bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acolhimento com classificação de risco em unidades de pronto atendimento: avaliação sob a ótica do enfermeiro
Authors: Rodrigues Mayzza Campina , Mota Alyne Nunes , Melo Rebeca Eloy de , Sousa Eduardo Espíndola , Quaresma Fernando Rodrigues Peixoto , Maciel Erika Da Silva 
Published: September 2020

Objetivo: O objetivo do trabalho foi avaliar a percepção dos enfermeiros frente ao Acolhimento com Classificação de Risco implantado em Unidades de Pronto Atendimento. Método: Trata-se de um estudo descritivo com corte transversal e abordagem quantitativa. Para análise dos dados utilizou-se de estatística padrão e a classificação se deu conforme os escores preconizados na metodologia dos instrumentos. Resultados: Participaram do estudo 35 profissionais. As dimensões estrutura e resultados, foram classificadas como Regular, assim como Classificação Geral. Conclusão: Os resultados indicam que os serviços oferecidos demandam de ações para aprimoramento da Política Nacional de Humanização. A capacitação no acolhimento à demanda espontânea pode representar um caminho para melhoria das condições dos serviços ofertados
Urinary Nerve Growth Factor Levels In Multiple Sclerosis Patients With Urinary System Symptoms
Authors: SEYİTHANOĞLU Muhammed , İNANÇ Yılmaz , BAVLİ Songül 
Published: September 2020

Aim: To estimate the sensitivity and specificity of the serum and urinary nerve growth factor (NGF) in MS patients as markers of detrusor overactivity.
Materials and Methods: 20 volunteers who were diagnosed with MS and who had urinary tract symptoms and 29 volunteers who were diagnosed with MS however who did not have urinary tract symptoms were included in the study. A comprehensive anamnesis and spot urine samples were obtained from the subjects. Twenty seven healthy volunteers with similar age and gender distribution were included for making a comparison with regard to NGF levels and spot urine samples were obtained.
Results: Urinary NGF levels and NGF/urinary creatinine ratios were found lower in the group composed of MS patients who had urinary symptoms compared to the group composed of MS patients who did not have urinary symptoms but the difference was not statistically significant. These parameters were found lower in patient group who did not have urinary symptoms compared to control group however the difference was not statistically significant (p: 0,114 and 0,833)
Conclusions: urinary neurotrophins in patients with multiple sclerosis can be used to diagnose detrusor overactivity.
Across the great divide:The impact of digital inequality on Scotland’s Gypsy/Traveller children and young people during the COVID-19 emergency
Authors: Tammi Lynne 
Published: September 2020

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­This article examines current Scottish national and local government awareness of, and responses to, the learning and development needs and entitlements of Gypsy/Traveller children and young people pre and during the COVID-19 pandemic. A snapshot analysis of emerging testimony from Learning and Development Workers and parents and young people focuses on, and gives insight to, how the lack of access to digital devices and data and front-line workers’ discretionary decision making has impacted on young Gypsy/Travellers’ ability to access formal and non-formal learning and development during the pandemic.
A Frequency-Dependent Model for the Shape of the Fourier Amplitude Spectrum of Acceleration at High Frequencies
Authors: Haendel Annabel , Anderson John G. , Pilz Marco , Cotton Fabrice 
Published: September 2020

ABSTRACTThe high-frequency decay term of the acceleration spectrum κ is a commonly used parameter in engineering seismology. In recent years, the assumption of a linearly decaying spectrum in log–linear space has been recognized to not always be valid as the value of κ depends on the analyzed frequency band. We present an alternative model for the spectral falloff in which the frequency dependence is explicitly taken into account. This is motivated by observations that the quality factor Q has a power-law dependence on frequency at high frequencies. The new model describes the spectral decay with the help of two variables, opposite to the single parameter κ. The approach is applied to borehole data of the EUROSEISTEST site in Greece. The misfit between modeled and observed spectra is reduced with the new approach compared with the classical kappa model. The new estimates compare well with κ estimates if the same frequency interval is considered but additionally allows for the capture of the frequency dependence of the spectral shape.
Geriatricians’ Standpoint of the Informed Consent Process among Patients with Alzheimer's Disease: The Lebanese Context
Authors: Fakhro Mohammed Ali 
Published: September 2020

Abstract
BackgroundDespite the existence of laws that ensure that patients’ capacity to consent is assessed systematically, many gray areas remain with that regard. As dementia progresses, some patients lose their capacity to make decisions. The aim was to characterize Lebanese geriatricians’ perspectives about decision-making capacity (DMC) of their patients with Alzheimer’s disease (AD). Moreover, to propose an algorithm for a reliable, comprehensive, and valid assessment of DMC. MethodsA cross-sectional descriptive study was designed to empirically collect data via an e-survey. Accordingly, a comprehensive list of geriatricians was provided by the Lebanese Order of Physicians. Geriatricians were approached via a phone call, to provide them with study-specific information. Those who accepted to participate received a link to the study’s survey via an e-mail.ResultsAmong the eligible geriatricians, 75% had successfully completed the e-survey, with a mean of 14.7 ± 9.6 years of experience. More than half of the geriatricians failed to recognize that assessing the patients’ DMC is an integral component of the informed consent (IC) process. Yet, 88.9% assessed the DMC of their patients with AD using different modalities. However, the majority were unable to clearly justify their judgment of DMC based on the tools they have selected.ConclusionLebanese geriatricians have demonstrated a poor understanding of the concept of autonomy and the need for the DMC assessment as part of the IC’s process. Moreover, they were unable to select adequate tools to assess and judge the DMC of their patients with AD.
A Comparison of Global Surgery Tariffs and the Actual Cost of Bills at Hazrate Rasoole Akram Educational and Medical Center
Authors: abutorabi ali , radinmanesh maryam , rezapour aziz , afshari mahnaz , taheri ghasem 
Published: September 2020

Abstract
Background: the health service tariff is an appropriate policymaking tool and the financial leverage of the health system control which affects quality, availability, cost, efficiency, equity and accountability of health services. Global surgeries include 91 common cases of general and specialized surgeries in hospitals; fixed tariffs are annually defined for these surgeries, and insurance companies must pay medical centers based on these tariffs. The aim of this study was to examine and compare hospital bills with global surgery tariffs at Hazrate Rasoole Akram Educational and Medical Center in 2017.Methods: This descriptive-analytic study was conducted retrospectively and compared the global and actual costs of global surgeries performed in the third quarter of the year 2017 at Hazrate Rasoole Akram Educational and Medical Center. Required data on the actual costs of surgeries was collected through the Hospital Information System (HIS) and patients’ records. Information on the global costs was obtained from the Annual Circulars of Insurance Council for the studied period about the cost of global surgeries. Linear regression (STATA13 software) was used to investigate the effect of items on tariff and invoice differences; concerning other calculations, EXCEL software was used.Results: The highest frequency of global surgeries was related to ophthalmic surgery which accounted for approximately half of total surgeries performed at Hazrate Rasoole Akram Hospital. The most significant difference between global tariff and invoice was also related to ophthalmic surgery (188709.3 Dollar a year).Overall, the actual hospital bills were much higher than the tariffs approved for global surgeries, and the total difference was 461805.5 Dollar. The results revealed that there was a significant relationship between some of the items such as the cost of operating rooms, anesthesia and other services.Conclusions: Referral hospitals which are at the level three of referral networks usually treat more complex patients; this should be taken into account when defining surgery tariffs of these centers. On the other hand, hospitals need to control the costs and reduce the end cost of these surgeries by improving clinical management and cost management. In addition, prospective and case-based payment methods can control health costs.
Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Deaths Surveillance (JSANDS) system
Authors: Shattnawi Khulood Kayed , Khader Yousef S. , Alyahya Mohammad S. , Al-Sheyab Nihaya , Batieha Anwar 
Published: September 2020

Abstract
Background: Annually, 2.6 million stillbirths occur around the world, with approximately 98% occurring in low- and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries. Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyze, and disseminate data on stillbirths, neonatal deaths, and their contributing conditions. Data on births, stillbirths and their contributing conditions, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analyzed.Results: A total of 10,328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths), with a rate of 9.9 per 1000 total births. The main contributing fetal conditions of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (hypoxia) (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main contributing maternal conditions of antepartum stillbirths included complications of the placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Contributing fetal conditions of intrapartum stillbirths included congenital malformations, deformations and chromosomal abnormalities, other specified intrapartum disorders, and intrapartum death of unspecified cause (33.3% each). Contributing maternal conditions of intrapartum stillbirths included complications of the placental cord and membranes. In the multivariate analysis, small for gestational age (SGA) pregnancies were associated with a significant 3-fold increased risk of stillbirth compared to appropriate for gestational age (AGA) pregnancies.Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for the early identification of high-risk pregnancies, including the early detection of SGA pregnancies, and ensuring adequate antenatal obstetric interventions.
Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study
Authors: Schönenberger Nicole , Sottas Beat , Merlo Christoph , Essig Stefan , Gysin Stefan 
Published: September 2020

Abstract
Background: Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices.Methods: We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis.Results: The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and style of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion: Our results suggested that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seemed to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.
Does Additional Extracorporeal Shock Wave Therapy Improve the Effect of Isolated Percutaneous Radiofreqency Coblation in Patients with Insertional Achilles Tendinopathy? Study Protocol for A Randomized Controlled Clinical Trial
Authors: Song Yu-Jie , Xuan Wen-Kai , Hua Ying-Hui 
Published: September 2020

Abstract
Background: No conclusive evidence recommends a prior treatment for insertional Achilles tendinopathy (IAT). It is theorized that both percutaneous radiofreqency coblation and extracorporeal shockwave therapy (ESWT) relieve pain within the insertion. However, no clinical evidence shows that either treatment promote the regeneration of the tendon or if the combination of these 2 interventions offer better function and less pain than one therapy. Methods: The study is a randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients with insertional Achilles tendinopathy who are not satisfied with the effect of conservative treatment will be screened. A minimum of 38 patients will be enrolled after deciding to participate in the trial on an informed basis. Then the intervention group and the control group perform radial ESWT and sham-ESWT respectively at 6 months after percutaneous radiofreqency coblation. The primary outcome will be the Victorian Institute of Sports Assessment Achilles (VISA-A) Score. Secondary outcome measures will be Foot and Ankle Outcome Score (FAOS) scale, Visual Analogue Scale (VAS), Tegner Score, and MRI ultra-short echo time (UTE) T2* value. The assessments will occur in 6 months, 1 year, and 2 years post-operatively. The differences between 2 groups will be conducted as intention-to-treat basis. Discussion: We aim to investigate if radiofreqency coblation associated with ESWT can provide more encouraging imaging findings as well as functional and clinical outcomes regarding the treatment of the IAT comparing to the single radiofreqency coblation treatment.Trial registration: ChiCTR1800017898; Pre-results. Registered on 20 August 2018.
Effects of Prenatal Mindfulness-Based Childbirth Education on Child-Bearers’ Trajectories of Distress: A Randomized Control Trial
Authors: Sbrilli Marissa Danielle , Duncan Larissa G. , Bardacke Nancy , Laurent Heidemarie K. 
Published: September 2020

Abstract
Background. The perinatal period is a time of immense change, which can be a period of stress and vulnerability for mental health difficulties. Mindfulness-based interventions have shown promise for reducing distress, but further research is needed to identify long-term effects and moderators of mindfulness training in the perinatal period. Methods. The current study used data from a pilot randomized control trial (RCT) comparing a condensed mindfulness-based childbirth preparation program—the Mind in Labor (MIL)—to treatment as usual (TAU) to examine whether prenatal mindfulness training results in lower distress across the perinatal period, and whether the degree of benefit depends on child-bearers’ initial levels of risk (i.e., depression and anxiety symptoms) and protective (i.e., mindfulness) characteristics. Child-bearers (N=30) in their third trimester were randomized to MIL or TAU and completed assessments of distress—perceived stress, anxiety, and depressive symptoms—at pre-intervention, post-intervention, six-weeks post-birth, and one-year postpartum. Results. Multilevel modeling of distress trajectories revealed greater decreases from pre-intervention to 12 months postpartum for those in MIL compared to TAU, especially among child-bearers who were higher in anxiety and/or lower in dispositional mindfulness at baseline. Conclusions. The current study offers preliminary evidence for durable perinatal mental health benefits following a brief mindfulness-based program and suggests further investigation of these effects in larger samples is warranted.Trial registration: The ClinicalTrials.gov identifier for the study is: NCT02327559. The study was retrospectively registered on June 23, 2014. https://clinicaltrials.gov/ct2/show/NCT02327559
Relationship between the atlantodental interval and T1 slope after atlantoaxial fusion in patients with rheumatoid arthritis
Authors: Ha Byeong Jin , Won Yu Deok , Ryu Jeil , Han Myung-Hoon , Cheong Jin Hwan , Kim Jae Min , Chun Hyoung-Joon , Bak Koang-Hum , Bae In-Suk 
Published: September 2020

Abstract
Background: Atlantoaxial fusion has been widely used for the treatment of atlantoaxial instability (AAI). However, atlantoaxial fusion sacrifices the motion of atlantoaxial articulation, and postoperative loss of cervical lordosis and aggravation of cervical kyphosis are observed. We investigated various factors under the hypothesis that the atlantodental interval (ADI) and T1 slope may be associated with sagittal alignment after atlantoaxial fusion in patients with rheumatoid arthritis (RA).Methods: We retrospectively investigated 64 patients with RA who underwent atlantoaxial fusion due to AAI. Radiological factors, including the ADI, T1 slope, Oc-C2 angle, cervical sagittal vertical axis, and C2-C7 angle, were measured before and after surgery.Results: The various factors associated with atlantoaxial fusion before and after surgery were compared according to the upper and lower preoperative ADIs. There was a significant difference in the T1 slope 1 year after surgery (p=0.044) among the patients with lower preoperative ADI values. The multivariate logistic regression analysis showed that the preoperative ADI (>7.92 mm) defined in the receiver-operating characteristic curve analysis was an independent predictive factor for the increase in the T1 slope 1 year after atlantoaxial fusion (odds ratio, 4.59; 95% confidence interval, 1.34-15.73; p=0.015).Conclusion: We found an association between the preoperative ADI and difference in the T1 slope after atlantoaxial fusion in the patients with RA. A preoperative ADI (>7.92 mm) was an independent predictor for the increase in the T1 slope after atlantoaxial fusion. Therefore, performing surgical treatment when the ADI is low would lead to better cervical sagittal alignment.
MiR-146a-5p targeting SMAD4 and TRAF6 inhibits adipogenensis through TGF-β and AKT/mTORC1 signal pathways in porcine intramuscular preadipocytes
Authors: Zhang Que , Cai Rui , Tang Guorong , Zhang Wanrong , Pang Weijun 
Published: September 2020

Abstract
Background: Intramuscular fat (IMF) content is a vital parameter for assessing pork quality. Increasing evidence has shown that microRNAs (miRNAs) play an important role in regulating porcine IMF deposition. Here, a novel miRNA implicated in porcine IMF adipogenesis was found, and its effect and regulatory mechanism were further explored with respect to intramuscular preadipocyte proliferation and differentiation.Results: By porcine adipose tissue miRNA sequencing analysis, we found that miR-146a-5p is a potential regulator of porcine IMF adipogenesis. Further studies showed that miR-146a-5p mimics inhibited porcine intramuscular preadipocyte proliferation and differentiation, while the miR-146a-5p inhibitor promoted cell proliferation and adipogenic differentiation. Mechanistically, miR-146a-5p suppressed cell proliferation by directly targeting SMAD family member 4 (SMAD4) to attenuate TGF-β signaling. Moreover, miR-146a-5p inhibited the differentiation of intramuscular preadipocytes by targeting TNF receptor-associated factor 6 (TRAF6) to weaken the AKT/mTORC1 signaling downstream of the TRAF6 pathway.Conclusions: MiR-146a-5p targets SMAD4 and TRAF6 to inhibit porcine intramuscular adipogenesis by attenuating TGF-β and AKT/mTORC1 signaling, respectively. These findings provide a novel miRNA biomarker for regulating intramuscular adipogenesis to promote pork quality.
Preoperative false-negative transthoracic echocardiographic results in native valve infective endocarditis patients: a retrospective study from 2001 to 2018
Authors: Ren Zuning , Zhang Jian , Chen Hongjie , Mo Xichao , Cai Shaohang , Peng Jie 
Published: September 2020

Abstract
Background: Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results.Methods: Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018.Results: A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (<10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors.Conclusions: Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.