bluuebunny/crossref_metadata_2025_split huggingface dataset:
17-Hydroxy Wortmannin Restores TRAIL's Response by Ameliorating Increased Beclin 1 Level and Autophagy Function in TRAIL-Resistant Colon Cancer Cells
Authors: Dai Sheng , Yang Shu , Hu Xin , Sun Wei , Tawa Gregory , Zhu Wenge , Schimmer Aaron D. , He Chao , Fang Bingliang , Zhu Hongbo , Zheng Wei 
Published: May 2019

AbstractTargeting of extrinsic apoptosis pathway by TNF-related apoptosis-inducing ligand (TRAIL) is an attractive approach for cancer therapy. However, two TRAIL drug candidates failed in clinical trials due to lack of efficacy. We identified 17-hydroxy wortmannin (17-HW) in a drug repurposing screen that resensitized TRAIL's response in the resistant colon cancer cells. The deficiency of caspase-8 in drug-resistant cells along with defects in apoptotic cell death was corrected by 17-HW, an inhibitor of PIK3C3-beclin 1 (BECN1) complex and autophagy activity. Further study found that BECN1 significantly increased in the TRAIL-resistant cells, resulting in increased autophagosome formation and enhanced autophagy flux. The extracellular domain (ECD) of BECN1 directly bound to the caspase-8 catalytic subunit (p10), leading to sequestration of caspase-8 in the autophagosome and its subsequent degradation. Inhibition of BECN1 restored the caspase-8 level and TRAIL's apoptotic response in the resistant colon cancer cells. An analysis of 120 colon cancer patient tissues revealed a correlation of a subgroup of patients (30.8%, 37/120) who have high BECN1 level and low caspase-8 level with a poor survival rate. Our study demonstrates that the increased BECN1 accompanied by enhanced autophagy activity is responsible for the TRAIL resistance, and a combination of TRAIL with a PIK3C3-BECN1 inhibitor is a promising therapeutic approach for the treatment of colon cancer.
ФУНКЦІОНАЛЬНО-ОРГАНІЗАЦІЙНА МОДЕЛЬ СИСТЕМИ УПРАВЛІННЯ ЯКІСТЮ СЕСТРИНСЬКОЇ СПРАВИ
Authors: Perepadya O. V. 
Published: May 2019

Мета: розробити комплексну функціонально-організаційну модель системи управління якістю сестринської справи.
Матеріали і методи. Використовуючи аналітичний метод та метод системного підходу проаналізовано механізми реалізації державної політики у сестринській справі та запропоновано комплексну функціонально-організаційну модель системи управління якістю сестринської справи.
Результати. У статті на основі критичного вивчення та глибокого аналізу досвіду організації управління сестринською службою запропоновано методичний підхід до розробки та запровадження у системі охорони здоров’я України функціонально-організаційної моделі системи управління якістю сестринської справи. На основі отриманих даних для розробки функціонально-організаційної моделі системи управління якістю сестринської справи застосовано системний підхід; визначено складові елементи зазначеної системи; запропоновано та обґрунтовано напрямки розвитку системи на коротко-, середньо- та довгострокову перспективу. Зазначену модель було розроблено із використанням шести компонентів системного підходу із застосуванням інноваційних на сьогодні компонентів, а саме Центр підвищення кваліфікації медичного персоналу, стандарти та алгоритми для медичних сестер у системі управління якістю, а також зростання ролі регіональних асоціацій медичних сестер.
Висновки. Запропоновано комплексну функціонально-організаційну модель системи управління якістю сестринської справи, елементи якої повністю кореспондуються із головними питаннями реформування системи охорони здоров’я та її автономізації.
Incidence of Syncope During Pregnancy: Temporal Trends and Outcomes
Authors: Chatur Safia , Islam Sunjidatul , Moore Linn E. , Sandhu Roopinder K. , Sheldon Robert S. , Kaul Padma 
Published: May 2019

Background
We examined temporal trends, timing, and frequency, as well as adverse neonatal and maternal outcomes occurring in the first year postpartum among women experiencing syncope during pregnancy.

Methods and Results

This was a retrospective study of pregnancies between January 1, 2005, and December 31, 2014, in the province of Alberta, Canada. Of 481 930 pregnancies, 4667 had an episode of syncope. Poisson regression analysis found a 5% increase/year (rate ratio, 1.05; 95%
CI,
1.04–1.06) in the age‐adjusted incidence of syncope. Overall, 1506 (32.3%) of the syncope episodes first occurred in the first trimester, 2058 (44.1%) in the second trimester, and 1103 (23.6%) in the third trimester; and 8% (n=377) of pregnancies had >1 episode of syncope. Compared with women without syncope, women who experienced syncope were younger (age <25 years; 34.7% versus 20.8%;
P
<0.001), and primiparous (52.1% versus 42.4%;
P
<0.001). The rate of preterm birth was higher in pregnancies with syncope during the first trimester (18.3%), compared with the second (15.8%) and third trimesters (14.2%) and pregnancies without syncope (15.0%;
P
<0.01). The incidence of congenital anomalies among children born of pregnancies with multiple syncope episodes was significantly higher (4.9%) compared with children of pregnancies without syncope (2.9%;
P
<0.01). Within 1 year after delivery, women with syncope during pregnancy had higher rates of cardiac arrhythmias and syncope episodes than women with no syncope during pregnancy.

Conclusions
Pregnant women with syncope, especially when the syncopal event occurs during the first trimester, may be at a higher risk of adverse pregnancy outcomes as well as an increased incidence of cardiac arrhythmia and syncope postpartum.
Vertical Resolution Requirements in Atmospheric Simulation
Authors: Skamarock William C. , Snyder Chris , Klemp Joseph B. , Park Sang-Hun 
Published: May 2019

Abstract
The role of vertical mesh spacing in the convergence of full-physics global atmospheric model solutions is examined for synoptic, mesoscale, and convective-scale horizontal resolutions. Using the MPAS-Atmosphere model, convergence is evaluated for three solution metrics: the horizontal kinetic energy spectrum, the Richardson number probability density function, and resolved flow features. All three metrics exhibit convergence in the free atmosphere for a 15-km horizontal mesh when the vertical grid spacing is less than or equal to 200 m. Nonconvergence is accompanied by noise, spurious structures, reduced levels of mesoscale kinetic energy, and reduced Richardson number peak frequencies. Coarser horizontal mesh solutions converge in a similar manner but contain much less noise than the 15-km solutions for coarse vertical resolution. For convective-scale resolution simulations with 3-km cell spacing on a variable-resolution mesh, solution convergence is almost attained with a vertical mesh spacing of 200 m. The boundary layer scheme is the dominant source of vertical filtering in the free atmosphere. Although the increased vertical mixing at coarser vertical mesh spacing depresses the kinetic energy spectra and Richardson number convergence, it does not produce sufficient dissipation to effectively halt scale collapse. These results confirm and extend the results from a number of previous studies, and further emphasize the sensitivity of the energetics to the vertical mixing formulations in the model.
Occupational performance and multisensory stimulation during post-traumatic amnesia: An observational and randomized controlled trial protocol
Authors: Walsh Hayley , Fleming Jennifer , Silvestre Edo Cristina , Bernabeu Guitart Montserrat , Murillo Narda 
Published: May 2019

Background. Occupational performance (OP) and interventions during post-traumatic amnesia (PTA) following traumatic brain injury are poorly understood. Purpose. This study aims to describe a study protocol to (a) track person factors of OP throughout PTA and (b) assess the feasibility of a randomized controlled trial (RCT) protocol comparing an occupation-based multisensory stimulation and environmental enrichment intervention with usual care during PTA. Method. A prospective observational study will be conducted with an embedded Phase II RCT with 30 participants in PTA. Participants will be randomly assigned to group and regularly assessed on PTA and OP measures. Feasibility aspects will be recorded in a logbook. All measures will be repeated at PTA resolution and 1 month later, with a follow-up questionnaire completed at 6 months postinjury. Findings. Observational data will be analyzed using correlations. Feasibility will be examined descriptively, and group comparisons will be conducted to determine effect size. Implications. Results will provide a broader understanding of OP during PTA and inform future trials.
The relationship between calcium (water) density and age distribution in adult women with spectral CT: initial result compared to bone mineral density by dual-energy X-ray absorptiometry
Authors: Yue Dong , Li Fei Sun , Jing Chen , Ru Xin Wang , Rui Tong Dong , Ai Lian Liu , Luo Ya Hong 
Published: May 2019

Background Calcium (water) density (DCa(Wa)) of gemstone spectral imaging by spectral computed tomography (CT) is a new method of evaluating bone structures. Purpose To investigate age-related change of DCa(Wa) of a chosen lumbar vertebra in adult women with spectral CT and the correlation between the DCa(Wa) and bone mineral density (BMD) of dual-energy X-ray absorptiometry (DXA). Material and Methods A total of 305 adult women underwent spectral CT, 127 of whom simultaneously underwent DXA. All the patients were divided into 11 subgroups based on age. DCa(Wa) and BMD were measured at the second lumbar vertebra on the calcium (water)-based material decomposition images of spectral CT and DXA, respectively. A one-way analysis of variance (ANOVA) was performed for the difference of the measurements among adjacent age subgroups. Pearson correlation was used to assess the association between age and DCa(Wa), age and BMD, as well as DCa(Wa) and BMD. Results There was a significant negative correlation between DCa(Wa) and age (r = −0.719) as well as BMD and age(r = −0.851). The mean DCa(Wa) of L2 vertebral body was significantly different between the 40–44- and 45–49-, 45–49- and 50–54-, 55–59- and 60–64-, 65–69- and 70–74-year-old age subgroups. BMD was significantly different between the 35–39- and 40–44-, 45–49- and 50–54-, and 65–69- and 70–74-year-old age subgroups. There was a significant positive correlation between DCa(Wa) and BMD. Conclusions The DCa(Wa) of lumbar vertebra by spectral CT demonstrated similar age distribution as BMD of DXA and could be used as a method of measuring the vertebral bone mineral density in adult women.
Effectiveness of Reconstruction of the Anterior Cruciate Ligament with Quadrupled Hamstrings and Bone-Patellar Tendon-Bone Autografts
Authors: Chouliaras Vasileios , Ristanis Stavros , Moraiti Constantina , Stergiou Nicholas , Georgoulis Anastasios D. 
Published: May 2019

Background The 2 most frequently used autografts for anterior cruciate ligament reconstruction are the bone-patellar tendon-bone and the quadrupled hamstrings tendon. Hypothesis Hamstring tendon graft is superior to patellar tendon graft in restoring tibial rotation during highly demanding activities because of its superiority in strength and linear stiffness and because it is closer morphologically to the anatomy of the natural anterior cruciate ligament. Study Design Case control study; Level of evidence, 3. Methods Eleven patients with patellar tendon graft anterior cruciate ligament reconstruction, 11 patients with hamstring tendon graft anterior cruciate ligament reconstruction, and 11 controls were assessed. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects descended stairs and, immediately after, pivoted on their landing leg. The dependent variable examined was the tibial internal-external rotation during pivoting. All patients in both groups were also assessed clinically and with the use of a KT-1000 arthrometer to evaluate anterior tibial translation. Results The results demonstrated that reconstructions with either graft successfully restored anterior tibial translation. However, both anterior cruciate ligament reconstruction groups had significantly increased tibial rotation when compared with the controls, whereas no differences were found between the 2 reconstructed groups. Conclusion The 2 most frequently used autografts for anterior cruciate ligament reconstruction cannot restore tibial rotation to normal levels. Clinical Relevance New surgical techniques are needed that can better approximate the actual anatomy and function of the anterior cruciate ligament.
Antipsychotiques à Action Prolongée: Révision de l’algorithme QAAPAPLE
Authors: Stip Emmanuel , Abdel-Baki Amal , Roy Marc-André , Bloom David , Grignon Sylvain 
Published: May 2019

Contexte : Il y a 8 ans, un comité d’experts issus des 4 départements de psychiatrie universitaires québécois a proposé l’algorithme QAAPAPLE visant à guider les cliniciens à l’égard de l’utilisation des APAP pour les patients atteints de troubles psychotiques. Objectif : Faire une mise à jour de l’algorithme QAAPAPLE. Méthodes : Grâce à une revue qualitative et sélective de la littérature, les experts se sont intéressés à plusieurs aspects en lien avec l’utilisation des APAP et sur la pertinence de modifier l’algorithme: 1) données nouvelles sur les APAP (incluant polypharmacie et co-prescription avec clozapine, fréquence et intervalle d’administration); 2) perception et attitude sur des algorithmes et données probantes; 3) difficultés d’application des algorithmes; 4) polypharmacie impliquant les APAP et co-prescriptions avec clozapine; 5) avis des patients partenaires sur l’algorithme. Résultats : 13 méta-analyses ont été publiées et complètent les études observationnelles (incluant celles sur des registres nationaux) confirmant les avantages des APAP. La littérature apporte des précisions quant à l’utilisation de certaines associations médicamenteuses, fréquence et intervalle d’administration. L’algorithme a donc été modifié en tenant compte des avancées scientifiques. Conclusion : En interaction avec les psychiatres québécois, nous avons examiné les changements des prescriptions, la littérature, pour mieux comprendre l’utilisation de l’algorithme. Le comité a actualisé l’algorithme QAAPAPLE, pour mieux guider les cliniciens dans l’utilisation des APAP dans la trajectoire des patients atteints de psychoses dès le premier épisode et à travers les différents contextes cliniques (incluant la résistance au traitement) afin de le rendre plus flexible et convivial. Implications cliniques : Les études observationnelles (naturalistes) montrent que les APAP réduisent les rechutes, les ré-hospitalisations et la surmortalité. La palette de fréquence d’injection permet des intervalles de deux semaines à trois mois, ce qui permet un ajustement aux besoins du patient en termes de stabilité clinique et de fréquence des contacts. Les APAP restent une modalité thérapeutique sous-utilisée, un algorithme peut aider à se repérer et donc en faciliter l’utilisation. Limites : Le comité a produit une revue de la littérature narrative et systématique, plutôt que quantitative; toutefois, il s’est complètement basé sur les conclusions des méta-analyses. La participation aux sondages reliés à ce projet demeure sous optimale. Le comité n’a pas examiné la littérature concernant les aspects spécifiques reliés à la prescription d’APAP chez les personnes âgées ou les enfants.
Postoperative Risk Factors and Outcome of Patients With Liver Transplantation Who Were Admitted to Pediatric Intensive Care Unit: A 10-Year Single-Center Review in China
Authors: Qian Juan , Zhou Tao , Qiu Bi-Jun , Xiang Long , Zhang Jian , Ning Bo-Tao , Ren Hong , Li Bi-Ru , Xia Qiang , Wang Ying 
Published: May 2019

Introduction: The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals. Methods: A retrospective chart review study was performed according to our hospital’s medical records and the pediatric liver transplant database of Renji hospital. Results: A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation. 8.8% (16/208) and 14.4% (81/559) of patients were transferred to PICU in stages I and II, respectively, and was comparable in the 2 stages ( P = .017). The majority of patients was late postoperative children (median 185 post-LT days) in stage I. More patients were transferred to PICU directly in stage II. PICU admitted more younger (median 8.2 months) and early postoperative patients in stage II. The median length of PICU stay was 11.0 (6.0-20.5) days. The median length of mechanical ventilation was 5.0 (0.0-12.0) days. The most frequent complications were pulmonary complications (52 [53.6%] patients), surgical complications (22 [22.7%] patients), sepsis (7 [7.2%]), and other miscellaneous complications (16 [16.5%] patients). The overall 28-day PICU mortality was 25.8% (n = 25) and 64.0% (n = 16) of the deaths happened in the early postoperative period. There was significant difference concerning mortality in children with surgical complications and medical problems (54.5% [12/22] vs 17.3% [13/75], P = .001). Multivariate analysis by regression showed that the pediatric risk of mortality III score was the only independent prognostic factor ( P = .031). Conclusions: Multiple complications occur in children with LT. Although challenging, interdisciplinary cooperation between different hospitals is an effective mean to enable children to maximize the benefit gained from LT in China.
Individual emergency-preparedness efforts: A social justice perspective
Authors: McNeill Charleen C , Richie Cristina , Alfred Danita 
Published: May 2019

Background: Since 2010, the United States has experienced 228 disasters, affecting over 86 million people. Because of population shifts, the growing number of people living with chronic conditions or disabilities, and the growing number of older citizens living independently, access and service gaps often exist for those without money or other transferable resources. There is a lack of evidence regarding individual community members’ capacity to prepare for emergencies. Research objective: The purpose of this study is to highlight participant experiences in becoming better prepared for emergencies and provide insight from a social justice perspective. Research design: This is a descriptive qualitative study, staying very close to the data as an end product rather than a beginning for interpretation. Participants and research context: A total of 13 low-income, uninsured, or under-insured attendees at a medical outreach clinic were interviewed. Ethical considerations: Institutional Review Board approval was obtained from the University of Texas at Tyler. Findings: Four themes emerged from the interview data: (a) evaluation of the emergency-preparedness education, (b) making emergency plans, (c) challenges in preparing for emergencies, and (d) facilitators of emergency preparedness. Discussion: Identifying the potential challenges to individual emergency preparedness among vulnerable populations is the first step in overcoming them. The capacity to comply with such measures, especially the ability of those with limited incomes and other vulnerable populations, must be considered. Conclusion: Synchronized, well-ordered assistance will close gaps in recovery and enhance efficiency in pre- and post-event aid. Theoretically, doing so will promote engaged and resilient members of society who are better able to withstand adverse events. The importance of the relationship between individual preparedness levels and the resiliency of nations supports the social justice imperative to address the needs of vulnerable populations in the mitigation and planning phase of the emergency management cycle.
Attitudes towards gossip and patient privacy among paediatric nurses
Authors: Ceylan Sibel Serap , Çetinkaya Bengü 
Published: May 2019

Background: Nurses providing 24-h care for the primary caregiver role have a number of significant roles to play in potential problems or conflicts associated with patient privacy and confidentiality. Research objectives: The objective of the study is to determine the prevailing attitudes towards gossip and the patient privacy practices of nurses working in paediatric units. Research design: A descriptive and cross-sectional design was used. A Descriptive Characteristics Form, a Gossip and Rumour Attitude Scale and a Patient Privacy Scale were used to collect data. Participants and research context: A total of 112 paediatric nurses working in Turkey were included in the study. The response rate was 79.43%. Ethical considerations: Permission to conduct the study was obtained from the university’s ethics committee. The participants were informed of the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them. Findings: It was observed that nurses who had a higher education level, who were educated about patient privacy and who had read the patient rights regulations were more concerned about patient privacy. Negative correlations were found between the attitudes towards gossiping and the average scores on the patient confidentiality scale. Nurses who negatively defined gossip were more concerned about patient confidentiality. Discussion: Privacy is important for securing and protecting the personal, physical and psychological things that are important and special for patients. It is argued that obstacles to maintaining the privacy of hospitalized children and adolescents are a tolerant attitude towards gossiping, a lack of education about patient privacy and insufficient information about patient’s rights regulations and the Convention on the Rights of the Child. Conclusion: A nurse’s knowledge about the provision of patient confidentiality affects their privacy practices. For this reason, regular training sessions are recommended in hospitals.
Speech-Language Pathologists’ Views About Aspiration Risk and Comfort Feeding in Advanced Dementia
Authors: Berkman Cathy , Ahronheim Judith C. , Vitale Caroline A. 
Published: May 2019

Background: Speech-language pathologists (SLPs) are often called upon to assess swallowing function for older adults with advanced dementia at high risk of aspiration and make recommendations about whether the patient can safely continue oral nutrition. Objective: To describe the circumstances under which SLPs recommend oral nutritional intake for these patients. Methods: A mail survey of a national probability sample of SLPs (n = 731). Speech-language pathologists were asked if there were circumstances in which they would recommend oral feeding for patients with advanced dementia at high risk of aspiration, and if yes, to describe the circumstances under which they do so. Results: Six themes emerged: (1) when patient preferences are known; (2) for quality of life near end of life; (3) if aspiration risk mitigation strategies are employed; (4) if physician’s preference; (5) if aspiration risk is clearly documented and acknowledged; and (6) if SLP is knowledgeable about current evidence of lack of benefit of feeding tubes in advanced dementia or that nothing by mouth status will not necessarily prevent aspiration pneumonia. Conclusions: Speech-language pathologists have an important role within the interprofessional team in assessing swallowing in patients with advanced dementia, advising family and hospital staff about risks and benefits of oral feeding, and the safest techniques for doing so, to maximize quality of life for these patients near the end of life. Speech-language pathologists are often faced with balancing concerns about aspiration risk and recommending the more palliative approach of oral feeding for pleasure and comfort, potentially creating moral distress for the SLP.