bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-contact monitoring of agitation and use of a sheltering device in patients with dementia in emergency departments: a feasibility study
Authors: Kroll Lisa , Böhning Nikolaus , Müßigbrodt Heidi , Stahl Maria , Halkin Pavel , Liehr Birgit , Grunow Christine , Kujumdshieva-Böhning Borjana , Freise Christian , Hopfenmüller Werner , Friesdorf Wolfgang , Jockers-Scherübl Maria , Somasundaram Rajan 
Published: April 2020

Abstract
Background
Agitation is common in geriatric patients with cognitive impairment, e.g. in persons with dementia (PWD), who are admitted to an emergency department (ED). It might be a first sign of upcoming delirium and is associated with a higher risk of an unfavorable clinical course. Hence, monitoring of vital signs and enhanced movement as indicators of upcoming agitation is essential in these patients during their stay in the ED. Since PWD rarely tolerate fixed monitoring devices, a novel developed non-contact monitoring system (NCMSys) might represent an appropriate alternative.
Aim of this feasibility study was to test the validity of a NCMSys and of the tent-like “Charité Dome” (ChD), aimed to shelter PWD from the busy ED environment. Furthermore, effects of the ChD on wellbeing and agitation of PWD were investigated.

Methods
Both devices were attached to patient’s bed. Tests on technical validity and safety issues of NCMSys and ChD were performed at the iDoc institute with six healthy volunteers. A feasibility study evaluating the reliability of the NCMSys with and without the ChD was performed in the real-life setting of an ED and on a geriatric-gerontopsychiatric ward. 19 patients were included, ten males and nine females; mean age: 77.4 (55–93) years of which 14 were PWD. PWD inclusion criteria were age ≥ 55 years, a dementia diagnosis and a written consent (by patients or by a custodian). Exclusion criteria were acute life-threatening situations and a missing consent.

Results
Measurements of heart rate, changes in movement and sound emissions by the NCMSys were valid, whereas patient movements affected respiratory rate measurements. The ChD did not impact patients’ vital signs or movements in our study setting. However, 53% of the PWD (7/13) and most of the patients without dementia (4/5) benefited from its use regarding their agitation and overall wellbeing.

Conclusions
The results of this feasibility study encourage a future controlled clinical trial in geriatric ED patients, including PWD, to further evaluate if our concept of non-contact measurement of vital signs and movement combined with the “Charité Dome” helps to prevent upcoming agitation in this vulnerable patient group in the ED.

Trial registration
ICTRP: “Charité-Dome-Study - DRKS00014737” (retrospectively registered).
Subjective social status is an important determinant of perceived stress among adolescents: a cross-sectional study
Authors: Steen Pernille Bach , Poulsen Per Høgh , Andersen Johan Hviid , Biering Karin 
Published: April 2020

AbstractBackgroundStress is an increasing public health problem, and the association between stress and subjective social status (SSS) among adolescents has received little attention. SSS in society have shown to be associated with perceived stress, but the association between SSS in school and stress has never been examined. The aim of this study was to explore the association between SSS and perceived stress in Danish adolescent boys and girls.MethodsData was collected in 2017 in frame of The Danish Occupation of Children and Adolescents Cohort (FOCA cohort), where Danish 9th graders (age 15/16) from 1746 schools participated in a survey (4527 girls, 3654 boys, aged 15 to 16 years). SSS in society and SSS in school were the exposure variables, and the level of perceived stress was the outcome variable. Associations between SSS in school and in society separately with perceived stress was analysed using linear regression models stratified by gender and adjusted to social and health-related factors (e.g. neighbourhood safety, home characteristics, grade meaning, homework load, self-rated health, smoking, alcohol consumption).ResultsThe mean overall PSS score was 14.7; for girls the score was 16.3, and for boys it was 12.6. The analyses revealed a strong linear association between SSS, in both society and school, and perceived stress. The lower the SSS, the higher perceived stress. The associations were the same for both genders, but girls reported a higher level of stress than did boys.ConclusionWe found that girls reported a higher level of perceived stress than boys. Furthermore, we found a strong association between low SSS in society and especially SSS in school and a high level of perceived stress among Danish adolescents.
Knowledge of and attitudes towards erosive tooth wear among students of two Chinese universities
Authors: Hong Deng-wei , Lin Xiu-jiao , Wiegand Annette , Yu Hao 
Published: April 2020

Abstract
Background
To assess the knowledge of and attitudes towards erosive tooth wear among dental, medical, and non-medical university students of two Chinese universities.

Methods
A questionnaire containing 15 questions on knowledge of erosive tooth wear and 10 questions on attitudes towards erosive tooth wear was designed, and its psychometric properties (reliability and validity) were analysed in a pilot study (n = 120 students). The following 3 groups of university students (n = 635) were recruited based on a convenience sampling technique and were distributed the questionnaire via an online survey system: dental students (DSs), medical students (MSs), and non-medical students (NSs). Differences in the scores between groups and genders were analysed by one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to determine the association between the knowledge and attitude scores (P < 0.05).

Results
The questionnaire was found to be reliable, valid and reproducible. A total of 435 students participated in this study (response rate: 69.6%). The knowledge score of the DSs (11.5 ± 3.4) was significantly higher than those of the NSs (5.5 ± 4.0) and MSs (6.1 ± 4.0) (P < 0.001). The attitude score of the DSs (45.2 ± 6.5) was significantly higher than those of the NSs (41.1 ± 6.9) and MSs (41.8 ± 6.4) (P < 0.001). The majority of DSs expressed attitudes that were more accurate and positive than those expressed by the other 2 groups. The attitude score was positively correlated with the knowledge score (r = 0.237, P < 0.001).

Conclusions
Dental students had more accurate knowledge of and more positive attitudes towards erosive tooth wear than medical and non-medical students. In this population, a positive correlation was established between knowledge of and attitudes towards erosive tooth wear.
Changes in individual and contextual socio-economic level influence on reproductive behavior in Spanish women in the MCC-Spain study
Authors: Gómez-Acebo Inés , Dierssen-Sotos Trinidad , Palazuelos Camilo , Castaño-Vinyals Gemma , Pérez-Gómez Beatriz , Amiano Pilar , Fernández-Villa Tania , Ardanaz Eva , Suarez-Calleja Claudia , Alguacil Juan , Molina-Barceló Ana , Jiménez-Moleón José J. , Molero Jessica Alonso , Roca-Barceló Aina , Chirlaque María-Dolores , Vázquez José Pedro Fernández , Molinuevo Amaia , Aragonés Nuria , Serra Maria Sala , Binefa Gemma , Moreno Victor , Pollán Marina , Kogevinas Manolis , Llorca Javier 
Published: April 2020

Abstract
Background
The association between socioeconomic level and reproductive factors has been widely studied. For example, it is well known that women with lower socioeconomic status (SES) tend to have more children, the age at first-born being earlier. However, less is known about to what extent the great socioeconomic changes occurred in a country (Spain) could modify women reproductive factors. The main purpose of this article is to analyze the influence of individual and contextual socioeconomic levels on reproductive factors in Spanish women, and to explore whether this influence has changed over the last decades.

Methods
We performed a cross-sectional design using data from 2038 women recruited as population-based controls in an MCC-Spain case-control study.

Results
Higher parent’s economic level, education level, occupational level and lower urban vulnerability were associated with higher age at first delivery and lower number of pregnancies. These associations were stronger for women born after 1950: women with unfinished primary education had their first delivery 6 years before women with high education if they were born after 1950 (23.4 vs. 29.8 years) but only 3 years before if they were born before 1950 (25.7 vs. 28.0 years). For women born after 1950, the number of pregnancies dropped from 2.1 (unfinished primary school) to 1.7 (high education), whereas it remained almost unchanged in women born before 1950.

Conclusions
Reproductive behavior was associated with both individual and area-level socio-economic indicators. Such association was stronger for women born after 1950 regarding age at first delivery and number of pregnancies and for women born before 1950 regarding consumption of hormonal contraceptives or postmenopausal therapy.
Who should decide for local health services? A mixed methods study of preferences for decision-making in the decentralized Philippine health system
Authors: Liwanag Harvy Joy , Wyss Kaspar 
Published: April 2020

AbstractBackgroundThe Philippines decentralized government health services through devolution to local governments in 1992. Over the years, opinions varied on the impact of devolved governance to decision-making for local health services. The objective of this study was to analyze decision-makers’ perspectives on who should be making decisions for local health services and on their preferred structure of health service governance should they be able to change the situation.MethodsWe employed a mixed methods approach that included an online survey in one region and in-depth interviews with purposively-selected decision-makers in the Philippine health system. Study participants were asked about their perspectives on decision-making in the functions of planning, health financing, resource management, human resources for health, health service delivery, and data management and monitoring. Analysis of survey results through visualization of data on charts was complemented by the themes that emerged from the qualitative analysis of in-depth interviews based on the Framework Method.ResultsWe received 24 online survey responses and interviewed 27 other decision-makers. Survey respondents expressed a preference to shift decision-making away from the local politician in favor of the local health officer in five functions. Most survey participants also preferred re-centralization. Analysis of the interviews suggested that the preferences expressed were likely driven by an expectation that re-centralization would provide a solution to the perceived politicization in decision-making and the reliance of local governments on central support.ConclusionsRather than re-centralize the health system, one policy option for consideration for the Philippines would be to maintain devolution but with a revitalized role for the central level to maintain oversight over local governments and regulate their decision-making for the functions. Decentralization, whether in the Philippines or elsewhere, must not only transfer decision-making responsibility to local levels but also ensure that those granted with the decision space could perform decision-making with adequate capacities and could grasp the importance of health services.
Managerial competences in public organisations: the healthcare professionals’ perspective
Authors: Fanelli Simone , Lanza Gianluca , Enna Cristiana , Zangrandi Antonello 
Published: April 2020

AbstractBackgroundHuman resources play a critical role in encouraging efficient performance within organisations, especially for public healthcare organisations, where competences of staff are key aspects of the quality of services provided. In this context, the enhancement of competences are strategic objectives for Human Resources Management (HRM) in order to achieve excellent and lasting results. However, competences of healthcare professionals are both clinical and managerial. This study identifies specific managerial competences perceived as crucial by healthcare professionals in order to improve their performance and develop suitable HRM practices.MethodsThe research methodology was divided into three main phases using mixed methods, commencing with literature review to identify the initial framework about managerial competences. Focus groups were then used to discuss evidence from the literature. Feedback from focus groups was used to draft the final questionnaire. Finally, the answers to the questionnaire were analysed through statistical software.ResultsThe results show that managers and professionals share a view of what specific managerial competences for healthcare organisations should be. Main competences are: quality evaluation based on outcomes; enhancement of professional competences; programming based on process management; project cost assessment; informal communication style; and participatory leadership.ConclusionsAlthough the issue of managerial skills in healthcare is widely discussed in literature, findings are often fragmentary. Our work includes a systematic literature review useful for more empirical studies. Furthermore, our results can support public managers who want to set up positive HRM practices for healthcare professionals.
Multiple links between 5-methylcytosine content of mRNA and translation
Authors: Schumann Ulrike , Zhang He-Na , Sibbritt Tennille , Pan Anyu , Horvath Attila , Gross Simon , Clark Susan J. , Yang Li , Preiss Thomas 
Published: April 2020

Abstract
Background
5-Methylcytosine (m5C) is a prevalent base modification in tRNA and rRNA but it also occurs more broadly in the transcriptome, including in mRNA, where it serves incompletely understood molecular functions. In pursuit of potential links of m5C with mRNA translation, we performed polysome profiling of human HeLa cell lysates and subjected RNA from resultant fractions to efficient bisulfite conversion followed by RNA sequencing (bsRNA-seq). Bioinformatic filters for rigorous site calling were devised to reduce technical noise.

Results
We obtained ~ 1000 candidate m5C sites in the wider transcriptome, most of which were found in mRNA. Multiple novel sites were validated by amplicon-specific bsRNA-seq in independent samples of either human HeLa, LNCaP and PrEC cells. Furthermore, RNAi-mediated depletion of either the NSUN2 or TRDMT1 m5C:RNA methyltransferases showed a clear dependence on NSUN2 for the majority of tested sites in both mRNAs and noncoding RNAs. Candidate m5C sites in mRNAs are enriched in 5′UTRs and near start codons and are embedded in a local context reminiscent of the NSUN2-dependent m5C sites found in the variable loop of tRNA. Analysing mRNA sites across the polysome profile revealed that modification levels, at bulk and for many individual sites, were inversely correlated with ribosome association.

Conclusions
Our findings emphasise the major role of NSUN2 in placing the m5C mark transcriptome-wide. We further present evidence that substantiates a functional interdependence of cytosine methylation level with mRNA translation. Additionally, we identify several compelling candidate sites for future mechanistic analysis.
Clinical evaluation of modified invaginated pancreaticojejunostomy for pancreaticoduodenectomy
Authors: Wang Dong , Liu Xiao , Wu Hongwei , Liu Kun , Zhou Xiaona , Liu Jun , Guo Wei , Zhang Zhongtao 
Published: April 2020

Abstract
Background
Pancreaticoduodenectomy (PD) remains the major curative operation for malignant neoplasm of pancreas or cancerous tumors near the pancreas. Despite advancements in recent years, the postoperative recurrence rate of these neoplasms and tumors remains high. Moreover, overall morbidity remains high due to clinically relevant postoperative pancreatic fistula (POPF).

Methods
To compare the clinical outcomes of modified invaginated anastomosis and mucosa-to-mucosa anastomosis, this retrospective study included 343 patients who underwent PD from January 2008 to January 2019 at Beijing Friendship Hospital, Capital Medical University. The patients’ general conditions and disease status were preoperatively evaluated. The surgical procedure was recorded, and operative management was appropriately performed.

Results
Compared with mucosa-to-mucosa anastomosis, modified invaginated anastomosis resulted in a higher intraoperative blood transfusion rate (P < 0.001) and lower hospitalization expenses (P = 0.049). However, no significant differences were found in operation time (P = 0.790), intraoperative bleeding (P = 0.428), postoperative recovery exhaust time (P = 0.442), time to normal flow of food (P = 0.163), and hospitalization time (P = 0.567). Operation time was a risk factor for POPF (odds ratio 1.010; 95% confidence interval 1.003–1.016; P = 0.003). The incidence of pancreatic fistula (grades B and C) was lower in the patients who underwent modified invaginated anastomosis (14.1%) than in those who underwent mucosa-to-mucosa anastomosis (15.3%). The operation time was greater in the POPF group than in the non POPF group among the patients who received modified invaginated anastomosis (P = 0.003) and mucosa-to-mucosa anastomosis (P = 0.002).

Conclusion
Modified invaginated pancreaticojejunostomy for PD resulted in a decreased incidence of POPF; it may serve as a new approach for PD while managing patients who have undergone PD.
Performing ICSI within 4 hours after denudation optimizes clinical outcomes in ICSI cycles
Authors: Zhang Yini , Ma Yongzhuang , Fang Zishui , Hu Shiqiao , Li Zhou , Zhu Lixia , Jin Lei 
Published: April 2020

Abstract
Background
The study aimed to investigate whether and how general and partial time intervals between processes, from human chorionic gonadotrophin (HCG) trigger to intracytoplasmic sperm injection (ICSI), affected the laboratory and reproductive outcomes in ICSI cycles.

Methods
This was a retrospective data analysis of 3602 women who underwent ICSI treatment cycles using partner or donor sperms, performed at Reproduction Medicine Center of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology (Wuhan, China) between October 2016 and September 2018. The clinical pregnancy rate was the major outcome in the study. The fertilization and available embryo rates were secondary outcomes.

Results
Data from 3602 consecutive fresh ICSI cycles was analysed. Multivariate linear regression and logistic regression analysis of factors related to fertilization and clinical pregnancy rates showed that fertilization rate (P = 0.001) and clinical pregnancy rate (P = 0.037) were significantly associated with denudation (DN)-ICSI interval. Long DN-ICSI interval was associated with higher rate of fertilization than short DN-ICSI interval but significantly decreased clinical pregnancy rate when the interval is over 4 h (P < 0.05).

Conclusions
DN-ICSI time interval can act as an independent predictor for clinical outcomes in ICSI cycles. The optimal time for ICSI is within 4 h after oocyte denudation for excellent laboratory and reproductive outcomes in ICSI cycles.
Discerning undifferentiated anxiety from syndromal anxiety in acute-phase schizophrenia
Authors: Naidu Kalai , van Staden Werdie , Fletcher Lizelle 
Published: April 2020

AbstractBackgroundLiterature on anxiety in schizophrenia is confined to well-established diagnostic syndromes and the diagnostic category of unspecified anxiety disorder has not been quantitatively verified in this population. This study examined whether anxiety that is not differentiated into the well-established syndromes is empirically discernible from syndromal anxiety and no anxiety in acute-phase schizophrenia.MethodsAfter sampling 111 acute-phase schizophrenia patients, they were stratified into three groups: syndromal anxiety; undifferentiated anxiety; and without anxiety disorder. The groups were compared statistically in two data sets on measures for anxiety, psychotic severity, depressive features, akathisia and medication use.ResultsOn two measures of anxiety and for both data sets, the groups were significantly different without evidence of a confounding influence by akathisia, medication, or psychotic severity. The undifferentiated group was different from the syndromal group on the Staden Schizophrenia Anxiety Rating Scale (S-SARS) for both data sets (mean difference = 7.46,p < 0.001; mean difference = 7.69,p < 0.002) and on the Hamilton Anxiety Rating Scale for the one data set (mean difference = 14.68,p < 0.001) but not for the replicative data set (mean difference = 1.49,p = 0.494). The undifferentiated anxiety group was different from the no anxiety group for the respective data sets on both anxiety scales (S-SARS: mean difference = 8.67,p < 0.001; mean difference = 8.64,p < 0.001)(HAM-A: mean difference = 6.05,p < 0.001; mean difference = 8.67,p = 0.002). When depressive features had a confounding effect, it was small relative to the group differences.ConclusionsThe results suggest some patients in acute-phase schizophrenia present with undifferentiated anxiety that is discernible from both syndromal anxiety and those without an anxiety disorder. This finding may serve as empirical grounds for clinicians to recognise undifferentiated anxiety in acute-phase schizophrenia, and for further research into the clinical importance of undifferentiated anxiety in this population.
Connecting healthcare professionals in Central America through management and leadership development: a social network analysis
Authors: Prado Andrea M. , Pearson Andy A. , Bertelsen Nathan S. , Pagán José A. 
Published: April 2020

Abstract
Background
Leadership and management training has become increasingly important in the education of health care professionals. Previous research has shown the benefits that a network provides to its members, such as access to resources and information, but ideas for creating these networks vary. This study used social network analysis to explore the interactions among Central American Healthcare Initiative (CAHI) Fellowship alumni and learn more about information sharing, mentoring, and project development activities among alumni. The CAHI Fellowship provides leadership and management training for multidisciplinary healthcare professionals to reduce health inequities in the region. Access to a network was previously reported as one of the top benefits of the program.

Results
Information shared from the work of 100 CAHI fellows from six countries, especially within the same country, was analyzed. Mentoring relationships clustered around professions and project types, and networks of joint projects clustered by country. Mentorship, which CAHI management promoted, and joint project networks, in which members voluntarily engaged, had similar inclusiveness ratios.

Conclusion
Social networks are strategic tools for health care leadership development programs to increase their impact by promoting interactions among participants. These programs can amplify intergenerational and intercountry ties by organizing events, provide opportunities for alumni to meet, assign mentors, and support collaborative action groups. Collaborative networks have great value to potentiate health professionals’ leadership and management capabilities in a resource-constrained setting, such as the Global South.