bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing surgical site infection rates in colorectal surgery – a quality improvement approach to implementing a comprehensive bundle
Authors: Falconer Rachel , Ramsay George , Hudson Jemma , Watson Angus ,   the Highland Colorectal SSI Group
Published: August 2021

AbstractAimSurgical site infections (SSIs) are a preventable cause of morbidity following surgical procedures. Strategies to reduce rates of SSI must address pre‐, peri‐ and postoperative factors and multiple interventions can be combined into ‘bundles’. Adoption of these measures can reduce SSIs, but this is dependent on high levels of compliance. The aim of this work is to assess the change in rates of SSI in elective colorectal surgery after implementing a colorectal SSI bundle.MethodThis is a single‐centre prospective cohort study. All elective colorectal procedures from 2011 until 2018 (inclusive) were included. The primary outcome was inpatient SSI. A multimodal bundle was implemented using quality improvement methodology. The bundle was altered during the timeframe of the study to optimize outcomes. Data were analysed by interrupted time series analysis assessing points at which the bundle was altered.ResultsIn the study period, 1075 elective colorectal procedures were performed. Prior to the introduction of the colorectal SSI bundle, the SSI rate was 16.4%. During the implementation period (2013–2015), the overall rate of SSI fell from 15.9% to 9.4%, with the most significant reduction being in superficial SSI, from 8.6% to 4.7%. In the postimplementation period from 2015–2018, there was a further reduction in the overall rate of SSI (5.1%). In 2018, there were 87 consecutive cases without infection.ConclusionA successful reduction in the rate of SSI following elective colorectal surgery can be achieved by adopting a comprehensive perioperative bundle. This is complemented by a process of continuous measurement and evaluation. The current bundle has achieved a significant reduction in superficial SSI.
Changes in waitlist and posttransplant outcomes in patients with adult congenital heart disease after the new heart transplant allocation system
Authors: Kainuma Atsushi , Ning Yuming , Kurlansky Paul A. , Wang Amy S. , Axom Kelly , Farr Maryjane , Sayer Gabriel , Uriel Nir , Naka Yoshifumi , Takeda Koji 
Published: August 2021

AbstractObjectiveIn 2018, the United Network for Organ Sharing (UNOS) introduced new criteria for heart allocation. This study sought to assess the impact of this change on waitlist and posttransplant outcomes in adult congenital heart disease (ACHD) recipients.MethodsBetween January 2010 and March 2020, we extracted first heart transplant ACHD patients listed from the UNOS database. We compared waitlist and post‐transplant outcomes before and after the policy change.ResultsA total of 1206 patients were listed, 951 under the old policy and 255 under the new policy. Prior to transplant, recipients under the new policy era were more likely to be treated with extracorporeal membrane oxygenation (P = .018), and have intra‐aortic balloon pumps (P < .001), and less likely to have left ventricular assist devices (P = .027).Compared to patients waitlisted in the pre‐policy change era, those waitlisted in the post policy change era were more likely to receive transplants (P = .001) with no significant difference in waiting list mortality (P = .267) or delisting (P = .915). There was no difference in 1‐year survival post‐transplant between the groups (P = .791).ConclusionThe new policy altered the heart transplant cohort in the ACHD group, allowing them to receive transplants earlier with no changes in early outcomes after heart transplantation
High prevalence and little awareness in patients with chronic inflammatory skin diseases and genital involvement
Authors: Staubach Petra , Plavic‐Radeka Natascha , Peveling‐Oberhag Adriane , Sohn Anna , Zimmer Sebastian , Weyer‐Elberich Veronika , Lang Berenice Mareen 
Published: August 2021

SummaryBackgroundGenital involvement in patients with chronic inflammatory skin diseases is frequent, yet insufficiently acknowledged.ObjectiveTo evaluate the prevalence of genital symptoms in psoriasis and chronic urticaria patients, effects on quality of life, physician‐patient relations and disease management.Patients and Methods100 patients with psoriasis and 100 with chronic urticaria from our outpatient clinic, as well as 50 healthy controls were included. Data was collected using questionnaires developed by dermatological experts.ResultsOut of 250 subjects, 74 % had already experienced genital symptoms – 70 % of psoriasis patients and 58 % of urticaria patients. Seven out of ten even complained about recurrent genital involvement. 50 % of psoriasis and 41 % of urticaria patients reported an impact on quality of life. 41 % identified genital pruritus as the main symptom, with one out of three expecting a better management for this specific problem. Furthermore, 74 % complained about a lack of awareness among physicians: 79 % of urticaria patients and 58 % of psoriasis patients reported never having been questioned about genital symptoms by their physicians.ConclusionsThe majority of patients with psoriasis and chronic urticaria suffer from genital involvement and an impaired quality of life. Patient and physician reported outcomes should include genital symptoms as an influencing factor for quality of life.
The Irish economy during the century after partition
Authors: Ó Gráda Cormac , O'Rourke Kevin Hjortshøj 
Published: August 2021

AbstractThis article provides a centennial overview of the Irish economy in the one hundred years following partition and independence. A comparative perspective allows us to distinguish between those aspects of Irish policies and performance that were unique to the country, and those which mirrored developments elsewhere. While Irish performance was typical in the long run, the country under‐performed prior to the mid‐1980s and over‐performed for the rest of the twentieth century. Real growth after 2000 was slow. The mainly chronological narrative highlights the roles of convergence forces, trade and industrial policy, and monetary and fiscal policy. While the focus is mostly on the South of the island, we also survey the Northern Irish experience during this period.
Long noncoding RNA NEAT1 promotes tumorigenesis in H. pylori gastric cancer by sponging miR‐30a to regulate COX‐2/BCL9 pathway
Authors: Rao Xiwu , Liu Xuan , Liu Ningning , Zhang Yi , Zhang Zhaozhou , Zhou Lihong , Han Gang , Cen Rong , Shi Nuolin , Zhu Huirong , Gong Hangjun , Huang Chen , Ji Qing , Li Qi 
Published: August 2021

AbstractBackgroundHelicobacter pylori (H. pylori) is a carcinogenic factor for gastric cancer. Our previous study demonstrated that H. pylori decreased the expression of micro‐RNA (miRNA)‐30a to promote the tumorigenesis of gastric cancer. However, the upstream regulatory molecules of miR‐30a are not well elucidated. In this study, we found the long non‑coding RNA (lncRNA) nuclear paraspeckle assembly transcript 1 (NEAT1) may sponge miR‐30a to regulate COX‐2/BCL9 pathway.MethodsThe expression of NEAT1 was detected in gastric cancer tissues and tumor‐adjacent tissues by fluorescence in situ hybridization (FISH) analysis and RT‐qPCR. LncRNA‐miRNA interaction networks were constructed using the RNAhybrid and starBase v.2.0. and then validated using a dual‐luciferase reporter assay. The effects of NEAT1 dysregulation on the proliferative, migratory, and invasive abilities of H. pylori filtrate‐infected gastric cancer cells were observed by cell counting kit‐8 (CCK‐8), colony formation, wound healing test, and transwell assays. Western blot and RT‐qPCR were performed to detect protein and RNA expression. Immunohistochemistry (IHC) was carried out to analyze the localization and expression of COX‐2 and BCL9.ResultsFISH and RT‐qPCR demonstrated that the expression of NEAT1 was up‐regulated in gastric cancer tissues, especially in H. pylori‐infected gastric cancer tissues, and the expression of NEAT1 was negatively correlated with miR‐30a (miR‐30a‐3p and miR‐30a‐5p). The upregulation of NEAT1 enhanced proliferation, migration, and invasion of H. pylori filtrate‐infected gastric cancer cells, while the downregulation of NEAT1 decreased these abilities, and miR‐30a could reverse the effect of NEAT1 on these abilities. The dual‐luciferase reporter assay identified that NEAT1 directly targeted miR‐30a (miR‐30a‐3p and miR‐30a‐5p). Because miR‐30a (miR‐30a‐3p and miR‐30a‐5p) negatively regulates the expression of downstream COX‐2 and BCL9, NEAT1 was identified to upregulate indirectly the expression of COX‐2 and BCL9. IHC showed that the expression of COX‐2 and BCL9 was increased in H. pylori gastric cancer tissues.ConclusionThe study demonstrated that lncRNA NEAT1 may act as a promoter of tumorigenesis in H. pylori gastric cancer, by sponging miR‐30a (miR‐30a‐3p and miR‐30a‐5p) to regulate the COX‐2/BCL9 pathway.
Patient engagement in care: A scoping review of recently validated tools assessing patients' and healthcare professionals' preferences and experience
Authors: Clavel Nathalie , Paquette Jesseca , Dumez Vincent , Del Grande Claudio , Ghadiri Djahanchah Philip (Sacha) , Pomey Marie‐Pascale , Normandin Louise 
Published: August 2021

AbstractBackgroundPatient engagement in care is a priority and a key component of clinical practice. Different approaches to care have been introduced to foster patient engagement. There is a lack of a recent review on tools for assessing the main concepts and dimensions related to patient engagement in care.ObjectiveOur scoping review sought to map and summarize recently validated tools for assessing various concepts and dimensions of patient engagement in care.Search StrategyA scoping review of recent peer‐reviewed articles describing tools that assess preferences in and experience with patient engagement in care was conducted in four databases (Ovid Medline, Ovid EMBASE, Cochrane Database of Systematic Reviews, CINAHL‐EBSCO). We adopted a broad definition based on the main concepts of patient engagement in care: patient‐centredness, empowerment, shared decision‐making and partnership in care.Main ResultsOf 2161 articles found, 16, each describing a different tool, were included and analysed. Shared decision‐making and patient‐centredness are the two main concepts evaluated, often simultaneously in most of the tools. Only four scales measure patient‐centredness, empowerment and shared decision‐making at the same time, but no tool measures the core dimensions of partnership in care. Most of the tools did not include patients in their development or validation or just consulted them during the validation phase.Discussion and ConclusionThere is no tool coconstructed with patients from development to validation, which can be used to assess the main concepts and dimensions of patient engagement in care at the same time.Patient and Public ContributionThis manuscript was prepared with a patient expert who is one of the authors. Vincent Dumez, who is a patient expert and codirector of the Center of Excellence on Partnership with Patients and the Public, has contributed to the preparation of the manuscript.
Memory B cells and plasma cells: The differentiative continuum of humoral immunity
Authors: Cancro Michael P. , Tomayko Mary M. 
Published: August 2021

SummaryImmunological memory is a composite of lasting antibody titers maintained by plasma cells in conjunction with memory T and B cells. Memory B cells are a critical reservoir for plasma cell generation in the secondary response. Identification of memory B cells requires that they be distinguished from naïve, activated, and germinal center precursors and from plasma cells. Memory B cells are heterogeneous in isotype usage, immunoglobulin mutational content, and phenotypic marker expression. Phenotypic subsets of memory B cells are defined by PD‐L2, CD80, and CD73 expression in mice, by CD27 and FCRL4 expression in humans and by T‐bet in both mice and humans. These subsets display marked functional heterogeneity, including the ability to rapidly differentiate into plasma cells versus seed germinal centers in the secondary response. Memory B cells are located in the spleen, blood, other lymphoid organs, and barrier tissues, and recent evidence indicates that some memory B cells may be dedicated tissue‐resident populations. Open questions about memory B cell longevity, renewal and progenitor‐successor relationships with plasma cells are discussed.
A systematic review of the qualitative literature on older individuals’ experiences of care and well‐being during physical rehabilitation for acquired brain injury
Authors: Lafiatoglou Panagiota , Ellis‐Hill Caroline , Gouva Mary , Ploumis Avraam , Mantzoukas Stefanos 
Published: August 2021

AbstractAimsTo acquire an in‐depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well‐being and care when undergoing physical rehabilitation.DesignSystematic literature review.Data sourcesThe electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted.Review methodsA systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool.ResultsSeventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well‐being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well‐being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation.ConclusionOrganizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision‐making and goal‐setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well‐being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI.ImpactThere is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients’ concerns over their involvement in decision‐making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’ sense of well‐being.
Human landscape modification and expansion of tropical woodland in southern Arabia during the mid‐Holocene from rock hyrax middens
Authors: Ivory Sarah J. , Cole Kenneth L. , Anderson R. Scott , Anderson Andrew , McCorriston Joy 
Published: August 2021

AbstractAimDryland ecosystems, such as those in southern Arabia, are particularly vulnerable to climate and land‐use change. Aridification and human subsistence changes at the end of the Holocene Humid Period at 6–4 ka have been used as an iconic example for evaluating such impacts to resilience of arid systems. Although records of ancient environments can provide critical insight into the biotic and abiotic mechanisms that alter ecosystems, traditional archives, such as lake deposits, are not common in southern Arabia after 6 ka; thus, we must use alternative archives.LocationYemen.TaxonPlants; Rock Hyrax (Procavia capensis).MethodsWe use fossil pollen and stable isotopes (δ15N; δ13C) of rock hyrax (P. capensis) middens from Wadi Sana, Yemen, to look at changes in ecosystem structure and function across this key transition from 6 ka to the present. A total of 17 middens were radiocarbon‐dated and stable isotopes were measured. Of these, pollen was extracted from hyraceum of 14 middens and identified using a light microscope. Fossil pollen assemblages were then compared to existing modern pollen samples from throughout Arabia.ResultsDuring the mid‐Holocene from at least 6 to 4.7 ka, the pollen flora reflects a landscape with abundant tropical trees. These included foundational woody taxa, such as Terminalia and Boswellia sacra (frankincense), which had a strong positive influence on local hydrology and the economy, respectively. Increased charcoal abundances also suggest that wildfire occurred periodically.Main conclusionsConnections with archaeological evidence suggest a strong link between human management and the presence of Terminalia woodland during the mid‐Holocene. These may have promoted increased groundwater storage and ponding as regional rainfall was decreasing. The mid‐Holocene expansion of Boswellia sacra (frankincense) may have helped support resin trade that became a critical export from the region. Fires were more common than today, suggesting semi‐arid but continuous vegetation cover across what is now bare ground. Finally, after 1 ka, increased sedge abundances at the expense of grasses and trees suggest the development of desert conditions.
Exploring age and gender differences of computational thinkers in primary school: A developmental perspective
Authors: Jiang Shan , Wong Gary K. W. 
Published: August 2021

AbstractOver the past decade, the call to foster computational thinking (CT) in every child has received considerable attention. However, there is little understanding of whether children are developmentally ready to think computationally and what specific CT concepts and skills can be developed at various ages. This study explored the developmental and gender differences in CT skills of 197 Grade 4–6 students (aged 9–13) before being exposed to instruction and investigated the age–gender interaction effects on their CT acquisition in an intervention combining both programming and non‐programming (unplugged) activities. Results show that students' CT skills followed a developmental progression before instruction. Gender difference across ages was insignificant in conditionals, logical operators, pattern recognition and generalization skills. Additionally, students of different ages developed CT differently during the intervention, and their CT acquisition was unaffected by gender. Implications for practice and research in CT education were discussed.
A new brain‐penetrant glucosylceramide synthase inhibitor as potential Therapeutics for Gaucher disease
Authors: Fujii Takahiro , Tanaka Yuta , Oki Hideyuki , Sato Sho , Shibata Sachio , Maru Takamitsu , Tanaka Yuta , Tanaka Maiko , Onishi Tomohiro 
Published: August 2021

AbstractGaucher disease (GD), the most common lysosomal storage disorders, is caused by GBA gene mutations resulting in glycosphingolipids accumulations in various tissues, such as the brain. While suppressing glycosphingolipid accumulation is the central strategy for treating peripheral symptoms of GD, there is no effective treatment for the central nervous system symptoms. As glycosphingolipid biosynthesis starts from ceramide glycosylation by glucosylceramide synthase (GCS), inhibiting GCS in the brain is a promising strategy for neurological GD. Herein, we discovered T‐036, a potent and brain‐penetrant GCS inhibitor with a unique chemical structure and binding property. T‐036 does not harbor an aliphatic amine moiety and has a noncompetitive inhibition mode to the substrates, unlike other known inhibitors. T‐036 exhibited sufficient exposure and a significant reduction of glucosylsphingolipids in the plasma and brain of the GD mouse model. Therefore, T‐036 could be a promising lead molecule for treating central nervous system symptoms of GD.
image
The effect of nurse‐led care on fatigue in patients with rheumatoid arthritis: A systematic review and meta‐analysis of randomised controlled studies
Authors: Sezgin Merve Gozde , Bektas Hicran 
Published: August 2021

AbstractAims and objectivesThis study aimed to investigate the effect of nurse‐led care on fatigue in patients with rheumatoid arthritis.BackgroundEvaluating the effect of nurse‐led care on fatigue in patients with rheumatoid arthritis will be useful in planning appropriate nursing interventions to increase the functional status and quality of life of patients.DesignSystematic review and meta‐analysis.MethodsA comprehensive literature review was conducted on the Cochrane Library, Web of Science, PubMed, EBSCOhost/CINAHL Complete, Springer Link, ProQuest, Science Direct and Ovid databases. The selected articles were examined by two independent ratters with the PICOS criteria, and the methodological quality of the studies included in the study was evaluated with the Quality Assessment Tool for Quantitative Studies. The Comprehensive Meta‐Analysis 3 software was used in the analysis of the data. The study was conducted using the checklist for PRISMA.ResultsThis meta‐analysis study included six of 1,445 randomised controlled trials. These six studies consisted of a total of 994 patients and provided education and psychosocial support through 30‐minute to 2‐hour consultations, visits and briefings. No significant publication bias was found in the main outcomes. According to the results of the meta‐analysis, the fatigue in patients with rheumatoid arthritis decreased significantly in nurse‐led care groups compared with control groups (Hedge's g = −0.18; 95% CI = −0.3 to −0.06).ConclusionsThe findings in this systematic review and meta‐analysis indicated that nurse‐led care played an important role in reducing fatigue in patients with rheumatoid arthritis.Relevance to clinical practiceNurse‐led care is an effective and appropriate method in reducing fatigue in patients with rheumatoid arthritis. The awareness of all health professionals about the importance of nurse‐led care will increase. We recommend the implementation of nurse‐led education and psychosocial support interventions to reduce the fatigue of patients with rheumatoid arthritis.