bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the pressure ulcer management self‐efficacy scale for nurses
Authors: Dellafiore Federica , Arrigoni Cristina , Ghizzardi Greta , Baroni Irene , Conte Gianluca , Turrini Francesca , Castiello Gianluca , Magon Arianna , Pittella Francesco , Caruso Rosario 
Published: April 2019

AbstractBackgroundPressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self‐efficacy in managing PUs could predict patients’ outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task‐specific self‐efficacy has not yet been developed.ObjectivesTo develop a valid and reliable scale to assess nurses’ self‐efficacy in managing PUs, that is, the pressure ulcer management self‐efficacy scale for nurses (PUM‐SES).MethodsThis study had a multi‐method and multi‐phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items’ generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three‐step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM‐SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM‐SES and an established general self‐efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency.ResultsPUM‐SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM‐SES had four domains, labelled as follows: assessment, planning, supervision and decision‐making. These domains were predicted by the same second‐order factor, labelled as PU management self‐efficacy.ConclusionPUM‐SES is a 10‐item scale to measure nurses’ self‐efficacy in PU management. A standardised 0–100 scoring is suggested for computing each domain and the overall scale. PUM‐SES might be used in clinical and educational research.Relevance to clinical practiceOptimising nurses’ self‐efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.
Adolescents’ Subjective Social Status Predicts Day‐to‐Day Mental Health and Future Substance Use
Authors: Russell Michael A. , Odgers Candice L. 
Published: April 2019

Adolescents’ subjective social status (SSS) is associated with mental and behavioral health outcomes, independent of socioeconomic status (SES). Many previous findings, however, come from cross‐sectional studies. We report results from a longitudinal study with 151 adolescents identified as at risk for early substance use and behavioral problems sampled from low‐SES neighborhoods. We examined whether adolescent's SSS predicted mental health (depression, anxiety, and inattention/impulsivity) measured over 30 days via ecological momentary assessment and risk for substance use at an 18‐month follow‐up. Results showed that with each perceived step “up” the SSS ladder, adolescents experienced fewer mental health symptoms in daily life and lower future substance use risk after adjusting for objective SES and previous psychopathology. Implications of these findings are discussed.
Evaluating the Effects of a Personal Hygiene Program on the Knowledge, Skills, and Attitudes of Intellectual Disabilities Teenagers and their Parents
Authors: Konuk Sener Dilek , Aydin Meryem , Cangur Sengul 
Published: April 2019

AbstractTo determine the effects of personal hygiene training on the knowledge, skills, attitudes and behavior of teenagers with mild intellectual disabilities (ID), this study employed a randomized controlled type, social cognitive theory design. A 10‐week, 10‐session program was given to the teenagers (17.38 ± 1.61 years) and their parent. Included in the program were activities covering the washing of hands/face/hair/body, oral hygiene/brushing teeth, clothing hygiene, and menstrual and genital hygiene. At the end of the program and again 3 months later, the personal hygiene habits of the teenagers were significantly improved compared to before the training program. Significantly positive changes were observed in hygiene habits compared to pretraining (p < .001). Compared to pretraining, a significant increase occurred in the skill behavior demonstrated by the teenagers (p < .001). Consequently, it is recommended that the program be implemented by healthcare professionals for all teenagers with mild ID and their parents.
An EFR‐Cf‐9 chimera confers enhanced resistance to bacterial pathogens by SOBIR1‐ and BAK1‐dependent recognition of elf18
Authors: Wu Jinbin , Reca Ida‐Barbara , Spinelli Francesco , Lironi Damiano , De Lorenzo Giulia , Poltronieri Palmiro , Cervone Felice , Joosten Matthieu H.A.J. , Ferrari Simone , Brutus Alexandre 
Published: April 2019

SummaryThe transfer of well‐studied native and chimeric pattern recognition receptors (PRRs) to susceptible plants is a proven strategy to improve host resistance. In most cases, the ectodomain determines PRR recognition specificity, while the endodomain determines the intensity of the immune response. Here we report the generation and characterization of the chimeric receptor EFR‐Cf‐9, which carries the ectodomain of the Arabidopsis thaliana EF‐Tu receptor (EFR) and the endodomain of the tomato Cf‐9 resistance protein. Both transient and stable expression of EFR‐Cf‐9 triggered a robust hypersensitive response (HR) upon elf18 treatment in tobacco. Co‐immunoprecipitation and virus‐induced gene silencing studies showed that EFR‐Cf‐9 constitutively interacts with SUPPRESSOR OF BIR1‐1 (SOBIR1) co‐receptor, and requires both SOBIR1 and kinase‐active BRI1‐ASSOCIATED KINASE1 (BAK1) for its function. Transgenic plants expressing EFR‐Cf‐9 were more resistant to the (hemi)biotrophic bacterial pathogens Pseudomonas amygdali pv. tabaci (Pta) 11528 and Pseudomonas syringae pv. tomato DC3000, and mounted an HR in response to high doses of Pta 11528 and P. carotovorum. Taken together, these data indicate that the EFR‐Cf‐9 chimera is a valuable tool for both investigating the molecular mechanisms responsible for the activation of defence responses by PRRs, and for potential biotechnological use to improve crop disease resistance.
Global population genomics of the forest pathogen Dothistroma septosporum reveal chromosome duplications in high dothistromin‐producing strains
Authors: Bradshaw Rosie E. , Sim Andre D. , Chettri Pranav , Dupont Pierre‐Yves , Guo Yanan , Hunziker Lukas , McDougal Rebecca L. , Van der Nest Ariska , Fourie Arista , Wheeler David , Cox Murray P. , Barnes Irene 
Published: April 2019

SummaryDothistroma needle blight is one of the most devastating pine tree diseases worldwide. New and emerging epidemics have been frequent over the last 25 years, particularly in the Northern Hemisphere, where they are in part associated with changing weather patterns. One of the main Dothistroma needle blight pathogens, Dothistroma septosporum, has a global distribution but most molecular plant pathology research has been confined to Southern Hemisphere populations that have limited genetic diversity. Extensive genomic and transcriptomic data are available for a D. septosporum reference strain from New Zealand, where an introduced clonal population of the pathogen predominates. Due to the global importance of this pathogen, we determined whether the genome of this reference strain is representative of the species worldwide by sequencing the genomes of 18 strains sampled globally from different pine hosts. Genomic polymorphism shows substantial variation within the species, clustered into two distinct groups of strains with centres of diversity in Central and South America. A reciprocal chromosome translocation uniquely identifies the New Zealand strains. Globally, strains differ in their production of the virulence factor dothistromin, with extremely high production levels in strain ALP3 from Germany. Comparisons with the New Zealand reference revealed that several strains are aneuploids; for example, ALP3 has duplications of three chromosomes. Increased gene copy numbers therefore appear to contribute to increased production of dothistromin, emphasizing that studies of population structure are a necessary adjunct to functional analyses of genetic polymorphisms to identify the molecular basis of virulence in this important forest pathogen.
Endothelin‐A receptor in gastric cancer and enhanced antitumor activity of trastuzumab in combination with the endothelin‐A receptor antagonist ZD4054
Authors: Shen Weisong , Xi Hongqing , Li Chenyang , Bian Shibo , Cheng Haidong , Cui Jianxin , Wang Ning , Wei Bo , Huang Xiaohui , Chen Lin 
Published: April 2019

AbstractEndothelin‐A receptor (ETAR) is overexpressed in cancers and can function through transactivation of the epidermal growth factor receptor. We explored ETAR in gastric cancer and investigated the antitumor effect of trastuzumab in combination with the ETAR antagonist ZD4054. The expression of ETAR was significantly correlated with the expression of vascular endothelial growth factor. Univariate and multivariate analyses further showed that ETAR expression correlated with reduced survival in gastric cancer patients. In vitro, ZD4054 increased the antiproliferative effect of trastuzumab in gastric cancer cell lines. Moreover, the addition of ZD4054 to trastuzumab significantly increased apoptosis in gastric cancer cell lines. In vivo, tumor growth was considerably inhibited by treatment with ZD4054 and trastuzumab, and the tumor volume in the trastuzumab and ZD4054 combination group was smaller than in the other groups. The detection of ETAR could help predict the prognosis of gastric cancer patients. Additionally, this study provides support for the therapeutic use of the combination of ZD4054 and trastuzumab as an anticancer treatment, especially for gastric cancer.
Accuracy of pulse oximeters at low oxygen saturations in children with congenital cyanotic heart disease: An observational study
Authors: Kim Eun‐Hee , Lee Ji‐Hyun , Song In‐Kyung , Kim Hee‐Soo , Jang Young‐Eun , Yoo Seokha , Kim Jin‐Tae 
Published: April 2019

AbstractBackgroundPulse oximetry overestimates arterial oxygen saturation (SaO2) at less than 90% saturation in cyanotic children. The Masimo Blue sensor (Masimo Corp., Irvine, CA) is a pulse oximetry sensor developed for use in children with cyanosis. However, there remains a lack of research in actual clinical practice.AimsWe evaluated the intraoperative performance of three different pulse oximeters to measure oxyhemoglobin saturation (SpO2) at low saturations in pediatric patients with cyanotic heart disease and the influence of clinical variables (SaO2, hemoglobin concentration, perfusion index, and weight) on the accuracy of the sensors.MethodsThis prospective observational study compared SpO2 measured using three pulse oximeters (Masimo Blue [Masimo Corp., Irvine, CA]; Masimo LNCS, and Nellcor [Medtronic, Dublin, Ireland]) at selected SaO2 ranges (≥85%, 75%‐84%, 60%‐74%, and < 60%). Accuracy was evaluated according to bias and Bland‐Altman analysis with appropriate correction for multiple measurements. Relationships between bias and clinical variables were assessed using a generalized estimating equation.ResultsTwo hundred and fifty‐eight samples were analyzed. The mean overall bias (limits of agreement) of Masimo Blue, Masimo LNCS, and Nellcor sensor was −5.3 (−20.9 to 10.3%), −7.4 (−21.9 to 7.1%), and −7.4 (−22.5 to 15.1%), respectively. However, there was no difference in bias among the three sensors at SaO2 <60%. Generalized estimating equation showed that SaO2 value was associated with bias of all sensors. Perfusion index affected the bias of Blue sensor and LNCS sensor, and patients' weight was associated with bias of Nellcor sensor.ConclusionMasimo blue sensor demonstrated overall lower bias compared to the other two sensors. However, the accuracy of all sensors was similarly poor at SaO2 less than 60%. Bias was influenced by SaO2, perfusion index, and body weight.
Optimizing the spatial relocation of hospitals to reduce urban traffic congestion: A case study of Beijing
Authors: Wang Yuxia , Tong Daoqin , Li Weimin , Liu Yu 
Published: April 2019

AbstractTraffic congestion represents an ongoing serious issue in many large cities. Many public facilities, such as hospitals, tend to be centrally located to ensure they are most accessible to local residents; as a result, they may contribute significantly to a city's traffic congestion. In this study, a multi‐objective spatial optimization model was provided to help formulate hospital relocation plans, taking into account both traffic congestion and hospital accessibility. Using intra‐urban movement data, we proposed a method to estimate the area‐wide traffic congestion caused by hospital visits and to identify potential hospitals to be relocated. An NSGA‐II (Non‐dominated Sorting Genetic Algorithm II) algorithm was applied to solve the hospital relocation optimization problem; we applied our model to study optimal hospital relocation plans in Beijing. Analysis results provide a tradeoff between traffic congestion relief and hospital accessibility. We discussed plans that significantly reduce traffic congestion while maintaining a high level of hospital accessibility. Our study has significant policy implications and provides insights for future facility planning and transportation planning.
A large deletion spanning XG and GYG2 constitutes a genetic basis of the Xgnull phenotype, underlying anti‐Xga production
Authors: Lee Yan Quan , Storry Jill R. , Karamatic Crew Vanja , Halverson Gregory R. , Thornton Nicole , Olsson Martin L. 
Published: April 2019

BACKGROUNDThe PBDX/XG gene encoding the Xga blood group antigen was described in 1994, but the genetic determinant of XG expression on RBCs was reported only in 2018. However, the frequencies of Xg(a−) individuals could not explain the rarity of anti‐Xga makers. We therefore sought to elucidate the molecular basis of the Xg(a−) phenotype in people producing anti‐Xga.STUDY DESIGN AND METHODSTwo genomic DNA (gDNA) and 13 plasma‐derived cell‐free DNA (cfDNA) samples from anti‐Xga makers were investigated (14 males and one female). PBDX/XG exon sequencing was attempted on one gDNA sample. Polymerase chain reaction assays were developed and bioinformatics used to define a suspected deletion in all samples.RESULTSInvestigation of one gDNA sample revealed a 114‐kb deletion (esv2662319) on the X chromosome that spans XG exons 4 through 10 and the downstream GYG2 gene. A 3555‐bp fragment bridging this deletion was amplified to confirm its presence. Another deletion‐specific polymerase chain reaction of 714 bp enabled identification of esv2662319 in both gDNA samples and eight cfDNA samples while ruling it out in one cfDNA. Males were hemizygous for esv2662319 and the female likely homozygous. Four cfDNA sample results were inconclusive, probably due to poor sample quality. Sanger sequencing recognized the recombination junctions as a heterogeneous LTR6B sequence.CONCLUSIONWe identified a large deletion on the X chromosome, resulting in a true, tissue‐wide Xgnull phenotype. This deletion was found in 10 of 11 anti‐Xga makers from which DNA could be amplified. One sample remained unexplained, indicating further heterogeneity to be explored.
Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults
Authors: Lim Wendy , Afif Waqqas , Knowles Sandra , Lim Gloria , Lin Yulia , Mothersill Charmaine , Nistor Irina , Rehman Faisal , Song Christine , Xenodemetropoulos Ted 
Published: April 2019

Background and ObjectivesRare but potentially life‐threatening hypersensitivity reactions can occur during the administration of intravenous iron. To provide guidance to healthcare professionals caring for adults receiving intravenous iron, a panel of 10 Canadian clinical experts developed a practical algorithm for the identification and management of hypersensitivity reactions to intravenous iron.Materials and methodsA systematic search of PubMed to February 2018 was performed. Articles related to hypersensitivity reactions were selected for review. The algorithm was developed during a 1‐day live meeting based on the literature review and clinical expertise where evidence was lacking. The algorithm was then refined through an iterative process involving a web‐based platform and virtual meetings.ResultsThe algorithm provides guidance to healthcare professionals in preparing for and administering IV iron, as well as recognizing and managing hypersensitivity reactions to intravenous iron. Considerations for re‐challenging patients who have experienced prior reactions are provided.ConclusionHealthcare professionals who are involved in the care of patients receiving intravenous iron should be trained to anticipate, recognize and manage hypersensitivity reactions to intravenous iron to optimize patient care.
Using natural language processing to extract structured epilepsy data from unstructured clinic letters: development and validation of the ExECT (extraction of epilepsy clinical text) system
Authors: Fonferko-Shadrach Beata , Lacey Arron S , Roberts Angus , Akbari Ashley , Thompson Simon , Ford David V , Lyons Ronan A , Rees Mark I , Pickrell William Owen 
Published: April 2019

ObjectiveRoutinely collected healthcare data are a powerful research resource but often lack detailed disease-specific information that is collected in clinical free text, for example, clinic letters. We aim to use natural language processing techniques to extract detailed clinical information from epilepsy clinic letters to enrich routinely collected data.DesignWe used the general architecture for text engineering (GATE) framework to build an information extraction system, ExECT (extraction of epilepsy clinical text), combining rule-based and statistical techniques. We extracted nine categories of epilepsy information in addition to clinic date and date of birth across 200 clinic letters. We compared the results of our algorithm with a manual review of the letters by an epilepsy clinician.SettingDe-identified and pseudonymised epilepsy clinic letters from a Health Board serving half a million residents in Wales, UK.ResultsWe identified 1925 items of information with overall precision, recall and F1 score of 91.4%, 81.4% and 86.1%, respectively. Precision and recall for epilepsy-specific categories were: epilepsy diagnosis (88.1%, 89.0%), epilepsy type (89.8%, 79.8%), focal seizures (96.2%, 69.7%), generalised seizures (88.8%, 52.3%), seizure frequency (86.3%–53.6%), medication (96.1%, 94.0%), CT (55.6%, 58.8%), MRI (82.4%, 68.8%) and electroencephalogram (81.5%, 75.3%).ConclusionsWe have built an automated clinical text extraction system that can accurately extract epilepsy information from free text in clinic letters. This can enhance routinely collected data for research in the UK. The information extracted with ExECT such as epilepsy type, seizure frequency and neurological investigations are often missing from routinely collected data. We propose that our algorithm can bridge this data gap enabling further epilepsy research opportunities. While many of the rules in our pipeline were tailored to extract epilepsy specific information, our methods can be applied to other diseases and also can be used in clinical practice to record patient information in a structured manner.
Working-age adults’ perspectives on living with persistent postural-perceptual dizziness: a qualitative exploratory study
Authors: Sezier Ann Elisabeth Ignace , Saywell Nicola , Terry Gareth , Taylor Denise , Kayes Nicola 
Published: April 2019

ObjectivesTo (a) explore the experiences of persistent postural-perceptual dizziness (PPPD), formerly chronic subjective dizziness on the personal, work and social lives of working-age adults; (b) enhance current understandings of the condition and its impact on the lives of working-age adults and (c) highlight points for consideration and importance to clinical practice.MethodsThis qualitative exploratory study drew on interpretive descriptive methodology. Working-age adults (n=8) diagnosed with PPPD were recruited from a single New Zealand community-based specialist clinic. Data from interviews (n=8) and postinterview reflections (n=2) were analysed using thematic analysis.ResultsThree themes were constructed: (1) It sounds like I’m crazy—referring to the lack of medical, social and self-validation associated with PPPD; (2) I’m a shadow of my former self—representing the impact of the condition on sense of self and life trajectory and (3) How will I survive?— highlighting individual coping processes.ConclusionThis study contributed to the existing body of knowledge by highlighting the complexity and fluidity of experiencing PPPD. It also drew attention to the tension between the acute illness framework that forms the basis of many therapeutic interactions and the enduring psychosocial support needs of the person experiencing PPPD. The findings highlighted that contextual factors need to be taken into account and that a person-centred and biopsychosocial approach, rather than a condition-specific biomedical approach, is needed for care to be perceived as meaningful and satisfactory.
Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis
Authors: Yang Michael M H , Hartley Rebecca L , Leung Alexander A , Ronksley Paul E , Jetté Nathalie , Casha Steven , Riva-Cambrin Jay 
Published: April 2019

ObjectivesInadequate postoperative pain control is common and is associated with poor clinical outcomes. This study aimed to identify preoperative predictors of poor postoperative pain control in adults undergoing inpatient surgery.DesignSystematic review and meta-analysisData sourcesMEDLINE, Embase, CINAHL and PsycINFO were searched through October 2017.Eligibility criteriaStudies in any language were included if they evaluated postoperative pain using a validated instrument in adults (≥18 years) and reported a measure of association between poor postoperative pain control (defined by study authors) and at least one preoperative predictor during the hospital stay.Data extraction and synthesisTwo reviewers screened articles, extracted data and assessed study quality. Measures of association for each preoperative predictor were pooled using random effects models.ResultsThirty-three studies representing 53 362 patients were included in this review. Significant preoperative predictors of poor postoperative pain control included younger age (OR 1.18 [95% CI 1.05 to 1.32], number of studies, n=14), female sex (OR 1.29 [95% CI 1.17 to 1.43], n=20), smoking (OR 1.33 [95% CI 1.09 to 1.61], n=9), history of depressive symptoms (OR 1.71 [95% CI 1.32 to 2.22], n=8), history of anxiety symptoms (OR 1.22 [95% CI 1.09 to 1.36], n=10), sleep difficulties (OR 2.32 [95% CI 1.46 to 3.69], n=2), higher body mass index (OR 1.02 [95% CI 1.01 to 1.03], n=2), presence of preoperative pain (OR 1.21 [95% CI 1.10 to 1.32], n=13) and use of preoperative analgesia (OR 1.54 [95% CI 1.18 to 2.03], n=6). Pain catastrophising, American Society of Anesthesiologists status, chronic pain, marital status, socioeconomic status, education, surgical history, preoperative pressure pain tolerance and orthopaedic surgery (vs abdominal surgery) were not associated with increased odds of poor pain control. Study quality was generally high, although appropriate blinding of predictor during outcome ascertainment was often limited.ConclusionsNine predictors of poor postoperative pain control were identified. These should be recognised as potentially important factors when developing discipline-specific clinical care pathways to improve pain outcomes and to guide future surgical pain research.PROSPERO registration numberCRD42017080682.