bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the availability and utility of the paramedic record in the emergency department
Authors: O'Connor Katherine , Golding Michael 
Published: November 2020

AbstractObjectiveClinical handover between pre‐hospital ambulance service and the ED is important for patient safety and quality care. This study assessed the availability and utility of the paramedic record to ED clinicians in their patient assessment.MethodsThe document transfer in 110 handovers between ambulance service and a tertiary metropolitan hospital ED was observed. Timestamps were recorded when the electronic paramedic record was printed, when it was placed in the hospital's paper‐based patient medical record, when ED patient assessment occurred and it was noted if there was a verbal handover from paramedic to ED clinician. ED clinicians were surveyed about the availability and usefulness of the paramedic record.ResultsThe paramedic record was printed prior to the patient being seen in only 49% of encounters and was available in the medical record at the time of initial clinical assessment in 32% of encounters. When available it was reviewed in over 90% of encounters. 87% of these reviews were reported as ‘significantly’ or ‘somewhat useful’. The paramedic record could not be located at all in 21% of encounters. In 98% of encounters the treating ED clinician would have preferred the paramedic record to have been electronic. The ED system data was corrupt in 4% of encounters.ConclusionsThe information in the paramedic record was found to be useful to ED clinicians when it was available. Increasing the availability of the paramedic record for ED clinical assessment may be an opportunity to improve patient safety and flow.
Assessment and management of urinary tract infections in aged care facilities
Authors: Khatri Dipti , Burrows Judith 
Published: November 2020

AbstractObjectivesTo compare assessment and management of urinary tract infections (UTI) for residents in aged care facilities (ACF) with evidence‐based infection criteria and recommended therapy.MethodsA retrospective clinical audit was conducted for all short‐course antibiotics (SCA) prescribed to treat presumed UTIs (p‐UTIs). Surveillance, microbiological and dispensing data determined whether p‐UTIs met the revised McGeer criteria for infection and the extent to which SCAs complied with guideline recommendations.ResultsTen out of 74 (14%) p‐UTIs were confirmed infections, that is met both the clinical and microbiological criteria for infection. Thirty‐four out of 74 (46%) p‐UTIs were classified as asymptomatic bacteriuria. The dose and frequency of the prescribed SCA were concordant with guideline recommendations for 87% and 85% of the courses, respectively; however, only 42% of the SCAs followed the recommended duration of therapy.ConclusionOverdiagnosis of UTIs and consequent overprescribing of antibiotics, specifically extended duration, are consistent with similar studies.
The predicted clinical workload associated with early post‐term surveillance and inductions of labour in south Asian women in a non‐tertiary hospital setting
Authors: Green Brittany , Howat Paul , Hui Lisa 
Published: November 2020

BackgroundStillbirth increases steeply after 42 weeks gestation; hence, induction of labour (IOL) is recommended after 41 weeks. Recent Victorian data demonstrate that term stillbirth risk rises at an earlier gestation in south Asian mothers (SAM).AimsTo determine the impact on a non‐tertiary hospital in Melbourne, Australia, if post‐dates IOL were recommended one week earlier at 40 + 3 for SAM; and to calculate the proportion of infants with birthweight < 3rd centile that were undelivered by 40 weeks in SAM and non‐SAM, as these cases may represent undetected fetal growth restriction.Materials and MethodsSingleton births ≥ 37 weeks during 2017–18 were extracted from the hospital Birthing Outcomes System. Obstetric and neonatal outcomes for pregnancies that birthed after spontaneous onset of labour or IOL were analysed according to gestation and country of birth.ResultsThere were 5408 births included, and 24.9% were born to SAM (n = 1345). SAM women had a higher rate of IOL ≥ 37 weeks compared with non‐SAM women (42.5% vs 35.0%, P < 0.001). If all SAM accepted an offer of IOL at 40 + 3, there would be an additional 80 term inductions over two years. There was no significant difference in babies < 3rd centile undelivered by 40 weeks in SAM compared with non‐SAM (29.6% vs 37.7%, P = 0.42).ConclusionsEarlier IOL for post‐term SAM would only modestly increase the demand on birthing services, due to pre‐existing high rates of IOL. Our current practices appear to capture the majority at highest risk of stillbirth in our SAM population.
Ethnic disparities for thyroid surgery
Authors: Wu Johnny , Ebrahim AK 
Published: November 2020

AbstractBackgroundSignificant health disparities exist between Māori and non‐Māori patients in New Zealand. Māori patients treated medically for their thyroid disease are less likely to be euthyroid. The prevalence of thyroid disease and characteristics of Māori presenting for thyroid surgery has not been well studied. We aim to assess the differences in ethnic representation for thyroid surgery.MethodsA retrospective analysis of cases performed between 2009 and 2019 at the Otolaryngology/Head and Neck Department in Waikato District Health Board (DHB) was completed. All patients who received a thyroid operation were included and divided into Māori and non‐Māori groups. Clinical and operation notes were reviewed and the duration of presenting symptoms, weight, volume and diagnosis of the thyroid gland were assessed.ResultsA total of 93 patients were included in our study, of whom 71 patients were female and 22 male with 37 being Māori and 56 non‐Māori. Māori patients had significantly higher rates of retrosternal extension, compressive symptoms, post‐operative complications, delayed presentation and larger thyroid goitres when compared to non‐Māori (P < 0.05).ConclusionOur study confirms that there is a significant ethnic disparity for Māori patients requiring thyroid surgery. This highlights an additional poor health outcome for Māori compared to non‐Māori patients.
Trends and geographic variations in self‐reported diabetes incidence: A prospective open cohort study of Chinese men and women, 1997–2015
Authors: Yu Xuexin , Xia Fan , Zhang Wei 
Published: November 2020

AbstractAimThis study aims to evaluate the trends and geographic variations of incident diabetes as well as the corresponding sex differences in China.MethodsThe open cohort study derived data of 16,610 individuals from the China Health and Nutrition Survey 1997–2015. Direct standardisation was employed to calculate the age‐standardised diabetes incidence. Mixed effects logistic regression models with interaction terms were performed to examine variations in incident diabetes. Socio‐demographic (age, sex, marital status, racial compositions and educational attainment) and lifestyle attributes (smoking history, BMI and waist circumference) were sequentially included as covariates.ResultsOverall age‐standardised diabetes incidence increased from 2.94 per 1000 person‐years (95% CI, 2.44–3.44) in 1997–2004 to 5.54 (95% CI, 4.94–6.14) in 2009–2015. Models with interaction terms suggest that the increase among men was higher than that among women (wave 2006–2009 × Female: OR = 0.45, 95% CI 0.28–0.72). Age‐standardised incidence of diabetes varied across regions, ranging from 5.67 (95% CI, 4.95–6.40) in Eastern China to 2.69 (95% CI 2.19–3.19) in Western China. Subsequent modelling analyses suggest that the geographic variations could be mostly explained by the variations in the BMI and waist circumference across regions.ConclusionsResults suggest that the incidence of self‐reported diabetes approximately doubled during the study period. The increase among men was steeper than that among women. Public interventions reducing the population's obesity level hold promise to alleviate geographic variations and flatten the growth curve.
Randomized trial of a patient empowerment and cognitive training program for older people with diabetes mellitus and cognitive impairment
Authors: Wong Chit‐wai , O Wai‐Tsun William , Wong Kin‐Wai Shirley , Ma Ronald , Hui Elsie , Kwok Chi‐yui Timothy 
Published: November 2020

AimTo evaluate the effectiveness of a combined patient empowerment program (PEP) and cognitive training (CT) program on improving glycemic control among older subjects with diabetes and cognitive impairment.MethodsA prospective single blinded, randomized controlled study was carried out in 139 older patients with diabetes aged ≥65 years with memory complaints and recent glycosylated hemoglobin level of 7–9%. They were randomly assigned to either undergo once‐weekly PEP combined with CT for 10 weeks (intervention group, N = 73) or receive no intervention (control group, N = 66). All participants were followed up at months 4 and 12 to examine the immediate and long‐term effects on glycemic control, cognition, mood and compliance to drug and diabetes self‐management.ResultsThe intervention did not significantly reduce glycosylated hemoglobin. The intervention group showed significant progressive improvement in memory over 1 year and executive function improved significantly at month 12. There was no significant change in diabetes self‐management activities with the intervention.ConclusionsCombination of PEP and CT did not improve glycemic control or self‐care activities in older patients with diabetes and memory complaints but was effective in improving cognitive function in the longer term. Geriatr Gerontol Int 2020; 20: 1164–1170.
Fabrication of C/C‐SiC composites using high‐char‐yield resin
Authors: Yang Jinhua , Ai Yingjun , Lv Xiaoxu , Qi Zhe , Jiao Jian 
Published: November 2020

AbstractCarbon fiber reinforced ceramic matrix composites (C/C‐SiC composites) were fabricated using a type of high‐char‐yield phenolic resin with the char yield of 81.17 wt.%. Firstly, the fabric prepreg was prepared by spreading the phenolic resin solution onto the two dimensional carbon fiber plain weave fabric and dried consequently. Afterward, the resin was cured and then the carbon fiber reinforced polymer (CFRP) was pyrolyzed to get amorphous carbon. Finally, C/C‐SiC composites were obtained through liquid silicon infiltration (LSI) process. SEM micrographs showed that the Si/SiC area was homogeneously dispersed in the matrix, and during the siliconization process, a layer of SiC was formed along the surface of carbon fibers or carbon matrix. The fiber volume of CFRP was about 40 vol.%, which was much lower than other studies. XRD result indicated that only β‐SiC type was formed. The result of X‐ray computed tomography clearly showed the structure changes before and after the melt infiltration process. Mechanical property test showed that the composites had fracture strength of 186 ± 23 MPa, and a flexural modulus of 106 ± 8 GPa.
Impact of a nurse‐led intervention on quality of life in patients with chronic non‐malignant pain: An open randomized controlled trial
Authors: Morales‐Fernández Ángeles , Jimenez‐Martín José Manuel , Morales‐Asencio José Miguel , Vergara‐Romero Manuel , Mora‐Bandera Ana María , Aranda‐Gallardo Marta , Canca‐Sanchez José Carlos 
Published: November 2020

AbstractAimsTo determine the effect of a comprehensive nurse‐led programme for patients with chronic non‐malignant pain, on quality of life, level of pain, anxiety, and depression, as primary outcomes and patients' satisfaction as a secondary end point.DesignAn open‐label randomized controlled trial was carried out.MethodsThe experimental group received both a nurse‐led intervention on healthy lifestyles, education on self‐esteem, pain awareness, communication, and relaxation techniques. The control group received usual care. Quality of life, level of pain, anxiety, and depression were the main outcomes. Data were obtained at baseline, immediately after the intervention, and 6 and 9 months. The study was carried out from 2015–2017.ResultsThe sample was composed of 279 patients. At 9 months, the effect size (non‐parametric effect size statistic A) favoured the intervention group for SF‐36 mental health score (A = 0.79; 95% CI: 0.73–0.85), anxiety (A = 0.58; 95% CI: 0.51–0.65), pain intensity (A = 0.57; 95% CI: 0.51–0.64), and depression (A = 0.58; 95% CI: 0.51–0.65). Smaller differences were found on physical scores between the intervention and the usual care group. Patients showed a high level of satisfaction with the introduced intervention.ConclusionA comprehensive nurse‐led programme for patients with chronic non‐malignant pain has a positive impact on their quality of life, level of pain, and mental health.ImpactStudies have reported that the problem of chronic pain is not optimally controlled. A structured nurse‐led programme has been tested to facilitate healthy behaviours to help patients manage their chronic pain and to provide them with the necessary tools for their self‐care. This nurse‐led intervention improved their mental health and decreased their level of pain.
Morphological evolution of silica scales in the freshwater genus Synura (Stramenopiles)
Authors: Jadrná Iva , Siver Peter A. , Škaloud Pavel 
Published: November 2020

A high degree of morphological variability is expressed between the ornately sculptured siliceous scales formed by species in the chrysophycean genus, Synura. In this study, we aimed to uncover the general principles and trends underlying the evolution of scale morphology in this genus. We assessed the relationships among thirty extant Synura species using a robust molecular analysis that included six genes, coupled with morphological characterization of the species‐specific scales. The analysis was further enriched with addition of morphological information from fossil specimens and by including the unique modern species, Synura punctulosa. We inferred the phylogenetic position of the morphologically unique S. punctulosa, to be an ancient Synura lineage related to S. splendida in the section Curtispinae. Some morphological traits, including development of a keel or a labyrinth ribbing pattern on the scale, appeared once in evolution, whereas other structures, such as a hexagonal meshwork pattern, originated independently several times over geologic time. We further uncovered numerous construction principles governing scale morphology and evolution, as follows: (i) scale roundness and pore diameter decreased during evolution; (ii) elongated scales became strengthened by a higher number of struts or ribs; (iii) as a consequence of scale biogenesis, scales with spines possessed smaller basal holes than scales with a keel and; and (iv) the keel area was proportional to scale area, indicating its potential value in strengthening the scale against breakage.
A de novo mutation in KRT5 in a crossbred calf with epidermolysis bullosa simplex
Authors: Jacinto Joana G. P. , Häfliger Irene M. , Veiga Inês M. B. , Drögemüller Cord , Agerholm Jørgen S. 
Published: November 2020

AbstractA 6‐day‐old Belgian Blue‐Holstein calf was referred because of a syndrome resembling epidermolysis bullosa simplex (EBS). The clinical phenotype included irregular and differently sized erosions and ulcerations spread over the body, in particular on the limbs and over bone prominences, as well as in the nasal planum and oral mucosa. Blisters were easily induced by rubbing the skin. The skin lesions displayed a clear dermal‐epidermal separation at the level of the basal cell layer. Post mortem examination revealed erosions in the pharynx, proximal esophagus, and rumen. Whole‐genome sequencing revealed a heterozygous disruptive in‐frame deletion variant in KRT5 (c.534_536delCAA). Genotyping of both parents confirmed the variant as de novo mutation. Clinicopathological and genetic findings were consistent with the diagnosis of KRT5‐related EBS providing the second example of a spontaneous mutation causing epidermolysis bullosa in cattle.
CHH DNA methylation increases at 24‐PHAS loci depend on 24‐nt phased small interfering RNAs in maize meiotic anthers
Authors: Zhang Mei , Ma Xuxu , Wang Chunyu , Li Qing , Meyers Blake C. , Springer Nathan M. , Walbot Virginia 
Published: November 2020

Summary

Plant phased small interfering RNAs (phasiRNAs) contribute to robust male fertility; however, specific functions remain undefined. In maize (Zea mays), male sterile23 (ms23), necessary for both 24‐nt phasiRNA precursor (24‐PHAS) loci and Dicer‐like5 (Dcl5) expression, and dcl5‐1 mutants unable to slice PHAS transcripts lack nearly all 24‐nt phasiRNAs.

Based on sequence capture bisulfite‐sequencing, we find that CHH DNA methylation of most 24‐PHAS loci is increased in meiotic anthers of control plants but not in the ms23 and dcl5 mutants.

Because dcl5‐1 anthers express PHAS precursors, we conclude that the 24‐nt phasiRNAs, rather than just activation of PHAS transcription, are required for targeting increased CHH methylation at these loci.

Although PHAS precursors are processed into multiple 24‐nt phasiRNA products, there is substantial differential product accumulation. Abundant 24‐nt phasiRNA positions corresponded to high CHH methylation within individual loci, reinforcing the conclusion that 24‐nt phasiRNAs contribute to increased CHH methylation in cis.
Differential nucleosome occupancy modulates alternative splicing in Arabidopsis thaliana
Authors: Jabre Ibtissam , Chaudhary Saurabh , Guo Wenbin , Kalyna Maria , Reddy Anireddy S. N. , Chen Weizhong , Zhang Runxuan , Wilson Cornelia , Syed Naeem H. 
Published: November 2020

Summary

Alternative splicing (AS) is a major gene regulatory mechanism in plants. Recent evidence supports co‐transcriptional splicing in plants, hence the chromatin state can impact AS. However, how dynamic changes in the chromatin state such as nucleosome occupancy influence the cold‐induced AS remains poorly understood.

Here, we generated transcriptome (RNA‐Seq) and nucleosome positioning (MNase‐Seq) data for Arabidopsis thaliana to understand how nucleosome positioning modulates cold‐induced AS.

Our results show that characteristic nucleosome occupancy levels are strongly associated with the type and abundance of various AS events under normal and cold temperature conditions in Arabidopsis. Intriguingly, exitrons, alternatively spliced internal regions of protein‐coding exons, exhibit distinctive nucleosome positioning pattern compared to other alternatively spliced regions. Likewise, nucleosome patterns differ between exitrons and retained introns, pointing to their distinct regulation.

Collectively, our data show that characteristic changes in nucleosome positioning modulate AS in plants in response to cold.
Comparing Pain Neuroscience Education Followed by Motor Control Exercises With Group‐Based Exercises for Chronic Low Back Pain: A Randomized Controlled Trial
Authors: Rabiei Pouya , Sheikhi Bahram , Letafatkar Amir 
Published: November 2020

AbstractBackgroundDifferent individualized interventions have been used to improve chronic low back pain (CLBP). However, their superiority over group‐based interventions has yet to be elucidated. We compared an individualized treatment involving pain neuroscience education (PNE) plus motor control exercise (MCE) with group‐based exercise (GE) in patients with CLBP.MethodsSeventy‐three patients with CLBP were randomly assigned into the PNE plus MCE group (n = 37) and GE group (n = 36). Both PNE plus MCE and GE were administered twice weekly for 8 weeks. Pain intensity (as measured using the VAS), disability (as measured using the Roland‐Morris Disability Questionnaire), fear‐avoidance beliefs (as measured using the Fear‐Avoidance Beliefs Questionnaire), and self‐efficacy (as measured using the Pain Self‐Efficacy Questionnaire) were assessed at baseline and 8 weeks post‐intervention. A 2 × 2 variance analysis (treatment group × time) with a mixed‐model design was applied to statistically analyze the data.ResultsBoth groups showed significant improvements in all the outcome measures, with a large effect size (P < 0.001, partial eta squared [ηp2] = 0.66 to 0.81) after the intervention. The PNE plus MCE group showed greater improvements, with a moderate effect size in pain intensity (P = 0.041, ηp2 = 0.06) and disability (P = 0.021, ηp2 = 0.07) compared to the GE group. No significant difference was found in fear‐avoidance beliefs during physical activity and work, and self‐efficacy (P > 0.05) between the 2 groups.ConclusionPNE and MCE seem to be better at reducing pain intensity and disability compared to GE, while no significant differences were observed for fear‐avoidance beliefs and self‐efficacy between the 2 groups in patients with CLBP. With regard to the superiority of individualized interventions over group‐based ones, more studies are warranted.
Dynamic Survival Prediction Combining Landmarking with a Machine Learning Ensemble: Methodology and Empirical Comparison
Authors: Tanner Kamaryn T. , Sharples Linda D. , Daniel Rhian M. , Keogh Ruth H. 
Published: November 2020

AbstractDynamic prediction models provide predicted survival probabilities that can be updated over time for an individual as new measurements become available. Two techniques for dynamic survival prediction with longitudinal data dominate the statistical literature: joint modelling and landmarking. There is substantial interest in the use of machine learning methods for prediction; however, their use in the context of dynamic survival prediction has been limited. We show how landmarking can be combined with a machine learning ensemble—the Super Learner. The ensemble combines predictions from different machine learning and statistical algorithms with the goal of achieving improved performance. The proposed approach exploits discrete time survival analysis techniques to enable the use of machine learning algorithms for binary outcomes. We discuss practical and statistical considerations involved in implementing the ensemble. The methods are illustrated and compared using longitudinal data from the UK Cystic Fibrosis Registry. Standard landmarking and the landmark Super Learner approach resulted in similar cross-validated predictive performance, in this case, outperforming joint modelling.
What Good is the Canon for a Diversified and Decolonized Curriculum?
Authors: Cooper Gabriel 
Published: November 2020

AbstractIn the interest of fostering a socially critical and inclusive German Studies, this article urges instructors to pursue curricular reforms to diversify and decolonize German curricula at colleges and universities. While the literary canon's centrality to the German major has tended to leave monolithic impressions of “Germany” and “Germanness” on students, and thus presents an obstacle to such efforts, the canon's function might be reconceived so that the “good” it has to offer can serve different pedagogical ends. Using a German program at a liberal arts college as an example, this article presents strategies – from departmental and course learning goals to curricular structure and course design – for how to decenter the canon in the German curriculum in order to foreground social justice concerns and facilitate encounters with diverse perspectives.