bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing the symptom science model with environmental health
Authors: Castner Jessica , Amiri Azita , Rodriguez Jeannie , Huntington‐Moskos Luz , Thompson Lisa M. , Zhao Shuang , Polivka Barbara 
Published: July 2019

AbstractObjectiveGlobally, indoor and outdoor pollutants are leading risk factors for death and reduced quality of life. Few theories explicitly address environmental health within the nursing discipline with a focus on harmful environmental exposures. The objective here is to expand the National Institutes of Health Symptom Science Model to include the environmental health concepts of environmental endotype (causative pathway) and environmental exposure.DesignMeleis’ research to theory strategy for theory refinement was used. Research workshop proceedings, environmental health nursing research expert consensus, panelist research trajectories, and review of the literature were utilized as data sources.ResultsOngoing emphasis on the physical environment as a key determinant of health and theoretical perspectives for including environmental exposures and endotypes in symptom science are presented. Definitions of these concepts, further developed, are provided. Recommendations to strengthen environmental health nursing research and practice through capacity building/infrastructure, methods/outcomes, translational/clinical research, and basic/mechanistic research are included.ConclusionThe revised model deepens theoretical support for clinical actions that include environmental modification, environmental health education, and exposure reduction. This modification will enable a middle‐range theory and shared mental model to inspire the prioritization of environmental health in nursing leadership, research, practice, and education.
The efficacy of UVA1 phototherapy in psoriasis: Clinical and histological aspects
Authors: Silpa‐archa Narumol , Pattanaprichakul Penvadee , Charoenpipatsin Norramon , Jansuwan Natchaya , Udompunthurak Suthipol , Chularojanamontri Leena , Wongpraparut Chanisada 
Published: July 2019

AbstractBackgroundAlthough ultraviolet A1 (UVA1) phototherapy is available for nearly 30 years, only few studies have been conducted for plaque‐type psoriasis.ObjectivesTo determine the efficacy and safety of UVA1 phototherapy in psoriasis by assessing the clinical and histological outcomes.MethodsThis open study enrolled 15 patients with moderate to severe plaque‐type psoriasis. All of the patients had skin type IV. A whole‐body UVA1 device consisting of 24 lamps, was irradiated at a medium dose of 50 J/cm2 three‐times weekly for 30 sessions. Topical and systemic psoriasis treatments were discontinued before and during treatment; patients could only use emollients and antihistamines until 1‐month post‐completion. Psoriasis Area and Severity Index (PASI) scores were determined at baseline; at sessions 10th, 20th and 30th; and 1 month after treatment. Four‐millimetre punch biopsies were obtained from the same psoriasis lesion at baseline and session 30th. Changes in histopathological gradings and polymorphonuclear, lymphocyte and Langerhans cell numbers were monitored.ResultsTwelve patients completed the study. The mean age was 41.3 years (range: 25‐71). The median PASI scores at baseline, session 30th and 1‐month post‐treatment were 16 (8.2, 43.3), 11 (4.4, 43.3) and 9.2 (2.7, 36.4), respectively. Although the PASI scores had improved significantly by 1‐month post‐treatment (P = .006), the histological parameters demonstrated minimal changes. All patients tolerated the phototherapy well and the most common side effect was skin tanning.ConclusionsWhile medium‐dose UVA1 phototherapy demonstrated some efficacy in moderate to severe plaque‐type psoriasis. However, it might not be an excellent choice.
The Political Side of Consociationalism Reconsidered: Switzerland between a Polarized Parliament and Delicate Government Collegiality
Authors: Freiburghaus Rahel , Vatter Adrian 
Published: July 2019

AbstractThis paper builds upon the concept of “coalescent elite behaviour” which is crucial in consociational theory, but contested regarding its actual conceptualization. Contrary to Lijphart's (1968) original assumption that elites are generally committed to an “overarching cooperation”, we hypothesize that institutional venues must be taken in account. Thus, the aim of this paper is twofold: Conceptually, we try to clarify the nature of “amicable agreement” regarding two core institutions (i.e. parliament, government), and regarding executive‐legislative relations. Empirically, we follow a two‐step empirical approach that combines a cross‐time comparison of the decision‐making process regarding the revision of the Swiss basic pension scheme (AHV) with a cross‐case assessment following Fischer's two‐dimensional typology. More generally, our findings serve to inductively refine the “political side” of consociationalism.
Does Private Schooling Affect Noncognitive Skills? International Evidence Based on Test and Survey Effort on PISA
Authors: DeAngelis Corey A. 
Published: July 2019

ObjectiveThis study estimates the effects of private schooling on noncognitive outcomes as measured by patterns of student responses on exams and surveys.MethodsI use Programme for International Student Assessment (PISA) data from over 300,000 individual students within 44 countries in 2009 and a historical natural experiment to estimate the causal impact of private schooling on student effort. Since nations with larger shares of Catholics in 1900 tend to have larger shares of private schooling today, the study uses the Catholic share of the population in 1900 as an exogenous instrument to predict whether a given child is in a private school in 2009.ResultsThe results suggest that private schooling increases student effort on PISA tests, as measured by test decline, while decreasing diligence on student surveys, as measured by careless answer patterns and nonresponse rates. In addition, I find that private schooling substantially increases PISA test scores, and that stronger noncognitive skills are associated with higher PISA scores.ConclusionSince this is the first study to connect school sector to these noncognitive outcomes, additional research on this topic is especially welcome. More research is also needed on the validity of measures such as test decline, careless answer patterns, and nonresponse rates.
Clinical Debrief: learning and well‐being together
Authors: Farrington Rebecca , Collins Lisa , Fisher Pip , Danquah Adam , Sergeant Jamie 
Published: July 2019

SummaryBackgroundClinical environments can be so stressful to medical students as to be detrimental to their learning and well‐being. Our intervention, Clinical Debrief, integrates learning through clinical experience with the development of positive coping strategies. Students shared cases and experiences during weekly small group classroom discussions, facilitated by general practitioners (from outside their current hospital placement), throughout two consecutive 12‐week blocks of their first clinical year. Alongside enquiry‐based and clinical reasoning learning, we gave students a safe space to reflect on their affect. Our aim was to critically examine students’ views in Clinical Debrief.MethodAnonymised quantitative and qualitative evaluation data were collected over 3 years using online questionnaires on completion of each 12‐week block. The data relating to psychological supervision were analysed independently and in parallel, using thematic analysis for qualitative data.We aim to help students develop positive coping mechanisms, promoting empathy,self‐awarenessand wellbeingResultsA total of 1857 evaluations were extracted (response rate 67%). The median (interquartile range) overall rating for Clinical Debrief sessions was 9 (8–10), where 10 indicates ‘excellent’ and 1 indicates ‘significant improvement needed’. The rating for the supervisory aspects of the sessions and free‐text comments were positive. Students appreciated safe environments, the session structure, facilitator role modelling, transitional support and processing of emotional experiences.DiscussionMandatory integrated longitudinal supervision, using trained clinician facilitators, was positively received by students in transition to clinical placements. Normalising the emotional impact of medical work destigmatises distress. Linking clinical reasoning with affective state awareness to contextualise case management, following Mezirow's transformative learning theory, brings added benefit to learning and well‐being. Student demand for the expansion of Clinical Debrief is evidence of success.
Decreased risk of HIV‐associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population‐based analysis
Authors: Kerschberger Bernhard , Schomaker Michael , Telnov Alex , Vambe Debrah , Kisyeri Nicholas , Sikhondze Welile , Pasipamire Lorraine , Ngwenya Siphiwe Mavis , Rusch Barbara , Ciglenecki Iza , Boulle Andrew 
Published: July 2019

AbstractObjectivesThis paper assesses patient‐ and population‐level trends in TB notifications during rapid expansion of antiretroviral therapy in Eswatini which has an extremely high incidence of both TB and HIV.MethodsPatient‐ and population‐level predictors and rates of HIV‐associated TB were examined in the Shiselweni region in Eswatini from 2009 to 2016. Annual population‐level denominators obtained from projected census data and prevalence estimates obtained from population‐based surveys were combined with individual‐level TB treatment data. Patient‐ and population‐level predictors of HIV‐associated TB were assessed with multivariate logistic and multivariate negative binomial regression models.ResultsOf 11 328 TB cases, 71.4% were HIV co‐infected and 51.8% were women. TB notifications decreased fivefold between 2009 and 2016, from 1341 to 269 cases per 100 000 person‐years. The decline was sixfold in PLHIV vs. threefold in the HIV‐negative population. Main patient‐level predictors of HIV‐associated TB were recurrent TB treatment (adjusted odds ratio [aOR] 1.40, 95% confidence interval [CI]: 1.19–1.65), negative (aOR 1.31, 1.15–1.49) and missing (aOR 1.30, 1.11–1.53) bacteriological status and diagnosis at secondary healthcare level (aOR 1.18, 1.06–1.33). Compared with 2009, the probability of TB decreased for all years from 2011 (aOR 0.69, 0.58–0.83) to 2016 (aOR 0.54, 0.43–0.69). The most pronounced population‐level predictor of TB was HIV‐positive status (adjusted incidence risk ratio 19.47, 14.89–25.46).ConclusionsThis high HIV‐TB prevalence setting experienced a rapid decline in TB notifications, most pronounced in PLHIV. Achievements in HIV‐TB programming were likely contributing factors.
MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient
Authors: Gallastegui Aitor , Davies Emma , Zwingenberger Allison L. , Nykamp Stephanie , Rishniw Mark , Johnson Philippa J. 
Published: July 2019

AbstractComplete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty‐nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty‐eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3‐32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.
Barriers and Facilitators for the Use of NURSING Bedside Handovers: Implications for Evidence‐Based Practice
Authors: Malfait Simon , Eeckloo Kristof , Van Biesen Wim , Van Hecke Ann 
Published: July 2019

AbstractBackgroundPrevious studies on bedside handovers have identified nurse‐related barriers and facilitators for implementing bedside handovers, but have neglected the existing ward’s nursing care system as an important influencing factor.AimsTo determine the association between the existing nursing care system (i.e., decentralized, two‐tier, or centralized) on a ward and the barriers and facilitators of the bedside handover.MethodsStructured individual interviews (N = 106) on 14 nursing wards in eight hospitals were performed before implementation of bedside handovers. The structured interview guide was based on a narrative review. Direct content analysis was used to determine the nursing care system of a ward and the degree to which barriers and facilitators were present. Pearson’s Chi‐square analysis was used to determine whether there were associations between the nursing care systems concerning the presence of barriers and facilitators for implementing bedside handovers.ResultsTwelve barriers and facilitators were identified, of which three are new to literature: the possible loss of opportunities for socializing, collegiality, and overview; head nurse’s role; and role of colleagues. The extent to which barriers and facilitators were present differed across nursing care systems, with the exception of breach of confidentiality (barrier), and an existing structured handover (facilitator). Overall, nurses working in decentralized nursing care systems report fewer barriers against and more facilitators in favor of using bedside handovers than nurses in two‐tier or centralized systems.Linking Evidence to ActionBefore implementing bedside handovers, the context of the nursing care system may be considered to determine the most effective process to implement change. Based on these study findings, implementing bedside handovers could be more challenging on wards with a two‐tier or centralized care system.
Prevalence and characterization of multidrug resistance and variant Salmonella genomic island 1 in Salmonella isolates from cattle, poultry and humans in Iran
Authors: Ghoddusi Arefeh , Nayeri Fasaei Bahar , Zahraei Salehi Taghi , Akbarein Hesameddin 
Published: July 2019

AbstractSalmonella enterica is a common food‐borne pathogen with occasional multidrug resistance (MDR). Salmonella genomic island (SGI1) is a horizontally transmissible genomic island, containing an MDR gene cluster. All Salmonella serotypes are public health concern, although there is an additional concern associated with those that harbour SGI1. In Iran, there are no data on the presence of SGI1 variants in Salmonella isolates. The present study was conducted to identify MDR‐ and SGI1‐carrying Salmonella strains isolated from various sources and to compare their genetic relatedness between human and animal sources. In total, 242 Salmonella isolates collected from chicken, cattle, and humans from 2008 through 2014 were studied. The isolates were tested for resistance to 14 antimicrobials via the disc diffusion method. They were also tested for the presence of SGI1 variants via PCR, and genetic relatedness was evaluated based on pulsed‐field gel electrophoresis (PFGE). Resistance to at least one antimicrobial agent was observed in 132 (54%) Salmonella isolates (n = 242), while more than 40% of the isolates showed MDR. Based on PCR analysis, eight variants of SGI1, including SGI1, SGI1‐B, SGI1‐C, SGI1‐D, SGI1‐F, SGI1‐I, SGI1‐J and SGI1‐O, were found in both human and animal isolates. Statistical analysis revealed no significant difference in the prevalence of SGI1 variants between human and animal isolates (p > 0.05). Macrorestriction PFGE analysis of the isolates with the same SGI1 variant and resistance patterns revealed genetic relatedness ranging from 70% to 100% among human and animal isolates. According to our review, this is the first documentation of SGI1 in Salmonella isolates in Iran. The presence of similar SGI1 variants in both humans and animals, along with their related PFGE patterns, suggests that food‐producing animals may be a source of MDR Salmonella isolates in Iran.
Machine Learning to Aid Tuning of Numerical Parameters in Topology Optimization
Authors: Lynch Matthew E. , Sarkar Soumalya , Maute Kurt 
Published: July 2019

Abstract
Recent advances in design optimization have significant potential to improve the function of mechanical components and systems. Coupled with additive manufacturing, topology optimization is one category of numerical methods used to produce algorithmically generated optimized designs making a difference in the mechanical design of hardware currently being introduced to the market. Unfortunately, many of these algorithms require extensive manual setup and control, particularly of tuning parameters that control algorithmic function and convergence. This paper introduces a framework based on machine learning approaches to recommend tuning parameters to a user in order to avoid costly trial and error involved in manual tuning. The algorithm reads tuning parameters from a repository of prior, similar problems adjudged using a dissimilarity metric based on problem metadata and refines them for the current problem using a Bayesian optimization approach. The approach is demonstrated for a simple topology optimization problem with the objective of achieving good topology optimization solution quality and then with the additional objective of finding an optimal “trade” between solution quality and required computational time. The goal is to reduce the total number of “wasted” tuning runs that would be required for purely manual tuning. With more development, the framework may ultimately be useful on an enterprise level for analysis and optimization problems—topology optimization is one example but the framework is also applicable to other optimization problems such as shape and sizing and in high-fidelity physics-based analysis models—and enable these types of advanced approaches to be used more efficiently.
Early Neoproterozoic continental arc system at the central Jiangnan Orogen, South China: Geochronological and geochemical constraints on the key igneous rock-association
Authors: Zhang Yuzhi , Wang Yuejun 
Published: July 2019

Abstract
To better reveal the tectonic process of the Jiangnan Orogen in creating the united South China Block (SCB), a set of new geochronological, geochemical, and Sr-Nd-Hf-O isotopic data is herein presented for the coeval early Neoproterozoic mafic to acid rocks in the Lengjiaxi Group and its equivalents. Our data show that these rocks belong to subalkaline basalt, basaltic andesite, andesite, and dacite in composition, and can be geochemically classified into N-MORB- and arc-like mafic (Group 1 and Group 2, respectively), along with high-Mg andesitic-dacitic (Group 3) rocks. They yield zircon U-Pb ages of 837 ± 4 Ma, 832 ± 11 Ma, and 835 ± 7 Ma, respectively, suggesting their early Neoproterozoic (ca. 835 Ma) origin. Group 1 has SiO2 = 47.21–52.45 wt%, MgO = 7.36–10.07 wt% with Mg-number of 56–68, 87Sr/86Sr(t) = 0.7062–0.7136 and εNd(t) = +1.3–+9.4, along with N-MORB-like REE- (rare earth element) and PM (primitive mantle)-normalized patterns, suggesting its derivation from a refractory MORB-like source newly introduced by slab-derived fluid. The Group 2 samples are classified as tholeiitic basalt and basaltic andesite with SiO2 = 48.78–55.75 wt%, MgO = 7.70–12.74 wt%, Mg-number = 63–77, 87Sr/86Sr(t) = 0.7046–0.7098 and εNd(t) = –1.6 to –0.4. They exhibit similar “spiky” REE- and PM-normalized patterns to typical arc basalt, with pronounced enrichment in (large ion lithophile elements) and sharp depletion in (high field strength elements), probably inheriting from a sub-arc source modified by fluids and/or melts released from recycled sedimentary component. The Group 3 rocks show SiO2 = 57.74–66.30 wt%, FeOt = 6.22–8.59 wt%, Mg-number = 43–66, K2O+Na2O = 3.18–6.17 wt% with K2O/Na2O of 0.59–3.28, classified as high-Mg andesites and dacites. Diagnostic elemental and isotopic ratios of Group 3 include (La/Yb)cn = 7.7–11.4, (Gd/Yb)cn = 1.44–1.87, Eu/Eu* = 0.49–0.80, Nb/La = 0.27–0.42 and εNd(t) = –7.3 to –5.4, resembling to those of other early Neoproterozoic high-Mg intermediate rocks in the SCB, originating from a mantle wedge source with proportional addition of the recycled SCB sediment-derived components. In combination with the available data and geological observations, it is concluded that the N-MORB- and arc-like mafic, along with high-Mg andesitic rocks are coeval in the Lengjiaxi Group and its equivalents along the central Jiangnan Orogen and formed at ca. 847–832 Ma of the early Neoproterozoic period. The synthesis of these observations suggests the development of an early Neoproterozoic continental arc-basin setting. The arc-basin system westerly subducted and finally closed at ca. 830 Ma and the assembly of the Yangtze and Cathaysia blocks terminated at ca. 810 Ma along the central Jiangnan Orogen.
The Xiaoqinling metamorphic core complex: A record of Early Cretaceous backarc extension along the southern part of the North China Craton
Authors: Li Yunjian , Zhu Guang , Su Nan , Xiao Shiye , Zhang Shuai , Liu Cheng , Xie Chenglong , Yin Hao , Wu Xiaodong 
Published: July 2019

AbstractMany metamorphic core complexes (MCCs) of Early Cretaceous age are documented in the northern part of the North China Craton (NCC), which formed in a backarc extensional setting. However, whether or not the MCCs are also present in the southern part of the NCC, and where the western boundary of backarc extension lies, remain unclear. We present new structural and geochronological data to show that Early Cretaceous structures in the Xiaoqinling region (China) lying in the southern part of the central NCC represent a Cordilleran-type MCC. The NW-dipping detachment zone on the northwestern edge of the Xiaoqinling MCC is a ductile extensional shear zone that is overprinted by a later brittle detachment fault. The footwall (lower plate) consists of Archean metamorphic rocks and Mesozoic plutonic rocks, and was cut by a series of ductile normal sense shear belts and later brittle normal faults that strike predominantly NE-SW. Both the ductile and brittle structures indicate that NW-SE extension was responsible for the development of the MCC. Geochronological data suggest that the MCC initiated at 138 Ma and lasted until 100 Ma, recording a protracted extensional history. The MCC experienced an early phase of crustal-scale normal faulting (138–126 Ma) and later isostatic doming (125–100 Ma), consistent with the “rolling-hinge” model. The Xiaoqinling MCC shows similar features and a similar evolution to other intraplate MCCs in the northern and southeastern parts of the NCC, and shows that the southern part of the NCC was also involved in intense backarc extension and magmatism. Distribution of these intraplate MCCs indicates synchronous backarc extension over a length of around 1800 km. Delamination of a flat oceanic slab during roll-back is consistent with such large-scale, synchronous extension in the overriding plate.