bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rotations with Crotalaria spp. do not suppress populations of Meloidogyne incognita in cotton
Authors: Khanal Churamani , Galbieri Rafael , Timper Patricia 
Published: March 2021

Summary
Field studies were conducted in Mato Grosso, Brazil and Georgia, USA to evaluate the efficacy of Crotalaria spp. as a rotational cover crop for managing Meloidogyne incognita in cotton (Gossypium hirsutum). The two studies differed in how Crotalaria spp. were incorporated into the cotton production system to reflect differences in climate (tropical vs subtropical) and production systems typical for the two regions. In Mato Grosso, Crotalaria juncea and C. spectabilis were planted after soybean in late summer, grown for approximately 300 days, and incorporated into the soil 6-15 days prior to cotton planting. In Georgia, C. juncea and a nematode-resistant cowpea, Vigna ungiculata, were planted after maize in the late summer, grown until killed by frost in the early winter, and cotton was planted in the next season. Soil population densities of M. incognita and root galling in cotton were similar in cotton following either fallow, resistant cowpea, or Crotalaria spp. However, Crotalaria spp. significantly increased cotton plant height at the time of harvest relative to the other treatments. Except for one of the experiments in Brazil, incorporation of Crotalaria spp. in the rotational scheme did not increase cotton yield. Results indicate that a cover crop of Crotalaria spp. does not suppress M. incognita in cotton production system more than a fallow period or planting a resistant cover crop.
Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis
Authors: Tieges Zoë , Quinn Terence , MacKenzie Lorn , Davis Daniel , Muniz-Terrera Graciela , MacLullich Alasdair M. J. , Shenkin Susan D. 
Published: March 2021

AbstractBackgroundDelirium is a heterogeneous syndrome with inattention as the core feature. There is considerable variation in the presence and degree of other symptom domains such as altered arousal, psychotic features and global cognitive dysfunction. Delirium is independently associated with increased mortality, but it is unclear whether individual symptom domains of delirium have prognostic importance. We conducted a systematic review and meta-analysis of studies in hospitalised adults in general settings to identify the relationship between symptom domains of delirium and outcomes.(PROSPERO: CRD42018093935).MethodsWe searched MEDLINE, EMBASE, PsycINFO, CINAHL,clinicaltrials.govand the Cochrane Central Register of Controlled Trials from inception to November 2019. We included studies of hospitalised adults that reported associations between symptom domains of delirium and 30-day mortality (primary outcome), and other outcomes including mortality at other time points, length of stay, and dementia. Reviewer pairs independently screened articles, extracted data, and assessed risk of bias (Risk of Bias Assessment tool for Non-randomized Studies) and quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework. We performed random-effects meta-analyses stratified by delirium domain where possible.ResultsFrom 7092 citations we included 6 studies (6002 patients, 1112 with delirium). Higher mortality (ranging from in-hospital to follow-up beyond 12 months) was associated with altered arousal (pooled Odds Ratio (OR) 2.80, 95% Confidence Interval (CI) 2.33–3.37; moderate-quality evidence), inattention (pooled OR 2.57, 95% CI 1.74–3.80; low-quality evidence), and in single studies with disorientation, memory deficits and disorganised thoughts. Risk of bias varied across studies but was moderate-to-high overall, mainly due to selection bias, lack of blinding of assessments and unclear risk of selective outcome reporting. We found no studies on the association between psychotic features, visuospatial deficits or affective disturbances in delirium and outcomes, or studies reporting non-mortality outcomes.ConclusionsFew studies have related symptom domains of delirium to outcomes, but the available evidence suggests that altered arousal and inattention in delirium are associated with higher mortality than normal arousal and attention in people with or without delirium. Measurable symptom domains of delirium may have value in predicting survival and stratifying patients for treatment. We recommend that future delirium studies report outcomes by symptom domain.
Comparison of novel and established caries diagnostic methods: a clinical study on occlusal surfaces
Authors: Litzenburger Friederike , Schäfer Gerrit , Hickel Reinhard , Kühnisch Jan , Heck Katrin 
Published: March 2021

AbstractBackgroundThe purpose of this prospective clinical diagnostic study with validation was to compare the diagnostic accuracy of near-infrared transillumination (NIRT), laser fluorescence measurement (LF), alternating current impedance spectroscopy (ACIS) and their combinations as adjunct methods to visual examination (VE) for occlusal caries detection using a hybrid reference standard.MethodsNinety-six first and second non-cavitated permanent molars from 76 individuals (mean age 24.2) were investigated using (VE) (ICDAS) and bitewing radiography (BWR), as well as NIRT, LF and ACIS. The findings of BWR and NIRT were evaluated by two examiners while the other examinations were conducted by one calibrated dentist. The hybrid reference standard consisted of non-operative validation based on the results of VE and BWR and operative validation. Statistical analysis included cross-tabulations, calculation of sensitivity, specificity and area under the receiver operating characteristic curve at three diagnostic thresholds: caries in general, enamel caries and dentin caries.ResultsNIRT, LF and ACIS exhibited high sensitivity for caries in general [1.00 (1.00–1.00), 0.77 (0.65–0.88), 0.75 (0.63–0.87)) and for dentin caries (0.97 (0.91–1.03), 0.76 (0.76–0.90), 0.64 (0.47–0.80)]. Sensitivity values for enamel caries were weak (0.21, 0.11, 0.37). Specificity values did not fall below 0.65 (NIRT) for all categories and methods, except for NIRT at the caries detection threshold (0.27). A combination of LF and ACIS with VE improved the diagnostic performance at the overall and the enamel caries threshold. The other methods showed fair to excellent discrimination at the overall caries threshold (NIRT 0.64, LF 0.89 and ACIS 0.86) and acceptable discrimination at the dentin caries threshold (NIRT 0.82, LF 0.81 and ACIS 0.79). AUROC for enamel caries exhibited the weakest discrimination. Accuracy was 65.6% for VE, 69.8% for BWR, 50.0% for NIRT, 53.1% for LF and 74.0% for ACIS. Reliability assessment for BWR and NIRT showed at least substantial agreements for all analyses.ConclusionsThe methods, NIRT, LF and ACIS, revealed different potential but no impeccable performance for occlusal caries detection. All are suitable instruments to detect hidden carious lesion in dentin. As auxiliaries to VE, LF and ACIS showed an increase in diagnostic performance.
Job preferences of medical and nursing students seeking employment in rural China: a discrete choice experiment
Authors: Bao Meiling , Huang Cunrui 
Published: March 2021

Abstract
Background
China has a shortage of health workers in rural areas, but little research exists on policies that attract qualified medical and nursing students to rural locations. We conducted a discrete choice experiment to determine how specific incentives would be valued by final–year students in a medical university in Guizhou Province, China.

Methods
Attributes of potential jobs were developed through the literature review, semi–structured interviews, and a pilot survey. Forty choice sets were developed using a fractional factorial design. A mixed logit model was used to estimate the relative strength of the attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates.

Results
The final sample comprised 787 medical and nursing students. The statistically significant results indicated “Bianzhi” (the number of personnel allocated to each employer by the government) and physical conflicts between doctors and patients were two of the most important non-monetary job characteristics that incentivized both medical and nursing students. Policy simulation suggested that respondents were most sensitive to a salary increase, and the effect of incentive packages was stronger for students with a rural family background.

Conclusions
Strategies for patient–doctor relationships, Bianzhi and salary should be considered to attract final–year medical and nursing students to work in rural China. In addition, specific recruitment policy designs tailored for students with different majors and backgrounds should be taken into account.
Student nurses in the primary care network: a pilot
Authors: Heath Shaun , Wilcox Rebecca , Leonelli Silvia 
Published: March 2021

Shaun Heath, Rebecca Wilcox and Silvia Leonelli discuss how South East London developed a hub and spoke placement pilot to place students in primary care networks, rather than with individual practices With support from Capital Nurse, primary care in South East London developed a hub and spoke placement pilot to support student nurses in a primary care network (PCN). Two groups of students were placed in two PCN's, one in an inner London borough (PCN 1) and another in an outer London borough (PCN 2). Our pilot had substantial benefits for the students, the assessors/supervisors, the PCN and, ultimately, the future development of the primary care workforce. We advocate developing strong nurse leadership within the PCN to support and grow the educational unit, and we recommend that recurrent funding be made available to support this and the preceptorship programmes within the Sustainability and Transformation Partnerships (STP)/Integrated Care System (ICS).
Advance care planning in older hospitalised patients following an emergency admission: A mixed methods study
Authors: Bielinska Anna-Maria , Archer Stephanie , Obanobi Adetokunbo , Soosipillai Gehan , Darzi Lord Ara , Riley Julia , Urch Catherine 
Published: March 2021

Introduction
Although advance care planning may be beneficial for older adults in the last year of life, its relevance following an emergency hospitalisation requires further investigation. This study quantifies the one-year mortality outcomes of all emergency admissions for patients aged 70+ years and explores patient views on the value of advance care planning following acute hospitalisation.

Method
This mixed methods study used a two-stage approach: firstly, a quantitative longitudinal cohort study exploring the one-year mortality of patients aged 70+ admitted as an emergency to a large multi-centre hospital cohort; secondly, a qualitative semi-structured interview study gathering information on patient views of advance care planning.

Results
There were 14,260 emergency admissions for 70+-year olds over a 12-month period. One-year mortality for admissions across all conditions was 22.6%. The majority of these deaths (59.3%) were within 3 months of admission. Binary logistic regression analysis indicated higher one-year mortality with increasing age and male sex. Interviews with 20 patients resulted in one superordinate theme, “Planning for health and wellbeing in the spectrum of illness”. Sub-themes entitled (1) Advance care planning benefitting healthcare for physical and psycho-social health, (2) Contemplation of physical deterioration death and dying and 3) Collaborating with healthcare professionals to undertake advance care planning, suggest that views of advance care planning are shaped by experiences of acute hospitalisation.

Conclusion
Since approximately 1 in 5 patients aged 70+ admitted to hospital as an emergency are in the last year of life, acute hospitalisation can act as a trigger for tailored ACP. Older hospitalised patients believe that advance care planning can benefit physical and psychosocial health and that discussions should consider a spectrum of possibilities, from future health to the potential of chronic illness, disability and death. In this context, patients may look for expertise from healthcare professionals for planning their future care.
Genetic ablation of fibroblast activation protein alpha attenuates left ventricular dilation after myocardial infarction
Authors: Hoffmann Daniel B. , Fraccarollo Daniela , Galuppo Paolo , Frantz Stefan , Bauersachs Johann , Tillmanns Jochen 
Published: March 2021

Introduction
Regulating excessive activation of fibroblasts may be a promising target to optimize extracellular matrix deposition and myocardial stiffness. Fibroblast activation protein alpha (FAP) is upregulated in activated fibroblasts after myocardial infarction (MI), and alters fibroblast migration in vitro. We hypothesized that FAP depletion may have a protective effect on left ventricular (LV) remodeling after MI.

Materials and methods
We used the model of chronic MI in homozygous FAP deficient mice (FAP-KO, n = 51) and wild type mice (WT, n = 55) to analyze wound healing by monocyte and myofibroblast infiltration. Heart function and remodeling was studied by echocardiography, morphometric analyses including capillary density and myocyte size, collagen content and in vivo cell-proliferation. In non-operated healthy mice up to 6 months of age, morphometric analyses and collagen content was assessed (WT n = 10, FAP-KO n = 19).

Results
Healthy FAP-deficient mice did not show changes in LV structure or differences in collagen content or cardiac morphology. Infarct size, survival and cardiac function were not different between FAP-KO and wildtype mice. FAP-KO animals showed less LV-dilation and a thicker scar, accompanied by a trend towards lower collagen content. Wound healing, assessed by infiltration with inflammatory cells and myofibroblasts were not different between groups.

Conclusion
We show that genetic ablation of FAP does not impair cardiac wound healing, and attenuates LV dilation after MI in mice. FAP seems dispensable for normal cardiac function and homeostasis.
Aqueous humor monocyte chemoattractant protein-1 predicted long-term visual outcome of proliferative diabetic retinopathy undergone intravitreal injection of bevacizumab and vitrectomy
Authors: Lei Jianqin , Ding Guolong , Xie Anming , Hu Yaguang , Gao Ning , Fan Xiaojuan 
Published: March 2021

Purpose
We aim to investigate the risk factors associated with the prognosis of proliferative diabetic retinopathy (PDR) after a sequential treatment of intravitreal injection of bevacizumab (IVB) and pars plana vitrectomy (PPV).

Methods
In this cohort study, 63 eyes from 55 patients (21 females) diagnosed with PDR, who needed PPV for non-clearing vitreous hemorrhage or fibrovascular membrane proliferation were enrolled. All the eyes underwent IVB followed by PPV. Anterior chamber tap was performed at the beginning of both procedures to evaluate the concentration of vascular endothelial growth factor (VEGF), interleukin (IL)-6, IL-8, and monocyte chemoattractant protein (MCP)-1.

Results
Forty-seven patients (54 eyes) were followed over six months, averaging 12±5 (6–19) months. The concentration of VEGF significantly decreased after IVB (P<0.001), while other cytokines did not change significantly. The aqueous humor level of IL-8 after IVB (R = 0.378, P = 0.033), MCP-1 before (R = 0.368, P = 0.021) and after (R = 0.368, P = 0.038) IVB, and combined phacoemulsification (R = 0.293, P = 0.032) was correlated with the logMAR visual acuity at the last follow-up. Multivariate analysis showed that MCP-1 was the predictor for a worse visual outcome (B = 0.108, 95% CI 0.013–0.202; P = 0.027).

Conclusions
MCP-1 was a predictor for the unfavorable visual outcome of PDR after IVB pretreatment and PPV.
Experiences of oral pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence
Authors: Giovenco Danielle , Gill Katherine , Fynn Lauren , Duyver Menna , O’Rourke Shannon , van der Straten Ariane , Morton Jennifer F. , Celum Connie L. , Bekker Linda-Gail 
Published: March 2021

IntroductionThere is limited understanding of how social dynamics impact pre-exposure prophylaxis (PrEP) adherence among adolescent girls and young women (AGYW) in generalized HIV-epidemic settings. We examined experiences of oral PrEP use disclosure to various social groups with the goal of identifying supportive relationships that can be leveraged to promote adherence.MethodsWe used qualitative methods to explore experiences disclosing PrEP use and the perceived impact of disclosure on adherence among 22 South African AGYW (16–25 years) taking daily oral PrEP. Serial in-depth-interviews (IDIs) were conducted 1-, 3-, and 12-months post-PrEP initiation. Respondents also self-reported their disclosures separately for various social groups and adherence was assessed using intracellular tenofovir-diphosphate levels.ResultsQualitative respondents had a median age of 20.5 years and reported disclosing their PrEP use to friends (n = 36 total disclosures), partners, siblings, other family members (n = 24 disclosures each), and parents (n = 19 disclosures). IDI data revealed that parents and partners provided the most support to respondents and a lack of support from these groups was most often perceived as negatively affecting PrEP use. AGYW described difficulties explaining PrEP to their mothers, who believed PrEP was HIV treatment or would lead to HIV infection. Disclosure to household members was notably meaningful for AGYW (both positively and negatively). Respondents reported leveraging supportive relationships for pill reminders. For respondents who perceived a household member would be unsupportive, however, non-disclosure was less feasible and PrEP use was often stigmatized. To avoid stigma, several respondents hid or discontinued PrEP.ConclusionsWhile supportive relationships may facilitate PrEP use, disclosure can also lead to stigma. Counselors should support AGYW in disclosing to key people in their social networks and provide AGYW with materials that lend credibility to explanations of PrEP. Community education is necessary to alleviate PrEP-related stigma and facilitate disclosure.
Plasma NT-proBNP and pulmonary to systemic blood flow ratio in congenital heart defects with left-to-right shunts
Authors: Kunta Adjie Eko Kristanto , Kartika Yantie Ni Putu Veny , Utama Made Gede Dwi Lingga , Gunawijaya Eka , Ariawati Ketut , Subanada Ida Bagus , Widnyana Anak Agung Ngurah Ketut Putra 
Published: March 2021

Background Cardiac left-to-right shunts changes to the pulmonary-to-systemic blood flow ratio (Qp/Qs ratio). This ratio can be used to monitor the hemodynamics of the heart. Left-to right-shunts cause the release of amino terminal proB-ty natriuretic peptide (NT-proBNP) that can be utilized as a specific marker for the presence of heart failure in children with congenital heart defects (CHDs). Early intervention such as defect closure in CHD is important to prevent heart failure.
Objective To assess for a correlation between the level of NT pro-BNP and Qp/Qs ratio in CHD patients with left-to-right shunts.
Methods This cross-sectional, analytical study was conducted in 32 children who underwent cardiac catheterization at Sanglah General Hospital, Denpasar, Bali, and were recruited by consecutive sampling. NT-proBNP levels were measured by ELISA with a two-step sandwich assay system; Qp/Qs ratio using Fick rules. Statistical analyses included Shapiro-Wilk test, descriptive analysis for subject characteristics, and Pearson’s correlation analysis. A P value of <0.05 was considered to be statistically significant. Age and defect size were analyzed as confounding factors by partial correlation test.
Results The correlation value between NT-proBNP and Qp/Qs ratio was r=0.384 (P<0.05), after controlling for age and defect size as cofounding factors.
Conclusion There is a weak positive correlation between NT-proBNP levels and pulmonary-to-systemic blood flow ratio in patients with left-to-right shunt, after controlling for age and defect size as confounding factors.
Metastatic pancreatic ductal adenocarcinoma in a teenage girl: A rare disease
Authors: Sutaryo Sutaryo , Kristian Scolastika Dita 
Published: March 2021

Pancreatic ductal adenocarcinoma (PDAC) is highly uncommon in patients < 20 years of age, at less than 0.1% of population.1 Pancreatic tumors in children and adolescents can develop from endocrine or exocrine cells. The tumor types include solid pseudopapillary tumor, ductal adenocarcinoma, pancreatoblastoma, acinar cell carcinoma, and pancreatic endocrine neoplasm (malignant and benign).2 Other types of tumors may be attached to it or secondarily engage the gland or emerge from other kinds of non-pancreatic cells inside the pancreas. The prevalent type of classic PDAC in adults is highly uncommon in children. We report here on a fifteen-year old girl with metastatic pancreatic ductal adenocarcinoma (mPDAC), who presented with abdominal discomfort and jaundice.
First record of a wild population of Laelia dawsonii f. dawsonii (Orchidaceae) for the state of Jalisco, Mexico
Authors: Cházaro-Basáñez Miguel J. , Jiménez-Vázquez Alexander , Pérez-García Eduardo A. 
Published: March 2021

The existence of a wild population of Laelia dawsonii f. dawsonii is recorded for the first time in the Mexican State of Jalisco. Laelia dawsonii has a wide geographical distribution throughout the Sierra Madre del Sur (Oaxaca, Guerrero, and Jalisco); however, the populations are very isolated, and each one has very few individuals. Until now, no wild populations of this species had been registered outside of the State of Oaxaca. The population found in Jalisco is composed of about 100 plants. Due to its horticultural importance, L. dawsonii has been frequently extracted from the field, and its Oaxacan populations have been decimated since the end of the 19th century. Currently, this species is considered endangered in Mexico.
Keywords: biogeography, conservation, Laeliinae, Laelia anceps
Diarreia no paciente crítico: conhecimento e conduta de profissionais de unidades de terapia intensiva
Authors: Siqueira Beatriz Silva de Sousa , Melo Fernanda Godoi 
Published: March 2021

OBJETIVO: avaliar o conhecimento e conduta de profissionais de saúde em relação à diarreia em pacientes recebendo nutrição enteral. MÉTODOS: estudo transversal realizado com profissionais de saúde de duas Unidades de Terapia Intensiva de adultos. Os dados foram coletados por meio de um questionário autoaplicável. RESULTADOS: participaram do estudo 37 profissionais, sendo 17 (45,9%) auxiliares ou técnicos em enfermagem, 8 (21,6%) enfermeiros, 8 (21,6%) médicos, 3 (8,1%) nutricionistas e 1 (2,8%) profissão omissa. A definição mais comum encontrada para diarreia foi “três ou mais episódios de evacuações líquidas ou semilíquidas/dia.” As principais causas citadas para diarreia foram a “infecção” e a “dieta”. A atitude/conduta mais observada foi “comunicação à equipe”. A maioria (16; 43,2%) presencia, com muita frequência, dietas interrompidas por causa de diarreia e a “adequação da dieta” e a “capacitação da equipe multiprofissional” foram as soluções mais citadas para se prevenir essa interrupção. A maioria (20; 54%) dos profissionais não participou de nenhum treinamento sobre diarreias, e 33 profissionais (cerca de 90%) considera importante a implementação de um protocolo. CONCLUSÃO: há divergências entre os profissionais de saúde, tanto em seus conhecimentos quanto nas condutas frente ao paciente com diarreia na UTI, o que pode influenciar diretamente no cuidado com o mesmo. A capacitação da equipe multiprofissional e a criação de um protocolo são essenciais.