bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating simulation training during clinical practice in nursing homes: an experimental study of nursing students’ knowledge acquisition, self-efficacy and learning needs
Authors: Olaussen Camilla , Steindal Simen A. , Jelsness-Jørgensen Lars-Petter , Aase Ingunn , Stenseth Hege Vistven , Tvedt Christine Raaen 
Published: February 2022

Abstract
Background
Limited access to supervision, feedback and quality learning experiences pose challenges to learning in the clinical setting for first-year nursing students who are beginning their clinical experiences. Prior studies have indicated that simulation training, as a partial replacement of clinical practice hours, may improve learning. However, there has been little research on simulation training integrated as a partial replacement during first-year students’ clinical practice in nursing homes. The primary aim of this study was to examine first-year nursing students’ knowledge acquisition and self-efficacy in integrating a partial replacement of clinical hours in nursing homes with simulation training. Its secondary aim was to examine perceptions of how learning needs were met in the simulated environment compared with the clinical environment.

Design
The primary aim was addressed using an experimental design that included pre- and post-tests. The secondary aim was investigated using a descriptive survey-based comparison.

Methods
First-year students at a Norwegian university college (n = 116) were asked to participate. Those who agreed (n = 103) were randomly assigned to the intervention group (n = 52) or the control group (n = 51). A knowledge test, the General Self-efficacy Scale and the Clinical Learning Environment Comparison Survey were used to measure students’ outcomes and perceptions. The data were analysed using independent samples t-tests, chi-square tests and paired samples t-tests.

Results
Knowledge scores from pre- to post-tests were significantly higher in the intervention group than in the control group with a medium to large effect size (p < 0.01, Hedges’ g = 0.6). No significant differences in self-efficacy were identified. Significant differences (p <  0.05) were observed between the simulated and the clinical environment with regard to meeting learning needs; effect sizes ranged from small and medium to large (Cohen’s d from 0.3 to 1.0).

Conclusion
Integrating the partial replacement of clinical hours in nursing homes with simulation training for first-year nursing students was positively associated with knowledge acquisition and meeting learning needs. These findings are promising with regard to simulation as a viable partial replacement for traditional clinical practice in nursing homes to improve learning.
Cross-border reproductive healthcare attitudes and behaviours among women living in Florence, Italy
Authors: Meier Stephanie , Ramos-Ortiz Jaziel , Basille Kelsie , D’Eramo Alyson C. , Diaconu Adria M. , Flores Lesley J. , Hottle Savannah , Mason-Yeary Kaylee , Ruiz Yumary , DeMaria Andrea L. 
Published: February 2022

AbstractBackgroundThe number of women living in Italy and seeking cross-border reproductive care (CBRC), especially for medically assisted reproduction (MAR), has increased. The purpose of this study was to explore CBRC attitudes and behaviours among a cohort of reproductive-aged women who have never engaged in CBRC to gauge social and cultural perceptions and gain a deeper understanding of family planning discourse.MethodsIn-depth interviews were conducted during May – June 2018 with 30 women aged 18–50 living in or around Florence, Italy and enrolled in the Italian healthcare system. Interviews offered in-depth insight into CBRC attitudes, behaviours, and experiences among a cohort of women living in Italy who had never engaged in CBRC. Researchers used an expanded grounded theory through open and axial coding. Emergent themes were identified via a constant comparison approach.ResultsThree themes and two subthemes emerged from the data. Participants discussed how limitations in Italy’s access to MAR can lead women to seek reproductive healthcare in other countries. Women had mixed feelings about the effect of religion on legislation and reproductive healthcare access, with many views tied to religious and spiritual norms impacting MAR treatment-seeking in-country and across borders. Participants perceived infertility and CBRC-seeking as socially isolating, as the motherhood identity was highly revered. The financial cost of traveling for CBRC limited access and exacerbated emotional impacts.ConclusionsFindings offered insight into CBRC perceptions and intentions, presenting a deeper understanding of the existing family planning discourse among reproductive-aged women. This may allow policymakers and practitioners to address social and cultural perceptions, increase access to safe and effective local care, and empower women in their family planning decisions.
Associations between ambient temperature and adult asthma hospitalizations in Beijing, China: a time-stratified case-crossover study
Authors: Chen Yuxiong , Kong Dehui , Fu Jia , Zhang Yongqiao , Zhao Yakun , Liu Yanbo , Chang Zhen’ge , Liu Yijie , Liu Xiaole , Xu Kaifeng , Jiang Chengyu , Fan Zhongjie 
Published: February 2022

Abstract
Background
Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China.

Methods
We collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures.

Results
From 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0–30 days was 2.32 with a 95% confidence interval (CI) of 1.57–3.42 for extreme cold corresponding to the 2.5th percentile (− 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52–2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5–38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1–28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19–64 years old).

Conclusions
There was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations.
Vaginal bleeding as a sign of Crimean–Congo hemorrhagic fever infection: a case report
Authors: Qaderi Shohra , Hatami Hossein , Omid Ahmad Murad , Sayad Jalal 
Published: February 2022

Abstract
Background
Crimean–Congo hemorrhagic fever is a severe vector-borne viral hemorrhagic fever with considerable mortality in humans. This disease is endemic in Afghanistan, and its incidence rate has rapidly increased in recent years. This infection can cause a broad range of hemorrhage manifestations including epistaxis, petechial or purpuric rashes, hematemesis, and melena; however, vaginal bleeding is also reported as a rare manifestation.

Case presentation
We report the case of a previously healthy 30-year-old Afghan female of shepherding occupation, with a sudden onset of fever, generalized body pain, epistaxis, and vaginal bleeding. She was admitted to the hospital after 7 days of symptom manifestation, with predominant signs being high fever, vaginal bleeding, and elevated liver enzymes. The serological test result for Crimean–Congo hemorrhagic fever was positive. She was treated with oral ribavirin and discharged with normal parameters.

Conclusions
People in high-risk professions in endemic areas should be informed that vaginal bleeding is a serious symptom and requires immediate action and, therefore, might be attributed to nongynecologic disorders.
Biology and resource acquisition of mistletoes, and the defense responses of host plants
Authors: Muche Meseret , Muasya A. Muthama , Tsegay Berhanu Abraha 
Published: February 2022

Abstract
Background
Mistletoes are the most successful group of obligatory hemi-parasitic flowering plants that attach to the host via haustorium for obtaining water and minerals. This review aims to assess the current knowledge on mistletoes host plant recognition, haustorium formation, water/minerals acquisition, and host plants’ defense signaling and responses against mistletoe attack.

Results
Some mistletoes are host-specific while others are generalists occurring on a wide range of vascular plants. The host nitrogen (N) content, parasite–host chemical interactions, compatibility, and dispersal agents are the main determinant factors for host specificity. Mistletoes take up substantial amounts of water and minerals passively via apoplastic routes, and most are xylem feeders, but could shift to phloem-feeding during the physiological stress of the host plants. Current evidence highlighted that cell wall loosening and modification are critical during the development of the haustorium in the host tissue. This is made possible by the application of physical pressures by the developing haustorium and cell wall degradation using enzymes (xyloglucan endotransglycosylases, glucanase, expansins, etc.) produced by the mistletoe. Host plants defend against mistletoe infection mechanically by producing spines, lignin, suberin, etc., which discourages dispersers, and chemically defend by killing the infector or inhibiting the establishment of the haustorium using their secondary metabolites such as terpenes, phenolics, and N-containing compounds. Although the host plants' response to mistletoe attack resembles the response to other biotic stresses, unlike short-term stressors, the effect of mistletoe attack is long-term and depends on the parasite load. Infection by mistletoe leads to water and nutrient stress of the host plant and deteriorates its healthy establishment and survival.

Conclusion
Mistletoes are heterogeneous group in the order Santalales which have versatile mechanisms for pollination, seed dispersal and nutrient acquisition from host plants. Infection by mistletoes triggers host plant responses, varying from mechanical to chemical mechanisms which are analogous to herbivory defences, and negatively impacts host plant growth and reproduction.
Spatio-temporal analysis of leprosy risks in a municipality in the state of Mato Grosso-Brazilian Amazon: results from the leprosy post-exposure prophylaxis program in Brazil
Authors: Machado Lúbia Maieles Gomes , dos Santos Emerson Soares , Cavaliero Arielle , Steinmann Peter , Ignotti Eliane 
Published: February 2022

AbstractBackgroundLeprosy post-exposure prophylaxis (LPEP) with single dose rifampicin (SDR) can be integrated into different leprosy control program set-ups once contact tracing has been established. We analyzed the spatio-temporal changes in the distribution of index cases (IC) and co-prevalent cases among contacts of leprosy patients (CP) over the course of the LPEP program in one of the four study areas in Brazil, namely the municipality of Alta Floresta, state of Mato Grosso, in the Brazilian Amazon basin.MethodsLeprosy cases were mapped, and socioeconomic indicators were evaluated to explain the leprosy distribution of all leprosy cases diagnosed in the period 2016–2018. Data were obtained on new leprosy cases [Notifiable diseases information system (Sinan)], contacts traced by the LPEP program, and socioeconomic variables [Brazilian Institute of Geography and Statistics (IBGE)]. Kernel, SCAN, factor analysis and spatial regression were applied to analyze changes.ResultsOverall, the new case detection rate (NCDR) was 20/10 000 inhabitants or 304 new cases, of which 55 were CP cases among the 2076 examined contacts. Changes over time were observed in the geographic distribution of cases. The highest concentration of cases was observed in the northeast of the study area, including one significant cluster (Relative risk = 2.24; population 27 427,P-value < 0.001) in an area characterized by different indicators associated with poverty as identified through spatial regression (Coefficient 3.34,P-value = 0.01).ConclusionsThe disease distribution was partly explained by poverty indicators. LPEP influences the spatial dynamic of the disease and results highlighted the relevance of systematic contact surveillance for leprosy elimination.Graphical Abstract
Determination of atrazine and propazine metabolites deemed endocrine disruptors in human seminal plasma by LC–ESI-MS/MS
Authors: Rodríguez-Robledo Virginia , Vendrell Alberto , García-Cifuentes Alicia , Villaseca-González Noemí , Guiberteau-Cabanillas Carmen , Martínez Lydia Luque , Garde José Julián , Fernández-Santos María Rocío 
Published: February 2022

Abstract
Background
The increasing prevalence of male infertility and the declining trend in sperm quality has been associated to compounds known as “endocrine-disruptors”. The proven endocrine-disrupting effects of atrazine and propazine herbicides led us to conduct long-term research based on highly accurate specific analytical methods with a view to confirming the suspected association. Among the proposed developments was a sensitive analytical method for the simultaneous determination of three metabolites of atrazine and propazine.

Results
In this work, the method was for first time used for the chromatographic separation and determination of deethyl- and deisopropyl-atrazine (DEA and DIA, respectively) and propazine-2-hydroxy (PP-2OH) in human seminal plasma by LC–ESI-MS/MS using deuterated atrazine (d5-AT) as internal standard (IS). Chromatographic and mass spectrometric conditions such as the mobile phase composition and flow-rate, injected volume, dry gas source temperature and flow-rate, nebulizer pressure and capillary voltage were all carefully optimized. Analytes were identified and quantified by using the multiple reaction monitoring (MRM) mode as applied to positive ions ([M + H]+). Transitions at three different m/z values for each analyte were selected from precursor ions, and the 212.1 → [128]+, 188.1 → [146]+ and 174.1 → [68.1]+ transitions for PP-2OH, DEA and DIA, respectively, were found to be quantitative. The proposed method was validated in terms of precision (repeatability and reproducibility), linear range (10–240 ng mL–1), limit of detection (150–210 pg mL–1), and quantification (500–700 pg mL–1), recovery, accuracy and matrix effects on extracts from variably treated seminal plasma samples. The overall analytical method was successfully applied to human seminal plasma samples from volunteers. PP-2OH was found at concentrations from 1.10 to 11.3 ng mL–1 in four of the six samples, and so was DIA at 9.60 ng mL–1 in one.

Conclusions
These results are suggestive of bioaccumulation of the target analytes in humans. Untargeted analytes including suspected parent molecules (atrazine and propazine) and other ions [viz., deethyldeisopropyl-atrazine (DD) and diamino-s-chlorotriazine (DACT)] were also detected under the working conditions used. These results may open up new prospects for as yet very incipient research into the bioaccumulation of endocrine disruptors in seminal plasma.

Graphical Abstract
Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis
Authors: Pozuelo-Carrascosa Diana P. , Cobo-Cuenca Ana Isabel , Carmona-Torres Juan Manuel , Laredo-Aguilera Jose Alberto , Santacruz-Salas Esmeralda , Fernandez-Rodriguez Ruben 
Published: February 2022

Abstract
Background
The evidence about the best body position to prevent ventilator-associated pneumonia (VAP) is unclear. The aim of this study was to know what the best body position is to prevent VAP, shorten the length of intensive care unit (ICU) and hospital stay, and reduce mortality among patients undergoing mechanical ventilation (MV).

Methods
We performed a network meta-analysis of randomized controlled trials including intubated patients undergoing MV and admitted to an ICU. The assessed interventions were different body positions (i.e., lateral, prone, semi-recumbent) or alternative degrees of positioning in mechanically ventilated patients.

Results
Semi-recumbent and prone positions showed a risk reduction of VAP incidence (RR: 0.38, 95% CI: 0.25–0.52) and mortality (RR: 0.70, 95% CI: 0.50–0.91), respectively, compared to the supine position. The ranking probabilities and the surface under the cumulative ranking displayed as the first best option of treatment the semi-recumbent position to reduce the incidence of VAP (71.4%), the hospital length of stay (68.9%), and the duration of MV (67.6%); and the prone position to decrease the mortality (89.3%) and to reduce the ICU length of stay (59.3%).

Conclusions
Cautiously, semi-recumbent seems to be the best position to reduce VAP incidence, hospital length of stay and the duration of MV. Prone is the most effective position to reduce the risk of mortality and the ICU length of stay, but it showed no effect on the VAP incidence.
Registration PROSPERO CRD42021247547
Comparison between total least squares and ordinary least squares in obtaining the linear relationship between stable water isotopes
Authors: Lee Jeonghoon , Lee Won Sang , Jung Hyejung , Lee Seung-Gu 
Published: February 2022

AbstractThe linear relationship between two stable water isotopes (δD and δ18O) has been used to examine the physical processes and movements or changes of three water phases (water vapor, liquid water and ice), including deuterium excess. The ordinary least squares (OLS) method has been the most commonly used method to fit the linear relationship between two isotopic compositions of water. However, an alternative method, the total least squares (TLS) method, has been proposed because it considers the presence of errors in the explanatory variable (horizontal axis, δ18O). However, not many studies have examined the differences of the relationship using two stable isotopes between the OLS and TLS for various types of water. In this work, these two methods were compared using isotopic compositions of three types of water (Antarctic snow, water vapor and summer and winter rainfall). Statistically, the slopes and intercepts obtained by the two linear regression methods were not significantly different except for summer rainfall, which has the smallest coefficient of variations (R2). The TLS method produced larger slopes than the OLS method and the degrees of difference between the two methods were greater when the coefficient of variation was lower. In addition, with a Monte Carlo method, we showed that the differences between the two methods increased as the uncertainty increased. Moreover, the results of Bayesian linear regression were consistent with the two linear regressions. Although the TLS method is theoretically more suited to the linear regression for the stable water isotopes than the OLS method is, the application of the widely used OLS method can be recommended in the case of small measurements uncertainties after testing whether the linear parameters, slopes and intercepts, derived from the two methods are statistically significant different.
Characteristics of Complex Systems in Sports Injury Rehabilitation: Examples and Implications for Practice
Authors: Yung Kate K. , Ardern Clare L. , Serpiello Fabio R. , Robertson Sam 
Published: February 2022

AbstractComplex systems are open systems consisting of many components that can interact among themselves and the environment. New forms of behaviours and patterns often emerge as a result. There is a growing recognition that most sporting environments are complex adaptive systems. This acknowledgement extends to sports injury and is reflected in the individual responses of athletes to both injury and rehabilitation protocols. Consequently, practitioners involved in return to sport decision making (RTS) are encouraged to view return to sport decisions through the complex systems lens to improve decision-making in rehabilitation. It is important to clarify the characteristics of this theoretical framework and provide concrete examples to which practitioners can easily relate. This review builds on previous literature by providing an overview of the hallmark features of complex systems and their relevance to RTS research and daily practice. An example of how characteristics of complex systems are exhibited is provided through a case of anterior cruciate ligament injury rehabilitation. Alternative forms of scientific inquiry, such as the use of computational and simulation-based techniques, are also discussed—to move the complex systems approach from the theoretical to the practical level.
Hybrid high-intensity interval training using functional electrical stimulation leg cycling and arm ski ergometer for people with spinal cord injuries: a feasibility study
Authors: Vestergaard M. , Jensen K. , Juul-Kristensen B. 
Published: February 2022

Abstract
Aim
The aim was to assess safety and feasibility of Hybrid High-Intensity Interval Training (HIIT) using Functional Electrical Stimulation (FES) leg cycling and arm ski ergometer in people with Spinal Cord Injuries (SCI).

Method
Eight outpatients (mean age 42.8 years; 7 men) with stable SCI paraplegia (mean 14.5 years since injury) participated in hybrid HIIT (90% peak watts; 4 × 4–min intervals), three times a week (over 8 weeks). Primary outcomes were Adverse Events (AE), participant acceptability, shoulder pain, training intensity (% peak watts), and attendance.
Secondary outcomes were effect on peak oxygen uptake (VO2peak) during FES hybrid poling, mean watts, self-reported leisure time physical activity, quality of life, and fatigue.

Results
No serious AE occurred; acceptability with the training modality was high, while shoulder pain increased by 9% (SD 95.2). During training, 50% of the participants reached > 90% peak watts during the intervals, three with the legs (FES cycle) and one with the arms (Ski-Erg). Overall, mean training intensity (% peak watts) was 92% (SD 18.9) for legs and 82% (SD 10.3) for arms. Proportion of fulfilled training minutes was 82% (range 36–100%); one participant dropped out after 6 weeks due to back pain. Mean VO2peak increased by 17% (SD 17.5). Participants reported increased leisure time physical activity and health-related quality of life, besides reduced fatigue.

Conclusion
Hybrid HIIT was safe for people with SCI paraplegia. The majority of the criteria for feasibility were met with acceptable attendance rate, limited drop out, participants enjoyed training, and increased VO2peak and mean watts. However, the intensity of 90% peak watts was reached by < 60% of the participants despite high RPE ratings during training. The method of measuring and calculating intensity needs to be studied further before a study using this HIIT protocol is undertaken.

Trial registration
Clinicaltrials.gov, NCT04211311, registered 12 December 2019 retrospectively registered