bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between blood coagulability and sense of burden among caregivers of patients with dementia
Authors: Hirano Akemi , Suzuki Yusuke , Umegaki Hiroyuki , Hayashi Toshio , Ina Koichiro , Onishi Joji , Hasegawa Jun , Kuzuya Masafumi 
Published: July 2019

AimThis study aimed to examine the relationship between blood coagulability and sense of burden among caregivers of patients with senile dementia of the Alzheimer type.MethodsA cross‐sectional study was carried out involving healthy older caregivers who lived with their patients with senile dementia of the Alzheimer type. We evaluated the Zarit Burden Interview score, levels of von Willebrand factor antigen, D‐dimer, thrombin–antithrombin III complex, tissue plasminogen activator/plasminogen activator inhibitor type 1 complex, number of chronic diseases, body mass index and number of medications. A linear regression model was used to estimate adjusted associations.ResultsThrombin–antithrombin III complex levels were higher in female caregivers than in male caregivers (P = 0.07). Headaches were significantly more frequent in female caregivers than in male caregivers, as assessed by a visual analog scale (P < 0.01). The number of chronic diseases and body mass index were positively associated with levels of tissue plasminogen activator/plasminogen activator inhibitor type 1 complex (P < 0.05). Similarly, the number of medications was positively associated with levels of D‐dimer (P < 0.05). However, the Zarit Burden Interview score was not associated with blood coagulability (P > 0.05).ConclusionsThe present study found that the number of chronic diseases and body mass index were associated with blood coagulability, and that female caregivers were more prone to headaches and higher blood coagulability than male caregivers. These findings highlight the essential nature of health management during caregiving. The impact of caregiver burden on blood coagulability is likely to differ depending on the long‐term or short‐term psychological stress associated with caregiving conditions. Geriatr Gerontol Int 2019; 19: 804–808.
Development of the Barthel Index 5 years after hip fracture: Results of a prospective study
Authors: Knauf Tom , Buecking Benjamin , Hack Juliana , Barthel Juliane , Bliemel Christopher , Aigner Rene , Ruchholtz Steffen , Eschbach Daphne 
Published: July 2019

AimThe importance of proximal femoral fractures is increasing due to demographic change. Despite appropriate care, these are associated with poor results. We are still lagging behind, and require information on the long‐term functional outcome of these patients and the predictive factors involved.MethodsBetween 2009 and 2011, 402 patients aged >60 years with hip fractures were included in this prospective observational study. Patients were assessed with the Barthel Index before fracture, at discharge, and 6 months, 1 year and 5 years after surgery. In addition, a variety of parameters (sex, age, fracture type, American Society of Anesthesiologists classification, Mini‐Mental State Examination, housing situation, occurrence of complications during inpatient stay and type of care) were collected to identify the possible independent predictive factors using multivariate analysis.ResultsThe lowest Barthel Index was found at discharge (66 ± 24) for patients from an acute hospital. The Barthel Index improved within the first 6 months (86 ± 21) and decreased afterwards. The factors associated with a significantly higher point loss of the Barthel Index in the multivariate analysis were age (P‐value 0.020), pre‐fracture Barthel Index, (P ≤ 0.001), Mini‐Mental State Examination (P ≤ 0.001) and type II complications (P = 0.001). The other values showed no significant influence on the Barthel Index.ConclusionsThe present results showed that patients after a hip fracture have a great rehabilitation potential within the first 6 months after the event. More attention should be paid to type II complications and the occurrence of cognitive impairment. Both seem to be a surrogate parameter for the frailty of the patients. Geriatr Gerontol Int 2019; 19: 809–814.
Quality indicators and community pharmacy services: a scoping review
Authors: Alhusein Nour , Watson Margaret C 
Published: July 2019

Abstract

Background
Quality indicators are a commonly used improvement tool in health care. There is growing interest and activity in the use of quality indicators to improve community pharmacy practice.

Objectives
To conduct a scoping review of the use of quality indicators for community pharmacy practice, including their methods of development and evaluation.

Methods
Electronic databases (EMBASE and PubMed) were searched to identify papers published between January 2008 and April 2018. No limits were applied for language of publication or country of origin. Studies were included if they reported empirical data regarding the development or evaluation of quality indicators. All study designs were eligible for inclusion. Duplicate independent screening was undertaken of the search results. Data extraction was performed by one reviewer.

Results
Of the 988 records identified from the database search, 15 articles were included. The studies were conducted in 12 countries from six continents. Eleven studies described the development of quality indicators, eight of which included the evaluation of the psychometric properties of the indicators developed. Four studies examined the impact of quality indicators on practice all of which reported improvements in some aspects of quality, mainly with structure indicators rather than those relating to process and outcome.

Conclusions
Whilst there is a growing emphasis on promoting improvement in community pharmacy services, evidence is lacking of the effect of indicators on improving quality. Measurable process and outcome indicators are needed. The future development of quality indicators would also benefit from a multi-stakeholder approach.
Wolbachia dominate Spiroplasma in the co‐infected spider mite Tetranychus truncatus
Authors: Yang Kun , Xie Kang , Zhu Yu‐Xi , Huo Shi‐Mei , Hoffmann Ary , Hong Xiao‐Yue 
Published: July 2019

AbstractWolbachia and Spiroplasma are both maternally inherited endosymbionts in arthropods, and they can co‐infect the same species. However, how they interact with each other in the same host is not clear. Here we investigate a co‐infected Tetranychus truncatus spider mite strain that shares the same genetic background with singly infected and uninfected strains to detect the impacts of the two symbionts on their host. We found that Wolbachia‐infected and Spiroplasma‐infected mites can suffer significant fitness costs involving decreased fecundity, although with no effect on lifespan or development. Wolbachia induced incomplete cytoplasmic incompatibility in T. truncatus both in singly infected and doubly infected strains, resulting in female killing. In both females and males of the co‐infected spider mite strain, Wolbachia density was higher than Spiroplasma density. Transcriptome analysis of female adults showed that the most differentially expressed genes were found between the co‐infected strain and both the singly infected Spiroplasma strain and uninfected strain. The Wolbachia strain had the fewest differentially expressed genes compared with the co‐infected strain, consistent with the higher density of Wolbachia in the co‐infected strain. Wolbachia, therefore, appears to have a competitive advantage in host mites over Spiroplasma and is likely maintained in populations by cytoplasmic incompatibility despite having deleterious fitness effects.
Prokaryotic RNA activates endothelial cells promoting neutrophil transmigration
Authors: Castillo Luis A , Birnberg Weiss Federico , Rodriguez‐Rodrigues Nahuel , Pittaluga José R , Martire‐Greco Daiana , Milillo Maria A , Grinstein Sebastian F , Camelli María R , Mena Aybar Ana J , Landoni Verónica I , Fernández Gabriela C 
Published: July 2019

AbstractEndothelial cell (EC)–neutrophil (PMN) interactions are crucial in the resolution of bacterial infections. Prokaryotic RNA (pRNA) has been reported as a pathogen‐associated molecular pattern that is released from bacteria upon death and is able to activate PMN. In this work, we studied the effects of pRNA on EC and investigated whether these effects could modulate EC–PMN interaction. For this purpose, we purified total pRNA from Escherichia coli and used it as a stimulus for Human Umbilical Vein Endothelial Cells (HUVEC). We found that the incubation of pRNA with HUVEC caused the increase of surface intercellular adhesion molecule 1 (ICAM‐1 or CD54) expression on HUVEC, and the secretion of IL‐8 and von Willebrand factor, characteristics consistent with HUVEC activation, without causing toxic effects. Moreover, pRNA‐treated HUVEC also induced PMN adhesion and the conditioned medium obtained from treated‐HUVEC was chemotactic for PMN and caused their activation, as determined by CD11b upregulation. As reported previously, the degradation products of pRNA induced similar biological effects. The treatment of HUVEC with endocytosis inhibitors revealed that the entry of pRNA partially relied on a clathrin‐dependent mechanism, whereas the effects of degradation products could not be inhibited by any of the inhibitors tested. Using a transwell system, we found that pRNA or degraded pRNA were also able to stimulate HUVEC when recognized from the basolateral side. Our results indicate that pRNA activates EC, resulting in the modulation of EC–PMN interaction by inducing PMN chemotaxis, adhesion and activation. In the context of infection, pRNA sensed by EC and PMN could favor bacterial clearance.
Effects of Holocene climate changes on alpine ecosystems: Nonequilibrium dynamics drive insect species richness on alpine islands
Authors: Marta Silvio , Lacasella Federica , Cesaroni Donatella , Sbordoni Valerio 
Published: July 2019

AbstractAimTo identify the effect of multiple, temporally close, forcing events (i.e. climate‐driven habitat fragmentations/homogenizations) in shaping current patterns of biodiversity in alpine areas. Given their spatial configuration, alpine areas have been traditionally seen as islands surrounded by an “ocean” of unsuitable lands. A quantitative assessment of the effects of Holocene climate fluctuations on islands area and inter‐island connectivity is crucial to finely reconstruct past biodiversity dynamics and forecast species responses to future changes.LocationItaly.TaxaCarabidae (Ground beetles), Chrysomelidae (Leaf beetles), Elateridae (Click beetles), Orthoptera (Grasshoppers and Crickets) and Papilionoidea (Butterflies and Skippers).MethodsA total of 1,077 species for 128,093 records were analysed and a classification based on their functional traits allowed identifying groups of good and poor dispersers within each taxon. A dynamic discrete model of ecosystem evolution provided the spatio‐temporal context to test two competing (transient equilibria vs. nonequilibrium) dynamics based on different colonization capabilities. In the transient equilibria dynamic the species are able to respond to island evolution through successful dispersal and colonization events, whereas in the nonequilibrium dynamic ineffective immigration constrains the current species richness to that generated by the strongest island contraction.ResultsWith the exception of Elateridae, good dispersers (Chrysomelidae and Papilionoidea) responded to environmental changes by establishing a series of transient equilibria. In contrast, the nonequilibrium dynamic better described patterns of species richness in poor dispersers (Carabidae and Orthoptera).Main conclusionsOur approach could be used as the basis for the development of spatially and temporally explicit models of island evolution and could be a valuable tool for quantifying the sensitivity of single taxa to climate‐driven habitat changes. It also represents a further step towards the forecasting of future responses to climate change and the accompanying development of conservation strategies that more effectively respond to the detrimental impacts of climate change on biodiversity.
Level of contact hypersensitivity response to diphencyprone and keratinocyte cancer
Authors: Bullen A. , Polcz M. , Rowe C.J. , Byrom L. , Soyer H.P. , Khosrotehrani K. 
Published: July 2019

AbstractBackgroundKeratinocyte cancers (KC) are common and pose a significant financial burden globally. Ultraviolet radiation is a significant factor in their development, through mutagenesis promotion but also through local and systemic immunosuppression. Although systemic immunosuppression is well understood, cutaneous immunity has been more difficult to evaluate.ObjectivesThis study used a contact sensitizer, diphencyprone (DPCP), which elicits a contact hypersensitivity reaction in skin, to compare the degree of reactivity to DPCP in patients with a high KC burden versus those with a low KC burden.MethodsA prospective study was performed in immunocompetent patients aged 70 ± 5 years of age, comparing patients with a high KC burden (>10 previous KC) with those with a low KC burden (<2 previous KC). All patients were sensitized with 2% DPCP and then patch tested two weeks later with eight different concentrations of DPCP with the threshold concentration and total degree of reaction recorded.ResultsNine patients were recruited, 5 in the ‘high cancer’ group and 4 in the ‘low cancer’ group. All patients were Fitzpatrick skin type 1 or 2. All patients developed a reaction to DPCP. Patients in the low cancer group developed a reaction at a significantly lower threshold DPCP concentration than the high cancer group (P = 0.039). The cumulative intensity of reaction was higher in the low cancer group (P = 0.087).ConclusionPatients with a high KC burden required a higher threshold concentration of DPCP to elicit a hypersensitivity reaction, supporting the concept of a lower skin immunity in these patients. DPCP reactivity threshold could be a useful tool in the evaluation of skin immunity and propensity to develop keratinocyte cancers.
Ex vivo confocal laser scanning microscopy for bullous pemphigoid diagnostics: new era in direct immunofluorescence?
Authors: Bağcı I.S. , Aoki R. , Krammer S. , Ruzicka T. , Sárdy M. , French L.E. , Hartmann D. 
Published: July 2019

AbstractBackgroundEx vivo confocal laser scanning microscopy (ex vivo CLSM) is a novel diagnostic method allowing rapid, high‐resolution imaging of excised skin samples. Furthermore, fluorescent detection is possible using fluorescent‐labelled antibodies.ObjectiveTo assess the applicability of ex vivo CLSM in the detection of basement membrane (BM) fluorescence in bullous pemphigoid (BP) and to compare its diagnostic accuracy with direct immunofluorescence (DIF) microscopy.MethodsA total of 81 sections of 49 BP patients with positive DIF microscopy findings were examined using ex vivo CLSM in reflectance and fluorescence mode following staining with fluorescent‐labelled IgG and C3 antibodies.ResultsEx vivo CLSM showed an overall performance of 65.3% in identifying BM fluorescence in BP patients. IgG and C3 deposition along the BM was detected in 50% and 45.5% of the patients, respectively. The sensitivity of ex vivo CLSM in detecting BM fluorescence was low (IgG: 50%, C3: 45.5%), but the specificity was high (IgG: 100, C3: 90%). In addition to immunoreactivity, ex vivo CLSM could display subepidermal inflammatory cells similar to histological examination in 84% of patients.ConclusionsBasement membrane fluorescence could be identified with ex vivo CLSM in the skin sections of BP patients. Ex vivo CLSM enables simultaneous and rapid detection of histopathological and immunofluorescence findings in the same session, albeit with a lower sensitivity than DIF in detecting BM fluorescence.
Developing and psychometric testing of the anaesthesia nursing competence scale
Authors: Jeon Yunsuk , Meretoja Riitta , Vahlberg Tero , Leino‐Kilpi Helena 
Published: July 2019

AbstractRationale, aims, and objectivesThe competence of nurses in anaesthesia care is important for the quality of anaesthesia nursing care and patient safety. However, there is a lack of psychometrically tested instruments to measure the competence. Therefore, this study aimed to develop and test the psychometric properties of an anaesthesia nursing competence scale (AnestComp) assessing nurses' competence in anaesthesia care.MethodThe scale development and psychometric testing had three phases: (1) based on literature reviews and the description of experts, competence areas were identified and items were created; (2) the content validity of the scale was tested by a content expert group, and the scale was pilot tested; and (3) psychometric testing of scale was tested by anaesthesia nurses' (n = 222) and nursing students' (n = 205) self‐assessments. The psychometric testing assessed the reliability when using Cronbach's α and the construct validity using factor analyses (confirmatory and exploratory) and known‐group technique. Nursing students were included for the purpose of construct validity testing.ResultsThe AnestComp has 39 items and consists of seven competence areas: (a) ethics of anaesthesia care, (b) patient's risk care, (c) patient engagement with technology, (d) collaboration within patient care, (e) anaesthesia patient care with medication, (f) peri‐anaesthesia nursing intervention, and (g) knowledge of anaesthesia patient care. Cronbach's α values were high in all categories (0.83‐0.95), and factor analyses and known‐group technique supported a seven‐factor model.ConclusionThe initial results supported the reliability and construct validity of the AnestComp. The scale is considered a promising instrument for measuring anaesthesia nursing competence among anaesthesia nurses. Further research with larger and more diverse samples is suggested to refine the current psychometric evaluation.
Index admission cholecystectomy for acute biliary pancreatitis favorably impacts outcomes of hospitalization in cirrhosis
Authors: Patel Kishan P , Mumtaz Khalid , Li Feng , Luthra Anjuli K , Hinton Alice , Lara Luis F , Conwell Darwin L , Krishna Somashekar G 
Published: July 2019

AbstractBackground and AimDespite higher rates of gallstones in patients with cirrhosis, there are no population‐based studies evaluating outcomes of acute biliary pancreatitis (ABP). Therefore, we sought to evaluate the predictors of early readmission and mortality in this high‐risk population.MethodsWe utilized the Nationwide Readmission Database (2011–2014) to evaluate all adults admitted with ABP. Multivariable logistic regression models were used to assess independent predictors for 30‐day readmission, index admission mortality, and calendar year mortality.ResultsAmong 184 611 index admissions with ABP, 4344 (2.4%) subjects had cirrhosis (1649 with decompensation). Subjects with cirrhosis, when compared with those without, incurred higher rates of 30‐day readmission (20.9% vs 11.2%; P < 0.001), index mortality (2.0% vs 1.0%; P < 0.001), and calendar year mortality (4.2% vs 0.9%; P < 0.001). Decompensation in cirrhosis was associated with significantly fewer cholecystectomies (26.7% vs 60.2%; P < 0.001) and endoscopic retrograde cholangiopancreatographies (23.3% vs 29.9%; P < 0.001). Multivariate analysis revealed that severe acute pancreatitis (odds ratio [OR]: 14.8; 95% confidence interval [CI]: 5.3, 41.2), sepsis (OR: 12.6; 95% CI: 5.8, 27.4), and decompensation (OR: 3.1; 96% CI: 1.4, 6.6) were associated with increased index admission mortality. Decompensated cirrhosis (OR: 1.8; 95% CI: 1.1, 3.0) and 30‐day readmission (OR: 5.6; 95% CI: 3.3, 9.5) were predictors of calendar year mortality. However, index admission cholecystectomy was associated with decreased 30‐day readmissions (OR: 0.6; 95% CI: 0.4, 0.7) and calendar year mortality (OR: 0.44; 95% CI: 0.25, 0.78).ConclusionsThe presence of cirrhosis adversely impacts hospital outcomes of patients with ABP. Among modifiable factors, index admission cholecystectomy portends favorable prognosis by reducing risk of early readmission and consequent calendar year mortality.
Innovations in Midwifery Education: The Academic Medical Center Model
Authors: Krause Susan A. , DeJoy Susan A. , Sankey Heather Z. 
Published: July 2019

AbstractWorkforce analyses project a need for women's health care providers, especially in maternity care. With a stagnant number of certified nurse‐midwife/certified midwife (CNM/CM) education programs, the present production of new CNMs/CMs is not robust enough to meet the growing demand. This article describes an existing but underutilized model for CNM/CM education programs, based in an academic medical center with an existing academic affiliation. Advantages include a federal funding source through the Centers for Medicare and Medicaid Services, lower tuition costs than most current programs, and expanded job satisfaction for CNMs/CMs in clinical practice.
Identification of compounds inhibiting prion replication and toxicity by removing PrPC from the cell surface
Authors: Biggi Silvia , Pancher Michael , Stincardini Claudia , Luotti Silvia , Massignan Tania , Dalle Vedove Andrea , Astolfi Andrea , Gatto Pamela , Lolli Graziano , Barreca Maria Letizia , Bonetto Valentina , Adami Valentina , Biasini Emiliano 
Published: July 2019

AbstractThe vast majority of therapeutic approaches tested so far for prion diseases, transmissible neurodegenerative disorders of human and animals, tackled PrPSc, the aggregated and infectious isoform of the cellular prion protein (PrPC), with largely unsuccessful results. Conversely, targeting PrPC expression, stability or cell surface localization are poorly explored strategies. We recently characterized the mode of action of chlorpromazine, an anti‐psychotic drug known to inhibit prion replication and toxicity by inducing the re‐localization of PrPC from the plasma membrane. Unfortunately, chlorpromazine possesses pharmacokinetic properties unsuitable for chronic use in vivo, namely low specificity and high toxicity. Here, we employed HEK293 cells stably expressing EGFP‐PrP to carry out a semi‐automated high content screening (HCS) of a chemical library directed at identifying non‐cytotoxic molecules capable of specifically relocalizing PrPC from the plasma membrane as well as inhibiting prion replication in N2a cell cultures. We identified four candidate hits inducing a significant reduction in cell surface PrPC, one of which also inhibited prion propagation and toxicity in cell cultures in a strain‐independent fashion. This study defines a new screening method and novel anti‐prion compounds supporting the notion that removing PrPC from the cell surface could represent a viable therapeutic strategy for prion diseases.
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