bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical student education in sleep and its disorders is still meagre 20 years on: A cross‐sectional survey of UK undergraduate medical education
Authors: Romiszewski Stephanie , May Felix Edward Kelly , Homan Elizabeth Jane , Norris Ben , Miller Michelle A. , Zeman Adam 
Published: March 2020

AbstractSleep is a pillar of health, alongside adequate nutrition and exercise. Problems with sleep are common and often treatable. Twenty years ago, UK medical school education on sleep disorders had a median teaching time of 15 min; we investigate whether education on sleep disorders has improved. This is a cross‐sectional survey, including time spent on teaching sleep medicine, subtopics covered and forms of assessment. Thirty‐four medical degree courses in the UK were investigated via a questionnaire. We excluded responses not concerned with general undergraduate education (i.e. optional modules). Twenty‐five (74%) medical schools responded. Time spent teaching undergraduates sleep medicine was: median, 1.5 hr; mode, <1 hr; mean, 3.2 hr (SD = 2.6). Only two schools had a syllabus or core module (8%) and five (22%) were involved in sleep disorders research. Despite the above, half of the respondents thought provision was sufficient. Free‐text comments had recurring themes: sleep medicine is subsumed into other specialties, obstructive sleep apnea dominates teaching, knowledge of sleep disorders is optional, and there is inertia regarding change. A substantial minority of respondents were enthusiastic about improving provision. In conclusion, little has changed over 20 years: sleep medicine is neglected despite agreement on its importance for general health. Sleep research is the exception rather than the rule. Obstacles to change include views that “sleep is not a core topic” or “the curriculum is too crowded”. However, there is enthusiasm for improvement. We recommend establishment of a sleep medicine curriculum. Without better teaching, doctors will remain ill‐equipped to recognize and treat these common conditions.
Pharmacokinetics and clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia
Authors: Guedes Alonso , Knych Heather , Tucker Laura , Almeida Daniel C. , Baldo Caroline F. , Wendt‐Hornickle Erin , Allweiler Sandra 
Published: March 2020

AbstractThis study determined the pharmacokinetics and compared the clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. Six healthy horses aged 8.5 ± 3 years and weighing 462 ± 50 kg were anesthetized with isoflurane for 2 hr under standard conditions on two occasions one‐week apart. In recovery, horses received 200 μg/kg xylazine or 0.875 μg/kg dexmedetomidine intravenously and were allowed to recover without assistance. These doses were selected because they have been used for postanesthetic sedation in clinical and research studies. Serial venous blood samples were collected for quantification of xylazine and dexmedetomidine, and the pharmacokinetic parameters were calculated. Two individuals blinded to treatment identity evaluated recovery quality with a visual analog scale. Times to stand were recorded. Results (mean ± SD) were compared using pairedttests or Wilcoxon signed‐ranked test withp < .05 considered significant. Elimination half‐lives (62.7 ± 21.8 and 30.1 ± 8 min for xylazine and dexmedetomidine, respectively) and steady‐state volumes of distribution (215 ± 123 and 744 ± 403 ml/kg) were significantly different between xylazine and dexmedetomidine, whereas clearances (21.1 ± 17.3 and 48.6 ± 28.1 ml/minute/kg), times to stand (47 ± 24 and 53 ± 12 min) and recovery quality (51 ± 24 and 61 ± 22 mm VAS) were not significantly different. When used for postanesthetic sedation following isoflurane anesthesia in healthy horses, dexmedetomidine displays faster plasma kinetics but is not associated with faster recoveries compared to xylazine.
Ecosystem size predicts the probability of speciation in migratory freshwater fish
Authors: Yamasaki Yo Y. , Takeshima Hirohiko , Kano Yuichi , Oseko Naoharu , Suzuki Toshiyuki , Nishida Mutsumi , Watanabe Katsutoshi 
Published: March 2020

AbstractPredicting speciation is a fundamental goal of research in evolutionary ecology. The probability of speciation is often positively correlated with ecosystem size. Although the mechanisms driving this correlation are generally difficult to identify, a shared geographical and ecological context provides a suitable condition to study the mechanisms that promote speciation in large ecosystems by reducing the number of factors to be considered. Here, we determined the correlation between speciation and ecosystem size, and discuss the underlying mechanisms of this relationship, using a probable parallel ecotype formation for freshwater fish. Our population genetic analysis revealed that speciation of the landlocked goby, Rhinogobius sp. YB, of the Ryukyu Archipelago, Japan, from its migratory ancestor, R. brunneus, occurred in parallel across five islands. Logistic regression analysis showed that speciation probability could be predicted using island size. The results suggest that ecosystem size predicts the occurrence of adaptation and reproductive isolation, probably through its association with three possible factors: divergent selection strength, population persistence, and occurrence probability of habitat separation.
The photoreceptor UVR8 mediates the perception of both UV‐B and UV‐A wavelengths up to 350 nm of sunlight with responsivity moderated by cryptochromes
Authors: Rai Neha , O'Hara Andrew , Farkas Daniel , Safronov Omid , Ratanasopa Khuanpiroon , Wang Fang , Lindfors Anders V. , Jenkins Gareth I. , Lehto Tarja , Salojärvi Jarkko , Brosché Mikael , Strid Åke , Aphalo Pedro J. , Morales Luis O. 
Published: March 2020

AbstractThe photoreceptors UV RESISTANCE LOCUS 8 (UVR8) and CRYPTOCHROMES 1 and 2 (CRYs) play major roles in the perception of UV‐B (280–315 nm) and UV‐A/blue radiation (315–500 nm), respectively. However, it is poorly understood how they function in sunlight. The roles of UVR8 and CRYs were assessed in a factorial experiment with Arabidopsis thaliana wild‐type and photoreceptor mutants exposed to sunlight for 6 or 12 hr under five types of filters with cut‐offs in UV and blue‐light regions. Transcriptome‐wide responses triggered by UV‐B and UV‐A wavelengths shorter than 350 nm (UV‐Asw) required UVR8 whereas those induced by blue and UV‐A wavelengths longer than 350 nm (UV‐Alw) required CRYs. UVR8 modulated gene expression in response to blue light while lack of CRYs drastically enhanced gene expression in response to UV‐B and UV‐Asw. These results agree with our estimates of photons absorbed by these photoreceptors in sunlight and with in vitro monomerization of UVR8 by wavelengths up to 335 nm. Motif enrichment analysis predicted complex signaling downstream of UVR8 and CRYs. Our results highlight that it is important to use UV waveband definitions specific to plants' photomorphogenesis as is routinely done in the visible region.
Bortezomib for autoimmune hemolytic anemia after intestinal transplantation
Authors: Knops Noël , Emonds Marie‐Paule , Herman Jean , Levtchenko Elena , Mekahli Djalila , Pirenne Jacques , Van Geet Chris , Dierickx Daan 
Published: March 2020

AbstractAIHA is rare in the general population and associated with a mortality of 8%. In contrast, AIHA occurs in up to 12.2% of cases after intestinal transplantation and is associated with mortality up to 50%. Treatment entails a “step‐up” approach including corticosteroids, IvIg, plasmapheresis, and rituximab. However, AIHA after transplantation often is refractory to this strategy, contributing to a poor outcome. We describe a child with microvillous inclusion disease who developed AIHA 1 year after multivisceral transplantation that was refractory to standard therapy and was subsequently treated with bortezomib.We observed remission of AIHA within 1 week after the start of bortezomib. Bortezomib was associated with transient diarrhea, leucopenia, and elevated liver enzymes. Three years later, he remains in remission without important complications. Published data on bortezomib for autoimmune cytopenias outside SOT are discussed. This is the first report to support bortezomib as an important therapeutic alternative for AIHA after SOT. The occurrence and treatment of AIHA after SOT, and specifically intestinal transplantation, should be the subject of future registry studies to collect additional experience and explore the optimal therapeutic approach.
Registered Nurses' medication administration skills: a systematic review
Authors: Luokkamäki Sanna , Härkänen Marja , Saano Susanna , Vehviläinen‐Julkunen Katri 
Published: March 2020

AimsThe aim of this review was to identify methods for measuring Registered Nurses' medication administration skills and to describe these skills.DesignA systematic literature review.Data sourcesThe CINAHL, PubMed, Scopus, Cochrane, PsycInfo and Medic databases were searched for articles from the period 2007–2018.Review methodsTwo researchers independently selected the articles and evaluated their quality using the National Heart, Lung and Blood Institute study quality assessment tools. The data were analysed using content analysis.ResultsA total of 727 studies were identified of which 22 studies were included in this review. A total of six different measurement methods were identified: questionnaire or survey, observation, knowledge test or exam, focus group interviews, chart reviews and voluntarily reported errors. Different methods provided different information on medication administration skills. Medication administration skills were classified under nine areas: (1) safe ordering, handling, storing and discarding of medications, (2) preparing of medications, (3) the administration of medications to patients, (4) documentation, (5) evaluation and assessment of medication‐related issues, (6) drug calculation skills, (7) cooperation with other professionals and (8) with the patients and (9) reporting of medication information. The results demonstrated that there are many areas that need to be improved to increase medication safety.ConclusionsMedication administration includes many different phases, as a result of which nurses need to have many various skills to cope with medication administration as required by their profession. This review shows that nurses' medication administration skills need to be developed, and special attention should be paid to the preparation and administration phases. It is important to regularly utilise different teaching strategies and verify nurses' medication competence. As each research method has different limitations, it is vital that further studies combine different methods to form a comprehensive picture of nurses' medication administration skills.
Oncology nurses’ experiences of meeting with men with cancer‐related fatigue: a qualitative study
Authors: Robertsen Inger‐Lise , Skär Lisa 
Published: March 2020

BackgroundCancer treatment often causes side effects, among which fatigue is common and can persist for years among disease‐free cancer survivors. Living with fatigue can lead to reduced life expectancy and quality of life.Aims and objectivesTo describe oncology nurses’ experiences of meeting with men with cancer and talking about cancer‐related fatigue.Design and MethodsThe data were collected via semi‐structured interviews with nine oncology nurses recruited using a purposeful sampling method and analysed using thematic content analysis. This qualitative design was conducted to describe and interpret the content of experiences.Ethical issues and approvalThe study was approved by a regional Ethical Review Board, and research ethical principles were followed.ResultsThe analysis revealed one major theme, namely take the whole person into consideration, and three subthemes: the importance of (i) establishing trust in the nurse–patient relationship, (ii) supporting the patient’s understanding of cancer‐related fatigue, and (iii) managing the challenging emotions experienced by patients. The major theme describes the oncology nurses’ approach when meeting with men with cancer‐related fatigue.ConclusionThe results provide insight into how oncology nurses can increase their knowledge about fatigue to establish trust in nurse–patient relationships. They can acquire knowledge about how to make men with cancer‐related fatigue feel safe when handling their daily lives despite their fatigue. Oncology nurses require knowledge, presence and commitment in their interactions with men with cancer‐related fatigue to be able to take the whole person into consideration. This study demonstrates the importance of the approach oncology nurses take when interacting with men with cancer‐related fatigue and the strategies required when talking about cancer‐related fatigue.
Immersion pulmonary edema in a patient on maintenance dialysis: A case report
Authors: Morimoto Nobuhisa , Tanabe Madoka , Imono Atsuhiro , Otani Megumi , Shioji Shingo , Hirasawa Suguru , Aki Shota , Aoyagi Makoto , Tanaka Hiroyuki 
Published: March 2020

AbstractImmersion pulmonary edema (IPE) is a rare condition observed in divers. We report a case of a 66‐year‐old man on maintenance dialysis who developed acute dyspnea and blood‐tinged sputum after scuba diving. Vital signs on admission were significant for elevated blood pressure at 209/63 mmHg and hypoxia with an oxygen requirement of 6 L/min. Physical examination was remarkable for bilateral coarse crackles and systolic ejection murmur. Chest radiography revealed bilateral pulmonary edema. Echocardiography showed aortic stenosis and diffuse hypokinesis of left ventricular wall motion. We started bilevel positive airway pressure and administered nitroglycerin and nicardipine to maintain adequate oxygenation and reduce blood pressure. We started hemodialysis and extracorporeal ultrafiltration to remove excess fluid. His dyspnea subsided and oxygen was no longer required on Day 3. His long‐standing hypertension, increased afterload due to vasoconstriction induced by cold water, increased capillary pressure due to impaired left ventricular motion and increased preload caused by exertion, and aortic stenosis probably contributed to pulmonary congestion. We propose maintenance dialysis as a novel risk factor for IPE due to its tendency to induce volume overload, increase pulmonary capillary pressure, and increase aortic stenosis risk. Patients on hemodialysis should refrain from diving to prevent this life‐threatening condition.
External quality assessment of noninvasive fetal RHD genotyping
Authors: Clausen Frederik Banch , Hellberg Åsa 
Published: March 2020

Background and objectivesFetal RHD genotyping of cell‐free maternal plasma DNA from RhD negative pregnant women can be used to guide targeted antenatal and postnatal anti‐D prophylaxis for the prevention of RhD immunization. To assure the quality of clinical testing, we conducted an external quality assessment workshop with the participation of 31 laboratories.Materials and methodsAliquots of pooled maternal plasma from gestational week 25 were sent to each laboratory. One sample was fetal RHD positive, and a second sample was fetal RHD negative. A reporting scheme was supplied for data collection, including questions regarding the methodological setup, results and clinical recommendations. The samples were tested blindly.ResultsDifferent methodological approaches were used; 29 laboratories used qPCR and two laboratories used ddPCR, employing a total of eight different combinations of RHD exon targets. Fetal RHD genotyping was performed with no false‐negative and no false‐positive results. One inconclusive result was reported for the RHD positive sample. All clinical conclusions were satisfactory.ConclusionThis external quality assessment workshop demonstrates that despite the different approaches taken to perform the clinical assays, fetal RHD genotyping is a reliable laboratory assay to guide targeted use of Rh prophylaxis in a clinical setting.
Rejuvenation solution as an adjunct cold storage solution maintains physiological haemoglobin oxygen affinity during early‐storage period of red blood cells
Authors: Evans Brooke A. , Ansari Andrea K. , Srinivasan Amudan J. , Kamyszek Reed W. , Stoner Keaton C. , Fuller Matthew , Poisson Jessica L. , Welsby Ian J. 
Published: March 2020

AbstractBackgroundRed blood cell (RBC) units accumulate morphologic and metabolic lesions during storage before transfusion. Pyruvate–inosine–phosphate–adenine (PIPA) solutions (Rejuvesol, Biomet, Warsaw, IN) can be incubated with RBC units to mitigate storage lesions. This study proposes a PIPA treatment process, termed cold ‘rejuvenation’, using Rejuvesol as an adjunct additive solution, to prevent biomechanical storage lesions while avoiding the 1 h PIPA incubation required with standard PIPA treatment. We compared the efficacy of cold to standard ‘rejuvenation’ in improving metabolic lesions that occur during cold storage of RBCs, without altering function.MethodsTwelve leucoreduced, A‐positive RBC units were obtained. Each unit was aliquoted into either control (standard storage), washed (W), standard rejuvenation (SR) or cold rejuvenation (CR) groups, the latter two requiring washing. A volume‐adjusted dose of Rejuvesol was instilled into the CR group upon receipt (Day 3). After 15 days of storage, p50, RBC deformability, in‐bag haemolysis and mechanical fragility were analysed. ‘Any treatment’ is defined as W, SR and CR, with comparisons in reference to control.ResultsHigher p50s were seen in rejuvenated groups (>30 mmHg vs. <19 mmHg; P < 0·0001). Any treatment significantly increased elongation index (P = 0·034) but did not significantly increase in‐bag haemolysis (P = 0·062). Mechanical fragility was not significantly different between groups (P = 0·055) at baseline, but the control (CTL) group was more fragile after 2 h in a cardiac bypass simulation than any treatment (P < 0·0001).ConclusionsThis study demonstrates that rejuvenation (standard or cold) prevents the leftward p50 shift of storage lesions without detrimental effect on RBC deformity, in‐bag haemolysis or mechanical fragility.
Red‐blood‐cell manufacturing methods and storage solutions differentially induce pulmonary cell activation
Authors: Wirtz Mathijs R. , Almizraq Ruqayyah J. , Weber Nina C. , Norris Philip J. , Pandey Suchitra , Spinella Philip C. , Muszynski Jennifer A. , P. Acker Jason , Juffermans Nicole P. 
Published: March 2020

Background and ObjectivesRed‐blood‐cell (RBC) transfusion is associated with lung injury, which is further exacerbated by mechanical ventilation. Manufacturing methods of blood products differ globally and may play a role in the induction of pulmonary cell activation through alteration of the immunomodulatory property of the products. Here, the effect of different manufacturing methods on pulmonary cell activation was investigated in an in vitro model of mechanical ventilation.Materials and MethodsPulmonary type II cells were incubated with supernatant from fresh and old RBC products obtained via whole blood filtration (WBF), red cell filtration (RCF), apheresis‐derived (AD) or whole blood‐derived (WBD) methods. Lung cells were subjected to 25% stretch for 24 h. Controls were non‐stretched or non‐incubated cells.ResultsFresh but not old AD products and WBF products induce lung cell production of pro‐inflammatory cytokines and chemokines, which was not observed with WBD or RCF products. Effects were associated with an increased amount of platelet‐derived vesicles and an increased thrombin‐generating capacity. Mechanical stretching of lung cells induced more severe cell injury compared to un‐stretched controls, including alterations in the cytoskeleton, which was further augmented by incubation with AD products. In all read‐out parameters, RCF products seemed to induce less injury compared to the other products.ConclusionsOur findings show that manufacturing methods of RBC products impact pulmonary cell activation, which may be mediated by the generation of vesicles in the product. We suggest RBC manufacturing method may be an important factor in understanding the association between RBC transfusion and lung injury.
Factors affecting seed germination and emergence of Aegilops tauschii
Authors: Wang Hengzhi , Zhao Kongping , Li Xiangju , Chen Xiutao , Liu Weitang , Wang Jinxin 
Published: March 2020

AbstractInformation on seed germination and emergence ecology of Aegilops tauschii is scant, despite it being a widespread invasive weed in China. We conducted this study to determine the effects of various factors on seed germination and seedling emergence in three A. tauschii populations. Seeds germinated across a wide range of temperatures (5–35°C), with germination of over 90% at 15–20°C. Germination was completely inhibited when dry seeds were exposed to a temperature of 160°C for 5 min; a similar response was observed for pre‐soaked seeds at 100°C. Light was neither required for nor inhibited germination. Germination was not significantly affected by pH. Aegilops tauschii was relatively tolerant to low osmotic potential and high salt stress: over 80% of seeds germinated at −0.3 MPa, and all three populations germinated in the presence of 400 mM salt (NaCl) although salt tolerance varied among the populations. Seeds buried at depths of 1–3 cm emerged well, but emergence was completely inhibited at depths greater than 8 cm. The addition of maize straw caused a linear reduction in seedling emergence, although the rate of reduction varied among the populations. The results of this study have contributed to understanding the requirements of A. tauschii germination and emergence and optimising an integrated management system for this weed in Huang–Huai–Hai Plain of China. In addition, our study provides data for development of models to predict the geographical distribution of this weed.
Robust Simultaneous Stabilization Using Derivative State Feedback
Authors: Suresh Deshmukh Venkatesh 
Published: March 2020

Abstract
In simultaneous stabilization of continuous time switched linear system models of inertially coupled dynamic systems with bounded persistent external disturbance and internal parameter variations, the generalized proportional integral derivative (PID) controller suffers from a serious drawback. It loses the ability to guarantee exponential stability of the closed-loop error response, which is the difference between the actual and the desired closed-loop responses. The high value of the hardware gain has no control over the situation. On the contrary, the derivative state feedback (DSF) controller effectively employs the hardware gain in diminishing the effects of external and internal disturbances. These facts are proved and illustrated by suitable examples. The proposed method of simultaneous stabilization is shown to be an easier alternative to solve Diophantine equations encountered. The method for single input single output (SISO) systems is also shown to extend seamlessly to the control of multiple input multiple output (MIMO) square models with equal number of inputs and outputs. The shortcoming of the method is pointed out when the models are not square. The advantages of the proposed methodology over the existing methods are outlined. Finally, an efficient time domain simulation scheme is presented for the numerical study of such models in time and transfer function domain with nonzero initial conditions.