bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to the effective de-escalation of conflict behaviours in forensic high-secure settings: A qualitative study
Authors: Goodman Helena Mary , Brooks Cat Papastavrou , Price Owen , Barley Elizabeth Alexandra 
Published: November 2019

Abstract
Background: Violent and aggressive incidents are common within mental health settings and are often managed using high-risk physical interventions such as restraint and seclusion. De-escalation is a potentially safer alternative first-line technique to manage conflict behaviours and prevent violence and aggression. There is limited research into the use of de-escalation in high-secure settings, and none which consider the patient or carer perspective. This study investigated staff, patient and carer perspectives on the barriers and facilitators to using de-escalation for conflict behaviours. Methods: Semi-structured individual interviews (n=12) and focus groups (n=3) were conducted with eight patients, four carers and twenty-five staff members in a high-secure hospital in England. Interviews and focus groups were informed by the theoretical domains framework and were digitally recorded, transcribed verbatim and analysed using framework analysis and the COM-B behaviour change model. Results: Four themes and 15 sub-themes (barrier and facilitators) were identified. Themes related to capabilities (building relationships: knowing the patient and knowing yourself), opportunities (filling the void: high-security as an inherently deprived environment; dynamic relationships) and motivation (keeping everyone safe). Strong staff-patient therapeutic relationships underpinned by trust, fairness, consistency and an awareness of the trauma-aggression link were considered key to successful de-escalation. Specific psychological and interpersonal skills including empathy, respect, reassurance, sincerity, genuine concern and validation of the patient perspective are needed to achieve this. Barriers related to the physical environment; organisational resources, practices and systems; staff traumatisation; hierarchical and punitive attitudes towards patient care, and an insufficient understanding of psychiatric diagnoses, especially personality disorder. It was apparent across themes that fear, which was experienced by both staff and patients, was a driver for many behaviours. Conclusions: This work has identified organizational and behaviour change targets for interventions seeking to reduce violence and restrictive practices through the use of de-escalation in high-secure hospitals. The potential for, and occurrence of, violence in such settings is high and leads to fear in patients and staff. The different factors which promote fear in each group should be addressed in de-escalation training.
The Fair Decision-making of Children and Adolescents with High-functioning Autism Spectrum Disorder from the Perspective of Dual-process Theories
Authors: Jin Peiying , Wang Yao , LI Yun , Xiao Yunhua , Li Chunyan , Qiu Nana , Weng Jiao , Fang Hui , Ke Xiaoyan 
Published: November 2019

Abstract
Background: Fairness, as a core component of moral society, has received much attention. At present, there are inconsistencies in the findings regarding the fair decision-making of high-functioning autism spectrum disorder (HF-ASD). Previous studies have shown that the fair decision-making of typically developing children is influenced by theory of mind(ToM) and executive function(EF).Dual-process theories propose that both intuitive processes and reasoning processes participate in fair decision-making. As those with HF-ASD have defects in both domains, this study aims to explore the differences in fair decision-making between children and adolescents with HF-ASD and those with typical development (TD). Methods: We used a mini ultimatum game (mini-UG) to explore 31 children and adolescents with HF-ASD and 38 children and adolescents with TD. Ttests and chi-square tests are used to compare group differences, Pearson correlation analysis and stepwise regression analysis was used to analyse the influencing mechanism of the two groups' unfair acceptance rates. Results: The results showed that children with HF-ASD were more likely to accept unfair offers, but when it came to adolescents, the difference was no longer significant. Regression analysis showed that the interaction between the Behavioral Regulation Index(BRI) and age could negatively predict the unfair acceptance rate of children and adolescents with HF-ASD. Working memory and ToM can negatively predict the unfair acceptance rate of those with TD. Conclusion: This study concluded that the development of fair decision-making by children and adolescents with HF-ASD fell far behind that of those with TD. Intuition processes play a dominant role in the fair decision-making processes of children and adolescents with HF-ASD, and we believe that comorbidity, age, experience and emotional management are important factors influencing the fair decision-making of individuals with HF-ASD.
Dimensions of leisure-time physical activity and risk of depression in the “SEGUIMIENTO UNIVERSIDAD DE NAVARRA” (SUN) prospective cohort
Authors: Montero Alejandro Fernández , Moreno-Galarraga Laura , Sánchez-Villegas Almudena , Lahortiga-Ramos Francisca , Ruiz-Canela Miguel , Martínez-González Miguel Ángel , Molero Patricio 
Published: November 2019

Abstract
Background An inverse association between total leisure-time physical activity (LTPA) and depression has been previously documented in the scientific literature. Our objective was to prospectively assess the association of LTPA with the risk of depression, focusing on several dimensions of LTPA (intensity, duration and type). Methods The SUN (Seguimiento Universidad de Navarra) project is a prospective cohort study formed by Spanish university graduates. A total of 15,488 adults (40.2% men, mean age 37±12 years) initially free of depression were assessed. A report of a validated medical diagnosis of depression or the habitual use of antidepressants (any of both) were considered as incident cases of depression. LTPA was estimated through previously validated self-reported questionnaires. Participants were classified following Physical Activity recommendations from the World Health Organization, and according to the intensity, duration and type of LTPA. Cox proportional hazards regression models were run, adjusted for demographic, lifestyle, and dietary factors, to estimate adjusted hazard ratios (HR) of depression and 95% confidence intervals (CI). Results During 163,059 person-years of follow-up we registered 870 incident cases of depression. Participants with higher total LTPA (METs-h/week) and higher duration of LTPA (hours/week) exhibited a lower risk of depression HR=0.84 (95% CI: 0.72-0.99) and HR=0.83 (0.70-0.99) respectively, whereas intensity of LTPA (MET) did not show any association with depression. Conclusion Participants with higher LTPA had a lower risk of depression. The inverse association was stronger for total LPTA time than for its intensity. Higher duration of LTPA should be encouraged to prevent depression.
Low sense of coherence in long-term follow up of adolescents with anorexia nervosa
Authors: Vagedes Jan , Kleih Theresa , Simmance Cara , Svaldi Jenifer , Hautzinger Martin , von Schoen-Angerer Tido 
Published: November 2019

Abstract
Background: Sense of coherence is a personal resource known to be low in eating disorders. We wanted to know if sense of coherence is still correlated to anorexia symptoms several years after initial hospitalisation for anorexia. Methods: 86 former female patients diagnosed with anorexia were contacted 5-11 years after hospitalisation in a German hospital; 68 of 149 women (46%) could be contacted and agreed to participate in a survey with the Eating Disorder Inventory (EDI-2) and the Sense of Coherence Questionnaire (SOC-13). Results: 17.6% of participants stated that they suffered from an eating disorder currently, with 7.4% having anorexia nervosa. Mean EDI-2 subscales (except for the bulimia sub-scale) were in the <40th percentile for women with anorexia. Sense of coherence was low (percentile rank 20). All EDI-2 subscales correlated negatively with the SOC-13 score (p<0.01). Conclusions: The sense of coherence is low in long-term follow up of anorexia nervosa and is correlated with on-going anorexia symptoms.
Tumor Characteristics and Treatment Outcomes of Older Women with Breast Cancer in a Developing Country
Authors: Abdel-Razeq Hikmat , Rahman Fadwa Abdel , Al-Masri Hanan , Abdelelah Hazem , Nasser Mahmoud Abu , Salam Mourad , Taqash Ayat 
Published: November 2019

Abstract
Background Less than 10% of newly diagnosed breast cancer in our region are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and have poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in such patients.Patients and methods Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes.Results A total of 553 patients, median age 70 (range: 65-91) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), GIII in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (34.0%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.0001) and for those with node-negative compared to node-positive disease; 85.4% vs. 74.1%, P=0.0024. On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.0476).Conclusions Older Jordanian women with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Because of comorbidities and poor performance status, some patients were not aggressively treated.
Perinatal Mood and Anxiety Disorders, Serious Mental Illness, and Delivery-Related Health Outcomes, United States, 2006-2015
Authors: McKee Kimberly Schmitt , Admon Lindsay K. , Winkelman Tyler N. A. , Muzik Maria , Hall Stephanie , Dalton Vanessa K. , Zivin Kara 
Published: November 2019

Abstract
Purpose: National estimates of perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI) among delivering women over time, as well as associated outcomes and costs, are lacking. We examined the prevalence of perinatal mood and anxiety disorders and serious mental illness, from 2006-2015 and associated risk of adverse obstetric outcomes, including severe maternal morbidity and mortality (SMMM), and delivery costs. Methods: We conducted a serial, cross-sectional analysis using National Inpatient Sample data. We estimated the prevalence of PMAD and SMI among delivering women as well as obstetric outcomes, healthcare utilization, and delivery costs using adjusted weighted logistic with predictive margins and generalized linear regression models, respectively. Results : We identified an estimated 39,025,974 delivery hospitalizations from 2006-2015 in the U.S. PMAD increased from 18.4 (95% CI 16.4-20.0) to 40.4 (95% CI 39.3-41.6) per 1,000 deliveries. SMI also increased among delivering women over time, from 4.2 (95% CI 3.9-4.6) to 8.1 (95% CI 7.9-8.4) per 1,000 deliveries. Medicaid covered 72% (95% CI 71.2-72.9) of deliveries complicated by SMI compared to 44% (95% CI 43.1-45.0) and 43.5% (95% CI 42.5-44.5) among PMAD and all other deliveries, respectively. Women with PMAD and SMI experienced higher incidence of SMMM, and increased hospital transfers, lengths of stay, and delivery-related costs compared to other deliveries ( P <.001 for all). Conclusion : Over the past decade, the prevalence of both PMAD and SMI among delivering women increased substantially across the United States, and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries.
Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses
Authors: Hu Yanli , Jiao Miaorui , Li Fan 
Published: November 2019

Abstract
Background: Although spiritual care is a basic element of holistic nursing, nurses' spiritual care knowledge and abilities are often unable to satisfy patients' spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care.
Design: A non-randomized controlled trial.
Objective : To establish a spiritual care training protocol and verify its effectiveness.
Methods: This study recruited 92 nurses at a cancer-treatment hospital in a certain province via voluntary sign-up. The nurses were divided into two groups: the experimental group (45 people) and the control (wait-listed) group (47 people) using a coin-toss method. The experimental group received one spiritual care group training session each six months based on their routine nursing education; this training chiefly consisted of lectures by experts, group interventions, clinical practice, and case sharing. The control group participated in monthly nursing education sessions organized by the hospital for 12 continuous months.
Results : After 12 months of intervention, the nurses in the experimental group had significantly higher overall spiritual health and spiritual care competency scores as well as significantly higher scores on all individual dimensions compared with those in the control group ( P <0.01).
Conclusions: A spiritual care training protocol for nurses based on the concept of mutual growth with patients enhances nurses' spiritual well-being, spiritual care competencies.Trial registration: ChiCTR1900020930. Registered 22 January 2019.
Transcriptomic profiling and discovery of key genes involved in adventitious root formation from green cuttings of highbush blueberry (Vaccinium corymbosum L.)
Authors: An Haishan , Zhang Jiaying , Xu Fangjie , Jiang Shuang , Zhang Xueying 
Published: November 2019

Abstract
Background Propagation of cuttings was mostly used in various plant species including blueberry, the special root characteristics of blueberry usually resulted in a difficulty in adventitious root (AR) formation. The AR formation was influenced by various factors, of which auxin was considered to play a center role, however little is known of the related regulative mechanisms. In this study, transcriptome analysis using RNA_seq from the stem of green cuttings of southern highbush blueberry 'Biloxi' was performed to discover candidate genes associated with AR formation.Results Rooting phenotypes, especially rooting rate, was significantly promoted by exogenous auxin IBA application. The adventitious root primordium initiation (rpi) began to be formed at 14 day (d) after cutting, developed into root primordium (rp) at 21d, finally the rp further developed to mature AR at 28d. Higher IAA and lower ABA and zeatin might facilitate the AR formation and development. A time series transcriptome analysis indentified 14970 differentially expressed genes (DEGs) during AR formation, of which there were 7467 up-regulated and 7503 down-regulated genes, respectively. Of these, about 35 candidate DEGs involved in auxin-induced pathway and AR formation were further identified, including 10 auxin respective genes ARFs and SAURs , 13 transcription factors LOB domain-containing protein ( LBD s), 6 auxin transporter AUX22 , LAX3/5 and PIN-like 6s ( PIL6s ) and 6 rooting-associated genes root meristem growth factor 9 ( RGF9 ), lateral root primordium 1 ( LRP1s ), dormancy-associated protein homolog 3 ( DRMH3 ). All these identified DEGs were highly up-regulated in certain AR developed stage, indicating their potential roles in blueberry AR formation.Conclusions The transcriptome profiling indicated candidate genes or major regulative factors that influence adventitious root formation in blueberry, and provided a comprehensive understanding of rooting mechanism of the auxin-induced AR formation from blueberry green cuttings.
Polymorphisms of ATP-binding cassette, sub-family A, member 4 (rs560426 and rs481931) and non-syndromic cleft lip/palate: A systematic review and meta-analysis
Authors: Imani Mohammad Moslem , Safaei Mohsen , Lopez-Jornet Pia , López Eduardo Pons-Fuster , Sadeghi Masoud 
Published: November 2019

Abstract
Background A number of gene loci are closely associated with the incidence of non-syndromic cleft lip/palate (NSCL/P). Herein, this meta-analysis assessed the association between ATP-binding cassette, sub-family A, member 4 (ABCA4) polymorphisms (rs560426 and rs481931) and the risk of NSCL/P by reviewing case-control studies.Methods Four databases including Scopus, Cochrane Library, Web of Science, and PubMed were searched for articles published up to December 2018. The Review Manager 5.3 software was used to calculate the crude odds ratio (OR) and 95% confidence interval (CI).Results Of 82 retrieved studies, 12 were analyzed in this meta-analysis (2,859 NSCL/P patients and 3,792 controls for ABCA4 rs560426 polymorphism and 1,333 NSCL/P patients and 1,884 controls for ABCA4 rs481931 polymorphism). There was no significant association between the polymorphisms and the risk of NSCL/P, with the exception of the allelic model (OR=1.13; 95% CI: 1.01, 1.27; p=0.03), the homozygote model (OR=1.53; 95% CI: 1.01, 2.31; p=0.04), and the recessive model (OR=1.30; 95% CI: 1.03, 1.63; p=0.03) in the Asian ethnicity for rs560426 polymorphism.Conclusion The findings confirmed that G allele and GG genotype of rs560426 polymorphism were significantly associated with the risk of NSCL/P in the Asian population, but not for rs481931polymorphism. Also, there was no association between both polymorphisms (rs560426 and rs481931) with the risk of NSCL/P in the Caucasian and the mixed ethnicities, as well as the source of controls. Therefore, ethnicity may play a significant role in this association.
Identification and analysis of KLF13 variants in patients with congenital heart disease
Authors: Li Wenjuan , Li Baolei , Li Tingting , Zhang Ergeng , Wang Qingjie , Chen Sun , Kun Sun 
Published: November 2019

Abstract
Background: The protein Kruppel-like factor 13 (KLF13) is a member of the KLF family that has been identified as a novel cardiac transcription factor which is involved in heart development. However, the relationship between KLF13 variants and CHDs in humans remains largely unknown. The present study aimed to screen the KLF13 variants in CHDs patients and genetically analyze the function of these variants. Methods: KLF13 variants were sequenced in a cohort of 309 CHD patients and population-matched healthy controls (n = 200) using targeted sequencing. To investigate the effect of variants on the functional ability of the KLF13 protein, the expressions and subcellular localization of protein, as well as the transcriptional activities of downstream genes and physically interacted with other transcription factor were assessed. Results: Two novel heterozygous variants, c.487C>T (P163S) and c.467G>A (S156N), were identified in two out of 309 CHDs patients with Tricuspid-valve atresia and transposition of the great arteries, respectively. No variants were found among healthy controls. The variant c.467G>A (S156N) increased protein expression and enhanced functionality compared with that of wild-type, without affecting the subcellular localization. The other variant, c.487C>T (P163S), did not show any abnormalities in protein expression and subcellular localization, however it eliminated the transcriptional activities of downstream target genes and physically interacted with TBX5, another cardiac transcription factor. Conclusion: Our results show that the S156N and P163S variants contributed to CHD etiology. Additionally, our findings suggest that KLF13 may be a potential gene contributing to congenital heart disease.
Genome-Wide Association Study of Prevalent and Persistent Cervical High-Risk Human Papillomavirus(HPV) Infection
Authors: Adebamowo Sally N. , Adeyemo Adebowale A , Rotimi Charles N , Olaniyan Olayinka , Offiong Richard B. , Adebamowo Clement A 
Published: November 2019

Abstract
Background: Genetic factors may influence the susceptibility to high-risk human papillomavirus (hrHPV) infection and persistence. We conducted the first genome-wide association study (GWAS) to identify variants associated with cervical hrHPV infection and persistence. Methods: Participants were 517 Nigerian women evaluated at baseline and 6 months follow-up visits for HPV. HPV was characterized using SPF10/LiPA25. hrHPV infection was positive if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was done using the Illumina Multi-Ethnic Genotyping Array (MEGA) and imputation was done using the African Genome Resources Haplotype Reference Panel. Association analysis was done under additive genetic models adjusted for age, HIV status and the first principal component (PC) of the genotypes. Results: The mean (±SD) age of the study participants was 38 (±8) years, 48% were HIV negative, 24% were hrHPV positive and 10% had persistent hrHPV infections. The top three variants associated with hrHPV infections were intronic variants clustered in KLF12 (all OR: 7.06, p=1.43 x 10-6). The top variants associated with cervical hrHPV persistence were in DAP(OR: 6.86, p=7.15 x 10-8), NR5A2(OR: 3.65, p=2.03 x 10-7) and MIR365-2(OR: 7.71, p=2.63 x 10-7) gene regions. Conclusions: This exploratory GWAS yielded novel candidate risk loci for cervical hrHPV infection and persistence. The identified loci have biological annotation and functional data supporting their role in hrHPV infection and persistence. Given our limited sample size, larger discovery and replication studies are warranted to further characterize the reported associations.