bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethical conflicts in patient relationships: Experiences of ambulance nursing students
Authors: Bremer Anders , Holmberg Mats 
Published: April 2020

Background Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts. Aim To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies. Research design An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses. Participants The 69 participants attended a 1-year educational programme for ambulance nurses at a Swedish university. Ethical considerations The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study. Findings The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care. Discussion Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. Conclusion The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability.
Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
Authors: Neupane Gagan , Acharya Sameer , Bhattarai Manoj , Upadhyay Ashish , Belbase Bishal , Bhandari Manoj , Pandeya Drona , Pokharel Shatakshi , Ghimire Sulochana , Thapa Gorakh , Karmacharya Biraj , Bhatt Madan Raj , Spertus John A , Neupane Dinesh , Timsina Lava , Pokharel Yashashwi 
Published: April 2020

Background Noncommunicable diseases (NCDs) are the leading causes of deaths globally. Currently, there are limited high-quality data on the epidemiology and usefulness of community-based screening and treatment of NCDs in low-to-middle-income countries (LMIC), like Nepal. We describe the protocol of a community-based, longitudinal epidemiological study of screening and management of NCDs in rural Nepal. Methods We organize monthly mobile health clinics to screen NCDs among 40- to 75-year-old residents from municipal subdivision wards 3, 4, 6, and 7 of Ghorahi submetropolitan city, Dang, Nepal (approximately 406 km west of the capital, Kathmandu). We estimate a total of 7052 eligible participants. After obtaining informed consent, trained personnel will collect sociodemographic and lifestyle data, medical, medication, and family history using validated questionnaires, plus anthropometric measures and capillary glucose levels. We will screen for hypertension, diabetes, obesity, dyslipidemia, tobacco and alcohol use, self-reported physical activity, dietary habits, cardiovascular disease, stroke, chronic lung disease, cancer, and chronic kidney disease. We will also check hemoglobin A1C, lipid panel, serum creatinine, sodium, potassium, urine dipstick, and urine albumin-to-creatinine ratio in high-risk participants. We will offer lifestyle counseling, pharmacotherapy or refer to higher level care, where appropriate; routinely follow participants with NCDs for continuity of care; and follow individuals without NCDs but with elevated glucose, prehypertension or other risk factors every year, and those without risk factors every 2 years. We will monitor participants in the community to reduce attrition and to track all-cause and disease-specific mortality. Discussion Understanding the community burden of NCDs in resource-limited setting and testing effectiveness of community-based screening and management of NCDs will provide insights to develop national policy to address NCD burden in LMIC like Nepal.
Cognitive aging in migraine sufferers is associated with more subjective complaints but similar age-related decline: a 5-year longitudinal study
Authors: Martins Isabel Pavão , Maruta Carolina , Alves Pedro Nacimento , Loureiro Clara , Morgado Joana , Tavares Joana , Gil-Gouveia Raquel 
Published: April 2020

Abstract
Objectives and background
The effect of headache on cognitive performance is controversial, due to conflicting results obtained from studies in clinical or population settings. We aimed to understand if migraine and other headaches modify the rates of decline on different cognitive measures, during a 5-year interval.

Design and method
A cohort of community dwelling adults (> 50 years) with migraine (MH), non-migraine headaches (NMH) and controls without headache (WoH), was assessed by a comprehensive neuropsychological battery with tests of memory, language and executive functions, repeated 5 years apart. Change in performance between baseline and reevaluation was compared between groups, and controlled for age, gender, literacy and depressive symptoms.

Results
A total of 275 participants (78.5% WoH, 12.7% MH, 8.7% NMH) were reevaluated (average age 70.40 + 8.34 years, 64% females). Cognitive decline or dementia occurred in 11.4%, with a similar proportion among the three groups. Although MH participants had significantly more subjective cognitive complaints (p = 0.030, 95%CI:]-3.929,-0.014[), both MH and NMH subjects showed an age-associated decline identical to controls. Furthermore, migraine features (disease and attack duration, frequency and aura) were unrelated with cognitive performance.

Conclusion
Migraine and non-migraine headache are not associated with increasing risk of dementia or cognitive decline at an older age although subjects with migraine have more cognitive complaints. Longer longitudinal studies are necessary to understand if this pattern persists for more than 5 years.
A Comparative Study on the Ferroelectric Performances in Atomic Layer Deposited Hf0.5Zr0.5O2 Thin Films Using Tetrakis(ethylmethylamino) and Tetrakis(dimethylamino) Precursors
Authors: Kim Baek Su , Hyun Seung Dam , Moon Taehwan , Do Kim Keum , Lee Young Hwan , Park Hyeon Woo , Lee Yong Bin , Roh Jangho , Kim Beom Yong , Kim Ho Hyun , Park Min Hyuk , Hwang Cheol Seong 
Published: April 2020

AbstractThe chemical, physical, and electrical properties of the atomic layer deposited Hf0.5Zr0.5O2 thin films using tetrakis(ethylmethylamino) (TEMA) and tetrakis(dimethylamino) (TDMA) precursors are compared. The ligand of the metal-organic precursors strongly affects the residual C concentration, grain size, and the resulting ferroelectric properties. Depositing Hf0.5Zr0.5O2 films with the TDMA precursors results in lower C concentration and slightly larger grain size. These findings are beneficial to grow more ferroelectric-phase-dominant film, which mitigates its wake-up effect. From the wake-up test of the TDMA-Hf0.5Zr0.5O2 film with a 2.8 MV/cm cycling field, the adverse wake-up effect was well suppressed up to 105 cycles, with a reasonably high double remanent polarization value of ~40 μC/cm2. The film also showed reliable switching up to 109 cycles with the 2.5 MV/cm cycling field without involving the wake-up effect but with the typical fatigue behavior.
Curcumin-Loaded Nanoparticles with Low-Intensity Focused Ultrasound-Induced Phase Transformation as Tumor-Targeted and pH-Sensitive Theranostic Nanoplatform of Ovarian Cancer
Authors: Guo Xiaoxia , Mei Jie , Jing Yong , Wang Shiguang 
Published: April 2020

AbstractWe have developed a simple and versatile nanoplatform using pH-sensitive ferritin nanocages co-loaded with the anticancer drug curcumin (Cur) and liquid fluorocarbon perfluorohexane (PFH) inside the core and conjugated tumor-targeting molecule FA outside the shell referred to as FA-FCP. The synthesized FA-FCP has an average particle diameter of 47 nm, with stable and favorable physicochemical properties in different media, and high biocompatibility and biosafety in vivo and in vitro. Under the conditions of low-intensity focused ultrasound (LIFU) and at pH = 5.0, FA-FCP released a large amount of drugs (53.2%) in 24 h. After 4 min of LIFU (7 W) treatment, FA-FCP provided contrast-enhanced ultrasound imaging capabilities at pH = 5.0. Due to FA receptor-mediated endocytosis, FA-FCP could efficiently enter the cells and further relocate to lysosomes. Eighteen hours after injection of FA-FCP, the tumor was stimulated by LIFU, resulting in a contrast-enhanced ultrasound image. In vivo and in vitro experiments showed that the combined use of FA-FCP and LIFU had significant tumor treatment effects. Based on the results, it was concluded that FA-FCP combined with the external LIFU and the endogenic acidic environment can have powerful theranostic functions and provide a novel type of non-invasive and integrated tumor theranostic option.
Synergistic Delamination Toughening of Glass Fiber-Aluminum Laminates by Surface Treatment and Graphene Oxide Interleaf
Authors: Wu Xiaopeng , Ning Huiming , Liu Yaolu , Hu Ning , Liu Feng , Wang Shu , Huang Kaiyan , Jiao Yudu , Weng Shayuan , Liu Qiang , Wu Liangke 
Published: April 2020

AbstractThe synergistic effects of surface treatment and interleaf on the interlaminar mechanical properties of glass fiber-aluminum laminates were studied. Aluminum sheets were treated with alkaline etching. Meanwhile, a graphene oxide (GO) interleaf was introduced between the aluminum sheet and the glass fiber-reinforced epoxy composite. Double cantilever beam and end-notched flexure tests were employed to evaluate the interlaminar fracture toughness of the glass fiber-aluminum laminates. The obtained results show that the toughening efficiency of the interleaf is dependent on the aluminum surface characteristics as well as the GO loading. Further comparison reveals that the highest mode-I and mode-II fracture toughnesses are obtained in the specimens with alkali etching treatment and addition of GO interleaf with 0.5 wt% of GO loading, which are 510% and 381% higher in comparison to the plain specimen. Fracture surfaces were observed to further uncover the reinforcement mechanisms.
The toxicity of lithium to human cardiomyocytes
Authors: Shen Junwei , Li Xin , Shi Xiujuan , Wang Wei , Zhou Hua , Wu Jiawen , Wang Xin , Li Jue 
Published: April 2020

Abstract
Background
Lithium is widely used in the electronic consumer market and electric vehicles and has a great contribution to the world economy, resulting in large quantities of lithium waste in the environment. The Yangtze River Basin is one of the most developed areas in China. However, the environmental influence of lithium in the Yangtze River Basin and its roles in cardiomyocytes have not yet been clarified.

Results
Here, we found that the concentration of lithium in the water environment is very high in Shanghai, as well as in tap water, which might be caused by the pollution of lithium batteries. Lithium inhibits cell viability and proliferation of human cardiomyocytes. Moreover, lithium promotes cell apoptosis significantly. And we found that lithium controls cardiomyocytes’ functions through regulating glycogen synthase kinase 3 beta signaling.

Conclusions
This study reveals that the water environment of Shanghai might be polluted by the lithium batteries; and the enrichment of lithium might cause damage to human cardiomyocytes. It is imperative to detect lithium concentration in the water environments (such as tap water and irrigation water) and effectively recycle lithium batteries in the future.
General trends in freshwater ecological restoration practice in China over the past two decades: the driving factors and the evaluation of restoration outcome
Authors: Wu Juan , Dai Yanran , Cheng Shuiping 
Published: April 2020

Abstract
Background
Although freshwater ecological restoration (FER) has undergone an immense development over the past two decades in China either in the number of projects or in the spatial scale of implementations, a dearth of clear and comprehensive trends in this field is still a particular concern. We conducted a literature survey through searching the database of Web of Science between 1997 and 2017 to investigate the driving force behind FER practice and to summarize the restoration outcomes.

Results
A total of 2047 publications were hit and 198 of them were finally retained after manual screening. The number of studies in this field has been steadily increasing in recent years and their provincial distribution is positively correlated with GDP growth and the investment to pollution control and environmental protection, suggesting that economic development is a key driving factor of FER practice. Among the remaining articles, nearly half (46.5%) focus on lake ecosystems, and 34.8% and 32.8% of the studies indicate that land reclamation and eutrophication are the predominant causes of freshwater ecosystem degradation. The overarching target of the restoration is biodiversity increase (31.4%), followed by water quality improvement (24.7%) and ecosystem services (23.9%). Revegetation is a dominant restoration approach (40.9%). Reference sites for assessment of restoration projects are normally control locations without intervention (60%), or the status of the targeted sites before the interventions. For the restoration outcome evaluation, 86% of the studies present positive outcomes in terms of water quality improvement, and 79% have improvement in biological features. The most frequently monitored organisms are macrophytes (31%), followed by benthos as indicators of ecological condition.

Conclusions
Economic growth, water pollution and investment into environmental protection are the main driving factors of FER practice in China. The effort of restoration and evaluation over the past two decades has not been limited to improving hydrological function and water quality, but also pay increasingly more attention to biological processes and ecological integrity, and further the ecosystem services in recent years. However, the lack of long-term monitoring and socioeconomic attributes considered in restoration success assessments are still particular issues that need to be addressed in the future FER researches and projects.
Distinguishing pleiotropy from linked QTL between milk production traits and mastitis resistance in Nordic Holstein cattle
Authors: Cai Zexi , Dusza Magdalena , Guldbrandtsen Bernt , Lund Mogens Sandø , Sahana Goutam 
Published: April 2020

AbstractBackgroundProduction and health traits are central in cattle breeding. Advances in next-generation sequencing technologies and genotype imputation have increased the resolution of gene mapping based on genome-wide association studies (GWAS). Thus, numerous candidate genes that affect milk yield, milk composition, and mastitis resistance in dairy cattle are reported in the literature. Effect-bearing variants often affect multiple traits. Because the detection of overlapping quantitative trait loci (QTL) regions from single-trait GWAS is too inaccurate and subjective, multi-trait analysis is a better approach to detect pleiotropic effects of variants in candidate genes. However, large sample sizes are required to achieve sufficient power. Multi-trait meta-analysis is one approach to deal with this problem. Thus, we performed two multi-trait meta-analyses, one for three milk production traits (milk yield, protein yield and fat yield), and one for milk yield and mastitis resistance.ResultsFor highly correlated traits, the power to detect pleiotropy was increased by multi-trait meta-analysis compared with the subjective assessment of overlapping of single-trait QTL confidence intervals. Pleiotropic effects of lead single nucleotide polymorphisms (SNPs) that were detected from the multi-trait meta-analysis were confirmed by bivariate association analysis. The previously reported pleiotropic effects of variants within theDGAT1andMGST1genes on three milk production traits, and pleiotropic effects of variants inGHRon milk yield and fat yield were confirmed. Furthermore, our results suggested that variants inKCTD16,KCNK18andENSBTAG00000023629had pleiotropic effects on milk production traits. For milk yield and mastitis resistance, we identified possible pleiotropic effects of variants in two genes,GCandDGAT1.ConclusionsMulti-trait meta-analysis improves our ability to detect pleiotropic interactions between milk production traits and identifies variants with pleiotropic effects on milk production traits and mastitis resistance. In particular, this should contribute to better understand the biological mechanisms that underlie the unfavorable genetic correlation between milk yield and mastitis.
Gut microbiota in children with juvenile idiopathic arthritis: characteristics, biomarker identification, and usefulness in clinical prediction
Authors: Qian Xubo , Liu Yong-Xin , Ye Xiaohong , Zheng Wenjie , Lv Shaoxia , Mo Miaojun , Lin Jinjing , Wang Wenqin , Wang Weihan , Zhang Xianning , Lu Meiping 
Published: April 2020

Abstract
Background
Recent studies have suggested that the gut microbiota is altered in children with juvenile idiopathic arthritis (JIA). However, age, sex, and body mass index (BMI) were not matched in the previous studies, and the results are inconsistent. We conducted an age-, sex-, and BMI-matched cross-sectional study to characterize the gut microbiota in children with JIA, and evaluate its potential in clinical prediction.

Methods
A total of 40 patients with JIA and 42 healthy controls, ranging from 1 to 16 years, were enrolled in this study. Fecal samples were collected for 16S rDNA sequencing. The data were analyzed using QIIME software and R packages. Specifically, the random forest model was used to identify biomarkers, and the receiver operating characteristic curve and the decision curve analysis were used to evaluate model performance.

Results
A total of 39 fecal samples from patients with JIA, and 42 fecal samples from healthy controls were sequenced successfully. The Chao 1 and Shannon–Wiener index in the JIA group were significantly lower than those in the control group, and the Bray-Curtis dissimilarity also differed significantly between the two groups. The relative abundance of 4 genera, Anaerostipes, Dialister, Lachnospira, and Roseburia, decreased significantly in the JIA group compared to those in the control group. The 4 genera included microbes that produce short-chain fatty acids (SCFAs) and were negatively correlated with some rheumatic indices. Moreover, 12 genera were identified as potential biomarkers by using the nested cross-validation function of the random forest. A random forest model constructed using these genera was able to differentiate the patients with JIA from the healthy controls, and the area under the receiver operating characteristic curve was 0.7975. The decision curve analysis indicated that the model had usefulness in clinical practice.

Conclusions
The gut microbiota in patients with JIA is altered and characterized by a decreased abundance of 4 SCFA-producing genera. The decreases in the 4 genera correlated with more serious clinical indices. Twelve genera could be used as biomarkers and predictors in clinical practice.

Trial registration
The study is registered online at the Chinese Clinical Trial Registry on 11 May 2018 (registration number: ChiCTR1800016110).
The barley stripe mosaic virus expression system reveals the wheat C2H2 zinc finger protein TaZFP1B as a key regulator of drought tolerance
Authors: Cheuk Arnaud , Ouellet Francois , Houde Mario 
Published: April 2020

Abstract
Background
Drought stress is one of the major factors limiting wheat production globally. Improving drought tolerance is important for agriculture sustainability. Although various morphological, physiological and biochemical responses associated with drought tolerance have been documented, the molecular mechanisms and regulatory genes that are needed to improve drought tolerance in crops require further investigation. We have used a novel 4-component version (for overexpression) and a 3-component version (for underexpression) of a barley stripe mosaic virus-based (BSMV) system for functional characterization of the C2H2-type zinc finger protein TaZFP1B in wheat. These expression systems avoid the need to produce transgenic plant lines and greatly speed up functional gene characterization.

Results
We show that overexpression of TaZFP1B stimulates plant growth and up-regulates different oxidative stress-responsive genes under well-watered conditions. Plants that overexpress TaZFP1B are more drought tolerant at critical periods of the plant’s life cycle. Furthermore, RNA-Seq analysis revealed that plants overexpressing TaZFP1B reprogram their transcriptome, resulting in physiological and physical modifications that help wheat to grow and survive under drought stress. In contrast, plants transformed to underexpress TaZFP1B are significantly less tolerant to drought and growth is negatively affected.

Conclusions
This study clearly shows that the two versions of the BSMV system can be used for fast and efficient functional characterization of genes in crops. The extent of transcriptome reprogramming in plants that overexpress TaZFP1B indicates that the encoded transcription factor is a key regulator of drought tolerance in wheat.