bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency and safety of renal denervation via cryoablation (Cryo-RDN) in Chinese patients with uncontrolled hypertension: study protocol for a randomized controlled trial
Authors: Chen Han , Ji Meng , Zhang Yi , Xu Yawei , Qiao Lingjuan , Shen Li , Ge Junbo 
Published: November 2019

Abstract
Background
Clinical data show that due to the limited effects of lifestyle regulation and unsatisfactory drug adherence, only half of the hypertensive population have their blood pressure (BP) under control. In recent years, catheter-based renal denervation (RDN) has been used as a novel approach for treating uncontrolled hypertension. The safety and efficacy of catheter-based RDN have been confirmed by a number of studies and trials in which the participants were all non-Chinese and RDN was conducted via radiofrequency or ultrasound.

Methods/design
This study is a prospective multicenter randomized sham-controlled trial that aims to investigate the safety and efficacy of cryoablation RDN (cryo-RDN) using a novel dedicated cryoablation balloon catheter (Cryofocus, China). A total of 200 Chinese patients who have uncontrolled hypertension despite standard medical treatment will be enrolled. With drug standardization, eligible participants will be randomized in a 1:1 ratio to undergo cryo-RDN treatment or renal angiography alone as a sham treatment.
The primary endpoint is defined as the change in 24-h ambulatory systolic blood pressure from baseline to 6 months. Office BP and other 24-h ambulatory BP are included as secondary endpoints. Safety endpoints primarily include any adverse effects.

Discussion
This study was designed to verify the safety and efficacy of cryo-RDN with Cryofocus balloon catheters in uncontrolled hypertensive patients on polypharmacy. The aim is to provide a new way to improve the control of hypertension in China as a complement to drug therapy.

Trial registration
ChiCTR, ChiCTR1800017707. Registered on 10 August 2018.
Chimney Trial: study protocol for a randomized controlled trial
Authors: Mäkäräinen-Uhlbäck Elisa , Wiik Heikki , Kössi Jyrki , Nikberg Maziar , Ohtonen Pasi , Rautio Tero 
Published: November 2019

Abstract
Background
Parastomal hernias (PSHs) are common, troubling the lives of people with permanent colostomy. In previous studies, retromuscular keyhole mesh placement has been the most-used technique for PSH prevention but results have been controversial. Additionally, surgical treatment of PSHs is associated with a high rate of complications and recurrences. Therefore, it is crucial to find the most effective way to prevent PSHs in the first place without an increased risk of complications. Due to a lack of adequate research, there is no clear evidence or recommendations on which mesh or technique is best to prevent PSHs.

Methods/design
The Chimney Trial is a Nordic, prospective, randomized controlled, multicenter trial designed to compare the feasibility and the potential benefits of specifically designed, intra-abdominal onlay mesh (DynaMesh®-Parastomal, FEG Textiltechnik GmbH, Aachen, Germany) against controls with permanent colostomy without mesh.
The primary outcome of the Chimney Trial is the incidence of a PSH detected by a computerized tomography (CT) scan at 12-month follow-up. Secondary outcomes are the rate of clinically detected PSHs, surgical-site infection as defined by the Centers for Disease Control and Prevention (CDC), complications as defined by the Clavien-Dindo classification, the reoperation rate, operative time, length of stay, quality of life as measured by the RAND-36 survey and colostomy impact score, and both direct and indirect costs. For each group, 102 patients were enrolled at attending hospitals and randomized at a ratio of 1:1 by browser-based software to receive a preventive mesh or a conventional colostomy without a mesh. Patients will be followed for 1 month and at 1, 3, and 5 years after the operation for long-term results and complications.

Discussion
The Chimney Trial aims to provide level-I evidence on PSH prevention.

Trial registration
ClinicalTrials.gov, ID: NCT03799939. Registered on 10 January 2019
Teaching and learning nature of scientific knowledge: Is it Déjà vu all over again?
Authors: Lederman Norman G. , Lederman Judith S. 
Published: November 2019

AbstractThis review traces the history of research on the teaching and learning of nature of scientific knowledge (NOSK), and its implications for curriculum and instruction. Initially, the complex rubric of NOSK is clearly conceptualized, while recognizing that there is no singularly accepted definition. As part of this conceptualization NOSK is distinguished from the body of scientific knowledge and science practices/inquiry, the latter of which is often conflated with NOSK. The empirical research on NOSK related to teaching, learning, and assessment is briefly reviewed, followed by a discussion of the challenges that teachers face and a delineation of research foci that can help alleviate teachers’ challenges. Finally, a variety of important questions yet to be answered are delineated and explained.
No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women
Authors: Iribarren Carlos , Chandra Malini , Molloi Sabee , Sam Danny , Sanchez Gabriela , Bidgoli Fatemeh Azamian , Cho Hyo-Min , Ding Huanjun , Lo Joan C 
Published: November 2019

Abstract

Context
The association between bone mineral density (BMD) and breast arterial calcification (BAC) remains poorly understood and controversial.

Objective
The objective of this article is to examine the association between BMD and BAC in a large cohort of postmenopausal women undergoing routine mammography.

Design
A cross-sectional analysis of baseline data from a multiethnic cohort was performed.

Setting
The setting for this analysis is an integrated health care delivery system in Northern California in the United States.

Patients
A total of 1273 women age 60 to 79 years (mean age, 67 years) were recruited within 12 months of screening mammography.

Main outcome measure
A BAC score (mg) was obtained from digital mammograms using a novel densitometry method. BAC presence was defined as a BAC score greater than 0 mg, and severe BAC as a BAC score greater than 20 mg.

Results
Overall, 53% of women had osteopenia and 21% had osteoporosis. The prevalence of BAC greater than 0 mg was 29%, 30%, and 29% among women with normal BMD, osteopenia, and osteoporosis, respectively (P = 0.98). The prevalence of BAC greater than 20 mg was 5%, 3%, and 5% among women with normal BMD, osteopenia and osteoporosis, respectively (P = .65). The odds ratios (ORs) of BAC greater than 0 mg vs BAC = 0 mg after multivariable adjustment were 1.09 (95% CI, 0.81-1.48; P = .54) for osteopenia and 0.99 (95% CI, 0.69-1.48; P = .98) for osteoporosis. The adjusted ORs for BAC greater than 20 mg vs BAC 20 mg or less were 1.03 (95% CI, 0.52-2.01; P = .93) for osteopenia and 1.89 (95 CI, 0.81-4.47; P = .14) for osteoporosis.

Conclusion
Our findings do not support an association of either osteopenia or osteoporosis with BAC presence or severity among postmenopausal women.
Quantification of plan robustness against different uncertainty sources for classical and anatomical robust optimized treatment plans in head and neck cancer proton therapy
Authors: Cubillos-Mesías Macarena , Troost Esther G C , Lohaus Fabian , Agolli Linda , Rehm Maximilian , Richter Christian , Stützer Kristin 
Published: November 2019

Objective:
Classical robust optimization (cRO) in intensity-modulated proton therapy (IMPT) considers isocenter position and particle range uncertainties; anatomical robust optimization (aRO) aims to consider additional non-rigid positioning variations. This work compares the influence of different uncertainty sources on the robustness of cRO and aRO IMPT plans for head and neck squamous cell carcinoma (HNSCC).

Methods:
Two IMPT plans were optimized for 20 HNSCC patients who received weekly control CTs (cCT): cRO, using solely the planning CT, and aRO, including 2 additional cCTs. The robustness of the plans in terms of clinical target volume (CTV) coverage and organ at risk (OAR) sparing was analyzed considering stepwise the influence of (1) non-rigid anatomical variations given by the weekly cCT, (2) with fraction-wise added rigid random setup errors and (3) additional systematic proton range uncertainties.

Results:
cRO plans presented significantly higher nominal CTV coverage but are outperformed by aRO plans when considering non-rigid anatomical variations only, as cRO and aRO plans presented a median target coverage (D 98%) decrease for the low-risk/high-risk CTV of 1.8/1.1 percentage points (pp) and −0.2 pp/−0.3 pp, respectively. Setup and range uncertainties had larger influence on cRO CTV coverage, but led to similar OAR dose changes in both plans. Considering all error sources, 10/2 cRO/aRO patients missed the CTV coverage and a limited number exceeded some OAR constraints in both plans.

Conclusion:
Non-rigid anatomical variations are mainly responsible for critical target coverage loss of cRO plans, whereas the aRO approach was robust against such variations. Both plans provide similar robustness of OAR parameters.

Advances in knowledge:
The influence of different uncertainty sources was quantified for robust IMPT HNSCC plans.
Methodological problems of modern pedagogy
Authors: Vasianovych Hryhoriy , Muszkieta Radosław 
Published: November 2019

The article analyzes the nature and the content of the term “methodology”, and concludes that so far tere is no clear approach to the notion definition. Much attention is paid to determine the relationship between methodology and science, and to reveal dialectical aspects of this relationship.The author studies the main factors of methodology influence on improving teaching reality and pedagogical activity, and defines the role of methodology in forming the content of pedagogical education. It is proved that the improvement of the educational process and study of its main components depends on methodological culture of a teacher.
O PAPEL DAS UNIVERSIDADES EM SISTEMAS DE INOVAÇÃO EM CUBA E URUGUAI: REFLEXÕES PARA O CASO BRASILEIRO
Authors: Marcellino Israel Sanches , Borin Elaine Cavalcante Peixoto 
Published: November 2019

Resumo: Reconhecendo a importância das especificidades de cada local, o objetivo deste trabalho é analisar o papel das universidades nos Sistemas de Inovação (SI), tendo os casos de Cuba e do Uruguai como estudo. A partir dessa análise, será possível destilar conceitos que proporcionem perspectivas úteis para a compreensão do caso brasileiro. O período atual traz novas dinâmicas ao sistema capitalista com desdobramentos para as lógicas da produção de conhecimento e da inovação. Logo, a emergência de um paradigma baseado em conhecimento e ciência, além das contradições impostas pelo processo de financeirização, tem posto em xeque o padrão tradicional de inserção das universidades nos SI. O avanço da financeirização sobre os orçamentos públicos em países como os da América Latina suscita questões relacionadas ao financiamento das universidades públicas. No esteio da lógica custo-benefício, surgem questões adicionais relacionadas ao impacto social e econômico efetivo das atividades universitárias. As universidades encontram-se compelidas a uma fase de transição em nível global. Essa transição, contudo, é um processo em andamento, pleno de incertezas e sem rumos únicos definidos.Palavras-chave: Sistema de Inovação. Universidade. América Latina.Abstract: Recognizing the importance of the specificities of each location, the aim of this paper is to analyze the role of universities in innovation systems (IS), taking as a study the case of Cuba and Uruguay. From this analysis, it will be possible to distill concepts that provide useful perspectives for understanding the Brazilian case. The present period brings new dynamics to the capitalist system with consequences for the logic of knowledge production and innovation. Thus, the emergence of a knowledge-based and science-based paradigm and the contradictions imposed by the financialization process have challenged the traditional pattern of insertion of universities in IS. The advancement of financialization over public budgets in countries such as Latin America raises questions related to the financing of public universities. Underlying the cost-benefit logic, additional questions arise regarding the effective social and economic impact of university activities. Universities are compelled to undergo a transitional phase at the global level. This transition, however, is an ongoing process, full of uncertainties and with no single defined directions. Keywords: Innovation System. University. Latin America.
Factors influencing nurses' knowledge and skills in the prevention and management of postpartum haemorrhage
Authors: Angelina Joho A. , Kibusi Stephen M. , Mwampagatwa Ipyana 
Published: November 2019

Background: Postpartum haemorrhage (PPH) is one of the main causes of maternal death. In Tanzania, 25% of maternal deaths are the result of PPH. Gaps in practitioner knowledge in the prevention and management of this issue may lead to severe maternal complications and death. Little has been documented about nurses' knowledge and skills regarding PPH prevention and management. Objective: To determine the factors influencing nurses' knowledge and skill in the prevention and management of PPH in the Dodoma Region, Central Tanzania. Method: A cross-sectional study was conducted involving 172 nurses working in Dodoma, Tanzania. Data on the sociodemographic characteristics of the nurses was collected using a structured questionnaire. Knowledge on PPH was assessed using a validated questionnaire and skills were assessed using an observational checklist. The chi-squared test was used to find associations between sociodemographic characteristics and knowledge and skills. Binary logistic regression (both reduced and full models) was used to identify significant predictors of knowledge and skills. Results: The findings indicated that being ≥40 years old (OR=2.87, P=0.004), being a registered nurse (OR=2.73, P=0.002), having >3 years of professional training (OR=2.38, P=0.01), and having ≥5 years of experience in a maternity unit (OR=3.06, P<0.00) were significant predictors for knowledge in the prevention and management of PPH in a reduced model of binary logistic regression. Being ≥40 years old (OR=11.5, P=0.00), having >3 years of professional training (OR=4.58, P<0.00), and having ≥5 years of experience in a maternity unit (OR=9.14, P<0.00) were significant predictors for skills in the reduced model. After adjusting to control for possible confounders, being a registered nurse was the only significant predictor of nurses' knowledge (AOR=3.35, P=0.001), while having ≥5 years experience in a maternity unit was the only significant predictor of nurses' skills (AOR=3.89, P=0.01). Conclusion: Professional qualification and experience in a maternity unit are significant factors influencing nurses' knowledge and skills, respectively, in the prevention and management of PPH.
‘It's the relationship you develop with them’: emotional intelligence in nurse leadership. A qualitative study
Authors: Mansel Beryl , Einion Alys 
Published: November 2019

Aim: to investigate emotional intelligence (EI) and its relationship to nursing leadership. Background: strong, effective leadership is core to organisational competency and significantly influences care quality. EI is the ability to understand one's own feelings and to assess and respond to the feelings of others. It is linked to self-awareness, self-management, social awareness and social skills, all of which are vital in leadership roles. However, insufficient research explores EI in nursing leadership from the perspective of nurse leaders. Design: a qualitative study employed interpretive phenomenological analysis methods, using a purposive sample of band 7 sisters/charge nurses/team managers (n=5) from one Welsh health board. Semistructured interviews were recorded and analysed in four stages. Findings: four clusters of themes were identified, each with two to three subthemes. These were: sensing others—the empathetic leader; experiencing the affected sense of self; strategies employed to build the team; and reading the flux of the organisation. Conclusion: although the nurse leaders were unfamiliar with the concept of EI, their narratives reflected some core values of EI. However, significant barriers around time, pressure and staffing levels impeded their potential to use EI to become more effective leaders. Nurse leaders should harness the power of emotions to influence others to achieve excellent care.
Drawing as a democratic space within higher education, fine and applied arts: Categorization, process, outcome
Authors: Hall Andrew 
Published: November 2019

Abstract
This article tracks the presence, influence of and development of drawing as a creative practice in Higher Education, Art and Design at Central Saint Martins (CSM) University of the Arts London (UAL) since 1896. Connecting to both a historical and a contemporary discourse on the practice of drawing within this institution, the article explores the educational role that drawing has played in the fine and applied arts (in particular, graphic communication design) and its present state of evolution as an embodied practice within an expanded field that is intrinsically and fundamentally linked to the creative process and final creative outcome. Also cited are notable academics, creative practitioners and critical theorists who have made it their goal to open up the practice of drawing as a democratic space for all to participate in, and one can observe this territory through three distinctive, although interlinked, lenses: categorization, process and outcome.
Drawing as research: Correlating skills and practices with surgical training
Authors: Wright Jenny 
Published: November 2019

Abstract
There are highly creative and meticulous elements to both fine art drawing and surgical practices, especially with regard to close observation, use of tools and interaction with materials. Both artists and surgeons have a dynamic, physical interaction with surfaces, as well as an ability to review and select key features from complex structures. Building on my own drawing practice and observations of surgeons' work I have been able to develop a method for comparing and evaluating drawings. Analysing series of images made by students at Kings College Dental Institute, London, I correlated their data from the HapTEL learning system which was used to practice drilling and removing caries from a virtual tooth, and found evidence of a link between drawing aptitudes and a particular surgical skills. My work supports evidence of positive application of arts practices, with the possibility of building future work incorporating drawing and surgical training.
Sex Differences in the Association Between Frailty and Sarcopenia in Patients With Cirrhosis
Authors: Fozouni Laila , Wang Connie W. , Lai Jennifer C. 
Published: November 2019

OBJECTIVES:
Frailty is prevalent in patients with cirrhosis and is hypothesized to result in part from sarcopenia, but the precise contribution of sarcopenia to frailty in this population is poorly understood.

METHODS:
Included were patients with cirrhosis from 2011 to 2014 who had an ambulatory frailty assessment and abdominal computed tomography scan within 3 months. Logistic regression assessed the associations between frailty (=Liver Frailty Index ≥4.5), and sarcopenia (=skeletal muscle index of <39 cm2/m2 for women and <50 cm2/m2 for men).

RESULTS:
Two hundred ninety-one participants were included: 33% were female. The median (interquartile range) Liver Frailty Index was 3.7 (3.3–4.2); 19% were frail. The median (interquartile range) skeletal muscle index was 49 cm2/m2 (31–69); 36% had sarcopenia. Among the 54 frail participants, 48% had sarcopenia. In univariable logistic regression, sarcopenia was associated with a 1.86× increased odds of being frail (95% confidence interval [CI], 1.02–3.38). After adjusting for sex, etiology, hepatocellular carcinoma, MELDNa, ascites, encephalopathy, and hypertension, sarcopenia was associated with a 2.38× increased odds of being frail (95% CI, 1.17–4.85). After stratifying by sex and adjusting for MELDNa, sarcopenia among males was associated with a significantly increased odds of frailty (odds ratio 2.81, 95% CI, 1.19–6.67), whereas sarcopenia among females was not (odds ratio 1.38; 95% CI, 0.45–4.25).

DISCUSSION:
In patients with cirrhosis, sarcopenia was associated with a nearly 2-fold increased odds of being frail. Two-thirds of frail men displayed sarcopenia compared with only one-quarter of frail women. Contributors to the frail phenotype may differ by sex and support the need for sex-specific strategies to reduce frailty in this population.
Substrate-controlled Diastereoselective Michael Addition of Alkylidene Malonates by Grignard Reagents
Authors: Zhou Wei , Xiao Qingwei , Chang Yuanyuan , Liu Qifa , Zang Xiaohao , Hu Mengmeng , Zeng Xi , Du Zhiyun , Zhong Guifa 
Published: November 2019

AbstractHerein is described a diastereoselective Michael addition of Grignard reagents to α, β- unsaturated diethyl malonates incorporated with a 2-oxazolidone chiral auxiliary. The catalyst-free Michael addition proceeds with good chemical efficiency and excellent stereoselectivity; and it provides new thoughts to the asymmetric synthesis of β-substituted β3amino acid derivatives.
Domini est salus. Gebetspraktische Aspekte in Text- und Bildausstattung des Amuletts Ms Princeton 235
Authors: Hartmann Marie 
Published: November 2019

Abstract
In medieval Europe, Christian amulets comprised of illuminations and/or script were considered powerful apotropaic shields. This article focuses on a single example, Ms Princeton 235. It is argued that this object primarily functions as a prayer aid rather than as a magical object. Comparable to rosaries or prayer nuts, this amulet conveys its assumed protective powers through specific devotional acts. Its textual program prefigures such pious practices, which include carrying the amulet above one’s heart, folding and unfolding it, reciting a profession of faith and the divine names, making the sign of the cross, and contemplatively looking at a miniature showing the Arma Christi. Through an analysis of how the textual and visual features of Ms Princeton 235 prompt devotional practices, its claim to mediate divine grace and power become comprehensible.
Künstliches Licht im Kontext mittelalterlicher Gebetspraxis
Authors: Henkelmann Vera 
Published: November 2019

Abstract
Approaching the interplay of medieval prayer and artificial light, my article shows how artificial light had multiple levels of meaning and functions pertaining to the situation, the subject, and the intention of praying. It served practical purposes such as illuminating and highlighting spaces of prayer, thus enabling the devotees to read. What is more, artificial lighting contributed to orchestrating places of prayer, especially in church buildings, as spaces removed from everyday life, thereby emphasizing the sacredness of liturgical prayers and acts. In this context light also visualized the divine counterpart of prayer and the supernatural par excellence. Furthermore, it enveloped the praying person, who through his baptism regarded himself as a child of light, as it were. The goal of prayer, God’s love and care, seemed to be fulfilled in the here and now and materialized in the light. Artificial lighting was therefore immanent and transcendent at the same time. It communicated the divine and how this reality could reveal itself to human beings in the light – like a medium of salvation.
Die Schulordnung als Klang – und Zeit
Authors: Großmann Rolf 
Published: November 2019

Abstract
Schule und Hochschule sind als als dispositive Ordnung in diversen Texten thematisiert worden, etwa bei Michel Foucault und Michel Serres zum Spannungsfeld von Unterwerfung und Selbstbestimmung. Die performative Beschreibung der Schulsituation durch Elise v. Bernstorff ermöglicht dabei eine neue Perspektive auf das Dispositiv von Klang und Zeit, der hier nachgegangen wird.