bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myoarchitectural disarray of hypertrophic cardiomyopathy begins pre‐birth
Authors: Garcia‐Canadilla Patricia , Cook Andrew C. , Mohun Timothy J. , Oji Onyedikachi , Schlossarek Saskia , Carrier Lucie , McKenna William J. , Moon James C. , Captur Gabriella 
Published: July 2019

AbstractMyoarchitectural disarray – the multiscalar disorganisation of myocytes, is a recognised histopathological hallmark of adult human hypertrophic cardiomyopathy (HCM). It occurs before the establishment of left ventricular hypertrophy (LVH) but its early origins and evolution around the time of birth are unknown. Our aim is to investigate whether myoarchitectural abnormalities in HCM are present in the fetal heart. We used wild‐type, heterozygous and homozygous hearts (n = 56) from a Mybpc3‐targeted knock‐out HCM mouse model and imaged the 3D micro‐structure by high‐resolution episcopic microscopy. We developed a novel structure tensor approach to extract, display and quantify myocyte orientation and its local angular uniformity by helical angle, angle of intrusion and myoarchitectural disarray index, respectively, immediately before and after birth. In wild‐type, we demonstrate uniformity of orientation of cardiomyocytes with smooth transitions of helical angle transmurally both before and after birth but with traces of disarray at the septal insertion points of the right ventricle. In comparison, heterozygous mice free of LVH, and homozygous mice showed not only loss of the normal linear helical angulation transmural profiles observed in wild‐type but also fewer circumferentially arranged myocytes at birth. Heterozygous and homozygous showed more disarray with a wider distribution than in wild‐type before birth. In heterozygous mice, disarray was seen in the anterior, septal and inferior walls irrespective of stage, whereas in homozygous mice it extended to the whole LV circumference including the lateral wall. In conclusion, myoarchitectural disarray is detectable in the fetal heart of an HCM mouse model before the development of LVH.
Parent's and Children's Emotion Regulation and the Work–Family Interface
Authors: Melim Beatriz , Matias Marisa , Ferreira Tiago , Matos Paula M. 
Published: July 2019

ObjectiveThis study investigates the mediating role of parent–child relationship quality on the association between parents' work‐related exhaustion and children's emotion regulation and lability. The moderating role of parent's emotion suppression is also considered.BackgroundWork‐related exhaustion has a significant impact in family life. However, few studies have investigated its relationship with both parent–child relationships and children's outcomes.MethodStructural equation modeling and path analysis were used on a sample of 120 dual‐earner couples living in Portugal with children aged 2 to 6 years.ResultsAnalysis revealed that (a) the quality of the father–child relationship mediates the link between father's work‐related exhaustion and child's emotion regulation and lability and (b) the quality of mother–child relationship mediates the link between mother's work‐related exhaustion and children's lability; (c) mother's work‐related exhaustion and emotion suppression negatively relate to mother–child as well as father–child relationship quality; (d) father's work‐related exhaustion and emotion suppression were only negatively associated with father–child (but not mother–child) relationship quality. Moreover, the indirect effect of mother's work‐related exhaustion on children's emotion regulation and lability through father–child relationship quality was only significant when mother's emotion suppression was low.ConclusionNot only is parental work‐related exhaustion associated with children's emotion regulation through parent–child relationship quality but also emotion suppression may have a moderating role on family relationships.
The outcome of a training programme (RESPECT) on staff’s attitudes towards causes and management of aggression in a Regional Referral Hospital of northern Uganda
Authors: Coneo Ana M.C. , Thompson Andrew R. , Parker Kim , Harrison Greg 
Published: July 2019

Accessible SummaryWhat is known on the subject?

Health systems in many low‐ to middle‐income countries (LMICs) are heavily underfunded, and staff training opportunities are limited.

There is a lack of empirical data on the development and use of sustainable training programmes in aggression management skills in LMICs.

What does this paper add to existing knowledge?

After RESPECT, participants showed greater agreement with statements about the role of environmental and relational factors as antecedents of aggression and described favouring the use of non‐physical techniques to manage aggressive behaviour.

Attitudes towards management practices of seclusion, medication and restraint remained unchanged after RESPECT training.

What are the implications for practice?

Training programmes like RESPECT may be useful to improve attitudes towards causes of aggression and its management in LMIC hospitals. However, further evidence is required to demonstrate whether these results can be sustained over time and whether these attitudinal changes are associated with reduction of workplace violence.

Mental health nurses and other mental health professionals can play a key role in establishing hospital‐wide training and sharing skills across geographical boundaries.

AbstractIntroductionOccupational violence has been demonstrated to impact negatively on the well‐being of nurses and patients. Staff attitudes towards causes and management of patients’ aggression influence their practice. Training is likely to influence attitudes towards aggression; however, Uganda's health system lacks adequate resources to provide aggression management training for staff.AimTo assess the impact of a training programme (RESPECT) on staff attitudes towards causes and management of patient's aggression in a Ugandan hospital.MethodsThis study used a mixed‐methods convergent design. A convenience sample of nurses and support staff employed in the psychiatric ward and other services across the hospital (N = 90) completed the Management of Aggression and Violence Attitude Scale (MAVAS) pre‐ and post‐training. The views of a smaller sample (n = 35) were captured via interviews and focus groups and analysed using thematic analysis.ResultsParticipants reported greater agreement with patients’ physical and social environment (external and situational causative models) as factors influencing patient's aggression. Qualitative findings substantiated the results identified in the survey. Attitudes towards seclusion, restraint and medication remained unchanged.Discussion and implications for practiceRESPECT has the potential to change staff attitudes towards aggression in the short term. Further research is needed to investigate long‐term effects and impact on incidents of aggression.
The role of preemptive antimicrobial therapy in kidney recipients of urine‐only positive donor cultures
Authors: Cabrera Pierina , Centeno Alexandra , Revollo Jane , Camargo Jose F. 
Published: July 2019

AbstractBackgroundThe use of preemptive antimicrobial therapy for recipients of donors with microbial growth on pre‐transplant urine cultures remains poorly studied.MethodsSingle‐center retrospective study of kidney transplant recipients of allografts from deceased donors with urine‐only (ie, in absence of donor bacteremia) positive cultures (September 2011 to August 2015). Transplant outcomes, including donor‐derived infections (DDI) within the first three months post transplant, were analyzed.ResultsOf the 970 kidney transplants performed during the study period, urine cultures were obtained from all donors, and of these, 27 (2.8%) yielded growth. Twenty‐nine (73%) recipients were treated preemptively after transplantation. All of the recipients of donors with urine cultures positive for Enterococcus, Pseudomonas, or Candida spp. received therapy whereas only one of seven recipients with urine cultures positive for Escherichia coli was treated (P < .0001). All E coli isolates were susceptible to trimethoprim‐sulfamethoxazole (TMP‐SMX), which was given to all patients for Pneumocystis pneumonia (PCP) prophylaxis. Infection within 3 months was evident in 16 (40%) patients: 10 out of 29 (35%) in the preemptive group and 6 out of 11 (55%) in the not‐treatment group (P = .29). Evidence of DDI occurred in two recipients, one in each group. There were no differences in one‐year graft and patient survival between groups.ConclusionPreemptive antibiotic therapy did not seem to impact transmission events and transplant outcomes in this small cohort. Low transmission rates might have been influenced by administration of PCP prophylaxis and universal preemptive therapy for positive donor urine cultures with virulent organisms. Larger studies are needed.
Safety and effectiveness of a prothrombin complex concentrate in approved and off‐label indications
Authors: Marcos‐Jubilar M. , García Erce J. A. , Martínez‐Calle N. , Páramo J. A. , Martínez Virto A. , Quintana‐Díaz M. 
Published: July 2019

SummaryObjectiveTo evaluate the effectiveness and safety of prothrombin complex concentrates (PCCs) in approved and off‐label indications.BackgroundPCCs are approved for the urgent reversal of vitamin K antagonists (VKAs). Data concerning the efficacy, safety and dosing for off‐label indications are limited, but they are included in massive bleeding protocols.MethodsThis was a retrospective review of cases treated with four‐factor PCCs (4F‐PCCs) between January 2009 and 2016. Efficacy end‐points include: (i) VKA reversal efficacy assessed by international normalised ratio (INR) normalisation (<1·5) and (ii) clinical efficacy as bleeding cessation and/or decreased number of transfused blood components and 24‐h mortality in bleeding coagulopathy. The safety end‐point is the incidence of thromboembolic events.ResultsA total of 328 patients were included (51·8% male, median age 78 years old). Indications were as follows: VKA reversal (66·6%), bleeding coagulopathy (30·5%) and direct anticoagulant (DOAC) reversal due to bleeding (2·5%).VKA reversal was effective in 97·1% of patients, and 76·5% demonstrated complete reversal (INR < 1·5); only 34·3% patients needed hemoderivatives. Prior to emergency procedures, PCCs achieved global responses in 83% of patients, with no bleeding complication during intervention. DOAC reversal was effective in 88·9% of patients. Bleeding cessation was associated with the dose administered (P = 0·002). In coagulopathy bleeding, haemorrhage cessation, established by the International Society of Thrombosis and Haemostais (ISTH) definition, occurred in 56·7% of massive bleeding events and in 42·5% of other coagulopathies; 24‐h mortality was 30%, mainly related to active bleeding. Ten thrombotic episodes were observed (3·1%).Conclusion4F‐PCC was effective as adjuvant treatment with an acceptable safety profile, not only for the emergent reversal of VKAs but also for refractory coagulopathy associated with major bleeding.
Analyzing the Simonshaven Case With and Without Probabilities
Authors: Verheij Bart 
Published: July 2019

AbstractThis paper is one in a series of rational analyses of the Dutch Simonshaven case, each using a different theoretical perspective. The theoretical perspectives discussed in the literature typically use arguments, scenarios, and probabilities, in various combinations. The theoretical perspective on evidential reasoning used in this paper has been designed to connect arguments, scenarios, and probabilities in a single formal modeling approach, in an attempt to investigate bridges between qualitative and quantitative analytic styles. The theoretical perspective uses the recently proposed logical formalism of case models, where cases represent possible combinations of evidence and events, ordered by an ordering relation. In the context of evidential reasoning, the ordering relation can be represented by a probability function. As an ordering relation is qualitative in nature, the theoretical perspective is in a formally precise sense simultaneously with and without probabilities.
Economic Model Predictive Control of Sampled-Data Linear Systems With Piecewise Constant Control
Authors: Liang Haojiao , Li Huiping , Xu Demin 
Published: July 2019

Abstract
The paper studies an economic model predictive control (EMPC) problem for sampled-data linear systems with system constraints. The cost function consists of an economic part and a regulatory part, and a new EMPC algorithm with piecewise constant control is designed. Iterative feasibility of the designed optimization problem and input-to-state stability (ISS) of the closed-loop system are proved. In particular, we show that the closed-loop system is input-to-state stable with respect to the supremum norm of the economic cost, and the system state is ultimately bounded within a bound determined by the economic cost. Through thorough simulations, the effectiveness of the designed algorithm is verified and the tradeoff between control and economic performance is demonstrated.
Numerical Analysis of Heat and Mass Transfer Coupled With Gaseous Fuel Injection in Reactive Porous Media
Authors: Cheng Zhilong , Yang Jian , Guo Zhigang , Fu Pei , Ihme Matthias , Wang Qiuwang 
Published: July 2019

Abstract
Iron ore sintering is a typical application of reactive porous media combustion (RPMC) which has been widely reported. In this work, a computational model of RPMC is developed, in which heat and mass transfer, as well as main chemical subprocesses in reactive porous media are incorporated. A gaseous-fuel injection method is examined to enable better heat pattern. However, the imbalance of heat distribution in the flow direction caused by internally recirculating heat released via a solid matrix is still problematic on energy efficiency. Through computations, it is observed that the heat pattern and melting quantity index (MQI) are sensitive on gaseous-fuel concentration, providing a possibility of improving the heat distribution imbalance. Numerical results are presented to demonstrate the benefits of fuel segregation. Finally, more reasonable heat pattern is observed by combinations of gaseous-fuel segregation with hot air and oxygen enrichment. The dynamics of gaseous/solid-fuel combustion zones caused by the hot air and oxygen enrichment would contribute to an expansion of melting zone near the inlet, producing a more reasonable and uniform heat distribution in a sintering bed.
Knowledge mobilisation: an ethnographic study of the influence of practitioner mindlines on atopic eczema self-management in primary care in the UK
Authors: Cowdell Fiona 
Published: July 2019

ObjectiveTo explore how atopic eczema specific mindlines are developed by primary care practitioners.DesignEthnographic study.SettingOne large, urban general practice in central England.ParticipantsIn observation, all practitioners and support staff in the practice and in interviews a diverse group of practitioners (n=16).ResultsObservation of over 250 hours and interview data were combined and analysed using an ethnographic approach through the lenses of mindlines and self-management. Three themes were identified: beliefs about eczema, eczema knowledge and approaches to self-management. Eczema mindlines are set against a backdrop of it being a low priority and not managed as a long-term condition. Practitioners believed that eczema is simple to manage with little change in treatments available and prescribing limited by local formularies. Practice is largely based on tacit knowledge and experience. Self-management is expected but not often explicitly facilitated. Clinical decisions are made from knowledge accumulated over time. Societal and technological developments have altered the way in which practitioner mindlines are developed; in eczema, for most, they are relatively static.ConclusionsThe outstanding challenge is to find novel, profession and context-specific, simple, pragmatic strategies to revise or modify practitioner mindlines by adding reliable and useful knowledge and by erasing outdated or inaccurate information thus potentially improve quality of eczema care.
Protocol for a longitudinal study to evaluate the use of tenofovir-based PrEP for safer conception and pregnancy among women in South Africa
Authors: Matthews Lynn T , Jaggernath Manjeetha , Kriel Yolandie , Smith Patricia M , O’Neil Kasey , Haberer Jessica E , Hendrix Craig , Baeten Jared M , Ware Norma C , Wirth Kathleen , Psaros Christina , Bangsberg David R , Smit Jennifer A 
Published: July 2019

IntroductionWomen who choose to conceive a baby with a partner living with HIV or a partner whose HIV serostatus is unknown in HIV-endemic settings need prevention strategies to mitigate HIV acquisition during conception and pregnancy.Methods and analysisWe are conducting a single-arm longitudinal study offering oral tenofovirdisoproxil fumarate/emtricitabine (TDF/FTC) as pre-exposure prophylaxis (PrEP) for periconception use to 350 HIV-uninfected women in KwaZulu-Natal, South Africa. PrEP is offered as part of woman-centred safer conception programme that promotes couples-based HIV counselling and testing, antiretroviral therapy for partners who are HIV-infected, treatment for sexually transmitted infections and safer conception strategies, such as limiting condomless sex to peak fertility. We enrol HIV-uninfected women who are not currently pregnant, in a stable relationship (≥6 months) with a partner living with HIV or of unknown serostatus, and personal or partner plans for pregnancy in the next 12 months. We follow enrolled women for 12 months. Women who become pregnant are followed through pregnancy outcome, independent of their decisions regarding PrEP use. The primary objective of the study is to evaluate the uptake of and adherence to PrEP during the periconception period and pregnancy. Secondary outcomes include the uptake of other safer conception strategies. We also measure clinical outcomes including HIV seroconversion rates and pregnancy and infant outcomes. Finally, we will explore conduct and evaluate qualitative interviews in 25 participants to further inform our conceptual framework for periconception PrEP uptake and adherence among HIV-exposed women in South Africa.Ethics and disseminationThe protocol has been approved by the Human Research Ethics Committee at the University of the Witwatersrand (Johannesburg, South Africa) and the Institutional Review Board of Partners Healthcare (Boston, Massachusetts, USA). Study findings will be made available to interested participants. Results will be presented to local health officials and stakeholders at meetings. Investigators will share the results at meetings and in manuscripts. De-identified quantitative data will be made available.Trial registration numberThe protocol is registered with the South African Health Products Regulatory Agency (SAHPRA, formerly known as the Medicine Controls Council, MCC#20170131) and ClinicalTrials.gov (NCT03194308); Pre-results.
How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study
Authors: Najafi Kalyani Majid , Jamshidi Nahid , Molazem Zahra , Torabizadeh Camellia , Sharif Farkhondeh 
Published: July 2019

IntroductionOn entry into the clinical environment, nursing students are confronted with many challenges. It is a common problem throughout the world, including Iran. Although many studies have been conducted on the problems of nursing students in the clinical environment, limited information is available on nursing students’ experiences of the clinical learning environment and the way they respond to these experiences. Identifying nursing students’ experiences is essential to develop interventions to reduce challenges.ObjectiveThis study aimed to explore nursing students’ experiences in a clinical learning environment and the way they responded to these experiences.DesignThe present study was conducted based on the qualitative research design of the grounded theory methodology.SettingThis study was conducted at schools of nursing in academic settings in Iran.ParticipantsThe participants included 19 nursing students, 4 nursing instructors and 3 clinical nurses.MethodsThe data were collected using semistructured interviews, field notes and observation, and were analysed using Strauss and Corbin’s approach.ResultsStudents, as a result of the inadequacy of the educational environment, were faced with ‘confusion of identity’, stating this as their main concern. When confronted with this concern, they employed specific strategies, some of which prevented them from getting into unpleasant conditions. These strategies did not help students solve their problems and also prevented them from accepting their professional roles and responsibilities. Conversely, some other strategies led them to advanced professional development and enabled them to accept their role and the clinical environment.ConclusionAccording to the results of this study, educational policymakers should focus on improving the clinical environment. Identifying professional models and increasing their influence on management, education and clinical education, as well as teaching positive and constructive strategies, will promote positive strategies in coping with inadequate educational contexts. This is necessary for the professional development of nursing students.
Sino Longitudinal Study on Cognitive Decline (SILCODE): protocol for a Chinese longitudinal observational study to develop risk prediction models of conversion to mild cognitive impairment in individuals with subjective cognitive decline
Authors: Li Xuanyu , Wang Xiaoni , Su Li , Hu Xiaochen , Han Ying 
Published: July 2019

IntroductionUnderstanding the biological mechanism of subjective cognitive decline (SCD) in preclinical Alzheimer’s disease (AD) and identifying those who will soon convert to mild cognitive impairment (MCI) are critical for developing appropriate strategies for early diagnosis and intervention of AD. We present the study protocol of the Sino Longitudinal Study on Cognitive Decline (SILCODE), a longitudinal observational study focusing on SCD in the context of AD.Methods and analysisWithin SILCODE, approximately 800 subjects with SCD who are between 50 and 79 years old will be recruited through standardised public advertisements or memory clinics. They will undergo extensive assessment, including clinical and neuropsychological assessments, blood sample collection for plasma beta-amyloid and ApoE genotype, urine samples collection for AD7c-NTP, and multimodal MRI scans (structural MRI, diffusion tensor imaging, resting-state functional MRI and optional task-based functional MRI) as well as optional glucose metabolism and amyloid positron emission tomography. Subjects will be contacted by telephone every 3 months and interviewed, on average, every 15 months for 5 years. The study endpoint is the development of mild cognitive impairment or dementia. Jak & Bondi’s actuarial neuropsychological method will be used for diagnosis of MCI. The least absolute shrinkage and selection operator logistic regression model followed by the sub-distribution hazard function model with death as a competing risk will be constructed to establish risk prediction models.Ethics and disseminationThe ethics committee of the Xuanwu Hospital of Capital Medical University has approved this study protocol (ID: [2017]046). The results will be published in peer-reviewed journals and presented at national and international scientific conferences.Trial registration numberNCT03370744; Pre-results.