bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the early‐stage implementation of a patient engagement support intervention in an integrated‐care context—A qualitative study of a participatory process
Authors: Menichetti Julia , Pitacco Giuliana , Graffigna Guendalina 
Published: October 2018

Aims and objectivesTo explore: (a) the usual patient education in different care services of an integrated‐care organisation, (b) the healthcare professionals’ experiences with adding a patient engagement support intervention called PHEinAction in the patient education practice and (c) the co‐designed activities to assist the implementation.BackgroundIncluding individual support for engaging patients in care into patient education practice is a key effort of integrated‐care organisations. However, there is a paucity of studies exploring the implementation of similar efforts.Design and methodsWe conducted a qualitative study of a participatory process with 26 healthcare professionals—mostly nurses (n = 22) with leading roles (n = 12)—of different care services in one Italian integrated‐care organisation. Data were collected through multiple sources (observations and shadowing; interviews; documents/artefacts; workshops) during the first 6 months of the implementation of PHEinAction. A thematic analysis using a hybrid approach was performed. COREQ guidelines were followed.ResultsThe existing patient education practice of hospital, ambulatory and community healthcare services of the organisation differed in contents, perceived responsibility and focus area. These key aspects of patient education influenced the healthcare professionals’ experiences with the implementation. The experiences informed the activities enacted during the participatory process to assist the implementation, from the co‐creation of artefacts to the deployment of peer group supervision.ConclusionThe implementation of a brief intervention for patient engagement support required a process of adjustment to the single settings and a continuous support to healthcare professionals. It also required performing complementary activities to assist the implementation and its adoption in new care services.Relevance to clinical practiceThis qualitative study contributes to the understanding of the pitfalls and strategies that may surround embedding patient engagement support in the educational practice of complex organisations, potentially facilitating the deployment to other care settings.
Self‐awareness in nursing: A scoping review
Authors: Rasheed Subia P. , Younas Ahtisham , Sundus Amara 
Published: October 2018

AbstractAims and objectivesTo outline and examine the literature about self‐awareness in nursing and to identify areas for future research and practice.BackgroundSelf‐awareness is important for the personal and professional development of nurses, for developing an effective nurse–patient relationship and for improving nursing abilities. Despite its importance in nursing and therapeutic nurse–patient relationship and its evolving nature, the knowledge base for self‐awareness in nursing remains under‐examined.DesignA scoping review using PRISMA guidelines.MethodsA five‐step approach: (a) identification of research question; (b) identification of relevant studies using a three‐step search: keywords search within PubMed and CINAHL, literature search within PubMed, CINAHL, ERIC, PsycINFO, Science Direct and Google Scholar, and literature search of references lists; (c) study selection; (d) data extraction and charting; (e) data collation, summarisation and reporting, was used.FindingsOf 1,531 identified sources, 76 full‐text sources were read and 29 English language sources, published from January 1980 until January 2018, which included nurses or nursing students, were reviewed. Two themes: perspectives on self‐awareness and strategies for enhancing self‐awareness emerged. Under these themes, conceptualisation of self‐awareness; its antecedents and value; and theory‐based, educational and personal strategies for its enhancement were described. There is sufficient literature regarding self‐awareness conceptualisation and theory‐based strategies for its enhancement, but inconclusive evidence regarding value of self‐awareness, and educational and personal strategies for its improvement.ConclusionThere is limited research on self‐awareness. Most of the literature comprises of theoretical discussions and opinions which adequately provide a conceptual understanding of self‐awareness. However, more empirical and applied research is needed to apply the available theoretical knowledge in practice.Relevance to clinical practiceThis review delineated theoretical, educational and personal strategies for nurses to improve their self‐awareness and indicated that engagement in self‐awareness at relational and contextual levels is essential for developing nurse–patient relationship.
Suprapubic pressure facilitates the procedure of office hysteroscopy: A randomized controlled trial
Authors: Török Péter , Herman Tünde , Lőrincz Judit , Molnár Szabolcs , Lampé Rudolf , Póka Róbert 
Published: October 2018

AbstractAimTo minimize the experienced pain during office hysteroscopy, a number of technical approaches and maneuvers are used. The aim of the study was to assess the effect of suprapubic pressure (SuPuP) applied during hysteroscopy. The impact of this maneuver on experienced pain (assessed by visual analog scale [VAS]) and duration of passage through the cervical canal was measured and compared to a reference group with no SuPuP.MethodsHysteroscopy was performed in study subjects as part of their infertility work‐up. Patients were randomized into two groups as part of a controlled trial. In group 1, SuPuP was applied while inserting the scope; in group 2, SuPuP was not applied. Pain experienced during the procedure was measured on a 0–10 VAS. Duration of passage through the cervical canal was measured by analyzing the video of the procedure. The effect of SuPuP was estimated by testing for between‐groups differences in these outcomes.ResultsThe number of patients included the study was 60. Mean (SD) VAS score was 3.40 (1.276) in group 1 compared to 3.33 (0.802) in group 2 (P = 0.809). Mean (SD) time of passage through the cervical canal in group 1 was 30.5 (18.37) seconds compared to 43.0 (24.51) seconds in group 2 (P = 0.029).ConclusionApplying suprapubic pressure could facilitate the procedure by significantly shortening the duration of the passage through the cervical canal, but significantly not reduces the pain experienced during hysteroscopy. Further studies are to be undertaken to investigate the advantages of suprapubic pressure during office hysteroscopy.
Total tooth loss without denture wear is a risk indicator for difficulty eating among older adults with intellectual disabilities
Authors: Mac Giolla Phadraig Caoimhin , Nunn June , McCallion Philip , Donnelly‐Swift Erica , van Harten Maria , McCarron Mary 
Published: October 2018

SummaryObjectivesThis study tests whether total tooth loss is a risk indicator for difficulty eating among a population with intellectual disability and whether complete denture wear mediates this risk.MethodsDentate status and difficulty eating were reported for a Nationally representative sample of 690 adults over forty with intellectual disabilities as part of The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS‐TILDA). A logistic regression model tested the relationship between theDifficulty eatingandDentate status, controlling for the effects of other factors.ResultsOf the 690 participants, 505 had some teeth (Group 1), 56 had no teeth and reported wearing dentures (Group 2) and 129 had no teeth, not using dentures (Group 3). A parsimonious regression model was developed including all 406 cases with no missing data. Adjusting for the effects of other factors, it was found that, compared to Group 1, the odds of difficulty eating was twice as great (OR = 2.01, 95% CI = 1.02‐4.03) among people without teeth, not using dentures (Group 3). Conversely, edentulous participants who had dentures (Group 2) had far lower odds (OR = 0.21, 95% CI = 0.06‐0.64) of reporting difficulty eating compared with Group 1.ConclusionsFor adults with ID, total tooth loss was predictive of difficulty eatingonlywhen untreated. People with disabilities should be encouraged to maintain a functional dentition through preventive and conservative treatment. When adults with ID become edentulous, oral rehabilitation may reduce the risk of difficulty eating. Dental assessment should be undertaken if people with ID present with difficulty eating.
Rabbit metabolic response and selected meat quality traits: Evaluation of dietary PLX®23 and LycoBeads®feed supplement
Authors: Palazzo Marisa , Schiavitto Michele , Cinone Mario , Vizzarri Francesco 
Published: October 2018

AbstractEffects of dietary supplementation of verbascoside and lycopene, alone and in combination, on some blood parameters, plasma oxidative status and meat quality traits in intensively reared rabbits were investigated. The test lasted 60 days and was conducted on 200 weaned‐rabbits, divided into four groups of 50 animals each (5 animals each cage × 10 repetitions). The control group (CON) received a fattening feed without any feed supplements, whereas the experimental groups received the following: the first, an integration in 22 g of PLX®23 (Lippia citriodoraextract; VB group) per ton of feed; the second, an integration in 100 g of LycoBeads®(Solanum lycopersicumextract; LIC group) per ton of feed; and the third, an integration of both feed supplements in combination at the same doses (LIC+VB group). The dietary supplementation withLippia citriodoraandSolanum lycopersicumresulted in an improvement of the blood lipid profile, oxidative plasma markers, and hepatic and renal activity of treated growing rabbits. Feed additives also produced meat with a lower content in SFA and an increased PUFA content, and inhibited the lipid oxidation improving the oxidative stability of rabbit meat. The dietary supplementation, even reporting no effects on productive parameters and carcass yield, showed an improvement on several blood parameters, as indicator of animal welfare, and on quality and healthy meat markers.
Polyphasic approach using multilocus analyses supports the establishment of the new aerophytic cyanobacterial genus Pycnacronema (Coleofasciculaceae, Oscillatoriales)
Authors: Martins Mariéllen Dornelles , Machado‐de‐Lima Náthali Maria , Branco Luis Henrique Zanini 
Published: October 2018

A new Phormidium‐like genus was found during an investigation of Oscillatoriales diversity in Brazil. Eight aerophytic populations from south and southeastern regions were isolated in monospecific cultures and submitted to polyphasic evaluation. The populations presented homogeneous morphology with straight trichomes, not attenuated, and apical cell with thickened cell wall. Phylogenetic analyses based on 16S rRNA gene sequences showed that these populations, plus the Brazilian strain Phomidium sp. B‐Tom from GenBank, formed a highly supported and distinctive clade, which corresponds to the new genus Pycnacronema, comprising six new species: P. brasiliensis (type species), P. arboriculum, P. conicum, P. marmoreum, P. rubrum, and P. savannensis. These results were confirmed and supported by rpoC1 and rbcL genes evaluated independently and by the concatenated analysis of 16S rRNA, rpoC1 and rbcL genes (for all species but P. savannensis). Secondary structures of the D1‐D1′, box‐B, and V3 regions of the internal transcribed spacer were informative at specific level, being conserved in P. brasiliensis and variable among the other strains, also confirming the phylogenetic analyses. The generic name and specific epithets of the new taxa are proposed under the provisions of the International Code of Nomenclature of algae, fungi, and plants.
Autonomy and Free Will
Authors: Weissman David 
Published: October 2018

AbstractAutonomy and free will are essential conditions for moral agency: we aren’t responsible for effects we couldn’t choose or avert. Skeptics argue that the experience of free will is illusory; those defending it say that the conscious experience of intention and responsibility are sufficient evidence of free choice. This essay defends autonomy and free will from an alternate perspective: it affirms that choice has exhaustively material conditions but disputes the determinist claim that every choice is an involuntary step in a causal trajectory progressing blindly from nature’s original conditions. There is a paradox: we are responsible for much we choose and do, though all that comes to pass has sufficient conditions. This is the virtue of soft determinism and its emphasis on autonomy: the sensibility evolving within us is often a barrier to other influences while a sufficient condition for one’s choices and deeds.
Von Willebrand factor contribution to pathophysiology outside of von Willebrand disease
Authors: Mojiri Anahita , Alavi Parnian , Jahroudi Nadia 
Published: October 2018

AbstractVWF is a procoagulant protein that plays a central role in the initiation of platelets aggregate formation and thrombosis. While von Willebrand disease has long been known to result from qualitative and quantitative deficiencies of VWF, it is recently that contribution of elevated levels of VWF to various pathological conditions including thrombosis, inflammation, angiogenesis, and cancer metastasis has been appreciated. Here, we discuss contribution of elevated levels of VWF to various thrombotic and nonthrombotic pathological conditions.
TgDrpC, an atypical dynamin‐related protein in Toxoplasma gondii, is associated with vesicular transport factors and parasite division
Authors: Heredero‐Bermejo Irene , Varberg Joseph M. , Charvat Robert , Jacobs Kylie , Garbuz Tamila , Sullivan William J. , Arrizabalaga Gustavo 
Published: October 2018

SummaryDynamin‐related proteins (Drps) are involved in diverse processes such as organelle division and vesicle trafficking. The intracellular parasite Toxoplasma gondii possesses three distinct Drps. TgDrpC, whose function remains unresolved, is unusual in that it lacks a conserved GTPase Effector Domain, which is typically required for function. Here, we show that TgDrpC localizes to cytoplasmic puncta; however, in dividing parasites, TgDrpC redistributes to the growing edge of the daughter cells. By conditional knockdown, we determined that loss of TgDrpC stalls division and leads to rapid deterioration of multiple organelles and the IMC. We also show that TgDrpC interacts with proteins that exhibit homology to those involved in vesicle transport, including members of the adaptor complex 2. Two of these proteins, a homolog of the adaptor protein 2 (AP‐2) complex subunit alpha‐1 and a homolog of the ezrin–radixin–moesin (ERM) family proteins, localize to puncta and associate with the daughter cells. Consistent with the association with vesicle transport proteins, re‐distribution of TgDrpC to the IMC during division is dependent on post‐Golgi trafficking. Together, these results support that TgDrpC contributes to vesicle trafficking and is critical for stability of parasite organelles and division.
Quantitative gingival crevicular fluid proteome in type 2 diabetes mellitus and chronic periodontitis
Authors: Marinho Marcelo C. , Pacheco Ana Beatriz F. , Costa Giovani C. V. , Ortiz Nina D. , Zajdenverg Lenita , Sansone Carmelo 
Published: October 2018

AbstractObjectiveThe aim of this study was to investigate the proteome of the gingival crevicular fluid comparing the relative abundance of proteins from type 2 diabetes mellitus (2DM) individuals and chronic periodontitis (CP) affected sites, subjects affected by both conditions and healthy individuals.Material and MethodsTwenty individuals were equally allocated in four groups, 2DM with CP, 2DM periodontally healthy, CP without 2DM, and periodontally healthy without 2DM. The relative quantification of proteins was accessed with iTRAQ labeling and mass spectrometry.Results and ConclusionA total of 104 proteins showed significant differences in abundance in pairwise comparisons. Some presented different levels in all diseased groups as compared to control, either increasing (rap guanine nucleotide exchange factor, S100A8, S100A9, and immunoglobulins) or decreasing (actins, myristoylated alanine‐rich C‐kinase substrate, and glutathione S‐transferase). Other differences were specific for a given condition: Titin, neutrophil elastase, and myeloperoxidase levels were higher in the DP group, cathelicidin antimicrobial peptide decreased in CP, and annexin decreased in DH. These differences in the proteome can provide clues for further studies that will validate the variation in their levels and their role in both diseases.
Orthognathic surgery induces genomewide changes longitudinally in DNA methylation in saliva
Authors: Yamaguchi Tetsutaro , Hosomichi Kazuyoshi , Takahashi Masahiro , Haga Shugo , Nakawaki Takatoshi , Hikita Yu , Maki Koutaro , Tajima Atsushi 
Published: October 2018

AbstractObjectiveOrthognathic surgery dramatically changes morphology of the maxillofacial deformity and improves the malocclusion morphologically and functionally. We investigated the influence of orthognathic surgery on genomewide DNA methylation in saliva.MethodsSaliva was obtained from nine patients undergoing orthognathic surgery and two healthy reference individuals before and 3 months after orthognathic surgery. Genomewide DNA methylation profiling of saliva (341,482 CpG dinucleotides) was conducted using Infinium HumanMethylation450 BeadChips.ResultsComparison between pre‐ and postsurgery saliva samples revealed significant changes in DNA methylation patterns at 2,381 CpG sites (p < 0.01) with suggestive significance. The differentially methylated probe sets were significantly associated with the cancer pathway (p = 2.8 × 10−7; a false discovery rate q‐value = 3.7 × 10−4) and PI3K‐Akt signalling pathway (p = 2.4 × 10−5; a false discovery rate q‐value = 3.1 × 10−2).ConclusionPathway enrichment analysis of genes with suggestive significance demonstrated that altered DNA methylation in saliva of patients undergoing orthognathic surgery, possibly as a response to surgical stress or bone injury. Further studies with a large sample size and long‐term observation are needed to validate the phenomena identified in this study.
Association between changes in the intrathoracic impedance and ventricular arrhythmias in patients with heart failure
Authors: Osman Mohammed , Ahmed Azza , Alzubi Hussam , Kheiri Babikir , Osman Khansa , Barbarawi Mahmoud , Ríos‐Bedoya Carlos F. , Bachuwa Ghassan , Hassan Mustafa 
Published: October 2018

AbstractBackgroundVentricular arrhythmias (VAs) are independently related to mortality risk in patients with heart failure (HF). The wide availability of implantable cardioverter defibrillators and cardiac resynchronization therapy devices now offers an opportunity to clinically correlate the two disease processes. We hypothesized that there is an association between changes in the intrathoracic impedance and episodes of VA.MethodsNonconcurrent prospective study of adults (age >20 years) with known HF with reduced ejection fraction (<35%). The OptiVol threshold was categorized as follows: 0‐30 Ω‐days, 31‐60 Ω‐days, 61‐90 Ω‐days, 91‐120 Ω‐days, and >120 Ω‐days. Patients with OptiVol values at 0‐30 Ω‐days were used as the reference group. Receiver operating characteristic analysis was used to estimate the sensitivity and specificity at each threshold.ResultsOf the 87 eligible patients, 65.5% were males. The mean age of the sample was 73.3 years (±12.7). Compared to patients in the 0‐30 Ω‐days category, those in the 31‐60, 61‐90, 91‐120, and >120 Ω‐days groups had, on average, 1.48, 1.64, 2.24, and 1.6 more VAs, respectively (P = 0.002, 0.009, 0.010 and 0.009, respectively). The sensitivity and specificity of each threshold were as follows: 82.6% and 61.7% at 31‐60 Ω‐days, 43.5% and 78.3% at 61‐90 Ω‐days, 30.4% and 85.0% at 91‐120 Ω‐days, and 21.7% and 88.3% at >121 Ω‐days.ConclusionOur study found a significant positive relationship between changes in intrathoracic impedance and episodes of VAs in patients with HF.
Postoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study
Authors: Luo Rong , Zuo YunXia , Liu Hai Bei , Pan Yan 
Published: October 2018

SummaryBackgroundThe perioperative period can be psychologically challenging, and children may exhibit behavioral changes following surgical anesthesia. It is unknown whether children in China have additional risk factors associated with negative behavioral changes.ObjectivesThe aim of this study was to investigate the incidence of behavioral changes in children after hypospadias repair surgery and to identify potential risk factors associated with negative behavioral changes.MethodsA prospective cohort of 177 children aged 2‐12 years scheduled for hypospadias repair surgery from 2016 to 2017 was studied. The primary outcome was the incidence of behavioral changes on postoperative days 14 and 30 evaluated with the Post‐Hospitalization Behavioral Questionnaire. Data collected included demographic data, anesthesia details, procedure details, admission details, child anxiety, child temperament, pain, and emergence delirium. Multivariable logistic regression was used to identify risk factors associated with postoperative negative behavioral changes.ResultsA total of 60.5% (107/177) of children exhibited negative postoperative behavioral changes on day 14 and 46.5% (79/170) exhibited changes on day 30 after the surgery. Approximately 2.3% (4/177) and 2.4% (4/170) of children showed improved behavior on postoperative days 14 and 30, respectively. The frequency of temper tantrums changed the most. The logistic regression results suggested that a younger age (odds ratio: 0.86; 95% confidence interval 0.76‐0.96), emotional temperament (odds ratio: 1.1; 95% confidence interval 1.0‐1.2) and maternal education (odds ratio: 2.2; 95% confidence interval 1.1‐4.5) were associated with negative postoperative behavioral changes on day 14. On day 30, a younger age (odds ratio: 0.87; 95% confidence interval 0.77 to 0.98) was the only factor associated with negative postoperative behavioral changes.ConclusionFor children undergoing hypospadias repair surgery in our institution, approximately three in five showed postoperative behavioral changes. In addition to a younger age and a higher maternal education, an emotional temperament is associated with a high incidence of negative postoperative behavioral changes.
Disseminated visceral Kaposi´s sarcoma in a pediatric bilateral lung transplant recipient
Authors: Galluzzo Mutti Laura , Álvarez Mariana , Siminovich Mónica , Pérez Celeste , Lucero Belén , Nieto Mary , Castaños Claudio , Haag Dora , Boglione Mariano 
Published: October 2018

AbstractCancer is a major adverse outcome of solid organ transplantation, and risks are especially high for malignancies caused by viral infections. HHV‐8 is the etiologic agent of Kaposi´s sarcoma (KS). We report a case of visceral KS occurring in a 15‐year‐old patient after lung transplantation. The evolution was dramatically fast and interestingly, KS lesions were diffusely observed, but not in the skin. The autopsy showed the presence of numerous tumoral lesions in many organs. Microscopically, they all had very similar features, regardless of the organ affected. KS presented without cutaneous involvement. The girl was not tested for HHV‐8 prior to transplantation as it was not part of our protocol. The donor was negative. The aim of the report is to alert other teams, especially those working in pediatrics, about this rare but potential complication in the setting of solid organ transplantation.