bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies used to facilitate the discussion of advance care planning with older adults in primary care settings: A literature review
Authors: Solis Guillermina R. , Mancera Bibiana M. , Shen Megan Johnson 
Published: May 2018

Background and purpose:
The purpose of this literature review was to evaluate strategies used in primary care settings to initiate advance care planning (ACP) conversations leading to the completion of an advance directive (AD). Approximately 50% of older adults have an AD; few talk to their primary care provider (PCP) about end-of-life wishes. The Institute of Medicine report and recent changes in Medicare reimbursement policies create opportunities for PCPs to address ACP in primary care settings.

Methods:
We used a systematic review approach. The search included seven Elton B. Stephens Company databases, limited to English language and peer-reviewed publications from 1991 to 2017 using 10 key words.

Conclusions.
Effective interventions were educational materials using various methods of delivery, computer-generated triggers for PCPs, inclusion of multidisciplinary professionals for content delivery, and patient preparation for PCP visit.

Implications for practice:
The identified strategies provide a starting point for PCPs to consider increasing the ACP discussion with their patients. Primary care providers must create opportunities to meet the needs of their patients and their families. Established guidelines and reimbursement for ACP challenge PCPs to identify and contribute to the formulation of best practices to facilitate AD completion in primary care settings.
Removing restrictions on nurse practitioners' scope of practice in New York State: Physicians' and nurse practitioners' perspectives
Authors: Poghosyan Lusine , Norful Allison A. , Laugesen Miriam J. 
Published: May 2018

ABSTRACT

Background and purpose:
In 2015, New York State adopted the Nurse Practitioners Modernization Act to remove required written practice agreements between physicians and nurse practitioners (NPs) with at least 3,600 hours of practice experience. We assessed the perspectives of physicians and NPs on the barriers and facilitators of policy implementation.

Methods:
Qualitative descriptive design and individual face-to-face interviews were used to collect data from physicians and NPs. One researcher conducted interviews, which were audio-taped and transcribed. Twenty-six participants were interviewed. Two researchers analyzed the data.

Results:
The new law has not yet changed NP practice. Almost all experienced NPs had written practice agreements. Outdated organizational bylaws, administrators' and physicians' lack of awareness of NP competencies, and physician resistance and lack of knowledge of the law were barriers. Collegial relationships between NPs and physicians and positive perceptions of the law facilitated policy implementation.

Conclusions:
Policy makers and administrators should make efforts to remove barriers and promote facilitators to assure the law achieves its maximum impact.

Implications for practices:
Efforts should be undertaken to implement the law in each organization by engaging leadership, increasing awareness about the positive impact of the law and NP independence, and promoting relationships between NPs and physicians.
Results of a national survey of certified nurse coaches with implications for advanced practice nurses
Authors: Ross Alyson , Brooks Alyssa Todaro , Yang Li , Touchton-Leonard Kate , Raju Shravya , Bevans Margaret 
Published: May 2018

ABSTRACT

Background and purpose:
Evidence suggests that nurse-coaching can improve health outcomes, but application of this skill is not well understood. The purpose of this study is to describe the practices of nurse coaches including their work settings, clients/health conditions, motivations behind becoming certified as coaches, and the personal benefits experienced by nurse coaches.

Methods:
A cross-sectional online survey was emailed to certified nurse coaches (n = 315); 164 completed the survey, including 68 (41.5%) advanced practice nurses.

Conclusions:
The most frequent conditions seen by coaches included the following: anxiety/stress (n = 39, 27.1%), cardiometabolic conditions (n = 24, 16.7%), and pain (n = 20, 13.9%). Coaching varied in frequency, method (individual versus group), and mode (in-person, by phone, or electronically). Participants became coaches to gain skills for enhancing their practice, deliver care that fits with their values and philosophy, meet personal needs (starting a private practice and improve their own self-care), attain credentials/validation, and empower others. The majority agreed/strongly agreed that since becoming a nurse coach, their own interpersonal relationships (80.3%), health/health behaviors (84.8%), and job satisfaction (70.7%) improved.

Implications for practice:
Nurse practitioners may be strategically situated to provide coaching and have the knowledge and skills needed to intervene with medically complex, at-risk populations.
Entyvio lengthen dose-interval study: lengthening vedolizumab dose interval and the risk of clinical relapse in inflammatory bowel disease
Authors: Chan Webber , Lynch Nicole , Bampton Peter , Chang Jeff , Chung Alvin , Florin Timothy , Hetzel David J. , Jakobovits Simon , Moore Gregory , Pavli Paul , Radford-Smith Graham , Thin Lena , Baraty Brandon , Haifer Craig , Yau Yunki , Leong Rupert W.L. 
Published: May 2018

Background
Vedolizumab (VDZ), an α4β7 anti-integrin antibody, is efficacious in the induction and maintenance of remission in ulcerative colitis (UC) and Crohn’s disease (CD). In the GEMINI long-term safety study, enrolled patients received 4-weekly VDZ. Upon completion, patients were switched to 8-weekly VDZ in Australia. The clinical success rate of treatment de-escalation for patients in remission on VDZ has not been described previously.

Aim
To determine the proportion of patients who relapsed after switching from 4 to 8-weekly VDZ, the mean time to relapse, and the recapture rate when switching back to 8-weekly dosing.

Materials and methods
This was a retrospective, observational, multicenter study of patients previously recruited into GEMINI long-term safety in Australia. Data on the demographics and biochemical findings were collected.

Results
There were 34 patients [23 men, mean age 49.1 (±13.1) years] and their mean disease duration was 17.6 (±8.5) years. The mean 4-weekly VDZ infusion duration was 286.5 (±48.8) weeks. A total of five (15%) patients relapsed on dose-interval increase (4/17 UC, 1/17 CD) at a median duration from dose interval lengthening to flare of 14 weeks (interquartile range=6–25). Eighty percent (4/5) of patients re-entered remission following dose-interval decrease back to 4-weekly. No clinical predictors of relapse could be determined because of the small cohort size.

Conclusion
The risk of patients relapsing when switching from 4 to 8-weekly VDZ ∼15% and is similar between CD and UC. Dose-interval decrease recaptures 80% of patients who relapsed. Therapeutic drug monitoring of VDZ may be of clinical relevance.
Is Adjunctive Progesterone Effective in Reducing Seizure Frequency in Patients With Intractable Catamenial Epilepsy? A Critically Appraised Topic
Authors: Valencia-Sanchez Cristina , Crepeau Amy Z. , Hoerth Matthew T. , Butler Kristina A. , Almader-Douglas Diana , Wingerchuk Dean M. , O’Carroll Cumara B. 
Published: May 2018

Background:
Catamenial epilepsy refers to cyclic seizure exacerbation in relation to the menstrual cycle. Three distinct patterns have been described: C1-perimenstrual, C2-periovulatory, and C3-inadequate luteal. There is experimental and clinical evidence that gonadal steroid hormones affect neuronal excitability with estrogens being mainly proconvulsant and progesterone anticonvulsant. If reproductive steroids have a role in seizure occurrence, they may also have a role in treatment.

Objective:
The objective of this study was to critically assess current evidence regarding the efficacy of progesterone as adjunctive therapy in women with intractable catamenial epilepsy.

Methods:
The objective was addressed through the development of a structured critically appraised topic. This included a clinical scenario with a clinical question, literature search strategy, critical appraisal, results, evidence summary, commentary, and bottom line conclusions. Participants included consultant and resident neurologists, medical librarian, and content experts in the fields of epilepsy and gynecology.

Results:
A randomized, placebo-controlled clinical trial was selected for critical appraisal. This trial compared the efficacy of adjunctive cyclic natural progesterone therapy versus placebo for seizures in women with intractable partial epilepsy, stratified by catamenial and noncatamenial status. There was no significant difference in proportions of responders between progesterone and placebo in the catamenial and noncatamenial strata. Prespecified secondary analysis showed that the level of perimenstrual seizure exacerbation is a significant predictor of the responder rate for progesterone therapy.

Conclusions:
Cyclic natural progesterone is not superior to placebo in reducing seizure frequency in women with intractable partial epilepsy. Posthoc findings suggest that progesterone may benefit a subset of women with perimenstrually exacerbated seizures.
Cost-Effectiveness Analysis of Routine Venous Doppler Ultrasound for Diagnosis of Deep Venous Thrombosis at Admission to Inpatient Rehabilitation
Authors: Pinto Shanti M. , Yassin Mohamed , Galang Gary 
Published: May 2018

ObjectiveThe aims of the study were to identify whether timing of venous thromboembolism diagnosis is associated with differences in patient outcomes and to perform a cost-effectiveness analysis of routine venous Doppler ultrasound at admission to inpatient rehabilitation, taking into account costs associated with prolonged inpatient rehabilitation length of stay, and development of pulmonary embolism.DesignThis was a retrospective cohort study of 2312 consecutive patient discharges from a single inpatient rehabilitation facility for an 18-mo period. Cost-effectiveness model was built using TreeAge Healthcare Pro. The base case was constructed using probabilities and inpatient rehabilitation length of stay identified from retrospective analysis. Cost of Doppler ultrasound was obtained through the literature, and daily inpatient rehabilitation cost was obtained from the study institution.ResultsVenous thromboembolism was diagnosed in 6.6% of patients. Asymptomatic patients diagnosed with venous thromboembolism on screening Doppler ultrasound had shorter inpatient rehabilitation length of stay (P= 0.045) and lower rate of pulmonary embolism (P< 0.001) and acute hospital transfer (P= 0.002) than those diagnosed after clinical symptoms developed. Use of routine Doppler ultrasound at inpatient rehabilitation admission was found to be cost-effective, with a total cost of US $20,265 per admission compared with $20,269 per admission without use of Doppler ultrasound at inpatient rehabilitation admission.ConclusionsRoutine Doppler ultrasound screening for venous thromboembolism at inpatient rehabilitation admission is associated with improved patient outcomes without added cost per admission.
Heart enhancers with deeply conserved regulatory activity are established early in development
Authors: Yuan Xuefei , Song Mengyi , Devine Patrick , Bruneau Benoit G. , Scott Ian C. , Wilson Michael D. 
Published: May 2018

AbstractDuring the phylotypic period embryos from different genera show similar gene expression patterns, implying common regulatory mechanisms. To identify enhancers involved in the initial events of cardiogenesis, which occurs during the phylotypic period, we isolated early cardiac progenitor cells from zebrafish embryos and characterized 3838 open chromatin regions specific to this cell population. Of these regions, 162 overlapped with conserved non-coding elements (CNEs) that also mapped to open chromatin regions in human. Most of the zebrafish conserved open chromatin elements tested drove gene expression in the developing heart. Despite modest sequence identity, human orthologous open chromatin regions could recapitulate the spatial temporal expression patterns of the zebrafish sequence, potentially providing a basis for phylotypic gene expression patterns. Genome-wide, we discovered 5598 zebrafish-human conserved open chromatin regions, suggesting that a diverse repertoire of ancient enhancers is established prior to organogenesis and the phylotypic period.
Yield performance of chromosomally engineered durum wheat-Thinopyrum ponticum recombinant lines in a range of contrasting rain-fed environments across three countries
Authors: Kuzmanović Ljiljana , Ruggeri Roberto , Able Jason A. , Bassi Filippo M. , Maccaferri Marco , Tuberosa Roberto , De Vita Pasquale , Rossini Francesco , Ceoloni Carla 
Published: May 2018

AbstractIntrogressions of Thinopyrum ponticum 7AgL chromosome segments, spanning 23%, 28% and 40% of the distal end of durum wheat 7AL arm, were previously shown to contain multiple beneficial gene(s)/QTL for yield-related traits, in addition to effective disease resistance (Lr19, Sr25) and quality (Yp) genes. In the present study, durum wheat near isogenic recombinant lines (NIRLs), harbouring each of the three introgressions, were included for the first time in multi-location field trials, to evaluate general and environment-specific effects of the alien chromatin on 26 yield-related traits. The results from nine different trials across contrasting environments of Italy, Morocco and South Australia over four years revealed that the overall impact of 7AgL introgressions into the tetraploid wheat background did not imply, except in one environment, major yield penalty. The comprehensive effect of the three 7AgL segments on individual yield-contributing traits, resulted in significant increases of biomass m−2 (+9%), spike number m−2 (+13%), grain number m−2 (+11%) and spikelet−1 (+8%), but also in a general, significant decrease of grain weight (−8%). When the separate NIRLs were analysed, each of the three 7AgL segments turned out to be associated with variation of specific yield components. The effects of the 40%-long segment proved to be the most stably expressed across environments and involved significant increases of spike and grain number m−2 (13% and 15%, respectively), grain number spike−1 (10%) and spike fertility index (46%), though accompanied by a significant decrease in thousand grain weight (−23%). In spite of this trade-off between grain number and grain weight, their interplay was such that in four trials, including dryer environments, a grain yield advantage was observed. This evidence, and comparison with the two other NIRLs, substantiates the hypothesized existence of major gene(s)/QTL for grain number in the most proximal 28-40% 7AgL region, exclusive to the 40%-long 7AgL introgression. The present study represents an important validation of the use of chromosomally engineered genetic stocks for durum wheat improvement, targeting not only disease resistance and quality traits but also relevant yield components.
ESCRT-mediated lysosome repair precedes lysophagy and promotes cell survival
Authors: Radulovic Maja , Bongiovanni Antonino , Schink Kay O. , Nähse Viola , Wenzel Eva M. , Lafont Frank , Stenmark Harald 
Published: May 2018

AbstractAlthough lysosomes perform a number of essential cellular functions, damaged lysosomes represent a potential hazard to the cell. Such lysosomes are therefore engulfed by autophagic membranes in the process known as lysophagy, which is initiated by recognition of luminal glycoprotein domains by cytosolic lectins such as Galectin-3. Here we show that, under various conditions that cause injury to the lysosome membrane, components of the endosomal sorting complex required for transport (ESCRT) machinery are recruited. This recruitment occurs before that of Galectin-3 and the lysophagy machinery. Subunits of the ESCRT-III complex show a particularly prominent recruitment, which depends on the ESCRT-I component TSG101 and the TSG101- and ESCRT-III-binding protein ALIX. Interference with ESCRT recruitment abolishes lysosome repair and causes otherwise reversible lysosome damage to become cell lethal. Vacuoles containing the intracellular pathogenCoxiella burnetiishow reversible ESCRT recruitment, and interference with this recruitment reduces intravacuolar bacterial replication. We conclude that the cell is equipped with an endogenous mechanism for lysosome repair which protects against lysosomal damage-induced cell death but which also provides a potential advantage for intracellular pathogens.
Geographic variation in adult and embryonic desiccation tolerance in a terrestrial-breeding frog
Authors: Rudin-Bitterli T.S. , Evans J.P. , Mitchell N.J. 
Published: May 2018

ABSTRACTIntra-specific variation in the ability of individuals to tolerate environmental perturbations is often neglected when considering the impacts of climate change. Yet this information is potentially crucial for mitigating any deleterious effects of climate change on threatened species. Here we assessed patterns of intra-specific variation in desiccation tolerance in the frogPseudophryne guentheri, a terrestrial-breeding species experiencing a drying climate. Adult frogs were collected from six populations across a rainfall gradient and their dehydration and rehydration rates were assessed. We also compared desiccation tolerance of embryos and hatchlings originating from within-population parental crosses from four of the six populations, where selection on desiccation tolerance should be especially strong given that embryos cannot move to escape unfavourable microclimates. Embryos were reared on soil at three soil-water potentials, ranging from wet to dry (ψ = −10, −100 & −400 kPa), and their desiccation tolerance was assessed across a range of traits including survival, time to hatch after inundation, wet mass at hatching, hatchling malformations and swimming performance. We found significant and strong patterns of intra-specific variation in almost all traits, both in adults and first generation offspring. Adult frogs exhibited clinal variation in their water balance responses, with populations from drier sites both dehydrating and rehydrating more slowly compared to frogs from more mesic sites. Similarly, desiccation tolerance of embryos and hatchlings was significantly greater in populations from xeric sites. Taken together, our findings suggest that populations within this species will respond differently to the regional reduction in rainfall predicted by climate change models. We emphasise the importance of considering geographic variation in phenotypic plasticity when predicting how species will respond to climate change.
Enterovirus 71 structural viral protein 1 promotes mouse Schwann cell autophagy via endoplasmic reticulum stress-mediated peripheral myelin protein 22 upregulation
Authors: Li Pei-qing , Yang Si-da , Hu Dan-dan , WeEI Dan , Lu Jing , Zheng Huan-ying , Nie Shu-shan , Liu Guang-ming , Yang Hao-mei 
Published: May 2018

AbstractEnterovirus 71 (EV71) accounts for the majority of hand, foot and mouth disease-related deaths due to fatal neurological complications. The clinical observations and animal models found the early invasion of nervous system, and the demyelinating phenomenon was observed. As one of the receptors of EV71 structural viral protein 1 (VP1), SCARB2 mainly exists on the myelin sheath. EV71 VP1 can promote viral replication through inducing autophagy in neuron cells. This study aims to investigate the role and mechanism of VP1 in autophagy of mouse Schwann cells (MSCs). An EV71 VP1-expressing vector (pEGFP-C3-VP1) was generated and transfected into MSCs. Transmission electron microscopy (TEM) and Western blot analysis of the autophagy marker microtubule-associated proteins 1A/1B light chain 3B (LC3B) were used to assess autophagy in the cells. Real-time PCR and immunofluorescent staining were performed to determine the expression of PMP22. Small interfering RNA against PMP22 was employed to investigate the role of PMP22 in MSCs autophagy. Selective endoplasmic reticulum (ER) stress inhibitor salubrinal (SAL) was employed to determine whether PMP22 is mediated by ER stress. Our results demonstrated that VP1 played a promotive role in MSC autophagy. Overexpression of VP1 upregulated PMP22. PMP22 deficiency downregulated LC3B and thus inhibited autophagy. Furthermore, PMP22 expression was significantly suppressed by SAL. VP1 promotes MSC autophagy through upregulating ER stress-mediated PMP22 expression. VP1/ER stress/ PMP22 axis in autophagy may be a potential therapeutic target for EV71 infection-induced fatal neuronal damage.
Real time portable genome sequencing for global food security
Authors: Boykin Laura M. , Ghalab Ammar , De Marchi Bruno Rossitto , Savill Anders , Wainaina James M. , Kinene Tonny , Lamb Stephen , Rodrigues Myriam , Kehoe Monica A. , Ndunguru Joseph , Tairo Fred , Sseruwagi Peter , Kayuki Charles , Mark Deogratius , Erasto Joel , Bachwenkizi Hilda , Alicai Titus , Okao-Okuja Geoffrey , Abidrabo Phillip , Osingada John Francis , Akono Jimmy , Ateka Elijah , Muga Brenda , Kiarie Samuel 
Published: May 2018

AbstractThe United Nations has listed Zero Hunger as one of the 17 global sustainable development goals to end extreme poverty by 2030. Plant viruses are a major constraint to crop production globally causing an estimated $30 billion in damage 1 leaving millions of people food insecure 2. In Africa, agriculture employs up to 50% of the workforce, yet only contributes 15% to the GDP on average 3, suggesting that there is low productivity and limited value addition. This can be addressed through continued innovation in the fields of science and technology as suggested in the Science Agenda for Agriculture in Africa (S3A) 4. Sustainable management of plant viruses and their associated vectors must include efficient diagnostics for surveillance, detection and identification to inform disease management, including the development and strategic deployment of virus resistant varieties. To date, researchers have been utilizing conventional methods such as; PCR, qPCR, high throughput sequencing (RNA-Seq, DNA-Seq) and Sanger sequencing for pathogen identification. However, these methods are both costly and time consuming, delaying timely control actions. The emergence of new tools for real-time diagnostics, such as the Oxford Nanopore MinION, have recently proven useful for early detection of Ebola 6 and Zika 7,8, even in low resourced laboratories. For the first time globally, the MinION portable pocket DNA sequencer was used to sequence whole plant virus genomes. We used this technology to identify the begomoviruses causing the devastating CMD which is ravaging smallholder farmers’ crops in sub-Saharan Africa. Cassava, a carbohydrate crop from which tapioca originates, is a major source of calories for over eight hundred (800) million people worldwide. With this technology, farmers struggling with diseased crops can take immediate, restorative action to improve their livelihoods based on information about the health of their plants, generated using a portable, real-time DNA sequencing device.