bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thiazolidinediones were associated with higher risk of cardiovascular events in patients with type 2 diabetes and cirrhosis
Authors: Yen Fu‐Shun , Wei James Cheng‐Chung , Chiu Lu‐Ting , Hsu Chih‐Cheng , Hou Ming‐Chih , Hwu Chii‐Min 
Published: October 2020

AbstractBackground& AimsType 2 diabetes mellitus (T2DM) management in patients with cirrhosis is complicated. No clinical trials have investigated appropriate antidiabetic drug use in these patients. This study compared the risks of all‐cause mortality, major adverse cardiovascular events (MACE) and hepatic outcomes between patients with T2DM and cirrhosis using and not using thiazolidinedione (TZD).MethodsWe selected 1,705 propensity score–matched TZD users and nonusers from a Taiwan National Health Insurance Research Database cohort of T2DM patients with compensated cirrhosis between January 1, 2000, and December 31, 2012 and followed them until December 31, 2013. Cox proportional hazards models with robust sandwich standard error estimates were used to assess risks of investigated outcomes for TZD users.ResultsMACE incidence rates during follow‐up were 2.14 and 1.30 per 100 patient‐years for TZD users and nonusers, respectively (adjusted hazard ratio [aHR] 1.70; 95% confidence interval [CI], 1.32‐2.19). On the basis of TZD use, the aHRs (95% CIs) for stroke, ischemic heart disease and heart failure were 1.81 (1.28‐2.55), 1.59 (1.03‐2.44) and 2.09 (1.22‐3.60) respectively. Compared with TZD nonusers, rosiglitazone users had significantly higher aHR [1.67 (1.26‐2.20)] and pioglitazone users had no significant difference of aHR [1.12 (0.90‐1.64)]. All‐cause mortality, hepatocellular carcinoma, decompensated cirrhosis and hepatic failure risks did not differ significantly between TZD users and nonusers.ConclusionsCompared with nonuser, TZD users demonstrated significantly higher MACE risks. Therefore, the risks of cardiovascular complications should be considered when prescribing TZDs to patients with T2DM and cirrhosis.
Parents' experiences of VOICE: A novel support programme in the NICU
Authors: van den Hoogen Agnes , Eijsermans Rian , Ockhuijsen Henriette D. L. , Jenken Floor , Oude Maatman Sabine M. , Jongmans Marian J. , Verhage Lianne , van der Net Janjaap , Latour Jos M. 
Published: October 2020

AbstractBackgroundAdmission of an infant to a neonatal intensive care unit (NICU) is often a stressful experience for parents and can be associated with feelings of inadequacy to fulfil the desirable parental role. The values, opportunities, integration, control, and evaluation (VOICE) programme was developed to engage parents in care, to decrease stress, and to increase empowerment.AimTo explore the experiences of parents regarding involvement in the VOICE programme during admission of their infant to the NICU.DesignThe VOICE programme includes at least five personal structured meetings between parents, nurses, and other health care professionals throughout the pathway from birth, NICU, and follow up. A qualitative design was adopted using semi‐structured interviews. Interviews with 13 parents of 11 infants born at <27 weeks' gestational age were conducted: nine mothers and two couples of father and mother. Thematic analysis was deployed.ResultsThe findings have been described in one overarching theme: “parental empowerment.” Parents felt strengthened and were empowered in the development of their role as primary caretaker by the VOICE programme. The parental empowerment theme emerged from four related interpretive themes that were derived: (a) involvement in care, (b) personalized information and communication, (c) transition to a parental role, and (d) emotional support.ConclusionThe VOICE programme can be a structured approach used to implement family support in a NICU to empower parents to become a partner in the care of their infant and feel confident.Relevance to clinical practiceThis study encourages health care professionals to provide parental support through a structured intervention programme, which contributes to the empowerment of parents in the NICU and encouraged them to participate in care and decision‐making.
British Association of Critical Care Nurses: Evidence‐based consensus paper for oral care within adult critical care units
Authors: Collins Tim , Plowright Catherine , Gibson Vanessa , Stayt Louise , Clarke Sarah , Caisley Jo , Watkins Claire Harcourt , Hodges Emily , Leaver Gillian , Leyland Sarah , McCready Patricia , Millin Sara , Platten Julie , Scallon Michelle , Tipene Patsy , Wilcox Gabby 
Published: October 2020

AbstractBackgroundPatients who are critically ill are at increased risk of hospital acquired pneumonia and ventilator associated pneumonia. Effective evidence based oral care may reduce the incidence of such iatrogenic infection.AimTo provide an evidence‐based British Association of Critical Care Nurses endorsed consensus paper for best practice relating to implementing oral care, with the intention of promoting patient comfort and reducing hospital acquired pneumonia and ventilator associated pneumonia in critically ill patients.DesignA nominal group technique was adopted. A consensus committee of adult critical care nursing experts from the United Kingdom met in 2018 to evaluate and review the literature relating to oral care, its application in reducing pneumonia in critically ill adults and to make recommendations for practice. An elected national board member for the British Association of Critical Care Nurses chaired the round table discussion.MethodsThe committee focused on 5 aspects of oral care practice relating to critically ill adult patients. The evidence was evaluated for each practice within the context of reducing pneumonia in the mechanically ventilated patient or pneumonia in the non‐ventilated patient. The five practices included the frequency for oral care; tools for oral care; oral care technique; solutions used and oral care in the non‐ventilated patient who is critically ill and is at risk of aspiration. The group searched the best available evidence and evaluated this using the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of evidence from high to very low, and to formulate recommendations as strong, moderate, weak, or best practice consensus statement when applicable.ResultsThe consensus group generated recommendations, delineating an approach to best practice for oral care in critically ill adult patients. Recommendations included guidance for frequency and procedure for oral assessment, toothbrushing, and moisturising the mouth. Evidence on the use of chlorhexidine is not consistent and caution is advised with its routine use.ConclusionOral care is an important part of the care of critically ill patients, both ventilated and non‐ventilated. An effective oral care programme reduces the incidence of pneumonia and promotes patient comfort.Relevance to Clinical practiceEffective oral care is integral to safe patient care in critical care.
Jasmonates induce Arabidopsis bioactivities selectively inhibiting the growth of breast cancer cells through CDC6 and mTOR
Authors: Bömer Moritz , Pérez‐Salamó Imma , Florance Hannah V. , Salmon Deborah , Dudenhoffer Jan‐Hendrik , Finch Paul , Cinar Aycan , Smirnoff Nicholas , Harvey Amanda , Devoto Alessandra 
Published: October 2020

Summary

Phytochemicals are used often in vitro and in vivo in cancer research. The plant hormones jasmonates (JAs) control the synthesis of specialized metabolites through complex regulatory networks. JAs possess selective cytotoxicity in mixed populations of cancer and normal cells.

Here, direct incubation of leaf explants from the non‐medicinal plant Arabidopsis thaliana with human breast cancer cells, selectively suppresses cancer cell growth. High‐throughput LC‐MS identified Arabidopsis metabolites. Protein and transcript levels of cell cycle regulators were examined in breast cancer cells.

A synergistic effect by methyljasmonate (MeJA) and by compounds upregulated in the metabolome of MeJA‐treated Arabidopsis leaves, on the breast cancer cell cycle, is associated with Cell Division Cycle 6 (CDC6), Cyclin‐dependent kinase 2 (CDK2), Cyclins D1 and D3, indicating that key cell cycle components mediate cell viability reduction. Bioactives such as indoles, quinolines and cis‐(+)‐12‐oxophytodienoic acid, in synergy, could act as anticancer compounds.

Our work suggests a universal role for MeJA‐treatment of Arabidopsis in altering the DNA replication regulator CDC6, supporting conservation, across kingdoms, of cell cycle regulation, through the crosstalk between the mechanistic target of rapamycin, mTOR and JAs. This study has important implications for the identification of metabolites with anti‐cancer bioactivities in plants with no known medicinal pedigree and it will have applications in developing disease treatments
Overcoming the trade‐off between grain weight and number in wheat by the ectopic expression of expansin in developing seeds leads to increased yield potential
Authors: Calderini Daniel F. , Castillo Francisca M. , Arenas‐M Anita , Molero Gemma , Reynolds Matthew P. , Craze Melanie , Bowden Sarah , Milner Matthew J. , Wallington Emma J. , Dowle Adam , Gomez Leonardo D. , McQueen‐Mason Simon J. 
Published: October 2020

Summary

Wheat is the most widely grown crop globally, providing 20% of all human calories and protein. Achieving step changes in genetic yield potential is crucial to ensure food security, but efforts are thwarted by an apparent trade‐off between grain size and number. Expansins are proteins that play important roles in plant growth by enhancing stress relaxation in the cell wall, which constrains cell expansion.

Here, we describe how targeted overexpression of an α‐expansin in early developing wheat seeds leads to a significant increase in grain size without a negative effect on grain number, resulting in a yield boost under field conditions.

The best‐performing transgenic line yielded 12.3% higher average grain weight than the control, and this translated to an increase in grain yield of 11.3% in field experiments using an agronomically appropriate plant density.

This targeted transgenic approach provides an opportunity to overcome a common bottleneck to yield improvement across many crops.
Loss of COMT activity reduces lateral root formation and alters the response to water limitation in sorghum brown midrib (bmr) 12 mutant
Authors: Saluja Manny , Zhu Feiyu , Yu Hongfeng , Walia Harkamal , Sattler Scott E. 
Published: October 2020

Summary

Lignin is a key target for modifying lignocellulosic biomass for efficient biofuel production. Brown midrib 12 (bmr12) encodes the sorghum caffeic acid O‐methyltransferase (COMT) and is one of the key enzymes in monolignol biosynthesis. Loss of function mutations in COMT reduces syringyl (S) lignin subunits and improves biofuel conversion rate. Although lignin plays an important role in maintaining cell wall integrity of xylem vessels, physiological and molecular consequences due to loss of COMT on root growth and adaptation to water deficit remain unexplored.

We addressed this gap by evaluating the root morphology, anatomy and transcriptome of bmr12 mutant. The mutant had reduced lateral root density (LRD) and altered root anatomy and response to water limitation. The wild‐type exhibits similar phenotypes under water stress, suggesting that bmr12 may be in a water deficit responsive state even in well‐watered conditions.

bmr12 had increased transcript abundance of genes involved in (a)biotic stress response, gibberellic acid (GA) biosynthesis and signaling. We show that bmr12 is more sensitive to exogenous GA application and present evidence for the role of GA in regulating reduced LRD in bmr12.

These findings elucidate the phenotypic and molecular consequences of COMT deficiency under optimal and water stress environments in grasses.
Three‐dimensional assessment of accelerating orthodontic tooth movement—micro‐osteoperforations vs piezocision: A randomized, parallel‐group and split‐mouth controlled clinical trial
Authors: Alqadasi Basema , Xia Hou Yu , Alhammadi Maged Sultan , Hasan Hadeel , Aldhorae Khalid , Halboub Esam 
Published: October 2020

AbstractObjectiveTo compare the effects of micro‐osteoperforations (MOPs) vs piezocision (Piezo) in accelerating orthodontic tooth movement in adults.Setting and Sample PopulationIn this randomized, single‐blinded, parallel‐group, split‐mouth clinical trial, 24 patients aged 15‐40 years were recruited.Subjects and MethodsPatients were randomly allocated into two groups: MOPs and Piezo groups. One side of the maxilla was allocated randomly for treatment with one of these techniques, and the other side was treated conventionally to act as a split‐mouth control. The rate of canine retraction was evaluated up to 3 months by three‐dimensional digital models using a conventional labial appliance. Root resorption and bone height were evaluated using cone beam computed tomography.ResultsThe MOPs and Piezo groups showed a significantly higher rate of tooth movement after 3 months on the experimental sides than the control sides. However, the net movements in the MOPs and Piezo groups did not reveal a higher rate of tooth movement. Similarly, the overall net movement was −0.32 ± 1.14 and ‐0.55 ± 0.89 mm for MOPs and Piezo, respectively (P = .606). Regarding root resorption, the overall changes in intra‐ or intergroup comparisons were insignificant. Decreased canine palatal bone height was reported on the experimental side of the Piezo group (P = .015) after 3 months, but the overall changes were insignificant.ConclusionsThe effect of MOPs and Piezo techniques in accelerating the orthodontic canine retraction was comparable to each other, and to the conventional methods. Neither technique caused root resorption or increased vertical bone loss.
Not a “first world problem”—Care of the anesthetist in East and Southern Africa
Authors: Workneh Rediet Shimeles , Tuyishime Eugene , Mumbwe Mbangu , Igaga Elizabeth Namugaya , Bould M. Dylan 
Published: October 2020

AbstractBurnout and related concepts such as resilience, wellness, and taking care of healthcare professionals have become increasingly prevalent in the medical literature. Most of the work in this area comes from high‐income countries, with the remainder from upper‐middle‐income countries, and very little from lower‐middle‐income or low‐income countries. Sub‐Saharan Africa is particularly poorly represented in this body of literature. Anglo‐American concepts are often applied to different jurisdictions without consideration of cultural and societal differences. However, anesthesia providers in this region have unique challenges, with both the highest burden of “surgical” disease in the world and the least resources, both in terms of human resources for health and in terms of essential drugs and equipment. The effect of burnout on healthcare systems is also likely to be very different with the current human resources for the health crisis in East and Central Africa. According to the Joint Learning Initiative Managing for Performance framework, the three essential factors for building a workforce to effectively support a healthcare system are coverage, competence, and motivation. Current efforts to build capacity in anesthesia in East and Southern Africa focus largely on coverage and competence, but neglect motivation at the risk of failing to support a sustainable workforce. In this paper, we include a review of the relevant literature, as well as draw from personal experience living and working in East and Southern Africa, to describe the unique issues surrounding burnout, resilience, and wellness in this region.
Infantile toxic epidermal necrolysis: Successful treatment of an 8‐week‐old with intravenous immunoglobulin and amniotic membrane transplant
Authors: Nassim Janelle S. , Karim Sabrina A. , Grenier Pierre‐Olivier , Schmidt Birgitta , Jones Krystal M. 
Published: October 2020

AbstractStevens‐Johnson syndrome and toxic epidermal necrolysis comprise a spectrum of severe mucocutaneous hypersensitivity reactions. A paucity of data limits current understanding of the etiology, treatment options, and prognosis of this entity in the infantile population compared to that in the adult and pediatric literature. We describe the case of an 8‐week‐old male with toxic epidermal necrolysis treated successfully with intravenous immunoglobulin and amniotic membrane transplant. This patient is the youngest surviving infant with toxic epidermal necrolysis to be reported.
Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students
Authors: Mårtensson Sophie , Hodges Eric A. , Knutsson Susanne , Hjelm Carina , Broström Anders , Swanson Kristen M. , Björk Maria 
Published: October 2020

RationaleTo maintain patients’ dignity and well‐being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non‐caring behaviours. Defining and measuring both verbal and nonverbal caring and non‐caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.AimThe aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.MethodAn instrument development process was used for behavioural coding including observational data from thirty‐eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.ResultThe Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non‐caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed‐event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter‐rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.Discussion/ConclusionThe CBCS is a theory‐based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non‐caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well‐being.
Diagnosis and clinical management of auricular chondritis in a dog presenting for evaluation of severe pain
Authors: Noxon James O. , Berger Darren J. , Ackermann Mark A. , Petersen Jennifer R. , Smith Jodi D. 
Published: October 2020

BackgroundThe aetiology and appropriate treatment for auricular chondritis in the dog are currently unclear. This report describes a unique presentation and successful treatment of a dog with auricular chondritis.Clinical summaryA 12‐year‐old, female spayed, Labrador retriever dog was presented for severe pain thought to be neurological in origin. The pain was located to the right pinna and two punch biopsies were acquired and evaluated, revealing lymphoplasmacytic to pyogranulomatous inflammation involving the auricular cartilage with no infectious agents. Treatment with systemic oral prednisone resulted in resolution of clinical signs within four weeks of initiation of treatment. The dog remained free of clinical signs for six months following discontinuation of treatment before being euthanized for an unrelated reason.ConclusionsFurther evaluation of canine auricular chondritis is needed, yet pain may be a prominent finding; monotherapy with systemic prednisone may provide quick and complete resolution of clinical sysmptoms.
Serum Epitope Repertoire Analysis Enables Early Detection of Lyme Disease with Improved Sensitivity in an Expandable Multiplex Format
Authors: Reifert Jack , Kamath Kathy , Bozekowski Joel , Lis Ewa , Horn Elizabeth J. , Granger Dane , Theel Elitza S. , Shon John , Sawyer Jaymie R. , Daugherty Patrick S. 
Published: October 2020

Widely employed diagnostic antibody serology for Lyme disease, known as standard two-tier testing (STTT), exhibits insufficient sensitivity in early Lyme disease, yielding many thousands of false-negative test results each year. Given this problem, we applied serum antibody repertoire analysis (SERA), or next-generation sequencing (NGS)-based serology, to discover IgG and IgM antibody epitope motifs capable of detecting Lyme disease-specific antibodies with high sensitivity and specificity. Iterative motif discovery and bioinformatic analysis of epitope repertoires from subjects with Lyme disease (
n
= 264) and controls (
n
= 391) yielded a set of 28 epitope motifs representing 20 distinct IgG antibody epitopes and a set of 38 epitope motifs representing 21 distinct IgM epitopes, which performed equivalently in a large validation cohort of STTT-positive samples.
Hypertensive retinopathy in a neonate
Authors: Goyal Prakhar , Agarwal Komal 
Published: October 2020

A 23-day-old female child diagnosed as having systemic hypertensive emergency was referred for retinal screening. The fundus examination showed bilateral intraretinal haemorrhages and hard exudates especially at the macula. Venous looping was noted. The ocular features were suggestive of hypertensive retinopathy. Control of systemic hypertension was advised and was managed conservatively with close follow-up. Widefield fundus photography was done at presentation and follow-up to document the change in retinopathy with control of hypertension.The haemorrhages and exudates resolved on follow-up but significant retinal pigment epithelium changes with beaten bronze appearance were noted at the area of previous oedema. Presence of hypertensive retinopathy in a neonate is rare and has long-term effects on visual development. This report describes the course of hypertensive retinopathy in a neonate.