bluuebunny/crossref_metadata_2025_split huggingface dataset:
Everyday work, working culture and patient care. A qualitative study on professionals’ perceptions of the establishment of a specialized brief therapy unit in a district psychiatric center.
Authors: Markussen Hilde Våbenø , Aasdahl Lene , Rise Marit By 
Published: April 2020

Abstract
Background: Increasing mental health problems and a scarcity of treatment resources put pressure on service innovation in mental health services. Innovative efforts include providing brief or short-term treatment to patients who have moderate mental health problems. So far, there is limited knowledge on how implementing brief therapy approaches in mental health organizations influence the professionals and their work. The aim of this study was to explore the professionals’ perceptions on how the establishment of a specialized brief therapy unit in a district psychiatric center had affected the work in the outpatient clinics, specifically the everyday work, working culture and patient care. Methods: Eleven professionals, five men and six women, took part in semi-structured individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Results: The professionals’ experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were by some, perceived as “forgotten”. (3) The establishment process had elucidated different treatment cultures in the outpatient clinics and had set off (3) a discussion regarding the criteria for prioritizing in mental health services. Conclusion: Implementation of new services calls attention to the distribution of scarce resources and differences in professional cultures. A strong focus on efficiency might challenge professionals’ perceptions of autonomy. Focusing on patients with moderate mental health problems can raise questions concerning resource use and the appropriate level of treatment provision. Before implementing new services, it is important to ensure information and, if possible, understanding for the process in the organization.
Comparison of adenocarcinoma and adenosquamous carcinoma prognoses in Chinese patients with FIGO stage IB-IIA cervical cancer following radical surgery
Authors: Lou hanmei , Zhang Xiaojing , Lv Zunfu , Xu Xiaoxian , Yin Zhuomin 
Published: April 2020

Abstract
Objective To compare adenocarcinoma (AC) and adenosquamous carcinoma (ASC) prognoses in patients with FIGO stage IB–IIA cervical cancer who underwent radical hysterectomy. Methods We performed a retrospective analysis of 240 patients with AC and 130 patients with ASC. Kaplan–Meier curves, Cox regression models, and log-rank tests were used for statistical analysis. Results Patients with ASC had higher frequencies of lymphovascular space invasion (LVSI) and serum squamous cell carcinoma antigen (SCC-Ag) >5 ng/ml ( p =0.049 and p =0.013, respectively); moreover, they were much older ( P =0.029) than patients with AC. There were no clinically significant differences in overall survival between the groups. When stratified into three risk groups based on clinicopathological features, survival outcomes did not differ between patients with AC and those with ASC in the three risk groups. Multivariate analysis showed that lymph node metastasis (LNM) was an independent risk factor for RFS and OS in patients with AC and in patients with ASC. Carcinoembryonic antigen (CEA) >5 ng/ml and SCC-Ag >5 ng/ml were independent risk factors for RFS and OS in patients with AC. In addition, among those stratified as intermediate-risk, patients with ASC who received concurrent chemoradiotherapy (CCRT) had a significantly better RFS and OS ( P =0.036, and P =0.047 for RFS and OS, respectively). Conclusion We did not find evidence to suggest that AC and ASC subtypes of cervical cancer were associated with different survival outcomes. CCRT is beneficial to survival for intermediate-risk-group patients with ASC, but not those with AC. Serum tumour markers can assist in evaluating prognosis and in providing additional information for patient-tailored therapy for cervical AC.
Emerging SARS-CoV-2 mutation hot spots include a novel RNA-dependent-RNA polymerase variant
Authors: Pachetti Maria , Marini Bruna , Benedetti Francesca , Giudici Fabiola , Mauro Elisabetta , Storici Paola , Masciovecchio Claudio , Angeletti Silvia , Ciccozzi Massimo , Gallo Robert Charles , Zella Davide , Ippodrino Rudy 
Published: April 2020

Abstract
Background. SARS-CoV-2 is a RNA coronavirus responsible for the pandemic of the Severe Acute Respiratory Syndrome (COVID-19). RNA viruses are characterized by a high mutation rate, up to a million times higher than that of their hosts. Virus mutagenic capability depends upon several factors, including the fidelity of viral enzymes that replicate nucleic acids, as SARS-CoV-2 RNA dependent RNA Polymerase (RdRp). Mutation rate drives viral evolution and genome variability, thereby enabling viruses to escape host immunity and to develop drug resistance. Methods. We analyzed 220 genomic sequences from the GISAID database derived from patients infected by SARS-CoV-2 worldwide from December 2019 to mid-March 2020. SARS-CoV-2 reference genome was obtained from the GenBank database. Genomes alignment was performed using Clustal Omega. Mann-Whitney and Fisher-Exact tests were used to assess statistical significance.Results. We characterized 8 novel recurrent mutations of SARS-CoV-2, located at positions 1397, 2891, 14408, 17746, 17857, 18060, 23403 and 28881. Mutations in 2891, 3036, 14408, 23403 and 28881 positions are predominantly observed in Europe, whereas those located at positions 17746, 17857 and 18060 are exclusively present in North America. We noticed that the 14408 mutation, emerged for the first time in Europe in mid-February 2020, is present in the SARS-CoV-2 RdRp gene sequence. Viruses with RdRp mutation have a median of 3 point mutations [range: 2-5], otherwise they have a median of 1 mutation [range: 0-3] (p value < 0.001). Conclusions. These findings suggest that the virus is evolving and European, North American and Asian strains might coexist, each of them characterized by a different mutation pattern. The contribution of the mutated RdRp to this phenomenon needs to be investigated. To date, several drugs targeting RdRp enzymes are being employed for SARS-CoV-2 infection treatment. Some of them have a predicted binding moiety in a SARS-CoV-2 RdRp hydrophobic cleft, which is adjacent to the 14408 mutation we identified. Consequently, it is important to study and characterize SARS-CoV-2 RdRp mutation in order to assess possible drug-resistance viral phenotypes. It is also important to recognize whether the presence of some mutations might correlate with different SARS-CoV-2 mortality rates.
A heuristic model for collaborative practice – Part 1: A meta-synthesis of empirical findings on collaborative strategies in community mental health and substance abuse practice
Authors: Sundet Rolf , Kim Hesook Suzie , Karlsson Bengt , Borg Marit , Sælør Knut Tore , Ness Ottar 
Published: April 2020

Abstract
Background Collaboration has become a cornerstone for healthcare practice in recent decades resulting in the efforts at international and national levels to integrate the concept into healthcare practice and services. However, there is a paucity of research delineating strategies for professionals to apply in collaborative practice with clients in general as well as in mental health and substance abuse (MHSA) care. Methods The method applied in this paper is a form of qualitative meta-synthesis referring to the integration of findings from multiple qualitative studies within a program of research by the same investigators. Eighteen empirical papers with the focus on community MHSA practice and recovery-orientation with relevance to the service user-professional relationship in MHSA practice were included in this meta-synthesis. Results Three types of processes of collaboration specified by meta-themes were identified. The meta-themes of the interactive-dialogical process type include (a) maintaining human relationship, (b) walking alongside, (c) information sharing, (d) seizing the present moment, (e) taking the perspective of the other, and (f) aligning/scaffolding. The meta-themes of the negotiated-participatory engagement type include (a) feedback-informing process, (b) putting differences to work, (c) negotiated partnering, (d) accommodating user participation, and (e) addressing the tension between help and control. The meta-themes of the negotiated supportive process type are (a) helping in context, (b) coordinating, (c) pulling together, (d) advocating, and (e) availing. These meta-themes are strategies for collaboration applicable in MHSA practice.
Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort
Authors: Melén Erik , Bergström Anna , Kull Inger , Almqvist Catarina , Andersson Niklas , Asarnoj Anna , Borres Magnus P , Georgellis Antonis , Pershagen Göran , Westman Marit , Hage Marianne van , Ballardini Natalia 
Published: April 2020

Abstract
Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based birth cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4,089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3,069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46 - 1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93 - 1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.
Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients
Authors: Liest Ann-Lisbeth , Rosenberg Per , Omran Ahmed Shaker , Mikiver Rasmus , Uppugunduri Srinivas 
Published: April 2020

Abstract
Introduction: Epithelial Ovarian Cancer, tubal- and peritoneal cancer (EOC) is still the major cause of death in gynecological cancer. The outcome of primary surgery is an important prognostic factor. The primary aim of this study was to study the utility of HE4 and CA125 in monitoring the response of chemotherapy during treatment and in predicting prognosis and recurrence during follow-up. We have also evaluated the role of HE4 as a predictor of the result of surgical intervention. Methods: Seventy-eight patients scheduled for chemotherapy were monitored with serum HE4 and CA125 during treatment and follow-up. In 39 patients samples for tumor markers were also obtained prior to surgical intervention. Results: Both HE4 and CA125 decreased in response to treatment. PFS and OS were strongly dependent on HE4 levels prior to start of chemotherapy with significantly prolonged PFS and OS when HE4 levels were under upper reference limit of 82 pmol/L (P=0.018 resp. P<0.001). The levels of HE4 correlated with primary surgical outcome with significantly lower postoperative HE4 in the radically operated group (P<0.001). An increase in HE4 and/or CA125, signals a recurrence 3-6 months before diagnosis. Median levels for both HE4 and CA125 before start, during and at the end of treatment were significantly higher for platinum resistant patients (P<0.005). Conclusion: Both tumor markers are valuable in monitoring the response of chemotherapy as well as in predicting recurrence during follow-up. Postoperative HE4 holds promise as an objective marker to evaluate the result of surgery and is highly predictive for future prognosis.
COL4A1 promotes the growth and metastasis of hepatocellular carcinoma cells by activating FAK-Src signaling
Authors: Wang Ting , Jin Haojie , Hu Jingying , Ran Haoyu , Xu Huili , Wei Lin , Gu Jianren , Qin Wenxin , Luo Xiaoying , Hao Yujun 
Published: April 2020

Abstract
Background: Collagens are the most abundant proteins in extra cellular matrix and important components of tumor microenvironment. Recent studies have showed that aberrant expression of collagens can influence tumor cell behaviors. However, their roles in hepatocellular carcinoma (HCC) are poorly understood. Methods: In this study, we screened all 44 collagen members in HCC using whole transcriptome sequencing data from the public datasets, and collagen type IV alpha1 chain (COL4A1) was identified as its most significantly differential expression. Expression of COL4A1 was detected in HCC samples by quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). Relationship between COL4A1 expression and clinicopathological parameters was also analyzed. Finally, functions and potential mechanisms of COL4A1 were explored in HCC progression. Results: COL4A1 is the most significantly overexpressed collagen gene in HCC and it closely correlates with clinical stage. Upregulation of COL4A1 facilitates the proliferation, migration and invasion of HCC cells through FAK-Src signaling. Expression of COL4A1 is upregulated by RUNX1 in HCC. HCC cells with high COL4A1 expression are sensitive to the treatment with FAK or Src inhibitor. Conclusion: COL4A1 facilitates growth and metastasis in HCC via activation of FAK-Src signaling. High level of COL4A1 may be a potential biomarker for diagnosis and treatment with FAK or Src inhibitor for HCC.
Prevalence of multimorbid degenerative lumbar spinal stenosis with knee and/or hip osteoarthritis: protocol for a systematic review and meta-analysis
Authors: Young James J. , Hartvigsen Jan , Jensen Rikke K. , Roos Ewa M. , Ammendolia Carlo , Juhl Carsten Bogh 
Published: April 2020

Abstract
Background: Lumbar spinal stenosis (LSS) and knee and hip osteoarthritis (OA) are prevalent conditions in the aging population and previous literature suggests they share many symptoms and are present at the same time in patients. However, no prevalence estimates of multimorbid LSS and knee and/or hip OA are currently available. The primary objective of this systematic review is therefore to estimate the prevalence of multimorbid LSS with knee and/or hip OA using radiological, clinical, and combined case definitions. Methods: This systematic review protocol has been designed according to the guidelines from the Cochrane Collaboration and are reported according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A comprehensive search will be performed in the following databases: MEDLINE, EMBASE, CENTRAL, and CINAHL. Web of Science will be used for forward citation tracking. No restriction in the search for publication data and language will be applied, but only articles in English will be included. The search strategy will include the following domains: LSS, knee OA, and hip OA. Retrieved citations will be screened by two authors independently. Disagreements will be discussed until consensus, or a third reviewer will be consulted if consensus cannot be reached. Data extraction and assessment of methodological quality will be done by two authors independently, using a standardized data extraction form and modified Risk of Bias Tool for Prevalence studies. Meta-analysis estimating prevalence with 95% CI will be performed using a random effects model. Meta-regression analyses will be performed to investigate the impact of LSS clinical presentations, sample population, healthcare setting, risk of bias, and other patient characteristics on prevalence estimates for multimorbid LSS and knee and/or hip OA. Discussion: The results of this review will provide the first estimates of the prevalence of multimorbid LSS and hip and knee OA based on various case definitions. The impact of covariates such as LSS clinical presentations, sample population, healthcare setting, risk of bias, and patient characteristics on prevalence estimates will also be presented. These findings will help to better understand the relationship between LSS and knee and/or hip OA and identify future research priorities. Systematic review registration: Submitted to PROSPERO, awaiting registration Keywords: Lumbar spinal stenosis, Hip osteoarthritis, Knee osteoarthritis, Multimorbidity, Prevalence, Systematic review protocol
Impact of Early Postoperative Oral Nutritional Supplement Utilization on Clinical Outcomes in Colorectal Surgery
Authors: Williams David G.A. , Ohnuma Tetsu , Krishnamoorthy Vijay , Raghunathan Karthik , Sulo Suela , Cassady Bridget A. , Hegazi Refaat , Wischmeyer Paul E. 
Published: April 2020

Abstract
Background: Small randomized trials of early postoperative oral nutritional supplementation (ONS) suggest various health benefits following colorectal surgery (CRS). However, real-world evidence of the impact of early ONS on clinical outcomes in CRS is lacking.Methods: Using a nationwide administrative-financial database (Premier Healthcare Database), we examined the association between early ONS use and postoperative clinical outcomes in patients undergoing elective open or laparoscopic CRS between 2008–2014. Early ONS was defined as the presence of charges for ONS before postoperative day (POD) 3. The primary outcome was composite infectious complications. Key secondary efficacy (intensive care unit (ICU) admission and gastrointestinal complications) and falsification (blood transfusion and myocardial infarction) outcomes were also examined. Propensity score matching was used to assemble patient groups that were comparable at baseline and differences in outcomes were examined.Results: Overall, patients receiving early ONS were older with greater comorbidities, and more likely to be Medicare beneficiaries with malnutrition. In a well-matched sample of early-ONS recipients (n=267) versus non-recipients (n= 534), infectious complications were significantly lower in early-ONS recipients (6.7% vs. 11.8%, P<0.03). Early-ONS use was also associated with significantly reduced rates of pneumonia (P<0.04), ICU admissions (P<0.04), and gastrointestinal complications (P<0.05). There were no significant differences in falsification outcomes. Conclusions: Although early postoperative ONS after CRS was more likely to be utilized in elderly patients with greater comorbidities, use of early ONS was associated with reduced infectious complications, pneumonia, ICU admission, and gastrointestinal complications. This propensity-score matched study using real-world data suggests that clinical outcomes are improved with early ONS use, a simple and inexpensive intervention in CRS patients.
A Cluster Randomized Trial of Delivery of Intermittent Preventive Treatment of Malaria in Pregnancy at the Community Level in Burkina Faso
Authors: Gutman Julie , Stephens Daniel K , Tiendrebeogo Justin , Badolo Ousmane , Dodo Mathurin , Burke Danielle , Williamson John , Vibbert Kristen , Youll Susan J , Savadogo Yacouba , Brieger William R. 
Published: April 2020

Abstract
Background: Malaria in pregnancy is responsible for 8–14% of low birth weight and 20% of stillbirths in sub-Saharan Africa. To prevent these adverse consequences, the World Health Organization recommends intermittent preventive treatment of pregnant women (IPTp) with sulfadoxine-pyrimethamine be administered at each ANC visit starting as early as possible in the second trimester. Global IPTp coverage in targeted countries remains unacceptably low. Community delivery of IPTp was explored as a means to improve coverage. Methods: A cluster randomized, controlled trial was conducted in 12 health facilities in a 1:1 ratio to either an intervention group (IPTp delivered by CHWs) or a control group (standard practice, with IPTp delivered at HFs) in three districts of Burkina Faso to assess the effect of IPTp administration by community health workers (CHWs) on the coverage of IPTp and antenatal care (ANC). The districts and facilities were purposively selected taking into account malaria epidemiology, IPTp coverage, and the presence of active CHWs. Pre- and post-intervention surveys were carried out in March 2017 and July–August 2018, respectively. A difference in differences (DiD) analysis was conducted to assess the change in coverage of IPTp and ANC over time, accounting for clustering at the health facility level. Results: Altogether 374 and 360 women were included in the baseline and endline surveys, respectively. At baseline, women received a median of 2.1 doses; by endline, women received a median of 1.8 doses in the control group and 2.8 doses in the intervention group (p-value <.0001). There was a non-statistically significant increase in the proportion of women attending four ANC visits in the intervention compared to control group (DiD= 12.6%, p-value= 0.16). By the endline, administration of IPTp was higher in the intervention than control, with a DiD of 17.6% for IPTp3 (95% confidence interval (CI) -16.3, 51.5; p-value 0.31) and 20.0% for IPTp4 (95% CI -7.2, 47.3; p-value= 0.15). Conclusions: Community delivery of IPTp could potentially lead to a greater number of IPTp doses delivered, with no apparent decrease in ANC coverage.