bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of competency‐based education on clinical performance of health care providers: A systematic review and meta‐analysis
Authors: Imanipour Masoomeh , Ebadi Abbas , Monadi Ziarat Hadiseh , Mohammadi Mohammad Mehdi 
Published: August 2021

AbstractAimThis study aimed to investigate the effects of competency‐based education on the clinical performance of health care providers.BackgroundHaving in mind the importance of developing an intervention to enhance the clinical performance of health care providers, the researchers carried out the present study to investigate the effect of competency‐based education on the clinical performance of health care providers.MethodsThis was a systematic review and meta‐analysis carried out by searching six international electronic databases including PubMed, Ovid, Cochrane Library, Web of Science, ProQuest, Scopus and Google Scholar, as well as two national electronic databases including IranMedex and SID. The studies relevant to the research aims were included in the study. To assess the quality of the studies, the Cochrane Collaboration's Risk of Bias Tool was used.ResultsBased on the random effects model, competency‐based education could enhance the clinical performance of the health care providers in the intervention group compared with that of the control group (standardized mean difference [SMD] = −2.717, 95% CI: −3.722 to −1.712). However, more recent studies have shown that competency‐based education has little effect on clinical performance (β = −.255, 95% CI: −0.319 to −0.192, P < .001).ConclusionCompetency‐based education can enhance the clinical performance of health care providers. However, there is increasing concern over the attenuation of the positive effect of competency‐based education on the clinical performance of health care providers, which deserves further studies.
Differentiated nursing practice as a catalyst for transformations in nursing: A multiphase qualitative interview study
Authors: Van Kraaij Julia , Lalleman Pieterbas , Walravens Anoesjka , Van Oostveen Catharina ,   RN2Blend consortium
Published: August 2021

AbstractAimTo identify and follow‐up on the transition towards differentiated nursing practice among bachelor trained and vocationally trained nurses in Dutch hospitals.DesignA multiphase general qualitative interview study.MethodsFifty semi‐structured interviews with project managers in charge of introducing differentiated nursing practice to their hospital were conducted. Purposive sampling was used, and data were collected in 2017, 2019 and 2020. A meta‐analysis was conducted after independent primary thematic analysis of each data collection.ResultsThe introduction of differentiated nursing practice to Dutch hospitals was perceived as uncertain and ambiguous. Three themes were identified during the transition towards differentiated nursing practice: (1) call to action; (2) sitting and waiting; and (3) new beginnings and open ends. The change to differentiated nursing practice is not straightforward and these findings highlight the emerging awareness among project managers of the nature and complexity of the transition. During the study period, professionalization of the nursing profession was recognized as fundamental in hospital organizations.ConclusionNursing cannot be separated from differentiated nursing practice. Visible leadership is important at all organizational levels and nurses’ opinions must be considered as nurses are essential to such changes in healthcare.ImpactDifferentiated nursing practice based on nursing education allows nurses to make the best use of their experience, skills and competencies, and could promote the provision of effective and high‐quality patient care. However, in many cases, a nurse's practice role is based on their nursing licensure instead of their educational background. The change to differentiated nursing practice in hospitals is not straightforward and the nature and complexity of the transition needs to be acknowledged. Nurses have an important role in healthcare transformation and need to be active in developing and formulating rather than just implementing the changes.
Genomic prediction in a numerically small breed population using prioritized genetic markers from whole‐genome sequence data
Authors: Moghaddar Nasir , Brown Daniel J , Swan Andrew A , Gurman Phillip M , Li Li , van der Werf Julius H 
Published: August 2021

AbstractThe objective of this study was to investigate the accuracy of genomic prediction of body weight and eating quality traits in a numerically small sheep population (Dorper sheep). Prediction was based on a large multi‐breed/admixed reference population and using (a) 50k or 500k single nucleotide polymorphism (SNP) genotypes, (b) imputed whole‐genome sequencing data (~31 million), (c) selected SNPs from whole genome sequence data and (d) 50k SNP genotypes plus selected SNPs from whole‐genome sequence data. Furthermore, the impact of using a breed‐adjusted genomic relationship matrix on accuracy of genomic breeding value was assessed. The selection of genetic variants was based on an association study performed on imputed whole‐genome sequence data in an independent population, which was chosen either randomly from the base population or according to higher genetic proximity to the target population. Genomic prediction was based on genomic best linear unbiased prediction (GBLUP), and the accuracy of genomic prediction was assessed according to the correlation between genomic breeding value and corrected phenotypes divided by the square root of trait heritability. The accuracy of genomic prediction was between 0.20 and 0.30 across different traits based on common 50k SNP genotypes, which improved on average by 0.06 (absolute value) on average based on using prioritized genetic markers from whole‐genome sequence data. Using prioritized genetic markers from a genetically more related GWAS population resulted in slightly higher prediction accuracy (0.02 absolute value) compared to genetic markers derived from a random GWAS population. Using high‐density SNP genotypes or imputed whole‐genome sequence data in GBLUP showed almost no improvement in genomic prediction accuracy however, accounting for different marker allele frequencies in reference population according to a breed‐adjusted GRM resulted to on average 0.024 (absolute value) increase in accuracy of genomic prediction.
Investigation of hydrogel temperature and concentration on tapioca xerogel formation
Authors: Stephen Jaspin , Manoharan Dharini , Boopathy Bhavadharini , Rajan Anbarasan , Radhakrishnan Mahendran 
Published: August 2021

AbstractThis study was aimed to examine the assessment of temperature and concentration on tapioca hydrogel into xerogel formation during sessile drop drying. The processing conditions during gelatinization of tapioca flour had an impact on xerogel characteristics. Various concentrations (5, 7.5, and 10% [wt/vol]) of tapioca flour dispersion were heated at a temperature of 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, and 100°C for developing tapioca xerogel. Pasting parameters and least gelation concentration were investigated to confirm tapioca flour concentration. Contact angle, swelling power, solubility, surface tension, and transmittance were found to test the impact of tapioca hydrogel temperature. Rise in density, swelling power, solubility is due to the good starch‐water binding. The reduction in light transmittance specifies birefringence and crystallinity loss because of disruption of granular structure. Increase in surface tension and contact angle indicates higher gelation of starch. It was concluded that 5% (wt/vol) tapioca flour dispersion gelatinized at 65°C exhibited improved integrity with no deformation and cracks in the xerogel structure.Practical ApplicationsFlat packed ready‐to‐cook products with the addition of flavor/seasonings could be utilized as edible snack products like pasta, noodles, and chips. The designed tapioca xerogel can be impregnated with bioactive components in the development of functional foods and nutraceuticals. These two‐dimensional flour‐based xerogels have the capability of undergoing three‐dimensional customized shape change during frying/cooking. This emerging technique of food processing could sort out the increased usage of packaging materials, diminishes the transportation cost, and also enhances consumer acceptance.
Assessing compound flooding potential with multivariate statistical models in a complex estuarine system under data constraints
Authors: Santos Víctor M. , Wahl Thomas , Jane Robert , Misra Shubhra K. , White Kathleen D. 
Published: August 2021

AbstractCompound flooding may result from the interaction of two or more contributing processes, which may not be extreme themselves, but in combination lead to extreme impacts. Here, we use statistical methods to assess compounding effects from storm surge and multiple riverine discharges in Sabine Lake, TX. We employ several trivariate statistical models, including vine‐copulas and a conditional extreme value model, to examine the sensitivity of results to the choice of data pre‐processing steps, statistical model setup, and outliers. We define a response function that represents water levels resulting from the interaction between discharge and surge processes inside Sabine Lake and explore how it is affected by including or ignoring dependencies between the contributing flooding drivers. Our results show that accounting for dependencies leads to water levels that are up to 30 cm higher for a 2% annual exceedance probability (AEP) event and up to 35 cm higher for a 1% AEP event, compared to assuming independence. We also find notable variations in the results across different sampling schemes, multivariate model configurations, and sensitivity to outlier removal. Under data constraints, this highlights the need for testing various statistical modelling approaches, while the choice of an optimal approach remains subjective.
Controlled release and improved stability of vitaminD3within nanoliposomes stabilized by palmitic acid
Authors: Molaveisi Mohammad , Shahidi‐Noghabi Mostafa , Naji‐Tabasi Sara 
Published: August 2021

AbstractThe entrapment of fat‐soluble vitamins in liposomes is an effective technique to protect them from optical and chemical degradation and oxidation. In this study palmitic acid (PA) was incorporated into the liposomal membrane to increase the stability of the nanoliposomes loaded with vitamin D3 (VD3). The liposomal formulations were prepared by the thin‐layer hydration method with different rations of soy phosphatidylcholine (SPC), cholesterol (CHO), and PA as membrane compounds. The encapsulation efficiency (EE%), particle size, particle size distribution, zeta potential, thermal properties, morphology, stability, antioxidant activity, moisture content, solubility, and in vitro release of nanoliposomes were studied. Results showed that the addition of PA to nanoliposomes in the proportions of 1% increased the EE, stability, antioxidant activity, moisture content, and solubility but reduced their particle size, particle size distribution, and zeta potential. Furthermore, the spectra of Fourier transform infrared (FTIR) spectroscopy showed that the complex formed between VD3 and PA was a physical interaction. The high release of VD3 (95.4%) in the intestine medium followed the Fickian diffusion mechanism. Generally, the incorporation of PA in nanoliposomes is a promising approach to improve the stability of VD3‐loaded liposomes during storage.
Long‐term assessment of recurrence of hepatocellular carcinoma in patients with chronic hepatitis C after viral cure by direct‐acting antivirals
Authors: Ogawa Eiichi , Nakamuta Makoto , Furusyo Norihiro , Kajiwara Eiji , Dohmen Kazufumi , Kawano Akira , Ooho Aritsune , Azuma Koichi , Takahashi Kazuhiro , Satoh Takeaki , Koyanagi Toshimasa , Yamashita Nobuyuki , Ichiki Yasunori , Yamashita Naoki , Kuniyoshi Masami , Yanagita Kimihiko , Amagase Hiromasa , Morita Chie , Sugimoto Rie , Kato Masaki , Shimoda Shinji , Nomura Hideyuki , Hayashi Jun ,   The Kyushu University Liver Disease Study (KULDS) Group
Published: August 2021

AbstractBackground and AimEarly hepatocellular carcinoma (HCC) recurrence is common, even after achieving hepatitis C virus (HCV) cure. This study was carried out to assess the long‐term trends and predictors of recurrence after HCV cure by direct‐acting antivirals (DAAs).MethodsThis retrospective, multicenter cohort study enrolled 365 consecutive patients with chronic hepatitis C who required HCC treatment following sustained viral response (SVR) by DAA administration. Patients with HCC recurrence before SVR were excluded. Late HCC recurrence and its predictors beyond the post‐treatment early phase (24 weeks after SVR) were evaluated.ResultsThe data of 326 patients were available for the final analysis. The median follow‐up duration from SVR determination was 2.7 years. Median age was 74, and 220 (67.5%) were 70 or over. The corresponding 5‐year cumulative HCC recurrence rates of previous curative and palliative treatment groups were 45.4% and 65.7%, respectively (log‐rank test: P < 0.001). Cox regression multivariable analysis revealed that cirrhosis (hazard ratio [HR] 1.85, P = 0.021), the number of HCC nodules (≥ 2) (HR 1.52, P = 0.031), and previous palliative HCC treatment (HR 1.71, P = 0.012) were independent predictors of late recurrence, in addition to the predictors of early recurrence; AFP > 7 ng/mL at 12 weeks after DAA administration, time from HCC complete response (CR) to DAA initiation (< 1 year), and the number of HCC treatments necessary to achieve CR (≥ 2).ConclusionsThe evaluation of fibrosis and characteristics of the previous HCC would allow for better HCC recurrence stratification, which would be helpful for developing long‐term surveillance strategies.
Characteristics and progression of childhood‐onset and adult‐onset eosinophilic esophagitis
Authors: Wong Stephanie , Ellison Samuel , Haj Ali Sara , Hawkes Joanna , Collinson Jane , O'Neill Thomas , Ruszkiewicz Andrew , Moore David , Holloway Richard H , Nguyen Nam Q 
Published: August 2021

AbstractBackground and AimThe prevalence and incidence of eosinophilic esophagitis (EoE) has been increasing over recent years. However, the natural history remains incompletely understood particularly the differences in disease characteristics and progression of childhood‐onset and adult‐onset EoE. The aim of this study was to evaluate the disease characteristics and progression of childhood‐onset and adult‐onset EoE.MethodsA cross‐sectional, questionnaire‐based study, on 87 adults and 67 children from 2 major tertiary hospitals in South Australia was conducted. Data of those who were diagnosed with EoE between 1999 and 2018 were collected and correlated with medical records.ResultsOf the 87 adults with EoE, 34 (39%) were diagnosed at the age of < 18 years (childhood‐onset EoE). Reflux symptoms were more common in childhood‐onset EoE, whereas asthma was more common in adult‐onset EoE. The median duration of symptoms prior to diagnosis of EoE was > 1–4 years in childhood‐onset disease (44%) and ≥ 10 years in adult‐onset disease (34%). Food impaction was significantly more common on initial presentation in those with adult‐onset EoE, whereas weight loss was more common in childhood‐onset EoE. At the time of questionnaire, regurgitation, abdominal pain, and bloating were more common in childhood‐onset EoE. Those with childhood‐onset EoE were more likely to have multiple symptoms at questionnaire when compared with their adult‐onset counterparts. In both groups, 15% (5/34 childhood‐onset EoE and 8/53 adult‐onset EoE) were asymptomatic at the time of questionnaire.ConclusionChildhood‐onset EoE appears to be a progressive disease from childhood to adulthood, however with more inflammatory‐type symptoms post transition compared to those with adult‐onset EoE.
Fisetin for COVID‐19 in skilled nursing facilities: Senolytic trials in the COVID era
Authors: Verdoorn Brandon P. , Evans Tamara K. , Hanson Gregory J. , Zhu Yi , Langhi Prata Larissa G. P. , Pignolo Robert J. , Atkinson Elizabeth J. , Wissler‐Gerdes Erin O. , Kuchel George A. , Mannick Joan B. , Kritchevsky Stephen B. , Khosla Sundeep , Rizza Stacey A. , Walston Jeremy D. , Musi Nicolas , Lipsitz Lewis A. , Kiel Douglas P. , Yung Raymond , LeBrasseur Nathan K. , Singh Ravinder J. , McCarthy Teresa , Puskarich Michael A. , Niedernhofer Laura J. , Robbins Paul D. , Sorenson Matthew , Tchkonia Tamara , Kirkland James L. 
Published: August 2021

AbstractThe burden of senescent cells (SnCs), which do not divide but are metabolically active and resistant to death by apoptosis, is increased in older adults and those with chronic diseases. These individuals are also at the greatest risk for morbidity and mortality from SARS‐CoV‐2 infection. SARS‐CoV‐2 complications include cytokine storm and multiorgan failure mediated by the same factors as often produced by SnCs through their senescence‐associated secretory phenotype (SASP). The SASP can be amplified by infection‐related pathogen‐associated molecular profile factors. Senolytic agents, such as Fisetin, selectively eliminate SnCs and delay, prevent, or alleviate multiple disorders in aged experimental animals and animal models of human chronic diseases, including obesity, diabetes, and respiratory diseases. Senolytics are now in clinical trials for multiple conditions linked to SnCs, including frailty; obesity/diabetes; osteoporosis; and cardiovascular, kidney, and lung diseases, which are also risk factors for SARS‐CoV‐2 morbidity and mortality. A clinical trial is underway to test if senolytics decrease SARS‐CoV‐2 progression and morbidity in hospitalized older adults. We describe here a National Institutes of Health‐funded, multicenter, placebo‐controlled clinical trial of Fisetin for older adult skilled nursing facility (SNF) residents who have been, or become, SARS‐CoV‐2 rtPCR‐positive, including the rationale for targeting fundamental aging mechanisms in such patients. We consider logistic challenges of conducting trials in long‐term care settings in the SARS‐CoV‐2 era, including restricted access, consent procedures, methods for obtaining biospecimens and clinical data, staffing, investigational product administration issues, and potential solutions for these challenges. We propose developing a national network of SNFs engaged in interventional clinical trials.
Effect of intrapartum vitamin D levels on labor pain
Authors: Koyucu Refika G. , Özcan Tuğba 
Published: August 2021

AbstractAimVitamin D has widespread receptor distribution in the body, and therefore it has vital roles in numerous pathophysiological conditions. It also affects pain manifestation through its functions at various stages of the pain pathways. This study aimed to investigate the effects of intrapartum vitamin D levels on pain experienced by women during the first stage of labor.MethodsA total of 127 term‐nulliparous women at the early stage of labor were included in the study. Serum 25 (OH) vitamin D levels were measured at the beginning of labor to determine intrapartum vitamin D levels. Labor pain was assessed using the Visual Analog Scale at different stages of cervical dilation (VAS0, VAS1, VAS2). Postpartum pain (VASpp) and women's birth satisfaction score (BSS) were also evaluated during the early postpartum period.ResultsThere was a moderate negative correlation between vitamin D and VAS0 and VAS1 (r2 = 0.4, p = 0.000; r2 = −0.570, p = 0.000, respectively), and a weak negative correlation between vitamin D and VAS2 (r2 = −0.373, p = 0.000). No significant correlation was found between vitamin D and BSS and length of labor (p = 0.127, p = 0.126, respectively).ConclusionIn nulliparous women with low vitamin D levels, the first stage of labor and the early postpartum period may be more painful. To facilitate management of labor pain, during the antenatal period vitamin D levels should be monitored, and in cases where the levels are deficient, vitamin D supplementation should be started.
Factors associated with paediatric and adolescent Emergency Department presentations involving acute behavioural disturbance events
Authors: Lovett Caitlyn J , Hiles Jo‐Anne , Calver Leonie , Pallas Jeremy D , Thomson Bowe Katherine , Downes Michael A 
Published: August 2021

AimStudies reporting factors associated with paediatric/adolescent acute behavioural disturbance (ABD) in the Emergency Department (ED) are lacking. The aim of this study is to describe paediatric/adolescent ED presentations involving ABD events.MethodsA retrospective chart review of presentations involving ABD events, identified via hospital security log, to a tertiary referral paediatric ED during the 2017 calendar year. Data reported included: cause of presentation, use of sedation/physical restraint, ED/inpatient length of stay (LOS) and time requiring security staff presence.ResultsFrom 280 reported ABD episodes 26 were excluded leaving 254 events involving 150 patients across 233 presentations of whom 38 (25.3%) presented on multiple occasions. Median age was 14 years (interquartile range (IQR): 13–16), 132/233 (56.7%) were female, 167/233 (71.7%) primary mental health complaints, 30/233 (12.9%) deliberate self‐harm, 18/233 (7.7%) deliberate self‐poisoning, 11/233 (4.7%) acute intoxication and 7/233 (3.0%) other.Transport to hospital involved police and ambulance in 124/233 (53.2%), ambulance only 71/233 (30.5%), police only 16/233 (6.9%), relative or carer 20/233 (8.6%), with self‐presentation in 2/233 (0.9%).Sedation or physical restraint was used in 81/233 (34.8%), both 38/233 (16.3%), restraint only 26/233 (11.2%) and sedation only 17/234 (7.3%). Intra‐muscular droperidol accounted for 57/96 (59.4%) sedations, IM/IV benzodiazepines 15/96 (15.6%), IM/IV ketamine 5/96 (5.2%) and 19/96 (19.8%) other.Discharge from ED occurred in 171/233 (73.1%) with median ED LOS 5.1 h (IQR: 3.5–7.7) and median hospital LOS 92.4 h (IQR: 47.5–273.4) for those admitted. The Mental Health Act was utilised in 183/233 (78.5%) presentations.Median security staff time requirement per presentation was 2.4 h (IQR: 1.0–3.9).ConclusionsPaediatric/adolescent ED presentations involving ABD are primarily due to mental health complaints. Less than half require the use of sedation/physical restraint. Time requiring security staff involvement is a significant resource consumption.
What do children think about doctors' communication at the Teddy Bear Hospital?
Authors: Moore David Edward , White Andrew , Jordan Brigid , Uahwatanasakul Wonie 
Published: August 2021

AimExcellent communication is essential for health professionals working with children. Teddy Bear Hospital (TBH) is an innovative method of developing paediatric communication skills in health‐care students. By exploring the child's perspective of medical students' communication at the TBH, we sought to better understand the role TBH plays in the development of the communication skills in medical students.MethodsSemi‐structured interviews were conducted with 31 children, aged 3–8 years old, who were attending a TBH run by third year medical students at the Royal Children's Hospital in Melbourne. These interviews were recorded and transcribed after which themes were generated by inductive content analysis using the programme NVivo 12.ResultsChildren used mostly positive language when describing interactions with teddy doctors. However, almost half of the children could not recall the medical students explaining why their teddy was sick or how their teddy would get better. Furthermore, many teddies returned from TBH with medical issues different to their initial presentation.ConclusionsThe communication described at TBH was overwhelmingly positive with children describing little difference between medical students and actual doctors. However, the mismatch in teddy medical issues before and after a visit to TBH along with the lack of understanding on teddy health management plans, suggests the need for further evidence‐based training in communication skills for medical students to improve their ability to communicate with very young children.