bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computerised scoring protocol for identification and quantification of different immune cell populations in breast tumour regions by the use of QuPath software
Authors: Berben Lieze , Wildiers Hans , Marcelis Lukas , Antoranz Asier , Bosisio Francesca , Hatse Sigrid , Floris Giuseppe 
Published: April 2020

AimsAs important prognostic and predictive information can be obtained from the composition, functionality and spatial arrangement of different immune cell subtypes, this study aims at characterizing the immune infiltrate in breast tumours.Methods and resultsTumour‐infiltrating lymphocytes (TILs) in 62 patients with luminal B‐like breast cancer were characterised by immunohistochemical staining with standard markers, and were subsequently classified and quantified by the use of QuPath software. In different delineated tumour regions, the proportion and density of CD3+, CD4+, CD5+, CD8+, CD20+ and FOXP3+ cells were assessed. The results of the software analysis were compared with those of manual counting for CD8 and CD20 staining. The QuPath scoring protocol slightly overestimated positive, negative and total lymphocyte counts and density, while minimally underestimating the proportion of positively stained lymphocytes. However, for density and proportion, no real differences from manual counting were observed. For all markers, the density of positively stained immune cells was higher in the invasive front than in the tumour centre, pointing to an accumulation of immune cells near the tumour boundaries. When we looked at the proportion of immunohistochemically positive immune cells, we observed enrichment of CD5 (P = 0.025) and CD20 (P < 0.001) at the periphery, and FOXP3 enrichment in the centre (P < 0.001).ConclusionThe QuPath scoring protocol can adequately identify positively stained immune cells in breast tumours, and allows the evaluation of differences in immune cell proportion and density within different tumour regions. The entire tumour section can be quantitatively assessed quite rapidly, which is a major advantage over manual counting.
High night‐time temperature during flowering and pod filling affects flower opening, yield and seed fatty acid composition in canola
Authors: Pokharel Meghnath , Chiluwal Anuj , Stamm Michael , Min Doohong , Rhodes Davina , Jagadish S.V. Krishna 
Published: April 2020

AbstractWinter canola (Brassica napus L.) is highly sensitive to increasing temperatures during the reproductive and pod‐filling stages. Although the impact of high day‐time temperature stress on yield and quality has been documented in canola, similar information under high night‐time temperature (HNT) stress is not available. Using six hybrids and four open‐pollinated cultivars, we observed a marked shift in peak flowering towards earlier, cooler hours of the morning under HNT. Averaged across two independent experiments, the photochemical efficiency of photosystem II was significantly decreased (3%), with a significant increase in thylakoid membrane damage (13%) in the leaves of susceptible cultivars under HNT stress. Similarly, the susceptible cultivars also recorded significant reduction in biomass (34%), pod number (22%), pod weight (37%) and total seed weight (40%) per plant while the same set of agronomic traits were not affected among the tolerant cultivars. Quantitative impact of heat stress was confirmed with increased sensitivity to HNT exposure from gametogenesis until maturity resulting in a significantly higher yield loss compared to stress exposure from post‐flowering till maturity. HNT significantly decreased oil concentration, but increased protein concentration and saturated fatty acid levels in seeds of the susceptible cultivars. However, HNT had no impact on the unsaturated fatty acids in both hybrids and the open‐pollinated cultivars. Breeding targets based on fatty acid composition for enhancing canola seed quality may not be easily amenable due to the inconsistency documented with the compositional changes under heat stress. In summary, our findings conclude that canola hybrids are better suited to regions experiencing heat stress, compared to open‐pollinated cultivars, indicating the possibility of a complete shift to hybrid canola cultivation under predicted hotter climates in the future.
A structural model for quality of life of alcoholics
Authors: Gu Minkyung , Lee Hye Kyung , Sok Sohyune R. 
Published: April 2020

AbstractAimsTo investigate the factors affecting the quality of life of alcoholics and to identify the relationships between these factors to establish and verify a hypothetical model for the quality of life of alcoholics.DesignCovariance structure analysis using structural equation model.MethodsParticipants were 223 adults who were hospitalized at alcohol addiction treatment centre after being diagnosed with alcoholism in Gyunggi‐do, South Korea. Data included the general characteristics of study participants, depression, abstinence self‐efficacy, stress level, stress coping strategy, social support and quality of life. Data were collected from March – 28 May 2016 and were analysed using SPSS 22.0 and AMOS 22.0.ResultsThe factors affecting the quality of life of alcoholics included alcohol abstinence self‐efficacy (β = 0.37, t = 4.56), stress copying strategy (β = 0.23, t = 2.37), stress level (β = −0.20, t = −2.08) and social support (β = 0.14, t = 2.52). Factor analysis and statistical significance level was used for model coefficients and t‐value estimation.ConclusionThis study suggested that to improve the quality of life of alcoholics, their alcohol abstinence self‐efficacy should be increased, measures to improve their stress coping strategy and ability should be prepared, their stress level should be lowered and the social support system perceived by them should be strengthened. Health professionals need to pay attention to the affecting factors to improve the quality of life of alcoholics.ImpactAlcoholism is emerging as a social problem, not just an individual problem. Alcohol abstinence self‐efficacy had the greatest direct effect on the quality of life of alcoholics, followed by stress coping strategy, stress level and social support, which had significant direct effects. Depression had significant indirect effect on the quality of life of alcoholics. Health professionals need to pay attention to the affecting factors to improve the quality of life of alcoholics in clinical practice or community fields.
A scoping review of complexity science in nursing
Authors: Olsson Annakarin , Thunborg Charlotta , Björkman Annica , Blom Anneli , Sjöberg Fredric , Salzmann‐Erikson Martin 
Published: April 2020

AbstractAimTo describe how complexity science has been integrated into nursing.DesignA scoping review.Data source/review methodAcademic Search Elite, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed and Web of Science were searched November 2016, updated in October 2017 and January 2020. The working process included: problem identification, literature search, data evaluation, synthesizing and presentation.ResultsFour categories were found in the included 89 articles: (a) how complexity science is integrated into the nursing literature in relation to nursing education and teaching; (b) patients' symptoms, illness outcome and safety as characteristics of complexity science in nursing; (c) that leaders and managers should see organizations as complex and adaptive systems, rather than as linear machines; and (d) the need for a novel approach to studying complex phenomena such as healthcare organizations. Lastly, the literature explains how complexity science has been incorporated into the discourse in nursing and its development.ConclusionThe review provided strong support for use in complexity science in the contemporary nursing literature. Complexity science is also highly applicable and relevant to clinical nursing practice and nursing management from an organizational perspective. The application of complexity science as a tool in the analysis of complex nursing systems could improve our understanding of effective interactions among patients, families, physicians and hospital and skilled nursing facility staff as well as of education.ImpactUnderstanding complexity science in relation to the key role of nurses in the healthcare environment can improve nursing work and nursing theory development.The use of complexity science provides nurses with a language that liberates them from the reductionist view on nursing education, practice and management.
The nurse’s experience of decision‐making processes in missed nursing care: A qualitative study
Authors: Abdelhadi Nasra , Drach‐Zahavy Anat , Srulovici Einav 
Published: April 2020

AbstractAimsTo explore nurses’ perspectives regarding the decision‐making processes that lead to missed nursing care and to identify the personal and contextual attributes involved in these processes.DesignA qualitative study was undertaken between April – October 2018.MethodsA total of 28 registered nurses working in different wards in hospital settings participated in nine focus groups with semi‐structured interviews. An interview guide encouraged nurses to share perceptions of missed care and the personal and contextual attributes shaping their decision‐making.ResultsContent analysis revealed three themes related to nurses’ decision‐making processes for whether to omit or delay care. First, nurses emphasized the role of nurses’ agency, suggesting explicit or implicit rationing of care, regardless of scarce resources. Second, nurses distinguished between two modes of thinking that they labelled “automated thinking,” activated in routine situations and “effortful thinking,” initiated in more novel situations. Finally, nurses identified situational factors triggering fluctuations in their awareness such as task type, difficult patients and the presence of relatives and the head nurse.ConclusionsNurses are aware of the processes guiding a decision to omit or delay care. They pointed to patient, nurse and ward conditions that serve as cues in their decision whether to miss care. Identifying these cues supports Hammond's cognitive continuum theory of decision‐making and may serve in the development of training programmes for nurses aimed at limiting the phenomenon.ImpactThe study addressed missed nursing care through a decision‐making lens. The findings pointed to nurses’ agency as shaping decisions about whether to miss care and identified the personal and contextual cues that guide nurses’ decisions. These findings call for organizational training programmes encouraging nurses to identify barriers and facilitators of missed nursing care and how to overcome them.
A deviation too many? Healthcare professionals’ knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity
Authors: Sommarö Susanna , Andersson Agneta , Skagerström Janna 
Published: April 2020

AbstractBackgroundPeople with intellectual disability (ID) have few role models for sexual expression and behaviour, and those who identify as LGBTQ experience dual marginalization. The aim of this study is to explore knowledge and attitudes concerning patients with both ID and norm‐breaking sexuality and/or gender identity among healthcare professionals in habilitation centres.MethodData were collected from four focus group interviews that included 19 healthcare professionals from child and adult teams at two Swedish habilitation centres. Data were analysed using thematic analysis.ResultsThree themes were identified as follows: heteronormative treatment in health care, barriers for inclusion and possibilities for inclusion.ConclusionsNorm‐breaking sexuality and gender identity are still relatively invisible in habilitation centres. People with ID are still predominately desexualized and perceptions regarding their sexuality are lagging behind the rest of society. Conditions that allow for more LGBTQ‐affirmative practice were described by the teams that have undergone LGBTQ training.
Latitudinal patterns of species richness and range size of ferns along elevational gradients at the transition from tropics to subtropics
Authors: Hernández‐Rojas Adriana C. , Kluge Jürgen , Krömer Thorsten , Carvajal‐Hernández César , Silva‐Mijangos Libertad , Miehe Georg , Lehnert Marcus , Weigand Anna , Kessler Michael 
Published: April 2020

AbstractAimTo assess the range size patterns of ferns and lycophytes along elevational gradients at different latitudes in an ecographical transition zone and search for predictors of range size from a set of environmental factors.LocationMexico, from 15° to 23° N.TaxonFerns and lycophytes.MethodsAll terrestrial and epiphytic species were recorded in 658 plots of 400 m2 along eight elevational gradients. To test whether the range size within assemblages increases with elevation and latitude, we calculated the latitudinal range using the northern and southern limits of each species and averaged the latitudinal range of all species within assemblages weighted by their abundances. We related climatic factors and the changes with latitude and elevation with range size using linear mixed‐effects models.ResultsSpecies richness per plot increased with elevation up to about 1,500–2,000 m, with strong differences in overall species richness between transects and a reduction with increasing latitude. The mean weighted range size of species within assemblages declined with elevation, and increased with latitude, as predicted by theory. However, we also found marked differences between the Atlantic and Pacific slopes of Mexico, as well as low range size in humid regions. The best models described about 76%–80% of the variability in range size and included the seasonality in both temperature and precipitation, and annual cloud cover.Main conclusionLatitudinal and elevational patterns of range size in fern assemblages are driven by an interplay of factors favouring wide‐ranging species (higher latitudes with increasing temperature seasonality; dryer habitat conditions) and those favouring species with restricted ranges (higher elevations; humid habitat conditions), with additional variation introduced by the specific conditions of individual mountain ranges. Climatically stable, humid habitats apparently provide favourable conditions for small‐ranged fern species, and should accordingly be given high priority in regional conservation planning.
Performance of electrophysiology procedures at an academic medical center amidst the 2020 coronavirus (COVID‐19) pandemic
Authors: Rubin Geoffrey A. , Biviano Angelo , Dizon Jose , Yarmohammadi Hirad , Ehlert Frederick , Saluja Deepak , Rubin David A. , Morrow John P. , Waase Marc , Berman Jeremy , Kushnir Alexander , Abrams Mark P. , Garan Hasan , Wan Elaine Y. 
Published: April 2020

AbstractA global coronavirus (COVID‐19) pandemic occurred at the start of 2020 and is already responsible for more than 74 000 deaths worldwide, just over 100 years after the influenza pandemic of 1918. At the center of the crisis is the highly infectious and deadly SARS‐CoV‐2, which has altered everything from individual daily lives to the global economy and our collective consciousness. Aside from the pulmonary manifestations of disease, there are likely to be several electrophysiologic (EP) sequelae of COVID‐19 infection and its treatment, due to consequences of myocarditis and the use of QT‐prolonging drugs. Most crucially, the surge in COVID‐19 positive patients that have already overwhelmed the New York City hospital system requires conservation of hospital resources including personal protective equipment (PPE), reassignment of personnel, and reorganization of institutions, including the EP laboratory. In this proposal, we detail the specific protocol changes that our EP department has adopted during the COVID‐19 pandemic, including performance of only urgent/emergent procedures, after hours/7‐day per week laboratory operation, single attending‐only cases to preserve PPE, appropriate use of PPE, telemedicine and video chat follow‐up appointments, and daily conferences to collectively manage the clinical and ethical dilemmas to come. We discuss also discuss how we perform EP procedures on presumed COVID positive and COVID tested positive patients to highlight issues that others in the EP community may soon face in their own institution as the virus continues to spread nationally and internationally.
The challenge of simplifying blood pressure screening in children and adolescents
Authors: Stabouli Stella , Antza Christina , Chrysaidou Katerina , Kotsis Vasilios 
Published: April 2020

AbstractSimplified methods of blood pressure screening could facilitate the clinical routine of the primary care physicians and may increase adherence to pediatric hypertension guidelines. Blood‐pressure‐to‐height ratios are appealing for the simplicity of data needed to evaluate a child's blood pressure status, including only office blood pressure values and height. In several epidemiological studies around the world blood‐pressure‐to‐height ratios showed good predictive power in identifying children with high blood pressure in terms of area under the curve and sensitivity compared to the gold standard National High Blood Pressure Education Program blood pressure tables, but low positive predictive values meaning a high rate of false‐positive cases and possibly increased subsequent work load for primary physicians. Finally, blood‐pressure‐to height ratios seem to be dependent to age, sex, and weight status. In conclusion, blood‐pressure‐to‐height ratios need to be further improved and validated in different pediatric populations before routine clinical use.
Wilms' tumour 1‐associating protein inhibits endothelial cell angiogenesis by m6A‐dependent epigenetic silencing of desmoplakin in brain arteriovenous malformation
Authors: Wang Lin‐jian , Xue Yimeng , Li Hao , Huo Ran , Yan Zihan , Wang Jie , Xu Hongyuan , Wang Jia , Cao Yong , Zhao Ji‐zong 
Published: April 2020

AbstractBrain arteriovenous malformations (AVMs) are congenital vascular abnormality in which arteries and veins connect directly without an intervening capillary bed. So far, the pathogenesis of brain AVMs remains unclear. Here, we found that Wilms' tumour 1‐associating protein (WTAP), which has been identified as a key subunit of the m6A methyltransferase complex, was down‐regulated in brain AVM lesions. Furthermore, the lack of WTAP could inhibit endothelial cell angiogenesis in vitro. In order to screen for downstream targets of WTAP, we performed RNA transcriptome sequencing (RNA‐seq) and Methylated RNA Immunoprecipitation Sequencing technology (MeRIP‐seq) using WTAP‐deficient and control endothelial cells. Finally, we determined that WTAP regulated Desmoplakin (DSP) expression through m6A modification, thereby affecting angiogenesis of endothelial cells. In addition, an increase in Wilms' tumour 1 (WT1) activity caused by WTAP deficiency resulted in substantial degradation of β‐catenin, which might also inhibit angiogenesis of endothelial cells. Collectively, our findings revealed the critical function of WTAP in angiogenesis and laid a solid foundation for the elucidation of the pathogenesis of brain AVMs.
Mechanical and structural adaptations to migration in the flight feathers of a Palaearctic passerine
Authors: de la Hera Iván , Hernández‐Téllez Irene , Pérez‐Rigueiro José , Pérez‐Tris Javier , Rojo Francisco Javier , Tellería José Luis 
Published: April 2020

AbstractCurrent avian migration patterns in temperate regions have been developed during the glacial retreat and subsequent colonization of the ice‐free areas during the Holocene. This process resulted in a geographic gradient of greater seasonality as latitude increased that favoured migration‐related morphological and physiological (co)adaptations. Most evidence of avian morphological adaptations to migration comes from the analysis of variation in the length and shape of the wings, but the existence of intra‐feather structural adjustments has been greatly overlooked despite their potential to be under natural selection. To shed some light on this question, we used data from European robinsErithacus rubeculaoverwintering in Campo de Gibraltar (Southern Iberia), where sedentary robins coexist during winter with conspecifics showing a broad range of breeding origins and, hence, migration distances. We explicitly explored how wing length and shape, as well as several functional (bending stiffness), developmental (feather growth rate) and structural (size and complexity of feather components) characteristics of flight feathers, varied in relation to migration distance, which was estimated from the hydrogen stable isotope ratios of the summer‐produced tail feathers. Our results revealed that migration distance not only favoured longer and more concave wings, but also promoted primaries with a thicker dorsoventral rachis and shorter barb lengths, which, in turn, conferred more bending stiffness to these feathers. We suggest that these intra‐feather structural adjustments could be an additional, largely unnoticed, adaptation within the avian migratory syndrome that might have the potential to evolve relatively quickly to facilitate the occupation of seasonal environments.
Cement opacity and color as influencing factors on the final shade of metal‐free ceramic restorations
Authors: Carrabba Michele , Vichi Alessandro , Tozzi Gianluca , Louca Chris , Ferrari Marco 
Published: April 2020

AbstractObjectiveTo investigate the influence of opacity and color of luting cements on the final shade of metal‐free restorations.Materials and MethodsFive resin cement colors in combination with four different thicknesses of CAD/CAM ceramic materials were tested, and a composite substrate was used as dentin color reference (n = 3). Specimen color was measured with a spectrophotometer equipped with an integrating sphere before and after cementation (CIELAB). Cement and ceramic color and opacity (TP) were assessed by measuring the tested ceramic thickness as a 1‐mm thick disk for each of the cement shades. The differences in color were evaluated (ΔE00). Data were statistically analyzed by a Two‐Way ANOVA followed by the Tukey Test for post‐hoc comparison (P < .05) and multiple comparison Pearson's test (P < .05); the acceptability and perceptibility threshold were evaluated.ResultsStatistically significant influence was found for factors ceramic thickness and cement shade (P < .001). Perceptible and unacceptable color changes were induced on the final restoration by resin cements (ranging from ΔE00 = 0.69 ± 0.54 to ΔE00 = 5.53 ± 0.46), the correlation between factors became strong (r2 > 0.6) in case of mismatch between color and translucency of cement and ceramic. Only the clear shade in combination with the thickest ceramic, resulted in an imperceptible color change (ΔE00 = 0.69 ± 0.54).ConclusionsThe final shade of ceramic restorations can be influenced by resin cements; the magnitude of influence is related to the cement optical properties.Clinical SignificanceIn order to influence the final shade of a ceramic restoration, a cement more opaque than the restorative material should be used. Conversely, in the case of a fitting shade of the restoration, a cement more translucent than the restoration should be used to avoid undesired changes.