bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conformation control of the histidine kinase BceS of Bacillus subtilis by its cognate ABC‐transporter facilitates need‐based activation of antibiotic resistance
Authors: Koh Alan , Gibbon Marjorie J. , Van der Kamp Marc W. , Pudney Christopher R. , Gebhard Susanne 
Published: September 2020

AbstractBacteria closely control gene expression to ensure optimal physiological responses to their environment. Such careful gene expression can minimize the fitness cost associated with antibiotic resistance. We previously described a novel regulatory logic in Bacillus subtilis enabling the cell to directly monitor its need for detoxification. This cost‐effective strategy is achieved via a two‐component regulatory system (BceRS) working in a sensory complex with an ABC‐transporter (BceAB), together acting as a flux‐sensor where signaling is proportional to transport activity. How this is realized at the molecular level has remained unknown. Using experimentation and computation we here show that the histidine kinase is activated by piston‐like displacements in the membrane, which are converted to helical rotations in the catalytic core via an intervening HAMP‐like domain. Intriguingly, the transporter was not only required for kinase activation, but also to actively maintain the kinase in its inactive state in the absence of antibiotics. Such coupling of kinase activity to that of the transporter ensures the complete control required for transport flux‐dependent signaling. Moreover, we show that the transporter likely conserves energy by signaling with sub‐maximal sensitivity. These results provide the first mechanistic insights into transport flux‐dependent signaling, a unique strategy for energy‐efficient decision making.
Nursing perspectives and strategies in patients with respiratory insufficiency
Authors: Leonardsen Ann‐Chatrin , Gulbrandsen Tove , Wasenius Catrin , Fossen Linn Therese 
Published: September 2020

AbstractBackgroundApproximately 30% of patients admitted to an intensive care unit experience respiratory distress. The COVID‐19 pandemic has led to an enormous increase in patients with respiratory symptoms. Nurse competence is essential for ensuring quality treatment and care for these patients; however, research on nursing strategies for patients with respiratory insufficiency is limited.AimThis study explored nurses' perspectives on and nursing strategies in patients with respiratory insufficiency when admitted to three different intensive care units.DesignThe study had an exploratory, descriptive, qualitative design.MethodsFour focus group interviews with a total of 20 nurses, critical care nurses, and critical care nursing students were conducted. Data were analysed using content analysis.ResultsParticipants' perspectives fell into two main themes: “nurse competence” and “the art of balancing.” “Nurse competence” incorporated the sub‐themes “observations and assessments,” “to make decisions,” and “collaboration.” The theme ‘the art of balancing’ incorporated the sub‐themes “nursing interventions,” “patients feeling safe,” and “patient participation.”ConclusionThis study contributes new knowledge about nurses' perspectives on patients with respiratory insufficiency. Nurse competence was assumed essential to observe, assess, and treat patients with respiratory insufficiency. Nursing strategies included balancing nursing interventions, conducting medical treatment, and taking a whole‐person approach to patients' needs.Relevance to clinical practiceThe COVID‐19 pandemic has shown the need for nurse competence in caring for patients with respiratory insufficiency. This study adds to existing literature emphasizing the need for competence in health care services. Caring for patients with respiratory insufficiency requires nurses with experience; competence in observation, assessment, and medical treatment; and a whole‐person approach to patients' needs.
The impact of providing third molar extraction patients with pre‐consultation internet guidance upon their knowledge, anxiety, decision‐making and consultation outcomes: a pilot randomized controlled trial
Authors: Hanna K. , Sambrook P. , Armfield J.M. , Brennan D.S. 
Published: September 2020

AbstractAimsIdentifying whether providing third molar extraction (TME) patients with pre‐consultation internet guidance influences: (1) shared decision‐making (SDM); (2) TME knowledge, dental anxiety, clinicians’ satisfaction and count of TME.MethodologyEqual arm, parallel groups randomized controlled trial. Participants were public TME patients with internet access. The Study group received best online resources identified in a previous study before the consultation. SDM was measured using the dyadic SDM‐9Q‐Pt (Patient) and SDM‐9Q‐Doc (Doctor). TME knowledge and dental anxiety (using the IDAF‐4C) were collected before the consultation. Other outcomes were collected during the consultation.ResultsWe randomized 120 eligible participants and we did not observe any difference at the baseline. At the consultation, we followed‐up 37 patients from the study group (61%) and 35 from the control group (58%). TME knowledge was associated with SDM‐9Q‐Pt and SDM‐9Q‐Doc (P < 0.05). Resources used did not improve TME knowledge (t = −.32,P = 0.753) which resulted in no difference in SDM‐9Q‐Pt (t = 1.76,P = 0.083) or SDM‐9Q‐Doc (t = −0.78,P = 0.436). IDAF‐4C scores were significantly higher than Australian norms (mean = 17.0, SD = 9.0, 95% CI: 16.2, 20.5). Resources used did not influence the IDAF‐4C scores (t = −.32,P = 0.753). No differences were observed in clinicians’ satisfaction with consultation time, patients’ knowledge and the count of TME.ConclusionTME knowledge is associated with SDM. The best available online resources used as an intervention did not improve the participants’ knowledge and therefore, the RCT outcomes were not affected. This suggests a need for developing patient‐centred resources. The high levels of dental anxiety among TME patients need clinicians’ attention.Trial registration:ACTRN12614000593639.
Relational and psychological mediators of change in low‐income couples' perceived health
Authors: Roddy McKenzie K. , Doss Brian D. 
Published: September 2020

AbstractExperimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab‐based studies. The present study evaluated relational and psychological mediators of change in perceived health in a sample of 742 low‐income couples (1,484 individuals) who participated in a randomized controlled trial of two online relationship education programs and a waitlist control group. Results partially supported the Strengths and Strains Model of Relationships and Physical Health. Relationship functioning and some psychological functioning were mediators of change in perceived health. Future research is needed to understand how relationship functioning improved perceived health through mediators other than psychological functioning tested here.
Public employment services: Building social resilience in youth?
Authors: Assmann Marie‐Luise , Tolgensbakk Ida , Vedeler Janikke S. , Bøhler Kjetil K. 
Published: September 2020

AbstractIt is contested to what extent public employment services (PES) help build resilience in young unemployed people. Drawing on qualitative interviews with 19 people born in Germany and Norway between 1990 and 1995, the article examines stories about how PES, in two different activation regimes, help young people find meaningful work. The analysis and discussion are carried out within a theoretical framework that combines the capability approach with social resilience literature in a novel way. The findings show that PES are portrayed as being more present in young Germans' lives. The German informants seem to feel undue pressure from PES and they describe differences between personal aims and the “placement priority” of PES. Sanctions imposed by PES were also a much more predominant topic among the German informants. The Norwegian data were dominated by stories about young people in activation programmes who had been demotivated by being trapped in a cycle of programme participation, which did not result in employment. Across the two countries, our data suggest that PES rarely build social resilience: PES provided young people with a means to survive, but rarely helped to build their capacity to overcome their difficult situation. In line with previous research, the stories of young Germans and Norwegians also emphasise the need for a PES that provides tailor‐made services that build on young people's motivation and ambition. The article demonstrates that combining the capability approach with social resilience theory enables a dynamic perspective on the development of people's capabilities.
Effect of timing of cattle urine deposition and pasture composition on nitrogen leaching losses
Authors: Talbot William D. , Malcolm Brendon J. , Cameron Keith C. , Di Hong J. , Whitehead David 
Published: September 2020

AbstractA lysimeter experiment using undisturbed monoliths from a stony silt loam soil was carried out to quantify the effects different pasture types on N losses from urine applied to soil on different dates. Three pasture types were tested: (a) perennial ryegrass (Lolium perenne)/white clover (Trifolium repens) (PRG/WC), (b) perennial ryegrass/white clover/plantain (Plantago lanceolata) (PRG/WC/P) and (c) Italian ryegrass (Lolium multiforum)/white clover/plantain (IRG/WC/P), with four different urine applications dates (late summer, early autumn, mid‐autumn and late autumn). Cattle urine was applied at the equivalent of 700 kg N−1 ha−1. There was a significant reduction in total amount of nitrate (NO3−‐N) leached under the PRG/WC/P (14% reduction) and IRG/WC/P (24% reduction) compared with the PRG/WC. High NO3−‐N leaching losses were found at each urine application date (>181 kg NO3−‐N/ha), suggesting there may be higher than expected N leaching losses when urine is deposited onto shallow stony soils, during warmer months (late summer and early autumn). There was no significant interaction between pasture type and urine timing on NO3−‐N leaching losses.
(+)‐Sesamin‐oxidising CYP92B14 shapes specialised lignan metabolism in sesame
Authors: Harada Erisa , Murata Jun , Ono Eiichiro , Toyonaga Hiromi , Shiraishi Akira , Hideshima Kosuke , Yamamoto Masayuki P. , Horikawa Manabu 
Published: September 2020

SummarySesamum spp. (sesame) are known to accumulate a variety of lignans in a lineage‐specific manner. In cultivated sesame (Sesamum indicum), (+)‐sesamin, (+)‐sesamolin and (+)‐sesaminol triglucoside are the three major lignans found richly in the seeds. A recent study demonstrated that SiCYP92B14 is a pivotal enzyme that allocates the substrate (+)‐sesamin to two products, (+)‐sesamolin and (+)‐sesaminol, through multiple reaction schemes including oxidative rearrangement of α‐oxy‐substituted aryl groups (ORA). In contrast, it remains unclear whether (+)‐sesamin in wild sesame undergoes oxidation reactions as in S. indicum and how, if at all, the ratio of the co‐products is tailored at the molecular level. Here, we functionally characterised SrCYP92B14 as a SiCYP92B14 orthologue from a wild sesame, Sesamum radiatum, in which we revealed accumulation of the (+)‐sesaminol derivatives (+)‐sesangolin and its novel structural isomer (+)‐7´‐episesantalin. Intriguingly, SrCYP92B14 predominantly produced (+)‐sesaminol either through ORA or direct oxidation on the aromatic ring, while a relatively low but detectable level of (+)‐sesamolin was produced. Amino acid substitution analysis suggested that residues in the putative distal helix and the neighbouring heme propionate of CYP92B14 affect the ratios of its co‐products. These data collectively show that the bimodal oxidation mechanism of (+)‐sesamin might be widespread across Sesamum spp., and that CYP92B14 is likely to be a key enzyme in shaping the ratio of (+)‐sesaminol‐ and (+)‐sesamolin‐derived lignans from the biochemical and evolutionary perspectives.
One‐year conditional survival of dogs and cats with invasive mammary carcinomas: A concept inspired from human breast cancer
Authors: Chocteau Florian , Mordelet Valentin , Dagher Elie , Loussouarn Delphine , Abadie Jérôme , Nguyen Frédérique 
Published: September 2020

AbstractNumerous studies have described the prognostic factors of canine and feline mammary carcinomas (MCs), that is, variables that predict patient survival after diagnosis. But how does survival estimation evolve in patients that escaped early death from their cancer? In human oncology, conditional survival (CS), the probability of surviving X further years when cancer patients have already survived Y years, is used to analyse cancer outcomes in a long‐term perspective. In this cohort of 344 dogs and 342 cats with surgically removed stage I to III invasive MCs, with a minimal follow‐up of 2 years, we calculated the 1‐year CS, that is, the probability for patients that have survived 1 year, to survive or to die from cancer during the subsequent year. The 1‐year conditional specific survival probabilities were 59% and 48% at diagnosis of invasive MC respectively in dogs and cats, and 80% and 52% in 1‐year surviving dogs and cats respectively, suggesting that 1‐year surviving dogs were relatively protected from cancer‐related death, whereas feline MCs remained life‐threatening cancers for longer periods of time. Among the most significant parameters associated with CS in surviving dogs and cats were the nodal stage and lymphovascular invasion, as well as patient age, cancer stage and margin status in surviving dogs. By comparison, tumour size and the histological grade did not significantly alter CS probabilities in surviving dogs and cats. Conditional survival may be considered a very interesting tool for veterinary practitioners to estimate the likely outcome of cancer survivors.
Perspectivas jurídico-canónicas para la protección del patrimonio cultural eclesial en Colombia
Authors: Flórez Sandra Lidia 
Published: September 2020

Este artículo busca mostrar la importancia que ha tenido el patrimonio cultural eclesiástico en la labor de la Iglesia, su evolución histórica y su desarrollo legislativo en materia tanto eclesial como civil.
La sociedad actual ha ido estableciendo diferentes marcos legislativos civiles para su protección, elementos que deben ser aprovechados por la Iglesia, según el llamado de los romanos pontífices en los últimos tiempos. Por este motivo, se quiere dar a conocer herramientas legislativas tanto en el derecho civil como en el canónico que permitan una mayor eficacia en la protección de este patrimonio, referido principalmente al caso colombiano.
Patients use fewer analgesics following supervised exercise therapy and patient education: an observational study of 16 499 patients with knee or hip osteoarthritis
Authors: Thorlund Jonas Bloch , Roos Ewa M , Goro Patricia , Ljungcrantz Emily Gromelsky , Grønne Dorte Thalund , Skou Søren T 
Published: September 2020

Objectives
To investigate changes in analgesic use before and after supervised exercise therapy and patient education in patients with knee or hip osteoarthritis (OA).

Methods
We recruited 16 499 of 25 933 eligible patients (64%; mean age 64.9; SD 9.6; 73% women) from the Good Life with osteoArthritis in Denmark (GLA:D) registry. Change in proportions of analgesic users (categorised according to analgesic risk profile; opioids > non-steroidal anti-inflammatory drugs > paracetamol) was assessed from before to after an 8-week supervised exercise therapy and patient education programme targeting knee or hip OA pain and functional limitations.

Results
Patients reported 13.2 mm (95% CI 12.8 to 13.6) less pain (visual analogue scale 0–100 mm) at follow-up compared with baseline. The proportion of analgesic users reduced from 62.2% (95% CI 61.5 to 63.0) at baseline to 44.1% (95% CI 43.3 to 44.9) at follow-up (absolute change: 18.1% (95% CI 17.3 to 19.0)). Among patients using analgesics at baseline, 52% changed to a lower risk analgesic or discontinued analgesic use. The proportion of opioid users after the exercise therapy was 2.5% (95% CI 2.1 to 2.9) lower than baseline; this represents a relative reduction of 36%.

Conclusion
Among patients with knee or hip OA using analgesics, more than half either discontinued analgesic use or shifted to lower risk analgesics following an 8-week structured exercise therapy and patient education programme (GLA:D). These data encourage randomised controlled trial evaluation of whether supervised exercise therapy, combined with patient education, can reduce analgesic use, including opioids, among patients with knee and hip OA pain.
Implementation of robotic devices in nursing care. Barriers and facilitators: an integrative review
Authors: Servaty Ricarda , Kersten Annalena , Brukamp Kirsten , Möhler Ralph , Mueller Martin 
Published: September 2020

BackgroundRobots in healthcare are gaining increasing attention; however, their implementation is challenging due to the complexity of both interventions themselves and the contexts in which they are implemented. The objective of this integrative review is to identify barriers to and facilitators of the implementation of robotic systems in nursing.MethodsArticles published from 2002 to 2019 reporting on projects to implement robotic devices in nursing care were searched on Medline (via PubMed), CINAHL and databases on funded research projects (Community Research and Development Information Services and Technische Informationsbibliothek) and in journals for robotic research in November 2017 and July 2019 for an update. No restrictions regarding study designs were imposed. All included articles underwent quality assessments with design-specific critical appraisal tools. Barriers to and facilitators of implementation were classified using the Context and Implementation of Complex Interventions framework.ResultsAfter removing all duplicates, the search revealed 11 204 studies, of which 17 met the inclusion criteria and were included in the synthesis. The majority of the studies dealt with the implementation of robots designed to support individuals, either living at home or in nursing homes (n=11). The studies were conducted in Europe, the USA and New Zealand and were carried out in nursing homes, individual living environments, hospital units and laboratories. The quality of reporting and quality of evidence were low in most studies. The most frequently reported barriers were in socioeconomic and ethical domains and were within the implementation outcomes domain. The most frequently reported facilitators were related to the sociocultural context, implementation process and implementation strategies.DiscussionThis review identified barriers to and facilitators of the implementation of robotic devices in nursing within different dimensions. The results serve as a basis for the development of suitable implementation strategies to reduce potential barriers and promote the integration of elements to facilitate implementation.PROSPERO registration numberCRD42018073486.
Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach
Authors: Manges Kirstin A , Ayele Roman , Leonard Chelsea , Lee Marcie , Galenbeck Emily , Burke Robert E 
Published: September 2020

BackgroundDespite the increased focus on improving patient’s postacute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this study was to observe processes used to prepare patients for postacute care in SNFs, and to explore differences between hospital-SNF pairs with high or low 30-day readmission rates.DesignWe used a rapid ethnographic approach with intensive multiday observations and key informant interviews at high-performing and low-performing hospitals, and their most commonly used SNF. We used flow maps and thematic analysis to describe the process of hospitals discharging patients to SNFs and to identify differences in subprocesses used by high-performing and low-performing hospitals.Setting and participantsHospitals were classified as high or low performers based on their 30-day readmission rates from SNFs. The final sample included 148 hours of observations with 30 clinicians across four hospitals (n=2 high performing, n=2 low performing) and corresponding SNFs (n=5).FindingsWe identified variation in five major processes prior to SNF discharge that could affect care transitions: recognising need for postacute care, deciding level of care, selecting an SNF, negotiating patient fit and coordinating care with SNF. During each stage, high-performing sites differed from low-performing sites by focusing on: (1) earlier, ongoing, systematic identification of high-risk patients; (2) discussing the decision to go to an SNF as an iterative team-based process and (3) anticipating barriers with knowledge of transitional and SNF care processes.ConclusionIdentifying variations in processes used to prepare patients for SNF provides critical insight into the best practices for transitioning patients to SNFs and areas to target for improving care of high-risk patients.
European Registry onHelicobacter pylorimanagement (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients
Authors: Nyssen Olga P , Bordin Dmitry , Tepes Bojan , Pérez-Aisa Ángeles , Vaira Dino , Caldas Maria , Bujanda Luis , Castro-Fernandez Manuel , Lerang Frode , Leja Marcis , Rodrigo Luís , Rokkas Theodore , Kupcinskas Limas , Pérez-Lasala Jorge , Jonaitis Laimas , Shvets Oleg , Gasbarrini Antonio , Simsek Halis , Axon Anthony T R , Buzás György , Machado Jose Carlos , Niv Yaron , Boyanova Lyudmila , Goldis Adrian , Lamy Vincent , Tonkic Ante , Przytulski Krzysztof , Beglinger Christoph , Venerito Marino , Bytzer Peter , Capelle Lisette , Milosavljević Tomica , Milivojevic Vladimir , Veijola Lea , Molina-Infante Javier , Vologzhanina Liudmila , Fadeenko Galina , Ariño Ines , Fiorini Giulia , Garre Ana , Garrido Jesús , F Pérez Cristina , Puig Ignasi , Heluwaert Frederic , Megraud Francis , O'Morain Colm , Gisbert Javier P 
Published: September 2020

ObjectiveThe best approach forHelicobacter pylorimanagement remains unclear. An audit process is essential to ensure clinical practice is aligned with best standards of care.DesignInternational multicentre prospective non-interventional registry starting in 2013 aimed to evaluate the decisions and outcomes inH. pylorimanagement by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap. Variables included demographics, previous eradication attempts, prescribed treatment, adverse events and outcomes. Data monitoring was performed to ensure data quality. Time-trend and geographical analyses were performed.Results30 394 patients from 27 European countries were evaluated and 21 533 (78%) first-line empiricalH. pyloritreatments were included for analysis. Pretreatment resistance rates were 23% to clarithromycin, 32% to metronidazole and 13% to both. Triple therapy with amoxicillin and clarithromycin was most commonly prescribed (39%), achieving 81.5% modified intention-to-treat eradication rate. Over 90% eradication was obtained only with 10-day bismuth quadruple or 14-day concomitant treatments. Longer treatment duration, higher acid inhibition and compliance were associated with higher eradication rates. Time-trend analysis showed a region-dependent shift in prescriptions including abandoning triple therapies, using higher acid-inhibition and longer treatments, which was associated with an overall effectiveness increase (84%–90%).ConclusionManagement ofH. pyloriinfection by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve over 90% eradication rates. European recommendations are being slowly and heterogeneously incorporated into routine clinical practice, which was associated with a corresponding increase in effectiveness.