bluuebunny/crossref_metadata_2025_split huggingface dataset:
Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses' perspectives
Authors: Ali Parveen Azam , Watson Roger 
Published: November 2017

Aim and objectiveTo explore nurses’ perspectives of language barriers and their impact on the provision of care to patients with limited English proficiency from diverse linguistic background.Design and methodsA qualitative descriptive approach was used. Using individual interviews and focus group discussions, data were collected from 59 nurses working in tertiary care hospitals in England. A thematic analysis was used to analyse the data.FindingsThree themes, “multi‐ethnicities and language barriers,” “the impact of language barriers” and “communicating via interpreters,” were identified. Communication was identified as the most important aspect of care provision and an essential component of a nurse's professional role regardless of the clinical area or speciality. Language barriers were identified as the biggest obstacles in providing adequate, appropriate, effective and timely care to patients with limited English proficiency. Use of professional interpreters was considered useful; however, the limitations associated with use of interpretation service, including arrangement difficulties, availability and accessibility of interpreters, convenience, confidentiality and privacy‐related issues and impact on the patient's comfort were mentioned.ConclusionsLanguage barriers, in any country or setting, can negatively affect nurses’ ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs.Relevance to clinical practiceAn understanding of language barriers can help nurses find appropriate strategies to overcome such barriers and, consequently, enhance the provision of effective care to patients affected by language barriers in any clinical setting in any healthcare system. The findings of the study have international relevance as language barriers affect healthcare provision in any country or setting.
The third person in the room: The needs of care partners of older people in home care services—A systematic review from a person‐centred perspective
Authors: Anker‐Hansen Camilla , Skovdahl Kirsti , McCormack Brendan , Tønnessen Siri 
Published: November 2017

Aims and objectivesTo identify and synthesise the needs of care partners of older people living at home with assistance from home care services.Background“Ageing in place” is a promoted concept where care partners and home care services play significant roles. Identifying the needs of care partners and finding systematic ways of meeting them can help care partners to cope with their role.Design/methodsThis study is based on the PRISMA reporting guidelines. The systematic review of qualitative and quantitative studies was guided by the Joanna Briggs Institute methodology.ResultsIn total, 16 studies were included in the review, eleven qualitative and five quantitative. Three main categories were revealed in the analysis: the need for quality interaction, the need for a shared approach to care and the need to feel empowered.ConclusionCare partners of older people have several, continuously unmet needs. A person‐centred perspective can contribute new understandings of how to meet these needs. A knowledge gap has been identified regarding the needs of care partners of older people with mental health problems. There is a need to develop a tool for systematic collaboration between home care services and care partners, so that the identified needs can be met in a more thorough, systematic and person‐centred way.Relevance to clinical practiceThe carers in home care services need competence to identify and meet the needs of care partners. The implementation of person‐centred values in home care services can contribute to meet the needs of care partners to a greater extent than today. Future research on the needs of care partners of older people with mental health problems needs to be undertaken.
Clinical evaluation of the multifunctional suprapubic catheter in patients requiring permanent suprapubic cystostomy: A prospective randomised trial in a single centre
Authors: Dong Hai‐Jing , Lu Yi , Zhang Nian‐Zhao , Zhang Wen‐Hua , Wu Shuai , Zhao Hui , Zhang Chang‐Cun , Hou Si‐Chuan 
Published: November 2017

Aims and objectivesTo assess the clinical effect of the multifunctional suprapubic catheter (MSC) on occurrence of cystospasm, catheter occlusion, the catheter‐related urinary tract infection and remission of overactivity bladder, by comparing with the conventional suprapubic catheter (CSC) in patients with permanent suprapubic cystostomy.BackgroundThe conventional suprapubic catheter usually presents with high incidence of catheter‐associated complications.DesignA prospective randomised clinical trial in a single centre.MethodsBetween January 2014 and January 2015, a total of 91 consecutive patients with permanent suprapubic cystostomy were prospectively randomised into two groups: the MSC group (n = 43) and CSC group (n = 48).ResultsOur results showed that the total times of cystospasm in the MSC group were significantly less than that in the CSC group during the follow‐up time (p < .001). In addition, the mean spasmodic duration per time in the MSC group was significantly shorter than that in the CSC group (p < .001). Besides, catheter occlusions were observed in 23 (25.27%) patients, including 5 (11.63%) in the MSC group and 18 (37.50%) in the CSC group (p = .005). The lower rate of positive urine culture was also found in the MSC group but with no significant difference (p = .540). Furthermore, the urodynamic measurement data demonstrated that the patients in the MSC group had a greater remission rate of overactivity bladder after catheter change (p < .001).ConclusionsThe present data showed that the multifunctional suprapubic catheter could significantly reduce the incidence of catheter occlusion, ameliorate the symptom of cystospasm and relieve the overactivity bladder, but have no influence on the catheter‐related urinary tract infection.Relevance to clinical practiceThe application of our self‐devised multifunctional suprapubic catheter may result in better management of the patients with permanent suprapubic cystostomy.
Increased severity of obstructive sleep apnea is associated with less anxiety and depression
Authors: Bjorvatn Bjørn , Rajakulendren Narvini , Lehmann Sverre , Pallesen Ståle 
Published: November 2017

SummaryThe objective was to investigate symptoms of depression and anxiety in relation to the presence and severity of obstructive sleep apnea (OSA) among patients referred with suspicion of OSA. The sample comprised 3770 consecutive patients with a mean age of 49.1 years; 69.7% were male. OSA was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor. Patients completed the validated Hospital Anxiety and Depression Scale (HADS) prior to the sleep study. In addition, they answered questions about whether they were currently in treatment for mental disorders and whether they had been diagnosed previously with depression. We adjusted for sex, age, smoking, alcohol consumption and obesity in the logistic regression analyses. In total, 35.1% had apnea–hypopnea index (AHI) < 5 (no OSA), 31.9% had AHI: 5–14.9 (mild OSA), 17.3% had AHI: 15–29.9 (moderate OSA) and 15.7% had AHI ≥ 30 (severe OSA). The prevalence of anxiety and depressive symptoms were significantly lower with increased OSA severity, and also when adjusting for sex, age, smoking, alcohol consumption and obesity (AHI ≥ 15 as dependent variable). Similarly, currently being in treatment for mental disorders and being diagnosed previously with depression were both associated negatively with OSA severity, with only the latter remaining significant in the fully adjusted model. Furthermore, multiple linear regressions showed that HADS anxiety and depression total scores were associated negatively with AHI. In conclusion, symptoms of anxiety and depression were associated negatively with OSA severity in these referred patients. The findings remained significant also after adjusting for several relevant confounders.
Knowledge regarding hepatitis B mother‐to‐child transmission among healthcare workers in South China
Authors: Chen Y. , Xie C. , Zhang Y. , Li Y. , Ehrhardt S. , Thio C. L. , Nelson K. E. , Chen Y. , Lin C.‐S. 
Published: November 2017

SummaryTo determine the knowledge regarding hepatitis B virus (HBV) mother‐to‐child transmission (MTCT) and its prevention and treatment among healthcare workers (HCWs) in Guangdong Province, China, an HBV endemic area. An HBV knowledge questionnaire was administered to 900 HCWs from the 3rd Affiliated Hospital of Sun Yat‐Sen University and 2 rural hospitals in Guangdong Province. The 27 items in the questionnaire fell into 3 sections: HBV MTCT general knowledge, respondents’ practices of preventing HBV MTCT and awareness of the resources of preventing HBV MTCT. The data collected were coded and analysed using SPSS software version 20. In total, 503 of 900 HCWs responded to the survey (response rate: 55.9%). Eighty‐four individuals responded correctly to all of the knowledge questions: 58 were doctors, and 26 were nurses (P < .05). Doctors more often performed practices than nurses (t = 3.591, P < .01). Participants from the infectious disease department demonstrated a significantly higher proportion of correct answers and resource utilization than other specialties (χ2 = 14.052, 7.998, P < .01). In terms of the average knowledge score, t test or ANOVA showed that there were significant differences between the specialty groups (t = 3.110, P < .01), hospital level groups (t = 2.337, P < .05) and age groups (F = 3.020, P < .05). Respondents’ initiative increased with hospital level and age (t = 2.993, 7.493, P < .01). A considerable percentage of HCWs has misconceptions about HBV MTCT. Healthcare workers, in particular nurses, those working in noninfectious disease departments or township hospitals and younger medical staff, lack systematic and comprehensive knowledge about HBV MTCT and are in urgent need of HBV‐related training.
Low incidence of hepatitis B virus reactivation and subsequent hepatitis in patients with chronic hepatitis C receiving direct‐acting antiviral therapy
Authors: Tamori A. , Abiru S. , Enomoto H. , Kioka K. , Korenaga M. , Tani J. , Enomoto M. , Sugiyama M. , Masaki T. , Kawada N. , Yatsuhashi H. , Nishiguchi S. , Mizokami M. 
Published: November 2017

SummaryTo determine the clinical characteristics of hepatitis B virus (HBV) reactivation in patients undergoing interferon‐free antihepatitis C virus (HCV) therapy, we examined HBV DNA in 25 HBV co‐infected patients and 765 patients with resolved HBV infection during and after treatment with direct‐acting antiviral agents (DAAs). Among those with HCV genotype 1, asunaprevir plus daclatasvir was administered to 160 patients, sofosbuvir (SOF) plus ledipasvir to 438 patients and paritaprevir plus ombitasvir and ritonavir to 25 patients. In total, 167 patients with genotype 2 were treated with SOF plus ribavirin. Three patients with an HBV DNA level ≥2000 IU/mL were treated with entecavir before anti‐HCV therapy, without reactivation of HBV. In 3 of 22 (12%) HBV surface antigen (HBsAg)‐positive patients with an HBV DNA level <2000 IU/mL, the viral load increased during treatment. However, hepatitis flare did not occur in these patients. There was no significant difference in clinical history between patients with and without HBV reactivation. Among 765 patients with resolved HBV infection, HBV reactivation occurred in 1 (0.1%) patient after initial resolution, whose HBV DNA level spontaneously decreased after DAA therapy. We compared anti‐HBs titres at baseline with those at post‐DAA therapy in 123 patients without HBsAg. There was no significant difference in anti‐HBs levels between the two points (P = .79). In conclusion, HBV reactivation was rare in HBsAg‐negative patients treated with DAA therapy. Additionally, hepatitis did not occur in HBV‐reactivated patients with a baseline HBV DNA level <2000 IU/mL before DAA therapy.
Independent signalling cues underpin arbuscular mycorrhizal symbiosis and large lateral root induction in rice
Authors: Chiu Chai Hao , Choi Jeongmin , Paszkowski Uta 
Published: November 2017

Summary

Perception of arbuscular mycorrhizal fungi (AMF) triggers distinct plant signalling responses for parallel establishment of symbiosis and induction of lateral root formation. Rice receptor kinase CHITIN ELICITOR RECEPTOR KINASE 1 (CERK1) and α/β‐fold hydrolase DWARF14‐LIKE (D14L) are involved in pre‐symbiotic fungal perception.

After 6 wk post‐inoculation with Rhizophagus irregularis, root developmental responses, fungal colonization and transcriptional responses were monitored in two independent cerk1 null mutants; a deletion mutant lacking D14L, and with D14L complemented as well as their respective wild‐type cultivars (cv Nipponbare and Nihonmasari).

Here we show that although essential for symbiosis, D14L is dispensable for AMF‐induced root architectural modulation, which conversely relies on CERK1.

Our results demonstrate uncoupling of symbiosis and the symbiotic root developmental signalling during pre‐symbiosis with CERK1 required for AMF‐induced root architectural changes.
Molecular basis for immunohistochemical and inflammatory changes during progression of gingivitis to periodontitis
Authors: Kurgan Sivge , Kantarci Alpdogan 
Published: November 2017

AbstractTwo common diseases – gingivitis and periodontitis – affect the periodontium. Symptoms of disease entities are used for distinguishing various forms of gingivitis and periodontitis. Gingivitis follows a linear and progressive course when a healthy individual stops oral care, as shown by the experimental gingivitis model. It is not known if and when gingivitis transforms into periodontitis. A very limited number of studies present direct evidence regarding the histological changes over time and how they correlate to the clinical transition from gingivitis to periodontitis. This review focuses on the pathological changes that occur during the progression of gingivitis into periodontitis through discussing the molecular, cellular and immunohistochemical aspects of the inflammatory process. Molecular pathways regulating periodontal inflammation also determine the outcomes of disease and healing. Treatment of inflammatory diseases, particularly periodontitis in which extensive tissue damage could result from the inflammatory process, needs to target full restoration of the lost tissues. This can only be accomplished by a thorough understanding of the activation and resolution of periodontal disease and of the molecular events that occur during these phases.
Host modulation therapy with anti‐inflammatory agents
Authors: Preshaw Philip M. 
Published: November 2017

AbstractHost modulation therapy refers to a treatment concept in which drug therapies are used as an adjunct to conventional periodontal treatment to ameliorate destructive aspects of the host inflammatory response. This strategy is not new in the treatment of periodontitis. Previously, nonsteroidal anti‐inflammatory drugs have been investigated in this regard, with evidence of reductions in alveolar bone resorption when these drugs are used for prolonged periods of time. However, the risk of significant unwanted effects precludes the use of both nonselective nonsteroidal anti‐inflammatory drugs and the selective cyclooxygenase‐2 inhibitors as adjunctive treatments for periodontitis. Currently, the only available adjunctive host response modulator that is licensed for the treatment of periodontitis is subantimicrobial dose doxycycline, which functions as an inhibitor of matrix metalloproteinases. Although clinical benefits have been shown in carefully conducted randomized controlled trials, the efficacy of subantimicrobial dose doxycycline in routine clinical practice has yet to be determined. Anti‐cytokine therapies have been developed for use in the treatment of rheumatoid arthritis, the pathogenesis of which bears many similarities to that of periodontitis; however, the significant risk of unwanted effects (as well as cost and lack of human trials in the treatment of periodontal diseases) precludes the use of any of the currently available anti‐cytokine therapies in the treatment of periodontitis. The identification of pro‐resolving lipid mediators as well as small molecule biologicals that influence inflammatory responses offers the best potential, at the present time, for the development of novel host response modulators in periodontal therapy, but much research remains to be done to confirm safety and efficacy.
1.25 L Turbocharged Diesel for Demanding Non-Road Applications
Authors: Sykes David M. , Carpenter Andrew L. , Wagner Jerald G. , Gattoni John M. , Merical Kyle I. , Yelvington Paul E. 
Published: November 2017

A design process was defined and implemented for the rapid development of purpose-built, heavy-fueled engines using modern CAE tools. The first exercise of the process was the clean sheet design of the 1.25 L, three-cylinder, turbocharged AMD45 diesel engine. The goal of the AMD45 development program was to create an engine with the power density of an automotive engine and the durability of an industrial/military diesel engine. The AMD45 engine was designed to withstand 8000 hours of operation at 4500 RPM and 45 kW output, while weighing less than 100 kg. Using a small design team, the total development time to a working prototype was less than 15 months.
Following the design phase, the AMD45 was fabricated and assembled for first prototype testing. The minimum-material-added design approach resulted in a lightweight engine with a dry weight 89 kg for the basic engine with fuel system. At 4500 RPM and an intake manifold pressure of 2.2 bar abs., the AMD45 produced 62 kW with a peak brake fuel-conversion efficiency greater than 34%. Predictions of brake power and efficiency from the design phase matched to within 5% of experimental values. When the engine is detuned to 56 kW maximum power, the use of multi-pulse injection and boost pressure control allowed the AMD45 to achieve steady state emissions (as measured over the ISO 8178 C1 test cycle) of CO and NOx+NMHC that met the EPA Tier 4 Non-road standard without exhaust after-treatment, with the exception of idle testing. PM emissions were also measured, and a sulfur-tolerant diesel particulate filter has been designed for PM after-treatment.
Combustion Performance and Unburned Hydrocarbon Emissions of a Natural Gas–Diesel Dual Fuel Engine at a Low Load Condition
Authors: Guo Hongsheng , Liko Brian , Luque Luis , Littlejohns Jennifer 
Published: November 2017

The combustion of natural gas reduces fuel cost and generates less emissions of carbon dioxide and particulate matter than diesel and gasoline. Replacing diesel by natural gas in internal combustion engines is of great interest for transportation and stationary power generation. Dual fuel combustion is an efficient way to burn natural gas in internal combustion engines.
In natural gas–diesel dual fuel engines, unburned hydrocarbon emissions increase with increasing natural gas fraction. Many studies have been conducted to improve the performance of natural gas–diesel dual fuel engines and reported the performance of combustion and emissions of regulated pollutants and total unburned hydrocarbon at various engine operating strategies. However, little has been reported on the emissions of different unburned hydrocarbon components. In this paper, an experimental investigation was conducted to investigate the combustion performance and emissions of various unburned hydrocarbon components, including methane, ethane, ethylene, acetylene, propylene, formaldehyde, acetaldehyde and benzaldehyde, at a low engine load condition. The operating conditions, such as engine speed, load, intake temperature and pressure, were well controlled during the experiment. The combustion and emissions performance of pure diesel and natural gas–diesel dual fuel combustion were compared. The effect of diesel injection timing was analyzed. The results show that appropriately advancing diesel injection timing to form a homogeneous charge compression ignition-like combustion is beneficial to natural gas–diesel dual fuel combustion at low load conditions. The emissions of different unburned hydrocarbon components changed in dual fuel combustion, with emissions of some unburned hydrocarbon components being primarily due to the combustion of natural gas, while those of others being more related to diesel combustion.
EGR and Backpressure Effects on Knock Behavior in Stoichiometric Natural Gas Engines
Authors: Williams D. Ryan , Knutzen Henry , Chiera Domenico , Hampson Gregory J. 
Published: November 2017

Increasingly restrictive limits on NOx levels are driving the change from lean-burn to stoichiometric combustion strategies on heavy-duty on-highway natural gas engines in order to take advantage of inexpensive and effective three-way catalyst technology. The change to stoichiometric combustion has led to increased tendency for engine knock due to higher in-cylinder temperatures. Exhaust Gas Recirculation (EGR) has been proposed as a method to suppress knock via charge dilution while maintaining a stoichiometric air-fuel ratio. Two of the more common EGR driving architectures and the challenges associated with each architecture are described.
A series of engine tests were devised and performed on a 7-liter heavy-duty natural gas engine to explore the relationships between EGR knock suppression and engine backpressure. A unique concept for an external EGR pumping cart which allowed for the exploration of higher EGR rates independent of backpressure is also described. Results showed that for the conditions tested, increasing EGR rates beyond a certain point did not result in decreased knock tendency. 1D Simulation showed that the effectiveness of the EGR is limited by trapped hot residual gasses which resulted in higher in-cylinder temperatures and nullified the cooling effects of the EGR. These results suggest that attention must be paid to reducing backpressure via efficient EGR system architecture design in order to achieve the highest possible efficiency.