bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evaluation of evidence‐informed changes to an internationally educated nurse registration process
Authors: Kwan J.A. , Wang M. , Cummings G.G. , Lemermeyer G. , Nordstrom P. , Blumer L. , Horne N. , Giblin C. 
Published: May 2019

AimTo evaluate effectiveness of specific policy and practice changes to the process of registration for internationally educated nurses.BackgroundLittle research exists to inform registration policy for internationally educated health professionals.IntroductionInternationally educated nurse employment can help address nursing shortages. Regulators assess competencies for equivalency to Canadian‐educated nurses, but differences in health systems, education and practice create challenges.MethodsThe study setting was a Canadian province. We used a mixed methods approach, with a pre–post‐quasi‐experimental design and a qualitative evaluation. Previous analysis of relationships between applicant variables, registration outcomes and timelines informed changes to our registration process. Implementation of these changes composes the intervention. Comparisons between pre‐ and post‐implementation exemplar subgroups and timeline analyses were conducted using descriptive statistics, univariate analysis and non‐parametric tests. Data were collected from complete application files before (n = 426) and after (n = 287) implementation of the intervention. Interviews, focus groups and consultations were completed with various stakeholders.FindingsThe time between steps in the process was significantly reduced following implementation. Stakeholders reported an increase in perceived efficiency, transparency and use of evidence.DiscussionResults indicated that initial impacts of the policy changes streamlined the process for applicants and staff.ConclusionMaintaining a consistent and systematic review of an organization's data coupled with implementation of findings to effect policy and practice change may have an important impact on regulatory policy.Implications for Nursing PolicyThese findings represent the beginning of an international policy conversation. Policy changes based on organizational data can underlie major process improvement initiatives. Ongoing nursing shortages across the globe and increasing mobility of nurses make it important to have efficient and transparent regulatory policy informed by evidence.
Decision‐making in civil litigation: Effects of attorney credibility, evidence strength, and juror cognitive processing
Authors: Wood Steve M. , DeVault Alicia , Miller Monica K. , Kemmelmeier Markus , Summers Alicia D. 
Published: May 2019

AbstractThe current study examined the relationship between juror cognitive processing (measured by need for cognition [NFC]), attorney credibility, evidence strength, and civil litigation verdicts (liability, likelihood of causation, and compensatory damages). Participants (N = 446) viewed a videotaped mock civil trial in which the credibility of the attorneys and the strength of the plaintiff's evidence were manipulated. Plaintiff attorney credibility, defense attorney credibility, and strength of evidence interacted with one another for liability verdicts. In the strong evidence condition, the likelihood of a liable verdict was higher for a credible plaintiff attorney than a non‐credible plaintiff attorney when facing a non‐credible defense attorney. In the ambiguous evidence condition, the likelihood of a liable verdict was higher for a credible plaintiff attorney than a non‐credible plaintiff attorney when facing a credible defense attorney. Plaintiff attorney credibility, however, was found to be more influential on jurors’ decision‐making than case evidence for likelihood of causation and compensatory damage award decisions. Participants’ NFC also interacted with plaintiff attorney credibility. High NFC jurors were more influenced by a credible plaintiff attorney than low NFC jurors. Although these findings are counter to common findings in the NFC literature, they conform to a body of literature that supports the notion that jurors view attorney credibility as a piece of case evidence and not a peripheral cue as is often assumed. Thus, the findings indicate that attorneys do matter to the outcomes of cases. Policy and practice implications for attorneys and the courts are discussed.
Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline
Authors: Zhou Yaqing , Jia Limei , Lu Baojin , Gu Guoqiang , Hu Haijuan , Zhang Ziyuan , Bai Long , Cui Wei 
Published: May 2019

AbstractIn 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated the Guideline of Prevention, Detection, Evaluation and Management and Management of High Blood Pressure (HBP) in Adults. The purpose of the current study was to evaluate the potential impact of the 2017ACC/AHA HBP guideline on hypertension prevalence, awareness, and control rates. The data were collected from Physical Examination Center of the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 66 977), including demographic information and risk factors of hypertension. The hypertension prevalence, awareness, and control rates of people were evaluated according to the new guideline. Additionally, the factors related to hypertension prevalence were also assessed. According to previous HBP guideline, hypertension prevalence, awareness, and control rate were 30.54%, 44.33%, and 13.04%, respectively. However, when the 2017 ACC/AHA HBP guideline was introduced, the population with hypertension increased from 20 453 to 34 460, the hypertension prevalence rate increased from 30.54% to 51.45%, the awareness rate decreased from 44.33% to 26.31%, and the control rate declined from 13.04% to 2.72%. The most newly diagnosed hypertension patients were from the low‐risk population with young age and without the above histories. The 2017ACC/AHA HBP guideline indicated that high hypertension prevalence rate still existed with a substantial increase, while the awareness and control rates were relatively lowered.
Clinical visible signs of disease activity in vitiligo: a systematic review and meta‐analysis
Authors: van Geel N. , Grine L. , De Wispelaere P. , Mertens D. , Prinsen C.A.C. , Speeckaert R. 
Published: May 2019

AbstractVitiligo is an unpredictable depigmenting disorder for which a static method to assess disease activity is lacking. Presence of certain skin manifestations may be indicative of disease activity. Here, we evaluated the current evidence for an association between clinical signs and reported disease activity in vitiligo. A systematic review and meta‐analysis was performed based on a search in PubMed, Embase and Cochrane Library. Literature reporting skin manifestations and disease activity was analysed based on descriptive analyses and, if applicable, odd ratios. Forty‐six observational studies were selected and analysed, including 28 case reports. Reported clinical signs in relation to active vitiligo were as follows: Koebner's phenomenon, confetti‐like depigmentations, tri‐ and hypochromic lesions (including poorly defined borders), inflammatory borders/areas, itch and leukotrichia. Based on this search, strong evidence was found for Koebner's phenomenon. Poorly defined borders and confetti lesions are potential markers, although more data are needed to confirm this. Evidence for other skin manifestations was inconclusive, whereas case reports on inflammatory borders were indicative of active disease. Limitations included the lack of randomized controlled trials, large‐scale prospective studies and heterogeneity due to inconsistent definitions. This systematic review urges the vitiligo community to come forward with consensus‐based definitions as well as a reliable scoring system to assess these clinical signs and to design optimal trials to investigate their true predictive value.
Perceptions and psychosocial impact of food, nutrition, eating and drinking in people with inflammatory bowel disease: a qualitative investigation of food‐related quality of life
Authors: Czuber‐Dochan W. , Morgan M. , Hughes L. D. , Lomer M. C. E. , Lindsay J. O. , Whelan K. 
Published: May 2019

AbstractIntroductionExtensive research has provided an important understanding of the impact of inflammatory bowel disease (IBD) on nutrient intake, requirements and metabolism. By contrast, there has been limited research examining the psychosocial aspects of food, eating and drinking in IBD. The present study aimed to address this unmet need.MethodsQualitative semi‐structured interviews regarding the perceptions and psychosocial impact of food, eating and drinking were undertaken with 28 purposively selected people with IBD. Interviews were audio‐recorded and transcribed verbatim. Colaizzi's framework was used to structure the data analysis.ResultsFive major themes were identified. IBD symptoms and both surgical and medical treatments were described as having a direct impact on eating and drinking, with participants also using different food‐related strategies to control IBD symptoms. These included a process of experimentation to identify trigger foods, following a severely restricted and limited diet, eating small portions, and eating more frequently. However, their limited knowledge about if, and how, food affected their symptoms, often resulted in negative coping strategies that impacted on psychosocial functioning, including a lack of enjoyment of eating, being afraid to eat and finding social occasions stressful. Managing food and drinking also made food shopping and preparation more burdensome, creating problems with families, at work and for social life, as well as the need for careful preparation and advanced planning of activities.ConclusionsInflammatory bowel disease has a profound impact on psychosocial aspects of food and nutrition, which impacts on ‘food‐related quality of life’ (FRQoL). Further research is required to identify interventions that will improve FRQoL in patients with IBD.
Labor Market and Financial Shocks: A Time‐Varying Analysis
Authors: CORSELLO FRANCESCO , NISPI LANDI VALERIO 
Published: May 2019

AbstractWe estimate a time‐varying VAR model to analyze the effects of a financial shock on the U.S. labor market. We find that a tightening of financial conditions is highly detrimental to the labor market. We show that while negative financial shocks have been responsible for increases in unemployment, our model does not find significant contributions of financial shocks during periods of expansion. The source of this asymmetry is the time‐varying standard deviation of the identified shock, which is higher in times of financial distress; on the other hand, we find that the transmission mechanism does not significantly change over time.
A cohort study of the impact of epidural analgesia on maternal and neonatal outcomes
Authors: Yin Huifen , Hu Rong 
Published: May 2019

AbstractAimTo explore the impact of epidural analgesia on maternal and neonatal outcomes, especially the relation between epidural analgesia and intrapartum fever.MethodsA retrospective cohort study was conducted in a tertiary hospital for all deliveries from November 2017 to December 2017. A total of 506 women were divided into epidural and non‐epidural group by whether to receive analgesia or not. Univariate and multivariate analyses were performed with P < 0.05 as significant.ResultsEpidural analgesia was associated with higher risk of maternal intrapartum fever (relative risk [RR] = 3.28, 95% confidence interval, 1.55–6.95), more intravenous use of antibiotics (36.66% vs 17.04%, P<0.001), longer time of second stage (58.55 ± 33.75 vs 47.39 ± 28.36 min，P = 0.001) and longer total duration of labor (790.32 ± 433.71 vs 461.33 ± 270.39 min，P<0.001), but had no influence on mode of delivery, the amount of post‐partum hemorrhage or hospital stay after delivery and all the neonatal outcomes we studied. Further time effect analysis found that epidural analgesia less than 6 h did not increase the risk of intrapartum fever (RR = 1.73, P = 0.15), however, when epidural analgesia lasted over 6 h, it significantly increased the risk of fever (RR = 5.23, P<0.001) but did not increase more adverse outcomes.ConclusionHaving epidural anesthesia 6 h or more increases the risk of developing fever, but the prognosis of mothers and children is less affected.
An Evaluation of an Unstructured and Structured Approach to Increasing Recess Physical Activity
Authors: Behrens Timothy K. , Holeva‐Eklund Whitney M. , Luna Carmen , Carpenter Dick , Tucker Elizabeth , Field Julaine , Kelly Cheryl 
Published: May 2019

ABSTRACTBACKGROUNDThe purpose of this study was to evaluate an unstructured and a structured program designed to increase physical activity (PA). The unstructured program increased the amount of equipment during recess, whereas the structured program introduced activities to students.METHODSPA was observed using the System for Observing Play and Leisure Activity in Youth (SOPLAY) in two school districts in Colorado. Researchers recorded baseline and follow‐up observations for sedentary activity, moderate PA, and vigorous PA, as well as for available equipment for the unstructured program. Observations from schools were aggregated for data analyses at the district level.RESULTSFor the program increasing equipment, moderate PA and vigorous PA increased, while sedentary behavior decreased. For the structured program, moderate PA and vigorous PA did not increase, whereas sedentary behaviors increased following the program.CONCLUSIONSOther variables are likely influencing student PA during recess, such as teachers' interaction with students or the fidelity of the program. Results indicate that funding and implementing a program aimed at increasing PA will not necessarily accomplish that goal, and additional research should be performed to determine the best practice for increasing PA.
Transcriptome analysis of gingival tissues of enamel‐renal syndrome
Authors: Wang Yi‐Ping , Lin Hung‐Ying , Zhong Wen‐Lan , Simmer James P. , Wang Shih‐Kai 
Published: May 2019

AbstractBackground and objectiveBiallelic loss‐of‐function mutations of human FAM20A have been known to cause enamel‐renal syndrome (ERS), featured by agenesis of dental enamel, nephrocalcinosis, and other orodental abnormalities, including gingival hyperplasia. However, while the histopathology of this gingival anomaly has been analyzed, its underlying molecular mechanism remains largely unknown. This study aimed to unravel the pathogenesis of gingival hyperplasia in ERS.MethodsWhole‐exome sequencing was conducted for an ERS case. Transcriptome analyses, using RNA sequencing, of the patient's gingiva were performed to unravel dysregulated molecules and aberrant biological processes underlying the gingival pathology of ERS, which was further confirmed by histology and immunohistochemistry.ResultsTwo novel frameshift FAM20A mutations in Exon 1 (g.5417delG; c.129delG; p.Cys44Alafs*101) and Exon 5 (g.62248_62249delAG; c.734_735delAG; p.Glu245Glyfs*11) were identified. Transcriptional profiling of patient's gingival tissue revealed a total of 1683 genes whose expression had increased (1129 genes) or decreased (554 genes) at least 2‐fold compared to control gingival tissues. There were 951 gene ontology (GO) terms of biological process being significantly over‐represented or under‐represented. While GOs involved in extracellular matrix organization, angiogenesis, biomineralization, and epithelial cell proliferation appeared to be activated in ERS gingiva, genes related to keratinocyte differentiation, epithelial development, and keratinization were of decreased expression. FAM20A immunohistochemistry revealed a strong reactivity at the suprabasal layers of epithelium in control gingiva but showed a significantly diminished and scattered signal in ERS tissues. For genes showing significant over‐expression in the transcriptome analyses, namely ALPL, SPARC, and ACTA2, an increased immunoreactivity was observed.ConclusionOur results unraveled a potential role for FAM20A in homeostasis of both gingival epithelium and connective tissues.
Interaction effect of obstructive sleep apnea and periodic limb movements during sleep on heart rate variability
Authors: Li Xiao , Covassin Naima , Zhou Junying , Zhang Ye , Ren Rong , Yang Linghui , Tan Lu , Li Taomei , Xue Pei , Tang Xiangdong 
Published: May 2019

SummaryWe aimed at assessing cardiac autonomic function by heart rate variability during sleep in patients with obstructive sleep apnea and periodic limb movements during sleep, and to compare it with that of patients with obstructive sleep apnea only, periodic limb movements during sleep only, and controls. We also aimed at investigating the interaction effect between apnea–hypopnea index and periodic limb movement index on heart rate variability. Four groups of patients (n = 42 each, total = 168) were identified based on the presence/absence of obstructive sleep apnea and periodic limb movements during sleep: + obstructive sleep apnea/− periodic limb movements during sleep (5 ≤ apnea–hypopnea index < 30 events per hr), − obstructive sleep apnea/+ periodic limb movements during sleep (periodic limb movement index > 15 events per hr), + obstructive sleep apnea/+ periodic limb movements during sleep, − obstructive sleep apnea/− periodic limb movements during sleep (controls). All groups were matched for age, sex and body mass index. Time‐ and frequency‐domain heart rate variability measures were calculated over 5‐min periods of stable stage 2 non‐rapid eye movement sleep. In patients with both obstructive sleep apnea and periodic limb movements during sleep, LFnu and LF/HF ratio were higher than in those with obstructive sleep apnea only, periodic limb movements during sleep only, and controls, while HFnu was the lowest among the four groups. LFnu, HFnu and LF/HF ratio were significantly and independently associated with minimal oxygen saturation in the + obstructive sleep apnea/+ periodic limb movements during sleep group. There was a significant interaction effect between apnea–hypopnea index and periodic limb movement index on LF/HF ratio (p = 0.038) in patients with obstructive sleep apnea. Patients with elevated apnea–hypopnea index and elevated periodic limb movement index exhibited higher sympathovagal balance compared with those with high apnea–hypopnea index and low periodic limb movement index, and compared with those with low apnea–hypopnea index (regardless of periodic limb movement index). Increased sympathetic activation and decreased parasympathetic control appear to be related to the severity of oxygen desaturation. Apnea–hypopnea index and periodic limb movement index had interactive effects on increased sympathovagal balance in patients with obstructive sleep apnea.
External validation of a data‐driven algorithm for muscular activity identification during sleep
Authors: Cesari Matteo , Christensen Julie A. E. , Sorensen Helge B. D. , Jennum Poul , Mollenhauer Brit , Muntean Maria‐Lucia , Trenkwalder Claudia , Sixel‐Döring Friederike 
Published: May 2019

AbstractSeveral automated methods for scoring periodic limb movements during sleep (PLMS) and rapid eye movement (REM) sleep without atonia (RSWA) have been proposed, but most of them were developed and validated on data recorded in the same clinic, thus they may be biased. This work aims to validate our data‐driven algorithm for muscular activity detection during sleep, originally developed based on data recorded and manually scored at the Danish Center for Sleep Medicine. The validation was carried out on a cohort of 240 participants, including de novo Parkinson's disease (PD) patients and neurologically healthy controls, whose sleep data were recorded and manually evaluated at Paracelsus‐Elena Klinik, Kassel, Germany. In the German cohort, the algorithm showed generally good agreement between manual and automated PLMS indices, and identified with 88.75% accuracy participants with PLMS index above 15 PLMS per hour of sleep, and with 84.17% accuracy patients suffering from REM sleep behaviour disorder (RBD) showing RSWA. By comparing the algorithm performances in the Danish and German cohorts, we hypothesized that inter‐clinical differences may exist in the way limb movements are manually scored and how healthy controls are defined. Finally, the algorithm performed worse in PD patients, probably as a result of increased artefacts caused by abnormal motor events related to neurodegeneration. Our algorithm can identify, with reasonable performance, participants with RBD and increased PLMS index from data recorded in different centres, and its application may reveal inter clinical differences, which can be overcome in the future by applying automated methods.
The influence of batter formulation and predrying time on interparticle space fractions of a coated meat analog
Authors: Rahimi Jamshid , Adedeji Akinbode , Ngadi Michael 
Published: May 2019

AbstractThe purpose of the study was to understand the mechanism of microstructural changes in vegetable‐based meat analogs coated with different batter formulations. A meat analog (substrate) was developed by using vegetable proteins, coated with batters formulated from different combinations of wheat and rice flours, predried at various durations, and subsequently fried. The effect of batter formulation, predrying time, and frying time on spaces occupied by air (porosity, SOA), moisture (SOM), and fat (SOF) in the core region (the meat analog) was studied. The SOA, SOM, and SOF ranged between 8.28–32.72%, 16.73–58.31%, and 16.73–58.31%, respectively. All three fractions of pores in the meat analog were significantly influenced by predrying and frying times; however, batter formulation did not show any significant influence. Batter formulation did not show any significant influence on moisture and fat content within the meat analog. Fat content was not influenced by frying time; and only 90 min predrying made a difference.