bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurse roles in the advance directive system in Korea
Authors: Hwang Hyeyoung , Kim Claire Junga 
Published: June 2021

BackgroundIn 2016, the Act on Decisions on Life‐Sustaining Treatment for Patients in Hospice and Palliative Care was implemented in Korea, providing a broad framework for end‐of‐life decision‐making for the first time and making advance directives legally recognized documents. This Act can correct long‐standing under‐recognition of patients as valid decision makers for their own treatment choices. However, limited recognition of patient self‐determination, rigid legal forms for documenting patient wishes, and the roles of family under the Act may pose challenges both to patients and nurses.AimThis paper critiques whether this newly introduced system of advance directives can truly guarantee protection of the patient’s interests and respect for patient autonomy in real life​, and discusses ethical and legal issues regarding the Act.Source of evidenceWe reviewed the current system of advance directives by raising three questions: (1) Do advance directives reflect a competent person’s voluntary and informed choice?, (2) Are advance directives applicable in diverse clinical situations?, and (3) Does the Korean advance directive system ensure that such directives are honored in reality?ConclusionAlthough the Act is an important first step in respecting patient autonomy in end‐of‐life decision‐making, it remains inadequate as it fails to provide thorough guidance in terms of the quality of writing process, applicability, and the guaranteed effects of advance directives.Implications for nursing and health policyAs nurses are best situated for addressing these limitations due to their roles and competencies in clinical practice, expanding the roles of nurses in every stage of advance directive practice could help achieve the original purpose of advance directives. This calls for a policy that promotes an expanded role of nurses to improve the quality of advance directive practice.
Attitudes, beliefs and practice of Egyptian healthcare workers towards seasonal influenza vaccination
Authors: Hakim Sally Adel , Amin Wagdy , Allam Mohamed Farouk , Fathy Asmaa M. , Mohsen Amira 
Published: June 2021

AbstractBackgroundSeasonal influenza vaccination is highly recommended for healthcare workers (HCWs) every year to protect them and reduce the risk of disease transmission at workplaces. Relatively few studies addressed influenza vaccination in the Eastern Mediterranean Region.ObjectivesThe main objective of this study was to explore the attitudes, beliefs and practice of Egyptian HCWs towards seasonal influenza vaccine.MethodsThis is a nationwide cross‐sectional study. Data were collected through self‐administered structured questionnaire. A sample of 3534 HCWs (physicians and nurses) was collected from different levels of healthcare facilities.ResultsThe proportion of seasonal influenza vaccine uptake during the last season was 30.7% while the percentage of ever vaccinated was 46.8%. The most identified reason for non‐compliance was lack of trust about vaccine efficacy and its adverse events. Around 80% of participants expressed positive attitude towards influenza vaccine and the vast majority (98%) agreed to uptake the vaccine during pandemic. There was significant positive association between attitude score and influenza vaccine uptake. Raising awareness about vaccine and ensuring vaccine availability were the main suggestions by HCWs to improve vaccine uptake.ConclusionsAlthough there was positive attitude towards influenza vaccine, yet vaccination coverage was suboptimal particularly among those working in university hospitals. Educational messages and operational strategies addressing motivators and barriers that emerged from this study are needed to optimize vaccine uptake.
The distributive impacts of the Belt and Road Initiative
Authors: Luo Zhi , Wan Guanghua , Wang Chen , Zhang Xun 
Published: June 2021

AbstractThe mission of the Belt and Road Initiative (BRI) is to achieve shared prosperity through cross‐border trade, investment flows, connectivity, people bond, and policy coordination. This motivates us to explore and evaluate the distributive effects of trade and investments under the BRI, as it offers a quasi‐natural experiment for impact evaluation by taking the BRI economies as the treatment group and other countries as the control group. Estimation results show that the BRI has generated benign distributive impacts, as the Gini estimates in BRI economies are significantly reduced after the implementation of the BRI. Further, the benign distributive impacts are found to come from imports from China. More specifically, imports from China that are complementary to local labor inputs are positively correlated with labor participation, thereby helping raise the labor share in national income and reduce income inequality. Conversely, imports of machinery, agricultural products, minerals, and so on from China are found to be negatively correlated with the GDP share of the primary industry. In other words, they help promote industrialization and urbanization in BRI economies, which are expected to lead to better income distribution in the long run.
Environmental regulation and inward foreign direct investment: Evidence from the eleventh Five‐Year Plan in China
Authors: Li Yanyun , Lin Faqin , Wang Wenxiao 
Published: June 2021

AbstractThis paper investigates whether environmental regulations affect inward foreign direct investment (FDI). The identification strategy uses the reduction target policy for air pollutants during eleventh Five‐Year Plan period implemented by the Chinese government in 2006. Our difference‐in‐difference‐in‐differences estimation employs three‐dimension of variations; prefecture (i.e., high target prefectures vs. low target prefectures), industry (more polluting industries relative to less polluting ones), and year (i.e., before and after 2005). We find that tougher environmental regulations lead to less inward FDI through increasing the probability of exit and reducing the probability of entry of foreign invested enterprises. Mechanism analysis shows that foreign invested enterprises with relatively low productivity demonstrate strong negative response. This allocation of resource improves industry productivity.
Optimal route design of electric transit networks considering travel reliability
Authors: Tong Pei , Yan Yadan , Wang Dongwei , Qu Xiaobo 
Published: June 2021

AbstractTravel reliability is the most essential determinant for operating the transit system and improving its service level. In this study, an optimization model for the electric transit route network design problem is proposed, under the precondition that the locations of charging depots are predetermined. Objectives are to pursue maximum travel reliability and meanwhile control the total cost within a certain range. Constraints about the bus route and operation are also considered. A Reinforcement Learning Genetic Algorithm is developed to solve the proposed model. Two case studies including the classic Mandl's road network and a large road network in the context of Zhengzhou city are conducted to demonstrate the effectiveness of the proposed model and the solution algorithm. Results suggest that the proposed methodology is helpful for improving the travel reliability of the transit network with minimal cost increase.
Age‐related hearing loss and cognitive decline: MRI and cellular evidence
Authors: Jafari Zahra , Kolb Bryan E. , Mohajerani Majid H. 
Published: June 2021

AbstractExtensive evidence supports the association between age‐related hearing loss (ARHL) and cognitive decline. It is, however, unknown whether a causal relationship exists between these two, or whether they both result from shared mechanisms. This paper intends to study this relationship through a comprehensive review of MRI findings as well as evidence of cellular alterations. Our review of structural MRI studies demonstrates that ARHL is independently linked to accelerated atrophy of total and regional brain volumes and reduced white matter integrity. Resting‐state and task‐based fMRI studies on ARHL also show changes in spontaneous neural activity and brain functional connectivity; and alterations in brain areas supporting auditory, language, cognitive, and affective processing independent of age, respectively. Although MRI findings support a causal relationship between ARHL and cognitive decline, the contribution of potential shared mechanisms should also be considered. In this regard, the review of cellular evidence indicates their role as possible common mechanisms underlying both age‐related changes in hearing and cognition. Considering existing evidence, no single hypothesis can explain the link between ARHL and cognitive decline, and the contribution of both causal (i.e., the sensory hypothesis) and shared (i.e., the common cause hypothesis) mechanisms is expected.
‘Fair Quiet, have I found thee here?’: The relationship between garden settings and otium–negotium in sixteenth‐century philosophical dialogues
Authors: Moncrieff Ross 
Published: June 2021

AbstractWhilst the literary form of the Renaissance philosophical dialogue has increasingly received scholarly attention in recent years, dialogic settings have rarely been the specific, concentrated focus of these efforts. This article will thus pay close attention to the settings, namely garden settings, of Thomas More’s Utopia, Niccolò Machiavelli’s The Art of War and Justus Lipsius’ De Constantia. Building on recent scholarship exploring Renaissance gardens, it suggests that the garden settings of these philosophical dialogues were chosen in order to reflect concerns about the relative merits of the contemplative and active life. Reading the garden as being associated with the contemplative life of otium, it compares the different approaches each of the authors take to their respective garden settings, arguing that the differing portrayals of the garden are informed by an author’s stance on otium and the active life of negotium. It demonstrates that paying attention to the settings of philosophical dialogues can open up new and interesting ways of interrogating a text, and that the utility of the garden setting for authors concerned with the otium‐negotium conflict was that it was both a stable symbol of otium as well as a site of potential ambiguity and contestation.
Semiparametric Model Averaging Prediction for Lifetime Data via Hazards Regression
Authors: Li Jialiang , Yu Tonghui , Lv Jing , Lee Mei-Ling Ting 
Published: June 2021

AbstractForecasting survival risks for time-to-event data is an essential task in clinical research. Practitioners often rely on well-structured statistical models to make predictions for patient survival outcomes. The nonparametric proportional hazards model, as an extension of the Cox proportional hazards model, involves an additive nonlinear combination of covariate effects for hazards regression and may be more flexible. When there are a large number of predictors, nonparametric smoothing for different variables cannot be simultaneously optimal using the conventional fitting program. To address such a limitation and still maintain the nonparametric flavour, we present a novel model averaging method to produce model-based prediction for survival outcome and our method automatically offers optimal smoothing for individual nonparametric functional estimation. The proposed semiparametric model averaging prediction (SMAP) method basically approximates the underlying unstructured nonparametric regression function by a weighted sum of low-dimensional nonparametric submodels. The weights are obtained from maximizing the partial likelihood constructed for the aggregated model. Theoretical properties are discussed for the estimated model weights. Simulation studies are conducted to examine the performance of SMAP under various evaluation criteria. Two real examples from genetic research studies motivated our work and are analysed by the proposed SMAP to produce new scientific findings.
Biochemical and cellular markers differentiate recovered, in‐line filtered plasma, and plasma obtained by apheresis methods
Authors: Siekmann Jürgen , Weber Alfred , Bauer Christoph , Turecek Peter L. 
Published: June 2021

AbstractBackground and ObjectivesAssessment of plasma quality often focuses on the common safety tests for minimizing the risk of transmitting blood‐borne pathogens. Little attention is paid to the possible quality attributes that ensure a consistent biochemical composition of plasma for fractionation. We therefore investigated the suitability of selected biochemical and haematological attributes that could be used as markers of plasma quality obtained by different separation and pre‐treatment procedures.Material and MethodsWe characterized six plasma types, including source plasma, plasma recovered by classic means and in‐line filtered plasma, by determining the analytical attributes protein content, coagulation factors and markers of coagulation, contact and complement activation. Residual cell content and cell‐specific variables were also measured.ResultsWe found relevant differences between the plasma types in complement activation, as indicated by C3a measurements, while thrombin antithrombin complex values and, to a minor extent, activated factor XII concentrations indicated only moderate differences in activation levels of coagulation and contact systems. The most striking differences, however, were detected in residual cell content and concentrations of the platelet‐associated proteins, platelet factor 4 and β‐thromboglobulin. We showed that leucocyte reduction filters disrupt cells. This includes platelets, thereby releasing the platelet‐associated proteins platelet factor 4 and β‐thromboglobulin, and leucocytes as demonstrated by the release of elastase from polymorphonuclear leucocytes. Furthermore, the filtration processing of whole blood can lead to activation of the complement system.ConclusionOur results show that biochemical and cellular surrogate markers are valuable discriminators of plasma types.
Vector‐mediated expression of muscle specific kinase restores specific force to muscles in the mdx mouse model of Duchenne muscular dystrophy
Authors: Ban Joanne , Beqaj Besa , Phillips William D. 
Published: June 2021

New Findings
What is the central question of this study?
The (dystrophin‐deficient) muscles of mdx mice generate less contractile force per cross‐sectional area (specific force) than those of healthy wild‐type mice: what is the influence of muscle specific kinase (MuSK) upon the properties of the tibialis anterior (TA) muscle in mdx mice?
What is the main finding and its importance?
Injection of adeno‐associated viral vector encoding MuSK into the TA muscle of young mdx mice increased the specific force of the muscle, suggesting the MuSK signalling system has the potential to restore healthy growth to dystrophin‐deficient muscles.
AbstractIn the mdx mouse model of Duchenne muscular dystrophy, muscle fibres are fragile and prone to injury and degeneration. Compared to wild‐type mice, muscles of mdx mice also develop less specific force (contractile force/cross‐sectional area). We recently reported that injecting adeno‐associated viral vector encoding muscle specific kinase (AAV‐MuSK) into muscles of mdx mice increased utrophin expression and made the muscles more resistant to acute stretch‐induced injury. Here we injected AAV‐MuSK unilaterally into the tibialis anterior muscle of mdx mice at a younger age (4 weeks), and recorded contraction force from the muscles in situ at 12 weeks of age. Compared to contralateral empty‐vector control muscles, muscles injected with AAV‐MuSK produced 28% greater specific force (P = 0.0005). They did not undergo the compensatory hypertrophy that normally occurs in muscles of mdx mice. Injection of AAV encoding rapsyn (a downstream effector of MuSK signalling) caused no such improvement in muscle strength. Muscles injected with AAV‐MuSK displayed a 10% reduction in the number of fibres with centralized nuclei (P = 0.0015). Our results in mdx mice suggest that elevating the expression of MuSK can reduce the incidence of muscle fibre regeneration and improve the strength of dystrophin‐deficient muscles.
Mean and Dynamic Aspects of the Wakes of a Surface-Mounted Cube and Block
Authors: da Silva Barbara L. , Sumner David , Bergstrom Donald J. 
Published: June 2021

Abstract
The flow downstream of surface-mounted finite height square prisms with aspect ratio AR = 1 (cube) and 0.5 (block) was investigated experimentally in a low-speed wind tunnel, to determine the overall structure and dynamic behavior of the wake and the source of the streamwise vorticity. The Reynolds number based on the prisms' width D was Re =7.5×104 and the boundary layer thickness at the location of the prisms was δ/D=0.73. A vortex shedding frequency was found in the wake of the cube, but no periodicity was found in the wake of the block. The mean wake of the cube showed features of prisms below the critical AR, but the wake of the block had a distinct behavior due to the dominant shear flow from the boundary layer. The shear changed the downwash and, consequently, the streamwise vorticity distribution in the wake, in addition to reducing the magnitude of the Reynolds stresses. The phase-average analysis for the cube revealed the alternate shedding of inclined structures related to the streamwise vorticity in the upper part of the wake. These vorticity regions were caused by the alternate bending and entrainment of the side flow, caused by the downwash. The periodic component of the total Reynolds stresses was, however, significantly smaller than the turbulence-related stresses. This study showed that the wake had a transitional behavior for the cube, but became fundamentally different for the block when compared with prisms of higher AR.
Molecular Beacon DNA Probes with Fluorescein Bifluorophore
Authors: Brylev V. A. , Lysenko I. L. , Kokin E. A. , Martynenko-Makaev Y. V. , Ryazantsev D. Y. , Shmanai V. V. , Korshun V. A. 
Published: June 2021

Abstract—
An azido-derivative of a fluorescein bifluorophore was obtained and used for the synthesis of “molecular beacon”-type oligonucleotide fluorogenic probes for RT-PCR. Eight probe variants were synthesized based on an optimized sequence: with one or two quencher residues at the 3'-end, with a single or bifluorophore fluorescein label attached to 5'-end using modifying phosphoramidites (short linker) or “click reaction” (long linker). Comparison of probes in RT-PCR showed that probes with a doubled quencher (single fluorescein on a short linker) and doubled dye on a short linker (single dye) are somewhat superior in sensitivity to a standard probe (single quencher, single dye on a short linker) by the value of ΔCt = 1–2.
Promoting social emotional development during the paediatric well-child visit: a demonstration project
Authors: Johnson Meghan L , Butts-Dion Sue , Menon Meera , Edwards Kelly , Berns Scott D 
Published: June 2021

Supporting social emotional development, beginning at birth, can improve lifelong health. The American Academy of Paediatrics recommends 12 well-child visits between birth and age 3 years. Each well-child visit provides a unique opportunity to interact with and support families to promote social emotional development of children. Eighteen US paediatric practices joined a learning community to use improvement science to test and implement evidence-informed strategies that nurture parent–child relationships and promote the social emotional development of young children.Quality improvement methods were used to integrate 11 strategies into well-child visits between birth and age 3 years and measure the improvements with a set of outcome, process and balancing measures. Participation among the 18 paediatric practices was high with 72% of teams attending monthly webinars and 97% of teams attending the three learning sessions. Over 12 months, the percentage of children receiving age-appropriate social emotional development screens at participating practices’ well-child visits increased from a baseline median of 83% to 93%.Current paediatric practice in the USA focuses primarily on cognitive and physical development, and paediatric providers are less familiar with established practices to screen for social emotional development and promote the caregiver–child relationship. This project suggests that improvement methods show promise in increasing the number of children who receive age-appropriate social emotional development screens or assessments at well-child visits.
FEM SIMULATION ASSESSMENT OF MACHINING TITANIUM GRADE 2 USING TEXTURED TOOL
Authors: ROY RIMA SINGHA , MAITY KALIPADA 
Published: June 2021

This work focuses on the 3D numerical investigation of machinability criteria using textured tools for the dry machining of titanium grade 2. For the development of the 3D finite element model, DEFORM-3D (version 10.1) software was used. Dimple patterns were created nearer to the cutting edge region on the rake face of carbide inserts so as to predict their effect and investigate the machinability criteria. Comparison of dimple-textured tool was being made with a conventional tool based on the cutting forces ([Formula: see text], [Formula: see text] and [Formula: see text], cutting temperature, tool wear, effective stress and effective strain. The numerical study revealed that the dimple-patterned tool improved the machinability of titanium grade 2. The cutting forces (tangential cutting force, feed force and radial force) reduced while machining with a dimple-patterned tool as compared to the conventional nontextured tool. There was an enhancement of tool life and a decrease in effective stress and effective strain while dry turning grade-2 titanium alloy using the textured tool.
Heterozygous variants of CLPB are a cause of severe congenital neutropenia
Authors: Warren Julia T. , Cupo Ryan R. , Wattanasirakul Peeradol , Spencer David H. , Locke Adam E. , Makaryan Vahagn , Bolyard Audrey Anna , Kelley Merideth L. , Kingston Natalie L. , Shorter James , Bellanné-Chantelot Christine , Donadieu Jean , Dale David C. , Link Daniel C. 
Published: June 2021

Abstract
Severe congenital neutropenia is an inborn disorder of granulopoiesis. Approximately one third of cases do not have a known genetic cause. Exome sequencing of 104 persons with congenital neutropenia identified heterozygous missense variants of CLPB (caseinolytic peptidase B) in 5 severe congenital neutropenia cases, with 5 more cases identified through additional sequencing efforts or clinical sequencing. CLPB encodes an adenosine triphosphatase that is implicated in protein folding and mitochondrial function. Prior studies showed that biallelic mutations of CLPB are associated with a syndrome of 3-methylglutaconic aciduria, cataracts, neurologic disease, and variable neutropenia. However, 3-methylglutaconic aciduria was not observed and, other than neutropenia, these clinical features were uncommon in our series. Moreover, the CLPB variants are distinct, consisting of heterozygous variants that cluster near the adenosine triphosphate-binding pocket. Both genetic loss of CLPB and expression of CLPB variants result in impaired granulocytic differentiation of human hematopoietic progenitor cells and increased apoptosis. These CLPB variants associate with wild-type CLPB and inhibit its adenosine triphosphatase and disaggregase activity in a dominant-negative fashion. Finally, expression of CLPB variants is associated with impaired mitochondrial function but does not render cells more sensitive to endoplasmic reticulum stress. Together, these data show that heterozygous CLPB variants are a new and relatively common cause of congenital neutropenia and should be considered in the evaluation of patients with congenital neutropenia.