BACKGROUND To date, there has been no published work towards understanding or classifying patient safety incidents (PSIs) or their aftermath as potential morally injurious experiences (pMIEs). A morally injurious experience is one that violates deeply held moral values and beliefs, and can put an individual at risk for burnout, post-traumatic stress disorder, and other trauma-related problems. This can also set the stage for moral injury, which can occur when there has been a betrayal of what is right by someone in a position of legitimate authority, or by one’s self, in a high-stakes situation. OBJECTIVE The objective of this review of nurse second victim literature is to describe symptoms of moral injury empirically observed in nurses in the aftermath of a PSI. METHODS A critical review using a SALSA (search, appraisal, synthesis, analysis) method commenced with a search of electronic data base-indexed original evidence between 1980 and December 2018, focusing on registered nurses involved with a PSI. RESULccurately reflecting the pMIEs of the aftermath. © 2020 Sigma Theta Tau International.A combination of Angelicae Dahuricae Radix and Acori Tatarinowii Rhizoma has been widely used as the herb-pair in traditional Chinese medicine to treat stroke, migraine and epilepsy. However, the underlying synergistic mechanism of the herb-pair remains unknown. This study was aimed at investigating the effects of Acori Tatarinowii Rhizoma volatile oil on the pharmacokinetic parameters of xanthotoxol, oxypeucedanin hydrate and byakangelicin from Angelicae Dahuricae Radix in rat, and in vitro absorption behavior of the three compounds using rat everted gut sac, in situ single-pass intestinal perfusion and Caco-2 cell monolayer models. The pharmacokinetic study exhibited clear changes in the key pharmacokinetic parameters of the three main coumarins through co-administering with Acori Tatarinowii Rhizoma volatile oil (50 mg/kg), the area under curve and the maximum plasma concentration of xanthotoxol increased 1.36 and 1.31 times; the area under curve, the maximum plasma concentration, mean residence time, half-life of elimination and the time to reach peak concentration of oxypeucedanin hydrate raised 1.35, 1.18, 1.24, 1.19 and 1.49 times, respectively; the area under curve, mean residence time, half-life of elimination and time to reach peak concentration of byakangelicin climbed 1.29, 1.27, 1.37 and 1.28 times, respectively. The three coumarin components were absorbed well in the jejunum and ileum in the intestinal perfusion model, when co-administered with Acori Tatarinowii Rhizoma volatile oil (100 μg/mL). The in vivo and in vitro experiments showed good relevance and consistency. The results demonstrated that the three coumarin compounds from Angelicae Dahuricae Radix were absorbed through the active transportation, and Acori Tatarinowii Rhizoma volatile oil could promote the intestinal absorption and transport of these compounds via inhibiting P-gp-mediated efflux. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.PROBLEM The adverse effects of bullying victimization among adolescents have been examined extensively. However, few studies have examined how bullying perpetration affects health. Moreover, ethnic or religious minorities are particularly at risk for bullying involvement, but little is known about bullying among Arab Americans. The purpose of this study is to examine how bullying perpetration and victimization are related-independently and concurrently-to physical and psychological problems among Arab American adolescents. METHOD Arab American adolescents (N = 150), ages 12-16, were recruited from a community center and a mosque located in Southeast Michigan. Selleck CT99021 Participants completed the Adolescent Peer Relations Instrument, the Children’s Somatization Inventory, the Kessler Psychological Distress Scale, and the Perceived Stress Scale. FINDINGS Both bullying perpetration and victimization correlated positively with physical and psychological symptoms. Hierarchical regressions indicated that both perpetration and victimization simultaneously and significantly predicted physical and psychological symptoms, and these relationships were independent of the demographic factors and general life stress. CONCLUSIONS Bullying perpetration and victimization are associated with adverse health outcomes in Arab American adolescents, independent of life stress. These findings are among the first ones in this population and pave the way for future research and intervention programs. © 2020 Wiley Periodicals, Inc.Cell-to-cell variability in stress response is a bottleneck for the construction of accurate and predictive models which could guide clinical diagnosis and treatment of certain diseases, for example, cancer. Indeed, such phenotypic heterogeneity can lead to fractional killing and persistence of a subpopulation of cells which are resistant to a given treatment. The heat shock response network plays a major role in protecting the proteome against several types of injuries. link2 Here, we combine high-throughput measurements and mathematical modeling to unveil the molecular origin of the phenotypic variability in the heat shock response network. Although the mean response coincides with known biochemical measurements, we found a surprisingly broad diversity in single-cell dynamics with a continuum of response amplitudes and temporal shapes for several stimulus strengths. We theoretically predict that the broad phenotypic heterogeneity is due to network ultrasensitivity together with variations in the expression level of chaperones controlled by the transcription factor heat shock factor 1. Furthermore, we experimentally confirm this prediction by mapping the response amplitude to chaperone and heat shock factor 1 expression levels. © 2020 Federation of European Biochemical Societies.Prescribing pathways for Australian dietitians are limited in comparison to dietitians practising in New Zealand and the United Kingdom. Therefore where medication dose may be titrated relative to dietary intake, such as in pancreatic exocrine insufficiency, dietitians in Australia are unable to initiate therapy or adjust dosage. AIM To explore current practice roles of Australian dietitians working with patients requiring pancreatic enzyme replacement therapy (PERT), and opinions and influences on these practices. METHODS An online survey and telephone interviews with self-nominated dietitians who identified with extended scope of practice with patients on PERT. Thematic analysis was undertaken through an inductive approach to better understand the contexts and reasoning around a dietitian’s extended scope of practice. RESULTS The majority of participants in the online survey (74/81) described roles beyond traditional scope of practice with patients requiring PERT, especially in a multidisciplinary team environment. Most respondents (97%) believed PERT prescribing for dietitians would be beneficial. Nine semi-structured telephone interviews with experienced dietitians revealed perceived benefits of current advanced and informal extended scope of practice for dietitians including greater efficiency; improved patient care; increased job satisfaction and enhanced inter-professional communication. Dietitians believe they are adequately equipped to prescribe medication where dose is largely dependent upon diet. CONCLUSIONS In Australia, it is common for dietitians in care of patients prescribed PERT to engage in informal, extended scope of practice. Further research is required to determine the framework to achieve formal extended scope of practice related to PERT and potentially other medications. © 2020 Dietitians Association of Australia.Glycogen storage disease type III (GSD III) is a rare autosomal recessive inborn error of glycogen degradation pathway due to deficiency or reduced activity of glycogen debranching enzyme (GDE) that results in accumulation of abnormal glycogen in the liver, muscle, and heart. The cardinal hallmarks are hepatomegaly, fasting hypoglycemia, seizures, growth retardation, progressive skeletal myopathy, and cardiomyopathy in few. To date, 258 mutations in amyloglucosidase (AGL) gene have been identified worldwide. However, the mutation spectrum in the Asian Indian region is yet to be well characterized. We investigated 24 patients of Asian origin from 21 unrelated families with a provisional diagnosis of GSD III based on clinical and biochemical criteria. Molecular diagnosis was assessed by bidirectional sequencing and the impact of novel missense variants on the tertiary (three-dimensional) structure of GDE was evaluated by molecular modeling approach. Eighteen different pathogenic variants were identified, out of which 78% were novel. Novel variants included five nonsense, three small duplications and two small deletions, a splice site variant, and three missense variants. Variations in Exons 4, 14, 19, 24, 27, and 33 accounted for 61% of the total pathogenic variants identified and Allele p.Gly798Alafs*3 showed a high allele frequency of 11%. link3 Molecular modeling study of novel pathogenic missense variants indicated the probable underlying molecular mechanism of adverse impact of variations on the structure and catalytic function of human GDE. Our study is the first large study on GSD III from the Asian subcontinent, which further expands the mutation spectrum of AGL. © 2020 Wiley Periodicals, Inc.BACKGROUND Single tool approaches often fail to provide effective long-term suppression of pest populations, such that combining several tools into an integrated management strategy is critical. Yet studies that harness the power of population models to explore the relative efficacy of various management tools and their combinations remain rare. We constructed a Leslie matrix population model to evaluate the potential of crop resistance, acting alone or in combination with biological control, to reduce populations of the wheat stem sawfly, Cephus cinctus Norton, a major pest of wheat in North America. RESULTS Our model projections indicated that crop resistance reduced, but did not stop, C. cinctus population growth, suggesting that implementing multiple management tools will be necessary for longer term control of this pest. The levels of parasitism needed to curtail population growth were much lower in model projections for resistant solid-stemmed compared with susceptible hollow-stemmed cultivars (22 vs 86%). Furthermore, even when accounting for the reduced levels of parasitism observed in resistant cultivars, projected population growth rates for C. cinctus were always lower in resistant compared with susceptible wheat cultivars. CONCLUSION Despite some empirical evidence for antagonistic interactions between resistance and biological control, our models suggest that combining these two approaches will always reduce population growth rates to lower levels than implementing either strategy alone. More work focused on integrating biological control into crop resistance breeding programs, and determining how these approaches affect performance of limiting life stages, will be important to optimize sustainable approaches to integrated pest management in this system and more broadly. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.