bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved detection of hepatocellular carcinoma by dynamic computed tomography in cirrhotic patients with chronic hepatitis B: A multicenter study
Authors: Kim Ji Hyun , Kang Seong Hee , Lee Minjong , Choi Hoon Sung , Jun Baek Gyu , Kim Tae Suk , Choi Dae Hee , Suk Ki Tae , Kim Moon Young , Kim Young Don , Cheon Gab Jin , Baik Soon Koo , Kim Dong Joon 
Published: March 2020

AbstractBackground and AimsCurrent guidelines for chronic hepatitis B (CHB) patients are to undergo surveillance for hepatocellular carcinoma (HCC) with 6‐monthly ultrasonography (US). However, sensitivities of US to detect early‐stage HCC in cirrhotic patients are suboptimal. We aimed to compare overall survival and detection rates of very‐early‐stage HCC in two groups: group A, undergoing 6‐monthly US versus group B, undergoing 6‐monthly US alternating with dynamic computed tomography (CT).MethodsThis retrospective multicenter study assessed 1235 cirrhotic patients with CHB under entecavir/tenofovir therapy from 2007 to 2016. The primary endpoint was overall survival rates between the two groups. The Cox proportional hazards model and propensity score matching analyses were used to assess the effect of surveillance modalities on overall survival and detection of Barcelona Clinic Liver Cancer stage 0 HCC after balancing.ResultsDuring a median follow‐up of 4.5 years, 10‐year cumulative HCC incidence rates of 16.3% were significantly higher in group B (n = 576) than 13.7% in group A (n = 659; P < 0.001). However, in patients with HCC, 10‐year overall survival rates of 85.1% were significantly higher in group B than 65.6% in group A (P = 0.001 by log‐rank test). CT exam alternating with US was independently associated with reduced overall mortality (hazard ratio 0.47, P = 0.02). Cumulative incidence of Barcelona Clinic Liver Cancer stage 0 HCC was significantly higher in group B than in group A (hazard ratio 2.82, P < 0.001).ConclusionIn cirrhotic patients with CHB, dynamic CT exam alternating with US led to higher detection rates of very‐early‐stage HCC and benefit of overall survival than did US exams.
A Critical Review: Moral Injury in Nurses in the Aftermath of a Patient Safety Incident
Authors: Stovall Mady , Hansen Lissi , van Ryn Michelle 
Published: March 2020

AbstractBackgroundTo date, there has been no published work towards understanding or classifying patient safety incidents (PSIs) or their aftermath as potential morally injurious experiences (pMIEs). A morally injurious experience is one that violates deeply held moral values and beliefs, and can put an individual at risk for burnout, post‐traumatic stress disorder, and other trauma‐related problems. This can also set the stage for moral injury, which can occur when there has been a betrayal of what is right by someone in a position of legitimate authority, or by one’s self, in a high‐stakes situation.ObjectiveThe objective of this review of nurse second victim literature is to describe symptoms of moral injury empirically observed in nurses in the aftermath of a PSI.MethodsA critical review using a SALSA (search, appraisal, synthesis, analysis) method commenced with a search of electronic data base–indexed original evidence between 1980 and December 2018, focusing on registered nurses involved with a PSI.ResultsThe nurse empirical literature reviewed included qualitative (n = 10), quantitative (n = 7), and mixed‐methods (n = 4) studies (total n = 21). Core moral injury symptoms included guilt (67%), shame (71%), spiritual‐existential crisis (9%), and loss of trust (52%). Secondary symptoms of moral injury included depression (33%), anxiety (57%), anger (71%), self‐harm, (19%), and social problems (48%).ImplicationsMoral injury better describes what historically has been called the nurse second victim phenomenon. Through identification of pMIEs and symptoms of moral injury, nurses and organizations can be empowered to advance training and intervention programs addressing pMIEs that affect nurses’ safety and retention in the aftermath of a PSI.Clinical RelevanceBy describing the experiences associated with a PSI as potentially morally injurious, we set the stage to describe the potential consequences associated with the aftermath of the PSI. Furthermore, this language avoids victimizing those involved by more accurately reflecting the pMIEs of the aftermath.
Healthcare professionals providing care coordination to people living with multimorbidity: An interpretative phenomenological analysis
Authors: Peart Annette , Lewis Virginia , Barton Chris , Russell Grant 
Published: March 2020

AbstractAims and objectivesTo explore the healthcare professionals (HCP) experience of providing care coordination to people living with multimorbidity.BackgroundThere is increasing interest in improving care of people living with multimorbidity who need care coordination to help manage their health. Little is known about the experiences of HCP working with people living with multimorbidity.DesignPhenomenological approach to understanding the experiences of HCP.MethodsWe interviewed 18 HCP, including 11 registered nurses, working in care coordination in Melbourne, Australia. We used interpretative phenomenological analysis to identify themes from descriptions of providing care, identifying and responding to a person’s needs, and the barriers and facilitators to providing person‐centred care.ResultsWe identified four themes as follows: (a) Challenge of focusing on the person; (b) “Hear their story,” listening to and giving time to clients to tell their story; (c) Strategies for engagement in the programme; and, (d) “See the bigger picture,” looking beyond the disease to the needs of a person. Our results are reported using COREQ.ConclusionsThe HCP experienced challenges to a traditional approach to care when focusing on the person. They described providing care that was person‐centred, and acknowledged that optimal, guideline‐oriented care might not be achieved. They took the necessary time to hear the story and see the context of the person’s life, to help the person manage their health.Relevance to clinical practiceFor registered nurses in care coordination programmes, focusing on the client may challenge traditional approaches to care. Providing care involves developing a relationship with the client to optimise health outcomes. Experienced registered nurses appear to use skills in reflective practice and accept the parameters of care to improve the client’s health and well‐being.
Identified opportunities for gamification in the elective primary fast‐track total hip and knee arthroplasty journey: Secondary analysis of healthcare professionals’ interviews
Authors: Jansson Miia , Koivisto Jonna , Pikkarainen Minna 
Published: March 2020

AbstractAims and objectivesTo identify opportunities for gamification in the elective primary fast‐track total hip and knee arthroplasty journey in order to support patients’ health‐related behaviour.BackgroundGamification provides an opportunity to increase engagement in a given health behaviour and, eventually, the possibility of reaching improved outcomes through continued or consistent behaviour.DesignA secondary analysis.MethodsSemi‐structured interviews were conducted with 20 healthcare professionals in a single joint‐replacement centre in Finland during autumn 2018. NVivo software was used for deductive and inductive coding. The open codes were also calculated. The consolidated criteria for reporting qualitative research were followed.ResultsGamification opportunities were identified related to six dimensions: accomplishment, challenge, competition, guided, playfulness and social experience. Based on the frequencies of the coded content, most opportunities for gamification can be identified in the context of personalised counselling, monitoring and social support.ConclusionsSeveral opportunities for gamification were identified and quantified. While various needs and limitations need to be considered when developing digital gamified solutions and more research into the effectiveness of such solutions will be required, the current study opens possible future avenues for exploring the use of gamification in lower limb joint replacement journey and other specialisms.Relevance to clinical practiceThis study provides an important insight into healthcare professionals’ views of the current state of the total hip and knee arthroplasty journey and the potential for its development. In addition, it pinpoints the biggest opportunities for gamified services in the context of personalised counselling, monitoring and social support. Despite the focus of this secondary analysis being on the arthroplasty journey, the findings can also be generalised in other surgical journeys.
Pain assessment and interventions by nurses in the emergency department: A national survey
Authors: Varndell Wayne , Fry Margaret , Elliott Doug 
Published: March 2020

AbstractAimThe aim of this study was to examine the knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses.BackgroundPain is the most commonly reported symptom in patients presenting to the emergency department, with over half rating their pain as moderate‐to‐severe. Patients unable to communicate, such as critically ill intubated patients, are at greater risk of inadequate pain management.DesignThis cross‐sectional exploratory study used survey methodology to explore knowledge, perceptions and factors influencing pain management practices among Australian emergency nurses.MethodsAustralian emergency nurses were invited to complete an online survey comprising 91 items. The response rate was 450 of 1,488 (30.2%). STROBE guidelines were used in reporting this study.ResultsVariations in level of acute pain management knowledge, especially in older, cognitively impaired or mechanically ventilated patients were identified. Poor interprofessional communication, workload and staffing negatively impacted on nurses’ intention to administer analgesia. For intubated patients, validated observation pain assessment instruments were rarely used, although respondents recognised the importance of pain management in critically ill patients.ConclusionsEmergency nurses recognise the importance of pain relief. The ability to nurse‐initiate analgesia, education and training in pain management education is variable. Little education is provided on assessing and managing acute pain in elderly, cognitively impaired or mechanically ventilated patients. Use of validated pain assessment instruments to assess pain in critically ill patients is poor.Relevance to clinical practiceWhile pain management is the responsibility of all healthcare professionals, in the emergency department, it is a core role of emergency nursing. This study highlights the variation in ability to nurse‐initiate analgesia, level of acute pain knowledge, education and training, and use of validated pain assessment instruments to guide pain management in critically ill intubated patients.
Nonverbal communication between registered nurses and patients during chronic disease management consultations: Observations from general practice
Authors: James Sharon , Desborough Jane , McInnes Susan , Halcomb Elizabeth J. 
Published: March 2020

AbstractAims and objectivesThis study explores nonverbal communication behaviours between general practice nurses and patients during chronic disease consultations.BackgroundNonverbal communication is an important aspect of nurse–patient lifestyle risk reduction conversations. Despite the growing role of general practice nurses in lifestyle risk modification when managing chronic disease, few studies have investigated how this communication occurs.DesignObservational study within a concurrent mixed methods project.MethodsThirty‐six consultations by 14 general practice nurses were video‐recorded between August 2017 and March 2018. Video analysis used the Nonverbal Accommodation Analysis System. The STROBE checklist was used to guide this paper.ResultsJoint convergence of nurse–patient behaviours such as laughing, smiling and eye contact was most common (44%; n = 157). Patient–nurse eye contact time decreased significantly across the consultation, while nurse gesturing increased significantly. No significant relationship between consultation length and convergent to divergent behaviour categorisation or nurse–computer use across the consultation was found.ConclusionsThe high levels of convergent behaviours are promising for person‐centred care. However, scope exists to enhance nonverbal interactions around lifestyle risk reduction. Supporting nurses with skills and improved environments for lifestyle risk communication has potential to improve therapeutic relationships and patient outcomes.Relevance to clinical practiceThese results indicate that nurses support patients through nonverbal interactions during conversations of lifestyle risk reduction. However, there are opportunities to improve this practice for future interventions.
When Three’s (Good) Company: Third‐Party Friendships on Cooperation across Departments
Authors: Wong Sze‐Sze , Boh Wai Fong , Wu Anne 
Published: March 2020

AbstractThe social embeddedness perspective highlights that socially embedded dyads are more cooperative than dyads that are not embedded by common third parties. Going beyond the traditional emphasis on the number of third parties, our study examines which third parties are more influential in promoting cooperation in interdepartmental dyads. Based on the logic of dependence from interdependence theory, we show that providers are more cooperative to recipients when third‐party friends have more organizational knowledge to offer socio‐emotional support to providers, but this effect is reduced when providers themselves have more organizational knowledge. Third‐party influence is also marginally attenuated when providers have a larger circle of friends. Overall, our findings advance the social embeddedness perspective by instilling a greater appreciation for dyad member’s dependence upon the third party in explaining third‐party influence on cooperation.
A new phoenix? Large plants regeneration policies in Italy
Authors: Accetturo Antonio , Albanese Giuseppe , D'Ignazio Alessio 
Published: March 2020

AbstractThe fall of employment in manufacturing that the world's most advanced economies have been experiencing in the past 40 years has triggered a number of policies, undertaken in several countries. In this paper, we evaluate the effectiveness of a place‐based policy, carried out in Italy, aimed at both generating private investments and increasing employment in areas affected by deep industrial decline. By means of an instrumental variable identification strategy, we show that the program has been largely unsuccessful.
Ant‐eating spider maintains specialist diet throughout its ontogeny
Authors: Gajski D. , Petráková L. , Pekár S. 
Published: March 2020

AbstractPredators should be selected to maximize their fitness by catching the most profitable prey. As predators grow in size, they often shift their preferences to larger prey during the course of development. Alike generalist predators, specialized predators should also shift to larger prey within the pool of focal prey. Here, we have studied the natural diet of a specialized ant‐eating spider Zodarion rubidum by means of molecular methods. We tested the hypothesis of a trophic shift during postembryonic ontogenesis and if there is a difference in the diet between sexes due to sexual dimorphism. In addition, a feeding trial was performed to estimate the time at which prey DNA can be detected. The diet of all stages consisted solely of ants (nine genera), thus confirming their strict ant specialization. There was no shift in prey size or prey type during ontogenetic development, but the diversity of prey declined with age. In adult males, very few prey were detected. The feeding trial showed that prey DNA can be detected inside the spider's gut up to 2 weeks after feeding.
A model for the relationship between wing fray and chronological and ovarian ages in tsetse (Glossinaspp)
Authors: Hargrove J. W. 
Published: March 2020

AbstractAge‐dependent mortality changes in haematophagous insects are difficult to measure but are important determinants of population dynamics and vectorial capacity. A Markov process was used to model age‐dependent changes in wing fray in tsetse (Glossinaspp), calibrated using published mark–recapture data for maleG. m. morsitansin Tanzania. The model was applied to femaleG. m. morsitans, captured in Zimbabwe using a vehicle‐mounted electric net and subjected to ovarian dissection and wing fray analysis. Rates of fray increased significantly with age in males but not females, where the rate was constant for ovarian categories 0–3. A jump in mean fray between ovarian categories 3 and 4 + 4nis consistent with the latter category including flies that have ovulated 4, 8, 12, 16 times and so on. The magnitude of the jump could, theoretically, facilitate improved mortality estimates. In practice, although knowledge of fly mortality was required for modelling wing fray, mortality estimates derived from ovarian dissection data are independent of patterns and rates of change in wing fray. Significantly better fits to ovarian age data resulted when age‐specific mortality was modelled as the sum of two exponentials, with high mortality in young and old flies, than when mortality was constant at 2.3% per day.
Adaptive regulation of virulence genes by microRNA‐like RNAs in Valsa mali
Authors: Xu Ming , Guo Yan , Tian Runze , Gao Chen , Guo Feiran , Voegele Ralf T. , Bao Jiyuan , Li Chenjing , Jia Conghui , Feng Hao , Huang Lili 
Published: March 2020

Summary

MicroRNAs play important roles in the regulation of gene expression in plants and animals. However, little information is known about the action mechanism and function of fungal microRNA‐like RNAs (milRNAs).

In this study, combining deep sequencing, molecular and histological assays, milRNAs and their targets in the phytopathogenic fungus Valsa mali were isolated and identified. A critical milRNA, Vm‐milR16, was identified to adaptively regulate the expression of virulence genes.

Fourteen isolated milRNAs showed high expression abundance. Based on the assessment of a pathogenicity function of these milRNAs, Vm‐milR16 was found to be a critical milRNA in V. mali by regulating sucrose non‐fermenting 1 (VmSNF1), 4,5‐DOPA dioxygenase extradiol (VmDODA), and a hypothetical protein (VmHy1). During V. mali infection, Vm‐milR16 is downregulated, while its targets are upregulated. Overexpression of Vm‐milR16, but not mutated Vm‐milR16, significantly reduces the expression of targets and virulence of V. mali. Furthermore, deletion of VmSNF1, VmDODA and VmHy1 significantly reduce virulence of V. mali. All three targets seem to be essential for oxidative stress response and VmSNF1 is required for expression of pectinase genes during V. mali–host interaction.

Our results demonstrate Vm‐milRNAs contributing to the infection of V. mali on apple trees by adaptively regulating virulence genes.
In and out of synchrony—Behavioral and physiological dynamics of dyadic interpersonal coordination
Authors: Mayo Oded , Gordon Ilanit 
Published: March 2020

AbstractInterpersonal synchrony, the temporal coordination of actions, emotions, thoughts and physiological processes, is a widely studied ubiquitous phenomenon. Research has already established that more synchrony is not always more beneficial, especially in the fields of emotional and physiological synchrony. Despite this fact, the dominant tone in the literature is that behavioral interpersonal synchrony is a pro‐social phenomenon, and hence, in social contexts, more behavioral synchrony is generally considered better. In accordance with that tone, the naturally occurring dynamics of moving in and out of synchrony have rarely been studied or considered as an adaptive state. In the present article, we aim to present a new model of interpersonal synchrony, based on the existing literature assessing synchrony as well as the ideas of complex dynamical systems. At the core of our model is the idea that two tendencies exist simultaneously, one to synchronize with others and another to move out of synchrony and act independently. We suggest that an adaptive interpersonal system is a flexible one, able to continuously adjust itself to the social context. We suggest that the concept of meta‐stability might be a marker of such a flexible interpersonal system. Moreover, the model considers both behavioral and physiological aspects in order to provide a more extensive account. We present research implications of the model, as well as a demonstration of the model's applicability to data, and provide code researchers can use to analyze their own data in these methods. Finally, we discuss future directions in detail.
Relationship between reproductive and productive traits in Holstein cattle using multivariate analysis
Authors: Dominguez‐Castaño Pablo , Vargas de Oliveira Matheus Henrique , El Faro Lenira , de Vasconcelos Silva Josineudson Augusto II 
Published: March 2020

AbstractMultivariate procedures are used for the extraction of variables from the correlation matrix of phenotypes in order to identify those traits that explain the largest proportion of phenotypic variation and to evaluate the relationship structure between these traits. The reproductive traits (days from calving to first estrus [CFE], days from calving to last service [CLS], calving interval [CI] and gestation length [GL]) and milk production traits (milk yield at 305 days of lactation [MY305], peak yield [PY] and milk yield per day of calving interval [MYCI]) of 5,217 Holstein females (primiparous and multiparous) were measured. Principal component analysis (PCA) and factor analysis of the correlation matrix were used to estimate the correlation between traits. Analysis grouped the seven traits into three principal components and four latent factors that retained approximately 81.5% and 88.9% of the total variation of the data, respectively. The production variables exhibited positive phenotypic correlation coefficients of high magnitude (>.67). The phenotypic correlation estimates between the productive and reproductive traits were low, ranging from .13 to .22. A strong association (.99) was observed between CLS and CI. Our results indicate that multivariate analysis was effective in generating correlations between the traits studied, grouping the seven traits in a smaller number of variables that retained approximately 81% of the total variation of the data.
The Living Ladder: Introduction and Validity Over 6‐Month Follow‐Up of a One‐Item Measure of Readiness to Continue Living in Suicidal Patients
Authors: Britton Peter C. , Conner Kenneth R. , Maisto Stephen A. 
Published: March 2020

ObjectiveThe ability to predict suicide outcomes is limited by the lack of consideration of protective factors. This study examined the validity of the Living Ladder, a measure of readiness to continue living among individuals thinking of suicide.MethodsThe Living Ladder consists of one item that assesses an individual’s readiness to continue living when thinking about suicide. Participants (N = 130) completed the Living Ladder in‐person at baseline and by‐phone at 1‐, 3‐, and 6‐month follow‐up. The prospective association of the Living Ladder with suicidal ideation and risk for a suicide attempt was examined using models adjusting for baseline ideation and suicide attempts, respectively.ResultsEach rung on the Living Ladder was associated with 18% lower likelihood of suicidal ideation, OR (95% CI) = 0.82 (0.68, 0.96), and less severe suicidal ideation among those with ideation. Scores >2, indicating contemplation of living, were associated with 64% lower risk for a suicide attempt, HR (95% CI) = 0.36 (0.13, 0.98). Findings for suicidal ideation were replicated when administered by‐phone.ConclusionsThe Living Ladder is a one‐item measure that is prospectively associated with suicidal ideation and suicide attempts. Findings support the relevance of motivation to live to suicide outcomes.