bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precision Medicine
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract:Precision medicine represents a personalized approach to healthcare, tailoring treatment and prevention strategies to individual genes, environment, and lifestyle variations. This approach often employs whole-genomic sequencing to decipher a patient’s entire DNA sequence, guiding therapeutic intervention. Predictive genomic testing assesses disease risk, diagnostic genomic testing verifies diagnoses, and pharmacogenomic testing determines appropriate medication dosages. Although promising, precision medicine raises several ethical concerns. These include complex patient autonomy issues, such as familial implications, healthcare disparities exacerbation, and privacy and confidentiality issues. Economic pressures further complicate these ethical considerations. The drive to create universal drugs, rather than personalized ones, may lead to excluding individuals at higher risk of adverse reactions. This could make drug development more profitable but result in “orphan patients” without optimal treatment options based on genetic risks. This underscores the need to consider economic and ethical factors carefully.
Racial Concordance
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract:Racial concordance in healthcare refers to patients’ preference for choosing a practitioner with the same racial or ethnic identity and cultural background. As society diversifies, it has been argued that the healthcare workforce should reflect this diversity. The patient–practitioner relationship is vital, and racial concordance may enhance this relationship. Patients have autonomy in their choices, whereas practitioners must prioritize patients’ best interests and work to reduce healthcare disparities. Unjust discrimination is illegal, unprofessional, and unethical, and practitioners must be self-aware of implicit biases while following healthcare standards of care. The professional character of practitioners is essential for providing society with stability and consistency in healthcare.
Sexual Boundaries
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
The practitioner–patient relationship is unique and requires strict boundaries to protect the patient’s autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair). The American College of Physicians and the American Medical Association (AMA) Code of Medical Ethics view sexual relationships between a practitioner and a current patient as unethical and detrimental to the patient’s well-being. The AMA also states that a practitioner should avoid nonsexual contact with a patient that may lead to romantic or sexual contact. The practitioner should avoid sexual or romantic relations with anyone directly involved with the patient’s health. The patient–practitioner relationship is one-sided, with the patient divulging protected health information, making the patient vulnerable to exploitation by the practitioner. It is therefore essential for the practitioner to maintain clear and distinct boundaries to protect the patient’s best interests.
Social Media Boundaries
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Social media integration into the healthcare profession has occurred, along with its associated challenges. The use of social media by the healthcare community has increased dramatically in recent years, but it must be used with care to avoid blurring professional and personal boundaries. Students and practitioners must be aware of institutional social media policies, as well as Health Insurance Portability and Accountability Act privacy laws, and the consequences of violating them. Patients’ autonomy, practitioner’s obligation to “do good” and “do no harm,” and public policy principles of justice must be taken into consideration when using social media. Social media can result in both positive and negative consequences, and clear boundaries must be established to maximize the patient’s best interests and maintain professional and legal standards.
Telemedicine
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
There are three main types of telemedicine: synchronous, asynchronous, and monitoring. Synchronous telemedicine involves real-time interactions between patients and practitioners, whereas asynchronous telemedicine involves non-real-time interactions and is used for educational purposes and non-emergency communications. Monitoring involves tracking a patient’s vital signs and other data remotely. To ensure patient autonomy, practitioners must obtain informed consent and ensure privacy and security protocols. Practitioners must also follow the principles of beneficence (do good) and nonmaleficence (do no harm) and establish clear professional boundaries. Telemedicine is primarily regulated by state legislation, with some states having telemedicine parity laws mandating reimbursement for telemedicine visits at the same rate as in-person visits. As telemedicine becomes more widespread, there is a growing need to consider whether healthcare licensure should be national rather than state-based. Issues also arise with state-based healthcare licensure exams and dispersing state Medicaid funds to practitioners in other states.
Terminology of suicide and suicidal behaviour, and the meaning of suicide in different cultural backgrounds
Authors: Schneider Barbara , Milin Sascha , Wolfersdorf Manfred 
Published: September 2024

Abstract
The interpretation and meaning of suicidal behaviour are different across cultures and subcultures. In the Western world, psychiatric disorders or severe psychosocial and existential crises are at the centre of interpretation and the meaning of suicidal behaviour. However, cross-cultural commonalities in characteristics of individuals who die by suicide (such as depression, hopelessness, and relationship problems) are observed. These let us assume universality and invariance in cross-cultural meanings of suicide. Worldwide, there is no unique and universally valid definition of suicidality—most definitions are based on psychiatric and psychological concepts. The meanings of suicidal behaviour in all forms, like death wishes, suicidal thoughts, suicide attempts, death by suicide, and self-destructive behaviours, which have no acute suicidal intent but are self-destructive in the long range—are different, because they are based on cultural traditions. Only by differentiating as precisely as possible the ethnic-, culture-, and subculture-dependent meanings of suicide can valid theories of causation and prediction, and also intervention and prevention programmes, be developed.
Suicidal behaviour and sociocultural factors among South Asians in the United Kingdom
Authors: Poppleton Aaron , Saini Pooja , Panagioti Maria , Husain Nusrat 
Published: September 2024

Abstract
British South Asians form the largest ethnic minority group in the United Kingdom (UK). Variations in British South Asian culture, religion, and demography influence community mental health, including rates and characteristics of self-harm and suicide. Specific factors predisposing and protecting this community from self-harm and suicide have been identified, including mental health stigma, cultural identity, religion, marriage and relationships, domestic violence, and mental and physical health conditions. Further multilevel factors influence British South Asian uptake of and engagement with mental health services, in addition to use of alternative healers. Universal and targeted approaches to cultural adaptation of self-harm and suicide prevention and management strategies are required to improve community trust and service engagement. Possibilities include school- and community-based health education programmes, resource development, clinician and wider health care staff training in cultural competence, and adaptation of psychological interventions and therapies to address interpersonal triggers for self-harm and suicide.
Suicide in Indonesia
Authors: Marthoenis Marthoenis , Safuni Nani , Dahlia  , Fathiariani Liza 
Published: September 2024

Abstract
Suicide is an alarming problem in Indonesia. Even though the estimated rate of suicidal behaviour is increasing, the exact number of suicide cases remains unknown. Several factors have been reported to be associated with suicidal behaviour among Indonesians, including cultural beliefs, financial and familial issues, and the Islamic beliefs in the Indonesian population. This chapter discusses the epidemiology of suicide in Indonesia, suicidal behaviour among adolescents and people with a mental disorder, suicide methods used in Indonesian population, Indonesian mass media reporting of suicidal cases, Islamic culture and suicide in Indonesia, suicide prevention initiatives, and the case of culture-related suicidal behaviour in a province of Indonesia. The chapter concludes by highlighting that more attention should be paid to suicide prevention nationwide.
Pregnancy and childbirth
Authors: Andrew Marion I. , Cyna Allan M. 
Published: September 2024

Abstract
As a core member of a multidisciplinary team caring for mother and baby, the anaesthetist has a unique opportunity to positively influence the environment women and their partners experience in the obstetric setting. This chapter offers the anaesthetist strategies and examples to gradually move away from repeated phrases, and ingrained patterns of speech that emphasize negative perceptions of pregnancy, labour, and delivery. With an understanding of acceptance and subconscious responses, language can be used to engender an atmosphere of calm where women experience being supported, encouraged, and respected for their individual strengths and preferences. The chapter covers both routine contexts as well as ‘urgent’ epidural or emergency caesarean section where ‘LAURS’ and ‘GREAT’ frameworks provide a foundation for building trust and gaining cooperation even in the most challenging of circumstances such as loss and bereavement.
Other challenges
Authors: Hood Gillian M. , Tan Suyin G.M. 
Published: September 2024

Abstract
Patients with complex communication needs are a heterogenous group encompassing people with language impairment and intellectual or behavioural disability requiring additional consideration of communication technique. Firstly, the communication issue should be recognized and defined. Identification of the barriers and mindfulness of our own and the patient’s emotional responses helps formulate appropriate strategies. When working with patients with intellectual disability or rare syndromes, parents and carers are an invaluable resource. Understanding the patient’s particular likes, dislikes, triggers, and needs helps to shape personalized care that builds on the patient’s strengths and avoids causing distress. There are a variety of strategies to avert or defuse a meltdown.
Patients with adverse developmental experience or previous traumatic hospital experiences are commonly encountered in acute care settings. These patients may not be well recognized and frequently have difficulty engaging in care. Creating a ‘psychologically safe’ environment is paramount. ‘LAURS’ principles guide the approach.
Needle phobia
Authors: Cyna Allan M. , Andrew Marion I. 
Published: September 2024

Abstract
Effectively managing patients with needle phobia requires a patient’s trust and confidence. It is important to recognize the specific conscious and subconscious aspects of the problem—consciously the patient has come for safe and optimal care but subconsciously is preventing that care from occurring. Rapport building through a ‘LAURS’ approach promotes autonomy; empowers the patient and increases a sense of control. Metaphor and positive expectancy generated by a confident, calm approach with a clear expectation of success is helpful. It is vital to ask permission at each stage of cannula placement, since control and trust are critical. It is also important to reinforce any success achieved. Such techniques frequently succeed when logic, cajoling or ‘jollying along’ has failed.
Safety critical communication
Authors: Prineas Stavros 
Published: September 2024

Abstract
The high-fidelity transfer of meaning during critical phases of anaesthetic practice is essential to patient safety. In any hierarchical training environment, there are significant implicit barriers to speaking up. A survey of over 1,300 healthcare professionals found that 55% felt barriers to speaking up about patient safety concerns. There was a fear of retaliation or negative feedback, fear of being wrong, or a sense of futility that nothing would change. Rather than assuming that staff will know when and how to assert themselves, healthcare organizations have an obligation to monitor and actively cultivate a work environment where personnel feel comfortable, safe, and supported. This can be done through a range of tools. This chapter details a number of practical tools to facilitate good communication in specific clinical situations, including communication styles, graded assertiveness, handover techniques, leadership styles, debriefing and giving feedback, and other useful techniques.
The theatre team
Authors: Tan Suyin G.M. 
Published: September 2024

Abstract
Communication skills are integral to good teamwork and can be learned and developed. Understanding the similarities and differences between surgeons and anaesthetists helps improve communication. Conflict management is a key skill and there are a variety of techniques that can be employed to achieve resolution. Principles include recognizing emotion; focusing on facts; avoiding blame; taking ownership of the problem and staying focused on patient care. Team members should support each other logistically, professionally, and emotionally. Quality communication during a crisis requires situational awareness, recognition of emotional and subconscious responses, clarity around required tasks, and precision around requests for information and equipment. Handover during anaesthesia is a high-risk procedure and requires a standardized approach. ‘GREAT’ is a helpful template to use.
Benign prostatic hyperplasia and urinary retention
Authors: Garthwaite Mary , Hayes John 
Published: September 2024

Abstract
Benign prostate hyperplasia (BPH) refers to the actual histological changes of stromal-glandular hyperplasia seen within the prostate. The condition becomes clinically significant when this overgrowth of benign tissue is associated with bothersome lower urinary tract symptoms (LUTS) with or without bladder outflow obstruction (BOO). Although the causes of LUTS are multifactorial, a significant proportion will be secondary to benign enlargement of the prostate due to BPH. The prevalence of LUTS and BPH increases with age. Epidemiological studies suggest that &gt;80% of 80 year-olds have the disease. With our ageing population the need for medical and surgical treatment will continue to increase. Progression of the disease can result in complications such as acute or chronic urinary retention, recurrent urinary tract infections, haematuria and bladder stone formation. The aims of treatment are to reduce the severity of LUTS and to prevent the development of complications. Medical therapy including alpha-blockers and 5-alpha reductase inhibitors are the most commonly used. A myriad of surgical treatments now exist and are indicated if maximal medical therapy is insufficient to alleviate symptoms and improve quality of life, or if complications arise. The initial management of acute urinary retention involves prompt catheterization, either urethral or suprapubic, to swiftly alleviate the obstruction, ensure the patient is comfortable, and allow the resolution of any secondary renal impairment. A measurement of bladder residual volume, examination of the prostate via digital rectal examination, and exclusion of obstructive uropathy are important in the initial work-up. Catheterization is usually temporary until surgery can be performed as definitive management, but may be required in the long term if the patient is unfit for surgery or there is detrusor failure secondary to the chronic retention of urine.
Stochastic nature and physiological implications of 5′-NAD RNA cap in bacteria
Authors: Wiedermannová Jana , Babu Ravishankar , Yuzenkova Yulia 
Published: September 2024

Abstract
RNA 5′-modification with NAD+/NADH (oxidized/reduced nicotinamide adenine dinucleotide) has been found in bacteria, eukaryotes and viruses. 5′-NAD is incorporated into RNA by RNA polymerases (RNAPs) during the initiation of synthesis. It is unknown (i) which factors and physiological conditions permit substantial NAD incorporation into RNA in vivo and (ii) how 5′-NAD impacts gene expression and the fate of RNA in bacteria. Here we show in Escherichia coli that RNA NADylation is stimulated by low cellular concentration of the competing substrate ATP, and by weakening ATP contacts with RNAP active site. Additionally, RNA NADylation may be influenced by DNA supercoiling. RNA NADylation does not interfere with posttranscriptional RNA processing by major ribonuclease RNase E. It does not impact the base-pairing between RNAI, the repressor of plasmid replication, and its antisense target, RNAII. Leaderless NADylated model mRNA cI-lacZ is recognized by the 70S ribosome and is translated with the same efficiency as triphosphorylated cI-lacZ mRNA. Translation exposes the 5′-NAD of this mRNA to de-capping by NudC enzyme. We suggest that NADylated mRNAs are rapidly degraded, consistent with their low abundance in published datasets. Furthermore, we observed that ppGpp inhibits NudC de-capping activity, contributing to the growth phase-dependency of NADylated RNA levels.
RIN4 immunity regulators mediate recognition of the core effector RipE1 of Ralstonia solanacearum by the receptor Ptr1
Authors: Lu Jingwei , Cao Peng , Zhang Shuangxi , Wang Qinhu , Xiao Zhiliang , Meng He , Sun Zhimao , Bai Bixin , Cheng Lirui , Yang Aiguo , An Yuyan , Zhang Meixiang 
Published: September 2024

Abstract
Ralstonia solanacearum causes lethal bacterial wilt diseases in numerous crops, resulting in considerable yield losses. Harnessing genetic resistance is desirable for safeguarding plants against phytopathogens. However, genetic resources resistant to bacterial wilt are limited in crops. RipE1, a conserved type Ⅲ effector with cysteine protease activity, is recognized in Nicotiana benthamiana and Arabidopsis (Arabidopsis thaliana). Here, using a virus-induced gene silencing approach, we identified the gene encoding N. benthamiana homolog of Ptr1 (NbPtr1a), a coiled-coil nucleotide-binding leucine-rich repeat receptor (NLR) recognizing RipE1. Silencing or editing NbPtr1a completely abolished RipE1-induced cell death, indicating recognition of RipE1 by NbPtr1a. Genetic complementation confirmed this recognition, which is conserved across multiple solanaceous plants. Expression of RipE1 in planta or within pathogenic bacteria promoted pathogen colonization of Nbptr1a mutant plants, demonstrating its virulence function independent of NLR recognition. Silencing NbRIN4 enhanced RipE1-induced cell death, while expressing NbRIN4 inhibited it, suggesting that NbRIN4 is involved in recognition of NbPtr1a-RipE1. Furthermore, RipE1 associated with and cleaved NbRIN4, AtRIN4, and tomato (Solanum lycopersicum) SlRIN4 proteins through its cysteine protease activity. Silencing NbRIN4 in Nbptr1a mutants did not prevent RipE1 from promoting pathogen colonization, suggesting that NbRIN4 is not the primary target for RipE1-mediated virulence. Additionally, NbRIN4 suppressed self-association of the coiled-coil domain of NbPtr1a, which is critical for NbPtr1a-mediated cell death and resistance. Finally, we demonstrated that activation of NbPtr1a requires RipE1-mediated elimination of NbRIN4. Given the conserved nature of RipE1, Ptr1 holds great potential for protecting crops from diverse R. solanacearum strains and other distinct pathogens.
ISBAR Communication Guideline
Authors: Duah Oliver Boamah , Jonassen Susie Marie 
Published: September 2024

Abstract
Competency in communication and collaboration is essential in forming interprofessional partnerships for nursing practice. However, many students in nursing programs struggle with professional oral and written communication, leading to poor communication and incivility. Generational differences and expectations exacerbate communication breakdown and incivility among students and faculty. Implementing communication guidelines using a standardized communication tool in a traditional bachelor of science in nursing program helped facilitate professional and civil communication between students and faculty. Using the standardized tool improved student civility, professionalism, and accountability.
Meta-Analysis of eVisit Technology on Psychological Anxiety and Factors Influencing the Parents of NICU Newborns
Authors: Wang Jiayi , He Guijuan 
Published: September 2024

Background:
Due to the geographical distance, work obligations, and parenting responsibilities, it is often difficult for parents to visit the neonatal intensive care unit (NICU). Limited parent presence might also constrain updates about infant status thus increasing anxiety, which potentially leads to a stronger necessity for visitation.

Purpose:
Examine the evidence for use of electronic visit (eVisit) technology for parents of newborns in NICU, for example, do eVisits decrease anxiety and are there other factors that demonstrate effectiveness.

Data Sources:
Seven databases were used to search for evidence from 1 January 2000 to 13 November 2023.

Study Selection:
Studies were included with terms related to eHealth, NICU, infant, parent and 41 eligible studies were assessed.

Data Extraction:
Data were extracted by 2 reviewers with a systematic-staged review approach.

Results:
Eight studies with a total of 1450 cases were included. Results of meta-analysis showed that eVisit technology improved anxiety compared with conventional visitation (MD = − 5.04, 95% CI [−5.92, − 4.17], P < .01) and hospitalization satisfaction (RR = 1.09, 95% CI [1.05, 1.13], P < .01), but the effect was not significant with regard to reduction in infant length of stay (MD = − 1.07, 95% CI [−5.39, 3.25], P = .63).

Implications for Practice and Research:
A large sample, high-quality, multi-centered randomized controlled study needs to be conducted to validate the effect of eVisit technology on the psychological state of parents, implications for nursing practice as well as potential newborn affects to improve future ease of use.

Video Abstract:
Available for more insights from the authors. This video shows the concept, current status, significance, and implications for practice and research of eVisit technology.