bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multicenter observational study investigating care errors, staffing levels, and workload in small animal intensive care units
Authors: Hayes Galina M. , Bersenas Alexa M. , Mathews Karol , Lane William G. , LaLonde‐Paul Denise F. , Steele Andrea , Avellaneda Ana 
Published: September 2020

AbstractObjectiveTo investigate associations among care errors, staffing, and workload in small animal ICUs.DesignMulticenter observational cohort study conducted between January 2017 and September 2018.SettingThree small animal teaching hospital ICUs.AnimalsNone.InterventionsNone.Measurements and main resultsData on patient numbers, illness severity (assesed via the acute patient physiologic and laboratory evaluation [APPLE] score), care burden, staffing levels, technician experience/education level, and care errors were collected at each study site. Care errors were categorized as major (unanticipated arrest or death; patient endangerment through IV line, arterial catheter, chest tube or other invasive device mismanagement, or errors in drug calculation/administration) or minor. Median patient:technician ratio was 4.3 (range: 1–18). Median patient illness severity was 15.1 (4.7–27.1) APPLE score units. A total of 221 major and 3,317 minor errors were observed over the study period. The odds of a major error increased by an average of 11% (odds ratio [OR] = 1.11; 95% confidence interval [CI], 1.02–1.20; P = 0.012) for each 1 patient increase in the patient:technician ratio after averaging by ICU location. The major error incident rate ratio was 2.53 (95% CI, 1.84–3.54; P < 0.001) for patient:technician ratios of >4.0 compared with ≤4.0. The odds of a major error increased by 0.5% per total unit APPLE score increase (OR = 1.005; 95% CI, 1.002–1.007; P < 0.001). The major error incident rate ratio was 1.71 (95% CI, 1.30–2.25; P < 0.001) for APPLEfast:technician ratios of >73 compared with ≤73. The odds of a major error decreased by 2% (OR = 0.98; 95% CI, 0.97–0.99; P = 0.01) for each year increase in total technician years of ICU work experience.ConclusionsSubstantial reductions in major care errors may be achieved by maintaining ICU patient:technician ratios at ≤4. Technician experience and total unit burden of patient illness severity are also associated with error incidence, and should be taken into consideration when scheduling staff.
Sociocultural Perspectives of Science and Learning: Contributions on Pedagogical Practices on STEM teachers in Service
Authors: Tocora Milena Alcocer , Hernandez Carola Hernandez 
Published: September 2020

This research study contributes to science teacher training by analyzing a curriculum that takes in sociocultural perspectives of science and learning in in-service teachers' pedagogical practices. It is a qualitative study with a critical hermeneutic methodology. The method used was a multiple case study, which inquires by exploring different cases in depth. The information was collected within the framework of a postgraduate training program, with in-service teachers from the areas of Science, Technology, Engineering, and Mathematics (STEM), in two settings: the training program and the observation of their pedagogical practice. Results show that this sociocultural perspective of the curriculum contributed to the pedagogical practices of the teachers under study in six different ways: i) generation of new understandings of science, learning, and the discipline they teach; ii) identification of other meanings for the concepts they teach; iii) changes in-class activities that help to recognize the identity of the scientific community; iv) inclusion of strategies that foster the negotiation of meaning in the community; v) changes in the evaluation strategies, giving more importance to feedback; and vi) generation of reflexive processes about the pedagogical practice in a more conscious way.
Performance Evaluation of ANCF Tetrahedral Elements in the Analysis of Liquid Sloshing
Authors: Zhang Dayu , Grossi Emanuele , Shabana Ahmed A. 
Published: September 2020

Abstract
The performance of the absolute nodal coordinate formulation (ANCF) tetrahedral element in the analysis of liquid sloshing is evaluated in this paper using a total Lagrangian nonincremental solution procedure. In this verification study, the results obtained using the ANCF tetrahedral element are compared with the results of the ANCF solid element which has been previously subjected to numerical verification and experimental validation. The tetrahedral-element model, which allows for arbitrarily large displacements including rotations, can be systematically integrated with computational multibody system (MBS) algorithms that allow for developing complex sloshing/vehicle models. The new fluid formulation allows for systematically increasing the degree of continuity in order to obtain higher degree of smoothness at the element interface, eliminate dependent variables, and reduce the model dimensionality. The effect of the fluid/container interaction is examined using a penalty contact approach. Simple benchmark problems and complex railroad vehicle sloshing scenarios are used to examine the performance of the ANCF tetrahedral element in solving liquid sloshing problems. The simulation results show that, unlike the ANCF solid element, the ANCF tetrahedral element model exhibits nonsmoothness of the free surface. This difference is attributed to the gradient discontinuity at the tetrahedral-element interface, use of different meshing rules for the solid- and tetrahedral-elements, and the interaction between elements. It is shown that applying curvature-continuity conditions leads, in general, to higher degree of smoothness. Nonetheless, a higher degree of continuity does not improve the solution accuracy when using the ANCF tetrahedral elements.
End-of-life decisions in neonatal care: a conversation analytical study
Authors: Marlow Neil , Shaw Chloe , Connabeer Kat , Aladangady Narendra , Gallagher Katie , Drew Paul 
Published: September 2020

ObjectiveTo understand the dynamics of conversations between neonatologists and parents concerning limitation of life-sustaining treatments.DesignFormal conversations were recorded, transcribed and analysed according to the conventions and methods of conversation analysis.SettingTwo tertiary neonatal intensive care units.ParticipantsConsultant neonatal specialists and families.Main outcome measuresWe used conversation analysis and developed an inductive coding scheme for conversations based on the introduction of limiting life-sustaining treatments and on the parental responses.ResultsFrom recordings with 51 families, we identified 27 conversations about limiting life support with 20 families and 14 doctors. Neonatologists adopted three broad strategies: (1) ‘recommendations’, in which one course of action is presented and explicitly endorsed as the best course of action, (2) a ‘single-option choice’ format (conditional: referring to a choice that should be made, but without specifying or listing options), and (3) options (where the doctor explicitly refers to or lists options). Our conversation analysis-informed coding scheme was based on the opportunities available for parents to ask questions and assert their preference with minimal interactional constraint or pressure for a certain type of response. Response scores for parents presented with conditional formats (n=15, median 5.0) and options (n=10, median 5.0) were significantly higher than for those parents presented with ‘recommendations’ (n=16, median 3.75; p=0.002) and parents were more likely to express preferences (p=0.005).ConclusionEncouraging different approaches to conversations about limitation of life-supporting treatment may lead to better parent engagement and less misalignment between the conversational partners.
Throwing darts in ICU: how close are we in estimating energy requirements?
Authors: Grguric Laryssa , Musillo Lisa , DiGiacomo Jody C , Munnangi Swapna 
Published: September 2020

BackgroundIndirect calorimetry (IC) is the gold standard for determining energy requirement. Due to lack of availability in many institutions, predictive equations are used to estimate energy requirements. The purpose of this study is to determine the accuracy of predictive equations (ie, Harris-Benedict equation (HBE), Mifflin-St Jeor equation (MSJ), and Penn State University equation (PSU)) used to determine energy needs for critically ill, ventilated patients compared with measured resting energy expenditure (mREE).MethodsThe researchers examined data routinely collected as part of clinical care for patients within intensive care units (ICUs). The final sample consisted of 68 patients. All studies were recorded during a single inpatient stay within an ICU.ResultsPatients, on average, had an mREE of 33.9 kcal/kg using IC. The estimated energy requirement when using predictive equations was 24.8 kcal/kg (HBE×1.25), 24.0 kcal/kg (MSJ×1.25), and 26.8 kcal/kg (PSU).DiscussionThis study identified significant differences between mREE and commonly used predictive equations in the ICU.Level of evidenceIII.
Activation of M3AChR (Type 3 Muscarinic Acetylcholine Receptor) and Nrf2 (Nuclear Factor Erythroid 2–Related Factor 2) Signaling by Choline Alleviates Vascular Smooth Muscle Cell Phenotypic Switching and Vascular Remodeling
Authors: He Xi , Deng Juan , Yu Xiao-Jiang , Yang Si , Yang Yang , Zang Wei-Jin 
Published: September 2020

Objective:
Phenotypic switching of vascular smooth muscle cells (VSMCs) plays a critical role in atherosclerosis, vascular restenosis, and hypertension. Choline exerts cardioprotective effects; however, little is known about its effects on VSMC phenotypic switching and vascular remodeling. Here, we investigated whether choline modulates VSMC phenotypic changes and explored the underlying mechanisms.

Approach and Results:
In cultured VSMCs, choline promoted Nrf2 (nuclear factor erythroid 2–related factor 2) nuclear translocation, inducing the expression of HO-1 (heme oxygenase-1) and NQO-1 (NAD[P]H quinone oxidoreductase-1). Consequently, choline ameliorated Ang II (angiotensin II)–induced increases in NOX (NAD[P]H oxidase) expression and the mitochondrial reactive oxygen species level, thereby attenuating Ang II–induced VSMC phenotypic switching, proliferation, and migration, presumably via M3AChRs (type 3 muscarinic acetylcholine receptors). Downregulation of M3AChR or Nrf2 diminished choline-mediated upregulation of Nrf2, HO-1, and NQO-1 expression, as well as inhibition of VSMC phenotypic transformation, suggesting that M3AChR and Nrf2 activation are responsible for the protective effects of choline. Moreover, activation of the Nrf2 pathway by sulforaphane suppressed Ang II–induced VSMC phenotypic switching and proliferation, indicating that Nrf2 is a key regulator of VSMC phenotypic switching and vascular homeostasis. In a rat model of abdominal aortic constriction in vivo, choline attenuated VSMC phenotypic transformation and vascular remodeling in a manner related to activation of the Nrf2 pathway.

Conclusions:
These results reveal that choline impedes VSMC phenotypic switching, proliferation, migration, and vascular remodeling by activating M3AChR and Nrf2-antioxidant signaling and suggest a novel role for Nrf2 in VSMC phenotypic modulation.
ENSO Teleconnection to Eastern African Summer Rainfall in Global Climate Models: Role of the Tropical Easterly Jet
Authors: Vashisht Amandeep , Zaitchik Benjamin , Gnanadesikan Anand 
Published: September 2020

AbstractGlobal climate models (GCMs) are critical tools for understanding and projecting climate variability and change, yet the performance of these models is notoriously weak over much of tropical Africa. To improve this situation, process-based studies of African climate dynamics and their representation in GCMs are required. Here, we focus on summer rainfall of eastern Africa (SREA), which is crucial to the Ethiopian Highlands and feeds the flow of the Blue Nile River. The SREA region is highly vulnerable to droughts, with El Niño–Southern Oscillation (ENSO) being a leading cause of interannual rainfall variability. Adequate understanding and accurate representation of climate features that influence regional variability is an important but often neglected issue when evaluating models. We perform a process-based evaluation of GCMs, focusing on the upper-troposphere tropical easterly jet (TEJ), which has been hypothesized to link ENSO to SREA. We find that most models have an ENSO–TEJ coupling similar to observed, but the models diverge in their representation of TEJ–SREA coupling. Differences in the latter explain the majority (80%) of variability in ENSO teleconnection simulation across the models. This is higher than the variance explained by rainfall coupling with the Somali jet (44%) and African easterly jet (55%). However, our diagnostics of the leading hypothesized mechanism in the models—variability in divergence in the TEJ exit region—are not consistent across models and suggest that a deeper understanding of the mechanisms of TEJ–precipitation coupling should be a priority for studies of climate variability and change in the region.
The unique role of the Chinese government in the protection of overseas citizens
Authors: Liu Lianlian , Gammon Jessica 
Published: September 2020

How to optimize China’s protective mechanism for overseas citizens has become the top agenda of China’s public administration. A comparison of the evacuation policies of China and the US in the 2010s reveals that the Chinese government’s operations attach more importance to the actual effects of evacuation and the feelings of citizens, while considering the responsibility of citizens and cost burden less. This generous evacuation policy can be partly rationalized by China’s domestic factors, such as the “Going Global” policy, its contemporary image as a populous rising power, and its traditional family-country narrative, which generates a familial conception of state–citizen relations and encourages the government to take extra responsibility for citizens. While the familial conception of state–citizen relations is conductive to building national identity and cohesion, it blurs the dividing line between civic responsibility and governmental responsibility, undercuts the efficiency of public administration, causes waste of public resources, and overburdens governmental agencies. As China’s industrialization and urbanization progress, how to revise the long-established familial conception of state–citizen relations and establish a responsible civil society based on contractual rule of law has become an urgent issue. Points for practitioners This study highlights the parental role of the Chinese government in the protection of overseas citizens and attributes it partly to the traditional family-country narrative, which generates a family conception of state–citizen relations. While this conception is conductive to building national identity and cohesion, it causes waste of public resources and overburdens governmental agencies. It is necessary to revise the long-established conception and cultivate a responsible civil society to improve the efficiency of public administration in contemporary China.
Assessing The “Millennial Self-Care Obsession” Among Social Workers: #NotSoMuch
Authors: Miller J Jay , Grise-Owens Erlene 
Published: September 2020

Summary Despite the importance of self-care to social work practice, misnomers about the construct persist. One misperception is that millennials are overly focused on self-care and engage in high-levels of self-care, to the detriment of performing work duties. This study examined the self-care practices of social work practitioners (N = 3079) in the United States. Researcher investigated self-care practices across five domains: Professional Support, Professional Development, Life Support, Cognitive Awareness, and Daily Balance. Findings Overall, data suggest that social workers in all generations engaged in moderate amounts of self-care. Analyses revealed that millennials engaged in significantly fewer self-care practices related to Professional Support and Daily Balance, when compared to Generation X and Baby-boomer participants. While not statistically significant, millennials scored lower across all other self-care domains. Applications This is the first known study to explicitly investigate generational differences in self-care within any professional discipline. Within the next five years, millennials will make up nearly 75% of the world’s workforce. Findings from this research suggest the need to reshape prevailing anecdotes about self-care and millennials. Further, data offer insights to organizations looking to better support social workers of all generations in engaging in self-care.
Nonmyeloablative allogeneic transplantation achieves clinical and molecular remission in cutaneous T-cell lymphoma
Authors: Weng Wen-Kai , Arai Sally , Rezvani Andrew , Johnston Laura , Lowsky Robert , Miklos David , Shizuru Judith , Muffly Lori , Meyer Everett , Negrin Robert S. , Wang Erica , Almazan Timothy , Million Lynn , Khodadoust Michael , Li Shufeng , Hoppe Richard T. , Kim Youn H. 
Published: September 2020

Abstract
The majority of patients with refractory, advanced-stage mycosis fungoides (MF) or Sézary syndrome (SS) have a life expectancy of &lt;5 years. Here, we report a phase 2 study of a novel nonmyeloablative allogeneic transplantation strategy tailored for this patient population. This study has completed the enrollment, and 35 patients (13 MF, 22 SS) have undergone transplant as planned. The majority (80%) of the patients had stage IV disease and received multiple previous systemic therapies. All patients had active disease at the time of conditioning using total skin electron beam therapy, total lymphoid irradiation, and antithymocyte globulin, and received allograft infusion as outpatients. Cyclosporine or tacrolimus and mycophenolate mofetil were used for graft-versus-host disease (GVHD) prophylaxis. Patients tolerated the transplant well, with 1- and 2-year nonrelapse mortality of 3% and 14%, respectively. The day +180 cumulative incidence of grade 2 to 4 acute GVHD was 16%, and the 2-year incidence of moderate/severe chronic GVHD was 32%. With a median posttransplant follow-up of 5.4 years, the 2-, 3-, and 5-year overall survival rates were 68%, 62%, and 56%. Using high-throughput sequencing of the T-cell receptor for minimal residual disease monitoring, we observed that 43% achieved molecular remission, which was associated with a lower incidence of disease progression or relapse (9% vs 87%; P = .02). Our study also showed that patients who were aged ≥65 years at the time of allotransplant had similar clinical outcomes compared with younger patients. Thus, we have developed an alternative and potentially curative nonmyeloablative allogeneic transplant regimen for patients with advanced stage MF/SS. This trial was registered at www.clinicaltrials.gov as #NCT00896493.
Developing the novel bioinformatics algorithms to systematically investigate the connections among survival time, key genes and proteins for Glioblastoma multiforme
Authors: You Yujie , Ru Xufang , Lei Wanjing , Li Tingting , Xiao Ming , Zheng Huiru , Chen Yujie , Zhang Le 
Published: September 2020

Abstract
Background
Glioblastoma multiforme (GBM) is one of the most common malignant brain tumors and its average survival time is less than 1 year after diagnosis.

Results
Firstly, this study aims to develop the novel survival analysis algorithms to explore the key genes and proteins related to GBM. Then, we explore the significant correlation between AEBP1 upregulation and increased EGFR expression in primary glioma, and employ a glioma cell line LN229 to identify relevant proteins and molecular pathways through protein network analysis. Finally, we identify that AEBP1 exerts its tumor-promoting effects by mainly activating mTOR pathway in Glioma.

Conclusions
We summarize the whole process of the experiment and discuss how to expand our experiment in the future.
Awareness, utilization and influencing factors of social supports for main informal caregivers of schizophrenia patients: a cross-sectional study in primary care settings in Beijing, China
Authors: Wang Meirong , Jin Guanghui , Wei Yun , Wang Feiyue , Pan Zhaolu , Chen Lifen , Lu Xiaoqin 
Published: September 2020

Abstract
Background
Most schizophrenia patients are supported by main informal caregivers at home in China. This study aims to investigate the further needs of social supports for main informal caregivers of schizophrenia patients and to analyze influencing factors on the awareness and utilization of social supports in Beijing. The results of this study could potentially act as reference for health professionals to implement appropriate and effective support programs.

Methods
A mixed-methods approach was used in this study. Awareness, utilization and influencing factors of social supports for main informal caregivers were investigated using questionnaires in 6 urban districts in Beijing. Meanwhile, individual in-depth interviews with 10 main informal caregivers from the urban districts of Beijing were conducted to identify the caregivers’ perspective on social supports and their further needs.

Results
Quantitative results showed that although the government provided multi-channel resources for schizophrenia patients and their families, awareness and utilization of the resources such as rehabilitation and relevant subsidies were less than 10.0 and 5.0% respectively. Most caregivers in in-depth interviews expressed that they had negative experiences with respect to obtaining social supports, and they emphasized that more support would be needed in terms of financial support, respect, and rehabilitation institutions.

Conclusions
The awareness and utilization of social supports are low for main informal caregivers of schizophrenia patients. More services and improved public attitudes are needed for schizophrenia patients and their caregivers.