bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families
Authors: Bennardi Marco , Diviani Nicola , Gamondi Claudia , Stüssi Georg , Saletti Piercarlo , Cinesi Ivan , Rubinelli Sara 
Published: April 2020

Abstract
Background
Despite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization.
This study aims to synthesize knowledge on cognitive barriers and facilitators to palliative care use in oncology and hemato-oncology from the experiences of health professionals, patients, and their families.

Methods
A systematic review was conducted. PubMed, PsycINFO, International Association for Hospice and Palliative Care/Cumulative Index of Nursing and Allied Health Literature (IAHPC/CINAHL), and Communication & Mass Media Complete (CMMC) were systematically searched for the main core concepts: palliative care, barriers, facilitators, perspectives, points of view, and related terms and synonyms. After screening of titles, abstracts, and full-texts, 52 studies were included in the qualitative thematic analysis.

Results
Four themes were identified: awareness of palliative care, collaboration and communication in palliative care-related settings, attitudes and beliefs towards palliative care, and emotions involved in disease pathways. The results showed that cognitive barriers and facilitators are involved in the educational, social, emotional, and cultural dimensions of palliative care provision and utilization. In particular, these barriers and facilitators exist both at the healthcare professional level (e.g. a barrier is lack of understanding of palliative care applicability, and a facilitator is strategic visibility of the palliative care team in patient floors and hospital-wide events) and at the patient and families level (e.g. a barrier is having misconceptions about palliative care, and a facilitator is patients’ openness to their own needs).

Conclusions
To optimize palliative care services utilization, awareness of palliative care, and healthcare professionals’ communication and emotion management skills should be enhanced. Additionally, a cultural shift, concerning attitudes and beliefs towards palliative care, should be encouraged.
Mutual interaction between endoplasmic reticulum and mitochondria in nonalcoholic fatty liver disease
Authors: Wang Jin , He Wanping , Tsai Ping-Ju , Chen Pei-Hsuan , Ye Manxiang , Guo Jiao , Su Zhengquan 
Published: April 2020

AbstractNonalcoholic fatty liver disease (NAFLD) is a common metabolic syndrome. Imbalances between liver lipid output and input are the direct causes of NAFLD, and hepatic steatosis is the pathological premise and basis for NAFLD progression. Mutual interaction between endoplasmic reticulum stress (ERS) and oxidative stress play important roles in NAFLD pathogenesis. Notably, mitochondria-associated membranes (MAMs) act as a structural bridges for functional clustering of molecules, particularly for Ca2+, lipids, and reactive oxygen species (ROS) exchange. Previous studies have examined the crucial roles of ERS and ROS in NAFLD and have shown that MAM structural and functional integrity determines normal ER- mitochondria communication. Upon disruption of MAM integrity, miscommunication directly or indirectly causes imbalances in Ca2+ homeostasis and increases ERS and oxidative stress. Here, we emphasize the involvement of MAMs in glucose and lipid metabolism, chronic inflammation and insulin resistance in NAFLD and summarize MAM-targeting drugs and compounds, most of which achieve their therapeutic or ameliorative effects on NAFLD by improving MAM integrity. Therefore, targeting MAMs may be a viable strategy for NAFLD treatment. This review provides new ideas and key points for basic NAFLD research and drug development centred on mitochondria and the endoplasmic reticulum.
Orotic acid-treated hepatocellular carcinoma cells resist steatosis by modification of fatty acid metabolism
Authors: Matilainen Johanna , Mustonen Anne-Mari , Rilla Kirsi , Käkelä Reijo , Sihvo Sanna P. , Nieminen Petteri 
Published: April 2020

Abstract
Background
Orotic acid (OA) has been intensively utilized to induce fatty liver in rats. Although the capacity of OA to cause steatosis is species-specific, previous in vitro studies indicate that humans could also be susceptible to OA-induced fatty liver. The aim of the present study was to re-elucidate the potential of OA exposure to modulate the cellular mechanisms involved in both non-alcoholic fatty liver disease pathogenesis and cellular protection from lipid accumulation. In addition, alterations in detailed fatty acid (FA) profiles of cells and culture media were analyzed to assess the significance of lipid metabolism in these phenomena.

Methods
In our experiments, human hepatocellular carcinoma HepG2 cells were exposed to OA. Bacterial endotoxin, lipopolysaccharide (LPS), was used to mimic hepatic inflammation. The lipogenic and inflammatory effects of OA and/or LPS on cells were assessed by labeling cellular lipids with Nile red stain and by performing image quantifications. The expression levels of key enzymes involved in de novo lipogenesis (DNL) and of inflammatory markers related to the disease development were studied by qRT-PCR. FA profiles of cells and culture media were determined from total lipids with gas chromatography–mass spectrometry.

Results
Our data indicate that although OA possibly promotes the first stage of DNL, it does not cause a definite lipogenic transformation in HepG2 cells. Reduced proportions of 16:0, increased stearoyl-Coenzyme A desaturase 1 mRNA expression and relatively high proportions of 16:1n-7 suggest that active delta9-desaturation may limit lipogenesis and the accumulation of toxic 16:0. Inflammatory signaling could be reduced by the increased production of long-chain n-3 polyunsaturated FA (PUFA) and the active incorporation of certain FA, including 18:1n-9, into cells. In addition, increased proportions of 20:4n-6 and 22:6n-3, total PUFA and dimethyl acetal 18:0 suggest that OA exposure may cause increased secretion of lipoproteins and extracellular vesicles.

Conclusions
The present data suggest that, apart from the transcription-level events reported by previous studies, modifications of FA metabolism may also be involved in the prevention of OA-mediated steatosis. Increased delta9-desaturation and secretion of lipoproteins and extracellular vesicles could offer potential mechanisms for further studies to unravel how OA-treated cells alleviate lipidosis.
Association of long-term consumption of repeatedly heated mix vegetable oils in different doses and hepatic toxicity through fat accumulation
Authors: Ambreen Gul , Siddiq Afshan , Hussain Kashif 
Published: April 2020

Abstract
Background
Hepatic diseases are one of the chief reasons for worldwide morbidity and mortality. The increased incidence in Asian countries is driving researchers to explore preventive ways from nature. It is more practical to go with healthy routine edibles like vegetable oils to avoid environmental and chemical hepatic injuries. With the use of thermally oxidized oils overproduction of reactive oxygen species (ROS) with overwhelmed cellular antioxidants defense system results in oxidative stress, the known cause of cardiovascular diseases (CVDs), cancers and neurodegenerative disorders. Little is investigated about the effect of daily used oxidized cooking oils on hepatic function changes with oxidative stress especially in the animal model that mimics the human situation.

Methods
In this study, healthy adult male rabbits of local strain were divided into 4 groups (n = 12). First, two sets of rabbits were treated with 1 and 2 ml/kg/day of repeatedly heated mix vegetable oils (RHMVO) respectively. The third set of rabbits was given 1 ml/kg/day of single time heated mix vegetable oils (STHMVO) and the fourth set of rabbits served as controls and fed with normal rabbit diet to for 16 weeks. Serum liver function markers including total-protein, albumin, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) along with the activity of hepatic antioxidant-enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA) for lipid peroxidation were compared among different groups of rabbits. Histopathological examination was performed for all four groups.

Results
Significantly (p < 0.05) elevated hepatic enzymes and MDA levels, with lower total protein, serum albumin, GPx, SOD and CAT levels were found in high and low doses RHMVO treated groups, in comparison to control. In the STHMVO group, all mentioned markers were insignificantly changed. Accumulation of liver fat in low and high dose oil-treated groups was further confirmed under the microscopic examination of liver tissues, presented significant fat accumulation in liver tissues, in addition, 40–60% increased oxidative stress compared to control, in a dose-dependent manner.

Conclusions
These results conclude that consumption of thermally oxidized mix vegetable oils for longer duration can impair the liver function and destroy its histological structure significantly through fat accumulation and oxidative stress both in high as well as low doses.
Mid-term effect of balloon aortic valvuloplasty on mitral regurgitation in aortic stenosis
Authors: Masaki Ryota , Iwasaki Masamichi , Tanaka Hidekazu , Hamana Tomoyo , Odajima Susumu , Fujimoto Wataru , Kuroda Koji , Hatani Yutaka , Inoue Takumi , Okamoto Hiroshi , Okuda Masanori , Hayashi Takatoshi , Hirata Ken-ichi 
Published: April 2020

Abstract
Background
Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS.

Methods
Our analysis was based on the data from 83 patients with severe AS (mean age, 86 ± 5 years; female, 68) treated using BAV. Echocardiography was performed before the procedure and at 1 and 3 months after. MR was quantified by measuring the MR jet area, with more-than-moderate MR being clinically significant.

Results
Forty patients were classified in this group (MR group). Significant reduction of MR was observed in the MR group at 1 month and 3 months after procedure, with no improvement in patients in the non-MR group. At 3 months, 15 of the 40 patients in the MR group still had significant MR, with the change at 1 month in the left ventricular end-systolic dimension (OR: 1.36; 95% CI: 1.05–1.76; P = 0.022) and MR jet area (OR: 1.95; 95% CI: 1.16–3.29; P = 0.012) being predictive of persisting significant MR at 3 months after BAV. The prevalence of New York Heart Association functional class III or IV decreased at 1 and 3 months after BAV in both groups.

Conclusions
BAV provides a useful therapeutic strategy for elderly patients with severe AS who are not candidates for surgical or transcatheter aortic valve replacement, especially in those with significant MR.
Linear-time algorithms for phylogenetic tree completion under Robinson–Foulds distance
Authors: Bansal Mukul S. 
Published: April 2020

Abstract
Background
We consider two fundamental computational problems that arise when comparing phylogenetic trees, rooted or unrooted, with non-identical leaf sets. The first problem arises when comparing two trees where the leaf set of one tree is a proper subset of the other. The second problem arises when the two trees to be compared have only partially overlapping leaf sets. The traditional approach to handling these problems is to first restrict the two trees to their common leaf set. An alternative approach that has shown promise is to first complete the trees by adding missing leaves, so that the resulting trees have identical leaf sets. This requires the computation of an optimal completion that minimizes the distance between the two resulting trees over all possible completions.

Results
We provide optimal linear-time algorithms for both completion problems under the widely-used Robinson–Foulds (RF) distance measure. Our algorithm for the first problem improves the time complexity of the current fastest algorithm from quadratic (in the size of the two trees) to linear. No algorithms have yet been proposed for the more general second problem where both trees have missing leaves. We advance the study of this general problem by proposing a useful restricted version of the general problem and providing optimal linear-time algorithms for the restricted version. Our experimental results on biological data sets suggest that completion-based RF distances can be very different compared to traditional RF distances.
Effects of adding sodium dichloroacetate to low-protein diets on nitrogen balance and amino acid metabolism in the portal-drained viscera and liver of pigs
Authors: Sun Weizhong , Li Yunxia , Tang Zhiru , Chen Huiyuan , Wan Ke , An Rui , Wu Liuting , Sun Zhihong 
Published: April 2020

Abstract
Background
Identifying regulatory measures to promote glucose oxidative metabolism while simultaneously reducing amino acid oxidative metabolism is one of the foremost challenges in formulating low-protein (LP) diets designed to reduce the excretion of nitrogen-containing substances known to be potential pollutants. In this study, we investigated the effects of adding sodium dichloroacetate (DCA) to a LP diet on nitrogen balance and amino acid metabolism in the portal-drained viscera (PDV) and liver of pigs.
To measure nitrogen balance, 18 barrows (40 ± 1.0 kg) were fed one of three diets (n = 6 per group): 18% crude protein (CP, control), 13.5% CP (LP), and 13.5% CP + 100 mg DCA/kg dry matter (LP-DCA). To measure amino acid metabolism in the PDV and liver, 15 barrows (40 ± 1.0 kg) were randomly assigned to one of the three diets (n = 5 per group). Four essential amino acids (Lys, Met, Thr, and Trp) were added to the LP diets such that these had amino acid levels comparable to those of the control diet.

Results
The LP-DCA diet reduced nitrogen excretion in pigs relative to that of pigs fed the control diet (P < 0.05), without any negative effects on nitrogen retention (P > 0.05). There were no differences between the control and LP-DCA groups with respect to amino acid supply to the liver and extra-hepatic tissues in pigs (P > 0.05). The net release of ammonia into the portal vein and production rate of urea in the liver of pigs fed the LP-DCA diet was reduced relative to that of pigs fed the control and LP diets (P < 0.05).

Conclusion
The results indicated that addition of DCA to a LP diet can efficiently reduce nitrogen excretion in pigs and maximize the supply of amino acids to the liver and extra-hepatic tissues.
Reduced integration schemes in micromorphic computational homogenization of elastomeric mechanical metamaterials
Authors: Rokoš Ondřej , Zeman Jan , Doškář Martin , Krysl Petr 
Published: April 2020

AbstractExotic behaviour of mechanical metamaterials often relies on an internal transformation of the underlying microstructure triggered by its local instabilities, rearrangements, and rotations. Depending on the presence and magnitude of such a transformation, effective properties of a metamaterial may change significantly. To capture this phenomenon accurately and efficiently, homogenization schemes are required that reflect microstructural as well as macro-structural instabilities, large deformations, and non-local effects. To this end, a micromorphic computational homogenization scheme has recently been developed, which employs the particular microstructural transformation as a non-local mechanism, magnitude of which is governed by an additional coupled partial differential equation. Upon discretizing the resulting problem it turns out that the macroscopic stiffness matrix requires integration of macro-element basis functions as well as their derivatives, thus calling for higher-order integration rules. Because evaluation of a constitutive law in multiscale schemes involves an expensive solution of a non-linear boundary value problem, computational efficiency of the micromorphic scheme can be improved by reducing the number of integration points. Therefore, the goal of this paper is to investigate reduced-order schemes in computational homogenization, with emphasis on the stability of the resulting elements. In particular, arguments for lowering the order of integration from expensive mass-matrix to a cheaper stiffness-matrix equivalent are outlined first. An efficient one-point integration quadrilateral element is then introduced and a proper hourglass stabilization is discussed. Performance of the resulting set of elements is finally tested on a benchmark bending example, showing that we achieve accuracy comparable to the full quadrature rules, whereas computational cost decreases proportionally to the reduction in the number of quadrature points used.
The benefits and caveats of using clickstream data to understand student self-regulatory behaviors: opening the black box of learning processes
Authors: Baker Rachel , Xu Di , Park Jihyun , Yu Renzhe , Li Qiujie , Cung Bianca , Fischer Christian , Rodriguez Fernando , Warschauer Mark , Smyth Padhraic 
Published: April 2020

AbstractStudent clickstream data—time-stamped records of click events in online courses—can provide fine-grained information about student learning. Such data enable researchers and instructors to collect information at scale about how each student navigates through and interacts with online education resources, potentially enabling objective and rich insight into the learning experience beyond self-reports and intermittent assessments. Yet, analyses of these data often require advanced analytic techniques, as they only provide a partial and noisy record of students’ actions. Consequently, these data are not always accessible or useful for course instructors and administrators. In this paper, we provide an overview of the use of clickstream data to define and identify behavioral patterns that are related to student learning outcomes. Through discussions of four studies, we provide examples of the complexities and particular considerations of using these data to examine student self-regulated learning.
Physician Practice Variability in the Use of Extended-Fraction Radiation Therapy for Bone Metastases: Are We Choosing Wisely?
Authors: Gupta Arjun , Wang Peiqi , Sedhom Ramy , Chino Fumiko , Waddle Mark R. , Miller Robert C. , Johnson David H. , Sanford Nina N. , Narang Amol , Alcorn Sara R. , Makary Martin A. 
Published: April 2020

PURPOSE: Routine use of extended-fraction (> 10 fractions) radiation therapy (RT) for palliation of bone metastases is recognized as a low-value intervention by the American Society for Radiation Oncology. We examined contemporary practice patterns of, and physician characteristics associated with extended-fraction RT use. MATERIALS AND METHODS: We conducted a retrospective cohort study using Medicare fee-for-service data. We included patients who underwent 2- or 3-dimensional external-beam RT for bone metastases between January 1, 2016, and December 31, 2018. Physicians treating > 10 patients over the study period were analyzed for their individual practice. Hierarchic logistic regression modeling was used to identify patient- and physician-level factors associated with extended-fraction RT use. RESULTS: A total of 12,221 patients (median age, 75.6 years; 40.9% women, 87.6% white) were included. The rate of extended-fraction RT was 23.4%. A total of 1,432 physicians treated any patient. Among the 382 physicians treating > 10 patients, 127 (33.2%) used extended-fraction RT > 30% (consensus threshold). Physician factors associated with decreased odds of extended-fraction RT were years since medical school graduation (≤ 10 years and 11-20 years v ≥ 31 years: adjusted odds ratio [aOR], 0.32 [95% CI, 0.20 to 0.51] and 0.64 [95% CI, 0.44 to 0.93]) and practicing in the Northeast or Midwest versus the South (aOR, 0.36 [95% CI, 0.22 to 0.58] and 0.48 [95% CI, 0.31 to 0.74]). Physicians treating > 20 patients ( v 11-14 patients) over the study period had increased odds of delivering extended-fraction RT (aOR, 1.53 [95% CI, 1.10 to 2.12]). CONCLUSION: In this study, almost one fourth of patients received extended-fraction RT, and one third of physicians had an extended-fraction RT use rate of > 30%. Personalized feedback of performance data, clinical pathways and peer review, and updated reimbursement models are potential mechanisms to address this low-value care.
Evidence in Support for the Progressive Nature of Ovarian Endometriomas
Authors: Ding Ding , Wang Xi , Chen Yishan , Benagiano Giuseppe , Liu Xishi , Guo Sun-Wei 
Published: April 2020

AbstractContextWhether endometriosis is a progressive disease is a highly contentious issue. While progression is reported to be unlikely in asymptomatic deep endometriosis, progression in symptomatic deep endometriosis has recently been reported, especially in menstruating women. However, pathophysiological reasons for these differences are unclear.ObjectiveThis study was designed to investigate whether ovarian endometrioma (OE) is progressive or not.Setting, Design, Patients, Intervention and Main Outcome MeasuresThirty adolescent patients, aged 15 to 19 years, and 32 adult patients, aged 35 to 39 years, all laparoscopically and histologically diagnosed with OE, were recruited into this study after informed consent. Their demographic and clinical information were collected. Their OE tissue samples were collected and subjected to immunohistochemical analysis for E-cadherin, α-smooth muscle actin (α-SMA), desmin, and adrenergic receptor β2 (ADRB2), as well as quantification of lesional fibrosis by Masson trichrome staining.ResultsOE lesions from the adolescent and adult patients are markedly different, with the latter exhibiting more extensive and thorough progression and more extensive fibrosis, suggesting that lesions in adults progressed to a more advanced stage. Adult lesions and higher staining level of α-SMA and ADRB2 are positively associated with the extent of lesional fibrosis, while the lesion size and the E-cadherin staining are negatively associated.ConclusionsOur data provide a more definitive piece of evidence suggesting that OE is a progressive disease, since the adult lesions have had a longer time to progress. In addition, the pace of progression depends on lesional age as well as the severity of endometriosis-associated dysmenorrhea, if any.