bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Advanced Practice Provider Staffing on Emergency Department Care: Productivity, Flow, Safety, and Experience
Authors: Pines Jesse M. , Zocchi Mark S. , Ritsema Tamara , Polansky Maura , Bedolla John , Venkat Arvind ,   for the US Acute Care Solutions Research Group
Published: July 2020

AbstractObjectivesWe examined emergency department (ED) advanced practice provider (APP) productivity and how APP staffing impacted ED productivity, safety, flow, and experience.MethodsWe used 2014 to 2018 data from a national emergency medicine group. The exposure was APP coverage: APP hours as a percentage of total clinician hours at the ED‐day level. Multivariable regression was used to assess the relationship between APP coverage and productivity outcomes (patients/clinician hour, relative value units [RVUs]/clinician hour, RVUs/visit, and RVUs/salary‐adjusted hour), flow outcomes (length of stay and left without treatment), safety (72‐hour returns, incident reports), and experience (Press‐Ganey scores), adjusting for patient and facility characteristics.ResultsIn 13.02 million patient visits in 105,863 ED‐days across 94 EDs from 2014 to 2018, nurse practitioners and physician assistants managed 5.4 and 18.6% of visits independently, 74.6% by emergency physicians alone, and 1.4% jointly. APP visits had lower RVUs/visit (2.8 vs. 3.7) and lower patients/hour (1.1 vs. 2.2) compared to physician visits. Higher APP coverage (by 10%) at the ED‐day level was associated with lower patients/clinician hour by 0.12 (95% confidence interval [CI] = −0.15 to −0.10) and lower RVUs/clinician hour by 0.4 (95% CI = −0.5 to −0.3). There was no impact of increasing APP coverage on RVUs/salary‐adjusted hour or RVUs/visit. There was also no effect of increasing APP coverage on flow, safety, or patient experience.ConclusionIn this group, APPs treated less complex visits and half as many patients/hour compared to physicians. Higher APP coverage allowed physicians to treat higher‐acuity cases. We found no economies of scale for APP coverage, suggesting that increasing APP staffing may not lower staffing costs. However, there were also no adverse observed effects of APP coverage on ED flow, clinical safety, or patient experience, suggesting little risk of increased APP coverage on clinical care delivery.
Predictive values of heart rate variability, deceleration and acceleration capacity of heart rate in post‐infarction patients with LVEF ≥35%
Authors: Liu Xiang , Xiang Li , Tong Guangming 
Published: July 2020

AbstractBackground and aimsThe aim was to investigate the predictive values of heart rate variability, deceleration, and acceleration capacity of heart rate in sudden cardiac death in postinfarction patients with left ventricular ejection fraction (LVEF) ≥ 35%.MethodsWe enrolled 138 acute myocardial infarction patients (MI) randomly in sinus rhythm with LVEF ≥ 35% after myocardial infarction. Data on heart rate variability, deceleration runs, deceleration, and acceleration capacity were obtained from 24h‐dynamic electrocardiogram recordings. Clinical characteristics, medications, and echocardiography data were noted. The endpoints were sudden cardiac arrhythmias (SCA), including malignant arrhythmias in the hospital and viewed sudden death out of the hospital. Relationships between autonomic parameters and endpoints were evaluated.ResultsDuring follow‐up for over 24 months in MI patients, 10 patients occurred sudden cardiac arrhythmias. Subjects with SCA showed lower levels of SDNN (p = .018), TP (p = .007), VLF (p < .001), DC (p < .001), and low‐risk DRs (p < .001) than those without SCA. A low SDNN level (HR: 8.888, p = .006), low VLF level (HR: 14.699, p = .016), low DC level (HR: 4.430, p = .045), and higher risk DRs (HR: 3.81, p = .040) were identified as independent risk factors of SCA for postinfarction patients with LVEF ≥ 35%. The area under the ROC curve (AUC) of SDNN, VLF, and DC for identification of SCA were, respectively, 0.724 (p = .019), 0.807 (p < .001), and 0.804 (p = .002). SDNN, VLF, and DC combined assessment area under the ROC curve were 0.828 (p < .001).ConclusionDecreased SDNN, VLF, DC, and abnormal DRs are independently associated with increased risks of sudden cardiac arrhythmias in post‐MI patients with LVEF ≥ 35%. Combined SDNN, VLF, and DC may help identify a high‐risk group of malignant arrhythmias in postinfarction patients.
Tree‐gouging by marmosets (Primates: Callitrichidae) enhances tree turnover
Authors: Souza‐Alves João Pedro , Barbosa Guilherme V. , Hilário Renato Richard 
Published: July 2020

AbstractWe tested whether gouging by Callithrix jacchus affects tree survival. The proportion of dead gouged trees was higher than the proportion of dead non‐gouged trees, with larger effects on smaller trees. The number of holes did not affect tree survival. Tree‐gouging by marmosets may enhance forest turnover.Abstract in Portuguese is available with online material.
Robots as Malevolent Moral Agents: Harmful Behavior Results in Dehumanization, Not Anthropomorphism
Authors: Swiderska Aleksandra , Küster Dennis 
Published: July 2020

AbstractA robot's decision to harm a person is sometimes considered to be the ultimate proof of it gaining a human‐like mind. Here, we contrasted predictions about attribution of mental capacities from moral typecasting theory, with the denial of agency from dehumanization literature. Experiments 1 and 2 investigated mind perception for intentionally and accidentally harmful robotic agents based on text and image vignettes. Experiment 3 disambiguated agent intention (malevolent and benevolent), and additionally varied the type of agent (robotic and human) using short computer‐generated animations. Harmful robotic agents were consistently imbued with mental states to a lower degree than benevolent agents, supporting the dehumanization account. Further results revealed that a human moral patient appeared to suffer less when depicted with a robotic agent than with another human. The findings suggest that future robots may become subject to human‐like dehumanization mechanisms, which challenges the established beliefs about anthropomorphism in the domain of moral interactions.
‘Aerial Silk Roads’: Airport Infrastructures in China's Belt and Road Initiative
Authors: Lin Weiqiang , Ai Qi 
Published: July 2020

ABSTRACTThe Belt and Road Initiative (BRI) is widely touted as China's answer to development through international connectivity. The scheme has often been linked to China's objectives of crafting a new world order centred on itself and/or stabilizing its economy through externalizing surplus capacity. While important in broadly framing China's relationship with the world, this article posits that such a fixation on state‐centric visions of development leaves the door open for misinterpretation, mistaking the BRI for a coherent set of projects imposed ‘from above’. Delving into the execution of infrastructure planning on the ground, this article argues that taking a practice‐oriented approach to large‐scale developmental schemes can more accurately shed light on their internally fractured processes. Two airport projects in central China branded as part of the country's ‘aerial Silk Roads’ are examined to illustrate these dynamics, with particular attention paid to the airports’ shifting conceptualizations, the competitive motivations behind their (re)construction, and the social relations sustaining them. The authors argue that closely tracking the unfolding of a range of infrastructure planning practices within specific projects can demystify modern‐day developmental programmes like the BRI, by revealing how their ‘grand’ visions are often reinterpreted, altered and frustrated at local levels, even before they have a chance to influence the world.
Left atrial size and strain in elite athletes: A cross‐sectional study at the NBA Draft Combine
Authors: Cheema Baljash , Kinno Menhel , Gu David , Ryan Juliet , Mitter Sumeet , Rigolin Vera , Thomas James , Puthumana Jyothy 
Published: July 2020

AbstractIntroductionAtrial dilatation is common but of unclear physiologic significance in high‐performance athletes. Myocardial deformation analysis utilizing speckle‐tracking echocardiography has emerged as a promising tool to evaluate atrial function. In a cohort of elite basketball players attending the National Basketball Association (NBA) Draft Combine, we investigate changes in left atrial (LA) size as well as function as measured by strain.Methods and ResultsFrom 2013 to 2018, all male athletes who attended the NBA Draft Combine in Chicago, IL, received a cardiac evaluation including a comprehensive transthoracic echocardiogram. Using the P‐wave as the reference point, speckle‐tracking was utilized to measure LA booster, conduit, and reservoir strain over one cardiac cycle. Left atrial volume index (LAVI) of ≥34 mL/m2 was considered enlarged. 307 athletes received cardiac evaluation including a transthoracic echocardiogram, with 272 studies amenable for atrial strain analysis. Mean age was 21.0 years. Mean LAVI was 34.5 mL/m2 and LAVI was enlarged in 131 (48.2%) athletes. Comparing LA strain in those with enlarged vs normal sized atria, reservoir strain was significantly reduced (32.1% [SD 6.0%] vs 35.2% [SD 8.2%], P < .001), as was conduit strain (22.9% [SD 5.2%] vs 25.7% [SD 7.4%], P < .001), with no difference seen in booster strain (9.2% [SD 2.1%] vs 9.4% [SD 2.7%], P = .45).ConclusionIn this group of elite basketball players, LA enlargement was common and associated with reduced LA reservoir and conduit strain, with no difference in LA booster strain.
Elevated plasma high‐sensitivity C‐reactive protein at admission predicts the occurrence of post‐stroke fatigue at 6 months after ischaemic stroke
Authors: Liu X. , Wang B. , Wang X. , Tian M. , Wang X. , Zhang Y. 
Published: July 2020

Background and purposePost‐stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High‐sensitivity C‐reactive protein (hs‐CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs‐CRP and PSF after acute ischaemic stroke.MethodsIn all, 212 acute ischaemic stroke patients were consecutively recruited within the first 14 days after stroke onset and followed up for 6 months. Plasma hs‐CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score ≥ 43 is defined as PSF.ResultsSixty‐eight stroke patients (32.1%) were diagnosed with PSF at 6 months’ follow‐up. In the patients with PSF, plasma hs‐CRP levels were significantly higher compared with those in non‐PSF patients (t = −8.524, P ≤ 0.001). In multivariate analyses, plasma levels of hs‐CRP were independently associated with PSF at 6 months (odds ratio 3.435, 95% confidence interval 2.222–5.309; P ≤ 0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut‐off value of plasma hs‐CRP levels as an indicator for the prediction of PSF was projected to be 0.52 mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725–0.864; P ≤ 0.001).ConclusionElevated plasma hs‐CRP levels at admission were associated with PSF 6 months after stroke, suggesting that these alterations might predict the development of PSF in stroke patients.
Validity and reliability of the Indonesian version of the Pittsburgh Sleep Quality Index in adolescents
Authors: Setyowati Anggi , Chung Min‐Huey 
Published: July 2020

AbstractAimThe study aims to examine the psychometric properties of the Pittsburgh Sleep Quality Index‐Indonesian version.BackgroundThe Pittsburgh Sleep Quality Index has never been translated into Bahasa.DesignThis study employs a cross‐sectional and correlational study.MethodsData were collected from 528 adolescents of junior high school age (13–16 years) during August to September 2014. All participants agreed on the Indonesian version of Pittsburgh Sleep Quality Index and Beck Depression Inventory‐II. Psychometric properties were examined including internal consistency, construct validity and known group validity, and the receiver operating characteristic curve was used to measure the cut‐off point.ResultsThe Cronbach's alpha for the Pittsburgh Sleep Quality Index‐Indonesian version was adequate. There were positive correlations between the total score and seven component scores. Construct validity revealed that the total score of the Pittsburgh Sleep Quality Index‐Indonesian version was correlated with the total score of the Indonesian version of the Beck Depression Inventory‐II. Known group validity indicated that adolescents without depression risk had better sleep quality. According to receiver operating characteristic curve analysis, the cut‐off point at a score of 6.5 indicated the best possible relationship of sensitivity and specificity.ConclusionThe Pittsburgh Sleep Quality Index‐Indonesian version has high reliability and validity for screening sleep quality among adolescents.
Depressive symptoms, professional quality of life and turnover intention in Korean nurses
Authors: Pang Y. , Dan H. , Jung H. , Bae N. , Kim O. 
Published: July 2020

AimThe purpose of this study was to identify the effects of depressive symptoms and professional quality of life on turnover intention.BackgroundThe high turnover rate of nurses is a critical healthcare issue globally.IntroductionNurses often experience depressive symptoms and compassion fatigue due to the efforts of patient care. The impact of such psychological health issues on turnover intention needs to be confirmed.MethodsParticipants were 10 163 female nurses who completed an online or mobile survey using the Korea Nurses’ Health Study. To identify the influencing factors on the turnover intention of nurses, descriptive statistics, spearman’s correlation coefficients and multivariable ordinal logistic regression were performed.ResultsThe turnover intention increased by about 2.81–4.60 times when depressive symptom was moderate or more, 1.14 times when secondary traumatic stress disorder was moderate or more, and 1.54 times when burnout was moderate or more. When compassion satisfaction was moderate or high, the turnover intention decreased by 0.72 and 0.52 times.DiscussionKorean nurses demonstrated high levels of depressive symptoms, secondary traumatic stress and burnout, while demonstrating lower levels of compassion satisfaction. The results of this study demonstrate that depressive symptoms, secondary traumatic stress, burnout and compassion satisfaction affect turnover intention.ConclusionsTo reduce nurses’ turnover intention, it is necessary to reduce depressive symptoms and enhance the quality of professional life.Implications for nursing and health policyHospital managers need to maintain adequate nurse‐to‐patient ratios and provide nurses with a supportive work environment. Also, health policymakers need to identify factors affecting hospital nurses’ turnover intention and provide strategies to address them. These conditions may reduce the excessive workload placed on nurses, thereby preventing depression and burnout and improving nurses’ quality of work–life.
The application of platelet‐rich plasma for skin graft enrichment: A meta‐analysis
Authors: Chen Jianguo , Wan Yingying , Lin Yan , Jiang Haiyue 
Published: July 2020

AbstractExisting evidence demonstrated that the role of platelet‐rich plasma (PRP) in skin graft enrichment is uncertain. The aim of this study was to evaluate the efficacy and safety of PRP for skin graft. PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for randomised controlled trials that compared outcomes of skin graft treated with PRP versus those treated with blank controls. The outcomes mainly included the rate of skin graft take, number of skin graft loss and haematoma formation, and complications. There were 11 studies involving a total of 910 cases of skin grafts. Compared with the control group, PRP group had a significantly higher rate of skin graft take (mean difference = 5.47%; 95% confidence interval [CI], 2.80%‐8.14%; P < .0001), fewer number of skin graft loss (risk ratio [RR] = 0.26; 95% CI, 0.13‐0.55; P = .0004) and fewer cases of haematoma formation (RR = 0.24; 95% CI, 0.11‐0.54; P = .0006). There was no significant difference in the incidence of complications between two groups. This meta‐analysis summarises current evidence and indicates that PRP is a safe and effective adjuvant for skin graft enrichment.
Highly dense 0.3CaCeNbWO8‐0.7LaMnO3 composite ceramics fabricated by cold sintering process
Authors: Fu Zhilong , Liu Yafei , Zhang Bo , Chang Aimin 
Published: July 2020

AbstractThe cold sintering process (CSP) has been used for fabricating functional ceramics at a low sintering temperature. In this study, highly dense 0.3CaCeNbWO8‐0.7LaMnO3 composite ceramics have been successfully fabricated by CSP. The phase structure, microstructure, and electrical properties of composite ceramics have been investigated. The composite ceramic is mainly composed of a tetragonal CaCeNbWO8 phase with scheelite structure and an orthorhombic LaMnO3 phase with perovskite structure. The relative density of composite ceramic is 94.5%, and is higher than that of single phase ceramic. The resistivity of composite ceramic exhibits negative temperature coefficient characteristics, with an aging coefficient less than 2%. Such a sintering methodology is of great significance, since it provides a feasible idea for preparing composite ceramics.
Regression to the mean in home blood pressure: Analyses of the BP GUIDE study
Authors: Wang Nelson , Atkins Emily R. , Salam Abdul , Moore Myles N. , Sharman James E. , Rodgers Anthony 
Published: July 2020

AbstractThe aim of our study was to estimate the size of regression to the mean with home blood pressure (BP) monitoring and compare with that for office BP. Office and home BP measures were obtained from the BP GUIDE (value of central Blood Pressure for GUIDing managEment for hypertension) study, in which 286 patients had BP measured every 3 months for 12 months. Patients were categorized by 10 mm Hg strata of baseline BP, and regression to the mean measures was calculated for home and office BP. High baseline home BP readings tended to be lower on long‐term follow‐up, and low baseline readings tended to be higher. For example, patients in the group with mean baseline home systolic BP ≥ 150 mm Hg had a mean baseline systolic BP of 156 mm Hg, which fell to 143 mm Hg at 12 months; and patients in the group with mean baseline home systolic BP < 120 mm Hg had a mean baseline systolic BP of 113 mm Hg which rose to 120 mm Hg at 12 months. Similar patterns were seen in intervention and control groups, and for diastolic BP. The regression dilution ratio for home systolic BP and diastolic BP was 0.52 and 0.64, respectively, compared to 0.40 and 0.55 for office systolic BP and diastolic BP, respectively. Home BP is subject to regression to the mean to a similar degree as office BP. These findings have implications for the diagnosis and management of hypertension using home BP.
Retracted: Ectopic expression of ROR1 prevents cochlear hair cell loss in guinea pigs with noise‐induced hearing loss
Authors: Zhang Jun , Zhang Wei , Zhang Qinliang 
Published: July 2020

AbstractNoise‐induced hearing loss (NIHL) is one of the most frequent disabilities in industrialized countries. Evidence shows that hair cell loss in the auditory end organ is responsible for the majority of various ear pathological conditions. The functional roles of the receptor tyrosine kinase ROR1 have been underscored in various tumours. In this study, we evaluated the ability of ROR1 to influence cochlear hair cell loss of guinea pigs with NIHL. The NIHL model was developed in guinea pigs, with subsequent measurement of the auditory brainstem response (ABR). Gain‐of‐function experiments were employed to explore the role of ROR1 in NIHL. The interaction between ROR1 and Wnt5a and their functions in the cochlear hair cell loss were further analysed in response to alteration of ROR1 and Wnt5a. Guinea pigs with NIHL demonstrated elevated ABR threshold and down‐regulated ROR1, Wnt5a and NF‐κB p65. The up‐regulation of ROR1 was shown to decrease the cochlear hair cell loss and the expression of pro‐apoptotic gene (Bax, p53) in guinea pig cochlea, but promoted the expression of anti‐apoptotic gene (Bcl‐2) and the fluorescence intensity of cleaved‐caspase‐3. ROR1 interacted with Wnt5a to activate the NF‐κB signalling pathway through inducing phosphorylation and translocation of p65. Furthermore, Wnt5a overexpression decreased the cochlear hair cell loss. Collectively, this study suggested the protection of overexpression of ROR1 against cochlear hair cell loss in guinea pigs with NIHL via the Wnt5a‐dependent NF‐κB signalling pathway.
Fecal microbial DNA markers serve for screening colorectal neoplasm in asymptomatic subjects
Authors: Liang Jessie Qiaoyi , Wong Sunny H , Szeto Chun Ho , Chu Eagle SH , Lau Harry C , Chen Yingxuan , Fang Jingyuan , Yu Jun , Sung Joseph JY 
Published: July 2020

AbstractBackground and AimWe have previously shown that fecal microbial markers might be useful for non‐invasive diagnosis of colorectal cancer (CRC) and adenoma. Here, we assessed the application of microbial DNA markers, as compared with and in combination with fecal immunochemical test (FIT), in detecting CRC and adenoma in symptomatic patients and asymptomatic subjects.MethodsWe recruited 676 subjects [210 CRC, 115 advanced adenoma (AA), 86 non‐advanced adenoma, and 265 non‐neoplastic controls], including 241 symptomatic and 435 asymptomatic subjects. Fecal abundances of Fusobacterium nucleatum, a Lachnoclostridium sp. m3, Bacteroides clarus, and Clostridium hathewayi were quantified by quantitative PCR. Combining score of the four microbial markers (4Bac) and diagnostic prediction were determined using our previously established scoring model and cutoff values and FIT with a cutoff of 100 ng Hb/mL.Results4Bac detected similar percentages of CRC [85.3% (95%CI: 79.2–90.2%) vs 84.9% (68.1–94.9%)] and AA [35.7% (12.8–64.9%) vs 38.6% (29.1–48.8%)], while FIT detected more CRC [72.1% (63.7–79.4%) vs 66.7% (48.2–82.0%)] and AA [28.6% (8.4–58.1%) vs 16.8% (10.1–25.6%)], in symptomatic vs asymptomatic subjects, respectively. Focusing on the asymptomatic cohort, 4Bac was more sensitive for diagnosing CRC and AA than FIT (P < 0.001), with lower specificity [83.3% (77.6–88.0%) vs 98.6% (96.0–99.7%)]. FIT failed to detect any non‐advanced adenoma [0% (0.0–4.2%)] compared with 4Bac [41.9% (31.3–53.0%), P < 0.0001]. Combining 4Bac with FIT improved sensitivities for CRC [90.9% (75.7–98.1%)] and AA [48.5% (38.4–58.7%)] detection.ConclusionQuantitation of fecal microbial DNA markers may serve as a new test, stand alone, or in combination with FIT for screening colorectal neoplasm in asymptomatic subjects.