Tag: pubmed

Nurse Educ Pract. 2021 Jul 14;55:103150. doi: 10.1016/j.nepr.2021.103150. Online ahead of print.

ABSTRACT

AIM/OBJECTIVE: This paper sought to investigate the influence of the supernumerary clinical nurse educator role on the newly qualified graduate nurses’ professional development and successful transition to competent and confident practitioners in the acute care hospital environment.

BACKGROUND: The novice nurses learning in the inpatient clinical environment is affected by increasing patient acuity, complex conditions and organisational expectations. The supernumerary clinical nurse educator is uniquely positioned to prioritise these nurses’ education through protected and available time to support adaption in the workplace culture and retention in the organisation.

DESIGN: A convergent mixed methods design was used to investigate the relationship between the supernumerary clinical nurse educator role through the opinions and experiences of the graduate nurse.

METHODS: Data were collected in February – July 2015 from graduate nurses from three hospital sites in a healthcare organisation in Western Australia. The research used online questionnaires (n = 39) and face to face interviews (n = 10). Analysis of quantitative data used descriptive statistics and qualitative data used thematic analysis.

RESULTS: Four main themes were identified. These were: acknowledges new and challenging experiences, available to provide constructive responses, sympathises with anxiety and missing in action.

CONCLUSION: The graduate registered nurses perceived that clinical sympathy provided by the clinical nurse educator was essential to their new role of frontline nurses influencing their delivery of quality patient care and as a practical solution to champion the graduate nurses’ longevity in the future nursing workforce.

PMID:34293705 | DOI:10.1016/j.nepr.2021.103150

J Environ Manage. 2021 Jul 19;297:113316. doi: 10.1016/j.jenvman.2021.113316. Online ahead of print.

ABSTRACT

Agriculture and the food system emit a considerable amount of Greenhouse Gas (GHG) emissions in the atmosphere. Hence, current researchers, policymakers, and other stakeholders are calling for improving the environmental performance of agriculture. This study utilizes the countries of The Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) to investigate the effect of agriculture value-added, pesticide use, renewable energy adoption, human capital, and economic growth on greenhouse gas emissions. The moderation effect of renewable energy use and human capital is also introduced to see whether they can offset agriculture’s emissions in these BIMSTEC economies. Having reported a state-of-the-art literature review, the econometric procedure applies the second-generation unit root tests, panel cointegration and panel quantile regression for three preferred model specifications. The result from the Panel quantile regression method reveals a U-shaped relationship between agriculture value-added and greenhouse gas emissions, suggesting the significance of a small farming system. Human capital has a negative effect, whereas pesticide use has a positive effect on greenhouse gas emissions. Furthermore, the moderation effect of human capital and pesticide use suggests that human capital is not significant enough to offset the effect of pesticide use on the greenhouse gas emissions, whereas the interaction of renewable and pesticide use suggests that renewable energy adoption in the agriculture sector can mitigate the effect of pesticide use on GHG emissions. Finally, the conclusions of the study support the achievement of few sustainable development goals.

PMID:34293673 | DOI:10.1016/j.jenvman.2021.113316

J Mech Behav Biomed Mater. 2021 May 23;122:104521. doi: 10.1016/j.jmbbm.2021.104521. Online ahead of print.

ABSTRACT

A solution is obtained for incompressible non-linearly elastic membranes that describes the bending of a cylindrical sector to form a perfect cylinder for a wide class of materials that includes isotropic materials and orthotropic materials reinforced by two families of mechanically equivalent fibres that are wound helically about the axial direction. Despite the relative simplicity of the physical problem, the solution of the corresponding boundary value problem for thick cylinders requires a numerical solution for even the simplest models. It is shown, however, that the thin shell solution provides an excellent approximation to the solution of the problem for cylindrical sectors whose thicknesses are an order of magnitude greater than that assumed for membranes. The approximate stress distribution in such thin shells is obtained. In these residually stressed cylinders, the radial stress is approximately zero but the hoop and axial stresses are finite. Estimates of the residual stresses in the unloaded state are obtained. A closed-form solution for the bending moment necessary to effect the deformation is also obtained.

PMID:34293693 | DOI:10.1016/j.jmbbm.2021.104521

Clin Neurol Neurosurg. 2021 Jul 10;207:106808. doi: 10.1016/j.clineuro.2021.106808. Online ahead of print.

ABSTRACT

INTRODUCTION: Meningiomas are usually considered benign lesions, however a proportion of them shows a more aggressive behavior, defined high-grade meningiomas (HGM). Effective medical treatments are lacking, especially at the time of recurrence.

METHODS: Through a retrospective analysis, we examined epidemiological, diagnostic, therapeutic, recurrence information and survival data of HGM treated at our institution between 2010 and 2018.

RESULTS: 183 patients (105 females and 78 males), with median age of 58 years (25-88), were included; 168 were atypical, 12 anaplastic, 3 rhabdoid. Overall, m-PFS was 4.2 years, and m-OS was 10.3 years. Gross-total resection had a 5-year survival rate of 95% compared with subtotal/partial resection (86% and 67%) (p = 0.002). Higher expression of Ki-67/MIB-1 seems associated with higher risk of death (HR:1.06 with 95% CI, 1.00-1.12, p = 0.03). No statistically significant differences were seen in survival between the group managed with a wait-and-see strategy vs the group treated with RT while a difference on PFS was seen (4.1 years vs 5.2 years p = 0.03). After second recurrence, the most employed treatments were systemic therapies with a very limited effect on disease control.

CONCLUSIONS: Data confirmed the aggressive behavior of HGM. The extent of resection seems to correlate with a favorable outcome regardless histological subtypes. The role of RT remains controversial, with no statistically significant impact on OS but a possible role on PFS. Recurrent HGM remains the real challenge, to date no chemotherapies are able to achieve disease control. Future research should focus on biological/molecular predictors in order to achieve a patient-tailored treatment.

PMID:34293659 | DOI:10.1016/j.clineuro.2021.106808

Curr Opin Biotechnol. 2021 Jul 19;71:91-97. doi: 10.1016/j.copbio.2021.06.024. Online ahead of print.

ABSTRACT

Microbial organisms engage in a variety of metabolic interactions. A crucial part of these interactions is the exchange of molecules between different organelles, cells, and the environment. The main forces mediating this metabolic exchange are transporters. This transport can be difficult to measure experimentally because several transport mechanisms remain opaque. However, theoretical calculations about the inputs and outputs of cells via metabolic exchanges have enabled the successful inference of the workings of intra-organismal and inter-organismal systems. Kinetic, metabolic, and statistical modeling approaches in combination with omics data are enhancing our knowledge and understanding about metabolic exchange and mass resource allocation. This model-driven analytics approach can guide effective experimental design and yield new insights into biological function and control.

PMID:34293631 | DOI:10.1016/j.copbio.2021.06.024

J Stroke Cerebrovasc Dis. 2021 Jul 19;30(9):105992. doi: 10.1016/j.jstrokecerebrovasdis.2021.105992. Online ahead of print.

ABSTRACT

OBJECTIVE: Unruptured intracranial vertebral artery dissection (VAD) generally heals spontaneously. A chronological evaluation of intramural hematoma (IMH) using T1-weighted vessel wall imaging (VWI) may provide a more detailed understanding of the pathophysiology of VAD. We herein investigated the relationship between chronological signal changes in IMH on VWI and the spontaneous healing of VAD.

MATERIALS AND METHODS: We retrospectively investigated 26 patients with 27 unruptured VADs who underwent magnetic resonance (MR) imaging more than three times during the follow-up period. Morphological changes were evaluated using MR angiography (MRA). The relative signal intensity (RSI) of IMH against the posterior cervical muscle on T1-weighted VWI was calculated. The ratio of chronological RSI changes was defined as follows: maximum RSI/minimum RSI (RSI _max/min). Based on the median value of RSI _max/min, 27 VADs were divided into VADs with and without chronological RSI changes. Statistical analyses were performed to compare clinical and radiological findings between the two groups.

RESULTS: Spontaneous healing occurred in 17 out of 27 VADs (63%). The median value of RSI _max/min was 1.48. The RSI of VADs with chronological RSI changes (RSI _max/min ≥ 1.48) increased until three weeks after their onset and decreased over time, while that of VADs without chronological RSI changes (RSI _max/min < 1.48) showed no change. The frequency of healing was significantly higher in VADs with than without chronological RSI changes (100% vs 23%, p < 0.0001).

CONCLUSIONS: Chronological signal changes in IMH on T1-weighted VWI have potential as a diagnostic imaging marker of the spontaneous healing of VAD.

PMID:34293642 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105992

Chemosphere. 2021 Jul 17;286(Pt 1):131566. doi: 10.1016/j.chemosphere.2021.131566. Online ahead of print.

ABSTRACT

It is well documented that fine particles matter (PM_2.5), ozone (O₃), and nitrogen dioxide (NO₂) are associated with a range of adverse health outcomes. However, most epidemiologic studies have focused on understanding their additive effects, despite that individuals are exposed to multiple air pollutants simultaneously that are likely correlated with each other. Therefore, we applied a novel method – Bayesian Kernel machine regression (BKMR) and conducted a population-based cohort study to assess the individual and joint effect of air pollutant mixtures (PM_2.5, O₃, and NO₂) on all-cause mortality among the Medicare population in 15 cities with 656 different ZIP codes in the southeastern US. The results suggest a strong association between pollutant mixture and all-cause mortality, mainly driven by PM_2.5. The positive association of PM_2.5 with mortality appears stronger at lower percentiles of other pollutants. An interquartile range change in PM_2.5 concentration was associated with a significant increase in mortality of 1.7 (95% CI: 0.5, 2.9), 1.6 (95% CI: 0.4, 2.7) and 1.4 (95% CI: 0.1, 2.6) standard deviations (SD) when O₃ and NO₂ were set at the 25th, 50th, and 75th percentiles, respectively. BKMR analysis did not identify statistically significant interactions among PM_2.5, O₃, and NO₂. However, since the small sub-population might weaken the study power, additional studies (in larger sample size and other regions in the US) are in need to reinforce the current finding.

PMID:34293557 | DOI:10.1016/j.chemosphere.2021.131566

J Reprod Immunol. 2021 Jul 19;147:103350. doi: 10.1016/j.jri.2021.103350. Online ahead of print.

ABSTRACT

Synergistic interplay of immune endocrine interaction is prerequisite for an effective maternal fetal tolerance. Pre-term birth (PTB) may be a consequence of altered immune-endocrine crosstalk during third trimester resulting in early breakdown of this tolerance. Myeloid derived suppressor cells (MDSCs), a heterogenous population of immature immune cells are increased in pregnant women and healthy newborns, but their role in PTB still remains obscure. We now report that granulocytic MDSCs (G-MDSCs) is decreased in women delivering prematurely, suggesting their potential role in maintaining maternal fetal tolerance. Interestingly, in contrast statistically significant increase in MDSCs and monocytic MDSCs (M-MDSCs) along with positive correlation with cord serum estradiol (E2), and overexpressed ER-α in placental tissue suggested E2 mediated accumulation of M-MDSCs in PTB babies. MDSCs mediated immune suppression is accompanied with subsequent decline in total T cells and its subtypes: Th and Tc in PTB babies, which signifies their potential contribution towards the impaired immune system of PTB babies.

PMID:34293589 | DOI:10.1016/j.jri.2021.103350

Eur J Paediatr Neurol. 2021 Jul 7;34:14-20. doi: 10.1016/j.ejpn.2021.06.006. Online ahead of print.

ABSTRACT

PURPOSE: To compare Melatonin with Triclofos for efficacy (proportion of successful EEG, need of augmentation, sleep onset latency (SOL), yield of discharges, duration of sleep, presence and grade of artifacts) and tolerability (adverse effect profile).

METHODS: A randomized trial was performed (block randomization). All children were advised regarding sleep deprivation, EEG technician administered the drug. EEG was labelled successful if at least 30 min of record could be obtained (sleep with or without awake state). Pediatric neurologist reported the EEG findings-sleep onset latency, epileptiform abnormalities and graded the artifacts (excess beta activity and movement artifacts if present). The parents were interviewed telephonically next day by a pediatric resident for any adverse effects. The parents, pediatric neurologist and pediatric resident were blinded for the drug given.

RESULTS: 228 children were randomized (114 each received Melatonin and Triclofos). Both the groups were comparable at baseline for age group and demographic data. The proportion of successful EEG was 89.4% in Melatonin and 91.2% in Triclofos. First dose was effective in 64% in Melatonin and 63.15% in Triclofos group. Augmentation dose was needed in 25.4% in Melatonin and 28% in Triclofos group. Mean total sleep duration was 80 min after Melatonin and 82.39 after Triclofos administration. Adverse effects were observed in 6.14% of Melatonin and 8.65% of Triclofos group. None of the results were statistically significant.

CONCLUSION: There was no significant difference between efficacy and tolerability of Melatonin and Triclofos. Melatonin can be safely used to achieve sleep for EEG in children.

PMID:34293628 | DOI:10.1016/j.ejpn.2021.06.006

Hear Res. 2021 Jul 10;408:108310. doi: 10.1016/j.heares.2021.108310. Online ahead of print.

ABSTRACT

Animal studies have demonstrated that noise exposure can lead to the loss of the synapses between the inner hair cells and their afferent auditory nerve fiber targets without impacting auditory thresholds. Although several non-invasive physiological measures appear to be sensitive to cochlear synaptopathy in animal models, including auditory brainstem response (ABR) wave I amplitude, the envelope following response (EFR), and the middle ear muscle reflex (MEMR), human studies of these measures in samples that are expected to vary in terms of the degree of noise-induced synaptopathy have resulted in mixed findings. One possible explanation for the differing results is that synaptopathy risk is lower for recreational noise exposure than for occupational or military noise exposure. The goal of this analysis was to determine if EFR magnitude and ABR wave I amplitude are reduced among young Veterans with a history of military noise exposure compared with non-Veteran controls with minimal noise exposure. EFRs and ABRs were obtained in a sample of young (19-35 years) Veterans and non-Veterans with normal audiograms and robust distortion product otoacoustic emissions (DPOAEs). The statistical analysis is consistent with a reduction in mean EFR magnitude and ABR wave I amplitude (at 90 dB peSPL) for Veterans with a significant history of noise exposure compared with non-Veteran controls. These findings are in agreement with previous ABR wave I amplitude findings in young Veterans and are consistent with animal models of noise-induced cochlear synaptopathy.

PMID:34293505 | DOI:10.1016/j.heares.2021.108310