bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nature of nursing errors and their contributing factors in intensive care units
Authors: Eltaybani Sameh , Mohamed Nadia , Abdelwareth Mona 
Published: April 2018

ABSTRACTBackgroundErrors tend to be multifactorial and so learning from nurses' experiences with them would be a powerful tool toward promoting patient safety.AimTo identify the nature of nursing errors and their contributing factors in intensive care units (ICUs).MethodsA semi‐structured interview with 112 critical care nurses to elicit the reports about their encountered errors followed by a content analysis.ResultsA total of 300 errors were reported. Most of them (94·3%) were classified in more than one error category, e.g. ‘lack of intervention’, ‘lack of attentiveness’ and ‘documentation errors’: these were the most frequently involved error categories. Approximately 40% of reported errors contributed to significant harm or death of the involved patients, with system‐related factors being involved in 84·3% of them. More errors occur during the evening shift than the night and morning shifts (42·7% versus 28·7% and 16·7%, respectively). There is a statistically significant relation (p ≤ 0·001) between error disclosure to a nursing supervisor and its impact on the patient.ConclusionsNurses are more likely to report their errors when they feel safe and when the reporting system is not burdensome, although an internationally standardized language to define and analyse nursing errors is needed. Improving the health care system, particularly the managerial and environmental aspects, might reduce nursing errors in ICUs in terms of their incidence and seriousness.Relevance to clinical practiceTargeting error‐liable times in the ICU, such as mid‐evening and mid‐night shifts, along with improved supervision and adequate staff reallocation, might tackle the incidence and seriousness of nursing errors. Development of individualized nursing interventions for patients with low health literacy and patients in isolation might create more meaningful dialogue for ICU health care safety.
When all seems lost: management of refractory constipation—Surgery, rectal irrigation, percutaneous endoscopic colostomy, and more
Authors: Wilkinson‐Smith V. , Bharucha A. E. , Emmanuel A. , Knowles C. , Yiannakou Y. , Corsetti M. 
Published: April 2018

AbstractWhile the pharmacological armamentarium for chronic constipation has expanded over the past few years, a substantial proportion of constipated patients do not respond to these medications. This review summarizes the pharmacological and behavioral options for managing constipation and details the management of refractory constipation. Refractory constipation is defined as an inadequate improvement in constipation symptoms evaluated with an objective scale despite adequate therapy (ie, pharmacological and/or behavioral) that is based on the underlying pathophysiology of constipation. Minimally invasive (ie, rectal irrigation and percutaneous endoscopic colostomy) and surgical therapies are used to manage refractory constipation. This review appraises these options, and in particular, percutaneous endoscopic colostomy, which as detailed by an article in this issue, is a less invasive option for managing refractory constipation than surgery. While these options benefit some patients, the evidence of the risk: benefit profile for these therapies is limited.
Quantifying Rome symptoms for diagnosis of the irritable bowel syndrome
Authors: Chang J. Y. , Almazar A. E. , Richard Locke G. , Larson J. J. , Atkinson E. J. , Talley N. J. , Saito Y. A. 
Published: April 2018

AbstractBackgroundIrritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, diagnosed on symptom‐based criteria. Many have reported discrepancies between formal Rome criteria and diagnoses made in clinical practice. The aim of the study was to explore whether a quantitative version of the Rome criteria would better represent a clinical diagnosis of IBS than the current dichotomous criteria for symptom measure.MethodsAs part of a large, case‐control study, participants completed a validated bowel disease questionnaire. Rome criteria were analyzed based on 15 individual symptoms. Penalized logistic regression model with stepwise selection was used to identify significant symptoms of IBS which were independently associated with case‐control status.Key ResultsIn cases with a clinical diagnosis of IBS, 347 (70%) met Rome criteria for IBS. Increasing number of Rome symptoms were found related to the odds of being diagnosed with IBS. Nearly half of the Rome‐negative case group experienced infrequent symptoms suggesting milder disease. Five of 15 Rome symptoms were associated with predicting case‐control status in the final model, with 96% correctly classified among Rome‐positive cases, 76% for Rome‐negative cases, and 91% for controls.Conclusions and InferencesIrritable bowel syndrome appears to be a spectrum disorder. Quantifying individual symptoms of Rome criteria has greater utility than the current application in representing the degree of IBS affectedness and appears to better reflect a clinical diagnosis of IBS applied by physicians. The use of a quantitative diagnostic Rome “score” may be helpful in clinical practice and research studies to better reflect the degree an individual is affected with IBS.
Reduction in pain: Is it worth the gain? The effect of opioids on the GI tract
Authors: Nee J. , Rangan V. , Lembo A. 
Published: April 2018

AbstractThe use of opioid medications for acute and chronic pain has increased significantly in the past 20 years in the United States. Given the high density of opioid receptors in the gastrointestinal tract, side effects are common in these patients including constipation, dysphagia, bloating, nausea, and vomiting. These side effects, which are experienced by most patients who take opioids, can lead to significant impairment in quality of life. Unlike other side effects from opioids, gastrointestinal side effects do not diminish with continued use, often leading patients to reduce or discontinue their opioid treatment to relieve these side effects. Therefore, physicians must be aware and anticipate potential side effects in patients receiving opioids to ensure appropriate pain management.
The tomato Ethylene Response Factor Sl‐ERF.B3 integrates ethylene and auxin signaling via direct regulation of Sl‐Aux/IAA27
Authors: Liu Mingchun , Chen Yao , Chen Ya , Shin Jun‐Hye , Mila Isabelle , Audran Corinne , Zouine Mohamed , Pirrello Julien , Bouzayen Mondher 
Published: April 2018

Summary

Plant growth and development is coordinated by complex networks of interacting hormones, and cross‐talk between ethylene and auxin signaling is essential for a wide range of plant developmental processes. Nevertheless, the molecular links underlying the interaction between the two hormones remain poorly understood.

In order to decipher the cross‐talk between the Ethylene Response Factor Sl‐ERF.B3 and Sl‐IAA27, mediating ethylene and auxin signaling, respectively, we combined reverse genetic approaches, physiological methods, transactivation experiments and electrophoretic mobility shift assays.

Sl‐ERF.B3 is responsive to both ethylene and auxin and ectopic expression of its dominant repressor version (ERF.B3‐SRDX) results in impaired sensitivity to auxin with phenotypes recalling those previously reported for Sl‐IAA27 downregulated tomato lines. The expression of Sl‐IAA27 is dramatically reduced in the ERF.B3‐SRDX lines and Sl‐ERF.B3 is shown to regulate the expression of Sl‐IAA27 via direct binding to its promoter.

The data support a model in which the ethylene‐responsive Sl‐ERF.B3 integrates ethylene and auxin signaling via regulation of the expression of the auxin signaling component Sl‐IAA27. The study uncovers a molecular mechanism that links ethylene and auxin signaling in tomato.
Arabidopsis pollen tube germination and growth depend on the mitochondrial calcium uniporter complex
Authors: Selles Benjamin , Michaud Caroline , Xiong Tou‐cheu , Leblanc Olivier , Ingouff Mathieu 
Published: April 2018

Summary

The mitochondrial calcium uniporter complex (MCUc) was recently characterized in details in metazoans and consists of pore‐forming units (MCUs) and regulatory factors that channel calcium (Ca2+) ion into the mitochondria. MCUs participate in many stress and developmentally related processes involving Ca2+.

Although multiple homologues of MCUs and one regulatory subunit are usually present in plants, the first functional characterization and contribution to Ca2+ related processes of these proteins have been reported recently. Here, we focused on two predicted Arabidopsis MCUs and studied their role in the germination and the growth of pollen tube, a tip‐growing cell type highly dependent on Ca2+ homeostasis.

Heterologous expression of MCU1 or MCU2 in yeast is sufficient to generate a mitochondrial Ca2+ influx. MCU1 and MCU2 fluorescent reporters are co‐expressed in the vegetative cell mitochondria of the pollen grain but are undetectable in the embryo sac. We demonstrate that MCU1 and MCU2 can form a heterotypic complex. Phenotypic analyses revealed an impaired pollen tube germination and growth in vitro only for the mcu2 mutants suggesting a predominant role of MCU2.

Our results show that mitochondrial Ca2+ controlled by MCUs is an additional player in Arabidopsis pollen tube germination and growth.
Inter‐individual differences in weight change following exercise interventions: a systematic review and meta‐analysis of randomized controlled trials
Authors: Williamson P. J. , Atkinson G. , Batterham A. M. 
Published: April 2018

SummaryPrevious reports of substantial inter‐individual differences in weight change following an exercise intervention are often based solely on the observed responses in the intervention group. Therefore, we aimed to quantify the magnitude of inter‐individual differences in exercise‐mediated weight change. We synthesized randomized controlled trials (RCTs) of structured, supervised exercise interventions. Fourteen electronic databases were searched for relevant studies published up to March 2017. Search terms focused on structured training, RCTs and body weight. We then sifted these results for those RCTs (n = 12, 1500 participants) that included relevant comparator group data. Standard deviations (SDs) of weight change were extracted, thereby allowing the SD for true inter‐individual differences in weight loss to be calculated for each study. Using a random effects meta‐analysis, the pooled SD (95% CI) for true individual responses was 0.8 (−0.9 to 1.4) kg. The 95% prediction interval (based on 2SDs) for true inter‐individual responses was −2.8 to 3.6 kg. The probability (% chance) that the true individual response variability would be clinically meaningful (>2.5 kg) in a future study in similar settings was 23% (‘unlikely’). Therefore, we conclude that evidence is limited for the notion that there are clinically important individual differences in exercise‐mediated weight change.
Prevention of perioperative venous thromboembolism in pediatric patients: Guidelines from the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI)
Authors: Morgan Judith , Checketts Matthew , Arana Amaia , Chalmers Elizabeth , Maclean Jamie , Powis Mark , Morton Neil ,   the Association of Paediatric Anaesthetists of Great Britain and Ireland Guidelines Working Group on Thromboprophylaxis in Children
Published: April 2018

SummaryThe Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Guidelines Working Group on Thromboprophylaxis in Children has reviewed the literature and where possible provided advice on the care of children in the perioperative period. Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence. Routine prophylaxis cannot be recommended for young children. Postpubertal adolescents (approximately 13 years and over) are at a slightly increased risk of VTE and should be assessed for prophylaxis and may warrant intervention if other risk factors are present. However, the incidence of VTE is significantly lower than in the adult population. This special interest review presents a summary and discussion of the key recommendations, a decision‐making algorithm and a risk assessment chart. For the full guideline, go to www.apagbi.org.uk/publications/apa-guidelines.
Consensus statement on clear fluids fasting for elective pediatric general anesthesia
Authors: Thomas Mark , Morrison Christa , Newton Richard , Schindler Ehrenfried 
Published: April 2018

SummaryPediatric anesthetic guidelines for the management of preoperative fasting of clear fluids are currently 2 hours. The traditional 2 hours clear fluid fasting time was recommended to decrease the risk of pulmonary aspiration and is not in keeping with current literature. It appears that a liberalized clear fluid fasting regime does not affect the incidence of pulmonary aspiration and in those who do aspirate, the sequelae are not usually severe or long‐lasting. With a 2‐hour clear fasting policy, the literature suggests that this translates into 6‐7 hours actual duration of fasting with several studies up to 15 hours. Fasting for prolonged periods increases thirst and irritability and results in detrimental physiological and metabolic effects. With a 1‐hour clear fluid policy, there is no increased risk of pulmonary aspiration and studies demonstrate the stomach is empty. There is less nausea and vomiting, thirst, hunger, and anxiety, if allowed a drink closer to surgery. Children appear more comfortable, better behaved and possibly more compliant. In children less than 36 months this has positive physiological and metabolic effects. It is practical to allow children to drink until 1 hour prior to anesthesia on the day of surgery. In this joint consensus statement, the Association of Paediatric Anaesthetists of Great Britain and Ireland, the European Society for Paediatric Anaesthesiology, and L'Association Des Anesthésistes‐Réanimateurs Pédiatriques d'Expression Française agree that, based on the current convincing evidence base, unless there is a clear contraindication, it is safe and recommended for all children able to take clear fluids, to be allowed and encouraged to have them up to 1 hour before elective general anesthesia.
The impact of general anesthesia on child development and school performance: a population‐based study
Authors: Schneuer Francisco J , Bentley Jason P , Davidson Andrew J , Holland Andrew JA , Badawi Nadia , Martin Andrew J , Skowno Justin , Lain Samantha J , Nassar Natasha 
Published: April 2018

SummaryBackgroundThere has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood.AimsThe aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood.MethodsWe included children born in New South Wales, Australia of 37+ weeks’ gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade‐3 school test results in 2008‐2014. We compared children exposed to general anesthesia aged <48 months to those without any hospitalization. Children with only 1 hospitalization with general anesthesia and no other hospitalization were assessed separately. Outcomes included being classified developmentally high risk at school entry and scoring below national minimum standard in school numeracy and reading tests.ResultsOf 211 978 children included, 82 156 had developmental assessment and 153 025 had school test results, with 12 848 (15.7%) and 25 032 (16.4%) exposed to general anesthesia, respectively. Children exposed to general anesthesia had 17%, 34%, and 23% increased odds of being developmentally high risk (adjusted odds ratio [aOR]: 1.17; 95% CI: 1.07‐1.29); or scoring below the national minimum standard in numeracy (aOR: 1.34; 95% CI: 1.21‐1.48) and reading (aOR: 1.23; 95% CI: 1.12‐1.36), respectively. Although the risk for being developmentally high risk and poor reading attenuated for children with only 1 hospitalization and exposure to general anesthesia, the association with poor numeracy results remained.ConclusionChildren exposed to general anesthesia before 4 years have poorer development at school entry and school performance. While the association among children with 1 hospitalization with 1 general anesthesia and no other hospitalization was attenuated, poor numeracy outcome remained. Further investigation of the specific effects of general anesthesia and the impact of the underlying health conditions that prompt the need for surgery or diagnostic procedures is required, particularly among children exposed to long duration of general anesthesia or with repeated hospitalizations.
Reverse modelling to estimate yield losses caused by crop diseases
Authors: Willocquet L. , Félix I. , de Vallavieille‐Pope C. , Savary S. 
Published: April 2018

Yield loss analysis is critical to inform tactical and strategic decisions in crop health management, and requires quantification of three elements: the levels of injury caused by disease or pest, the actual (injured) yield, and the attainable (uninjured) yield. Reverse modelling allows reconstruction of an object or a process from limited information combined with a mathematical model. This approach is applied to estimate yield losses caused by diseases in winter wheat using a process‐based simulation model (WHEATPEST), in combination with field data generated by a network of experiments across France, where multiple disease injuries and actual yields, but not attainable yields, were measured. The analysis covers 70 [year × region × variety × crop management] combinations encompassing five years (2004–2008), four French regions, two winter wheat varieties (one high‐yielding and one hardy variety), and two levels of crop management corresponding to two levels of chemical intensification. The analysis involved three main successive modelling steps where actual yield, attainable yield and yield losses associated with individual diseases were simulated. Overall, simulated yield losses to combined diseases ranged from 0 to 4.2 t ha−1, and averaged 0.80 t ha−1. Septoria tritici blotch caused the highest mean yield loss of 0.66 t ha−1. The results highlight the contribution of varietal improvement to agricultural sustainability and performances. Reverse modelling can be applied to other crops and diseases or pests, in order to estimate individual and combined disease yield losses.
The microeconomic impact of political instability: Firm‐level evidence from Tunisia
Authors: Matta Samer , Appleton Simon , Bleaney Michael 
Published: April 2018

AbstractThis paper explores the impact of political instability on firms in the context of Tunisia, which experienced a surge in political instability events after the 2011 Jasmine revolution. Using a new dataset, we show that political instability was a major concern for small and exporting firms as well as those that were operating in the tourism sector, those that suffered from acts of vandalism or arson, and those that were located in the interior region of Tunisia. More importantly, we find strong evidence that political instability was the most damaging constraint to firm growth in Tunisia after the Arab Spring.
Multivariate Latent Variable Transition Models of Longitudinal Mixed Data: An Analysis on Alcohol Use Disorder
Authors: Cagnone Silvia , Viroli Cinzia 
Published: April 2018

SummaryAlcohol abuse is a dangerous habit in young people. The National Youth Survey is a longitudinal American study in part devoted to the investigation of alcohol disorder over time. The symptoms of alcohol disorder are measured by binary and ordinal items. In the literature it is well recognized that alcohol abuse can be measured by a latent construct; therefore generalized latent variable models for mixed data represent the ideal framework to analyse these data. However, it might be desirable to cluster individuals according to the different severity of their alcohol use disorder and to investigate how the groups vary over time. We present a new methodological framework that includes two levels of latent variables: one continuous hidden variable for dimension reduction and clustering and a discrete random variable accounting for the dynamics of alcohol disorder symptoms. The effect of covariates is also measured and a testing procedure for the temporal assumption is developed. This work addresses three important issues. First, it represents a unified framework for the analysis of longitudinal multivariate mixed data. Secondly, it captures and models the unobserved heterogeneity of the data. Finally it describes the dynamics of the data through the definition of latent constructs.
Female Economic Participation with Information and Communication Technology Advancement: Evidence from Sub‐Saharan Africa
Authors: Efobi Uchenna R. , Tanankem Belmondo V. , Asongu Simplice A. 
Published: April 2018

AbstractThis study complements existing literature by investigating how the advancement in information and communication technology affects the formal economic participation of women. The focus is on 48 African countries for the period 1990‐2014. The empirical evidence is based on ordinary least squares, fixed effects and the generalized method of moments regressions. The results show that improving communication technology increases female economic participation with the following consistent order of increasing magnitude: mobile phone penetration, internet penetration and fixed broadband subscriptions. The findings are robust to the control for heterogeneities across countries. Policy implications are discussed in the paper.
Dual immune effect of iNKT cells considering human cutaneous and visceral leishmaniasis: An example of cell plasticity according to different disease scenarios
Authors: Gois B. M. , Peixoto R. F. , Maciel B. L. L. , Gomes J. A. S. , de Azevedo F. L. A. A. , Veras R. C. , de Medeiros I. A. , de Lima Grisi T. C. S. , de Araújo D. A. M. , do Amaral I. P. G. , Keesen T. S. L. 
Published: April 2018

AbstractAlthough the semi‐invariant natural killer T cells (iNKT) are a small subpopulation of cells in the peripheral blood, they are presumed to play a role in early stages of infection against various pathogens, including protozoa. This work investigates the activation status and cytokine profile of iNKT cells during human Leishmania infantum and Leishmania braziliensis infection. We studied iNKT cells in patients with symptomatic active visceral leishmaniasis (AVL) (n = 8), patients with symptomatic active cutaneous leishmaniasis (ACL) (n = 13), negative endemic controls (NEC) (n = 6) and non‐endemic controls (NonEC) (n = 6), with and without total Leishmania antigen stimulus (TLA). The number of iNKT cells in the peripheral blood of patients with ACL and AVL unaltered in relation to control groups. Moreover, the iNKT cells from ACL showed a hyperactivation profile compared to patients with AVL. Additionally, TLA induced IFN‐gamma production in iNKT cells from patients with ACL, while in iNKT of patients with AVL, TLA induced a decrease in this cytokine. Higher IL‐17 and IL‐10 production by iNKT cells from patients with ACL were also observed compared to all other groups. There were no changes in iNKT IL‐10‐producing cells in AVL after TLA stimulation. However, TLA induced increase in IL‐10 in iNKT cells in patients with ACL. These findings suggest that, although iNKT cells showed distinct profiles in patients with ACL and AVL, they play a dual role in immune modulation in both Leishmania infections.