bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional variation and temporal trend of primary biliary cholangitis epidemiology: A systematic review and meta‐analysis
Authors: Lv Tingting , Chen Sha , Li Min , Zhang Dong , Kong Yuanyuan , Jia Jidong 
Published: November 2020

AbstractBackground and AimWe aimed to estimate the worldwide incidence and prevalence, with focus on the geographical differences and temporal trends.MethodsStudies on epidemiology of primary biliary cholangitis (PBC) in PubMed, Embase, and Cochrane Library were systematically retrieved from inception to October 2, 2020. Random‐effect model was applied to estimate the pooled PBC incidence and prevalence rates. Subgroup analysis, meta‐regression, and sensitivity analysis were conducted to find out the cause for heterogeneity.ResultsOut of 3974 records identified through database searching, 47 population‐based studies were finally included. The pooled global incidence and prevalence of PBC were 1.76 and 14.60 per 100 000 persons, respectively. Both the PBC incidence and prevalence were lower in the Asia‐Pacific region (0.84, 9.82 per 100 000 persons) than that in North America (2.75, 21.81 per 100 000 persons) and Europe (1.86, 14.59 per 100 000 persons) (P < 0.05). The incidence and prevalence showed an increasing tendency in all three regions, with the fastest growth of prevalence in North America (P < 0.05). We found a similar incidence and a lower prevalence of PBC in Northern Europe than that in Southern Europe. A higher incidence and prevalence were observed in female individuals and in the elderly (60–79).ConclusionThe PBC incidence and prevalence varied widely across regions, with North America being the highest, followed by Europe, and the lowest in the Asia‐Pacific region. Both the incidence and prevalence showed an increasing tendency worldwide, especially in North America.
Professional identity and its work‐related factors among psychiatric nurses: A cross‐sectional study
Authors: Qi Wenwen , Sheng Meiqing , Shi Zhongying 
Published: November 2020

AbstractObjectiveTo investigate the level of professional identity among psychiatric nurses and to explore what work‐related factors may affect their professional identity.MethodsFour hundred and twelve nurses were investigated. Two self‐report questionnaires were used: (a) Nursing Professional Identity Scale (NPIS, range: 30 ~ 150); and (b) Practice Environment Scale of Nursing Work (PESNW, range: 0 ~ 100) with six dimensions: nursing‐related hospital affairs, high‐quality nursing care, ability of nursing manager, manpower and material resources, cooperation between nurses and doctors, and salary and social status. Higher scores indicated higher professional identities and better work environments.ResultsThree hundred and ninety‐one of the participants completed the questionnaires and were analyzed. The mean age of the participants was 32.53 years, and 93.3% of them were female. The mean score of NPIS was 100.03 (SD: 17.44). Multiple linear regression showed that professional identity was significantly and positively associated with two dimensions of PESNW: salary and social status and ability of nursing manager.ConclusionsProfessional identity among psychiatric nurses was at a moderate level. Salary and social status and ability of nursing manager positively contributed to their professional identity. These results may indicate the directors to construct better work environments for psychiatric nursing to improve professional identity.
Nurses’ experiences of continuity of care for patients with heart failure: A thematic analysis
Authors: Östman Malin , Bäck‐Pettersson Siv , Sundler Annelie J. , Sandvik Ann‐Helén 
Published: November 2020

AbstractAims and ObjectivesThis study aimed to describe nurses’ experiences of continuity of care for patients with heart failure.BackgroundHeart failure is a life‐influencing condition that causes varying care needs over time with risks of fragmentation. Nurses play an important role in caring for patients with heart failure. However, nurses’ experiences of continuity of care seem to be less explored in this context.DesignA qualitative study with a descriptive design.MethodsFour focus groups were chosen to collect the data, and the analysis was made by using a method for thematic analysis. A purposeful sampling of nurses (n = 14) with experiences from hospital‐connected heart failure clinics, primary healthcare centres and municipal home healthcare settings was recruited. The COREQ checklist was used in this study.ResultsThe nurses’ experiences of continuity of care for patients with heart failure were described in four themes: access and flexibility, responsibility and transparency, trustful and caring relationships and communication and collaboration.ConclusionsThe results indicate that nurses have an excellent position to act as the “hub” in caring for patients with heart failure, but they need to have the possibility of networking and establishing trusting relationships with their colleagues. From the nurses’ point of view, mutual trust between the nurse, the patient and the patient's next of kin is crucial for promoting and maintaining continuity of care in patients with heart failure.Relevance to clinical practiceTo promote continuity of care for patients with heart failure, nurses expressed the necessity of establishing trusting relationships in a continuity‐promoting organisation with seamless coordination. Nurses can be the “hub” supporting a person‐centred care approach based on the patients’ needs. There seems to be a need for better collaboration with common guidelines across and within primary healthcare centres, hospital‐connected heart failure clinics and municipal home healthcare settings.
Mental health training to improve communication with children and adolescents: A process evaluation
Authors: Moran Rachel , Gutman Leslie Morrison 
Published: November 2020

AbstractAims and objectiveTo characterise the intervention components, mechanisms of change and barriers to implementation of an intervention to improve communication behaviour of hospital staff surrounding mental health with children and adolescents.BackgroundHealthcare professionals consistently report a lack of confidence and knowledge to care for young people experiencing mental health difficulties. We Can Talk is a one‐day training, delivered to hospital staff, which provides tools to improve their communication with children and adolescents about mental health. Initial evaluation suggests the training improved confidence and skills regarding communication; however, the effective intervention components and mechanisms of change are not yet understood.DesignA process evaluation was conducted using a qualitative research design.MethodsDocument analysis of the training manual, using the Behaviour Change Technique Taxonomy, characterised intervention components. Ten interviews with paediatric staff from an east London hospital were conducted post‐intervention. Using the Theoretical Domains Framework, the mechanisms of change and remaining barriers to communication were coded thematically. COREQ checklist was used in the reporting of the study.ResultsTwenty behaviour change techniques were identified. Communication about mental health was mainly facilitated through improving the knowledge, cognitive and interpersonal skills, and beliefs about capabilities of healthcare professionals. A small number of staff continued to experience barriers to communication including a lack of opportunity for communication, beliefs that their professional role is not suited to supporting mental health and nervousness. Behaviour change techniques are highlighted to address remaining barriers reported post‐intervention.ConclusionsUsing validated and systematic behaviour change tools, this process evaluation contributes to the translation of evidence to clinical practice for more effective, sustainable and transparent mental health care, reducing the research‐practice gap in this area.Relevance to clinical practiceThese findings can facilitate implementation of evidence‐based practice and inform interventions, improving clinical practice and outcomes for children and adolescents.
The energy level of the diet in Holstein cows in the first third of lactation alters the expression of immune genes in the mammary gland
Authors: Gómez‐Martínez Juan Esteban , Rodríguez‐Osorio Nélida , Echeverri‐Zuluaga José Julián , López‐Herrera Albeiro 
Published: November 2020

AbstractOur goal was to define the effect of the energy intake in Holstein cows’ diet in the first third lactation on gene expression profile of immune system in mammary gland through RNA‐seq. Twelve Holstein cows were used in the first third of lactation, arranged in four treatments or diets: (a) hypocaloric (HYPO, 85% of the net energy of lactation (NEl) requirements), (b) isocaloric (ISO, 100% of the NEl requirements, control diet), (c) hypercaloric (HYPER, 115% of the NEl requirements) and (d) isocaloric plus sunflower oil supplementation (OIL, 106% of the NEl requirements). A biopsy of mammary gland tissue was carried out after 25 days per diet, from which the RNA was extracted and sequenced using the Illumina HiSeqTM 2,500 sequencer. The analysis of reads obtained from the sequencing in the QIAGEN® CLC Genomics Workbench 10.0 bioinformatics software was performed. From 27,368 genes annotated in the reference genome, 17,429 genes expressed in the evaluated treatments were identified. Moreover, 1,743 differentially expressed genes (DEGs) were found, of which 15 DEGs were found in the ISO vs. OIL comparison, 1,196 DEGs in the ISO vs. HYPO comparison and 532 DEGs in the ISO vs. HYPER comparison. Thus, of the 1,743 DEGs, 401 correspond to genes involved in the functioning of the immune system, encompassing 23% of the total number of DEGs involved in the analysis, and 13.6% of the total number of genes involved in the functioning of the immune system. The energy intake in Holstein cows’ diet has impact in the expression of immune genes CXCL13, TRDC among others, present in the regulation of immune system processes. This immune system altered might increase the somatic cells score and therefore reach some diseases. It is recommended to measure the energy intake according to the animals’ energy requirements and to cover them the closest to the 100%.
Perioperative pharmacokinetics and pharmacodynamics of meloxicam in emus (Dromaius novaehollandiae) of different age groups using nonlinear mixed effect modelling
Authors: Castineiras Diego , Armitage Lucy , Lamas Luís Pardon , De Baere Siegrid , Croubels Siska , Pelligand Ludovic 
Published: November 2020

AbstractMeloxicam is a widely used nonsteroidal anti‐inflammatory drug in avian species. However, variability in pharmacokinetic (PK) and pharmacodynamic (PD) parameters in birds warrants species‐specific studies for dose and dosing interval optimization. We performed a perioperative PK study of meloxicam (0.5 mg/kg, intravenously) on emus of three different age groups: 3 chicks (5 weeks old, 3.5 kg), 4 juveniles (26 weeks old, 18.8 kg) and 6 adults (66 weeks old, 38.8 kg). A two‐compartment population PK model including weight as a significant covariate on clearance and central volume of distribution (V1) best fitted the data. The typical values (20 kg bird) for clearance and V1 were 0.54 L/kg/h and 0.095 L/kg. Both parameters significantly decreased with increasing weight/age. Meloxicam potency and selectivity for COX‐1 and COX‐2 were measured in whole blood assays (TxB2 production endpoint). Meloxicam was partially selective in emus (IC50 COX‐1:COX‐2 = 9.1:1). At the current empirical dose (0.5 mg/kg/24 hr), plasma meloxicam concentration is above IC50 of COX‐2 for only 2 hr. PK/PD predicted dose required for 80% COX‐2 inhibition over 24 hr were 3.4, 1.4 and 0.95 L/kg/day in chicks, juveniles and adult emus, respectively. The safety, therapeutic efficacy and practicality of modifying the daily dose or dose interval should be considered for dose recommendations in emus.
CryoEM of bacterial secretion systems: A primer for microbiologists
Authors: Umrekar Trishant R. , Cohen Eli , Drobnič Tina , Gonzalez‐Rodriguez Nayim , Beeby Morgan 
Published: November 2020

Abstract“CryoEM” has come of age, enabling considerable structural insights into many facets of molecular biology. Here, we present a primer for microbiologists to understand the capabilities and limitations of two complementary cryoEM techniques for studying bacterial secretion systems. The first, single particle analysis, determines the structures of purified protein complexes to resolutions sufficient for molecular modeling, while the second, electron cryotomography and subtomogram averaging, tends to determine more modest resolution structures of protein complexes in intact cells. We illustrate these abilities with examples of insights provided into how secretion systems work by cryoEM, with a focus on type III secretion systems.
Achalasia: physiology and diagnosis
Authors: Rieder Erwin , Fernandez‐Becker Nielsen Q. , Sarosiek Jerzy , Guillaume Alexandra , Azagury Dan E. , Clarke John O. 
Published: November 2020

AbstractAchalasia is a rare motility disorder with incomplete relaxation of the lower esophageal sphincter and ineffective contractions of the esophageal body. It has been hypothesized that achalasia does not result from only one pathway but rather involves a combination of infectious, autoimmune, and familial etiological components. On the basis of other observations, a novel hypothesis suggests that a muscular form of eosinophilic esophagitis is involved in the pathophysiology of achalasia in some patients. This appears to progressively diminish the myenteric plexus at stage III, gradually destroy it at stage II, and finally eliminate it at stage I, the most advanced and final stage of achalasia. Although high‐resolution manometry has identified these three different types of achalasia, another subset of patients with a normal‐appearing sphincter relaxation has been proposed. Provocative maneuvers, such as the rapid drinking challenge, have recently been demonstrated to improve diagnosis in certain borderline patients, but have to be studied in more detail. However, whether the different types of achalasia will have a long‐term impact on tailored therapies is still a matter of debate. Additionally, novel aspects of the standard timed barium swallow appear to be an important adjunct of diagnosis, as it has been shown to have a diagnostic as well as a predictive value.
Classification of submandibular salivary stones based on ultrastructural studies
Authors: Tretiakow Dmitry , Skorek Andrzej , Wysocka Joanna , Darowicki Kazimierz , Ryl Jacek 
Published: November 2020

AbstractIntroductionSialolithiasis remains a clinical problem with unclear etiopathogenesis, lack of prevention methods, and only surgical treatment.Materials and methodsAn ultrastructure examination of submandibular sialoliths obtained from patients with chronic sialolithiasis was conducted using a scanning electron microscope and X‐ray photoelectron spectroscopy.ResultsBased on the results, we divided sialoliths into three types: calcified (CAL), organic/lipid (LIP), and mixed (MIX). The core structure of the CAL and MIX is very similar. The core of the LIP has a prevalence of organic components. The intermediate layers’ structure of the CAL is different from LIP and MIX. In LIP and MIX, the organic component begins to increase in intermediate layers rapidly. The structure of the superficial layers for all types of sialoliths is similar.ConclusionsWe introduced a new classification of the submandibular salivary gland stones. Based on the results, it can be said that sialoliths type CAL and LIP have their separate path of origin and development, while MIX is formed as CAL stone, and the further pathway of their growth passes as LIP stones. Organic components were much more than inorganic in all layers of salivary gland stones, which highly prevents their dissolution in the patient's salivary gland duct.
Plant–plant facilitation increases with reduced phylogenetic relatedness along an elevation gradient
Authors: Duarte Milen , Verdú Miguel , Cavieres Lohengrin A. , Bustamante Ramiro O. 
Published: November 2020

Environmental conditions can modify the intensity and sign of ecological interactions. The stress gradient hypothesis (SGH) predicts that facilitation becomes more important than competition under stressful conditions. To properly test this hypothesis, it is necessary to account for all (not a subset of) interactions occurring in the communities and consider that species do not interact at random but following a specific pattern. We aim to assess elevational changes in facilitation, in terms of species richness, frequency and intensity of the interaction as a function of the evolutionary relatedness between nurses and their associated species. We sampled nurse and their facilitated plant species in two 1000–2000 m. elevation gradients in Mediterranean Chile where low temperature imposes a mortality filter on seedlings. We first estimated the relative importance of facilitation as a mechanism adding new species to communities distributed along these gradients. We then tested whether the frequency and intensity of facilitation increases with elevation, taking into account the evolutionary relatedness of the nurse species and the facilitated species.We found that nurses increase the species richness of the community by up to 35%. Facilitative interactions are more frequent than competitive interactions (56% versus 44%) and facilitation intensity increased with elevation for interactions involving distantly related lineages.Our results highlight the importance of including an evolutionary dimension in the study of facilitation to have a clearer picture of the mechanisms enabling species to coexist and survive under stressful conditions. This knowledge is especially relevant to conserve vulnerable and threatened communities facing new climate scenarios, such as those located in Mediterranean‐type ecosystems.
Important considerations for drugs, nutritional, and herbal supplements in pediatric solid organ transplant recipients
Authors: Pilch Nicole A. , Sell Megan L. , McGhee William , Venkataramanan Raman 
Published: November 2020

AbstractPediatric transplant recipients are on multiple prescription and non‐prescription drugs. Many patients also use dietary, nutritional, and herbal supplements. This manuscript researched formulations of immunosuppressive drugs currently available and presents information on generic immunosuppressive drugs, commonly used non‐prescription medications, dietary supplements, and herbal supplements. Immunosuppressive drugs are available in various formulations. Not all formulations are interchangeable. A number of FDA‐approved generic formulations are available commercially in the United States. Generally generic formulations produce similar blood concentration vs time profiles compared to brand name products in adults and are considered to be bioequivalent. NSAID should be avoided in transplant patients due to potential drug interactions and increased risk associated with NSAID use; and appropriate doses of acetaminophen should be used for treatment of pain. Over‐the‐counter medications, such as guaifenesin and dextromethorphan, antihistamine medications, including diphenhydramine, loratadine, cetirizine, and fexofenadine, can be safely used in pediatric solid organ transplant population. Many safe and effective over‐the‐counter options exist for stool softening and as laxative. Diarrhea can lead to an increase in calcineurin inhibitor levels. Food can alter the absorption of immunosuppressive drugs. Several herbal products can alter immune status of the patients or alter the blood concentration of immunosuppressive drugs or may produce renal or hepatic toxicities and should be avoided in pediatric transplant recipients. It is important to educate pediatric transplant recipients and their families about not only immunosuppressive drug therapy but also about non‐prescription drugs, dietary, and herbal supplement use.
Multicenter data to improve health for pediatric renal transplant recipients in North America: Complementary approaches of NAPRTCS and IROC
Authors: Hooper David K. , Misurac Jason , Blydt‐Hansen Tom , Chua Annabelle N. 
Published: November 2020

AbstractKidney transplantation increases life expectancy and improves quality of life for children with end‐stage kidney disease, yet sequelae of transplantation and treatment make it difficult for transplant recipients to enjoy health and quality of life similar to their healthy peers. The NAPRTCS network was among the first to use multicenter data to inform improvements in care and outcomes for children with a kidney transplant through observational research. Now, with new technologies and unprecedented access to data, it is possible to create learning health systems as envisioned by the US National Academy of Sciences to seamlessly integrate research and continuous improvement of clinical care. In this review, we present two pre‐eminent North American networks focused on using multicenter data to drive improved care and outcomes for children with a kidney transplant. Whereas, for the past 30 years NAPRTCS has focused on discovery of best practices through observational research and clinical trials, the Improving Renal Outcomes Collaborative, established in 2016, engages patients, families, clinicians, and researchers in redesigning the healthcare delivery system to enable practice change and continuous improvement of health outcomes. We discuss the history and past contributions of these networks, as well as current activities, barriers, and potential future solutions to more fully realize the vision of a true learning health system for pediatric kidney transplant recipients.
Allogeneic hematopoietic stem cell transplant in pediatric acute myeloid leukemia: Lessons learnt from a tertiary care center in India
Authors: Arora Shalabh , Pushpam Deepam , Tiwari Akash , Choudhary Priyanshu , Chopra Anita , Gupta Ritu , Kumar Rajive , Bakhshi Sameer 
Published: November 2020

AbstractThere is paucity of data on outcomes of MSD‐HSCT in children with relapsed or high‐risk AML from developing countries, which have unique challenges including adverse host factors and resource constraints. We retrospectively reviewed records of children (age ≤ 18 years) who underwent MSD‐HSCT for AML at our center from 2009 to 2019 to evaluate clinical outcome and its predictors using Cox proportional hazards model. There were 46 children (36 boys and 10 girls) with mean age 10.7 ± 4.8 years. Indication for HSCT was relapsed AML in CR2 (n = 37), primary refractory (n = 3), or relapsed refractory disease (n = 3); high‐risk (n = 1) or secondary (n = 2) AML in CR1. Five‐year EFS and OS were 33.3 ± 7.2% and 36.3 ± 7.6%, respectively. On multivariate analysis, CR1 duration less than 12 months, presence of active disease at transplant, and use of bone marrow stem cell graft were associated with poorer EFS and OS. There was one (2.2%) TRM, while disease relapse occurred in 20/40 patients who underwent HSCT in remission. Though the 5‐year EFS and OS were inferior to results reported from high‐income countries, relapse (and not TRM) was the major cause of treatment failure. A well‐sustained CR1, achievement of disease remission, and use of peripheral blood allograft seem imperative to a successful transplant. Targeted therapy along with HSCT may be the option for those with early relapse.