bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staff and patient accounts of PRN medication administration and non‐pharmacological interventions for anxiety
Authors: Martin Krystle , Ham Elke , Hilton N. Zoe 
Published: May 2018

AbstractMost psychiatric inpatients will receive psychotropic PRN medication during their hospital stay for agitation, anxiety, and/or insomnia. While helpful in some cases, caution is warranted with regard to PRN use due to inherent risks of additional medication; therefore, experts advise that non‐pharmacological interventions should be attempted first where indicated. However, research to date highlights that, in practice, non‐pharmaceutical approaches are attempted in a minority of cases. While some information is known about the practice of PRN administration and the use of and barriers to implementing non‐pharmacological interventions for treating acute psychiatric symptoms, full understanding of this practice is hampered by poor or altogether missing documentation of the process. This study used interviews with patients and staff from two psychiatric hospitals to collect first‐person accounts of administering PRN medication for anxiety, thereby addressing the limitations of relying on documented notation found in previous research. Our results indicate that nurses are engaging in non‐pharmacological interventions more often than had previously been captured in research. However, the types of strategies suggested are not typically evidence based and further, only happening approximately half the time. The barriers to providing such care are centred on two main beliefs about client choice and efficacy of these non‐medical strategies. Implications for research and practice are discussed.
Putin's Peaks: Russian Election Data Revisited
Authors: Kobak Dmitry , Shpilkin Sergey , Pshenichnikov Maxim S. 
Published: May 2018

Abstract
Two years ago, Dmitry Kobak, Sergey Shpilkin and Maxim S. Pshenichnikov uncovered anomalies in Russia's election data. Following President Vladimir Putin's re-election in March this year, they take a fresh look at two new sets of data – but find much the same story within
“Zombie Trucks”: Cleaning up the Working Dead
Authors: Kaur Dipleen , Krall Jenna R. 
Published: May 2018

Abstract
“Zombie” or “glider trucks” bring old engines back to life, but a rule change that requires those engines to meet current emissions standards is stuck in limbo. Dipleen Kaur and Jenna R. Krall discuss the impact this delay may have on pollution and health
Tribal Economies: Water Settlements, Agriculture, and Gaming in the Western U.S.
Authors: Deol Suhina , Colby Bonnie 
Published: May 2018

AbstractThis paper examines patterns in water rights quantification, agriculture, gaming, and economic characteristics across selected Native American nations in the United States (U.S.) to provide a perspective across tribal nations and regions. A unique set of data was analyzed, drawing from the U.S. Census Bureau, U.S. Department of Agriculture, court decrees, water rights data, and other sources. Fifty‐one tribal nations are included in this study, based on availability of data on agricultural and economic indicators. Data analysis indicates the following: 1) tribes with quantified water rights also have higher agricultural revenue, 2) tribes which have quantified their water rights are more likely to also operate a casino, 3) tribes which have quantified their water rights tend to be more commonly located close to major cities, and 4) tribes which operate at least one casino have notably higher annual household income compared to tribes which do not. A number of interesting regional differences are observed: 1) Northwest tribes have significantly higher rates of water quantification than other regions, 2) Midwest tribes have the highest prevalence of casino operations compared to the other areas, and 3) the Southwest has the smallest proportion of tribes with casino operations. This paper identifies patterns across multiple tribal nations and across regions, and does not focus on establishing cause‐and‐effect. Causal relationships among tribal water quantification, farming, gaming, income levels, and unemployment will vary by location and tribe. Identifying cause and effect among different components of tribal economic development warrants further inquiry. The examination of patterns presented here illuminates interesting differences among tribal nations and regions, and provides a broad context for tribal leaders how best to cultivate sustainable, resilient economies and water resource management.
Assessing Tribal College Priorities for Enhancing Climate Adaptation on Reservation Lands
Authors: Fillmore Helen M. , Singletary Loretta , Phillips John 
Published: May 2018

AbstractOn reservation lands, tribal colleges and universities (TCUs) are key to preparing indigenous communities to adapt to the effects of a changing climate. The original mission of TCUs, to improve access to higher education and to sustain the cultural heritage of indigenous people, facilitates close ties between TCU faculty and staff and the indigenous communities they serve. Since 1994, the land‐grant status of TCUs allows access to limited federal funds in support of research, education, and outreach to improve food security, natural resource management, and rural quality of life, while expanding public access to higher education to underserved populations in remote rural areas. This study was designed to assess the priorities for enhancing climate adaptation on reservation lands. It summarizes the results of an assessment implemented at the 2016 Annual First Americans Land‐Grant Consortium Conference. Study participants included faculty, administrators, outreach educators, support staff, and students representing 25 of the 37 TCUs in the United States. Results from this national assessment suggest that in order for TCUs to effectively meet the climate adaptation needs of indigenous communities, additional fiscal and human resource investments are necessary. Specifically, this includes fiscal support to enhance climate science teaching, research, and professional development programs. Additional goals include creating or expanding food‐sovereignty programs, increasing community outreach education, investigating climate change impacts on water resource quality, access, and related ecological services, and exploring renewable and alternative energy opportunities.
Climate Change in the Lumbee River Watershed and Potential Impacts on the Lumbee Tribe of North Carolina
Authors: Emanuel Ryan E. 
Published: May 2018

AbstractA growing body of research focuses on climate change and Indigenous peoples. However, relatively little of this work focuses on Native American tribes living in the Atlantic Coastal Plain of the United States. The Lumbee Tribe of North Carolina is a large (60,000 member) Native American tribe located on the Coastal Plain in present day North Carolina (U.S.). The tribe has deep connections to the Lumbee River, which flows through a watershed dominated by extensive forested wetlands. In this paper, I outline key issues associated with climate change and water in the region, and I use long‐term climatic and hydrologic datasets and analysis to establish context for understanding historical climate change in the Lumbee River watershed. Downscaled climate model outputs for the region show how further changes may affect the hydrologic balance of the watershed. I discuss these changes in terms of environmental degradation and potential impacts on Lumbee culture and persistence, which has remained strong through centuries of adversity and has also experienced a resurgence in recent years. I close by acknowledging the especially vulnerable position of the Lumbee Tribe as a non‐federal tribe that lacks access to certain resources, statutory protections, and policies aimed at helping Native American tribes deal with climate change and other environmental challenges.
The effect of cooling rate on structural and electrical properties of multiferroic BLF‐PT ceramics
Authors: Shen Shujin , Chen Jianguo , Jian Jie , Luo Feng , Mei Jing , Cheng Jinrong 
Published: May 2018

AbstractThe solid solutions of 0.57(Bi0.8La0.2)FeO3‐0.43PbTiO3 (BLF‐PT) were prepared by the solid‐state reaction process. The as‐sintered ceramics were annealed at 350°C and then cooled in different media. BLF‐PT ceramics cooled in boiling water (BW) and NaCl solutions exhibit the rhombohedral structure with higher domain density, while the tetragonal structure was observed in the specimen cooled in the furnace. Moreover, BLF‐PT ceramics cooled in BW with cooling rate of about 10°C/s exhibit the enhanced electrical properties with dielectric constant εr, remnant polarization Pr, piezoelectric constant d33 of 940, 28 μC/cm2 and 210 pC/N, respectively. Rayleigh analysis was utilized to study of domain wall motion of BLF‐PT ceramics cooled in different media.
Limits to genetic rescue by outcross in pedigree dogs
Authors: Windig J.J. , Doekes H.P. 
Published: May 2018

SummaryOutcrossing should reduce inbreeding levels and associated negative effects in highly inbred populations. In this study, we investigated the effectiveness of different outcrossing schemes using computer simulations. The inbreeding rate estimated for a 25‐year period of 2.1% per generation in a highly inbred dog breed reduced to 1.8% when a single litter was produced by an outcross without backcrosses. To reduce the inbreeding rate below 1%, more than eight of the 14 litters born yearly in the recipient breed had to be outcrossed. However, outcrossing in pedigree dogs is usually followed by backcrossing and generally involves one or a few litters. Backcrossing reduced the effect of outcrossing considerably. When two litters were produced by an outcross followed by one generation of backcross, the inbreeding rate was 2.0% per generation. Continuously outcrossing was more effective than a single or a few outcrosses. When each newborn litter during 25 years had a 5% chance of being produced by an outcross, the inbreeding rate reduced to −0.2%. To investigate the possibility that new alleles were introduced from the donor population into the recipient population, the fate of different type of alleles (varying from completely lethal to beneficial) before and after an outcross was investigated by first simulating 80 years of natural selection prior to the outcross and then different types of outcross. Because natural selection reduced the frequency of lethal alleles before outcrossing, the introduction of a lethal allele that was segregating in the donor breed but not in the recipient breed occurred rarely. Introduction of slightly detrimental alleles or neutral alleles occurred more frequently. In conclusion, outcrossing only had a limited short‐term effect unless repeated continuously. Nevertheless, it may help to buy time in which the population structure can be changed so that the effective population size increases.
Effects of incorporating environmental cost and risk aversion on economic values of pig breeding goal traits
Authors: Ali B.M. , de Mey Y. , Bastiaansen J.W.M. , Oude Lansink A.G.J.M. 
Published: May 2018

SummaryEconomic values (EVs) of traits, accounting for environmental impacts and risk preferences of farmers, are required to design breeding goals that contribute to both economic and environmental sustainability. The objective of this study was to assess the effects of incorporating environmental costs and the risk preferences of farmers on the EVs of pig breeding goal traits. A breeding goal consisting of both sow efficiency and production traits was defined for a typical Brazilian farrow‐to‐finish pig farm with 1,500 productive sows. A mean‐variance utility function was employed for deriving the EVs at finishing pig level assuming fixed slaughter weight. The inclusion of risk and risk aversion reduces the economic weights of sow efficiency traits (17%) while increasing the importance of production traits (7%). For a risk‐neutral producer, inclusion of environmental cost reduces the economic importance of sow efficiency traits (3%) while increasing the importance of production traits (1%). Genetic changes of breeding goal traits by their genetic standard deviations reduce emissions of greenhouse gases, and excretions of nitrogen and phosphorus per finished pig by up to 6% while increasing farm profit. The estimated EVs could be used to improve selection criteria and thereby contribute to the sustainability of pig production systems.
Implementing computer‐mediated intercultural communication in English education: A critical reflection on its pedagogical challenges
Authors: Lee K. 
Published: May 2018

AbstractIntegrating computer‐mediated intercultural communication (CMIC) activities into language curricula has been discussed as an innovative approach. Despite the increasing number of successful examples reporting positive outcomes of adopting CMIC activities in language‐learning environments, it has also been noted that there are significant pedagogical challenges observed when CMIC activities are introduced into classrooms. However, previous studies tend only to briefly mention some of those challenges and to list general solutions to them, rather than deeply engaging with the issues and their educational and social consequences upon students' learning practices. Thus, this qualitative case study documents diverse pedagogical challenges faced by Korean students and teacher in their English‐as‐a‐foreign language classroom, in which a series of CMIC activities were set up and conducted. The challenges analysed in this paper include the unrealistically high implementation cost, the educational inequality issues created by irreducible gaps in students' socio‐economic backgrounds, and the unresolved struggles to develop positive student subjectivities and linguistic identities. In conclusion, the article proposes three instructional principles, drawn in turn from the two closely interrelated theories: multiliteracies pedagogy and critical pedagogy. Fundamentally, the author argues that effective adoption of CMIC activities needs a more pedagogically, socially, and culturally sensitive approach.
Modelling the impact of new patient visits on risk adjusted access at 2 clinics
Authors: Kolber Michael A. , Rueda Germán , Sory John B. 
Published: May 2018

AbstractObjectiveTo evaluate the effect new outpatient clinic visits has on the availability of follow‐up visits for established patients when patient visit frequency is risk adjusted.Data SourcesDiagnosis codes for patients from 2 Internal Medicine Clinics were extracted through billing data.Study DesignThe HHS‐HCC risk adjusted scores for each clinic were determined based upon the average of all clinic practitioners' profiles. These scores were then used to project encounter frequencies for established patients, and for new patients entering the clinic based on risk and time of entry into the clinics.Principal FindingsA distinct mean risk frequency distribution for physicians in each clinic could be defined providing model parameters. Within the model, follow‐up visit utilization at the highest risk adjusted visit frequencies would require more follow‐up slots than currently available when new patient no‐show rates and annual patient loss are included. Patients seen at an intermediate or lower visit risk adjusted frequency could be accommodated when new patient no‐show rates and annual patient clinic loss are considered.ConclusionsValue‐based care is driven by control of cost while maintaining quality of care. In order to control cost, there has been a drive to increase visit frequency in primary care for those patients at increased risk. Adding new patients to primary care clinics limits the availability of follow‐up slots that accrue over time for those at highest risk, thereby limiting disease and, potentially, cost control. If frequency of established care visits can be reduced by improved disease control, closing the practice to new patients, hiring health care extenders, or providing non‐face to face care models then quality and cost of care may be improved.
Quality improvement opportunities for handover practices in birth centres: A case study from a process perspective
Authors: Hitzert Marit , Boesveld Inge C. , Hermus Marieke A. A. , de Graaf Johanna P. , Wiegers Therese A. , Steegers Eric A.P. , Meijboom Berthold R. , Akkermans Henk A. 
Published: May 2018

AbstractRationale, aims and objectivesHandovers within and between health care settings are known to affect quality of care. Health care organizations, struggle how to guarantee best care during handovers. The aim of this paper is to evaluate handover practices in Dutch birth centres from a process perspective, to identify obstacles and opportunities for quality improvements.MethodsThis case study in 7 Dutch birth centres was undertaken from a process perspective by conducting observations and using process mapping. This study is part of the Dutch Birth Centre Study.ResultsSolutions to obstacles during handovers from a birth centre to a hospital were identified in at least 1 of the 7 birth centres. Four of the centres had agreements with a hospital for client support when a caregiver in a birth centre was absent. Face‐to‐face communication during handover was observed in 6 of the 7 centres. An electronic health record was noted in 1 centre; joint training of acute situations was available in 2 centres with 3 centres indicating that this was not compulsory. Continuity of caregiver was present in 4 birth centres with postpartum care available in 3 centres.ConclusionsEnsuring quality during handovers requires a case‐specific process approach. This study reveals distinctive aspects during handovers, concrete obstacles, and potential solutions for quality improvements in inter‐organizational networks, transferrable to birth centres in other countries as well.
Burden of non‐alcoholic fatty liver disease in Australia
Authors: Mahady Suzanne E , Adams Leon A 
Published: May 2018

AbstractNon‐alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease in the Australian population, although precise estimates of prevalence are lacking. NAFLD may progress to liver fibrosis, cirrhosis, decompensated liver disease, and liver cancer and is becoming an increasingly common indication for liver transplantation in Australia and New Zealand. There is an extrahepatic burden of NAFLD extending beyond the liver, which is manifested by an increased risk of developing cardiovascular disease, diabetes, and chronic renal impairment, all of which are common causes of morbidity in the Australian population. Early recognition of those patients at high risk of developing advanced liver disease is essential in order to target those who will benefit from intensive lifestyle modification. In this review, we present data on the epidemiology of NAFLD within Australia, its associated health burden in terms of hepatic and extrahepatic complications, common clinical presentations, and indications for treatment. We also propose a research agenda that highlights knowledge needed to improve diagnosis and management specific to the Australian context.
Cardiovascular Outcomes of Cholinesterase Inhibitors in Individuals with Dementia: A Meta‐Analysis and Systematic Review
Authors: Isik Ahmet Turan , Soysal Pinar , Stubbs Brendon , Solmi Marco , Basso Cristina , Maggi Stefania , Schofield Patricia , Veronese Nicola , Mueller Christoph 
Published: May 2018

ObjectivesTo evaluate the cardiovascular (CV) effects of acetylcholinesterase inhibitors (AChEIs) in individuals with dementiaDesignSystematic review and meta‐analysis.SettingTwo authors independently searched major electronic databases from inception until June 17, 2017, for longitudinal (without a control group) and cohort (with a control group) studies reporting CV outcomes in relation to AChEIs. Randomized controlled trials were excluded because they included relatively healthy subjects.ParticipantsIndividuals with dementia and controls.MeasurementsChanges in CV parameters were summarized using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Event rates were used to assess incidence of hypertension and bradycardia. Incidence of CV events in demented patients versus in healthy controls were compared using hazard ratios (HRs).ResultsOf 4,588 initial hits, 31 studies including 258,540 individuals with dementia and 2,246,592 controls were analyzed. In longitudinal and open‐label studies, AChEIs were associated with a significantly greater incidence of hypertension (n=1,573, 4%, 95% CI=2–8%, I2=47%) and bradycardia (n=13,703, 2%, 95% CI=1–6%, I2=98%). AChEIs were associated with a decrease in heart rate (SMD=–1.77, 95% CI=–3.58–0.03, I2=78%) and an increase in PR interval (SMD=0.10, 95% CI=0.008–0.19, I2=3%) from baseline. During a median follow‐up of 116 weeks, AChEIs were associated with a significantly lower risk of CV events (stroke, acute coronary syndrome, CV mortality; HR=0.63, 95% CI=0.45–0.88, I2=18%), without a significantly greater risk of bradycardic events (HR=1.40, 95% CI=0.76–2.59, I2=98%).ConclusionAChEI therapy may be associated with negative chronotropic and hypertensive effects but also with lower risk of CV events.
How to optimize the design of a quantitative HREM experiment so as to attain the highest precision
Authors: DEN DEKKER A. , SIJBERS J. , VAN DYCK D. 
Published: May 2018

SummaryUsing parameter estimation theory, an expression is derived for the maximum precision with which the position of a single atom can be estimated from high resolution transmission electron microscopy images. This expression, being a complicated function of the object as well as of the microscope parameters and the electron dose, can be used to optimize the design of an HREM experiment so as to attain the highest precision.
Retrograde transport of γ‐secretase from endosomes to the trans‐Golgi network regulates Aβ42 production
Authors: Kanatsu Kunihiko , Hori Yukiko , Ebinuma Ihori , Chiu Yung Wen , Tomita Taisuke 
Published: May 2018

AbstractThe aberrant metabolism of amyloid‐β protein (Aβ) in the human brain has been implicated in the etiology of Alzheimer disease (AD). γ‐Secretase is the enzyme that generates various forms of Aβ, such as Aβ40 and Aβ42, the latter being an aggregation‐prone toxic peptide that is involved in the pathogenesis of AD. Recently, we found that clathrin‐mediated endocytosis of γ‐secretase affects the production and deposition of Aβ42 in vivo, suggesting that the membrane trafficking of γ‐secretase affects its enzymatic activity. However, the detailed intracellular trafficking pathway of γ‐secretase and its contribution to Aβ42 generation remain unclear. Here, we show that Retro‐2, which inhibits the retrograde transport, elevated the Aβ42‐generating activity both in cultured cells and mice brain. However, the result of in vitro γ‐secretase assay using a recombinant substrate suggested that Retro‐2 did not elevate the intrinsic Aβ42‐production activity of γ‐secretase. Immunocytochemistry and cell‐surface biotinylation experiments revealed that γ‐secretase is recycled via the endosome‐to‐trans‐Golgi network transport. In addition, γ‐secretase is retrogradely transported by syntaxin 5/6, known as targets of Retro‐2, independent pathway. Conversely, TPT‐260, which enhances the trafficking function of retromers, lowered Aβ42 levels and the Aβ42/(Aβ40 + Aβ42) ratio in secreted Aβ from cultured cells. Our results strongly suggest that the endosome‐to‐trans‐Golgi network trafficking of γ‐secretase regulates its Aβ42 production activity. Modulation of this trafficking pathway might be a potential target for the development of Aβ42‐lowering AD therapeutics.Open science badgesThis article has received a badge for *Open Materials* because it provided all relevant information to reproduce the study in the manuscript. The complete Open Science Disclosure form for this article can be found at the end of the article. More information about the Open Practices badges can be found at https://cos.io/our-services/open-science-badges/.
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