bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional intake is associated with activities of daily living and complications in older inpatients with stroke
Authors: Kokura Yoji , Wakabayashi Hidetaka , Nishioka Shinta , Maeda Keisuke 
Published: July 2018

AimThere is no consensus on energy intake in the acute stage and how it relates to improvement in activities of daily living (ADL) in geriatric stroke patients. We examined whether energy intake after admission is related to improvement in ADL and complications.MethodsThis retrospective cohort study evaluated the data from stroke inpatients at five acute care hospitals, including the mean daily energy intake during the first week after admission. Patients were categorized into two groups based on their daily energy intake; cases where the energy intake per day reached the basal energy expenditure calculated by the Harris–Benedict equation were designated as the intake energy sufficiency group. Patient characteristics were compared between groups. We assessed ADL using the Functional Independence Measure; a secondary outcome was the presence of complications.ResultsOf the 192 participants (mean age 79.6 ± 7.6 years) included in the study, 131 patients were admitted for cerebral infarction, 58 for intracerebral hemorrhage and three for subarachnoid hemorrhage. Of the two groups, that with an energy sufficiency had a greater gain in total Functional Independence Measure (median 27 and 9, respectively; P = 0.001) and a lower complication rate (6.7% and 26.5%, respectively; P ≤ 0.001). Multivariate analyses showed that energy sufficiency was independently associated with the total Functional Independence Measure gain and complication rate.ConclusionsEnergy intake during the first week after admission affected improvement of ADL and onset of complications during hospitalization in geriatric stroke inpatients. Geriatr Gerontol Int 2018; 18: 1334–1339.
Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
Authors: Riste Lisa K. , Coventry Peter A. , Reilly Siobhan T. , Bower Peter , Sanders Caroline 
Published: July 2018

AbstractBackgroundPerson‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient.ObjectiveTo describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people.MethodsWe followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides.ResultsThirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion.ConclusionsThis study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the “real” patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This “absence of patients” and time pressures within the MDGs led to reliance on the “virtual” record, enhanced by additional “soft” knowledge provided by staff, rather than ensuring the patient's voice was included.
Isocitrate dehydrogenase 1 mutations in melanoma frequently co‐occur with NRAS mutations
Authors: Linos Konstantinos , Tafe Laura J 
Published: July 2018

AimsIsocitrate dehydrogenase 1 (IDH1) is a metabolic enzyme that converts isocitrate to α‐ketoglutarate. IDH1 mutations are associated with the accumulation of the oncometabolite D‐2‐hydroxyglutarate, which acts as an epigenetic modifier, and the development of multiple malignancies.Methods and resultsFrom May 2013 to June 2017, 252 melanoma samples from 214 patients with advanced or distant metastatic disease were tested for somatic mutations with the 50‐gene AmpliSeq version 2 Cancer Hotspot Panel. Two hundred and twenty‐six samples were sequenced successfully from 206 patients with 26 samples being characterised as quantity not sufficient. Melanomas from 10 separate patients (4.9%) were positive for IDH1 R132C (nine) or R132S (one). In six cases, the tumours also had a co‐existing NRAS mutation (p.Q61R, Q61L and Q61K in two patients each) (P = 0.0044), whereas three patients had BRAF non‐V600E mutations (V600K, V600G and V600R). Two cases had a TP53 variant, two cases an ATM variant, one a CDKN2A variant and one had an APC variant. The patients’ ages ranged from 45 to 82 years (mean = 65.3, median = 65 years) and three of 10 patients were female (M:F ratio = 2:3). Three patients were stage 3 and seven were stage 4. Two are deceased, five are alive with stable disease (four on pembrolizumab) and three have no evidence of disease.ConclusionIDH mutations may define a unique subset of melanoma patients who are eligible for IDH1 targeted therapies or combined therapies, such as MEK inhibitors when there is co‐existing NRAS mutations, or immunotherapy.
Relationships among structural empowerment, innovative behaviour, self‐efficacy, and career success in nursing field in mainland China
Authors: Dan Xin , Xu Suhuan , Liu Jingying , Hou Ruonan , Liu Yanhui , Ma Hongwen 
Published: July 2018

AbstractAimThe purpose of the study is to explore the relationships among structural empowerment, innovative behaviour, self‐efficacy, and career success by nurses in mainland China.MethodA cross‐sectional study was designed, and participants were recruited from 6 tertiary hospitals in Tianjin, China. The study used an anonymous questionnaire, filled voluntarily by 460 nurses in spring 2017. Structural equation modelling analyses were conducted.ResultsThe results reveal that innovative behaviour is positively associated with career success and self‐efficacy, which, in turn, mediates the relationship between structural empowerment and career success. Structural empowerment is positively associated with innovative behaviour and career success. Self‐efficacy is positively associated with career success and mediates the relationship between innovative behaviour and career success.ConclusionHigher perceived structural empowerment, innovative behaviour, and self‐efficacy can increase career success of Chinese nurses.
Work‐related stress among nursing staff working in government hospitals and primary health care centres
Authors: Alenezi Ali Mohammed , Aboshaiqah Ahmad , Baker Omar 
Published: July 2018

AbstractAimWork‐related stress (WRS) in the nursing working environment is prevalent and significantly affects the performance of nurses and organizations. Poor nursing and administrative performance affects the delivery of safety and quality patient care. Thus, this study aims to compare the sources and factors of stress among nurses from hospitals and primary health care centres.MethodsA cross‐sectional study was conducted in five government hospitals and four sectors of primary health care centres in Saudi Arabia. Through a survey, the Nursing Stress Scale was completed by 347 nurses from February to March 2016.ResultsWorkload is perceived as the most common source of WRS, whereas inadequate preparation is regarded as the least. Other major sources are conflicts with physicians and nurses in primary centres and the lack of support and uncertainty concerning treatment in hospitals. The nurses' age, marital status, nationality, and job position are the significantly identified factors that contribute to stress.ConclusionOverall, the sources and factors of WRS significantly vary with nurses' working environment. Hence, understanding the perception of nurses towards their working environment can be a strategic basis in modifying policies in occupational stress management.
The effect of workload on nurses' non‐observance errors in medication administration processes: A cross‐sectional study
Authors: Jin Haizhe , Chen Han , Munechika Masahiko , Sano Masataka , Kajihara Chisato 
Published: July 2018

AbstractAimThis study, based on actual medical error cases involving nurses, sought to identify non‐observance errors—defying the standard operating procedures—in medication administration processes, and clarify the relationship between nursing workload and such behaviours.MethodsBased on a cross‐sectional survey, non‐observance error cases were collected from three Japanese hospitals between January and December 2014, using self‐reported data from participating nurses. Standard operating procedures and actual error content were compared to identify non‐observance errors and workload. The statistical analysis was used to determine the relationship between non‐observance error and workload.ResultsA total of 637 error cases were found in administering medication, of which 163 (25.6%) were workload‐related non‐observance errors. Individual analysis of the 163 cases identified seven workload issues that caused non‐observance error and six categories of non‐observance errors. The relationship between workload and such errors was also clarified.ConclusionOur findings clarify the influence of workload on non‐observance errors and may also help identify adjacent areas for specific improvements.
Management characteristics and corporate performance of Chinese chemical companies: the moderating effect of managerial ability
Authors: Wang Wei‐Kang , Lu Wen‐Min , Kweh Qian Long , Lee Jhong‐Jhe 
Published: July 2018

AbstractThis study examines the association between management characteristics and corporate performance, as well as how it is moderated by managerial ability among 103 Chinese chemical companies for the period 2008–2010. While we measure management characteristics from the perspectives of human quality, team structure, and economic incentives, we employ dynamic data envelopment analysis to gauge managerial ability. Our ordinary least squares regression results show that management characteristics are positively related to corporate performance, which is proxied by Tobin's Q. Furthermore, we find that managerial ability can further strengthen the positive relationship between management characteristics and corporate performance. In addition, we include graphs highlighting the moderating effects of managerial ability on the relationship between management characteristics and corporate performance. Overall, this study provides a greater understanding of the upper‐echelon theory and insights of managerial ability in a dynamic context.
Thermo‐mechanical properties of mullite ceramics: New data
Authors: Krenzel Thomas F. , Schreuer Jürgen , Laubner Derek , Cichocki Michel , Schneider Hartmut 
Published: July 2018

AbstractCoefficients of elastic stiffnesses and thermal expansion of hot isostatically pressed, reaction‐sintered and technical fused‐mullite ceramics were measured between 100 and 1673 K in comparison with single crystal mullite employing resonant ultrasound spectroscopy and dilatometry, respectively. Additionally, chemical and phase compositions and the microstructure of the ceramics were studied using X‐ray diffraction techniques and scanning electron microscopy. Our studies revealed that despite polycrystallinity and slight porosity of up to 1.6%, the elastic behavior of the hot isostatically pressed ceramics is near to ideal aggregate elastic properties of mullite single crystal, for example, their bulk moduli fit within 0.7% to B = 170.0 GPa of single crystal mullite. On the other hand, with B = 155 GPa, the reaction‐sintered mullite behaves significantly softer. The difference can be explained with more tight grain to grain contacts in hot isostatically pressed ceramics as compared to reaction‐sintered materials. The thermal expansion of both types of ceramics almost coincides with the corresponding averaged behavior of single crystal mullite. For example, between 573 and 1273 K, the volume expansion coefficients of all these materials are (18.0 ± 0.3)·10−6 K−1. Obviously, the microstructural features are less important for the macroscopic thermal expansion. Due to heterogeneous microstructure and high α‐alumina and zirconia contents, the corresponding properties of fused‐mullite refractory deviate strongly from those of the other mullite materials.
Measuring emotional support in family networks: Adapting the Family Network Method for individuals with a mild intellectual disability
Authors: Giesbers Sanne A. H. , Tournier Tess , Hendriks Lex , Hastings Richard P. , Jahoda Andrew , Embregts Petri J. C. M. 
Published: July 2018

AbstractBackgroundInformal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support.MethodTheFNMis designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts.ResultsBy carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the originalFNM. Data obtained by theFNM‐IDcan be analysed using social network analysis. Thereby, theFNM‐IDprovides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability.ConclusionsTheFNM‐IDis a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability.
Cuff challenges in blood pressure measurement
Authors: Palatini Paolo , Asmar Roland 
Published: July 2018

The characteristics of the optimal cuff for blood pressure (BP) measurement are still the subject of much debate. The choice of the appropriate cuff in obese individuals depends not only on the arm circumference but also on its shape because a conically shaped arm makes it difficult to fit the cuff to the arm. When a large‐size cylindrical cuff is used in conical arms, an overestimation of the true BP is likely to occur with BP discrepancies that may be as large as 10 mm Hg. With the advent of automatic oscillometric devices, the choice of the appropriate cuff became even more controversial because with oscillometric BP measurement the reference point is not the artery occlusion but the oscillometric peak signal. To overcome the problem of miscuffing in obese individuals, special cuffs that can accommodate a wide range of arm sizes have been designed. Using these cuffs, accurate oscillometric BP measurements can be obtained over a wide range of arm circumferences using a unique software algorithm. These wide‐range cuffs coupled to oscillometric devices may represent a good option for BP measurement in very obese subjects. However, their reliability should be confirmed in larger populations and different settings.
Surgical treatment of peri‐implantitis lesions with or without the use of a bone substitute—a randomized clinical trial
Authors: Renvert Stefan , Roos‐Jansåker Ann‐Marie , Persson Gösta Rutger 
Published: July 2018

AbstractAimTo assess whether the treatment outcome differed between surgical debridement, with or without a bone substitute.Materials and MethodsForty‐one adults with three‐ or four‐wall peri‐implant bone defects were enrolled in a 1‐year RCT. Surgical debridement (control group), or in combination with a bone substitute (Endobon®) (test group) was performed.ResultsRadiographic evidence of defect fill (primary outcome) was only significant in the test group (P = 0.004). At year 1, no bleeding on probing (BOP) in the control and test groups were 7/20 (35%) and 10/21 (47.6%), respectively (χ2 = 0.67, P = 0.41). Plaque scores did not differ by study group at baseline (P = 0.31), or at year 1 (P = 0.08). Mid‐buccal soft tissue recession changes did not differ by groups (P = 0.76). Successful treatment outcome (defect fill ≥1.0 mm, PPD values at implant ≤5 mm, no BOP, and no suppuration was identified in 1/20 (5.0%) control, and 9/21 (42.9%) test individuals (F = 7, 9, P < 0.01). Number needed to treat analysis identified an absolute risk reduction of 32.8% in benefit of the test procedure. (F = 7, 9, P < 0.01).ConclusionsSuccessful treatment outcome using a bone substitute was more predictable when a composite therapeutic endpoint was considered.
What confidence should we have in GRADE?
Authors: Mercuri Mathew , Baigrie Brian S. 
Published: July 2018

AbstractRationale, Aims, and ObjectivesConfidence (or belief) that a therapy is effective is essential to practicing clinical medicine. GRADE, a popular framework for developing clinical recommendations, provides a means for assigning how much confidence one should have in a therapy's effect estimate. One's level of confidence (or “degree of belief”) can also be modelled using Bayes theorem. In this paper, we look through both a GRADE and Bayesian lens to examine how one determines confidence in the effect estimate.MethodsPhilosophical examination.ResultsThe GRADE framework uses a criteria‐based method to assign a quality of evidence level. The criteria pertain mostly to considerations of methodological rigour, derived from a modified evidence‐based medicine evidence hierarchy. The four levels of quality relate to the level of confidence one should have in the effect estimate. The Bayesian framework is not bound by a predetermined set of criteria. Bayes theorem shows how a rational agent adjusts confidence (ie, degree of belief) in the effect estimate on the basis of the available evidence. Such adjustments relate to the principles of incremental confirmation and evidence proportionism. Use of the Bayesian framework reveals some potential pitfalls in GRADE's criteria‐based thinking on confidence that are out of step with our intuitions on evidence.ConclusionsA rational thinker uses all available evidence to formulate beliefs. The GRADE criteria seem to suggest that we discard some of that information when other, more favoured information (eg, derived from clinical trials) is available. The GRADE framework should strive to ensure that the whole evidence base is considered when determining confidence in the effect estimate. The incremental value of such evidence on determining confidence in the effect estimate should be assigned in a manner that is theoretically or empirically justified, such that confidence is proportional to the evidence, both for and against it.
Identification of a novel PLCD1 mutation in Chinese Han pedigree with hereditary leukonychia and koilonychia
Authors: Xue Ke , Zheng Yajie , Shen Changbing , Cui Yong 
Published: July 2018

SummaryBackgroundHereditary leukonychia is a rare nail dystrophy characterized by distinctive whitening of the nail plate. Mutations in the PLCD1 gene have been identified as a major causative factor in hereditary leukonychia (HL). However, few reports have analyzed the relationship between genotype and phenotype, especially in Chinese HL patients. Our study aims to explore the typical clinical features of hereditary leukonychia cases in Chinese Han pedigree and the correlations with PLCD1 gene mutation.Patients and methodsIn this study, two Chinese patients presented with leukonychia and koilonychia. Whole‐exome sequencing (WES) was performed to screen for the mutations in PLCD1 gene and other candidate genes for hereditary leukonychia. Parents with PLCD1 mutation were selected for Sanger sequencing.ResultsA novel heterozygote missense mutation in exon 9 of PLCD1 gene was identified in the proband and his mother. Whole‐exome sequencing revealed both, the proband (III.5) and his mother (II.4) carrying c.1451A>G mutation, while other family members had a normal sequence of the PLCD1 gene.ConclusionFor the first time, a hereditary leukonychia case with PLCD1 mutation has been described in Chinese Han pedigree. This finding suggests the PLCD1 mutation maybe involved in hereditary leukonychia.
The diagnosis and management of idiosyncratic drug‐induced liver injury
Authors: Hassan Ammar , Fontana Robert J. 
Published: July 2018

AbstractDrug‐induced liver injury (DILI) is an uncommon but important cause of liver disease that can arise after exposure to a multitude of drugs and herbal and dietary supplements. The severity of idiosyncratic DILI varies from mild serum aminotransferase elevations to the development of severe liver injury that can progress to acute liver failure resulting in death or liver transplantation within days of DILI onset. Chronic liver injury that persists for more than 6 months after DILI onset is also becoming increasingly recognized in up to 20% of DILI patients. Host demographic (age, gender, race), clinical and laboratory features at DILI onset have been associated with the severity and outcome of liver injury in DILI patients. In addition to cessation of the suspect drug, other medical interventions including the use of N‐acetylcysteine and corticosteroids in selected patients have shown some clinical benefit, but additional prospective studies are needed. A number of promising diagnostic, prognostic and mechanistic serum and genetic biomarkers may help improve our understanding of the pathogenesis and treatment of idiosyncratic DILI.
Molecular bloodmeal analyses reveal that Trypanosoma cruzi‐infected, native triatomine bugs often feed on humans in houses in central Brazil
Authors: Minuzzi‐Souza T. T. C. , Silva L. R. , Hagström L. , Hecht M. , Nitz N. , Gurgel‐Gonçalves R. 
Published: July 2018

AbstractThe identification of bloodmeal sources in triatomine bugs (Hemiptera: Reduviidae) is important in understanding vector–host associations and in measuring the risk for Chagas' disease transmission. The bloodmeal sources of triatomines infected with Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) caught in houses in central Brazil (Goiás State and the Federal District) were investigated during 2012–2014. Mitochondrial cytochrome b amplicons were used to identify bloodmeals through high‐resolution melting and DNA sequencing. Most bugs were found to have fed on either humans (45.7%) or chickens (43.1%). Human blood was detected in Triatoma sordida (n = 22/50 bugs), Triatoma pseudomaculata (n = 7/11 bugs), Panstrongylus megistus (n = 10/24 bugs), Panstrongylus geniculatus (n = 1/3 bugs) and Rhodnius neglectus (n = 18/28 bugs) (all: Hemiptera: Reduviidae). Sequencing identified Necromys (Rodentia: Cricetidae) mouse blood in P. geniculatus and Tropidurus (Squamata: Tropiduridae) lizard blood in T. pseudomaculata and T. sordida. These findings reveal new vector–host associations. The present results suggest frequent contact between humans and T. cruzi‐infected triatomines in central Brazil and indicate that Chagas' disease transmission by native vectors is an ongoing threat.