bluuebunny/crossref_metadata_2025_split huggingface dataset:
Goals of patient care system change with video‐based education increases rates of advance cardiopulmonary resuscitation decision‐making and discussions in hospitalised rehabilitation patients
Authors: Johnson Claire E. , Chong Jeffrey C. , Wilkinson Anne , Hayes Barbara , Tait Sonia , Waldron Nicholas 
Published: April 2017

AbstractBackgroundAdvance cardiopulmonary resuscitation (CPR) discussions and decision‐making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non‐beneficial CPR.AimTo assess the utility and safety of two interventions to increase CPR decision‐making, documentation and communication for hospitalised older patients.MethodsA pre‐post study tested two interventions: (i) standard ward‐based education forums with CPR content; and (ii) a combined, two‐pronged strategy with ‘Goals of Patient Care’ (GoPC) system change and a structured video‐based workshop; against usual practice (i.e. no formal training). Participants were a random sample of patients in a hospital rehabilitation unit.The outcomes were the proportion of patients documented as: (i) not for resuscitation (NFR); and (ii) eligible for rapid response team (RRT) calls, and rates of documented discussions with the patient, family and carer.ResultsWhen compared with usual practice, patients were more likely to be documented as NFR following the two‐pronged intervention (adjusted odds ratio (aOR): 6.4, 95% confidence interval (CI): 3.0; 13.6). Documentation of discussions with patients was also more likely (aOR: 3.3, 95% CI:1.8; 6.2). Characteristics of patients documented NFR were similar between the phases, but were more likely for RRT calls following Phase 3 (P 0.03).ConclusionAn increase in advance CPR decisions occurred following GoPC system change with education. This appears safe as NFR patients had the same level of frailty between phases but were more likely to be eligible for RRT review. Increased documentation of discussions suggests routine use of the GoPC form may improve communication with patients about their care.
Medical students' attitudes towards the use of virtual patients
Authors: Sobocan M. , Klemenc‐Ketis Z. 
Published: April 2017

AbstractAn increasing number of virtual patients (VPs) are being used in the classroom, which raises questions about how to implement VPs to improve students' satisfaction and enhance their learning. This study developed and validated a scale that measures acceptability and attitudes of medical students towards the use of the VP education tool in the classroom.This mixed method study first explored attitudes with 11 students in two focus groups. Later on, eight experts performed item reduction and transformation through three rounds of the Delphi‐study method, and an initial version of the scale [virtual patient integration rating scale (VPIRS)] was developed. The scale was administered among 138 medical students to determine its reliability.A total of 88 medical students responded to the final version of the VPIRS. Principal component analysis was performed in order to determine questionnaire domains. The final, validated scale contains 25 items in four domains, with a reliability of 0.864. The identified domains are as follows: (1) acquiring and maintaining knowledge, (2) facilitation of learning, (3) inauthentic learning and (4) disadvantages of learning.To the best of our knowledge, this is the first time a VP rating scale has been developed. VPIRS allows for targeted engagement with students regarding learning and evaluation with VPs, thereby providing opportunities for student‐centred teaching.
Atrial electrophysiological and molecular remodelling induced by obstructive sleep apnoea
Authors: Channaveerappa Devika , Lux Jacob C. , Wormwood Kelly L. , Heintz Timothy A. , McLerie Meredith , Treat Jacqueline A. , King Hannah , Alnasser Donia , Goodrow Robert J. , Ballard Glenn , Decker Robert , Darie Costel C. , Panama Brian K. 
Published: April 2017

AbstractObstructive sleep apnoea (OSA) affects 9–24% of the adult population. OSA is associated with atrial disease, including atrial enlargement, fibrosis and arrhythmias. Despite the link between OSA and cardiac disease, the molecular changes in the heart which occur with OSA remain elusive. To study OSA‐induced cardiac changes, we utilized a recently developed rat model which closely recapitulates the characteristics of OSA. Male Sprague Dawley rats, aged 50–70 days, received surgically implanted tracheal balloons which were inflated to cause transient airway obstructions. Rats were given 60 apnoeas per hour of either 13 sec. (moderate apnoea) or 23 sec. (severe apnoea), 8 hrs per day for 2 weeks. Controls received implants, but no inflations were made. Pulse oximetry measurements were taken at regular intervals, and post‐apnoea ECGs were recorded. Rats had longer P wave durations and increased T wave amplitudes following chronic OSA. Proteomic analysis of the atrial tissue homogenates revealed that three of the nine enzymes in glycolysis, and two proteins related to oxidative phosphorylation, were down regulated in the severe apnoea group. Several sarcomeric and pro‐hypertrophic proteins were also up regulated with OSA. Chronic OSA causes proteins changes in the atria which suggest impairment of energy metabolism and enhancement of hypertrophy.
Identification of a synergistic interaction between endothelial cells and retinal pigment epithelium
Authors: Spencer Carrie , Abend Stephanie , McHugh Kevin J. , Saint‐Geniez Magali 
Published: April 2017

AbstractThe retinal pigment epithelium located between the neurosensory retina and the choroidal vasculature is critical for the function and maintenance of both the photoreceptors and underlying capillary endothelium. While the trophic role of retinal pigment epithelium on choroidal endothelial cells is well recognized, the existence of a reciprocal regulatory function of endothelial cells on retinal pigment epithelium cells remained to be fully characterized. Using a physiological long‐term co‐culture system, we determined the effect of retinal pigment epithelium‐endothelial cell heterotypic interactions on cell survival, behaviour and matrix deposition. Human retinal pigment epithelium and endothelial cells were cultured on opposite sides of polyester transwells for up to 4 weeks in low serum conditions. Cell viability was quantified using a trypan blue assay. Cellular morphology was evaluated by H&E staining, S.E.M. and immunohistochemistry. Retinal pigment epithelium phagocytic function was examined using a fluorescent bead assay. Gene expression analysis was performed on both retinal pigment epithelium and endothelial cells by quantitative PCR. Quantification of extracellular matrix deposition was performed on decellularized transwells stained for collagen IV, fibronectin and fibrillin. Our results showed that presence of endothelial cells significantly improves retinal pigment epithelium maturation and function as indicated by the induction of visual cycle‐associated genes, accumulation of a Bruch's membrane‐like matrix and increase in retinal pigment epithelium phagocytic activity. Co‐culture conditions led to increased expression of anti‐angiogenic growth factors and receptors in both retinal pigment epithelium and endothelial cells compared to monoculture. Tube‐formation assays confirmed that co‐culture with retinal pigment epithelium significantly decreased the angiogenic phenotype of endothelial cells. These findings provide evidence of critical interdependent interactions between retinal pigment epithelium and endothelial cell involved in the maintenance of retinal homeostasis.
Phloretin attenuates hyperuricemia‐induced endothelial dysfunction through co‐inhibiting inflammation and GLUT9‐mediated uric acid uptake
Authors: Liu Shuyun , Yuan Yujia , Zhou Yijie , Zhao Meng , Chen Younan , Cheng Jingqiu , Lu Yanrong , Liu Jingping 
Published: April 2017

AbstractHyperuricemia is an important risk factor for cardiovascular and renal diseases. Phloretin had shown antioxidant and anti‐inflammatory properties, but its role in endothelial injury is rarely reported. In this study, we aimed to investigate the protective effect of phloretin on UA‐induced injury in human umbilical vein endothelial cells. The effects of UA and phloretin on cell viability, inflammation, THP‐1 monocyte adhesion, endothelial cell tube formation, GLUT9 expression and UA uptake in human umbilical vein endothelial cells were evaluated. The changes of nuclear factor‐kappa B/extracellular regulated protein kinases signalling were also analysed. Our results showed that UA reduced cell viability and tube formation, and increased inflammation and monocytes adhesion in human umbilical vein endothelial cells in a dose‐dependent manner. In contrast, phloretin significantly attenuated pro‐inflammatory factors expression and endothelial injury induced by UA. Phloretin inhibited the activation of extracellular regulated protein kinases/nuclear factor‐kappa B pathway, and reduced GLUT9 and it mediated UA uptake in human umbilical vein endothelial cells. These results indicated that phloretin attenuated UA‐induced endothelial injury via a synergic mechanism including direct anti‐inflammatory effect and lowering cellular UA uptake. Our study suggested that phloretin might be a promising therapy for hyperuricemia‐related cardiovascular diseases.
Application of an adaptive neuro_fuzzy inference system (ANFIS) in the modeling of rapeseeds' oil extraction
Authors: Farzaneh Vahid , Bakhshabadi Hamid , Gharekhani Mehdi , Ganje Mohammad , Farzaneh Farahnaz , Rashidzadeh Shilan , Carvalho Isabel S. 
Published: April 2017

AbstractIn the present study, the temperature and moisture content of the output seeds of the cooking pot were considered as inputs or independent variables and the insoluble fine partial content of the extracted oil, moisture content of the extracted oil and obtained meals, as well as the oil content of the achieved meals and acidity value of the extracted oil were considered as responses and were designed. Three different activation functions, including Gaussian membership and triangular as well as trapezoidal were applied and studied. The trapezoidal function with a 3–3 membership function for the three output variables including insoluble fine partials of oil, oil acidity and moisture content of the meals as well as the triangle membership function with 2–2 and 3–3 functions, respectively, for moisture content of the extracted oil and the oil content of the obtained meals were evaluated and detected as optimized models in the current study. The above mentioned models demonstrated higher correlation coefficients (R2) between the experimental and predicted values and the lowest root mean squared errors, confirming the adaptability of the applied models in the present study.Practical applicationsToday, because of the high demand for crops for extensive application in the human diet, increases in the efficiency of the processing are attracting much more attention. In this regard, discovering and detection of the optimized conditions for processing with the minimum wastes looks very important and economic. Therefore, the uses of predictive methods in different food processes have been considered appropriate tools for improving of the efficiency of the processes as well as the enhancement of the quality of the produced products. In this respect, the ANFIS design as a novel predictive analytic tool, along with Response Surface Methodology (RSM) and Artificial Neural Network (ANN), are applied extensively. Thus regarding the above mentioned content, ANFIS design was applied to predict and optimize some of the selected physico‐chemical properties of the extracted oil through the extraction process. Therefore prediction of the optimized conditions of oil extraction could improve the quality of the extracted oil and performance of the extraction process with the minimum wastes during short and logical extraction time.
Impact of Transitional Care Services for Chronically Ill Older Patients: A Systematic Evidence Review
Authors: Le Berre Mélanie , Maimon Geva , Sourial Nadia , Guériton Muriel , Vedel Isabelle 
Published: April 2017

Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self‐management, discharge planning, structured follow‐up and coordination among the different healthcare professionals. We conducted a systematic review to determine the effectiveness of interventions targeting transitions from hospital to the primary care setting for chronically ill older patients.. Randomized controlled trials were identified through Medline, CINHAL, PsycInfo, EMBASE (1995–2015). Two independent reviewers performed the study selection, data extraction and assessment of study quality (Cochrane “Risk of Bias”). Risk differences (RD) and number needed to treat (NNT) or mean differences (MD) were calculated using a random‐effects model. From 10,234 references, 92 studies were included. Compared to usual care, significantly better outcomes were observed: a lower mortality at 3 (RD: −0.02 [−0.05, 0.00]; NNT: 50), 6, 12 and 18 months post‐discharge, a lower rate of ED visits at 3 months (RD: −0.08 [−0.15, −0.01]; NNT: 13), a lower rate of readmissions at 3 (RD: −0.08 [−0.14, −0.03]; NNT: 7), 6, 12 and 18 months and a lower mean of readmission days at 3 (MD: −1.33; [−2.15, −0.52]), 6, 12 and 18 months. No significant differences were observed in quality of life. In conclusion, TC improves transitions for older patients and should be included in the reorganization of healthcare services.
The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial
Authors: Coppens Imgard , Verhaeghe Sofie , Van Hecke Ann , Beeckman Dimitri 
Published: April 2017

Aims and objectivesThe aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self‐efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes.BackgroundCrisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self‐efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self‐efficacy, team efficacy and technical skills is not clear.DesignRandomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015–April 2015.MethodsParticipants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self‐efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted.ResultsThe intervention group increased on self‐efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group.ConclusionCombining crisis resource management principles and team debriefings in simulation training increases self‐efficacy and team efficacy. The debriefing phase contributes the most to these effects.Relevance to clinical practiceBy partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety.
Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals
Authors: Handberg Charlotte , Voss Anna Katarina 
Published: April 2017

Aims and objectivesTo describe the perspectives of healthcare professionals caring for intubated patients on implementing augmentative and alternative communication (AAC) in critical care settings.BackgroundPatients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalisation and rehabilitation. Little is known about the use of AAC in critical care settings.MethodThe design was informed by interpretive descriptive methodology along with the theoretical framework symbolic interactionism, which guided the study of healthcare professionals (n = 48) in five different intensive care units. Data were generated through participant observations and 10 focus group interviews.ResultsThe findings represent an understanding of the healthcare professionals' perspectives on implementing AAC in critical care settings and revealed three themes. Caring Ontology was the foundation of the healthcare professionals' profession. Cultural Belief represented the actual premise in the interactions during the healthcare professionals' work, saving lives in a biomedical setting whilst appearing competent and efficient, leading to Triggered Conduct and giving low priority to psychosocial issues like communication.ConclusionLack of the ability to communicate puts patients at greater risk of receiving poorer treatment, which supports the pressuring need to implement and use AAC in critical care. It is documented that culture in biomedical paradigms can have consequences that are the opposite of the staffs' ideals. The findings may guide staff in implementing AAC strategies in their communication with patients and at the same time preserve their caring ontology and professional pride.Relevance to clinical practiceImproving communication strategies may improve patient safety and make a difference in patient outcomes. Increased knowledge of and familiarity with AAC strategies may provide healthcare professionals with an enhanced feeling of competence.
Validation of a modified early warning score‐linked Situation‐Background‐Assessment‐Recommendation communication tool: A mixed methods study
Authors: Burger Debora , Jordan Sue , Kyriacos Una 
Published: April 2017

Aims and objectivesTo develop and validate a modified Situation‐Background‐Assessment‐Recommendation communication tool incorporating components of the Cape Town modified early warning score vital signs chart for reporting early signs of clinical deterioration.BackgroundReporting early signs of physiological and clinical deterioration could prevent “failure to rescue” or unexpected intensive care admission, cardiac arrest or death. A structured communication tool incorporating physiological and clinical parameters allows nurses to provide pertinent information about a deteriorating patient in a logical order.DesignMixed methods instrument development and validation.MethodsWe used a sequential three‐phase method: cognitive interviews, content validation and inter‐rater reliability testing to validate a self‐designed communication tool. Participants were purposively selected expert nurses and doctors in government sector hospitals in Cape Town.ResultsCognitive interviews with five experts prompted most changes to the communication tool: 15/42 (35.71%) items were modified. Content validation of a revised tool was high by a predetermined ≥70% of 18 experts: 4/49 (8.2%) items were modified. Inter‐rater reliability testing by two nurses indicated substantial to full agreement (Cohen's kappa .61–1) on 37/45 (82%) items. The one item achieving slight agreement (Cohen's kappa .20) indicated a difference in clinical judgement. The high overall percentage agreement (82%) suggests that the modified items are sound. Overall, 45 items remained on the validated tool.ConclusionThe first modified early warning score‐linked Situation‐Background‐Assessment‐Recommendation communication tool developed in South Africa was found to be valid and reliable in a local context.Relevance to clinical practiceNurses in South Africa can use the validated tool to provide doctors with pertinent information about a deteriorating patient in a logical order to prevent a serious adverse event. Our findings provide a reference for other African countries to develop and validate communication tools for reporting early signs of clinical deterioration.
Clinical comparison of the efficacy of three different bowel preparation methods on the infectious complications following transrectal ultrasonography‐guided prostate biopsy in nursing practice
Authors: Zhang Xin‐hong , Jia Yong , Guo Wei‐hua , Ma Yu‐rong , Yang Jing , Zhang Yu , Hou Si‐chuan , Zhang Chang‐cun 
Published: April 2017

Aims and objectivesTo assess the effects of three different bowel preparation methods on the incidence of infectious complications in patients who underwent transrectal ultrasonography‐guided prostate biopsy.BackgroundThe standard bowel preparation protocol for prostate biopsy has not been established.DesignA retrospective study in a single centre.MethodsFrom January 2013–December 2015, the clinical records of 1,130 patients who underwent prostate biopsy were, respectively, reviewed. All the patients received metronidazole prophylaxis before biopsy. The patients were divided into three groups according to the bowel preparation methods: patients in Group A (n = 402) received only soapy enema; patients in Group B (n = 413) received polyethylene glycol; while patients in Group C (n = 315) received polyethylene glycol plus povidone–iodine enema. Infectious complications were classified as fever (>37.5°C), urinary tract infection and sepsis. The postoperative adverse events were also observed.ResultsThe overall postbiopsy infectious complications were observed in 48 (4.25%) patients of all the cases, including 23 (5.72%) cases in Group A, 20 (4.84%) cases in Group B and five patients (1.59%) in Group C. There was significant difference among the groups (p = .018). In detail, these infectious complications included 22 (1.95%) cases of fever and 26 (2.30%) cases of urinary tract infection. No sepsis was observed among the total patients. The incidence of adverse events was 14.43% (58/402) occurred in Group A, 25.91% (107/413) in Group B and 26.67% (84/315) in Group C. The difference was statistically significant.ConclusionsOur study confirmed that combined preparation regimens of polyethylene glycol with povidone–iodine enema could significantly reduce the postbiopsy infection rate. Conventional soapy enema is associated with less adverse events.Relevance to clinical practiceFindings of this study provide useful evidence‐based information for healthcare professionals. The application of combined preparation regimens of polyethylene glycol with povidone–iodine enema resulted in better improvement in the prevention of postbiopsy infection.