bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary transitional cell carcinoma of the fallopian tube
Authors: Lee Dong-Hyun , Cho Dong-Hyu , Kim Kyoung Min , Yim Chang-Yeol , Lee Na-Ri 
Published: May 2020

Abstract

Introduction:
Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor.

Patient concerns:
A 79-year-old woman presenting with vaginal discharge.

Diagnosis:
Pelvic magnetic resonance imaging revealed a predominantly solid mass with a lobulated contour, measuring 5.5 cm × 4.6 cm, in the left ovary. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological analysis revealed a high-grade TCC, measuring 7.5 cm × 4 cm, in the left fallopian tube (International Federation of Gynecology and Obstetrics stage IIB).

Intervention:
Forty-three months postoperation, recurrence was diagnosed as peritoneal metastasis. The patient underwent 6 cycles of palliative chemotherapy consisting of cisplatin and gemcitabine, the recommended regimen for TCC of the urinary tract.

Outcome:
The patient has survived for 27 months without recurrence after palliative chemotherapy, 76 months after diagnosis.

Conclusion:
It is rare that primary TCC of the fallopian tube responds to a urinary tract treatment regimen for TCC, even when followed up for an extended period. More research is warranted to determine which treatment regimen will benefit patients the most.
Effects of compound Caoshi silkworm granules on stable COPD patients and their relationship with gut microbiota
Authors: Hu Yibing , Shi Qinghuan , Ying Songmin , Zhu Dan , Chen Hui , Yang Xiguang , Xu Jilin , Xu Feila , Tao Feibao , Xu Bin 
Published: May 2020

Abstract

Background and purpose:
Patients with chronic obstructive pulmonary disease (COPD) usually experience recurrent acute exacerbations. These patients, especially those with stable COPD, require an effective intervention for treating exacerbations. This study aimed to evaluate the efficacy of Compound Caoshi silkworm granules (CCSGs) in stable COPD patients and to investigate their potential mechanism.

Methods:
A randomized controlled trial was performed at Jinhua Hospital, Zhejiang University. Patients were enrolled in this study if they met the criterion of stable COPD. A total of 40 patients were randomly divided into the following 2 groups: Group A (n = 20, routine treatment (RT) group) and Group B (n = 20, RT plus CCSGs [RT plus CCSGs] group). The duration of treatment was 3 months. Stool samples were collected from all patients on day 0 and the gut microbiota was analyzed using 16s rRNA sequencing. The St. George's Respiratory Questionnaire (SGRQ) scores and lung function were assessed at month 0 and month 3.

Results:
The components of gut microbiota differed between stable COPD patients and the healthy population. The RT plus CCSGs group showed improved SGRQ scores compared to the RT group. There was no difference in forced expiratory volume-one second, forced vital capacity, and forced expiratory volume-one second/forced vital capacity between the two groups. Furthermore, the abundance of gut microbiota in patients with the top 10 SGRQ scores (Group N) differed from the abundance of gut microbiota in those with the lowest 10 SGRQ scores (Group T).

Conclusion:
CCSGs have beneficial effects in the improvement of symptoms in stable COPD patients over a 3-month treatment period. The potential underlying mechanism may be attributable to the difference in gut microbiota among patients. However, more research is needed to confirm this conclusion.
A Systematic Review of Intra-Articular Ketamine for Postoperative Analgesia
Authors: Covington Stephen M. , D’Souza Ryan S. , Erwin Patricia J. , Qu Wenchun 
Published: May 2020

Background
This systematic review appraises the evidence from human clinical trials comparing postoperative pain scores and opioid consumption in patients receiving intra-articular ketamine versus other modalities of analgesia after orthopedic joint procedures.

Methods
Studies were identified from Embase, Scopus, and OVID Medline databases. Included studies compared patients receiving intra-articular ketamine versus other modalities of analgesia. The primary outcome of interest was postprocedural pain score and total opioid consumption, whereas secondary outcomes included time to rescue analgesic medication request, active range of motion, time to mobilization, and adverse effects.

Results
Seventeen studies were included. Dosage of ketamine varied widely from 0.25 to 2 mg/kg. Fifteen of 17 demonstrated decreased overall pain scores and decreased total postoperative opioid consumption in patients receiving intra-articular ketamine versus control groups. Included studies generally demonstrated reduced time to mobilization and increased latency until rescue analgesic medication in the intra-articular ketamine group.

Conclusions
Patients who received intra-articular ketamine generally reported lower pain scores and had lower postoperative opioid consumption after orthopedic joint procedures. This suggests that the intra-articular route of ketamine delivery may be a useful analgesic modality, although future larger-scale trials should explore its pharmacokinetics, optimal dosing, safety, and cost-effectiveness.
Engaging Children as Simulated Patients in Healthcare Education
Authors: Budd Natasha , Andersen Patrea , Harrison Penny , Prowse Nycole 
Published: May 2020

Summary Statement
The value of “simulation” as a learning strategy is well established among healthcare professionals (Educ Prim Care 2015; 26(4):242–7).1 The use of “simulated patients (SPs)” to present real-world scenarios provides opportunities for students to develop “soft skills,” including interpersonal communication, critical thinking, and problem solving.4 These skills are particularly relevant in pediatric care, where healthcare providers must consider the patient's cognitive development, emotional state, and familial context. This article focuses on middle childhood (6–12 years)11 a distinctive developmental stage between 2 major developmental transition stages: infancy and adolescence. Middle childhood is associated with compulsory school attendance, developing skills in self-discipline, conflict resolution, and decision-making. Child SPs can play an important role in healthcare education providing direct insight into this unique period of development. They can contribute to the design and delivery of simulations to increase fidelity and provide meaningful real-time feedback to learners on children's experience of the healthcare system. Despite children's expertise and particular care delivery needs, documented simulations using child SPs are limited. This article considers the role of child SPs to support a case for further research into the value of engaging middle years children in the development and delivery of “simulation-based learning experiences”.4 It addresses the gap in child-focused education, the challenges inherent in working with children and outlines strategies and guidelines for effective practice.
Immunotherapeutic options for inflammation in trauma
Authors: Tobin Joshua M. , Gavitt Brian J. , Nomellini Vanessa , Dobson Geoffrey P. , Letson Hayley L. , Shackelford Stacy A. 
Published: May 2020

BACKGROUND
Surgical management of trauma in the last 20 years has evolved in parallel with the military's experience in the current conflicts. Therapies such as widespread tourniquet use, empiric administration of fresh frozen plasma, and airborne intensive care units had been viewed skeptically but are now common practice. There is an opportunity to expand the envelope of care even further through similarly innovative approaches and varied avenues of research.

RESULTS
As the molecular biology of trauma is elucidated, research methodologies must also be developed to capitalize on innovative approaches to resuscitation. Blood component therapy and control of bleeding remain as the fundamental concepts in trauma care. The inflammo-immune response to injury, however, plays an increasingly recognized role in recovery of organ function. Perhaps the inflammatory cascade of trauma can be manipulated to extend the treatment envelope of at risk trauma patients.
In trauma, the additional challenge of delivering effective treatment, often required very early after injury, necessitates the development of treatments to be implemented on the front lines of trauma care that are cost-effective, portable, and environmentally stable. Future conflicts may not offer ready access to high-level surgical care; therefore, resuscitative therapies will be needed for wounded service members because they are evacuated to the surgeon. Manipulation of the inflammatory response to trauma may offer a solution. As our understanding of the immune response continues to develop, the potential for improved outcomes for the wounded expands.

CONCLUSION
A review of basic concepts in immunology is necessary to appreciate any potential impact of immunotherapeutic approaches to trauma and inflammation. An overview of current options will focus on outcome benefits of available therapies and suggest possible areas for future investigation. Quantitative approaches will leverage basic science to identify high-yield strategies to improve care of the injured combatant.

LEVEL OF EVIDENCE
Review, level III.
Long-term Outcome of Orthotopic Liver Transplantation in Patients With Hemochromatosis: A Summary of a 30-year Transplant Program
Authors: Dobrindt Eva Maria , Keshi Eriselda , Neulichedl Julian , Schöning Wenzel , Öllinger Robert , Pratschke Johann , Eurich Dennis 
Published: May 2020

Background.
Hemochromatosis (HC) is an autosomal recessive disease characterized by impaired iron metabolism and a rare indication for orthotopic liver transplantation (LT). Data about iron reaccumulation and remodeling of the liver graft after LT are limited. Therefore, we performed an evaluation of the histopathologic changes during long-term follow-up in patients with HC.

Methods.
A retrospective analysis of patients undergoing LT at our center between 1990 and 2016 identified 29 patients with HC. End points were the evaluation of post-LT iron reaccumulation and the stage of fibrosis as well as the degree of inflammation of the liver graft. Secondary end points were patient survival and postoperative complications.

Results.
The median age was 52.7 y, and there were more male (82.8%) than female patients (17.2%). Post-LT serum ferritin values (>1000 μg/L) were only temporarily elevated in 2 patients. The median estimated survival after LT was 45.5 mo (0.1–285.9 mo). Twenty patients (69%) died during follow-up of 10 y. The survival of patients with HC was significantly worse (P = 0.001) when compared with the overall cohort of patients undergoing LT because of to other causes.

Conclusions.
There was no significant iron overload detected in patients with HC after LT, and only minimal iron deposits were described in liver biopsies. Nevertheless, patients suffering from HC show a lower post-LT survival when compared with patients without iron storage disease but mostly because of extrahepatic causes.
Hoogsteen base pairs increase the susceptibility of double-stranded DNA to cytotoxic damage
Authors: Xu Yu , Manghrani Akanksha , Liu Bei , Shi Honglue , Pham Uyen , Liu Amy , Al-Hashimi Hashim M. 
Published: May 2020

AbstractAs the Watson-Crick faces of nucleobases are protected in double-stranded DNA (dsDNA), it is commonly assumed that deleterious alkylation damage to the Watson-Crick faces of nucleobases predominantly occurs when DNA becomes single-stranded during replication and transcription. However, damage to the Watson-Crick faces of nucleobases has been reported in dsDNAin vitrothrough mechanisms that are not understood. In addition, the extent of protection from methylation damage conferred by dsDNA relative to single-stranded DNA (ssDNA) has not been quantified. Watson-Crick base-pairs in dsDNA exist in dynamic equilibrium with Hoogsteen base-pairs that expose the Watson-Crick faces of purine nucleobases to solvent. Whether this can influence the damage susceptibility of dsDNA remains unknown. Using dot-blot and primer extension assays, we measured the susceptibility of adenine-N1 to methylation by dimethyl sulfate (DMS) when in an A-T Watson-Crick versus Hoogsteen conformation. Relative to unpaired adenines in a bulge, Watson-Crick A-T base-pairs in dsDNA only conferred ~130-fold protection against adenine-N1 methylation and this protection was reduced to ~40-fold for A(syn)-T Hoogsteen base-pairs embedded in a DNA-drug complex. Our results indicate that Watson-Crick faces of nucleobases are accessible to alkylating agents in canonical dsDNA and that Hoogsteen base-pairs increase this accessibility. Given the higher abundance of dsDNA relative to ssDNA, these results suggest that dsDNA could be a substantial source of cytotoxic damage. The work establishes DMS probing as a method for characterizing A(syn)-T Hoogsteen base pairsin vitroand also lays the foundation for a sequencing approach to map A(syn)-T Hoogsteen and unpaired adenines genome-widein vivo.
Unspecific post-mortem findings despite multiorgan viral spread in COVID-19 patients
Authors: Remmelink Myriam , De Mendonça Ricardo , D’Haene Nicky , De Clercq Sarah , Verocq Camille , Lebrun Laetitia , Lavis Philomène , Racu Marie-Lucie , Trépant Anne-Laure , Maris Calliope , Rorive Sandrine , Goffard Jean-Christophe , Dewitte Olivier , Peluso Lorenzo , Vincent Jean-Louis , Decaestecker Christine , Taccone Fabio Silvio , Salmon Isabelle 
Published: May 2020

AbstractBackgroundPost-mortem studies can provide important information for understanding new diseases and small autopsy case series have already reported different findings in COVID-19 patients.MethodsWe evaluated whether some specific post-mortem features are observed in these patients and if these changes are related to the presence of the virus in different organs. Complete macroscopic and microscopic autopsies were performed on different organs in 17 COVID-19 non-survivors. Presence of SARS-CoV-2 was evaluated with immunohistochemistry (IHC) in lung samples and with real-time reverse-transcription polymerase chain reaction (RT-PCR) test in lung and other organs.ResultsPulmonary findings revealed early-stage diffuse alveolar damage (DAD) in 15 out of 17 patients and microthrombi in small lung arteries in 11 patients. Late-stage DAD, atypical pneumocytes and/or acute pneumonia were also observed. Four lung infarcts, two acute myocardial infarctions and one ischemic enteritis were observed. There was no evidence of myocarditis, hepatitis or encephalitis. Kidney evaluation revealed the presence of hemosiderin in tubules or pigmented casts in most patients. Spongiosis and vascular congestion were the most frequently encountered brain lesions. No specific SARS-CoV-2 lesions were observed in any organ. IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e. lung, heart, spleen, liver, colon, kidney and brain).ConclusionsIn conclusion, autopsies revealed a great heterogeneity of COVID-19-related organ injury and the remarkable absence of any specific viral lesions, even when RT-PCR identified the presence of the virus in many organs.
Collaborative contracting in the Singapore construction industry: current status, major barriers and best solutions
Authors: Zhang Na , Hwang Bon-Gang , Deng Xiaopeng , Tay Fiona 
Published: May 2020

PurposeCollaborative contracting (CC) is the direction that Singapore is venturing into in line with the Construction Industry Transformation Map. For its successful adoption, it is necessary to examine the potential barriers and possible solutions. Therefore, this study aims to explore the current status, major barriers and best solutions for the adoption of CC in the Singapore construction industry.Design/methodology/approachTo achieve these objectives, a comprehensive literature review was carried out and 26 barriers, as well as 21 solutions, were identified. Then a questionnaire was designed to assess the priority of these barriers and solutions. After a pilot study, 165 questionnaires were distributed, and 31 responses were received. And the survey result was validated by post-survey with three industry professionals.FindingsResults revealed that only a small percent of projects adopted CC in Singapore. Seven significant barriers hindering CC implementation were found out. They are “inherent difficulties in changing organizational culture,” “lack of incentives/financial support,” “lack of legislative regulations,” “resistant to change the current way of working,” “seeking for the lowest cost” and “difficulties in converting strategic decisions to operational levels” and “unclear contract terms and objectives.” Also, five best solutions were suggested to overcome the identified barriers.Originality/valueThe findings of this study could enable industry practitioners to be aware of the potential barriers to adopting CC and choose suitable solutions to overcome these barriers. It is also helpful for authorities to come up with effective policies to promote the adoption of CC.
Existing apartment buildings as a spatial reserve for assisted living
Authors: Kaasalainen Tapio , Huuhka Satu 
Published: May 2020

PurposeAgeing populations induce needs to adapt existing housing. With ageing, the number of frail old people, who require assistance in daily life, is also increased. Converting existing housing into assisted living enables them to remain in their community while receiving necessary support and care. The purpose is to investigate whether post-war mass housing is spatially appropriate for adaptation into group homes for older people.Design/methodology/approachThe research material is attained from Finland. Spatial requirements for group homes are drawn from 130 units built or renovated during 2000–2015. Spatial characteristics of mass housing are mapped from 105 apartment buildings built in the 1970s. The latter are matched with the former by comparing the connectivity of layouts, sizes of units and the numbers and sizes of individual spaces.FindingsGroup homes typically utilize a linear layout, which can easily be created in apartment buildings. Individual spaces of a group home fit apartment buildings effortlessly. Whole group home units mostly prove to be spatially feasible but result in looser dimensioning than is typical in existing units. The mass housing stock can be considered a spatial reserve for adaptation into group homes.Originality/valueThis is the first study to employ a large-scale, multi-case spatial mapping approach to analyse the adaptability properties of mass housing into assisted living. The findings pertain primarily to the Finnish context, but a methodology is presented which can be applied to other countries and also to other spatial functions.
Student food insecurity and the social equity pillar of campus sustainability
Authors: White Stacey Swearingen 
Published: May 2020

Purpose
College and university campuses serve as a vital test bed for sustainability solutions of various types. To date, though, campus sustainability efforts have focused more on the environmental and economic aspects of sustainability, with less attention to its social aspects. This paper aims to draw on a study of student food insecurity to consider how sustainability’s three pillars might be more holistically engaged.

Design/methodology/approach
First, the paper reviews the literature on-campus food sustainability and student food insecurity to propose a preliminary characterization of sustainable food. Second, data from a study of food insecurity among students at a major research university are presented. The survey data measure the degree and attributes of food insecurity among undergraduate and graduate students. The focus group and interview data provide a detailed understanding of students’ experience with food insecurity, particularly with regard to how that experience resonates with the characteristics of sustainable food. Finally, the paper suggests that the systems thinking approach may be the best way to engage the social pillar of sustainability.

Findings
Food insecurity is prevalent among university students. These students find affordability and nutrition to be the most important characteristics of the diets they desire to have. The ability to access such foods conveniently is also important, whereas the sourcing of foods is not resonant.

Research limitations/implications
This is a study of a single campus in the USA. Findings may be different on campuses that have different demographics and other characteristics.

Originality/value
Campus sustainability efforts must fully engage the social aspects of sustainability. This paper uses the example of food and food insecurity to show how and why this is important. It also points to systems thinking approach as appropriate for this holistic effort.
How spatial contexts, institutions and self-identity affect entrepreneurial intentions
Authors: Ndofirepi Takawira Munyaradzi 
Published: May 2020

Purpose
This study aims to examine how spatial contexts, institutions and entrepreneurial self-identity affected the formation of entrepreneurial intentions of a sample of students in Zimbabwe.

Design/methodology/approach
Data were obtained from 284 students enrolled in two vocational education institutions located in Midlands Province of Zimbabwe. To select the respondents, convenience sampling was used. The sample size was determined by the total number of students agreeing to participate in the research. Hypotheses were tested using structural equation modelling (maximum likelihood estimation method).

Findings
Social approval, supportive cultural environment and entrepreneurial self-identity had positive statistically significant direct effects on entrepreneurial intentions. Also, entrepreneurial self-identity partially mediated the effects of social approval and supportive cultural environment on entrepreneurial intentions. The total effect of supportive higher education institutions on entrepreneurial intentions was statistically significant, despite the direct and indirect effects being non-significant.

Practical implications
The findings suggest a need to cultivate supportive social contexts and higher education institutions for nurturing entrepreneurial self-identity and entrepreneurial intentions, factors that are integral to the development of future entrepreneurs.

Originality/value
The study examined the validity of a novel conceptual model based on the contribution of entrepreneurial self-identity, spatial context and institutional variables in shaping entrepreneurial intentions of selected college students in the global south.