bluuebunny/crossref_metadata_2025_split huggingface dataset:
Movements and trends in intensive care pain treatment and sedation: What matters to the patient?
Authors: Wøien Hilde 
Published: January 2020

AbstractBackgroundOversedation, delirium and immobilisation in the intensive care unit are associated with increased length of stay in the unit. Routines of systematic pain and sedation assessment and the use of valid tools are highly stressed in international guidelines. For improving the quality of pain treatment and sedation in a Norwegian intensive care unit, in 2009–2015, we compared supplementation with an analgosedation approach and the existing systematic approach, measured by the adherence to current international pain, sedation and delirium guidelines.MethodsIn a longitudinal study following the Standards for Reporting Implementation Studies, pain, sedation, delirium and mobilisation data from patients' complete intensive care unit stays, encompassing three separate periods of 4–6 months, were compared. The primary outcome was adherence to current protocol including assessment and documentation of patients' level of pain, sedation and prevalence of delirium at least every 8 hr, early mobilisation and titration towards a light level of sedation.ResultsWe included 205 patients, corresponding to 1,607 patient intensive care unit days. The patient sedation levels, measured by the Richmond Agitation and Sedation Scale, decreased significantly, from −2.2 in 2009–−1.7 in 2015, so did the amount of administrated propofol. Mean pain scores measured by the numeric rating scale during activity were maximum 3.1 in 2014, decreasing to 2.2 in 2015. In patients not able to self‐report, pain mean scores were 1.7 in 2014 and 1.6 in 2015, measured by the Critical Care Pain Observational Tool. The number of patients unable to assess for delirium decreased significantly. By discounting the group of patients unable to assess, the prevalence of delirium varied from 32%, 25% and 33%.ConclusionThe goal of having an awake patient able to cooperate, with acceptable levels of pain, was gradually achieved during a 6‐year period. The results showed that pain treatment and sedation in the intensive care unit primarily succeeded in the setting of an established routine of systematic assessment and documentation.Relevance to clinical practiceThe results of the study draw attention to pain treatment, sedation and delirium in intensive care patients, as well as implementation strategies aimed at achieving healthcare personnel's adherence to international guidelines in clinical practice.
The Demography of Families: A Review of Patterns and Change
Authors: Smock Pamela J. , Schwartz Christine R. 
Published: January 2020

ABSTRACTThe authors review demographic trends and research on families in the United States, with a special focus on the past decade. They consider the following several topics: (a) marriage and remarriage, (b) divorce, (c) cohabitation, (d) fertility, (e) same‐gender unions, (f) immigrant families, and (g) children's living arrangements. Throughout, the authors review both overall trends and patterns as well as those by social class and race–ethnicity. The authors discuss major strands of recent research, emphasizing emerging themes and promising directions. They close with a summary of central patterns and trends and conclude that recent trends are not as uniform as they tended to be in earlier decades, making the description of family change increasingly complex.
Parenthood and Well‐Being: A Decade in Review
Authors: Nomaguchi Kei , Milkie Melissa A. 
Published: January 2020

AbstractUnderstanding social aspects of parental well‐being is vital because parents' welfare has implications not only for the parents themselves but also for child development, fertility, and the overall health of a society. This article provides a critical review of scholarship on parenthood and well‐being in advanced economies published from 2010 to 2019. It focuses on the role of social, economic, cultural, and institutional contexts of parenting in influencing adult well‐being. The authors identify major themes, achievements, and challenges and organize the review around the demands‐rewards perspective and two other theoretical frameworks: the stress process model and the life course perspective. The analysis shows that rising economic insecurities and inequalities and a diffusion of intensive parenting ideology were major social contexts of parenting in the 2010s. Scholarship linking parenting contexts and parental well‐being illuminated how stressors related to providing and caring for children could unjustly burden some parents, especially mothers, those with fewer socioeconomic resources, and those with marginalized statuses. In that vein, researchers continued to emphasize how stressors diverged by parents' socioeconomic status, gender, and partnership status, with new attention to strains experienced by racial/ethnic minority, immigrant, and sexual minority parents. Scholars' comparisons of parents' positions in various countries expanded, enhancing knowledge regarding specific policy supports that allow parents to thrive. Articulating future research within a stress process model framework, the authors show vibrant theoretical pathways, including conceptualizing potential parental social supports at multiple levels, attending to the intersection of multiple social locations of parents, and renewing attention to local contextual factors and parenting life stages.
Understanding Implicit Bias: Putting the Criticism into Perspective
Authors: Brownstein Michael , Madva Alex , Gawronski Bertram 
Published: January 2020

AbstractWhat is the status of research on implicit bias? In light of meta‐analyses revealing ostensibly low average correlations between implicit measures and behavior, as well as various other psychometric concerns, criticism has become ubiquitous. We argue that while there are significant challenges and ample room for improvement, research on the causes, psychological properties, and behavioral effects of implicit bias continues to deserve a role in the sciences of the mind as well as in efforts to understand, and ultimately combat, discrimination and inequality.
Parents' roles and question‐asking during pretend and real activities
Authors: Taggart Jessica , Ellwood Meghan , Vasc Dermina , Chin Sarah , Lillard Angeline S. 
Published: January 2020

AbstractAll activities—real and pretend—provide children opportunities to learn new facts and skills, and parents are often facilitators. Yet little is known about whether and how parents' roles and interactions differ during pretend versus real activities. Here, we examine whether parents self‐report adopting different roles during pretend and real activities and whether we observe changes in their behavior, in particular in their question‐asking; either could impact the potential learning opportunities available to children. Thirty‐two parents engaged their 4‐year ‐olds in one pretend and one real activity (cleaning and snacking, counterbalanced). They self‐reported their roles, and speech was transcribed and coded. Parents regarded their role as a partner in fun during pretend and as a teacher or monitor during real activities. Across pretend and real contexts, they mostly asked information‐seeking questions, followed by rhetorical and pedagogical questions. They asked significantly more questions during pretend than real activities, particularly rhetorical questions. During real activities, parents' roles were not related to the number or types of questions they asked. However, during pretend, their roles were related to the number of rhetorical questions they asked: Monitors asked significantly fewer than teachers. Possible complementary benefits of each activity based on patterns of roles and questions are discussed.
Use of a cloud‐based search engine of a centralized donor database to identify historical antigen‐negative units in hospital inventories
Authors: Denomme Gregory A. , Reinders Steve , Bensing Kathleen M. , Piefer Cindy , Schanen Michael , Curnes Jennifer , Treml Angela , Gottschall Jerome L. , Anani Waseem Q. 
Published: January 2020

BACKGROUNDThe provision of units with antigen‐negative attributes is required for alloimmunized transfusion recipients and to avoid alloimmunization among patients on chronic transfusion support. Recent evidence confirms that the demand for antigen‐typed units is increasing.STUDY DESIGN AND METHODSA cloud‐based search engine was designed by the blood center to find antigen‐negative units. The service provided access to historical antigen information for units in hospital inventories. The hospital transfusion service was required to confirm the antigen phenotype. The results of 16 hospitalsʼ use over 5 years were analyzed to determine trends and value of the service. The time commitment of the cloud‐based query was compared to the hospital performing manual phenotyping with an outcome of at least one unit found with the desired antigen‐negative attribute(s).RESULTSHospitals were located between 4 miles and 200 miles away from the blood center. A total of 6,081 queries were submitted over the 5 years, with an overall 50% success rate of finding at least one unit. Single antigen queries accounted for 67% of total searches, with two antigen queries and three or more antigen queries accounting for 24% and 9% of the units found, respectively. The cloud‐based antigen query was most efficient for combined antigen frequencies <0.5 for two or more antigen‐negative attributes.CONCLUSIONA cloud‐based search engine provides hospitals with access to historical antigen information housed at the blood center. Future refinements may consider regulatory submission of a process to provide confirmed historical information through this cloud‐based program.
Drying Characteristics of Elephant Foot Yam and Performance Evaluation of Convective Dryer in Kinetically and Equilibrium Controlled Regime Under Varying Conditions
Authors: Singh Punit , Talukdar Prabal 
Published: January 2020

AbstractDrying characteristics of elephant foot yam (EFY) are determined at three different air velocities and temperatures using an innovative convective dryer. The performance of the convective dryer is also determined and compared based on four parameters namely total energy consumption, specific energy consumption (SEC), drying and thermal efficiency, working in kinetically controlled regime (KCR), and equilibrium controlled regime (ECR). EFY has excellent medicinal properties and used for the treatment of various diseases; in spite of that, its drying characteristics have not been reported. The entire drying process of the EFY sample can be divided into three stages, and it is observed that around 80% of the moisture is removed in the first stage and only 5% of the moisture is removed in the last stage. The constant drying rate period is absent, and depending on the different slopes, the entire drying rate period comes under three falling rate periods. A correlation of EFY with air velocity and temperature is developed, and the maximum and minimum values of effective moisture diffusivity (EMD) are found to be 2.65 × 10−10 and 7.15 × 10−10 m2/s, respectively.
Proteolytic Cleavage of Subunits of the Nucleocapsid of the Paramyxovirus Simian Virus 5
Authors: Mountcastle Walter E. , Compans Richard W. , Lackland Henry , Choppin Purnell W. 
Published: January 2020

The protein subunits of the nucleocapsid of the parainfluenza virus simian virus 5 isolated from infected cells after dispersion with trypsin, chymotrypsin, or ficin are cleaved proteolytically. The molecular weights of the subunits which result from cleavage depend on the enzyme used, but are around 43,000, compared to the native subunit of 61,000. In most instances cleavage of the subunit appears to be due to the protease used to disperse the cell, and follows cell disruption. Nucleocapsids composed of native, uncleaved subunits can frequently be obtained from infected cells dispersed without a proteolytic enzyme; however, cleavage occasionally occurs even under those conditions, indicating that cellular proteases can at times cleave this protein. Nucleocapsids containing uncleaved subunits can be isolated from cells persistently infected with simian virus 5, indicating that persistent infection is not invariably associated with intracellular cleavage of this protein. Nucleocapsids composed of native subunits are hydrophobic, whereas those composed of the cleaved subunit can be dispersed in aqueous solution. It is suggested that the portion of the molecule removed by cleavage may be responsible for a specific interaction during virus assembly between the nucleocapsid and those areas of plasma membrane which contain the non-glycosylated viral membrane protein, which is also hydrophobic. An amino acid analysis of native and cleaved subunits has been done. The portion of the subunit removed by cleavage does not have a high proportion of hydrophobic residues, suggesting that those present are arranged together to form a hydrophobic domain.
The N termini of both the native and cleaved subunits are blocked. This suggests that the portion of the molecule which is externally disposed and removed by cleavage contains the C terminus, and the cleaved subunit which reacts with the viral RNA contains the N terminus.
Tankyrase Inhibitors Target Colorectal Cancer Stem Cells via AXIN-Dependent Downregulation of c-KIT Tyrosine Kinase
Authors: Jang Myung-Kyu , Mashima Tetsuo , Seimiya Hiroyuki 
Published: January 2020

Abstract
Cancer stem cells (CSC) constitute heterogeneous cell subpopulations of a tumor. Although targeting CSCs is important for cancer eradication, no clinically approved drugs that target CSCs have been established. Tankyrase poly(ADP-ribosyl)ates and destabilizes AXIN, a negative regulator of β-catenin, and promotes β-catenin signaling. Here, we report that tankyrase inhibitors downregulate c-KIT tyrosine kinase and inhibit the growth of CD44-positive colorectal CSCs. c-KIT expression in CD44-positive subpopulations of colorectal cancer COLO-320DM cells is associated with their tumor-initiating potential in vivo. Tankyrase inhibitors downregulate c-KIT expression in established cell lines, such as COLO-320DM and DLD-1, and colorectal cancer patient–derived cells. These effects of tankyrase inhibitors are caused by reducing the recruitment of SP1 transcription factor to the c-KIT gene promoter and depend on AXIN2 stabilization but not β-catenin downregulation. Whereas c-KIT knockdown inhibits the growth of CD44-positive COLO-320DM cells, c-KIT overexpression in DLD-1 cells confers resistance to tankyrase inhibitors. Combination of a low-dose tankyrase inhibitor and irinotecan significantly inhibited the growth of COLO-320DM tumors in a mouse xenograft model. These observations suggest that tankyrase inhibitors target c-KIT–positive colorectal CSCs and provide a novel therapeutic strategy for cancer.
Relative Change of Protidemia Level Predicts Intradialytic Hypotension
Authors: Assayag Maureen , Levy David , Seris Pascal , Maheas Catherine , Langlois Anne‐Lyse , Moubakir Kamal , Laplanche Sophie , Ridel Christophe , Touzot Maxime 
Published: January 2020

Background

Hemodialysis patients are at risk of intradialytic hypotension (
IDH
), which is associated with mortality and cardiovascular and neurological events. The use of biomarkers of volemia such as relative change in protidemia and BNP (B‐natriuretic peptide) levels to predict
IDH
remains unknown.

Methods and Results

We conducted a prospective observational study, which enrolled 170 chronic hemodialysis patients in a single center from September 2015 to March 2016.
BNP
and the relative change of protidemia level (Δprotidemia=postdialysis protidemia−predialysis protidemia) were measured monthly over 6 months. A logistic mixed regression model was used to define the best biomarkers that predict the 30‐day risk of
IDH
. Receiver operating characteristic analysis area under the curve was used to define the cutoff values of Δprotidemia that predict
IDH
A logistic mixed model reveals that Δprotidemia predicts the 30‐day risk of
IDH
but not
BNP
or age; odds ratio=1.12, 95%
CI
1.08‐1.17), odds ratio=0.81, 95%
CI
(0.64; 1.07) and odds ratio =0.015 95%
CI
(0.99; 1.03), respectively. Adding the ultrafiltration rate did not improve the model. A receiver operating characteristic curve analysis showed that Δprotidemia of 10 g/L allowed for discrimination of the patients with
IDH
(area under the curve= 0.67; 95%
CI
0.62‐0.72,
P
<0.05). There was an increase in area under the curve to 0.71 (95%
CI
0.63‐0.76) in a subgroup of hemodialysis with
BNP
<300 ng/L, for a cutoff value of 11 g/L, especially for the nondiabetic patients.

Conclusions

Relative change in protidemia level (Δprotidemia) outperforms
BNP
and ultrafiltration rate as a predictor for 30‐day risk of
IDH
. These results should be confirmed by a prospective study.
Proof of concept of participant informed, psycho-educational, community-based intervention for people with severe mental illness in rural Vietnam
Authors: Nguyen Trang , Tran Tuan , Green Sally , Hsueh Arthur , Tran Thach , Tran Ha , Fisher Jane 
Published: January 2020

Background: There is a lack of an intervention model that empowers people with severe mental illness (SMI) and their families and addresses the mental health gap in low- and middle-income countries. There is a significant gap in care for people with SMI in rural Vietnam due to the low quality of care in the formal mental health system and the lack of access to an evidence-informed informal approach to care. Objectives: To assess acceptability, feasibility, preliminary evidence of impact and potential cost savings of a mental health support group intervention for people with SMI in the community. Methods: The proof of concept used a pre–post design with qualitative assessment, impact evaluation and cost analysis. Results: A mental health support group intervention facilitated by Women’s Union staff using a positive deviance approach was conducted among 68 people with SMI. Qualitative evaluation showed that the approach was highly acceptable and feasible. There was a significant improvement in personal functioning and a reduction in stigma and discrimination experienced by intervention participants. The intervention was found to reduce significantly the financial burden on the families having members with SMI. Conclusion: The proof of concept of the mental health support group intervention delivered by informal community care providers for people with SMI provides promising evidence to address the mental health gap with high acceptability, feasibility and low-cost for low- and middle-income countries.
Synergic effect of GPIBA and von Willebrand factor in pathogenesis of deep vein thrombosis
Authors: Li Da , Zhang Xiaosong , Zhang Honggang , Li Xiaoqiang 
Published: January 2020

Objectives In cardiovascular disease, deep vein thrombosis is one of the vital symptoms causing pulmonary thromboembolism. However, the pathogenesis of deep vein thrombosis is still not clear. One of the critical factors leading to deep vein thrombosis is the platelet aggregation that is mediated by a set of key genes including platelet membrane protein coded by platelet glycoprotein Ib alpha chain (GPIBA). Methods Deep vein thrombosis model was established according to the previous protocol, and venous blood and thrombi were collected for further analysis. Results The dynamic changes of GPIBA and coagulation factor, von Willebrand factor, were observed in deep vein thrombosis models. Meanwhile, critical proteins participating in adhesion and binding of platelets such as epithelial membrane protein 2 (EMP2), vascular cell adhesion protein 1 (VCAM1), immunoreceptor tyrosine-based activation motif 1 (ITAM1), integrin subunit alpha M (ITGAM), or fibronectin were also differentially expressed in deep vein thrombosis models. Conclusions Application of heparin could reverse these dynamic changes in deep vein thrombosis models. Thus, we explained the potential synergic role of GPIBA and von Willebrand factor in regulating the occurrence of deep vein thrombosis and provide therapeutic target against cardiovascular disease.
An Update on Wrong-Site Spine Surgery
Authors: DeVine John G. , Chutkan Norman , Gloystein David , Jackson Keith 
Published: January 2020

Study Design: Broad narrative review of current literature and adverse event databases. Objective: The aim of this review is to report the current state of wrong-site spine surgery (WSSS), whether the Universal Protocol has affected the rate, and the current trends regarding WSSS. Methods: An updated review of the current literature on WSSS, the Joint Commission sentinel event statistics database, and other state adverse event statistics database were performed. Results: WSSS is an adverse event that remains a potentially devastating problem, and although the incidence is difficult to determine, the rate is low. However, given the potential consequences for the patient as well as the surgeon, WSSS remains an event that continues to be reported alarmingly as often as before the implementation of the Universal Protocol. Conclusions: A systems-based approach like the Universal Protocol should be effective in preventing wrong-patient, wrong-procedure, and wrong-sided surgeries if the established protocol is implemented and followed consistently within a given institution. However, wrong-level surgery can still occur after successful completion of the Universal Protocol. The surgeon is the sole provider who can establish the correct vertebral level during the operation, and therefore, it is imperative that the surgeon design and implement a patient-specific protocol to ensure that the appropriate level is identified during the operation.
Anticoagulation and Spine Surgery
Authors: Porto Guilherme B. F. , Jeffrey Wessell DO , Alvarado Anthony , Arnold Paul M. , Buchholz Avery L. 
Published: January 2020

Study Design: Literature review. Objective: Preoperative management of therapeutic anticoagulation in spine surgery is critical to minimize risk of thromboembolic events yet prevent postsurgical complications. Limited research is available, and most guidelines are based on drug half-lives. We aim to clarify current guidelines and available evidence for safe practice of spine surgery in this patient population. Methods: A literature search in PubMed was done encompassing comprehensive search terms to locate published literature on anticoagulation and spine surgery. Predefined inclusion and exclusion criteria were applied and data extraction was performed. Results: A total of 17 articles met the final inclusion criteria. Of these, 12 articles were retrospective chart reviews, 3 were prospective observational studies, and 2 were systematic reviews. Current practice suggests holding warfarin until international normalized ratio <1.4, anti-Xa drugs for 48 to 72 hours, 12 to 24 hours for low-molecular-weight heparin, and 4 to 24 hours for heparin, before surgery. Antiplatelet agents can be stopped for 1 to 3 days prior to operation (81-500 mg) but must be stopped for 1 week for doses >1 g/d. For Plavix, 5 to 7 days of discontinuation advised to prevent complications. Conclusions: This review provides an overview of main anticoagulation agents seen in preoperative setting for spine patients. Although data is mixed and no true randomized control trials are available, there is growing evidence suggesting the aforementioned guidelines are needed to optimize anticoagulation in setting of spine surgery. Further studies are needed to elucidate risk of complications while operating under therapeutic levels of anticoagulation for a variety of comorbid conditions.