bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reference Values and Related Factors for Peak Expiratory Flow in Middle-aged and Elderly Chinese
Authors: Ji Chao , Dai Huixu , Zhao Zhiying , Liu Tiancong , Tong Shuhui , Zhang Xiaohang , Xia Yang 
Published: August 2020

Abstract
Background: Peak expiratory flow (PEF), as an essential index used for screening and monitoring asthma, chronic obstructive pulmonary disease, and respiratory mortality especially in elderly, is recommended especially for low resource settings in low- and middle-income countries. However, few reports have focused on the reference of PEF in China, especially in the middle-aged and elderly. Thus, the aim of this study was to determine age- and sex-specific reference values of PEF in the middle-aged and older Chinese population.Methods: There were 11,717 participants included for reference value analysis and 11,340 participants were included for risk factor analysis. The PEF was measured using a peak flow meter in L/min. The distribution of PEF terciles stratified by sex and age were reported. Multiple linear regression analysis was used to determine the associations between risk factors and PEF.Results: The PEF was higher in men than women across all age subgroups. The value of PEF decreased with age in both men and women. Height, weight, handgrip strength, and household air pollution were positively associated with PEF, and age, waist circumference smoking status were negatively associated with PEF significantly in both men and women (all P <0.05). The mean values were 9.38 L/min and 64.12 L/min for men and women. Meanwhile, the prevalence of low PEF was 1.62% and 2.16% for men and women, respectively.Conclusions: Age- and sex-specific centiles of PEF for the middle-aged and older Chinese population were estimated. The reference values for low PEF were provided for epidemiological studies and clinical practice in the future. Interventions on lung function or respiratory disease should be pay more attention on factors associated with PEF.
In-depth analysis of the genomic landscape of 86 metastatic neuroendocrine neoplasms reveals subtype-heterogeneity and potential therapeutic targets
Authors: Mostert Bianca , Riet Job van , de Werken Harmen van , Cuppen Edwin , Eskens Ferry , Tesselaar Margot , Veenendaal Linde , Klümpen Heinz-Josef , Dercksen Marcus , Valk Gerlof , Lolkema Martijn , Sleijfer Stefan 
Published: August 2020

Abstract
Metastatic neuroendocrine neoplasms (mNEN) form clinically and genetically heterogeneous malignancies, characterized by distinct prognoses based upon primary tumor localization, functionality, grade, proliferation index and diverse outcomes to treatment. Here, we report the mutational landscape of 86 whole-genome sequenced mNEN. This landscape revealed distinct genomic subpopulations of mNEN based on primary localization and differentiation grade; we observed relatively high tumor mutational burdens (TMB) in neuroendocrine carcinoma (5.45 somatic mutations per megabase) with TP53, KRAS, RB1, MYC and APC as major drivers versus an overall low TMB in neuroendocrine tumors (1.08). Furthermore, we observed distinct drivers which were enriched with somatic aberrations in pancreatic (MEN1, ATRX, DAXX, PCNT and SETD2) and midgut-derived neuroendocrine tumors (CDKN1B). Finally, 49% of mNEN patients revealed extensions of their treatment-repertoire based upon actionable (and responsive) somatic aberrations; potentially directing improvements in mNEN treatment strategies.
Recognition and Management of Agitation in Acute Mental Health Services: A Qualitative Evaluation of Staff Perceptions
Authors: Tucker Joshua , Whitehead Lisa , Palamara Peter , Rosman Josephine Xenia , Seaman Karla 
Published: August 2020

Abstract
Background: Agitation among patients is a common and distressing behaviour across a variety of health care settings, particularly inpatient mental health. Unless recognised early and effectively managed it can lead to aggression and personal injury. The aim of this paper is to explore the experiences of mental health nurses in recognising and managing agitation in an inpatient mental health setting and the alignment of these experiences with best practice and person-centred care. Methods: This study used a qualitative cross-sectional descriptive methodology. Semi-structured focus group interviews were conducted with twenty-one nurses working in a mental health unit in 2018. Nursing staff described their experiences of assessing and managing agitation. Descriptive and Thematic Analysis were undertaken of the transcribed focus group dialogue. Results: Nurses combined their clinical knowledge, assessment protocols and training with information from patients to make an individualised assessment of agitation. Nurses also adopted an individualised approach to management by engaging patients in decisions about their care. In keeping with best practice recommendations, de-escalation strategies were the first choice option for management, though nurses also described using both coercive restraint and medication under certain circumstances. From the perspective of patient-centred care, the care provided aligned with elements of person-centred care nursing care.Conclusion: The findings suggest that clinical mental health nurses assess and manage agitation, with certain exceptions, in line with best practice and a person-centred care nursing framework.
A Novel Handheld Bimanual&nbsp;Surgical Robot for&nbsp;Single-Port Laparoscopic Surgery
Authors: Feng Zhe , Dong Dinghui , Ma Tao , Wang Yue , Chen Huan , Wu Rongqian , Lv Yi , Zhu HaoYang 
Published: August 2020

Abstract
Background: single-port laparoscopic surgery is a hotspot of minimally invasive surgery, but its promotion is limited because of operational triangulation and instrument conflict. Robot technologies can cleverly solve this dilemma. But most of the surgery robots need high cost and long time to setup and mainly for complex surgery currently. There is no portable single-port laparoscopic robotic surgical instruments suitable for simple abdominal surgery. Method: This paper presents a handheld single-port laparoscopic surgical robot. It consists of two manipulate arms, both of the arms have 2 degrees of freedom, and two more degrees of freedom can be applied by handheld. The left arm has the function of pulling tissue, while the right arm is equipped with a laser fiber, which can be used for tissue cutting and hemostasis with a 980nm diode laser. Kinematics analysis, dynamic simulation, modal analysis and vitro simulation experiments were conducted to verify the feasibility for the handheld single-port laparoscopic robot. Result: The bimanual surgical robot can provide enough workspace, the gripper and laser head have stable working ability, and can successfully complete the fenestration and drainage of hepatic cyst. Conclusion: This bimanual surgical robot has the potential to become a surgical instrument for simple intraperitoneal surgery. It can provide a small, portable and inexpensive surgical robot system.
Long-segment versus short-segment fixation through a posterior approach for tuberculous spondylodiscitis of the mid-thoracic spine in adults: a study of mid- to long-term efficacy
Authors: Xu Zhenchao , Wang Xiyang , Chen Gang , Liu Zheng 
Published: August 2020

Abstract
Background

This retrospective study aimed to perform comparatively evaluate the mid- to long-term efficacy of long-segment and short-segment fixations via the posterior approach as treatment for tuberculous spondylodiscitis in the mid-thoracic spine.
Methods

A total of 95 patients with tuberculous spondylodiscitis in the mid-thoracic spine underwent surgery via the posterior approach including single-stage posterior debridement, interbody fusion, and pedicle screw fixation. Long-segment fixations were performed for 46 patients (group A), while short-segment fixations were performed for the other 49 patients (group B). Clinical and radiological outcomes were assessed during mid- to long-term follow-up.
Results

The average follow-up periods for groups A and B were 75.5 ± 11.8 and 76.8 ± 11.6 months, respectively. The operative time and intraoperative blood loss were lower in group B than in group A (P < 0.05). Both management approaches significantly corrected the kyphotic deformity detected either in the early postoperative period or at the final visit after long-term follow-up (P > 0.05). Bony fusion was generated after average periods of 10.8 ± 2.1 months and 11.0 ± 2.0 months in groups A and B, respectively. Favorable outcomes were observed on assessment of neurological function and patients’ well-being at the final follow-up.
Conclusion

No therapeutic differences were observed between long-segment and short-segment fixation as surgical treatment for mid-thoracic Pott’s disease during mid- to long-term follow-up. Kyphotic deformity and neurological impairment were significantly relieved via both posterior fixation approaches, with patients’ well-being reaching a favorable level. Moreover, short-segment fixation led to less blood loss and required a shorter operative time.
Coping Abilities of Nursing Graduates Under Public Health Emergency (COVID-19): A Cross-Sectional Study
Authors: Xu Bin , Yu Jian , Li Suyuan , Chen Lu , Lin Zheng 
Published: August 2020

Abstract
Background: Public health emergencies are serious social problems, threatening people's lives, causing considerable economic losses, and related to all mankind life and health and safety. Nurses are essential in the fight against the public health emergency, corona virus disease 2019 (COVID-19). Nursing graduates are considered as backup health care providers for licensed nurses, the coping abilities and crisis management of nursing students at present deserve attention all around the world. Methods: 2035 graduating nursing graduates were invited to participate in mobile phone app-based survey from Feb 6 to 20, 2020. The demographic items, psychological and behavioral responses, and the coping abilities were conducted. Multiple linear regression was used to identify the independent factors to nursing graduates’ coping abilities under COVID-19.Results: 1992 submitted were valid. Multiple linear regression analysis showed that Confidence to overcome difficulties, Optimism, Active coping, Help seeking and Practice hospital as designated treatment unit were independently associated with the positive coping of graduates. Fear of COVID-19, Optimism, Avoidance, Help seeking and Severity of epidemic around were independently associated with the negative coping of graduates.
Dialysis Care for U.S. Military Veterans in Puerto Rico during the 2017 Atlantic Hurricane Season, a Retrospective Cohort Study
Authors: Lukowsky Lilia , Dobalian Aram , Kalantar-Zadeh Kamyar , Der-Martirosian Claudia 
Published: August 2020

Abstract
Continuity of care for End Stage Renal Disease (ESRD) patients is critical as they are at heightened risk for increased morbidity and mortality if their typically 3-times a week hemodialysis treatment is interrupted because of disaster-related disruptions in equipment, electricity, water, communication, or transportation.(1-4) For example, a month after Hurricane Katrina (2005), more than 50% of the dialysis facilities in Louisiana were still closed due to major damage caused by the hurricane.(5) These closures contributed to an increase in renal-related hospitalizations in the hurricane-affected areas.(6),(7) Similarly, during Hurricane Sandy (October 29, 2012), 306 dialysis facilities in New York and New Jersey were closed right after the hurricane struck.(2) Major disruptions in dialysis services caused by Sandy led to missed dialysis care during the first week post-Sandy for both U.S. Department of Veterans Affairs (VA) and non-VA patients. Major disruptions in dialysis services might have contributed to an increase in the 30-day mortality rate of 1.83% in Sandy-affected areas compared to 1.6% for the same month in the preceding year.(5, 8)
Exploring the Consequences of Early Marriage among Kurdish Women: A Qualitative Study in Western Iran
Authors: Solhi Mahnaz , Azar Farbod Ebadi Fard , Farahani Farideh Khalajabadi , Lebni Javad Yoosefi 
Published: August 2020

Abstract
Background: Early marriage is one of the most important social issues for young women, which can have many consequences, so this study was conducted to explain the consequences of early marriage among Kurdish women in western Iran.Methods: This qualitative study was conducted with the approach of conventional content analysis among Iranian Kurdish women who were married under the age 18. The data were saturated through semi-structured interviews with 30 women selected by purposeful sampling. Data analysis was performed by Graneheim and Lundman method.Results: 389 codes, 14 subcategories, 4 sub-categories and 2 main categories were extracted from data analysis. Negative consequences of early marriage include 1- Physical and psychological problems (high-risk pregnancy and childbirth, physical illnesses, yearning and remorse, psychological challenges) 2- Family problems (experience of violence, dissatisfaction with married life, experience of multiple roles, lack of independence in Family life) 3. Social problems (social deviance, deprivation of social and health services, social isolation, deprivation of job and educational opportunities) and positive consequences include receiving intra- family support, improving living conditions and opportunities for progress and empowerment.Conclusions: It is possible to reduce the negative consequences of early marriage through teaching young women to have a less dangerous pregnancy and childbirth, training and using psychological counseling on how to deal with personal problems and married life, and providing appropriate social and health services for them.
Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension
Authors: Zuo Hui-Juan , Ma Ji-Xiang , Wang Jin-Wen , Chen Xiao-Rong 
Published: August 2020

Abstract
Background: Home blood pressure monitoring (HBPM) is recommended and specified for diagnosis, treatment adjustment and management of most hypertension cases by hypertension guidelines. This study aimed to evaluate the HBPM behaviour and to explore the routine-practice gap among Chinese adults with hypertension. Methods: Between October 2014 and November 2014, data were collected from 20 communities across three cities and six townships in three provinces located in Beijing, Shandong and Jiangsu Provinces in China. A total of 2,272 patients with hypertension aged ≥35 years were registered with a primary health station in local communities were selected by simple random sampling. Results: Among 2,272 subjects, 45.3% owned a home sphygmomanometer. In addition, 27.5% (625/2,272) engaged in HBPM weekly or more frequently. Healthcare providers’ advice was the strongest factor contributing to home sphygmomanometer ownership and weekly HBPM behaviour, with an odds ratio of 13.50 and 8.97. Patients with uncontrolled hypertension were more likely to conduct HBPM regularly (morning and evening), measure their BP two or three times in each measuring session and report 7 consecutive days of HBPM than patients with controlled hypertension (8.8% vs. 5.8%, P=0.042; 14.3% vs. 8.1%, P=0.002; and 19.9% vs. 12.4%, P=0.005, respectively). Only 16.0% (165/1,030) of patients actively reported their HBPM readings to doctors. Conclusion: The strategies of HBPM specified by ESH/ESC hypertension guidelines (2013) and those from China (2018) are seldom achieved in current practice in China. Only a small proportion of patients actively participate in utilizing home BP measurements to enhance their care. HBPM may be improved by healthcare providers’ specific advice and training.
Challenges and coping strategies in non-communicable disease management during COVID-19 in Addis Ababa, Ethiopia: A qualitative study
Authors: Ketema Bezawit , Kaba Mirgissa , Addissie Adamu , Kantelhardt Eva Johanna 
Published: August 2020

Abstract
Background People with comorbidities are at higher risk of becoming severely ill with COVID-19. Evidence has shown that those with cardiovascular diseases, chronic respiratory diseases, diabetes and cancer had more severe illness and worse prognosis with COVID-19 compared to patients without comorbidities. Insufficient numbers of health workers, high financial barriers and lack of access to quality-assured medicines have been challenges for patients with non-communicable diseases (NCDs) in developing countries, even before COVID-19. Therefore, this study aimed to explore the challenges and coping strategies in NCD management during COVID-19 in Addis Ababa, Ethiopia.Methods This study followed a phenomenological study approach to explore challenges and coping strategies using the experience of healthcare professionals (HCPs) and people with NCDs. Twenty-two individuals (13 HCPs and nine people with NCDs) were recruited purposively and invited for in-depth interview. All interviews were made by telephone and data collected using interview guide. There was pre-interview telephonic conversation to ask participants for a convenient time and date for the actual interview. At the end of every interview, a summary of the interview notes was read to the participants to ensure the correct interpretation of participants’ original views. ATLAS.ti version 7 software was used to assist in the coding and categorisation. Thematic analysis was employed to understand the challenges and coping strategies in NCD management during COVID-19 in Addis Ababa, Ethiopia.Results Challenges posed by COVID-19 to people with NCD included postponement of NCD follow-up due to fear of COVID-19 infection, transportation problems and unwelcoming healthcare facilities; stress related to fear of death and absence of social support; and reduced physical activity in relation to staying at home. For the HCPs, a shortage of personal protective equipment and an absence of standards and guidelines were the common challenges. Telemedicine was the typical coping strategy used by HCPs, while people with NCDs were mostly expecting spiritual protection and safeguarding.Conclusions We concluded that the postponement of NCD follow-up, in addition to stress and reduced physical activity, may worsen the increasing mortality from preventable NCDs in the country. We recommend every COVID-19 response measures to target NCD health service independently.
Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea
Authors: Shin Ji Yeh , Kim Ha Jin , Cho BeLong , Yang Yun Jun , Yun Jae Moon 
Published: August 2020

Abstract
Background: Diabetes is one of the fastest growing diseases with approximately 463 million patients worldwide. It is established that to manage diabetes, continuity of care in primary care setting is crucial. We aim to statistically define and analyze factors of continuity that are associated with patient, clinic and geographical relationship.Methods: We used 2014~2015 claim data from National Health Insurance Service (NHIS), with 39,096 eligible outpatient attendances across 29,912 office-based clinics. We applied multivariable logistic regression to analyze factors that may affect three kinds of continuity of care index for each patient: most frequent provider continuity index (MFPC), modified-modified continuity index (MMCI), and continuity of care index (COC). Results: Mean value of continuity of care indices were MFPC 0.90, MMCI 0.96, COC 0.85. Among patient factors, old age above 80 (MFPC 0.81 [0.74-0.89], MMCI 0.84 [0.76-0.92], COC 0.81 [0.74-0.89]) and disability were strongly associated with lower continuity of care. Another significant factor was residential area: further the patients lived from their primary care clinic, lower the continuity of diabetes care (MFPC 0.74 [0.70–0.78], MMCI 0.70 [0.66–0.73], COC 0.74 [0.70–0.78]). Patients who lived in metropolitan area had higher continuity of care compared to other areas (metropolitan area, MFPC 1.19 [1.17-1.27], MMCI 1.17 [1.10-1.25], COC 1.19 [1.12-1.27]). There was no statistical significance among clinic factors, such as number of hired physicians or nurses hired per clinic, between the lower and the higher continuity of care groups.Conclusion: Geographical proximity of patient’s residential area and clinic location showed highest correlation as factor of continuity. Political support is necessary to geographically align the imbalance of supply and demand of medical needs.
GSD_1.0 (canFam4): A novel canine reference genome resolves genomic architecture and uncovers transcript complexity
Authors: Wang Chao , Wallerman Ola , Arendt Maja-Louise , Sundström Elisabeth , Karlsson Åsa , Nordin Jessika , Mäkeläinen Suvi , Pielberg Gerli Rosengren , Hanson Jeanette , Ohlsson Åsa , Saellström Sara , Rönnberg Henrik , Ljungvall Ingrid , Häggström Jens , Bergström Tomas , Hedhammar Åke , Meadows Jennifer , Lindblad-Toh Kerstin 
Published: August 2020

Abstract
We present GSD_1.0, a novel high-quality domestic dog reference genome with chromosome length scaffolds and gap number reduced 41-fold, from 23,836 to 585. Annotation with novel and existing long and short read RNA-seq, miRNA-seq and ATAC-seq, revealed that 32.1% of closed gaps harboured previously hidden functional elements, including promoters, genes and miRNAs. A catalogue of canine “dark” regions was made to facilitate mapping rescue. Alignment in these regions is difficult, but we demonstrate that they harbour trait-associated variation. Key genomic regions were completed, including the Dog Leukocyte Antigen (DLA), T Cell Receptor (TCR) and 366 COSMIC cancer genes. The sequencing of 27 dogs from 19 breeds with linked read technology uncovered 22.1 million SNPs, indels and larger structural variants. Intersection with protein coding genes showed that 1.4% could directly influence gene products, and so provide a source of normal or aberrant phenotypic modifications.
A Case Report of Infective Endocarditic&nbsp;Aortic Valve Abscess&nbsp;with Perforation in Infant
Authors: Yang Yanfeng , Si Feifei , Jin Mei , Yang Sheng 
Published: August 2020

Abstract
Background: Infective endocarditis (IE) is an uncommon but a potentially life-threatening infectious disease in children. The epidemiology of IE has changed in the past three to four decades and its incidence has been increasing recently. This case with atypical present including culture-negative and no-cardiovascular diseases got cardiovascular structural damage that deteriorate in short time. Case presentation: This case was an infant less than one year old without basic cardiovascular disease,and this case was admitted with Kawasaki disease early. His diagnosis was infective endocarditic aortic valve abscess with perforation. The patient received intravenous injection of cefotaxime for two days and piperacillin sulbactam and cefazolin for six days. On 9 th day, piperacillin sulbactam combining with vancomycin were used. On 10 th day, the patient was sent to cardiac surgery department to receive aortic valve repair. The operation is successful.The abscess cavity of the inferior aortic valve and the vegetations on the aortic valve were completely removed, the left coronary valve was removed, and the left coronary valve was locally widened by autologous pericardial patch. Conclusions: Infective Endocarditis in children may be difficult to diagnosis and manage.and the treatment are becoming a new challenge for conventional antibiotic therapy. Some IE require serial follow-up to determine potential need for subsequent cardiovascular surgery (CVS) intervention despite microbiologic cure with antimicrobial therapy.