bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ward nurses' experiences and perceptions of the critical care outreach service: A qualitative study undertaken in a large teaching hospital in the West of Ireland
Authors: Hession Caroline Anne , Meaney Teresa 
Published: July 2021

AbstractBackgroundThe critical care outreach service (CCOS) was established in a large teaching hospital in the West of Ireland in 2014 to provide an extension of CCOS between the intensive care unit (ICU) and the wards outside ICU. With the ever‐increasing pressure on ICU resources, CCOS seems to offer an additional service to patients who are critically ill and deteriorating in hospital wards.AimThe aim of this study is to explore ward nurses' experiences and perceptions of the CCOS.Study designA qualitative descriptive methodology aimed to obtain a descriptive account of ward nurses' experiences of the CCOS. Data were collected using semi‐structured interviews. Twelve nurses from the West of Ireland participated in the study. Braun and Clarke's six‐step thematic analysis was used to analyse the data.ResultsThree core themes identified in this study included clinical support and decision‐making; sharing knowledge and skills, and communication. All 12 nurses identified the positive impacts that they felt the current outreach service provided to them on a daily basis.ConclusionsStudy findings indicate that nurses value the role of the CCOS in supporting the care of the critically ill and deteriorating patients at ward level. The CCOS has become invaluable to the ward nurses in their daily practice especially at a time when resources are lacking and patient acuity is on the rise.
DASH cryptochrome 1, a UV‐A receptor, balances the photosynthetic machinery of Chlamydomonas reinhardtii
Authors: Rredhi Anxhela , Petersen Jan , Schubert Melvin , Li Wei , Oldemeyer Sabine , Li Wenshuang , Westermann Martin , Wagner Volker , Kottke Tilman , Mittag Maria 
Published: July 2021

Summary

Drosophila, Arabidopsis, Synechocystis, Homo (DASH) cryptochromes belong to the cryptochrome/photolyase family and can act as DNA repair enzymes. In bacteria and fungi, they also can play regulatory roles, but in plants their biological functions remain elusive. Here, we characterize CRY‐DASH1 from the green alga Chlamydomonas reinhardtii.

We perform biochemical and in vitro photochemical analysis. For functional characterization, a knock‐out mutant of cry‐dash1 is used.

CRY‐DASH1 protein is localized in the chloroplast and accumulates at midday. Although the photoautotrophic growth of the mutant is significantly reduced compared to the wild‐type (WT), the mutant has increased levels of photosynthetic pigments and a higher maximum photochemical efficiency of photosystem II (PS II). Hyper‐stacking of thylakoid membranes occurs together with an increase in proteins of the PS II reaction center, D1 and its antenna CP43, but not of their transcripts. CRY‐DASH1 binds fully reduced flavin adenine dinucleotide and the antenna 5,10‐methenyltetrahydrofolate, leading to an absorption peak in the UV‐A range. Supplementation of white light with UV‐A increases photoautotrophic growth of the WT but not of the cry‐dash1 mutant.

These results suggest a balancing function of CRY‐DASH1 in the photosynthetic machinery and point to its role as a photoreceptor for the UV‐A range separated from the absorption of photosynthetic pigments.
Impact of microclimatic conditions and resource availability on spring and autumn phenology of temperate tree seedlings
Authors: Vitasse Yann , Baumgarten Frederik , Zohner Constantin M. , Kaewthongrach Rungnapa , Fu Yongshuo H. , Walde Manuel G. , Moser Barbara 
Published: July 2021

Summary

Microclimatic effects (light, temperature) are often neglected in phenological studies and little information is known about the impact of resource availability (nutrient and water) on tree’s phenological cycles.

Here we experimentally studied spring and autumn phenology in four temperate trees in response to changes in bud albedo (white‐painted vs black‐painted buds), light conditions (nonshaded vs c. 70% shaded), water availability (irrigated, control and reduced precipitation) and nutrients (low vs high availability).

We found that higher bud albedo or shade delayed budburst (up to +12 d), indicating that temperature is sensed locally within each bud. Leaf senescence was delayed by high nutrient availability (up to +7 d) and shade conditions (up to +39 d) in all species, except oak. Autumn phenological responses to summer droughts depended on species, with a delay for cherry (+7 d) and an advance for beech (−7 d).

The strong phenological effects of bud albedo and light exposure reveal an important role of microclimatic variation on phenology. In addition to the temperature and photoperiod effects, our results suggest a tight interplay between source and sink processes in regulating the end of the seasonal vegetation cycle, which can be largely influenced by resource availability (light, water and nutrients).
The coronavirus disease 2019 pandemic and the rights of the child in Japan
Authors: Yamaguchi Arisa , Hosozawa Mariko , Hasegawa Ayaka , Okubo Yusuke , Sampei Makiko , Sawada Naomi , Piedvache Aurelie , Morisaki Naho , Hangai Mayumi , Tanaka Kyoko , Yamaoka Yui 
Published: July 2021

AbstractBackgroundFew studies have used direct reports by children to assess how the rights documented in the United Nations Convention on the Rights of the Child (CRC) have been affected during the pandemic of coronavirus disease 2019 (COVID‐19).MethodsData were obtained from the CORONA‐CODOMO Survey, a web‐based survey conducted from April to May 2020 in Japan, targeting children aged 7–17 and parents/guardians of children aged 0–17. We focused on self‐reports from children, including two open‐ended questions asking their needs and opinions. The results were analyzed according to the five categories of rights defined by the CRC: education, health, safety, play, and participation.ResultsAmong the 2,591 children who participated in the survey, 1,292 children (49.9%) answered at least one of the two open‐ended questions. The most frequent concern was COVID‐19 infecting members of their families (78.2%), followed by the inability to see their friends (74.3%). There were 1,523 direct comments from children. The comments covered a wide range of the rights in the CRC, including reopening of schools, disparities in education, access to health information, alternatives for playing and seeing friends, and needs for participation and being heard. Few comments were related to safety whereas a certain proportion of children were victimized within households.ConclusionsOur results suggest that the rights outlined in the CRC have been restricted during the COVID‐19 pandemic. Health and educational professionals working with children and policymakers should introduce the rights‐based approach to protect the best interests of children during and after the pandemic.
Time-Resolved Measurements of the Unsteady Boundary Layer in an Annular Low-Pressure Turbine Configuration With Perturbed Inlet
Authors: Sinkwitz Martin , Winhart Benjamin , Engelmann David , di Mare Francesca 
Published: July 2021

AbstractIn this study, the unsteady behavior of the boundary layers developing on a low-pressure turbine (LPT) stator profile and their effect on secondary flow patterns in a 1.5-stage turbine configuration are investigated under the influence of periodic inflow perturbations. The experimental setup previously employed to analyze the unsteady secondary flow in the stator wake has been enhanced by hot-film sensor arrays placed on the stator profiles at different blade height positions to provide time-resolved data from within the passage. The stator inflow is perturbed by a rotating wake generator, and a modified T106 profile has been considered for the blading. The modified profile, labeled as T106RUB, was developed for matching the transition and separation characteristics of the popular original T106 profile at low flow speeds, thus facilitating measurements to be taken in a large-scale test rig with its improved accessibility. The transition phenomena occurring in the profile boundary layers are investigated under both unperturbed and periodically perturbed inflow by means of spectral analysis, the semi-quantitative characterization of the wall-stress system, and an evaluation of the statistic quantities. In particular, the periodic changes of the suction-side boundary layer flow region toward the trailing edge are studied in detail. Furthermore, time-resolved hot-film measurements at different blade height positions facilitate a detailed comparison of the quasi two-dimensional mid-span profile flow and the near end-wall profile flow, which is subject to the influence of secondary flow structures. These information are employed to assess to which extent the additional turbulence originating from the wakes affects the blade boundary layers and thus the secondary flow structures. Furthermore, the role of the perturbation frequency on the coupled system of boundary layers and secondary flow structures is evaluated.
COVID-19: Myths and Reality
Authors: Kordyukova Larisa V. , Shanko Andrey V. 
Published: July 2021

Abstract
COVID‑19, a new human respiratory disease that has killed nearly 3 million people in a year since the start of the pandemic, is a global public health challenge. Its infectious agent, SARS‑CoV‑2, differs from other coronaviruses in a number of structural features that make this virus more pathogenic and transmissible. In this review, we discuss some important characteristics of the main SARS‑CoV‑2 surface antigen, the spike (S) protein, such as (i) ability of the receptor-binding domain (RBD) to switch between the “standing-up” position (open pre-fusion conformation) for receptor binding and the “lying-down” position (closed pre-fusion conformation) for immune system evasion; (ii) advantage of a high binding affinity of the RBD open conformation to the human angiotensin-converting enzyme 2 (ACE2) receptor for efficient cell entry; and (iii) S protein preliminary activation by the intracellular furin-like proteases for facilitation of the virus spreading across different cell types. We describe interactions between the S protein and cellular receptors, co-receptors, and antagonists, as well as a hypothetical mechanism of the homotrimeric spike structure destabilization that triggers the fusion of the viral envelope with the cell membrane at physiological pH and mediates the viral nucleocapsid entry into the cytoplasm. The transition of the S protein pre-fusion conformation to the post-fusion one on the surface of virions after their treatment with some reagents, such as β-propiolactone, is essential, especially in relation to the vaccine production. We also compare the COVID‑19 pathogenesis with that of severe outbreaks of “avian” influenza caused by the A/H5 and A/H7 highly pathogenic viruses and discuss the structural similarities between the SARS‑CoV‑2 S protein and hemagglutinins of those highly pathogenic strains. Finally, we touch on the prospective and currently used COVID‑19 antiviral and anti-pathogenetic therapeutics, as well as recently approved conventional and innovative COVID‑19 vaccines and their molecular and immunological features.
Discrimination capability of pretest probability of stable coronary artery disease: a systematic review and meta-analysis suggesting how to improve validation procedures
Authors: Mincarone Pierpaolo , Bodini Antonella , Tumolo Maria Rosaria , Vozzi Federico , Rocchiccioli Silvia , Pelosi Gualtiero , Caselli Chiara , Sabina Saverio , Leo Carlo Giacomo 
Published: July 2021

ObjectiveExternally validated pretest probability models for risk stratification of subjects with chest pain and suspected stable coronary artery disease (CAD), determined through invasive coronary angiography or coronary CT angiography, are analysed to characterise the best validation procedures in terms of discriminatory ability, predictive variables and method completeness.DesignSystematic review and meta-analysis.Data sourcesGlobal Health (Ovid), Healthstar (Ovid) and MEDLINE (Ovid) searched on 22 April 2020.Eligibility criteriaWe included studies validating pretest models for the first-line assessment of patients with chest pain and suspected stable CAD. Reasons for exclusion: acute coronary syndrome, unstable chest pain, a history of myocardial infarction or previous revascularisation; models referring to diagnostic procedures different from the usual practices of the first-line assessment; univariable models; lack of quantitative discrimination capability.MethodsEligibility screening and review were performed independently by all the authors. Disagreements were resolved by consensus among all the authors. The quality assessment of studies conforms to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A random effects meta-analysis of area under the receiver operating characteristic curve (AUC) values for each validated model was performed.Results27 studies were included for a total of 15 models. Besides age, sex and symptom typicality, other risk factors are smoking, hypertension, diabetes mellitus and dyslipidaemia. Only one model considers genetic profile. AUC values range from 0.51 to 0.81. Significant heterogeneity (p<0.003) was found in all but two cases (p>0.12). Values of I2>90% for most analyses and not significant meta-regression results undermined relevant interpretations. A detailed discussion of individual results was then carried out.ConclusionsWe recommend a clearer statement of endpoints, their consistent measurement both in the derivation and validation phases, more comprehensive validation analyses and the enhancement of threshold validations to assess the effects of pretest models on clinical management.PROSPERO registration numberCRD42019139388.
Prevalence and distribution of HPV infection and subtypes in oral squamous cell carcinoma in Africa: a systematic review protocol
Authors: Holmes Haly Karen , Afrogeh Amir , Adeola Henry , Kimmie-Dhansay Faheema , Engel Mark E 
Published: July 2021

IntroductionHuman papillomavirus (HPV) is an established risk factor for oropharyngeal squamous cell carcinoma, regardless of a history of other known risk factors such as alcohol and tobacco. While cases of HPV-related oral squamous cell carcinoma (OSSC) are increasing in the USA, Europe and South Central Asian countries, little is known about the impact of the disease on the African continent.Methods and analysisWe describe a protocol for a systematic review to synthesise the best current evidence to assess the disease burden in Africa. Electronic databases including EBSCOhost, MEDLINE, CINAHL, ACADEMIC SEARCH COMPLETE, ScienceDirect, Web of Science, Scopus, SciCENTRAL, Cochrane Library, International Prospective Register of Systematic Reviews) and WorldCAT will be comprehensively searched for studies reporting on the defined outcomes, in Africa, published from 1985 (when HPV was first reported) to the latest current entries, with no language restriction. Supplemental handsearching of grey literature, conference abstract proceedings, reference lists of included studies and citations in Google Scholar will be conducted. Authors will be contacted, where necessary, to assist with missing data. A customised data extraction form, with specified criteria, will be used for data extraction. Overall study quality assessment will be done using an appropriate risk of bias tool suited to the study design. Where available, qualitative data from studies reporting on the outcomes will be captured on the data extraction form. Using Stata software, we will apply the random-effects meta-analysis model to aggregate prevalence estimates with 95% CI, incorporating the Freeman-Tukey transformation to account for between-study variability. A narrative report of the findings will be presented where data are insufficient in terms of the outcome/s. Subgroup analysis will be done subject to sufficient available data.Ethics and disseminationEthics approval or written consent is not required as the review will be conducted using published data. The findings will be distributed through a peer-review publication and conference presentation.
Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature
Authors: Darr Jenifer Olive , Franklin Richard C , McBain-Rigg Kristin Emma , Larkins Sarah , Roe Yvette , Panaretto Kathryn , Saunders Vicki , Crowe Melissa 
Published: July 2021

BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.
COVIDTrach: a prospective cohort study of mechanically ventilated patients with COVID-19 undergoing tracheostomy in the UK
Authors:   COVIDTrach collaborative
Published: July 2021

ObjectivesCOVIDTrach is a UK multicentre prospective cohort study project that aims to evaluate the outcomes of tracheostomy in patients with COVID-19 receiving mechanical ventilation and record the incidence of SARS-CoV-2 infection among healthcare workers involved in the procedure.DesignData on patient demographic, clinical history and outcomes were entered prospectively and updated over time via an online database (REDCap). Clinical variables were compared with outcomes, with logistic regression used to develop a model for mortality. Participants recorded whether any operators tested positive for SARS-CoV-2 within 2 weeks of the procedure.SettingUK National Health Service departments involved in treating patients with COVID-19 receiving mechanical ventilation.ParticipantsThe cohort comprised 1605 tracheostomy cases from 126 UK hospitals collected between 6 April and 26 August 2020.Main outcome measuresMortality following tracheostomy, successful wean from mechanical ventilation and length of time from tracheostomy to wean, discharge from hospital, complications from tracheostomy, reported SARS-CoV-2 infection among operators.ResultsThe median time from intubation to tracheostomy was 15 days (IQR 11, 21). 285 (18%) patients died following the procedure. 1229 (93%) of the survivors had been successfully weaned from mechanical ventilation at censoring and 1049 (81%) had been discharged from hospital. Age, inspired oxygen concentration, positive end-expiratory pressure setting, fever, number of days of ventilation before tracheostomy, C reactive protein and the use of anticoagulation and inotropic support independently predicted mortality. Six reports were received of operators testing positive for SARS-CoV-2 within 2 weeks of the procedure.ConclusionsTracheostomy appears to be safe in mechanically ventilated patients with COVID-19 and to operators performing the procedure and we identified clinical parameters that are predictive of mortality.Trial registration numberThe study is registered with ClinicalTrials.Gov (NCT04572438).
Analysis of microRNA signatures in ischemic stroke thrombus
Authors: Kim Jeong-Min , Byun Jun-Soo , Kim Jiah , Park Moo-Seok , Hong Soon Auck , Nam Taek-Kyun , Choi Hyun Ho , Hong Sungguan , Han Su-Hyun , Jeong Hae-Bong , Park Kwang-Yeol , Kim Hye Ryoun 
Published: July 2021

BackgroundWe investigated the microRNA expression pattern from thrombus retrieved by mechanical thrombectomy in acute stroke patients to understand the stroke mechanism.MethodsThis study included acute ischemic stroke patients who had undergone intra-arterial thrombectomy at Chung-Ang University Hospital in Seoul, Korea between February 2016 and March 2019. The thrombus was retrieved and stored at −70℃ after obtaining informed consent. MicroRNA microarray analysis was performed for the patients with identified stroke mechanisms including (1) large artery atherosclerosis, (2) cardioembolism with atrial fibrillation, and (3) cardioembolism with valvular heart disease. The microRNAs derived from microarray analysis were validated by quantitative real-time polymerase chain reaction (qRT-PCR) from different patient populations. The correlation analysis was performed between microRNA levels and laboratory data to understand the functional relevance of the altered microRNA.ResultsIn total, 55 thrombi were obtained from 74 patients, and the microRNAs were analyzed in 45 samples. Microarray analysis of 2578 microRNAs revealed that 50 microRNAs were significantly altered among the three groups. Validation using qRT-PCR showed that miR-378f and miR-450b-5p were significantly elevated among the cardioembolic thrombi; both microRNAs were inversely correlated with the ejection fraction from echocardiography. Thrombi from patients with early neurological deterioration exhibited higher levels of miR-93-5p and lower levels of miR-629-5p than those from neurologically stable patients.ConclusionsThe microRNA expression pattern can provide information regarding the mechanism of stroke by reflecting the underlying pathological status of the organ from which the thrombus was derived.