bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Obesity and Other Chronic Conditions on Lifestyle Exercise During the Year After Completion of Cardiac Rehabilitation
Authors: Sattar Abdus , Josephson Richard , Moore Shirley M. 
Published: December 2016

Purpose:
Patients who attend cardiac rehabilitation programs have a high prevalence of multiple chronic conditions (MCCs). The extent to which different constellations of MCC influence lifestyle exercise in the year after completion of an outpatient phase 2 cardiac rehabilitation program (CRP) is unknown. Our objective was to examine the effects of MCC on lifestyle exercise in the year after completion of a CRP.

Methods:
The effects of different constellations of comorbidities on objectively measured lifestyle exercise were examined using data from a randomized controlled trial testing lifestyle behavior change interventions in patients with cardiac events (n = 379) who completed a phase 2 CRP. Adjusting for important covariates, the relationships between the primary outcome, exercise amount, and the presence of common chronic conditions (hypertension, obesity, diabetes, and arthritis) were studied using robust linear mixed-effects models.

Results:
Diabetes, hypertension, obesity, and their dyads, triads, and quads have a negative impact on amount of exercise. For example, the cooccurrences of obesity and hypertension reduced lifestyle exercise by 2.83 hours per month (95% CI, 1.33-4.33) after adjustment for the effects of covariates. The presence of obesity was a major factor in the comorbid constellations affecting lifestyle exercise.

Conclusions:
The presence of obesity and other chronic conditions negatively impacts lifestyle exercise in the year after a CRP. The magnitude of the effect depends on the comorbidities. Different constellations of comorbid conditions can be used to identify those persons at greatest risk for not exercising after cardiac rehabilitation.
A Study of Interpersonal Conflict Among Operating Room Nurses
Authors: Chang Tsui-Fen , Chen Chung-Kuang , Chen Ming-Jia 
Published: December 2016

ABSTRACT

Background:
Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important.

Purpose:
The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict.

Methods:
This study investigated 201 OR nurses who had worked for more than 6 months at the target hospitals, which were located in the three counties of Changhua, Yunlin, and Chiayi. The questionnaire that was used to collect data included three components: a demographic and work-related variables survey, interpersonal conflict management factor analysis scale, and interpersonal conflict parties and frequency scale. Data were analyzed using independent t test, analysis of variance, Scheffe’s test, and Pearson’s correlation coefficient.

Results:
The main findings were as follows: (a) Integration and arbitration were the major interpersonal conflict management strategies adopted by the participants; (b) medical doctor, OR nurses, and anesthetists were the primary targets of conflict for the participants; (c) the factors of educational background, job position, experience in other departments, seniority, attending courses in conflict management, and level of hospital significantly affected the strategies that participants used to manage interpersonal conflict; and (d) license level, experience in other departments, seniority, and inclination toward serving in the OR were each found to relate significantly to the target of interpersonal conflict and the frequency of interpersonal conflict incidents.

Conclusions/Implications for Practice:
The main implications of this study are as follows: (a) The environment for communication in the OR should be made more friendly to encourage junior OR nurses to adopt constructive interpersonal conflict management strategies; (b) prior experience in other departments should be one of the most important factors of consideration when recruiting new nurses for the OR; and (c) hospitals should provide more interpersonal conflict management training courses to support the capability of OR nursing staffs in terms of adopting cooperativeness strategies and coping effectively with all types of interpersonal conflicts.
Moral Distress Model Reconstructed Using Grounded Theory
Authors: Ko Hsun-Kuei , Chin Chi-Chun , Hsu Min-Tao 
Published: December 2016

ABSTRACT

Background:
The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan.

Purpose:
The aim of this study was to reconstruct the model of moral distress using the grounded theory.

Methods:
Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan. Data were collected using intensive, 2- to 3-hour interviews with each participant. Audio recordings of the interviews were made and then converted into transcripts. The data were analyzed using the grounded theory.

Results:
In the clinical setting, the perspective that nurses take toward clinical moral events reflects their moral values, which trigger moral cognition, provocation, and appraisal. The moral barriers that form when moral events that occur in clinical settings contradict personal moral values may later develop into moral distress. In handling moral barriers in the clinical environment, nurses make moral judgments and determine what is morally correct. Influenced by moral efficacy, the consequence may either be a moral action or an expression of personal emotion. Wasting National Health Insurance resources and Chinese culture are key sources of moral distress for nurses in Taiwan. The role of self-confidence in promoting moral efficacy and the role of heterodox skills in promoting moral actions represent findings that are unique to this study.

Conclusions:
The moral distress model was used in this study to facilitate the development of future nursing theories. On the basis of our findings, we suggested that nursing students be encouraged to use case studies to establish proper moral values, improve moral cognition and judgment capabilities, and promote moral actions to better handle the regular pressures of moral distress in future clinical or workplace settings. Moreover, a better understanding of moral distress may help retain staff nurses.
Sudden Death in a Male Infant Due to Histiocytoid Cardiomyopathy
Authors: Xie Hanbing , Chen Xueqin , Chen Ni , Zhou Qiao 
Published: December 2016

AbstractHistiocytoid cardiomyopathy (HC) is a very rare cardiac disorder that mainly affects female infants younger than 2 years. It may manifest as ventricular tachycardia or dilated cardiomyopathy and frequently causes sudden death. The most common grossly change is multifocal uneven thickening of the endocardium, presenting a yellowish color, with some area forming nodular appearance, and histologically featured by scattered clusters of histiocytoid myocytes under the endocardium. Here, we present a 19-month-old male infant who died of heart failure, and an autopsy was performed and confirmed the diagnosis of HC. We also reviewed the literature and focused on the research progression of the origin and genetic/molecular features of HC in recent years.
Forensic Analysis of Parachute Deaths
Authors: Burke Michael Philip , Chitty Johannes 
Published: December 2016

Abstract
Deaths associated with parachuting are very uncommon. However, these deaths do tend to be “high profile” in the traditional and social media. When forensic pathologists examine the deceased after a fatal parachuting incident, the anatomical cause of death is usually not in question. For most forensic pathologists, it is usually the case that we will have very limited knowledge of parachuting equipment or the mechanics of a typical successful parachute jump. As such, the investigation of the death should involve a multidisciplinary approach with an appropriate expert providing the formal forensic examination of the parachuting equipment. We have endeavored to describe, in simple terms, the usual components of a typical parachute rig, a précis of the sequence of events in a routine skydive and BASE jump, and the various types of malfunctions that may occur. Last, we present a case report of a BASE jump fatality to illustrate how an expert examination of the BASE jumper's gear aided the medicolegal investigation of the death with some important aspects in the forensic examination of the jumper's equipment.
A Novel Method of Intraosseous Infusion of Adenosine for the Treatment of Supraventricular Tachycardia in an Infant
Authors: Helleman Krista , Kirpalani Amrit , Lim Rodrick 
Published: December 2016

Abstract
Supraventricular tachycardia is a common arrhythmia faced by emergency physicians in the pediatric population. In most cases, antecubital intravenous access can be established, and adenosine can be administered in a rapid and timely fashion. The role and administration of intraosseous adenosine are poorly established. We describe a case where the administration of adenosine was successful via a mixed method administration.
Lung Ultrasound as First-Line Examination for the Diagnosis of Community-Acquired Pneumonia in Children
Authors: Boursiani Contantinia , Tsolia Maria , Koumanidou Chrysoula , Malagari Aikaterini , Vakaki Marina , Karapostolakis Georgios , Mazioti Argyro , Alexopoulou Efthymia 
Published: December 2016

Objectives
The diagnosis of pediatric community-acquired pneumonia (CAP) is based on clinical criteria. Even though chest x-ray (CXR) is only recommended in severe cases, it is often requested from physicians in mild cases, thus increasing radiation exposure. Lung ultrasound (LUS) is not included in the diagnostic workup. The objective of this study was to evaluate the diagnostic performance of LUS against CXR.

Methods
Children who presented to the emergency department with clinical signs suggesting CAP and had already been evaluated with a CXR were included in the study. Availability of a pediatric sonographer expert in LUS was also considered a criterion for participation. Chest x-ray and LUS were considered positive for CAP in cases of alveolar or interstitial pattern of disease. The diagnostic criterion standard was the ex post diagnosis of pneumonia, made by an independent senior expert pediatrician, after evaluation of the complete medical chart.

Results
Sixty-nine children were enrolled in the study, with 66 of 69 positive for CAP. Receiver operating characteristic curve analysis results for CXR were 95.5% sensitivity and 100% specificity, whereas for LUS, sensitivity was reported 92.42% and specificity 100%. Comparison of the 2 receiver operating characteristic curves revealed no difference in the diagnostic value of the 2 methods for the diagnosis of pneumonia (P = 0.658). However, LUS classified more cases as alveolar disease compared with CXR.

Conclusions
Lung ultrasound plays a significant role in the detection of CAP, not inferior to CXR. The aim of this study was to encourage the use of ultrasound as a first-line examination for CAP in children.
Parallel adaptation to higher temperatures in divergent clades of the nematodePristionchus pacificus
Authors: Leaver Mark , Kayhan Merve , McGaughran Angela , Roedelsperger Christian , Hyman Anthony A. , Sommer Ralf J. 
Published: December 2016

AbstractStudying the effect of temperature on fertility is particularly important in the light of ongoing climate change. We need to know if organisms can adapt to higher temperatures and, if so, what are the evolutionary mechanisms behind such adaptation. Such studies have been hampered by the lack different populations of sufficient sizes with which to relate the phenotype of temperature tolerance to the underlying genotypes. Here, we examined temperature adaptation in populations of the nematodePristionchus pacificus, in which individual strains are able to successfully reproduce at 30°C. Analysis of the frequency of heat tolerant strains in different temperature zones on La Réunion supports that this trait is subject to natural selection. Reconstruction of ancestral states along the phylogeny of highly differentiatedP. pacificusclades suggests that heat tolerance evolved multiple times independently. This is further supported by genome wide association studies showing that heat tolerance is a polygenic trait and that different loci are used by individualP. pacificusclades to develop heat tolerance. More precisely, analysis of allele frequencies indicated that most genetic markers that are associated with heat tolerance are only polymorphic in individual clades. While in someP. pacificusclades, parallel evolution of heat tolerance can be explained by ancestral polymorphism or by gene flow across clades, we observe at least one clearly distinct and independent scenario where heat tolerance emerged byde novomutation. Thus, temperature tolerance evolved at least two times independently in the evolutionary history of this species. Our data suggest that studies of wild populations ofP. pacificuswill reveal distinct cellular mechanisms driving temperature adaptation.
PeripheralHttsilencing does not ameliorate central signs of disease in the B6.HttQ111/+mouse model of Huntington’s Disease
Authors: Coffey Sydney R. , Bragg Robert M. , Shawn Minnig , Ament Seth A. , Anne Glickenhaus , Daniel Shelnut , Carrillo José M. , Shuttleworth Dominic D. , Julie-Anne Rodier , Kimihiro Noguchi , Bennett C. Frank , Price Nathan D. , Kordasiewicz Holly B. , Carroll Jeffrey B. 
Published: December 2016

AbstractHuntington’s disease (HD) is an autosomal dominant neurodegenerative disease whose neuropathological signature is a selective loss of medium spiny neurons in the striatum. Despite this selective neuropathology, the mutant protein (huntingtin) is found in virtually every cell so far studied, and, consequently, phenotypes are observed in a wide range of organ systems both inside and outside the central nervous system. We, and others, have suggested that peripheral dysfunction could contribute to the rate of progression of striatal phenotypes of HD. To test this hypothesis, we lowered levels of huntingtin by treating mice with antisense oligonucleotides (ASOs) targeting the murineHuntingtingene. To study the relationship between peripheral huntingtin levels and striatal HD phenotypes, we utilized a knock-in model of the human HD mutation (the B6.HttQ111/+mouse). We treated mice with ASOs from 2-10 months of age, a time period over which significant HD-relevant signs progressively develop in the brains ofHttQ111+mice. Peripheral treatment with ASOs led to persistent reduction of huntingtin protein in peripheral organs, including liver, brown and white adipose tissues. This reduction was not associated with alterations in the severity of HD-relevant signs in the striatum ofHttQ111/+mice at the end of the study, including transcriptional dysregulation, the accumulation of neuronal intranuclear inclusions, and behavioral changes such as subtle hypoactivity and reduced exploratory drive. These results suggest that the amount of peripheral reduction achieved in the current study does not significantly impact the progression of HD-relevant signs in the central nervous system.
DeepScope: Nonintrusive Whole Slide Saliency Annotation and Prediction from Pathologists at the Microscope
Authors: Schaumberg Andrew J. , Sirintrapun S. Joseph , Al-Ahmadie Hikmat A. , Schüffler Peter J. , Fuchs Thomas J. 
Published: December 2016

AbstractModern digital pathology departments have grown to produce whole-slide image data at petabyte scale, an unprecedented treasure chest for medical machine learning tasks. Unfortunately, most digital slides are not annotated at the image level, hindering large-scale application of supervised learning. Manual labeling is prohibitive, requiring pathologists with decades of training and outstanding clinical service responsibilities. This problem is further aggravated by the United States Food and Drug Administration’s ruling that primary diagnosis must come from a glass slide rather than a digital image. We present the first end-to-end framework to overcome this problem, gathering annotations in a nonintrusive manner during a pathologist’s routine clinical work: (i) microscope-specific 3D-printed commodity camera mounts are used to video record the glass-slide-based clinical diagnosis process; (ii) after routine scanning of the whole slide, the video frames are registered to the digital slide; (iii) motion and observation time are estimated to generate a spatial and temporal saliency map of the whole slide. Demonstrating the utility of these annotations, we train a convolutional neural network that detects diagnosis-relevant salient regions, then report accuracy of 85.15% in bladder and 91.40% in prostate, with 75.00% accuracy when training on prostate but predicting in bladder, despite different pathologists examining the different tissues. When training on one patient but testing on another, AUROC in bladder is 0.7929±0.1109 and in prostate is 0.9568±0.0374. Our tool is available at https://bitbucket.org/aschaumberg/deepscope.
Fast Assembling of Neuron Fragments in Serial 3D Sections
Authors: Chen Hanbo , Iascone Daniel M. , da Costa Nuno Macarico , Lein Ed S. , Liu Tianming , Peng Hanchuan 
Published: December 2016

Abstract:Reconstructing neurons from 3D image-stacks of serial sections of thick brain tissue is very time-consuming and often becomes a bottleneck in high-throughput brain mapping projects. We developed NeuronStitcher, a software suite for stitching non-overlapping neuron fragments reconstructed in serial 3D image sections. With its efficient algorithm and user-friendly interface, NeuronStitcher has been used successfully to reconstruct very large and complex human and mouse neurons.
Lights and shadows of Affordable Care Act and its influence on world civilization
Authors: Migheli Matteo , Di Novi Cinzia 
Published: December 2016

Purpose
The Obama’s reform of the US healthcare system has been a major topic of debate in the USA. The USA feels the need to provide 48 million residents with health insurance. The Affordable Care Act has this goal, but the several factors have limited its capacity and implementation. The purpose of this paper is to discuss this reform, paying attention to its potential implications for the human and economic development of both the USA and the rest of the world. The authors show that developed countries also need policies for enhancing human development and also the developing world may benefit from policy changes in the “first world.”

Design/methodology/approach
The methodology is based on discursive discussion. The argumentation first presents the reform, and highlights its advantages and its flaws for the citizens of both the USA and of developing countries.

Findings
The authors claim that the reform presents some flaws that render it still insufficient to cover all the health needs of the poor in the USA. However, the reform is likely to attract more immigrant workers to the USA, since it is likely to improve the living conditions of immigrants as well as those of their families.

Originality/value
The original point of the paper is the link between the reform and the benefits for non-US citizens. The extant literature has widely discussed the impact of the reform on the domestic market and on the US citizens. The authors widen this perspective showing that an important reform in a large country may be beneficial for people living elsewhere as well.
The effect of intimate partner violence on labor market decisions
Authors: Rios-Avila Fernando , Javier Canavire-Bacarreza Gustavo 
Published: December 2016

Purpose
The purpose of this paper is to investigate the heterogeneous labor market responses of indigenous and non-indigenous women to intimate partner violence (IPV) using information from the 2003 Demographic and Health Survey for Bolivia.

Design/methodology/approach
This analysis employs an instrumental variable with a Heckman correction approach to account for possible endogeneity problems between IPV and job exit decisions, and the self-selection of women into the labor force. It also analyses the sample across different population characteristics to search for heterogeneity and potential explanations to the observed effects.

Findings
The results show that the effect of IPV on women’s job exits is stronger among non-indigenous women compared to their indigenous counterparts. These differences could be tied to the cultural differences between these two segments of the population. These results are robust using different methodologies and specifications.

Originality/value
To the best of the authors’ knowledge, this paper is the first one to compare the relationship between domestic violence and labor market outcomes in a multi-ethnic developing country, such as Bolivia.
Safety net for agriculture: effect of idiosyncratic income shock on remittance payments
Authors: Akobeng Eric 
Published: December 2016

Purpose
The purpose of this paper is to examine the effect of illness-driven agriculture income shocks on remittance payments in Ghana using a nationally representative household pseudo-panel data set for 1991/1992, 1998/1999 and 2005/2006.

Design/methodology/approach
The two-stage least square instrumental variable technique is used. This is compared with the ordinary least squares estimator.

Findings
The author finds that households in Ghana use remittances to protect themselves from negative agriculture income shocks. The study further reveals that the protection is resilient in female-headed households.

Research limitations/implications
The question of remittances as a safety net mechanism is interesting, but the limitation is the challenges involving the counterfactual setup in studying the effects of endogenous migration choices.

Practical implications
The study provides that, as far as microeconomic factors are concerned, remittances increase in times of negative agriculture income shocks attributed to illness in Ghana.

Social implications
The finding points to the fact that remittance payments play an essential role as an informal safety net during illness-driven agriculture income shock especially for female-headed households in Ghana. This has an important implication for poverty reduction in Ghana.

Originality/value
It provides an empirical test of the claim that remittance flows buffer idiosyncratic shock with micro-level household data that incorporates both internal and international remittances. The paper introduces gender dimension into idiosyncratic shocks’ impact. Also, the data set makes it possible to provide a reliable set of agriculture income shock estimates.