bluuebunny/crossref_metadata_2025_split huggingface dataset:
Theoretical feasibility of dual‐energy radiography for structural and functional imaging of chronic obstructive pulmonary disease
Authors: Basharat Fateen , Belli Michael , Kirby Miranda , Tanguay Jesse 
Published: October 2020

PurposeChronic obstructive pulmonary disease (COPD) affects ∼200 million people worldwide. We propose two‐dimensional (2D) dual‐energy (DE) x‐ray imaging of lung structure and function for the assessment of COPD, and investigate the resulting image quality theoretically.MethodsWe investigated xenon‐enhanced DE (XeDE) radiography for functional imaging of COPD and unenhanced DE radiography for structural imaging of COPD. We modeled the ability of human observers to detect ventilation defects in XeDE images and emphysema in (unenhanced) DE images using the detectability index () as a figure of merit. We accounted for the extent of emphysematous destruction and functional impairment as a function of disease severity, defect/lesion contrast, spatial resolution, x‐ray scatter, quantum noise, anatomic noise, and the efficiency of human observers. Whether or not disease was detectable was determined based on a detectability threshold of two. For (unenhanced) DE imaging of emphysema, we compared detectability with that of single‐energy (SE) imaging. Models of signal and noise were compared to published data.ResultsModels of signal and noise agreed well with published data, and model predictions of the detectability of emphysema by SE radiography were consistent with poor sensitivity (i.e., ) to mild to moderate COPD but moderate sensitivity (i.e., ) to severe COPD. The detectability of emphysema by DE radiography was greater than that of SE radiography, but did not cross the threshold of detectability for mild to moderate COPD. The detectability index for XeDE imaging exceeded the detectability threshold for mild, moderate, and severe COPD.ConclusionsDual‐energy radiography may offer modest improvements in the detection of emphysema relative to SE imaging, but will unlikely enable detecting mild and moderate COPD. However, XeDE radiography may enable detection of functional abnormalities associated with mild, moderate and severe COPD at x‐ray exposures typical of those used in conventional chest radiography, thus warranting further investigation as a low‐dose, low‐cost alternative to CT‐ and MRI‐based approaches for functional imaging of COPD.
Utilization of a standardized discharge checklist to improve the transition of care for patients receiving parenteral nutrition
Authors: Doh Jean , Hencken Laura , Mlynarek Linda , MacDonald Nancy 
Published: October 2020

AbstractBackgroundGuidelines recommend using discharge checklists to discharge patients receiving parenteral nutrition (PN). Transition‐of‐care (TOC) tools have not been extensively studied in the PN population. The purpose of this study is to evaluate the impact of a standardized PN discharge checklist on TOC for PN patients.MethodsThis is an Institutional Review Board–approved, retrospective quasi‐experimental study of patients discharged receiving PN between January 1, 2014, and May 31, 2018. The primary end point was the completion of a PN discharge bundle (identification of a responsible provider to monitor PN after discharge, meeting daily caloric requirement of 20–35 kcal/kg/d, cycling PN prior to discharge). Secondary end points included documentation of PN discharge checklist components, hospital length of stay, frequency of 30‐day hospital encounters, cause of hospital encounters, and time to readmission.ResultsFifty encounters were included in the pregroup and postgroup each (n = 100). There was a significant increase in completion of the TOC bundle in the postgroup (54% vs 76%, P = .035), driven by identification of a responsible provider for outpatient PN management (54% vs 82%, P = .005). Other PN discharge checklist components impacted included the following: case manager had the PN prescription for home infusion (50% vs 80%, P = .003), assessment for home glucometer (40% vs 90%, P < .001), and PN plan‐of‐care note documentation at discharge (18% vs 82%, P < .001).ConclusionsA standardized PN discharge checklist improved completion of discharge bundle.
Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies
Authors: Yang Chao , Lu Yifei , Wan Min , Xu Dengfeng , Yang Xian , Yang Ligang , Wang Shaokang , Sun Guiju 
Published: October 2020

AbstractThe purpose of this meta‐analysis was to summarize randomized controlled trial (RCT) evidence and evaluate the efficacy and safety of vitamin D (VD) supplementation as an adjunct to antibiotics for the treatment of pneumonia. Data sources published from the inception dates up to January 2020 were searched. RCTs of VD supplementation of any duration, age, and dosing regimen type were eligible for inclusion if data on pneumonia were collected. Thirteen studies (4786 randomized participants) fulfilled eligibility criteria. VD supplementation significantly increased levels of serum 25(OH)D (mean difference = 15.97; 95% CI, 7.49–24.44; P = .002) and reduced incidence of repeat episodes of pneumonia (risk ratio [RR] = 0.68; 95% CI, 0.50–0.93; P = .02). Subgroup analysis revealed VD supplementation had more reducing effects on repeat episodes of pneumonia among participants in trials in which the population were children (RR = 0.66; 95% CI, 0.48–0.90), duration <3 months (RR = 0.55; 95% CI, 0.33–0.91), or dose of VD <300,000 IU (RR = 0.51; 95% CI, 0.29–0.89). Although our results suggested that VD supplementation had a positive effect on recovery rate of pneumonia (RR = 1.28; 95% CI, 0.94–1.74; I2 = 13%), there was no statistical difference (P = .12). High‐dose VD intervention may have an effect on reducing the incidence rate of repeat episodes of pneumonia by enhancing immune efficacy, although more population studies are needed to support that VD supplementation has therapeutic effects on pneumonia itself.
The need for oral assessment and referral practices tool for palliative patients in Brunei Darussalam: A cross‐sectional study
Authors: Dhaliwal Jagjit S. , Murang Zaidah R. , Haji Husaini Hajah A. , Idris Deeni R. , Venkatasalu Munikumar R. 
Published: October 2020

AbstractAimThis study aimed to investigate knowledge, experiences, perceptions and barriers of healthcare professionals regarding palliative oral care.MethodsThe study involved 169 palliative care professionals in Brunei. Data collection tool was pretested, validated and self‐administered with sections on demographics; knowledge, attitude and practices; referral of patients; perspectives; and barriers to oral palliative care.Results97.3% of participants believed that palliative patients need oral care, and 11.6% of participants were trained in this area. 43.8% were unsure about referral process, and 66.1% of participants had never used a tool to assess oral conditions of palliative patients. Most common oral condition encountered was mucositis (54.5%). 74.1% of participants expected family members to be responsible, and the absence of proper guidelines for assessment (66.1%) was the top challenge in providing oral care for palliative patients.ConclusionThis study highlights perceptions and experiences of healthcare professionals and need for improved care through development of oral assessment and referral practices tool for palliative patients.
“Often Relatives are the Key […]” –Family Involvement in Treatment Decision Making in Patients with Advanced Cancer Near the End of Life
Authors: Laryionava Katsiaryna , Hauke Daniela , Heußner Pia , Hiddemann Wolfgang , Winkler Eva C. 
Published: October 2020

Abstract

Background
Family communication has been increasingly recognized as an important factor in decision making near the end of life. However, the role of the family in decision making is less studied in oncology settings, where most patients are conscious and able to communicate almost until dying. The aim of this study was to explore oncologists’ and nurses’ perceptions of family involvement in decision making about forgoing cancer-specific treatment in patients with advanced cancer.

Materials and Methods
Qualitative semistructured interviews with 22 oncologists and 7 oncology nurses were analyzed according to the grounded theory approach. The results were discussed against the background of the clinical and ethical debate on family role near the end of life.

Results
We could identify two approaches shared by both oncologists and nurses toward family involvement. These approaches could be partly explained by different perception and definition of the concept of patients' autonomy: (a) a patient-focused approach in which a patient's independence in decision making was the highest priority for oncologists and (b) a mediator approach with a family focus in which oncologists and nurses assigned an active role to patients' family in decision making and strived for building consensus and resolving conflicts.

Conclusion
The main challenge was to involve family, increasing their positive influences on the patient and avoiding a negative one. Thereby, the task of both oncologists and oncology nurses is to support a patient's family in understanding of a patient's incurable condition and to identify a patient's preference for therapy.

Implications for Practice
This study focused on oncologists’ and oncology nurses’ perceptions of family involvement in decision making about treatment limitation in patients with advanced cancer who are able to communicate in a hospital setting. Oncologists and oncology nurses should be aware of both positive aspects and challenges of family involvement. Positive aspects are patients’ emotional support and support in understanding and managing the information regarding treatment decisions. Challenges are diverging family preferences with regard to treatment goals that might become a barrier to advanced care planning, a possible increased psychological burden for the family. Especially challenging is involving the family of a young patient because increased attention, more time investment, and detailed discussions are needed.
Clinical impact of hypothalamic‐pituitary disorders after conformal radiation therapy for pediatric low‐grade glioma or ependymoma
Authors: van Iersel Laura , van Santen Hanneke M. , Potter Brian , Li Zhenghong , Conklin Heather M. , Zhang Hui , Chemaitilly Wassim , Merchant Thomas E. 
Published: October 2020

AbstractBackgroundTo determine the impact of hypothalamic‐pituitary (HP) disorders on health outcomes in children and adolescents who received conformal radiation therapy (RT) for central nervous system tumors.ProcedureCohort study including 355 patients (age ≤25 years at diagnosis) treated with high‐dose (50.4‐59.4 Gy) RT using photons for low‐grade glioma or ependymoma. Patients (median age, 6.4 years at RT) received systematic endocrine follow‐up (median duration, 10.1 years; range, 0.1‐19.6). Associations between HP disorders and adverse health outcomes were determined by multivariable analysis.ResultsPrevalence was 37.2% for growth hormone deficiency (GHD), 17.7% for gonadotropin deficiency (LH/FSHD), 14.9% for thyroid‐stimulating hormone deficiency (TSHD), 10.3% for adrenocorticotropic hormone deficiency (ACTHD), and 12.6% for central precocious puberty (CPP). Hypothalamus mean dose ≥ 36 Gy was associated with higher odds of any deficiency. GHD was associated with short stature (OR 2.77; 95% CI 1.34‐5.70), low bone mineral density (OR 3.47; 95% CI 1.16‐10.40), and TSHD with dyslipidemia (OR 5.54; 95% CI 1.66‐18.52). Patients with ACTHD and CPP had lower intelligence quotient scores, and memory scores were impaired in patients with GHD (P = 0.02). Treatment of GHD was not associated with increased risk for tumor recurrence, secondary tumors, or mortality.ConclusionsHP disorders occur frequently in patients receiving high‐dose RT and are related to physical and neurocognitive well‐being. Future studies are needed to assess whether further optimization of endocrine management yields better health outcomes.
Cyclic dipeptides: Biological activities and self‐assembled materials
Authors: Zhao Kaili , Xing Ruirui , Yan Xuehai 
Published: October 2020

AbstractCyclic dipeptides (CDPs) are the smallest cyclic peptides containing 2,5‐diketopiperazine rings. CDPs have advantages of structures and properties, including excellent hydrogen‐bonding‐forming ability (two hydrogen bonding acceptors and two hydrogen bonding donors), structural rigidity, and enzymatic stability, which make CDPs potential candidates as core scaffolds for drug discovery and building blocks for self‐assembly. In this review, we focus on distinctive bioactivities of CDPs, such as antitumor, antimicrobial, antivirus and antioxidant, and self‐assembly properties of CDPs and their derivatives. Emphasis will be placed on the thermodynamics and kinetics CDPs self‐assembly and applications of self‐assembled materials. This review provides insight into the development of CDPs and their corresponding assembled materials as drug delivery carriers and optoelectronic materials.
Choice of Acid Suppressant Therapy and Long‐Term Graft Outcomes After Kidney Transplantation
Authors: January Spenser E. , Progar Kristin , Nesselhauf Nicole M. , Hagopian Jennifer C. , Malone Andrew F. 
Published: October 2020

Study ObjectiveThe purpose of this study was to comprehensively evaluate the long‐term adverse effects of proton pump inhibitors (PPIs) compared with histamine‐2 receptor antagonists (H2RAs) in kidney transplant recipients.MethodsThis retrospective cohort compared 582 patients treated with PPI with 705 patients treated with H2RA and evaluated adverse effects throughout their course of acid suppressant therapy to a maximum of nine years posttransplant. The primary outcome of interest was renal function at 1 year posttransplant; secondary outcomes included renal function at 30 days, 3, 5, and 9 years posttransplant as well as rejection, electrolyte and laboratory abnormalities, osteoporosis, pneumonia, and Clostridium difficile infections.ResultsRenal function did not significantly differ at any timepoint posttransplant. Rejection rates and Clostridium difficile infections were similar between groups; osteoporosis and pneumonia rates were numerically higher in the PPI treated arm but did not reach statistical significance. Proton pump inhibitor (PPI) treated patients were more likely to experience hypomagnesemia requiring supplementation. High dose PPI treated patients had significantly higher rates of pneumonia and osteoporosis compared with H2RA treated patients. Patients were maintained on PPI therapy for an average of 5 years and H2RA therapy for 3 years posttransplant, the majority without a clear indication for therapy.ConclusionsThere was no difference in renal function, rejection, or graft loss between PPI and H2RA treated patients. The majority of patients were maintained on PPI therapy for several years posttransplant without a clear indication; critical evaluation of ongoing need for acid suppressant therapy in the posttransplant course should be an area of future focus.
Fabrication and study of thermal and combustion resistance of DOPO‐functionalized polyamide reinforced with organo‐modified Mg(OH)2 nanoparticles
Authors: Hajibeygi Mohsen , Habibnejad Navid , Shabanian Meisam , Khonakdar Hossein Ali 
Published: October 2020

AbstractDOPO‐based dicarboxylic acid (DODA) was synthesized and used to prepare DOPO‐based polyamide (DOPA) using a direct polycondensation reaction. Also, DODA was used for the surface modification of Mg(OH)2 nanoparticles. Polyamide/Mg(OH)2 nanocomposites (DPANC) were prepared based on DOPA and the organically modified Mg(OH)2 nanoparticles through the solvent casting method. Further, to investigate the effect of the DOPO structure on the thermal and combustion properties, a poly(amide‐imine) (PAIm) without the DOPO structure was synthesized. The structure and morphology of the prepared nanocomposites were studied using various techniques. The results indicated that nanoparticles were uniformly dispersed in the polymer matrix. According to thermogravimetric analysis results, the temperature at 10% mass loss was increased from 309 to 337 °C in the DPANC sample containing 8 mass% of nanoparticles as compared to DOPA in inert atmosphere. Further, according to microscale combustion calorimetry results, the peak heat release rate (pHRR) was decreased from 33 to 19 W g−1 in the DPANC 5 sample, as compared to DOPA. Also, the pHRR value of PAIm was obtained as 138 W g−1, which was about 105 W g−1 higher than that of polyamide. © 2020 Society of Industrial Chemistry
Preparation and characterisation of poly(ethylene glycol)‐adsorbed graphene oxide nanosheets
Authors: Al‐Bermany Ehssan , Chen Biqiong 
Published: October 2020

AbstractPolymer–graphene nanocomposites are attracting growing attention of scientists and engineers as graphene‐based nanofillers may enhance the properties of polymers significantly. This study aims to understand the adsorption behaviour of polymers on graphene oxide (GO) nanosheets. GO is synthesised using Hummerʼs method by oxidising graphite. Poly(ethylene glycol)s (PEGs) with different molecular weights are used as polymer models. A series of PEG/GO nanohybrids is prepared by applying different parameters in the solution processing method. Fourier transform infrared spectroscopy, X‐ray diffraction, differential scanning calorimetry, thermogravimetric analysis, polarised optical microscopy, scanning electron microscopy and atomic force microscopy are used for characterising the hybrid nanomaterials. The characterisation results confirm the successful preparation of GO and the adsorption of the PEGs onto GO. The maximum amount of adsorbed PEG was 38 wt%. The adsorption amount of PEG increases by 46% after reducing the mixing time from 192 h to 72 h, 1700% due to an increase in the molecular weight from 1k to 100k, 13% for doubling the mixing ratio of PEG:GO from 1.5:1 to 3:1, 44% for applying no further washing procedure and 73% for applying all these parameters concurrently. The adsorption onto GO reduces the crystallinity of PEGs due to chain confinement. Different surface morphologies are observed in the hybrid nanomaterials showing various thicknesses of the PEG layer adsorbed on the GO nanosheets. This study may offer new insights into the manipulation of the interface in polymer–GO nanocomposites. © 2020 Society of Industrial Chemistry
Lower Trabecular Bone Score and Spine Bone Mineral Density Are Associated With Bone Stress Injuries and Triad Risk Factors in Collegiate Athletes
Authors: Tenforde Adam S. , Carlson Jennifer L. , Sainani Kristin L. , Chang Audrey O. , Kim Jae Hyung , Diaz Robert , Golden Neville H. , Fredericson Michael 
Published: October 2020

IntroductionDeterminants of bone health and injury are important to identify in athletes. Bone mineral density (BMD) is commonly measured in athletes with Female Athlete Triad (Triad) risk factors; the trabecular bone score (TBS) has been proposed to predict fracture risk independent of BMD. Evaluation of TBS and spine BMD in relation bone stress injury (BSI) risk has not been studied in female collegiate athletes.ObjectiveWe hypothesized that spine BMD and TBS would each independently predict BSI and that the combined measures would improve injury prediction in female collegiate athletes. We also hypothesized that each measure would be correlated with Triad risk factors.Design: Retrospective cohort.Setting: Academic Institution.MethodsDual energy x‐ray absorptiometry (DXA) of the lumbar spine was used to calculate BMD and TBS values. Chart review was used to identify BSI that occurred after the DXA measurement and to obtain Triad risk factors. We used logistic regression to examine the ability of TBS and BMD alone or in combination to predict prospective BSI.ResultsWithin 321 athletes, 29 (9.0%) sustained a BSI after DXA. BMD and TBS were highly correlated (Pearson correlation r = 0.62, P < .0001). Spine BMD and TBS had similar ability to predict BSI; the C‐statistic and 95% confidence intervals were 0.69 (0.58 to 0.81) for spine BMD versus 0.68 (0.57 to 0.79) for TBS. No improvement in discrimination was observed with combined BMD + TBS (C‐statistic 0.70, 0.59 to 0.81). Both TBS and BMD predicted trabecular‐rich BSI (defined as pelvis, femoral neck, and calcaneus) better than cortical‐rich BSI. Both measures had similar correlations with Triad risk factors.ConclusionLower BMD and TBS values are associated with elevated risk for BSI and similar correlation to Triad risk factors. TBS does not improve prediction of BSI. Collectively, our findings suggest that BMD may be a sufficient measure of skeletal integrity from DXA in female collegiate athletes.
The role of psychosocial support in the experiences of people living with advanced cancer: A qualitative exploration of patients' perspectives
Authors: Newton Jade C. , O'Connor Moira , Saunders Christobel , Moorin Rachael , Ali Sayed , Nowak Anna K. , Halkett Georgia K. B. 
Published: October 2020

AbstractBackgroundPeople living with advanced cancer experience significant distress and reduced quality of life due to their symptom burden and life‐limiting prognosis. Limited qualitative research has investigated their experiences accessing psychosocial supportive care, and how it meets their needs.AimTo explore patients' perspectives of the role of psychosocial support in their experiences of living with advanced cancer.MethodsThis study used an exploratory qualitative research design and drew upon a social constructionist interpretive framework. Semi‐structured interviews were conducted with 23 participants. Participants were asked about their experiences accessing and using psychosocial support following their diagnosis. Audio‐recorded interviews were transcribed and analysed using deductive thematic analysis.ResultsThe following six themes can be used to describe participants' experiences with psychosocial support: (1) accessing different types of support, (2) appreciating support, (3) need, (4) difficulties accessing support, (5) knowing about support and (6) asking for support. Sources of psychosocial support included family and friends, health professionals, and psychosocial supportive care services. Not all participants were able to access care that met their needs; barriers included suitability of available support, accessibility and stigma surrounding support use.ConclusionParticipants experienced broad variation in their awareness and access to psychosocial support services to meet their needs. Providers of psychosocial supportive care for advanced cancer patients need to consider service accessibility issues. Future psychosocial interventions targeting people living with advanced cancer should consider these issues during development and implementation.
Chemical insights into the electronic structure of Fe(II) porphyrin using FCIQMC, DMRG, and generalized active spaces
Authors: Weser Oskar , Freitag Leon , Guther Kai , Alavi Ali , Li Manni Giovanni 
Published: October 2020

AbstractStochastic‐CASSCF and DMRG procedures have been utilized to quantify the role of the electron‐correlation mechanisms that, in an Fe‐porphyrin model system, are responsible for the differential stabilization of the 3Eg over the 5A1g state. Orbital entanglement diagrams and CI coefficients of the wave function in a localized orbital basis allow for an effective interpretation of the role of charge‐transfer configurations. A preliminary version of the Stochastic Generalized Active Space Self‐Consistent Field method has been developed and is here introduced to further assess the π backdonation stabilizing effect. By the new method, excitations between metal and ligand orbitals can selectively be removed from the complete CI expansion. It is demonstrated that these excitations are key to the differential stabilization of the triplet, effectively leading to a quantitative measure of the correlation‐enhanced π backdonation.