bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges of university nursing transfer students in an Asian context: a qualitative study
Authors: Ching Shirley S Y , Zhang Lillian Weiwei , Guan Gwendoline Yuanyuan , Cheung Kin 
Published: May 2020

ObjectivesTo explore the social and academic experiences of nursing transfer students’ (NTSs) in an Asian context.DesignA descriptive qualitative study design using focus groups and individual interviews with Chinese NTSs. The data were transcribed verbatim and analysed by using qualitative content analysis.SettingA university offering preregistration nursing programmes in Hong Kong.ParticipantsChinese NTSs studying in a 3-year special pattern within a 5-year Bachelor of Nursing programme in a university in Hong Kong.ResultsFour main categories were identified: ‘expectations about study at the beginning of the programme’, ‘challenges during transition’, ‘coping by prioritising’ and ‘our world is small’. The NTSs had clear goals for becoming professional nurses and consequently aimed at higher academic achievements throughout the study. They anticipated enjoying university life at the beginning of their study; however, the challenges caused by heavy study workloads and transition from passive to independent learning approaches, compounded by the limited time of 3-year study, forced them to develop coping strategies to reconcile and prioritise their preconceived notions, academic pursuits, social engagements and personal well-being. Their high prioritisation of good academic performance confined their university lives to the small world of the academic arena.ConclusionsThe study identified challenges faced by NTSs in adjusting to university study. Suggestions are offered to different stakeholders to address the issues at individual, institutional and government levels so as to enhance NTSs’ learning experiences at university.
Mucosal inflammation predicts response to systemic steroids in immune checkpoint inhibitor colitis
Authors: Mooradian Meghan J , Wang Daniel Y , Coromilas Alexandra , Lumish Melissa , Chen Tianqi , Giobbie-Hurder Anita , Johnson Douglas B. , Sullivan Ryan J. , Dougan Michael 
Published: May 2020

BackgroundImmune-related colitis is a common, often serious complication of immune checkpoint inhibition (ICI). Although endoscopy is not strictly recommended for any grade of diarrhea/colitis, emerging evidence suggests that endoscopic evaluation may have important therapeutic implications. In this retrospective study, we sought to comprehensively characterize the clinical and histologic features of ICI-induced colitis with a specific focus on evaluating the prognostic role of endoscopy.MethodsData were collected from the medical records of 130 patients with confirmed ICI-induced colitis. In a subset of patients (n=44) with endoscopic and pathologic data, endoscopic data were scored using the Mayo Endoscopic Score (MES) with scores ranging from 0 (no inflammation) to 3 (colonic ulceration). The impact of infliximab on antitumor outcomes was evaluated using progression-free survival (PFS) and overall survival (OS).ResultsWe identified 130 patients with ICI-induced colitis across two institutions. All patients were treated with corticosteroids. Additional and/or alternative immunosuppression was employed in 59 cases, with 52 patients (42%) requiring at least one infusion of infliximab 5 mg/kg. Endoscopic assessment with biopsy was performed in 123 cases of suspected colitis (95%), with 44 cases available for MES tabulation. Presence of ulceration (MES 3) was associated with use of infliximab (p=0.008) and MES was significantly higher in patients who received infliximab compared with those who did not (p=0.003) with a median score of 2.5; conversely, those with an MES of zero rarely required secondary immunosuppression. Notably, symptoms of colitis based on Common Terminology Criteria for Adverse Events grade had no association with endoscopic findings based on MES classification. After adjustment for baseline patient and disease characteristics, there was no significant difference in steroid duration or cancer-related outcomes in patients treated with infliximab.ConclusionsIn our study, we demonstrate the association of endoscopic features, specifically the MES, with immunosuppressive needs. Importantly, we also show that MES was not related to severity of patient symptoms. The data suggest that endoscopic features can guide clinical decision-making better than patient symptoms, both identifying high-risk patients who will require infliximab and those who are likely to respond to initial corticosteroids.
Nivolumab and dinutuximab beta in two patients with refractory neuroblastoma
Authors: Ehlert Karoline , Hansjuergens Ina , Zinke Andreas , Otto Sylke , Siebert Nikolai , Henze Guenter , Lode Holger 
Published: May 2020

BackgroundNeuroblastoma (NB) is the most frequent extracranial solid tumor in children. More than 50% of patients present with widespread (stage M) or refractory disease. In these patients, event-free and overall survival was improved by the addition of the anti-disialoganglioside antibody dinutuximab beta (DB) following multimodal conventional therapy. However, the prognosis of patients with refractory/relapsed NB remains poor. In the past decade, immunotherapy approaches with checkpoint inhibitors were approved for patients with certain malignant diseases such as melanoma or Hodgkin lymphoma. In preclinical models, DB resulted in an upregulation of the programmed cell death protein 1 (PD-1) checkpoint in NB cell lines and a combined treatment of DB with a murine anti-PD-1 checkpoint inhibitor showed a synergistic effect in a NB mouse model.Case presentationsTwo patients were admitted with refractory metastatic NB. In the 4-year-old girl, NB was diagnosed in 2013. She completed her first-line therapy with a first remission in 2015, but suffered a relapse in 2017. Treatment with chemotherapy and DB resulted in progressive disease after transient improvement. In the 17-year-old young man, NB was first diagnosed in April 2010. After two local relapses in 2011 and 2014, a metastatic relapse and a large abdominal tumor bulk were found in 2018. Despite transient improvement with multimodal therapy, progressive metastatic disease was observed in May 2019. Both patients had a satisfactory quality of life. Therefore, treatment with DB and nivolumab was performed—in the girl from October 2018 until August 2019, in the young man since June 2019. Tolerance to treatment was excellent. The girl continues to be in complete remission 6 months after therapy was stopped. In the young man, the soft tissue lesions disappeared completely, the skeletal lesions regressed substantially after 9 months of his still ongoing treatment.ConclusionsThe combination of DB with the checkpoint inhibitor nivolumab led to complete and a very good partial remission in two patients with relapsed/refractory NB. Prospective trials are warranted to clarify the role of this novel approach in a larger number of patients.
Intra-arterial chemotherapy for retinoblastoma: transradial and transfemoral approach
Authors: Sweid Ahmad , Jabbour Pascal 
Published: May 2020

AbstractIntraarterial chemotherapy (IAC) for retinoblastoma has notably changed the natural history of the disease and stands as an encouraging example of selective drug delivery. Targeted drug delivery allows achieving a high drug concentration within target tissue along with low systemic concentration. This maintains a high safety profile along with a high efficacy rate (97%).1–4 Increasing experience, refinements of the technique, and positive results of IAC over the past decade have expanded the indications to deliver treatment to a larger population. The most recent improvement introduced in our practice was administering the therapy using the transradial approach. Herein, we demonstrate the technique for IAC using both the transradial and transfemoral approach (video 1).
Intravenous cangrelor and oral ticagrelor as an alternative to clopidogrel in acute intervention
Authors: Linfante Italo , Ravipati Kaushik , Starosciak Amy Kathryn , Reyes Dennys , Dabus Guilherme 
Published: May 2020

BackgroundDual antiplatelet therapy (DAP) is necessary to prevent thromboembolic events during carotid stenting, stent-assisted coil embolization, and implant of flow diverters (FD). However, DAP in the acute phase may be challenging. An intravenous alternative, cangrelor, has rapid onset, short plasma half-life, and more reliable antiplatelet action for acute interventions. The study objective was to evaluate feasibility and safety of IV cangrelor during acute neuroendovascular surgery procedures.MethodsWe performed a retrospective analysis of our database of patients treated with stent-assisted coil embolization, FD placement for aneurysmal subarachnoid hemorrhage (aSAH), or stenting for acute internal carotid artery (ICA) occlusion where IV cangrelor was used. Morbidity, mortality, incidence of thromboembolic events, hemorrhages, and 90-day outcomes were reported.ResultsTen patients were found in our database from June 2018 through January 2019. Four patients had aSAH, four had middle cerebral artery strokes with tandem lesions, one had an ICA occlusion, and one had a vertebral artery aneurysm. One of the ten patients experienced a thrombotic event. One patient developed new post-procedural bleeding and two had worsening intracranial hemorrhage. Five patients were discharged home in stable condition, two to acute rehabilitation, one to a nursing facility, and two others expired (likely the result of the severe and evolving strokes). Of the eight who were discharged, six (75%) had a good 90-day functional outcome (modified Rankin Scale 0–2).ConclusionAcute administration of IV cangrelor with or without oral ticagrelor is a feasible antiplatelet treatment option for acute neuroendovascular procedures.
Deep neuromuscular block improves angiographic image quality during endovascular coiling of unruptured cerebral aneurysm: a randomized clinical trial
Authors: Kim Bo Young , Chung Sung Hoon , Park Seong-Joo , Han Sung-Hee , Kwon O-Ki , Chung Jun-Young , Kim Jin-Hee 
Published: May 2020

BackgroundNeuromuscular block (NMB) used during general anesthesia induces transient skeletal muscle paralysis, but patient movements during endovascular coiling still occur to some degree. Compared with moderate NMB, deep NMB may further improve the intervention condition during endovascular coiling for unruptured cerebral aneurysms; however, little research has focused on the angiographic image quality.MethodsThis prospective, randomized, double-blind clinical trial included 58 patients treated for unruptured cerebral aneurysms with endovascular coiling under general anesthesia. Patients were randomly allocated to either the deep NMB group (post-tetanic count 1 or 2) or the moderate NMB group (train-of-four 1 or 2). The primary outcome was the proportion of patients with a satisfactory intervention condition assessed by surgeons after the procedure using a 5-point intervention condition rating scale (ICRS) from 1 (unable to obtain image) to 5 (optimal); ICRS 5 was defined as satisfactory.ResultsThere were significantly more cases of satisfactory intervention condition in the deep NMB group than in the moderate NMB group (82.1% vs 51.7%, p=0.015). The frequency of each ICRS score was significantly different between the groups (ICRS 5/4/3/2/1: 23/5/0/0/0 vs 15/9/2/3/0, p=0.035). The incidence of major patient movement requiring rescue muscle relaxant was 10.3% in the moderate NMB group and 0% in the deep NMB group (p=0.237). The drugs used to maintain hemodynamic stability were not significantly different between the two groups.ConclusionsDeep NMB improves the intervention condition during endovascular coiling by improving the image quality.
Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment
Authors: Grulke Sigrid , Salciccia Alexandra , Arévalo Rodríguez José Manuel , Sandersen Charlotte , Caudron Isabelle , Serteyn Didier , de la Rebière de Pouyade Geoffroy 
Published: May 2020

BackgroundEpiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long‐term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed.MethodsThis study describes a technique of peroperative mesh closure of the EF in clinical cases and their long‐term follow up.ResultsIn the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases and enterotomy in 4 other cases. Fifteen of these survived to discharge. Long‐term follow‐up (one to three years, median three years) was favourable in all 15 horses not showing recurrence of EFE nor other related signs of colic. Laparoscopic evaluation of the EF was performed in two cases and showed integration of the mesh. One horse was euthanased 3.5 years after mesh placement for an unrelated cause and the mesh was well adherent obliterating the EF.ConclusionMesh closure of EF during emergency coeliotomy did not cause short‐term complications even in horses with resection or enterotomy and may reduce the risk of recurrence of EFE in horses.
Physiological response to eccentric and concentric cycling in patients with chronic obstructive pulmonary disease
Authors: Nickel Rolf , Troncoso Felipe , Flores Orlando , Gonzalez-Bartholin Roberto , Mackay Karen , Diaz Orlando , Jalon Mauricio , Peñailillo Luis 
Published: May 2020

We aimed to compare the cardiorespiratory, metabolic, and perceptual responses to high- and moderate-intensity eccentric cycling versus moderate-intensity concentric cycling in chronic obstructive pulmonary disease (COPD) patients. Ten patients with moderate COPD (forced expiratory volume in 1 s (FEV1) = 68.6% ± 20.4% of predicted; 68.3 ± 9.1 years) performed 30 min of moderate-intensity concentric (CONC-M: 50% maximum workload; Wmax), moderate-intensity eccentric (ECC-M: 50% Wmax), and high-intensity eccentric (ECC-H: 100% Wmax) cycling. Average power output, oxygen consumption (V̇O2), minute ventilation (VE), respiratory frequency (fR), oxygen saturation (SpO2), heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), rate of perceived exertion (RPE), and dyspnea were measured during cycling. Compared with CONC-M, lower V̇O2 (–52% ± 14%), VE (–47% ± 16%), fR (–21% ± 14%), HR (–14% ± 16%), SBP (–73% ± 54%), RPE (–36% ± 26%), and dyspnea (–41% ± 37%) were found during ECC-M. During ECC-H, a similar metabolic demand to CONC-M was found. However, average power output was 117% ± 79% higher during ECC-H. Eccentric cycling can be safely performed by COPD patients and induced lower cardiorespiratory, metabolic, and perceptual responses than concentric exercise when performed at the same workload. Novelty Moderate- and high-intensity eccentric cycling can be performed by COPD patients. Moderate-intensity eccentric cycling showed lower cardiorespiratory, metabolic, and perceptual demand than concentric cycling at the same workload in COPD patients. Even at double workload, eccentric cycling induces lower cardiorespiratory, metabolic, and perceptual demand than moderate-intensity concentric cycling.
Reliability analysis of welded stud shear connectors on simply-supported bridge girders
Authors: Sjaarda Matthew , West Jeffrey S. , Walbridge Scott 
Published: May 2020

This paper examines the reliability of welded stud shear connectors for steel-concrete composite bridge girders. A finite element model of a simply-supported bridge was created featuring link connector elements representing the shear studs between beam and shell elements, representing a steel girder and concrete deck, respectively. The model is programmed using a program interface to build a model including studs with random strengths. Using this approach, many analyses can be run in succession, with connectors failing between each analysis. This study considers the probabilistic characteristics of the welded studs and truck loading and recognizes the interaction between ultimate limit state and fatigue limit state. The example bridge employed in this study was designed according to the CSA S6-2014 code provisions. Based on the presented reliability analysis, an increase in the CSA S6-2014 24 MPa endurance limit of at least 1.45 times is found to be acceptable.
S-wave single heavy baryons with spin-3/2 at finite temperature
Authors: Azizi K. , Türkan A. 
Published: May 2020

AbstractThe thermal behavior of the spectroscopic parameters of the S-wave single heavy baryons $$ \Sigma _{Q}^{*}, \Xi _{Q}^{*}$$ΣQ∗,ΞQ∗ and $$ \Omega _{Q}^{*} $$ΩQ∗ with spin-3/2 are investigated in QCD at finite temperature. We analyze the variations of the mass and residue of these baryons taking into consideration the contributions of QCD thermal condensates up to dimension eight in Wilson expansion. At finite temperature, due to the breakdown of the Lorentz invariance by the choice of reference frame and presence of an extra O(3) symmetry, some new four-dimensional operators come out in the form of the fermionic and gluonic parts of the energy momentum tensor that are taken into account in the calculations. Our analyses show that at lower temperatures, the parameters of baryons under consideration are not affected by the medium. These parameters, however, show rapid variations with respect to temperature at higher temperatures near to a pseudo-critical temperature, after which the baryons are melted. The results of the masses and residues at $$ T\rightarrow 0 $$T→0 limit are compatible with the available experimental data and predictions of other theoretical studies.
Effect of electron beam on the crystal structure of nanoscale Al particles
Authors: Abdullayeva T. T. , Jabarov S. H. , Huseynli S. , Abdurakhimov B. A. , Abiyev A. S. , Mirzayev M. N. 
Published: May 2020

E-beam irradiation is one of the favorite methods of recent years and it can deliver the irradiation dose in just a few seconds to form nanoparticles. It is possible to obtain nanoparticles with different properties by changing the experimental conditions, as well as radiolytic reduction process can be adjusted through accelerators, it is possible to obtain oxides and hydroxides of metal nanoparticles. This paper reports the investigation of high-energy electron beams (EBs) on the crystal structure of 40–60 nm nanoscale Al particles. The crystal structure of the samples was calculated using the Rietveld method in the FullProf program. Structure analysis of three different irradiated ([Formula: see text], [Formula: see text], [Formula: see text]) Al samples and nonirradiated Al samples was performed by XRD. Occurring energy during the process of linear electron acceleration was around [Formula: see text][Formula: see text]2–3 MeV. All samples were irradiated at room temperature. In addition to STP, temperature changes can be observed when the particles are exposed to high energy for a long time. At STP, nanoscale Al particles combine with the oxygen of the air and form Al2O3. Also, X-ray diffraction study showed that the instability does not only belong to Al particles but also to Al2O3 in view of the fact that precarious Al(OH)3 crystal structures were observed. Thus, radiation dependence of lattice parameters was obtained, the mechanism of change of lattice parameters was determined due to radiation.
Concordance and Discordance of Echocardiographic Parameters Recommended for Assessing the Severity of Mitral Regurgitation
Authors: Uretsky Seth , Aldaia Lillian , Marcoff Leo , Koulogiannis Konstantinos , Argulian Edgar , Lasam Glenmore , Gillam Linda 
Published: May 2020

Background:
The American College of Cardiology/American Heart Association and American Society of Echocardiography guidelines recommend assessing several echocardiographic parameters when evaluating mitral regurgitation (MR) severity. These parameters can be discordant, making the assessment of MR challenging. The degree to which echocardiographic parameters of MR severity are concordant is not well studied.

Methods:

We enrolled 159 patients in a prospective multicenter study. Eight parameters were included in this analysis: proximal isovelocity surface area (PISA)–derived regurgitant volume, PISA-derived effective regurgitant orifice area, vena contracta, color Doppler jet/left atrial area, left atrial volume index, left ventricular end-diastolic volume index, peak E wave, and the presence of pulmonary vein systolic reversal. Each echocardiographic parameter was determined to represent severe or nonsevere MR according to the American Society of Echocardiography guidelines. A concordance score was calculated as

so that a higher score reflects greater concordance. There was no discordance when all the echocardiographic parameters agreed and high discordance when 3 or 4 parameters were discordant.

Results:
The mean concordance score was 75±14% for the entire cohort. There were 9 (6%) patients with complete agreement of all parameters and 61 (38%) with high discordance. There was greater discordance in patients with severe MR but no difference between primary versus secondary or central versus eccentric jets. There was an improvement in concordance when only considering PISA-based regurgitant volume, PISA-based effective regurgitant orifice area, and vena contracta with agreement in 68% of patients.

Conclusions:
There was limited concordance between the echocardiographic parameters of MR severity, and the discordance was worse with more severe MR. Concordance improved when considering only 3 quantitative measures of vena contracta and PISA-based effective regurgitant orifice area and regurgitant volume. These findings highlight the challenges facing echocardiographers when assessing the severity of MR and emphasize the difficulty of using an integrated approach that incorporates multiple components.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04038879.