bluuebunny/crossref_metadata_2025_split huggingface dataset:
Societal and Family Lifetime Cost of Dementia: Implications for Policy
Authors: Jutkowitz Eric , Kane Robert L. , Gaugler Joseph E. , MacLehose Richard F. , Dowd Bryan , Kuntz Karen M. 
Published: August 2017

ObjectivesTo estimate the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia.DesignWe developed an evidence‐based mathematical model to simulate disease progression for newly diagnosed individuals with dementia. Data‐driven trajectories of cognition, function, and behavioral and psychological symptoms were used to model disease progression and predict costs. Using modeling, we evaluated lifetime and annual costs of individuals with dementia, compared costs of those with and without clinical features of dementia, and evaluated the effect of reducing functional decline or behavioral and psychological symptoms by 10% for 12 months (implemented when Mini‐Mental State Examination score ≤21).SettingMathematical model.ParticipantsRepresentative simulated U.S. incident dementia cases.MeasurementsValue of informal care, out‐of‐pocket expenditures, Medicaid expenditures, and Medicare expenditures.ResultsFrom time of diagnosis (mean age 83), discounted total lifetime cost of care for a person with dementia was $321,780 (2015 dollars). Families incurred 70% of the total cost burden ($225,140), Medicaid accounted for 14% ($44,090), and Medicare accounted for 16% ($52,540). Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia. Total annual cost peaked at $89,000, and net cost peaked at $72,400. Reducing functional decline or behavioral and psychological symptoms by 10% resulted in $3,880 and $680 lower lifetime costs than natural disease progression.ConclusionDementia substantially increases lifetime costs of care. Long‐lasting, effective interventions are needed to support families because they incur the most dementia cost.
Arabidopsis EXO70A1 recruits Patellin3 to the cell membrane independent of its role as an exocyst subunit
Authors: Wu Chengyun , Tan Lu , van Hooren Max , Tan Xiaoyun , Liu Feng , Li Yan , Zhao Yanxue , Li Bingxuan , Rui Qingchen , Munnik Teun , Bao Yiqun 
Published: August 2017

AbstractThe exocyst is a well‐known complex which tethers vesicles at the cell membrane before fusion. Whether an individual subunit can execute a unique function is largely unknown. Using yeast‐two‐hybrid (Y2H) analysis, we found that EXO70A1 interacted with the GOLD domain of Patellin3 (PATL3). The direct EXO70A1‐PATL3 interaction was supported by in vitro and in vivo experiments. In Arabidopsis, PATL3‐GFP colocalized with EXO70A1 predominantly at the cell membrane, and PATL3 localization was insensitive to BFA and TryA23. Remarkably, in the exo70a1 mutant, PATL3 proteins accumulated as punctate structures within the cytosol, which did not colocalize with several endomembrane compartment markers, and was insensitive to BFA. Furthermore, PATL3 localization was not changed in the exo70e2, PRsec6 or exo84b mutants. These data suggested that EXO70A1, but not other exocyst subunits, was responsible for PATL3 localization, which is independent of its role in secretory/recycling vesicle‐tethering/fusion. Both EXO70A1 and PATL3 were shown to bind PI4P and PI(4,5)P2 in vitro. Evidence was obtained that the other four members of the PATL family bound to EXO70A1 as well, and shared a similar localization pattern as PATL3. These findings offered new insights into exocyst subunit‐specific function, and provided data and tools for further characterization of PATL family proteins.
Enhanced EDX images by fusion of multimodal SEM images using pansharpening techniques
Authors: FRANCHI G. , ANGULO J. , MOREAUD M. , SORBIER L. 
Published: August 2017

SummaryThe goal of this paper is to explore the potential interest of image fusion in the context of multimodal scanning electron microscope (SEM) imaging. In particular, we aim at merging the backscattered electron images that usually have a high spatial resolution but do not provide enough discriminative information to physically classify the nature of the sample, with energy‐dispersive X‐ray spectroscopy (EDX) images that have discriminative information but a lower spatial resolution. The produced images are named enhanced EDX. To achieve this goal, we have compared the results obtained with classical pansharpening techniques for image fusion with an original approach tailored for multimodal SEM fusion of information. Quantitative assessment is obtained by means of two SEM images and a simulated dataset produced by a software based on PENELOPE.
Phase imaging quality improvement by modification of AFM probes’ cantilever
Authors: SKIBINSKI J. , REBIS J. , KACZMAREK L. , WEJRZANOWSKI T. , PLOCINSKI T. , ROZNIATOWSKI K. 
Published: August 2017

SummaryImaging of the surface of materials by atomic force microscopy under tapping and phase imaging mode, with use of modified probes is addressed. In this study, the circularly shaped holes located in varying distance from the probe base, were cut out by focused ion beam. Such modification was a consequence of the results of the previous experiments (probe tip sharpening and cantilever thinning) where significant improvement of image quality in tapping and phase imaging mode has been revealed. The solution proposed herein gives similar results, but is much simpler from the technological point of view. Shorter exposition time of the tip onto gallium ions during FIB processing allows to reduce material degradation. The aim of this modification was to change harmonic oscillators’ properties in the simplest and fastest way, to obtain stronger signal for higher resonant frequencies, which can be advantageous for improving the quality of imaging in PI mode. Probes shaped in that way were used for AFM investigations with Bruker AFM nanoscope 8. As a testing material, titanium roughness standard sample, supplied by Bruker, was used. The results have shown that the modifications performed within these studies influence the oscillation of the probes, which in some cases may result in deterioration of the imaging quality under tapping mode for one or both self‐resonant frequencies. However, phase imaging results obtained using modified probes are of higher quality. The numerical simulations performed by application of finite element method were used to explain the results obtained experimentally. Phenomenon described within this study allows to apply developed modelling methodology for prediction of effects of various modifications on the probes' tip, and as a result, to predict how proposed modifications will affect AFM imaging quality.
Beveled posteromedial corner of the radial head: a three‐dimensional micro‐computed tomography modeling study
Authors: Adikrishna Arnold , Shin Young‐ho , Zulkarnain Rizki F. , Hong Hanpyo , Sun Yucheng , Jeon In‐Ho 
Published: August 2017

AbstractThe posteromedial quadrant of the radial head is known to be different from the other quadrants. However, the explanation of this unique anatomical feature remains elusive. Hence, this study was designed to address this unique anatomical variance using three‐dimensional μCT (micro‐computed tomography) analysis. Nine fresh cadaveric radial heads were scanned using μCT. Three‐dimensional subchondral bone and cartilage models were rendered. Both models were separated into the four quadrants at both the periphery (rim) and the articulating dish (fovea): anteromedial (AM), posteromedial (PM), posterolateral (PL), and anterolateral (AL). Each quadrant was analyzed in terms of (1) subchondral bone porosity (SBP), (2) mean subchondral bone thickness (MSBT), and (3) mean cartilage thickness (MCT). There was a significant difference between the fovea and the rim in terms of its microarchitectural features. Although within the fovea, the PM quadrant did not differ significantly from the other quadrants, a significant difference was found within the rim. In terms of SBP, PM, AM, PL and AL were calculated as 33, 37, 36 and 35%, respectively. In terms of MSBT, PM, AM, PL and AL were calculated as 0.11, 0.10, 0.09, and 0.09 mm, respectively. In terms of MCT, PM, AM, PL and AL were calculated 1.09, 0.81, 0.84 and 0.83 mm, respectively. The PM corner of the radial head between the 8 and 9 o'clock positions, was beveled. This might explain why the PM quadrant of the rim differed significantly from the other quadrants in terms of its microarchitectural features.
Examining the social construction of surveillance: A critical issue for health visitors and public health nurses working with mothers and children
Authors: Peckover Sue , Aston Megan 
Published: August 2017

Aims and objectivesTo critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada.BackgroundThe practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs.DesignWe present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings.MethodsConcepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance.ResultsSurveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power.ConclusionsHealthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice.Relevance to clinical practiceHealthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families.
“My mentor didn't speak to me for the first four weeks”: Perceived Unfairness experienced by nursing students in clinical practice settings
Authors: Jack Kirsten , Hamshire Claire , Harris W. Edwin , Langan Mark , Barrett Neil , Wibberley Christopher 
Published: August 2017

Aims and objectivesTo explore the perceived unfairness experienced by student nurses during their undergraduate clinical placements.BackgroundIt is important that student nurses feel supported by practice staff during their clinical placement education experiences. However, it has been reported that learners can feel ignored, unsupported and bullied by others in the clinical environment and this has a detrimental effect on their learning. It is important to understand the student nurse perspective and explore ways in which their feelings of belongingness might be enhanced in the clinical area.DesignA descriptive narrative approach was used to explore the qualitative data generated by the survey and interviews. Limited closed‐question survey data were acquired to explore a selection of quantified survey responses about placements and mentorship.MethodsA survey was conducted with 1,425 student nurses from adult and mental health degree nursing pathways, across nine institutions in the North West of England, UK. Unstructured interviews were undertaken with 22 student nurses from across these nine institutions. The data generated from both methods (free‐text survey responses and interview) were thematically analysed.ResultsThere were times when student nurses felt that they had been treated unfairly by various members of the healthcare team during their clinical placements. Unfairness was related to being ignored and unsupported or being used as an “extra pair of hands” and having their supernumerary status ignored. Student nurses want to have feelings of belongingness in the clinical area and value enthusiasm for teaching from mentors. Certain positive mentor qualities were identified through the data in this study. These have been used to inform a tiered model of mentorship, to inform future thinking about student nurse education.ConclusionStudent nurses can feel like they are being treated unfairly in the clinical area in numerous ways. Identifying ways in which mentorship practice can be developed to adequately support education is important. This can lead to satisfaction and development on both sides of the student/educator relationship.Relevance to practiceExploring student nurse perceptions of their learning is important when attempting to enhance educational practice in the clinical setting.
New graduate nurses’ preparation for recognition and prevention of failure to rescue: A qualitative study
Authors: Herron Elizabeth K. 
Published: August 2017

Aim and ObjectiveTo explore new graduate nurses’ experiences with recognition and prevention of failure to rescue.BackgroundFailure to rescue is recognised as a quality–of‐care indicator, a core measure of nursing care in hospitals, and a determinant for staffing in acute care facilities. Clinical reasoning is an essential component in preventing failure to rescue and should be emphasised in nursing education and new graduate orientation. Many nurses graduate without the ability to use clinical reasoning in providing patient care which can lead to adverse patient outcomes.DesignA descriptive phenomenological design was used.MethodsA purposive sample of 14 new graduate nurses from a nursing programme in the south‐eastern USA, in practice for no more than eighteen months, was recruited. Individual one‐on‐one interviews were conducted from January–June 2016 and audio‐recorded for accuracy. Data were evaluated using the consolidated criteria for reporting qualitative research (COREQ) guidelines. Recordings were professionally transcribed and reviewed.ResultsUsing Giorgi's methods for data analysis, five main themes were discerned in the data: clinical preparation in school; experience with emergent situations; development of clinical reasoning; low confidence as a new graduate; and responding to emergencies. Within each theme, subthemes emerged.ConclusionThe words of the participants provided rich detail into the preparation of new graduate nurses and how nurse educators, managers and preceptors can better focus learning opportunities to prepare them for practice. Experiential learning combined with collaboration among education stakeholders will lead to a better prepared and more confident nursing work force.Relevance to clinical practiceBetter preparation and continued support of new graduate nurses lead to positive patient outcomes and more satisfaction with their choice of nursing as a profession.
Stuck in tradition‐A qualitative study on barriers for implementation of evidence‐based nutritional care perceived by nursing staff
Authors: O′Connell Malene Barfod , Jensen Pia Søe , Andersen Signe Lindgård , Fernbrant Cecilia , Nørholm Vibeke , Petersen Helle Vendel 
Published: August 2017

Aims and objectivesTo explore the barriers for nutritional care as perceived by nursing staff at an acute orthopaedic ward, aiming to implement evidence‐based nutritional care.BackgroundPrevious studies indicate that nurses recognise nutritional care as important, but interventions are often lacking. These studies show that a range of barriers influence the attempt to optimise nutritional care. Before the implementation of evidence‐based nutritional care, we examined barriers for nutritional care among the nursing staff.DesignQualitative study.MethodsFour focus groups with thirteen members of the nursing staff were interviewed between October 2013–June 2014. The interview guide was designed according to the Theoretical Domains Framework. The interviews were analysed using qualitative content analysis.ResultsThree main categories emerged: lacking common practice, failing to initiate treatment and struggling with existing resources. The nursing staff was lacking both knowledge and common practice regarding nutritional care. They felt they protected patient autonomy by accepting patient′s reluctance to eat or getting a feeding tube. The lack of nutritional focus from doctors decreased the nursing staffs focus leading to nonoptimal nutritional treatment. Competing priorities, physical setting and limited nutritional supplements were believed to hinder nutritional care.ConclusionThe results suggest that nutritional care is in a transitional state from experience‐ to evidence‐based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence‐based nutritional care.Relevance to clinical practiceThis study contributes with valuable knowledge before the implementation of evidence‐based nutritional care. The study provides an understanding of barriers for nutritional care and presents explanations to why nutritional care has failed to become an integrated part of the daily treatment and care.
Attitudes toward pessary use among Thai women with pelvic organ prolapse
Authors: Mungpooklang Treewijit , Bunyavejchevin Suvit 
Published: August 2017

AbstractAimThis study was conducted to investigate attitudes toward pessary use in Thai women with pelvic organ prolapse (POP).MethodsNinety Thai women with symptomatic POP without any history of previous prolapse treatment were recruited. Participants completed a questionnaire about attitudes toward pessary use in Thai language. Patient characteristics and decision‐making factors were identified.ResultsForty eight women (53.3%) decided to use a pessary. Most respondents felt that pessary use would improve emotional status (56.2%), pain (52.0%) and quality of life (75%). The opinions of family members and post‐application bleeding, discharge, irritation and pain were important factors in decision‐making.ConclusionMany Thai women with POP prefer a pessary. Their decision is influenced by opinions of family members and complications of pessary use. Counseling about the advantages and uncommon complications of pessary use should be provided to both patients and family members to improve higher pessary acceptance.
Expressions of programmed death (PD)‐1 and PD‐1 ligand (PD‐L1) in cervical intraepithelial neoplasia and cervical squamous cell carcinomas are of prognostic value and associated with human papillomavirus status
Authors: Yang Wen , Lu Yan‐Ping , Yang Yi‐Zhou , Kang Jia‐Rui , Jin Yi‐Duo , Wang Hong‐Wei 
Published: August 2017

AbstractAimThe programmed death 1/programmed death 1 ligand (PD‐1/PD‐L1) pathway can decrease the immune clearance effects of antigen‐presenting cells and T lymphocytes to promote immune evasion of cervical cancer cells. However, the effects of this pathway on cervical intraepithelial neoplasia (CIN) progression and squamous cell carcinoma (SCC) metastasis are not clear. We herein investigated whether human papillomavirus infection could affect PD‐1 and PD‐L1 expression in CIN, and whether their expression is associated with CIN progression and SCC metastasis.MethodsWe collected paraffin‐embedded samples from two cohorts of patients: (i) CIN samples from cohort I (40 women who tested positive or negative for high‐risk human papillomavirus [HR‐HPV] with grades 0, I, and II–III CIN); and (ii) paired primary and metastatic tumor samples from cohort II (20 SCC patients with or without metastasis). Immunohistochemistry was used to detect expressions of PD‐L1 in tumor cells and PD‐1 in tumor‐associated macrophages and tumor‐infiltrating lymphocytes. We also measured P16INK4a expression and interferon‐γ levels in the cervical tissues.ResultsThe most common HPV type seen in both cohorts of patients was HPV16, followed by HPV18. Increase in PD‐L1 and PD‐1 expression was positively correlated with HPV‐positivity, increase in CIN grade, and tumor metastasis. Furthermore, upregulation of the PD‐1/PD‐L1 pathway was associated with decreased expression of the pro‐inflammatory cytokine, interferon‐γ and increased expression of P16INK4a.ConclusionExpression of PD‐L1 and PD‐1 could be used as clinical prognostic biomarkers for evaluating CIN and cervical cancer because of its positive correlation with CIN progression and tumor metastasis.
Predictors of distant relapse in patients with FIGO stage IIB–IVA cervical cancer treated with definitive radiotherapy
Authors: Okazawa‐Sakai Mika , Mabuchi Seiji , Isohashi Fumiaki , Kawashima Atsushi , Yokoi Eriko , Ogawa Kazuhiko , Kimura Tadashi 
Published: August 2017

AbstractAimTo investigate the predictors of distant relapse in International Federation of Gynecology and Obstetrics (FIGO) stage IIB–IVA cervical cancer patients treated with definitive radiotherapy (RT).MethodsThe clinical data of 219 patients with FIGO stage IIB–IVA cervical cancer treated with definitive RT between January 1997 and December 2011 were retrospectively reviewed. The cumulative distant relapse, progression‐free survival (PFS) and overall survival (OS) rates were calculated using the Kaplan–Meier method and compared using the log‐rank test. A Cox proportional hazards regression model was used to investigate the predictors of distant relapse in patients.ResultsFollowing treatment with definitive RT, 61 of the 219 (27.9%) patients developed distant relapse with median PFS and OS rates of 9.9 and 32.8 months, and estimated five‐year PFS and OS rates of 4.9% and 21.3%, respectively. Multivariate analysis revealed that pelvic node metastasis, pretreatment leukocytosis and pretreatment neutrophilia were significant predictors of distant relapse. The risk of developing distant relapse was found to be associated with the number of predictors that the patients displayed: the estimated five‐year distant relapse rates of the patients with no predictors, one predictor and two predictors were 20.3%, 35.5% and 88.9%, respectively.ConclusionsRoughly 28% of patients with FIGO stage IIB–IVA cervical cancer developed distant relapse after definitive RT. Pelvic lymph node metastasis and pretreatment leukocytosis/neutrophilia are independent predictors of distant relapse.
Clinical indications for hysteroscopic removal of uterine masses: Time, age at diagnosis, and mass size
Authors: Cho Hyun‐Woong , Koo Yu‐Jin , Hong Jin‐Hwa , Lee Jae‐Kwan 
Published: August 2017

AbstractAimThe aim of this study was to investigate clinical factors associated with abnormal pathologies of uterine masses resected via hysteroscopy.MethodsWomen who underwent hysteroscopic surgery for presumptive diagnoses of abnormal endometrial or endocervical masses, such as polyps or leiomyomas on ultrasonography, between January 2012 and April 2015, were enrolled. Clinical and pathologic data were retrospectively reviewed.ResultsAmong 189 patients, pathologic diagnoses of the uterine mass were abnormal in 172 (91.0%) cases, including polyps in 119 (63.0%), leiomyomas in 49 (26.0%), endometrial hyperplasia in two (1.0%), and endometrial cancer in two (1.0%). Seventeen (9.0%) women who underwent hysteroscopic removal showed unremarkable results on pathology, and the most common finding among them was the proliferative phase of the normal endometrium. Women aged over 40 years with uterine masses and a time since last menstrual period of over 15 days are four times more likely to be diagnosed with neoplastic masses than others (odds ratio [OR], 4.39, 95% confidence interval [CI], 1.33–14.48 and OR, 4.22, 95%CI, 1.35–13.21, respectively); those with masses over 1.5 cm in size are three times more likely to be neoplastic than others (OR, 3.08, 95%CI, 1.04–9.12).ConclusionLarge mass size, longer time after last menstrual period, and older age are risk factors for abnormal histologies of uterine masses resected via hysteroscopy. Clinicians should take particular care when contemplating hysteroscopic removal for women younger than 40 years, and those with masses of <1.5 cm in size in the proliferative phase of the endometrium to avoid an unnecessary surgery.