bluuebunny/crossref_metadata_2025_split huggingface dataset:
The working alliance with people experiencing suicidal ideation: A qualitative study of nurses’ perspectives
Authors: Vandewalle Joeri , Deproost Eddy , Goossens Peter , Verfaillie Jan , Debyser Bart , Beeckman Dimitri , Van Hecke Ann , Verhaeghe Sofie 
Published: August 2020

AbstractAimsThis study aimed to enhance the conceptual understanding of the working alliance in the context of nursing care for people experiencing suicidal ideation.DesignA qualitative study based on grounded theory was conducted.MethodsTwo authors conducted individual semi‐structured interviews from September 2017–January 2019. Twenty‐eight nurses in 13 wards of four psychiatric hospitals participated. The Qualitative Analysis Guide of Leuven was used to support constant data comparisons and the cyclic processes of data collection and data analysis.FindingsThe nurses’ perspectives revealed that the working alliance can be understood as an interpersonal and collaborative relational process. This relational process highlighted the core variable ‘seeking connectedness and attunement with the person at risk of suicide’. The core variable underpinned three clusters: investing in the foundations of the working alliance, nourishing the clinical dimension of the working alliance and realizing an impact with the working alliance.ConclusionThis study highlights the importance for nurses to assess, evaluate and respond to persons’ suicidal ideation in harmony with a commitment to connect with them and attune to their perspective.ImpactThe relational process uncovered through this study offers valuable insights to support advanced nursing practice, where nurses meaningfully integrate relational elements of care with their contributions to suicide prevention and treatment.
Mapping publication status and exploring hotspots in a research field: Rheumatoid arthritis with depression
Authors: Wang Xia , Zhang Ziyun , He Xifei , Meng Heng , Zhang Li , Zhang Lijuan , Lou Xuejiao , Fang Pengjian 
Published: August 2020

AbstractAimTo make a bibliometric analysis of the current research status and hot spots in the field of rheumatoid arthritis (RA) ‐related depression.DesignSystematic review.MethodsBased on the Web of Science database, studies in the past 5 years from 1 January 2015–5 November 2019 have been included. Data were analysed from annual number of published papers, main research institutions, core authors, core teams and research topics by using bibliometric approaches.ResultsRelated papers (N = 1,073) were obtained. The field of RA‐related depression is in a stable development stage, forming core authors and core teams. The epidemiological characteristics, influencing factors, prediction effect and the intervention of RA‐related depression are common research directions and themes. The common role of auto‐antibodies and inflammatory factors in the development of RA and depression, the risk of cardiovascular events and disease burden caused by RA‐related depression are newly emerging research topics.ConclusionThe RA‐related depression has been widely concerned by scholars and the research field is gradually mature. However, the research on the prevention and intervention of RA‐related depression is still wanting, which needs to be strengthened.Where and on whom will the research have an impact?The research revealed the most popular institutions, authors, research teams, emerging issues and ‘hot topics’ in the RA‐related depression field, which might suggest avenues for future research in this field.
Press, swipe and read: Do interactive features facilitate engagement and learning with e‐Books?
Authors: Xu Ying , Yau Joanna C. , Reich Stephanie M. 
Published: August 2020

AbstractYoung children are introduced to mobile technology at an early age, with many using touchscreens daily. One appeal of touchscreen technology is that it seems to be intuitive for very young children. As a result, many children's e‐books are designed for tablets rather than for e‐readers or computers. E‐books often contain hotspots—interactive areas children can press to receive immediate auditory or visual feedback. This study assessed whether children's (N = 76, aged 3–5 years) interactions with hotspots increased their engagement with reading when using an e‐book independently and how such interactions were related to their learning from the story. Our results suggested that interacting with hotspots enhanced children's emotional engagement and sustained visual attention but not verbal engagement. Interacting with hotspots also benefited children's recall of story elements relevant to the hotspot but not their overall comprehension of the story. These findings inform the design and use of touchscreen media in early childhood.
Review and synthesis of the experience of patients following total hip or knee arthroplasty in the era of rapidly decreasing hospital length of stay
Authors: Makimoto Kiyoko , Fujita Kimie , Konno Rie 
Published: August 2020

AbstractAimThe hospital length of stay for orthopedic surgery has been decreasing during the last couple of decades. Therefore, this study was performed to explore the postoperative experiences of adult/older patients (age ≥20 years) with osteoarthritis who underwent total hip or knee arthroplasty, focusing on the first 6 weeks following discharge.MethodsA systematic literature search on qualitative studies was conducted using six databases, such as Medline, CINAHL and Mednar. Verbatim interview data and themes or subthemes related to the patients' experience after discharge were extracted. Content analysis was used to code interview data. Codes similar in meaning were grouped, and subcategories were formed. These subcategories were then grouped into categories.ResultsSixteen qualitative studies with 253 participants were analyzed. In total, 136 codes were generated and formed 29 subcategories. Six categories were generated: (a) postoperative pain and medication; (b) difficulty in performing activities of daily living; (c) appreciation for support and difficulties associated with receiving support; (d) variability in recovery process and information‐seeking; (e) lack of patient‐centered care; and (f) transportation problems and social isolation.ConclusionOur review suggests that prospective patients and their caregivers need individually tailored presurgical education and advanced planning for postsurgical reduced mobility.
Endometrial stromal sarcoma: A review of rare mesenchymal uterine neoplasm
Authors: Capozzi V.A. , Monfardini L. , Ceni V. , Cianciolo A. , Butera D. , Gaiano M. , Berretta R. 
Published: August 2020

AbstractObjectiveThis review aims to analyze the pathological aspects, diagnosis and treatment of rare mesenchymal uterine tumors.MethodsOn August 2019, a systematic review of the literature was done on Pubmed, MEDLINE, Scopus, and Google Scholar search engines. The systematic review was carried out in agreement with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyzes statement (PRISMA). The following words and key phrases have been searched: “endometrial stromal sarcoma”, “low‐grade endometrial stromal sarcoma”, “high‐grade endometrial stromal sarcoma”, “uterine sarcoma”, “mesenchymal uterine tumors” and “uterine stromal sarcoma”. Across these platforms and research studies, five main aspects were analyzed: the biological characteristics of the neoplasms, the number of cases, the different therapeutic approaches used, the follow‐up and the oncological outcomes.ResultsOf the 94 studies initially identified, 55 were chosen selecting articles focusing on endometrial stromal sarcoma. Of these fifty‐five studies, 46 were retrospective in design, 7 were reviews and 2 randomized phases III trials.ConclusionEndometrial stromal sarcomas are rare mesenchymal uterine neoplasms and surgery represents the standard treatment. For uterus‐limited disease, the remove en bloc with an intact resection of the tumor (without the use of morcellation) is strongly recommended. For advanced‐stage disease, the standard surgical treatment is adequate cytoreduction with metastatectomy. Pelvic and para‐aortic lymphadenectomy is not recommended in patients with Low‐grade Endometrial Stromal Sarcoma (ESS), while is not clear whether cytoreduction of advanced tumors improves patient survival in High‐grade ESS. Administration of adjuvant radiotherapy or chemotherapy is not routinely used and its role is still debated.
Effects of pretreatment radiological and pathological lymph node statuses on prognosis in patients with ovarian cancer who underwent interval debulking surgery with lymphadenectomy following neoadjuvant chemotherapy
Authors: Komatsu Hiroaki , Iida Yuki , Osaku Daiken , Shimogai Ruri , Chikumi Jun , Sato Shinya , Oishi Tetsuro , Harada Tasuku 
Published: August 2020

AbstractAimTo analyze whether radiological and pathological lymph node statuses affected prognosis in patients with epithelial ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery.MethodsIn total, 82 patients undergoing interval debulking surgery, including systematic retroperitoneal lymphadenectomy, were eligible for this study. We retrospectively analyzed the association among radiological diagnosed retroperitoneal lymphadenopathy by computed tomographic scan before (rLN) and after (yrLN) neoadjuvant chemotherapy, pathological lymph node metastasis (pLN) and prognosis. Patient survival distribution was calculated using the Kaplan–Meier method.ResultsThere were 36 rLN+ cases (44%); there were no significant differences between rLN+ and rLN− with respect to progression‐free survival and overall survival. Progression‐free survival and overall survival did not differ between yrLN+ cases and yrLN− cases. Thirty‐nine cases (47.5%) were pLN+, and both progression‐free survival and overall survival were significantly shorter in pLN+ cases than in pLN− cases (P < 0.001 and P = 0.004, respectively). In univariate analysis, FIGO stage, pLN and surgical completion were prognostic factors for overall survival. Moreover, in multivariate analysis, pLN+ was the independent prognostic factor for progression‐free survival (P = 0.001, 95% confidence interval: 1.911–15.69), and pLN and surgical completion were the only independent prognostic factors for overall survival (P = 0.046, P = 0.012).ConclusionRadiological lymph node status may not be a prognostic factor in patients with ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery. Pathological lymph node metastasis affects progression‐free survival and overall survival.
Cerebrovascular function in hypertension: Does high blood pressure make you old?
Authors: Jennings J. Richard , Muldoon Matthew F. , Allen Ben , Ginty Annie T. , Gianaros Peter J. 
Published: August 2020

AbstractThe majority of individuals over an age of 60 have hypertension. Elevated blood pressure and older age are associated with very similar changes in brain structure and function. We review the parallel brain changes associated with increasing age and blood pressure. This review focuses on joint associations of aging and elevated blood pressure with neuropsychological function, regional cerebral blood flow responses to cognitive and metabolic challenges, white matter disruptions, grey matter volume, cortical thinning, and neurovascular coupling. Treatment of hypertension ameliorates many of these changes but fails to reverse them. Treatment of hypertension itself appears more successful with better initial brain function. We show evidence that sympathetic and renal influences known to increase blood pressure also impact brain integrity. Possible central mechanisms contributing to the course of hypertension and aging are then suggested. An emphasis is placed on psychologically relevant factors: stress, cardiovascular reactions to stress, and diet/obesity. The contribution of some of these factors to biological aging remains unclear and may provide a starting point for defining the independent and interacting effects of aging and increasing blood pressure on the brain.
Mitochondrial dysfunction in skeletal muscle of fukutin‐deficient mice is resistant to exercise‐ and 5‐aminoimidazole‐4‐carboxamide ribonucleotide‐induced rescue
Authors: Southern W. Michael , Nichenko Anna S. , Qualls Anita E. , Portman Kensey , Gidon Ariel , Beedle Aaron M. , Call Jarrod A. 
Published: August 2020

New Findings
What is the central question of this study?
Does fukutin deficiency in skeletal muscle cause mitochondrial dysfunction, and if so, can AMP‐activated protein kinase (AMPK) stimulation via 5‐aminoimidazole‐4‐carboxamide ribonucleotide attenuate this through regulation of mitochondrial biogenesis and autophagy?
What is the main finding and its importance?
Mitochondrial dysfunction is associated with fukutin deficiency and AMPK stimulation may benefit muscle contractility to a greater extent than mitochondrial function.
AbstractDisruptions in the dystrophin–glycoprotein complex (DGC) are clearly the primary basis underlying various forms of muscular dystrophies and dystroglycanopathies, but the cellular consequences of DGC disruption are still being investigated. Mitochondrial abnormalities are becoming an apparent consequence and contributor to dystrophy disease pathology. Herein, we demonstrate that muscle‐specific deletion of the fukutin gene (Myf5/fktn‐KO mice (Fktn KO)), a model of secondary dystroglycanopathy, results in ∼30% lower muscle strength (P < 0.001) and 16% lower mitochondrial respiratory function (P = 0.002) compared to healthy littermate controls (LM). We also observed ∼80% lower expression of the gene for peroxisome proliferator‐activated receptor‐γ coactivator 1α (PGC‐1α) (P = 0.004), a primary transcription factor for mitochondrial biogenesis, in Fktn KO mice that likely contributes to the mitochondrial defects. PGC‐1α is post‐translationally regulated via phosphorylation by AMP‐activated protein kinase (AMPK). Treatment with the AMPK agonist 5‐aminoimidazole‐4‐carboxamide ribonucleotide (AICAR) failed to rescue mitochondrial deficits in Fktn KO mice (P = 0.458) but did have beneficial (∼30% greater) effects on recovery of muscle contractility following injury in both LM and Fktn KO mice compared to saline treatment (P = 0.006). The beneficial effects of AMPK stimulation via AICAR on muscle contractile function may be partially explained by AMPK's other role of regulating skeletal muscle autophagy, a cellular process critical for clearance of damaged and/or dysfunctional organelles. Two primary conclusions can be drawn from this data: (1) fukutin deletion produces intrinsic muscular metabolic defects that likely contribute to dystroglycanopathy disease pathology, and (2) AICAR treatment accelerates recovery of muscle contractile function following injury suggesting AMPK signalling as a possible target for therapeutic strategies.
Loss Analysis of Unsteady Turbomachinery Flows Based on the Mechanical Work Potential
Authors: Leggett John , Richardson Edward , Priebe Stephan , Shabbir Aamir , Michelassi Vittorio , Sandberg Richard 
Published: August 2020

Abstract
Loss analysis is a valuable technique for improving the thermodynamic performance of turbomachines. Analyzing loss in terms of the “mechanical work potential” (Miller, R.J., ASME Turbo Expo 2013, GT2013-95488) provides an instantaneous and local account of the thermal and aerodynamic mechanisms contributing to the loss of thermodynamic performance. This study develops the practical application of mechanical work potential loss analysis, providing the mathematical formulations necessary to perform loss analysis using practical Reynolds-averaged Navier–Stokes (RANS) or large eddy simulations (LES). The analysis approach is demonstrated using RANS and LES of a linear compressor cascade, both with and without incoming wakes. Spatial segmentation is used to attribute loss contributions to specific regions of the flow, and phase-averaging is performed in order to associate the variation of different loss contributions with the periodic passage of wakes through the cascade. For this un-cooled linear cascade, viscous dissipation is the dominant source of loss. The analysis shows that the contribution of the viscous reheat effect depends on the operating pressure of the compressor stage relative to the ambient “dead state” pressure—implying that the optimal blade profile for a low-pressure compressor stage may be different from the optimal profile for a high-pressure compressor stage in the same engine, even if the operating conditions for both stages are dynamically similar.
Emergency care access to primary care records: an observational study
Authors: Bowden Thomas , Lyell David , Coiera Enrico 
Published: August 2020

ObjectiveTo measure lookup rates of externally held primary care records accessed in emergency care and identify patient characteristics, conditions and potential consequences associated with access.MeasuresRates of primary care record access and re-presentation to the emergency department (ED) within 30 days and hospital admission.DesignA retrospective observational study of 77 181 ED presentations over 4 years and 9 months, analysing 8184 index presentations in which patients’ primary care records were accessed from the ED. Data were compared with 17 449 randomly selected index control presentations. Analysis included propensity score matching for age and triage categories.Results6.3% of overall ED presentations triggered a lookup (rising to 8.3% in year 5); 83.1% of patients were only looked up once and 16.9% of patients looked up on multiple occasions. Lookup patients were on average 25 years older (z=−9.180, p<0.001, r=0.43). Patients with more urgent triage classifications had their records accessed more frequently (z=−36.47, p<0.001, r=0.23). Record access was associated with a significant but negligible increase in hospital admission (χ2(1, n=13 120)=98.385, p<0.001, phi=0.087) and readmission within 30 days (χ2(1, n=13 120)=86.288, p<0.001, phi=0.081).DiscussionEmergency care clinicians access primary care records more frequently for older patients or those in higher triage categories. Increased levels of inpatient admission and re-presentation within 30 days are likely linked to age and triage categories.ConclusionFurther studies should focus on the impact of record access on clinical and process outcomes and which record elements have the most utility to shape clinical decisions.
Pseudophakic corneal donor tissue in Descemet membrane endothelial keratoplasty (DMEK): implications for cornea banks and surgeons
Authors: Pilger Daniel , Torun Necip , Maier Anna-Karina B , Schroeter Jan 
Published: August 2020

ObjectiveIncreasingly, cornea banks are recovering donor tissue from pseudophakic donors. Little is known about their suitability for Descemet membrane endothelial keratoplasty (DMEK) surgery in terms of endothelial cell density (ECD) and preparation failure.Methods and AnalysisWe explored ECD during donor tissue preparation in 2076 grafts. Preparation failure was analysed in 1028 grafts used in DMEK surgery at our clinic. To monitor ECD and functional results, we matched 86 DMEK patients who received pseudophakic donor grafts with similar recipients of phakic donor grafts and followed them up for 36 months.ResultsAt recovery, mean ECD in pseudophakic donor grafts was 2193 cells/mm2(SD 28.7) and 2364 cells/mm2(SD 15.7) in phakic donor grafts (p<0.001). After cultivation, the difference increased as pseudophakic donor grafts lost 14% of ECD while phakic lost only 6% (p<0.001). At transplantation, mean ECD in pseudophakic donor grafts was 2272 cells/mm2(SD 250) and 2370 cells/mm2(SD 204) in phakic donor grafts (p<0.001). After transplantation, the difference in ECD increased as pseudophakic donor grafts lost 27.7% of ECD while phakic donor grafts lost only 13.3% (p<0.001). The risk of preparation failure in pseudophakic donor grafts was higher than in phakic donor grafts (OR 4.75, 95% CI 1.78 to 12.67, p=0.02). Visual acuity increased in both groups similarly.ConclusionsPseudophakic donor grafts have a lower ECD, are more prone to endothelial cell loss during recovery and surgery and are associated with a higher risk of preparation failure. Cornea banks and surgeons should consider this in the planning of graft preparation and transplantation.
Incidence of recreational sports-related sudden cardiac arrest in participants over age 12 in a general African population
Authors: Tchanana Gladys M K , Ngantcha Marcus , Yuyun Matthew F , Ajijola Olujimi A , Mbouh Samuel , Tchameni Steve C T , Suliman Ahmed , Bonny Aimé 
Published: August 2020

BackgroundThe incidence of sports-related sudden cardiac arrest (SrSCA) in sub-Saharan Africa is unknown.ObjectiveTo determine the incidence of sudden cardiac arrest (SCA) in non-competitive athletes in an urban population of Cameroon, a country in sub-Saharan Africa.MethodsTwo study populations in Cameroon were used. A 12-month, multisource surveillance system of 86 189 inhabitants over 12 years old recorded all deaths in two administrative districts of Douala City. All fields of sports, emergency medical service, local medical examiners and district hospital mortuaries were surveyed. Two blinded cardiologists used a verbal autopsy protocol to determine the cause of death. SCA was identified for all deaths occurring within 1 hour of onset of symptoms. A cross-sectional study was conducted among 793 persons in Yaoundé City, which is the second study population aimed at determining the proportion of people who are physically active.ResultsThe mean age in the cross-sectional study was 27.3±10.7, with more men (56.2%). The cross-sectional study showed that 69.0% (95% CI 65.8 to 72.2) of the population could be considered to have at least 3 hours of physical activity per week. The surveillance found that among 288 all-cause deaths, 27 (9.4%) were due to SCA. One SrSCA was registered in a 35-year-old woman while running. Merging both sources revealed an SrSCA incidence of 1.7 (95% CI 0.2 to 12.0) cases per 100 000 athletes per year.ConclusionThis pioneer study reports the incidence estimates of SrSCA in a sub-Saharan African general population and should be regarded as a first step to a big problem.
Pilot study: undergraduate sports & exercise medicine conferences: what role do they play?
Authors: Dadrewalla Arshan Jimmy , Pai Hari Venkatesh , Limaye Neil , Shankarghatta Rohan , Roy-Kundu Shammak , Guest Brendan 
Published: August 2020

ObjectivesSports & exercise medicine (SEM) is a specialty encompassing the management of medical problems and injuries related to physical activity through means such as exercise advice and prescription. The field of SEM has been recognised in the UK since 2005 yet there is inadequate exposure of SEM in medical curricula. Conferences may be a way to increase exposure where students meet SEM professionals, gaining greater understanding of SEM career pathways. We therefore carried out a pilot study to assess this.MethodsThe King’s College London Sports & Exercise Medicine Society organised a student-led conference consisting of six lectures. Seventy-five delegates were given questionnaires on their views on SEM before and after the conference, assessed using the 5-point Likert scale. Results were analysed using a Wilcoxon-Signed Rank statistical test.ResultsQuestionnaire feedback showed 67.4% of delegates (n=46) had received SEM related teaching in their current degree. Results of our statistical analysis showed an increase in SEM career interest (p=0.0359), an increase in understanding of what a career in SEM involves (p=0.0009) and an increase in delegate’s understanding of what is required to pursue a career in SEM (p=0.0004) after our conference.ConclusionThe study showed issues regarding poor exposure to SEM in medical curricula and highlighted the value of student conferences. Students felt they learnt more about the roles within the SEM specialty, aiding future career progression. Thus, we suggest that student-led conferences are a good platform to bridge this gap while medical schools introduce more SEM into their curricula.