bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating morphology andin vivoskeletal mobility with digital models to infer function in brittle star arms
Authors: Clark Elizabeth G. , Hutchinson John R. , Darroch Simon A. F. , Mongiardino Koch Nicolás , Brady Travis R. , Smith Sloane A. , Briggs Derek E. G. 
Published: October 2018

AbstractBrittle stars (Phylum Echinodermata, Class Ophiuroidea) have evolved rapid locomotion employing muscle and skeletal elements within their (usually) five arms to apply forces in a manner analogous to that of vertebrates. Inferring the inner workings of the arm has been difficult as the skeleton is internal and many of the ossicles are sub‐millimeter in size. Advances in 3D visualization and technology have made the study of movement in ophiuroids possible. We developed six virtual 3D skeletal models to demonstrate the potential range of motion of the main arm ossicles, known as vertebrae, and six virtual 3D skeletal models of non‐vertebral ossicles. These models revealed the joint center and relative position of the arm ossicles during near‐maximal range of motion. The models also provide a platform for the comparative evaluation of functional capabilities between disparate ophiuroid arm morphologies. We made observations on specimens ofOphioderma brevispinaandOphiothrix angulata. As these two taxa exemplify two major morphological categories of ophiuroid vertebrae, they provide a basis for an initial assessment of the functional consequences of these disparate vertebral morphologies. These models suggest potential differences in the structure of the intervertebral articulations in these two species, implying disparities in arm flexion mechanics. We also evaluated the differences in the range of motion between segments in the proximal and distal halves of the arm length in a specimen ofO. brevispina, and found that the morphology of vertebrae in the distal portion of the arm allows for higher mobility than in the proximal portion. Our models of non‐vertebral ossicles show that they rotate further in the direction of movement than the vertebrae themselves in order to accommodate arm flexion. These findings raise doubts over previous hypotheses regarding the functional consequences of ophiuroid arm disparity. Our study demonstrates the value of integrating experimental data and visualization of articulated structures when making functional interpretations instead of relying on observations of vertebral or segmental morphology alone. This methodological framework can be applied to other ophiuroid taxa to enable comparative functional analyses. It will also facilitate biomechanical analyses of other invertebrate groups to illuminate how appendage or locomotor function evolved.
The effect of gender‐friendliness barriers on perceived image in nursing and caring behaviour among male nursing students
Authors: Hung Chao‐An , Wu Pei‐Ling , Liu Nai‐Yu , Hsu Wen‐Yi , Lee Bih‐O , Pai Hsiang‐Chu 
Published: October 2018

AbstractAims and objectivesTo examine the relationships among nursing students’ perceived nursing image, caring behaviours and gender‐friendliness barriers to determine whether gender‐friendliness barriers affect nursing image and caring behaviour among male nursing students.BackgroundBecause caring is typically seen as a feminine trait, male nurses face gender‐role strains in the current nursing environment. Gender‐friendliness barriers may have an impact on the vital relationship between professional nursing image and caring behaviour.DesignThis study used a quantitative and cross‐sectional research design.MethodsParticipants were 141 male students who had obtained at least 1 month of clinical practice experience. We collected data using three instruments: The Caring Assessment Report Evaluation Q‐sort (CARE‐Q), Gender‐Friendliness Barriers in Nursing Programs (GFB‐NP), and Nursing Image—as a Profession Questionnaire (NIPQ). Data were collected from August 2016–July 2017. Partial least squares structural equation modelling (PLS‐SEM) with bootstrapping was used to test the hypothesis model.ResultsThe full model results indicated a direct positive and significant path from professional nursing image to caring behaviour (β = 0.47, 95% CI = 0.32 to 0.61, t = 6.19, p < 0.001). Gender‐friendliness barriers had a direct and significant negative relationship between professional nursing image (β = −0.31, 95% CI = −0.49 to −0.12, t = 3.17, p < 0.01) and caring behaviour (β = −0.18, 95% CI = −0.35 to −0.02, t = 2.18, p < 0.05). In addition, the variable of student‐perceived barriers to gender‐friendliness was indirectly and significantly negatively related to caring behaviour (β = −0.15, 95% CI = −0.27 to −0.05, t = 2.57, p < 0.05) through professional nursing image.ConclusionMale nursing students with a higher nursing image engage in greater caring behaviour. Gender‐friendliness barriers, however, decrease students’ nursing image and caring behaviour.Relevance to clinical practiceAs applied to nursing education, the goal should be to improve male nursing students’ caring behaviours and professional nursing image and decrease gender‐friendliness barriers.
Patients’ experiences of nurses’ heartfelt hospitality as caring: A qualitative approach
Authors: Kelly Rosalind , Wright‐St Clair Valerie , Holroyd Eleanor 
Published: October 2018

AbstractAims and ObjectivesTo answer the question “What is the lived experience of hospitality during a patient's hospital stay for elective surgery?”BackgroundHospitality centres on a host offering comfort to others, as in a personal care context. Caring constitutes the essence of what it is to be human, having a profound effect on well‐being and recovery from surgery. Caring is one of the most elusive and diversely contested concepts in nursing; however, care provided by nurses seldom transcends as deep human connections and social utility. This study explored the nature, meaning and experience of hospitality as care from the perspective of elective surgery patients. Consolidated Criteria for Reporting Qualitative criteria were used.DesignA hermeneutic phenomenological methodology.MethodsData were gathered through semi‐structured, face to face interviews with seven patients from both private and public hospitals, and from different cultural backgrounds.ResultsThree interpretative notions were as follows: experiences of hospitality as feeling “really” cared for, being at ease and being healed. Hospitality exists in the receiver's lived experience, evoking a special moment which leads to feelings of great comfort and feelings of being truly cared about. When hospitality is received, patients feel a connection; they begin to trust and their healing begins.ConclusionThe offering of often small, yet heartfelt acts of hospitality, indicated that nurses can evoke powerful lived experiences which benefit patients undergoing elective surgery.Relevance to clinical practiceThe importance of prioritising emotional and social connections to the hospitality experience needs emphasis at all levels of the clinical structure. Hospitality as caring needs to form a part of all undergraduate and postgraduate nursing curricula, and ongoing professional development. The participant quotes presented in this article could form exemplars for the provision of hospitable nursing care practices, highlighting nurses getting to know and understand their patients, and being interested in their lives.
Nurses’ integrity and coping strategies: An integrative review
Authors: Sastrawan Sastrawan , Newton Jennifer Margaret , Malik Gulzar 
Published: October 2018

AbstractIntroductionIntegrity is one of the core values in nursing that needs to be maintained by nurses in practice. However, the complexity in the nursing milieu can pose threats to integrity. An understanding of the common threats and coping strategies might assist nurses in preserving integrity in everyday practice.Aims and objectivesTo review and synthesis the concept of integrity in nursing and identify common threats and coping strategies.MethodsWhittemore and Knafl's integrative review method was implemented. A search was performed in Scopus, Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Proquest Health and Medical electronic databases published in English between 2000–2017. Two reviewers independently assessed eligibility for inclusion. Methodological appropriateness for the included studies was assessed using the critical appraisal skills programme. The constant comparative method of grounded theory was used to analyse and synthesise data from seven peer‐reviewed articles.ResultsTwo major conceptions of integrity were identified. These included the sense of wholeness with regard to personal–professional concerns and ethical–moral conducts. Five entities, self, patients, teamwork and work culture, the nature of work, and organisation, were identified as interweaving elements that may induce threats to integrity. When integrity is threatened, nurses use two key strategies to survive: adjusting and compensating. An emergent framework to facilitate understanding of nurses’ threats to integrity is discussed.ConclusionsA threat to nurses’ integrity takes form when there is an unmitigated gap between a nurse's expectation and reality. While the expectation comes from within the nurse, the reality materialises out of the complex interplays that occur in the healthcare workforce. Maintaining integrity demands a continual strive to balance personal expectations, professional concerns and nursing realities.
Interventions to increase hand hygiene compliance in a tertiary university hospital over a period of 5 years: An iterative process of information, training and feedback
Authors: Hoffmann Magdalena , Sendlhofer Gerald , Pregartner Gudrun , Gombotz Veronika , Tax Christa , Zierler Renate , Brunner Gernot 
Published: October 2018

AbstractAims and objectiveTo explore whether an iterative process of information and training paired with a feedback system to observed healthcare professionals and the respective management improves hand hygiene (HH) compliance.BackgroundHealthcare‐associated infections are a major risk for patient safety, and adherence to the “My five moments” (M5M) for HH varies significantly within organisations as well as within healthcare professional groups. Identified barriers in a baseline survey revealed the need of more information, training, repetitive compliance measurements and feedback to all healthcare professionals.DesignA quality improvement project using the method of direct observation of healthcare professionals in nonsurgical and surgical wards.MethodsBetween 2013 and 2017, 6,009 healthcare professionals were informed and trained, and HH compliance measurements were performed by hygiene experts. Compliance measurement results were documented in an online tool to give an immediate feedback to observed healthcare professionals. Additionally, a report was forwarded to the management of the respective department to raise awareness. Compliance rates per year were descriptively summarised. The research and reporting methodology followed SQUIRE 2.0.ResultsIn total, 84 compliance measurements with 19,295 “M5M for HH” were observed in 49 wards. Overall, mean HH compliance increased from 81.9 ± 5.2% in 2013 to 94.0 ± 3.6% in 2017. Physicians’ HH compliance rate improved from 69.0 ± 16.6% to 89.3 ± 6.6%, that of nurses from 86.0 ± 6.9% to 96.4 ± 3.1%, and that of others from 60.5 ± 27.9% to 83.8 ± 20.2%. All M5M for HH (#1–#5) increased over the study period (#1: +16.9%; #2: +20.5%; #3: +7.6%; #4: +5.9%; #5: +12.7%).ConclusionsResults demonstrated that an iterative process of information, training, observation and feedback over a period of 5 years can be successful in increasing HH compliance. Positive trends were observed for HH compliance rates across all healthcare professional groups as well as for all M5M for HH.
Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus
Authors: Muth C. , Blom J. W. , Smith S. M. , Johnell K. , Gonzalez‐Gonzalez A. I. , Nguyen T. S. , Brueckle M.‐S. , Cesari M. , Tinetti M. E. , Valderas J. M. 
Published: October 2018

AbstractThe complexity and heterogeneity of patients with multimorbidity and polypharmacy renders traditional disease‐oriented guidelines often inadequate and complicates clinical decision making. To address this challenge, guidelines have been developed on multimorbidity or polypharmacy. To systematically analyse their recommendations, we conducted a systematic guideline review using the Ariadne principles for managing multimorbidity as analytical framework. The information synthesis included a multistep consensus process involving 18 multidisciplinary experts from seven countries. We included eight guidelines (four each on multimorbidity and polypharmacy) and extracted about 250 recommendations. The guideline addressed (i) the identification of the target population (risk factors); (ii) the assessment of interacting conditions and treatments: medical history, clinical and psychosocial assessment including physiological status and frailty, reviews of medication and encounters with healthcare providers highlighting informational continuity; (iii) the need to incorporate patient preferences and goal setting: eliciting preferences and expectations, the process of shared decision making in relation to treatment options and the level of involvement of patients and carers; (iv) individualized management: guiding principles on optimization of treatment benefits over possible harms, treatment communication and the information content of medication/care plans; (v) monitoring and follow‐up: strategies in care planning, self‐management and medication‐related aspects, communication with patients including safety instructions and adherence, coordination of care regarding referral and discharge management, medication appropriateness and safety concerns. The spectrum of clinical and self‐management issues varied from guiding principles to specific recommendations and tools providing actionable support. The limited availability of reliable risk prediction models, feasible interventions of proven effectiveness and decision aids, and limited consensus on appropriate outcomes of care highlight major research deficits. An integrated approach to both multimorbidity and polypharmacy should be considered in future guidelines.
Multimorbidity and functional impairment–bidirectional interplay, synergistic effects and common pathways
Authors: Calderón‐Larrañaga A. , Vetrano D. L. , Ferrucci L. , Mercer S. W. , Marengoni A. , Onder G. , Eriksdotter M. , Fratiglioni L. 
Published: October 2018

AbstractThis review discusses the interplay between multimorbidity (i.e. co‐occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians’ fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug–drug and drug–disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age‐related health deterioration; this review provides an overview of knowledge gaps and future directions.
Synthetic surfactants with SP‐B and SP‐C analogues to enable worldwide treatment of neonatal respiratory distress syndrome and other lung diseases
Authors: Johansson J. , Curstedt T. 
Published: October 2018

AbstractTreatment of neonatal respiratory distress syndrome (RDS) using animal‐derived lung surfactant preparations has reduced the mortality of handling premature infants with RDS to a 50th of that in the 1960s. The supply of animal‐derived lung surfactants is limited and only a part of the preterm babies is treated. Thus, there is a need to develop well‐defined synthetic replicas based on key components of natural surfactant. A synthetic product that equals natural‐derived surfactants would enable cost‐efficient production and could also facilitate the development of the treatments of other lung diseases than neonatal RDS. Recently the first synthetic surfactant that contains analogues of the two hydrophobic surfactant proteins B (SP‐B) and SP‐C entered clinical trials for the treatment of neonatal RDS. The development of functional synthetic analogues of SP‐B and SP‐C, however, is considerably more challenging than anticipated 30 years ago when the first structural information of the native proteins became available. For SP‐B, a complex three‐dimensional dimeric structure stabilized by several disulphides has necessitated the design of miniaturized analogues. The main challenge for SP‐C has been the pronounced amyloid aggregation propensity of its transmembrane region. The development of a functional non‐aggregating SP‐C analogue that can be produced synthetically was achieved by designing the amyloidogenic native sequence so that it spontaneously forms a stable transmembrane α‐helix.
Association between tongue muscle strength and masticatory muscle strength
Authors: Hara Koji , Tohara Haruka , Kenichiro Kobayashi , Yamaguchi Kohei , Ariya Chantaramanee , Yoshimi Kanako , Nakane Ayako , Minakuchi Shunsuke 
Published: October 2018

SummaryBackgroundThe tongue is responsible for compressing food against the palate and squeezing it into the pharynx during the oral preparatory phase of swallowing. Tongue pressure (TP), an indicator of tongue muscle strength, has been observed to decline with age; maximum occlusal force (MOF), an indicator of chewing ability, is correlated with TP. However, no study has investigated the relationship between TP and MOF.ObjectiveTo investigate the correlation between TP and MOF according to age in healthy individuals.MethodsWe retrospectively collected handgrip strength (HGS), body mass index (BMI), TP, MOF and tooth loss data for 785 healthy participants (305 men, 480 women). All subjects had either unilateral or bilateral occlusal support, regardless of the presence of dentures or natural teeth. The participants were divided into two groups: an adult (20s‐50s, n = 497) group and an elderly (60s‐80s, n = 288) group. Multivariate linear regression analysis was performed to determine significant independent variables associated with TP in both groups.ResultsMultivariate analysis revealed that TP was significantly associated with age (β = −0.153), BMI (β = 0.205), HGS (β = 0.298) and MOF (β = 0.239) in the adult group (all P < 0.001) and with age (β = −0.266, P < 0.001), BMI (β = 0.160, P = 0.005), MOF (β = 0.217, P = 0.001) and tooth loss (β = 0.156, P = 0.011) in the elderly group.ConclusionsAs age and MOF are each associated with TP in both elderly and adult patients, age‐related TP decline can be prevented with routine lingual exercises, even before the onset of old age. Additionally, MOF deterioration may indicate a decline in TP for elderly.
Effect of Nanodiamond Addition on Flexural Strength, Impact Strength, and Surface Roughness of PMMA Denture Base
Authors: Al‐Harbi Fahad A. , Abdel‐Halim Mohamed S. , Gad Mohammed M. , Fouda Shaimaa M. , Baba Nadim Z. , AlRumaih Hamad S. , Akhtar Sultan 
Published: October 2018

AbstractPurposeTo assess the effect of addition of different concentrations of nanodiamonds (NDs) on flexural strength, impact strength, and surface roughness of heat‐polymerized acrylic resin.Materials and Methods120 specimens were fabricated from heat‐polymerized acrylic resin. They were divided into a control group of pure polymethylmethacrylate (PMMA; Major.Base.20) and three tested groups (PMMA‐ND) with 0.5%wt, 1%wt, and 1.5%wt of added ND to PMMA. Flexural strength was determined using the three‐point bending test. Impact strength was recorded by using a Charpy type impact test. Surface roughness test was performed using a Contour GT machine. One‐way ANOVA and Tukey's post‐hoc analysis (p ≤ 0.05) were used for statistical analysis.ResultsAcrylic resin reinforced with 0.5% ND displayed significantly higher flexural strength than the unreinforced heat‐polymerized specimens, acrylic resin reinforced with 1% ND and the 1.5% ND (p < 0.0001). The impact strength of unreinforced heat‐polymerized specimens was significantly higher than all nano‐composite materials (p < 0.0001) with no significant difference between 1% ND and the 1.5% ND (p > 0.05). The addition of 0.5% ND and 1% ND significantly decreased the surface roughness in comparison to both control and the 1.5% ND groups (p < 0.0001) while no significant differences between 0.5% ND and 1% ND (p > 0.05) were reported. Nano‐composite material (0.5% ND) showed significantly lower surface roughness when compared to other specimens.ConclusionsThe addition of NDs to acrylic denture base improved the flexural strength and surface roughness at low concentrations (0.5%), while the impact strength was decreased with ND addition.