bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meningitis gone viral: Description of the Echovirus Wave 2013 in Germany
Authors: Graf Jonas , Hartmann Christian , Lehmann Helmar C , Otto Carolin , Adams Ortwin , Karenfort Michael , Schneider Christian , Ruprecht Klemens , Bosse Hans Martin , Diedrich Sabine , Böttcher Sindy , Schnitzler Alfons , Hartung Hans-Peter , Aktas Orhan , Albrecht Philipp 
Published: November 2019

Abstract
BACKGROUND: Aseptic meningitis epidemics may pose various health care challenges. METHODS: We describe the German enterovirus meningitis epidemics in the university hospital centers of Düsseldorf, Cologne and Berlin between January 1st and December 31st, 2013 in order to scrutinize clinical differences from other aseptic meningitis cases.RESULTS: A total of 72 enterovirus (EV-positive) meningitis cases were detected in our multicenter cohort, corresponding to 5.8% of all EV-positive cases which were voluntarily reported within the National Enterovirus surveillance (EVSurv, based on investigation of patients with suspected aseptic meningitis/encephalitis and/or acute flaccid paralysis) by physicians within this period of time. Among these 72 patients, 38 (52.8%) were enterovirus positive and typed as echovirus (18 pediatric and 20 adult cases, median age 18.5 years; echovirus 18 (1), echovirus 2 (1), echovirus 30 (31), echovirus 33 (1), echovirus 9 (4)). At the same time, 45 aseptic meningitis cases in our cohort were excluded to be due to enteroviral infection (EV-negative). Three EV-negative patients were tested positive for varicella zoster virus (VZV) and one EV-negative patient for herpes simplex virus 2. Hospitalization was significantly longer in EV-negative cases. Cerebrospinal fluid analysis did not reveal significant differences between the two groups. After discharge, EV-meningitis resulted in significant burden of sick leave in our pediatric cohort as parents had to care for the children at home. CONCLUSIONS: Voluntary syndromic surveillance, such as provided by the EVSurv in our study may be a valuable tool for epidemiological research. Our analyses suggest that EV-positive meningitis predominantly affects younger patients and may be associated with a rather benign clinical course, compared to EV-negative cases.
Combined use of apatinib mesylate and vinorelbine versus single use of vinorelbine in recurrent or metastatic triple-negative breast cancer: study protocol for a randomized controlled clinical trial
Authors: Wu Shuo , Zhang Liang , Li Huan , Xu Junnan , Jiang Cui , Sun Tao 
Published: November 2019

Abstract
Background: The emergence of new molecular targeted drugs provides new prospects for the treatment of advanced breast cancer; the future therapeutic trend includes chemotherapy combined with molecular targeted therapy. Apatinib mesylate, a novel, small anti-angiogenic agent, highly selectively inhibits the activity of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib mesylate also blocks the signaling of vascular endothelial growth factor binding to its receptor, thereby, strongly inhibiting tumor angiogenesis and exerting an anti-tumor effect. However, a randomized controlled clinical trial of apatinib combined with vinorelbine for triple-negative breast cancer (TNBC) has not been reported. We will compare the therapeutic effect of vinorelbine alone or in combination with apatinib mesylate in patients with recurrent or metastatic TNBC in North China who have received at least two drug treatments including anthracyclines and taxanes. Methods/analysis: This study is a triple-blind, randomized, placebo-controlled, parallel-group clinical trial. We plan to include 164 female patients with locally recurrent or metastatic TNBC and without BRCA1 mutation (as BRCA-positive patients would have poor responses to the therapeutic methods designed in this study), admitted at the Liaoning Cancer Hospital & Institute, Northeast China. All enrolled patients will be randomized to orally take vinorelbine alone (40 mg orally, thrice a week (Mondays, Wednesdays, and Fridays) in each 3-week cycle) or combined with apatinib mesylate (500 mg orally, once daily of each 3-week cycle). Radiographic assessment will be performed every 6 weeks for 36 weeks, and every 9 weeks thereafter. The primary outcome is measurement of progression-free survival and secondary outcomes include overall survival, disease control rate, objective response rate, and incidence of adverse events at grades 3 and 4 as defined by the National Cancer Institute Common Toxicity Criteria [NCI-CTC] Version 4.0. Outcome measures will be evaluated at baseline (< 2 weeks before starting treatment), every 6 weeks during treatment, and at 4 weeks and every 3 months after treatment discontinuation. Discussion: Based on the data from this trial, we hope to identify a treatment plan that is suitable for female TNBC patients in Northeast China who have been treated with anthracyclines and taxanes.
Using digital tools in the recruitment and retention in randomised controlled trials: Survey of UK Clinical Trial Units and a qualitative study
Authors: Blatch-Jones Amanda Jane , Nuttall Jacqueline , Bull Abby , Worswick Louise , Mullee Mark , Peveler Robert , Falk Stephen , Tape Neil , Hinks Jeremy , Lane Athene J , Wyatt Jeremy C , Griffiths Gareth 
Published: November 2019

Abstract
Background Recruitment and retention of participants in Randomised Controlled Trials (RCTs) is a key determinant of success, but is challenging. Trialists and UK Clinical Research Collaboration (UKCRC) Clinical Trials Units (CTUs) are increasingly exploring the use of digital tools to identify, recruit and retain participants. The aim of this UK National Institute for Health Research (NIHR) study was to identify what digital tools are currently used by CTUs and understand the performance characteristics required to be judged useful.Methods A scoping of searches (and a survey with NIHR funding staff), a survey with all 52 UKCRC CTUs and 16 qualitative interviews were conducted with five stakeholder groups including trialists within CTUs, funders and research participants. A purposive sampling approach was used to conduct the qualitative interviews during March-June 2018. Qualitative data were analysed using a content analysis and inductive approach.Results Responses from 24 CTUs (46%) identified that database-screening tools were the most widely used digital tool for recruitment, with the majority being considered effective. The reason (and to whom) these tools were considered effective was in identifying potential participants (for both Site staff and CTU staff) and reaching recruitment target (for CTU staff/CI). Fewer retention tools were used, with Short Message Service (SMS) or email reminders to participants being the most reported. The qualitative interviews revealed five themes across all groups: ‘security and transparency’, ‘inclusivity and engagement’, ‘human interaction’, ‘obstacles and risks’ and ‘potential benefits’. There was a high level of stakeholder acceptance of the use of digital tools to support trials, despite the lack of evidence to support them over more traditional techniques. Certain differences and similarities between stakeholder groups demonstrated the complexity and challenges of using digital tools for recruiting and retaining research participants.Conclusions Our studies identified a range of digital tools in use in recruitment and retention of RCTs, despite the lack of high quality evidence to support their use. Understanding the type of digital tools in use to support recruitment and retention will help to inform funders and the wider research community about their value and relevance for future RCTs. Consideration of further focused digital tool reviews and primary research will help to reduce gaps in the evidence base.
An exploration of the experiences of professionals supporting patients approaching the end of life in medicines management at home. A qualitative study. An exploration of the experiences of professionals supporting patients approaching the end of life in medicines management at home. A qualitative study.
Authors: Wilson Eleanor , Caswell Glenys , Latif Asam , Anderson Claire , Faull Christina , Pollock Kristian 
Published: November 2019

Abstract
Background: The management of medicines towards the end of life can place increasing burdens and responsibilities on patients and families. This has received little attention yet it can be a source of great difficulty and distress patients and families. Dose administration aids can be useful for some patients but there is no evidence for their wide spread use or the implications for their use as patients become increasing unwell.
Aim: To explore how healthcare professionals describe the support they provide for patients to manage medications at home at end of life.
Methods: Qualitative interview study with thematic analysis. Participants were a purposive sample of 40 community healthcare professionals (including GPs, pharmacists, and specialist palliative care and community nurses) from across two English counties.
Results: Healthcare professionals reported a variety of ways in which they tried to support patients to take medications as prescribed. While the paper presents some solutions and strategies reported by professional respondents it was clear from both professional and patient/family caregiver accounts in the wider study that rather few professionals provided this kind of support. Standard solutions offered included: rationalising the number of medications; providing different formulations; explaining what medications were for and how best to take them. Dose administration aids were also regularly provided, and while useful for some, they posed a number of practical difficulties for palliative care. More challenging circumstances such as substance misuse and memory loss required more innovative strategies such as supporting ways to record medication taking; balancing restricted access to controlled drugs and appropriate pain management and supporting patient choice in medication use.
Conclusions: The burdens and responsibilities of managing medicines at home for patients approaching the end of life has not been widely recognised or understood. This paper considers some of the strategies reported by professionals in the study, and points to the great potential for a more widely proactive stance in supporting patients and family carers to understand and take their medicines effectively. By adopting tailored, and sometimes, ‘outside the box’ thinking professionals can identify immediate, simple solutions to the problems patients and families experience with managing medicines.
HIV testing experiences in Nairobi slums: The good, the bad and the ugly
Authors: Wekesa Eliud 
Published: November 2019

Abstract
Background
HIV testing is an integral component of HIV prevention, treatment and care and, therefore, is crucial in achieving UNAIDS 90-90-90 targets. HIV testing in Kenya follows both the voluntary counselling and testing (VCT) and provider initiated testing and counselling (PITC) models. However, little is known about the individual experiences of undergoing an HIV test in the two testing models. This study provides experiential evidence of undergoing an HIV test in a resource poor urban slum setting.
Methods
The study explored testing experiences and challenges faced in respect to ensuring the 3 Cs (consent, counselling and confidentiality), using in-depth interviews (N=41) with HIV-infected men and women in two slum settlements of Nairobi City. The in-depth interview respondents were aged above 18 years with 56% being females. All interviews were audio-recorded, transcribed and then translated into English. The transcribed data were analysed using thematic analysis method.
Results
The respondent HIV-testing experiences were varied and greatly shaped by circumstances and motivation for HIV testing. The findings show both positive and negative experiences, with sporadic adherence to the 3Cs principle in both HIV testing models. Although some respondents were satisfied with the HIV testing process, a number of them raised a number of concerns, with instances of coercion and testing without consent being reported.
Conclusion
The 3Cs (consent, counselling and confidentiality) principle must underlie HIV testing and counselling practices in order to achieve positive testing outcomes. The study concludes that adherence to the 3Cs during HIV testing contributes to both the individual and public health good – irrespective of whether testing is initiated by the individual or by the health provider.

Keywords: HIV testing, VCT, PITC, PLWHA, Slums, Kenya, sub-Saharan Africa
The IASP Pain curriculum for undergraduate allied health professionals: educators defining competence level using Dublin Descriptors.
Authors: Lankveld Wim van , Afram Basema , Staal J. Bart , Sande Rob van der 
Published: November 2019

Abstract
Background. Improving pain education for undergraduate health professionals is hampered by lacking shared education outcomes. This study describes how educators and pain experts operationalize content and competency levels deemed necessary for an undergraduate pain education core curriculum for health professionals (physical and occupational therapists, nurses, psychologists). Methods. Educators and experts on pain and pain education gave their opinion on content and competency level for each individual item of the International Association for the Study of Pain (IASP) inter professional curriculum. Participants decided whether or not to include each item in the undergraduate curriculum. Items were included when > 70% of the respondents agreed. The required competency for each item was rated using ordinal Dublin Descriptors. Results. Overall, 22 experts rated the curriculum, with > 70% agreement on inclusion on 62% of the IASP items. Within the IASP domain ‘Multidimensional nature of pain’ there was full agreement on the inclusion of 12 items. ‘Ethics’ was considered less important with only 1 item deemed necessary. There is a high number of items selected within the domains ‘Pain Assessment and measurement’ (78%) and ‘Management of Pain’ (74%). Considerably less items were chosen in the domain ’Clinical Conditions’ (41%). For most items the median required skills and competency level was either Knowledge and Understanding, or Applying Knowledge and Understanding. Conclusion. Overall, educators and experts in pain agreed on content and competency levels for an undergraduate pain curriculum based on the IASP. Defining a shared competency level will help improve definition of education outcome.
Musculoskeletal Symptoms among Radiologists in Saudi Arabia: A Multi-Center Cross-Sectional Study
Authors: Shammari Malak Al , Hassan Ali , Dandan Omran Al , Gadeeb Mohammed Al , Bubshait Dalal 
Published: November 2019

Abstract
Background : Musculoskeletal symptoms account for the majority of work-related illnesses resulting in a significant economic burden on society. Computer users are subject to unique repetitive strains that predispose them to musculoskeletal symptoms. In the digitalized field of radiology, radiologists spend long hours interpreting medical images on computers. This study aimed to determine the prevalence of musculoskeletal symptoms among radiologists in Saudi Arabia and their contributing factors. Methods : An online survey was sent to radiologists in all hospitals (academic, public and private) in the major cities of the Eastern Province of Saudi Arabia covering demographic characteristics, workload (e.g. the time spent at a computer workstation), and workstation environments including the number of monitors as well as the adjustability of the height of the workstation and the viewing distance. This survey of 263 radiologists was conducted in April 2019. It included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. The study outcome was the presence of disabling musculoskeletal symptoms in any body region, which restricted the performance of normal activities in the last 12 months. Results were analyzed descriptively using a Chi-square test and logistic regression analysis to estimate the odd ratio of experiencing disabling musculoskeletal symptoms in the last 12 months. Results : The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were aged below 40 years. A multivariate logistic regression analysis revealed being a female radiologist (OR = 2.7; 95% CI: 1.2–6.5), aged 30–39 years (OR = 4.1; 95% CI: 1.1–15.3), and predominantly reviewing computed tomography (CT) images (OR = 4.1; 95% CI: 1.4–12.3) or ultrasound scans (OR = 5.9; 95% CI: 1.4–25.3) were associated with higher prevalence of disabling musculoskeletal symptoms, compared to those aged below 30 years and those who reviewed various imaging modalities, respectively. Conclusions : Musculoskeletal symptoms are common among radiologists with lower back and neck pain being the most frequent complaints. Being a female radiologist, aged 30–39 years, and reviewing CT or ultrasound scans were associated with higher rates of disabling musculoskeletal symptoms.
A pilot study: A possible implication of Candida as an etiologically endogenous pathogen for oral lichen planus
Authors: He Hong , Xia Xinyu , Yang Haiping , Peng Qiao , Zheng Jiaoer 
Published: November 2019

Abstract
Background: The aim of this study wasto investigate the prevalence and genotypic profiles of Candida albicansinpatients with oral lichen planus (OLP).
Materials and Methods:Positive rates and genotypic profiles of Candida albicansstrains from OLP patients and healthy controls were analyzed. Random amplified polymorphic DNA and internal transcribed spacer of ribosome DNApolymerase chain reactions were used to sequence the DNA of these strains, and then their geneticsimilarity was measured using BLAST, UIV Band, and Vector NTI Suite Sequence AnalysesSoftware.
Results:The prevalence of C. albicansstrains detected from erosive-OLP, non-erosive OLP, and normal individuals was 18.87%, 18.75%, and 7.92%, respectively. Four different genotypes were revealed by the two methods. To be specific, type I was found only in the healthy subjects; type II a and II b were found in non-erosive OLP, and type III was identified in erosive OLP. Intragroup similarity coefficients, i.e. SABwere 100%, and inter-groups similarity coefficients, i.e. SABwere less than 30%.
Conclusions:The genotypic results of C. albicansin OLPrevealedan endogenous rather than exogenous infection of C. albicans. In addition, a possible pathogenic role of C. albicansin OLP, with theetiologic sense contributing to a more proper recognition on the pathogenesis,development, and progression of OLP, as well as some strategies for its diagnosis and treatment were identified.
Relocation experiences of the elderly to a long-term care facility in Taiwan: a qualitative study
Authors: Wu Chia-Shan , Rong Jiin-Ru 
Published: November 2019

Abstract
Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.
Canine colostrum exosomes: characterization, influence on canine mesenchymal stem cell secretory profile and fibroblast anti-oxidative capacity
Authors: Villatoro Antonio J , Martín-Astorga María del Carmen , Alcoholado Cristina , Becerra José 
Published: November 2019

Abstract
Background Colostrum is a specific secretion of the mammary gland fundamental for the survival of the puppy during the first weeks after birth. It contains important bioactive molecules involved in the passive immunity and the maturation of various organs, highlighting small vesicles named exosomes. Exosomes have not been described yet in canine colostrum milk, where its role is crucial in dam-newborn communication for the development of the neonate. Results Exosomes were abundant in canine colostrum milk and appeared with a characteristic cup-shaped morphology and well-defined round vesicles. Their size distribution was between 37−140 nm and western blot analysis showed an expression of specific exosomal markers. Proteomic analysis revealed a total of 826 proteins in exosomes cargo. We also found that exosomes modified proliferation and secretory profile in canine mesenchymal stem cells derived from bone marrow and adipose tissue, differently according to their origin. Besides, the exosomes of canine colostrum demonstrated a potent antioxidant effect on canine fibroblast. Conclusions We described for the first time the isolation and characterization of milk exosomes from canine colostrum. Our findings highlight the abundant presence of exosomes in the colostrum of the canine species and contribute to explain their important antioxidant capacity after parturition and their role in the modulation of cell development and tissue differentiation in the newborn, where mesenchymal stem cells seem to play a key role.