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CONCLUSIONS When reviewing the documentation of nurses in this study, it is easy to see how they can influence and bias the perspective of other staff. Such bias cascade and bias snowball have been shown in many domains, and in the context of nursing it can bias the type of care provided, the assessments made, and decisions formed by other professionals. RELEVANCE TO PRACTICE Given the critical role documentation plays in healthcare, our results indicate that efforts to improve documentation made by mental health nurses are needed and specifically, attention needs to be given to the writing styles of the notation. This article is protected by copyright. All rights reserved.Hepatoblastoma, is a rare primary hepatic malignancy, most commonly seen in infants and children less than 3 years of age. We present a rare case of mixed fetal-embryonal hepatoblastoma, diagnosed on fine needle aspiration cytology supplemented by immunocytochemistry on cell-block. Knowledge of the characteristic cytomorphologic and immunocytochemical features is important for rendering accurate pre-operative diagnosis for prompt management of these tumors. This article is protected by copyright. All rights reserved.Three main types of skin grafts are used in reconstruction of cutaneous surgical defects full-thickness skin grafts (FTSG), containing the entire epidermis and dermis, split-thickness skin grafts, containing epidermis and a variable portion of dermis, and composite grafts, usually containing skin and cartilage. Since vascular supply is lacking, skin graft survival will depend on the passive nutrient uptake and early establishment of blood supply from the recipient site. This article is protected by copyright. All rights reserved.AIMS AND OBJECTIVES To explore in depth discomfort in intensive care as experienced by patients and attended to by critical care nurses. BACKGROUND Discomfort in illness is complex and persistent, and its alleviation is a challenge for nurses working in intensive care units (ICU). In previous studies, we showed that ICU patients described little actual pain but suffer from much discomfort. Critical care nurses had a systematic approach to the treatment of pain, but were more haphazard in dealing with other types of discomfort. DESIGN Secondary qualitative analysis of data from two previous exploratory studies. METHODS Content analysis was used on existing data from 28 interviews with ICU patients, and 16 field notes and interviews with critical care nurses. Kolcaba's Comfort Theory was applied for further analysis. The COREQ checklist was used. RESULTS Three themes, "Being deprived of a functioning body", "Being deprived of a functioning mind" and "Being deprived of integrity" characterised the discomfort exp Journal of Clinical Nursing published by John Wiley & Sons Ltd.Early data from Wuhan, China show that patients with COVID-19 are typically male, aged 40 to 60 years, and about one-third have comorbidities. Moreover, of 138 COVID-19 patients hospitalized in Wuhan and treated in an intensive care unit (ICU), 25% had cardiovascular disease and 58% hypertension; the respective figures for non-ICU-treated COVID-19 patients were 10% and 22% [1]. Based on these early data, a predisposition to acute cardiac complications related to underlying atherosclerotic cardiovascular disease (ASCVD) may significantly increase the severity of COVID-19 in susceptible individuals. This article is protected by copyright. All rights reserved.Individuals shift their language to converge with interlocutors. Recent work has suggested that convergence can target not only observed but also expected linguistic behavior, cued by social information. However, it remains uncertain how expectations and observed behavior interact, particularly when they contradict each other. We investigated this using a cooperative map task experiment, in which pairs of participants communicated online by typing messages to each other in a miniature "alien" language that exhibited variation between alien species. The overall task comprised three phases, in each of which participants were told that they would be paired with a different partner. One member of the pair was given explicit linguistic expectations in each phase, while the software controlled whether or not observed behavior from their partner would be consistent or inconsistent with these expectations. The other participant was given no such expectations, allowing us to control for the role of expectation. Participants converged to both observed and expected linguistic behavior, and convergence was boosted when observation and expectation were aligned. When expected and observed behavior were misaligned, participants updated their expectations, though convergence levels did not drop. Furthermore, participants generalized what they learned about one partner to apparent novel partners of the same alien species. We also discuss individual variation in convergence patterns and the lack of a relationship between linguistic convergence and success at the map task. Findings are consistent with observations outside the laboratory that language users converge toward expected linguistic behavior. They also have broader implications for understanding linguistic accommodation and the influence of social information on linguistic processing and production. © 2020 Cognitive Science Society, Inc.OBJECTIVE Serum free light chain（FLC）level is closely associated with the functional state of B lymphocytes, and many studies have shown that delayed reconstitution of B lymphocytes contributed to chronic graft-versus-host disease (cGVHD). This study assessed the predictive value of FLC levels in serum collected early after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for cGVHD. METHODS 62 patients who had undergone allo-HSCT were retrospectively reviewed．The correlations between the FLC levels and the development of cGVHD were explored. Results Of the 62 patients, 33 cases developed cGVHD, with the prevalence of 53.2%.With Seattle classification, 19 cases had limited cGVHD while 14 cases contracted extensive cGVHD. While with NIH classification, 17 cases had mild cGVHD, 6 cases moderate cGVHD and 10 cases severe cGVHD. Multivariant statistical analysis showed that the FLC levels were not associated with all severities of cGVHD but were correlated with the development of extensive or moderate to severe cGVHD (P=0.01and 0.038, respectively). CONCLUSIONS Serum FLC levels early after HSCT may reflect the functional state of B cell reconstitution. Patients with low serum FLC Level early post allo-HSCT tend to develop extensive cGVHD or moderate to severe cGVHD. This article is protected by copyright. All rights reserved.BACKGROUND/OBJECTIVES Acute graft-versus-host disease (aGVHD) is a serious condition after allogeneic hematopoietic stem cell transplantation (HSCT), frequently involving skin, gut, and liver. It can be difficult to diagnose early, yet this is vital for adequate management. We sought to identify initial clinical and histopathological features in children with suspected GVHD and the association with clinical course and outcomes. METHODS Retrospective study of patients with skin biopsies for suspected aGVHD from 2006 to 2016. selleck chemicals llc We collected demographic and clinical information, histologic, and immunohistochemical (IHC) findings, and outcomes during follow-up. Bivariate and multivariate analyses were done to identify risk factors associated with remission, development of severe/life-threatening aGVHD, and mortality. RESULTS We included 42 patients, 15 females. Skin manifestations occurred 51 days (median) after HSCT. On biopsy, 76.2% had mild (stage 1-2) skin aGVHD; during the course of the disease, severity and s 2020 Wiley Periodicals, Inc.The metal-free cis selective hydrogenation of alkynes catalyzed by a boroxypyridine is reported. A variety of internal alkynes are hydrogenated at 80 °C under 5 bar H 2 with good yields and stereoselectivity. Furthermore, the catalyst described herein enables the first metal-free semihydrogenation of terminal alkynes. Mechanistic investigations, substantiated by DFT computations, reveal that the mode of action by which the boroxypyridine activates H 2 is reminiscent of the reactivity of an intramolecular frustrated Lewis pair. However, it is the change in the coordination mode of the boroxypyridine upon H 2 activation that allows the dissociation of the formed pyridone borane complex and subsequent hydroboration of an alkyne. This change in the coordination mode upon bond activation is described by the term boron-ligand cooperation. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.BACKGROUND Red algae have been reported to improve lipid and glucose metabolism in rats. We investigated the effects of Palmaria palmata (P. palmata), a red alga from northern Japan, on lipid metabolism and glycemic control in participants with hypercholesterolemia. METHODS We conducted an 8-week, randomized, double-blind, placebo-controlled, and parallel-group comparison trial. The study enrolled Japanese participants with a serum low-density protein cholesterol (LDL-C) ≥120 mg/dL. The participants were randomly assigned to take either capsules containing P. palmata (2 g/day) or placebo capsules. The primary endpoint was the change in LDL-C from baseline to week 8 and the secondary endpoints were the changes in other lipid parameters and glycemic control. RESULTS Of the 104 participants completed the study protocol. There were no significant differences in change in LDL-C, body mass index, waist circumference, or glycemic control between the two groups. However, serum triglyceride showed significantly greater improvement in women in the P. palmata group (-9.0 [-25.0, +5.0]) vs. those in the placebo group (-1.0 [-11.0, +19.0]; p = .03). CONCLUSIONS The present study did not show that P. palmata had significant effect on serum LDL-C nor glycemic control, but hypertriglyceridemia could be ameliorated by administration of P. palmata in women. © 2020 John Wiley & Sons, Ltd.An unprecedented spin cluster-based network architecture [Ni II 2 (pdaa)(OH) 2 (H 2 O)] n (1; H 2 pdaa =1,4-phenylene diacetic acid), comprising 1D linear chains of Ni II ions crosslinked via Ni 4 O 4 -cubanes, forms under hydrothermal conditions; this 3D coordination network exhibits magnetic ordering at 23.9 K as well as a second magnetic ordering process at 2.8 K likely associated with a structural phase transition. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Cholinergic urticaria (CholU) was described first by Duke1 in 1924. CholU is a skin disorder characterized by highly pruritic wheals, 1-2 mm in size, with surrounding erythema. CholU is a chronic inducible urticaria, and usually appears after sweating, which can be induced by hot baths, physical exercise, and/or emotional stress. This article is protected by copyright. All rights reserved.BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease. Human interleukin-10+ B cells (B10 cells) is one of regulatory B cells and is enriched in CD19+ CD24hi CD38hi B cells. Little is known about these cells in atopic dermatitis. OBJECTIVE To study CD19+ CD24hi CD38hi B cells and their clinical significance in Chinese adult patients with atopic dermatitis. METHODS Thirty-two adult patients with AD and nineteen healthy controls were enrolled. Peripheral blood mononuclear cells (PBMCs) were isolated and stained with fluorescein-conjugated monoclonal antibodies for CD19, CD24, CD27, CD38, Annexin-V. The stained PBMCs were analyzed by flow cytometry. B10 cells were prepared by stimulating PBMCs with CpG, LPS, CD40L followed by re-stimulation with phorbol12-myristate 13-acetate (PMA) and ionomycin. Serum IL-10, B-cell-activating factor (BAFF) and a proliferation inducing-ligand (APRIL) levels were measured by using the ELISA. Apoptosis and proliferation of CD19+ CD24hi CD38hi B cells were measured by flow cytometry.