bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health literacy and diabetes self‐care activities: The mediating effect of knowledge and patient activation
Authors: Kim Su Hyun 
Published: March 2021

AbstractBackgroundAn association between health literacy and health outcomes has been widely reported in the literature. However, models exploring the links between health literacy and the outcomes of health literacy need further testing. The purpose of this study was to examine the pathways of health literacy on diabetes self‐care activities amongst patients with Type 2 diabetes.MethodsA cross‐sectional survey using secondary data analysis was conducted on 155 patients with Type 2 diabetes recruited from the diabetes clinics of two university hospitals in a metropolitan city in South Korea. Structural equation modelling analysis using bootstrapping was carried out using the AMOS software.ResultsHealth literacy had no significant direct effect on diabetes self‐care activities. Rather, health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation.ConclusionThese findings indicate that interventions intended to improve self‐care activity amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care.
Survey of barriers to adherence to international inflammatory bowel disease guidelines: does gastroenterologists' confidence translate to high adherence?
Authors: Kanazaki Ria , Smith Ben , Girgis Afaf , Descallar Joseph , Connor Susan 
Published: March 2021

AbstractBackgroundDespite the availability of evidence‐based inflammatory bowel disease (IBD) guidelines, suboptimal care persists. There is little published research assessing barriers to IBD guideline adherence.AimTo identify barriers to IBD guideline adherence including gastroenterologists' knowledge and attitudes towards guidelines.MethodsAn online cross‐sectional survey of 824 Australian gastroenterologists was conducted from April to August 2018, with 198 (24%) responses. A novel survey was developed that was informed by the theoretical domain's framework.ResultsConfidence in guideline recommendations was high; however, referral to them was low. The European Crohn's and Colitis Organisation guidelines were referred to most commonly (43.6%). In multivariate analysis, significant predictors of frequent versus infrequent guideline referral were: high confidence in the guideline (odds ratio (OR) 7.70; 95% confidence interval (CI): 2.43–24.39; P = 0.001), and low (≤10 years) clinical experience (OR 3.62; 95% CI: 1.11–11.79; P = 0.03). The most common barriers to guideline adherence were not having time (62%), followed by guideline specifics being difficult to remember (61%). Low confidence was reported in managing pregnancy and IBD (34%) and loss of response to therapy (29%). High confidence was reported in managing immunomodulators; however, only 43% answered the associated knowledge question correctly.ConclusionAlthough gastroenterologists have high confidence in guidelines, they use them infrequently, primarily due to specifics being difficult to remember and lack of time. Self‐reported confidence in an area of IBD management does not always reflect knowledge. An intervention targeting these barriers, for example, computer‐based clinical decision support tools, might improve adherence and standardise care.
Use of a Victorian statewide surveillance programme to evaluate the burden of healthcare‐associated Staphylococcus aureus bacteraemia and Clostridioides difficile infection in patients with cancer
Authors: Valentine Jake C. , Hall Lisa , Verspoor Karin M. , Gillespie Elizabeth , Worth Leon J. 
Published: March 2021

AbstractBackgroundPatients with cancer are at high risk for infection, but the epidemiology of healthcare‐associated Staphylococcus aureus bacteraemia (HA‐SAB) and Clostridioides difficile infection (HA‐CDI) in Australian cancer patients has not previously been reported.AimsTo compare the cumulative aggregate incidence and time trends of HA‐SAB and HA‐CDI in a predefined cancer cohort with a mixed statewide patient population in Victoria, Australia.MethodsAll SAB and CDI events in patients admitted to Victorian healthcare facilities between 1 July 2010 and 31 December 2018 were submitted to the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. Descriptive analyses and multilevel mixed‐effects Poisson regression modelling were applied to a standardised data extract.ResultsIn total, 10 608 and 13 118 SAB and CDI events were reported across 139 Victorian healthcare facilities, respectively. Of these, 89 (85%) and 279 (88%) were healthcare‐associated in the cancer cohort compared with 34% (3561/10 503) and 66% (8403/12 802) in the statewide cohort. The aggregate incidence was more than twofold higher in the cancer cohort compared with the statewide cohort for HA‐SAB (2.25 (95% confidence interval (CI): 1.74–2.77) vs 1.11 (95% CI: 1.07–1.15) HA‐SAB/10 000 occupied bed‐days) and threefold higher for HA‐CDI (6.26 (95% CI: 5.12–7.41) vs 2.31 (95% CI: 2.21–2.42) HA‐CDI/10 000 occupied bed‐days). Higher quarterly diminishing rates were observed in the cancer cohort than the statewide data for both infections.ConclusionsOur findings demonstrate a higher burden of HA‐SAB and HA‐CDI in a cancer cohort when compared with state data and highlight the need for cancer‐specific targets and benchmarks to meaningfully support quality improvement.
A graph modeling framework to design and plan the downstream oil supply chain
Authors: Lima Camilo , Relvas Susana , Barbosa‐Póvoa Ana 
Published: March 2021

AbstractIn this paper, a deterministic mixed‐integer linear programming (MILP) model is proposed aiming at designing and planning the downstream oil supply chain. The optimization model defines the strategic network design, and then determines its tactical distribution plan. A multimodal transportation network is considered in which road, maritime, rail, and pipeline resources may be chosen. The network structure is represented through a graph modeling approach, so the diverse network operations, for example, the exchange of products between warehouses, may be readily incorporated into the optimization model. A case study based on the Brazilian oil industry is explored and analyzed to check and demonstrate the adequacy of the MILP model to solve a real‐world problem.
Effects of Holocene climate change, volcanism and mass migration on the ecosystem of a small, dry island (Brava, Cabo Verde)
Authors: Castilla‐Beltrán Alvaro , de Nascimento Lea , Fernández‐Palacios José María , Whittaker Robert J. , Romeiras Maria M. , Cundy Andrew B. , Edwards Mary , Nogué Sandra 
Published: March 2021

AbstractAimPalaeoecological data provide an essential long‐term perspective of ecological change and its drivers in oceanic islands. However, analysing the effects of multi‐scalar and potentially co‐occurring disturbances is particularly challenging in dry islands. Here, we aim to identify the ecological consequences of the integrated impacts of a regional drying trend, volcanic eruptions and human mass migrations in a spatially constrained environment—a small, dry oceanic island in Macaronesia.LocationBrava Island, Republic of Cabo Verde.TaxaTerrestrial vegetation and fungi.MethodsWe use palaeoecological analyses applied to a caldera soil profile that dates back to 9700 cal yr BP (calibrated years before the present). Analyses include pollen (vegetation history), non‐pollen palynomorphs (changes in fern and fungal communities), grain‐size distribution, loss‐on‐ignition and geochemistry (sedimentology and erosion regimes), microscopic tephra shards (volcanic ash deposition) and charcoal (fire regime).ResultsA regional drying trend after c. 4000 cal yr BP caused increased erosion but had limited immediate impacts on highland grassland vegetation. The expansion of fern‐rich woody scrubland was contemporaneous with significant deposition of volcanic ash and erosion between 1800 and 650 cal yr BP. About 300 cal yr BP, exogenous plants expanded, grazing and fires increased, and there was a decrease of native vegetation cover.Main conclusionsThroughout the Holocene, highland vegetation in Brava was characterized by the presence of open landscapes dominated by herbaceous species (e.g. Poaceae, Forsskaolea), with some presence of woody native taxa (e.g. Ficus, Dodonaea). A regional drying trend was a driver of erosion since the Mid Holocene but did not have an immediate influence on highland vegetation. Tephra deposition is a possible driver of vegetation change. Inter‐island mass migration after volcanic events in Fogo Island c. 1680 CE potentially triggered land use change and intensification, causing a reduction of native vegetation in Brava.
A single‐cell survey of the human glomerulonephritis
Authors: Chen Zhejun , Zhang Ting , Mao Kaiqiong , Shao Xinghua , Xu Yao , Zhu Minyan , Zhou Hang , Wang Qin , Li Zhenyuan , Xie YuanYuan , Yuan Xiaodong , Ying Liang , Zhang Ming , Hu Jiajia , Mou Shan 
Published: March 2021

AbstractGlomerulonephritis is the one of the major causes of the end‐stage kidney disease, whereas the pathological process of glomerulonephritis is still not completely understood. Single‐cell RNA sequencing (scRNA‐seq) emerges to be a powerful tool to evaluate the full heterogeneity of kidney diseases. To reveal cellular gene expression profiles of glomerulonephritis, we performed scRNA‐seq of 2 human kidney transplantation donor samples, 4 human glomerulonephritis samples, 1 human malignant hypertension (MH) sample and 1 human chronic interstitial nephritis (CIN) sample, all tissues were taken from the biopsy. After filtering the cells with < 200 genes and > 10% mitochondria (MT) genes, the resulting 14 932 cells can be divided into 20 cell clusters, consistently with the previous report, in disease samples dramatic immune cells infiltration was found, among which a proximal tubule (PT) subset characterized by wnt‐β catenin activation and a natural killer T (NKT) subset high expressing LTB were found. Furthermore, in the cluster of the podocyte, three glomerulonephritis related genes named FXYD5, CD74 and B2M were found. Compared with the mesangial of donor, the gene CLIC1 and RPS26 were up‐regulated in mesangial of IgA nephropathy(IgAN), whereas the gene JUNB was up‐regulated in podocyte of IgAN in comparison with that of donor. Meanwhile, some membranous nephropathy (MN) high expressed genes such as HLA‐DRB5, HLA‐DQA2, IFNG, CCL2 and NR4A2, which involve in highest enrichment pathway, display the cellular‐specific expression style, whereas monocyte marker of lupus nephritis (LN) named TNFSF13B was also found and interferon alpha/beta signalling pathway was enriched in B and NKT of LN comparing with donor. By scRNA‐seq, we first defined the podocyte markers of glomerulonephritis and specific markers in IgA, MN and LN were found at cellular level. Furthermore, the critical role of interferon alpha/beta signalling pathway was enriched in B and NKT of LN was declared.
The transition from inquiry to evidence to actionable clinical knowledge: A proposed roadmap
Authors: Kowalski Charles J. , Redman Richard W. , Mrdjenovich Adam J. 
Published: March 2021

AbstractRationale, aims, and objectivesWe consider the question “What should we do?” in the context of clinical research/practice. There are several steps along the way to providing a satisfactory answer, many of which have received considerable attention in the literature. We aim to provide a unified summary and explication of these “steps along the way”. The result will be an increased appreciation for the meaning and structure of “actionable clinical knowledge”.MethodsWe review the literature to identify pertinent works dealing with evidence production and translation into actionable clinical knowledge. We draw from insights in this literature about various aspects of reasoning relevant to clinical questions and integrate these into a unified approach to the processes that lead to actionable clinical knowledge.ResultsWe collect, collate, and integrate some of the work by Bauer, Carper, Goldman, Haack, McHugh and Walker, and Upshur and colleagues and obtain guidelines to aid in the evidence‐to‐actionable‐clinical‐ knowledge transition.ConclusionsClinical decision‐making is not infallible, and the steps we can take to minimize error are context dependent. Medical evidence, produced as it is by human effort, can never be perfect. We will be doing well by assuring that the evidence we use has been produced by a reliable process and is relevant to the question posed.
A prediction model of health‐related quality of life in young adult patients with stroke
Authors: Yoon Susie , Kim Hye Young , Kim Sung Reul 
Published: March 2021

AbstractAims and objectivesThis study aimed to establish and test a predictive model for explaining the health‐related quality of life of young adult patients with stroke.BackgroundIndividual characteristics, biological and physiological variables, social support, emotional and cognitive symptoms, physical function disability and general health perception may be interrelated and may directly or indirectly affect the health‐related quality of life of young adult patients with stroke.DesignA cross‐sectional study.Methods237 young outpatients with stroke were recruited and surveyed. Data collection used a structured questionnaire from July–November 2018. The collected data were analysed using SPSS version 25.0®and AMOS 23.0. This study is based on STROBE guidelines.ResultsThe hypothetical model's fit indices were adequate. Stroke severity, social support, fear of stroke recurrence, physical function disability and general health perceptions directly affected the health‐related quality of life. Additionally, stroke severity, depression and fear of stroke recurrence also indirectly affected it. These variables explained 60.3% of the variance in this quality.ConclusionsVariables such as severity of stroke, depression, fear of stroke recurrence, social support, physical function disability and general health perception were found to be related to the HRQoL of young adult patients with stroke.Relevance to clinical practiceA variety of physical, psychological, functional and social factors related to health‐related quality of life should be systematically monitored. Furthermore, nurses need to develop and apply detailed nursing interventions that take into account all these variables.
Hope and symptom burden of women with breast cancer undergoing chemotherapy: A cross‐sectional study
Authors: Li Yuan , Ni Na , Zhou Zijun , Dong Jianyu , Fu Ying , Li Jiaxin , Luan Ze , Peng Xin 
Published: March 2021

AbstractAimThis research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated.BackgroundChemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope.Design/MethodsA total of 450 women who were undergoing breast cancer chemotherapy participated in this cross‐sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines.ResultsChinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24–35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope.ConclusionsThe level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope.Relevance to clinical practiceIf nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope.
Rheological, textural, and technological modifications in wheat unleavened flatbread substituted with extruded finger millet
Authors: Kumar Pankaj , Kaur Charanjit , Jambh Harpreet Kaur 
Published: March 2021

AbstractFinger millet incorporation in wheat flour increases the nutritional value of flatbread and provides health benefits. However, it also has a detrimental effect on the quality of flatbread. The present study evaluates the effect of extruded finger millet (EFM) over unextruded finger millet (UFM) flour on pasting, textural and rheological properties of composite dough and their impact on the quality of flatbread. EFM modified the dough handling properties leading to higher viscoelastic moduli and elastic share of compliance. In addition, a significant reduction in firmness and increment in extensibility of dough was also observed. The flatbread prepared by substituting 20% of EFM in wheat flour exhibited better puffing and lower resistance, shrinkage, and baking time in comparison to flatbread prepared with UFM at the same level of substitution. The sensory score for the same was at par with the control whole wheat flatbread. Results suggest that the substitution of EFM flour in composite dough maintains the rheological and technological quality of composite wheat flatbread.
Vegetative and reproductive phenology in a tropical grassland–savanna–forest gradient
Authors: Santos de Oliveira Carolina , de Sousa Messeder João Vitor , Lopez Teixido Alberto , Reis Arantes Marcel Rozemberg , Oliveira Silveira Fernando Augusto 
Published: March 2021

AbstractQuestionClimate, particularly precipitation, is the primary factor driving tropical plant phenology because of its relevant role in regulating water availability. However, differences in soil physicochemical properties can also drive resource availability, potentially affecting plant phenology, especially under similar environments in terms of rainfall regime. We determined whether the seasonality and synchrony of the vegetative and reproductive phenophases differ along a grassland–savanna–forest gradient under the same climate regime in a Neotropical seasonal ecosystem. We hypothesized that species growing on shallow, nutrient‐impoverished soils have a higher capacity to respond to precipitation pulses than those on rich soils.LocationSerra do Cipó, southeastern Brazil.MethodsWe quantified soil physicochemical properties associated with fertility and water retention of the grassland (campo rupestre), savanna (cerrado) and forest, and determined the phenological strategies of 70 species across the three vegetation types by monitoring vegetative and reproductive phenophases over one year. For each phenophase, in each vegetation type, we evaluated the seasonality and synchrony of phenological patterns. We quantified the phylogenetic signal for phenophases to disentangle the relative roles of historical vs ecological drivers of plant phenology.ResultsSoils from campo rupestre were more nutrient‐ and water‐limited than those of cerrado and forest. Cerrado and forest communities had similar phenological strategies, whereas species from campo rupestre showed strategies that maximize resource acquisition and conservation. In the cerrado and forest, leafing and flowering patterns were seasonal, with leaf flushing and flowering peaking at the onset of the rainy season and leaf senescence in the dry season. Conversely, species from campo rupestre showed continuous leafing and flowering patterns, while fruiting was seasonal. Phenophases did not show a phylogenetic signal.ConclusionsWe demonstrated changes in vegetative and reproductive phenology that are likely associated with variations in soil physicochemical properties. We argue that more severe edaphic filters may have shaped different phenological patterns in campo rupestre.
Competence pili in Streptococcus pneumoniae are highly dynamic structures that retract to promote DNA uptake
Authors: Lam Trinh , Ellison Courtney K. , Eddington David T. , Brun Yves V. , Dalia Ankur B. , Morrison Donald A. 
Published: March 2021

AbstractThe competence pili of transformable Gram‐positive species are phylogenetically related to the diverse and widespread class of extracellular filamentous organelles known as type IV pili. In Gram‐negative bacteria, type IV pili act through dynamic cycles of extension and retraction to carry out diverse activities including attachment, motility, protein secretion, and DNA uptake. It remains unclear whether competence pili in Gram‐positive species exhibit similar dynamic activity, and their mechanism of action for DNA uptake remains unclear. They are hypothesized to either (1) leave transient cavities in the cell wall that facilitate DNA passage, (2) form static adhesins to enrich DNA near the cell surface for subsequent uptake by membrane‐embedded transporters, or (3) play an active role in translocating bound DNA via dynamic activity. Here, we use a recently described pilus labeling approach to demonstrate that competence pili in Streptococcus pneumoniae are highly dynamic structures that rapidly extend and retract from the cell surface. By labeling the principal pilus monomer, ComGC, with bulky adducts, we further demonstrate that pilus retraction is essential for natural transformation. Together, our results suggest that Gram‐positive competence pili in other species may also be dynamic and retractile structures that play an active role in DNA uptake.
From convolutional neural networks to models of higher‐level cognition (and back again)
Authors: Battleday Ruairidh M. , Peterson Joshua C. , Griffiths Thomas L. 
Published: March 2021

AbstractThe remarkable successes of convolutional neural networks (CNNs) in modern computer vision are by now well known, and they are increasingly being explored as computational models of the human visual system. In this paper, we ask whether CNNs might also provide a basis for modeling higher‐level cognition, focusing on the core phenomena of similarity and categorization. The most important advance comes from the ability of CNNs to learn high‐dimensional representations of complex naturalistic images, substantially extending the scope of traditional cognitive models that were previously only evaluated with simple artificial stimuli. In all cases, the most successful combinations arise when CNN representations are used with cognitive models that have the capacity to transform them to better fit human behavior. One consequence of these insights is a toolkit for the integration of cognitively motivated constraints back into CNN training paradigms in computer vision and machine learning, and we review cases where this leads to improved performance. A second consequence is a roadmap for how CNNs and cognitive models can be more fully integrated in the future, allowing for flexible end‐to‐end algorithms that can learn representations from data while still retaining the structured behavior characteristic of human cognition.