bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review
Authors: Ojangba Theodora , Boamah Solomon , Miao Yudong , Guo Xinghong , Fen Yifei , Agboyibor Clement , Yuan Jingjing , Dong Wenyong 
Published: May 2023

AbstractDespite the effectiveness of currently available antihypertensive medications, there is still a need for new treatment strategies that are more effective in certain groups of hypertensive and for additional resources to combat hypertension. However, medication non‐adherence was previously recognized as a major problem in the treatment of hypertension. The mechanisms behind the positive impacts of lifestyle changes might occur in different ways. In comparison with other studies, the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials. However, in this review, the attitudinal lifestyle modifications and barriers to blood pressure control were elaborated on. An effective method for reducing blood pressure (BP) and preventing cardiovascular events with antihypertensive medications has been outlined. Maintaining healthy lifestyle factors (body mass index, diet, smoking, alcohol consumption, sodium excretion, and sedentary behavior) could lower systolic blood pressure BP by 3.5 mm Hg and reduce the risk of cardiovascular disease (CVD) by about 30%, regardless of genetic susceptibility to hypertension. Conducting a lifestyle intervention using health education could improve lifestyle factors, such as reducing salt, sodium, and fat intake, changing eating habits to include more fruits and vegetables, not smoking, consuming less alcohol, exercising regularly, maintaining healthy body weight, and minimizing stressful conditions. Each behavior could affect BP by modulating visceral fat accumulation, insulin resistance, the renin‐angiotensin‐aldosterone system, vascular endothelial function, oxidative stress, inflammation, and autonomic function. Evidence of the joint effect of antihypertensive medications and lifestyle reforms suggests a pathway to reduce hypertension.
Academic motivation decreases across adolescence for youth with and without attention‐deficit/hyperactivity disorder: Effects of motivation on academic success
Authors: Smith Zoe R. , Flax Marcus , Becker Stephen P. , Langberg Joshua 
Published: May 2023

BackgroundThis longitudinal study examined growth trajectories of academic motivation in youth with and without attention‐deficit/hyperactivity disorder (ADHD) across the important developmental transition from middle school to high school, and associations with academic success. Consistent with self‐determination theory (SDT) of motivation, trajectories of amotivation, extrinsic motivation, and intrinsic motivation were modeled.MethodsThe study included a robust multi‐method, multi‐source assessment of academic outcomes, including homework performance ratings; reading and mathematics standardized test scores; and grade point average (GPA) obtained from school records. Participants included 302 adolescents (ages 12–14; Mage = 13.20) in eighth grade who were specifically recruited so that approximately half (n = 162) were diagnosed with ADHD and 140 adolescents comprising a comparison sample without ADHD. The sample was predominantly White (81.80%), with 7.90% identifying as bi/multiracial, 5.30% identifying as Black/African American, 4.60% identifying as Asian, and 0.30% identifying as Indigenous/Alaskan.ResultsAdolescents with ADHD had worse academic motivation at all timepoints. Growth curve analyses indicated the academic motivation of adolescents without ADHD decreased at faster rates across the transition to high school compared to adolescents with ADHD. However, for adolescents with ADHD, amotivation, extrinsic motivation, and intrinsic motivation each predicted GPA, with higher extrinsic and intrinsic motivation also predicting better homework performance and different aspects of math performance, whereas for youth without ADHD, only amotivation and extrinsic motivation predicted GPA.ConclusionsIntervention and school policy implications are discussed, including the importance of fostering autonomy and internal motivation, and consideration of whether current ADHD interventions primarily foster extrinsic motivation.
Maxillary occlusal device designed with an anterior platform for guiding the occlusal adjustments during the delivery appointment: A dental protocol
Authors: Kois John C. , Kois Dean E. , Zeitler Jonathan M. , Revilla‐León Marta 
Published: May 2023

AbstractObjectiveTo describe a technique for fabricating an additively manufactured maxillary occlusal device using a complete digital workflow.Clinical ConsiderationsThe maxillary occlusal device design may include an anterior platform to guide the positioning of the mandible in a reproducible position for facilitating the delivery procedure.ConclusionsThe described technique provides a more efficient and less time‐consuming method for designing and manufacturing a printed occlusal device, when compared with conventional fabrication techniques.Clinical SignificanceThe additively manufactured occlusal device designed with an anterior platform guides the positioning of the mandible in a reproducible position, facilitates the delivery procedures, and produces a more efficient and less time‐consuming method when compared with conventional methods.
Leucism in sharks: a histological examination
Authors: Wargat Bryanna N. , Adams Douglas H. , Habegger Maria Laura 
Published: May 2023

AbstractIsolated cases of skin pigment disorders, including leucism, in sharks and rays have been reported for multiple species. Nonetheless, the morphological basis behind these chromatic anomalies has not been examined histologically. In this study, the authors quantified and compared the presence of melanin in multiple tissue samples of leucistic and fully pigmented blacktip sharks Carcharhinus limbatus. The authors’ results support lack of melanin to be responsible for leucistic colouration. The histological differences responsible were evaluated.
The salt‐activated CBF1/CBF2/CBF3‐GALS1 module fine‐tunes galactan‐induced salt hypersensitivity in Arabidopsis
Authors: Yan Jingwei , Liu Ya , Yan Jiawen , Liu Zhihui , Lou Heqiang , Wu Jiasheng 
Published: May 2023

AbstractPlant growth and development are significantly hampered in saline environments, limiting agricultural productivity. Thus, it is crucial to unravel the mechanism underlying plant responses to salt stress. β‐1,4‐Galactan (galactan), which forms the side chains of pectic rhamnogalacturonan I, enhances plant sensitivity to high‐salt stress. Galactan is synthesized by GALACTAN SYNTHASE1 (GALS1). We previously showed that NaCl relieves the direct suppression of GALS1 transcription by the transcription factors BPC1 and BPC2 to induce the excess accumulation of galactan in Arabidopsis (Arabidopsis thaliana). However, how plants adapt to this unfavorable environment remains unclear. Here, we determined that the transcription factors CBF1, CBF2, and CBF3 directly interact with the GALS1 promoter and repress its expression, leading to reduced galactan accumulation and enhanced salt tolerance. Salt stress enhances the binding of CBF1/CBF2/CBF3 to the GALS1 promoter by inducing CBF1/CBF2/CBF3 transcription and accumulation. Genetic analysis suggested that CBF1/CBF2/CBF3 function upstream of GALS1 to modulate salt‐induced galactan biosynthesis and the salt response. CBF1/CBF2/CBF3 and BPC1/BPC2 function in parallel to regulate GALS1 expression, thereby modulating the salt response. Our results reveal a mechanism in which salt‐activated CBF1/CBF2/CBF3 inhibit BPC1/BPC2‐regulated GALS1 expression to alleviate galactan‐induced salt hypersensitivity, providing an activation/deactivation fine‐tune mechanism for dynamic regulation of GALS1 expression under salt stress in Arabidopsis.
Promoting self‐determination of persons with severe or profound intellectual disabilities: a systematic review and meta‐analysis
Authors: Kuld P. B. , Frielink N. , Zijlmans M. , Schuengel C. , Embregts P. J. C. M. 
Published: May 2023

AbstractPeople with severe or profound intellectual disabilities (IDs) are believed to experience low levels of self‐determination, which negatively affects their quality of life. This systematic review describes existing interventions aimed to support self‐determination or components thereof and synthesises evidence on the interventions' effects. Eight databases were searched, turning in 76 articles for the final inclusion. The studies included 631 people with severe or profound IDs of whom 81% had multiple disabilities. The studies had quantitative (k = 63), qualitative (k = 7) and mixed study designs (k = 6). Sample sizes ranged from 1 to 95 and a study quality index ranged from 40% to 100%. While many studies included several self‐determination components and intervention elements, overall, 53 studies focused on the self‐determination components choice making, independence and problem solving. Other studies included increased assistance (k = 14); engagement in meaningful activities and relationships (k = 10); community and societal participation (k = 5); supporting the basic psychological needs autonomy, competence and relatedness (k = 4); individuality and dignity (k = 3); supportive decision‐making (k = 2); self‐advocacy (k = 2); and motivation (k = 1). Intervention elements included technology (k = 33); multiple‐component training packages, goal setting, empowerment tactics and applied behaviour principles (k = 17); training of caretakers (k = 17); changes in policies and living arrangements (k = 9); supporter responsiveness (k = 1); drama therapy and storytelling (k = 1); electrical wheelchair training (k = 1); joint painting procedure (k = 1); youth advocacy project (k = 1); and multiliteracies training (k = 1). Reflecting the heterogeneity of the field, only four studies tested a similar intervention for this population and were eligible for the meta‐analysis, which combined showed a small effect size of 2.69. Further research is needed to explore relationships between individuals with severe or profound IDs and their relatives and health care professionals and create supportive environments that meet their basic psychological needs.
Real‐time quaking‐induced conversion assay using a small‐scale substrate production workflow for the diagnosis of Creutzfeldt‐Jakob disease
Authors: Thanapornsangsuth Poosanu , Chongsuksantikul Adipa , Saraya Abhinbhen W. , Hiransuthikul Akarin , Hemachudha Thiravat 
Published: May 2023

AbstractThe lack of a dedicated surveillance program for prion disease, particularly in low‐ and middle‐income countries (LMICs), has hindered the global effort to address this public health threat. Although cerebrospinal fluid (CSF) Real‐time quaking‐induced conversion (RT‐QuIC) is considered the most reliable test for sporadic Creutzfeldt‐Jakob disease (sCJD), its availability in LMICs is limited because of its cost and technical difficulty in generating the recombinant prion protein substrate (recPrP). This study aimed to evaluate the performance of RT‐QuIC with recPrP produced in‐house through a small‐scale method—that is, the application of reusable prepacked chromatography columns and subsequent dialysis. Here, CSF specimens from patients suspected of having prion disease were consecutively collected and stored between October 2015 and January 2023. Electronic medical record data were reviewed to clinically classify participants as probable sCJD or non‐sCJD. CSF RT‐QuIC was performed using in‐house recPrP. Its specificity and sensitivity for diagnosing probable sCJD were reported, along with details of other clinical data and investigations. We found that among 39 eligible participants, with a median (interquartile range) age of 64 (56–70) years and 16 (41%) female, 13 had probable sCJD and the remaining 26 unequivocally suffered from nonprion disorders. Magnetic resonance imaging and electroencephalogram were suggestive of sCJD in 100% (13/13) and 46.2% (6/13) of sCJD participants, respectively. RT‐QuIC was positive in 12/13 sCJD participants (sensitivity 0.92, 95% confidence interval [CI] 0.67–0.99) and negative in all non‐sCJD participants (specificity 1.00, 95% CI 0.87–1.00). CSF tau/p‐tau ratio showed sensitivity and specificity of 0.62–1.0 and 0.85–1.0, respectively. In summary, RT‐QuIC using recPrP generated through a small‐scale workflow demonstrated great performance in detecting sCJD. Given its performance results along with its low cost, this technique could feasibly be implemented in LMICs and potentially be the first step toward establishing local prion disease surveillance programs.image
Radiofrequency and microwave ablation controls hepatic oligoprogression of advanced gastroenteropancreatic neuroendocrine tumors
Authors: Matrood Sami , Gress Thomas Mathias , Rinke Anja , Mahnken Andreas Horst 
Published: May 2023

AbstractIn progression of multifocal liver metastases of gastroenteropancreatic neuroendocrine tumors (GEP‐NET) escalation of systemic therapy is indicated. The aim of this retrospective study was to investigate the potential of local thermal ablation in hepatic oligoprogression and otherwise stable disease in GEP‐NET. Patients with hepatic oligoprogression and otherwise stable disease, who underwent radiofrequency ablation (RFA) or microwave ablation (MWA) for local control, were included in the study. Thermal ablation was performed while maintaining the ongoing systemic therapy or without addition of a systemic therapy. The effectiveness of this therapeutic approach was evaluated by determination of local treatment success, improvement of progression‐free survival (PFS) and the safety. Seventeen thermal ablation procedures were performed in 13 patients with well differentiated NET including seven ileum NET, four pancreatic NET, one appendix NET and one rectum NET. RFA and MWA of liver metastases were well tolerated without major complications. Thermal ablation resulted in an estimated median PFS of 62.6 weeks (mean 50.5 weeks; range 10.1–78.9 weeks) per procedure. In four patients, two ablation procedures were performed throughout the course of their disease resulting in an estimated median PFS of 69.1 weeks (mean 71.6 weeks; range 10.1–123.1 weeks) per patient. Start or change of systemic therapy could be delayed up to 123.1 weeks by using thermal ablations for isolated progression of single liver metastases. 88% of thermal ablations prolonged PFS. Thermal ablation of liver metastases in a non‐curative intent has the potential to provide focal growth control and to prolong PFS in GEP‐NET patients with hepatic oligoprogression.
A scoping review of registered nurses' delegating care and support to unlicenced care and support workers
Authors: Wilson Nathan J. , Pracilio Amy , Morphet Julia , Kersten Michelle , Buckley Thomas , Trollor Julian N. , Cashin Andrew 
Published: May 2023

AbstractAimTo scope the international literature about registered nurses delegated models of care to unlicenced workers, identify gaps and reflect upon how the evidence relates to nursing in multiple contexts.DesignScoping review of the peer reviewed literature from the year 2000 onwards, using the PRISMA‐ScR checklist.MethodsThe study searched the following databases in February 2022: CINAHL, Medline, ProQuest, and SCOPUS, and included keywords, Boolean operators and subject headings relevant to registered nurses delegating the provision of care to unlicenced workers.ResultsA total of 49 articles met the eligibility criteria for this study, and relevant data were extractedThree models of delegation were highlighted within the literature: direct, indirect and a mixture of both. The data highlighted that direct delegation mainly occurred in acute contexts, with delegation decreasing with increasing patient acuity and/or complexity but the threshold of when this would occur was not clear. There was one intervention study that measured patient outcomes which could aid in the determination of what is effective delegation. For studies that did report on it (n = 6), there were few examples of better patient outcomes in cases where care was delegated from registered nurses to unlicenced workers.ConclusionsThe scoping review highlighted heterogeneity in practice areas and methods of delegation practice. A key gap in literature is the absence of studies focusing on patient outcomes, with a clear baseline to measure and identify effective delegation practices. Additionally, the legal and logistical implications presented in both direct and indirect delegation practices is not evident in the literature.Implications for the ProfessionDecisions related to delegation are often made at the service level and prescribed to those who work within the service, suggesting that models of indirect delegation are in fact not delegation at all, rather a re‐distribution of nurses' work.Relevance to clinical practiceDelegation is a vital component of the scope of practice of registered nurses. This review has highlighted unique differences in delegation by practice context, where the proliferation of unlicensed workers in certain contexts places a vastly different professional and legal burden on the registered nurse.
Nursing students' experience of workplace violence in clinical practice: A qualitative systematic review
Authors: Dafny Hila Ariela , McCloud Christine , Pearson Vincent , Brown Shannon , Phillips Craig , Waheed Nasreena , Freeling Michelle , Parry Yvonne Karen , Champion Stephanie 
Published: May 2023

AbstractAimsTo systematically identify, appraise and synthesise qualitative studies investigating Registered Nurse students' (RNS) experiences of workplace violence (WPV) while on clinical placement. It is expected that the literature review findings will guide the development of targeted programs and policies to address WPV against RNS.BackgroundWPV affects RNS during clinical placements as they are vulnerable to violence due to their limited experience and skills to challenge abusive behaviour. In this review, RNS are students enrolled in a Bachelor of Nursing program to become registered nurses and exclude students who are enrolled in nursing program that does not lead to registration as a registered nurse. For example, enrolled in nursing programs and postgraduate nursing programs. RNS are chosen for their scope of practice and the training requirements. RNS reported experiencing WPV mainly from colleagues, staff, teachers, doctors and supervisors, which resulted in leaving nursing practice, impacting students' progression and healthcare systems. This review examines all types of violence RNS face irrespective of the abuser.MethodsA qualitative systematic review of existing literature was conducted through a comprehensive database search of eight databases MEDLINE, CINAHL, Web of Science, Scopus, Embase, Cochrane Central and ProQuest. Furthermore, reference lists of included studies were searched to identify further research. English language qualitative primary studies of any study design were searched from inception to 6th June 2022 and included if they met the inclusion criteria. Double review process utilised from screening until data synthesis reported according to PRISMA. JBI critical appraisal tools were used to assess the studies, and data extraction utilised JBI QARI tool and screened for credibility and confidence in findings.ResultsA total of 18 studies met the inclusion criteria, and the studies were conducted in nine countries. Five main themes relating to RNS experiences of WPV while on clinical placement were identified, including: ‘Types of workplace violence’, ‘Perpetrators’, ‘Causes’, ‘Consequences’ and ‘Management of workplace violence’.ConclusionsThis qualitative systematic review provides new and significant knowledge in understanding the phenomenon of WPV experienced by RNS while on clinical placement.Relative to clinical practiceThis review highlights the unwillingness of RNS to reach out to instructors or clinical placement leaders in many situations and identifies avenues of support and awareness that are crucial to empower and enabling students to seek support.
Loneliness at end‐of‐life: A scoping review
Authors: Ho Ken Hok Man , Yang Chen , Ng Marques Shek Nam , Tao An , Chan Helen Yue Lai 
Published: May 2023

AbstractAims and ObjectivesTo map and synthesise the literature on loneliness at end‐of‐life and identify key knowledge gaps in loneliness research.BackgroundDeclined health conditions, reduced social engagement, loss of social roles, and fear of death may lead to loneliness at end‐of‐life. However, systematic information about loneliness at end‐of‐life is scant.MethodsThis scoping review followed the methodology proposed by Arksey and O'Malley. Nine electronic databases were searched from January 2001 to July 2022. Studies about loneliness at end‐of‐life were included. Two review authors independently screened and selected relevant studies and performed the data charting. The PAGER framework was employed to collate, summarise and report the results. The PRISMA‐ScR checklist was included.ResultsA total of 23 studies were included in this review (12 qualitative, 10 quantitative, and one mixed‐methods design). There was not reliable data about the prevalence of loneliness among adults at end‐of‐life internationally. Three or 20‐item UCLA loneliness scale was frequently used to measure loneliness. Factors predisposed adults at end‐of‐life to loneliness included passive and active withdrawal from social networks, inability to share emotions and to be understood, and inadequate support on spirituality. Four strategies were identified to alleviate loneliness, yet none have been substantiated in clinical trials. Interventions facilitating spirituality, social interactions and connectedness seem effective in alleviating loneliness.ConclusionsThis is the first scoping review on loneliness at end‐of‐life, synthesising evidence from qualitative, quantitative, and mixed‐methods studies. Loneliness among adults at end‐of‐life is under‐investigated and there is a prominent need to address existential loneliness at end‐of‐life.Relevance to clinical practiceAll nurses should proactively assess loneliness or perceived social isolation for clients with life‐limiting conditions, regardless of social networks. Collaborative efforts (e.g., medical‐social collaborations) to promote self‐worthiness, social engagement and connectedness with significant others and social networks are needed.Patient or Public ContributionNo patient or public involvement.