bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefit and risk profile of tofacitinib for the treatment of alopecia areata: a systemic review and meta‐analysis
Authors: Guo L. , Feng S. , Sun B. , Jiang X. , Liu Y. 
Published: September 2019

AbstractBackgroundRecent insights showed the possibility of using JAK inhibitors for the treatment of alopecia areata (AA). Most of the previous articles evaluated the overall efficacy of existing JAK inhibitors rather than evaluating one of them alone. Currently, the benefit and risk profile of tofacitinib for the treatment of AA is still not clear.ObjectiveTo estimate the safety and efficacy of tofacitinib in patients with AA based on summarizing the clinical outcomes.MethodsThe systematic review and meta‐analysis was performed according to PRISMA guidelines. ROBINS‐I (Risk of Bias in Non‐randomized Studies‐of Interventions) was used for quality assessment.ResultsWe enrolled 14 studies including six clinical trials and eight observational studies with 275 patients. The result of meta‐analysis showed that tofacitinib has reasonable effectiveness in patients with AA. The pooled good/complete hair regrowth rate of tofacitinib treating patient with AA was 54.0% (95% CI: 46.3%–61.5%), and the pooled rate of partial response in patients with AA taking tofacitinib was 26.1% (20.7–32.2%). Approximately a quarter of patients had experience of relapse, most of which was reported due to discontinuation of tofacitinib. In terms of toxicity, reported adverse effects included only mild symptoms. Upper respiratory infection, headache and acne were the most common adverse events.ConclusionTofacitinib seems to be a promising drug for the treatment of AA with only mild adverse effects. More thorough larger sized randomized clinical trials are required to further assess the safety and clinical efficacy of tofacitinib for the treatment of AA.
Treatment of rosacea and demodicosis with benzyl benzoate: effects of different doses on Demodex density and clinical symptoms
Authors: Forton F.M.N. , De Maertelaer V. 
Published: September 2019

AbstractBackgroundPatients with rosacea or demodicosis have high facial skin Demodex densities (Dds). Topical ivermectin, benzyl benzoate (BB) and crotamiton have been shown to decrease Dds in vivo, but there are few data on the clinical and acaricidal effects of BB among patients with rosacea.ObjectiveTo evaluate the impact of topical BB (+crotamiton) treatment on Dds and clinical symptoms of rosacea and demodicosis, and compare three BB treatment regimens.MethodsIn this retrospective observational study, 394 patients (117 with rosacea, 277 with demodicosis) were included. Three BB (+crotamiton) treatment regimens were compared: 12% once daily, 12% twice daily and 20% once daily. Dds were measured using two consecutive standardized skin surface biopsies [superficial (SSSB1) and deep (SSSB2)] before treatment and at the first follow‐up. Symptoms were evaluated using investigator global assessment. Treatment was considered effective if the Dd had normalized (SSSB1 ≤ 5 D/cm2 AND SSSB2 ≤ 10 D/cm²) or symptoms had cleared and curative if the Dd had normalized and symptoms had cleared.ResultsAt an average of 2.7 months after treatment start, the total Dd (SSSB1 + 2) had decreased by 72.4 ± 2.6% from the initial value across the whole cohort. Dds had normalized in 139 patients (35%), and symptoms had cleared in 122 (31%). Treatment was effective in 183 (46%) patients and curative in 78 (20%). Compliance was good: 77% of patients correctly followed treatment instructions. Results were similar in patients with rosacea and those with demodicosis. The 12% once‐daily regimen was less effective than the other doses and had poorer compliance than the 12% twice‐daily regimen.ConclusionTopical treatment with BB (+crotamiton) may be an effective treatment for rosacea and demodicosis, indirectly supporting a key role of the mite in the pathophysiology of rosacea. The two higher dose regimens were more effective than the lower dose.
Factors associated with improvement of quality of life among parents of children with atopic dermatitis: 1‐year prospective cohort study
Authors: Maksimovic N. , Zaric M. , Reljic V. , Nikolic M. , Gazibara T. 
Published: September 2019

AbstractBackgroundPrevious studies exploring the impact of atopic dermatitis (AD) in children focused on factors associated with parental quality of life at one point in time.ObjectiveTo examine factors associated with change of quality of life among parents of children affected with AD.MethodsThe study cohort comprised 98 parent–children pairs treated for AD at the Clinic of Dermatovenereology; however, 18 parents (18.4%) were lost to follow‐up after 1 year. Children were assessed with SCORing Atopic Dermatitis Index (SCORAD) and Children Dermatology Life Quality Index (CDLQI) or the Infants’ Dermatitis Quality of Life Index (IDQOL), depending on their age. Parents filled in socio‐demographic questionnaire and Dermatitis Family Impact Questionnaire (DFI). After 1 year, both children and parents were reassessed using the same AD‐related battery of questionnaires.ResultsAfter follow‐up, a significant improvement in the average total DFI score was observed, especially for domains of fatigue/exhaustion, emotional distress and impact of helping in child treatment. Lower baseline SCORAD, greater improvement of SCORAD over follow‐up, better CDLQI/IDQOL at baseline, greater improvement in CDLQI/IDQOL over follow‐up, not having asthma and having older child with AD were associated with better parental quality of life after 1 year of follow‐up. Parental higher education level, shorter AD duration, better baseline SCORAD and greater improvement in CDLQI/IDQOL over follow‐up were associated with greater improvement in parental life quality over 1 year of follow‐up.ConclusionContributors to parental quality of life after 1 year included clinical features of AD and child's comorbidity (asthma), but also the perception of child's quality of life and its improvement.
Epidemiology of hidradenitis suppurativa in Germany – an observational cohort study based on a multisource approach
Authors: Kirsten N. , Petersen J. , Hagenström K. , Augustin M. 
Published: September 2019

AbstractBackgroundHidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disease. In Germany, there are no population‐based data on the epidemiology of HS.ObjectivesThe objective of this study was to examine the occurrence of HS in inpatient as well as in outpatient settings.MethodsWe used three data sources for analysing the prevalence, incidence and case‐related occurrence of HS in different settings: data of two German statutory health insurance (SHI) companies and hospital discharge data provided by the Federal Statistical Office. The studied period was from 2010 to 2015.ResultsIn a representative sample of about 2.3 million insurees (out of 5.9 million total persons) of the SHI DAK‐Gesundheit, 791 were diagnosed with HS in 2010. This coding prevalence of 0.03% is in accordance with the data of another SHI (Barmer) on about 9 million total insurees. In 2015, at least 34.7% of incident persons with HS had one potential misdiagnosis in 2014.ConclusionThis population‐based study analyses the prevalence and incidence of HS in Germany. The coding prevalence of 0.03% observed in two independent SHI data sets is lower than expected. The findings of considerable potential misdiagnosis add to the underdiagnosis of HS in general and underline the need for future strategies to early detection and valid diagnosis of HS.
Serum levels of folate, 25‐hydroxyvitamin D3 and cobalamin during UVB phototherapy: findings in a large prospective trial
Authors: Weber B. , Marculescu R. , Radakovic S. , Tanew A. 
Published: September 2019

AbstractBackgroundNarrowband UVB phototherapy (NB‐UVB) is a mainstay in the treatment of numerous inflammatory dermatoses. Whereas, a wealth of studies has shown that NB‐UVB treatment increases 25‐hydroxyvitamin D3 (25(OH)D) levels, only sparse and controversial data exist on its effect on serum folate and cobalamin.ObjectivesTo determine whether exposure to NB‐UVB alters serum folate or cobalamin levels.MethodsA single‐centre, prospective, open observational study on 101 patients subjected to NB‐UVB phototherapy between late fall and early spring. Serum folate, 25(OH)D and cobalamin levels were measured after 0, 12, 24 and 36 NB‐UVB exposures.ResultsAfter 12 NB‐UVB exposures a significant decrease of mean serum folate (−1.0 nmol/L; P = 0.03) and cobalamin (−14.5 pmol/L, P = 0.03) levels was observed whereas serum levels of 25(OH)D showed a significant increase (35.4 nmol/L, P < 0.0001).ConclusionsA standard course of NB‐UVB induces a small but significant decrease of serum folate and cobalamin levels.
Direct and indirect effects of sexual signal loss on female reproduction in the Pacific field cricket (Teleogryllus oceanicus)
Authors: Heinen‐Kay Justa L. , Strub Daina B. , Balenger Susan L. , Zuk Marlene 
Published: September 2019

AbstractSexual signal evolution may present fitness consequences for the non‐signaling sex due to shared genes and altered social conditions, but this is rarely studied in natural populations. On the Hawaiian Island of Kauai, most male Teleogryllus oceanicus (Pacific field crickets) lack the ability to sing because of a novel wing mutation (flatwing) that arose and spread in <20 generations. Obligately silent flatwing males have been highly successful because they avoid detection by a deadly, acoustically‐orienting parasitoid fly. Little is known about how the flatwing mutation and resulting song‐less acoustic environment affects female fitness. We found that Kauai females carrying the flatwing allele invested less in reproductive tissues and experienced more instances of mating failure than normal‐wing‐carrying females, though total offspring production did not differ between female genotypes. Females from Oahu (HI, where the parasitoid and flatwing also occur) and Mangaia (an island in the Cook Islands which harbors neither the parasitoid nor flatwing) invested less in reproductive tissues when reared in a song‐less acoustic environment. Kauai females did not exhibit this plasticity, perhaps because they have experienced nearly song‐less conditions for the past ~15 years following the establishment of flatwing. We show that female T. oceanicus experience a mix of costly and beneficial effects of sexual signal loss, which should help maintain the wing polymorphism in the wild. Our results demonstrate that the non‐signaling sex can experience a nuanced set of phenotypic consequences resulting from signal evolution, which can further shape dynamics of sexual signal evolution.
Activation of alpha‐1 adrenergic receptors increases cytosolic calcium in neurones of the paraventricular nucleus of the hypothalamus
Authors: Milanick William J. , Polo‐Parada Luis , Dantzler Heather A. , Kline David D. 
Published: September 2019

AbstractNorepinephrine (NE) activates adrenergic receptors (ARs) in the hypothalamic paraventricular nucleus (PVN) to increase excitatory currents, depolarise neurones and, ultimately, augment neuro‐sympathetic and endocrine output. Such cellular events are known to potentiate intracellular calcium ([Ca2+]i); however, the role of NE with respect to modulating [Ca2+]i in PVN neurones and the mechanisms by which this may occur remain unclear. We evaluated the effects of NE on [Ca2+]i of acutely isolated PVN neurones using Fura‐2 imaging. NE induced a slow increase in [Ca2+]i compared to artificial cerebrospinal fluid vehicle. NE‐induced Ca2+ elevations were mimicked by the α1‐AR agonist phenylephrine (PE) but not by α2‐AR agonist clonidine (CLON). NE and PE but not CLON also increased the overall number of neurones that increase [Ca2+]i (ie, responders). Elimination of extracellular Ca2+ or intracellular endoplasmic reticulum Ca2+ stores abolished the increase in [Ca2+]i and reduced responders. Blockade of voltage‐dependent Ca2+ channels abolished the α1‐AR induced increase in [Ca2+]i and number of responders, as did inhibition of phospholipase C inhibitor, protein kinase C and inositol triphosphate receptors. Spontaneous phasic Ca2+ events, however, were not altered by NE, PE or CLON. Repeated K+‐induced membrane depolarisation produced repetitive [Ca2+]i elevations. NE and PE increased baseline Ca2+, whereas NE decreased the peak amplitude. CLON also decreased peak amplitude but did not affect baseline [Ca2+]i. Taken together, these data suggest receptor‐specific influence of α1 and α2 receptors on the various modes of calcium entry in PVN neurones. They further suggest Ca2+ increase via α1‐ARs is co‐dependent on extracellular Ca2+ influx and intracellular Ca2+ release, possibly via a phospholipase C inhibitor‐mediated signalling cascade.
Influence of workplace incivility on the quality of nursing care
Authors: Alshehry Abdualrahman Saeed , Alquwez Nahed , Almazan Joseph , Namis Ibrahim Mohammed , Cruz Jonas Preposi 
Published: September 2019

AbstractAims and objectivesTo examine the influence of workplace incivility on the quality of nursing care.BackgroundRecent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide. Exposure to workplace incivility can alter a nurse's behaviour, thought process and perspective towards the nursing profession. However, there is insufficient evidence to determine whether workplace incivility might be associated with the quality of nursing care in Saudi Arabia.DesignA quantitative and cross‐sectional study.MethodA survey was carried out amongst 378 nurses in two government hospitals in Saudi Arabia from February 2018–May 2018 using the Nurse Incivility and quality of nursing care scales. Multivariate multiple regression was performed to investigate the influence of the uncivil experiences of nurses from different sources on the different aspects of quality of nursing care. The study adhered to STROBE guideline (see Appendix S1).ResultsThe overall mean of the quality of nursing care scale was 3.14 (SD = 0.66) from a scale of 1–5, with patient satisfaction receiving the highest mean dimension (mean = 3.27, SD = 0.72) and health promotion the lowest mean dimension (mean = 3.08, SD = 0.74). Experience in the present hospital and the hospital were associated with the overall quality of nursing care. General and nurse incivility exerted a multivariate effect on overall quality of nursing care and its different dimensions.ConclusionGeneral incivility and nurse incivility were found to negatively impact quality of nursing care and its different dimensions.Relevance to clinical practiceStronger policies geared towards eliminating workplace incivility should be implemented as uncivil acts can lead to poor quality of nursing care. Nurse administrators and nurses should be pro‐active in recognising, preventing, approaching, reporting and intervening with uncivil acts in the hospital to protect these workers from these types of behaviours and avoid their negative impacts on patient care.
Identifying determinants for the application of physical or chemical restraint in the management of psychomotor agitation on the critical care unit
Authors: Teece Angela , Baker John , Smith Helen 
Published: September 2019

AbstractAims and objectivesTo identify key determinants, which lead to the decision to apply physical or chemical restraint on the critical care unit.BackgroundPsychomotor agitation and hyperactive delirium are frequently cited as clinical rationale for initiating chemical and physical restraint in critical care. Current restraint guidance is over a decade old, and wide variations in nursing and prescribing practice are evident. It is unclear whether restraint use is grounded in evidence‐based practice or custom and culture.Study designIntegrative review.MethodSeven health sciences databases were searched to identify published and grey literature (1995–2019), with additional hand‐searching. The systematic deselection process followed PRISMA guidance. Studies were included if they identified physical or chemical restraint as a method of agitation management in adult critical care units. Quality appraisal was undertaken using Mixed Methods Appraisal Tool. Data were extracted, and thematic analysis undertaken.ResultsA total of 23 studies were included. Four main themes were identified: the lack of standardised practice, patient characteristics associated with restraint use, the struggle in practice and the decision to apply restraint.ConclusionsThere are wide variations in restraint use despite the presence of international guidance. Nurses are the primary decision‐makers in applying restraint and report that caring for delirious patients is physically and psychologically challenging. The decision to restrain can be influenced by the working environment, patient behaviours and clinical acuity. Enhanced clinical support and guidance for nurses caring for delirious patients is indicated.Relevance to clinical practiceDelirium and agitation pose a potential threat to patient safety and the maintenance of life‐preserving therapies. Restraint is viewed as one method of preserving patient safety. However, use appears to be influenced by previous adverse experiences and subjective patient descriptors, rather than robust evidence‐based knowledge. The need for a precise language to describe restraint and quantify when it becomes necessary is indicated.
Perceptions and experiences of perioperative nurses and nurse anaesthetists in robotic‐assisted surgery
Authors: Schuessler Zohreh , Scott Stiles Anne , Mancuso Peggy 
Published: September 2019

AbstractAims and objectivesTo explore the perceptions and experiences of perioperative nurses and Certified Registered Nurse Anaesthetists (CRNAs) in robotic‐assisted laparoscopic surgery (RALS). The objective was to identify the factors that affect nursing care of patients who undergo robotic‐assisted laparoscopic surgery (RALS).BackgroundThe rapid introduction of technological innovations into the healthcare system has created new challenges for perioperative nurses. RALS affects the physical and interpersonal context of the surgical team's work and subsequent patient outcomes. Despite significant changes to the workflow for perioperative nurses and CRNAs, there is little research focusing on the nurses’ experience and their challenges with RALS.DesignA qualitative descriptive study.MethodSemi‐structured interview questions guided data collection. A total of seventeen participants including six preoperative and postoperative nurses, seven intraoperative nurses, and four CRNAs in the United States were interviewed. The interviews were conducted between 26 April–24 June 2018. Data were analysed using thematic analysis, and the COREQ checklist was used to report data collection, analysis and the results.ResultsThree major themes and two categories within each theme were identified: (a) surgical innovation: nurse perception and workflow; (b) interprofessional practice: teamwork and standards; and (c) outcome: patient outcomes and system outcomes.ConclusionsThe findings indicate that RALS has the potential to improve patient outcomes when performed in a timely fashion by skilled surgeons, and efficient, well‐trained surgical teams. For patients to experience full benefits of RALS, patient characteristics, the underlying reason for surgery, and cost must be considered.Relevance to clinical practiceThe results of this study highlight the necessity of promoting factors that improve the surgical team training and practice for RALS and will ultimately impact patient outcomes.
Barriers and enablers for the implementation of a hospital communication tool for patient participation: A qualitative study
Authors: Theys Sofie , Lust Elisa , Heinen Maud , Verhaeghe Sofie , Beeckman Dimitri , Eeckloo Kristof , Malfait Simon , Van Hecke Ann 
Published: September 2019

AbstractAims and objectivesTo investigate potential barriers and enablers prior to the implementation of the Tell‐us card.BackgroundPatient participation has the potential to improve quality of care and has a positive effect on health outcomes. To enhance participation of patients, adequate communication between patients, their relatives and healthcare professionals is vital. Communication is considered as a fundament of care according to the Fundamentals of Care Framework. A strategy to improve patient participation is the use of the Tell‐us card; a communication tool that patients and relatives can use during hospitalisation to point out what is important for them during their admission and before discharge. Investigating barriers and enablers is needed before implementation.DesignA qualitative study.MethodsSemistructured, individual interviews with (head)nurses, nurse assistants and midwifes. Interviews were audio‐recorded, transcribed and analysed using the framework analysis method. The COREQ checklist has been used.ResultsThe need to maintain control over care, reluctance to engage in in‐depth conversations, fear of being seen as unprofessional by patients, fear of repercussions from physicians, the lack of insight in the meaning of patient participation and the lack of appreciation of the importance of patient participation appeared to be majors barriers. Participants also elaborated on several prerequisites for successful implementation and regarded the cooperation of the multidisciplinary team as an essential enabler.ConclusionThe identified barriers and enablers revealed that nurses and midwives are rather reluctant towards patient participation and actively facilitating that by using the Tell‐us card communication tool.Relevance to clinical practiceA number of issues will have to be factored into the implementation plan of the communication tool. Tailored implementation strategies will be crucial to overcome barriers and to accomplish a successful and sustainable implementation of the Tell‐us card.