bluuebunny/crossref_metadata_2025_split huggingface dataset:
From Fable to Reality at Parkland Hospital: The Impact of Evidence-Based Design Strategies on Patient Safety, Healing, and Satisfaction in an Adult Inpatient Environment
Authors: Rich Renae K. , Jimenez Francesqca E. , Puumala Susan E. , DePaola Sheila , Harper Kathy , Roy Lonnie , Brittin Jeri 
Published: November 2020

Objective: This research aimed to evaluate the quantitative effects of new hospital design on adult inpatient outcomes. Background: Tenets of evidence-based healthcare design, notably single-patient acuity-adaptable and same-handed rooms, decentralized nursing stations, onstage offstage layout, and access to nature were expected to promote patient healing and increase patient satisfaction, while decreasing adverse events. Methods: Patient healing was operationalized through length of stay (LOS) and patient safety through three adverse events: falls, hospital-acquired infections (HAI), and medication-related events. Standard patient surveys captured patient satisfaction. Patient records from 2013 through 2017 allowed for equivalent time periods surrounding the move to the new hospital in August 2015. Stratified by hospital division where significant, pre/post comparisons utilized proportional hazards or logistic regression models as appropriate; interrupted time series analyses afforded longitudinal interpretations. Results: Observed higher postmove LOS was due to previously increasing trends, not increases after the move. In surgical and trauma units, a constant increase in falls was unaffected by the move. Medication events decreased consistently over time; medication events with harm dropped significantly after the move. No change in HAI was found. Significant improvement on most relevant patient satisfaction items occurred after the move. Call button response decreased immediately after the move but subsequently improved. Conclusion: Results did not clearly indicate a net change in adult inpatient outcomes of healing and safety due to the hospital design. There was evidence that the new hospital improved patient satisfaction outcomes related to the environment, including comfort, noise, temperature, and aesthetics.
A comparative study of motion detection with FMG and sEMG methods for assistive applications
Authors: Islam Muhammad Raza Ul , Waris Asim , Kamavuako Ernest Nlandu , Bai Shaoping 
Published: November 2020

Introduction While surface-electromyography (sEMG) has been widely used in limb motion detection for the control of exoskeleton, there is an increasing interest to use forcemyography (FMG) method to detect motion. In this paper, we review the applications of two types of motion detection methods. Their performances were experimentally compared in day-to-day classification of forearm motions. The objective is to select a detection method suitable for motion assistance on a daily basis. Methods Comparisons of motion detection with FMG and sEMG were carried out considering classification accuracy (CA), repeatability and training scheme. For both methods, classification of motions was achieved through feed-forward neural network. Repeatability was evaluated on the basis of change in CA between days and also training schemes. Results The experiments shows that day-to-day CA with FMG can reach 84.9%, compared with a CA of 77.8% with sEMG, when the classifiers were trained only on the first day. Moreover, the CA with FMG can reach to 86.5%, comparable to CA of 84.1% with sEMG, if classifiers were trained daily. Conclusions Results suggest that data recorded from FMG is more repeatable in day-to-day testing and therefore FMG-based methods can be more useful than sEMG-based methods for motion detection in applications where exoskeletons are used as needed on a daily basis.
Mental Health Literacy of Healthcare Providers in Arab Gulf Countries: A Systematic Review
Authors: Elyamani Rowaida , Hammoud Hamed 
Published: November 2020

Background: The concept of Mental Health Literacy (MHL) relies on our capacity to understand and recognize mental illnesses and the ability to maintain and promote a positive mentality for ourselves and others. In our review, we aim to examine the level of MHL among healthcare providers in the Arab Gulf States. Methods: PubMed, PsycINFO, Medline were searched till August 2019. Studies were included if at least one of the main components of mental health literacy was reported, including (a) knowledge of mental illnesses, (b) stigma toward mental illnesses, (c) confidence in helping patients, and (d) behavior of helping patients, regardless of study design. The risk of bias was rated according to the modified Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. Results: Seven studies were included in the review; all of them were cross-sectional, with a total of 3516 participants from the healthcare system. Overall most of the studies claimed limited knowledge, negative attitudes, behavior and/or confidence among nurses, pharmacists, and physicians, especially juniors. However, the overall quality of all outcomes was relatively very low. Conclusion: More high-quality evidence and in-depth qualitative studies are required to bridge the gap between mental health needs and services delivered by healthcare providers in the Gulf Arab region.
The Development of Instrument to Assess Physician’s Practice in the Management of Patients With Terminal Diseases
Authors: Arisanti Nita , Sasongko Elsa Pudji Setiawati , Pandia Veranita , Hilmanto Dany 
Published: November 2020

Background The need for improving knowledge and practice of palliative care delivered by health workers become an agenda in several countries. In order to measure the practice, an instrument is needed. The study analyzed the validity and reliability of the instrument to assess the physician’s practice in the management of patients with terminal diseases. Methods This was a cross-sectional study involving 89 physicians practicing in primary health care. The instrument of practice has been developed and resulted 5 domains consist of 20 items. An overview of reliability, construct validity, uni-dimensionality, and hierarchy of the person-items of the instrument were analyzed using Rasch Model. Results The reliability of the instrument is excellent with a person measure reliability of 0.85 and the item measure reliability of 0.96. Construct validity is confirmed with the MNSQ outfit values in the range of 0.54 to 1.59 and Pt Measure Corr. values in the range of 0.31 to 0.8. This instrument has a value of more than 20% unidimensionality which indicates the level of independence for items is good. Conclusion The instrument has good validity and reliability to assess physician’s practice in the management of patients with terminal disease.
Using a Wearable Activity Monitor to Accurately Measure Mobility After Surgery for Hip Fractures (MASH)—A Feasibility Study Protocol
Authors: Berwin James T. , Macdonald Hamish , Fleming Tom , Kempshall Peter , Engelke Daniel 
Published: November 2020

Introduction: Hip fractures are the most common reason for acute orthopaedic admission in the United Kingdom (UK) and pose a substantial cost to the National Health Service (NHS). A significant proportion of this expenditure is accounted for by hospital bed days, with additional contributions from health and social aftercare. Early ambulation following hip fracture surgery improves outcomes by accelerating functional recovery and reducing the need for ongoing care. The ability to track a patient’s rehabilitation is important in assessing their care needs. While this is challenging to assess accurately, doing so may help to further improve outcomes. The aim of this feasibility study is to determine whether it is possible to accurately measure Mobility After Surgery for Hip fractures (MASH) in the immediate post-operative period by tracking the frequency of mobilization, distance walked and overall activity in the first week following surgery using a wearable activity monitor, the activPAL device. Methods and Materials: A total of 50 patients will be recruited to participate in the study. Ethical approval was given to recruit patients with and without capacity to consent. Immediately after undergoing hip fracture surgery, a activPAL monitor weighing 9 grams and measuring 23.5 mm x 43 x 5 mm in size will be applied to the anterior aspect of the participants thigh with a standard adhesive dressing. We will be assessing the feasibility of using the activPALto measure mobility in this patient group. Discussion: The MASH study will contribute to the design and execution of the MASH trial, which will seek to assess the accuracy by which mobility can be measured following hip fracture surgery and how this information can best be used to improve rehabilitation and care.
The Epidemiology of Fractures and Muskulo-Skeletal Traumas During COVID-19 Lockdown: A Detailed Survey of 17.591 Patients in a Wide Italian Metropolitan Area
Authors: Dolci Andrea , Marongiu Giuseppe , Leinardi Lorenzo , Lombardo Massimo , Dessì Giuseppe , Capone Antonio 
Published: November 2020

Introduction: On 9 March 2020 the Italian Government declared a national lockdown to curb the spread of Covid-19. The aim of our study was to analyze the effects of such intervention on the traumatological emergency service, with particular emphasis on variations in trauma incidence and patients’ characteristics. Materials and Methods: An observational analysis was performed. Medical records were collected from 3 different trauma centers within a wide metropolitan area, and compared between 2 time periods: the full Italian lockdown period and the same period from the past year. The study population included all patients who were admitted to the Emergency Department (ED). For those who accessed for orthopedic reasons, the analyzed variables included the date of ED admission, age, gender, after visit discharge or hospitalization, place where the injury occurred, traumatic mechanism, diagnosis, relationship with sport activity, and time from injury/symptoms debut to ED access. Results: A total of 17591 ED accesses and 3163 ED trauma visits were identified. During the lockdown, ED trauma visits decreased by -59.8%, but required patient’s hospitalization significantly more frequently. The rate of ED trauma admissions in the elderlies significantly increased, together with the proportion of fragility fractures such as hip fractures. Road accident traumas (-79.6%) and sport-related injuries (-96.2%) significantly dropped. Admissions for less-severe reasons such as atraumatic musculoskeletal pain significantly decreased (-81.6%). Conclusions: The lockdown reduced the pressure on the Health System in at least 2 ways: directly, by curbing viral transmission and indirectly, by more than halving the ED trauma visits. Nonetheless, we observed an increased proportion of traumas in older patients, requiring hospitalizations, while the rate of less-severe cases decreased. This analysis may raise awareness of the effects of a lockdown on trauma services and may be helpful for those ones around the world who are now facing the emergency.
What You Should Know About Osteoarthritis Rehabilitation: A Bibliometric Analysis of the 50 Most-Cited Articles
Authors: Wang Shi-Qi , Wang Jian-Xiong , Zhang Chi , Sun Fu-Hua , Xie Yu-Jie , Jiang Wei , Ou Xia , Miyamoto Akira , Wang Li 
Published: November 2020

Background: Osteoarthritis is a degenerative disease that commonly occurs in middle-aged and elderly people. High-quality articles in the field of osteoarthritis rehabilitation have not been studied in detail. Objective: To identify and conduct a qualitative and quantitative analysis of the 50 most-cited articles on osteoarthritis rehabilitation and provide valuable scientific information for researchers. Methods: Fifty articles related to the rehabilitation of individuals with osteoarthritis were retrieved from the Web of Science Core Collection. Basic information, such as the authors, title, number of citations, year of publication, journal, country/territory, and research type, was extracted. CiteSpace was used to visualize the keywords. Results: The average number of citations per article was 244.54. The top 50 articles were published in 27 journals and published by 262 authors. Most of the top 50 articles were published in the United States. The top 50 articles included 23 randomized controlled trials, 21 cohort studies, 2 case series, and 4 expert opinion articles. The most commonly studied topics in osteoarthritis rehabilitation included rehabilitation for pain, gait abnormalities, muscle strength deficiencies, and other functional impairments caused by osteoarthritis in elderly people. Conclusions: The top articles in the field of osteoarthritis rehabilitation have a high level of evidence. Collaboration between authors was high for highly-cited articles. Moreover, the eminent articles can provide important information for the education of doctors and therapists specializing in osteoarthritis rehabilitation.
Nitrogen dioxide increases the risk of mortality in idiopathic pulmonary fibrosis
Authors: Yoon Hee-Young , Kim Sun-Young , Kim Ok-Jin , Song Jin Woo 
Published: November 2020

Ambient air pollution is associated with the prognosis of idiopathic pulmonary fibrosis (IPF) patients. We aimed to identify the impacts of individual exposure to particulate matter with a 50% cut-off aerodynamic diameter of 10 μm (PM10) and nitrogen dioxide (NO2) on IPF patients' mortality.1114 patients (mean age 65.7 years; male 80.5%) diagnosed with IPF between 1995 and 2016 were included in this study. Individual-level long-term concentrations of PM10and NO2at residential addresses of patients were estimated using a national-scale exposure prediction model. The effect of PM10and NO2on mortality was estimated using a Cox proportional hazards model adjusted for individual- and area-level covariates.The median follow-up period was 3.8 years and 69.5% of the patients died or underwent lung transplantation. When adjusted for individual- and area-level covariates, a 10 ppb increase in NO2concentration was associated with a 17% increase in mortality (hazard ratio (HR) 1.172, 95% CI 1.030–1.344; p=0.016). When IPF patients were stratified by age (≥65versus<65 years) or by sex, NO2was a significant prognostic factor for mortality in the elderly (HR 1.331, 95% CI 1.010–1.598; p=0.010). When stratified by age and sex jointly, NO2showed the stronger association with mortality in elderly males (HR 1.305, 95% CI 1.072–1.598; p=0.008) than in other groups. PM10was not associated with IPF mortality in all patients and in subgroups stratified by age or sex.Our findings suggest that increased exposure to NO2can increase the risk of mortality in patients with IPF, specifically in elderly males.
Genome-wide identification and functional characterization of the Camelina sativa WRKY gene family in response to abiotic stress
Authors: Song Yanan , Cui Hongli , Shi Ying , Xue Jinai , Ji Chunli , Zhang Chunhui , Yuan Lixia , Li Runzhi 
Published: November 2020

Abstract

Background
WRKY transcription factors are a superfamily of regulators involved in diverse biological processes and stress responses in plants. However, there is limited knowledge about the WRKY family in camelina (Camelina sativa), an important Brassicaceae oil crop with strong tolerance for various stresses. Here, a genome-wide characterization of WRKY proteins is performed to examine their gene structures, phylogenetics, expression, conserved motif organizations, and functional annotation to identify candidate WRKYs that mediate stress resistance regulation in camelinas.

Results
A total of 242 CsWRKY proteins encoded by 224 gene loci distributed unevenly over the chromosomes were identified, and they were classified into three groups by phylogenetic analysis according to their WRKY domains and zinc finger motifs. The 15 CsWRKY gene loci generated 33 spliced variants. Orthologous WRKY gene pairs were identified, with 173 pairs in the C. sativa and Arabidopsis genomes as well as 282 pairs in the C. sativa and B. napus genomes, respectively. A total of 137 segmental duplication events were observed, but there was no tandem duplication in the camelina genome. Ten major conserved motifs were examined, with WRKYGQK being the most conserved, and several variants were present in many CsWRKYs. Expression analysis revealed that 50% more CsWRKY genes were expressed constitutively, and a set of them displayed tissue-specific expression. Notably, 11 CsWRKY genes exhibited significant expression changes in seedlings under cold, salt, and drought stresses, showing a preferentially inducible expression pattern in response to the stress.

Conclusions
The present article describes a detailed analysis of the CsWRKY gene family and its expression profiles in 12 tissues and under several stress conditions. Segmental duplication is the major force underlying the broad expansion of this gene family, and a strong purifying pressure occurred for CsWRKY proteins during their evolution. CsWRKY proteins play important roles in plant development, with differential functions in different tissues. Exceptionally, eleven CsWRKYs, particularly five alternative spliced isoforms, were found to be the possible key players in mediating plant responses to various stresses. Overall, our results provide a foundation for understanding the roles of CsWRKYs and the precise mechanism through which CsWRKYs regulate high stress resistance as well as the development of stress tolerance cultivars among Cruciferae crops.
The piperazine compound ASP activates an auxin response in Arabidopsis thaliana
Authors: Xu Fengyang , Xue Shuqi , Deng Limeng , Zhang Sufen , Li Yaxuan , Zhao Xin 
Published: November 2020

Abstract
Background
Auxins play key roles in the phytohormone network. Early auxin response genes in the AUX/IAA, SAUR, and GH3 families show functional redundancy, which makes it very difficult to study the functions of individual genes based on gene knockout analysis or transgenic technology. As an alternative, chemical genetics provides a powerful approach that can be used to address questions relating to plant hormones.

Results
By screening a small-molecule chemical library of compounds that can induce abnormal seedling and vein development, we identified and characterized a piperazine compound 1-[(4-bromophenoxy) acetyl]-4-[(4-fluorophenyl) sulfonyl] piperazine (ASP). The Arabidopsis DR5::GFP line was used to assess if the effects mentioned were correlated with the auxin response, and we accordingly verified that ASP altered the auxin-related pathway. Subsequently, we examined the regulatory roles of ASP in hypocotyl and root development, auxin distribution, and changes in gene expression. Following ASP treatment, we detected hypocotyl elongation concomitant with enhanced cell elongation. Furthermore, seedlings showed retarded primary root growth, reduced gravitropism and increased root hair development. These phenotypes were associated with an increased induction of DR5::GUS expression in the root/stem transition zone and root tips. Auxin-related mutants including tir1–1, aux1–7 and axr2–1 showed phenotypes with different root-development pattern from that of the wild type (Col-0), and were insensitive to ASP. Confocal images of propidium iodide (PI)-stained root tip cells showed no detectable damage by ASP. Furthermore, RT-qPCR analyses of two other genes, namely, Ethylene Response Factor (ERF115) and Mediator 18 (MED18), which are related to cell regeneration and damage, indicated that the ASP inhibitory effect on root growth was not attributable to toxicity. RT-qPCR analysis provided further evidence that ASP induced the expression of early auxin-response-related genes.

Conclusions
ASP altered the auxin response pathway and regulated Arabidopsis growth and development. These results provide a basis for dissecting specific molecular components involved in auxin-regulated developmental processes and offer new opportunities to discover novel molecular players involved in the auxin response.
Pelvic collateral pathway during endovascular aortoiliac aneurysm repair with internal iliac artery interruption: a retrospective observational study
Authors: Nishi Satoshi , Hayashi Shogo , Omotehara Takuya , Kawata Shinichi , Suematsu Yoshihiro , Itoh Masahiro 
Published: November 2020

Abstract

Background
Ipsilateral branches of the deep femoral artery (DFA) are qualitatively identified as collateral arteries based on angiography after internal iliac artery (IIA) interruption. The purpose of this study was to quantitatively identify the major collateral pathway after unilateral IIA interruption during endovascular aortoiliac aneurysm repair to preserve the pelvic circulation and reduce the risk of ischemic complications.

Methods
The study population included 28 patients (mean age 76.3 years) with aortoiliac aneurysm who underwent endovascular aneurysm repair with unilateral IIA interruption from August 2012 to January 2020. The diameters of the bilateral preoperative and postoperative DFA, lateral femoral circumflex artery (LFCA), medial femoral circumflex artery (MFCA) and obturator artery (ObA) were measured on contrast-enhanced computed tomography using a 3-dimensional image analysis system. The measured values were evaluated and analyzed with a repeated measures two-way analysis of variance and Dunnett’s test.

Results
The postoperative diameters of the MFCA (P = 0.051) and ObA (P = 0.016) were observed to be larger than the preoperative diameters. Such increases in the MFCA (P < 0.001) and ObA (P < 0.001) diameters were only found to be significant on the unilateral side of the IIA interruption, and the diameter of the ipsilateral LFCA (P < 0.001) was also found to have significantly increased in size. However, no significant arterial extension was found on the contralateral side.

Conclusions
The ipsilateral MFCA-ObA pathway might therefore be a major collateral pathway arising from the DFA to preserve pelvic circulation after unilateral IIA interruption.
Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism
Authors: Liu Jichun , Chen Hao , Xie Xiangrong , Yang Yuwen , Tang Shengxing 
Published: November 2020

Abstract

Background
Lung tumor embolization leading to acute myocardial infarction (AMI) is rare. Previouscases of lung tumor embolization were reported in the coronary artery. We describe here a case of lung tumor embolization leading to the simultaneous occurrence of AMI and lower extremity arterial embolism.

Case presentation
A 64-year-old patient was admitted to the emergency department complaining of chest pain and was diagnosed with AMI.An echocardiography showed a mass in the left atrium that was speculated to be a myxoma. An emergency coronary angiography found no evidence of atherosclerosis. On the second day of admission, the patient was diagnosed with lower extremity arterial embolism. Initially, we speculated that the left atrium myxoma caused an embolism resulting in the AMI and lower extremity arterial embolism.However, a lung tumor was the real cause of both conditions. Unfortunately, the patient abandoned treatment when he learned of his disease and died three days later after being discharged from the hospital.

Conclusions
Lung tumor embolism is an extremely rare cause of AMI. Even rarer is the case presented here, in which a lung tumor embolism caused AMI and lower extremity arterial embolism. Clinicians should recognize lung tumor embolism as a potential cause of AMI.