bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing the use of physical restraints in home care - Development and feasibility testing of a multicomponent program to support the implementation of a guideline
Authors: Vandervelde Sara , Scheepmans Kristien , Milisen Koen , Achterberg Theo van , Vlaeyen Ellen , Flamaing Johan , de Casterlé Bernadette Dierckx 
Published: October 2020

Abstract
Background: A validated evidence-based guideline was developed to reduce physical restraint use in home care. However, the implementation of guidelines in home care is challenging. Therefore, this study aims to systematically develop and evaluate a multicomponent program for the implementation of the guideline for reducing the use of physical restraints in home care.Methods: Intervention Mapping was used to develop a multicomponent program. This method contains six steps. Each step comprises several tasks towards the design, implementation and evaluation of an intervention; which is theory and evidence informed, as well as practical. To ensure that the multicomponent program would support the implementation of the guideline in home care, a feasibility study of eight months was organized in one primary care district in Flanders, Belgium. A concurrent mixed methods design was used to evaluate the multicomponent program consisting of a knowledge test, focus groups and an online survey. Results: The Social Cognitive Theory and the Theory of Planned Behavior are the foundations of the multicomponent program. Based on modeling, active learning, guided practice, belief selection and resistance to social pressure, eight practical applications were developed to operationalize these methods. The key components of the program are: the ambassadors for restraint-free home care (n = 15), the tutorials, the physical restraint checklist and the flyer. The results of the feasibility study show the necessity to select uniform terminology and definition for physical restraints, to involve all stakeholders from the beginning of the process, to take time for the implementation process, to select competent ambassadors and to collaborate with other home care providers.Conclusions: The multicomponent program shows promising results. Prior to future use, further research needs to focus on the last two steps of Intervention Mapping (program implementation plan and developing an evaluation plan), to guide implementation on a larger scale and to formally evaluate the effectiveness of the multicomponent program.
Promoting healthy foods in the new digital era on Instagram: An experimental study on the effect of a popular real fit influencer versus a fictitious fit influencer on brand attitude and purchase intentions.
Authors: Folkvord Frans , Roes Elze , Bevelander Kris 
Published: October 2020

Abstract
Background: Most studies on social influencer marketing techniques have focused on the promotion of unhealthy foods whereas little is known about the promotion of healthier foods. The present experimental study investigated whether a popular real versus fictitious social influencer is more successful in promoting healthy food products. In addition, we examined the role of parasocial interaction as an underlying mechanism of healthy food product endorsement.Methods: We used a randomized between-subject design with 154 participants (mean age: 24.0 years). Viewers’ product attitude and purchase intention were tested after exposure to an Instagram post by a popular real ‘fit influencer’ (n = 77) or fictitious fit influencer (n= 77).Results: Results showed that parasocial interaction mediated the relation between the type of influencer and product attitude as well as purchase intention. Parasocial interaction was higher for participants exposed to the popular real fit influencer compared to the fictitious influencer, leading to higher healthy food brand attitude and purchase intention.Discussion: The findings showed that it is crucial for social influencers to establish a warm personal relationship and connection with the their followers when promoting a healthy product successfully. We suggest that the promotion of healthy foods could be more successful in public health when using popular social influencers.
Clinicopathologic Characteristics and Surgical Outcome of Synthetic Fiber Conjunctival Granuloma
Authors: Chen Zhang , Wang Tianyang , Pan Qintuo , Zhang Zhaoliang , Zhang Zongduan 
Published: October 2020

Abstract
Background: Until recently, synthetic fiber conjunctival granuloma (SFCG) is rarely reported and has been poorly understood. Our study was to explore the clinical features, histopathologic characteristics, surgical outcomes, and prognosis of SFCG after surgical excision. Methods: Retrospective review of clinical findings, histopathological and immunohistochemical studies identified 18 cases of SFCG. Specimens were routinely processed and stained with H&E. Immunohistochemical stains for GMS, PAS, CD68 and CK-pan were also performed.Results: Eighteen patients with an average age of 9.3±6.6 years had a tender white to red mass on the conjunctiva. All the lesions were completely removed, and none of the patients relapsed. Histologically, all of the specimens revealed inflammatory granulation tissues with a large number of inflammatory cells infiltration and the presence of synthetic fibers. Immunohistochemical stains were positive for CD68, CK, GMS and PAS. Conclusions: Synthetic fiber conjunctival granuloma is an uncommon lesion with foreign body sensation caused by inoculation of synthetic exogenous materials. These lesions are mostly unilateral and occur in the inferior conjunctival fornix. SFCGs are characterized by a large number of inflammatory cells infiltration and the presence of synthetic fibers. Surgical excision followed by topical corticosteroids has been clinically proven to be effective.
Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study
Authors: Scolari Fernando , Schneider Daniel , Fogazzi Débora Vacaro , Gus Miguel , Rover Marciane Maria , Bonatto Marcely Gimenes , de Araújo Gustavo Neves , Zimerman André , Sganzerla Daniel , Goldraich Lívia Adams , Teixeira Cassiano , Friedman Gilberto , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman 
Published: October 2020

Abstract
Background: To evaluate the prognostic value of peak serum lactate and lactate clearance at several time points in cardiogenic shock treated with temporary mechanical circulatory support (MCS) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP®.Methods: Serum lactate and clearance were measured before MCS and at 1h, 6h, 12h, and 24h post-MCS in 43 patients at four tertiary-care centers in Southern Brazil. Prognostic value was assessed by univariable and multivariable analysis and receiver operating characteristic (ROC) curves for 30-day mortality.Results: VA-ECMO was the most common MCS modality (58%). Serum lactate levels at all time points and lactate clearance after 6h were associated with mortality on unadjusted and adjusted analyses. Lactate levels were higher in non-survivors at 6h, 12h, and 24h after MCS. Serum lactate > 1.55 mmol/L at 24h was the best single prognostic marker of 30-day mortality [area under the ROC curve = 0.81 (0.67-0.94); positive predictive value = 86%). Failure to improve serum lactate after 24h was associated with 100% mortality.Conclusions: Serum lactate was an important prognostic biomarker in cardiogenic shock treated with temporary MCS. Serum lactate and lactate clearance at 24h were the strongest independent predictors of short-term survival.
Decomposition and stabilization of the organic matter in an old-growth tropical riparian forest: effects of soil properties and vegetation structure
Authors: Fernandes Pedro , Souza Andrea Teixeira , Tanaka Marcel , Sebastiani Renata 
Published: October 2020

Abstract
Background: Nutrient cycling in tropical forests has large importance for primary productivity, and decomposition of litterfall is a major process influencing nutrient balance in forest soils. Although large-scale factors strongly influence decomposition patterns, small-scale factors can have major influences, especially in old-growth forests that have high structural complexity and strong plant-soil correlations. We evaluated decomposition rates and stabilization of soil organic matter using the Tea Bag Index in an old-growth riparian forest in southeastern Brazil to evaluate the effects of forest structure and soil properties on decomposition processes. These data sets were described separately using Principal Components Analysis (PCA). The main axes for each analysis, together with soil physical properties (clay content and soil moisture), were used to construct different structural equations models that evaluated the different parameters of the TBI, decomposition rates and stabilization factor. The best model was selected using Akaike’s criterion.Results: Forest structure and soil physical and chemical properties presented large variation among plots within the studied forest. Clay content was strongly correlated with soil moisture and the first PCA axis of soil chemical properties, and model selection indicated that clay content was a better predictor than this axis. Decomposition rates presented a large variation among tea bags (0.009 and 0.098 g g-1 day-1) and were positively related with forest structure, as characterized by higher basal area, larger trees, and tree density. The stabilization factor varied between 0.211 – 0.426 and was related to forest stratification and soil clay content. Conclusions: The old-growth forest studied presented high heterogeneity in both forest structure and soil properties at small spatial scales, that influenced decomposition processes and probably contributed to small-scale variation in nutrient cycling. Decomposition rates were only influenced by forest structure, whereas the stabilization factor was influenced by both forest structure and soil properties. Heterogeneity in ecological processes can contribute to the resilience of old-growth forests, highlighting the importance of restoration strategies focused on the spatial variation of ecosystem processes.
The influence of medical insurance and social security cards on the floating population's settlement intention
Authors: Li Yulin , Huang Lingling , Xiang Li , Dou Dongmei 
Published: October 2020

Abstract
Background: There are many studies on the factors influencing the floating population's intentions to settle down. Medical insurance and social security cards are an important incentive for the floating population to live a stable life in their current residence, but there are limited studies on the influence of medical insurance and social security cards on settlement intentions. Therefore, the purpose of this paper was to study the impact of basic medical insurance for urban employees and the decision as to whether to apply for individual social security cards on the settlement intentions of the floating population. As the willingness to settle has increased, the development of health management and public health in the place of residence has improved. Methods: Based on the 2017 survey data from the dynamic monitoring of China's floating population, we explored the influence of basic medical insurance for urban employees and social security cards on the floating population's settlement intentions with binary logistic regression and structural equation models. Additionally, this study also examined the comprehensive causal relationship, with social integration as the mediator variable. Results: The settlement intention of members of the floating population after participating in basic medical insurance for urban employees was 23.2 percent higher than that of those who did not participate. The decision as to whether to apply for a personal social security card is related to their settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention were positive values, and the Z values of the overall effect, indirect effect, and direct effect were all greater than 1.96; the confidence interval of the indirect effect did not include 0. We found that this model is a partial intermediary model, with an intermediary ratio of 10.66 percent. Conclusions: This article highlights the important impact of basic medical insurance for urban employees and individual social security cards on the floating population. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intentions of the floating population and to improve the development of public health undertakings.
Parathyroid carcinoma with sarcomatoid differentiation: A case report and literature review
Authors: Hu Liang , Xie Xiaojun 
Published: October 2020

Abstract
Background Parathyroid carcinoma (PC) is a rare thyroid tumor. PC with sarcomatoid differentiation(PCSD) is even rarer and its exact etiology remains unclear. We here report a case of PCSD, and present the clinicopathological features and pathological diagnosis and review the literature. Case presentation A 71-year-old man presented with a mass of 4.5 cm × 3.5 cm in the right neck. The tumor was composed of nest-like transparent cells, and the septum had heterotypic rhabdoid cells with sarcomatoid differentiation. Immunophenotype was as follows: MyoD1, myogenin and desmin were positive; clear cells were positive for CGA, Syn and GATA-3; and Ki-67 proliferation index was 40%. Hematoxylin and eosin staining and immunohistochemistry were performed. The patient was diagnosed with PCSD, and died 6 months after surgery.Conclusions PCSD is a rare type of primary parathyroid tumor with high malignancy and poor prognosis. Definitive diagnosis should be based on histopathological morphology and immunophenotype, and surgical treatment should be performed as soon as possible.
A Correlative Study on Social Support and Quality of Life in Patients After Adult Liver Transplantation
Authors: Xiao Qigui , Zhang Bo , Lu Huapeng , Lang Lan , Zhang Jiaoqiong , Yang Qingling , Ma Qingyong , Sha Huanchen 
Published: October 2020

Abstract
Background: The purpose of this study was to investigate the quality of life among adult liver transplantation patients and to explore the relationship between social support and quality of life in patients. Methods: This descriptive study contain 105 patients who underwent liver transplantation. The general information questionnaire, social support rating scale (SSRS), and post-liver transplant quality of life questionnaire (pLTQ) were used. The data analysis was conducted using SPSS 18.0 software, and independent t test, ANOVA, Pearson and correlation analysis were implemented. Results: The total score of social support in adult liver transplant patients was 45.35 ± 7.31, including subjective support dimension (26.84 ± 4.13), objective support (11.42 ± 3.40), and utilization of social support (7.09 ± 2.12). The total score of quality of life in adult liver transplant patients was 138.08 ± 26.31, including anxious (37.23 ± 9.86), physical function (26.60 ± 5.51), emotional function (21.23 ± 4.35), financial (12.59 ± 4.80), healthcare (24.89 ± 5.27), and complications (15.55 ± 3.38). The total score of social support was positively correlated with the total score of quality of life (r = 0.313), anxious (r = 0.299), physical function (r = 0.255), emotional function (r = 0.215), healthcare (r = 214), and complications (r = 217). Objective support was positively correlated with total score of quality of life (r = 0.246), anxious (r = 0.209), emotional function (r = 0.210) and complications (r = 0.293). Subjective support was positively correlated with total score of quality of life (r = 0.361), anxious (r = 0.404), physical function (r = 0.305), economy (r = 0.281), healthcare (r = 0.199), and complications (r = 0.238). Conclusions: There is a positive correlation between social support and quality of life after adult liver transplantation.
Acceptance and Risk Perception of COVID-19 Vaccine in Uganda: A Cross Sectional Study in Western Uganda
Authors: Echoru Isaac , Ajambo Patricia Decanar , Bukenya Edmund Mugabi 
Published: October 2020

Abstract
Background: Many countries have drawn their attention on developing Corona virus disease 2019 vaccine however there is less emphasis on whether this vaccine could be accepted in most of these countries. This study aimed to investigate acceptance and risk perception of COVID-19 vaccine in Uganda. Method: A simplified snowball sampling technique was used to select 1067 respondents of 18-70 years in western Uganda using an online questionnaire from July to September 2020. Vaccine acceptability and risk perception was assessed using odds ratio at 95% confidence interval using R software version 3.6.3. Results: The acceptance rate for vaccination against COVID-19 was (53.6%; 572/1067) with participants in the reference age group 18-20 (OR: 1; 95%CI: NA); males (OR: 2.1; 95%CI: 1.56-2.71; P=0.000); tertiary level of education (OR: 2.8; 95%CI: 1.25-6.11; P=0.009); students (OR: 3.19; 95%CI: 1.98-5.15; P=0.000) and non-salary earners (OR: 2.29; 95%CI: 1.53-3.44; P=0.000) significantly more likely to accept the vaccine. Results also showed that (46.4%; 495/1067) of the respondents were un-likely to accept the vaccine. About (44.6%; 476/1067) of the respondents were likely to accept vaccine clinical trials with participants in the reference age group 18-20 (OR: 1; 95%CI: NA), students (OR: 2.37; 95%CI: 1.49-3.77; P=0.000), marrieds (OR: 1.3; 95%CI: 1.03-1.69; P=0.028), and non-salary (OR: 1.56; 95%CI: 1.05-2.30; P=0.029) significantly more likely to accept clinical trials. There were (46.7%; 500/1067) of the respondents who perceived the vaccine as being risky with males (OR: 3.13; 95%CI: 2.33-4.21; P=0.000); students (OR: 2.59; 95%CI: 1.63-4.13; P=0.000); Civil servants (OR: 1.49; 95%CI: 0.98-2.25; P=0.063); and non-salary earners; (OR: 2.34; 95%CI: 1.57-3.47; P=0.000) who significantly perceived the vaccine as being more risky.Conclusion: The level of vaccine acceptance (53.6%) and risk perception (46.7%) was relatively average in western Uganda. In order to ensure successful vaccination process, the government needs to prioritize vaccine acceptance strategies especially among the risky group in the community.
4DVAR HF radar assimilation South of Africa
Authors: Couvelard Xavier , Messager Christophe , Penven Pierrick , Lattes Phillipe 
Published: October 2020

Abstract
The oceanic circulation south of Africa is characterized by a complex dynamics with a strong variability due to the presence of the Agulhas current and numerous eddies. The area of interest of this paper, is also the location of several natural gas fields under seafloor which are targeted for drilling and exploitation.The complex and powerful ocean currents induce significant issues for ship operations at the surface as well as under the surface for deep sea operations. Therefore, the knowledge of the state of the currents and the ability to forecast them in a realistic manner could greatly enforce the safety of various marine operation. Following this objective an array of HF radar systems was deployed to allow a detailed knowledge of the Agulhas currents and its associated eddy activity. It is shown in this study that 4DVAR assimilation of HF radar allow to represent the surface circulation more realistically. Two kind of experiments have been performed, a one-month analysis and two days forecast. The one-month 4DVAR experiment have been compared to geostrophic currents issued from altimeters and highlight an important improvement of the geostrophic currents. Furthermore, despite the restricted size of the area covered with HF radar, we show that the solution is improved almost in the whole domain, mainly upstream and downstream of the HF radar's covered area. We also show that while benefits of the assimilation on the surface current intensity is significantly reduced in the first 6 hours of the forecast, the correction in direction persists after 48 hours.
Influence of Lawns on the Summer Thermal Environment and Microclimate of Heritage Sites: A Case Study of Fuling Mausoleum, China
Authors: Wang Xiaoyu , Liu Peng , Xu Gongwen 
Published: October 2020

Abstract
The thermal environment and microclimate of heritage sites has been severely impacted by rapid urbanization. This study collected various meteorological measurement data as a reference for computational fluid dynamics (CFD) simulation settings. Then CFD was applied to simulate the impact of lawns on the thermal environment and microclimate of Fuling Mausoleum. We found that lawns and soil can cool the air through evaporation, and thus have a specific cooling effect on the bricked ground. After lawns were planted, the bricked ground temperature decreased by 1.56–17.54°C than that before lawns were planted at 14:00, a decrease of 2.68%–24.20%. Under normal circumstances, when the wind speed or relative humidity increased, the ground temperature dropped. Greenbelt vegetation can adjust the microclimate and human thermal comfort indicators. The consistency of the difference between the actual measurement and the CFD simulation results shows that CFD simulation can thus accurately reflect the internal temperature field distribution if the selection of simulation parameters is reasonable. Theoretical calculation and analysis, experimental measurement research, and modern computer simulation analysis methods applied together constitute a complete system for studying modern physical environmental problems and can provide reliable and economic results.
Walking Stability in Patients With Benign Paroxysmal Positional Vertigo: An Objective Assessment Using Wearable Accelerometers and Machine Learning
Authors: Zhang Yuqian , Wang He , Yao Yifei , Liu Jianren , Sun Xuhong , Gu Dongyun 
Published: October 2020

Abstract
Background: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. Methods: Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing one accelerometer on the head and one on the lower trunk. Temporo-spatial variables and six walking stability related variables (root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry) derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to classify the BPPV severity of gait disturbances. Results: The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) = 0.87, 0.80, and 0.95 respectively for classifying the three stages of DHI subgroups. Conclusions: Results suggested that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BBPV.Trial registration: The trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on March 29, 2018. Registration number: ChiCTR1800015432 (http://www.chictr.org.cn/showproj.aspx?proj=25587).