bluuebunny/crossref_metadata_2025_split huggingface dataset:
“It should not be that difficult to manage a condition that is so frequent”: A qualitative study on hospital nurses’ experience of delirium guidelines
Authors: Emme Christina 
Published: April 2020

AbstractAims and objectivesTo explore hospital nurses’ experiences of enablers and barriers to apply the recommendations of a hospital delirium guideline, focusing on identification and nonpharmacological prevention and treatment.BackgroundNurses’ application of delirium guidelines is important as they have a pivotal role in identifying, preventing and managing delirium. Research is sparse concerning barriers and enablers to nurses´ application of guideline recommendations on nonpharmacological prevention and treatment of delirium.DesignQualitative design using focus group and individual interviews.MethodsTwenty‐three nurses, nurse supervisors and senior staff nurses from four departments in a Danish 530‐bed university hospital participated in the study. The interview guide was based on the Theoretical Domains Framework. Data were analysed using inductive content analysis. The COREQ checklist was used preparing the manuscript.ResultsThe analysis identified four main categories concerning barriers and enablers to applying the recommendations of a delirium guideline: factors relating to employing the guideline, the individual nurse, collaboration and the context. Lack of identification of delirium and lack of preventive actions were prominent, with inter‐related barriers such as lack of knowledge, lack of meaningfulness, lack of priority, lack of resources and working conditions, causing frustration and discouragement in the nurses.ConclusionsThe study identified a wide range of barriers and enablers experienced by hospital nurses to the application of a delirium guideline, showing the complexity of delirium care and applying guidelines.Relevance to clinical practiceImproving the identification, prevention and treatment for patients with delirium requires a determined and focused effort from all stakeholders, both clinicians, leaders and policymakers. Nurses, nurse leaders and educators must be aware of the barriers and enablers related to knowledge, attitudes and co‐operation. Managers and policymakers must be aware of the organisational factors related to priority and working conditions.
Pharmacists' readiness to adopt prescribing authority in Jordan
Authors: Nusair Mohammad B , Hijazi Bayan M , Jalaileh Raneen A , Naji Elaf A , Mohd Hana A 
Published: April 2020

Abstract

Objectives
The overall objective of this study is to assess the views and attitudes of Jordanian pharmacists on expanded pharmacist prescribing role.

Methods
A cross-sectional, questionnaire-based study was conducted using a web-based questionnaire. Pharmacists were invited to take part in this study through pharmacists' Facebook groups for pharmacists in Jordan. Descriptive statistics were used to analyze the data in addition to the t-test to compare the mean difference of support levels toward supplementary and independent prescribing.

Key findings
A total of 521 pharmacists took part in this study. The majority of respondents (n = 482; 92.5%) believe that pharmacists in Jordan should have an expanded prescribing role. Respondents were significantly in favour of supplementary prescribing (P &lt; 0.05) than independent prescribing for various medical condition (e.g. diabetes and asthma). Respondents identified securing more roles in healthcare (n = 464; 89%) and increasing pharmacy profits (n = 420; 80.7%) as key facilitators to adopt this new role. Whereas inadequate training in the diagnosis of disease (n = 457; 87.7%), and inadequate training in patient assessment and monitoring (n = 453; 86.9%) were reported as the most likely barriers.

Conclusion
Overall, Jordanian pharmacists strongly supported the expanded prescribing role and favoured supplementary prescribing for chronic conditions (e.g. diabetes). The study highlighted the need for additional training in various areas (e.g. diagnosing and managing some clinical conditions) to prepare Jordanian pharmacists for this new role.
Religiosity, Secular Participation, and Cultural Socialization: A Case Study of the 1933–1942 Urban English Cohort
Authors: McAndrew Siobhan , Richards Lindsay 
Published: April 2020

AbstractThe nature of secularization is of enduring interest in the social science of religion. Numerous recent papers have established downward cohort trends as characterizing religious change. We examine potential mechanisms by assessing cultural participation and secular engagement during the formative period of one cohort. We provide estimates of active and nominal religiosity, nonreligion and religious belief for those born between 1933 and 1942, using multiple surveys fielded between 1957 and 2018. We model the association between religiosity and secular cultural and social participation for this cohort in 1957, then examine how cultural socialization in childhood relates to religiosity in their later adulthood using surveys fielded between 2005 and 2007. Increased secular competition is found to be associated with less active religiosity. These trends were underpinned by an ethic of increasing autonomy for the young. We conclude by affirming the link between increasing secular competition, long‐run modernization, and changing cultural socialization.
Earliest evidence of a death and injury by a meteorite
Authors: Unsalan O. , Bayatlı A. , Jenniskens P. 
Published: April 2020

AbstractOur planet experiences falls of meteorites with different airburst and ground impact risk. Some of these meteors can survive after the atmospheric passage and fall into the ground. Although there are claims that people were hit and killed by meteorites in history, the historical records do not prove this fact so far. This issue might be due to the fact that either the manuscript was written in a language other than English or there is not enough interest in historical records. To the best of our knowledge, we show the first proof of an event ever that a meteorite hit and killed a man and left paralyzed another on August 22, 1888 in Sulaymaniyah, Iraq, based on three manuscripts written in Ottoman Turkish that were extracted from the General Directorate of State Archives of the Presidency of the Republic of Turkey. This event was also reported to Abdul Hamid II (34th sultan of the Ottoman Empire) by the governor of Sulaymaniyah. These findings suggest other historical records may still exist that describe other events that caused death and injuries by meteorites.
The lre‐miR159a‐LrGAMYB pathway mediates resistance to grey mould infection in Lilium regale
Authors: Gao Xue , Zhang Qian , Zhao Yu‐Qian , Yang Jie , He Heng‐Bin , Jia Gui‐Xia 
Published: April 2020

AbstractGrey mould is one of the most determinative factors of lily growth and plays a major role in limiting lily productivity. MicroRNA159 (miR159) is a highly conserved microRNA in plants, and participates in the regulation of plant development and stress responses. Our previous studies revealed that lre‐miR159a participates in the response of Lilium regale to Botrytis elliptica according to deep sequencing analyses; however, the response mechanism remains unknown. Here, lre‐miR159a and its target LrGAMYB gene were isolated from L. regale. Transgenic Arabidopsis overexpressing lre‐MIR159a exhibited larger leaves and smaller necrotic spots on inoculation with Botrytis than those of wild‐type and overexpressing LrGAMYB plants. The lre‐MIR159a overexpression also led to repressed expression of two targets of miR159, AtMYB33 and AtMYB65, and enhanced accumulation of hormone‐related genes, including AtPR1, AtPR2, AtNPR1, AtPDF1.2, and AtLOX for both the jasmonic acid and salicylic acid pathways. Moreover, lower levels of H2O2 and

were observed in lre‐MIR159a transgenic Arabidopsis, which reduced the damage from reactive oxygen species accumulation. Taken together, these results indicate that lre‐miR159a positively regulates resistance to grey mould by repressing the expression of its target LrGAMYB gene and activating a defence response.
MfOfd1 is crucial for stress responses and virulence in the peach brown rot fungus Monilinia fructicola
Authors: Zhang Ming-Ming , Wang Zuo-Qian , Xu Xiao , Huang Song , Yin Wei-Xiao , Luo Chao‐Xi 
Published: April 2020

AbstractMonilinia fructicola is the most widely distributed species among the Monilinia genus in the world, and causes blossom blight, twig canker, and fruit rot on Rosaceae fruits. To date, studies on genomics and pathogenicity are limited in M. fructicola. In this study, we identified a redox‐related gene, MfOfd1, which was significantly up‐regulated at 1 hr after inoculation of M. fructicola on peach fruits. We used the clustered regulatory inter‐spaced short palindromic repeats (CRISPR)/Cas9 system combined with homologous recombination to determine the function of the MfOfd1 gene. The results showed that the sporulation of knockdown transformants was reduced by 53% to 83%. The knockdown transformants showed increased sensitivity to H2O2 and decreased virulence on peach fruits compared to the wild‐type isolate Bmpc7. It was found that H2O2 could stimulate the expression of MfOfd1 in the wild‐type isolate. The transformants were also more sensitive to exogenous osmotic stress, such as glycerol, d‐sorbitol, and NaCl, and to dicarboximide fungicides (iprodione and dimethachlon). These results indicate that the MfOfd1 gene plays an important role in M. fructicola in sporulation, oxidative response, osmotic stress tolerance, and virulence.
Duodenal bile acids as determinants of intestinal mucosal homeostasis and disease
Authors: Keely Simon , Talley Nicholas J. 
Published: April 2020

AbstractThe duodenal epithelium plays a pivotal role in the uptake and transport of dietary nutrients while simultaneously acting as physical and biochemical barrier to protect against harmful bacteria and antigens. In the case of functional dyspepsia (FD), the duodenum is of particular interest, due to observed local immune involvement and the proximity to the stomach and exposure to acidopeptic secretions. Recent observations in FD pathophysiology, including those reported by Beeckmans et al in this issue of the journal, have identified a loss of barrier function in the duodenal epithelium, an altered duodenal microbiome and alterations in intestinal bile acid pools. Because FD symptoms coincide with food intake and, thus, secretion of bile acids, these findings may indicate loss or imbalance of bile‐acid‐microbiota‐epithelial homeostasis as a process driving FD. Here, we review the evidence linking these observations to FD symptoms.
The role of chloroplast protein remodeling in stress responses and shaping of the plant peptidome
Authors: Mamaeva Anna , Taliansky Michael , Filippova Anna , Love Andrew J. , Golub Nina , Fesenko Igor 
Published: April 2020

SummaryIn addition to photosynthesis, chloroplasts perform a variety of important cellular functions in the plant cell, which can, for example, regulate plant responses to abiotic and biotic stress conditions. Under stress, intensive chloroplast protein remodeling and degradation can occur, releasing large numbers of endogenous peptides. These protein‐derived peptides can be found intracellularly, but also in the plant secretome. Although the pathways of chloroplast protein degradation and the types of chloroplast proteases implicated in this process have received much attention, the role of the resulting peptides is less well understood. In this review we summarize the data on peptide generation processes during the remodeling of the chloroplast proteome under stress conditions and discuss the mechanisms leading to these changes. We also review the experimental evidence which supports the concept that peptides derived from chloroplast proteins can function as regulators of plant responses to (a)biotic stresses.
Body mass index and all‐cause mortality in older adults: A scoping review of observational studies
Authors: Javed Ayesha A. , Aljied Rumaisa , Allison David J. , Anderson Laura N. , Ma Jinhui , Raina Parminder 
Published: April 2020

SummaryIn older age, body composition changes as fat mass increases and redistributes. Therefore, the current body mass index (BMI) classification may not accurately reflect risk in older adults (65+). This study aimed to review the evidence on the association between BMI and all‐cause mortality in older adults and specifically, the findings regarding overweight and obese BMI. A systematic search of the OVID MEDLINE and Embase databases was conducted between 2013 and September 2018. Observational studies examining the association between BMI and all‐cause mortality within a community‐dwelling population aged 65+ were included. Seventy‐one articles were included. Studies operationalized BMI categorically (n = 60), continuously (n = 8) or as a numerical change/group transition (n = 7). Reduced risk of mortality was observed for the overweight BMI class compared with the normal BMI class (hazard ratios [HR] ranged 0.41‐0.96) and for class 1 or 2 obesity in some studies. Among studies examining BMI change, increases in BMI demonstrated lower mortality risks compared with decreases in BMI (HR: 0.83‐0.95). Overweight BMI classification or a higher BMI value may be protective with regard to all‐cause mortality, relative to normal BMI, in older adults. These findings demonstrate the potential need for age‐specific BMI cut‐points in older adults.
Marketization reforms and co‐production: Does ownership of service delivery structures and customer language matter?
Authors: James Oliver , Jilke Sebastian 
Published: April 2020

AbstractIn public services that are tax funded, public goods are sometimes marketized by being delivered using private companies instead of public organizations. In addition, marketization reforms can entail service users being described as customers for the service rather than as citizens. We assess the effects of these aspects of marketization reforms on users' willingness to co‐produce public services. First, service delivery using private companies risks reducing users' willingness to co‐produce because firms cannot commit ex ante to not appropriate donated labour for private gain. Second, using customer‐oriented language risks reductions by priming individualistic market norms that lower prosocial motivation compared to citizen‐oriented language priming citizenship duty. Using three survey experiments in the United States, we find that delivery structures are not neutral. Private firms delivering local public services reduce users' willingness to co‐produce, although similar effects are not evident from primimg customer rather than citizenship thinking.
Systemic and large local reactions during subcutaneous grass pollen immunotherapy in children
Authors: Gur Cetinkaya Pınar , Kahveci Melike , Esenboğa Saliha , Karaatmaca Betul , Soyer Ozge , Sekerel Bulent Enis , Tuncer Ayfer , Sahiner Umit Murat 
Published: April 2020

AbstractBackgroundSubcutaneous immunotherapy (SCIT) is the allergen‐specific curative treatment of allergic rhinitis. Adverse effects, most of which are local, can be observed during the immunotherapy. These adverse effects have been reported more frequently during the pollen season. The purpose of this study was to estimate the rate of local, large local, and systemic reactions during the treatment, to determine the relationship between adverse reactions and the season in which these reactions occur, as well as the risk factors for adverse reactions during the grass pollen–specific SCIT treatment in children.MethodsWe retrospectively collected and analyzed the data of 261 children who administered grass pollen SCIT between 2008 and 2018.ResultsA total of 261 children (177, 67.8% male), who received grass pollen SCIT, with a mean (±SD) age of 12.0 ± 3.0 years at the initiation of SCIT were enrolled to the study. The number of the patients who experienced local and large local reactions was 109 and 30, respectively. In addition, the number of the patients with systemic reactions was 35. After the 12 284 injections, local reactions occurred in 357 (2.9%), and this was followed by systemic reaction as 55 (0.4%) and large local reactions as 40 (0.3%). Frequency of local (P < .001) and systemic reactions (P = .003) was higher during grass pollen season than out of the grass pollen season. In multivariate analysis, initiation of SCIT during the grass pollen season [OR:7.351, 95%CI:1.532‐35.279, P = .013] and experiencing local reactions [OR:4.214, 95%CI:2.159‐8.224, P < .001] were independent predictors for the development of large local and systemic reactions.ConclusionSCIT, in which only mild‐to‐moderate systemic reactions occurred, is safe for the treatment of allergic rhinitis in children. Our study revealed that previous local reactions and initiation of immunotherapy during the grass pollen season were the predictors for large local and systemic reactions during SCIT in children.
Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover
Authors: Soresina Annarosa , Moratto Daniele , Chiarini Marco , Paolillo Ciro , Baresi Giulia , Focà Emanuele , Bezzi Michela , Baronio Barbara , Giacomelli Mauro , Badolato Raffaele 
Published: April 2020

AbstractBackgroundThe recent SARS‐CoV‐2 pandemic, which has recently affected Italy since February 21, constitutes a threat to normal subjects, as the coronavirus disease‐19 (COVID‐19) can manifest with a broad spectrum of clinical phenotypes ranging from asymptomatic cases to pneumonia or even death. There is evidence that older age and several comorbidities can affect the risk to develop severe pneumonia and possibly the need of mechanic ventilation in subjects infected with SARS‐CoV‐2. Therefore, we evaluated the outcome of SARS‐CoV‐2 infection in patients with inborn errors of immunity (IEI) such as X‐linked agammaglobulinemia (XLA).MethodsWhen the SARS‐CoV‐2 epidemic has reached Italy, we have activated a surveillance protocol of patients with IEI, to perform SARS‐CoV‐2 search by nasopharyngeal swab in patients presenting with symptoms that could be a manifestation of COVID‐19, such as fever, cough, diarrhea, or vomiting.ResultsWe describe two patients with X‐linked agammaglobulinemia (XLA) aged 34 and 26 years with complete absence of B cells from peripheral blood who developed COVID‐19, as diagnosed by SARS‐CoV‐2 detection by nasopharyngeal swab, while receiving immunoglobulin infusions. Both patients developed interstitial pneumonia characterized by fever, cough, and anorexia and associated with elevation of CRP and ferritin, but have never required oxygen ventilation or intensive care.ConclusionOur report suggests that XLA patients might present with high risk to develop pneumonia after SARS‐CoV‐2 infection, but can recover from infection, suggesting that B‐cell response might be important, but is not strictly required to overcome the disease. However, there is a need for larger observational studies to extend these conclusions to other patients with similar genetic immune defects.
Successful containment of Covid‐19 outbreak in a large maternity and perinatal center while continuing clinical service
Authors: Kabesch Michael , Roth Samra , Brandstetter Susanne , Häusler Sebastian , Juraschko Eva , Weigl Marco , Wellmann Sven , Lang Thomas , Schmidt Barbara , Salzberger Bernd , Ambrosch Andreas 
Published: April 2020

AbstractWith increasing number of SARS‐CoV‐2 infections and COVID‐19 patients to be taken care of by the health system, more and more health workers become affected by the disease. It has been reported that right from the beginning of the outbreak in Lombardy up to 20% of the doctors and nurses became infected. Under these circumstances, the regular operation of health institutions already suffering from a shortage of staff becomes difficult. This has led to complete or partial shutdowns of hospitals, either due to a lack of uninfected personnel or because of uncontrollable chains of infection endangering patients. In one of the largest university perinatal center in Bavaria with more than 3000 births per year, an outbreak of COVID‐19 occurred in March 2020, affecting 36 staff members, including doctors, nurses, and midwives. Here, we describe the outbreak and present the measures contributing to the successful containment of the outbreak within three weeks. At the same time, clinical services could be maintained, however, not without deployment of personnel exposed to employees infected with SARS‐CoV‐2. Apart from massive testing of personnel in pre‐defined phases and increased hygiene measures, including a general obligation to wear surgical face masks, we identified the need to monitor cases of illness across all groups of employees, to ensure social distancing within personnel and to evaluate contacts of clinical personnel outside of the hospital environment, in order to be able to interpret chains of infections and to disrupt them. Overall, only a bundle of measures is needed to contain such an outbreak.
Educational and learning morbidity in pediatric heart transplant recipients: A pediatric heart transplant society study
Authors: Brosbe Micah S. , Wright Lydia K. , Cantor Ryan , Dreyer William J. , Kirmani Sonya , Knight Margaret , Nakano Stephanie J. , Kindel Steven J. , Ryan Thomas D. , Kirklin James K. , Deshpande Shriprasad R. 
Published: April 2020

AbstractEducational development is an important component of quality of life for children with heart transplant. Aims include determining prevalence of and risk factors for modified education placement in a large representative sample of pediatric heart transplant recipients. Participants included 1495 patients (age 6‐18 years) from the PHTS database. Data on education placement and clinical predictors were collected at listing and at 1 and 3 years post‐transplant. At listing, 88% of patients were in typical education placement, while 12% were in modified education. Males (P = .02), those with CHD (P < .0001), those with non‐private insurance (P < .0001), and those with longer hospital stay (P = .001) were more likely to be in a modified education placement at time of listing. Age, race, listing status, mechanical support, and waitlist time were not significantly associated with placement. The prevalence of typical education placement was similar (87% at 1‐year and 86% at 3‐year) post‐transplant. Predictors of modified education placement at 3‐year follow‐up included placement at listing (OR = 12.9 [95% CI 7.6‐21.9],P < .0001), non‐private insurance (OR = 2.0 [95% CI 1.3‐3.2],P = .001), CHD (OR = 1.8 [95% CI 1.1‐2.7,P = .01), history of post‐transplant infection (OR = 1.9 [95% CI 1.2‐2.9,P = .007), and number of post‐transplant infections (OR = 1.3 [95% CI 1.1‐1.5,P = .002). Among pediatric heart transplant recipients, males, those with non‐private insurance, those with CHD, and those who experience post‐transplant infections are at greatest risk for modified academic placement, which persists for several years post‐transplant and deserves targeted intervention.