bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Uncertainty in Illness and Quality of Life in Patients With Heart Failure
Authors: An Yan , Zhang Yanting , Wang Lyu , Chen Cancan , Fan Xiuzhen 
Published: March 2021

Background
Previous investigators have demonstrated that uncertainty in illness is associated with quality of life (QoL) in patients with chronic illness. However, little is known about the mechanism underlying the relationship in patients with heart failure.

Objective
The aim of this study was to examine the multiple mediating effects of perceived stress and coping strategies on the relationship between uncertainty in illness and QoL in patients with heart failure.

Methods
We conducted a cross-sectional study in 302 patients with heart failure recruited at a general hospital in China from October 2016 to September 2017. Uncertainty in illness, perceived stress, coping strategies, and QoL were assessed using self-reported questionnaires. The multiple mediation model was tested using the PROCESS macro for SPSS.

Results
Of the 302 patients, 51.7% had poor physical QoL and 45.7% had poor mental QoL (physical component summary or mental component summary score of <50 points). Uncertainty in illness had a significantly negative indirect effect on mental QoL through perceived stress and acceptance-resignation (indirect effect, −0.02; 95% confidence interval, −0.04 to −0.01). Uncertainty in illness also had a significantly negative indirect effect on mental QoL via perceived stress only (indirect effect, −0.18; 95% confidence interval, −0.26 to −0.09).

Conclusions
Poor QoL is prevalent in patients with heart failure. Perceived stress and acceptance-resignation are important mediating factors between uncertainty in illness and mental QoL in patients with heart failure. Interventions aimed at reducing perceived stress and acceptance-resignation coping may be beneficial for improving mental QoL in patients with heart failure.
The Relationship Between Body Awareness and Self-care in Patients With Heart Failure
Authors: Lee Kyoung Suk , Choi Jin-Oh , Jeon Eun-Seok , Park Jae-Hyeong , Jung Mi Sook 
Published: March 2021

Background
Recognizing changing symptoms is challenging for patients with heart failure (HF), especially older patients. Body awareness involves an attentional focus on and awareness of internal bodily changes. Patients with poor body awareness are unlikely to recognize subtle bodily changes, which may result in improper self-care. Despite the potential benefits of body awareness, its contribution to HF management has not been examined.

Aims
The aims of this study were to examine the relationship between body awareness and self-care in patients with HF and explore whether this relationship varies by age.

Methods
Patients (N = 136) completed the Body Awareness Questionnaire and 2 scales of the Self-care of HF Index (maintenance and management). Linear regression models were constructed to explore the relationship between body awareness and self-care after controlling for covariates. The moderation effect of age on the relationship between body awareness and self-care was examined using the PROCESS macro.

Results
Body awareness was associated with self-care maintenance (unstandardized coefficient = 0.19; 95% confidence interval, 0.05–0.34) but not management. When the interaction effect of body awareness and age was entered in the regression model, neither self-care maintenance nor management was related to this interaction term.

Conclusion
We found that body awareness is conducive to self-care maintenance but not self-care management in patients with HF, and the relationship between body awareness and self-care did not vary by age. Our findings suggest that relying on internal body sensations may be insufficient to facilitate self-care management. Thus, other strategies along with the strategies to enhance body awareness are necessary to improve the full process of self-care in HF patients.
Gender Differences in Factors Associated With Physical Activity in Patients With Coronary Artery Disease
Authors: Huang Wan-Ting , Liu Chieh-Yu , Hung Huei-Fong , Hsu Shu-Pen , Chiou Ai-Fu 
Published: March 2021

Background
Although patients with coronary artery disease can benefit from adequate physical activity, low physical activity levels have been reported among these patients. Gender-based disparities might contribute to variations in physical activity. However, knowledge regarding gender differences in factors associated with physical activity among patients with coronary artery disease is limited.

Objective
This study aimed to examine gender differences in factors associated with physical activity in Taiwanese patients with coronary artery disease.

Methods
A cross-sectional design was used. A convenience sample of 215 patients with coronary artery disease was recruited from 1 medical center in northern Taiwan. Participants were interviewed using structured questionnaires to obtain information regarding their demographics, physical conditions, physical activity, self-efficacy, social support, and community exercise environment.

Results
Only 17.8% of male patients and 20% of female patients reported performing the recommended physical activity level. Men performed more vigorous and work-related activities, whereas women engaged in more household activities. In both genders, physical activity was significantly associated with age, disease symptoms, social support, self-efficacy, and environmental appraisal. Self-efficacy and age were significantly associated with physical activity in the linear regression analysis. Among male patients, physical activity was also related to work status, angina, comorbidity, medication, and hospitalizations, whereas disease duration was associated with physical activity among female patients.

Conclusion
Patients of both genders reported low levels of physical activity. Nurses should recognize gender differences in factors associated with physical activity in patients with coronary artery disease and develop individualized physical activity programs to improve patients' physical activity.
The Language of Self-Injury
Authors: Hasking Penelope A. , Boyes Mark E. , Lewis Stephen P. 
Published: March 2021

Abstract
Nonsuicidal self-injury (NSSI) is a behavior that can be perplexing to many people. Usually engaged as a means of regulating intense or unwanted emotions, it seems to counter the human instinct to avoid pain and harm to the self. The language people use to talk about NSSI, and individuals who engage in the behavior, can contribute to the significant stigma that is associated with NSSI. In this data-driven commentary, we report on the language clinicians and researchers typically use when talking about NSSI, and the language they consider appropriate to use. We observed some disparity in the language people use and what they deemed appropriate. Notably, researchers and clinicians report underusing terms that people with lived experience find most appropriate (someone with a history of self-injury; someone with lived experience of self-injury). We call on all researchers and clinicians to be mindful of the language they use to discuss NSSI and adopt person-centered and respectful language at all times.
Managing Back to School Anxiety During a COVID-19 Outbreak
Authors: Kamran Aziz , Naeim Mahdi 
Published: March 2021

Abstract
The outbreak of the coronavirus is becoming an international crisis these days, overshadowing everything. The outbreak of this disease in different countries, including Iran, has caused a lot of concern. In addition to the dangers it poses to human health, the spread of the virus has become a major challenge and a stressful test, putting additional pressure on these countries. Every step in the coming school year offers an opportunity for an ongoing two-way conversation with your child. Listen carefully to what they say and be careful not to burden them with your fears. Giving voice to concerns means sharing them so no one is holding their worries alone, and remember, kids' development is fluid and many kids can make up for lost time, academically and socially. Humans are resilient. Therefore, if schools do not open - or close their doors - it is important to be hopeful and positive about the future, despite everything that is currently being missed or delayed, whether academic or social.
Offset analgesia and onset hyperalgesia with different stimulus ranges
Authors: Fust Jens , Lalouni Maria , Vadenmark Lundqvist Viktor , Wärnberg Emil , Jensen Karin B. 
Published: March 2021

Abstract

Introduction:
Offset analgesia (OA), a large reduction in pain after a brief increase in intensity of an otherwise stable painful stimulus, has been established by a large body of research. But the opposite effect, onset hyperalgesia (OH), a disproportional hyperalgesic response after a briefly decreased intensity of a painful stimulus, has only been investigated in one previous study.

Objectives:
The aim of this study was to induce OA and OH in healthy participants and explore the effects of different stimulus ranges (increase/decrease of temperature) on OA and OH.

Methods:
A total of 62 participants were tested in 2 identical experiments. Offset analgesia and OH conditions included 2 different temperature deviations (±1°C/±2°C) from initial temperature and were compared with a constant temperature (control).

Results:
Offset analgesia was successfully elicited in OA1°C in experiment 1, and in OA1°C and OA2°C in experiment 2. Results indicate a continuous stimulus–response relationship between the stimulus range and the resulting hypoalgesic response. Onset hyperalgesia was only elicited in OH2°C in experiment 1. Exploratory analysis showed that the lack of OH response in experiment 2 could be explained by sex differences, and that OA and OH responses were only weakly correlated.

Conclusions:
The asymmetry between pain responses after a brief temperature increase and decrease suggests that different mechanisms are involved in the pain responses to increasing and decreasing temperature. This asymmetry may also be explained by high temperatures in OA condition (+1°C/+2°C above baseline) that could be seen as salient “learning signals,” which augment the response to following changes in temperature.
HIV Incidence by Male Circumcision Status From the Population-Based HIV Impact Assessment Surveys—Eight Sub-Saharan African Countries, 2015–2017
Authors: Hines Jonas Z. , Sachathep Karampreet , Pals Sherri , Davis Stephanie M. , Toledo Carlos , Bronson Megan , Parekh Bharat , Carrasco Maria , Xaba Sinokuthemba , Mandisarisa John , Kamobyi Royd , Chituwo Omega , Kirungi Wilford L. , Alamo Stella , Kabuye Geoffrey , Awor Anna Colletar , Mmbando Susan , Simbeye Daimon , Aupokolo Mekondjo A. , Zemburuka Brigitte , Nyirenda Rose , Msungama Wezi , Tarumbiswa Tapiwa , Manda Robert , Nuwagaba-Biribonwoha Harriet , Kiggundu Valerian , Thomas Anne G. , Watts Heather , Voetsch Andrew C. , Williams Dan B. 
Published: March 2021

Background:
Male circumcision (MC) offers men lifelong partial protection from heterosexually acquired HIV infection. The impact of MC on HIV incidence has not been quantified in nationally representative samples. Data from the population-based HIV impact assessments were used to compare HIV incidence by MC status in countries implementing voluntary medical MC (VMMC) programs.

Methods:
Data were pooled from population-based HIV impact assessments conducted in Eswatini, Lesotho, Malawi, Namibia, Tanzania, Uganda, Zambia, and Zimbabwe from 2015 to 2017. Incidence was measured using a recent infection testing algorithm and analyzed by self-reported MC status distinguishing between medical and nonmedical MC. Country, marital status, urban setting, sexual risk behaviors, and mean population HIV viral load among women as an indicator of treatment scale-up were included in a random-effects logistic regression model using pooled survey weights. Analyses were age stratified (15–34 and 35–59 years). Annualized incidence rates and 95% confidence intervals (CIs) and incidence differences were calculated between medically circumcised and uncircumcised men.

Results:
Men 15–34 years reporting medical MC had lower HIV incidence than uncircumcised men [0.04% (95% CI: 0.00% to 0.10%) versus 0.34% (95% CI: 0.10% to 0.57%), respectively; P value = 0.01]; whereas among men 35–59 years, there was no significant incidence difference [1.36% (95% CI: 0.32% to 2.39%) versus 0.55% (95% CI: 0.14% to 0.67%), respectively; P value = 0.14].

Discussion:
Medical MC was associated with lower HIV incidence in men aged 15–34 years in nationally representative surveys in Africa. These findings are consistent with the expected ongoing VMMC program impact and highlight the importance of VMMC for the HIV response in Africa.
TRIM28-dependent SUMOylation protects the adult ovary from activation of the testicular pathway
Authors: Rossitto Moïra , Déjardin Stephanie , Rands Chris M , Gras Stephanie Le , Migale Roberta , Rafiee Mahmoud-Reza , Neirijnck Yasmine , Pruvost Alain , Nguyen Anvi Laetitia , Bossis Guillaume , Cammas Florence , Gallic Lionel Le , Wilhelm Dagmar , Lovell-Badge Robin , Boizet-Bonhoure Brigitte , Nef Serge , Poulat Francis 
Published: March 2021

SummaryGonadal sexual fate in mammals is determined during embryonic development and must be actively maintained in adulthood. In the mouse ovary, oestrogen receptors and FOXL2 protect ovarian granulosa cells from transdifferentiation into Sertoli cells, their testicular counterpart. However, the mechanism underlying their protective effect is unknown. Here, we show that TRIM28 is required to prevent female-to-male sex reversal of the mouse ovary after birth. We found that upon loss ofTrim28, ovarian granulosa cells transdifferentiate to Sertoli cells through an intermediate cell type, different from gonadal embryonic progenitors. TRIM28 is recruited on chromatin in the proximity of FOXL2 to maintain the ovarian pathway and to repress testicular-specific genes. The role of TRIM28 in ovarian maintenance depends on its E3-SUMO ligase activity that regulates the sex-specific SUMOylation profile of ovarian-specific genes. Our study identifies TRIM28 as a key factor in protecting the adult ovary from the testicular pathway.
Heterotrophic bacterial diazotrophs are more abundant than their cyanobacterial counterparts in metagenomes covering most of the sunlit ocean
Authors: Delmont Tom O. , Karlusich Juan José Pierella , Veseli Iva , Fuessel Jessika , Eren A. Murat , Foster Rachel A. , Bowler Chris , Wincker Patrick , Pelletier Eric 
Published: March 2021

AbstractBiological nitrogen fixation is a major factor contributing to microbial primary productivity in the open ocean. The current view depicts a few cyanobacterial diazotrophs as the most relevant marine nitrogen fixers, whereas heterotrophic diazotrophs are more diverse and considered to have lower impacts on the nitrogen balance. Here, we used 891TaraOceans metagenomes to create a manually curated, non-redundant genomic database corresponding to free-living, as well as filamentous, colony-forming, particle-attached and symbiotic bacterial and archaeal populations occurring in the surface of five oceans and two seas. Notably, the database provided the genomic content of eight cyanobacterial diazotrophs includingTrichodesmiumpopulations and a newly discovered population similar toRichelia, as well as 40 heterotrophic bacterial diazotrophs organized into three main functional groups that considerably expand the known diversity of abundant marine nitrogen fixers compared to previous genomic surveys. Critically, these 48 populations may account for more than 90% of cells containing knownnifHgenes and occurring in the sunlit ocean, suggesting that the genomic characterization of the most abundant marine diazotrophs may be nearing completion. The newly identified heterotrophic bacterial diazotrophs are widespread, express theirnifHgenesin situ, and co-occur under nitrate-depleted conditions in large size fractions where they might form aggregates providing the low-oxygen microenvironments required for nitrogen fixation. Most significantly, we found heterotrophic bacterial diazotrophs to be more abundant than cyanobacterial diazotrophs in most metagenomes from the open oceans and seas. This large-scale environmental genomic survey emphasizes the considerable potential of heterotrophs in the marine nitrogen balance.
Identification of enzymes that are required for Rhodoquinone-dependent metabolism as targets for new species-specific inhibitors
Authors: Lautens Margot J. , Tan June H. , Serrat Xènia , Borrello Samantha Del , Schertzberg Michael R. , Fraser Andrew G. 
Published: March 2021

ABSTRACTSoil transmitted helminths (STHs) are major human pathogens that infect over a billion people. Resistance to current anthelmintics is rising and new drugs are needed. Here we combine multiple approaches to find druggable targets that are essential for RQ-dependent metabolism, an unusual form of anaerobic metabolism which STHs need to survive in their host. We identified 25 genes predicted to act in RQ-dependent metabolism from sensing hypoxia to RQ synthesis — this includes components of the kynurenine pathway we previously showed to be essential for RQ synthesis (Del Borrello et al., 2019). We found 9 genes to be required — since all have host orthologues, we used comparative genomics and structural modeling to identify those with helminth-specific active sites and found 4 such targets. These 4 high confidence targets open up the possibility of in silico screens to identify STH-specific inhibitors of these enzymes as new anthelmintics.
What do post-disaster reconstruction project success indicators look like? End-user’s perspectives
Authors: Charles Shawn Hezron , Chang-Richards Alice , Yiu Tak Wing 
Published: March 2021

PurposeThis paper aims to investigate the emergence of new success measures for buildings and infrastructure post-disaster reconstruction projects, beyond the traditional ”iron triangle”, which have gained prominence with the increased involvement of clients and end-users in these projects. Consequently, the industry is obliged to reconsider the critical factors regarding what constitutes a successful outcome from the perspectives of these stakeholders.Design/methodology/approachData was gathered from end-users in four Caribbean islands using a questionnaire survey on eight empirical success indicators obtained from an extensive systematic literature review. To elicit a ranking and correlations amongst the end-user’ perspectives on the indicators, factor analysis and structural equation modelling techniques (SEM) were conducted.FindingsThe factor analysis found “safety” to be the most important empirical success measure, while “change” ranked the least important. Correlation analysis using SEM identified two new composite indicators, namely, “competence” with delivering timely and quality environmentally friendly and sustainable projects and “adaptability” in ensuring project objectives reflect beneficiaries’ expectations amidst internal and external influences, to be critical of end-users’ measurement indicators that describe their assessment mechanism. Measurement and structural models validated “safety” and “satisfaction” to be the highest loading variables in the two composites, respectively.Research limitations/implicationsThe research focussed on findings in English language articles; therefore, any claim to a complete list of indicators from the literature can be amiss.Practical implicationsResults confirm the traditional “iron triangle” of time, cost and quality to be limited in assessing reconstruction project outcomes and the views and expectations of the potential beneficiaries need to be factored in the planning, design, execution and post-handover stages in all reconstruction projects.Originality/valueThis paper was very specific in its attempt to investigate new success indicators for reconstruction project outcomes, aiming to assist with developing comprehensive project objectives that resonate with all stakeholder groups.
A concept design stages protocol to support collaborative processes in architecture, engineering and construction projects
Authors: Leon Marianthi , Laing Richard 
Published: March 2021

Purpose
This paper proposes and tests, through a series of structured multi-disciplinary design activities, a “Concept Design Stages Protocol” (CDS Protocol) to structure project initiation, to attain smoother collaboration and greater consensus among multi-disciplinary project teams.

Design/methodology/approach
A collaborative approach from the outset is imperative for project success, especially when considering multi-disciplinary teams in the architecture, engineering and construction (AEC) industry. However, involving different disciplines hinders communication paths and affects informed decision-making.

Findings
Based on these findings, the research demonstrates that the CDS Protocol provides a solid foundation to aid in the optimal implementation of collaborative design, and with particular regard to multi-disciplinary working.

Originality/value
The research demonstrates the potential for significant improvement in the optimisation of the conceptual design stages, with positive implications for time, communication and whole-team engagement.
Environmental implication of coal and oil energy utilization in Turkey: is the EKC hypothesis related to energy?
Authors: Alola Andrew Adewale , Donve Ulrich Tiamgne 
Published: March 2021

PurposeIn spite of the drive toward environmental sustainability and the attainment of sustainable development goals (SDGs), coal, oil and natural gas energy utilization has remained the Turkey's largest energy mix. In view of this concern, this study examined the role of coal and oil energy utilization in environmental sustainability drive of Turkey from the framework of sustainable development vis-à-vis income expansion over an extended period of 1965–2017.Design/methodology/approachIn this regard, the authors employ carbon emission as an environmental and dependent variable while the Gross Domestic Product per capita (GDPC), coal and oil energy consumption are the explanatory variables employed in the study.FindingsThe study found that both energy mixes (coal and oil) have a detrimental impact on the environment in both the short and long run, but oil consumption exerts a less severe impact as compared to coal energy. In addition, sustainable development via income growth is not feasible because the income–environmental degradation relationship follows a U-shaped pattern (invalidating the Environmental Kuznets curve, EKC hypothesis) especially when coal and oil remained the major source of lubrication to the economy. At least the EKC hypothesis is unattainable in Turkey as long as the country's major energy mix or primary energy (coal and oil) is in use, thus the application of other socioeconomic, macroeconomic policies might be essential.Research limitations/implicationsConsidering the lingering energy challenge associated with Turkey, this novel insight further presented useful policy perspectives to the government and stakeholders in the country's energy sector.Originality/valueThis evidence (the U-shaped relationship) is further ascertained when the aggregate primary energy is employed. Thus, this study provides a novel insight that attaining a sustainable economic growth in Turkey remained a herculean task as long as a more aggressive energy transition approach is not encouraged.