bluuebunny/crossref_metadata_2025_split huggingface dataset:
The potential hepatoprotective effect of metformin in hepatitis C virus‐infected adolescent patients with beta thalassemia major: Randomised clinical trial
Authors: Abdel Monem Mona S. , Farid Samar F. , Abbassi Maggie M. , Youssry Ilham , Andraues Nevine G. , Hassany Mohamed , Selim Yasmeen M. M. , El‐Sayed Manal H. 
Published: February 2021

AbstractBackgroundIron overload‐induced oxidative stress and transfusion‐acquired hepatitis C virus (HCV) infection are the main reasons of liver damage in beta thalassemia major (β‐TM).ObjectivesBased on metformin’s hepatic benefits in nondiabetic populations, the study aims to investigate the safety and the potential hepatoprotective effect of metformin in HCV‐infected β‐TM adolescent patients.MethodsThis was a prospective, randomised, parallel, controlled, open‐label study in which 60 HCV‐infected β‐TM adolescent patients aged 11 to 18 years and receiving no antiviral therapy were selected and randomly assigned to treatment or control group in 1:1 allocation. Both groups were receiving β‐TM standard‐of‐care regimen, whereas metformin (500 mg, twice daily) was added to the treatment group's regimen only. Patients were prospectively followed up for 6 months with assessment of liver biochemical profile, oxidative stress markers, liver fibrosis, clinical symptom improvement and metformin's adverse effects.ResultsAspartate aminotransferase serum level decreased significantly over time in the treatment group only (P = .013). However, improvement was not clinically significant and did not attain normality. Change in total antioxidant capacity and malondialdehyde serum levels indicated significantly improved oxidative stress status in the treatment group versus significant deterioration in the control group (P < .001). Fibrosis grade improvement was observed in 14 patients in the treatment group versus one improved case in the control group.ConclusionThe use of metformin in HCV‐infected β‐TM adolescent patients as an adjuvant antioxidant hepatoprotective agent is promising and can improve liver damage.
Resource utilisation among patients with syncope presenting to the emergency department
Authors: Lombardi Kevin , Ong Justin , Kane Erin , Aljohani Bandar , Frasure Sarah E. , Almulhim Khalid , Pourmand Ali 
Published: February 2021

AbstractBackgroundSyncope is a common problem encountered in the emergency department (ED) and a significant source of ED resource utilisation, including advanced imaging modalities. Current guidelines do not recommend routine Computed Tomography (CT) imaging of the head for patients seen in the ED due to syncope.ObjectiveIn this study, we investigate resource allocation in the ED for syncope‐related visits, including advanced imaging modalities using a large national database.Outcomes analysisData from the CDC's National Hospital Ambulatory Medical Care Survey (NHAMCS) for years 2008‐2017 were compiled and analysed. Intrinsic survey and constructed variables were utilised to identify and investigate all syncope‐related ED visits in the United States during the study period that met study criteria. Appropriate bivariate and multivariate statistical analyses were applied in order to identify and compare the resource utilisation, demographics, and ED visit dynamics of syncope and non‐syncope‐related ED visits.ResultsDuring the study period, there were over 15 million ED visits for syncope. A high percentage of syncope visits received head CT compared with non‐syncope visits (34% vs. 4.5%, P > .001). When investigated by age‐grouping utilisation of head CT ranged from 26.5 (95% CI 18.9‐27.5) for ages 18‐40 to as high as 40.2% (95% CI 33.8‐47.1) for ages 80 and higher. Compared with non‐syncope ED visits, syncope‐related ED visits were older and more likely to have Medicare or private insurance.ConclusionSyncope continues to be a large and growing share of visits to US EDs. Despite well‐supported, evidence‐based recommendations that do not recommend routine utilisation of head CT in syncope‐related ED visits, these data suggest that emergency physicians routinely over‐utilise this modality. More specific guidelines may be required to help reduce the use of imaging studies for patients who present to the ED with syncope.
A recipe for thriving in nursing homes: A meta‐ethnography
Authors: Baxter Rebecca , Corneliusson Laura , Björk Sabine , Kloos Noortje , Edvardsson David 
Published: February 2021

AbstractAimTo explore contributors for thriving in nursing homes by evaluating, analysing and synthesizing peer‐reviewed qualitative literature on the topic.BackgroundThriving is a positive life‐world concept that has been explored by several qualitative studies; however, descriptions of thriving and contributors to thriving have not been compared or contrasted among different studies and contexts, nor have they been reviewed and synthesized.DesignQualitative meta‐ethnography.Data sourcesFour electronic databases were searched in October 2019, with sources published between 2000 and 2019 included.Review methodsSources of peer‐reviewed literature that employed qualitative methods to explore thriving in nursing homes were evaluated. In total, 1,017 sources were screened at title‐level, 95 advanced to abstract‐level review and 11 were assessed at full‐text level. Each source was evaluated by two researchers independently in relation to methodological quality and relevance to the study aim. Themes pertaining to thriving in nursing homes were extracted, interpreted and synthesized.ResultsIn total, seven sources of peer‐reviewed literature were included. Two main themes illustrating the contributors to thriving were identified: ingredients for thriving (subthemes: personal contributors and social contributors) and environment for thriving (subthemes: spacial contributors and societal contributors).ConclusionContributors to thriving in nursing homes include personal attributes, relationships with others, the lived environment and societal structures. Thriving for older people could thereby be defined as a holistic concept denoting lived experiences of situated contentment. Future studies should explore different temporal facets of thriving in the nursing home setting.ImpactThis meta‐synthesis proposes a ‘recipe’ for thriving as comprising the right ingredients and the right environment, determined by the preferred ‘taste’ of the individual person. The proposed definition and contributors illuminate thriving as a positive life‐world concept that is based on one's lived experiences and context.
Relative importance of ecological versus biological traits in driving range sizes of African dragonflies
Authors: Deacon Charl , Samways Michael J. , Pryke James S. 
Published: February 2021

AbstractAimEcological traits (e.g. biotope specialisation and habitat preference) and biological traits (e.g. mobility and life history) are highly variable among species. In insect conservation, considerable focus has been on ecological generalisation, with species occupying many biotope types (generalists) often assumed to be widely distributed, whereas species occupying few biotope types (specialists) are assumed as rare and localised. Although this may be valid in most cases, there is an increasing recognition that functional traits, such as insect mobility and life history, have similar importance as drivers of range size among species. Here, we investigate ecological and biological traits simultaneously to determine their relative importance as drivers of range size variation. We hypothesise that ecological traits are primary drivers, whereas biological traits related to mobility and life history are less important drivers of range size.LocationSub‐Saharan Africa.Taxon115 sub‐Saharan dragonfly species.MethodsFive measures of species range size were obtained from the Odonata Database of Africa. Number of biotope types occupied by adults and larvae, larval habitat preference and adult biological trait information were collated from published sources. We explore the relationships between ecological and biological traits. Using linear mixed models and model averaging, we determine the relative importance of number of biotope types occupied, overall habitat preference and traits related to mobility and life history that drive dragonfly range size while accounting for phylogenetic relationships among focal species.ResultsDragonflies occupying more biotope types had wider ranges, although these relationships were overall weak. Dragonflies with longer and later breeding seasons had wider ranges. Overall habitat preference and mobility traits had low importance in our models.Main conclusionsEcological versus biological traits are interactive in shaping the geographical ranges of dragonfly species across Africa. Single traits are weak predictors of species range sizes and we recommend investigating multiple traits simultaneously to improve the accuracy of predictions. In doing so, more informed decisions can be made to ensure effective large‐scale conservation of dragonflies.
Repellent activity of essential oils on adults of Halyomorpha halys (Heteroptera: Pentatomidae) in different physiological‐behavioural phases
Authors: Bulgarini Giacomo , Bortolini Sara , Maistrello Lara 
Published: February 2021

AbstractThe brown marmorated stink bug Halyomorpha halys is an invasive agricultural pest in North America and Europe, and also a dwelling nuisance in autumn, due to the overwintering adults aggregating inside buildings. The repellent potential of ginger, clove, vetiver and turmeric essential oils (EOs) was tested on H. halys adults of three different physiological‐behavioural phases: exiting overwintering (EXOV), active during summer (SUMM) and entering overwintering (ENOV). In a two‐choice apparatus, fresh food was used as an attractant in both sides, together with three males when testing ENOV individuals. A filter paper with different concentrations of the EOs was the treatment side, and a filter paper with ethanol acted as control. The position of the individually tested bugs was recorded after 1, 6 and 24 hr. All tested EOs were repellent at concentrations higher than 3%, independent of sex or length of exposure. Turmeric and clove were the most repellent EOs, whereas ginger and vetiver showed on average a medium‐to‐low repellency. Significant differences emerged among the physiological‐behavioural phases, with SUMM individuals showing a greater repellency to many of the tested concentrations, and EXOV individuals being overall the least susceptible to these substances. The response to vetiver oil was ambiguous, as at 25%, it elicited both a strong repellency in SUMM and a strong attraction in EXOV. Turmeric and clove EOs are promising candidates in integrated pest management strategies to reduce attacks by H. halys to susceptible crops especially during summer, as well as to prevent the entrance of overwintering bugs in buildings in autumn.
Integration of teaming therapy and mixed‐reality simulation as remote learning modality for couple and family therapy graduate training programs
Authors: Sampson Jennifer M. , Hughes Rachel L. , Wallace Laura B. , Finley Michelle A. 
Published: February 2021

AbstractIn response to COVID‐19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed‐reality simulation software. By utilizing teaming therapy‐‐a model with strong roots in systemic theory and practice‐‐ combined with cutting‐edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.
Personalized Risk Prediction for 30‐Day Readmissions With Venous Thromboembolism Using Machine Learning
Authors: Park Jung In , Kim Doyub , Lee Jung‐Ah , Zheng Kai , Amin Alpesh 
Published: February 2021

AbstractPurposeThe aim of the study was to develop and validate machine learning models to predict the personalized risk for 30‐day readmission with venous thromboembolism (VTE).DesignThis study was a retrospective, observational study.MethodsWe extracted and preprocessed the structured electronic health records (EHRs) from a single academic hospital. Then we developed and evaluated three prediction models using logistic regression, the balanced random forest model, and the multilayer perceptron.ResultsThe study sample included 158,804 total admissions; VTE‐positive cases accounted for 2,080 admissions from among 1,695 patients (1.31%). Based on the evaluation results, the balanced random forest model outperformed the other two risk prediction models.ConclusionsThis study delivered a high‐performing, validated risk prediction tool using machine learning and EHRs to identify patients at high risk for VTE after discharge.Clinical RelevanceThe risk prediction model developed in this study can potentially guide treatment decisions for discharged patients for better patient outcomes.
Clinical evaluation of the efficacy of a facial serum containing dioic acid, glycolic acid, salicylic acid, LHA, citric acid, and HEPES in treating post‐inflammatory hyperchromia and controlling oily skin in patients with acne vulgaris
Authors: Campos Valeria , Pitassi Luiza , Kalil Célia , Gonçalves Júnior José Euzébio , Sant’Anna Beatriz , Correia Priscila 
Published: February 2021

AbstractBackgroundAcne is a chronic disease that affects the pilosebaceous follicle and is characterized by the presence of non‐inflammatory and/or inflammatory lesions, affecting both adolescents and adults. Inflammatory acne lesions are capable to increase their melanin production and promote a post‐inflammatory hyperchromia.AimsTo assess the efficacy of a serum containing dioic acid, glycolic acid, salicylic acid, LHA, citric acid, and HEPES in treating post‐inflammatory hyperpigmentation and controlling skin oiliness in Brazilian patients with acne vulgaris.Patients/MethodsA single‐center, prospective, open‐label clinical study included 42 subjects, from both genders, presenting acne (grade I or II), oily skin and a clinical diagnosis of acne post‐inflammatory hyperpigmentation. The study was conducted for 56 days, with clinical (skin quality and the number of post‐inflammatory hyperchromic lesions) and instrumental (Sebumetry) evaluations after 7, 28, and 56 days of treatment. Standardized pictures were obtained using a VISIA‐6® device.ResultsA significant decrease in the grade of post‐inflammatory hyperchromic lesions was observed after 28 and 56 days, while the number of lesions decreases by 29.4% after 56 days (p < 0.001). Sebumetry values showed a significant decrease of 30.7% in the oiliness after 7 days of treatment, and then stable during the study conduction period of 56 days (p < 0.001 for all measurements).ConclusionsThe daily treatment using the investigational product showed an interesting decrease both in the grade and the number of post‐inflammatory hyperchromia acne lesions after 56 days, and in the oiliness after 7 days, being stable for all study period.
Management of delirium within intraoperative settings for older adults with hip fracture: a scoping review
Authors: White Laura Beth , Coyne Elisabeth , Grealish Laurie 
Published: February 2021

AbstractBackgroundDelirium is a common adverse event in older patients undergoing hip fracture repair surgery. The impact of hospital‐acquired delirium during intraoperative phase of their treatment can have a significant impact on post‐operative outcomes. While non‐pharmacological, multicomponent delirium prevention interventions are considered standard practice in acute medical units, delirium management in the intraoperative setting is less clear.ObjectivesThe aim was to identify evidence‐based delirium management interventions which are, and could be, undertaken within the intraoperative setting for older patients undergoing hip fracture repair surgery.DesignA scoping review following the principles developed by Arksey and O’Malley (2005).Data SourcesSeven databases including Cochrane, CINAHL, Embase, MEDLINE, PsychINFO, PubMed and SCOPUS were systematically searched. The search was limited to the last 11 years (2009–2020). Research studies included both primary and secondary sources of evidence.ResultsA total of 2464 articles were initially identified. These articles were further refined using keyword searches and exclusion criteria, with a final set of 16 articles meeting the inclusion criteria. Three main themes were as follows: anaesthetic‐related interventions used to prevent delirium; recognising non‐modifiable and potentially modifiable risk factors; and screening and diagnosis of delirium.ConclusionsWhile there is a strong focus on anaesthetist‐led interventions in the intraoperative setting, there are opportunities for more nurse‐led interventions through adequate pain management and haemodynamic monitoring that require further research. Identifying the best test for screening and diagnosing delirium in the intraoperative setting requires further research.
Spiritual care needs and associated factors among patients with ostomy: A Cross‐Sectional Study
Authors: Ayik Cahide , Özden Dilek , Kahraman Aysel 
Published: February 2021

AbstractAims and objectivesTo investigate the spiritual care needs and associated factors in patients with ostomy.BackgroundThe significance of the spiritual care needs of the patients has been emphasised across countries and cultures in the literature.DesignA descriptive, cross‐sectional study.MethodsOutpatients with an ostomy (n = 127) were recruited from proctology, wound and stoma therapy unit and general surgery clinics between January and 28 March 2020. The data were collected using the Socio‐demographic Characteristics Form and Spiritual Care Needs Inventory (SCNI). SCNI has two components, namely ‘meaning and hope’ and ‘caring and respect’. Descriptive statistics, correlation, Student's t test, ANOVA and multiple linear regression analyses were used to analyse the data. The STROBE checklist was used to report the study.ResultsThe mean scores of the spiritual care needs (65.31 ± 12.83), meaning and hope (37.35 ± 9.37), and caring and respect (27.96 ± 5.63) of the patients with ostomy were found to be moderate. The most significant factors affecting the meaning and hope component were the age, being female and decreases in the level of income. Scores of the patients who perceived the severity of the disease seriously and who practiced religious ritual regularly had more spiritual care needs for the component of caring and respect. Patients with ostomy needed interaction, respect for their privacy and dignity, to be shown concern and to be respected for their religious and cultural beliefs, which were the most salient needs.ConclusionsThere is an unambiguous requirement for nurses to ensure spiritual care for patients with ostomy. Showing interest and spending time for the interaction with patients with ostomy, need‐based spiritual practices and life review are key elements of spiritual care.Relevance to clinical practiceEvaluating patients with ostomy spiritually requires information about how spiritual needs may arise and how to talk about spiritual needs. The result of the present study may help nurses to begin the process of maintaining spiritual care for patients with ostomy.
What's going on after hospital? – Exploring the transition from hospital to home and patient experiences of nurse‐led follow‐up phone calls
Authors: Donsel Pernille Orloff , Missel Malene 
Published: February 2021

AbstractAims and ObjectivesTo explore the transition from hospital to home and patient experiences of nurse‐led post‐operative follow‐up phone calls after thoracic surgery.BackgroundEnhanced Recovery After Surgery protocol places new demands on patients after hospital. Need for a proactive approach to improve the post‐operative follow‐up process in the home is required.DesignQualitative intervention study.MethodsInterviews were conducted with patients who had received a post‐operative phone call after hospital discharge (n = 15). The analysis was inspired by Gadamer and Meleis. COREQ guidelines were followed.ResultsTwo overall themes emerged: (1) The follow‐up phone call, which concerns experiences involving the actual call and (2) Transitioning from hospital to home, which through four subthemes illuminates; how patients describe their initial time at home, that patients experience a changed body after surgery, that patients feel alone after returning home and that a call from a nurse can help patients not to feel left out and finally why it is absolutely essential that nurses initiate the phone call.ConclusionPatients are at different stages in their transition process after hospital, making timing of follow‐up tricky. Being part of an Enhanced Recovery After Surgery programme has implications for the initial period after discharge; dominated by fatigue, pain and experiences of a changed body. Patients experience being left alone with their illness, and the phone call helps to relieve this isolation. It is essential that the nurse call the patient since the patients want to avoid disturbing the staff.Relevance to clinical practiceHealthcare workers can use the findings to understand how patients experience the transition from hospital to home when enrolled in an Enhanced Recovery After Surgery programme. Need for support from a nurse following discharge is suggested.
Advance care planning among African American patients on haemodialysis and their end‐of‐life care preferences
Authors: Ahn Daniel , Williams Shellie , Stankus Nicole , Saunders Milda 
Published: February 2021

AbstractBackgroundAfrican Americans in the general population have been shown to be less likely than White ethnic groups to participate in advance care planning; however, advance care planning in the population receiving dialysis has not been well explored.ObjectiveWe examined the prevalence of African American patients receiving haemodialysis' advance care planning discussions, and whether advance care planning impacts end‐of‐life care preferences.DesignIn‐person interviewer‐administered surveys of African American patients receiving in‐centre haemodialysis.Setting/ParticipantsAbout 101 participants at three large dialysis organisation units in Chicago.OutcomesSelf‐reported advance care planning and preferences for life‐extending treatments at end‐of‐life.ResultsMost patients (69%) report no advance care planning discussions with their healthcare providers. Nearly all patients (92%) without prior advance care planning reported their healthcare providers approached them about advance care planning. While the majority of patients indicated preference for aggressive life‐extending care, prior conversations about end‐of‐life care wishes either with family members or a healthcare provider significantly decreased patients' likelihood of choosing aggressive life‐extending care across three scenarios (all p < 0.05). Significantly more patients reported that common end‐of‐life scenarios related to increased dependence/disability were “not worth living through” compared with those associated with increased burden on family, decreased cognitive function, and severe pain/discomfort.ConclusionAfrican Americans with end‐stage renal disease need more frequent, culturally‐sensitive advance care planning discussions. Despite a preference for aggressive life‐sustaining treatments, individuals with prior advance care planning discussions were significantly less likely to support aggressive end‐of‐life care. End‐of‐life care discussions that focus on the impact of life‐extending care on patients' independence could be more concordant with the values and priorities of the African American patients.