bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enablers and barriers to nurse-facilitated geriatric teleconsultations in nursing homes: a qualitative descriptive multi-site study
Authors: Qi Tan Apphia Jia , Chua Wei Ling , McKenna Lisa , Chin Tan Laurence Lean , Lim Yu Jun , Liaw Sok Ying 
Published: December 2022

Abstract

Background
Nurses play a major role in facilitating teleconsultations in nursing homes with remote physicians. Currently, evidence explicating their role in teleconsultations is lacking. As telemedicine usage grows, understanding the factors that enable or impede nurses’ role in teleconsultations allows for more support in the provision of patient care through this modality.

Objective
This study sought to explore enablers and barriers nurses faced in facilitating geriatric teleconsultations in nursing homes.

Methods
A qualitative descriptive study using semi-structured interviews was conducted in Singapore, from July to November 2021. Purposive sampling of nursing home nurses was undertaken. Data were inductively analysed using Braun and Clarke’s thematic analysis approach.

Results
Twenty-two nursing home nurses participated in the study. Six key themes were identified as enablers and barriers in nurse-facilitated geriatrics teleconsultations. Enablers included nurses’ acknowledgement of teleconsultations as needs-orientated service, close partnership with the hospital-based geriatric service for training and workflow support and nurses’ sense of empowerment in teleconsultation involvement. Barriers that existed were the nurses’ lack of confidence in physical assessment and communication competencies, role conflict due to nurses’ perceived inability to meet physicians’ expectations and limited scope of practice in performing teleconsultation-related tasks and the presence of technology-related challenges.

Conclusion
The identification of enablers and barriers in teleconsultations for nursing home residents provides insights for future research and development in telemedicine-related implementation and educational interventions in long-term care. Developing strong partnerships between telemedicine providers and nursing homes, further enhancement of nurses’ telemedicine competencies and optimising digital infrastructure are warranted.
Factors associated with informal caregivers’ ability to continue care: a subgroup analysis
Authors: Wang Shanshan , de Almeida Mello Johanna , Declercq Anja 
Published: December 2022

Abstract

Background/objective
maintaining informal caregiver’s ability to continue care can prevent early institutionalisation and decrease health care costs, contributing to sustainable health care. This study aims to identify factors associated with informal caregiver’s ability to continue care across several degrees of cognitive decline and risk of burden.

Methods
this is a cross-sectional study that collected nationwide data on frail older people and their informal caregivers living in the community. Instruments used were InterRAI Home Care, Zarit Burden Interview and questionnaire for the informal caregiver. Multivariate logistic regression analyses and a stratification of the population were performed.

Results
a total of 8,309 people had at least one primary caregiver, and a majority of them were able to continue care (68.2%). Cognitive impairment was a risk factor for being able to continue care, even the borderline (odds ratios (ORs): 0.72; 95% CI: 0.61–0.85) or mild condition (OR: 0.52; 95% CI: 0.43–0.61). Protective factors like social participation of older people, strong family support and availability of a secondary caregiver showed the highest association in subgroups with mild cognitive impairment (ORs: 2.20, 2.08, 1.64) and in subgroups at low risk of burden (ORs: 1.91, 2.77, 1.64).

Conclusion
factors associated with informal caregiver’s ability to continue care vary across several degrees of cognitive decline and risk of burden. Interventions related to family and social support resources are recommended, and informal caregivers at a lower level of risk may benefit most. Supportive counselling should be proactively provided to informal caregivers, considering the changes of associated factors with the ongoing caregiving situation.
Ultrasound-derived muscle assessment system for older adults: a promising muscle mass estimation tool
Authors: Tang Xinyi , Huang Songya , Huang Li , Feng Ziyan , Wang Ziyao , Yue Jirong , Qiu Li 
Published: December 2022

Abstract

Background
Quantitative assessment of muscle mass is a critical step in sarcopenia disease management. Expanding upon the use of ultrasound in foetal growth assessment, we established and validated an ultrasound-derived muscle assessment system for older adults at a risk of sarcopenia.

Methods
A total of 669 older adults were recruited in three cohorts in this cross-sectional study. In cohort 1(n = 103), the most valuable sites for skeletal muscle mass index (SMI) estimation were located among 11 ultrasound scanning sites. An ultrasound-derived SMI estimating algorithm based on muscle thickness (MT) was obtained in the modelling group composed of cohorts 1 and 2 (n = 309). The reliability of the muscle mass estimation equation and the validity of the obtained cut-off values were verified in cohort 3 (n = 257), which was selected as the verification group.

Results
In the modelling group, the cut-off values of ultrasound-derived e-SMI for low SMI were 7.13 kg/m2 for men and 5.81 kg/m2 for women. In the verification group, the intraclass correlation between e-SMI and SMI was 0.885. The sensitivity of the e-SMI in detecting low SMI was 93.6% for men and 89.7% for women, and the negative predictive value was 94.9% for men and 94.7% for women. Combined with the handgrip strength and gait speed, the e-SMI had an overall diagnostic sensitivity of 92.7% and a specificity of 91.0% for sarcopenia.

Conclusion
The ultrasound-derived muscle assessment system can be a promising muscle mass estimation tool and a potential disease classification tool.
Injurious falls before, during and after dementia diagnosis: a population-based study
Authors: Zhang Lulu , Wang Jiao , Dove Abigail , Yang Wenzhe , Qi Xiuying , Xu Weili 
Published: December 2022

Abstract

Background
the timing of incident injurious falls at different stages of dementia diagnosis is unclear.

Objectives
to identify when the occurrence of injurious falls begins to increase among individuals who are going to develop dementia, to explore the time point at which people living with dementia are at highest risk of injurious falls and to ascertain differences in fall-related factors pre- and post-dementia diagnosis.

Design
this study included 2,707 participants with incident dementia and 2,707 1:1 matched (i.e. same birth year and sex) controls without dementia.

Methods
dementia diagnosis and date of onset were identified from the National Patient Registry (NPR) and the Swedish Cause of Death Register following international criteria. Information on injurious falls and history of chronic disease was obtained from the NPR. Data were analysed using conditional Poisson regression and generalized estimating equation models.

Results
compared with controls, the incidence of injurious falls among participants with dementia started to increase beginning 4 years pre-diagnosis (incidence rate ratio [IRR] 1.70, 95% confidence interval [CI] 1.30–2.22), reaching a peak (IRR 3.73, 95% CI 3.16–4.41) in the year of dementia diagnosis. Heavy drinking, physically active and cardiometabolic diseases (CMDs) were associated with incident falls among those with dementia.

Conclusion
people with dementia have a higher incidence of injurious falls beginning 4 years leading up to diagnosis and peaking during the year of diagnosis. Older age, female, heavy drinking, physically active and CMDs may predict injurious falls among people with dementia.
Understanding Pathways into Care homes using Data (UnPiCD study): a retrospective cohort study using national linked health and social care data
Authors: Burton Jennifer Kirsty , Ciminata Giorgio , Lynch Ellen , Shenkin Susan D , Geue Claudia , Quinn Terence J 
Published: December 2022

Abstract

Background
Pathways into care are poorly understood but important life events for individuals and their families. UK policy is to avoid moving-in to care homes from acute hospital settings. This assumes that moves from secondary care represent a system failure. However, those moving to care homes from community and hospital settings may be fundamentally different groups, each requiring differing care approaches.

Objective
To characterise individuals who move-in to a care home from hospital and compare with those moving-in from the community.

Design and setting
A retrospective cohort study using cross-sectoral data linkage of care home data.

Methods
We included adults moving-in to care homes between 1/4/13 and 31/3/16, recorded in the Scottish Care Home Census. Care home data were linked to general and psychiatric hospital admissions, community prescribing and mortality records to ascertain comorbidities, significant diagnoses, hospital resource use, polypharmacy and frailty. Multivariate logistic regression identified predictors of moving-in from hospital compared to from community.

Results
We included 23,892 individuals moving-in to a care home, 13,564 (56.8%) from hospital and 10,328 (43.2%) from the community. High frailty risk adjusted Odds Ratio (aOR) 5.11 (95% Confidence Interval (CI): 4.60–5.68), hospital discharge with diagnosis of fracture aOR 3.91 (95%CI: 3.41–4.47) or stroke aOR 8.42 (95%CI: 6.90–10.29) were associated with moving-in from hospital. Discharge from in-patient psychiatry was also a highly significant predictor aOR 19.12 (95%CI: 16.26–22.48).

Conclusions
Individuals moving-in to care homes directly from hospital are clinically distinct from those from the community. Linkage of cross-sectoral data can allow exploration of pathways into care at scale.
A negative association between nectar standing crop and pollen transfer suggests nectar functions as a manipulator of pollinating bats
Authors: Domingos-Melo Arthur , Cocucci Andrea A , Tschapka Marco , Machado Isabel C 
Published: December 2022

Abstract

Background and Aims
Nectar standing crop has a fundamental role in controlling pollinator movements between flowers and individuals within a population. In bat pollination systems, plants take advantage of the cognitive abilities of nectarivorous bats, which integrate complex perceptions of the quality and spatial distribution of resources. Here, we propose that associations between standing crop and pollen transfer help to reveal the role of nectar as a manipulator of pollinator behaviour.

Methods
We used Harpochilus neesianus Ness (Acanthaceae), a bat-pollinated shrub from the Brazilian Caatinga, as a model system to assess nectar removal effects and standing crop, respectively, over the night and to test associations between the amount of nectar available to pollinators, and pollen import and export.

Key Results
Harpochilus neesianus showed continuous nectar secretion throughout the flower lifespan. Flowers subjected to successive nectar removals produced less nectar than flowers sampled just once, and showed, despite a higher sugar concentration, a lower absolute amount of sugar. Under these conditions, bats may realize that nectar production is decreasing after repeated visits to the same flower and could be manipulated to avoid such already pollinated flowers with little nectar, thus increasing the probability of visits to flowers with a high amount of nectar, and a still high pollen availability on anthers and low pollen deposition on stigmas. We found that during most of the period of anthesis, nectar standing crop volume was positively correlated with the number of pollen grains remaining in the anthers, and negatively with the number of pollen grains deposited on the stigma.

Conclusions
Nectar secretion patterns can function as a manipulator of pollinating bats in H. neesianus. We propose that the assessment of variability in nectar secretion in response to removal, and the correlation between nectar standing crop and relative pollen transfer throughout anthesis should be considered in order to understand the role of nectar in the manipulation of pollinators.
To each their own! Nectar plasticity within a flower mediates distinct ecological interactions
Authors: Balduino Hannelise de Kassia , Tunes Priscila , Giordano Emanuele , Guarnieri Massimo , Machado Silvia Rodrigues , Nepi Massimo , Guimarães Elza 
Published: December 2022

Abstract
Nuptial and extranuptial nectaries are involved in interactions with different animal functional groups. Nectar traits involved in pollination mutualisms are well known. However, we know little about those traits involved in other mutualisms, such as ant–plant interactions, especially when both types of nectaries are in the same plant organ, the flower. Here we investigated if when two types of nectaries are exploited by distinct functional groups of floral visitors, even being within the same plant organ, the nectar secreted presents distinct features that fit animal requirements. We compared nectar secretion dynamics, floral visitors and nectar chemical composition of both nuptial and extranuptial nectaries in natural populations of the liana Amphilophium mansoanum (Bignoniaceae). For that we characterized nectar sugar, amino acid and specialized metabolite composition by high-performance liquid chromatography. Nuptial nectaries were visited by three medium- and large-sized bee species and extranuptial nectaries were visited mainly by ants, but also by cockroaches, wasps and flies. Nuptial and extranuptial nectar differed regarding volume, concentration, milligrams of sugars per flower and secretion dynamics. Nuptial nectar was sucrose-dominated, with high amounts of γ-aminobutyric acid and β-aminobutyric acid and with theophylline-like alkaloid, which were all exclusive of nuptial nectar. Whereas extranuptial nectar was hexose-rich, had a richer and less variable amino acid chemical profile, with high amounts of serine and alanine amino acids and with higher amounts of the specialized metabolite tyramine. The nectar traits from nuptial and extranuptial nectaries differ in energy amount and nutritional value, as well as in neuroactive specialized metabolites. These differences seem to match floral visitors’ requirements, since they exclusively consume one of the two nectar types and may be exerting selective pressures on the composition of the respective resources of interest.
KMCP: accurate metagenomic profiling of both prokaryotic and viral populations by pseudo-mapping
Authors: Shen Wei , Xiang Hongyan , Huang Tianquan , Tang Hui , Peng Mingli , Cai Dachuan , Hu Peng , Ren Hong 
Published: December 2022

AbstractMotivationThe growing number of microbial reference genomes enables the improvement of metagenomic profiling accuracy but also imposes greater requirements on the indexing efficiency, database size and runtime of taxonomic profilers. Additionally, most profilers focus mainly on bacterial, archaeal and fungal populations, while less attention is paid to viral communities.ResultsWe present KMCP (K-mer-based Metagenomic Classification and Profiling), a novel k-mer-based metagenomic profiling tool that utilizes genome coverage information by splitting the reference genomes into chunks and stores k-mers in a modified and optimized Compact Bit-Sliced Signature Index for fast alignment-free sequence searching. KMCP combines k-mer similarity and genome coverage information to reduce the false positive rate of k-mer-based taxonomic classification and profiling methods. Benchmarking results based on simulated and real data demonstrate that KMCP, despite a longer running time than all other methods, not only allows the accurate taxonomic profiling of prokaryotic and viral populations but also provides more confident pathogen detection in clinical samples of low depth.Availability and implementationThe software is open-source under the MIT license and available at https://github.com/shenwei356/kmcp.Supplementary informationSupplementary data are available at Bioinformatics online.
Psychosocial Professionals in Chilean Justice Institutions. Reflections Based on the Experiences and Practice of Psychologists and Social Workers
Authors: Miranda-Pérez Fabiola , Andrade Guzmán Carlos 
Published: December 2022

AbstractThis study seeks to answer what is understood by the psychosocial and how this is implemented based on the experiences of those who apply it in Chilean justice institutions—specifically social workers and psychologists. A qualitative study was conducted in two regions of Chile with a high number of intervened cases in justice institutions. Results show that the psychosocial approach is a way to understand and address a complex social problem beyond the limits of psychological and social methods. However, even when this framework is theoretically considered throughout a professional’s formation, it may not be evident when applied in practice. Overall, the effort to incorporate this knowledge in justice needs to be expanded to achieve better interventions.
Morphological and environmental variability ofDianthus sylvestris(Caryophyllaceae) in the Balkan Peninsula
Authors: Terlević Ana , Temunović Martina , Bogdanović Sandro , Grgurev Marin , Ljubičić Ivica , Rešetnik Ivana 
Published: December 2022

AbstractSpecies with wide ranges often exhibit morphological variability that is mostly shaped by ecological and evolutionary processes, and the resulting diversity is frequently reflected in intraspecific taxonomy. Dianthus sylvestris in the Balkan Peninsula encompasses six subspecies (D. sylvestris subspp. alboroseus, bertisceus, kozjakensis, nodosus, sylvestris and tergestinus), the identification of which is problematic due to a great morphological variability and complex patterns of environmental variation. To explore morphological variation of described subspecies and to investigate how their morphology varies in relation to environmental variations across their geographical distribution, we evaluated 97 populations of D. sylvestris for variability in 25 morphological characters and 20 environmental variables. Number and shape of epicalyx scales, calyx length and petal denticulation captured the greatest extent of morphological variability between populations. Morphometric analyses revealed a continuous variability in quantitative morphological characters and an absence of clear morphological differentiation between the investigated subspecies. However, two main morphologically distinct entities, the north-western Balkan populations and the south-eastern Balkan populations, were identified and they were split approximately along the Neretva River valley. In addition, our results indicate that environment, rather than geography, plays a potentially more important role in shaping the morphological variability of this taxon. Overall, our results do not support the recognition of the described subspecies or the currently accepted taxonomic concept, instead pointing to a continuous morphological variability of D. sylvestris in the Balkan Peninsula.
Characterization of proteogenomic signatures of differentiation of CD4+ T cell subsets
Authors: Kanno Toshio , Konno Ryo , Miyako Keisuke , Nakajima Takahiro , Yokoyama Satoru , Sasamoto Shigemi , Asou Hikari K , Ohzeki Junichiro , Kawashima Yusuke , Hasegawa Yoshinori , Ohara Osamu , Endo Yusuke 
Published: December 2022

Abstract
Functionally distinct CD4+ helper T (Th) cell subsets, including Th1, Th2, Th17, and regulatory T cells (Treg), play a pivotal role in the regulation of acquired immunity. Although the key proteins involved in the regulation of Th cell differentiation have already been identified how the proteogenomic landscape changes during the Th cell activation remains unclear. To address this issue, we characterized proteogenomic signatures of differentiation to each Th cell subsets by RNA sequencing and liquid chromatography-assisted mass spectrometry, which enabled us to simultaneously quantify more than 10,000 protein-coding transcripts and 8,000 proteins in a single-shot. The results indicated that T cell receptor activation affected almost half of the transcript and protein levels in a low correlative and gene-specific manner, and specific cytokine treatments modified the transcript and protein profiles in a manner specific to each Th cell subsets: Th17 and Tregs particularly exhibited unique proteogenomic signatures compared to other Th cell subsets. Interestingly, the in-depth proteome data revealed that mRNA profiles alone were not enough to delineate functional changes during Th cell activation, suggesting that the proteogenomic dataset obtained in this study serves as a unique and indispensable data resource for understanding the comprehensive molecular mechanisms underlying effector Th cell differentiation.
Mean arterial pressure predicts 48 h clinical deterioration in intermediate-high risk patients with acute pulmonary embolism
Authors: Zuin Marco , Rigatelli Gianluca , Bongarzoni Amedeo , Enea Iolanda , Bilato Claudio , Zonzin Pietro , Casazza Franco , Roncon Loris 
Published: December 2022

Abstract

Aims
We assess the prognostic role of mean arterial pressure (MAP) for 48 h clinical deterioration in intermediate-high risk pulmonary embolism (PE) patients after admission.

Methods and results
A post hoc analysis of intermediate-high-risk PE and intermediate-low-risk PE patients enrolled in the Italian Pulmonary Embolism Registry (IPER) (Trial registry: ClinicalTrials.gov; No.: NCT01604538) was performed. Clinical deterioration within 48 h was defined as patient worsening from a stable to an unstable haemodynamic condition, need of catecholamine infusion, endotracheal intubation, or cardiopulmonary resuscitation. Of 450 intermediate-high risk PE patients (mean age 71.4 ± 13.8 years, 298 males), 40 (8.8%) experienced clinical deterioration within 48 h from admission. Receiver operating characteristic analysis established the optimal cut-off value for MAP, as a predictor of 48 h clinical deterioration, ≤81.5 mmHg [area under curve (AUC) of 0.77 ± 0.3] with sensitivity, specificity, positive predictive value, and negative predictive value were 77.5, 95.0, 63.2, and 97.7%, respectively. Multivariate Cox regression analysis showed that independent risk factors for 48 h clinical deterioration were age [hazard ratio (HR): 1.26, 95% confidence interval (CI): 1.19–1.28, P &lt; 0.0001], history of heart failure (HR: 1.76, 95% CI: 1.72–1.81, P &lt; 0.0001), simplified Pulmonary Embolism Severity Index (HR: 1.52, 95% CI: 1.49–1.58, P = 0.001), systemic thrombolysis (HR: 0.54, 95% CI: 0.30–0.65, P &lt; 0.0001), and a MAP of ≤81.5 mmHg at admission (HR: 3.25, 95% CI: 1.89–5.21, P &lt; 0.0001). The deteriorating group had a significantly higher risk of 30-day mortality (HR: 2.61, 95% CI: 2.54–2.66, P &lt; 0.0001) compared with the non-deteriorating group.

Conclusion
The mean arterial pressure appears to be a useful, bedside, and non-invasive prognostic tool potentially capable of promptly identifying intermediate-high risk PE patients at higher risk of 48 h clinical deterioration.