bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of the relationship between resilience, burnout and coping strategies in doctors
Authors: McCain R Scott , McKinley Nicola , Dempster Martin , Campbell W Jeffrey , Kirk Stephen J 
Published: August 2017

AbstractPurpose of the studyThe aim of this study was to measure resilience, coping and professional quality of life in doctors.Study designA cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors.Results283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors.ConclusionsDespite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life.
The impact of CMS inclusive jet data on parton distribution functions and their uncertainties
Authors: Aleedaneshvar A. , Khorramian A. 
Published: August 2017

It is well known that the jet production data at LHC provide important constraints on the medium and large-[Formula: see text] gluon parton distribution function (PDF), as well as on the large-[Formula: see text] sea quarks. In this work, we study the impact of recent CMS measurements for the inclusive jet production at center-of-mass energy of [Formula: see text][Formula: see text]=[Formula: see text]13 TeV on the PDFs and their uncertainties. To this aim, with use of the FastNLO and xFitter framework, we apply the parton distribution re-weighting procedure to study the impact of CMS data on two NLO modern CT14 and MMHT PDF sets. As a result, we found that the fit quality obtained using both of these PDF sets is very good. Moreover, the CMS data can impact both the central values and uncertainties of some PDFs especially at low and large [Formula: see text] regions. Overall, it is indicated that the CT14 PDFs compared with the MMHT ones are more affected. We emphasis that the inclusion of these data in a new global analysis of PDFs can improve the determination of the gluon and quark PDFs at both low and large [Formula: see text] regions.
BIOÉTICA E VIGILÂNCIA SANITÁRIA
Authors: Garrafa Volnei , Amorim Karla , Garcia Ticiana , Manchola Camilo 
Published: August 2017

As práticas regulatórias no campo da vigilância sanitária são indispensáveis. O objetivo deste estudo é mostrar, tomando como referência a Agência Nacional de Vigilância Sanitária, organismo referencial da vigilância sanitária no Brasil, que a bioética oferece aos organismos públicos uma série de ferramentas teóricas do campo da ética aplicada para o bom exercício e controle dessas práticas. Nesse intuito, o trabalho utiliza duas referências da bioética para o desenvolvimento de uma análise comparativa e de apoio às atividades regulatórias no campo da vigilância sanitária: a Declaração Universal sobre Bioética e Direitos Humanos da Unesco e a teoria da bioética de intervenção. Conclui-se que organismos e técnicos que trabalham com atividades de regulação podem aproveitar, em seu exercício profissional, os princípios e referenciais propostos pela bioética, especialmente aqueles relacionados à Declaração e à teoria de bioética da intervenção, esta última configurada pela observação e utilização dos princípios da prudência, precaução, proteção e prevenção.
ENTRE A FILOSOFIA JURÍDICA E A SAÚDE COLETIVA: O CONCEITO DE DESEMPENHO NO DECRETO N. 7.508/2011 VIS-À-VIS A INTEGRALIDADE DA ASSISTÊNCIA À LUZ DO PÓS-POSITIVISMO
Authors: Carnut Leonardo , Masseran Jorge Alberto Mamede 
Published: August 2017

O objetivo deste estudo foi analisar a noção de desempenho apresentada pelo Decreto n. 7.508/2011 e suas aproximações com o paradigma gerencialista da administração pública diante da integralidade da assistência. Metodologicamente, utilizou-se o Decreto n. 7.508/2011 como documento normativo para análise crítica e interpretação sob uma óptica pós-positivista, especialmente nos parágrafos relacionados ao desempenho. Após a análise, foi possível elucidar argumentos latentes ao texto de lei que demonstram o caráter gerencialista do desempenho, com diversas repercussões interpretativas para a compreensão sobre o direito ao acesso, especificamente no que tange à integralidade da assistência nos sistemas regionais de saúde. Concluiu-se que o desempenho gerencialista presente no decreto analisado, ao ser interpretado sob a luz do pós-positivismo jurídico, ao invés de fomentar a efetividade do direito à saúde via política pública, proporciona o cerceamento do acesso ao sistema pela prestação direta.
DIREITO À SAÚDE: UMA PROPOSTA DE CONCEITO PARA A OPERACIONALIZAÇÃO DE PESQUISAS QUALITATIVAS
Authors: D'Andrea Gustavo , Rodríguez Anna Maria Meyer Maciel , Ventura Carla Aparecida Arena , Mishima Silvana Martins 
Published: August 2017

Desde 1988, o direito à saúde tem sido objeto de estudo de investigações tanto no campo da saúde quanto no do direito, sob distintas perspectivas e abordagens. Este trabalho visa a propor um conceito sobre o tema considerando o prisma histórico e sua evolução conceitual para contribuir com a operacionalização das pesquisas qualitativas. Por meio de consulta à literatura técnica e científica sobre o assunto, a partir de sua regulamentação na Constituição Federal de 1988 até o ano de 2015, utilizou-se o descritor "direito à saúde” e o qualificador "história" para elencar os artigos científicos e identificar as perspectivas estudadas. Da leitura dos artigos selecionados, emergiram quatro grandes aspectos: sociopolítico, legislativo, bioético e de demandas específicas na área da saúde, que nortearam a discussão e elaboração do conceito de direito à saúde. Pode-se dizer que a definição de direito à saúde exige contextualização histórica, cultural, política, econômica e social e depende também de sua organização normativa, de sua natureza (individual e coletiva), da responsabilidade moral e do reconhecimento de sua exigibilidade.
ORGANIZAÇÃO MUNDIAL DA SAÚDE TEM NOVO DIRETOR-GERAL
Authors: Dallari Sueli Gandolfi 
Published: August 2017

A eleição foi mais transparente porque o voto foi estendido aos Estados-Membros, e não somente ao Comitê Executivo da OMS. Além disso, foram publicados manifestos e realizados debates, verificando-se o claro emprego de estratégias eleitorais – foi possível acompanhar, por exemplo, o giro dos candidatos em busca dos votos dos Estados-Membros.
OS IMPACTOS DA AÇÃO REGULATÓRIA EM DIFERENTES ÁREAS DA SAÚDE PÚBLICA
Authors: Cruz Verônica 
Published: August 2017

O campo de atuação da vigilância sanitária é por natureza amplo e difuso, quase sempre reverberando sobre outras áreas haja vista sua função precípua, qual seja: a de proteger a saúde da população. Não obstante, a atuação da Agência Nacional de Vigilância Sanitária (Anvisa) no Brasil, ao transpassar os limites mais óbvios relativos às questões sanitárias, encontra resistências de ordem política, econômica e até mesmo moral na sociedade. Os artigos que se seguem trazem para a seção "Tema em Debate" desta edição exatamente a diversidade de resistências e conflitos, bem como os interesses antagônicos e desvinculados da proteção à saúde que se colocam cotidianamente aos agentes reguladores desse campo de atuação.
Fifteen Genetic Loci Associated With the Electrocardiographic P Wave
Authors: Christophersen Ingrid E. , Magnani Jared W. , Yin Xiaoyan , Barnard John , Weng Lu-Chen , Arking Dan E. , Niemeijer Maartje N. , Lubitz Steven A. , Avery Christy L. , Duan Qing , Felix Stephan B. , Bis Joshua C. , Kerr Kathleen F. , Isaacs Aaron , Müller-Nurasyid Martina , Müller Christian , North Kari E. , Reiner Alex P. , Tinker Lesley F. , Kors Jan A. , Teumer Alexander , Petersmann Astrid , Sinner Moritz F. , Buzkova Petra , Smith Jonathan D. , Van Wagoner David R. , Völker Uwe , Waldenberger Melanie , Peters Annette , Meitinger Thomas , Limacher Marian C. , Wilhelmsen Kirk C. , Psaty Bruce M. , Hofman Albert , Uitterlinden Andre , Krijthe Bouwe P. , Zhang Zhu-Ming , Schnabel Renate B. , Kääb Stefan , van Duijn Cornelia , Rotter Jerome I. , Sotoodehnia Nona , Dörr Marcus , Li Yun , Chung Mina K. , Soliman Elsayed Z. , Alonso Alvaro , Whitsel Eric A. , Stricker Bruno H. , Benjamin Emelia J. , Heckbert Susan R. , Ellinor Patrick T. 
Published: August 2017

Background—
The P wave on an ECG is a measure of atrial electric function, and its characteristics may serve as predictors for atrial arrhythmias. Increased mean P-wave duration and P-wave terminal force traditionally have been used as markers for left atrial enlargement, and both have been associated with increased risk of atrial fibrillation. Here, we explore the genetic basis of P-wave morphology through meta-analysis of genome-wide association study results for P-wave duration and P-wave terminal force from 12 cohort studies.

Methods and Results—

We included 44 456 individuals, of which 6778 (16%) were of African ancestry. Genotyping, imputation, and genome-wide association study were performed at each study site. Summary-level results were meta-analyzed centrally using inverse-variance weighting. In meta-analyses of P-wave duration, we identified 6 significant (
P
<5×10
−
8
) novel loci and replicated a prior association with S
CN10A.
We identified 3 loci at
SCN5A
,
TBX5
, and
CAV1/CAV2
that were jointly associated with the PR interval, PR segment, and P-wave duration. We identified 6 novel loci in meta-analysis of P-wave terminal force. Four of the identified genetic loci were significantly associated with gene expression in 329 left atrial samples. Finally, we observed that some of the loci associated with the P wave were linked to overall atrial conduction, whereas others identified distinct phases of atrial conduction.

Conclusions—
We have identified 6 novel genetic loci associated with P-wave duration and 6 novel loci associated with P-wave terminal force. Future studies of these loci may aid in identifying new targets for drugs that may modify atrial conduction or treat atrial arrhythmias.
Annual Runoff is Highly Linked to Precipitation Extremes in Karst Catchments of Southwest China
Authors: Li Zhenwei , Xu Xianli , Xu Chaohao , Liu Meixian , Wang Kelin , Yu Bofu 
Published: August 2017

Abstract
Karst landforms cover 7%–12% of the Earth’s continental area and provide water resources for 25% of the global population. Climate, particularly frequent climate extremes, may greatly affect the annual runoff, especially in climate-sensitive regions such as a karst area of southwest China. Knowledge of the linkage between climate and runoff is urgently needed for smart water resources management. This study therefore selected five catchments that have different carbonized rock coverage (from 11% to 64%) to detect the dominant climatic variables driving changes in annual runoff for the period of 1957–2011 in southwest China. Because climatic variables are highly codependent, a partial least squares regression (PLSR) was used to elucidate the linkages between runoff and 17 climatic variables. Results indicated that the dominant climatic factors driving annual runoff are annual total precipitation, rainy days, heavy precipitation amount, heavy precipitation days, rainstorm amount, and rainstorm days. These six factors are generally used to represent extreme climatic events, and hence it may demonstrate that annual runoff is highly linked to precipitation extremes in this region. The PLSR approach presented in this study is beneficial and novel, as it enables the elimination of codependency among the variables and facilitates a more unbiased view of the contribution of the changes in climatic variables to the changes in runoff. As a practical and simple tool, the PLSR approach is thus recommended for application to a variety of other catchments.
Culturally Tailoring a Patient Empowerment and Diabetes Education Curriculum for the African American Church
Authors: Whitney Eric , Kindred Elijah , Pratt Abdullah , O’Neal Yolanda , Harrison Rev. Chauncey P. , Peek Monica E. 
Published: August 2017

Purpose The African American church has long been recognized as a valuable partner for health interventions in the community. While an extensive literature exists documenting the potential efficacy of diabetes education programs in church settings, there has yet to be an effort to leverage spiritual beliefs and practices to promote diabetes self-management and shared decision making within a faith-based framework that is culturally tailored to the African American church. The purpose of this article is to describe the translation of a clinic-based diabetes education program into faith-based education curriculum tailored for use in the African American church. Conclusions Themes extracted from focus groups and input from a faith-based community partner provided a methodical and patient-informed foundation for culturally tailoring and piloting a diabetes self-management curriculum for the African American church setting. This study illustrates how spirituality can be incorporated into interventions to enhance health promotion and behavioral change among African Americans with diabetes. Participants in our study described how religious beliefs play an active role in many aspects of diabetes care, including self-management behaviors, coping strategies, and patient/provider communication. In addition, this intervention can serve as a model for the development of patient-centered health interventions.
The inability of venous occlusion air plethysmography to identify patients who will benefit from stenting of deep venous obstruction
Authors: Kurstjens Ralph LM , Catarinella Fabio S , Lam Yee Lai , de Wolf Mark AF , Toonder Irwin M , Wittens Cees HA 
Published: August 2017

Background The aim of this study was to assess whether venous occlusion plethysmography can be used to identify venous obstruction and predict clinical success of stenting. Method Receiver operated characteristic curves were used to determine the ability of venous occlusion plethysmography to discriminate between the presence and absence of obstruction, measured by duplex ultrasound and magnetic resonance venography, and to discriminate between successful and non-successful stenting, measured by VEINES-QOL/Sym. Result Two hundred thirty-seven limbs in 196 patients were included. Areas under the curve for post-thrombotic obstruction were one-second outflow volume 0.71, total venous volume 0.69 and outflow fraction 0.59. Stenting was performed in 45 limbs of 39 patients. Areas under the curve for identifying patients with successful treatment at one year after stenting were 0.57, 0.54 and 0.63, respectively. Conclusion Venous occlusion plethysmography cannot be used to identify venous obstruction proximal to the femoral confluence or to distinguish which patients will benefit from treatment.
Feasibility of peripheral nerve MR neurography using diffusion tensor imaging adapted to skeletal muscle disease
Authors: Keller Sarah , Wang Zhiyue J , Golsari Amir , Kim Anne Catherine , Kooijman Hendrik , Adam Gerhard , Yamamura Jin 
Published: August 2017

Background Diffusion tensor imaging (DTI) of peripheral nerves may provide additional information about nerve involvement in muscular disorders, but is considered difficult due to different optimal scan parameters tailored to magnetic resonance (MR) signal properties of muscle and neural tissues. Purpose To assess the feasibility of sciatic nerve DTI using two different approaches of region of interest (ROI)-localization in DTI scans with b-values 500 s/mm2, in participants with muscular disorders and in controls. Material and Methods DTI of the thigh was conducted on a 3T system in ten patients (6 men, 4 women; mean age =54 ± 15 years) with neuromuscular disorders and ten controls. T1-weighted (T1W) images were co-registered to fractional anisotropy (FA) color-encoded images. The apparent diffusion coefficient (ADC), FA, and fiber track length (FTL) were analyzed by two operators using a freehand ROI and a single-point ROI covering the sciatic nerve. Interclass correlation coefficient (ICC) and Bland–Altman analysis were used for evaluation of inter-operator and inter-technical agreement, respectively. Results Three-dimensional visualization of sciatic nerve fiber was achievable using both techniques. The ICC of DTI metrics showed excellent inter-operator agreement both in patients and controls. Bland–Altman analysis revealed good agreement of both techniques. A maximum FTL was achieved using the single-point ROI technique, but with a lower inter-operator agreement (ICC = 0.99 vs. 0.83). The ADC and maximum FTL were significantly decreased in patients compared to controls. Conclusion Both ROI localization techniques are feasible to analyze the sciatic nerve in the setting of muscular disease. A maximum FTL is reached using the single-point ROI, however, at the cost of lower inter-operator agreement.
The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis
Authors: Gutin Sarah A. , Amico K. Rivet , Hunguana Elsa , Munguambe António Orlando , Rose Carol Dawson 
Published: August 2017

Background: Positive health, dignity, and prevention (PHDP) is Mozambique’s strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. Methods: We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. Results: With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Conclusion: Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.
Integrin αIIbβ3 outside-in signaling
Authors: Durrant Tom N. , van den Bosch Marion T. , Hers Ingeborg 
Published: August 2017

AbstractIntegrin αIIbβ3 is a highly abundant heterodimeric platelet receptor that can transmit information bidirectionally across the plasma membrane, and plays a critical role in hemostasis and thrombosis. Upon platelet activation, inside-out signaling pathways increase the affinity of αIIbβ3 for fibrinogen and other ligands. Ligand binding and integrin clustering subsequently stimulate outside-in signaling, which initiates and amplifies a range of cellular events driving essential platelet processes such as spreading, thrombus consolidation, and clot retraction. Integrin αIIbβ3 has served as an excellent model for the study of integrin biology, and it has become clear that integrin outside-in signaling is highly complex and involves a vast array of enzymes, signaling adaptors, and cytoskeletal components. In this review, we provide a concise but comprehensive overview of αIIbβ3 outside-in signaling, focusing on the key players involved, and how they cooperate to orchestrate this critical aspect of platelet biology. We also discuss gaps in the current understanding of αIIbβ3 outside-in signaling and highlight avenues for future investigation.
Exposure to air pollution and tobacco smoking and their combined effects on depression in six low- and middle-income countries
Authors: Lin Hualiang , Guo Yanfei , Kowal Paul , Airhihenbuwa Collins O. , Di Qian , Zheng Yang , Zhao Xing , Vaughn Michael G. , Howard Steven , Schootman Mario , Salinas-Rodriguez Aaron , Yawson Alfred E. , Arokiasamy Perianayagam , Manrique-Espinoza Betty Soledad , Biritwum Richard B. , Rule Stephen P. , Minicuci Nadia , Naidoo Nirmala , Chatterji Somnath , Qian Zhengmin (Min) , Ma Wenjun , Wu Fan 
Published: August 2017

BackgroundLittle is known about the joint mental health effects of air pollution and tobacco smoking in low- and middle-income countries.AimsTo investigate the effects of exposure to ambient fine particulate matter pollution (PM2.5) and smoking and their combined (interactive) effects on depression.MethodMultilevel logistic regression analysis of baseline data of a prospective cohort study (n=41785). The 3-year average concentrations of PM2.5 were estimated using US National Aeronautics and Space Administration satellite data, and depression was diagnosed using a standardised questionnaire. Three-level logistic regression models were applied to examine the associations with depression.ResultsThe odds ratio (OR) for depression was 1.09 (95% CI 1.01–1.17) per 10 μg/m3 increase in ambient PM2.5, and the association remained after adjusting for potential confounding factors (adjusted OR = 1.10, 95% CI 1.02–1.19). Tobacco smoking (smoking status, frequency, duration and amount) was also significantly associated with depression. There appeared to be a synergistic interaction between ambient PM2.5 and smoking on depression in the additive model, but the interaction was not statistically significant in the multiplicative model.ConclusionsOur study suggests that exposure to ambient PM2.5 may increase the risk of depression, and smoking may enhance this effect.