bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the provision of end‐of‐life care in critical care settings: development and testing of a survey instrument
Authors: Ranse Kristen , Yates Patsy , Coyer Fiona 
Published: November 2014

AbstractAimTo develop and psychometrically test a survey instrument to identify the factors influencing the provision of end‐of‐life care by critical care nurses.BackgroundFollowing a decision to withdraw life‐sustaining treatment, critical care nurses remain with the patient and their family providing end‐of‐life care. Identification of factors influencing the provision of this care can give evidence to inform practice development and support nurses.DesignA cross‐sectional survey of critical care nurses.MethodAn online survey was developed, reviewed by an expert panel and pilot tested to obtain preliminary evidence of its reliability and validity. In May 2011, a convenience sample of critical care nurses (n = 392, response rate 25%) completed the survey. The analytical approach to data obtained from the 58 items measured on a Likert scale included exploratory factor analysis and descriptive statistics.ResultsExploratory factor analysis identified eight factors influencing the provision of end‐of‐life care: emotional support for nurses, palliative values, patient and family preferences, resources, organizational support, care planning, knowledge and preparedness. Internal consistency of each latent construct was deemed satisfactory. The results of descriptive statistics revealed a strong commitment to the inclusion of families in end‐of‐life care and the value of this care in the critical care setting.ConclusionThis paper reports preliminary evidence of the psychometric properties of a new survey instrument. The findings may inform practice development opportunities to support critical care nurses in the provision of end‐of‐life care and improve the care that patients and their families receive.
Is there an economic case for investing in nursing care – what does the literature tell us?
Authors: Twigg Diane E. , Myers Helen , Duffield Christine , Giles Margaret , Evans Gemma 
Published: November 2014

AbstractAimTo determine the cost effectiveness of increasing nurse staffing or changing the nursing skill mix in adult medical and/or surgical patients?BackgroundResearch has demonstrated that nurse staffing levels and skill mix are associated with patient outcomes in acute care settings. If increased nurse staffing levels or richer skill mix can be shown to be cost‐effective hospitals may be more likely to consider these aspects when making staffing decisions.DesignA systematic review of the literature on economic evaluations of nurse staffing and patient outcomes was conducted to see whether there is consensus that increasing nursing hours/skill mix is a cost‐effective way of improving patient outcomes. We used the Cochrane Collaboration systematic review method incorporating economic evidence.Data sourcesTheMEDLINE,CINAHL,SPORTDiscus and PsychINFOdatabases were searched in 2013 for published and unpublished studies in English with no date limits.Review methodsThe review focused on full economic evaluations where costs of increasing nursing hours or changing the skill mix were included and where consequences included nursing sensitive outcomes.ResultsFour‐cost benefit and five‐cost effectiveness analyses were identified. There were no cost‐minimization or cost‐utility studies identified in the review. A variety of methods to conceptualize and measure costs and consequences were used across the studies making it difficult to compare results.ConclusionThis review was unable to determine conclusively whether or not changes in nurse staffing levels and/or skill mix is a cost‐effective intervention for improving patient outcomes due to the small number of studies, the mixed results and the inability to compare results across studies.
A descriptive study of nurse‐reported missed care in neonatal intensive care units
Authors: Tubbs‐Cooley Heather L. , Pickler Rita H. , Younger Janet B. , Mark Barbara A. 
Published: November 2014

AbstractAimsThe aims of this study are to describe: (1) the frequency of nurse‐reported missed care in neonatal intensive care units; and (2) nurses’ reports of factors contributing to missed care on their last shift worked.BackgroundMissed nursing care, or necessary care that is not delivered, is increasingly cited as a contributor to adverse patient outcomes. Previous studies highlight the frequency of missed nursing care in adult settings; the occurrence of missed nursing care in neonatal intensive care units is unknown.DesignA descriptive analysis of neonatal nurses’ self‐reports of missed care using data collected through a cross‐sectional web‐based survey.MethodsA random sample of certified neonatal intensive care nurses in seven states was invited to participate in the survey in April 2012. Data were collected from nurses who provide direct patient care in a neonatal intensive care unit (n = 230). Descriptive statistics constituted the primary analytic approach.ResultsNurses reported missing a range of patient care activities on their last shift worked. Nurses most frequently missed rounds, oral care for ventilated infants, educating and involving parents in care and oral feedings. Hand hygiene, safety and physical assessment and medication administration were missed least often. The most common reasons for missed care included frequent interruptions, urgent patient situations and an unexpected rise in patient volume and/or acuity on the unit.ConclusionWe find that basic nursing care in the neonatal intensive care unit is missed and that system factors may contribute to missed care in this setting.
Phylogeography of a Holarctic rodent (Myodes rutilus): testing high‐latitude biogeographical hypotheses and the dynamics of range shifts
Authors: Kohli Brooks A. , Fedorov Vadim B. , Waltari Eric , Cook Joseph A. 
Published: November 2014

AbstractAimWe used the Holarctic northern red‐backed vole (Myodes rutilus) as a model organism to improve our understanding of how dynamic, northern high‐latitude environments have affected the genetic diversity, demography and distribution of boreal organisms. We tested spatial and temporal hypotheses derived from previous mitochondrial studies, comparative phylogeography, palaeoecology and the fossil record regarding diversification of M. rutilus in the Palaearctic and Beringia.LocationHigh‐latitude biomes across the Holarctic.MethodsWe used a multilocus phylogeographical approach combined with species distribution models to characterize the biogeographical and demographic history of M. rutilus. Our molecular assessment included widespread sampling (more than 100 localities), species tree reconstruction and population genetic analyses.ResultsThree well‐differentiated mitochondrial lineages correspond to geographical regions, but nuclear genes were less structured. Multilocus divergence estimates indicated that diversification of M. rutilus was driven by events occurring before c. 100 ka. Population expansion in all three clades occurred prior to the Last Glacial Maximum (LGM) and presumably led to secondary contact. Species distribution modelling predicted a broad LGM distribution consistent with population and range expansion during this period.Main conclusionsThe biogeographical history of M. rutilus differs from other boreal forest‐associated species. Well‐differentiated clades and the existence of secondary contact zones indicate prolonged isolation and persistence in Eurasian and Beringian refugia. Dynamic demographic and distributional changes emphasize the impact of pre‐LGM glacial–interglacial cycles on contemporary geographical structure. The Bering Strait was not a significant factor in the diversification of northern red‐backed voles.
The dissection of a Pleistocene refugium: phylogeography of the smooth newt, Lissotriton vulgaris, in the Balkans
Authors: Pabijan Maciej , Zieliński Piotr , Dudek Katarzyna , Chloupek Marta , Sotiropoulos Konstantinos , Liana Marcin , Babik Wiesław 
Published: November 2014

AbstractAimTo assess the role of the Balkan Peninsula as a Pleistocene refugium for the smooth newt, Lissotriton vulgaris, and to test whether its genetic differentiation is temporally compatible with the southern refugia model.LocationThe Balkan Peninsula.MethodsPhylogeographical analyses were conducted using mitochondrial DNA (mtDNA) sequences sampled from 49 populations of L. vulgaris. A fossil‐calibrated estimate of divergence times among major mtDNA clades was obtained.ResultsWe detected seven parapatrically distributed mtDNA clades with very little admixture among populations. Whereas most clades diverged in the Pleistocene, the earliest splits between Caucasian, Anatolian and Balkan clades occurred in the Pliocene. Clades C, D, K and M have local distributions within the Balkans and have evolved in isolation from other groups. Clade L originated in the Pannonian Basin and northern margin of the Balkan Peninsula and recently expanded across central and western Europe. Clades H and E have recently arrived in the Balkans from source populations in the Apennine Peninsula and Anatolia, respectively.Main conclusionsThe history of L. vulgaris involves multiple, independent refugial populations in the Balkans. Only one of them, located at the northern periphery of the peninsula, showed evidence of post‐glacial expansion into western and northern Europe. The Balkans have therefore served as a reservoir of old diversity for L. vulgaris. By contrast, populations at the northern and eastern frontiers of the peninsula have experienced non‐equilibrium dynamics. Our dating revealed that very little, if any, pre‐Pliocene genetic diversity has survived in Europe, despite an extensive fossil record for this species in the Miocene and Pliocene. Differentiation of the European mtDNA clades thus seems to have been primarily moulded by Pleistocene climate change. None of the currently recognized subspecies present in the Balkans are reciprocally monophyletic in their mtDNA. We hypothesize that incomplete lineage sorting and mtDNA introgression account for the observed discrepancies.
Influence of Renal Function on Mortality and Ventricular Arrhythmias in Patients Undergoing First Implantable Cardioverter‐Defibrillator Generator Replacement
Authors: WAKS JONATHAN W. , HIGGINS ANGELA Y. , MITTLEMAN MURRAY A. , BUXTON ALFRED E. 
Published: November 2014

GFR, Mortality and ICD Therapy After ICD Generator ReplacementBackgroundImpaired renal function is associated with increased mortality among patients with implantable cardioverter‐defibrillators (ICDs). The relationship between renal function at time of ICD generator replacement and subsequent appropriate ICD therapies is not known.Methods and ResultsWe identified 441 patients who underwent first ICD generator replacement between 2000 and 2011 and had serum creatinine measured within 30 days of their procedure. Patients were divided into tertiles based on estimated glomerular filtration rate (eGFR). Adjusted Cox proportional hazard and competing risk models were used to assess relationships between eGFR and subsequent mortality and appropriate ICD therapy. Median eGFR was 37.6, 59.3, and 84.8 mL/min/1.73 m2 for tertiles 1–3, respectively. Five‐year Kaplan–Meier survival probability was 34.8%, 61.4%, and 84.5% for tertiles 1–3, respectively (P < 0.001). After multivariable adjustment, compared to tertile 3, worse eGFR tertile was associated with increased mortality (HR 2.84, 95% CI [1.36–5.94] for tertile 2; HR 3.84, 95% CI [1.81–8.12] for tertile 1). At 5 years, 57.0%, 58.1%, and 60.2% of patients remained free of appropriate ICD therapy in tertiles 1–3, respectively (P = 0.82). After adjustment, eGFR tertile was not associated with future appropriate ICD therapy. Results were unchanged in an adjusted competing risk model accounting for death.ConclusionsAt time of first ICD generator replacement, lower eGFR is associated with higher mortality, but not with appropriate ICD therapies. The poorer survival of ICD patients with reduced eGFR does not appear to be influenced by arrhythmia status, and there is no clear proarrhythmic effect of renal dysfunction, even after accounting for the competing risk of death.
Actinic keratosis with atypical basal cells (AK I) is the most common lesion associated with invasive squamous cell carcinoma of the skin
Authors: Fernández‐Figueras M.T. , Carrato C. , Sáenz X. , Puig L. , Musulen E. , Ferrándiz C. , Ariza A. 
Published: November 2014

AbstractBackgroundProgression from actinic keratosis (AK) to invasive squamous cell carcinoma (iSCC) of the skin is thought to occur after the development of full thickness epidermal neoplasia, as in the classic pathway of cervical cancer. Nevertheless, cutaneous iSCC may also directly arise from a proliferation of atypical basaloid cells limited mostly to the epidermal basal layer (AK I), akin to what happens in the ‘differentiated pathway’ of iSCC of the vulva, oral cavity and other locations.ObjectiveTo evaluate the prevalence of classic and differentiated pathways in the development of cutaneous iSCC.MethodsThe epidermis adjacent to and overlying iSCC, assumed to be representative of pre‐existing lesions, was histologically studied in 196 skin biopsy specimens showing iSCC.ResultsAK I, AK II and AK III lesions overlying iSCC were present in 63.8%, 17.9% and 18.4% of cases respectively. The corresponding percentages in the epidermis adjacent to iSCC were 77.9%, 6.6% and 8.3% respectively (stage could not be assessed in 8.1% of cases). Focal epidermal ulceration overlying iSCC was seen in 32% of AK I, 28.6% of AK II and 33.3% of AK III instances. Adnexal involvement by atypical keratinocytes (proliferative AK) was present more frequently in cases with overlying AK I (39/125, 31.2%) than with AK II (8/35, 22.9%) and AKII I (5/36, 13.9%).ConclusionDirect invasion from proliferating basaloid atypical keratinocytes limited to the epidermal basal layer (AK I), known as the differentiated pathway, was the most common form of progression to cutaneous iSCC in our series. On the other hand, stepwise progression from AK I to AK II and AK III (classic pathway) was seen to be operative in a substantial proportion of iSCC cases. All AK lesions, irrespective of intraepidermal neoplasia thickness, are therefore potentially invasive and tumour advance along adnexal structures might facilitate iSCC development from AK I lesions.
100 years of Wood's lamp revised
Authors: Klatte J.L. , van der Beek N. , Kemperman P.M.J.H. 
Published: November 2014

AbstractThe Wood's lamp is a diagnostic tool in dermatology. Unfortunately, this useful tool is often overlooked in the busy and hectic outdoor dermatology clinic. To emphasize its value in modern dermatology, we present an updated review of the principles and applications and shed new light on its proper place in our practice.
Explaining the sawtooth: latitudinal periodicity in a circadian gene correlates with shifts in generation number
Authors: Levy R. C. , Kozak G. M. , Wadsworth C. B. , Coates B. S. , Dopman E. B. 
Published: November 2014

AbstractMany temperate insects take advantage of longer growing seasons at lower latitudes by increasing their generation number or voltinism. In some insects, development time abruptly decreases when additional generations are fit into the season. Consequently, latitudinal ‘sawtooth’ clines associated with shifts in voltinism are seen for phenotypes correlated with development time, like body size. However, latitudinal variation in voltinism has not been linked to genetic variation at specific loci. Here, we show a pattern in allele frequency among voltinism ecotypes of the European corn borer moth (Ostrinia nubilalis) that is reminiscent of a sawtooth cline. We characterized 145 autosomal and sex‐linked SNPs and found that period, a circadian gene that is genetically linked to a major QTL determining variation in post‐diapause development time, shows cyclical variation between voltinism ecotypes. Allele frequencies at an unlinked circadian clock gene cryptochrome1 were correlated with period. These results suggest that selection on development time to ‘fit’ complete life cycles into a latitudinally varying growing season produces oscillations in alleles associated with voltinism, primarily through changes at loci underlying the duration of transitions between diapause and other life history phases. Correlations among clock loci suggest possible coupling between the circadian clock and the circannual rhythms for synchronizing seasonal life history. We anticipate that latitudinal oscillations in allele frequency will represent signatures of adaptation to seasonal environments in other insects and may be critical to understanding the ecological and evolutionary consequences of variable environments, including response to global climate change.
Receptive females mitigate costs of sexual conflict
Authors: Harano T. 
Published: November 2014

AbstractMales typically gain fitness from multiple mating, whereas females often lose fitness from numerous mating, potentially leading to sexual conflict over mating. This conflict is expected to favour the evolution of female resistance to mating. However, females may incur male harassment if they refuse to copulate; thus, greater female resistance may increase costs imposed by males. Here, I show that the evolution of resistance to mating raises fitness disadvantages of interacting with males when mating is harmful in female adzuki bean beetles, Callosobruchus chinensis. Females that were artificially selected for higher and lower remating propensity evolved to accept and resist remating, respectively. Compared with females that evolved to accept remating, females that evolved to resist it suffered higher fitness costs from continuous exposure to males. The costs of a single mating measured by the effect on longevity did not differ among selection line females. This study indicates that receptive rather than resistant females mitigate the fitness loss resulting from sexual conflict, suggesting that even though mating is harmful, females can evolve to accept additional mating.
Effect of Natural Additives on the Fatty Acid Signatures of Green Mussel Perna viridis L. in a Time‐Dependent Accelerated Shelf Life Study
Authors: Chakraborty Kajal , Chakkalakal Selsa J. , Joseph Deepu 
Published: November 2014

AbstractThe present study identified the freeze‐dried concentrate of green mussel to possess valuable nutritional properties with respect to long‐chain polyunsaturated fatty acids. The freeze‐dried concentrate (C0) was stabilized with different ratios of naturally derived antioxidative oleoresins of Rosmarinus officinalis and Curcuma longa along with trace amounts of other natural additives to obtain four combinations (C1, C2, C3 and C4) and was subjected to accelerated shelf storage for 90 days (d90) to understand their role in retaining the desired nutritional composition. A threshold level of oleoresins of C. longa : R. officinalis (0.8:0.4%) was sufficient for optimum antioxidant activity, and further addition of endogenous antioxidants did have negative impacts on stability of the polyunsaturated fatty acid compositions of the green mussel concentrate. The combinations C2 and C4 effectively arrested the isomeric conversion of cis polyunsaturated fatty acids to their trans conformers at d0 and d90 than recorded in C0.Practical ApplicationsThe nonconjugated olefinic system in the long‐chain polyunsaturated fatty acids in the marine products make them susceptible to oxidation, limiting the amount of time that such products can be stored on the shelf. The use of natural oleoresins in meat products and fried foods has been extensively researched and used in commercialized foods. The present work focused to study the use of natural antioxidative additives in increasing the shelf life of the freeze‐dried concentrate developed from green mussel Perna viridis and to retain the native form of unsaturated fatty acids, which are highly susceptible to oxidation. The study demonstrated that a combination of green mussel concentrate rich in long‐chain polyunsaturated fatty acids and naturally derived antioxidative substances might result in nutritionally valuable functional food products.
Charcot‐Marie‐Tooth disease: frequency of genetic subtypes in a Southern Italy population
Authors: Manganelli Fiore , Tozza Stefano , Pisciotta Chiara , Bellone Emilia , Iodice Rosa , Nolano Maria , Geroldi Alessandro , Capponi Simona , Mandich Paola , Santoro Lucio 
Published: November 2014

AbstractThe objective of this study is to assess the genetic distribution of Charcot‐Marie‐Tooth (CMT) disease in Campania, a region of Southern Italy. We analyzed a cohort of 197 index cases and reported the type and frequency of mutations for the whole CMT population and for each electrophysiological group (CMT1, CMT2, and hereditary neuropathy with susceptibility to pressure palsies [HNPP]) and for familial and isolated CMT cases. Genetic diagnosis was achieved in 148 patients (75.1%) with a higher success rate in HNPP and CMT1 than CMT2. Only four genes (PMP22, GJB1, MPZ, and GDAP1) accounted for 92% of all genetically confirmed CMT cases. In CMT1, PMP22 duplication was the most common mutation while the second gene in order of frequency was MPZ in familial and SH3TC2 in isolated cases. In CMT2, GJB1 was the most frequent mutated gene and GJB1 with GDAP1 accounted for almost 3/4 of genetically defined CMT2 patients. The first gene in order of frequency was GJB1 in familial and GDAP1 in isolated cases. In HNPP, the majority of patients harbored the PMP22 gene deletion. The novelty of our data is the relatively high frequency of SH3TC2 and GDAP1 mutations in demyelinating and axonal forms, respectively. These epidemiological data can help in panel design for our patients' population.