bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vehicle‐related flood fatalities in Australia, 2001–2017
Authors: Ahmed Mozumdar A. , Haynes Katharine , Taylor Mel 
Published: April 2020

AbstractThis study analyses the circumstances of vehicle‐related flood fatalities between 2001 and 2017, in Australia. The research identified 96 deaths from 74 incidents during this period. The aim of this analysis is to understand the demographic, spatial and temporal patterns, and the situational conditions in which those (n = 96) deaths have occurred. This is important for informing efficient and strategic risk reduction strategies to reduce vehicle related deaths and injuries in floodwater. Data were accessed from the Australian National Coronial Information System (NCIS), which includes witness and police statements, forensic documents, and detailed coronial findings. Analysis was conducted in two phases. In phase one, data were coded and categorised according to a range of factors previously identified as significant in vehicle‐related flood fatalities internationally. In phase two, a detailed analysis was conducted on 11 selected incidents for which there were complete sets of records. This detailed analysis provides insight into the multifaceted nature of fatal vehicle‐related flood fatality incidents. The overall results reveal that, for drivers, middle‐aged and elderly males are over‐represented in the fatality statistics. As passengers, young women and children are vulnerable. The study also identified deep floodwater with high flow contributes more to vehicle immersion, and the presence of alcohol and drugs, leading to impaired responses, reduces the chance of survival for the vehicle occupants.
Studying physiology within a flipped classroom: The importance of on‐campus activities for nursing students’ experiences of mastery
Authors: Bingen Hanne Maria , Steindal Simen A. , Krumsvik Rune Johan , Tveit Bodil 
Published: April 2020

AbstractAims and objectivesTo explore the on‐campus activities of the flipped classroom and their role in nursing students’ experiences of mastering physiology.BackgroundA nurse must be confident in their knowledge of physiology to feel confident as a nurse. However, many nursing students do not believe in their ability to master physiology. The flipped classroom design could facilitate active learning and promote students’ confidence and competence in physiology.DesignA design‐based research design was employed.MethodsTwenty‐three nursing students enrolled in an anatomy and physiology course participated in two focus group interviews and wrote two individual reflective notes. The data were analysed by means of systematic text condensation and activity theory. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Studies (COREQ).ResultsThe study findings underscore the importance of careful design of on‐campus activities within the flipped classroom to support students’ experiences of mastery in physiology. Four themes were identified: (a) preparation which builds a foundation for learning; (b) the use of digital tools; (c) learning through dialogue with peers; and (d) experience of the expected learning outcomes.ConclusionsOn‐campus learning activities within a flipped classroom design could support students’ experiences of confidence in and mastery of physiology. However, the study participants found learner‐centred activities challenging and described feeling doubtful of their ability to master physiology. A didactic framework could take into account the circumstance that students perceive educational technology differently. When designing on‐campus activities, emphasis should be placed on collaboration rather than competition to help students develop confidence in their knowledge of physiology.Relevance to clinical practiceIt is important to support nursing students’ knowledge acquisition in bioscience and their development of confidence as these skills could enhance their clinical judgment in practice. Comprehension of bioscience is necessary to provide safe patient care and competent nursing.
Caring in community nursing practice: Inductive content analysis reveals an inter‐dynamic system between patients and nurses
Authors: Yue Peng , Xu Tianmeng , Greene Brian , Wang Yongli , Wang Rongjin , Dai Guizhi , Xu Lijie 
Published: April 2020

AbstractAims and objectivesTo examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses.BackgroundAn increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person‐centred care with their clients. Furthermore, most community nurses—especially in China—lack systematic education and training about caring because the practical meaning of caring in community practice is unknown.DesignThe qualitative study described herein employed inductive content analysis.MethodsEleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty‐one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used.ResultsPatients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter‐dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship‐based framework of caring in community nursing practice was constructed.ConclusionsIdentifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care—in China or elsewhere.Relevance to clinical practiceThe systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.
Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial
Authors: Røsjø H. , Hijazi Z. , Omland T. , Westerbergh J. , Lyngbakken M.N. , Alexander J.H. , Gersh B.J. , Granger C.B. , Hylek E.M. , Lopes R.D. , Siegbahn A. , Wallentin L. 
Published: April 2020

AbstractBackgroundCardiac troponin T (cTnT) and I (cTnI) concentrations provide strong prognostic information in anticoagulated patients with atrial fibrillation (AF). Whether the associations between cardiac troponin concentrations and mortality and morbidity differ by sex is not known.ObjectivesTo assess whether men and women have different concentrations and prognostic value of cTnT and cTnI measurements in anticoagulated patients with AF.MethodscTnT and cTnI concentrations were measured with high‐sensitivity (hs) assays in EDTA plasma samples obtained from the multicentre ARISTOTLE trial, which randomized patients with AF and at least one risk factor for stroke or systemic embolic event to warfarin or apixaban. Patients were stratified according to sex and the associations between hs‐troponin concentrations, and all‐cause death, cardiac death, myocardial infarction, stroke or systemic embolic event and major bleeding were assessed in multivariable regression models.ResultsWe found higher cardiac troponin concentrations in men (n = 9649) compared to women (n = 5331), both for hs‐cTnT (median 11.8 [Q1‐3 8.1–18.0] vs. 9.6 [6.7–14.3] ng L−1, P < 0.001) and hs‐cTnI (5.8 [3.4–10.8] vs. 4.9 [3.1–8.8] ng L−1, P < 0.001). Adjusting for baseline demographics, comorbidities and medications, men still had significantly higher hs‐troponin concentrations than women. C‐reactive protein and N‐terminal pro‐B‐type natriuretic peptide concentrations were higher in female patients. Both hs‐cTnT and hs‐cTnI concentrations were associated with all clinical outcomes similarly in men and women (p‐value for interaction >0.05 for all end‐points).ConclusionMen have higher hs‐troponin concentrations than women in AF. Regardless of sex, hs‐troponin concentrations remain similarly associated with adverse clinical outcomes in anticoagulated patients with AF.
Clinical and epidemiological characteristics of 1420 European patients with mild‐to‐moderate coronavirus disease 2019
Authors: Lechien Jerome R. , Chiesa‐Estomba Carlos M. , Place Sammy , Van Laethem Yves , Cabaraux Pierre , Mat Quentin , Huet Kathy , Plzak Jan , Horoi Mihaela , Hans Stéphane , Rosaria Barillari Maria , Cammaroto Giovanni , Fakhry Nicolas , Martiny Delphine , Ayad Tareck , Jouffe Lionel , Hopkins Claire , Saussez Sven ,   COVID‐19 Task Force of YO‐IFOS
Published: April 2020

AbstractBackgroundThe clinical presentation of European patients with mild‐to‐moderate COVID‐19 infection is still unknown.ObjectiveTo study the clinical presentation of COVID‐19 in Europe.MethodsPatients with positive diagnosis of COVID‐19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes.ResultsA total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID‐19 symptoms of mild‐to‐moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild‐to‐moderate COVID‐19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients.ConclusionThe clinical presentation of mild‐to‐moderate COVID‐19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild‐to‐moderate COVID‐19 that needs to be recognized as such by the WHO.
Obesity in African‐Americans: The role of physiology
Authors: Gower B. A. , Fowler L. A. 
Published: April 2020

AbstractThe disproportionate obesity in African American (AA) women has a physiologic basis and can be explained by the interactive effects of insulin secretion, insulin clearance, insulin sensitivity and the glycaemic load of the diet. This review will present data supporting a physiologic basis for obesity propensity in obesity‐prone AA women that resides in their unique metabolic/endocrine phenotype: high beta‐cell responsiveness, low hepatic insulin extraction and relatively high insulin sensitivity, which together result in a high exposure of tissues and organs to insulin. When combined with a high‐glycaemic (HG) diet (that stimulates insulin secretion), this underlying propensity to obesity becomes manifest, as ingested calories are diverted from energy production to storage. Our data indicate that both weight loss and weight loss maintenance are optimized with low‐glycaemic (LG) vs HG diet in AA. Whether greater obesity in AA is mechanistically related to their greater prevalence of type 2 diabetes is debatable. This review provides data indicating that obesity is not strongly related to insulin resistance in AA. Rather, insulin resistance in AA is associated with relatively low adipose tissue in the leg, consistent with a genetic predisposition to impaired lipid storage. Greater bioenergetic efficiency has been reported in AA and, via resultant oxidative damage, could plausibly contribute to insulin resistance. In summary, it is proposed here that a subset of AA women are predisposed to obesity due to a specific metabolic/endocrine phenotype. However, greater diabetes risk in AA has an independent aetiology based on impaired lipid storage and mitochondrial efficiency/oxidative stress.
Endurance measurement of hyoid muscle activity and hyoid‐laryngeal position during tongue lift movement
Authors: Sunada Yukako , Magara Jin , Tsujimura Takanori , Ono Kazuhiro , Inoue Makoto 
Published: April 2020

AbstractBackgroundTongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients.ObjectiveThe present study aimed to characterize the time‐dependent endurance changes in hyoid muscle activity and hyoid‐laryngeal displacement during TLM in different ways.MethodsSixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon‐type tongue pressure instrument, followed by a 10‐second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S‐Hyo) and infrahyoid (I‐Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid‐laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late).ResultsTongue pressure was stably maintained for 10 seconds in all conditions. S‐Hyo iEMG and I‐Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S‐Hyo iEMG and I‐Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM.ConclusionThe current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.
Sleep neurophysiology in childhood onset schizophrenia
Authors: Markovic Andjela , Buckley Ashura , Driver David I. , Dillard‐Broadnax Diane , Gochman Peter A. , Hoedlmoser Kerstin , Rapoport Judith L. , Tarokh Leila 
Published: April 2020

AbstractAltered sleep neurophysiology has consistently been reported in adult patients with schizophrenia. Converging evidence suggests that childhood onset schizophrenia (COS), a rare but severe form of schizophrenia, is continuous with adult onset schizophrenia. The aim of the current study was to characterize sleep neurophysiology in COS. An overnight sleep electroencephalogram (EEG) was recorded in 17 children and adolescents with COS (16 years ± 6.6) and 17 age and gender‐matched controls. Non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep EEG power and coherence for the frequency bands delta (1.6–4.8 Hz), theta (5–8.4 Hz), alpha (8.6–11 Hz), beta 1 (16.4–20.2 Hz) and beta 2 (20.4–24.2 Hz) were compared between COS patients and controls. COS patients exhibited significant and widespread deficits in beta power during NREM and REM sleep. With regard to coherence, we found increases in COS patients across brain regions, frequency bands and sleep states. This study demonstrates the utility of the sleep EEG for studying vulnerable populations and its potential to aid diagnosis.
Dietary behaviours and weight management: A thematic analysis of pregnant women's perceptions
Authors: Flannery Caragh , Mtshede Mavis Nomsa , McHugh Sheena , Anaba Ann Ebere , Clifford Emma , O'Riordan Mairead , Kenny Louise C. , McAuliffe Fionnuala M. , Kearney Patricia M. , Matvienko‐Sikar Karen 
Published: April 2020

AbstractMaternal obesity is associated with increased risk of gestational diabetes and other complications. Although antenatal interventions to help prevent these complications are ongoing, an understanding of overweight and obese pregnant women's opinions and attitudes is lacking. Therefore, this study aims to explore these women's experiences and perceptions of dietary behaviours and weight management during pregnancy. Secondary analysis of qualitative data originally collected to examine lifestyle behaviours in pregnant women was conducted. The data were from a purposive sample of overweight and obese pregnant women attending a public antenatal clinic in Cork, Ireland. The data were explored using thematic analysis. Interviews with 30 overweight and obese pregnant women were analysed. Three themes were developed relating to overweight and obese women's dietary behaviours and weight management perceptions including ‘pregnancy's influence on dietary behaviours’, ‘external influences on dietary behaviours’ and ‘perception of and preferences for weight related advice and resources’. Together these themes reveal women's experiences of diet and how pregnancy factors (physiological changes) and external factors (family and friends) can influence dietary behaviours. Furthermore, perceptions of weight management advice and lack thereof were highlighted with women drawing attention to potential resources for future use during pregnancy. This study provides important insights into overweight and obese pregnant women's dietary behaviours and perceptions of weight management. According to these findings, there is a need for clear and unambiguous information about weight management, acceptable weight gain, food safety and how to achieve a balanced diet.
Becoming a clinician: Trainee identity formation within the general practice supervisory relationship
Authors: Brown James , Reid Helen , Dornan Tim , Nestel Debra 
Published: April 2020

AbstractObjectivesBecoming a clinician is a trajectory of identity formation in the context of supervised practice. This is a social process where the supervisory relationship is key. Therefore, to know how to support identity formation of clinical trainees, it is necessary to understand how this happens within the supervisory relationship. Our aim was to develop a conceptualisation of trainee identity formation within the general practice supervisory relationship to aid its support.MethodsWe took a critical realist approach using case study design and ‘cultural worlds’ theory as a conceptual frame. Each case comprised a general practice trainee and supervisor pair. Our data were weekly audiorecordings of interactions between trainee, supervisor and a patient over 12 weeks augmented by post‐interaction reflections and sequential interviews. We undertook interpretive analysis using dialogic methods focusing on the doing of language and the cultural discourses expressed.ResultsWe identified three social discourses centring on: clinical responsibility; ownership of clinical knowledge, and measures of trainee competency. Versions of these discourses defined four trainee‐supervisor relational arrangements within which trainee and supervisor assumed reciprocal identities. We labelled these: junior learner and expert clinician; apprentice assistant and master coach, and lead clinician and advisor. We found a trajectory across these identity arrangements. Behind this trajectory was an invitation by the supervisor to the trainee into the social space of clinician and a readiness of the trainee to accept this invitation. Congruence in supervisor and trainee positioning was important.ConclusionsIn the supervisory relationship, trainee and supervisor adopted reciprocal identities. For trainees to progress to identity of ‘lead clinician,’ supervisors needed to invite their trainee into this space and vacate it themselves. Congruence between supervisor positioning of their trainee and trainee authorship of themselves was important and was aided by explicit dialogue and common purpose. We offer a model and language for trainees, supervisors and departments or schools to facilitate this.
Non‐invasive measurement of retinal permeability in a diabetic rat model
Authors: Allen Claire L. , Malhi Naseeb K. , Whatmore Jacqueline L. , Bates David O. , Arkill Kenton P. 
Published: April 2020

AbstractObjectiveThe gold standard for measuring blood‐retinal barrier permeability is the Evans blue assay. However, this technique has limitations in vivo,including non‐specific tissue binding and toxicity. This study describes a non‐toxic, high‐throughput, and cost‐effective alternative technique that minimizes animal usage.MethodsSodium fluorescein fundus angiography was performed in non‐diabetic and diabetic Brown Norway rats on days 0, 7, 14, 21, and 28. Sodium fluorescein intensity in the retinal interstitium and a main retinal vessel were measured over time. The intensity gradients were used to quantify retinal vascular permeability. Post‐study eyes were fixed, dissected, and stained (isolectin B4) to measure required parameters for permeability quantification including total vessel length per retinal volume, radius, and thickness.ResultsIn the non‐diabetic cohort retinal permeability remained constant over the 28‐day study period. However, in the diabetic cohort there was a significant and progressive increase in retinal permeability from days 14‐28 (P < .01,P < .001,P < .0001).ConclusionsThis novel imaging methodology in combination with mathematical quantification allows retinal permeability to be non‐invasively and accurately measured at multiple time points in the same animal. In addition, this technique is a non‐toxic, rapid, sensitive, and cost‐effective alternative to the Evans blue assay.
Toward the Establishment of a Data‐Driven Learning Model: Role of Learner Factors in Corpus‐Based Second Language Vocabulary Learning
Authors: LEE HANSOL , WARSCHAUER MARK , LEE JANG HO 
Published: April 2020

AbstractWe investigated how learner factors, such as vocabulary proficiency, strategy use, and working memory, are associated with successful corpus‐based second language (L2) vocabulary learning, in which learners are encouraged to analyze and explore large, structured collections of authentic language data (i.e., corpora) to resolve their lexical issues (i.e., data‐driven learning [DDL]). After measuring L2 vocabulary proficiency and working memory capacity, 35 South Korean college students performed a DDL activity during an English reading task using a think‐aloud protocol to document their strategy use. Through this we identified participants’ lexical inferencing strategy use, including DDL‐focused strategies, based on qualitative coding. Using path analysis, we identified that participants’ DDL‐focused strategy use largely influenced their vocabulary acquisition and retention, highlighting the pedagogical advantages of these strategies for successful DDL. We found that participants’ L2 vocabulary proficiency and working memory contributed to their vocabulary acquisition and retention, indicating the roles of these factors in managing cognitive load in DDL. Future investigation into the causal relationship between improved working memory and corpus‐based L2 vocabulary learning and the role of other learner factors, including motivation and learning style, is needed to extend our understanding of DDL.