bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study
Authors: Perry Sara Jansen , Richter Jason P. , Beauvais Brad 
Published: June 2018

ObjectiveTo explore antecedents and outcomes of nurse self‐reported job satisfaction and dissatisfaction‐based turnover cognitions, theorizing (using Self‐Determination Theory) that leaders can foster work conditions that help fulfill innate needs, thereby fostering satisfaction of nurses and patients, and reducing adverse events.Data Sources/Study SettingPrimary and secondary data were collected within a 4‐month period in 2015, from 2,596 nurses in 110 Army treatment facilities (hospitals and clinics) across 35 health care systems.Data Collection/ExtractionWe collected individual nurse responses to the Practice Environment Scale‐Nursing Work Index, in addition to aggregated archival data from the same timeframe, including both facility‐level patient satisfaction records (the Army Provider Level Satisfaction Survey) and health care system‐level adverse events records (provided by the Army Programming, Analysis, and Evaluation office).Principal FindingsFive predictors of nurse satisfaction and turnover cognitions emerged—supportive leadership, staffing levels, nurse–physician teamwork, adoption of nursing care practice, and advancement opportunities. Aggregated nurse satisfaction was the most consistent predictor of both patient satisfaction and adverse events.ConclusionThese findings provide evidence of the importance of nurse attitudes in improving perceived and actual performance across facilities and health care systems; in addition to practical steps, managers can take to improve satisfaction and retention.
Macrophages are a source of IL‐17 in the human placenta
Authors: Pavlov Oleg , Selutin Aleksandr , Pavlova Oksana , Selkov Sergei 
Published: June 2018

ProblemTo determine if placental macrophages (Hofbauer cells) can synthesize and secrete cytokines of the IL‐17 family throughout pregnancy and to reveal the patterns of cytokine expression in early and late gestation.Methods of studyMacrophages were isolated from the first‐trimester and term placental villous tissues from normal pregnancies. Basal and stimulated intracellular production of IL‐17A, IL‐17E, IL‐17F as well as IL‐17A secretion was quantified by flow cytometry and cytometric bead array, respectively. The expression of IL‐17 and IL‐23 receptors was determined on the surface of the placental macrophages by flow cytometry after antibody staining.ResultsIn early and late gestation, a substantial proportion of the placental macrophages synthesized IL‐17A and IL‐17F, but not IL‐17E, as determined by intracellular staining of the cytokines. Neither the intracellular production nor the secretion of IL‐17 was significantly affected by LPS stimulation and spontaneous labour. The level of secretion decreased slightly but significantly at term. The IL‐23 receptor was absent on the surface of cells, whereas variable expression of the IL‐17 receptor was observed.ConclusionPlacental macrophages constitutively produced IL‐17 at different gestational ages and represent thus a source of this cytokine in the human placenta. Patterns of the cytokine and receptor expression suggest that this cell population may participate in non‐immune processes and contribute to the regulation of placental development and function.
A comparison of two techniques for induction of anaesthesia with target‐controlled infusion of propofol
Authors: Mu J. J. , Jiang T. , Deng L. P. , Choi S. W. , Irwin M. G. , Yuen V. M. 
Published: June 2018

SummaryInduction of anaesthesia with target‐controlled infusion of propofol may be achieved by stepwise increases in effect‐site concentration until the patient loses consciousness (titration method), or by setting a high effect‐site concentration target and observing the calculated effect‐site concentration at loss of consciousness (standard method). When the estimated effect‐site concentration at loss of consciousness is accurate, the difference between effect‐site concentration at loss of consciousness and at recovery of consciousness should be small. This prospective, randomised, controlled trial was designed to compare this difference (effect‐site concentration at loss of consciousness – effect‐site concentration at recovery of consciousness) associated with the two techniques. Sixty‐seven healthy patients undergoing elective hemithyroidectomy were recruited. Induction of anaesthesia was achieved using effect‐site target‐controlled infusion with the modified Marsh model and ke0 of 1.2 min−1. The median (IQR [range]) difference between effect‐site concentration at loss of consciousness and recovery of consciousness was significantly lower in patients in the titration group at 1.2 (0.8–1.5 [0.1–2.9]) μg.ml−1 compared with the standard group 2.1 (1.9–2.6 [0.2–3.6] μg.ml−1; p < 0.0001). There was a positive correlation between effect‐site concentration at loss of, and recovery of, consciousness (R = 0.41, p = 0.016) in the titration group, which was not seen in the standard group (R = −0.15, p = 0.44). In conclusion, using the modified Marsh pharmacokinetic model, the titration method for target‐controlled infusion propofol at induction of anaesthesia allows closer matching of propofol concentration to depth of anaesthesia than the standard method.
Milk compositional changes of Laoshan goat milk from partum up to 261 days postpartum
Authors: Chen Di , Zhao Xuan , Li Xiangying , Wang Jianmin , Wang Cunfang 
Published: June 2018

AbstractDespite the global increasing demand for goat milk, no data exist on the nutrient potential of Laoshan goat milk and limited information exists on its composition according to lactation period. In this study, the measured indicators, including dry matter, protein, immunoglobulin, lactoferrin, fat, ash, lactose, calcium, titratable acidity and pH from partum to 261 days postpartum of Laoshan goat milk, followed the same law of change. There was a significant difference over the first 5 days postpartum, after which no significant difference was observed until days 225 postpartum. However, days 255 postpartum was like a turning point, after which their values showed either an increasing or decreasing trend. We concluded that the colostrum for Laoshan dairy goat was considered from days 1 to 5 postpartum and after 5 days it was as transitioned to milk when all measured parameters were according to the normal ranges as described in this study. This work provided updated information on the current nutritive characteristics of Laoshan goat milk, which may be of importance in the fields of milk production, food technology, and nutritional mutual replenishment.
Can doctors identify older patients at risk of medication harm following hospital discharge? A multicentre prospective study in the UK
Authors: Parekh Nikesh , Stevenson Jennifer M. , Schiff Rebekah , Graham Davies J. , Bremner Stephen , Van der Cammen Tischa , Harchowal Jatinder , Rajkumar Chakravarthi , Ali Khalid ,   on behalf of the PRIME study group
Published: June 2018

AimsMedication‐related harm (MRH) is common in older adults following hospital discharge. In resource‐limited health systems, interventions to reduce this risk can be targeted at high‐risk patients. This study aims to determine whether (1) doctors can predict which older patients will experience MRH requiring healthcare following hospital discharge, (2) clinical experience and confidence in prediction influence the accuracy of the prediction.MethodsThis was a multicentre observational prospective study involving five teaching hospitals in England between September 2013 and November 2015. Doctors discharging patients (aged ≥65 years) from medical wards predicted the likelihood of their patient experiencing MRH requiring healthcare (hospital readmission or community healthcare) in the initial 8‐week period post‐discharge. Patients were followed up by senior pharmacists to determine MRH occurrence.ResultsData of 1066 patients (83%) with completed predictions and follow‐up, out of 1280 recruited patients, were analysed. Patients had a median age of 82 years (65–103 years), and 58% were female. Most predictions (85%) were made by junior doctors with less than 5 years' clinical experience. There was no relationship between doctors' predictions and patient MRH (OR 1.10, 95% CI 0.82–1.46, P = 0.53), irrespective of years of clinical experience. Doctors' predictions were more likely to be accurate when they reported higher confidence in their prediction, especially in predicting MRH‐associated hospital readmissions (OR 1.58, 95% CI 1.42–1.76, P < 0.001).ConclusionsClinical judgement of doctors is not a reliable tool to predict MRH in older adults post‐discharge.
Sex differences in brain structure among adolescents with bipolar disorder
Authors: Mitchell Rachel HB , Metcalfe Arron WS , Islam Alvi H , Toma Simina , Patel Ronak , Fiksenbaum Lisa , Korczak Daphne , MacIntosh Bradley J , Goldstein Benjamin I 
Published: June 2018

ObjectivesBipolar disorder (BD) is twice as prevalent amongst female as amongst male adolescents. Thus far, little is known regarding the neurostructural substrates underlying this disparity. We therefore examined sex differences in neurostructural magnetic resonane imaging (MRI) phenotypes amongst adolescents with BD.MethodsT1‐weighted structural MRI was acquired from 44 BD (25 female [F] and 19 male [M]) and 58 (28 F and 30 M) healthy control (HC) adolescents (13‐21 years old). Whole‐brain and region‐of‐interest (ROI) analyses examined structural volume and cortical thickness using FreeSurfer. ROIs included the ventrolateral prefrontal cortex (vlPFC), anterior cingulate cortex (ACC), amygdala and hippocampus. General linear models evaluated sex‐by‐diagnosis interactions, controlling for age and intracranial volume.ResultsWhole‐brain analysis revealed sex‐by‐diagnosis interactions in the left supramarginal gyrus (SMG) (P = .02, η2 = 0.02) and right inferior parietal lobule (IPL) volumes (P = .04, η2 = 0.01). Sex differences in HCs were found in the SMG (M > F) and IPL (F > M). In BD, sex differences were reversed and of smaller magnitude in the SMG (M < F) and of greater magnitude in the IPL (F > M), driven by trends towards smaller SMG and IPL in BD vs HC male participants (P = .05 and .14). Whole‐brain analyses for cortical thickness, and ROI analyses for volume and cortical thickness, were not significant.ConclusionsNormative sex differences may be disrupted in adolescent BD in the SMG and IPL, heteromodal association network hubs responsible for higher order integration of cognitive and emotional processing. Unexpectedly, these findings may inform our understanding of aberrant brain structure in adolescent BD male patients, rather than female patients. Future work should focus on replication, as well as the impact of puberty status and sex hormones on measures of brain structure and function.
The USP8 mutational status may predict long‐term remission in patients with Cushing's disease
Authors: Albani Adriana , Pérez‐Rivas Luis G. , Dimopoulou Christina , Zopp Stephanie , Colón‐Bolea Paula , Roeber Sigrun , Honegger Jürgen , Flitsch Jörg , Rachinger Walter , Buchfelder Michael , Stalla Günter K. , Herms Jochen , Reincke Martin , Theodoropoulou Marily 
Published: June 2018

SummaryObjectiveAlmost half of the cases of Cushing's disease (CD) tumours carry recurrent activating somatic mutations in the ubiquitin‐specific protease eight gene (USP8). The USP8 mutational status could predict remission in patients with CD, so our objective was to correlate the presence of somatic USP8 mutations with the rate of recurrence after transsphenoidal surgery (TSS) retrospectively.DesignBiochemical, radiological and clinical data were retrospectively assessed in 48 patients. USP8 mutational status was determined from corticotroph tumour samples. Association between USP8 mutational status, remission and recurrence was investigated.PatientsPatients with Cushing's disease from a single‐centre cohort who underwent TSS between 1991 and 2012.MeasurementsLong‐term remission and recurrence rate after TSS with at least 6 months follow‐up. Biochemical, radiological and clinical data, including sex, age at diagnosis, tumour size and pre‐operative hormonal levels. USP8 mutational status.ResultsPatients with USP8 mutant corticotroph tumours (18 of 48; 37%) were diagnosed significantly earlier (mean ± SD 46 ± 10 years vs 53 ± 11 years; P = 0.028) and presented with higher pre‐operative 24‐hour urinary‐free cortisol levels (median IQR μg/24 hours 1174.0, 1184.5 vs 480.0, 405.3; P = 0.045). The incidence of recurrence in a 10‐year follow‐up was significantly higher in patients with USP8 mutant tumours after the initial remission (58% vs 18% P = 0.026). Recurrence appeared significantly earlier in these patients (months 70, 44‐97 95% CI vs 102, 86‐119 95% CI; P = 0.019).ConclusionRecurrence appears to be more frequent and earlier after TSS in patients with USP8 mutant corticotroph tumours.
Survivorship care for early‐stage colorectal cancer: a national survey of general surgeons and colorectal surgeons
Authors: Choi Y. , Huntley J. H. , Efron J. E. , Sato K. , Marohn M. R. , Pollack C. E. 
Published: June 2018

AbstractAimFew data are available on the optimal long‐term care of early‐stage colorectal cancer survivors, termed survivorship care. We aimed to investigate current practice in the management of patients following treatment for early‐stage colorectal cancer.MethodWe performed an internet survey of members of the American Society for Colon and Rectal Surgeons about several aspects of long‐term care, including allocation of clinician responsibility, challenges with transitions to primary care physicians (PCPs), long‐term care plan provision and recommended surgical follow‐up duration.ResultsOverall, 251 surgeons responded. Surgeons reported taking primary responsibility for managing adverse surgical effects (93.2%) and surveillance testing (imaging and laboratories 68.6%, endoscopy 82.4%). Barriers to PCP handoffs included patient preference for surgical follow‐up (endorsed by 76.6%) and inadequate communication with PCPs (endorsed by 36.9%). Approximately one‐third of surgeons routinely provide survivorship care plans to PCPs; surgeons who received formal survivorship training were more likely to do so compared to those without such training (OR 3.29, 95% CI 1.57, 6.92). Although only 20.4% of surgeons follow their patients beyond 5 years, individuals in practice longer were more likely to continue long‐term follow‐up than those with ≤ 10 years of experience.ConclusionsThis is the largest survey of surgeons regarding long‐term management for early‐stage colorectal cancer and highlights the potential for improved coordination with PCPs and increased implementation of survivorship care plans.
Reliability of arterial stiffness indices at rest and following a single bout of moderate‐intensity exercise in older adults
Authors: Perissiou Maria , Bailey Tom G. , Windsor Mark , Leicht Anthony S. , Golledge Jonathan , Askew Christopher D. 
Published: June 2018

SummaryShort‐term changes in arterial stiffness with exercise are proposed to better reflect vascular impairments than resting measures alone and are suggested as a prognostic indicator of cardiovascular risk in older adults. Arterial stiffness indices are reliable at rest, but the time‐course and reliability of postexercise changes in arterial stiffness in older adults are unknown. The precision of postexercise changes in arterial stiffness should be determined prior to their use in large prospective trials. This study assessed the between‐day reliability of the changes in pulse wave velocity (PWV), augmentation index (AIx75) and reflection magnitude (RM) following an exercise bout in older adults. Ten older adults (71 ± 5 years) were tested on three separate days, 7 days apart. PWV, AIx75 and RM were assessed at rest, immediately post and at 20, 40 and 60 min during recovery after moderate‐intensity cycling. Intraclass correlation coefficient (ICC) and reliability coefficient (RC) were used to assess the relative and absolute reliability of arterial stiffness responses. PWV increased, and RM decreased immediately after exercise (P<0·05), and returned to baseline during recovery. AIx decreased during recovery (P<0·001). Resting ICC values were 0·91 (PWV), 0·72 (AIx75) and 0·40 (RM). Reliability of the immediate changes following exercise was high for PWV (ICC:0·87, RC:1·9 m s−1) and moderate for AIx75 (ICC:0·64, RC:7%) and RM (ICC:0·59, RC:9%). Reliability of the postexercise responses was similar to that at rest for all measures of arterial stiffness. These findings indicate that postexercise changes in arterial stiffness indices are reliable in healthy older adults and supports further investigation of the prognostic value of these responses.
Arterial stiffness is associated with visceral fat mass in kidney transplanted patients—A nationwide cohort study
Authors: von Düring Marit Elizabeth , Jenssen Trond , Bollerslev Jens , Godang Kristin , Hartmann Anders , Åsberg Anders 
Published: June 2018

AbstractArterial stiffness, visceral fat, and hyperglycemia are acknowledged risk factors for adverse outcomes after transplantation, but whether arterial stiffness is associated with visceral adipose tissue and hyperglycemia is unknown. We studied 162 non‐diabetic kidney transplant recipients 8‐10 weeks after transplantation. Arterial stiffness was measured as pulse wave velocity (PWV) by SphygmoCor and visceral fat using a validated software applied on DXA scans. Also a standard oral glucose tolerance test was performed. Median PWV was 8.6 m/s (IQR 7.3‐10.4 m/s). Patients in the upper quartile of PWV had 31%‐106% higher visceral fat percentage (P < 0.001), they were older (P < 0.001) and had a fasting plasma glucose of 5.8 mmol/L that was higher than in the other quartiles (P = 0.006). In univariate analysis, visceral fat percentage and age were the parameters strongest associated with PWV (P < 0.001), but cholesterol and glucose were also significant (P < 0.05). In multivariate analysis, visceral fat was the only significant predictor of PWV along with age (P < 0.001). In conclusion, arterial stiffness is significantly associated with visceral fat but not hyperglycemia in non‐diabetic kidney transplant patients. We identified age and VAT as risk variables for arterial stiffness. A potential reversibility of arterial wall stiffness with reduction in VAT needs further study.
Evolution of research ethics in a low resource setting: A case for Uganda
Authors: Ochieng Joseph , Mwaka Erisa , Kwagala Betty , Sewankambo Nelson 
Published: June 2018

AbstractBackgroundThe globalization of clinical research in the last two decades has led to a significant increase in the volume of clinical research in developing countries. As of 2016, Uganda was the third largest destination for clinical trials in Africa. This requires adequate capacity and systems to facilitate ethical practice.MethodsThis was a retrospective study involving review of laws, guidelines, policies and records from 1896 to date.ResultsModern medicine evolved from 1896 and by the time of Uganda's independence in 1962, a 1500 bed national referral hospital was in place and a fully‐fledged medical school was established at the Makerere University. As the practice of medicine evolved in the country, so did medical research that addressed priority health issues.The growth in modern medicine was not matched with development of research infrastructure and regulatory systems. The first documented regulation of research activities was in 1970 while the first research ethics committee established in 1986 was to facilitate review of research related to the HIV/AIDs pandemic. In 1990 an Act of Parliament was passed to facilitate development and implementation of policies, hence the development of the national guidelines in 1997, training, establishment and accreditation of research ethics committees, conferences and research site monitoring.ConclusionOver the past 120 years, the implementation and structural aspects of research ethics in Uganda have evolved through 70 years of no regulation, followed by 30 years of rudimentary regulation while the last 20 years have shown significant growth in the regulatory system associated with supportive laws, institutionalization of regulatory and training processes.
Power mobility for children: a survey study of American and Canadian therapists’ perspectives and practices
Authors: Kenyon Lisa K , Jones Maria , Livingstone Roslyn , Breaux Becky , Tsotsoros Jessica , Williams Kelly M 
Published: June 2018

AimTo explore the views and practices of paediatric occupational therapists and physical therapists in Canada and theUSAregarding the implementation of power mobility for children with mobility limitations.MethodThis descriptive study utilized a web‐based survey that included questions pertaining to therapists’ decisions to trial and use power mobility, agreement or disagreement with statements developed from published practice considerations regarding power mobility, and the frequency of performing tasks related to power mobility prescription and training.ResultsMost respondents reported that child characteristics (e.g. cognition, safety awareness) were important factors in decision‐making about power mobility, whereas other child characteristics (e.g. communication abilities, age) were not as important. Family resources and home accessibility were also not considered important. The average age at which respondents considered power mobility for children was 2 years 3 months. The majority of respondents agreed with statements developed from published practice considerations and most frequently performed various power mobility tasks twice a year or less.InterpretationAlthough most respondents appeared to have positive views regarding power mobility, few appeared to actively perform power mobility tasks in their practice. Resources to support therapists in the early introduction of power mobility may be beneficial.What this paper addsOccupational and physical therapists positively view early introduction of power mobility for children with mobility limitations.Few therapists actively provide early power mobility experiences.Power mobility training and monitoring power mobility devices are important therapist roles.
Meta‐analysis evaluating resting laryngeal endoscopy as a diagnostic tool for recurrent laryngeal neuropathy in the equine athlete
Authors: Elliott S. , Cheetham J. 
Published: June 2018

SummaryBackgroundResting endoscopy has commonly been used as a method to predict laryngeal function at exercise.ObjectivesTo perform a meta‐analysis to determine the sensitivity and specificity of resting laryngeal endoscopy to predict clinical recurrent laryngeal neuropathy at exercise.Study designMeta‐analysis.MethodsManuscripts were included if data were available for both resting and exercising airway function on all or a subset of horses. Normal resting endoscopy was defined as laryngeal grades 1 or 2 on a 4‐/7‐point scale or 1, 2 or 3 on a 5‐point scale and normal dynamic endoscopy as a dynamic laryngeal grade A.ResultsTwelve studies including 1827 horses were evaluated. A small proportion of horses with grade 1 or grade 2 laryngeal function at rest, 3.5 and 11.9%, respectively, were identified as having abnormal laryngeal function at exercise. Within the horses with grade 3 laryngeal function at rest, 16% were classified as grade A, 26.4% as grade B and 57.6% as grade C at exercise. Worsening subgrades within resting grade 3 demonstrated an increasing proportion of complete or partial paralysis at exercise. The sensitivity and specificity of resting endoscopy was 74.4 and 95.1%, respectively, and the positive and negative predictive values were 85.6 and 90.5% respectively.Main limitationsUse of two separate grading systems for evaluating resting laryngeal function. Other forms of dynamic airway collapse were not evaluated.ConclusionsResting endoscopy is sensitive and highly specific for predicting laryngeal function at exercise. Dynamic endoscopy is important to assess multiple causes of airway collapse.