bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Nurses whisper.’ Identities in nurses’ patient safety narratives of nurse‐trainee doctors’ interactions
Authors: Samuriwo Ray , Bullock Alison , Webb Katie , Monrouxe Lynn V. 
Published: June 2021

AbstractContextNurses are integral to patient safety, but little is known about their narrative constructions of identity in relation to their dyadic interactions with trainee doctors about patient safety and competence during the trajectory of a medical career.AimWe sought to examine how identities are constructed by experienced nurses in their narratives of patient safety encounters with trainee doctors.MethodsOur qualitative study gathered narrative data through semi‐structured interviews with nurses of different professional standing (n = 20). Purposive sampling was used to recruit the first eight participants, with the remainder recruited through theoretical sampling. Audio recordings were transcribed verbatim and analysed inductively through a social constructionist framework and deductively using a competence framework.ResultsWe classified seven identities that participants constructed in their narratives of dyadic interactions with trainee doctors in relation to patient safety: nurses as teacher, guardian of patient wellbeing, provider of emotional support, provider of general support, expert advisor, navigator and team player. These identities related to the two key roles of nurses as educators and as practitioners. As they narrated these dyadic interactions, participants constructed identities that positioned trainee doctors in character tropes, suggesting gaps in professional competence: nurses as provider of general support was commonly narrated in the context of perceived deficits of personal or functional capabilities and nurses as team player was mainly associated with concerns (or reassurances) around ethical capabilities.Discussion and ConclusionOur findings are consistent with, and extend the wider literature on the development of professional competence, interprofessional collaboration in health care, and the nature and organisation of nursing work. Nurses' work in ensuring patient safety and support trainee doctors’ professional development merits greater formal recognition and legitimation.
Neurodegenerative disorders affecting the autonomic nervous system: Pure autonomic failure and multiple system atrophy
Authors: Yamanaka Yoshitaka , Araki Nobuyuki , Kuwabara Satoshi 
Published: June 2021

AbstractPure autonomic failure (PAF) and multiple system atrophy (MSA) are representative neurodegerative diseases present with a severe autonomic dysfunction in the urinary, cardiovascular, and pupillary systems, as well as the gastrointestinal tract and skin/sweat glands. Clinically PAF is characterized by chronic progressive pure autonomic dysfunction occasionally associated with parkinsonism or cognitive dysfunction (Lewy body disease), whereas MSA is associated with cerebellar manifestation and/or parkinsonism. Pathology of both PAF and MSA is characterized by α‐synuclein deposition, but in PAF major involvement exists in the sympathetic ganglion and postganglionic autonomic nerve fibers, whereas MSA mainly affects the central autonomic system, such as the vagal nerve lateral nucleus, locus coeruleus, spinal cord medial lateral nucleus, and sacral Onuf's nucleus. Therefore, it is necessary to evaluate whether peripheral or central autonomic function is predominantly affected by the differential diagnosis of PAF and MSA. Autonomic dysfunction is also frequently present in patients with Parkinson's disease, but usually not so severe as in PAF or MSA. This review summarizes features of autonomic dysfunction in PAF and MSA.
Alterations in the CO2 availability induce alterations in the phosphoproteome of the cyanobacterium Synechocystis sp. PCC 6803
Authors: Spät Philipp , Barske Thomas , Maček Boris , Hagemann Martin 
Published: June 2021

Summary

Cyanobacteria are the only prokaryotes that perform plant‐like oxygenic photosynthesis. They evolved an inorganic carbon‐concentrating mechanism to adapt to low CO2 conditions.

Quantitative phosphoproteomics was applied to analyze regulatory features during the acclimation to low CO2 conditions in the model cyanobacterium Synechocystis sp. PCC 6803.

Overall, more than 2500 proteins were quantified, equivalent to c. 70% of the Synechocystis theoretical proteome. Proteins with changing abundances correlated largely with mRNA expression levels. Functional annotation of the noncorrelating proteins revealed an enrichment of key metabolic processes fundamental for maintaining cellular homeostasis. Furthermore, 105 phosphoproteins harboring over 200 site‐specific phosphorylation events were identified. Subunits of the bicarbonate transporter BCT1 and the redox switch protein CP12 were among phosphoproteins with reduced phosphorylation levels at lower CO2, whereas the serine/threonine protein kinase SpkC revealed increased phosphorylation levels. The corresponding ΔspkC mutant was characterized and showed decreased ability to acclimate to low CO2 conditions. Possible phosphorylation targets of SpkC including a BCT1 subunit were identified by phosphoproteomics.

Collectively, our study highlights the importance of posttranscriptional regulation of protein abundances as well as posttranslational regulation by protein phosphorylation for the successful acclimation towards low CO2 conditions in Synechocystis and possibly among cyanobacteria.
Can patients’ narratives in nursing enhance the healing process?
Authors: Damsgaard Janne Brammer , Simonÿ Charlotte , Missel Malene , Beck Malene , Birkelund Regner 
Published: June 2021

AbstractAlthough there is a growing acknowledgement of the potential of a more nuanced healthcare paradigm and practice, the discourses of health promotion—and with that nursing and other healthcare professionals’ practice—still tend to focus on the medical diagnosis, disease and the rationale of biomedicine. There is a need for shifting to a human practice that draws on a broader perspective related to illness. This requires a transformation of practices which can be constructed within a narrative understanding. A narrative approach appreciates the importance of emotion and intersubjective relation in the telling and listening that occur in the clinical encounter. The essence of nursing lies in the creative imagination, the sensitive spirit and the intelligent understanding of the individuals’ possibilities of becoming empowered in his or her own life. This entails that the focus of the use of patients’ narratives is, ultimately, not the story itself, but the nurses’ and other healthcare professionals’ ability to support the patients in finding useful meaning in their stories. Herein, it is of particular importance to let the patients narrate about what is sparkling moments or events in the lived life. Stories with such focus can open up for patients’ hopes and dreams, which gives inspiration for finding meaningful ways to cope in life empowering personal recovery. It is, therefore, crucial to transform clinical settings into places that acknowledge the need for imagination and creativity, aiming at creating the opportunity for sensibility and vision essential to encouraging a narrative approach and thereby the ability to reflect upon and promote a healing process.
Pharmacologic neuroprotection in ischemic brain injury after cardiac arrest
Authors: Katz Alyson , Brosnahan Shari B. , Papadopoulos John , Parnia Sam , Lam Jason Q. 
Published: June 2021

AbstractCardiac arrest has many implications for morbidity and mortality. Few interventions have been shown to improve return of spontaneous circulation (ROSC) and long‐term outcomes after cardiac arrest. Ischemic‐reperfusion injury upon achieving ROSC creates an imbalance between oxygen supply and demand. Multiple events occur in the postcardiac arrest period, including excitotoxicity, mitochondrial dysfunction, and oxidative stress and inflammation, all of which contribute to ongoing brain injury and cellular death. Given that complex pathophysiology underlies global brain hypoxic ischemia, neuroprotective strategies targeting multiple stages of the neuropathologic cascade should be considered as a means of mitigating secondary neuronal injury and improving neurologic outcomes and survival in cardiac arrest victims. In this review article, we discuss a number of different pharmacologic agents that may have a potential role in targeting these injurious pathways following cardiac arrest. Pharmacologic therapies most relevant for discussion currently include memantine, perampanel, magnesium, propofol, thiamine, methylene blue, vitamin C, vitamin E, coenzyme Q10, minocycline, steroids, and aspirin.
Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema
Authors: Gustin Jennifer , Bohman Lisa , Ogle Julie , Fadayel Gina , Mitchell Maria C. , Narendran Vivek , Visscher Marty O. , Carr Andrew N. 
Published: June 2021

AbstractBackground/ObjectiveNewborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen consisting of a diaper with an emollient and apertures on the inner liner (topsheet) with an acidic, pH‐buffered wipe (Regimen A) lowered newborn skin pH and reduced the enzymatic activity on skin post‐stool cleaning versus a regimen without these features (Regimen B). This study extends these findings to determine the impact of Regimen A on diaper area erythema severity over a 2‐week use period.MethodsThis IRB‐approved, blinded, randomized, crossover study enrolled newborn infants >7 days and ≤8 weeks. Participants exclusively used two unique diaper and wipe combinations, Regimen A and Regimen B (non‐emollient, non‐aperture containing topsheet and wipe with limited buffering capacity), each for 14 days and preceded by a 3‐day washout regimen.ResultsDiapered skin pH was reduced during Regimen A use to values similar to that of a non‐diapered control site (chest), while use of Regimen B was associated with a more alkaline skin pH. Regimen A resulted in significantly fewer severe erythema episodes. At the site of highest erythema, the perianal space, the average erythema score was significantly lower and more newborns were free of erythema while using Regimen A vs. Regimen B (P < .05).ConclusionsThese findings demonstrate that diapering products can have a significant impact on newborn skin. They reinforce the need to support the physiological normalization of skin pH and protection from skin irritation and damage.
Vaccines: Considerations for pediatric dermatology patients on immunosuppressive agents
Authors: Munshi Mumtaz A. , Noe Megan H. , Chiu Yvonne E. , Streicher Jenna L. 
Published: June 2021

AbstractPediatric dermatologists should be aware of immunization schedules and special recommendations for patients on immunosuppressive agents due to the increased risk of vaccine‐preventable infections. Prior to initiating immunosuppressive therapy, pediatric dermatologists should review a vaccine history and administer any necessary age‐appropriate or catch‐up vaccines. Live vaccines are typically contraindicated while on immunosuppressive therapy, while inactivated vaccines are generally safe to administer.
Mycobacteriumabscessus infection in a patient with ornithine transcarbamylase deficiency and liver transplant
Authors: Li Yumeng M. , Desai Karishma , Saad Ali G. , Galimberti Fabrizio V. 
Published: June 2021

AbstractRapidly growing mycobacteria, including Mycobacterium abscessus, have become a common cause of post‐procedural infections and are notoriously difficult to diagnose and treat. Here, we report a 10‐month‐old male status post‐orthotopic liver transplantation due to ornithine transcarbamylase deficiency who presented with a 4‐month history of hypertrophic and friable granulation tissue of surgical wounds refractory to treatment with broad spectrum antibiotics and surgical debridement. Skin biopsy and tissue culture yielded a diagnosis of M abscessus infection that demonstrated excellent clinical response to appropriate antibiotic and surgical treatment.
Factors influencing school re‐entry among adolescents in Kenya
Authors: Henzan Hanae , Takeuchi Rie , Njenga Sammy M. , Gregorio Ernesto R. , Ichinose Yoshio , Nonaka Daisuke , Kobayashi Jun 
Published: June 2021

AbstractBackgroundThe number of out‐of‐school children and adolescents has been increasing globally. In sub‐Saharan Africa, an estimated 23 million adolescents leave school due to poverty, teenage pregnancy, and unspecified illnesses. The reasons for absenteeism are well‐known but the factors involved in the decision to return to school have not been analyzed. This study aimed to identify the factors that promote primary school re‐entry among chronic adolescent absentees in rural sub‐Saharan Africa.MethodsQualitative data were gathered through participant observation, in‐depth interviews, and focus group discussions involving nine pupils who returned to school after chronic absenteeism and 140 adult stakeholders in Mbita sub‐county, Kenya. Data were analyzed using thematic analysis.ResultsThe thematic analysis results showed that four factors promoted school re‐entry, namely: (1) social norms: “school for a better life”; (2) linkage of community and school; (3) supportive environment; and (4) using discipline to make adolescents serious about their education.ConclusionsSchool re‐entry among chronic absentees in Mbita sub‐county is promoted by both community and school factors. It was observed that social norms regarded an education as a “passport to a better life.” Adolescents, teachers, and community leaders view education as a means of improving one’s socio‐economic status. Two essential elements of health‐promoting schools, a supportive environment and a linkage with community, effectively promoted returning to the school among adolescents. The introduction of health‐promoting schools was recommended to implement a school re‐entry policy in Kenya effectively.
Multi‐laboratory study of hybrid diffuse reflectance spectroscopy to assess sunscreen SPF and UVA‐PFs
Authors: Ruvolo Eduardo , Rohr Mathias , Oliveira Sergio , Nogueira Luciano , Carvalho José , Cole Curtis 
Published: June 2021

AbstractBackgroundProof‐of‐principle studies have established the use of Hybrid Diffuse Reflectance Spectroscopy (HDRS) methods to assess both Ultraviolet‐A Protection Factor (UVA‐PF) and Sun Protection Factor (SPF) indices in individual laboratories.MethodsMultiple laboratories evaluated 23 emulsions and two spray sunscreen products to evaluate repeatability and accuracy of assessment of SPF and UVA‐PF values, using HDRS test systems from various manufacturers using different designs.ResultsAll of the laboratories reported similar SPF and UVA‐PF values within a narrow range of values to establish the reliability of the HDRS methodology across laboratories, independent of equipment manufacturer or operator.ConclusionHDRS test methodology provides a reliable objective instrumental estimation of sunscreen SPF and UVA‐PF. These data were provided to ISO‐TC217 WG7 to substantiate the ongoing development of an ISO Standard HDRS Method.
Maternal periconceptional folic acid supplements use and fetus risk for limb defects
Authors: Zhang Jie , Jin Lei , Wang Di , Wang Cheng , Tong Mingkun , Yu Jinhui , Meng Wenying , Ren Aiguo , Jin Lei 
Published: June 2021

AbstractBackgroundAssociations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent.ObjectiveTo explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies.MethodsData were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Information on maternal periconceptional FAO and MMFA supplementation was collected via face‐to‐face interviews at first trimester. Pregnancy outcomes including limb defects were ascertained in livebirths, stillbirths, and elective pregnancy terminations and were recorded into the system. Propensity score methods were used to adjust for potential confounders.ResultsA total of 63 969 women with a singleton delivery were included. The overall prevalence of limb defects was 47.5 per 10 000 (n = 63 969) singleton deliveries. Decreased prevalence of limb defects was found among FAO/MMFA users compared with women who did not take supplements (nonusers) (46.1 vs. 61.9 per 10 000 births, adjusted risk ratio [RR] 0.80, 95% confidence interval [CI] 0.56, 1.12). Compared with nonusers (n = 6462, 10.2%), women who took either FAO (n = 26 567, 42.0%) or MMFA (n = 30 259, 47.8%) had a lower risk for total clubfoot (RR 0.40, 95% CI 0.20, 0.84), and for isolated clubfoot (RR 0.41, 95% CI 0.17, 0.97). For other limb defects except clubfoot, FAO supplementation did not appear to be associated with reduced risk, while MMFA supplementation group had 30%‐50% reduced risks for other limb defects. A lower risk for limb defects or isolated limb defects was found with MMFA supplementation when FAO supplementation was used as a control.ConclusionsMaternal periconceptional supplements with either FAO or MMFA had inverse association with clubfoot in offspring, and MMFA was associated with lower risk for isolated limb defects compared with FAO.
Apathy and executive functioning among non‐demented community‐dwelling elderly individuals in an everyday environment: the mediating effect of impulsivity
Authors: Cuvillier Cécilia , Bayard Sophie 
Published: June 2021

BackgroundApathy is common in normal ageing and widely recognized as a predictor of cognitive decline, especially in executive functions. Much less characterized than apathy in the elderly is impulsivity, which increases with ageing. It is also frequently described in comorbidity with apathy in various clinical populations, in whom it is associated with poorer executive functioning. In the present study, by capitalizing on a multidimensional approach, we explore the mediating role of facets of impulsivity on the bidirectional relationships between apathy dimensions and executive functioning in non‐demented community‐dwelling elderly individuals in daily life.MethodsA sample of non‐demented community‐dwelling older adults (n = 101) completed self‐rated questionnaires. Apathy was measured by the Apathy Evaluation Scale; impulsivity was examined through the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency (UPPS‐P) Impulsive Behaviour Scale; and executive functioning in daily life was assessed by the Behaviour Rating Inventory of Executive Function‐Adult (BRIEF‐A). Two models positing mediation were tested using conditional process modelling.ResultsHierarchical regressions controlling for depressive symptoms indicated that the cognitive apathy dimension was associated with the UPPS‐P facets sensation seeking, lack of perseverance, and premeditation. Among the UPPS‐P facets, lack of perseverance and negative urgency were found to contribute significantly to BRIEF‐A Metacognitive index variance. Finally, in both models, lack of perseverance was found to totally mediate the relationship between cognitive apathy and the BRIEF‐A Metacognitive index.ConclusionsThese preliminary findings suggest that, in normal ageing, apathy may share an overlap with impulsivity, contradicting the notion they represent opposite ends of a single behavioural spectrum. Our results argue for bidirectional relationship between a specific apathy dimension (i.e. cognitive apathy) and executive functioning. Moreover, they shed new light on the underlying psychological process implicated (i.e. lack of perseverance) among older adults without dementia and represent an interesting prospect for psychological interventions.
Unusual intraclast conglomerates in a stormy, hot‐house lake: The Early Triassic North China Basin
Authors: Ji Kaixuan , Wignall Paul B. , Peakall Jeff , Tong Jinnan , Chu Daoliang , Pruss Sara B. 
Published: June 2021

AbstractEarly Triassic temperatures were some of the hottest of the Phanerozoic, sea‐surface temperatures approached 40°C, with profound consequences for both the sedimentology and faunal distributions in the oceans. However, the impact of these temperatures in terrestrial settings is unclear. This study examines shallow lacustrine sediments from the Lower Triassic succession of North China. These consist of diverse fluvial to shallow lacustrine sandstones and also spectacular, coarse conglomerates composed of diverse, intraformational clasts reworked from the interbedded sediments. The conglomerate beds can show inverse grading and high angle, flat‐pebble imbrication in their lower part and vertically orientated flat pebbles in their upper part. The cobbles include cemented and reworked conglomerate intraclasts and sandstone concentrically‐laminated concretions that record multi‐step histories of growth and reworking, pointing to rapid cementation of the sandy lake bed (likely facilitated by high temperatures). The conglomerates record frequent, high‐energy events that were capable of brecciating a lithified lake bed and transporting cobbles in wave‐influenced sediment‐gravity flows. Initially, powerful oscillatory flows brecciated and deflated the lake bed and subsequently helped to sustain turbulence during short‐distance lateral flow. It is possible that hurricanes, originating from the adjacent hyper‐warm, Palaeo‐Tethyan Ocean travelled into the major lakes of the North China continent during the Early Triassic.
Conceptualizing death: How do suicidal adolescents view the end of their lives?
Authors: Tezanos Katherine M. , Pollak Olivia H. , Cha Christine B. 
Published: June 2021

AbstractObjectiveAdolescence marks an important time to detect suicide risk, as suicidal ideation often emerges during this developmental period. Death‐themed cognitions represent a promising domain of risk factors for suicidal ideation, but they have been understudied among adolescents. To address this knowledge gap, the present study examines the association between adolescents’ attitudes and beliefs about death, hereafter referred to as death conceptualizations, and suicidal ideation.MethodsSeventy‐four adolescents (12–19 years) completed a self‐report measure assessing three types of death conceptualizations: Death Avoidance (i.e., suppression of death‐related thoughts), Neutral Acceptance (i.e., belief that death is a natural part of life), and Escape Acceptance (i.e., belief that death is a viable escape from pain). Suicidal ideation was assessed at baseline, as well as 3 and 6 months later.ResultsAt baseline, suicidal adolescents endorsed higher Escape Acceptance and lower Death Avoidance. Suicidal and nonsuicidal adolescents did not differ in their degree of Neutral Acceptance. Death conceptualizations, especially Escape Acceptance, also predicted future suicidal ideation.ConclusionsInitial findings suggest that suicidal adolescents are more likely to believe that death is a viable escape from pain and that this death‐related cognition is a risk factor for suicidal ideation.