bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle Mass and Direct Oral Anticoagulant Activity in Older Adults With Atrial Fibrillation
Authors: Bendayan Melissa , Mardigyan Vartan , Williamson David , Chen‐Tournoux Annabel , Eintracht Shaun , Rudski Lawrence , MacNamara Elizabeth , Blostein Mark , Afilalo Marc , Afilalo Jonathan 
Published: January 2021

BackgroundDirect oral anticoagulants (DOAC) are hydrophilic drugs with plasma levels inversely proportional to lean body mass. Sarcopenic patients with low muscle mass may be at risk for supra‐therapeutic DOAC levels and bleeding complications. We therefore sought to examine the influence of lean body mass on DOAC levels in older adults with atrial fibrillation (AF).MethodsA prospective cohort study was conducted with patients 65 years of age or more receiving rivaroxaban or apixaban for AF. Appendicular lean mass (ALM) was measured using a bioimpedance device and a dual X‐ray absorptiometry scanner. DOAC levels were measured using a standardized anti‐Xa assay 4 hours after (peak) and 1 hour before (trough) ingestion.ResultsThe cohort consisted of 62 patients (47% female, 77.0 ± 6.1 years). The prescribed DOACs were apixaban 2.5 mg (21%), apixaban 5 mg (53%), and rivaroxaban 20 mg (26%). Overall, 16% had supra‐therapeutic DOAC levels at trough and 25% at peak. In the multivariable logistic regression model, lower ALM was independently associated with supra‐therapeutic DOAC levels at trough (odds ratio per ↓ 1‐kg 1.23, 95% confidence interval 1.02 to 1.49) and peak (odds ratio per ↓ 1‐kg 1.18, 95% confidence interval 1.02 to 1.37). Addition of ALM to a model consisting of age, total body weight, and renal function resulted in improved discrimination for supra‐therapeutic DOAC levels.ConclusionOur proof‐of‐concept study has identified an association between ALM and DOAC levels in older adults with AF. Further research is needed to determine the impact of ALM on bleeding complications and the potential role of ALM‐guided dosing for sarcopenic patients.
Defining a good death for people with dementia: A scoping review
Authors: Takahashi Zaiya , Yamakawa Miyae , Nakanishi Miharu , Fukahori Hiroki , Igarashi Naoko , Aoyama Maho , Sato Kazuki , Sakai Shima , Nagae Hiroko , Miyashita Mitsunori 
Published: January 2021

AbstractAimEnd‐of‐life care for people with dementia is becoming increasingly important as the global population ages. However, there is no agreed definition of a good death for people with dementia. The current review examined previous literature to establish the current state of knowledge on this issue.MethodsWe conducted a scoping review using a standard methodological framework. Relevant studies were identified from four databases. Studies were included if they were in English, discussed palliative or end‐of‐life care for dementia, and defined or explained a good death. The definitions or explanations of a good death were categorized into subthemes, and grouped into broader themes.ResultsWe identified 11 articles discussing or explaining a good death in dementia, which were published between 2009 and 2017. Most of these studies drew on the views of healthcare professionals and/or family members of people with dementia, and only one considered the views of people with dementia themselves. Ten themes were identified, including pain‐free status, peaceful/comfort, dignity, family presence, surrounded by familiar things and people, person‐centered communication, spirituality, life completion, treatment preferences, and other.ConclusionsThe characteristics of a good death in dementia showed similarities with those identified more generally. However, there were some themes that were specific to end‐of‐life care in dementia, notably “surrounded by familiar things and people” and “person‐centered communication”. To obtain a fuller picture of the nature of a good death in dementia, researchers need to examine the views of people living with dementia.
Effectiveness of nursing care provided for fall prevention: Survival analysis of nursing records in a tertiary hospital
Authors: Suh Minhee , Cho Insook 
Published: January 2021

AbstractAimThis study was carried out to analyze nursing care provided to patients on high and low fall‐risk days and to evaluate the effectiveness of nursing care in terms of preventing falls.MethodsA retrospective review of medical records was conducted for patients admitted to a tertiary hospital in Korea. General and clinical information, fall occurrences, Hendrich II Fall Risk Model (HFRM II) fall‐risk assessment scores, nursing care related to fall prevention, and medications administered were extracted.ResultsData from 43,267 days of records for 11,718 patients were analyzed. Nursing assessment, intervention, and administration of medication were provided more frequently on high fall‐risk days than on low fall‐risk days. Analysis performed on the entire cohort days showed fall occurrence was significantly associated with infrequent mobility assessment and greater usage of anti‐anxiety agents. On high fall‐risk days, fall occurrence was related to less restraint assessment and greater usage of vessel dilatators.ConclusionsThe implementation of risk‐targeted interventions for fall prevention based on fall‐risk assessment is needed. For general fall prevention, assessment of patients' mobility should be strengthened. For high fall‐risk patients, it may be more effective for nurses to focus on assessing restraints, evaluating medication records, and withdrawing medications related to falls.
Garnet as a monitor for melt–rock interaction: Textural, mineralogical, and compositional evidence of partial melting and melt‐driven metasomatism
Authors: Goncalves Philippe , Raimondo Tom , Paquette Jean‐Louis , Santos de Souza de Oliveira Jailma 
Published: January 2021

AbstractIn this study, we focus on a partially melted garnet‐bearing granulite from the Salvador–Esplanade Belt (Salvador da Bahia, Brazil), and examine the behaviour of major and trace elements during partial melting and melt‐driven metasomatism. Phase equilibria modelling and U–Th–Pb geochronology show that the sample underwent partial melting during the heating segment of the decompression path from ~1.2 GPa and 675–700°C to ~0.8 GPa and 790°C at c. 2.06 Ga. During the final stage of decompression, from 0.8 to ~0.5 GPa, physical segregation of melt resulted in the establishment of chemical potential gradients and mass transfer between the host granulite and the leucosome. Modelling shows that H2O, CaO, K2O, and Na2O diffused from the melt into the host residue, whereas SiO2 was transferred from the host granulite into the adjacent leucosome. Opposed senses of diffusional transfer resulted in the formation of a quartz‐rich anhydrous leucosome and a quartz‐depleted selvedge in the host granulite. Compositional maps show that garnet exhibit contrasting major and trace element distributions depending on their textural position. The largest garnet located in the quartz‐depleted selvedge preserve their original Ca and trace element growth zoning. A transition from bell‐shaped profiles for Y and heavy rare earth elements to bowl‐shaped profiles for light rare earth elements is consistent with a typical Rayleigh fractionation model, fast intergranular element mobility, and rock‐wide equilibrium during prograde partial melting. In contrast, smaller garnet away from the leucosome show prograde growth zoning modified by intragranular diffusion, as evidenced by a network of open channels and healed cracks that act as connecting pathways between the matrix and garnet core. This results in either subtle modification of both major and trace elements adjacent to the inner core inclusions, or a complete re‐equilibration. Recognition that the original Ca growth zoning was later modified by intragranular diffusion implies that misleading thermobarometric results and tectonic interpretations would be obtained if the core composition was used to fingerprint the early garnet nucleation stage. This study demonstrates that at high temperature (>750°C) and in the presence of melt, REE are not less vulnerable to diffusive resetting than divalent cations like Ca2+.
Site‐specific angular dependent determination of inelastic mean free path of 300 keV electrons in GaN nanorods
Authors: Ghatak Jay , Chatterjee Abhijit , Shivaprasad S. M. 
Published: January 2021

AbstractInelastic mean free path (IMFP) of the electron is a very important parameter for quantitative analysis of several electron spectroscopies and transport properties. In spite of being a fundamental material property, its experimental determination is not trivial due to complexity of the various electron scattering processes in matter. In this report, we demonstrate a procedure to determine the IMFP of 300 keV electrons in GaN, using the log‐ratio technique where the local specimen thickness needs to be accurately known. The GaN nanorod morphology of the sample used here allows the accurate measurement of thickness by ‘thickness map’ under EFTEM measurements which enable the site specific determination of IMFP. IMFP for different collection semi angles have also been measured to validate the angular dependence. Our experimental results estimates the IMFP of GaN for 300 keV electrons to be 143 ± 11 nm at no‐aperture condition and exhibit a strong inverse angular dependence at smaller collection semi angles (β < 20 mrad) and a near angular independence at larger collection semi angles (β > 30 mrad). We discuss these results in the light of three different theoretical models prevalent in the literature.
A historical perspective on the interactions of insulin at the blood‐brain barrier
Authors: Rhea Elizabeth M. , Banks William A. 
Published: January 2021

AbstractSubsequent to the discovery of insulin in 1921, the role of insulin in the brain has been investigated throughly. The ability of insulin to act within the brain to regulate peripheral glucose levels helped evolve the research surrounding the ability of insulin to be transported into the brain. Investigations aiming to determine the transport of insulin into the brain from the circulation soon followed. Once it was established that insulin could enter the brain, the ability of insulin to bind brain microvessels and regulators of this process were determined. As technology advanced, quantitative measurements to specify the transport rate of insulin across the blood‐brain barrier (BBB) and the impact of physiological conditions and diseases were the logical next steps. Lastly, with the advent of genetic mouse models and high‐specificity antagonists, the specific role of the insulin receptor in mediating insulin transport could begin to be explored. In this review, we summarise the main findings throughout the decades regarding the interactions of insulin at the BBB.
Predicting nurses' intentions in allowing family presence during resuscitation: A cross‐sectional survey
Authors: Park Ju Young , Ha Jiyeon 
Published: January 2021

AbstractAims and ObjectivesThis study examined nurses' intention to allow family presence during resuscitation (FPDR) by applying the theory of planned behaviour with an extended concept.BackgroundMedical institutions, including nurses and other medical professionals working in emergency and intensive care units, are reluctant to allow FPDR. However, this practice reduces the family's anxiety and stress while fostering well‐being and minimises their feelings of helplessness and distress by making them believe that they have helped the patient.DesignA cross‐sectional descriptive design was used in this study.MethodsThe participants were 252 nurses who had been working for at least 3 months in a general hospital in South Korea. Data were collected using self‐report questionnaires in April 2020 and were analysed using descriptive statistics, Pearson's correlation analysis and multiple regression analysis. The instruments were intention to allow FPDR (five constructs: intention to allow FPDR, positive attitude, negative attitude, subjective norm and perceived behavioural control), perception of FPDR and self‐confidence. The STROBE checklist was used for reporting this study.ResultsThe mean score for the intention to allow FPDR was 3.47 out of 5. The regression analysis results indicated that perception of FPDR, positive attitude and negative attitude predicted the intention to allow FPDR.ConclusionsIt is necessary to develop educational programmes to change the perceptions of and attitudes towards FPDR. Additionally, written policies and protocols for FPDR in South Korea are needed to develop systematic care for patients’ families during cardiopulmonary resuscitation.Relevance to clinical practiceThe findings of this study provide baseline data for developing FPDR policies and guidelines that could minimise the family's distress and allow them to feel that they have helped the patient.
Pathways of diabetes distress, decisional balance, self‐efficacy and resilience to quality of life in insulin‐treated patients with type 2 diabetes: A 9‐month prospective study
Authors: Hsu Hui‐Chun , Chen Shi‐Yu , Lee Yau‐Jiunn , Chen Wan‐Yi , Wang Ruey‐Hsia 
Published: January 2021

AbstractAims and ObjectivesTo construct a path model addressing influences of diabetes distress, self‐efficacy of injecting insulin, resilience and decisional balance of injecting insulin to quality of life (QoL) in insulin‐treated patients with type 2 diabetes (T2DM).BackgroundInsulin regimens more negatively impact QoL than oral medication treatments in patients with T2DM. Understanding the factors and influencing pathways associated with subsequent QoL will help nurses design timely interventions to improve QoL of insulin‐treated T2DM patients.DesignA 9‐month prospective design was employed in this study.MethodsSelf‐reported questionnaires were used to collect data from 185 insulin‐treated T2DM patients. At baseline, diabetes distress and self‐efficacy of injecting insulin were collected, while QoL, resilience and decisional balance of injecting insulin were collected 9 months later. Data were collected from February 2017 to February 2018. Structural equation modelling was used for analysis. This study was conducted based on the STROBE.ResultsLow baseline diabetes distress and high 9‐month decisional balance of injecting insulin directly associated with high 9‐month QoL. High baseline self‐efficacy of injecting insulin and high 9‐month resilience directly associated with high 9‐month decisional balance of insulin injection and indirectly associated with high 9‐month QoL. High baseline diabetes distress directly and indirectly associated with poor 9‐month QoL.ConclusionsDiabetes distress, self‐efficacy of injecting insulin, resilience and decisional balance of injecting insulin play different roles in associating with QoL in insulin‐treated T2DM patients.Relevance to clinical practiceNurses could provide educational programs focusing on enhancing decisional balance of injecting insulin to improve QoL in insulin‐treated patients. Improving self‐efficacy of injecting insulin and resilience could be promising strategies to improve the decisional balance of injecting insulin. More timely assessment of diabetes distress and intervention might be powerful strategies to improve subsequent QoL in these patients.
Application of serum markers in diagnosis and staging of ovarian endometriosis
Authors: Tang Ting , Lai Huichao , Huang Xuemei , Gu Liqin , Shi Haiying 
Published: January 2021

AbstractAimsLaparoscopic surgery is widely used for diagnosing ovarian endometriosis but it has medical risks. This study explored the application of blood indicators in diagnosis and staging of ovarian endometriosis, aiming to develop a noninvasive diagnostic method.MethodsA total of 190 ovarian endometriosis patients were included in observation group, among these participants, 77 patients among them were stages I–II, and the rest 113 patients were stages III–IV, and a total of 103 healthy women as control group. Serum biochemical indexes, tumor markers, and cytokines levels in two groups were used for the diagnosis and staging of the disease. Area under the receiver operating characteristic (ROC) curve (AUC) predicted the value of individual and joint tests for indicators.ResultsBiochemical indexes, namely, alkaline phosphatase (ALP), total protein (TP), and glucose (Glu) could distinguish patients from normal women; and that ALP and Glu could indicate disease staging. In tumor markers, alpha fetoprotein (AFP), carcinoembryonic antigen (CA) 125, CA199 and human epididymis protein 4 (HE4) helped to diagnose endometriosis; CA125, HE4, and cytokeratin 19 fragment (CYFRA21‐1) could differentiate stages. In cytokines, vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF)‐α, interleukin (IL)‐6, soluble fms‐like tyrosine kinase receptor 1 (sflt‐1), monocyte chemoattractant protein (MCP)‐1 therefore, have values to diagnose endometriosis; VEGF, TNF‐α, IL‐6, and sflt‐1 helped to differentiate disease staging.ConclusionSerological indicators in ovarian endometriosis patients were different from healthy women, which were of certain differential values in diagnosis and disease staging. The current study provided a novel strategy for endometriosis diagnosis.
Postpartum endometritis after uterine cleaning versus no cleaning in cesarean sections: Randomized clinical trial
Authors: Hamdy Mostafa A. , Taha Omima T. , Elprince Mohamed 
Published: January 2021

AbstractAimThe aim of the study was to compare the rates of postpartum endometritis due to uterine cleaning and no cleaning in patients delivered by elective cesarean section.MethodsThis was a randomized clinical trial conducted at the Obstetrics and Gynecology Department, Suez Canal University Hospital, Ismailia, from June 2019 to November 2019. We recruited patients undergoing cesarean delivery aged 18–45 years with singleton pregnancy, intact membranes, either first or repeated delivery, without labor pains. Patients were allocated into two groups, uterine cleaning (336 patients) and no cleaning (312 patients). The main outcome measure was the occurrence of postpartum endometritis.ResultsBoth groups were matched in their demographic characters. Twelve patients (3.6%) developed endometritis in the cleaning group versus one patient (0.3%) in the other one. Estimated blood loss was 754.35 ± 247.13 and 730.36 ± 232.77 for the cleaning and no cleaning groups, respectively, with a P value of 0.201. Septic wound infection (21 patients, 6.3%) was predominant in the cleaning group.ConclusionUterine cleaning after delivery of the placenta during CS can be omitted as a surgical step during the operation. It was associated with increased rates of postpartum endometritis and blood loss.
Inflammatory bowel disease in Hermansky–Pudlak syndrome: a retrospective single‐centre cohort study
Authors: O’Brien K. J. , Parisi X. , Shelman N. R. , Merideth M. A. , Introne W. J. , Heller T. , Gahl W. A. , Malicdan M. C. V. , Gochuico B. R. 
Published: January 2021

AbstractBackgroundKnowledge about inflammatory bowel disease (IBD) in patients with Hermansky–Pudlak syndrome (HPS), a rare autosomal recessive disorder characterized by defective biogenesis of lysosome‐related organelles, could provide insights into IBD in general.ObjectiveTo expand the understanding of IBD in patients with HPS.MethodsRetrospective review of records from patients with HPS evaluated at the National Institutes of Health Clinical Center from 1995 to 2019 was conducted. Clinical features of IBD, genotyping results and histologic findings of colectomy specimens were analysed.ResultsIBD affected 37 (14.2%; 12 male, 25 female) of 261 patients with HPS. Median age of onset was 17 years; range was 1 to 52 years. The most common symptoms of HPS IBD were hematochezia, abdominal pain and loose stools. Fistulae or extra‐intestinal manifestations developed in 30% or 22%, respectively. Genotyping showed that patients with biallelic variants in HPS1, HPS3, HPS4 or HPS6 were diagnosed with IBD. Six children had very early‐onset IBD. Patients with HPS‐3 had mild manifestations of IBD. Medical therapy and bowel resection were utilized to treat 73% and 35% of patients with HPS IBD, respectively; 7 of 13 patients receiving anti‐tumor necrosis factor alpha therapy had prolonged clinical responses. Active cryptitis, chronic inflammatory changes, granulomas and ceroid lipofuscinosis were histopathologic findings in three colectomy specimens.ConclusionsIBD resembling Crohn’s disease affects some patients with HPS; genetic heterogeneity is a feature of HPS IBD. HPS3 is a new gene associated with human IBD. Very early‐onset IBD can develop in HPS.
Telehealth mitigates COPD disease progression compared to standard of care: a randomized controlled crossover trial
Authors: Rassouli F. , Germann A. , Baty F. , Kohler M. , Stolz D. , Thurnheer R. , Brack T. , Kähler C. , Widmer S. , Tschirren U. , Sievi N. A. , Tamm M. , Brutsche M. H. 
Published: January 2021

AbstractBackgroundWe showed excellent adherence and satisfaction with our telehealth care (TC) approach for COPD. Here, the results of a consecutive randomized controlled trial are presented.MethodsPatients were randomly assigned to TC or standard care (SC). During TC, patients answered six daily questions online, and focused on the early recognition of exacerbations, in addition to SC.ResultsThe mean increase in COPD assessment test (CAT) was 1.8 vs. 3.6 points/year in the TC and SC groups, respectively (P = 0.0015). Satisfaction with care (VAS) at baseline was 8.2; at the end of SC, 8.5 (P = 0.062); and after TC, 8.8 (P < 0.001). We detected significantly more moderate exacerbations during TC.ConclusionWhilst receiving TC, the slope of the CAT increase – an indicator of the naturally progressive course of COPD – was reduced by 50%. Satisfaction with care increased with TC. The higher number of detected moderate exacerbations probably indicates a higher diagnostic sensitivity than without TC.
Post‐Separation Parenting Time Schedules in Joint Physical Custody Arrangements
Authors: Steinbach Anja , Augustijn Lara 
Published: January 2021

AbstractObjectiveThe objective of the study was to examine patterns of parenting time schedules in joint physical custody (JPC) arrangements.BackgroundAlthough the importance of contact with the non‐residential parent for children's well‐being after family dissolution is well‐documented, the measures used in surveys are often crude and do not capture the two dimensions of post‐separation parenting time schedules: the proportion of time children spend with each parent and the number of transitions children make between parental homes.MethodThe analyses are based on the Family Models in Germany study, a German sample of families with children aged 0–14 that was conducted in 2019. As this study includes a residential calendar capturing the children's stays with each parent over 4 weeks, it was possible to calculate both dimensions of post‐separation parenting time schedules for 463 JPC families.ResultsThe results revealed that 55.5% of JPC families practiced an asymmetric (at least 30% with one parent) and 44.5% practiced a symmetric care arrangement (50% with each parent). The mean number of transitions children experienced was 9.5 within a month. The factors that were found to be positively associated with practicing symmetric JPC were working hours of the responding parent and parents' relationship quality. However, working hours of the responding parent and the distance between the parents' homes reduced the number of transitions between the parents' homes, whereas a good parental relationship increased them.ConclusionEmpirical investigations of children in post‐separation families should take the two dimensions of physical custody into account.