bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with injuries among tornado victims in Yancheng and Chifeng, China
Authors: Deng Qiangyu , Lv Yipeng , Zhao Fangjie , Yu Wenya , Dong Junqiang , Zhang Lulu 
Published: November 2019

Abstract
Background
As extremely violent meteorological disasters, tornadoes often cause serious casualties. The study aims to analyze the characteristics and causes of tornado injuries in China under certain humanistic and geographical conditions.

Methods
A random sampling questionnaire survey was developed and distributed to tornado victims from two separate occurrences: an Enhanced Fujita 4 tornado in Yancheng, and a Fujita 3 tornado in Chifeng. The information of demographic characteristics, disaster environment, and individual behaviors in victims was collected. Chi-square test and binary logistic regression were used to analyze influencing factor of injuries.

Results
A total of 94 valid questionnaires (participation rate 95.9%) were finally collected in Yancheng tornado and 67 valid questionnaires (participation rate 93.1%) in Chifeng tornado. Residents’ annual income (OR = 0.10, 95% CI 0.02–0.50, P = 0.005), degree of house collapse (OR = 183.12, 95% CI 8.04–4173.34, P = 0.001) have a significant impact on the probability of injury. Differences in tornado disaster drill awareness (P = 0.009), individual behaviors (P = 0.011) and fear level (P = 0.011) significantly affected the incidence of trauma. Whether victims were indoors or not has no statistical difference on injuries in China.

Conclusions
Our study clarifies risk factors and is conducive to the expansion of the investigation in tornado casualties. The government should improve the wind-resistance of residential buildings. Victims should participate in disaster prevention drills to take effective disaster avoidance actions.
Computational modeling of human bone fracture healing affected by different conditions of initial healing stage
Authors: Ghiasi Mohammad S. , Chen Jason E. , Rodriguez Edward K. , Vaziri Ashkan , Nazarian Ara 
Published: November 2019

Abstract
Background
Bone healing process includes four phases: inflammatory response, soft callus formation, hard callus development, and remodeling. Mechanobiological models have been used to investigate the role of various mechanical and biological factors on bone healing. However, the effects of initial healing phase, which includes the inflammatory stage, the granulation tissue formation, and the initial callus formation during the first few days post-fracture, are generally neglected in such studies.

Methods
In this study, we developed a finite-element-based model to simulate different levels of diffusion coefficient for mesenchymal stem cell (MSC) migration, Young’s modulus of granulation tissue, callus thickness and interfragmentary gap size to understand the modulatory effects of these initial phase parameters on bone healing.

Results
The results quantified how faster MSC migration, stiffer granulation tissue, thicker callus, and smaller interfragmentary gap enhanced healing to some extent. However, after a certain threshold, a state of saturation was reached for MSC migration rate, granulation tissue stiffness, and callus thickness. Therefore, a parametric study was performed to verify that the callus formed at the initial phase, in agreement with experimental observations, has an ideal range of geometry and material properties to have the most efficient healing time.

Conclusions
Findings from this paper quantified the effects of the initial healing phase on healing outcome to better understand the biological and mechanobiological mechanisms and their utilization in the design and optimization of treatment strategies. It is also demonstrated through a simulation that for fractures, where bone segments are in close proximity, callus development is not required. This finding is consistent with the concepts of primary and secondary bone healing.
Small is beautiful? Explaining resident satisfaction in Swedish nursing home care
Authors: Spangler Douglas , Blomqvist Paula , Lindberg Ylva , Winblad Ulrika 
Published: November 2019

Abstract
Background
Resident satisfaction is an important aspect of nursing home quality. Despite this, few studies have systematically investigated what aspects of nursing home care are most strongly associated with satisfaction. In Sweden, a large number of processual and structural measures are collected to describe the quality of nursing home care, though the impact of these measures on outcomes including resident satisfaction is poorly understood.

Methods
A cross-sectional analysis of data collected in two nationally representative surveys of Swedish eldercare quality using multi-level models to account for geographic differences.

Results
Of the factors examined, nursing home size was found to be the most important predictor of resident satisfaction, followed by the amount of exercise and activities offered by the nursing home. Measures of individualized care processes, ownership status, staffing ratios, and staff education levels were also weakly associated with resident satisfaction. Contrary to previous research, we found no clear differences between processual and structural variables in terms of their association with resident satisfaction.

Conclusions
The results suggest that of the investigated aspects of nursing home care, the size of the nursing home and the amount activities offered to residents were the strongest predictors of satisfaction. Investigation of the mechanisms behind the higher levels of satisfaction found at smaller nursing homes may be a fruitful avenue for further research.
Ultrasound-guided totally implantable venous access ports via the right innominate vein: a new approach for patients with breast cancer
Authors: Xu Liang , Qin Wenming , Zheng Weiwei , Sun Xingwei 
Published: November 2019

Abstract
Background
To evaluate the feasibility and safety of ultrasound-guided totally implantable venous access port (TIVAP) implantation via the right innominate vein in patients with breast cancer.

Methods
Sixty-seven breast cancer patients underwent ultrasound-guided implantation of TIVAPs via the right innominate vein for administration of chemotherapy. Clinical data including technical success, success rate for the first attempt, periprocedural, and postoperative complications were recorded and retrospectively studied.

Results
All patients underwent successful surgery. The success rate of the first attempt was 95.52% (64/67). The operation time was 28 to 45 min, with an average of 36 ± 6 min. Periprocedural complications included artery punctures in 1 (1.50%, 1/67) patient. Prior to this study, the mean TIVAP time was 257 ± 3 days (range 41 to 705 days). The rate of postoperative complications was 4.48% (3/67), including catheter-related infections in 1 case and fibrin sheath formation in 2 cases. Up to the present study, three people had unplanned port withdrawal due to complications, and the TIVAPs for 25 patients were still in normal use.

Conclusions
The success rate of ultrasound-guided TIVAPs via the right innominate vein is high with low complications, thus safe and feasible. This technique can provide a new option for chemotherapy of breast cancer patients.
Pathogenicity of the entomopathogenic fungus, Beauveria bassiana (Bals.) Vuill. endophytic and a soil isolate against the squash beetle, Epilachna chrysomelina (F.) (Coleoptera: Coccinellidae)
Authors: Hassan Feyroz Ramadan , Abdullah Samir Khalaf , Assaf Lazgeen Haji 
Published: November 2019

AbstractLaboratory and field bioassays were conducted to evaluate the pathogenicity of an endophytic and a soil isolate of the entomopathogenic fungus, Beauveria bassiana (Bals.) Vuill. against different stages of squash beetle, Epilachna chrysomelina (F.) (Coleoptera: Coccinellidae). Both isolates were identified by ITS rDNA sequence analysis. Both isolates were pathogenic to the squash beetle; however, their potential was different according to the conidia concentration and the exposure period. Three days post treatment, (100%) mortality rate was obtained, when the first and second larval instars were treated by the B. bassiana ES (soil isolate) compared to 83.67 and 72.60%, respectively when treated with the endophytic isolate. A percentage of 17.67% malformation occurred among the adults that emerged from treated pupae. The highest mortality percentage under field conditions were 28.67 and 22.33% for larvae and adults, respectively.
Pharmacogenetic (PGx) guided cancer pain management in an oncology palliative medicine (PM) clinic.
Authors: Patel Jai Narendra , Boselli Danielle , Symanowski James Thomas , Wodarski Stephanie , Turner ShRhonda , Slaughter Courtney , Waller Melissa , Baldassare Donna , Edwards Rebecca , Susi Beth , Greiner Rebecca , Edelen Connie 
Published: November 2019

117 Background: About 30% of cancer patients presenting with pain have symptomatic improvement using conventional strategies within one month. PGx may help personalize opioid selection and improve cancer pain management. Methods: This is a pragmatic pilot trial investigating the feasibility and application of PGx testing to improve pain management in adults with uncontrolled cancer pain referred to an oncology PM clinic. PM providers assessed patients using Edmonton Symptom Assessment Scale at baseline and opioid therapy was initiated or modified. A buccal swab was obtained for genotyping single nucleotide polymorphisms in: COMT, CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, and OPRM1. The first assessment occurred within one week of baseline and a second within another week if intervention was required. PGx results were available before the first assessment and utilized, if applicable, throughout the one-month study period. Pain improvement rate (≥ 2-point reduction on a 0-10 scale) from baseline to final visit, was compared to historical control data by a one-sided exact binomial test of proportions. Results: Of 75 undergoing PGx testing, 52 were evaluable for the primary endpoint (54% female, 81% white, 17% black, median age 63, 75% stage 3 or 4 disease, median personalized pain goal 3 [0-6]). 56% had pain improvement compared to 30% in historical controls (p < 0.001). At final assessment, 35% met their personalized pain goal. Of 26 (50%) requiring opioid adjustments, 18 (69%) had an actionable genotype with a 61% pain improvement rate. The two most common genes for opioid adjustment were CYP2D6 (16/18; 89%) and COMT (8/18; 44%). The most common PGx-guided modification involved switching from a CYP2D6-metabolized drug (hydrocodone, oxycodone, tramadol) to a non-CYP2D6-metabolized drug (fentanyl, hydromorphone, methadone, morphine). Conclusions: PGx implementation in an oncology PM clinic was feasible and improved pain management. Half of those requiring opioid adjustments had an actionable genotype, with the largest impact from CYP2D6 polymorphisms. Future studies should focus on preemptive PGx testing to guide initial drug selection and confirm clinical utility in a randomized trial. Clinical trial information: NCT02542397.
Prospective, longitudinal study of risk factors for cancer-related distress in colorectal cancer survivors from prior to surgery until one year after surgery: Results from the ColoCare study.
Authors: Han Claire J , Gigic Biljana , Schneider Martin , Kulu Yakup , Peoples Anita Roselyn , Ose Jennifer , Koelsch Torsten , Jacobsen Paul B. , Colditz Graham A. , Figueiredo Jane C. , Grady William M. , Li Christopher I. , Shibata David , Siegel Erin M. , Toriola Adetunji T. , Ulrich Alexis B. , Ulrich Cornelia M. , Syrjala Karen L 
Published: November 2019

146 Background: Although cancer-related distress is known to persist long after completion of colorectal cancer (CRC) treatment, factors related to distress are largely unexplored in CRC survivors. We examined changes over time and risk factors for distress in CRC patients over the first year after surgery. Methods: We included 212 CRC patients who consented pre-surgery, with data at 6 and 12 months post-surgery from the ColoCare Study in Heidelberg, Germany. Sociodemographic and lifestyle factors, social support and health-related quality of life (QOL) prior to surgery were evaluated as predictors of cancer-related distress. Distress was measured with the Cancer and Treatment Distress instrument (CTXD). Linear regression analyses examined associations between risk factors and distress. Results: Although overall mean of six distress subscales did not change from 6 to 12 months, distress subscale scores varied over time: health burden subscale score increased ( p < .001), while finances ( p = .004), medical demands ( p < .001), and identity ( p < .001) subscale scores decreased from 6 to 12 months. Uncertainty and family strain subscale scores did not change. Younger age, lower income, advanced cancer stage, poorer social support, and poorer baseline QOL scores predicted worse distress at 6 and 12 months. Conclusions: Cancer-related distress continues unresolved at 6 and 12 months post-surgery in this population of CRC survivors. Although some risk factors are difficult to alter, lack of social support may be modifiable and those at risk can be identified early after diagnosis. Screening for risk factors pre-surgery would allow for targeted interventions including strategies to improve resources for those with low support, thereby reducing long-term distress in CRC survivors.
Symptom monitoring and the uncertain threat of disease recurrence: A deductive thematic analysis with adolescent and young adult (AYA) cancer survivors.
Authors: Heathcote Lauren C , Loecher Nele , Spunt Sheri L. , Simon Pamela , Dahl Gary , Moiceanu Silvana , Cruanes Gael , Tutelman Perri , Schapira Lidia , Mueller Claudia , Chiu Bill , Simons Laura 
Published: November 2019

147 Background: Symptom monitoring plays an important role in both the physical and psychological challenges of surviving cancer. Anecdotally, cancer survival is characterized by uncertainty, symptom-related fear, and the interpretation of normal bodily sensations as symptomatic of cancer recurrence. This fear may lead to over-vigilance of benign bodily sensations, increasing anxiety and decreasing quality of life. Yet, there are few studies investigating how cancer survivors interpret and make sense of post-cancer symptoms. These studies are needed to guide considerations for clinical practice and the development of supportive interventions. Methods: We conducted in-depth semi-structured interviews with 18 AYA cancer survivors about how they interpret, manage, and respond to physical symptoms during survivorship. Participants were 15-25 years old. The sample was diverse in terms of disease history, ethnicity (8 Hispanic), and gender (9 females, 1 nonbinary). We conducted thematic analysis using a deductive coding scheme that was developed using our Cancer Threat Interpretation (CTI) theoretical model of cognitive, affective, and behavioral processes in post-cancer symptom perception. Results: AYA cancer survivors reported experiencing anxiety in the face of common physical sensations. These sensations were often interpreted as potential signs of recurrence or as late effects of treatment. Survivors most commonly reported worries about pain and fatigue, but also other sensations such as breathlessness. We coded participant transcripts into the following themes: biased attending towards symptoms, biased interpretations of symptoms as threatening, fear and worry about symptoms, and behavioral response to symptoms. In addition, we generated a new theme that was not previously captured in the CTI model: trust in the body. Conclusions: Knowing how to appraise and respond to symptoms such as pain is a challenge for AYA cancer survivors. This rich qualitative data provides support for the CTI model and suggests future directions. The results of this study can inform how clinicians talk to their patients about symptom monitoring after treatment ends.
Racial disparities in end-of-life care among Louisiana cancer decedents in a population-based study from 2011-2017.
Authors: Perry Laura M , Walsh Leah E. , Horswell Ronald , Miele Lucio , Chu San , Melancon Brian , Lefante John , Blais Christopher M. , Hoerger Michael 
Published: November 2019

46 Background: Cancer patients’ comfort near the end of life is often undermined by unnecessary aggressive treatments. Furthermore, Black adults receive more aggressive end of life care compared to White adults. We hypothesized that these inequalities would be especially pronounced in Louisiana given regional trends of high cancer mortality coupled with inaccessibility to high quality cancer care. Methods: This was a retrospective analysis of end-of-life care using a Patient-Centered Outcomes Research Institute (PCORI)-funded PCORnet database in the Deep South, called Research Action for Health Network (REACHnet). Of 3,089,092 individuals included, 1,290 met eligibility criteria for the present study: 1) died in Louisiana with a metastatic cancer diagnosis between January 1, 2011 and December 31, 2017, 2) had at least one outpatient clinic visit within six months of death, and 3) self-identified as White or Black. In collaboration with the Louisiana Clinical and Translational Science (LA CaTS) Center, we extracted data on five validated indicators of aggressive care in the final 30 days of life: chemotherapy use, inpatient hospitalizations, ED admissions, ICU admissions, and mechanical ventilation. Hypotheses were analyzed using binary logistic regression to examine whether patient race (White vs. Black) was associated with receipt of each indicator of aggressive end-of-life care, while controlling for sex, age, number of comorbidities, and cancer type. Results: Patients were either White ( n = 875, 67.8%) or Black ( n = 415, 32.2%) adults, and the majority were ≥60 years old (72.4%). Most patients (85.0%) received at least one indicator of aggressive care in the last 30 days of life ( M = 1.91, SD = 1.23), most commonly inpatient hospitalizations (77.0%). Black individuals were more likely than White individuals to be hospitalized ( OR = 1.66, 95% CI: 1.21 to 2.27, p= .002) or admitted to the ED ( OR= 1.57, 95% CI: 1.16 to 2.13, p= .004) during their last month of life, but race was not associated with other indicators. Conclusions: Findings have implications for informing healthcare decision making near the end of life for patients, families, and clinicians in the Deep South.
Patient perspectives on participation in phase 1 clinical trials.
Authors: Smith Thomas J. , Williams Anna Cathy , Ferrell Betty R. , Borneman Tami R. , Chung Vincent , Koczywas Marianna 
Published: November 2019

48 Background: Patients with solid tumors in Phase 1 clinical trials are at an important phase in the cancer trajectory. Understanding patients’ experiences can guide healthcare providers to provide optimum care. The main objectives of this study were to describe patient perspectives on participating in a Phase 1 trial, understand their disease status and treatment options and, to describe the impact of the disease and clinical trial participation on quality of life (QOL). Methods: Phase 1 patients (n = 30) who were participating in a larger randomized NCI-funded intervention trial (n = 470), were interviewed and tape recorded. The interviews were transcribed and content analysis methods were used to identify common themes. Results: Patients reported participating in the Phase 1 clinical trial because their doctors informed and encouraged them, they had no other treatment options if they wanted to live longer, or they wanted to help future cancer patients. Most patients believed that participation would improve or stabilize their illness and improve quality of life. They believed that when the clinical trial ended, there would be new treatments available. Participants reported that the physicians, nursing staff, social worker, and their families had been supportive. They reported that the treatment had been difficult on their families. Patients reported that compassion, cultural awareness, spiritual support, and the need for individual attention was important. There was little mention of end-of-life care or advance care planning. Conclusions: Patients participating in Phase 1 trials remain optimistic about treatment options while aware of their mortality. They have important needs for support to address quality of life concerns as well as better understanding their disease status, treatment options, and advance care planning for end of life care. Clinical trial information: NCT01828775.
Oncology practice changes during a multistep Oncology Care Model practice transformation project.
Authors: Wujcik Debra , Owenby Susan T. , Khushman Moh'd M. , Cameron Daniel , Butler Thomas Wayne , Tinnea Cathy , Cadden Austin , Young Pierce Jennifer , Pai Sachin Gopalkrishn 
Published: November 2019

88 Background: Treatment of lung cancer has seen a paradigm shift in recent years. While the availability of newer treatment options such as targeted therapy and immunotherapy have provided new hope for better outcomes, this has added to the cost of care. Participation in the Center for Medicare Services’ Oncology Care Model (OCM) provides opportunities for oncology practices to identify practice transformation (PT) change strategies that result in improved quality of care (QOL) and cost savings. Methods: A lung cancer PT team convened to facilitate changes that improve patient outcomes and decrease costs at an OCM organization. The year-long project included clinical treatment updates, quantitative and qualitative assessments, and data sharing. Practice changes focused on biomarker driven treatment selection, nurse navigation to better manage symptoms and decrease emergency department (ED) visits and hospitalizations, and earlier advanced care planning (ACP) discussions. Surveys were completed by oncology physicians and nurse practitioners at baseline (n = 9) and end of the project (n = 7). Results: After education, there were more correct responses in 3 of 6 knowledge questions and providers noted less concern about performance status or co-morbidities when prescribing immunotherapy. Providers noted fewer barriers with biomarker documentation; self-reported confidence in 4 questions of biomarker selection was unchanged. Providers reported increased participation of nurse navigators to impact ED visits and hospitalizations over time. Documentation of ACP discussions increased, 42% (8/19) to 56% (13/23), but did not reach statistical significance due to sample size. Although providers reported changes toward earlier ACP discussions, 1 in 3 still wait until performance status declines to initiate discussion. Conclusions: Systematic PT can improve quality of patients care and measures used in value-based care reimbursement models. Providers need ongoing education, practice feedback, and organizational support to effect positive practice changes. In addition, new strategies to increase provider ability to initiate end of life discussions need to be explored.
Biofunctional Molecules Inspired by Protein Mimicry and Manipulation
Authors: Muraoka Takahiro 
Published: November 2019

Abstract
This account focuses on synthetic approaches to develop functional molecules on the basis of mimicry and manipulation of proteins. Proteins are one of the central molecules serving vital functions and maintaining biological homeostasis. The sophisticated roles and dynamic functions found in proteins provide lots of useful clues to develop synthetic functional molecules. This account describes the development of synthetic supramolecular ion channels made of multiblock structures that can switch ion transportation in response to external stimuli by mimicking ligand-gated and mechano-responsive transmembrane proteins. Multiblock amphiphiles also perform membrane budding and self-assembly in a bilayer. This account also describes functionalization of poly(ethylene glycol) by structuring, which allows for controlling the thermal properties and protein aggregation suppression. The thermal response of poly(ethylene glycol) is also effective in a solid state to develop crystals showing thermal polymorphic transitions.