bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of quality improvement intervention with nurse training in nursing homes: A systematic review
Authors: Chen Huijing , Feng Hui , Liao Lulu , Wu Xinyin , Zhao Yinan , Hu Mingyue , Li Hui , Hu Hengyu , Yang Xiufen 
Published: April 2020

AbstractIntroductionQuality improvement may be a promising approach to improve the quality of care in nursing homes, and nurse training is a key step in a successful quality improvement practice. The implementation of training measures may be related to the quality of quality improvement practice. Little is known about the quality of quality improvement practice or effective nurse training measures that affect the quality of quality improvement interventions in nursing homes.AimsThe aim of this review was to assess the quality of available quality improvement intervention designs and present effective nurse training measures that contribute to a high‐quality quality improvement intervention.MethodsWe searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and the Cochrane Library for articles published before March 2019. quality improvement intervention quality was evaluated using a standardised assessment tool. Descriptive synthesis was used for the analysis. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) Checklist was used for transparency.ResultsWe included 12 articles, 1 was rated as perfect quality and 7 good quality. Out of these 8 studies, 3 features primarily reflected differences in quality: compliance, sustainability and replication ability of the interventions. They were affected by measures included provision of advanced training, available training resources, feedback process, building quality improvement teams, setting up mentors and nursing leadership training. Other recommended measures included external cooperation and leadership empowerment.ConclusionA high‐quality quality improvement intervention should consider how to improve compliance, sustainability and replication ability. Adapting measures that are compatible with nurse training may ensure a successful implementation of quality improvement programmes that are conducive to the effective improvement of service quality.Relevance to clinical practiceQuality improvement programmes should take into account measures that are compatible with nursing staff training. These measures should help improve the quality of interventions and promote care service of nursing homes.
Effects of increasing alfalfa (Medicago sativa) leaf levels on the fattening and slaughtering performance of organic broilers
Authors: Pleger Lydia , Weindl Petra Nicole , Weindl Peter Andreas , Carrasco Luz Salomé , Leitao Céline , Zhao Minjie , Schade Benjamin , Aulrich Karen , Bellof Gerhard 
Published: April 2020

AbstractA feeding trial was conducted to evaluate the effects of increasing alfalfa leaf levels on the performance of organic broilers. The impact of drying temperature on the nutritional value of alfalfa leaves and thereby on broiler performance was studied using alfalfa leaves dried at either low (alfalfa leaves low temperature (ALLT)) or high temperatures (alfalfa leaves (AL)). Six hundred male Hubbard JA‐757 broilers were divided into five feeding groups (Control (C), AL2, AL3, AL4 and ALLT5). Alfalfa leaf content was increased in each of the three fattening phases by 5% (C: 0%–0%–0%; AL2: 0%–5%–10%; AL3: 5%–10%–15%; AL4: 10%–15%–20%; and ALLT5: 10%–15%–20%). At the end of the experiment, broilers in group C had the highest body and carcass weights. Groups AL3, AL4 and ALLT5 showed the lowest body and carcass weights. In particular, the early introduction of alfalfa leaves (5% in phase 1) and high alfalfa leaf content (15%–20%) significantly decreased performance. Antinutritional substances such as saponins occur in alfalfa. In fact, the saponin analysis showed high contents of 3‐Glc‐Glc‐28‐Ara‐Rha‐medicagenic acid and HexA‐dHex‐Pen‐Pen‐Pen‐zanhic acid in both high‐ and low‐temperature alfalfa leaves.
Campomanesia sp. flour attenuates non‐alcoholic fatty liver disease on rats fed with a hypercaloric diet
Authors: Loubet Filho Paulo Sérgio , Santos Thayná Gil , Reis Vitória Helena de Oliveira Teixeira , Santee Cynthia Monteiro , da Costa Matheus Pereira , Cândido Camila Jordão , Filiú Wander Fernando de Oliveira , Portugal Luciane Candeloro , dos Santos Elisvânia Freitas 
Published: April 2020

AbstractNon‐alcoholic fatty liver disease (NAFLD) is a metabolic disorder caused by excess consumption of hypercaloric foods. Guavira (Campomanesia sp.) pulp has broad technological applicability, yet the peel and seeds are considered industrial residue. The objective of this unprecedented study was to evaluate the effects of the flour from guavira's industrial residue (GF) consumption in rats fed with hypercaloric diet (HD). During 65 days, 50 rats were separated into a control group: 1%, 2%, 4% and 8% HD with GF complementation in the diet. The GF chemical composition, phenolic compounds, antioxidant capacity, serum biochemical parameters (glucose, cholesterol, HDL, non‐HDL, triglycerides, AST, ALT, and oral glucose tolerance test), fat liver content, and hepatic histomorphology had been characterized. GF is mainly composed of fibres, with phenolic content of 7,391.09 mg AGE/100 g GF and relevant antioxidant capacity (IC50 2.22 and ORAC 155.68 μmol/TE g−1). Serum biochemical analysis did not differ statistically (except ALT reduction, p < .05). Fat liver content was smaller on HD2%GF (p < .0001). The control group and 1% GF showed greater diffuse microvesicular steatosis compared to the other groups when using hepatic morphological analysis (p < .05). GF consumption attenuated NAFLD caused by a hypercaloric diet, and this effect may be related to the fibre content and bioactive compounds in GF.
Using species abundance and phylogeny conjointly to approach vegetation classification: A case study on Macaronesia’s woody vegetation
Authors: Capelo Jorge 
Published: April 2020

AbstractQuestionsCan co‐occurrence and phylogenetic resemblance of taxa in plots be integrated into a single composite numerical framework so that vegetation classification expresses both in a unique system? How should phylogenetic similarity of vicariant taxa, in synvicariant communities, be dealt with for use in vegetation classifications? Is this meaningful to Vegetation Science and Biogeography? Is Macaronesia's woody vegetation an adequate paradigm to test a methodological workflow for phylogenetically informed classification?LocationMacaronesia: the Azores, Madeira, Canaries, and Cape Verde archipelagos.MethodsWe used both (a) co‐occurrence‐only and (b) phylogenetic Bray–Curtis similarity indexes in straightforward classification algorithms: Ward's method clustering andisopamdivisive classification. Phylogenetic distances for (b) were taken from an ad hoc phylogenetic tree. The tree was obtained by grafting/pruning subtrees from DNA sequence alignments ofrcbL, ITS andmatKinto a subset of an available megaphylogeny.ResultsCo‐occurrence‐only similarity is not a reliable predictor of phylogenetic similarity. Two distinct approaches to similarity imply significant differences in classifications. As groups in both classifications may be equated to woody‐vegetation classes, alternative arrangements of such will appear. Vegetation classes are quasi‐specific to each archipelago if accounting for co‐occurrence‐only. Conversely, larger units spanning several archipelagos emerge when phylogeny is considered.ConclusionWe recognise the usefulness of incorporating phylogeny in the definition of formal vegetation units so that the concept ofsyntaxonmay include it. Supra‐class units issuing from phylogenetically informed similarity originate, for the most, from vegetation synvicariance rather than from sharing of species. Therefore, these units correspond preferably to biogeographical concepts (phytochoria), not to phytocoenological units. Regarding “Macaronesia” being a consistent biogeographical unit, if compositional and ecological vegetation patterns are preferred, we support the separation of Macaronesia in several biomes and thus into several Regions within two Kingdoms. Contrariwise, if common ancestry of taxa and synvicariance in syntaxa is to be emphasised, then the one‐Macaronesia Region model re‐appears.
Integrating permanent plot and palaeoecological data to determine subalpine post‐fire succession, recovery and convergence over 128 years
Authors: Burge Olivia R. , Bellingham Peter J. , Arnst Elise A. , Bonner Karen I. , Burrows Larry E. , Richardson Sarah J. , Wiser Susan K. , Wood Jamie R. , Wilmshurst Janet M. 
Published: April 2020

AbstractAimsPost‐fire succession in low‐productivity ecosystems is rarely directly measured. We test whether taxonomic, functional, or baseline convergence has occurred 128 years after a major fire in 1890 in a low‐productivity, fire‐susceptible subalpine ecosystem. The historical plots represent one of the longest‐running quantitative ecological studies in the world.LocationArthur's Pass, South Island, New Zealand.MethodsWe remeasured historical plots at sites established 42 years after the fire, and modernised previous chart quadrat data to percentage frequency. We tested whether taxonomic and functional dissimilarity within the site, and within environmentally similar transect groups, reduced over time. We used pollen data preserved in soil cores taken on the plots to test whether the site had returned to the reference pre‐fire baseline.ResultsThere is little evidence of taxonomic convergence across the site and dissimilarity remains high. Functional dissimilarity showed little reduction or evidence of convergence. Within maximally similar groups of transects, taxonomic and functional dissimilarity declined over time. Tree frequency increased significantly year‐on‐year. There is a lack of convergence with the pre‐fire baseline, accompanied by a reduction in the proportion of tree pollen represented on most transects.ConclusionsThe taxonomic rate of successional change has yet to slow, and a steady state has yet to be reached, suggesting it is too early to consider the site has attained maximal convergence. Palaeoecological data have allowed quantification of the effect of a novel fire regime to which the ecosystems are poorly adapted: we found compositional, structural, and dominant‐species differences between pre‐ and post‐fire vegetation. Combining permanent transects and palaeoecological data allows for a synthesis of data at multiple time scales, permitting investigations of long‐duration successions.
Nonalcoholic fatty liver disease is associated with increased risk of atrial fibrillation
Authors: Cai Xiaoyan , Zheng Sulin , Liu Ying , Zhang Yan , Lu Jianhua , Huang Yuli 
Published: April 2020

AbstractBackground & AimsWhether nonalcoholic fatty liver disease (NAFLD) is associated with risk of incident atrial fibrillation (AF) independent of established cardiovascular risk factors remains controversial. We aimed to provide a quantitative estimate of the association between NAFLD and risk of AF after adjustment for cardiometabolic risk factors.MethodsIn this study, we searched PubMed and Embase for studies published from database inception until January 31, 2020. Cohort studies reported adjusted relative risks (RRs) and 95% confidence intervals (CIs) for AF of NAFLD compared with non‐NAFLD were included for analysis.ResultsA total of 6 cohort studies were included, comprising 614 673 individuals for analysis. The median follow‐up duration was 10.0 years with 7271 cases of incident AF. Compared with non‐NAFLD, minimally adjusted models without adjustment for cardiometabolic risk factors showed that NAFLD was associated with increased risk of AF (RR 1.65, 95% CI 1.23‐2.20, I2 = 63.0%). After adjustment for multiple cardiometabolic risk factors, the association between NAFLD and risk of AF was still higher than that in non‐NAFLD (RR 1.19, 95% CI 1.04‐1.31, I2 = 54.0%). There was significant heterogeneity for the risk of AF between minimally and maximally adjusted models (I2 = 77.1%, P for heterogeneity = 0.04). Compared with non‐NAFLD, the absolute risk increase in NAFLD for AF was 1.3 (95% CI 0.5‐2.1) per 1000 person‐years.ConclusionsNAFLD is associated with increased risk of incident AF. The strength of the association between NAFLD and AF is partially attributed to the co‐existing cardiometabolic risk factors.
Ramucirumab in elderly patients with hepatocellular carcinoma and elevated alpha‐fetoprotein after sorafenib in REACH and REACH‐2
Authors: Kudo Masatoshi , Galle Peter R. , Llovet Josep M. , Finn Richard S. , Vogel Arndt , Motomura Kenta , Assenat Eric , Merle Philippe , Brandi Giovanni , Daniele Bruno , Okusaka Takuji , Tomášek Jiří , Borg Christophe , Dadduzio Vincenzo , Morimoto Manabu , Pracht Marc , Jen Min‐Hua , Drove Ubreva Nora , Widau Ryan C. , Shinozaki Kenta , Yoshikawa Reigetsu , Zhu Andrew X. 
Published: April 2020

AbstractBackground & AimsLimited data on treatment of elderly patients with hepatocellular carcinoma (HCC) increase the unmet need. REACH and REACH‐2 were global phase III studies of ramucirumab in patients with HCC after prior sorafenib, where patients with alpha‐fetoprotein (AFP) ≥400 ng/mL showed an overall ssurvival (OS) benefit for ramucirumab. These post‐hoc analyses examined efficacy and safety of ramucirumab in patients with HCC and baseline AFP ≥ 400 ng/mL by three prespecified age subgroups (<65, ≥65 to <75 and ≥75 years).MethodsIndividual patient data were pooled from REACH (baseline AFP ≥400 ng/mL) and REACH‐2. Kaplan‐Meier and Cox proportional hazards regression methods (stratified by study) assessed OS, progression‐free survival (PFS), time to progression (TTP) and patient‐reported outcomes (Functional Hepatobiliary System Index‐8 [FHSI‐8] score).ResultsA total of 542 patients (<65 years: n = 302; ≥65 to <75 years: n = 160; ≥75 years: n = 80) showed similar baseline characteristics between ramucirumab and placebo. Older subgroups had higher hepatitis C and steatohepatitis incidences, and lower AFP levels, than the <65 years subgroup. Ramucirumab prolonged OS in patients <65 years (hazard ratio [HR], 0.753; 95% CI 0.581‐0.975), ≥65 to <75 years (0.602; 0.419‐0.866) and ≥75 years (0.709; 0.420‐1.199), PFS and TTP irrespective of age. Ramucirumab showed similar overall safety profiles across subgroups, with a consistent median relative dose intensity ≥97.8%. A trend towards a delay in symptom deterioration in FHSI‐8 with ramucirumab was observed in all subgroups.ConclusionsIn this post‐hoc analysis, ramucirumab showed a survival benefit across age subgroups with a tolerable safety profile, supporting its use in advanced HCC with elevated AFP, irrespective of age, including ≥75 years.
Preoperative evaluation of microvascular invasion with circulating tumour DNA in operable hepatocellular carcinoma
Authors: Wang Dong , Xu Yaping , Goldstein Jennifer B. , Ye Ke , Hu Xi , Xiao Liang , Li Lifeng , Chang Lianpeng , Guan Yanfang , Long Guo , He Qiongzhi , Yi Xin , Zhang Jianjun , Wang Zhiming , Xia Xuefeng , Zhou Ledu 
Published: April 2020

AbstractBackground & AimsMicrovascular invasion (MVI) is a critical prognostic factor for operable hepatocellular carcinoma (HCC). This study aimed to explore the performance of circulating tumour DNA (ctDNA) in evaluating MVI status preoperatively.MethodsSeventy‐three HCC patients were enrolled and randomly divided into a training cohort and a validation cohort in a 2:1 ratio, and preoperative blood and surgical tissue samples were obtained. Genomic alterations were analysed using targeted deep sequencing with a 1021‐gene panel.ResultsIn training cohort, 260 somatic mutations were identified in 40 blood samples (81.6%). CtDNA mutation was verified in paired tissue sample in 39 patients (97.5%). In univariate analysis, ctDNA allele frequency (AF) and largest tumour diameter were associated with the presence of MVI, but ctDNA AF was the only independent risk factor in multivariate analysis. With the cut‐off value of 0.83%, ctDNA AF determined the presence of MVI with the sensitivity of 89.7% and specificity of 80.0% in the training cohort, and the sensitivity of 78.6% and the specificity of 81.8% in the validation cohort. In preoperative evaluation, ctDNA AF, AFP level and BCLC staging were associated with recurrence‐free survival in both univariate and multivariate analysis.ConclusionsCtDNA can serve as an independent risk factor of MVI for operable HCC and help determining precise treatment strategies. The integration of ctDNA in the management of operable HCC may achieve better clinical outcomes.
Soluble CD163 and mannose receptor as markers of liver disease severity and prognosis in patients with primary biliary cholangitis
Authors: Bossen Lars , Rebora Paola , Bernuzzi Francesca , Jepsen Peter , Gerussi Alessio , Andreone Pietro , Galli Andrea , Terziroli Benedetta , Alvaro Domenico , Labbadia Giancarlo , Aloise Chiara , Baiocchi Leonardo , Giannini Edoardo , Abenavoli Ludovico , Toniutto Pierluigi , Marra Fabio , Marzioni Marco , Niro Grazia , Floreani Annarosa , Møller Holger J. , Valsecchi Maria G. , Carbone Marco , Grønbæk Henning , Invernizzi Pietro 
Published: April 2020

AbstractIntroductionIn primary biliary cholangitis (PBC), macrophages are involved in liver inflammation and fibrosis. The macrophage activation markers, soluble (s)CD163 and mannose receptor (sMR) are associated with liver disease severity and prognosis in other chronic liver diseases. We aimed to investigate sCD163 and sMR in patients with PBC.MethodsWe investigated PBC patients from the Italian PBC Study Group cohort and measured macrophage activation markers in serum at study enrolment. Patients were followed from enrolment until they experienced an event or were censored at their last visit. Events were defined as follows: (a) death from a liver‐related cause; or (b) liver transplantation (LT) for PBC. We used Cox regression to investigate the association between sCD163 and sMR and long‐term prognosis.ResultsIn total, 202 PBC patients were included. Median age was 62 years (interquartile range (IQR), 53‐71) at enrolment and 93% were women. Median sCD163 was 3.43 mg/L (IQR 2.48‐5.35) and median sMR was 0.35 mg/L (IQR 0.28‐0.45). There was an increase in sCD163 and sMR with increasing alkaline phosphatase. Two hundred and one patients were followed for a median of 8.6 years, and sCD163 and sMR predicted long‐term risk of liver‐related death or LT in univariate analyses, while sCD163 was also associated with outcome after confounder adjusting (adjusted HR = 1.14, 95% CI 1.00‐1.30). Finally, we showed an increase in the prediction accuracy of poor outcome by adding sCD163 to the UK‐PBC risk score.ConclusionThe macrophage activation markers sCD163 and sMR represent a non‐invasive measure of PBC disease severity that provides useful long‐term prognostic information.
A multicentre retrospective analysis on growth of residual hepatocellular adenoma after resection
Authors: Klompenhouwer Anne J. , van Rosmalen Belle V. , Haring Martijn P. D. , Thomeer Maarten G. J. , Doukas Michail , Verheij Joanne , de Meijer Vincent E. , van Gulik Thomas M. , Takkenberg Robert B. , Kazemier Geert , Nevens Frederik , de Man Robert A. , Ijzermans Jan N. M. 
Published: April 2020

AbstractBackground & AimsHepatocellular adenoma (HCA) is a benign liver tumour that may require resection in select cases. The aim of this study was to the assess growth of residual HCA in the remnant liver and to advise on an evidence‐based management strategy.MethodThis multicentre retrospective cohort study included all patients with HCA who underwent surgery of HCA and had residual HCA in the remnant liver. Growth was defined as an increase of >20% in transverse diameter (RECIST criteria). Data on patient and HCA characteristics, diagnostic work‐up, treatment and follow‐up were documented and analysed.ResultsA total of 134 patients were included, one male. At diagnosis, median age was 38yrs (IQR 30.0‐44.0) and median BMI was 29.9 kg/m2 (IQR 24.6‐33.3). After resection, median number of residual sites of HCA was 3 (IQR 2‐6). Follow‐up of residual HCA showed regression in 24.6%, stable HCA in 61.9% and growth of at least one lesion in 11.2%. Three patients (2.2%) developed new HCA that were not visible on imaging prior to surgery. Four patients (3%, one male) underwent an intervention as growth was progressive. No statistically significant differences in clinical characteristics were found between patients with growing residual or new HCA versus those with stable or regressing residual HCA.ConclusionIn patients with multiple HCA who undergo resection, growth of residual HCA is not uncommon but interventions are rarely needed as most lesions stabilize and do not show progressive growth. Surveillance is indicated when residual HCA show growth after resection, enabling intervention in case of progressive growth.
Sigma‐1 receptor activation‐induced glycolytic ATP production and endothelial barrier enhancement
Authors: Motawe Zeinab Y. , Farsaei Forouzandeh , Abdelmaboud Salma S. , Cuevas Javier , Breslin Jerome W. 
Published: April 2020

AbstractObjectiveWe tested the hypothesis that σ1 modulates endothelial barrier function due to its influence on endothelial bioenergetics.MethodsCultured HUVEC monolayers were used to model the endothelial barrier. ECIS, Transwell assays, and immunofluorescence labeling of junctional proteins were used to evaluate endothelial barrier function. Endothelial cell bioenergetics was determined using extracellular flux analysis and direct ATP level measurements. The endothelial‐specific contribution of σ1 was tested using the σ1‐selective agonist, PRE‐084, and with targeted knockdown of σ1 expression using siRNA.ResultsActivation of σ1 with PRE‐084 significantly enhanced endothelial barrier function and decreased permeability to albumin and dextran. Knockdown of σ1 with siRNA reduced barrier function and abolished PRE‐084‐induced endothelial barrier enhancement. PRE‐084 upregulated endothelial glycolysis and glycolytic ATP production, but this response was abolished by siRNA‐mediated knockdown of σ1 expression. PRE‐084 also reduced the degree of endothelial barrier dysfunction caused by the mitochondrial oxidative phosphorylation uncoupler CCCP.ConclusionActivation of σ1 enhances endothelial barrier function and modulates the ratio of glycolytic versus mitochondrial ATP production. These novel findings suggest that endothelial σ1 may prove beneficial as a novel therapeutic target for reducing microvascular hyperpermeability and counteracting mitochondrial dysfunction.
Convex relaxation for efficient sensor layout optimization in large‐scale structures subjected to moving loads
Authors: Błachowski Bartłomiej , Świercz Andrzej , Ostrowski Mariusz , Tauzowski Piotr , Olaszek Piotr , Jankowski Łukasz 
Published: April 2020

AbstractThis paper proposes a computationally effective framework for load‐dependent optimal sensor placement in large‐scale civil engineering structures subjected to moving loads. Two common problems are addressed: selection of modes to be monitored and computational effectiveness. Typical sensor placement methods assume that the set of modes to be monitored is known. In practice, determination of such modes of interest is not straightforward. A practical approach is proposed that facilitates the selection of modes in a quasi‐automatic way based on the structural response at the candidate sensor locations to typical operational loads. The criterion used to assess sensor placement is based on Kammer's Effective Independence (EFI). However, in contrast to typical implementations of EFI, which treat the problem as a computationally demanding discrete problem and use greedy optimization, an approach based on convex relaxation is proposed. A notion of sensor density is applied, which converts the original combinatorial problem into a computationally tractable continuous optimization problem. The proposed framework is tested in application to a real tied‐arch railway bridge located in central Poland.