bluuebunny/crossref_metadata_2025_split huggingface dataset:
Newly graduated nurses’ socialisation resulting in limiting inquiry and one‐sided use of knowledge sources—An ethnographic study
Authors: Voldbjerg Siri Lygum , Wiechula Rick , Sørensen Erik Elgaard , Grønkjær Mette 
Published: December 2020

AbstractAimTo explore how the socialisation into the clinical setting and interaction between newly graduated nurses and experienced nurses influences the new graduates’ use of knowledge sources.BackgroundNewly graduated nurses’ use of knowledge sources in decision‐making has been subject to an increased interest in relation to evidence‐based practice. Despite interventions to strengthen nurses’ competencies required for making reflective clinical decisions within an evidence‐based practice, studies highlight that new graduates only draw on knowledge from research, patients and other components within evidence‐based practice to a limited extent. Research exploring new graduates’ use of knowledge sources calls attention to the experienced nurses’ decisive role as a valued knowledge source. The new graduates’ process of socialisation and their interaction with the experienced nurse raises further questions.MethodsEthnography using participant‐observation and individual semi‐structured interviews of nine newly graduated nurses from a University Hospital in Denmark. Data were collected in 2014. The study adheres to COREQ.ResultsTwo main structures were found: “Striving for acknowledgment” and “Unintentionally suppressed inquiry.”ConclusionsNew graduates are socialised into limiting their inquiry on clinical practice and unintentionally being restricted to using the experienced nurse as predominant knowledge source. Depending on how the experienced nurse responds to the role as predominant knowledge source, they could either limit or nurture the new graduates’ inquiry into practice and thus the variety of knowledge sources used in clinical decision‐making. Limited inquiry into the complexity of nursing practice indirectly excludes the use of a variety of knowledge sources, which are fundamental to an evidence‐based practice.RelevanceIf clinical practice wishes to benefit from the newly graduated nurses’ inquiring approach and skills within evidence‐based practice, clinical practice will have to greet the nurses with a supportive culture where questioning practice is seen as a strength rather than a sign of insecurity and incompetence.
Prognostic impact of sarcopenia in cirrhotic patients stratified by different severity of portal hypertension
Authors: Paternostro Rafael , Bardach Constanze , Hofer Benedikt S. , Scheiner Bernhard , Schwabl Philipp , Asenbaum Ulrika , Ba‐Ssalamah Ahmed , Scharitzer Martina , Bucscis Theresa , Simbrunner Benedikt , Bauer David , Trauner Michael , Mandorfer Mattias , Reiberger Thomas , Lampichler Katharina 
Published: December 2020

AbstractBackground and AimsPortal hypertension (PH) and sarcopenia are common in patients with advanced chronic liver disease (ACLD). However, the interaction between PH and sarcopenia and their specific and independent impact on prognosis and mortality has yet to be systematically investigated in patients with ACLD.MethodsConsecutive patients with ACLD and hepatic venous pressure gradient (HVPG) ≥10 mm Hg with available CT/MRI imaging were included. Sarcopenia was defined by transversal psoas muscle thickness (TPMT) at <12 mm/m in men and <8 mm/m in women at the level of the third lumbar vertebrae. Hepatic decompensation and mortality was recorded during follow‐up.ResultsAmong 203 patients (68% male, age: 55 ± 11, model for end‐stage liver disease [MELD]: 12 [9‐15]), sarcopenia was observed in 77 (37.9%) and HVPG was ≥20 mm Hg in 98 (48.3%). There was no correlation between TPMT and HVPG (r = .031, P = .66), median HVPG was not different between patients with vs without sarcopenia (P = .211). Sarcopenia was significantly associated with first/further decompensation both in compensated (SHR: 3.05, P = .041) and in decompensated patients (SHR: 1.86, P = .021). Furthermore, sarcopenia (SARC) was a significant predictor of mortality irrespective of HVPG (HVPG < 20‐SARC: SHR: 2.25, P = .021; HVPG ≥ 20‐SARC: SHR: 3.33, P = .001). On multivariate analysis adjusted for age, HVPG and MELD, sarcopenia was an independent risk factor for mortality (aHR: 1.99, 95% confidence interval: 1.2‐3.3, P = .007).ConclusionSarcopenia has a major impact on clinical outcomes both in compensated and in decompensated ACLD patients. The presence of sarcopenia doubled the risk for mortality independently from the severity of PH.
Generating liver using blastocyst complementation: Opportunities and challenges
Authors: Aravalli Rajagopal N. 
Published: December 2020

AbstractOrthotopic liver transplantation (OLT) is the only definitive treatment option for many patients with end‐stage liver disease. Current supply of donor livers for OLT is not keeping up with the growing demand. To overcome this problem, a number of experimental strategies have been developed either to provide a bridge to transplant for patients on the waiting list or to bioengineer whole livers for OLT by replenishing them with fresh supplies of hepatic cells. In recent years, blastocyst complementation has emerged as the most promising approach for generating whole organs and, in combination with gene editing technology, it has revolutionized regenerative medicine. This methodology was successful in producing xenogeneic organs in animal hosts. Blastocyst complementation has the potential to produce whole livers in large animals that could be xenotransplanted in humans, thereby reducing the shortage of livers for OLT. However, significant experimental and ethical barriers remain for the production of human livers in domestic animals, such as the pig. This review summarizes the current knowledge and provides future perspectives for liver xenotransplantation in humans.
Combustion of Torrefied Pellets of Furniture Work Dusts as Blends With Lignite
Authors: Yilgin Melek , Hoş Bedriye , Pehlivan Dursun 
Published: December 2020

Abstract
In this study, torrefaction of pellets formed from furniture work dusts collected as a part of space cleaning actions in the industry has been examined. Burning behavior of torrefied dusts and lignite blends was studied. Torrefaction experiments were done under a nitrogen atmosphere for 1 h at temperatures of 220, 260, and 300 °C which corresponded to light, mild, and severe torrefaction, respectively. Combustion of blend pellets prepared by adding lignite in specific ratios to powders of torrefied pellets was carried out at 700 °C initial temperature using a vertical furnace system through which air was flowing in natural convection. Ignition times of blend pellets were affected by volatile matter and moisture contents. Volatile matter combustion rates were lower than those of raw waste, and accordingly, combustion times were higher. However, no relation between volatile matter combustion rates and times was observed. Blending raw or torrefied furniture work dusts with lignite have significantly influenced volatile matter and carbon combustion periods. There was no relation between carbon combustion rates and times. It was concluded that blend pellets of mild or severe torrefaction products of furniture work dusts and lignite behaved similarly to lignite during combustion.
Adjoint-Based Calculation of Parametric Thermoacoustic Maps of an Industrial Combustion Chamber
Authors: Silva Camilo F. , Prieto Laura , Ancharek Maximiliano , Marigliani Pablo , Mensah Georg A. 
Published: December 2020

Abstract
The aim of this study is to efficiently calculate parametric thermoacoustic maps of typical combustion chambers. Two configurations are considered: an academic configuration based on a Rijke tube, and an industrial combustion chamber, which is the core of a recently developed microturbine for power generation. Such maps can be understood as the collection of loci of thermoacoustic eigenfrequencies obtained under systematic variations of some defined parameters, while considering the Helmholtz equation as the thermoacoustic model of interest. In this study we consider variations on two parameters: the gain n and time-delay τ associated with a generic flame response model. We also show the feasibility of the proposed approach when considering more realistic flame responses. A straight-forward way to calculate such a thermoacoustic map is by solving the Helmholtz equation, and, thus, the corresponding nonlinear eigenvalue problem (NLEVP), one time per parameter combination. With that approach, the nonlinear eigenvalue problem needs to be solved hundreds or thousands of times if an adequate resolution of the thermoacoustic map is sought. Such a strategy may be computationally unaffordable. In order to overcome this difficulty, this work utilizes an adjoint-based, high-order perturbation method. The actual eigenvalue problem is only solved once at a baseline point. After applying the perturbation equations at that point, a polynomial rational function—the Padé approximant—is obtained to estimate the eigenfrequency drift that results for a small or large perturbation in the flame response. It is demonstrated, for both academic and industrial test cases, that the obtained maps are accurate. Additionally, it is shown that these maps reveal a large variety of thermoacoustic features, such as stability boundaries, intrinsic thermoacoustic modes, and exceptional points. The numerical costs for such calculations are negligible even for the industrial combustion chamber investigated.
Performance-Determining Variables in Long-Distance Events: Should They Be Determined From a Rested State or After Prolonged Submaximal Exercise?
Authors: Noordhof Dionne A. , Øfsteng Sjur J. , Nirenberg Linnea , Hammarström Daniel , Hansen Joar , Rønnestad Bent R. , Sandbakk Øyvind 
Published: December 2020

Performance-determining variables are usually measured from a rested state and not after prolonged exercise, specific to when athletes compete for the win in long-distance events. Purpose: (1) To compare cross-country skiing double-poling (DP) performance and the associated physiological and biomechanical performance-determining variables between a rested state and after prolonged exercise and (2) to investigate whether the relationship between the main performance-determining variables and DP performance is different after prolonged submaximal DP than when tested from a rested state. Methods: Male cross-country skiers (N = 26) performed a blood lactate profile test and an incremental test to exhaustion from a rested state on day 1 (D1; all using DP) and after 90-minute submaximal DP on day 2 (D2). Results: The DP performance decreased following prolonged submaximal DP (D1: peak speed = 15.33–20.75 km·h−1, median = 18.1 km·h−1; D2: peak speed = 13.68–19.77 km·h−1, median = 17.8 km·h−1; z = −3.96, P < .001, effect size r = −.77), which coincided with a reduced submaximal gross efficiency and submaximal and peak cycle length, with no significant change in peak oxygen uptake (P = .26, r = .23). The correlation coefficient between D1 cycle length at 12 km·h−1 and D2 performance is significantly smaller than the correlation coefficient between D2 cycle length at 12 km·h−1 and D2 performance (P = .033), with the same result being found for peak cycle length (P < .001). Conclusions: The reduced DP performance after prolonged submaximal DP coincided with a reduced submaximal gross efficiency and shorter peak cycle length. The results indicate that performance-determining variables could be determined after prolonged exercise to gain more valid insight into long-distance DP performance.
Multimodal imaging in subclinical best vitelliform macular dystrophy
Authors: Parodi Maurizio Battaglia , Arrigo Alessandro , Calamuneri Alessandro , Aragona Emanuela , Bandello Francesco 
Published: December 2020

BackgroundTo analyse multimodal imaging alterations in the subclinical form of best vitelliform macular dystrophy (BVMD).MethodsThe study was designed as an observational, cross-sectional case series. Eleven eyes of 7 subclinical patients with BVMD and 12 age-matched and sex-matched controls were included. Multimodal imaging included fundus blue-light autofluorescence, near-infrared autofluorescence (NIR-AF), structural optical coherence tomography (OCT) and OCT angiography (OCTA). The quantitative analysis included the calculation of the following parameters: vessel density (VD), vessel tortuosity (VT), vessel dispersion (Vdisp), vessel rarefaction (VR), foveal avascular zone (FAZ) area, reflectivity of the outer retinal bands and choriocapillaris porosity (CCP).ResultsMean best-corrected visual acuity was 0.0±0.0 LogMAR in both groups. The round central hypoautofluorescent alteration on NIR-AF corresponded to a significant reflectivity attenuation of the outer retinal bands on structural OCT (0.55±0.18 vs 0.75±0.08; p<0.001). VD, VT, VR and Vdisp were normal compared with controls (all p>0.05). The FAZ area turned out to be significantly restricted at the level of the deep capillary plexus in subclinical BVMD eyes (p<0.001). Furthermore, quantitative OCTA revealed a significant central increase of CCP, compared with controls (18.25±2.43 vs 4.58±1.36; p<0.001).ConclusionsThe subclinical stage of BVMD is characterised by significant alterations of the outer retinal bands and the choriocapillaris. Quantitative multimodal imaging assessment suggests that subclinical BVMD is affected by the functional impairment of the outer retinal structures, leading to an alteration in melanin and growth factor production.
Estimation of Goldmann applanation tonometer intraocular pressure (IOP) from scleral Schiotz IOP values in eyes with type-1 keratoprostheses
Authors: Senthil Sirisha , Chary Raghava , Ali Mohammed Hasnat , Choudhari Nikhil S , Garudadri Chandra Sekhar 
Published: December 2020

PurposeTo validate estimation of Goldmann applanation tonometer (GAT) intraocular pressure (IOP) from scleral Schiotz IOP measurements using a regression model in normal eyes and eyes with type-1 keratoprostheses.MethodsIn this prospective cross-sectional study, cohort-1 had 253 normal anterior segment eyes, and cohort-2 had 100 eyes with type-1 keratoprostheses. Scleral Schiotz IOP measurements were used (in a non-linear model) to predict GAT IOP values for these eyes. Accuracy of predicted GAT IOP values was assessed using actual GAT IOP values for normal eyes, while for type-1 keratoprosthetic eyes, finger tension (FT) IOP assessments by an experienced glaucoma specialist were used. Primary outcome was agreement between FT IOP (assessed by an experienced glaucoma specialist) and predicted GAT IOP-derived clusters.ResultsThe actual values of GAT IOP measurements in normal eyes (n=253; mean age ±SD, 51.35±15.56 years) ranged between 6 mm Hg and 62 mm Hg (mean=22±10.05 mm Hg). Estimated and actual GAT IOP values for normal eyes were very similar (mean difference=0.05 mm Hg with limits of agreement: −5.39 to 5.5 by Bland-Altman plot). Of the 100 eyes with type-1 keratoprostheses, 68 were classified as having digitally normal IOP, 28 as borderline and 4 as high. The agreement between classification by FT assessment and model-predicted GAT IOP values was substantial (Kappa=0.81, 95% CI 0.69 to 0.93). The accuracy of the model in assessing IOP was found to be 91% (95% CI 0.84 to 0.96).ConclusionScleral Schiotz IOP values along with our predictive model can be an alternative objective method to FT IOP in assessing IOP in eyes with type-1 keratoprostheses.
Effect of gender affirming hormones on athletic performance in transwomen and transmen: implications for sporting organisations and legislators
Authors: Roberts Timothy A , Smalley Joshua , Ahrendt Dale 
Published: December 2020

ObjectiveTo examine the effect of gender affirming hormones on athletic performance among transwomen and transmen.MethodsWe reviewed fitness test results and medical records of 29 transmen and 46 transwomen who started gender affirming hormones while in the United States Air Force. We compared pre- and post-hormone fitness test results of the transwomen and transmen with the average performance of all women and men under the age of 30 in the Air Force between 2004 and 2014. We also measured the rate of hormone associated changes in body composition and athletic performance.ResultsParticipants were 26.2 years old (SD 5.5). Prior to gender affirming hormones, transwomen performed 31% more push-ups and 15% more sit-ups in 1 min and ran 1.5 miles 21% faster than their female counterparts. After 2 years of taking feminising hormones, the push-up and sit-up differences disappeared but transwomen were still 12% faster. Prior to gender affirming hormones, transmen performed 43% fewer push-ups and ran 1.5 miles 15% slower than their male counterparts. After 1 year of taking masculinising hormones, there was no longer a difference in push-ups or run times, and the number of sit-ups performed in 1 min by transmen exceeded the average performance of their male counterparts.SummaryThe 15–31% athletic advantage that transwomen displayed over their female counterparts prior to starting gender affirming hormones declined with feminising therapy. However, transwomen still had a 9% faster mean run speed after the 1 year period of testosterone suppression that is recommended by World Athletics for inclusion in women’s events.
Association of physical activity and sedentary behavior with type 2 diabetes and glycemic traits: a two-sample Mendelian randomization study
Authors: Meisinger Christa , Linseisen Jakob , Leitzmann Michael , Baurecht Hansjoerg , Baumeister Sebastian Edgar 
Published: December 2020

IntroductionObservational studies suggest that physical activity lowers and sedentary behavior increases the risk of type 2 diabetes. Despite of some supportive trial data for physical activity, it is largely unresolved whether these relations are causal or due to bias.ObjectiveWe investigated the associations between accelerometer-based physical activity and sedentary behavior with type 2 diabetes and several glycemic traits using two-sample Mendelian randomization analysis.Research design and methodsSingle nucleotide polymorphisms (SNPs) associated at p<5×10−8with accelerometer-based physical activity average accelerations, vigorous physical activity (fraction of accelerations >425 milligravities), and sedentary behavior (metabolic equivalent task ≤1.5) in a genome-wide analysis of the UK Biobank served as instrumental variables.OutcomesType 2 diabetes, hemoglobin A1c (HbA1c), fasting glucose, homeostasis model assessment of beta-cell function (HOMA-B), and homeostasis model assessment of insulin resistance (HOMA-IR).ResultsPhysical activity and sedentary behavior were unrelated to type 2 diabetes, HbA1c, fasting glucose, HOMA-B, and HOMA-IR. The inverse variance weighted ORs per SD increment for the association between average accelerations and vigorous physical activity with type 2 diabetes were 1.00 (95% CI 0.94 to 1.07, p=0.948) and 0.83 (95% CI 0.56 to 1.23, p=0.357), respectively. These results were confirmed by sensitivity analyses using alternative MR-methods to test the robustness of our findings.ConclusionsBased on these results, genetically predicted objectively measured average or vigorous physical activity and sedentary behavior is not associated with type 2 diabetes risk or with glycemic traits in the general population. Further research is required to deepen the understanding of the biological pathways of physical activity.
Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar
Authors: Mugo Ngatho Samuel , Mya Kyaw Swa , Raynes-Greenow Camille 
Published: December 2020

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.