bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships between cardiometabolic disorders and obstructive sleep apnea: Implications for cardiovascular disease risk
Authors: Zhao Xiaolong , Li Xinyi , Xu Huajun , Qian Yingjun , Fang Fang , Yi Hongliang , Guan Jian , Yin Shan kai 
Published: January 2019

Previous studies have reported the effects of obstructive sleep apnea (OSA) and cardiometabolic disorders on cardiovascular disease (CVD), but associations between cardiometabolic biomarkers and two cardinal features of OSA (chronic intermittent hypoxia and sleep fragmentation) and their interactions on CVD in OSA populations remain unclear. A total of 1727 subjects were included in this observational study. Data on overnight polysomnography parameters, biochemical biomarkers, and anthropometric measurements were collected. Metabolic syndrome (MS), including blood pressure, waist circumference (WC), fasting glucose, triglycerides (TG), and high‐density lipoprotein cholesterol (HDL‐C), was diagnosed based on modified criteria of the Adult Treatment Panel III. WC, mean arterial pressure, TG and low‐density lipoprotein cholesterol (LDL‐C) were independently associated with apnea‐hypopnea index (AHI) after adjustment for confounding factors (β = 0.578, P = 0.000; β = 0.157, P = 0.001; β = 1.003, P = 0.019; and β = 4.067, P = 0.0005, respectively). Furthermore, the interaction analysis revealed joint effects between hypertension, obesity, hyperglycemia, and LDL‐C dyslipidemia and AHI on CVD. The relative excess risks of CVD due to the interactions with OSA were 2.06, 1.02, 0.48, and 1.42, respectively (all P < 0.05). In contrast, we found no independent effect of the microarousal index (MAI) on CVD. However, LDL‐C level and some MS components (WC, TG) were associated with MAI. Our findings indicate that hypoxemia and cardiometabolic disorders in OSA may potentiate their unfavorable effects on CVD. Sleep fragmentation may indirectly predispose patients with OSA to an increased risk of CVD. Thus, cardiometabolic disorders and OSA synergistically influence cardiometabolic risk patterns.
A multi‐university assessment of patient safety competence during clinical training among baccalaureate nursing students: A cross‐sectional study
Authors: Alquwez Nahed , Cruz Jonas Preposi , Alshammari Farhan , Felemban Ebaa Marwan , Almazan Joseph U. , Tumala Regie B. , Alabdulaziz Hawa M. , Alsolami Fatmah , Silang John Paul Ben T. , Tork Hanan M. M. 
Published: January 2019

AbstractAims and objectivesTo assess the perceived patient safety competence during clinical training of Saudi nursing students.BackgroundEnsuring safety in healthcare settings requires improvements in the educational and clinical practice of professionals. Experts stressed that shared patient safety culture must be of primary importance; they also emphasised the resolute need for theoretically driven research approaches for patient safety competence in healthcare organisations and educational institutions.DesignDescriptive, cross‐sectional design.MethodsThis study was conducted in six government universities in Saudi Arabia. A sample of 829 nursing students was surveyed using the health professional education in patient safety survey. Descriptive and inferential statistics were used to analyse the data. The study adhered to the STROBE guideline for cross‐sectional studies (See Supporting Information Appendix S1).ResultsThe percentage of agreement on the items of the health professional education in patient safety survey ranged from 61.5%–76.5%. The dimension “understanding human and environmental factors” received the highest perceived competence, whereas the dimension “working in teams” received the lowest competence. Significant differences in students’ patient safety competence from different universities were reported. Male students perceived their competence in “working in teams” higher than the female students. Students in their internship year had significantly higher levels of competence in all the six dimensions of the health professional education in patient safety survey than students in the third‐ and fourth‐year levels.ConclusionsSaudi nursing students have positive perceptions towards their patient safety competencies. Significant differences were found in the patient safety competence of nursing students between universities, gender and year of study.Relevance to clinical practiceThe results provide valuable insights and guidance for improving the patient safety competence of nursing students. The findings can be used to guide the creation of policies and interventions that may ensure the continuous development of patient safety competence of nursing students as they navigate the clinical area.
Nursing students’ knowledge and attitudes of blood donation: A multicentre study
Authors: Cicolini Giancarlo , Comparcini Dania , Alfieri Sara , Zito Elena , Marta Elena , Tomietto Marco , Simonetti Valentina 
Published: January 2019

AbstractAims and objectivesTo investigate factors involved in the blood donation (BD) in a population of Italian nursing students (NSs).BackgroundYoung people are still numerically limited among potential blood donors. Recent research on this topic has underlined the need to promote recruitment programmes and focused advertising campaigns to specific targeted population.DesignCross‐sectional study. The STROBE checklist was used to grant adequate and complete reporting of research.MethodsThe study was carried out in five Italian Universities, and a structured, 22‐item questionnaire was distributed to 532 NSs (mean age = 24.64, SD = 7.41, min = 19; max = 55; population, female = 80.8% of total) to explore propensity, obstacles, knowledge of BD and to assess associations between variables. Descriptive (frequency, mean and SD) and inferential (χ2) statistics were conducted.ResultsThe overall level of knowledge among NSs donors is high, when compared with non‐donors (p < 0.05); the propensity for donation is acceptable (34.8% of the total are donors; mean = 3.17 donation). The obstacles perceived by participants are “practical” (20% and 22.8% think they do not have enough time to donate or are unsuitable because of lifestyle reasons; respectively). A relevant aspect regards the NSs’ perceived role as future healthcare professionals to be responsible to educate and influence potential donors (81.5%).ConclusionsSpecifically tailored BD campaigning should be implemented to sensitise University students. NSs could become effective motivators among students of different Universities or faculties. Thanks to their role and capability to put themselves in the peer group. NSs could contribute to the promotion of this selfless practice and to the development of a mature, responsible civic attitude.Relevance to clinical practiceNursing educators should play a pivotal role in developing teaching methods to promote BD among NSs.
Persistence and outcomes of non‐vitamin K antagonist oral anticoagulants versus warfarin in patients with non‐valvular atrial fibrillation
Authors: Wu Shanshan , Xie Shuo , Xu Yingjie , Que Dongdong , Yau Tung On , Wang Lizi , Huang Yuanping 
Published: January 2019

AbstractAims and objectivesTo compare persistence and outcomes of non‐vitamin K antagonist oral anticoagulants (NOACs) versus warfarin in Chinese patients with non‐valvular atrial fibrillation (AF).BackgroundGiven the unpredictable warfarin response and the costliness of NOACs, more research is needed to clarify which drug enjoys better persistence and outcomes, helping to provide personalised care for patients.DesignA prospective cohort study.MethodsChinese patients taking NOACs or warfarin from March 2016–April 2018 were followed up by telephone or outpatient visit at 3, 6 months and half a year thereafter. Anticoagulant persistence and outcomes including stroke and bleeding were collected. We used Cox regression to analyse data. This study was reported according to the STROBE guideline.ResultsA total of 344 patients were enrolled; 146 patients received NOACs including dabigatran and rivaroxaban, and 198 patients received warfarin. Persistence with anticoagulants was low and dropped sharply at the third month. Patients on NOACs had worse persistence at 3, 6 and 12 months than those on warfarin. There was no difference in the incidence of ischaemic stroke and bleeding between groups, although ischaemic stroke and major bleeding occurred less frequently in the NOACs group. Paroxysmal AF, no heart failure and no stroke were predictors of NOACs non‐persistence. Prior catheter ablation and no diabetes were associated with poor persistence of warfarin. The main reason for anticoagulant cessation was patient preference.ConclusionsChinese patients taking NOACs had lower persistence, similar rate of ischaemic stroke and bleeding compared with those on warfarin. Further inventions are needed to improve persistence in Chinese patients on NOACs.Relevance to clinical practiceAnticoagulation should highlight both persistence and outcomes emphasising personalised care of different drugs. Further interventions to improve persistence should be developed based on causes and risk factors and carried out in the third month of therapy.
How do parents influence their adolescents’ use of over‐the‐counter analgesics: A review of the current literature
Authors: Skarstein Siv , Lagerløv Per , Helseth Sølvi , Leegaard Marit 
Published: January 2019

AbstractAim and objectivesContinuous use of over‐the‐counter analgesics (OTCAs) may prevent adolescents from learning healthier options and might lead to lifelong use of such medicines. It is possible that parents’ own use of OTCAs might influence adolescents, but little is known about this issue. Our research questions were; “What are the main factors leading to a high use of OTCAs among adolescents and how can health professionals support these adolescents in their pain management?”BackgroundFrequent consumption of OTCAs may cause health problems such as drug‐induced headache and liver failure. Some adolescents frequently use non‐prescribed pain medication and their attitudes towards the use of OTCAs vary from responsible to careless.DesignA “systematic search and review” was conducted between March 2017 and May 2018. Quantitative and qualitative studies were included.MethodsWe used the PRISMA Statement checklist, the PRISMA flow diagram and The Critical Appraisal Skills Programme for quality appraisal. Our search identified 3,386 possible sources, 2,043 articles were selected for title examination, and 70 articles underwent abstract review. Fourteen articles were reviewed entirety. Ten articles were of acceptable quality.ResultsThe importance of parental influence on adolescent use of OTCAs is significant. These findings seem to be independent of country and culture.ConclusionParents are the most important source of information regarding the use of OTCAs; further, they are the main supplier of the medicine. A broad understanding of human development, health, pain and use of pain medication is needed to develop targeted information and support adolescents with high consumption of non‐prescription pain medication.Relevance to clinical practiceInformation from professionals such as school nurses is important. Professionals must consider the physical, social and psychological aspects influencing the use of OTCAs. Information should be made available to adolescents, parents and society in general.
Evaluation of the Marginal and Internal Fit of Implant‐Supported Metal Copings Fabricated with 3 Different Techniques: An In Vitro Study
Authors: Yildirim Bengisu , Paken Gamze 
Published: January 2019

AbstractPurposeTo compare the marginal and internal fit of cobalt‐chromium (Co‐Cr) alloy copings fabricated by with lost wax technique (LW), computer‐aided design and computer‐aided manufacturing (CAD/CAM), and direct metal laser sintering (DMLS).Materials and MethodsThirty‐six tissue level, straight titanium abutments were screwed onto implant replicas. All specimens were embedded in acrylic resin and randomly divided into 3 subgroups according to the fabrication of metal coping: LW, CAD/CAM, and DMLS. In total, 36 (n = 12/group) Co‐Cr implant‐supported metal copings were prepared. Marginal, intermarginal, axial, and occlusal fits of each coping were measured using the silicone replica technique. The data were evaluated statistically using one‐way ANOVA and Bonferioni post‐hoc test (α = 0.05).ResultsThe CAD/CAM group showed significantly lower marginal fit than the LW group and DMLS groups (p < 0.001). The marginal fit of the LW group was not significantly different from the DMLS group (p = 0.721). No significant difference found among the fabrication methods in terms of intermarginal fit (p = 0.913). The CAD/CAM group showed lower axial fit than the LW group (p = 0.026), but there was no statistical difference between the DMLS group and the LW (p = 0.999) and CAD/CAM groups (p = 0.247). No significant differences found among the fabrication methods in terms of occlusal fit (p = 0.158).ConclusionsThe LW and DMLS groups showed better marginal fit compared to the CAD/CAM group; however, the CAD/CAM group was better than the LW group in terms of axial fit. All fabrication methods demonstrated similar intermarginal and occlusal fit.
Optimal Consumption and Investment Problem Incorporating Housing and Life Insurance Decisions: The Continuous Time Case
Authors: Kung Ko‐Lun , Yang Shang‐Yin 
Published: January 2019

AbstractThis study considers the optimal consumption‐investment‐insurance problem incorporating housing decisions of a household when interest rates and labor income are stochastic. Under the complete market assumption, we derive the closed‐form solution of the optimal insurance demand, portfolio choice, and housing consumption. We calibrate the model using data from the financial market of Taiwan. We find that the insurer's pricing strategy has a significant impact on the household's consumption pattern. Specifically, additional loading in insurance premium allows the life‐cycle model to produce hump‐shaped consumptions of both perishable goods and housing. Loading also creates an unfair background risk to households. However, we only find a small portfolio risk reduction, because households optimally choose a large coverage to mitigate the mortality exposure. This suggests empirical background risk studies overestimate the risk reduction when insurance is available.
Selection and Redistribution in the Irish Tontines of 1773, 1775, and 1777
Authors: Li Yikang , Rothschild Casey 
Published: January 2019

AbstractWe construct and analyze a new data set on the mortality experience of the nominees of the 1773, 1775, and 1777 Irish tontines. The active participation of Genevan speculators in these Irish tontines has been well documented. We use our new data to quantify both the extent to which these nominees were longer‐lived and the financial consequences of their enhanced longevity. The Genevan nominees were indeed notably longer‐lived than non‐Genevan nominees—particularly so for the 50 nominees selected by a Genevan investment syndicate. Their enhanced longevity had only trivial financial consequences for the issuer, but it led to significant redistribution from non‐Genevan to Genevan investors. We highlight the implications of this across‐group distributional risk for modern proposals to introduce tontine‐like elements into modern retirement pensions.
Integrating life history traits into predictive phylogeography
Authors: Sullivan Jack , Smith Megan L. , Espíndola Anahí , Ruffley Megan , Rankin Andrew , Tank David , Carstens Bryan 
Published: January 2019

AbstractPredictive phylogeography seeks to aggregate genetic, environmental and taxonomic data from multiple species in order to make predictions about unsampled taxa using machine‐learning techniques such as Random Forests. To date, organismal trait data have infrequently been incorporated into predictive frameworks due to difficulties inherent to the scoring of trait data across a taxonomically broad set of taxa. We refine predictive frameworks from two North American systems, the inland temperate rainforests of the Pacific Northwest and the Southwestern Arid Lands (SWAL), by incorporating a number of organismal trait variables. Our results indicate that incorporating life history traits as predictor variables improves the performance of the supervised machine‐learning approach to predictive phylogeography, especially for the SWAL system, in which predictions made from only taxonomic and climate variables meets only moderate success. In particular, traits related to reproduction (e.g., reproductive mode; clutch size) and trophic level appear to be particularly informative to the predictive framework. Predictive frameworks offer an important mechanism for integration of organismal trait, environmental data, and genetic data in phylogeographic studies.
Interpretive phenomenological methodologists in nursing: A critical analysis and comparison
Authors: Burns Margie , Peacock Shelley 
Published: January 2019

AbstractPhenomenology is one of the most popular qualitative research methodologies used in nursing research. Although interpretive phenomenology is often a logical choice to address the concerns of nursing, the vast number of methods of phenomenology means choosing an appropriate method can be daunting, especially for novice researchers. It is critical that nurse researchers select a phenomenological method that fits the research problem and the skill and world view of the researcher; doing so will result in a research experience that resonates with and excites the researcher. The interpretive phenomenological methodologies of Benner, Munhall, and Conroy each offer unique methods of phenomenological inquiry. However, to date, we are not aware of any literature that explores and compares the methodological approaches of these nurses. In this paper, the origins and influence of phenomenology as both a philosophy and methodology on nurse researchers will be explored, followed by a critical analysis and comparison of these three nurses. By highlighting the distinctive differences and attributes of each method, this paper provides an analysis and comparison of the approaches of these prominent nurses. In doing so, we aim to aid the researcher in their methodological selection, thereby resulting in a successful and rewarding research endeavor.
Gastrointestinal motility in patients with end‐stage renal disease on chronic hemodialysis
Authors: Broberg Bo , Madsen Jan L. , Fuglsang Stefan , Holst Jens J. , Christensen Karl Bang , Rydahl Casper , Idorn Thomas , Feldt‐Rasmussen Bo , Hornum Mads 
Published: January 2019

AbstractBackgroundPrevious studies indicated delayed gastric emptying in patients with end‐stage renal disease (ESRD) using indirect methods. The objective of the current study was to examine gastrointestinal motility using a direct method as well as the role of the incretin hormones and glucagon.MethodsPatients on chronic hemodialysis and with either normal glucose tolerance, impaired glucose tolerance or type 2 diabetes, and healthy control subjects (N = 8, respectively) were studied. Gastric emptying time was measured by repeated gamma camera imaging for 6 hours after intake of a radioactive labeled standardized mixed solid and liquid meal. Glucagon, glucagon‐like peptide‐1 (GLP‐1), and glucose‐dependent insulinotropic polypeptide (GIP) levels were measured.Key ResultsPatients were age, gender and BMI matched with controls. We found significantly higher gastric retention at 15 minutes, prolonged gastric mean emptying time, and gastric half‐emptying time of the solid marker in all three groups of ESRD patients compared to controls. Significant differences in mean total area under the concentration curve (AUC) values across the four groups for GIP (P = 0.001), but not for GLP‐1 and glucagon. The ESRD group had significant higher total AUC of GIP and glucagon compared to controls (P < 0.001 and P < 0.04) but not for GLP‐1 (P = 0.4). No difference in incremental AUC was found.Conclusions and InferencesWe found altered gastrointestinal motility in dialysis patients, with higher gastric retention and prolonged gastric emptying, and higher total AUC of GIP and glucagon independent of the presence of diabetes or prediabetes.
Azithromycin and erythromycin susceptibility and macrolide resistance genes in Prevotella from patients with periodontal disease
Authors: Arredondo Alexandre , Blanc Vanessa , Mor Carolina , Nart José , León Rubén 
Published: January 2019

AbstractObjectivesTo study oral Prevotella spp. isolated from patients with chronic periodontitis, to determine their susceptibility to azithromycin and erythromycin and to screen the presence of macrolide resistance genes therein.Material and MethodsIsolates with a Prevotella‐like morphology were obtained from subgingival samples of 52 patients with chronic periodontitis. Each isolate was identified to the species level by sequencing of the 16S rRNA gene. In 100 Prevotella spp. isolates, azithromycin and erythromycin susceptibility was determined using the E test method, and the screening of erm(A), erm(B), erm(C), erm(F), erm(G), erm(Q) and mef(A) genes was done by PCR.ResultsPrevotella intermedia and Prevotella nigrescens were the most identified species (33% each). Minimum inhibitory concentrations (MICs) ranges for both antibiotics were 0.016/0.032 to >256 μg/ml. MIC50 values for azithromycin and erythromycin were 1.5 and 1 μg/ml, respectively, and MIC90 values were >256 μg/ml for both antibiotics. Nineteen per cent of the isolates carried erm(B), and 51% carried erm(F).ConclusionsThe MIC values found were high compared to previous studies. erm(F) was greatly prevalent, and we describe for the first time the erm(B) gene in Prevotella spp. The presence of either of the genes seems to be associated with a higher degree of resistance to azithromycin and erythromycin.
The Contemporary Presidency Energy or Chaos? Turnover at the Top of President Trump’s White House
Authors: Kumar Martha Joynt 
Published: January 2019

The group of approximately two dozen White House staff titled “assistant to the president” form a president’s core leadership team, making turnover at this level particularly important for the stability and direction of the presidential decision‐making process. Among the assistants to the president group, President Donald Trump’s White House had the highest turnover of top‐ranked staff experienced by any recent president. At 20 months, two‐thirds of assistants appointed by President Trump in his first year in office left or announced their imminent departure. That level of turnover led to leadership changes in the dozen White House offices that are key to the processing of presidential decisions; to the policies a chief executive develops, initiates, and implements; and to those units charged with managing a president’s relationships with those outside of the administration. Without a team working together, it is difficult for a president’s staff to coordinate its plans and work as well as develop and articulate commonly shared presidential priorities and goals.