bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Acceptor Side of Photosystem II Is the Initial Target of Nitrite Stress in Synechocystis sp. Strain PCC 6803
Authors: Zhang Xin , Ma Fei , Zhu Xi , Zhu Junying , Rong Junfeng , Zhan Jiao , Chen Hui , He Chenliu , Wang Qiang 
Published: November 2016

ABSTRACT

Nitrite, a common form of inorganic nitrogen (N), can be used as a nitrogen source through N assimilation. However, high levels of nitrite depress photosynthesis in various organisms. In this study, we investigated which components of the photosynthetic electron transfer chain are targeted by nitrite stress in
Synechocystis
sp. strain PCC 6803 cells. Measurements of whole-chain and photosystem II (PSII)-mediated electron transport activities revealed that high levels of nitrite primarily impair electron flow in PSII. Changes in PSII activity in response to nitrite stress occurred in two distinct phases. During the first phase, which occurred in the first 3 h of nitrite treatment, electron transfer from the primary quinone acceptor (Q
A
) to the secondary quinone acceptor (Q
B
) was retarded, as indicated by chlorophyll (Chl)
a
fluorescence induction, S-state distribution, and Q
A
−
reoxidation tests. In the second phase, which occurred after 6 h of nitrite exposure, the reaction center was inactivated and the donor side of photosystem II was inhibited, as revealed by changes in Chl fluorescence parameters and thermoluminescence and by immunoblot analysis. Our data suggest that nitrite stress is highly damaging to PSII and disrupts PSII activity by a stepwise mechanism in which the acceptor side is the initial target.

IMPORTANCE
In our previous studies, an alga-based technology was proposed to fix the large amounts of nitrite that are released from NO
X
-rich flue gases and proved to be a promising industrial strategy for flue gas NO
X
bioremediation (W. Chen et al., Environ Sci Technol 50:1620–1627, 2016,
https://doi.org/10.1021/acs.est.5b04696
; X. Zhang et al., Environ Sci Technol 48:10497–10504, 2014,
https://doi.org/10.1021/es5013824
). However, the toxic effects of high concentrations of nitrite on algal cells remain obscure. The analysis of growth rates, photochemistry, and protein profiles in our study provides important evidence that the inhibition by nitrite occurs in two phases: in the first phase, electron transfer between Q
A
−
and Q
B
is retarded, whereas in the second, the donor side of PSII is affected. This is an excellent example of investigating the “early” inhibitory effects (i.e., within the first 6 h) on the PSII electron transfer chain
in vivo
. This paper provides novel insights into the mechanisms of nitrite inhibition of photosynthesis in an oxygenic phototrophic cyanobacterium.
Spiritual issues of people living and dying with advanced heart failure in Kenya: a qualitative serial interview study
Authors: Kimani Kellen N , Murray Scott A , Grant Liz 
Published: November 2016

BackgroundExploring patients' spiritual issues is vital for informing holistic care. The spiritual concerns of patients living and dying with advanced heart failure in sub-Saharan Africa remains unknown. Our aim was to describe spiritual issues in the context of the lived experiences of patients with heart failure in Kenya.MethodsWe purposively recruited 18 patients admitted with advanced heart failure at a rural district hospital in Kenya. We conducted serial in-depth interviews with patients at 0, 3 and 6 months after recruitment. We conducted bereavement interviews with their carers. Interviews were recorded, transcribed into English and analysed using a thematic approach, assisted by Nvivo software package.ResultsPatients expressed traditional and Christian spiritual beliefs in response to their illness. At diagnosis, some patients felt their illness had occurred because they had wronged God, while others felt betrayed by God. Some expressed comfort from God and optimism believing that God was in control and would heal their illness. During acute episodes patients questioned whether witchcraft or curses caused their illness. Younger patients experienced more spiritual distress. Although church fellowship generally offered spiritual and social support, some patients felt let down by the church which they perceived to favour those who offered more tithes.ConclusionsThis is the first study to explore the spiritual issues of people living with advanced heart failure in Kenya. Understanding patients' spiritual concerns is important for developing evidence-based patient-centred holistic care to promote multidimensional well-being.
‘Once there is life, there is hope’ Ebola survivors' experiences, behaviours and attitudes in Sierra Leone, 2015
Authors: Karafillakis Emilie , Jalloh Mohamed F , Nuriddin Azizeh , Larson Heidi J , Whitworth Jimmy , Lees Shelley , Hageman Kathy M , Sengeh Paul , Jalloh Mohammad B , Bunnell Rebecca , Carroll Dianna D , Morgan Oliver 
Published: November 2016

BackgroundIn Sierra Leone, over 4000 individuals survived Ebola since the outbreak began in 2014. Because Ebola survivorship was largely unprecedented prior to this outbreak, little is known about survivor experiences during and post illness.MethodsTo assess survivors' experiences and attitudes related to Ebola, 28 in-depth interviews and short quantitative surveys with survivors from all four geographic regions of Sierra Leone were conducted in May 2015.ResultsSurvivor experiences, emotions and attitudes changed over time as they moved from disease onset to treatment, discharge and life post-discharge. Survivors mentioned experiencing acute fear and depression when they fell ill. Only half reported positive experiences in holding centres but nearly all were positive about their treatment centre experiences. Survivor euphoria on discharge was followed by concerns about their financial situation and future. While all reported supportive attitudes from family members, about a third described discrimination and stigma from their communities. Over a third became unemployed, especially those previously engaged in petty trade. Survivor knowledge about sexual transmission risk reflected counselling messages. Many expressed altruistic motivations for abstinence or condom use. In addition, survivors were strongly motivated to help end Ebola and to improve the healthcare system. Key recommendations from survivors included improved counselling in holding centres and long-term government support for survivors, including opportunities for participation in Ebola response efforts.ConclusionsSurvivors face myriad economic, social and health challenges. Addressing survivor concerns, including the discrimination they face, could facilitate their reintegration into communities and their contributions to future Ebola responses.
Retrospective analysis of age-adjusted body mass index among pre-pregnant women in the Lithuanian urban area during three decades
Authors: Francaite-Daugeliene Migle , Petrenko Vladimiras , Baliutaviciene Dalia , Velickiene Dzilda 
Published: November 2016

BackgroundThe prevalence of maternal obesity at the beginning of pregnancy is increasing. However, there are some studies reporting the stabilisation of obesity epidemic or even the downward trend in the general population.ObjectiveTo determine the prevalence of overweight and obesity in Lithuanian pre-pregnant women during 3 decades.MethodsThis observational retrospective study included a sample of 2827, women aged 18–44 years who gave birth in 1987–1989, 1996–1997 and 2007–2010: 861 (30.5%), 995 (35.2%) and 971 (34.3%), respectively. All women were divided into groups by body mass index (BMI) calculated from self-reported weight and height, and age reported during the first antenatal visit. Quantitative parametric variables were expressed as mean and SD; qualitative variables, as absolute numbers (n) and percentage (%). For parametric data, analysis of variance (ANOVA) was used. Differences were considered statistically significant at p<0.05.ResultsThe prevalence of overweight and obesity among women aged 18–24 years decreased from 20.9% in 1987–1989 to 9.5% in 1996–1997 but increased to 15.7% in 2007–2010; among women aged 25–34 years, decreased from 35.5% in 1987–1989 to 23% in 1996–1997 and to 22.4% in 2007–2010; and among women aged 35–44 years decreased from 64.9% in 1987–1989 to 34% in 1996–1997 but increased to 45.3% in 2007–2010. BMI increased with an increasing age (r=0.254, p<0.05). Analysis by separate periods (1987–1989, 1996–1997 and 2007–2010) revealed a positive correlation between BMI and age at the first antenatal visit in all periods (r=0.325, p<0.01; r=0.266, p<0.01; and r=0.210, p<0.01, respectively).ConclusionsThe prevalence of overweight and obesity among pre-pregnant women tended to decrease in the Lithuanian urban area during 3 decades. A slight increase in overweight and obesity documented in 2007–2010 compared with 1996–1997 most likely was caused by older maternal age.
Determinants of the sustained employment of physician assistants in hospitals: a qualitative study
Authors: Timmermans Marijke J C , van Vught Anneke J A H , Maassen Irma T H M , Draaijer Lisette , Hoofwijk Anton G M , Spanier Marcel , van Unen Wijnand , Wensing Michel , Laurant Miranda G H 
Published: November 2016

ObjectivesTo identify determinants of the initial employment of physician assistants (PAs) for inpatient care as well as of the sustainability of their employment.DesignWe conducted a qualitative study with semistructured interviews with care providers. Interviews continued until data saturation was achieved. All interviews were transcribed verbatim. A framework approach was used for data analysis. Codes were sorted by the themes, bringing similar concepts together.SettingThis study was conducted between June 2014 and May 2015 within 11 different hospital wards in the Netherlands. The wards varied in medical speciality, as well as in hospital type and the organisational model for inpatient care.ParticipantsParticipant included staff physicians, residents, PAs and nurses.ResultsThe following themes emerged to be important for the initial employment of PAs and the sustainability of their employment: the innovation, individual factors, professional interactions, incentives and resources, capacity for organisational change and social, political and legal factors.Conclusions10 years after the introduction of PAs, there was little discussion among the adopters about the added value of PAs, but organisational and financial uncertainties played an important role in the decision to employ and continue employment of PAs. Barriers to employ and continue PA employment were mostly a consequence of locally arranged restrictions by hospital management and staff physicians, as barriers regarding national laws, PA education and competencies seemed absent.
Impact of smoking on fertility and age of menopause: a population-based assessment
Authors: Oboni Jean-Baptiste , Marques-Vidal Pedro , Bastardot François , Vollenweider Peter , Waeber Gérard 
Published: November 2016

Background and aimsStudies in patients seeking medically assisted reproduction have shown that smoking reduces fertility, but little information is available in the general population. We assessed the associations between smoking and the number of children, childbearing planning and age at menopause in a representative sample of the population of Lausanne, Switzerland.MethodsData from 6711 participants (3530 women, age range 35–75 years) collected between 2003 and 2006 and again in 2009 and 2012. Smoking status, number of offsprings and age of menopause were assessed.ResultsWomen who currently smoke had significantly less children than former or never smokers: the number of children per women (average±SD) was 1.38±1.05, 1.45±1.07 and 1.576±1.16, respectively (p<0.001). Women who currently smoke had their first child at an earlier age than the others: 26.7±5.2, 27.4±5.4 and 26.9±5.2 years old for current, former and never smokers, respectively, (p=0.01). Similar findings were found for men: number of children per men 1.475±1.16, 1.67±1.13 and 1.55±1.22 for current, former and never smokers, respectively (p<0.001); no difference was found regarding age at the first child. The difference persisted after multivariate adjustment (adjusted for age, body mass index, Caucasian origins, alcohol consumption, caffeinated drinks consumption, educational level, receiving social help and women taking contraceptives) for the age at first child among women. No association was found between Heaviness of Smoking Index and the number of children among current smokers in both genders. Women who smoke had their menopause more than 1 year prior than never-smoking women (48.9±0.2 years compared with 47.8±0.3 years, respectively, p=0.002).ConclusionsSmoking is associated with an earlier age of having the first child and of menopause among women.
Preventing postnatal maternal mental health problems using a psychoeducational intervention: the cost-effectiveness ofWhat Were We Thinking
Authors: Ride Jemimah , Lorgelly Paula , Tran Thach , Wynter Karen , Rowe Heather , Fisher Jane 
Published: November 2016

ObjectivesPostnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention,What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems.DesignThe economic evaluation, including cost-effectiveness and cost-utility analyses, was conducted alongside a cluster-randomised trial.Setting48 Maternal and Child Health Centres in Victoria, Australia.ParticipantsParticipants were English-speaking first-time mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm.InterventionWWWTis a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue.Outcome measuresThe evaluation considered public sector plus participant out-of-pocket costs, while outcomes were expressed in the 30-day prevalence of depression, anxiety and adjustment disorders, and quality-adjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics.ResultsThe intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost-effectiveness ratios were $A36 451 per QALY gained and $A152 per percentage-point reduction in 30-day prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost-effectiveness threshold of $A55 000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability thatWWWTwould be considered cost-effective at that threshold.ConclusionsThe results suggest that, althoughWWWTshows promise as a preventive intervention for postnatal maternal mental health problems, further research is required to reduce the uncertainty over its cost-effectiveness as there were no statistically significant differences in costs or outcomes.Trial registration numberACTRN12613000506796; results.
Reporting quality in abstracts of meta-analyses of depression screening tool accuracy: a review of systematic reviews and meta-analyses
Authors: Rice Danielle B , Kloda Lorie A , Shrier Ian , Thombs Brett D 
Published: November 2016

ObjectiveConcerns have been raised regarding the quality and completeness of abstract reporting in evidence reviews, but this had not been evaluated in meta-analyses of diagnostic accuracy. Our objective was to evaluate reporting quality and completeness in abstracts of systematic reviews with meta-analyses of depression screening tool accuracy, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for Abstracts tool.DesignCross-sectional study.Inclusion CriteriaWe searched MEDLINE and PsycINFO from 1 January 2005 through 13 March 2016 for recent systematic reviews with meta-analyses in any language that compared a depression screening tool to a diagnosis based on clinical or validated diagnostic interview.Data extractionTwo reviewers independently assessed quality and completeness of abstract reporting using the PRISMA for Abstracts tool with appropriate adaptations made for studies of diagnostic test accuracy. Bivariate associations of number of PRISMA for Abstracts items complied with (1) journal abstract word limit and (2) A Measurement Tool to Assess Systematic Reviews (AMSTAR) scores of meta-analyses were also assessed.ResultsWe identified 21 eligible meta-analyses. Only two of 21 included meta-analyses complied with at least half of adapted PRISMA for Abstracts items. The majority met criteria for reporting an appropriate title (95%), result interpretation (95%) and synthesis of results (76%). Meta-analyses less consistently reported databases searched (43%), associated search dates (33%) and strengths and limitations of evidence (19%). Most meta-analyses did not adequately report a clinically meaningful description of outcomes (14%), risk of bias (14%), included study characteristics (10%), study eligibility criteria (5%), registration information (5%), clear objectives (0%), report eligibility criteria (0%) or funding (0%). Overall meta-analyses quality scores were significantly associated with the number of PRISMA for Abstracts scores items reported adequately (r=0.45).ConclusionsQuality and completeness of reporting were found to be suboptimal. Journal editors should endorse PRISMA for Abstracts and allow for flexibility in abstract word counts to improve quality of abstracts.
Predictors of care home and hospital admissions and their costs for older people with Alzheimer's disease: findings from a large London case register
Authors: Knapp Martin , Chua Kia-Chong , Broadbent Matthew , Chang Chin-Kuo , Fernandez Jose-Luis , Milea Dominique , Romeo Renee , Lovestone Simon , Spencer Michael , Thompson Gwilym , Stewart Robert , Hayes Richard D 
Published: November 2016

ObjectivesTo examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs.DesignObservational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations.SettingCatchment area for South London and Maudsley National Health Service Foundation Trust, provider for 1.2 million people in Southeast London.ParticipantsEvery individual with diagnosis of Alzheimer's disease seen and treated by mental health services in the catchment area, with at least one rating of cognition, not resident in care home at time of assessment (n=3075).InterventionsUsual treatment.Main outcome measuresRisk of admission to, and days spent in three settings during 6-month period following routine clinical assessment: care home, mental health inpatient care and general hospital inpatient care.ResultsPredictors of probability of care home or hospital admission and/or associated costs over 6 months include cognition, functional problems, agitation, depression, physical illness, previous hospitalisations, age, gender, ethnicity, living alone and having a partner. Patterns of association differed considerably by destination.ConclusionsMost people with dementia prefer to remain in their own homes, and funding bodies see this as cheaper than institutionalisation. Better treatment in the community that reduces health and social care needs of Alzheimer's patients would reduce admission rates. Living alone, poor living circumstances and functional problems all raise admission rates, and so major cuts in social care budgets increase the risk of high-cost admissions which older people do not want. Routinely collected data can be used to reveal local patterns of admission and costs.
Macquarie Surgical Innovation Identification Tool (MSIIT): a study protocol for a usability and pilot test
Authors: Blakely Brette , Selwood Amanda , Rogers Wendy A , Clay-Williams Robyn 
Published: November 2016

IntroductionMedicine relies on innovation to continually improve. However, innovation is potentially risky, and not all innovations are successful. Therefore, it is important to identify innovations prospectively and provide support, to make innovation as safe and effective as possible. The Macquarie Surgical Innovation Identification Tool (MSIIT) is a simple checklist designed as a practical tool for hospitals to identify planned surgical innovations. This project aims to test the usability and pilot the use of the MSIIT in a surgical setting.Methods and analysisThe project will run in two phases at two Australian hospitals, one public and one private. Phase I will involve interviews, focus groups and a survey of hospital administrators and surgical teams to assess the usability and system requirements for the use of the MSIIT. Current practice regarding surgical innovation within participating hospitals will be mapped, and the best implementation strategy for MSIIT completion will be established. Phase II will involve trialling the MSIIT for each surgery within the trial period by various surgical personnel. Follow-up interviews, focus groups and a survey will be conducted with trial participants to collect feedback on their experience of using the MSIIT during the trial period. Comparative data on rates of surgical innovation during the trial period will also be gathered from existing hospital systems and compared to the rates identified by the MSIIT.Ethics and disseminationEthical approval has been obtained. The results of this study will be presented to interested health services and other stakeholders, presented at conferences and published in a peer-reviewed MEDLINE-indexed journal.