León Francisco , López‐Bucio José , Herrera‐Estrella Luis 
Published: October 2020

Summary

Phosphate (Pi) is a critical macronutrient for the biochemical and molecular functions of cells. Under phosphate limitation, plants manifest adaptative strategies to increase phosphate scavenging. However, how low phosphate sensing links to the transcriptional machinery remains unknown.

The role of the MEDIATOR (MED) transcriptional co‐activator, through its MED16 subunit in Arabidopsis root system architecture remodeling in response to phosphate limitation was assessed. Its critical function acting over the SENSITIVE TO PROTON RHIZOTOXICITY1 (STOP1)‐ALUMINUM‐ACTIVATED MALATE TRANSPORT1 (ALMT1) signaling module was tested through a combination of genetic, biochemical, and genome‐wide transcriptomic approaches.

Root system configuration in response to phosphate scarcity involved MED16 functioning, which modulates the expression of a large set of low‐phosphate‐induced genes that respond to local and systemic signals in the Arabidopsis root tip, including those directly activated by STOP1. Biomolecular fluorescence complementation analysis suggests that MED16 is required for the transcriptional activation of STOP1 targets, including the membrane permease ALMT1, to increase malate exudation in response to low phosphate.

Our results unveil the function of a critical transcriptional component, MED16, in the root adaptive responses to a scarce plant macronutrient, which helps understanding how plant cells orchestrate root morphogenesis to gene expression with the STOP1‐ALMT1 module.
Reducing shade avoidance can improve Arabidopsis canopy performance against competitors
Authors: Pantazopoulou Chrysoula K. , Bongers Franca J. , Pierik Ronald 
Published: October 2020

AbstractPlants that grow in high density communities activate shade avoidance responses to consolidate light capture by individuals. Although this is an evolutionary successful strategy, it may not enhance performance of the community as a whole. Resources are invested in shade responses at the expense of other organs and light penetration through the canopy is increased, allowing invading competitors to grow better. Here we investigate if suppression of shade avoidance responses would enhance group performance of a monoculture community that is invaded by a competitor. Using different Arabidopsis genotypes, we show that suppression of shade‐induced upward leaf movement in the pif7 mutant increases the pif7 communal performance against invaders as compared to a wild‐type canopy. The invaders were more severely suppressed and the community grew larger as compared to wild type. Using computational modelling, we show that leaf angle variations indeed strongly affect light penetration and growth of competitors that invade the canopy. Our data thus show that modifying specific shade avoidance aspects can improve plant community performance. These insights may help to suppress weeds in crop stands.
Lipoblastoma phenotype contains a somatic PIK3CA mutation
Authors: Sudduth Christopher L. , Konczyk Dennis J. , Al‐Ibraheemi Alyaa , Smits Patrick J. , Greene Arin K. 
Published: October 2020

AbstractLipoblastoma typically occurs in childhood and is associated with rearrangements of the PLAG1 gene. We present a patient with an isolated mass thought to be a lipoblastoma clinically, radiographically, and histologically. The lesion was diagnosed as a PIK3CA‐adipose lesion after the tissue was negative for PLAG1 rearrangement and contained a somatic PIK3CA mutation (H1047R). Although PIK3CA variants are associated with PROS (PIK3CA‐related overgrowth spectrum), this report illustrates a non‐syndromic, lipoblastoma phenotype caused by a PIK3CA mutation.
Extended letermovir administration, beyond day 100, is effective for CMV prophylaxis in patients with graft versus host disease
Authors: Bansal Rajat , Gordillo Christian A , Abramova Rachel , Assal Amer , Mapara Markus Y , Pereira Marcus R , Reshef Ran 
Published: October 2020

AbstractBackgroundCytomegalovirus (CMV) reactivation is associated with significant morbidity and mortality after an allogeneic hematopoietic cell transplant (AHCT), and graft versus host disease (GVHD) increases the risk of CMV reactivation. Letermovir is approved for CMV prophylaxis in CMV‐seropositive patients, but has only been studied through day 100 post‐transplantation in the registration trial. Its efficacy in preventing CMV in patients with GVHD requiring treatment beyond the day 100 milestone has not been studied.MethodsWe retrospectively analyzed all patients who underwent an AHCT at a single center over a period of 24 months, and identified a cohort of 20 patients who received extended duration of letermovir (beyond 100 days) after the diagnosis of GVHD. The primary end point was the incidence of clinically significant CMV infection, defined as onset of CMV disease or initiation of preemptive therapy with alternative antiviral agents.ResultsIn this high‐risk cohort, only one patient (5%) developed a clinically significant CMV infection, requiring preemptive therapy. No patients developed CMV organ disease. Three additional patients developed CMV viremia of ≥150 IU/mL while on letermovir and after the onset of GVHD, and none required additional treatment. Receipt of post‐transplant cyclophosphamide (PTCy) and low CD4 count after the development of GVHD were associated with breakthrough CMV viremia while on extended duration letermovir.ConclusionsExtended duration letermovir was efficacious in preventing clinically significant CMV infections in patients with GVHD.
Colonic malakoplakia in a dual stem cell and cardiac transplant recipient: A case report and literature review
Authors: Meredith Thomas , Dharan Nila , Killen Louise , Anandabaskaran Sulak , Kim Andrew , Yang Tao , Marriott Deborah , Hayward Christopher , Macdonald Peter 
Published: October 2020

AbstractWe describe the first published case of malakoplakia in a dual stem cell and cardiac transplant recipient. In the 2 months following cardiac transplantation, our patient developed persistent diarrhea and recurrent E coli bacteremia. Biopsies obtained from areas of colonic thickening revealed malakoplakia. Despite improvement in symptoms with prolonged antimicrobial therapy and reduction of his immunosuppression, he eventually died from sepsis. Our case highlights not only the importance of the timely diagnosis of this rare disorder, but also the difficulty in determining optimal treatment duration, particularly where excision of involved areas is not possible, as data on this disease are lacking. Here we describe our case and review the available literature published on malakoplakia in the cardiac transplant population.
The triangular purchasing power parity hypothesis: A comment
Authors: King Alan 
Published: October 2020

AbstractThe recently proposed triangular purchasing power parity (PPP) hypothesis posits that, in a world dominated by the United States, China and Euroland, the exchange rate between the US dollar and the euro will be a function of the Euroland price level relative to China’s price level. Contrary to conventional PPP, the US price level plays no role. We show that the theory underlying triangular PPP is flawed and that it is no more than a simple transformation of the conventional PPP relationship. Moreover, some of the empirical evidence presented in support of the triangular PPP actually refutes one of its central ideas.
Large-scale asymmetry in thickness of crustal accretion at the Southeast Indian Ridge due to deep mantle anomalies
Authors: Suo Yanhui , Li Sanzhong , Cao Xianzhi 
Published: October 2020

Abstract
Hot mantle plumes and ancient cold slabs have been observed beneath modern mid-ocean ridges, but their specific and detailed effects on mid-ocean ridge crustal accretion are poorly understood. The oceanic lithosphere beneath the Southeast Indian Ocean displays unique morphological, geophysical, and geochemical characteristics, which may reflect the influence of both mantle anomalies and upwelling plumes on seafloor spreading. In this study, we combined gravity-derived oceanic crustal thickness with plate tectonic reconstructions to investigate patterns of asymmetry in thickness of crust accreted at the Southeast Indian Ridge over the last 50 m.y. Our results reveal several distinct features: (1) small-scale, short-lived asymmetries in the thickness of crustal accretion of up to 0.75 km are alternatively distributed on the southern and northern flanks of the 90°–120°E Southeast Indian Ridge segment. These can be explained by variations in mantle depletion or mantle temperature. (2) Two large-scale, long-lived (duration of ∼50 m.y.) asymmetries in crustal accretion of &gt;2.5 km are observed around the Kerguelen Plateau and Balleny Islands, which we attribute to excess crust from the off-axis Kerguelen and Balleny mantle plumes. (3) Two large-scale, long-lived (duration of ∼50 m.y.) asymmetries in crustal accretion of 0.75–2.5 km are observed on the northern flank of the westernmost (70°–80°E) Southeast Indian Ridge and the southern flank of the eastern (120°–140°E) Southeast Indian Ridge segment, respectively. We attribute these to asymmetry in mantle temperature of up to 20–53 °C. We suggest these asymmetric temperatures across the Southeast Indian Ridge are associated with the foundered lithospheric fragments of the Indian Craton triggered by the African Large Low-Shear-Velocity Province during the breakup of Gondwanaland and an intraplate subducted slab of the Paleo-Tethys Ocean, respectively. The remnant craton fragments and subducted oceanic slab may have moved north in concert with the northward-migrating Southeast Indian Ridge beginning at 50 m.y. ago.
Further improvement in glycemic control after switching from exenatide two times per day to exenatide once-weekly autoinjected suspension in patients with type 2 diabetes: 52-week results from the DURATION-NEO-1 study
Authors: Wysham Carol H , Rosenstock Julio , Vetter Marion L , Wang Hui , Hardy Elise , Iqbal Nayyar 
Published: October 2020

IntroductionInvestigate the effects of switching from two times per day exenatide to once-weekly exenatide administered by autoinjector (exenatide once-weekly suspension by autoinjector (QWS-AI)) or treatment with exenatide QWS-AI for 1 year.Research design and methodsIn this phase III open-label study, adults with type 2 diabetes were randomized to receive exenatide QWS-AI (2 mg) or exenatide two times per day (5 mcg for 4 weeks, followed by 10 mcg) for 28 weeks. During a subsequent non-randomized 24-week extension, patients who received exenatide two times per day were switched to exenatide QWS-AI and those randomized to exenatide QWS-AI continued this treatment. Efficacy measures included changes from baseline in glycated hemoglobin (A1C), fasting plasma glucose (FPG), and body weight.ResultsIn total, 315 patients (mean baseline A1C of 8.5%) completed the initial 28 weeks of randomized treatment with exenatide QWS-AI (n=197) or exenatide two times per day (n=118) and were included in the 24-week extension (mean A1C of 7.0% and 7.3%, respectively, at week 28). From weeks 28–52, patients who switched from exenatide two times per day to exenatide QWS-AI had additional A1C reductions of approximately 0.5% (mean A1C change from baseline of –1.4% at week 52) and further reductions from baseline in FPG. Patients who continued exenatide QWS-AI treatment for 52 weeks showed clinically relevant A1C reductions (mean A1C change from baseline of –1.3% at week 52). Body-weight reductions achieved through week 28 were sustained at week 52 in both groups. There were no unexpected safety concerns or changes in the safety profile among patients who switched from exenatide two times per day to exenatide QWS-AI or those who continued exenatide QWS-AI treatment for 52 weeks.ConclusionsSwitching from exenatide two times per day to exenatide QWS-AI resulted in further A1C reductions and maintenance of earlier decreases in body weight, while continued therapy with exenatide QWS-AI for 52 weeks maintained A1C and body-weight reductions, without additional safety or tolerability concerns.Trial registration numberNCT01652716.
Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014
Authors: Coffey Cushla , Zhao Yuejen , Condon John R , Li Shu , Guthridge Steven 
Published: October 2020

ObjectivesTo examine long-term trends in acute myocardial infarction (AMI) incidence and survival among Aboriginal and non-Aboriginal people.DesignRetrospective cohort study.Setting, participantsAll first AMI hospital cases and deaths due to ischaemic heart disease in the Northern Territory of Australia (NT), 1992–2014.Main outcome measuresAge standardised incidence, survival and mortality.ResultsThe upward trend in Aboriginal AMI incidence plateaued around 2007 for males and 2001 for females. AMI incidence decreased for non-Aboriginal population, consistent with the national trends. AMI incidence was higher and survival lower for males, for Aboriginal people and in older age groups. In 2014, the age standardised incidence was 881 and 579 per 100 000 for Aboriginal males and females, respectively, compared with 290 and 187 per 100 000 for non-Aboriginal counterparts. The incidence disparity between Aboriginal and non-Aboriginal population was much greater in younger than older age groups. Survival after an AMI improved over time, and more so for Aboriginal than non-Aboriginal patients, because of a decrease in prehospital deaths and improved survival of hospitalised cases.ConclusionsThere was an important breakpoint in increasing trends of Aboriginal AMI incidence between 2001 and 2007. The disparity in AMI survival between the NT Aboriginal and non-Aboriginal populations reduced over time as survival improved for both populations.