bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bridge pier shape influence on wood accumulation: Outcomes from flume experiments and numerical modelling
Authors: De Cicco Pina N. , Paris Enio , Solari Luca , Ruiz‐Villanueva Virginia 
Published: February 2020

AbstractStreamwood accumulation at bridges exerts additional forces to bridge structures and may aggravate flooding, local scouring, and eventually may lead to bridge collapse. However, the important ecological role of streamwood in fluvial systems calls for a compromise between preservation of river ecosystems and prevention of streamwood‐related hazards (e.g., bridge clogging). This study evaluates the effect of bridge pier shape on wood accumulation or blockage, probability in lowland type of rivers. We conducted laboratory experiments in a flume testing various pier shapes and wood transport mechanisms under two different flow conditions, complemented with numerical modelling. Results revealed that the flow field immediately upstream from the pier has a significant influence on the blockage probability. The pier shape is controlling the flow field, thus, it has a significant influence on wood accumulation. In particular, a squared pier shape, higher Froude number and semi‐congested wood transport resulted in the highest blockage probability under the tested conditions. Our results may help to better design infrastructures to mitigate streamwood‐related hazards in rivers.
Critical infrastructure cascading effects. Disaster resilience assessment for floods affecting city of Cologne and Rhein‐Erft‐Kreis
Authors: Fekete Alexander 
Published: February 2020

AbstractAt the case study of the city of Cologne and the neighbouring Rhein‐Erft‐Kreis (a county), selected resilience aspects of critical infrastructure (CI) and cascading effects are analysed concerning major river floods. Using a Geographic Information System, the applicability of the approach is demonstrated using open source software and data, augmented by manual entries. This study demonstrates the feasibility and limitations of analysing lifeline features of interest for disaster risk and emergency management such as roads, bridges and electricity supply. By highlighting interdependencies of emergency services with CI such as roads, cascading effects of interconnected paths are shown. The findings indicate that in an extreme event flood scenario over 2,000 km of roads and eight bridges will be exposed to floods in the area of the rivers Rhine and Erft. This places huge demands on disaster and emergency management institutions and people affected and limits their resiliency.
Exploring psychosocial factors associated with frailty incidence among patients undergoing maintenance hemodialysis
Authors: Yuan Huaihong , Zhang Yingjun , Xue Guifang , Yang Yujie , Yu Shaobin , Fu Ping 
Published: February 2020

AbstractAim and objectiveWe investigated the correlation between the frailty status of maintenance haemodialysis (MHD) patients and psychosocial factors.BackgroundVarying degrees of frailty have been reported in MHD patients, which affect their quality of life.DesignWe adopted a cross‐sectional design in this study.MethodsClinical data of 187 patients at our centre were collected from December 2017–June 2018 using a cross‐sectional survey. Psychosocial factors were measured using the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, 10‐item Connor‐Davidson Resilience Scale (CD‐RISC), Chronic Disease Self‐Efficacy Scales and Perceived Social Support Scale. Frailty status was estimated using the fatigue, resistance, ambulation, illnesses and loss of weight (FRAIL) scale. Spearman's correlation and multiple logistic regression analysis were conducted to identify the risk factors for frailty. This study complied with the STROBE checklist.ResultsOf 187 patients, 11 cases (5.9%) of frailty were identified. Patient's age, comorbidities, parathyroid hormone level, sleep quality and depression were positively correlated with frailty (p < .05), while psychological resilience and social support were negatively correlated with frailty (p < .05). Logistic regression analysis revealed four risk factors for frailty among MHD patients, including age (p = .004), comorbidities (p = .023), depression (p = .023) and sleep disorders (p = .029). Conversely, protective factors included high psychological resilience (p = .019) and social support (p = .039).ConclusionAmong MHD patients, the risk factors for frailty included age, comorbidity, depression and sleep disturbance, whereas the protective factors included psychological resilience and social support.Relevance to clinical practiceFrailty is not only common among older patients, but also among people of all age groups suffering from chronic diseases. Therefore, it is important to consider the health status of MHD patients and adopt targeted nursing strategies to alleviate symptoms of frailty and improve physical condition by the following ways: postpone the progress of comorbidities, improve sleep quality, control the symptoms of depression, foster psychological resilience and facilitate support from social and family.
Evaluation and ranking of different interventions for pain relief during outpatient hysteroscopy: A systematic review and network meta‐analysis
Authors: Ghamry Nevein K. , Samy Ahmed , Abdelhakim Ahmed M. , Elgebaly Ahmed , Ibrahim Safaa , Ahmed Amal A. , Abdelbaky Waleed H. , Abdallah Khaled M. , Badawy Mahmoud A. , Mohammed Ahmed H. , Hamza Mohamed 
Published: February 2020

AbstractAimTo identify the highest‐ranked pharmacological and nonpharmacological interventions for pain relief during outpatient hysteroscopy.MethodsWe conducted an online bibliographic search in different databases from inception till July 2019. We included randomized controlled trials assessing effect of pharmacological and nonpharmacological interventions on pain relief during outpatient hysteroscopy. Our main outcomes were pain scores at different endpoints of the procedure. We applied this network meta‐analysis based on the frequentist approach using statistical package ‘netmeta’ (version 1.0‐1) in R.ResultsThe review included 39 randomized controlled trials (Women n = 3964). Misoprostol plus intracervical block anesthesia (mean difference [MD] = −3.32, 95% confidence interval [CI] [−6.06, −0.59]), misoprostol (MD = −1.92, 95% CI [−3.04, −0.81]) and IV analgesia (MD = −2.01, 95% CI [−3.27, −0.25]) were effective in reducing pain during the procedure compared to placebo. Ranking probability showed that misoprostol plus intracervical block anesthesia was the highest ranked pharmacological treatment for pain relief during the procedure (P score = 0.92) followed by misoprostol alone (P score = 0.78), and IV analgesia (P score = 0.76). Regarding nonpharmacological treatments, transcutaneous electrical nerve stimulation (TENS) showed a significant pain reduction compared to placebo (MD = −1.80, 95% CI [−3.31, −0.29]). TENS ranked as the best nonpharmacological treatment (P score = 0.80) followed by CO2 distention (P score = 0.65) and bladder distention (P score = 0.60).ConclusionCombination of misoprostol plus local anesthesia appears to be the most effective pharmacological approach for pain reduction during and after outpatient hysteroscopy. Nonpharmacological approaches as TENS and bladder distention showed considerable efficacy but should be further investigated.
Epigenetic insights into multiple sclerosis disease progression
Authors: Kular L. , Jagodic M. 
Published: February 2020

AbstractMultiple sclerosis (MS), a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system, is today a leading cause of unpredictable lifelong disability in young adults. The treatment of patients in progressive stages remains highly challenging, alluding to our limited understanding of the underlying pathological processes. In this review, we provide insights into the mechanisms underpinning MS progression from a perspective of epigenetics, that refers to stable and mitotically heritable, yet reversible, changes in the genome activity and gene expression. We first recapitulate findings from epigenetic studies examining the brain tissue of progressive MS patients, which support a contribution of DNA and histone modifications in impaired oligodendrocyte differentiation, defective myelination/remyelination and sustained neuro‐axonal vulnerability. We next explore possibilities for identifying factors affecting progression using easily accessible tissues such as blood by comparing epigenetic signatures in peripheral immune cells and brain tissue. Despite minor overlap at individual methylation sites, nearly 30% of altered genes reported in peripheral immune cells of progressive MS patients were found in brain tissue, jointly converging on alterations of neuronal functions. We further speculate about the mechanisms underlying shared epigenetic patterns between blood and brain, which likely imply the influence of internal (genetic control) and/or external (e.g. smoking and ageing) factors imprinting a common signature in both compartments. Overall, we propose that epigenetics might shed light on clinically relevant mechanisms involved in disease progression and open new avenues for the treatment of progressive MS patients in the future.
Estate recovery and long‐term care insurance
Authors: Courbage Christophe , Montoliu‐Montes Guillem 
Published: February 2020

AbstractEstate recovery is a policy under which the state recovers part of long‐term care (LTC) subsidies from the estates of deceased beneficiaries. This paper studies the effect of estate recovery on LTC insurance demand. This effect strongly relies on the bequest motive since the main purpose behind purchasing LTC insurance is to protect bequests from the financial costs of LTC. We find that the impact of estate recovery on LTC insurance depends on the level of parental bequests and on whether and how the parent anticipates the child's preferences with respect to informal care. More specifically, we show that estate recovery encourages the parent to purchase LTC insurance when his child is considered selfish or to like providing care. However, this policy could provide disincentives to LTC insurance purchase by the parent if his child is considered to dislike providing informal care. Our results also show that estate recovery reduces and may even eliminate public support crowding out of private LTC insurance demand. Finally, we characterize the welfare implications of financing LTC public support by estate recovery.
Beyond medicines provision: community pharmacists roles in meeting patient needs through value-added pharmacy services
Authors: Chukwu Otuto Amarauche 
Published: February 2020

Abstract

Objectives
Pharmacy practice now requires more patient-centred and outcome-oriented approach, hence the need for a more value-based model. In developing countries like Nigeria, out-of-pocket spending for health care is high and patients usually visit the community pharmacy first to attend to their health needs. Since patients need to get value for their money, assessing their perception on services provided and their need for value-added pharmacy services is imperative. Thus, this study aims at assessing the perception of patients on services provided by community pharmacies in Nigeria and to ascertain their needs for value-added pharmacy services.

Methods
A 15-item questionnaire was administered to randomly sampled respondents who routinely visit their community pharmacy. The questionnaire addressed demographics, satisfaction with community pharmacy practice, accessibility of healthcare professionals and need for value-added pharmacy services. The respondents gave oral informed consent prior to administration of the questionnaires. Descriptive statistics were applied in data analysis.

Key Findings
A total of 384 questionnaires were distributed, and 300 were duly filled and returned. The survey lasted for 3 months, and the questionnaires were self-completed. All respondents agreed that pharmacy practice is important in healthcare delivery in Nigeria. Seventy-one per cent stated that the community pharmacy was their first port of call for treating minor ailments and seeking advice on medicines and health. Furthermore, 61% indicated that they trust pharmacists more than other health professionals in the area of medicines provision and advice. All respondents agreed that they require provision of more services other than medication dispensing and advice from their pharmacists.

Conclusions
Results suggest that patients have a positive perception towards community pharmacists as the most accessible and trusted health professionals for minor ailments and medicines provision. However, in addition to medicines provision, these patients require more services from pharmacists that add value in meeting their various health and medicines needs.
Melatonin ameliorates aluminum toxicity through enhancing aluminum exclusion and reestablishing redox homeostasis in roots of wheat
Authors: Sun Chengliang , Lv Ting , Huang Lin , Liu Xiaoxia , Jin Chongwei , Lin Xianyong 
Published: February 2020

AbstractMelatonin is a universal regulator modulating plant development and responses to abiotic stresses. The alteration and potential roles of melatonin in mediating aluminum (Al) tolerance were investigated in two wheat genotypes differing in Al resistance. Using the high‐resolution mass spectrometry, we observed that melatonin contents in Xi Aimai‐1 were 1.7‐fold higher than that in Yangmai‐5. Application of melatonin conferred Al resistance in both genotypes. Melatonin treatment scavenged reactive oxygen species (ROS) accumulation and alleviated Al‐induced oxidative damage to lipids and proteins by stimulating antioxidant enzymes and augmenting antioxidants. Additionally, melatonin treatment decreased root tip‐Al contents by 19.0% and 15.5% in Xi Aimai‐1 and Yangmai‐5, respectively. Malate efflux, however, was not altered by melatonin under Al stress. The amount of cell wall polysaccharide and pectin methylesterase activity was significantly increased by Al treatment; but suppressed by melatonin. Melatonin synthesis inhibitor, p‐CPA, significantly increased the amount of the Al binding in cell walls of the tolerant genotype, whereas exogenous melatonin decreased cell wall Al content in the sensitive genotype. These results suggest that melatonin alleviated Al toxicity through augmenting antioxidants and inducing antioxidant enzymes to control ROS and enhancing exclusion of Al from root apex by altering cell wall polysaccharides in wheat.
Reduced movement of wildlife in Mediterranean landscapes: a case study of brown bears in Greece
Authors: de Gabriel Hernando M. , Karamanlidis A. A. , Grivas K. , Krambokoukis L. , Papakostas G. , Beecham J. 
Published: February 2020

AbstractThe survival of large carnivores in a rapidly changing, human‐modified world depends largely on their movements; therefore, understanding how movement patterns change within space and time and which factors affect them most is of paramount importance for their conservation. In a case study in Greece using brown bearsUrsus arctos, we evaluated the movement ecology of a recovering population in a Mediterranean landscape, where human activity is high. We found that during daytime bears moved less, when ambient temperatures were high and when they were far away from forests and close to settlements, where human activity is expected to be high. During night‐time, when human activity and mortality risk are expected to be low, bear movement was higher farther from forested areas, close to roads, and in less rough terrain. Although bear movement patterns in Greece were generally similar to those of other bear populations in Europe, home ranges were smaller than in northern populations. These findings indicate that increased human activity and high ambient temperatures reduce bear movement and ultimately contribute to the smaller home ranges in the warmer and human‐dominated Mediterranean landscapes. We suggest that management and conservation actions in Mediterranean landscapes should aim on separating humans and bears in space or time, so that bear movements are not constrained and, in turn, minimum home ranges that cover their essential requirements are guaranteed.
Non‐invasive liver fibrosis scores are strongly associated with liver cancer mortality in general population without liver disease
Authors: Sung Ki‐Chul , Johnston Michael P. , Lee Mi Y. , Byrne Christopher D. 
Published: February 2020

AbstractBackground & AimsIn a general population without known liver disease, we tested whether: (a) increased liver fibrosis scores (FIB‐4 and APRI) are associated with liver cancer mortality and (b) the probability that a person with a higher score died of liver cancer.MethodsIn a retrospective occupational cohort who underwent annual/biennial health examinations (between 2002 and 2015), subjects were excluded with known chronic liver disease. Based on their baseline FIB‐4 and APRI scores, subjects were categorised in low‐/intermediate‐/high‐risk groups for advanced liver fibrosis. Using Cox proportional hazards regression analyses adjusted hazard ratios (aHR) were estimated for liver cancer mortality, with the low‐risk FIB‐4/APRI group as the reference. Harrell's C statistics were also calculated.ResultsIn 200 479 participants, mean (SD) age was 36.4 (7.7) years. Median follow‐up was 4.1 years (IQR 2.10‐8.03) with 80 liver cancer deaths. High baseline FIB‐4 or APRI scores occurred in 0.25% and 0.09% of subjects respectively. A high FIB‐4 or APRI score was associated with a markedly increased risk of liver cancer mortality (aHRs 629.10 [95% CI 228.74‐1730.20] and 80.42 [95% CI 34.37‐188.18]) respectively. C statistics were FIB‐4 = 0.841 (95% CI 0.735‐0.946) and APRI = 0.933 (95% CI 0.864‐0.999).ConclusionsIn a general population without known liver disease, high FIB‐4 or high APRI (in keeping with a high probability of advanced fibrosis) occurred in 0.25% (FIB‐4) and 0.09% (APRI) of subjects. Both scores were associated with a markedly increased risk of liver cancer mortality and FIB‐4 and APRI models both strongly predicted liver cancer mortality.
The limits of rational belief revision: A dilemma for the Darwinian debunker
Authors: Vavova Katia 
Published: February 2020

AbstractWe are fallible creatures, prone to making all sorts of mistakes. So, we should be open to evidence of error. But what constitutes such evidence? And what is it to rationally accommodate it? I approach these questions by considering an evolutionary debunking argument according to which (a) we have good, scientific, reason to think our moral beliefs are mistaken, and (b) rationally accommodating this requires revising our confidence in, or altogether abandoning the suspect beliefs. I present a dilemma for such debunkers, which shows that either we have no reason to worry about our moral beliefs, or we do but we can self‐correct. Either way, moral skepticism doesn't follow. That the evolutionary debunking argument fails is important; also important, however, is what its failure reveals about rational belief revision. Specifically, it suggests that getting evidence of error is a non‐trivial endeavor and that we cannot learn that we are likely to be mistaken about some matter from a neutral stance on that matter.
The power of the Functional Activities Questionnaire for screening dementia in rural‐dwelling older adults at high‐risk of cognitive impairment
Authors: Yin Ling , Ren Yifei , Wang Xiang , Li Yunxia , Hou Tingting , Liu Keke , Cong Lin , Zhang Qinghua , Wang Yongxiang , Jiang Ziying , Du Yifeng 
Published: February 2020

AimA simple approach to detecting dementia in its early stages may help improve patient care. We therefore aimed to assess the power of the Functional Activities Questionnaire (FAQ) for screening dementia among rural‐dwelling older adults who are at high‐risk for cognitive impairment.MethodsThis study included 961 participants at a high‐risk for dementia who had been identified from a population‐based survey of Chinese rural residents. All participants were aged 65 years and older and positive for cognitive impairment according to the Mini‐Mental State Examination or the Ascertain Dementia 8‐item Informant Questionnaire screening tests. The FAQ scale was used to evaluate daily activities. Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria. Receiver operating characteristic curve analyses were used to determine the FAQ's optimal cut‐offs for dementia. The power (or accuracy) of the FAQ for screening dementia was analyzed in the total sample and in subgroups categorized by age, gender, and educational level.ResultsOf the 961 participants, 84 (8.7%) were clinically diagnosed with dementia. Among individuals who were positive for cognitive impairment on the Mini‐Mental State Examination or the Ascertain Dementia 8‐item Informant Questionnaire, the parameters for an FAQ cut‐off score ≥6 as a means of discriminating those with dementia from those without dementia were area under curve = 0.899, sensitivity = 94.1%, specificity = 75.1%, positive likelihood ratio = 3.78, and accuracy = 0.768. The discriminant abilities of the FAQ scale varied with age, gender, and educational level. The discriminant parameters of the FAQ scale were similar overall among individuals who were positive on either the Mini‐Mental State Examination or the Ascertain Dementia 8‐item Informant Questionnaire test alone.ConclusionThe FAQ scale has high discriminative power to screen for dementia among rural older residents with suspected cognitive impairment.
Frailty index predicts geriatric psychiatry inpatient mortality: a case–control study
Authors: Stolz Erwin , Rásky Éva , Jagsch Christian 
Published: February 2020

BackgroundMany geriatric psychiatry patients suffer from complex psychiatric and medical problems and a minority of patients dies in‐hospital. We assess whether a frailty index (FI) predicts inpatient mortality.MethodsElectronic health records from 276 patients of a geriatric psychiatry department over 3 years (2015–2017) in Austria were analysed using logistic regression analysis.ResultsMortality rate was 4.2%. The adjusted effect of frailty (per 0.1 FI) on mortality was odds ratio = 3.25 (95% CI = 2.29–4.79). The area under the curve of 0.81 (95% CI = 0.76–0.86) suggested acceptable predictive accuracy.ConclusionsWe found that a non‐negligible minority of geronto‐psychiatric patients died in‐hospital, which can be usefully predicted by the FI derived from routine electronic patient records.