bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visible and invisible caring in nursing from the perspectives of patients and nurses in the gerontological context
Authors: Canzan Federica , Heilemann MarySue V. , Saiani Luisa , Mortari Luigina , Ambrosi Elisa 
Published: December 2013

AimJust as in many countries all over the world, the number of older people in Italy has increased rapidly. Consequently, an increasing number of nurses are engaged in the care of older patients. However, due to a lack of understanding of how nurses and patients perceive caring, nursing care may be compromised. The aim of this study is to explore, describe and compare the perceptions of gerontological nurses and patients related to the dimensions of caring in nursing in an Italian hospital setting.MethodsIn this qualitative descriptive study, a variety of analytic techniques were used to analyse semi‐structured interview data from a purposeful sample of 20 nurses and 20 patients from geriatric units in two different Italian hospitals.FindingsAlthough both nurses and patients gave rich descriptions of caring experiences, patients described features of caring in nursing that were visible (including nurses' caring gestures, giving attention and being competent) while nurses predominantly emphasised aspects of caring that were relatively invisible (such as reflecting on the patient's past needs, evaluating the nursing care rendered, planning for more appropriate future nursing care, taking multiple complex contextual factors into account to protect the patient and being competent).ConclusionOur data revealed more nuanced insight into the meaning of invisible and visible caring in nursing within the gerontological context than has been previously reported in the literature. This has implications for nursing education and practice because it may help nurses meet the actual needs of older patients in hospital settings.
Association of cytochrome b5 with ETR1 ethylene receptor signaling through RTE1 in Arabidopsis
Authors: Chang Jianhong , Clay John M. , Chang Caren 
Published: December 2013

SummaryEthylene plays important roles in plant growth, development and stress responses, and is perceived by a family of receptors that repress ethylene responses when ethylene is absent. Repression by the ethylene receptor ETR1 depends on an integral membrane protein, REVERSION TO ETHYLENE SENSITIVITY1 (RTE1), which acts upstream of ETR1 in the endoplasmic reticulum (ER) membrane and Golgi apparatus. To investigate RTE1 function, we screened for RTE1‐interacting proteins using the yeast split‐ubiquitin assay, which yielded the ER‐localized cytochrome b5 (Cb5) isoform D. Cb5s are small hemoproteins that perform electron transfer reactions in all eukaryotes, but their roles in plants are relatively uncharacterized. Using bimolecular fluorescence complementation (BiFC), we found that all four ER‐localized Arabidopsis Cb5 isoforms (AtCb5–B, ‐C, ‐D and ‐E) interact with RTE1 in plant cells. In support of this interaction, atcb5 mutants exhibited phenotypic parallels with rte1 mutants in Arabidopsis. Phenotypes included partial suppression of etr1–2 ethylene insensitivity, and no suppression of RTE1‐independent ethylene receptor isoforms. The single loss‐of‐function mutants atcb5–b, ‐c and ‐d appeared similar to the wild‐type, but double mutant combinations displayed slight ethylene hypersensitivity. Over‐expression of AtCb5–D conferred reduced ethylene sensitivity similar to that conferred by RTE1 over‐expression, and genetic analyses suggested that AtCb5–D acts upstream of RTE1 in the ethylene response. These findings suggest an unexpected role for Cb5, in which Cb5 and RTE1 are functional partners in promoting ETR1‐mediated repression of ethylene signaling.
Status epilepticus attributed to inadvertent intrathecal injection of cefazolin during myelography
Authors: Griffith Carrie A. , Hoffmann Daniel E. 
Published: December 2013

AbstractObjectiveTo describe a case of status epilepticus believed to be a consequence of inadvertent intrathecal administration of cefazolin in a dog undergoing a myelogram.Case SummaryA 4‐year‐old, 6.5 kg, male neutered Dachshund was referred for evaluation of an acute onset hind limb paraparesis. While performing a lumbar myelogram, cefazolin was inadvertently injected into the ventral subarachnoid space. Subsequent refractory seizure activity was attributed to the epileptogenic effects of intrathecally administered cefazolin. Supportive therapy led to eventual complete recovery.New or Unique Information ProvidedAlthough epileptogenic effects of intrathecally administered cefazolin are well documented in the human and experimental animal model literature, to the authors’ knowledge this has not been characterized in the veterinary literature. This case highlights the need to be diligent and mindful when one administers medications, and describes the management of a dog adversely affected as a consequence of a medical error.
Myocardial injury in dogs with snake envenomation and its relation to systemic inflammation
Authors: Langhorn Rebecca , Persson Frida , Åblad Björn , Goddard Amelia , Schoeman Johan P. , Willesen Jakob L. , Tarnow Inge , Kjelgaard‐Hansen Mads 
Published: December 2013

AbstractObjectiveTo investigate the presence of myocardial injury in dogs hospitalized for snake envenomation and to examine its relationship with systemic inflammation.DesignProspective case‐control study.SettingUniversity teaching hospital and small animal referral hospital.AnimalsDogs naturally envenomed by the European viper (Vipera berus; n = 24), African puff adder (Bitis arietans; n = 5), or snouted cobra (Naja annulifera; n = 9).InterventionsBlood was collected from dogs envenomed by V. berus at admission, 12–24 hours postadmission, and 5–10 days postadmission. Blood was collected from dogs envenomed by B. arietans or N. annulifera at admission, and 12, 24, and 36 hours postadmission.Measurements and Main ResultsConcentrations of cardiac troponin I (cTnI), a marker of myocardial injury, and C‐reactive protein (CRP), a marker of systemic inflammation, were measured in each blood sample. Evidence of myocardial injury was found in 58% of dogs envenomed by V. berus at one or more time points. A significant correlation between cTnI and CRP concentrations was found at all time points. Evidence of myocardial injury was found in 80% of dogs envenomed by B. arietans at one or more time points; however, no correlation was found between cTnI and CRP concentrations. Evidence of myocardial injury was found in 67% of dogs envenomed by N. annulifera at one or more time points. A significant correlation between cTnI and CRP concentrations was found at admission, but not at other time points.ConclusionsMyocardial injury frequently occurred in dogs with snake envenomation. While the degree of systemic inflammation was significantly correlated with degree of myocardial injury in V. berus envenomation at all time points, this was not the case in dogs envenomed by N. annulifera or B. arietans. This could be due to differences in the toxic substances of the snake venoms or to differences in the cytokines induced by the venom toxins.
What do measures of agreement (κ) tell us about quality of exposure assessment? Theoretical analysis and numerical simulation
Authors: Burstyn Igor , de Vocht Frank , Gustafson Paul 
Published: December 2013

BackgroundThe reliability of binary exposure classification methods is routinely reported in occupational health literature because it is viewed as an important component of evaluating the trustworthiness of the exposure assessment by experts. The Kappa statistics (κ) are typically employed to assess how well raters or classification systems agree in a variety of contexts, such as identifying exposed participants in a population-based epidemiological study of risks due to occupational exposures. However, the question we are really interested in is not so much the reliability of an exposure assessment method, although this holds value in itself, but the validity of the exposure estimates. The validity of binary classifiers can be expressed as a method's sensitivity (SN) and specificity (SP), estimated from its agreement with the error-free classifier.Methods and resultsWe describe a simulation-based method for deriving information on SN and SP that can be derived from κ and the prevalence of exposure, since an analytic solution is not possible without restrictive assumptions. This work is illustrated in the context of comparison of job-exposure matrices assessing occupational exposures to polycyclic aromatic hydrocarbons.DiscussionOur approach allows the investigators to evaluate how good their exposure-assessment methods truly are, not just how well they agree with each other, and should lead to incorporation of information of validity of expert assessment methods into formal uncertainty analyses in epidemiology.
Primary prevention of diabetic retinopathy with fibrates: a retrospective, matched cohort study
Authors: Morgan Christopher Ll , Owens David R , Aubonnet Patrick , Carr Emma S M , Jenkins-Jones Sara , Poole Chris D , Currie Craig J 
Published: December 2013

ObjectivesTo compare the progression of diabetic retinopathy (DR) in people with type 2 diabetes treated with fibrates with that of non-exposed controls.DesignRetrospective, matched cohort study.SettingUK Clinical Practice Research Datalink (CPRD).Participants5038 people with type 2 diabetes with a history of fibrate exposure but without evidence of DR were identified. Three thousand one hundred and seventy-six (63%) people could be randomly matched to one non-exposed control; of these, 2599 (81.8%) were matched without any missing blood pressure or glycated haemoglobin (HbA1c) values.Main outcome measuresThe primary endpoint was first recorded DR with a secondary endpoint of all-cause mortality or first DR. Time to clinical endpoints was compared using Cox proportional hazards models.ResultsMean follow-up was 5.1 and 5.0 years for fibrate-exposed and non-exposed patients, respectively. For fibrate-exposed participants, there was a reduction in DR: 33.4 events/1000 person-years vs 40.4 (p=0.002), and in death or DR: 50.6 vs 60.2 (p<0.001). For those matched with full systolic blood pressure and HbA1c data, crude event rates were 34.3 versus 43.9 for DR (p<0.001) and 51.2 vs 63.4 (p<0.001) for death or DR. Following adjustment, DR was significantly delayed for those treated with fibrates, with an adjusted HR (aHR) of 0.785 (p<0.001) for participants with complete data and an aHR of 0.802 (p<0.001) for all participants.ConclusionsThe treatment with fibrates in people with type 2 diabetes was independently associated with reduced progression to a first diagnosis of DR.
Factors influencing trust in doctors: a community segmentation strategy for quality improvement in healthcare
Authors: Gopichandran Vijayaprasad , Chetlapalli Satish Kumar 
Published: December 2013

BackgroundTrust is a forward-looking covenant between the patient and the doctor where the patient optimistically accepts his/her vulnerability. Trust is known to improve the clinical outcomes.ObjectivesTo explore the factors that determine patients’ trust in doctors and to segment the community based on factors which drive their trust.SettingResource-poor urban and rural settings in Tamil Nadu, a state in southern India.ParticipantsA questionnaire was administered to a sample of 625 adult community-dwelling respondents from four districts of Tamil Nadu, India, chosen by multistage sampling strategy.Outcome measuresThe outcomes were to understand the main domains of factors influencing trust in doctors and to segment the community based on which of these domains predominantly influenced their trust.ResultsFactor analysis revealed five main categories, namely, comfort with the doctor, doctor with personal involvement with the patient, behaviourally competent doctor, doctor with a simple appearance and culturally competent doctor, which explained 49.3% of the total variance. Using k-means cluster analysis the respondents were segmented into four groups, namely, those who have ‘comfort-based trust’, ‘emotionally assessed trust’, who were predominantly older and belonging to lower socioeconomic status, those who had ‘personal trust’, who were younger people from higher socioeconomic strata of the community and the group who had ‘objectively assessed trust’, who were younger women.ConclusionsTrust in doctors seems to be influenced by the doctor's behaviuor, perceived comfort levels, personal involvement with the patient, and to a lesser extent by cultural competence and doctor's physical appearance. On the basis of these dimensions, the community can be segmented into distinct groups, and trust building can happen in a strategic manner which may lead to improvement in perceived quality of care.
Integrating patient safety into health professionals’ curricula: a qualitative study of medical, nursing and pharmacy faculty perspectives
Authors: Tregunno Deborah , Ginsburg Liane , Clarke Beth , Norton Peter 
Published: December 2013

BackgroundAs efforts to integrate patient safety into health professional curricula increase, there is growing recognition that the rate of curricular change is very slow, and there is a shortage of research that addresses critical perspectives of faculty who are on the ‘front-lines’ of curricular innovation. This study reports on medical, nursing and pharmacy teaching faculty perspectives about factors that influence curricular integration and the preparation of safe practitioners.MethodsQualitative methods were used to collect data from 20 faculty members (n=6 medical from three universities; n=6 pharmacy from two universities; n=8 nursing from four universities) engaged in medical, nursing and pharmacy education. Thematic analysis generated a comprehensive account of faculty perspectives.ResultsFaculty perspectives on key challenges to safe practice vary across the three disciplines, and these different perspectives lead to different priorities for curricular innovation. Additionally, accreditation and regulatory requirements are driving curricular change in medicine and pharmacy. Key challenges exist for health professional students in clinical teaching environments where the culture of patient safety may thwart the preparation of safe practitioners.ConclusionsPatient safety curricular innovation depends on the interests of individual faculty members and the leveraging of accreditation and regulatory requirements. Building on existing curricular frameworks, opportunities now need to be created for faculty members to act as champions of curricular change, and patient safety educational opportunities need to be harmonises across all health professional training programmes. Faculty champions and practice setting leaders can collaborate to improve the culture of patient safety in clinical teaching and learning settings.
Enumeration of monadic second-order queries on trees
Authors: Kazana Wojciech , Segoufin Luc 
Published: December 2013

We consider the enumeration problem of Monadic Second-Order (MSO) queries with first-order free variables over trees. In Bagan [2006] it was shown that this problem is in CONSTANT-DELAY

lin

. An enumeration problem belongs to CONSTANT-DELAY
lin
if for an input structure of size
n
it can be solved by:

—an
O
(
n
) precomputation phase building an index structure,

—followed by a phase enumerating the answers with no repetition and a constant delay between two consecutive outputs.
In this article we give a different proof of this result based on the deterministic factorization forest decomposition theorem of Colcombet [2007].
PPARα Activation Can Help Prevent and Treat Non–Small Cell Lung Cancer
Authors: Skrypnyk Nataliya , Chen Xiwu , Hu Wen , Su Yan , Mont Stacey , Yang Shilin , Gangadhariah Mahesha , Wei Shouzuo , Falck John R. , Jat Jawahar Lal , Zent Roy , Capdevila Jorge H. , Pozzi Ambra 
Published: December 2013

Abstract
Non–small cell lung cancer (NSCLC) not amenable to surgical resection has a high mortality rate, due to the ineffectiveness and toxicity of chemotherapy. Thus, there remains an urgent need of efficacious drugs that can combat this disease. In this study, we show that targeting the formation of proangiogenic epoxyeicosatrienoic acids (EET) by the cytochrome P450 arachidonic acid epoxygenases (Cyp2c) represents a new and safe mechanism to treat NSCLC growth and progression. In the transgenic murine K-Ras model and human orthotopic models of NSCLC, we found that Cyp2c44 could be downregulated by activating the transcription factor PPARα with the ligands bezafibrate and Wyeth-14,643. Notably, both treatments reduced primary and metastatic NSCLC growth, tumor angiogenesis, endothelial Cyp2c44 expression, and circulating EET levels. These beneficial effects were independent of the time of administration, whether before or after the onset of primary NSCLC, and they persisted after drug withdrawal, suggesting the benefits were durable. Our findings suggest that strategies to downregulate Cyp2c expression and/or its enzymatic activity may provide a safer and effective strategy to treat NSCLC. Moreover, as bezafibrate is a well-tolerated clinically approved drug used for managing lipidemia, our findings provide an immediate cue for clinical studies to evaluate the utility of PPARα ligands as safe agents for the treatment of lung cancer in humans. Cancer Res; 74(2); 621–31. ©2013 AACR.
Adenosine-to-Inosine RNA Editing Mediated by ADARs in Esophageal Squamous Cell Carcinoma
Authors: Qin Yan-Ru , Qiao Jun-Jing , Chan Tim Hon Man , Zhu Ying-Hui , Li Fang-Fang , Liu Haibo , Fei Jing , Li Yan , Guan Xin-Yuan , Chen Leilei 
Published: December 2013

Abstract
Esophageal squamous cell carcinoma (ESCC), the major histologic form of esophageal cancer, is a heterogeneous tumor displaying a complex variety of genetic and epigenetic changes. Aberrant RNA editing of adenosine-to-inosine (A-to-I), as it is catalyzed by adenosine deaminases acting on RNA (ADAR), represents a common posttranscriptional modification in certain human diseases. In this study, we investigated the status and role of ADARs and altered A-to-I RNA editing in ESCC tumorigenesis. Among the three ADAR enzymes expressed in human cells, only ADAR1 was overexpressed in primary ESCC tumors. ADAR1 overexpression was due to gene amplification. Patients with ESCC with tumoral overexpression of ADAR1 displayed a poor prognosis. In vitro and in vivo functional assays established that ADAR1 functions as an oncogene during ESCC progression. Differential expression of ADAR1 resulted in altered gene-specific editing activities, as reflected by hyperediting of FLNB and AZIN1 messages in primary ESCC. Notably, the edited form of AZIN1 conferred a gain-of-function phenotype associated with aggressive tumor behavior. Our findings reveal that altered gene-specific A-to-I editing events mediated by ADAR1 drive the development of ESCC, with potential implications in diagnosis, prognosis, and treatment of this disease. Cancer Res; 74(3); 840–51. ©2013 AACR.
Emergency Department Visits and Hospitalizations for Digoxin Toxicity
Authors: See Isaac , Shehab Nadine , Kegler Scott R. , Laskar S. Raja , Budnitz Daniel S. 
Published: December 2013

Background—
Recent data on digoxin prescribing and adverse events are lacking but could help inform the management of digoxin in contemporary heart failure treatment.

Methods and Results—
We determined nationally representative numbers and rates of emergency department (ED) visits for digoxin toxicity in the United States using 2005 to 2010 reports from the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project and the National Ambulatory (and Hospital Ambulatory) Medical Care Surveys. Based on 441 cases, an estimated 5156 (95% confidence interval [CI], 2663–7648) ED visits for digoxin toxicity occurred annually in the United States; more than three fourths (78.8% [95% CI, 73.5%–84.1%]) resulted in hospitalization. Serum digoxin level was ≥2.0 ng/mL for 95.8% (95% CI, 93.2%–98.4%) of estimated ED visits with levels reported (n=251 cases). The rate of ED visits per 10 000 outpatient prescription visits among patients ≥85 years was twice that of patients 40 to 84 years (rate ratio, 2.4 [95% CI, 1.2–5.0]); among women, the rate was twice that of men (rate ratio, 2.3 [95% CI, 1.1–4.7]). Digoxin toxicity accounted for an estimated 1.0% (95% CI, 0.6%–1.4%) of ED visits for all adverse drug events among patients ≥40 years, but an estimated 3.3% (95% CI, 2.3%–4.4%) of ED visits and 5.9% (95% CI, 4.0%–7.9%) of hospitalizations for all adverse drug events among patients ≥85 years. Estimated annual ED visits and hospitalizations remained relatively constant from 2005 to 2010.

Conclusions—
Digoxin toxicity is not declining; more careful prescribing to high-risk groups and improved monitoring of serum levels might be needed to reduce morbidity from outpatient digoxin use.
Impact of Transcatheter Pulmonary Valve Replacement on Biventricular Strain and Synchrony Assessed by Cardiac Magnetic Resonance Feature Tracking
Authors: Harrild David M. , Marcus Edward , Hasan Babar , Alexander Mark E. , Powell Andrew J. , Geva Tal , McElhinney Doff B. 
Published: December 2013

Background—
Transcatheter pulmonary valve (TPV) replacement is an emerging therapy intended to restore pulmonary valve function in patients with right ventricular outflow tract conduit dysfunction; the impact of this technique on ventricular strain and synchrony is not known.

Methods and Results—

Cardiac magnetic resonance and ECG data acquired at 1 center as part of the US Melody TPV trial were analyzed. Biventricular strain and mechanical synchrony measurements were made based on short-axis and 4-chamber steady-state free precession images using feature tracking software. Post- versus pre-TPV replacement findings were compared for all patients (n=31) and subgroups with predominant pulmonary regurgitation (n=13) or stenosis (n=18). Most patients had tetralogy of Fallot (18/31). After TPV replacement, left ventricular (LV) circumferential strain increased for the whole cohort (
P
<0.001) and both subgroups (pulmonary regurgitation
P
=0.01; pulmonary stenosis
P
=0.02). LV longitudinal strain increased for the whole cohort (
P
=0.02) and pulmonary regurgitation subgroup (
P
=0.05); circumferential right ventricular strain increased for the pulmonary stenosis group only (
P
=0.05). LV longitudinal synchrony improved significantly in the pulmonary regurgitation group (maximum wall delay
P
=0.03; cross-correlation delay
P
=0.01). Electric measures of synchrony did not improve.

Conclusions—
In patients with right ventricular outflow tract conduit dysfunction, TPV replacement is associated with improved global LV strain, as well as improved right ventricular strain and LV synchrony in subgroups. Given the associations between strain and synchrony and clinical outcomes, these findings support potential long-term benefits of TPV replacement.