bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informal carers’ support needs when caring for a person with dementia – A scoping literature review
Authors: Holt Clemmensen Trine , Hein Lauridsen Henrik , Andersen‐Ranberg Karen , Kaae Kristensen Hanne 
Published: August 2020

BackgroundInformal carers of people with dementia report having unmet needs for support and few supportive interventions have been shown to be effective. There is a need to develop needs assessment instruments and supportive interventions with a holistic and person‐centred approach to meet the various and complex needs of carers. The aim of this study was to provide an overview of carers’ support needs when caring for people with dementia with the objectives to map and synthesise knowledge on key concepts of carers’ support needs.MethodsA scoping review methodology was used. A literature search was conducted in PsycINFO, CINAHL, PubMed and EMBASE between January 2007 and October 2019. Three authors independently selected articles meeting the inclusion criteria, and data were extracted using a matrix developed for that purpose. Inductive content analysis was used to synthesise key concepts of carers’ support needs.ResultsThe search identified 2748 articles after removing duplicates, and 122 articles were included in the mapping of carers’ support needs. Synthesising carers’ support needs indicated that the full extent of support needs emerges in the interaction between the carer and the person cared for and that it is possible to categorise support needs into four key concepts related to: 1) the carer as a person, 2) managing being a carer, 3) providing care, and 4) knowledge of dementia.ConclusionThe findings of this study help to map a framework describing carers’ support needs that may guide the development of future needs assessment instruments and supportive interventions.
Variability in hemoglobin mass response to altitude training camps
Authors: Nummela Ari , Eronen Timo , Koponen Anne , Tikkanen Heikki , Peltonen Juha E. 
Published: August 2020

The present study investigated whether athletes can be classified as responders or non‐responders based on their individual change in total hemoglobin mass (tHb‐mass) following altitude training while also identifying the potential factors that may affect responsiveness to altitude exposure. Measurements were completed with 59 elite endurance athletes who participated in national team altitude training camps. Fifteen athletes participated in the altitude training camp at least twice. Total Hb‐mass using a CO rebreathing method and other blood markers were measured before and after a total of 82 altitude training camps (1350‐2500 m) in 59 athletes. In 46 (56%) altitude training camps, tHb‐mass increased. The amount of positive responses increased to 65% when only camps above 2000 m were considered. From the fifteen athletes who participated in altitude training camps at least twice, 27% always had positive tHb‐mass responses, 13% only negative responses, and 60% both positive and negative responses. Logistic regression analysis showed that altitude was the most significant factor explaining positive tHb‐mass response. Furthermore, male athletes had greater tHb‐mass response than female athletes. In endurance athletes, tHb‐mass is likely to increase after altitude training given that hypoxic stimulus is appropriate. However, great inter‐ and intra‐individual variability in tHb‐mass response does not support classification of an athlete permanently as a responder or non‐responder. This variability warrants efforts to control numerous factors affecting an athlete's response to each altitude training camp.
Identification of transcription factors controlling floral morphology in wild Petunia species with contrasting pollination syndromes
Authors: Yarahmadov Tural , Robinson Sarah , Hanemian Mathieu , Pulver Valentin , Kuhlemeier Cris 
Published: August 2020

SummaryAdaptation to different pollinators is an important driver of speciation in the angiosperms. Genetic approaches such as QTL mapping have been successfully used to identify the underlying speciation genes. However, these methods are often limited by widespread suppression of recombination due to divergence between species. While the mutations that caused the interspecific differences in floral color and scent have been elucidated in a variety of plant genera, the genes that are responsible for morphological differences remain mostly unknown. Differences in floral organ length determine the pollination efficiency of hawkmoths and hummingbirds, and therefore the genes that control these differences are potential speciation genes. Identifying such genes is challenging, especially in non‐model species and when studying complex traits for which little prior genetic and biochemical knowledge is available. Here we combine transcriptomics with detailed growth analysis to identify candidate transcription factors underlying interspecific variation in the styles of Petunia flowers. Starting from a set of 2284 genes, stepwise filtering for expression in styles, differential expression between species, correlation with growth‐related traits, allele‐specific expression in interspecific hybrids, and/or high‐impact polymorphisms resulted in a set of 43 candidate speciation genes. Validation by virus‐induced gene silencing identified two MYB transcription factors, EOBI and EOBII, that were previously shown to regulate floral scent emission, a trait associated with pollination by hawkmoths.
Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis
Authors: Ho Mu‐Hsing , Montgomery Amy , Traynor Victoria , Chang Chia‐Chi , Kuo Ken N. , Chang Hui‐Chen (Rita) , Chen Kee‐Hsin 
Published: August 2020

AbstractBackgroundCritical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment.AimTo evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients.MethodsWe searched five electronic databases including the Cochrane Library, PubMed, Embase, CINAHL, and a Chinese database for eligible diagnostic studies published in English or Mandarin up to December 2018. This diagnostic test accuracy meta‐analysis was limited to studies in intensive care unit (ICU) settings, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a standard reference to test the accuracy of delirium assessment tools. Eligible studies were critically appraised by two investigators independently. The summary of evidence was conducted for pooling and comparing diagnostic accuracy by a bivariate random effects meta‐analysis model. The pooled sensitivities and specificities, summary receiver operating characteristic curve (sROC), the area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated and plotted. The possibility of publication bias was assessed by Deeks’ funnel plot.Data SynthesisWe identified and evaluated 23 and 8 articles focused on CAM‐ICU and ICDSC, respectively. The summary sensitivities of 0.85 and 0.87, and summary specificities of 0.95 and 0.91 were found for CAM‐ICU and ICDSC, respectively. The AUC of the CAM‐ICU was 0.96 (95% CI, 0.94–0.98), with DOR at 99 (95% CI, 55–177). The AUC of the ICDSC was 0.95 (95% CI, 0.92–0.96), and the DOR was 65 (95% CI, 27–153).Linking Evidence to ActionCAM‐ICU demonstrated higher diagnostic test accuracy and is recommended as the optimal delirium assessment tool. However, the results should be interpreted with caution due to the between‐study heterogeneity of this diagnostic test accuracy meta‐analysis.
Tools to assess the measurement properties of quality of life instruments: a meta-review
Authors: Lorente Sonia , Viladrich Carme , Vives Jaume , Losilla Josep-Maria 
Published: August 2020

ObjectiveThis meta-review aims to discuss the methodological, research and practical applications of tools that assess the measurement properties of instruments evaluating health-related quality of life (HRQoL) that have been reported in systematic reviews.DesignMeta-review.MethodsElectronic search from January 2008 to May 2020 was carried out on PubMed, CINAHL, PsycINFO, SCOPUS, WoS, Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) database, Google Scholar and ProQuest Dissertations and Theses.ResultsA total of 246 systematic reviews were assessed. Concerning the quality of the review process, some methodological shortcomings were found, such as poor compliance with reporting or methodological guidelines. Regarding the procedures to assess the quality of measurement properties, 164 (66.6%) of reviewers applied one tool at least. Tool format and structure differed across standards or scientific traditions (ie, psychology, medicine and economics), but most assess both measurement properties and the usability of instruments. As far as the results and conclusions of systematic reviews are concerned, only 68 (27.5%) linked the intended use of the instrument to specific measurement properties (eg, evaluative use to responsiveness).ConclusionsThe reporting and methodological quality of reviews have increased over time, but there is still room for improvement regarding adherence to guidelines. The COSMIN would be the most widespread and comprehensive tool to assess both the risk of bias of primary studies, and the measurement properties of HRQoL instruments for evaluative purposes. Our analysis of other assessment tools and measurement standards can serve as a starting point for future lines of work on the COSMIN tool, such as considering a more comprehensive evaluation of feasibility, including burden and fairness; expanding its scope for measurement instruments with a different use than evaluative; and improving its assessment of the risk of bias of primary studies.PROSPERO registration numberCRD42017065232.
Electronic health records (EHR) simulation-based training: a scoping review protocol
Authors: Nuamah Joseph K , Adapa Karthik , Mazur Lukasz 
Published: August 2020

IntroductionEffective electronic health record (EHR)-based training interventions facilitate improved EHR use for healthcare providers. One such training intervention is simulation-based training that emphasises learning actual tasks through experimentation in a risk-free environment without negative patient outcomes. EHR-specific simulation-based training can be employed to improve EHR use, thereby enhancing healthcare providers’ skills and behaviours. Despite the potential advantages of this type of training, no study has identified and mapped the available evidence. To fill that gap, this scoping review will synthesise the current state of literature on EHR simulation-based training.Methods and analysisThe Arksey and O’Malley methodological framework will be employed. Three databases (PubMed, Embase and Cumulative Index to Nursing and Allied Health Literature) will be searched for published articles. ProQuest and Google Scholar will be searched to identify unpublished articles. Databases will be searched from inception to 29 January 2020. Only articles written in English, randomised control trials, cohort studies, cross-sectional studies and case-control studies will be considered for inclusion. Two reviewers will independently screen titles and abstracts against inclusion and exclusion criteria. Then, they will review full texts to determine articles for final inclusion. Citation chaining will be conducted to manually screen references of all included studies to identify additional studies not found by the search. A data abstraction form with relevant characteristics will be developed to help address the research question. Descriptive numerical analysis will be used to describe characteristics of included studies. Based on the extracted data, research evidence of EHR simulation-based training will be synthesised.Ethics and disseminationSince no primary data will be collected, there will be no formal ethical review. Research findings will be disseminated through publications, presentations and meetings with relevant stakeholders.
Place4Carers: a mixed-method study protocol for engaging family caregivers in meaningful actions for successful ageing in place
Authors: Graffigna Guendalina , Barello Serena , Morelli Niccolò , Gheduzzi Eleonora , Corbo Massimo , Ginex Valeria , Ferrari Roberta , Lascioli Andrea , Feriti Carolina , Masella Cristina 
Published: August 2020

IntroductionEngaging family caregivers could be a critical asset to make the ‘ageing-in-place’ imperative a reality. This is particularly evident in rural and remote areas, where caregivers can fill the gaps that exist due to the fragmentation of the welfare system. However, there is little knowledge about the expectations that family caregivers have from healthcare services in rural and remote areas.Place4Carers (P4C) project aims to co-produce an innovative organisational model of social and healthcare services for family caregivers of older citizens living in Vallecamonica (Italy). The project is expected to facilitate ageing-in-place for older citizens, thus helping caregivers in their daily care activities.Methods and analysisP4C is a community-based participatory research project featuring five work packages (WPs). WP1 consists of a survey of unmet needs of caregivers and older people receiving services in Vallecamonica. WP2 consists of a scoping literature review to map services that provide interventions of support to caregivers living in remote areas and promote engagement. WP3 organises co-creation workshops with caregivers to co-design, co-manage, and co-assess ideas and proposals for shaping caregiver-oriented services and organisational models. WP3 enriches the results of WP1 (survey) and WP2 (scoping literature review), and aims to co-create new ideas for intervention support with and for caregivers in relation to the objectives, features and characteristics of a new service able to address the caregivers’ needs and expectations. WP4 tests the service ideas co-created in WP3 through piloting an intervention based on ideas co-created with caregivers. Finally, WP5 assesses the transferability of the intervention to other similar contexts.Ethics and disseminationThe study has been approved by the Ethics Committees of the Department of Psychology of Università Cattolica del Sacro Cuore and Politecnico of Milan. Results will be disseminated through peer-reviewed journals, scientific meetings and meetings with the general population.
Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective
Authors: Messika-Zeitoun David , Candolfi Pascal , Enriquez-Sarano Maurice , Burwash Ian G , Chan Vincent , Philippon Jean-Francois , Toussaint Jean-Manuel , Verta Partrick , Feldman Ted E , Iung Bernard , Glineur David , Obadia Jean-Francois , Vahanian Alec , Mesana Thierry 
Published: August 2020

ObjectivesUnbiased information regarding the surgical management of patients with mitral regurgitation (MR) at the nationwide level are scarce and mainly US-based. The Programme de Médicalisation des Systèmes d’Information, a mandatory national database, offers the unique opportunity to assess the presentation and outcomes of all consecutive mitral valve (MV) surgeries performed in France in the contemporary era.MethodsWe collected all MV surgeries performed for MR in France in 2014–2016. MR aetiology was classified as degenerative (DMR), secondary (SMR) or Other (rheumatic or congenital disease and infective endocarditis).ResultsDuring the 3-year period, 18 167 MV surgeries were performed in France (55% repair and 45% replacement; 52% isolated). Age was 66±12 years and 59% were male. Aetiology was DMR in 42%, SMR in 16% and other in 42% including 19% with uncertain aetiologies. Overall, in-hospital mortality was 6.5% and increased with age, female gender, Charlson Comorbidity Index, type of surgery (replacement vs repair), associated surgery (combined vs isolated) and MR aetiology (all p<0.01). In-hospital mortality and rate of death/readmission for heart failure (HF) at 1 year were 3.4% and 13%, respectively for DMR (2.4% and 11% for isolated DMR) and 7.8% and 27%, respectively for SMR (5.5% and 23% for isolated SMR). Repair rate was 55% overall, 68% in DMR and 72% for isolated DMR surgery (70% of all DMR). Repair rates decreased with age, Charlson Comorbidity Index and female sex (all p<0.0001).ConclusionIn this cross-sectional contemporary prospective nationwide database, in-hospital mortality and 1 year rate of death and HF readmission were considerable overall and in all subsets. Repair rates were suboptimal overall especially in the elderly and women subsets. These results underline the need to develop strategies to improve management and outcomes of patients with both DMR and SMR.
Characteristics and predictors of burnout among healthcare professionals: a cross-sectional study in two tertiary hospitals
Authors: El-Menyar Ayman , Ibrahim Wanis H , El Ansari Walid , Gomaa Mohamed , Sathian Brijesh , Hssain Ali Ait , Wahlen Bianca , Nabir Syed , Al-Thani Hassan 
Published: August 2020

ABSTRACT

Background
The pattern and impact of burnout among the medical staff are not yet well defined. However, the consequences of burnout are not limited to the healthcare providers but also may affect their family, colleagues and patients in a negative manner. We aimed to assess the characteristics and predictors of burnout among health professionals at two large tertiary hospitals.

Methods
We conducted a cross-sectional study during the period from July 2018 to 31 December 2018. Data, via Maslach Burnout Inventory survey, were collected from physicians and other healthcare workers in two hospitals.

Results
A total of 624 responses to questionnaires were analysed. Half of the respondents were physicians, and men constituted the majority. About 10% (95% CI, 7.8 to 12.5) of the respondents satisfied the criteria of burnout. Emotional exhaustion (EE) was observed in 45.7%, depersonalisation (DP) in 26.9% and personal accomplishment (PA) in 41.2% of the respondents. There was a positive correlation between EE and DP (r=0.627, p=0.001), and a weak negative correlation between DP and PA (r=−0.195, p=0.001). Young age, less experience, trauma surgery, lack of habits and getting depressed ≥1 time/week were predictors of burnout.

Conclusions
Burnout affects one-tenth of the health professionals in the tertiary hospitals in Qatar. Physicians are more likely to have higher DP and lower PA, whereas nurses prone to have higher EE. In this study, no gender discrepancy is appreciated and the junior medical staff is at a higher risk of burnout.
Improved clinical outcome with biodegradable polymer drug-eluting stents compared to durable polymer drug-eluting stents for primary percutaneous coronary intervention
Authors: Andriyati Ratna , Firman Doni , Kurniawati Yovi , Alkatiri Amir Aziz , Pranata Raymond , Muliawan Hary Sakti , Rossimarina Vienna , Soerianata Sunarya 
Published: August 2020

ABSTRACTBackgroundStudies comparing the clinical outcomes of second-generation biodegradable polymer drug-eluting stents (BP-DES) and second-generation durable polymer drug-eluting stents (DP-DES) in patients with ST-segment elevation myocardial infarction (STEMI) with follow-up duration of more than 1 year are still limited.ObjectiveThis study aimed to compare the 2-year clinical outcome of BP-DES with second-generation DP-DES in patients undergoing primary percutaneous coronary intervention (PPCI).MethodsThis is a retrospective cohort study in patients with STEMI, the primary endpoint was major adverse cardiac events (MACE) defined as recurrent myocardial infarction, total repeat revascularisation and cardiac death. The secondary endpoint was stent thrombosis (ST) defined as definite, probable or possible.ResultsA total of 400 patients were analysed (197 BP-DES groups and 203 DP-DES groups). BP-DES were independently associated with lower incidence of MACE (adjusted HR 0.67, 95% CI 0.21 to 0.91, p=0.005) and ST (adjusted HR 0.62, 95% CI 0.19 to 0.73, p&lt;0.016) within 2 years of follow-up. Subgroup analysis of MACE individual components showed that BP-DES were associated with lower cardiac deaths (HR 0.35; 95% CI 0.18 to 0.94; p&lt;0.001) compared to DP-DES, but not recurrent myocardial infarction and total repeat revascularisation.ConclusionsBP-DES were associated with better clinical outcomes compared to second-generation DP-DES in patients with STEMI undergoing PPCI.
Inhomogeneous spacetimes in Weyl integrable geometry with matter source
Authors: Paliathanasis Andronikos , Leon Genly , Barrow John D. 
Published: August 2020

AbstractWe investigate the existence of inhomogeneous exact solutions in Weyl Integrable theory with a matter source. In particular, we consider the existence of a dust fluid source while for the underlying geometry we assume a line element which belongs to the family of silent universes. We solve explicitly the field equations and we find the Szekeres spacetimes in Weyl Integrable theory. We show that only the isotropic family can describe inhomogeneous solutions where the LTB spacetimes are included. A detailed analysis of the dynamics of the field equations is given where the past and future attractors are determined. It is interesting that the Kasner spacetimes can be seen as past attractors for the gravitation models, while the unique future attractor describes the Milne universe similar with the behaviour of the gravitational model in the case of General Relativity.
Quantum entanglement in inflationary cosmology
Authors: Koh Seoktae , Lee Jung Hun , Park Chanyong , Ro Daeho 
Published: August 2020

AbstractWe investigate the time-dependent entanglement entropy in the AdS space with a dS boundary which represents an expanding spacetime. On this time-dependent spacetime, we show that the Ryu–Takayanagi formula, which is usually valid in the static spacetime, provides a leading contribution to the time-dependent entanglement entropy. We also study the leading behavior of the entanglement entropy between the visible and invisible universes in an inflationary cosmology. The result shows that the quantum entanglement monotonically decreases with time and finally saturates a constant value inversely proportional to the square of the Hubble constant. Intriguingly, we find that even in the expanding universes, the time-dependent entanglement entropy still satisfies the area law determined by the physical distance.
Exotic fermionic fields and minimal length
Authors: da Silva J. M. Hoff , Beghetto D. , Cavalcanti R. T. , da Rocha R. 
Published: August 2020

AbstractWe investigate the effective Dirac equation, corrected by merging two scenarios that are expected to emerge towards the quantum gravity scale. Namely, the existence of a minimal length, implemented by the generalized uncertainty principle, and exotic spinors, associated with any non-trivial topology equipping the spacetime manifold. We show that the free fermionic dynamical equations, within the context of a minimal length, just allow for trivial solutions, a feature that is not shared by dynamical equations for exotic spinors. In fact, in this coalescing setup, the exoticity is shown to prevent the Dirac operator to be injective, allowing the existence of non-trivial solutions.