bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point-of-care ultrasound in Management for Dyspneic Uremic Patients: a case report
Authors: Wang Pei-Hsiu , Lien Wan-Ching 
Published: December 2019

Abstract
Background
Point-of-Care Ultrasound (PoCUS) is considered as an extension of clinicians’ patient care and can be integrated into daily clinical practice. Dyspnea is a common presentation in uremic patients. With the aids of PoCUS and integrated assessments of lung, heart and inferior vena cava (IVC), the etiology of dyspnea in uremic patients can be determined earlier.

Case presentation
A 67-year-old woman presented with progressive shortness of breath and bilateral legs edema for 3 weeks. The laboratory data revealed marked elevated level of serum creatinine and blood urea. A large amount of pericardial effusion was timely detected by PoCUS. Uremic pericarditis was suspected. Emergent hemodialysis was initiated and her symptoms improved.

Conclusions
PoCUS is a noninvasive and cost-effective imaging modality and it has been popular in the emergency department (ED). In uremic patients presenting with dyspnea, the integration of PoCUS into traditional physical examinations help emergency physicians narrow down the differential diagnoses.
A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine
Authors: Fleeman Nigel , Houten Rachel , Chaplin Marty , Beale Sophie , Boland Angela , Dundar Yenal , Greenhalgh Janette , Duarte Rui , Shenoy Aditya 
Published: December 2019

AbstractBackgroundTreatment with radioactive iodine is effective for many patients with progressive, locally advanced or metastatic, differentiated thyroid cancer. However, some patients become refractory to treatment. These types of patients are considered to have radioactive iodine refractory differentiated thyroid cancer (RR-DTC).MethodsWe searched Embase, MEDLINE, PubMed and the Cochrane Library from January 1999 through January 2017. Reference lists of included studies and ongoing trial registries were also searched. Reports of randomized controlled trials (RCTs), prospective observational studies, and systematic reviews/indirect comparisons were eligible for inclusion. In the absence of direct clinical trial evidence comparing lenvatinib versus sorafenib, we assessed the feasibility of conducting an indirect comparison to obtain estimates of the relative efficacy and safety of these two treatments.ResultsOf 2364 citations, in total, 93 papers reporting on 2 RCTs (primary evidence), 9 observational studies and 13 evidence reviews (supporting evidence) were identified. Compared to placebo, RCT evidence demonstrated improvements with lenvatinib or sorafenib in median progression-free survival (PFS) and objective tumour response rate (ORR). Overall survival (OS) was confounded by high treatment crossover (≥75%) in both trials. Adverse events (AEs) were more common with lenvatinib or sorafenib than with placebo but the most common AEs associated with each drug differed. Primarily due to differences in the survival risk profiles of patients in the placebo arms of the RCTs, we considered it inappropriate to indirectly compare the effectiveness of lenvatinib versus sorafenib. ORR and AE findings for lenvatinib and sorafenib from the supporting evidence were broadly in line with RCT evidence. Health-related quality of life (HRQoL) data were limited.ConclusionsLenvatinib and sorafenib are more efficacious than placebo (a proxy for best supportive care) for treating RR-DTC. Uncertainty surrounds the extent of the impact on OS and HRQoL. Lenvatinib could not reliably be compared with sorafenib. Choice of treatment is therefore likely to depend on an individual patient’s circumstances.
Why some donors are more willing to donate platelets? ----a qualitative study on 25 regular platelet donors in Guangzhou, China
Authors: Yu Chengpu , Lau Joseph Tak-fai , Zhong Weixing , Huang Xinting , Pan Chao , Chen Yu , Lu Huanpeng , Zhao Fengxiao , Zeng Siying , Lai Jinglin , Tie Chengwei , Li Xu , Zhang Jianlin , Zhang Chuangqi , Liu Ying , Jiang Qianli 
Published: December 2019

Abstract
Background
Since 1998, China has gradually moved toward voluntary uncompensated blood donation. In some cities, the shortage of platelets has been noticeably severe. Mutual assistance that collects blood from one’s family and social networks is a potential solution. The measure, however, turned out problematic. There are donors who choose to donate platelets over whole blood without compensations, and donate platelets directly to blood banks instead of via the mutual assistance system. This study explores reasons behind their choices qualitatively.

Methods
This report is based on data conducted from January to February 2018; 25 uncompensated regular platelet donors were interviewed. The blood component donation service team in Guangzhou facilitated the data collection process and referred prospectively eligible blood donors to our research team. The interviews took about 30 min to two hours to complete. The qualitative data were analyzed by using the software ATLAS.ti 8.

Results
Platelet donation takes a much long time than whole blood donation and requires complicated processes. It may also cause discomfort as the other blood components are returned to the body, causing physical and psychological distress due to worries about contamination. Thus, platelet donation tends to involve higher time and psychological costs than whole blood donation. Yet, it has short collection intervals that allows for more frequent donations, and urgency of a severer shortage than whole blood. Hence, regular platelet donors may feel higher significance in platelet donation than whole blood donation, with the belief that more lives would be saved. Some whole blood donors thus switched to become platelet donors. Mutual assistance blood donation was not chosen by the participants for platelet donation, because such donations may exert moral pressure to both the donors and recipients. Furthermore, “acquaintance” has been loosely defined; the system has sometimes been manipulated to become profit-making monetary transactions. It hence failed.

Conclusions
The practice of platelet donation reinforces the understanding that blood donation is a gift giving process performed among strangers. A safe and sustainable voluntary blood supply can only be secured in the absence of monetary transactions and moral pressure.
Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures
Authors: Zhong Rui , Liu Jianheng , Wang Runsheng , Liu Yihao , Chen Binbin , Jiang Wei , Mao Keya , Tang Peifu 
Published: December 2019

Abstract
Background
Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP).

Methods
We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups.

Results
The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level.

Conclusions
Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.
The impact of population ageing on end-of-life care in Scotland: projections of place of death and recommendations for future service provision
Authors: Finucane Anne M. , Bone Anna E. , Evans Catherine J. , Gomes Barbara , Meade Richard , Higginson Irene J. , Murray Scott A. 
Published: December 2019

Abstract
Background
Global annual deaths are rising. It is essential to examine where future deaths may occur to facilitate decisions regarding future service provision and resource allocation.

Aims
To project where people will die from 2017 to 2040 in an ageing country with advanced integrated palliative care, and to prioritise recommendations based on these trends.

Methods
Population-based trend analysis of place of death for people that died in Scotland (2004–2016) and projections using simple linear modelling (2017–2040); Transparent Expert Consultation to prioritise recommendations in response to projections.

Results
Deaths are projected to increase by 15.9% from 56,728 in 2016 (32.8% aged 85+ years) to 65,757 deaths in 2040 (45% aged 85+ years). Between 2004 and 2016, proportions of home and care home deaths increased (19.8–23.4% and 14.5–18.8%), while the proportion of hospital deaths declined (58.0–50.1%). If current trends continue, the numbers of deaths at home and in care homes will increase, and two-thirds will die outside hospital by 2040. To sustain current trends, priorities include: 1) to increase and upskill a community health and social care workforce through education, training and valuing of care work; 2) to build community care capacity through informal carer support and community engagement; 3) to stimulate a realistic public debate on death, dying and sustainable funding.

Conclusion
To sustain current trends, health and social care provision in the community needs to grow to support nearly 60% more people at the end-of-life by 2040; otherwise hospital deaths will increase.
Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study
Authors: Wijk Hanna , Ponzer Sari , Järnbert-Pettersson Hans , Kihlström Lars , Nordquist Jonas 
Published: December 2019

Abstract
Background
Educational leaders have been pointed out as being important for quality of medical education. However, their actual influence on the education can be limited. At the postgraduate level, educational leadership and its connection with quality is underexplored and knowledge about how to increase its impact is lacking. An increased understanding could be used in order to prioritize actions for strengthening the role. The aim of this study was to investigate factors related to the role of programme director associated with quality in postgraduate medical education.

Methods
A cross-sectional study was carried out. A questionnaire was sent to programme directors in Sweden (n = 519) comprising questions about background factors, work characteristics, work tasks, hindering and enabling factors, and the Utrecht Work Engagement Scale. A logistic regression and classification tree were used to identify factors associated with high qualitative education, defined as compliance with national regulations.

Results
The response rate was 54% (n = 279). In total, 62% of the programme directors reported high quality and factors associated with high quality included experiences of communication with residents, superiors and supervisors, and support from the supervisors. Other factors were consensus regarding postgraduate medical education at the workplace, adequate financial resources, the programme directors’ competence, and their perceived impact on education. Factors of particular importance seemed to differ depending on whether the programme directors were responsible for one or for multiple units. Most high-quality education was found in cases where programme directors were responsible for a single unit and perceived sufficient impact on education.

Conclusions
These results indicated that there was an association between factors related to programme director and quality in postgraduate medical education. The findings pointed out the importance of combining activities at both individual, group and organizational levels. Relational aspects should not be underestimated; faculty development and involvement are crucial.
What are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review
Authors: Davies Carmel , Fattori Francesco , O’Donnell Deirdre , Donnelly Sarah , Ní Shé Éidín , O. Shea Marie , Prihodova Lucia , Gleeson Caoimhe , Flynn Áine , Rock Bernadette , Grogan Jacqueline , O’Brien Michelle , O’Hanlon Shane , Cooney Marie Therese , Tighe Marie , Kroll Thilo 
Published: December 2019

AbstractBackgroundThe United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare.MethodsA Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, ‘what mechanisms enable healthcare professionals to adopt ADM into practice?’To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus.ResultsThe review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations.ConclusionsThis realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD.
Fibrosis independent atrial fibrillation in older patients is driven by substrate leukocyte infiltration: diagnostic and prognostic implications to patients undergoing cardiac surgery
Authors: Aguiar Christie M. , Gawdat Kareem , Legere Stephanie , Marshall Jean , Hassan Ansar , Kienesberger Petra C. , Pulinilkunnil Thomas , Castonguay Mathieu , Brunt Keith R. , Legare Jean-Francois 
Published: December 2019

Abstract
Background
The objectives of the study were to characterize and quantify cellular inflammation and structural remodeling of human atria and correlate findings with molecular markers of inflammation and patient surrogate outcome.

Methods
Voluntary participants undergoing heart surgery were enrolled in the study and blood samples were collected prior to surgery, and right atrium samples were harvested intraoperatively. Blood samples were analyzed by flow cytometry and complete blood counts. Atrial samples were divided for fixed fibrosis analysis, homogenized for cytokine analysis and digested for single cell suspension flow cytometry.

Results
A total of 18 patients were enrolled and samples assessed. Isolated cells from the atria revealed a CD45+ population of ~ 20%, confirming a large number of leukocytes. Further characterization revealed this population as 57% lymphocytes and 26% monocyte/macrophages (MoΦ), with the majority of the latter cells being classical (CD14++/CD16−). Interstitial fibrosis was present in 87% of samples and correlated significantly with patient age. Older patients (> 65) had significantly more atrial fibrosis and cellular inflammation. AFib patients had no distinguishing feature of atrial fibrosis and had significantly greater CD45+ MoΦ, increased expression of MMP9 and presented with a significant correlation in length of stay to CCL-2/MCP-1 and NLR (neutrophil-to-lymphocyte ratio).

Conclusion
Atrial fibrosis is correlated with age and not determinate to AFib. However, severity of atrial leukocyte infiltration and markers of matrix degradation are determinant to AFib. This also correlated with CCL2 (or MCP-1) and NLR-indicative of marked inflammation. These data show the potential importance of diagnostic and prognostic assessments that could inform clinical decision making in regard to the intensity of AFib patient management.
Zoledronic acid ameliorates the effects of secondary osteoporosis in rheumatoid arthritis patients
Authors: Xie Jun , Li Shaohua , Xiao Lianbo , Ouyang Guilin , Zheng Lin , Gu Yubiao , Gao Chengxin , Han Xiuwei 
Published: December 2019

Abstract
Background
Secondary osteoporosis may occur in patients with rheumatoid arthritis (RA), causing irreversible joint damage and disability. Bisphosphonates, the recently developed bone resorption inhibitors, have demonstrated significant therapeutic effects on senile and postmenopausal osteoporosis. This study evaluated the efficacy and safety of zoledronic acid (ZOL), with or without methotrexate (MTX), for the prevention and treatment of bone destruction in RA patients.

Methods
We recruited 66 RA patients with symptoms of secondary osteoporosis. They were randomized into three treatment groups—combined treatment with MTX and ZOL, ZOL monotherapy, or MTX monotherapy—in two consecutive 6-month periods. The participants were followed for 12 months. At the end of each treatment period, improvement in disease activity, bone destruction, and fracture risk were evaluated.

Results
Combined treatment with ZOL and MTX had significantly better clinical efficacy compared with either ZOL or MTX monotherapy (P < 0.05). The combination significantly improved the lumbar spine and hip BMD and reduced FRAX scores, suggesting that ZOL combined with MTX reduces bone loss and risk of hip fracture in RA patients with secondary osteoporosis.

Conclusion
ZOL has a synergistic effect when combined with MTX, inhibiting RA disease activity, reducing fracture risk, and improving quality of life in RA patients with secondary osteoporosis.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1800019290. Registered 3 November 2018–Retrospective registered, http://www.chictr.org.cn/showproj.aspx?proj = 31758
SOLO taxonomy as EFL students’ disciplinary literacy evaluation tool in technology-enhanced integrated astronomy course
Authors: Chubko Nadezhda , Morris Julia E. , McKinnon David H. , Slater Eileen V. , Lummis Geoffrey W. 
Published: December 2019

AbstractWhilst the role of disciplinary literacy in science, technology, engineering, and mathematics (STEM) education is becoming more prominent, there appears to be little adaptation or allowance made for English as a foreign or second language (EFL/ESL) students learning science in English, as well as no clear understanding of what comprises disciplinary literacy in science. In this article, we define the construct of disciplinary literacy in science education and justify the use of theStructure of the Observed Learning Outcome(SOLO) taxonomy (Biggs and Collis,Teaching for quality learning at university1982) as a tool for measuring EFL students’ disciplinary literacy development. This SOLO taxonomy was trialled in a STEM integrated astronomy course enhanced with a digital storytelling approach. Data were collected from adolescent EFL students’ written responses in their pre- and post-Astronomy Diagnostic Test. The results show a positive change in participants’ science disciplinary literacy development and contribute to the understanding of the EFL/ESL students’ science disciplinary literacy development and assessment.
Identification and prioritization of critical success factors in faith-based and non-faith-based organizations’ humanitarian supply chain
Authors: Azmat Muhammad , Atif Muhammad , Kummer Sebastian 
Published: December 2019

AbstractIn the last few decades, an exponential increase in the number of disasters, and their complexity has been reported, which ultimately put much pressure on relief organizations. These organizations cannot usually respond to the disaster on their own, and therefore, all actors involved in relief efforts should have end-to-end synchronization in order to provide relief effectively and efficiently. Consequently, to smoothen the flow of relief operation, a shared understanding of critical success factors in humanitarian supply chain serves as a pre-requisite for successful relief operation. Therefore, any member of the humanitarian supply chain might disrupt this synchronization by neglecting one or several of these critical success factors. However, in this study, we try to investigate how faith-based and non-faith-based relief organizations treat these critical success factors. Moreover, we also try to identify any differences between Islamic and Christian relief organizations in identifying and prioritizing these factors. To achieve the objective of this study, we used a two-stage approach; in the first stage, we collected the critical success factors from existing humanitarian literature. Whereas, in the second stage, using an online questionnaire, we collected data on the importance of selected factors from humanitarian relief organizations from around the world in collaboration with World Association of Non-Governmental Organizations (WANGO). Later, responses were analyzed to answer the research questions using non-parametric Binomial and Wilcoxon Rank-Sum tests. Test results indicate that for RQ1, two but all factors are significant for successful relief operation. For RQ2, we found significant differences for some CSF among faith-based and non-faith-based relief organizations. Similarly for RQ3, we found significant differences for some CSF among Islamic and Christian relief organizations.