bluuebunny/crossref_metadata_2025_split huggingface dataset:
New treatments for patients with non‐metastatic castration‐resistant prostate cancer: A nursing perspective
Authors: Olivier Kara M. , Floyd Rebecca , Smith Matthew R. , Shore Neal D. , Sutton Jennifer 
Published: February 2021

AbstractGlobally, prostate cancer (PC) is a leading cause of death in men. Although androgen deprivation therapy (ADT) is the cornerstone of treatment for the disease, most patients eventually develop castration‐resistant PC (CRPC). Patients with non‐metastatic (nm) CRPC, the earliest clinical manifestation of castration resistance, are at risk of progressing to metastatic CRPC, which is associated with reduced life expectancy and poor quality of life. The nmCRPC treatment landscape has recently been transformed by the approval of three next‐generation oral androgen receptor (AR) inhibitors: apalutamide, enzalutamide and darolutamide. This review addresses available new treatment options for nmCRPC that target the AR, considering the effects of adverse event (AE) profiles and drug‐drug interactions (DDIs) when tailoring patient‐centric treatment to individual need, and discussing management strategies and nursing interventions for patients who experience drug‐related AEs. While no head‐to‐head comparisons of apalutamide, enzalutamide and darolutamide have been conducted to date, all three drugs have demonstrated comparable efficacy and maintained quality of life in phase III clinical trials, with differing AE profiles. The three treatments also demonstrate different potential for DDIs with other common medications that may be taken simultaneously. With the availability of new AR‐targeted options for nmCRPC, oncology nurses play a crucial role in the decision‐making process, educating and supporting patients on managing their PC, and ensuring that they receive the most appropriate treatment. As patients with nmCRPC are largely asymptomatic from their disease (with the exception of urinary/erectile symptoms), maintaining quality of life becomes a major objective when prescribing pharmacotherapy. Therefore, weighing treatment efficacy against the respective drug safety profile and examining the potential for adverse drug interactions with concomitant medications are important clinical considerations. Oncology nurses educate patients on potential treatment‐emergent AEs and their management and serve as advocates to ensure that patients receive optimal care based on their individual therapeutic requirements. They also provide information on available auxiliary services for patients and caregivers. This article provides an overview for the oncology nurse of the efficacy, safety, quality of life and DDI potential of these new AR‐targeted therapies in the nmCRPC setting, highlighting considerations for tailoring patient‐centric treatment to individual need. The importance of the oncology nurse in managing adverse drug reactions associated with ADT and AR inhibitors is highlighted and recommendations provided.
Insulin’s other life: an autoantigen in type 1 diabetes
Authors: Mannering Stuart I , Bhattacharjee Pushpak 
Published: February 2021

AbstractOne hundred years ago, Frederick Banting, John Macleod, Charles Best and James Collip, and their collaborators, discovered insulin. This discovery paved the way to saving countless lives and ushered in the “Insulin Era.” Since the discovery of insulin, we have made enormous strides in understanding its role in metabolism and diabetes. Insulin has played a dramatic role in the treatment of people with diabetes; particularly type 1 diabetes (T1D). Insulin replacement is a life‐saving therapy for people with T1D and some with type 2 diabetes. T1D is an autoimmune disease caused by the T‐cell‐mediated destruction of the pancreatic insulin‐producing beta cells that leads to a primary insulin deficiency. It has become increasingly clear that insulin, and its precursors preproinsulin (PPI) and proinsulin (PI), can play another role—not as a hormone but as an autoantigen in T1D. Here we review the role played by the products of the INS gene as autoantigens in people with T1D. From many elegant animal studies, it is clear that T‐cell responses to insulin, PPI and PI are essential for T1D to develop. Here we review the evidence that autoimmune responses to insulin and PPI arise in people with T1D and discuss the recently described neoepitopes derived from the products of the insulin gene. Finally, we look forward to new approaches to deliver epitopes derived from PPI, PI and insulin that may allow immune tolerance to pancreatic beta cells to be restored in people with, or at risk of, T1D.
Stressed parents, happy parents. An assessment of parenting stress and family quality of life in families with a child with Phelan‐McDermid syndrome
Authors: Droogmans Gilles , Vergaelen Elfi , Van Buggenhout Griet , Swillen Ann 
Published: February 2021

AbstractBackgroundIndividuals with Phelan–McDermid syndrome (PMS) are characterised by phenotypical traits that can be experienced as challenging by their environment. This study assessed parenting stress and Family Quality of Life (FQOL) in parents of individuals with PMS and identified potential contributing variables.MethodMothers (n = 14) and fathers (n = 13) of individuals with PMS (n = 14; 6 females, 8 males; age 2–37, M = 20, SD = 11.92) completed questionnaires on parenting stress, FQOL, adaptive behaviour and background characteristics.ResultsMothers and fathers experienced high, similar and related levels of parenting stress and FQOL satisfaction. Parenting stress and FQOL satisfaction were inversely related. High and low ratings were retrieved for subscales measuring feelings of parental role restriction and emotional well‐being, respectively. The adaptive skills of the individuals with PMS were related to fathers’ parenting stress and FQOL satisfaction.ConclusionsClinical practice is encouraged to be attentive to family dynamics and grasp opportunities to interact with these dynamics.
Peri‐implant radiographic bone level and associated factors in Spain
Authors: Carral Cristina , Flores‐Guillén Juan , Figuero Elena , Rodrigo Daniel , Sanz‐Sánchez Ignacio , Llodra Juan Carlos , Bravo Manuel , Caffesse Raul G. , Vallcorba Nuria , Guerrero Adrián , Bujaldón Antonio , Herrera David 
Published: February 2021

AbstractObjectivesTo evaluate radiographic bone level (RxBL) at dental implants and its associated factors in Spain.Material and methodsThis cross‐sectional study was performed by a network of sentinel dentists from regions of Spain. RxBL was defined as the distance from the implant shoulder to the first clearly visible contact between the implant surface and the bone. Radiographic measurements were performed by two trained and experienced periodontists. Implant and patient data were also collected. Descriptive, bivariate, discriminative and multivariate analyses were done.ResultsA total of 49 sentinel dentists provided data 275 patients. Mean RxBL from 474 implants (5–13 years) was 1.87 mm (range: 0.00–13.17 mm). Statistically significant associations between RxBL and clinical output variables (bleeding on probing, oedema, plaque, probing depth, suppuration, keratinized tissue) were found. In the multiple regression analysis, statistically significant associations for RxBL were found for smoking habit, implant diameter, years of follow‐up and type of prosthesis (p < 0.01).ConclusionsPeri‐implant RxBL ranged from 0 to 13.17 mm. It was significantly associated with clinical output variables and with some potentially predictor variables, at patient‐ (smoking >10 cigarettes/day) and implant‐ (diameter, years of follow‐up, Toronto bridge) levels.
Assessment of hypoxia avoidance behaviours in a eurythermal fish at two temperatures using a modified shuttlebox system
Authors: Ern Rasmus , Esbaugh Andrew J. 
Published: February 2021

AbstractBehavioural avoidance responses of red drum (Sciaenops ocellatus) to aquatic hypoxia were investigated at 22 and 30°C using a modified shuttlebox system. Fish movement between a control side maintained at normoxia and a hypoxic side with stepwise decreasing water oxygen tension was analysed for entries into the hypoxic side, residence time per entry into the hypoxic side and total time in the hypoxic side. Acclimation to 30°C increased the oxygen threshold for the onset of hypoxia avoidance behaviours for entries and total time, while residence time per entry was unchanged.
Development and evaluation of colloidal gold immunochromatography test strip for rapid diagnosis of nervous necrosis virus in golden grey mullet (Chelon aurata)
Authors: Hassantabar Fatemeh , Zorriehzahra Mohammad J. , Firouzbakhsh Farid , Thompson Kim D. 
Published: February 2021

AbstractA lateral flow immunochromatography strip test, based on antibody–gold nanoparticles specific for nervous necrosis virus (NNV), was developed for rapid, on‐site detection of the virus in fish stocks. A monoclonal antibody against NNV was conjugated with colloidal gold as the detector antibody. A rabbit anti‐NNV polyclonal antibody and goat anti‐mouse IgG antibody were blotted onto the nitrocellulose membrane as the capture antibodies on the test line and control line, respectively. The reaction could be seen by the eye within 15 min and did not cross‐react with the other viruses tested. The detection limit of the strip was approximately 103 TCID50/ml and had good stability after storage at 4°C for 8 months. When brains of 70 naturally infected golden grey mullet, Chelon aurata, were tested with the strip test, the diagnostic specificity and sensitivity of the test compared to real‐time RT‐PCR were 100% and 74%, respectively. Therefore, the one‐step test strip developed here had high specificity, reproducibility, and stability. This, together with its simplicity to use and rapid detection, without the requirement of sophisticated equipment or specialized skills, makes the strip suitable for pond‐side detection of NNV in farmed fish.
Government Bailout Funds: Balancing Rules and Discretion
Authors: GRADSTEIN MARK 
Published: February 2021

AbstractThis paper studies government bailout design in the face of economic failures by multiple firms, with ensuing threats to economic stability. Assuming that a commitment to a bailout magnitude is possible, yet cannot be made contingent on unforeseen circumstances, it is argued that the optimal policy consists of stipulating a bailout fund whose upper limit cannot be exceeded. Such an equilibrium policy provides a balance between flexibility to adjust to future circumstances and restraint of moral hazard incentive faced by the firms. An extension to the baseline model considers the case where corporate interests, divergent from those of the public, play a role, and the cap on bailout spending matters for the bargaining outcome between those interests.
Monetary Policy and Reaching for Income
Authors: DANIEL KENT , GARLAPPI LORENZO , XIAO KAIRONG 
Published: February 2021

ABSTRACTUsing data on individual portfolio holdings and on mutual fund flows, we find that low interest rates lead to significantly higher demand for income‐generating assets such as high‐dividend stocks and high‐yield bonds. We argue that this “reaching‐for‐income” phenomenon is driven by investors who follow the “living off income” rule‐of‐thumb. Our empirical analysis shows that this preference for current income affects both household portfolio choices and the prices of income‐generating assets. In addition, we explore the implications of reaching for income for capital allocation and the effectiveness of monetary policy.
Different forms of bystander cardiopulmonary resuscitation in out‐of‐hospital cardiac arrest
Authors: Riva G. , Hollenberg J. 
Published: February 2021

AbstractOut‐of‐hospital cardiac arrest (OHCA) is a major cause of death in the Western world with an estimated number of 275 000 treated with resuscitation attempts by the Emergency Medical Services (EMS) in Europe each year. Overall survival rates remain low, and most studies indicate that around 1 out 10 will survive to 30 days. Amongst the strongest factors associated with survival in OHCA is first recorded rhythm amendable to defibrillation, early defibrillation and prompt initiation of cardiopulmonary resuscitation (CPR). Overall, CPR started prior to EMS arrival has repeatedly been shown to be associated with survival rates 2–3 times higher compared with no such initiation. The primary goal of CPR is to generate sufficient blood flow to vital organs, mainly the brain and heart, until restoration of spontaneous circulation can be achieved. Barriers to the initiation of CPR by bystanders in OHCA include fear of being incapable, causing harm, and transmission of infectious diseases. Partly due to these barriers, and low rates of CPR, the concept of CPR with compression only was proposed as a simpler form of resuscitation with the aim to be more widely accepted by the public in the 1990s. But how reliable is the evidence supporting this simpler form of CPR, and are the outcomes after CO‐CPR comparable to standard CPR?
Paediatric appendicitis during the COVID‐19 pandemic
Authors: Sheath Chloe , Abdelrahman Mohamed , MacCormick Andrew , Chan David 
Published: February 2021

AimThe repercussions of the pandemic on patients without COVID‐19 have been well documented. Although there is evidence that adult patients present later with complicated appendicitis, the impact on the paediatric population is unknown. Therefore, the aim of this study was to assess the impact of the COVID‐19 pandemic on the presentation and management of paediatric appendicitis.MethodsData from consecutive paediatric patients admitted with right iliac fossa pain to a teaching hospital from 1 March 2020 until 30 June 2020 (COVID‐19) were compared with patients admitted from 1 March 2019 until 30 June 2019 (control).ResultsOne hundred and seventy‐two patients were admitted with right iliac fossa pain (control = 97, COVID‐19 = 75). Seven patients had a normal diagnostic laparoscopy in the control group compared with none in the COVID‐19 group. The proportion of patients diagnosed with appendicitis was significantly higher during the COVID‐19 pandemic (24% vs. 10%, P = 0.03). They presented later (3 days vs. 1 day, P < 0.01) with higher inflammatory markers (white cell count 15.8 vs. 13.2 × 109 cells per litre, P = 0.02; C‐reactive protein 53 vs. 27 mg/L P = 0.04). The majority of patients underwent surgery within 1 day of admission (94% COVID‐19 vs. 70% control, P = 0.13). Although there was a trend towards a greater proportion of complicated appendicitis (22% vs. 10%, P = 0.6) during COVID‐19, this did not affect outcomes (no morbidity in both groups, length of hospital stay 4 vs. 2.5 days, P = 0.29).ConclusionDespite presenting later during COVID‐19, paediatric patients with appendicitis were treated expediently with good outcomes.
Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?
Authors: Page Denise , Gilroy Melissa , Joseph Ria , van der Meij Barbara 
Published: February 2021

AimHuman milk with fortification, providing additional energy, protein and micronutrients, is considered the optimal form of nutrition for preterm infants as it provides protection against infections and improves outcomes. Mothers' own milk (MOM) is the preferred choice, however in situations where MOM is insufficient or contraindicated; Pasteurised donor human milk (PDHM) is the preferred alternative. This study aimed to identify whether PDHM during neonatal critical care unit (NCCU) admission is associated with discharge nutrition in preterm infants.MethodsA retrospective observational cohort study was conducted over a 12‐month period in 2017. This included all inborn infants admitted to the NCCU with gestational age ≤ 28 weeks or ≤ 1000 g birthweight, who survived until discharge. Multivariate logistic models were used to detect the association between study groups (PDHM vs.No PDHM) and discharge nutrition.ResultsSeventy‐seven infants were included; 35 infants received PDHM during admission. At discharge, infants who received PDHM were significantly more likely to be on infant formula (IF) (86%) than infants who did not receive PDHM (26%). In contrast, infants who did not receive PDHM (No PDHM) were significantly more likely to be receiving MOM exclusively at discharge (74%), than those who did receive PDHM (14%). The odds of an infant being discharged on IF were 16.91 times higher if they received PDHM.ConclusionIn this study, infants born at ≤28 weeks or ≤ 1000 g who received PDHM were more likely to receive IF at NCCU discharge than infants who did not receive PDHM.
Secondary pollen presentation: More than to increase pollen transfer precision
Authors: Xu Yuan‐Qing , Luo Zhong‐Lai , Wang Jia , Pei Nan‐Cai , Zhang Dian‐Xiang 
Published: February 2021

AbstractPollination precision and efficiency have been deemed to be important driving forces in floral evolution. Herkogamy reduction is a main mechanism to increase pollination precision. Secondary pollen presentation (SPP), by which pollen is presented on other floral organs especially pistils, has been widely accepted as a special mechanism to increase pollen transfer precision through spatial reduction of the anther–stigma distance, that is, minimized herkogamy. This overlooks a potential driving force, that is expanding the pollination niche through converting pollen thieves and nectar robbers into effective pollinators. We selected two species as study models with typical pistillate SPP, Pavetta hongkongensis Bremek. (Rubiaceae) and Scaevola taccada (Gaertn.) Roxb. (Goodeniaceae). In both species, two distinct pollinator functional groups were recognized. Short‐tongued bees and flies fed on pollen on stigmas but also stole pollen from anthers and robbed nectar, whereas long‐tongued hawkmoths and butterflies only collected nectar. Emasculation had no influence on long‐tongued pollinators, but significantly decreased the visitation frequency of short‐tongued visitors and fruit set, compared to intact flowers, demonstrating short‐tongued visitors did not effectively pollinate and acted merely as pollen thieves or nectar robbers when SPP was absent. Data from the two plant species clearly indicated pistillate SPP has additional adaptive advantages of converting ineffective visitors into pollinators and consequently widening the pollination niche, which could help plants overcome environmental stochasticity. Our results suggest that multiple selective forces drive the evolution of SPP and the minimization of herkogamy.
Diagnostic accuracy of a point‐of‐care test using voided urine samples for detection of bacteriuria in dogs with signs of lower urinary tract disease
Authors: Grant David C. , Nappier Michael T. , Corrigan Virginia Kiefer 
Published: February 2021

AbstractBackgroundBacterial urine culture is recommended in dogs suspected of having urinary tract infection (UTI), but there is expense and delay in obtaining such results.Hypothesis/ObjectiveTo determine the diagnostic performance of a rapid immunoassay (RIA) dipstick for detection of bacteriuria using voided urine from dogs with clinical signs of lower UTI.AnimalsTwenty‐four client‐owned dogs.MethodsVoided urine was collected and the RIA performed within 30 minutes. Urine collected by cystocentesis was submitted for aerobic urine culture. McNemar's test and kappa coefficient were calculated to determine agreement between the 2 tests.ResultsNine of 21 dogs (43%) had UTI verified by aerobic urine culture. There was 1 false‐negative and no false‐positive RIA results. Sensitivity, specificity, positive predictive value, and negative predictive value of the RIA were 89%, 100%, 100%, and 92%, respectively.Conclusions and Clinical ImportanceThis RIA is promising for correctly identifying whether or not voided urine samples from dogs with lower urinary tract clinical signs have true bacteriuria in a rapid, inexpensive manner. Additional patients should be enrolled in a similar study to determine if diagnostic performance is robust in a large population.
Hypercoagulability in dogs with chronic enteropathy and association with serum albumin concentration
Authors: Dixon Amy , Hall Edward J. , Adamantos Sophie , Kathrani Aarti , McGrath Ciara , Black Vicki 
Published: February 2021

AbstractBackgroundDogs with protein‐losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown.HypothesisDogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration.MethodsDogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty‐eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α‐angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval.ResultsSeventeen of 38 (44.7%; 95% confidence interval [CI], 28.6‐61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm2; 95% CI, 7.26‐10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm2; 95% CI, 9.04‐13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age.Conclusions and Clinical ImportanceDogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.
Skeptical self‐regulation: Resident experiences of uncertainty about uncertainty
Authors: Ilgen Jonathan S. , Regehr Glenn , Teunissen Pim W. , Sherbino Jonathan , de Bruin Anique B. H. 
Published: February 2021

AbstractObjectivesManaging uncertainty is central to expert practice, yet how novice trainees navigate these moments is likely different than what has been described by experienced clinicians. Exploring trainees’ experiences with uncertainty could therefore help explicate the unique cues that they attend to, how they appraise their comfort in these moments and how they enact responses within the affordances of their training environment.MethodsInformed by constructivist grounded theory, we explored how novice emergency medicine trainees experienced and managed clinical uncertainty in practice. We used a critical incident technique to prompt participants to reflect on experiences with uncertainty immediately following a clinical shift, exploring the cues they attended to and the approaches they used to navigate these moments. Two investigators coded line‐by‐line using constant comparison, organising the data into focused codes. The research team discussed the relationships between these codes and developed a set of themes that supported our efforts to theorise about the phenomenon.ResultsWe enrolled 13 trainees in their first two years of postgraduate training across two institutions. They expressed uncertainty about the root causes of the patient problems they were facing and the potential management steps to take, but also expressed a pervasive sense of uncertainty about their own abilities and their appraisals of the situation. This, in turn, led to challenges with selecting, interpreting and using the cues in their environment effectively. Participants invoked several approaches to combat this sense of uncertainty about themselves, rehearsing steps before a clinical encounter, checking their interpretations with others and implicitly calibrating their appraisals to those of more experienced team members.ConclusionsTrainees’ struggles with the legitimacy of their interpretations impact their experiences with uncertainty. Recognising these ongoing struggles may enable supervisors and other team members to provide more effective scaffolding, validation and calibration of clinical judgments and patient management.