bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic changes in cerebral and peripheral markers of glutamatergic signaling across the human sleep–wake cycle
Authors: Weigend Susanne , Holst Sebastian C , Treyer Valérie , O’Gorman Tuura Ruth L , Meier Josefine , Ametamey Simon M , Buck Alfred , Landolt Hans-Peter 
Published: July 2019

Abstract
Sleep and brain glutamatergic signaling are homeostatically regulated. Recovery sleep following prolonged wakefulness restores efficient functioning of the brain, possibly by keeping glutamatergic signaling in a homeostatic range. Evidence in humans and mice suggested that metabotropic glutamate receptors of subtype-5 (mGluR5) contribute to the brain’s coping mechanisms with sleep deprivation. Here, proton magnetic resonance spectroscopy in 31 healthy men was used to quantify the levels of glutamate (Glu), glutamate-to-glutamine ratio (GLX), and γ-amino-butyric-acid (GABA) in basal ganglia (BG) and dorsolateral prefrontal cortex on 3 consecutive days, after ~8 (baseline), ~32 (sleep deprivation), and ~8 hours (recovery sleep) of wakefulness. Simultaneously, mGluR5 availability was quantified with the novel radioligand for positron emission tomography, [18F]PSS232, and the blood levels of the mGluR5-regulated proteins, fragile X mental retardation protein (FMRP) and brain-derived neurotrophic factor (BDNF) were determined. The data revealed that GLX (p = 0.03) in BG (for Glu: p < 0.06) and the serum concentration of FMRP (p < 0.04) were increased after sleep loss. Other brain metabolites (GABA, N-acetyl-aspartate, choline, glutathione) and serum BDNF levels were not altered by sleep deprivation (pall > 0.6). By contrast, the night without sleep enhanced whole-brain, BG, and parietal cortex mGluR5 availability, which was normalized by recovery sleep (pall < 0.05). The findings provide convergent multimodal evidence that glutamatergic signaling is affected by sleep deprivation and recovery sleep. They support a role for mGluR5 and FMRP in sleep–wake regulation and warrant further studies to investigate their causality and relevance for regulating human sleep in health and disease.
Clinical Trial Registration: www.clinicaltrials.gov (study identifier: NCT03813082)
Constitutional Statutes—Roots and Recognition
Authors: Mcgarry John , Spence Samantha 
Published: July 2019

Abstract
Sir John Laws, the originator of the principle of constitutional statutes, suggests that the protection accorded to them has its roots in the protection from implied repeal given to the European Communities Act 1972 and to constitutional fundamentals. We argue that this suggestion is more convincing with regard to the latter than it is with the former. Further, we contend that founding constitutional statutes on the protection afforded to constitutional fundamentals rather than the 1972 Act may provide a stronger basis for the principle of such statutes if the United Kingdom leaves the European Union. We then provide evidence that the idea of constitutional statutes has been accepted across the three arms of state and argue that, as a consequence, the rule of recognition may be taken to have changed to encompass the amendment to the implied repeal rule that such statutes represent.
Heterogeneity of the Cystic Fibrosis Phenotype in a Large Kindred Family in Qatar with Cystic Fibrosis Mutation (I1234V)
Authors: Wahab A. Abdul , Al Thani G. , Dawod S. T. , Kambouris M. , Al Hamed M. 
Published: July 2019

Summary
Twenty-nine subjects (17 families) with cystic fibrosis belonging to the same Bedouin tribe were screened for cystic fibrosis transmembrane regulator gene mutations (CFTR). Homozygous I1234V mutation in exon 19 was identified in all families with a relatively high rate of consanguinity (96.6 per cent). The homozygous I1234V mutation tended to present with a variable degree of pulmonary disease, pancreatic insufficiency and electrolyte imbalance. Homozygous I1234V was found to be a common mutation in the studied Bedouin tribe in Qatar.
Sero-molecular evaluation of Toxoplasma gondii infection among HIV-positive patients
Authors: Ahmadpour Ehsan , Pishkarie-Asl Reza , Spotin Adel , Samadi Kafil Hossein , Didarlu Hasan , Azadi Yaghob , Barac Aleksandra 
Published: July 2019

Abstract

Background
Toxoplasmosis is one of the most common comorbidities in HIV-positive patients with CD4+ T lymphocytes below 200 cells/μl. Early diagnosis and treatment of toxoplasmosis reduces the mortality rate in HIV-positive people. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in HIV-positive patients in northwest Iran using serological and molecular methods.

Methods
This prospective cross-sectional study included 124 HIV-positive outpatients and was conducted from January to May 2016. Anti-T. gondii IgM and IgG antibodies were detected from sera samples by chemiluminescence, while buffy coat samples were analyzed by RT-PCR for DNA detection. Patients’ socioepidemiological data were collected.

Results
Using chemiluminescence, 47/124 samples (37.9%) were positive for anti-Toxoplasma IgG antibodies, 2/124 samples (1.62%) were positive for IgM antibodies while 2/124 samples (1.62%) contained both IgM and IgG. There were no IgM-positive or IgG-negative patients. RT-PCR revealed four (3.22%) positive samples. On the basis of the results, a statistically significant relationship was found between anti-Toxoplasma IgG antibody seropositivity and residence (p=0.012).

Conclusions
The study showed a relatively low seroprevalence of anti-T. gondii IgG and IgM antibodies in HIV-positive patients in northwest Iran, while the prevalence was much higher in other regions of Iran. However, regular screening for T. gondii antibodies and early initiation of therapy are very important to decrease the mortality rate in HIV-positive patients.
The Influences Burnout and Lack of Empowerment Have on Creativity in Nursing Faculty
Authors: Drafahl Bridget 
Published: July 2019

Abstract

AIM
The aim was to establish a correlation between burnout and lack of empowerment in associate degree nursing faculty and their creativity in the classroom.

METHOD
A descriptive, quantitative research study was completed. An email with a survey link was sent to members of the National Organization for Associate Degree Nursing asking for anonymous, voluntary participation and inviting members to forward to additional faculty; 217 participants completed the survey in its entirety. Pearson correlation and multiple linear regression tests were completed on the data.

RESULTS
Statistically significant (personal burnout, p = .004; work burnout, p = .003; student burnout, p = .000) relationships were found between burnout and creativity. No relationship was established between lack of empowerment and creativity.

CONCLUSION
Nursing faculty who perceived feelings of burnout were less motivated or engaged in their workplace, including interactions with students, which was directly correlated to a decrease in perceived feelings of creativity.
Changing Practice Through Meaningful Assignments: Ideas for Supporting RN-BSN Students
Authors: DeBrew Jacqueline Kayler 
Published: July 2019

Abstract
Although nurses entering RN-BSN programs often perceive that earning the BSN will be of little benefit, upon completion, they do believe they have made professional gains, demonstrating that they have experienced a change in perspective. Mezirow’s theory of perspective transformation can guide educators to develop learning activities that allow RN-BSN students to find meaning in the BSN degree while enrolled in a program, rather than after the program has been completed. Examples of learning activities and student reflections are provided.
Exam Wrappers: It Is Time to Adopt a Nursing Student Metacognitive Tool for Exam Review
Authors: Williams Cheryl A. 
Published: July 2019

Abstract
Examining test performance, a common practice in nursing education, can be a vital learning tool, as well as a means of assessment. Exam or cognitive wrappers, performed by students after an exam but before the exam review, can explicitly teach students to discern between what they do and what they do not know. The process teaches metacognition, the highest level of critical thinking. Nursing students need to be proficient in metacognition for professional growth well beyond the classroom. However, little information about these cognitive exercises, known as exam wrappers, exists in nursing education today.
Role of the Neonatal Nurse Practitioner in the Community Hospital
Authors: Snapp Barbara , Reyna Barbara 
Published: July 2019

Background:
The role of the neonatal nurse practitioner (NNP) is well established in the neonatal intensive care unit. The level IV NNP is traditionally supported by large multidisciplinary teams while the level I to III NNP may be the sole in-house provider with limited resources.

Purpose:
The purpose of this research project is to identify the NNP role, responsibilities, and barriers to practice in the level I, II, and III newborn care settings.

Methods:
This study used a descriptive, exploratory design to examine NNP roles and responsibilities in level I, II, and III care centers via an online survey.

Results:
Of the respondents (171), the majority (71.3%) work 24-hour shifts, 51.5% being the single NNP during the day with 67.8% being alone at night. Nearly 27% have limited or are without ancillary support while 29.8% cannot meet some standards of care due to inadequate resources. Almost 22% lack written protocols and procedural opportunities are limited or a concern for 15.8% of the NNPs.

Implications for Practice:
A better understanding of the responsibilities of the level I to III NNP will assist with developing staffing guidelines, influence practice models, and guide recruitment and retention of the NNP.

Implications for Research:
A systematic literature review yielded articles on the value of nurse practitioners and their ability to deliver safe, effective and cost-conscience care but not on what the role entails on a daily basis. Further studies are needed to specifically compare the role of the level IV NNP to the level I, II, and III NNP to further delineate NNP functionality according to level of care.
Maternal Distress in the Neonatal Intensive Care Unit
Authors: Staver Morgan A. , Moore Tiffany A. , Hanna Kathleen M. 
Published: July 2019

Background:The neonatal intensive care unit (NICU) can cause significant psychological distress in a mother. There is no common definition of maternal distress in the NICU currently in use.Purpose:To develop a clear conceptual understanding of maternal distress in the NICU using conceptual definitions and empirical findings.Methods/Search Strategy:A literature search was conducted using EBSCOhost, MEDLINE, CINAHL, PsychINFO, and Google Scholar. The concept analysis was guided by Walker and Avant's (2011) guide.Findings/Results:Maternal distress in the NICU consists of a combination of depressive, anxiety, trauma, and posttraumatic stress symptoms. The symptoms occur together on a spectrum and present differently in each mother. The antecedents to maternal distress are a NICU hospitalization and a perceived interruption to the transition to motherhood. Consequences of maternal distress in the NICU are issues with developing a healthy maternal–infant bond, adverse infant development, and decreased maternal quality of life.Implications for Practice:A complete understanding of maternal distress in the NICU will lead to increased awareness of adverse mental health states in this population.Implications for Research:Identification of mothers at risk for maternal distress in the NICU, as well as the identification of antecedents and consequences related to the mother and the infant from maternal distress in the NICU. Using a single, clear definition of maternal distress in the NICU population will lead to a more cohesive body of literature.
Predictive Model of Factors Associated With Maternal Intensive Care Unit Admission
Authors: Rossi Robert M. , Hall Eric , Dufendach Kevin , DeFranco Emily A. 
Published: July 2019

OBJECTIVE:
Severe maternal morbidity has increased in the United States over the past two decades by approximately 200%, to 144 cases per 10,000 delivery hospitalizations. There are limited data available to assist in identifying at-risk women before parturition. We sought to evaluate risk factors associated with maternal admission to an intensive care unit (ICU).

METHODS:
We conducted a population-based cohort study of all live births delivered between 20 and 44 weeks of gestation in the United States during 2012–2016. Our primary objective was to identify prenatal factors associated with increased risk of maternal ICU admission to build a multivariable predictive model to estimate the association of these factors with ICU admission risk. We performed k-fold cross-validation for internal validation and then externally validated the model on a separate live birth cohort (2006–2011, n=856,255).

RESULTS:
There were 18,745,615 live births in the United States between 2012 and 2016. Among the mothers of these live newborns, 27,602 (0.15%) were admitted to the ICU in the peripartum period. Fourteen variables were selected for inclusion in the predictive model for maternal ICU admission. The predicted minimal and maximal risk for ICU admission ranged 0–25%. The receiver operating characteristic curve for these 14 variables achieved an area under the curve (AUC) of 0.81 (95% CI 0.79–0.81). External validation with a separate live birth cohort demonstrated a consistent measure of discrimination with an AUC of 0.83 (95% CI 0.82–0.84). Using a relatively high cut point of 5.0% or more predicted risk for ICU admission, achieved a positive predictive value (PPV) of only 4.0%.

CONCLUSION:
This model provides insight as to the cumulative effect of multiple risk factors on maternal ICU admission risk. The predictive model achieves an AUC of 0.81, discriminating women with significantly increased risk (30-fold) for ICU admission. Nonetheless, because of the low frequency of maternal ICU admission, the PPV of the model was low and therefore whether models such as ours may be beneficial in future efforts to reduce the prevalence and burden of maternal morbidity is uncertain.
Tissue Adhesive Compared With Sterile Strips After Cesarean Delivery
Authors: Braginsky Lena , Javellana Melissa , Cleveland Emily , Elue Rita , Wang Chi , Boyle Deborah , Plunkett Beth A. 
Published: July 2019

OBJECTIVE:
To assess whether tissue adhesive after closure of Pfannenstiel incision for cesarean delivery lowers the risk of wound complications when compared with sterile strips.

METHODS:
In this multicenter randomized controlled trial, women undergoing cesarean delivery using Pfannenstiel skin incision were randomized to receive tissue adhesive (2-octyl cyanoacrylate) compared with sterile strips after closure of the skin incision. The primary outcome was a composite of wound complications (drainage, cellulitis, abscess, seroma, hematoma, or isolated wound separation) within 8 weeks of delivery. Secondary outcomes included operative time, readmission, office or emergency department visits, or antibiotic use for wound complications, and patient satisfaction with the cesarean scar. With 80% power and a 95% CI, a sample size of 432 per group (n=864) was required to detect a 50% reduction in the primary outcome. A planned interim analysis was performed after 500 patients delivered. A conditional power analysis revealed that the probability of showing a benefit with tissue adhesive was extremely low (6.2%), and the study was halted owing to futility.

RESULTS:
Between November 2016 and April 2018, 504 patients were randomized, and follow-up was achieved in 479 (95%). Wound complications occurred in 18 out of 238 patients (7.6%) in the tissue adhesive group and 19 out of 241 patients (7.9%) in the sterile strips group (relative risk 0.96; 95% CI 0.51–1.78). There were no significant differences with regard to types of wound complications, operative time, readmission, office or emergency department visits, antibiotics prescribed for wound complications, or patient scar assessment scores of pain, stiffness, and irregularity between the two groups. However, tissue adhesive performed slightly better in regard to itchiness of scar and overall scar satisfaction.

CONCLUSION:
Compared with sterile strips, tissue adhesive after closure of Pfannenstiel incision for cesarean delivery is unlikely to lower the risk of wound complications.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02838017.
Severe Maternal Morbidity Among Stillbirth and Live Birth Deliveries in California
Authors: Wall-Wieler Elizabeth , Carmichael Suzan L. , Gibbs Ronald S. , Lyell Deirdre J. , Girsen Anna I. , El-Sayed Yasser Y. , Butwick Alexander J. 
Published: July 2019

OBJECTIVE:
To assess the prevalence and risk of severe maternal morbidity among delivery hospitalization for stillbirth compared with live birth deliveries.

METHODS:
Using data from the Office of Statewide Health Planning and Development in California, we performed a population-based cross-sectional study of 6,459,842 deliveries between 1999 and 2011. We identified severe maternal morbidity using an algorithm comprising diagnoses and procedures developed by the Centers for Disease Control and Prevention and used log-binomial regression models to examine the relative risk (RR) of severe maternal morbidity for stillbirth compared with live birth deliveries, adjusting for maternal demographic, medical, and obstetric characteristics. We also examined severe maternal morbidity prevalence by cause of fetal death among stillbirth deliveries.

RESULTS:
The prevalence of severe maternal morbidity for stillbirth and live birth was 578 and 99 cases per 10,000 deliveries, respectively. After adjusting for maternal demographic, medical, and obstetric characteristics, the risk of severe maternal morbidity among stillbirth deliveries was more than fourfold higher (adjusted RR 4.77; 95% CI 4.53–5.02) compared with live birth deliveries. The severe maternal morbidity prevalence was highest among stillbirths caused by hypertensive disorders and placental conditions (24 and 19 cases/100 deliveries, respectively), and lowest among stillbirths caused by fetal malformations or genetic abnormalities (1 case per 100 deliveries).

CONCLUSION:
Women who have stillbirths are at substantially higher risk for severe maternal morbidity than women who have live births, regardless of cause of fetal death. The prevalence of severe maternal morbidity varies by cause of fetal death.
Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women
Authors: Sinkey Rachel G. , Blanchard Christina T. , Szychowski Jeff M. , Ausbeck Elizabeth , Subramaniam Akila , Neely Cherry L. , Casey Brian M. , Tita Alan T. 
Published: July 2019

OBJECTIVE:
To compare perinatal and maternal outcomes in low-risk multiparous women who underwent elective induction of labor in the 39th week of gestation with those who were expectantly managed.

METHODS:
We performed a single center retrospective cohort study of low-risk multiparous women delivering nonanomalous singletons between 39 and 42 completed weeks of gestation from 2014 to 2018. The primary outcome was a perinatal composite of death, neonatal respiratory support, a 5-minute Apgar score of 3 or less, and shoulder dystocia. Groups were compared using χ2, Fisher exact, two sample t-test, and Wilcoxon rank sum tests, as appropriate. Multivariable logistic regression models were used to adjust for potential confounders.

RESULTS:
Of the 3,703 low-risk multiparous women meeting inclusion criteria, 453 (12%) delivered between 39 0/7 and 39 4/7 after an elective induction of labor. Women who underwent elective induction of labor were more likely to be privately insured, non-Hispanic, and weigh more at their first prenatal visit (all P<.01) compared with expectant management. An elective induction of labor was associated with decreased frequency of the perinatal composite morbidity (4.0% vs 7.1%; adjusted odds ratio [aOR] 0.57, 95% CI 0.34–0.96) compared with expectant management. Fewer cesarean deliveries occurred among women in the elective induction of labor group (5.1% vs 6.6%; aOR 0.60, 95% CI 0.37–0.97). Other maternal outcomes (hypertensive disorders, chorioamnionitis, and operative vaginal deliveries) as well as neonatal intensive care unit admissions were not different between groups.

CONCLUSION:
Elective induction of labor in low-risk multiparous women in the 39th week of gestation was associated with decreased perinatal morbidity and a lower frequency of cesarean delivery compared with expectant management.
Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers
Authors: Hill Amber L. , Jones Kelley A. , McCauley Heather L. , Tancredi Daniel J. , Silverman Jay G. , Miller Elizabeth 
Published: July 2019

OBJECTIVE:
To investigate demographic differences and evaluate how reproductive coercion and relationship abuse influences young females' care-seeking and sexual health behaviors.

METHODS:
We conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14–19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and nonpartner sexual violence victimization. Cluster-adjusted χ2 tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), and care-seeking and sexual health behaviors.

RESULTS:
Of 550 sexually active high school females, 12% reported recent reproductive coercion and 17% reported physical or sexual adolescent relationship abuse, with no significant demographic differences. Prevalence of recent nonpartner sexual violence was 17%. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95% CI 1.05–4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95% CI 1.51–14.4), having two or more recent sexual partners (aOR 3.86, 95% CI 1.57–9.48), and using hormonal contraception only (aOR 3.77, 95% CI 1.09–13.1 vs hormonal methods with condoms).

CONCLUSION:
Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school–aged adolescents, involving education, resources, and harm-reduction counseling to all patients.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT01678378.