bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral Competence, Moral Teamwork and Moral Action – The European Moral Case Deliberation Outcomes (Euro-MCD) Instrument 2.0 and its revision process
Authors: de Snoo-Trimp Janine , de Vet Riekie , Widdershoven Guy , Molewijk Bert , Svantesson Mia 
Published: June 2020

Abstract
Background Clinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process. Methods The revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.Results The Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.Conclusions: The Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD.
Traffic police officers’ use of first aid skills at work: a qualitative content analysis of focus group discussions in Dar es Salaam, Tanzania
Authors: Ndile Menti Lastone , Saveman Britt-Inger , Lukumay Gift G. , Mkoka Dickson A. , Outwater Anne H. , Backteman-Erlanson Susann 
Published: June 2020

Abstract
Background: The World Health Organisation (WHO) recommends involving lay people in prehospital care. Several training programmes have been implemented to build lay responder first aid skills. Findings show that most programmes significantly improved participants’ first aid skills. However, there is a gap in knowledge of what factors influence the use of these skills in real situations. The current study aimed to describe police officers’ views on and experiences of factors that facilitate or hinder their use of trained first aid skills at work. Methods Thirty-four police officers participated in five focus group discussions. A structured interview guide was used to collect data. Interviews were audio-recorded and transcribed verbatim. Data were analysed using qualitative content analysis. Results: We identified five categories of facilitators or hindrances. Training exposure was considered a facilitator; work situation and hospital atmosphere were considered hindrances; and the physical and social environments and the resources available for providing first aid could be either facilitators or hindrances.Conclusion: Practical exposure during training is perceived to improve police officers’ confidence in applying their first aid skills at work. However, contextual factors related to the working environment need to be addressed to promote this transfer of skills.
Chemical assessment of the explosive chamber in the projector system of Hayabusa2 for asteroid sampling
Authors: Takano Yoshinori , Yamada Keita , (Deceased) Chisato Okamoto , Sawada Hirotaka , Okazaki Ryuji , Sakamoto Kanako , Kebukawa Yoko , Kiryu Kento , Shibuya Takazo , Igisu Motoko , Yano Hajime , Tachibana Shogo 
Published: June 2020

Abstract
We report a chemical assessment of the explosive chamber in the projector system used during the sampling operation of the Hayabusa2 project at the surface of the C-type asteroid Ryugu. Although the explosion process was designed as a closed system (cf. Sawada et al., Space Sci. Rev., 2017), volatile combustion gases and semivolatile organics were produced together with quenched carbonaceous product. The chemical compositions of the gases, organics, and inorganics were investigated in the screening analysis. A solid-phase microextraction technique and thermal desorption coupled with gas chromatography/mass spectrometry analysis revealed that aliphatic (<C20 n-alkanes) and aromatic (<pyrene) hydrocarbons were produced in the closed chamber system. The aromatic ring compositions of the latter showed a semilogarithmic decrease: one ring > two rings > three rings > four rings, resulting in abiogenic molecular patterns. The most intense inorganic fingerprints were due to potassium (K+) and chloride (Cl–) ions derived from the initial KTB explosive and RK ignition charge. We discuss quality control and quality assurance issues applicable to future sample processes during the Hayabusa2 project.
Cross-cultural adaptation of the Participation and Environment Measure for Children and Youth (PEM-CY) into German: a qualitative study in three countries
Authors: Krieger Beate , Schulze Christina , Boyd Jillian , Amann Ruth , Piškur Barbara , Beurskens Anna , Teplicky Rachel , Moser Albine 
Published: June 2020

Abstract
Background

Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland.

Methods

Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence.

Results

Results show adaptations mainly focused on experiential and conceptual equivalence. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect typical ones in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions.

Conclusion

This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. As participation and environment are both complex concepts to measure, conceptual equivalence posed the highest challenges for this cultural adaptation. A culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
Left Atrial Spontaneous Echo Contrast Occurring in Patients with Low CHADS2 or CHA2DS2-VASc Scores
Authors: Akamatsu Kanako , Ito Takahide , Ozeki Michishige , Miyamura Masatoshi , Sohmiya Koichi , Hoshiga Masaaki 
Published: June 2020

Abstract
Background: Left atrial spontaneous echo contrast (LASEC) is common in patients with atrial fibrillation (AF), although scarce information exists on LASEC occurring in nonvalvular AF patients who have low thromboembolic risk scores. We therefore examined prevalence and determinants of LASEC under low CHADS 2 or CHA 2 DS 2 -VASc scores in these patients. Methods: Among 713 patients who underwent transesophageal echocardiography, 349 with a CHADS 2 score <2 (CHADS 2 group) (93 women, mean age 65 years) and 221 with a CHA 2 DS 2 -VASc score <2 (CHA 2 DS 2 -VASc group) (39 women, mean age 62 years) were separately examined for clinical and echocardiographic findings. Results: LASEC was found in 77 patients of CHADS 2 group (22%) and in 41 of CHA 2 DS 2 -VASc group (19%). Multivariate logistic regression analysis, adjusted for parameters including non-paroxysmal AF, LA diameter ≥50 mm, left ventricular (LV) hypertrophy, and an elevated serum B-type natriuretic peptide (BNP) (≥200 pg/mL), revealed that for CHADS 2 group, non-paroxysmal AF (Odds ratio 5.65, 95%CI 3.08-10.45, P <0.001), BNP elevation (Odds ratio 3.42, 95%CI 1.29-9.06, P = 0.013), and LV hypertrophy (Odds ratio 2.26, 95%CI 1.19-4.28, P = 0.013) were significant independent determinants of LASEC, and that for CHA 2 DS 2 -VASc group, non-paroxysmal AF (Odds ratio 3.38, 95%CI 1.51-7.54, P = 0.003) and LV hypertrophy (Odds ratio 2.53, 95%CI 1.13-5.70, P = 0.025) were significant independent determinants of LASEC.Conclusions: LASEC was present in a considerable proportion of patients with nonvalvular AF under low thromboembolic risk scores. Information on AF chronicity, BNP, and LV hypertrophy may help avoid transesophageal echocardiographic assessment of LASEC, but large-scale studies are necessary to confirm our observations.
A risk-based quality control approach of Clinical Trials from a GCP institution in China
Authors: Li Weihong , Wang Yanrong , Chen Ran , Dai Xinya 
Published: June 2020

Abstract
BackgroundThis paper developed and described a risk-based quality control approach of clinical trials for clinical trial sites to improve the quality control process and ensure the quality of data.Methods Based on the trial experience, well versed experts and the findings of previous literature, an integrated risk-based quality control approach is developed centered on three cornerstones: risk assessment, central data review, and triggered, adaptive on-the-spot or remote inspection.Results We have developed an innovative risk-based quality control approach for clinical trials including risk assessment, development of quality control plan, implementation of quality control activities, development and review of quality control report, undertake actions arising from quality control report, and the update of risk assessment results or quality control plan, which fuses the idea of PDCA circle and quality by design.Conclusion Our RBQC methodology can significantly improve the clinical quality control process and the monitoring-audit triggered procedure can synchronize the activities of site, sponsor and CROs to achieve all-win. It is an innovative and effective approach.
Pulmonary rehabilitation to improve physical capacity, dyspnea and quality of life following pulmonary embolism (the PeRehab study): Study protocol for a two-centre randomized controlled trial.
Authors: Haukeland-Parker Stacey , Jervan Øyvind , Johannessen Hege Hølmo , Gleditsch Jostein , Stavem Knut , Steine Kjetil , Spruit Martijn A , Holst Rene , Tavoly Mazdak , Klok Erik , Ghanima Waleed 
Published: June 2020

Abstract
Background: Recently, a large group of patients with persistent dyspnea, poor physical capacity and reduced health-related quality of life (HRQoL) following pulmonary embolism (PE) has been identified and clustered under the name “post pulmonary embolism syndrome” (PPS). These patients seem good candidates for pulmonary rehabilitation. The aim of the study is to explore whether a pulmonary rehabilitation program can improve physical capacity, dyspnea and HRQoL in PPS patients.Methods: A two-centre randomized controlled trial (RCT) is being performed at Østfold Hospital and Akershus University Hospital in Norway. Patients with PPS are 1:1 randomized into an intervention or a control group. The intervention consists of a supervised, outpatient rehabilitation program twice weekly (1 hour) for 8 weeks provided by experienced physiotherapists. The intervention involves individually adapted exercises based on existing pulmonary rehabilitation programs (relaxation, interval and resistance training), and an educational session including topics such as normal anatomy and physiology of the respiratory and circulatory system, information on PE/PPS, breathing strategies, and benefits of exercise/physical activity. Patients randomized to the control group receive usual care without specific instructions to exercise. Participants in the intervention and control groups will be compared based on assessments conducted at baseline, 12 weeks and 36 weeks after inclusion using the incremental shuttle walk test (primary outcome) and endurance shuttle walk test (exercise capacity), Sensewear activity monitor (daily physical activity), the Modified Medical Research Council scale, the Shortness of Breath questionnaire (dyspnea), and EQ-5D-5L and the Pulmonary Embolism Quality of Life Questionnaire (HRQoL).Recruitment of 190 patients is currently ongoing.Discussion: Results from this study may provide a currently untreated group of PPS patients with an effective treatment resulting in reduced symptoms of dyspnea, improved exercise capacity and better HRQoL following PE.Trial registration: NCT03405480, Clinical Trials (registered prospectively.Protocol version 1 (from original protocol September 2017).The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 1).
Spatial Estimation of Soil Erosion Using RUSLE Modeling: A case study of Dolakha District, Nepal
Authors: Thapa Pawan 
Published: June 2020

Abstract
Background: Soil erosion causes topsoil loss, which decreases fertility in agricultural land. Spatial estimation of soil erosion essential for an agriculture-dependent country like Nepal for developing its control plans. This study evaluated impacts on Dolakha using the Revised Universal Soil Loss Equation (RUSLE) model; analyses the effect of Land Use and Land Cover (LULC) on soil erosion.Results: The soil erosion rate categorized into six classes based on the erosion severity, and 5.01% of the areas found under extreme severe erosion risk (> 80 Mg ha-1yr-1) addressed by decision-makers for reducing its rate and consequences. Followed by 10 % classified between high and severe range from 10 to 80 Mg ha-1yr-1. While 15% and 70% of areas remained in a moderate and low-risk zone, respectively. Result suggests the area of the north-eastern part suffers from a high soil erosion risk due to steep slope.Conclusions: The result produces a spatial distribution of soil erosion over Dolakha, which applied for conservation and management planning processes, at the policy level, by land-use planners and decision-makers.
Efficacy of Tong-Xie-Yao-Fang Granule and its Impact on Whole Transcriptome Profiling in Diarrhea-Predominant Irritable Bowel Syndrome Patients: Study Protocol for a Randomized Controlled Trial
Authors: Liu Fengbin , Wang Yan , Huang Yong-quan , Zhu Shui-lian , Zhang Chang-rong , Chen Xin-lin , Hou Qiu-ke 
Published: June 2020

Abstract
Background: Irritable bowel syndrome (IBS) is one kind of common functional bowel disease with obscure pathogenesis and exploration about whole transcriptome profiling in IBS-D is still negligible. Conventional medications have limited effects, which makes focus shifted to traditional Chinese medicine (TCM). Tong-Xie-Yao-Fang, as a classic herbal formula in TCM, is pretty effective and safe for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), but the underlying therapeutic mechanism remains unknown. We aim to verify the efficacy and safety of TXYF granule (the formula particles mixed together) in IBS-D and elucidate the gene-level mechanism of IBS-D and therapeutic targets of TXYF granule based on whole transcriptome analysis. Methods/design: This is a randomized, double-blind and placebo-controlled clinical trial consisting of 2 weeks run-in period, 12 weeks treatment period and 8 weeks follow-up period. We will enroll 120 participants with IBS-D, who will be randomly assigned to TXYF granule group and the placebo group and recruit additional 10 healthy individuals as controls for mechanistic outcome. The two groups respectively take TXYF granule or placebo orally for treatment. The primary outcome is the response rate of IBS-Symptom Severity Score (IBS-SSS). The secondary outcomes include adequate relief (AR), IBS-Quality of Life Questionnaire (IBS-QOL) and long-term efficacy. Mechanistic outcome is the whole transcriptome profiling of the intestinal mucosae from IBS participants before and after the treatment and healthy individuals. Discussion: This trial will prove the effectiveness and safety of TXYF granule with high-quality evidence and provide a penetrating and comprehensive perspective on the molecular mechanism of IBS-D by whole transcriptome analysis, which makes us pinpoint specific biomarkers of IBS-D and therapeutic targets of TXYF.Trial registration: Chinese clinical trial Registry: ChiCTR-IOR-1900021785 (URL: http://www.chictr.org.cn/showproj.aspx?proj=36642).Date of registration: 9 March 2019.
Associations between adherence to MIND diet and severity, duration and frequency of migraine headaches among migraine patients
Authors: Askarpour Moein , yarizadeh Habib , Sheikhi Ali , Khorsha Faezeh , Mirzaei Khadijeh 
Published: June 2020

Abstract
Objectives: Migraine is a neurological disorder causing unbearable pain. Dietary approach is proposed as a preventive way of reducing the severity of migraine headaches. The present study aimed to examine the association between MIND diet and migraine headaches.Results: We found that participants with higher score of MIND diet compared to those with lower score, were less likely to have severe headaches (OR= 0.67; 95% CI: 0.43, 0.94; P= 0.01). Moreover, our results showed an inversed correlation between mind diet score and duration (β= -0.15, 95% CI: -1.44, -0.11, P=0.02) and frequency of headaches (β= -0.12, 95% CI: -0.96, -0.02, P= 0.04).
Comparative postoperative outcomes of GGN-dominant vs single lesion lung adenocarcinomas.
Authors: Hotta Takamasa , Tsubata Yukari , Tanino Akari , Nakao Mika , Amano Yoshihiro , Hamaguchi Megumi , Hamaguchi Shunichi , Kishimoto Koji , Isobe Takeshi 
Published: June 2020

Abstract
Background: Multiple synchronous ground glass nodules (GGNs) are known to be malignant, however, they tend to progress slowly. Multiple synchronous lesions in the same patient which show different characteristics must be treated individually.Methods: This was a retrospective review of 34 lung adenocarcinoma patients with multiple synchronous GGNs in an Asian population. One hundred twenty-seven single lung adenocarcinoma patients were included for comparison purposes. The follow-up period was 5 years for all patients. Results: The 5-year overall survival (OS) patients with multiple lesions did not differ from that of the patients with single lesions to a statistically significant extent (Single: 81.8% vs. Multiple: 88.2%, P=0.3602). Dominant tumors (DTs) with a ground glass component and consolidation were divided into three categories based on the consolidation-to-tumor ratio on radiological imaging. No significant differences were observed among the three DT categories. Twenty-four patients had unresected GGNs, while a progression of the unresected GGN occurred in 10 of these cases. The OS and disease-free survival (DFS) curves of patients with and without GGN progression did not differ to a statistically significant extent (OS: 80% vs. 92.9%, P=0.3870; DFS: 80% vs. 100%, P=0.0977).Conclusions: The outcomes were best predicted by the stage of the DT. After surgery patients require a careful follow-up because unresected GGNs may show progression. At the same time, the increase in residual lesions and the appearance of new GGNs were not related to OS. The management of such patients should be determined according to the DT with the worst prognosis.
Fabrication a controlled-release pesticide for improving UV-shielding properties and reducing toxicity via coating polydopamine
Authors: Wang Ya , Li Chaonan , Zhang Xing , Chen Wei , Zhang Ying , Li Xiaogang 
Published: June 2020

Abstract
In modern agriculture, controlled-release formulations (CRF) is greatly desirable for achieving valid utilization and loss reduction of pesticides. It can also alleviate the adverse effect on non-target organism. In this study, we used PDA as a depositing layer, constructed pyraclostrobin@SiO 2 @polydopamine microcapsule (Pyr@SiO 2 @PDA MC). The resulting microcapsule is a near-rod shape (about 1.152μm), which has a drug-loading efficiency of 55%. FT-IR and TG analysis revealed the successful entrapment of the pesticide. The microencapsulation had important function in the slow-release rate of the pyraclostrobin and superior UV-shielding properties. Moreover, bioactivity of the microcapsule against Fusarium oxysporum f.sp.vasinfectum was determined and it exhibited better inhibition activity than pyraclostrobin technical in the later stage. At last, acute toxicity tests demonstrated that Pyr@SiO 2 @PDA MC on zebrafish with lower toxicity on the first day. These results showed that Pyr@SiO 2 @PDA MC may process broader application potential in agriculture.
Insulin Resistance, Body Mass Index and Coronary Atherosclerotic Stenosis in Obese Adults
Authors: Zhang Nianrong , Liu Yumeng , Yang Guoshan , Zhou Biao , Qi Guanming , Yu Jianan , Yan Zhaoyang , Liu Huanmei , Meng Hua 
Published: June 2020

Abstract
Background: Obesity is associated with an increased risk of all-cause mortality. Mortality related to excess body weight occurs mostly due to coronary artery disease(CAD). This study is to observe the prevalence of coronary atherosclerotic stenosis in obese young-middle adults and outcomes of coronary stenosis in patients with obesity after metabolic surgery. Methods: Patients with obesity undergoing metabolic surgery were included from December 2015 to June 2017.Coronary computed tomography angiography(CTA) was examined preoperatively. Patients were divided into the stenosis group and the non-stenosis group and differences in clinical indicators and Homeostasis model assessment insulin resistance(HOMA-IR)were compared between the two groups. After metabolic surgery, the clinical indicators and severity of coronary stenosis were compared with those before metabolic surgery. Results: Among 217 consecutive obese patients with a mean body mass index(BMI) of 37.92±6.14kg/m2, 58(26.72%) patients were diagnosed with coronary atherosclerotic stenosis. Compared with the non-stenosis group, patients in the stenosis group had a more elder age, higher rates of male, smoking, hypertension and type 2 diabetes mellitus(T2DM), and higher levels of glycated haemoglobin(HbA1C),fasting blood glucose(FBG),fasting C-peptide and HOMA-IR(P<0.05). While there was no significant difference in BMI, waist circumstance(WC), serum lipid levels (P＞0.05). The multivariate binomial logistic regression analysis showed that the age(β=0.070, OR=1.073, 95% CI 1.028-1.120, P<0.001),smoking(β=1.371, OR=3.941, 95% CI 1.257-12.357, P=0.019), and HOMA-IR(β=0.040, OR=1.041, 95% CI 1.000-1.083, P=0.047) were independent risk factors of coronary stenosis. After metabolic surgery, coronary stenosis relieved in 11/19 cases (57.89%), in which 9 cases got complete remission; coronary stenosis was aggravated in one case and remained the same in another one case.Conclusions: HOMA-IR, as well as age and smoking, is an independent risk factor for CAD in obese patients. Metabolic surgery is possibly helpful to reverse mild to moderate coronary atherosclerotic stenosis in patients with obesity.