bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Community Differences in Tornado Warning Reception, Comprehension, and Response across the United States
Authors: Ripberger Joseph T. , Silva Carol L. , Jenkins-Smith Hank C. , Allan Jinan , Krocak Makenzie , Wehde Wesley , Ernst Sean 
Published: April 2020

AbstractEffective risk communication in the weather enterprise requires deep knowledge about the communities that enterprise members serve. This includes knowledge of the atmospheric and climate conditions in these communities as well as knowledge about the characteristics of the people living in these communities. Enterprise members often have access to data that facilitate the first type of knowledge, but relatively little social or behavioral data on the populations they serve. This article introduces an effort to overcome these challenges by developing a database of community statistics and an interactive platform that provides dynamic access to the database. Specific emphasis is given to one set of statistics in the community database: estimates of tornado warning reception, comprehension, and response by county warning area in the contiguous United States. Exploration of these estimates indicates significant variation in reception and comprehension across communities. This variation broadly aligns with tornado climatology, but there are noticeable differences within climatologically comparable regions that underline the importance of community-specific information. Verification of the estimates using independent observations from a random sample of communities confirms that the estimates are largely accurate, but there are a few consistent anomalies that prompt questions about why some communities exhibit higher or lower levels of reception, comprehension, and response than models suggest. The article concludes with a discussion of next steps and an invitation to use and contribute to the project as it progresses.
Financial divergences of equalization and their impact on regional development in Morocco
Authors: Benkada Aziza , Belouchi Mohammed 
Published: April 2020

The purpose of this article is to analyse the impact of financial equalization on regional development in Morocco. While the redistribution of wealth through the financial equalization mechanism promotes equality and equity in favour of poor and disadvantaged regions, this mechanism still suffers from several shortcomings. The following analysis confirms that financial equalization has an amortization effect both on the donor regions that are forced to allocate part of their resources and on the recipient regions that risk falling into a development trap. Notwithstanding this analysis, equalization promotes solidarity and equality between territories; however, the actual situation on the ground confirms that this mechanism does not encourage beneficiary regions to improve their tax effort or develop their development strategies. The effectiveness of the equalization system therefore requires a detailed understanding of the reasons for inequalities in order to act on the causes rather than on the symptoms. Points for practitioners In the processes of territorial public management, the scarcity of financial resources is all the more reason to opt for more efficient investments. The quality of investments is more important than their quantity. The adoption of such an approach is a strategic move if disastrous consequences on public facilities are to be avoided in the long term. The various levels of local authorities must also take responsibility for improving their own resources and building up their development strategies.
Moral distress: Developing strategies from experience
Authors: Helmers Andrew , Palmer Karen Dryden , Greenberg Rebecca A 
Published: April 2020

Background Moral distress was first described by Jameton in 1984, and has been defined as distress experienced by an individual when they are unable to carry out what they believe to be the right course of action because of real or perceived constraints on that action. This complex phenomenon has been studied extensively among healthcare providers, and intensive care professionals in particular report high levels of moral distress. This distress has been associated with provider burnout and associated consequences such as job attrition, with potential impacts on patient and family care. There is a paucity of literature exploring how middle and late career healthcare providers experience and cope with moral distress. Objectives We explore the experience of moral distress and the strategies and resources invoked to mitigate that distress in mid- and late-career healthcare providers practicing in paediatric intensive care, in order to identify ways in which the work environment can build a culture of moral resilience. Research design An exploratory, qualitative quality improvement project utilizing focus group and semi-structured interviews with pediatric intensive care front-line providers. Participants Mid-and-later career (10 + years in practice) pediatric intensive care front line providers in a tertiary pediatric hospital. Research context This work focuses on paediatric intensive care providers in a single critical care unit, in order to explore the site-specific perspectives of health care providers in that context with respect to moral distress coping strategies. Ethical considerations The study was approved by the Quality Management Office at the institution; consent was obtained from participants, and no identifying data was included in this project. Findings Participants endorsed perspective-building and described strategies for positive adaptation including; active, reflective and structured supports. Participants articulated interest in enhanced and accessible formal supports. Discussion Findings in this study resonate with the current literature in healthcare provider moral distress, and exposed ways in which the work environment could support a culture of moral resilience. Avenues are described for the management and mitigation of moral distress in this setting. Conclusion This exploratory work lays the groundwork for interventions that facilitate personal growth and meaning in the midst of moral crises in critical care practice.
Bleeding Risk Associated With Hemodynamically Stable Low-Energy Pelvic Fracture
Authors: Sng Marcus , Gentle Juliette , Asadollahi Saeed 
Published: April 2020

Introduction: Life-threatening hemorrhage associated with low-energy pelvic fracture has been described in single cases in the literature. However, there is limited evidence available on the bleeding risk associated with hemodynamically stable osteoporotic pelvic fractures. The objective of this study was to estimate the bleeding risk associated with low-energy osteoporotic pelvic fractures in the elderly population. Materials and Methods: A retrospective review of patients aged > 65 years old with pelvic fractures admitted between 2015 and 2018 was performed. Eighty-two patients were identified: 12 males and 70 females with a median age of 86 years. The median Charlson comorbidity index was 6 (interquartile range = 5-7). Eighty-one fractures were classified as lateral compression I or Tile A2, and 1 fracture was classified as lateral compression II or Tile B2. Forty patients were on concurrent anticoagulation treatment. In 4 patients on warfarin, this treatment was reversed on admission. Results: The mean hemoglobin (Hb) level on arrival was 12.36 g/dL (±1.67 g/dL). There were significant drops in Hb levels on day 1 (Hb = 11.22 ± 1.86 g/dL, P < .001) and day 4 (Hb = 10.97 ± 1.6 g/dL, P < .001). Nine percent of patients required a blood transfusion. The mean baseline Hb level pre-transfusion was 8.33 g/dL (±1.15). Preexisting anticoagulation treatment did not predispose patients to greater decreases in Hb levels on day 1 (mean difference = 0.16 g/dL, P = .62) or day 4 (mean difference = 0.29 g/dL, P = .48) post-admission. Discussion: An observed mean decrease in Hb level of up to 1.4 g/dL can occur in hemodynamically stable elderly patients with osteoporotic pelvic fractures, reflecting an approximate loss of 1.4 units of packed red blood cells. Conclusion: This degree of decrease in Hb may be clinically significant in geriatric patients with chronic anemia and a history of cardiovascular disease.
Middle-age-onset cerebellar ataxia caused by a homozygous TWNK variant: a case report
Authors: Kume Kodai , Morino Hiroyuki , Miyamoto Ryosuke , Matsuda Yukiko , Ohsawa Ryosuke , Kanaya Yuhei , Tada Yui , Kurashige Takashi , Kawakami Hideshi 
Published: April 2020

AbstractBackgroundTheTWNKgene encodes the twinkle protein, which is a mitochondrial helicase for DNA replication. The dominantTWNKvariants cause progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal dominant 3, while the recessive variants cause mitochondrial DNA depletion syndrome 7 and Perrault syndrome 5. Perrault syndrome is characterized by sensorineural hearing loss in both males and females and gonadal dysfunction in females. Patients with Perrault syndrome may present early-onset cerebellar ataxia, whereas middle-age-onset cerebellar ataxia caused byTWNKvariants is rare.Case presentationA Japanese female born to consanguineous parents presented hearing loss at age 48, a staggering gait at age 53, and numbness in her distal extremities at age 57. Neurological examination revealed sensorineural hearing loss, cerebellar ataxia, decreased deep tendon reflexes, and sensory disturbance in the distal extremities. Laboratory tests showed no abnormal findings other than a moderate elevation of pyruvate concentration levels. Brain magnetic resonance imaging revealed mild cerebellar atrophy. Using exome sequencing, we identified a homozygousTWNKvariant (NM_021830: c.1358G>A, p.R453Q).ConclusionsTWNKvariants could cause middle-age-onset cerebellar ataxia. Screening forTWNKvariants should be considered in cases of cerebellar ataxia associated with deafness and/or peripheral neuropathy, even if the onset is not early.
Characteristics of sleep/wake problems and delivery outcomes among pregnant Japanese women without gestational complications
Authors: Umeno Shiho , Kato Chiho , Nagaura Yuki , Kondo Hideaki , Eto Hiromi 
Published: April 2020

Abstract
Background
Frequently observed sleep/wake problems among pregnant women need comprehensive evaluation. This study was conducted to clarify the sleep/wake problems among pregnant women without gestational complications during the second and third trimester and the effects of sleep/wake problems on delivery outcomes.

Methods
A total of 88 Japanese pregnant women participated in this study. In their second and third trimester, subjective sleep quality, insomnia severity, excessive daytime sleepiness (EDS), and restless legs syndrome/Willis-Ekbom disease (RLS/WED) were assessed using questionnaires; also, sleep disordered breathing (SDB) was screened using a pulse oximeter.

Results
From the second to the third trimester, an increasing tendency of sleep/wake problems was observed. During the third trimester, the percentages of women experiencing decreased subjective sleep quality, difficulty maintaining sleep (DMS), EDS, RLS/WED, and 3% oxygen desaturation index (ODI) values ≥5/h were 62.5, 45.5, 48.9, 9.1, and 29.5%, respectively. In a logistic regression analysis for EDS in the third trimester, the adjusted odds ratio (95% confidence interval) of total sleep duration < 6 h, moderate to severe DMS, and 3% ODI values ≥5/h were 3.25 (1.16–9.10), 4.74 (1.60–14.00), and 0.90 (0.28–2.89), respectively. Although short sleep durations, decreased subjective sleep quality, EDS, and SDB did not affect delivery outcomes or the infant’s condition, the percentage of women undergoing cesarean sections in the severe insomnia group was significantly higher (p = 0.008).

Conclusions
Sleep/wake problems were frequent during pregnancy, especially during the third trimester. EDS among pregnant women was associated with shorter sleep durations and DMS rather than SDB. The effect of factors related to insomnia on delivery outcomes should thus be considered a crucial problem among pregnant Japanese women without gestational complications in clinical practice.
Etiological serotype and genotype distributions and clinical characteristics of group B streptococcus-inducing invasive disease among infants in South China
Authors: Zhu Yao , Wu Jiayin , Zheng Xinyi , Liu Dengli , Xu Liping , Chen Dongmei , Qiu Wenying , Huang Zhongling , Zhong Ronghua , Chen Ling , He Mingyuan , Ma Simin , Lin Yayin , Lin Xinzhu , Chen Chao 
Published: April 2020

Abstract
Background
Group B streptococcus (GBS)-induced invasive disease is a major cause of illness and death among infants aged under 90 days in China; however, invasive GBS infection remains unknown in China. We aimed to describe the serotype and genotype distributions of early-onset disease (EOD) and late-onset disease (LOD), and to show the clinical correlations among various GBS serotypes and genotypes obtained from infants with invasive GBS infections.

Methods
Between June 1, 2016 and June 1, 2018, 84 GBS strains were collected from patients younger than 90 days at seven Chinese hospitals. Clinical data were retrospectively reviewed. GBS serotyping was conducted and multi-locus sequence typing was performed.

Results
Serotypes Ia, Ib, II, III, and V were detected. Serotype III (60.71%) was the most common, followed by Ia (16.67%) and Ib (14.29%). Intrapartum temperature ≥ 37.5 °C, chorioamnionitis, and mortality were noted in 28.57, 42.86, and 28.57% of patients with serotype Ia, respectively, and these rates were higher than those in patients with serotypes Ib and III (P = 0.041, P = 0.031, and P = 0.023, respectively). The incidence of respiratory distress was lower (P = 0.039) while that of purulent meningitis was higher (P = 0.026) in the serotype III group. Eighteen sequence types were detected among isolates, and ST17 [42.86% (36/84)] was the most prevalent.

Conclusions
GBS isolates belonging to serotypes Ia, Ib, and III are common in southern mainland China, and ST17 is highly prevalent. Differences were found in the clinical manifestations of invasive GBS disease induced by serotypes Ia and III.
Cost-effectiveness and resource allocation (CERA) 18 years of evolution: maturity of adulthood and promise beyond tomorrow
Authors: Jakovljevic Mihajlo , Matter-Walstra Klazien , Sugahara Takuma , Sharma Tarang , Reshetnikov Vladimir , Merrick Joav , Yamada Tetsuji , Youngkong Sitaporn , Rovira Joan 
Published: April 2020

AbstractSince its inception in 2003, Cost Effectiveness and Resource Allocation journal has come a long way over the past 18 years. Possibly much longer than many of its contemporaries in the blossoming science of health economics might have anticipated. Today, entering 2020 it celebrates the Age of Maturity. We believe that in the third decade of XXI century the interdisciplinary science of health economics, will rejuvenate and come back to us younger than ever from its early historical roots almost a century ago. The spreading of economic globalization in several distinctive ways, either led by multinational business corporations or newly emerged Asian leadership, or both, is likely to make challenges for contemporary health systems far more serious. The fourth industrial revolution (cyber physical systems and artificial intelligence technology) and accelerated innovation in the field of E-Health and digital health, will probably change the workflow in medical and health care, and inevitably transform the labour market in the upcoming decades. So, let us be up to the task. Let us provide academic centres, industry-sponsored pharmaceutical and medical device innovation hubs, and governing authorities alike, with a powerful forum for debate on cost-effective resource allocation in the years to come.
Oncology nurses’ compassion fatigue, burn out and compassion satisfaction
Authors: Jarrad Reem Ahmad , Hammad Sawsan 
Published: April 2020

Abstract
Background
For oncology nurses, compassion fatigue, burn out and compassion satisfactions are frequently experienced psychosocial consequences of the oncology work environment. Surveying such phenomena helps to understand how nurses feel and behave when cancer care is provided. Besides, tracking the evolving nature of those three concepts can lend a hand for the early detection of personal and professional suffering of nurses while offering some healing remedies to their struggling bodies and souls.

Purpose
The purpose of this study was to explore the level of compassion fatigue, burn out and compassion satisfaction among a group of specialized oncology nurses. Besides, this study aimed to detect some probable interesting inferences between compassion satisfaction and the concept of rest and leisure. Correlations between compassion fatigue, burn out and compassion satisfaction were investigated. Correlations between oncology nurses’ scores on the three subscales and a group of demographic, organizational and leisure-related variables were examined.

Methods
This study adopted a descriptive correlation design to survey compassion fatigue, burn out and compassion satisfaction among a convenient sample of 100 oncology nurses who work in a specialized cancer care centre. Participants completed compassion fatigue self-test developed by Figely (Compassion fatigue, New York: Brunner/Mazel. B. HudnallStamm, Traumatic Stress Research Group; 1995–1998. http://www.dartmouth.edu/~bhstamm/index.htm, 1995) and a literature-based demographic survey. Analysis of data included descriptive statistics and Pearson correlation co-efficient.

Results
Nurses reported a low level of compassion satisfaction, moderate risk for burn out and an extremely high risk for compassion fatigue. Results revealed significant negative relationships among compassion satisfaction and the number of dependents per nurse. Additionally the correlation between compassion satisfaction and the nurses’ number of hours slept was positive. Only two components of the concept rest and leisure yielded statistical significance when correlated to the concept of compassion satisfaction. A significant negative relationship was observed between compassion satisfaction and compassion fatigue while a strong positive relationship was observed between compassion fatigue and burn out.

Conclusions
The studied oncology nurses sample had evidently low level of compassion satisfaction when contrasted to the significantly increased risks of burn out and compassion fatigue. Thus, health authorities and management are advised to care, in a holistic approach, for nurses who work in oncology departments. Staff-oriented services that offer comfort, reward, leisure, screening, consultation and support are urgently recommended.
Lamina-associated domains: peripheral matters and internal affairs
Authors: Briand Nolwenn , Collas Philippe 
Published: April 2020

AbstractAt the nuclear periphery, associations of chromatin with the nuclear lamina through lamina-associated domains (LADs) aid functional organization of the genome. We review the organization of LADs and provide evidence of LAD heterogeneity from cell ensemble and single-cell data. LADs are typically repressive environments in the genome; nonetheless, we discuss findings of lamin interactions with regulatory elements of active genes, and the role lamins may play in genome regulation. We address the relationship between LADs and other genome organizers, and the involvement of LADs in laminopathies. The current data lay the basis for future studies on the significance of lamin-chromatin interactions in health and disease.
SMASH standardised perioperative management of patients operated with acute abdominal surgery in a high-risk setting
Authors: Timan Terje Jansson , Sernert Ninni , Karlsson Ove , Prytz Mattias 
Published: April 2020

Abstract
Objective of the study
Emergency laparotomy and other high-risk acute abdominal surgery procedures have a high mortality rate. The perioperative management of these patients is complex and poses several challenges. The objective of the study is to implement and evaluate the outcome of protocol-based standardised care for patients in need of acute abdominal surgery in a Swedish setting. NÄL is a large county hospital in Sweden serving a population of approximately 270,000 inhabitants. The study seeks to determine whether standardised protocol-based perioperative management in emergency abdominal surgical procedures leads to a better outcome measured as short- and long-term mortality and postoperative complications compared with the present standard in Swedish routine care. The study is ongoing, and this article describes the methodology used in the study and discusses the benefits and limitations the study design.

Results
There are no results so far. The inclusion rate for the first 22 months is as expected; 404 patients have been included and protocols have been followed and reviewed according to the study plan. 25 patients have been missed and demographic data and outcome data for these patients will be collected and analysed.
Association between retinal thickness and β-amyloid brain accumulation in individuals with subjective cognitive decline: Fundació ACE Healthy Brain Initiative
Authors:   on behalf of the FACEHBI study group, Marquié Marta , Valero Sergi , Castilla-Marti Miguel , Martínez Joan , Rodríguez-Gómez Octavio , Sanabria Ángela , Tartari Juan Pablo , Monté-Rubio Gemma C. , Sotolongo-Grau Oscar , Alegret Montserrat , Pérez-Cordón Alba , Roberto Natalia , de Rojas Itziar , Moreno-Grau Sonia , Montrreal Laura , Hernández Isabel , Rosende-Roca Maitee , Mauleón Ana , Vargas Liliana , Abdelnour Carla , Gil Silvia , Esteban-De Antonio Ester , Espinosa Ana , Ortega Gemma , Lomeña Francisco , Pavia Javier , Vivas Assumpta , Tejero Miguel Ángel , Gómez-Chiari Marta , Simó Rafael , Ciudin Andreea , Hernández Cristina , Orellana Adelina , Benaque Alba , Ruiz Agustín , Tárraga Lluís , Boada Mercè 
Published: April 2020

Abstract
Background
Optical coherence tomography (OCT) of the retina is a fast and easily accessible tool for the quantification of retinal structural measurements. Multiple studies show that patients with Alzheimer’s disease (AD) exhibit thinning in several retinal layers compared to age-matched controls. Subjective cognitive decline (SCD) has been proposed as a risk factor for progression to AD. There is little data about retinal changes in preclinical AD and their correlation with amyloid-β (Aβ) uptake.

Aims
We investigated the association of retinal thickness quantified by OCT with Aβ accumulation and conversion to mild cognitive impairment (MCI) over 24 months in individuals with SCD.

Methods
One hundred twenty-nine individuals with SCD enrolled in Fundació ACE Healthy Brain Initiative underwent comprehensive neuropsychological testing, OCT scan of the retina and florbetaben (FBB) positron emission tomography (PET) at baseline (v0) and after 24 months (v2). We assessed the association of sixteen retinal thickness measurements at baseline with FBB-PET status (+/−) and global standardize uptake value ratio (SUVR) as a continuous measure at v0 and v2 and their predictive value on clinical status change (conversion to mild cognitive impairment (MCI)) at v2.

Results
Mean age of the sample was 64.72 ± 7.27 years; 62.8% were females. Fifteen participants were classified as FBB-PET+ at baseline and 22 at v2. Every 1 μm of increased thickness in the inner nasal macular region conferred 8% and 6% higher probability of presenting a FBB-PET+ status at v0 (OR = 1.08, 95% CI = 1.02–1.14, p = 0.007) and v2 (OR = 1.06, 95% CI = 1.02–1.11, p = 0.004), respectively. Inner nasal macular thickness also positively correlated with global SUVR (at v0: β = 0.23, p = 0.004; at v2: β = 0.26, p = 0.001). No retinal measurements were associated to conversion to MCI over 24 months.

Conclusions
Subtle retinal thickness changes in the macular region are already present in SCD and correlate with Aβ uptake.