bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced Practice Nurses in Primary Care in Switzerland: An Analysis of Interprofessional Collaboration
Authors: Josi Renata , Bianchi Monica , Brandt Sophie 
Published: January 2020

Abstract
Background: The increase in the number of chronically ill patients due to ageing is calling existing models of primary care (PC) into question. New care models have recently been implemented in Swiss PC and involve interprofessional teams. This paper aimed to investigate the practice of interprofessional collaboration between advanced practice nurses, registered nurses, and medical practice assistants within new models of PC in Switzerland using the National Interprofessional Competency Framework.
Methods: An ethnographic design comprising semi-structured interviews and non-participant observations was conducted. Sixteen interviews were conducted with care providers at their PC practice. Interviewees included four advanced practice nurses, two registered nurses, six medical practice assistants, and four general practitioners. Nine other health professionals were subsequently observed in their practice. Interviews and observations were conducted by the first author from February to April 2019.
Results: Our analysis of interview and observational data confirmed that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication have a significant influence on the interprofessional collaboration among health professionals in Swiss PC. Among these domains, role clarification and team functioning were the most frequently raised issues. Both were found to have the potential to negatively influence and, therefore, hinder efficient interprofessional collaboration within PC.
Conclusion: From the analysis, it emerged that role clarification is crucial for effective interprofessional collaboration within new care delivery models in the Swiss PC context. Our study results may inform international health policymakers and practitioners about six important domains of interprofessional care when implementing new care models. Practical experience with new models of care involving advanced practice nurses and medical practice assistants may also influence the regulation of the scope of practice of these health professionals in Switzerland.
Investigating Relationship Between Religious Commitment and Moral Sensitivity in Nurses Working in ICU
Authors: khalighi ebrahim , Solaimanizade Laleh , borji milad , tarjoman asma , soltani behrouz , zarei farzad 
Published: January 2020

Abstract
Objectives
this study aimed at determining the relationship between religious commitment and moral sensitivity among nurses working in the ICU sections in the west of Iran. The present study was a cross-sectional descriptive-analytic study carried out on nurses working in ICU wards of two western cities in Iran. The instrument used includes a demographic questionnaire, religious commitment questionnaire and moral sensitivity questionnaire in nurses. First, the researchers referred to the ICU wards of the hospitals in the cities after receiving permission from the relevant authorities by referring to three shifts in the morning, evening and night shifts and holidays. The researchers, while explaining the research goals for the nurses participating in the study, obtained their informed consent to participate in this study.
Results :
According to the findings, mean (SD) of the overall score of religious commitment was equal to 36.38 (4.58) and mean (SD) of MS score of nurses was 59.21 (12.65). Also, 91 nurses (82.7%) had average MS, 7 (6.4%) had low MS and 12 (10.9%) had high MS.
Keywords: Religious Commitment, Moral Sensitivity, Nurse
The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis
Authors: Park Jamie YE , Howren Alyssa M , Zusman Enav Z , Esdaile John M , De Vera Mary A 
Published: January 2020

Abstract
Background: As awareness for the importance of mental health continues to expand in rheumatology, it is important to understand the epidemiology of psychiatric complications in ankylosing spondylitis (AS) with the ultimate goal of future prevention and improved quality of care. This study aims to review evidence on the incidence and determinants of depression and/or anxiety among patients with AS. Methods: We searched Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL Complete, and PsycINFO for full-length observational studies that involved a sample or population of patients with AS and assessed depression and/or anxiety. Primary outcomes extracted were: 1) risk estimates for depression and/or anxiety (e.g., relative risk [RR]); and 2) determinants or factors identified as independent predictors of depression and/or anxiety using multivariable regression approaches and corresponding estimates (e.g., odds ratios [OR]). Where relevant, we pooled estimates using random effects models. Results: Out of 783 titles from our search strategy, we reviewed 39 manuscripts. Four studies assessed the incidence of depression and meta-analyzing reported estimates from three of these studies yielded a pooled RR of 1.51 (95% CI 1.28 to 1.79). Differences in risk of depression among men and women with AS were inconclusive, suggesting need for further study. The incidence of anxiety was comparatively less studied with only one included study reporting a hazard ratio of 1.85 (95% CI 1.37 to 2.49). Education level was a key determinant, with lower levels associated with higher odds of depression (OR 6.65; 9% CI 1.36 to 32.51) and anxiety (OR 9.31; 9% CI 1.39 to 62.19) among AS patients. Conclusions: Our systematic review and meta-analysis shows an increased risk of depression and anxiety among patients with AS. These findings suggest the importance of monitoring and care for psychiatric conditions in AS.
Single-stage treatment of chronic localized tibial osteomyelitis with local debridement and antibiotic-loaded calcium sulfate implantation: a retrospective study of 42 patients.
Authors: Zhou Chun-Hao , Ren Ying , Adem Abdulnassir , Meng Xiang-Qing , Zhang Hong-An , Fang Jia , Qin Cheng-He 
Published: January 2020

Abstract
Background: The management of chronic tibial osteomyelitis is still a challenge, even with various methods have been introduced. This study aims to assess a combined treatment method, local debridement combined with antibiotic-loaded calcium sulfate implantation, for the management of the local (Cierny-Mader type III) tibial osteomyelitis. Methods: 42 patients (43 limbs) with type III tibial osteomyelitis, from January 2012 to December 2018, who received above mentioned treatment method were included in the study. The infection remission rate, recurrence rate, complication rate and bone healing rate were respectively analyzed. Results: With a mean follow-up of 42.8 months, 38 limbs (37 patients) (88.4%, 38/43) achieved infection remission without recurrence. Among those patients, pain, limitation of movement, sinus tracts, topical redness and swelling were generally eliminated. Only 4 patients felt slight pain after a long-distance walk, while another 6 patients showed slight but acceptable discomfort in affected limbs. 5 patients (11.6%) suffered from osteomyelitis recurrence that required secondary surgical and medical treatment, but no amputation was necessary to eliminate the infection. Prolonged postoperative drainage was the most frequent complication that was seen in 13 patients (30.0%). They were successfully managed by appropriate wound caring in 10 patients and by re-debridement, months later, in 3 patients. According to the final X-rays examination, bone losses caused by local debridement were generally repaired, though the shape of tibia was not well restored to its initial form. No fracture was recorded during follow-up. Conclusion: Local debridement combined with antibiotic-loaded calcium sulfate implantation is effective and safe in a single-stage treatment of chronic Cierny-Mader III tibial osteomyelitis.
The effect of adding curcumin to sodium valproate in treatment of patients with bipolar disorder in the acute phase of mania: a clinical trial.
Authors: Akbarzadeh Farzad , Niksun Nabahat , Behdani Fatemeh , Mohammadpour Amir Hoshang , Jaafari Mahmoudreza , Ebrahimi Alireza , rajai Zahra , Hosseini Tayebeh 
Published: January 2020

Abstract
Background: Inflammatory processes in the brain play an important role in etiopathogenesis of many psychiatric disorders including, bipolar mood disorder (BMD) as a life-long episodic disease. An inefficient therapeutic intervention especially for resistant cases makes the necessity of doing more precise investigation to find out new therapeutic approaches apparent. This double-blind study aims to investigate the effect of Crucumin as anti-inflammatory herbal based drug in the treatment of BMD. Results: 78 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for BMD screening to participate in the trial. The participants included 32 patients in the placebo group receiving sodium valproate and crucumin and 38 patients in the control group receiving placebo and sodium valproate. At the beginning of the study and weeks 1, 2, 4 the patients were assessed by a psychiatrist using Young mania score (YMRS). Fifty four patients completed the trial. Mean age in patients group was 36.28±10.73 and in control group was 32.42 ±9.60.Clinical characteristics of the patients, such as age, did not differ between groups P value ≥0.05. Results showed the process of changes were significant different in both group. The results showed that the changes in the resultss of YMRS, MMSE and CGI scores were significant in each group (P value≤0.001), but no significant difference has been detected between the two groups (p≥0.05).Conclusions: this study suggested that crucumin cannot be an effective adjuvant agent in management of patients with BMD under treatment with sodium valproate.
Long-read sequencing of Chrysanthemum morifolium cv. ‘Hangju’ transcriptome reveals flavonoid biosynthesis and regulation
Authors: Wang Tao , Yang Feng , Guo Qiaosheng , Zou Qingjun , Zhang Wenyan , Zuo Lin 
Published: January 2020

Abstract
Background: The inflorescence of Chrysanthemum morifolium cv. ‘Hangju’ has been widely used in China due to its antioxidant and anti-inflammatory properties. The biosynthesis and regulation of flavonoids, a group of bioactive components, in C. morifolium are poorly understood. Transcriptome sequencing is an effective method for obtaining transcript information. Therefore, single-molecule real-time (SMRT) sequencing was performed to obtain the full-length genes involved in flavonoid biosynthesis and regulation in C. morifolium.Results: High-quality RNA was extracted from the inflorescence of C. morifolium at different developmental stages and used to construct two libraries (0-5 kb and 4.5-10 kb) for sequencing. Finally, 125,532 non-redundant isoforms with a mean length of 2,009 bp were obtained. Of these, 2,083 transcripts were annotated to pathways related to flavonoid biosynthesis, and 56 isoforms were annotated as CHS, CHI, F3H, F3’H, FNS Ⅱ, FLS, DFR and ANS genes. Based on gene expression levels at different stages, we predicted the major genes involved in flavonoid biosynthesis. By phylogenetic analysis, we found two candidate MYB transcription factors (CmMYBF1 and CmMYBF2) activating flavonol biosynthesis.Conclusions: Based on the full-length transcriptomic data and further quantitative analysis, the major genes involved in flavonoid biosynthesis and regulation in C. morifolium were predicted in our study. The results provide a valuable theoretical basis for the introduction and cultivation of C. morifolium cv. ‘Hangju’.
Characteristics of Intralimb Kinetic Coordination in the Lower Limbs During Gait in Patients with Hemiparesis Due to Stroke
Authors: Sekiguchi Yusuke , Owaki Dai , Honda Keita , Izumi Shin-ichi 
Published: January 2020

Abstract
Background: The main objective of the present study is to investigate the relationship between the principal components (PCs) of the sagittal kinetic variables in the lower limb and the ground reaction forces (GRFs) during gait in patients with hemiparesis. Methods: We recruited 21 patients with hemiparesis and 12 healthy controls. The 3-dimensional (3-D) coordinates of 33 markers were measured with a 3-D motion analysis system operating at 120 Hz and force plates as the subjects walked along a 7-meter walkway. The correlation coefficients between the over-time series of PCs, which is calculated using principle component analysis (PCA), and GRFs were compared among the left side of the controls and the paretic side (PS) and non-PS of the patients by using analysis of variance (ANOVA). Results: The correlation coefficient of the non-PS between the first PC and GRF in the anteroposterior-direction was significantly higher than that on the PS (P < 0.05) and that of the non-PS in the vertical-direction was lower than the PS (P < 0.05). Conclusions: The results indicated that intralimb kinetic coordination on the PS plays an essential role in weight support in patients with hemiparesis, whereas the kinetic coordination on the non-PS plays a role in generation of propulsion.
The mechanisms of protease-activated receptor 2 in mediating pain behaviors through nonselective cation channel signaling
Authors: Yue Yaping , Wang Na , Lau Yanming , Fu Yiran , Li Hao , Li Zhenzhong , Liu Zhen 
Published: January 2020

Abstract
Background: Activation of purinergic receptor P2X ligand-gated ion channel 3 (P2X3), transient receptor potential vanilloid type 1 (TRPV1), and transient receptor potential ankyrin 1 (TRPA1) by their specific ligands is a major mechanism contributing to magnified pain responses. The relationship between these nonselective cation channels and proteinase-activated receptor 2 (PAR2) activation mediated pain is still to be clarified.Methods: In this study, both in vitro model of dorsal root ganglion (DRG) neurons with PAR2 agonist SL-NH2 challenge and SL-NH2-induced pain rat model were used to approach these questions. The expression of P2X3, TRPV1, and TRPA1 in DRG neurons was investigated by quantitative real-time RT-PCR, Western blot, and immunofluorescence. The involvement of the PLCβ3/PKCε signaling pathway was also determined. The behavior test for mechanical allodynia and thermal hyperalgesia was performed. Results: SL-NH2 induced upregulation of P2X3, TRPV1, and TRPA1 through phosphorylation of phospholipase Cβ3 (PLCβ3) and protein kinase Cε (PKCε) signaling pathway in DRG neurons in vitro and in vivo. SL-NH2 also elevated the proportion of P2X3-, TRPV1-, and TRPA1-expressing neurons. The upregulation of P2X3, TRPV1, and TRPA1 and phosphorylation of PLCβ3 and PKCε in DRG neurons was paralleled with mechanical allodynia and thermal hyperalgesia behaviors in rats. Conclusions: The data of the present study imply that SL-NH2 as a noxious stimulus activates PAR2 which induces TRPV1, TRPA1, and P2X3 upregulation through PLCβ3/PKCε signaling pathway, thereby decreasing activation thresholds and increasing excitability, resulting in sustained nociceptive activity in DRG neurons, and then causing mechanical allodynia and thermal hyperalgesia behaviors. These data expanded our knowledge about PAR2-mediated pain sensitivity and its relationship with TRPV1, TRPA1, and P2X3 and provided new opportunities on management of pain behaviors.
Troubling Issues of Gender and Culture in the General Practitioners’ Consultation Room: a Contribution from the Netherlands.
Authors: Saharso Sawitri , Dekker Carlijn 
Published: January 2020

Abstract
Background: This paper discusses Dutch general practitioners (GPs) responses to patients, mostly women of migrant background, with health issues related to so-called Harmful Traditional Practices (HTPs) and other troubling issues of gender and culture, that harm the rights and well-being of women. GPs long-lasting personal relationship with their patients and familiarity with their situation make them well positioned to help these patients. Yet, we know very little what troubling health issues related to gender and culture GPs actually encounter in their consultation room and how they deal with them. We suspected, moreover, that their professional ethics offered insufficient moral guidance. Method: The paper is based on in-depth interviews with fourteen GPs in the Netherlands. Results: The GPs frequently encountered cases of gender and culture they found troubling, like honor related violence. Some GPs complied with requests for deceitful diagnoses, that were informed by harmful traditions, like requests for virginity certificates, because they believed this was in the patient’s best interest. They therewith compromised their own medical ethics. Their interventions possibly also contributed to the continuation of the harmful practice. On the other hand, respect for their patients’ autonomy made the GPs reticent to intervene, also in case of harmful practices. They required explicit consent or a concrete request from the patient, which might, given the coercive conditions of their patients’ lives, be overdemanding and risk wrongfully withholding help. Bioethics was of little help. Conclusions: Well-intended medical intervention may contribute to the continuation of cultural traditions that violate women’s human rights. Not intervening in harmful issues of gender and culture out of respect for the patient’s autonomy may, however, just as little contribute to the well-being of the patient, because it possibly overstates the patient’s freedom to request intervention. More reflection is needed among medical professionals and in medical education on these troubling issues of gender and culture and their implications for medical intervention.
Developing whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: A case-study of innovative local practice within the School Health Research Network
Authors: Gobat Nina H , Littlecott Hannah , Williams Andy , McEwan Kirsten , Stanton Helen , Robling Michael , Rollnick Stephen , Murphy Simon , Evans Rhiannon 
Published: January 2020

Abstract
Background: The evidence-base for whole school approaches aimed at improving student mental health and wellbeing remains limited. This may be due to a focus on developing and evaluating de-novo, research led interventions, while neglecting the potential of local, contextually-relevant innovation that has demonstrated acceptability and feasibility. This study reports a novel approach to modelling and refining the theory of a whole-school restorative approach, alongside plans to scale up through a national educational infrastructure in order to support robust scientific evaluation.Methods: We conducted a pragmatic formative process evaluation of a routinized whole-school restorative approach aimed at improving student mental health and wellbeing in Wales.Results: The study reports seven phases of the pragmatic formative process evaluation that researchers, policy-makers and practitioners may undertake in the development and evaluation of interventions already in routine practice: 1) identification of innovative local practice; 2) scoping review to identify intervention theory of change; antecedent and emergent contextual characteristics; implementation and outcomes; 3) establishment of a Transdisciplinary Action Research (TDAR) group; 4) co-production of intervention logic model with stakeholders; 5) confirmation of logic model with stakeholders; 6) planning for intervention refinement; and 7) planning for feasibility and outcome evaluation. The phases of this model are seen as being iterative.Conclusions: Formative, pragmatic process evaluations support researchers, policy-makers and practitioners in developing a robust scientific evidence-base for acceptable and feasible local innovation that does not have a clear evidence base. The case of a whole-school restorative approach provides an exemplar of how such an evaluation may be undertaken.
Association of Fine Particulate Matter Exposure with Acute Noncardiovascular Critical Illnesses and In-hospital Outcomes in Patients Receiving Intensive Cardiac Care
Authors: Chen Fei , Liu Qi , Huang Baotao , Huang Fangyang , Li Yiming , Peng Yong , Chen Mao 
Published: January 2020

Abstract
Background: The effect of short-term exposure to fine particulate matter (PM2.5) on the incidence of acute noncardiovascular critical illnesses (ANCIs) and clinical outcomes is unknown in patients with acute cardiovascular diseases.Methods: We conducted a retrospective study in 2,337 admissions to an intensive cardiac care unit (ICCU) from June 2016 to May 2017. We used the 2-day average PM2.5 concentration before ICCU admission to estimate the individual exposure level, and patients were divided into 3 groups according to the concentration tertiles. Major ANCI was defined as the composite of acute respiratory failure, acute kidney injury, gastrointestinal hemorrhage, or sepsis. The primary endpoint was all-cause death or discharge against medical advice in extremely critical condition.Results: More than 20 percent of admissions were complicated by major ANCI, and primary endpoints occurred in 7.6% of patients during their hospitalization. The association of short-term PM2.5 exposure levels with the incidence of acute respiratory failure (adjusted OR [odds ratio] =1.31, 95%CI [confidence interval]1.12-1.54) and acute kidney injury (adjusted OR=1.20, 95%CI 1.02-1.41) showed a significant trend. Additionally, there were numerically more cases of sepsis (adjusted OR=1.21, 95%CI 0.92-1.60) and gastrointestinal hemorrhage (adjusted OR=1.29, 95%CI 0.94-1.77) in patients with higher exposure levels. After further multivariable adjustment, short-term PM2.5 exposure levels were still significantly associated with the incidence of major ANCI (adjusted OR=1.32, 95%CI 1.12-1.56), as well as with in-hospital outcomes (adjusted OR=1.52, 95%CI 1.09-2.12). Conclusion: Short-term PM2.5 exposure before ICCU admission was associated with an increased risk of incident major ANCI and worse in-hospital outcomes in patients receiving intensive cardiac care.