bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil
Authors: Silva Guilherme Figueiredo , J. Simmonds Nicholas , Roth Dalcin Paulo de Tarso 
Published: July 2020

Abstract
Background
Advanced lung disease in adult cystic fibrosis (CF) drives most clinical care requirements. The aim was to evaluate outcome (time to death while in the study) in a cohort of adult CF patients with severe lung disease, and to determine the association among baseline patient characteristics and outcome.

Methods
A retrospective cohort study was performed and clinical records between 2000 and 2015 were reviewed. Severe lung disease was defined as forced expiratory volume in the first second (FEV1) < 30% of predicted. Outcomes of all patients, including their date of death or transplantation, were determined till January 1st, 2016. Clinical data were recorded at the entry date.

Results
Among 39 subjects included in the study, 20 (51.3%) died, 16 (41.0%) underwent bilateral lung transplantation, and 3 were alive at the end of the study period. Two variables were independently associated with death: body mass index (BMI ≥ 18.5 kg/m2) (HR = 0.78, 95% CI = 0.64–0.96 and p = 0.017) and use of tobramycin inhalation therapy (HR = 3.82, 95% CI = 1.38–10.6 and p = 0.010). Median survival was 37 (95% CI = 16.4–57.6) months. The best cut-off point for BMI was 18.5 kg/m2. Median survival in patients with BMI < 18.5 kg/m2 was 36 months (95% CI = 18.7–53.3).

Conclusion
Median survival of CF subjects with FEV1 < 30% was 37 months. BMI and tobramycin inhalation therapy were independently associated with death. Median survival in patients with BMI < 18.5 kg/m2 was significantly lower than in patients with BMI ≥ 18.5 kg/m2. The association of tobramycin inhalation with death was interpreted as confounding by severity (use was reserved for advanced lung disease).
Burnout among Iranian nurses: a national survey
Authors: Mahmoudi Sara , Barkhordari-Sharifabad Maasoumeh , Pishgooie Amir-Hosein , Atashzadeh-Shoorideh Foroozan , Lotfi Zahra 
Published: July 2020

AbstractBackgroundNurses, particularly critical care nurses, are exposed to high levels of stress and burnout. Burnout is associated with many deleterious consequences affecting health care outcomes. The present study is intended to determine the dimensions of burnout in nurses on surgical, medical and critical care units and its relationship with demographic characteristics.MethodsIn this descriptive research study, performed at critical and non- critical care units, 743 nurses were randomly selected by quota sampling from medical sciences universities in Iran. Data collection instruments included a “demographic questionnaire” and the “Persian version of the Copenhagen Burnout Inventory. Data were analyzed using SPSS20.ResultsThe findings showed that regarding all dimensions, the lowest level of burnout belonged to surgical wards whereas the highest level pertained to critical care wards indicating a significant difference among various aspects of burnout in different wards, i.e., surgery, medical, and critical care. There was no significant difference in gender, academic degree, and marital status in any of the aspects of burnout in critical care units; yet, the difference was significant between surgical and medical wards (P < 0.05). There were a negative significant correlation between some dimensions of burnout with age and nursing experience in critical care and medical wards (P < 0.05). Whereas in surgical wards, there were a positive significant correlation between some aspects of burnout with nursing experience and age (P < 0.05).ConclusionThis study found that the critical care nurses have significantly higher level of burnout compared to the medical-surgical nurses. These results should be considered when planning burnout prevention schedules for nurses.
Enacting quality improvement in ten European hospitals: a dualities approach
Authors: Nunes Francisco G. , Robert Glenn , Weggelaar-Jansen Anne Marie , Wiig Siri , Aase Karina , Karltun Anette , Fulop Naomi J. 
Published: July 2020

AbstractBackgroundHospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions inherent to hospitals’ quest for improved quality, this article aims to identify which organizational dualities managers should particularly pay attention to.MethodsA set of cross-national, multi-level case studies was conducted involving 383 semi-structured interviews and 803 h of non-participant observation of key meetings and shadowing of staff in ten purposively sampled hospitals in five European countries (England, the Netherlands, Portugal, Sweden, and Norway).ResultsSix dualities that describe the quest for improved quality, each embracing a seemingly contradictory feature were identified: plural consensus, distributed connectedness, orchestrated emergence, formalized fluidity, patient coreness, and cautious generativeness.ConclusionsWe advocate for a move from the usual sequential and project-based and systemic thinking about quality improvement to the development of meta-capabilities to balance the simultaneous operation of opposing ideas or concepts. Doing so will help hospital managers to deal with major challenges of change inherent to quality improvement initiatives.
Enrichment differentiation of human induced pluripotent stem cells into sinoatrial node-like cells by combined modulation of BMP, FGF, and RA signaling pathways
Authors: Liu Feng , Fang Yibing , Hou Xiaojie , Yan Ying , Xiao Haiying , Zuo Dongchuan , Wen Jing , Wang Linli , Zhou Zhichao , Dang Xitong , Zhou Rui , Liao Bin 
Published: July 2020

Abstract
Background
Biological pacemakers derived from pluripotent stem cell (PSC) have been considered as a potential therapeutic surrogate for sick sinus syndrome. So it is essential to develop highly efficient strategies for enrichment of sinoatrial node-like cells (SANLCs) as seed cells for biological pacemakers. It has been reported that BMP, FGF, and RA signaling pathways are involved in specification of different cardiomyocyte subtypes, pacemaker, ventricular, and atrial cells. We aimed to investigate whether combined modulation of BMP, FGF, and RA signaling pathways could enrich the differentiation of SANLC from human pluripotent stem cell (hiPSC).

Methods
During the differentiation process from human induced pluripotent stem cell to cardiomyocyte through small molecule-based temporal modulation of the Wnt signaling pathway, signaling of BMP, FGF, and RA was manipulated at cardiac mesoderm stage. qRT-PCR, immunofluorescence, flow cytometry, and whole cell patch clamp were used to identify the SANLC.

Results
qRT-PCR results showed that manipulating each one of bone morphogenetic protein (BMP), fibroblast growth factor (FGF), and retinoid acid (RA) signaling was effective for the upregulation of SANLC markers. Moreover, combined modulation of these three pathways displayed the best efficiency for the expression of SANLC markers, which was further confirmed at protein level using immunofluorescence and flow cytometry. Finally, the electrophysiological characteristics of upregulated SANLC were verified by patch clamp method.

Conclusion
An efficient transgene-independent differentiation protocol for generating SANLC from hiPSC was developed, in which combined modulating BMP, FGF, and RA signaling at cardiac mesoderm stage generates SANLC at high efficiency. This may serve as a potential approach for biological pacemaker construction.
Anaerobic co-digestion of rabbit manure and sorghum crops in a bench-scale biodigester
Authors: Adrover María Esperanza , Cotabarren Ivana , Madies Ezequiel , Rayes Manuel , Rodriguez Reartes Sabrina Belén , Pedernera Marisa 
Published: July 2020

AbstractAny type of biomass can be used as substrate for biogas production, but the performance of the biodigestion depends on the composition of the feed, and no direct extrapolation of the yield of the process from one substrate to another can be made. In this work, the performance of a bench-scale anaerobic biodigester of 93 L installed at ambient conditions is studied. The biodigester was set up in a region where temperature varies significantly during the year, and was operated under semi-batch conditions with non-thermal control for 16 months with a feed of rabbit manure and ground sorghum grains. To our knowledge, this is the first time the co-digestion of rabbit manure with sorghum grains is considered. To evaluate the biodigestion performance, critical operational variables (pH, temperature, biogas flowrate) were monitored, and composition of substrate, digestate and produced biogas was determined. Moreover, the following variables were quantified: (a) the theoretical methane potential, (b) the specific methane yield and (c) the degree of degradation of the substrate. A 1-D non-stationary model was formulated and validated with experimental data in order to analyze, in a theoretical form, the impact of incorporating thermal insulation to the unit. The results show that is it possible to produce biogas in a bench-scale biodigester, with a novel feed of rabbit manure and ground sorghum grains, in a region with significant temperature changes along the year. Moreover, it is shown that the 1-D model constitutes a useful tool for the design or improvement of biodigesters regarding the insulation system and the warming policies.
A feasibility study of the physiotherapy management of urinary incontinence in athletic women: trial protocol for the POsITIve study
Authors: Campbell K. Gillian , Batt Mark E. , Drummond Avril 
Published: July 2020

Abstract
Background
Urinary incontinence (UI) affects up to 40% of adult women within the UK, and pelvic floor muscle training can be effective as a treatment. The prevalence of UI is higher in athletic women than in their sedentary counterparts, but there is little research into reasons for this or into treatment within this population.
The aim of this study is to investigate the feasibility of conducting a future randomised controlled trial of physiotherapeutic management of UI in athletic women.

Methods
This is a mixed methods study with three distinct but related phases.
Phase 1: Semi-structured interviews with health care professionals in the community will explore current management practices of UI in women and particularly in female athletes in order to inform the control arm of a future study. It will also establish community health care professionals’ understanding of pelvic health physiotherapy.
Phase 2: Athletic and regularly exercising women recruited directly from gyms and sports clubs will undergo a course of physiotherapy to manage UI. This will establish study recruitment, eligibility, consent, attendance, attrition, and data completion rates. It will provide information regarding appropriate clinical venues and outcome measures to use for this patient group.
Phase 3: Semi-structured interviews with purposefully selected participants from phase 2 will investigate participant satisfaction with recruitment procedures, the intervention, outcome measures and the venues. Further, we will collect data regarding the use of a smartphone ‘app’ for adherence and monitoring of home exercises and participants’ beliefs around randomisation in a future study. We will explore the impact of UI on life and sport in more detail.

Discussion
This study will establish the ease and acceptability of recruiting athletic women directly from gyms and sports clubs and identify attrition rates. It will also explore the acceptability of the intervention, clinical venues and outcome measures. Data collected will be used to inform a future randomised controlled trial.

Trial registration
NCT03986411 (clinicaltrials.gov). Registered on 14 June 2019
Porous frontiers: priming as an extension of agenda setting and framing as a complementary approach
Authors: Mateus Samuel 
Published: July 2020

Agenda setting and priming both work under the premise that media affect audience evaluations by influencing the likelihood of some issues rather than other coming to mind. Framing, in turn, rests on the idea that, by representing the world in a certain way, media influence people to think about the world in particular ways. Agenda setting, priming and framing all suggest that media messages participate in the formation of the public knowledge and that knowledge is activated and used in politically relevant decisions.This paper provides a concise, accessible and clear overall perspective on these three theories and aims to provide theoretical and methodological clarifications that may lead to a better accommodation of these three ways of conceptualizing media influence on public opinion. The first part characterizes and elucidates on the meaning of priming and framing as traditionally being seen as an extension and a sub-species of agenda setting. It argues that although priming may be conceived as an extension of agenda setting, framing is not a sub species of agenda setting. In the second part, it contends that agenda setting and framing constitute different strands of research – namely, media effects based on an accessibility model and on a social constructivist, applicability model – and that, as such, they develop themselves autonomously and independently, even if they complement each other.
Pancreatite em Clínica Médica de Pequenos Animais: uma Revisão de Literatura / Pancreatitis in Small Animal Medical Clinic: a Literature Review
Authors: Mack Isabela Da Costa 
Published: July 2020

A pancreatite consiste na inflamação do pâncreas, órgão responsável pela produção de enzimas digestivas, de insulina e glucagon, que são responsáveis por regular os níveis de açúcar no sangue. Sendo essa enfermidade comum em cães e gatos, o presente artigo tem como finalidade tratar a respeito da doença, seus sintomas, diagnóstico, tratamento e prognóstico a partir de uma revisão de literatura com base em artigos científicos coletados no Google Acadêmico, uma dissertação de mestrado, um trabalho de conclusão de curso e um artigo publicado em um site especializado em medicina veterinária. Ao fim, conclui-se que existem dois tipos da doença, o agudo e o crônico, e que o prognóstico será mais ou menos favorável dependendo do estado geral do paciente. Além disso, o tratamento recomendado consiste basicamente em fluidoterapia e administração de analgésicos, antimicrobianos e antieméticos, com possibilidade de transfusão de plasma para animais em estados mais graves, sendo pouco recomendada a intervenção cirúrgica em virtude dos altos riscos que esse procedimento oferece. Palavras-chaves: Pancreatite; Inflamação; Pâncreas; Medicina Veterinária.
Incidence and Risk Factors of Recurrent Clostridioides difficile Infection in Patients With Cirrhosis
Authors: Phatharacharukul Parkpoom , Purpura Russell D. , Gandhi Devika , Xu Huiping , Bickett-Burkhart Katie , Chalasani Naga , Fischer Monika , Orman Eric S. 
Published: July 2020

INTRODUCTION:

Clostridioides difficile infection (CDI) is common in patients with cirrhosis and is associated with poor outcomes. CDI risk factors in this population have been well characterized; however, risk factors of recurrent CDI (R-CDI) after treatment have not been explored. We sought to estimate the incidence of R-CDI and its associated risk factors in patients with cirrhosis.

METHODS:
We performed a cohort study of patients with cirrhosis hospitalized with CDI between 2012 and 2016. We collected patient characteristics, including detailed information on the CDI, features of the underlying liver disease, and outcomes including R-CDI, hospital readmission, and mortality. R-CDI was defined as CDI occurring 2–8 weeks after the initial episode. Cox proportional hazards model was used to identify variables independently associated with the outcomes.

RESULTS:
A total of 257 hospitalized patients with cirrhosis and CDI were included. CDI was community associated in 22.6%. The incidence of R-CDI was 11.9%. R-CDI was not significantly associated with medications at hospital admission or discharge. Independent risk factors of R-CDI included increased Charlson Comorbidity Index (hazard ratio [HR] 1.30; 95% confidence interval [CI]: 1.09–1.55) and use of lactulose (HR 2.58; 95% CI: 1.09–6.09). The 30-day readmission rate was 37%, and readmission was associated with increased Charlson Comorbidity Index (HR 1.12; 95% CI: 1.03–1.23) and Model for End-Stage Liver Disease score (HR 1.04; 95% CI: 1.01–1.07). The 90-day mortality was 22.8%.

DISCUSSION:
In patients with cirrhosis, R-CDI is associated with comorbidity burden and lactulose use. Attention to these factors might aid clinicians in efforts to prevent R-CDI and improve outcomes in this population.
Regulatory Arbitrage: What’s Law Got To Do With It?
Authors: Langenbucher Katja 
Published: July 2020

Abstract
This paper explores regulatory arbitrage from a legal point of view. I start from the assumption that legislators will sometimes wish to prevent regulatory arbitrage and examine legal tools available to this end. To back up the underlying assumption, I present two perspectives on the phenomenon of regulatory arbitrage. One perspective stresses its competitive element, the other one focuses on instances of arbitrage as unwanted avoidance of a legal regime. It is suggested that from both perspectives we will find that – at least sometimes – regulatory arbitrage is unwanted. I move on to illustrate how EU and U.S. legislators have dealt with an example of unwanted arbitrage. The main part of the paper then deals with legal tools to suppress arbitrage. The main focus is on legislative drafting techniques such as choosing a narrow wording, a broad wording, anti-evasion rules or the concept of abuse. I conclude with a glance at problems of regulatory arbitrage in a corporate setting.
A new methodological approach (QEMSCAN®) in the mineralogical study of Polish loess: Guidelines for further research
Authors: Kenis Piotr , Skurzyński Jacek , Jary Zdzisław , Kubik Rafał 
Published: July 2020

Abstract
This article presents in detail the methodology dedicated strictly to loess mineralogical investigation by automated mineralogy system QEMSCAN® (quantitative evaluation of minerals by scanning electron microscopy (SEM)), which couples SEM and energy dispersive X-ray spectrometry to automatically deliver mineral and phase mapping. The present study provides guidelines for further loess investigation in Poland, in order to maintain the complete comparability of results which will be obtained. The methodology is then used to obtain the data on complex mineralogical composition (heavy, light, transparent and opaque phases). In total 1,159,107 particles have been measured for five bulk loess samples and 4–6% of them were heavy minerals (c.a. 10,000 per sample). The bulk samples are dominated by quartz (57.3–62.9%) and contain plagioclase (7.8–9.2%), K-feldspar (7.9–8.7%), carbonates (5.0–7.8%), muscovite (3.2–6.2%), biotite (4.2–7.5%), heavy minerals (4.3–5.8%) and clay minerals (0.9–1.6%). The heavy minerals (as a group recalculated to 100%) are mainly represented by phases such as clinopyroxene (38–51%), garnets (14–21%), TiO2 polymorphs (8–12%), Al2SiO5 polymorphs (3–7%), ilmenite (3–6%), iron oxides, e.g., hematite and magnetite (2–5%) and zircon (∼2%). Nearly 50% of the heavy minerals is classified in the 16–31 µm fraction, which determine the changes in the current research procedure traditionally used for Polish loess.
Urban Wi-Fi fingerprinting along a public transport route
Authors: Retscher Guenther , Bekenova Aizhan 
Published: July 2020

Abstract
The outreach of Wi-Fi localization is extended in this study for urban wide applications as they provide the high potential to employ them for numerous applications for localization and guidance in urban environments. The selected application presented in this paper is the localization and routing of public transport smartphone users. For the conducted investigations, Received Signal Strength Indicator (RSSI) values are collected for users who are travelling from home in a residential neighbourhood to work in the city centre and return along the same route. Special tramway trains are selected which provide two on-board Wi-Fi Access Points (APs). Firstly, the availability, visibility and RSSI stability of the Wi-Fi signal behavior of these APs and the APs in the surrounding environment along the routes is analyzed. Then the trajectories are estimated based on location fingerprinting. A first analyses reveals that significant differences exists between the six employed smartphones as well as times of the day, e. g. in the morning at peak hours or at off-peak hours. From the long-time observations it is seen that the two on-board APs show a high stability of the RSSI signals at the same times of the day and along the whole route. It is therefore currently investigated how they can confirm and validate user localization along the route and if they can contribute to constrain the overall positioning solution in combination with the inertial smartphone sensors. Moreover, the railway track can serve as a further constraint. As an outlook on future work, the development of a Simultaneous Localization and Mapping (SLAM) solution with a fusion with the smartphone inertial sensors is proposed.
Synthesis and crystal structure of (E)-1-benzyl-3-(4-methoxystyryl)quinoxalin-2(1H)-one, C24H20N2O2
Authors: Missioui Mohcine , Essassi El Mokhtar , Mague Joel T. , Ramli Youssef 
Published: July 2020

Abstract
C24H20N2O2, monoclinic, P21/c (no. 14), a = 11.1713(3) Å, b = 17.7718(5) Å, c = 10.9852(3) Å, β = 118.990(1)°, V = 1907.67(9) Å3, Z = 4, R
gt(F) = 0.0538, wR
ref(F
2) = 0.1582, T = 296(2) K.
The Purinergic Receptor P2rx3 is Required for Spiral Ganglion Neuron Branch Refinement during Development
Authors: Wang Zhirong , Jung Johnny S. , Inbar Talya C. , Rangoussis Katherine M. , Faaborg-Andersen Christian , Coate Thomas M. 
Published: July 2020

AbstractThe mammalian cochlea undergoes a highly dynamic process of growth and innervation during development. This process includes spiral ganglion neuron (SGN) branch refinement, a process whereby Type I SGNs undergo a phase of “debranching” before forming unramified synaptic contacts with inner hair cells. UsingSox2CreERT2andR26RtdTomatoas a strategy to genetically label individual SGNs in mice of both sexes, we report on both a time course of SGN branch refinement and a role for P2rx3 in this process. P2rx3 is an ionotropic ATP receptor that was recently implicated in outer hair cell spontaneous activity and Type II SGN synapse development (Ceriani et al., 2019), but its function in Type I SGN development is unknown. Here, we demonstrate that P2rx3 is expressed by Type I SGNs and hair cells during developmental periods that coincide with SGN branching refinement.P2rx3null mice show SGNs with more complex branching patterns on their peripheral synaptic terminals and near their cell bodies around the time of birth. Loss ofP2rx3does not appear to confer general changes in axon outgrowth or hair cell formation, and alterations in branching complexity appear to mostly recover by postnatal day (P)6. However, when we examined the distribution of Type I SGN subtypes using antibodies that bind Calb2, Calb1, and Pou4f1, we found thatP2rx3null mice showed an increased proportion of SGNs that express Calb2. These data suggest P2rx3 may be necessary for normal Type I SGN differentiation in addition to serving a role in branch refinement.