bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing Work Environment, Turnover Intention, Job Burnout, and Quality of Care: The Moderating Role of Job Satisfaction
Authors: Al Sabei Sulaiman Dawood , Labrague Leodoro J. , Miner Ross Amy , Karkada Suja , Albashayreh Alaa , Al Masroori Fatma , Al Hashmi Nasra 
Published: November 2019

AbstractPurposeThe purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention.DesignA cross‐sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman.MethodsAn electronic survey was used to assess nurses’ perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care.FindingsParticipation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high.ConclusionsImproving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention.Clinical RelevanceOrganizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.
A meta‐analysis of treatment effects of imiquimod for basal cell carcinoma
Authors: Li Meng‐Ya , Zhang Xin‐Ping , Duan Xin‐Bo , Cao Xiao‐Ci , Zhao Hai‐Jing 
Published: November 2019

AbstractObjectiveWe conducted this meta‐analysis to assess the efficacy and safety of imiquimod in comparison with other treatments in patients with BCC.MethodsA comprehensive literature search was performed in the database of PubMed, Embase, and Web of Science. Outcomes of interest included histological/composite clearance rate, success rate, complete response rate, tumor free survival, and adverse events. Pooled risk ratio (RR) with 95% confidence intervals (CIs) using a fixed‐effects or random‐effects model were determined for each outcome.ResultsA total of 13 studies involving 4256 patients were identified. Imiquimod was associated with significantly higher histological clearance rate (RR = 9.28, 95%CI: 5.56, 15.49; P < .001) and composite clearance rate (RR = 34.24, 95%CI: 21.29, 55.06; P = .001). Moreover, imiquimod also significantly increased complete response rate (RR = 3.15, 95%CI: 1.55, 6.38; P = .001) but had no effect in the success rate (RR = 0.98, 95%CI: 0.89, 1.08; P = .727) and probability of tumor‐free survival (RR = 1.15, 95%CI: 0.98, 1.35; P = .088), as compared with other treatments. There were more patients in imiquimod group who developed adverse events than in other treatment group (RR = 2.00, 95%CI: 1.39, 2.88; P < .001).ConclusionThis study indicated the effects of imiquimod in improving the histological/composite clearance rates as compared with other treatments. However, its treatment‐related adverse events also should be noticed. Our findings supported that, imiquimod could be used as the first‐choice treatment for BCC.
Heat‐killed Lactobacillus reuteri and cell‐free culture supernatant have similar effects to viable probiotics during interaction with Porphyromonas gingivalis
Authors: Geraldo Barbara M. C. , Batalha Marianna N. , Milhan Noala V. M. , Rossoni Rodnei D. , Scorzoni Liliana , Anbinder Ana Lia 
Published: November 2019

AbstractBackground and objectiveIn the last decade, numerous studies have been published to clarify the role of probiotics, especially Lactobacillus reuteri, as an adjunct to conventional periodontal treatment. Although the health benefits of probiotics are numerous, they are live bacteria, and the administration of live organisms is not risk‐free. We evaluated the antimicrobial effect of L reuteri and its cell‐free culture supernatant on Porphyromonas gingivalis, a keystone periodontal pathogen, in vitro. We also evaluated the influence of this probiotic in its live, heat‐killed (HKL, paraprobiotic) form and its supernatant on the Galleria mellonella invertebrate model after infection by P gingivalis.MethodsThe interaction assay was conducted with P gingivalis and L reuteri preparations (live cells and supernatant preparation). For this, P gingivalis and L reuteri preparations were added to tubes containing Brain Heart Infusion broth and incubated for 3 days. The suspensions were then seeded onto appropriate culture media for the calculation of colony‐forming units per mL (CFU/mL). An in vivo assay with the G mellonella model was also performed. Live L reuteri, HKL, or supernatant was inoculated 2 hours prior to infection with P gingivalis. Survival was evaluated over 7 days, and the number of hemocytes in the hemolymph was estimated 3 hours after P gingivalis infection. Data were then subjected to statistical testing (α = 5%).ResultsBoth live L reuteri and its supernatant had antimicrobial activity against P gingivalis (CFU reduction up to 86%, P < .05). Moreover, treatment with live and HKL had similar effects on G mellonella survival (increased survival up to 46%, P < .05). However, only live L reuteri was able to significantly increase the hemocyte density in this invertebrate model.ConclusionLactobacillus reuteri antimicrobial activity against P gingivalis and its effects on G mellonella survival after infection with a periodontopathogen do not depend on cell viability. This allows the development of products without live bacterium while maintaining similar effects.
Difficulties falling asleep among adolescents: Social inequality and time trends 1991–2018
Authors: Holstein Bjørn E. , Ammitzbøll Janni , Damsgaard Mogens Trab , Pant Sofie Weber , Pedersen Trine Pagh , Skovgaard Anne Mette 
Published: November 2019

SummarySleep problems in adolescence are increasingly common, and associated with adverse health and psychological outcomes. Adolescents’ sleep problems may be related to the family’s socioeconomic status, but studies are few and no study has examined whether social inequality in sleep problems changes as sleep problems become increasingly common. This study examined trends in difficulties falling asleep among adolescents in Denmark, whether this sleep problem was associated with socioeconomic status, and whether this association changed from 1991 to 2018. The study applied data from eight comparable surveys among 11–15 year olds in Denmark 1991–2018, the Danish arm of the international Health Behaviour in School‐aged Children study, N = 30,002. The prevalence of daily difficulties falling asleep increased from 7.0% to 13.4% in 1991–2018 with higher frequencies among girls and younger adolescents. The odds ratio (95% confidence interval) for daily difficulties was 1.14 (1.05–1.24) in middle and 1.52 (1.37–1.69) in low compared with high socioeconomic status. The absolute social inequality in difficulties falling asleep was persistent in 1991–2018 whereas the relative social inequality may have decreased. The increasing prevalence and the social inequality in difficulties falling asleep among adolescents is a serious public health concern that calls for more attention and efforts.
Clinical relevance of splenic nodules or heterogeneous splenic parenchyma assessed by cytologic evaluation of fine‐needle samples in 125 dogs (2011‐2015)
Authors: Yankin Igor , Nemanic Sarah , Funes Silvia , de Morais Helio , Gorman Elena , Ruaux Craig 
Published: November 2019

AbstractBackgroundSplenic nodules and heterogeneous parenchyma are seen frequently in abdominal ultrasound examinations of dogs, but the clinical importance of these lesions remains unclear.ObjectivesTo determine whether specific ultrasonographic findings correlate with clinically relevant cytologic diagnoses and determine what sonographic features are correlated with these diagnoses. Another objective was to develop a scoring rubric to help clinicians make decisions on whether or not certain ultasonographic findings of the spleen warrant evaluation by fine‐needle cytology.AnimalsOne‐hundred twenty‐five adult client‐owned dogs with ultrasonographically identified splenic nodules, heterogeneous parenchyma, or both.MethodsMedical records were retrospectively searched for ultrasound‐guided splenic fine‐needle cytology reports. Ultrasonographic images were assessed for nodule number, size, echogenicity and distal enhancement, degree of splenic heterogeneity, and peritoneal fluid. Dogs were divided into 2 groups: those with clinically important or clinically irrelevant cytologic findings. Potentially useful and discriminatory ultrasonographic findings were identified by statistical analysis, and the most useful findings were used to generate the scoring rubric.ResultsThe clinically important group included 25 of 125 dogs (22 malignancies, 3 suppurative inflammation). Splenic nodules 1‐2 cm in diameter, peritoneal fluid, and >1 targetoid nodule were associated with clinically important cytologic findings. Receiver operator characteristic analysis showed that the scoring rubric was useful for identifying dogs in the clinically important group.Conclusions and Clinical ImportanceSplenic fine‐needle cytologic findings identified a clinically relevant diagnosis in 20% of dogs, and larger nodule size, number of targetoid lesions, and presence of peritoneal fluid increase the likelihood of detection of clinically important disease.
Free‐living and symbiotic lifestyles of a thermotolerant coral endosymbiont display profoundly distinct transcriptomes under both stable and heat stress conditions
Authors: Bellantuono Anthony J. , Dougan Katherine E. , Granados‐Cifuentes Camila , Rodriguez‐Lanetty Mauricio 
Published: November 2019

AbstractReef‐building corals depend upon a nutritional endosymbiosis with photosynthetic dinoflagellates of the family Symbiodiniaceae for the majority of their energetic needs. While this mutualistic relationship is impacted by numerous stressors, warming oceans are a predominant threat to coral reefs, placing the future of the world's reefs in peril. Some Symbiodiniaceae species exhibit tolerance to thermal stress, but the in hospite symbiont response to thermal stress is underexplored. To describe the underpinnings of symbiosis and heat stress response, we compared in hospite and free‐living transcriptomes of Durusdinium trenchii, a pan‐tropical heat‐tolerant Symbiodiniaceae species, under stable temperature conditions and acute hyperthermal stress. We discovered that symbiotic state was a larger driver of the transcriptional landscape than heat stress. The majority of differentially expressed transcripts between in hospite and free‐living cells were downregulated, suggesting the in hospite condition is associated with the shutdown of numerous processes uniquely required for a free‐living lifestyle. In the free‐living state, we identified enrichment for numerous cell signalling pathways and other functions related to detecting and responding to a changing environment, as well as transcripts relating to mitosis, meiosis, and motility. In contrast, in hospite cells exhibited enhanced transcriptional activity for photosynthesis and carbohydrate transport as well as chromatin modifications and a disrupted circadian clock. Hyperthermal stress induced drastic alteration of transcriptional activity in hospite, suggesting symbiotic engagement with the host elicited an exacerbated stress response when compared to free‐living D. trenchii. Altogether, the dramatic differences in gene expression between in hospite and free‐living D. trenchii indicate the importance of considering symbiotic state in investigations of symbiosis and hyperthermal stress in Symbiodiniaceae.
A machine learning approach based on multifractal features for crack assessment of reinforced concrete shells
Authors: Athanasiou Apostolos , Ebrahimkhanlou Arvin , Zaborac Jarrod , Hrynyk Trevor , Salamone Salvatore 
Published: November 2019

AbstractThe geometric properties and spatial characteristics of crack patterns are significant indicators of the extent of damage on reinforced concrete structures. However, manual visual assessment is subjective and depends highly on the inspector's skills. The current study proposes an automated approach for the quantification of digitally documented crack patterns on reinforced concrete shell elements subjected to reversed cyclic shear loading. Multifractal analysis is proposed as a feature extractor for images depicting crack patterns and a set of artificial cracks is analyzed, to quantify how the properties of crack patterns vary as a function of cracking inclination. The results of the parametric study motivated the training of a multiclass classification model, which is used to provide damage level estimates for cracked reinforced concrete members. The training of the classifier is performed using experimental data of reinforced concrete shell elements under well‐defined and idealized two‐dimensional pure shear stress loading conditions. A dataset with 119 images from crack patterns of reinforced concrete shells is used for training. The multifractal features successfully translate the shape of the crack patterns into meaningful information about the extent of damage; achieving an overall test accuracy of 89.3%.
Deep convolutional neural networks for uncertainty propagation in random fields
Authors: Luo Xihaier , Kareem Ahsan 
Published: November 2019

AbstractThe development of a reliable and robust surrogate model is often constrained by the dimensionality of the problem. For a system with high‐dimensional inputs/outputs (I/O), conventional approaches usually use a low‐dimensional manifold to describe the high‐dimensional system, where the I/O data are first reduced to more manageable dimensions and then the condensed representation is used for surrogate modeling. In this study, a new solution scheme for this type of problem based on a deep learning approach is presented. The proposed surrogate is based on a particular network architecture, that is, convolutional neural networks. The surrogate architecture is designed in a hierarchical style containing three different levels of model structures, advancing the efficiency and effectiveness of the model in the aspect of training. To assess the model performance, uncertainty quantification is carried out in a continuum mechanics benchmark problem. Numerical results suggest the proposed model is capable of directly inferring a wide variety of I/O mapping relationships. Uncertainty analysis results obtained via the proposed surrogate have successfully characterized the statistical properties of the output fields compared to the Monte Carlo estimates.
Association between allelic variants in the glucagon‐like peptide 1 and cholecystokinin receptor genes with gastric emptying and glucose tolerance
Authors: Anderson Bradley , Carlson Paula , Laurenti Marcello , Vella Adrian , Camilleri Michael , Desai Anshuman , Feuerhak Kelly , Bharucha Adil E. 
Published: November 2019

AbstractBackgroundNutrient‐mediated release of cholecystokinin and glucagon‐like peptide‐1 (GLP‐1) regulates gastric emptying (GE) via duodenogastric feedback mechanisms; GLP‐1 also regulates postprandial insulin secretion. Some patients with functional upper gastrointestinal symptoms have impaired glucose tolerance during enteral dextrose infusion. Our hypothesis was that variants in CCK, GLP‐1, and TCF7L2 (transcription factor 7‐like 2 locus), which is associated with greatest genetic risk for development of type 2 diabetes mellitus, are associated with GE and independently with glucose tolerance. Our aims were to evaluate the associations between these GE, glucose tolerance, and these single nucleotide polymorphisms (SNPs).MethodsGenetic variants, scintigraphic GE of solids, plasma glucose, insulin, and GLP‐1 during enteral dextrose infusion (75gm over 2 hours) were measured. GE and enteral dextrose infusion were, respectively, evaluated in 44 (27 controls and 17 patients with functional dyspepsia or nausea) and 42 (28 controls, 14 patients) participants; of these, 51 participants consented to assessment of SNPs. Four functional SNPs were studied: rs6923761 and rs1042044 at GLP‐1 receptor, rs7903146 (TCF7L2), and rs1800857 (CCK receptor).Key ResultsGastric emptying was normal in 38, rapid in 4, and delayed in two participants; 38 had normal, and four had impaired glucose tolerance. The T allele at rs7903146 (TCF7L2) was non‐significantly associated (P = .14) with faster GE. The associations between SNPs and demographic variables, GE thalf, glucose tolerance and plasma GLP1 levels were not significant.Conclusions & InferencesThere is a trend toward an association between faster GE and the diabetes‐associated allele at rs7903146 in TCF7L2. However, these SNPs were not associated with plasma glucose or GLP1 concentrations during enteral dextrose infusion.
A quantitative method for inferring locomotory shifts in amniotes during ontogeny, its application to dinosaurs and its bearing on the evolution of posture
Authors: Chapelle Kimberley E. J. , Benson Roger B. J. , Stiegler Josef , Otero Alejandro , Zhao Qi , Choiniere Jonah N. 
Published: November 2019

AbstractEvolutionary transitions between quadrupedal and bipedal postures are pivotal to the diversification of amniotes on land, including in our own lineage (Hominini). Heterochrony is suggested as a macroevolutionary mechanism for postural transitions but understanding postural evolution in deep time is hindered by a lack of methods for inferring posture in extinct species. Dinosaurs are an excellent natural laboratory for understanding postural transitions because they demonstrate at least four instances of quadrupedality evolving from bipedality, and heterochronic processes have been put forward as an explanatory model for these transitions. We extend a quantitative method for reliably inferring posture in tetrapods to the study of ontogenetic postural transitions using measurements of proportional limb robusticity. We apply this to ontogenetic series of living and extinct amniotes, focusing on dinosaurs. Our method correctly predicts the general pattern of ontogenetic conservation of quadrupedal and bipedal postures in many living amniote species and infers the same pattern in some dinosaurs. Furthermore, it correctly predicts the ontogenetic postural shift from quadrupedal crawling to bipedal walking in humans. We also infer a transition from early ontogenetic quadrupedality to late‐ontogenetic bipedality in the transitional sauropodomorph dinosaur Mussaurus patagonicus and possibly in the early branching ceratopsian Psittacosaurus lujiatunensis but not in the sauropodomorph Massospondylus carinatus. The phylogenetic positions of these ontogenetic shifts suggest that heterochrony may play a role in the macroevolution of posture, at least in dinosaurs. Our method has substantial potential for testing evolutionary transitions between locomotor modes, especially in elucidating the role of evolutionary mechanisms like heterochrony.
Percutaneous Peripheral Nerve Stimulation for Chronic Low Back Pain: Prospective Case Series With 1 Year of Sustained Relief Following Short‐Term Implant
Authors: Gilmore Christopher A. , Kapural Leonardo , McGee Meredith J. , Boggs Joseph W. 
Published: November 2019

AbstractIntroductionPercutaneous peripheral nerve stimulation (PNS) provides an opportunity to relieve chronic low back pain and reduce opioid analgesic consumption as an alternative to radiofrequency ablation and permanently implanted neurostimulation systems. Traditionally, the use of neurostimulation earlier in the treatment continuum has been limited by its associated risk, invasiveness, and cost.MethodsPercutaneous PNS leads (SPRINT MicroLead) were placed bilaterally to target the medial branches of the dorsal rami nerves under image guidance. The percutaneous leads were connected to miniature wearable stimulators (SPRINT PNS System) for the 1‐month therapy period, after which the leads were removed. Pain and disability were assessed long‐term up to 12 months after lead removal.ResultsSubstantial, clinically significant reductions in average pain intensity (≥50% reduction as measured by the Brief Pain Inventory Short Form) were experienced by a majority of subjects (67%) at end of treatment compared to baseline (average 80% reduction among responders; P < 0.05, analysis of variance; n = 9). Twelve months after the end of PNS treatment, a majority of subjects who completed the long‐term follow‐up visits experienced sustained, clinically significant reductions in pain and/or disability (67%, n = 6; average 63% reduction in pain intensity and 32‐point reduction in disability among responders). No serious or unanticipated adverse events were reported.ConclusionsThis study challenges the long‐held notion that a positive trial of PNS should be followed by a permanent implant in responders. Percutaneous PNS may serve as an effective neurostimulation therapy for patients with chronic low back pain and should be considered earlier in the treatment continuum as a motor‐sparing means of avoiding opioids, denervation, and permanently implanted neurostimulation systems.
The Cognitive Role of Fictionality
Authors: Williams J. Robert G. , Woodward Richard 
Published: November 2019

AbstractThe question of the cognitive role of fictionality is this: what is the correct cognitive attitude to take to p, when it is fictional that p? We began by considering one answer to this question, implicit in the work of Kendall Walton, that the correct response to a fictional proposition is to imagine that proposition. However, this approach is silent in cases of fictional incompleteness, where neither p nor its negation are fictional. We argue that that Waltonians should embrace a pluralistic account of the cognitive role of fictional incompleteness: in some cases of fictional incompleteness, we are permitted to resolve the incompleteness during our engagement with the target fiction, and in other cases, we are obliged not to resolve the incompleteness. But though pluralism is accommodated by Walton’s wider account of fictionality, it puts tension on his motivating idea that fictionality stands to the imagination as truth stands to belief. And so we develop a rival conception of the cognitive role of fictionality that is built around a different analogy: on this evidentialist approach, (known) fictionality stands to the imagination as evidence stands to credence.
The effectiveness of oral hygiene instructions in sign language among hearing impaired adults in Saudi Arabia
Authors: Fageeh Hytham N. , Mansoor Manawar A. 
Published: November 2019

AbstractObjectiveTo improve knowledge of oral health among the hearing impaired in Saudi Arabia using videos with detailed oral hygiene instructions in Arabic sign language.MethodsVideos of oral hygiene instructions in Arabic sign language were produced under the supervision of a periodontist. Fifty male subjects above 18 years of age were chosen randomly from different deaf schools in Jazan, Saudi Arabia and divided into two groups as follows: Group 1 received printed booklets with oral hygiene instructions, and Group 2 received videos of the same instructions in Arabic sign language. Knowledge regarding oral health and hygiene practice was evaluated with the aid of a questionnaire before and after 4 weeks.ResultsThe estimated marginal mean of the knowledge regarding oral hygiene in Group 1 was 3.37, which was slightly increased to 4.40 after 4 weeks of general instructions. The estimated marginal mean in Group 2 was 3.70 before the distribution of the videos, which was significantly increased to 11 after 4 weeks (P < .001).ConclusionVideos of oral hygiene instructions in Arabic sign language had immensely improved knowledge regarding oral health and hygiene practices in the deaf/hearing impaired patients in this study.