bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring, Assessing and Recording: Pulse, Body Temperature, Respirations and Oxygen Saturation
Authors: Deamer Paula , Attoe Tina 
Published: November 2020

Abstract
As part of the measuring physical observations simulated examination, students will be asked to measure, assess and record pulse, body temperature, respirations and oxygen saturation. This assessment is becoming more common in all universities as it has been identified as a mandatory simulated assessment within the NMC Essential Skills Clusters (NMC 2007). Although this chapter will focus upon each observation in turn, it is imperative that when undertaking physical observations the findings are not assessed in isolation. Like a jigsaw, each result, alongside the patient’s appearance, pallor, demeanour and responsiveness, link together to form an overall picture of the patient’s condition. The skill of undertaking these observations may sometimes be reviewed as being routine, but the skill has important clinical significance. Students have to demonstrate their underpinning knowledge and to make sense of the relevance of the observations—this can be complex and challenging. Some student nurses will have previous experience, prior to commencing their nurse education training, of taking patients’ physical observations, but the ability to demonstrate an understanding of the underpinning knowledge differentiates between the role of a health care support worker and a student nurse. Revision of key material will enable the student to understand, undertake and assess the relevance of measuring pulse, body temperature, respirations and oxygen saturation. The importance of the professional nurse’s ability to accurately assess, record and evaluate pulse rate, body temperature, respirations and oxygen saturation cannot be underestimated. Concern has been raised that NHS staff are failing to recognize patient deterioration in a timely manner. In a study by the National Patient Safety Agency (NPSA 2007) factors for this lack of recognition included failure to take physical observations, not acknowledging the significance of the observations and finally not reporting on issues that were of concern, or acting upon these findings. Guidelines on recognizing and managing patient deterioration have been issued by NICE (2007) alongside competencies for recognition and management of a deteriorating patient, which all staff working in acute settings should achieve (DOH 2009). Throughout these the importance of assessing, recording, evaluating and appropriately reacting to the results of physical observations cannot be denied.
Basic Life Support (BLS)
Authors: Cree Clare 
Published: November 2020

Abstract
This chapter will focus on preparing you to undertake an OSCE in the skill of basic life support (BLS), in a cardiac arrest situation, following the Resuscitation Council (UK) Guidelines (2010). Basic life support guidance is aimed especially at adults who in their professions have a duty to respond to a cardiac arrest. Basic life support refers to maintaining the airway, breathing and circulation without the use of any equipment, other than protective devices (Resuscitation Council (UK) 2010). A number of studies (Ahmet and Sarac 2009; Berdowski et al. 2009; Oermann et al. 2011) recognize that effective implementation of guidance is likely to be enhanced by comprehensive and timely education. Soar et al. (2010) suggest that survival from cardiac arrest is dependent on a number of factors—particularly that respondents are well equipped and practiced in the skill and that quality educational packages are readily available to those responders. This chapter will endeavour to provide you with the relevant information to revise the components required to complete an OSCE in the skill. Emphasis is placed on the importance of providing effective, good quality chest compressions whilst minimizing any pauses and so maximizing blood flow and oxygenation. Note: The first aspect of the BLS skill you will be expected to carry out during your OSCE is a full risk assessment of the situation including safety and infection control issues. A respondent to any medical emergency should not put themselves or those around them at any risk. If this is impossible, however, measures should be taken to minimize that risk whilst ensuring no further harm comes to the casualty. In your OSCE, you will be expected to review the surrounding area for hazards, e.g. deep water, electricity, oncoming vehicles, fire and smoke, falling debris, biological threats, etc., to ensure your own and the patient’s safety. Note: This will depend on the way in which your OSCE station has been set up and if there are no threats to yourself or the patient you will need to verbalize to the examiner that you have checked the surrounding area and that it is safe for you to continue.
Understanding Cancer
Authors: Hughes Cathy 
Published: November 2020

Abstract
The aim of this chapter is provide an overview of cancer, a biologically similar, but diverse, group of diseases. Understanding the disease process will help the practising nurse to plan nursing care and to seek appropriate specialist advice. Cancer can affect almost any part of the body and has significance for different age groups and within different cultures, so the effect on the individual, the prognosis, and the treatment will significantly differ depending upon cancer site and treatment setting. This chapter will outline symptoms in relation to the site of the body affected to illustrate the effect of cancer on an individual, and consideration will also be given to the wider impact of the disease. This chapter is underpinned by the principles of evidence-based patient-centred care and will focus on the concepts associated with promoting lifestyles that reduce the risk of developing cancer, screening to identify those at risk, detection of early disease, and the care and management of the individual with and beyond cancer. Cancer refers to a condition in which there is abnormal growth of cells. The characteristics of cancer cells are that they divide uncontrollably, do not require stimulation for growth as do normal cells, and are not restrained by the presence of neighbouring cells. Because cancer is concerned with a failure in the growth control mechanism of the cell at a gene or DNA level and because there are potentially as many different types of cancer as there are types of body cell, no two cancers are exactly alike (Cancer Research UK, 2009). The site at which a cancer first develops (primary cancer), such as lung or breast, is often used broadly to describe it; however, cancer is generally defined by the origin of the type of cell that has become cancerous. The most frequent sites and types of cancer are as follows….● Carcinomas—arise in epithelial cells in the skin, gastrointestinal tract, and other internal organs, and make up about 85% of all cancers (Cancer Research UK, 2010a) ● Haematological (blood and lymphatic system) cancers—arise from blood or bone marrow cells; include leukaemia, lymphoma, and myeloma, and make up about 7% of all cancers, but leukaemia is the commonest cancer in children (Cancer Research UK, 2010b)…
Understanding Coronary
Heart Disease
Authors: Pottle Alison 
Published: November 2020

Abstract
The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with coronary heart disease (CHD) in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the causes, risk factors, and impact of CHD. In guiding you through patient assessment, the differences between acute coronary syndromes (ACS) and angina are established before exploring best practice to deliver care, as well as to prevent or to minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with coronary heart disease can be found in Chapters 15, 22, 24, and 25, respectively. CHD is defined as the failure of the coronary arteries to deliver adequate oxygen for myocardial work. It is almost always caused by atherosclerosis—a gradual build-up of fatty plaques within the artery wall that reduces blood flow. This failure to meet metabolic demands results in a range of clinical conditions sharing common pathological process (Baxendale, 1992), including ACS and angina. Chest pain is the symptom that informs clinical decision-making. It is classified based on history-taking and investigations such as the electrocardiogram (ECG). Angina was first described by Heberden in 1772 as a ‘painful and disagreeable sensation in the breast, which seems as if it would take their life away if it were to increase or continue.’ (cited by Fox et al., 2006). Stable angina is described as a clinical syndrome that is characterized by discomfort in the chest, jaw, shoulder, back, and arms, typically elicited by exertional emotional stress and relieved by rest or nitroglycerine (Fox et al., 2006). ACS is an umbrella term for several clinical presentations, including unstable angina, non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI). The European Society of Cardiology defines ACS as ‘. . . a life threatening manifestation of atherosclerosis . . . caused by a ruptured atherosclerotic plaque . . . causing sudden complete or critical reduction in blood flow’ (Bassand et al., 2007).
Resorption of immune deposits in membranous lupus nephritis following rituximabvsconventional immunosuppressive treatment
Authors: Zickert Agneta , Lannfelt Klas , Schmidt Mende Jan , Sundelin Birgitta , Gunnarsson Iva 
Published: November 2020

AbstractObjectivesStudies on repeat renal biopsies in membranous LN (MLN) are limited, and evaluation of treatment response is mainly based on proteinuria. EM of renal biopsies from rituximab (RTX)-treated MLN patients has revealed resorption of sub-epithelial ICs. Whether resorption phenomena are useful for treatment evaluation, or differs between treatment regimens is not known. We studied EM findings and clinical treatment response in MLN patients after RTX vs conventional immunosuppressive treatment.MethodsTwenty-four patients with MLN and renal biopsies performed before and after treatment were included in this retrospective observational study. Laboratory data were collected at both biopsy occasions. Seven patients had received RTX and 17 had received conventional treatment (CYC, MMF or AZA). Electron micrographs of renal tissue were scored using an arbitrary scale (0–3) for the level of sub-epithelial ICs, resorption of ICs and podocyte fusion.ResultsSub-epithelial ICs decreased after treatment, however not significantly and with no difference between treatments. The resorption phenomena increased after RTX (P = 0.028), but not after conventional therapy (P = 0.29). Six out of seven (86%) RTX-treated patients had increased resorption vs 7/17 (41%) after conventional therapies (P = 0.047). Clinical responders had more pronounced resorption of ICs vs non-responders (P = 0.022).ConclusionsWe report increased resorption of ICs in repeat renal biopsies in MLN, especially after RTX treatment. Increased resorption phenomena were associated with clinical response, suggesting that EM findings may be useful for treatment evaluation in MLN. Although of limited size, the study indicates that RTX is effective both clinically and at a tissue level.
Ultrasonographic Halo Score in giant cell arteritis: association with intimal hyperplasia and ischaemic sight loss
Authors: van der Geest Kornelis S. M. , Wolfe Konrad , Borg Frances , Sebastian Alwin , Kayani Abdul , Tomelleri Alessandro , Gondo Prisca , Schmidt Wolfgang A. , Luqmani Raashid , Dasgupta Bhaskar 
Published: November 2020

Abstract

Objectives
We investigated the relationship between the ultrasonographic Halo Score and temporal artery biopsy (TAB) findings in GCA.

Methods
This is a prospective study including 90 patients suspected of having GCA. Ultrasonography of temporal/axillary arteries and a TAB were obtained in all patients at baseline. An experienced pathologist evaluated whether TAB findings were consistent with GCA, and whether transmural inflammation, giant cells and intimal hyperplasia were present. Ultrasonographic Halo Scores were determined. Receiver operating characteristic analysis was performed.

Results
Twenty-seven patients had a positive TAB, while 32 patients with a negative TAB received a clinical diagnosis of GCA after 6 months of follow-up. Patients with a positive TAB showed higher Halo Scores than patients with a negative TAB. The presence of intimal hyperplasia in the biopsy, rather than the presence of transmural inflammation or giant cells, was associated with elevated Halo Scores in patients with GCA. The Halo Score discriminated well between TAB-positive patients with and without intimal hyperplasia, as indicated by an area under the curve of 0.82 in the receiver operating characteristic analysis. Patients with a positive TAB and intimal hyperplasia more frequently presented with ocular ischaemia (40%) than the other patients with GCA (13–14%).

Conclusion
The ultrasonographic Halo Score may help to identify a subset of GCA patients with intimal hyperplasia, a TAB feature associated with ischaemic sight loss.
Feasibility of using a peer coach to deliver a behavioral intervention for promoting postpartum weight loss in Black and Latina mothers
Authors: Herring Sharon J , Bersani Veronica M , Santoro Christine , McNeil Saleemah J , Kilby Linda M , Bailer Brooke 
Published: November 2020

Abstract
Peer coaching may provide a culturally relevant and potentially scalable approach for delivering postpartum obesity treatment. We aimed to evaluate the feasibility of peer coaching to promote postpartum weight loss among ethnic minority women with obesity. This pilot study was a prospective, parallel-arm, randomized controlled trial. Twenty-two obese, Black or Latina mothers ≤6 months postpartum were recruited from the Philadelphia Special Supplemental Nutrition Education Program for Women, Infants and Children (WIC) and randomly assigned to either: (a) a peer-led weight loss intervention (n = 11) or (b) usual WIC care (n = 11). The intervention provided skills training and problem solving via six calls and two in-person visits with a Black mother trained in behavioral weight control strategies. Text messaging and Facebook served as platforms for self-monitoring, additional content, and interpersonal support. Both arms completed baseline and 14 week follow-up assessments. All participants were retained in the trial. Intervention engagement was high; the majority (55%) responded to at least 50% of the self-monitoring text prompts, and an average of 3.4 peer calls and 1.7 visits were completed. Mean weight loss among intervention participants was −1.4 ± 4.2 kg compared to a mean weight gain of 3.5 ± 6.0 kg in usual WIC care. Most intervention participants strongly agreed that the skills they learned were extremely useful (90%) and that the coach calls were extremely helpful for weight control (80%). Results suggest the feasibility of incorporating peer coaching into a postpartum weight loss intervention for ethnic minority women with obesity. Future research should examine the sustained impact in a larger trial.
An ABA–flavonoid relationship contributes to the differences in drought resistance between different sea buckthorn subspecies
Authors: Gao Guori , Lv Zhongrui , Zhang Guoyun , Li Jiayi , Zhang Jianguo , He Caiyun 
Published: November 2020

Abstract
Drought is the most severe abiotic stress and hinders the normal growth and development of plants. Sea buckthorn (Hippophae rhamnoides Linn.) is a typical drought-resistant tree species. In this study, the leaves of the H. rhamnoides ssp. sinensis (‘FN’) and H. rhamnoides ssp. mongolica (‘XY’) were selected during drought-recovery cycles for RNA sequencing, and physiological and biochemical analyses. The results revealed that drought stress significantly decreased leaf water potential, net photosynthetic rate and stomatal conductance in both sea buckthorn subspecies. Similarly, the contents of flavone, flavonol, isoflavone and flavanone significantly decreased under drought stress in ‘XY’. Conversely, in ‘FN’, the flavone and abscisic acid (ABA) contents were significantly higher under drought stress and recovered after rehydration. Meanwhile, 4618 and 6100 differentially expressed genes (DEGs) were identified under drought stress in ‘FN’ and ‘XY’, respectively. In total, 5164 DEGs were observed in the comparison between ‘FN’ and ‘XY’ under drought stress. This was more than the 3821 and 3387 DEGs found when comparing the subspecies under control and rehydration conditions, respectively. These DEGs were mainly associated with carotenoid biosynthesis, flavonoid biosynthesis, photosynthesis and plant hormone signal transduction. Six hub DEGs (ABCG5, ABCG22, ABCG32, ABCG36, ABF2 and PYL4) were identified to respond to drought stress based on weighted gene co-expression network analysis and Basic Local Alignment Search Tool (BLAST) analysis using DroughtDB. These six DEGs were annotated to play roles in the ABA-dependent signaling pathway. Sixteen RNA sequencing results involving eight genes and similar expression patterns (12/16) were validated using quantitative real-time Polymerase Chain Reaction (PCR). The biochemical and molecular mechanisms underlying the regulation of drought responses by ABA and flavonoids in sea buckthorn were clarified. In this study, gene co-expression networks were constructed, and the results suggested that the mutual regulation of ABA and flavonoid signaling contributed to the difference in drought resistance between the different sea buckthorn subspecies.
Overlooked cryptic diversity inMuschampia(Lepidoptera: Hesperiidae) adds two species to the European butterfly fauna
Authors: Hinojosa Joan C , Dapporto Leonardo , Brockmann Ernst , Dincă Vlad , Tikhonov Valentin , Grishin Nick , Lukhtanov Vladimir A , Vila Roger 
Published: November 2020

AbstractCryptic species represent a challenge for documenting global biodiversity. Even in well-studied groups, such as European butterflies, the application of integrative approaches has allowed the recognition of an unexpected number of cryptic taxa. Here, we combine the analysis of mitochondrial (cytochrome c oxidase I, COI) and nuclear (internal transcribed spacer 2, ITS2) markers with geometric morphometrics of the male genitalia to study diversity within the butterfly Muschampia proto. The nuclear marker reveals three well-supported and deeply diverged lineages, which are also detected based on mitochondrial DNA, although the latter recovers one of them as paraphyletic with poor support. These lineages also present distinct male genital characters, which allow blind assignment of &gt; 97% of specimens when applying a jackknife procedure. We conclude that M. proto comprises three cryptic species that started to differentiate ~2 Mya: M. proto, distributed in northern Africa, the Iberian Peninsula and southern France; Muschampia alta comb. & stat. nov., occurring in southern Italy and the Balkan Peninsula; and Muschampia proteides, present in the easternmost part of Europe, the Near East and Iran. This discovery adds two new species to the European butterfly fauna and highlights the necessity to continue investigating potential cryptic diversity.
Creating Solutions to the Common Problems in Health Professional Workforce Learning Through Human-Centered Design
Authors: Leo Joan , Clark Robyn 
Published: November 2020

Abstract:
Health professionals operate within time and resource constrained environments, which can create barriers to engage in learning. There is increasing recognition that a large proportion of learning in the workplace is informal, unstructured, and occurring in the absence of an educator. The experiential nature of workplace learning, environmental constraints, and part-time health workforces require that learning be accessible, flexible, and engaging.
The interplay between HIV and COVID-19: summary of the data and responses to date
Authors: Brown Lillian B. , Spinelli Matthew A. , Gandhi Monica 
Published: November 2020

Purpose of review
We examine the interplay between the HIV and COVID-19 epidemics, including the impact of HIV on COVID-19 susceptibility and severe disease, the effect of the COVID-19 epidemic on HIV prevention and treatment, and the influence of the HIV epidemic on responses to COVID-19.

Recent findings
Evidence to date does not suggest that people living with HIV (PLWH) have a markedly higher susceptibility to SARS-CoV-2 infection, with disparities in the social determinants of health and comorbidities likely having a greater influence. The majority of literature has not supported a higher risk for severe disease among PLWH in Europe and the United States, although a large, population-based study in South Africa reported a higher rate of death due to COVID-19. Higher rates of comorbidities associated with COVID-19 disease severity among PLWH is an urgent concern. COVID-19 is leading to decreased access to HIV prevention services and HIV testing, and worsening HIV treatment access and virologic suppression, which could lead to worsening HIV epidemic control.

Conclusion
COVID-19 is threatening gains against the HIV epidemic, including the U.S. Ending the HIV Epidemic goals. The ongoing collision of these two global pandemics will continue to need both study and interventions to mitigate the effects of COVID-19 on HIV efforts worldwide.
Dose Assessment Following a 238Pu-contaminated Wound Case with Chelation and Excision
Authors: Poudel Deepesh , Klumpp John A. , Bertelli Luiz , Dumit Sara , Waters Tom L. 
Published: November 2020

Abstract
The urinary excretion and wound retention data collected after a 238Pu-contaminated wound were analyzed using Markov Chain Monte Carlo (MCMC) to obtain the posterior distribution of the intakes and doses. An empirical approach was used to model the effects of medical treatments (chelation and excision) on the reduction of doses. It was calculated that DTPA enhanced the urinary excretion, on average, by a factor of 17. The empirical analysis also allowed calculation of the efficacies of the medical treatments—excision and chelation averted approximately 76% and 5.5%, respectively, of the doses that would have been if there were no medical treatment. All bioassay data are provided in the appendix for independent analysis and to facilitate the compartmental modeling approaches being developed by the health physics community.