bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare professionals’ perceptions of advance care planning in palliative care unit: a qualitative descriptive study
Authors: Kuusisto Anne , Santavirta Jenni , Saranto Kaija , Haavisto Elina 
Published: December 2020

AbstractAims and objectivesTo describe healthcare professionals’ perceptions of advance care planning (ACP) in palliative care unit in hospital ward or outpatient clinic.BackgroundClinical guidelines recommend timely ACP as a central component of patient‐centred palliative care. However, the ACP concept and terminology have been judged to be confusing, and practices are not established. Professionals’ views are needed for ACP adoption and usage.DesignQualitative descriptive design.MethodsThe study used purposive sampling. The data were collected through focus group interviews with registered nurses and practical nurses and individual or couple interviews with physicians and social workers. The data (n = 33) were analysed by inductive content analysis. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.ResultsThree main categories emerged: Information content of ACP, coordination of care activities through ACP, and support for patients’ and family members’ coping. The information content of ACP included assessment of need for patient care, preparing for changes in patient's state of health and proactive medication. Coordination of care activities through ACP contained ACP care planning, cooperation and work practices between healthcare professionals. Support for patients’ and family members’ coping included communication between patient, family members and professionals and promoting patient self‐care.ConclusionsACP is a useful and proactive tool for integrating patient‐centred information, care and services as well as support for patients’ and family members’ coping. Palliative care activities can be coordinated through ACP in a multidisciplinary manner. ACP is significant and relevant for both professionals’ work and patient care throughout the service system.Relevance to clinical practiceResults highlight the importance of proactive, concrete and holistic ACP. ACP should be up to date to reflect patient's current wishes. Raising professional awareness and implementing ACP into work processes are essential. Results can be utilised in planning and implementing interprofessional in‐service training.
Associational Structures and Beyond: Evolution and Contemporary Articulations of Bhumihar Caste Associations in Bihar, India
Authors: Nandan Aniket , Santhosh R. 
Published: December 2020

AbstractThis paper examines the historical development, growth, and contemporary articulations of the Bhumihar caste associations in Bihar by focusing on their relationship with land, political economy, and ideological orientations. As a landowning upper caste, the Bhumihars negotiated with a host of structural as well socio‐political transformations in the state primarily by constructing the self‐image of a warrior caste holding a Brahmin status. The paper in particular examines the impact of land reforms, violence unleashed by the Bhumihar caste militia during the agrarian unrest and the rise of Backward Caste mobilisation followed by the Hindutva mobilisation on the changing articulation of the Bhumihar caste associations. The paper also focuses on the emergence of the Bhumihar middle class and points out that through a visible process of culturalisation, the Bhumihars are able to maintain their exclusivity and purported superiority in the contemporary Bihar society even while upholding the mantle of Hindutva unity along with other lower castes.
Matrix metalloproteinase‐2, ‐7, and ‐9 activities in dogs with idiopathic pulmonary fibrosis compared to healthy dogs and dogs with other respiratory diseases
Authors: Määttä Merita , Laurila Henna P. , Holopainen Saila , Aaltonen Kaisa , Lilja‐Maula Liisa , Viitanen Sanna , Rajamäki Minna M. 
Published: December 2020

AbstractBackgroundCanine idiopathic pulmonary fibrosis (CIPF) is a chronic, interstitial lung disease that mainly affects West Highland white terriers (WHWTs) and is characterized by excessive deposition of extracellular matrix (ECM) in the lung. Matrix metalloproteinases (MMPs) participate in remodeling of ECM.ObjectivesTo compare metalloproteinase‐2, ‐7 and ‐9 activities in blood or bronchoalveolar lavage fluid (BALF) samples or both of CIPF WHWTs with healthy WHWTs, healthy dogs of other breeds, and dogs with other lung diseases and determine if these MMPs could be used as diagnostic and prognostic markers for CIPF.AnimalsForty‐four CIPF WHWTs, 24 dogs with chronic bronchitis (CB), 17 with eosinophilic bronchopneumopathy (EBP), 10 with bacterial pneumonia, 39 healthy WHWTs, and 35 healthy dogs of other breeds.MethodsCross‐sectional observational study. Pro‐MMP and active MMP activities were analyzed by zymography.ResultsIn serum, significantly higher (P < .01) pro‐MMP‐7 activities were observed in CIPF WHWTs compared to healthy dogs of other breeds, dogs with CB and dogs with EBP. In BALF of CIPF WHWTs, both pro‐MMP‐9 and pro‐MMP‐2 activities were significantly higher (P < .01) compared to healthy WHWTs, but these differences were not detected in plasma. The CIPF WHWTs had significantly higher (P < .05) activities of pro‐MMP‐9 compared to dogs with CB and of pro‐MMP‐2 compared to dogs with CB and EBP. No statistically significant prognostic factors were observed in CIPF WHWTs.Conclusions and clinical relevanceSerum MMP‐7 and BALF MMP‐2 and ‐9 potentially may be useful diagnostic markers but not prognostic markers for CIPF.
Characterization of non‐response to cardiac resynchronization therapy by post‐procedural computed tomography
Authors: Pezel Théo , Mika Delphine , Logeart Damien , Cohen‐Solal Alain , Beauvais Florence , Henry Patrick , Laissy Jean Pierre , Moubarak Ghassan 
Published: December 2020

AbstractIntroductionCauses of non‐response to cardiac resynchronization therapy (CRT) include mechanical dyssynchrony, myocardial scar, and suboptimal left ventricular (LV) lead location. We aimed to assess the utility of Late Iodine Enhancement Computed Tomography (LIE‐CT) with image subtraction in characterizing CRT non‐response.MethodsCRT response was defined as a decrease in LV end‐systolic volume > 15% at 6 months. LIE‐CT was performed after 6 months, and analyzed global and segmental dyssynchrony, myocardial scar, coronary venous anatomy, and position of LV lead relative to scar and segment of latest mechanical contraction.ResultsWe evaluated 29 patients (age 71 ± 12 years; 72% men) including 18 (62%) responders. All metrics evaluating residual dyssynchrony such as wall motion index and wall thickness index were worse in non‐responders. There was no difference in presence and extent of scar between responders and non‐responders. However, in non‐responders, the LV lead was more often over an akinetic/dyskinetic area (72% vs. 22%, p = .007), a fibrotic area (64% vs. 8%, p = .0007), an area with myocardial thickness < 6 mm (82% vs. 22%, p = .002), and less often concordant with the region of maximal wall thickness (9% vs. 72%, p = .001). Among the 11 non‐responders, eight had at least another coronary venous branch visualized by CT, including three (27%) coursing over a potentially interesting myocardial area (free of scar, with normal wall motion, and with a myocardial thickness ≥6 mm).ConclusionLIE‐CT with image subtraction allows a comprehensive characterization of patients after CRT and may provide clues for management of non‐responders.
Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma
Authors: Skinner Owen T. , Souza Carlos H. de M. , Kim Dae Young 
Published: December 2020

AbstractObjectiveTo determine the rate of nodal metastasis to the medial retropharyngeal (MRP) and deep cervical lymph nodes in dogs surgically treated for thyroid carcinoma.Study designRetrospective study.AnimalsTwenty‐two client‐owned dogs.MethodsMedical records between July 2015 and October 2019 at the Universities of Missouri and Florida were reviewed. Dogs that underwent thyroidectomy with concurrent elective MRP lymphadenectomy ± deep cervical lymphadenectomy were included. Tumor site, preoperative staging, and histopathological findings were recorded.ResultsTwenty‐two dogs with 26 total thyroid carcinomas were included. Primary tumors were lateralized in 19 dogs, bilateral in two dogs, and bilateral and midline ectopic in one dog. All dogs underwent ipsilateral MRP resection, including bilateral resection in dogs with bilateral tumors. Three contralateral MRP lymph nodes were excised from dogs with unilateral carcinomas. Four deep cervical lymph nodes and one superficial cervical lymph node were excised. Metastases were identified in 14 lymph nodes in 10 of 22 (45%) dogs. All four excised deep cervical lymph nodes and one contralateral MRP lymph node were identified as metastatic. Size of deposit could be classified in 13 of 14 metastatic lymph nodes. Macrometastasis was detected in seven lymph nodes, micrometastasis was detected in one node, and isolated tumor cells were detected in five lymph nodes.ConclusionRegional metastasis was common within the lymph nodes sampled in this population of dogs with thyroid carcinoma.Clinical significanceThese results provide evidence to justify further exploration of a larger population to verify the rate of regional metastasis and determine the prognostic impact of nodal metastasis.
Association of food industry ties with findings of studies examining the effect of dairy food intake on cardiovascular disease and mortality: systematic review and meta-analysis
Authors: Chartres Nicholas , Fabbri Alice , McDonald Sally , Diong Joanna , McKenzie Joanne E , Bero Lisa 
Published: December 2020

ObjectiveTo determine if the association of dairy foods with cardiovascular disease (CVD) outcomes differs between studies with food industry ties versus those without industry ties. To determine whether studies with or without industry ties differ in their risk of bias.Eligibility criteriaWe included cohort and case–control studies that estimated the association of dairy foods with CVD outcomes in healthy adults.Information sourcesWe searched eight databases on 1 February 2019 from 2000 to 2019 and hand searched reference lists.Risk of biasWe used the Risk of Bias in Non-Randomised Studies-of Exposure tool.Included studies43 studies (3 case–controls, 40 cohorts).Synthesis of resultsThere was no clear evidence of an association between studies with industry ties (1/14) versus no industry ties (8/29) and the reporting of favourable results, risk ratio (RR)=0.26 (95% CI 0.04 to 1.87; n=43 studies) and studies with industry ties (4/14) versus no industry ties (11/29) and favourable conclusions, RR=0.75 (95% CI 0.29 to 1.95; n=43). Studies with industry sponsorship, (HR=0.78; n=3 studies) showed a decreased magnitude of risk of CVD outcomes compared with studies with no industry sponsorship (HR=0.97; n=18) (ratio of HRs 0.80 (95% CI 0.66 to 0.97); p=0.03).Strengths and limitations of evidenceEvery study had an overall high risk of bias rating; this was primarily due to confounding.InterpretationThere was no clear evidence of an association between studies with food industry ties and the reporting of favourable results and conclusions compared with studies without industry ties. The statistically significant difference in the magnitude of effects identified in industry-sponsored studies compared with non-industry-sponsored studies, however, is important in quantifying industry influence on studies included in dietary guidelines.PROSPERO registration numberCRD42019129659.
External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study
Authors: Mörelius Evalotte , Olsson Emma , Sahlén Helmer Charlotte , Thernström Blomqvist Ylva , Angelhoff Charlotte 
Published: December 2020

ObjectivesPerforming randomised controlled trials (RCTs) in neonatal intensive care is challenging in many ways. While restrictive inclusion criteria or busy study protocols are obvious barriers, external barriers leading to termination of a study are seldom discussed. The aim of this study was to describe barriers for inclusion of families in neonatal intensive care in an RCT aiming to evaluate the effects of continuous skin-to-skin contact on mood and sleep quality in parents of preterm infants, as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.DesignA descriptive study.SettingThree out of seven tertiary neonatal intensive care units in Sweden participated in a two-arm RCT that was terminated because of low inclusion rate.ParticipantsBefore termination of the study, 11 out of 242 families assessed for eligibility were included for participation.ResultsThe major barriers for inclusion in this RCT were external due to (1) lack of intensive care beds in the neonatal ward, causing medically stable infants to be transferred back to the referring hospital quicker than expected, (2) moving directly from the delivery room to a family room without passing an open bay intensive care room or (3) transferring from one neonatal ward to another with the same care level to increase availability of intensive care beds where needed. Other barriers were the inclusion criteria ‘single-birth’ and ‘Swedish-speaking parent’.ConclusionsThe major barriers for including participants were external constituted by transferals between neonatal wards and cities due to lack of intensive care beds. This is a multifactorial issue related to organisational structures. However, since this affects the possibilities to perform research this study highlights some suggestions to consider when planning prospective intervention studies within a neonatal setting.Trial registration numberNCT03004677.
Association between paediatric intraoperative anaesthesia handover and adverse postoperative outcomes
Authors: Kannampallil Thomas , Lew Daphne , Pfeifer Ethan E , Sharma Anshuman , Abraham Joanna 
Published: December 2020

ObjectiveTo determine whether intraoperative handover of patient care from one anaesthesia clinician to another was associated with an increased risk of adverse postoperative outcomes during paediatric surgeries.Design, setting and participantsA retrospective, population-based cohort study (1 April 2013–1 June 2018) at an academic medical centre.ExposureIntraoperative handover of care between pairs of anaesthesia clinicians from one care provider to another compared with no handover of anaesthesia care.Main outcomes and measuresThe primary outcome was a composite of all-cause mortality and major postoperative morbidity within 30 days after surgery. Secondary outcomes included individual components of the primary outcome and 30-day hospital readmission. Inverse probability of exposure weighting using propensity scores for intraoperative handovers was calculated. Weighted logistic regression was used to determine the association between intraoperative anaesthesia handovers and outcomes.Results78 321 paediatric surgical cases (n=5411 with handovers) were included for analysis. Patients were predominantly male (56.5%) with a median age of 6.56 (IQR: 2.65–12.53) years and a median anaesthesia duration of 76 (IQR: 55–126) min. In the weighted sample, the odds of the primary outcome (OR: 0.92; 95% CI 0.75 to 1.13; p=0.43), any morbidity (OR: 0.93; 95% CI 0.75 to 1.16; p=0.515), all-cause mortality (OR: 0.8; 95% CI 0.37 to 1.73; p=0.565) or 30-day readmission following surgery (OR: 0.99; 95% CI 0.84 to 1.18; p=0.95) did not significantly differ among surgeries with and without handovers.ConclusionsAmong paediatric patients undergoing surgery, intraoperative anaesthesia handovers were not associated with adverse postoperative outcomes, after accounting for relevant covariates. These findings provide a preliminary perspective on the role of intraoperative handovers as a care-neutral event, with implications for improving safety.
Reducing sedentary behaviour and physical inactivity in the workplace: protocol for a review of systematic reviews
Authors: Dieterich Anna Valeria , Müller Andre Matthias , Akksilp Katika , K C Sarin , Dabak Saudamini Vishwanath , Rouyard Thomas 
Published: December 2020

Background and objectiveIncreasing rates of urbanisation have been accompanied by higher levels of sedentary behaviour (SB) and reduced physical activity (PA) worldwide. While physical inactivity has long been identified as a major risk factor for morbidity and mortality, increased concerns about the detrimental associations between SB and health has led to the development of many interventions aimed at reducing SB and/or promoting PA. Due to the prominence of sedentary time spent at work, the workplace has been identified as a key setting to implement such interventions. Building an evidence base of effective strategies to reduce SB and/or promote PA at work is needed to help reduce the health risks faced by many employees.Methods and analysisWe aim to conduct a review of reviews (RoR) to identify, evaluate and synthesise all systematic reviews (SRs) of workplace interventions aimed at reducing SB and/or promoting PA among adults. Systematic searches for relevant SRs will be conducted in six databases: Cochrane Systematic Review Database, Cumulative Index to Nursing & Allied Health Literature through EBSCOhost, EMBASE, PubMed including MEDLINE, Scopus and Web of Science. Selection for final inclusion and data extraction will be performed by two independent reviewers. SRs will be included if they assessed interventions aimed at reducing SB or promoting PA in the workplace, and if they report on changes in the respective behavioural outcomes in the occupational domain.DiscussionThis RoR will be valuable to policy-makers and employers who are looking for strategies to promote health at work. This will also allow potential research gaps to be identified, so that the design of future studies can be better informed.Trial registerationThis study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42020171774).
Comparison of the Heel Enthesitis MRI Scoring System (HEMRIS) with clinical enthesitis and local metabolic activity on PET-CT
Authors: Kleinrensink Nienke J , Foppen Wouter , Ten Katen Iris , van der Veen Pieternella H , de Klerk Bo , Diepstraten Suzanne C E , Radstake Timothy R D J , Lafeber Floris P J G , de Jong Pim A , Leijten Emmerik F A 
Published: December 2020

ObjectiveTo compare the Heel Enthesitis MRI Scoring model (HEMRIS) with clinical and PET/CT outcomes in patients with cutaneous psoriasis (Pso), psoriatic arthritis (PsA) or ankylosing spondylitis (AS).MethodsThis prospective, observational study included 38 patients with Pso, PsA and AS. Patients were included regardless of presence or absence of clinical heel enthesitis. MRI-scans of both ankles and a whole-body18F-FDG PET/CT were acquired. MRIs were assessed for enthesitis by two independent and blinded observers according to the HEMRIS. A physician, blinded for imaging results, performed clinical evaluations of enthesitis at the Achilles tendon and plantar fascia.ResultsIn total, 146 entheses were scored according to the HEMRIS and clinically assessed for enthesitis (6 entheses were clinically affected). In Achilles tendons with clinical enthesitis, the HEMRIS structural damage score was significantly higher, compared to Achilles tendons without clinical enthesitis (respective median scores 1.0 and 0.5; p=0.04). In clinically unaffected entheses, HEMRIS abnormalities occurred in 44/70 (63%) of Achilles tendons and in 23/70 (33%) of plantar fascia. At the Achilles tendon, local metabolic activity measured on PET/CT was weakly associated with the structural (rs=0.25, p=0.03) and total HEMRIS (rs=0.26, p=0.03).ConclusionThis study revealed a high prevalence of subclinical HEMRIS abnormalities and discrepancy between HEMRIS and clinical and PET/CT findings. This may suggest that the HEMRIS is a sensitive method for detection of inflammatory and structural disease of enthesitis at the Achilles tendon and plantar fascia, although the clinical significance of these MRI findings remains to be determined in longitudinal studies.
Population dynamics of the threatened Cumberland Sound beluga (Delphinapterus leucas) population
Authors: Watt Cortney A. , Marcoux Marianne , Ferguson Steven H. , Hammill Mike O. , Matthews Cory J.D. 
Published: December 2020

Current scientific evidence indicates that the threatened Cumberland Sound beluga whale (Delphinapterus leucas (Pallas, 1776)) population is genetically differentiated and spatially segregated from other beluga whale populations. This population has been hunted for subsistence for centuries by Inuit who now live in the community of Pangnirtung, Nunavut, Canada, and was harvested commercially from 1860 until 1966. The commercial harvest removed at least 10 000 individuals from the population. Visual and photographic aerial surveys were flown during August 2014 and 2017 and produced beluga whale abundance estimates of 1151 (CV = 0.214; 95% confidence interval (CI) = 760–1744) and 1381 (CV = 0.043; CI = 1270–1502), respectively. Long-term trends in abundance were examined by fitting a Bayesian surplus-production population model to a time series of abundance estimates (n = 5), flown between 1990 and 2017, taking into account reported subsistence harvests (1960–2017). The model suggests the population is declining. Engaged co-management of the Cumberland Sound beluga population and information on demographic parameters, such as reproductive rates, and age and sex composition of the harvest, are needed to restore the ecological integrity of the Cumberland Sound marine ecosystem.
Reproductive patterns and energy management strategies of females of the fiddler crabLeptuca uruguayensiswith short reproductive seasons
Authors: Marciano A. , López Greco L.S. , Colpo K.D. 
Published: December 2020

Reproduction is a costly process that depends on the management of available resources. Here, we aimed to understand the energetic strategies of females of the fiddler crab Leptuca uruguayensis (Nobili, 1901) in a population with short reproductive seasons. For this, we developed an integrated approach to recognize the brooding time, spawning pattern modulated by female size, number of spawns per female, and content of reserves in the ovary and hepatopancreas. Based on the condition of the ovary and hepatopancreas, the reproductive season was divided into three periods. In each of these periods, it was possible to record a spawning event, which was mainly represented by large females. Most of the females had one spawn during the breeding season, and only large females had two spawns, with an interval of approximately 2 months. We propose that L. uruguayensis presents a mixed capital–income breeding strategy associated with the female size and period of the reproductive season. We conclude that large females make the greatest reproductive effort for the population because they can have two spawns, whereas medium-sized and small females make a low contribution because they are still investing energy in somatic growth to increase fecundity in the next reproductive season.