bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hydration Status, Body Composition and Anxiety Status in Aeronautical Military Personnel from Spain: a cross-sectional study
Authors: Carretero-Krug Alejandra , Velasco Carlos , Medina-Font Juan , Laguna Trinidad Trujillo , Varela-Moreiras Gregorio , Úbeda Natalia , Montero Ana 
Published: September 2020

Abstract
BackgroundAn adequate hydration status is critical to ensure efficiency during mental and physical activities. Our goal was to assess the hydration status of a Spanish group of aeronautical military men and to determine the association of hydration status with body composition and anxiety.Methods188 men were evaluated through a validated hydration questionnaire, anthropometric and biochemical parameters, and an anxiety questionnaire. According to that, criteria of hydration was established. Results81% of the total sample met hydration criteria (urine color = Well hydrated, Water Balance ≥ 0 mL, and total water intake/weight ≥35 mL/kg) and 19% did not meet hydration criteria (urine color = Not enough hydrated or Dehydrated, Water Balance < 0 mL, and total water intake/weight < 35 mL/kg). Subjects not meeting the hydration criteria had lower urine pH, negative water balance, and lower water intake. The latter also had higher anxiety status (score= 4 vs 3, p=0.026), weight (84.7 ± 10.5 vs 80.5 ± 10.2 Kg), Body Mass Index (26.3 ± 3.1 vs 25.2 ± 2.8 kg/m2), body fat (22.3 ± 5.6 vs 18.3 ± 6.5 %), urine specific gravity and urine color. The Hydration Status, in a logistic binary regression model was related significantly with the percentage of body fat (p=0.004), but no relation was found with age, comorbidity and medication.Furthermore, total water intake/weight was positively correlated with percentage of body water (rho=0.357, p=0.000) and negatively with body fat (kg) (rho= -0.427, p=0.000), percentage of body fat (rho= -0.405, p=0.000) and waist/hip ratio (rho= -0.223, p=0.002). The total water intake/weight, in a linear regression model was related significantly with the percentages of body fat (p=0.019) and body water (p= 0,035). No relation was found, however, with waist/hip ratio, age, comorbidity and medication.ConclusionAll these findings suggest a relationship between hydration status and body composition, but also set the bases for future studies that relate hydration status and anxiety status. These results can be used to improve the hydration status and body composition of military personnel.
Perioperative Risk Factors for Recovery Room Delirium After Elective Non-Cardiovascular Surgery Under General Anaesthesia
Authors: Wu Jiayi , Gao Shaojie , Zhang Shuang , Yu Yao , Liu Shangkun , Zhang Zhiguo , Mei Wei 
Published: September 2020

Abstract
Background: Although postoperative delirium is a frequent complication of surgery, little is known about risk factors for delirium occurring in the post-anaesthesia care unit (PACU). The aim of this study was to determine pre- and intraoperative risk factors for the development of recovery room delirium (RRD) in patients undergoing elective non-cardiovascular surgery. Methods: RRD was diagnosed according to the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). We collected perioperative data in 228 patients undergoing elective non-cardiovascular surgery under general anaesthesia, and performed univariate and multivariate logistic regression to identify risk factors related to RRD. PACU and postoperative events were recorded to assess the outcome of RRD. Results: 57 patients (25%) developed RRD. On multivariate analysis, maintenance of anaesthesia with inhalation anaesthetic agents (OR=6.294, 95%CI 1.4-28.8, p=0.018), malignant primary disease (OR=3.464, 95%CI=1.396-8.592, p=0.007), American Society of Anaesthesiologists Physical Status (ASA-PS) III-V (OR=3.389, 95%CI= 1.401-8.201, p=0.007), elevated serum total or direct bilirubin (OR=2.535, 95%CI=1.006-6.388, p=0.049) and invasive surgery (OR=2.431, 95%CI=1.103-5.357, p=0.028) were identified as independent risk factors for RRD. RRD was associated with higher healthcare costs (31,428 yuan [17,872-43,674] versus 16,555 yuan [12,618-27,788], p<0.001), a longer median hospital stay (17 days [12-23.5] versus 11 days [9-17], p<0.001), and a longer postoperative stay (11 days [7-15] versus 7 days [5-10], p<0.001]).Conclusions: Identifying patients at high risk for RRD preoperatively would enable the formation of more timely postoperative delirium management programmes.
Information Technology for Polypharmacy Appropriateness: What Factors Affect the Use of INTERCheckWEB?
Authors: Catrini Elisabetta , Ferrario Lucrezia , Mazzone Antonino , Varalli Luca , Gatti Federico , Cannavacciuolo Lorella , Ferruzzi Gabriella , Foglia Emanuela 
Published: September 2020

Abstract
Background: INTERCheckWEB is one of the most outstanding IT innovative technology that can be implemented at hospital level, supporting the clinicians in the evaluation of the therapy appropriateness for a patient, specially reducing the potentially inappropriate prescriptions for elderly patients in polytherapy. The present paper aims at investigating the relationship between physicians and support decision system in therapy appropriateness for elderly patients in polytherapy, in order to is to assess the factors that can foster or hamper physicians in using INTERCheckWEB for drug prescription.Methods: A qualitative questionnaire based on a model broadly addressed in literature (Technology Acceptance Model – TAM2), was administered to seventy clinicians referring to Internal Medicine wards, of four Italian medium size hospitals. Based on TAM2, authors assess how perceived usefulness, perceived ease of use, image and output quality, affect INTERCheckWeb intention to use. Inferential analyses were conducted to define the main aspects useful to understand the factors impacting on INTERCheckWeb adoption in clinical practice.Results: The regression analysis reported that image, perceived ease of use and perceived usefulness, as well as the moderator effect of the voluntary use between the perceived usefulness and the intention to use, are the factors that most influenced the use of INTERCheckWEB (Adjusted R2 = 0.870).Conclusions: The analysis has demonstrated that clinicians would effectively use INTERCheckWEB, when available, to identify all the information that could be dangerous for the patient, choosing the proper drug and preventing potential interactions and medical errors.
Urban Growth and Urban Need to Fair Distribution of Healthcare Service, Case Study: Shiraz Metropolitan
Authors: Rezaee Rita , Rahimi Fatemeh , Goli Ali 
Published: September 2020

Abstract
Objective: 1) To analyze urbanization development pattern in Shiraz after the year 1977; 2) To analyze hospital development model in Shiraz after the year 1977; 3) To review and prioritize location allocation criteria for hospitals; and 4) To specify appropriate locations for the establishment of potential future hospitals in Shiraz based on selected criteria.Results: Although a significant expansion is seen from different geographical directions (particularly northwest and southeast of the city) in the urbanization model after the year 1977, the construction of hospitals has been limited to the central parts of the city and the areas around the city lack any hospitals. The “open access path to the hospital during incidents and disasters and a light traffic” criterion has enjoyed the highest priority amongst the 24 selected hospital location allocation criteria. Appropriate locations for establishment of new hospitals in the future have been marked as colored maps. The present study has been able to determine and prioritize a comprehensive list of hospital location allocation criteria. Moreover, the achieved maps from this study can be used by policy makers to develop new hospitals.
Application of accelerated rehabilitation surgery concept in laparoscopic radical gastrectomy cancer for patients aged ≥70 years
Authors: Ma Jun , Shao Hongliang , Wang Yanzhong , Chen Yirui , Mou Yiping 
Published: September 2020

Abstract
Background: To explore the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years.Methods: Retrospective analysis of 120 aged ≥70 patients’ clinical data undergoing laparoscopic radical gastrectomy in our hospital from January 2017 to December 2018, which were divided into accelerated rehabilitation group (n = 73) and control group (n = 47). By comparing the postoperative clinical data of the two groups, we explored the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years.Results: Compared with the control group, the first time to get out of bed (2.1 ± 0.9 days vs 3.8 ± 1.5 days, P<0.01), the first exhaust time (3.2 ± 0.8 days vs 3.9 ± 1.2 days, P<0.01) and the first time to eat liquid food after surgery (1.8 ± 0.9 days vs 3.2 ± 1.3 days, P<0.01), and postoperative hospital stay (12.7 ± 4.3 days vs 15.8 ± 6.4 days, P<0.01) in the rehabilitation group were significantly lower. There was no significant difference in the overall postoperative complications between the two groups (P<0.05), however, the complications of pulmonary infection in the accelerated rehabilitation group was significantly lower than that in the control group (1.4% vs 10.6%, P = 0.03). Conclusions: The application of accelerated rehabilitation surgery concepts and measures after surgery in laparoscopic radical gastrectomy cancer for patients aged ≥70 years can promote early postoperative rehabilitation, reduce postoperative hospital stay, and reduce the incidence of postoperative pulmonary infection complications.
Protocol for the Development of a Repository of Individual Participant Data From Randomised Controlled Trials Conducted in&nbsp;UK Adult Care Homes (The Virtual International Care Homes Trials Archive (VICHTA))
Authors: Irvine Lisa , Burton Jennifer Kirsty , Ali Myzoon , Quinn Terence J , Goodman Claire 
Published: September 2020

Abstract
Background Approximately 418,000 people live in care homes in the UK, yet accessible, robust data on care home populations and organisation are lacking. This hampers our ability to plan, allocate resources or prevent risk. Large randomised controlled trials (RCTs) conducted in care homes offer a potential solution. The value of detailed data on residents’ demographics, outcomes and contextual information captured in RCTs has yet to be fully realised. Irrespective of the intervention tested, much of the trial data collected overlaps, in terms of structured assessments and descriptive information. Given the time and costs required to prospectively collect data in these populations, pooling anonymised RCT data into a structured repository offers benefit; secondary analyses of pooled RCT data can improve understanding of this under-researched population, and enhance future trial design. This protocol describes the creation of a repository of individual participant data (IPD) from trials conducted in care homes, to address the need for accurate, high quality IPD on this vulnerable population.Methods Informed by scoping of relevant literature, the principal investigators of RCTs conducted in adult care homes in UK since 2010 will be invited to contribute trial IPD. Contributing trialists will form a Steering Committee, who will oversee data sharing and remain gatekeepers of their own trial’s data. IPD will be cleaned and standardised in consultation with the Steering Committee for accuracy. Planned analyses include comparison of pooled IPD with point estimates from administrative sources, to assess generalisability of RCT data to the wider care home population. We will also identify key resident characteristics and outcomes from within the trial repository, which will inform development of a national minimum dataset for care homes. Following project completion, management will migrate to the Virtual Trials Archives, forming a legacy dataset which will be accessible to the wider research community for analyses. Discussion Analysis of pooled IPD has the potential to inform and direct future practice, research and policy at low cost, enhancing the value of existing data and reducing research waste. We aim to create a permanent archive for care home trial data, and welcome the contribution of emerging trial datasets.
Readiness for Hospital Discharge in Primary Caregivers for Children with Acute Lymphoblastic Leukemia
Authors: Feng Lu , Ge Zhang , Xiufang Zhao , Birua Luo 
Published: September 2020

Abstract
Background Readiness for hospital discharge is essential to the treatment and rehabilitation. But until now, little is known about the existing status and affecting factors of readiness for hospital discharge in primary caregivers for children with acute lymphoblastic leukemia in China.Methods A cross-sectional study of 253 leukemia patients including their family members from Nov 2016 to Aug 2017 was performed by convenience sampling and questionnaire survey.Results The total score of readiness of primary caregivers is 157.36. Factors including periods of chemotherapy (P<0.001), complications (P=0.019), family economic situation (P=0.023), understanding of leukemia (P<0.001), objective supports (P=0.004), subjective supports (P<0.001), and availability of support (P=0.045) are main influences.Conclusions 1. The readiness for hospital discharge in primary caregivers for childhood lymphoblastic leukemia patients is in an intermediate level, indicate that more efforts should be done in improving present situation, especially on the social support which got the lowest scores.2. In induction remission period of chemotherapy，with complications，with poorer family economic state，lacking knowledge about leukemia and with poor social support are possible factors leading to lower score in readiness for hospital discharge scale, which indicate that providing high quality family and primary caregiver assessment and discharge education throughout the hospitalization is the key to improve the readiness in nursing aspect.
The Effectiveness of Different Patient Referral Methods on Waiting Times for Adults Needing Elective Surgery - Systematic Review
Authors: Rathnayake Dimuthu , Clarke Mike 
Published: September 2020

Abstract
Background: Long waiting times and lengthy queues for elective surgery are common to many publicly funded health systems. Primary care practitioners play a major role in determining which patients are referred to the consultant surgeon and might represent an opportunity to improve this situation. With conventional methods of referrals, surgery clinics are often overcrowded with non-surgical referrals and surgical patients experience longer waiting times as a consequence. Improving the quality of referral communications should lead to more timely access and better cost-effectiveness for elective surgical care. This review summarises the research evidence for interventions within the scope of primary care referral methods in the surgical care pathway that might shorten waiting time for elective surgeries.Methods: We searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases in December 2019 to January 2020, for articles published after 2013. Eligibility criteria included major elective surgery lists of adult patients, excluding cancer and cancer related surgeries. Randomised trials and non-randomised controlled studies were eligible. The main outcome variable of interest was waiting time for the elective surgery. The quality of evidence was assessed using ROBINS-I, AMSTAR 2 and CASP, as appropriate to the study method used. The review presentation was limited to a narrative synthesis because of heterogeneity. The PROSPERO registration number is CRD42019158455.Results: The electronic search yielded 7543 records. Finally, nine articles were considered as eligible after deduplication and full article screening. The eligible research varied widely in design, scope, reported outcomes and overall quality, with one randomised trial, two quasi-experimental studies, two longitudinal follow up studies, three systematic reviews and one observational study. The included research showed that patient triage and prioritisation at the referral stage improved timely access and increased the number of consultations of surgical patients in clinics.Conclusions: The available studies included a variety of interventions and were of medium to high quality, showing that methods to improve the management of primary care referrals of patients for elective surgery can reduce waiting times and shorten waiting lists for elective surgery for adults.
Detection of Merkel Cell Polyomavirus Using Whole Exome Sequencing Data
Authors: Garcia-Mulero Sandra , Moratalla-Navarro Ferran , Curiel-Olmo Soraya , Moreno Victor , Vaqué José Pedro , Sanz-Pamplona Rebeca , Piulats Josep María 
Published: September 2020

Abstract
BackgroundMerkel cell carcinoma (MCC) is a highly malignant neuroendocrine tumor of the skin in which Merkel cell polyomavirus (MCV) DNA virus insertion can be detected in 75–89% of cases. Etiologic and phenotypic differences exist between MCC tumors with and without the inserted virus, thus it is important to distinguish between MCV+ and MCV- cases.MethodsHere we report a freely available bioinformatics methodology to identify MCV+ MCC tumors using whole exome sequencing (WES) data and to infer the virus insertion site into the tumor genome.ResultsOur method has been validated in a set of MCC samples previously characterized in the laboratory as MCV+ or MCV-. MCV insertions have also been reported in non-smokers lung tumors but no MCV+ was found in two tested datasets using our pipeline.ConclusionsWith our pipeline it is possible to use WES to interrogate for MCV insertions in cancer samples.
Multiscale heterogeneity in gastric adenocarcinoma evolution is an obstacle to precision medicine
Authors: Röcken Christoph , Amallraja Anu , Halske Christine , Opasic Luka , Traulsen Arne , Behrens Hans-Michael , Krüger Sandra , Liu Anne , Haag Jochen , Egberts Jan-Hendrik , Rosenstiel Philip , Meissner Tobias 
Published: September 2020

Abstract
Purpose: Cancer is a somatic evolutionary disease. Using multiregional whole exome sequencing, we tested the effect of somatic evolution on intratumoral heterogeneity and its putative clinical and biological implications in adenocarcinomas of the stomach and gastroesophageal junction (GC). Patients and Methods: The study comprised a prospective discovery cohort of 9 and a validation cohort of 463 GCs. Multiregional whole-exome sequencing was done using 48 tumor samples (range: 3-10 tumor samples/patient) of the discovery cohort.Results: In total, the discovery cohort harbored 16,537 non-synonymous mutations (mutations/sample: median n=159; mutations/patient: median n=369). Intratumoral heterogeneity of somatic mutations and copy number variants were present in all tumors of the discovery cohort. 53-91% of the non-synonymous mutations were not present in each patient’s sample; 399 genes harbored 2-4 different non-synonymous mutations in the same patient; 175 genes showed copy number variations, the majority being heterogeneous, including CD274 (PD-L1). Multi-sample tree-based analyses provided evidence for branched evolution being most complex in a microsatellite instable GC. The analysis of the mode of evolution showed a high degree of heterogeneity in deviation from neutrality within each tumor. Studies on the validation cohort showed that the subclonal loss of SMAD4 is an independent predictor for poor patient outcome in Caucasian patients.Conclusions: Neutral and non-neutral somatic evolution shape the mutational landscape in GC. It leads to complex spatial intratumoral heterogeneity and may have profound effects on patient management. It provides crucial information for an individualized understanding of clinical prognosis and therapeutic options in GC patients.
Do Economic Circumstances and Family Structures Affect Young Girls' Healthy Living Behaviors and Menstrual Symptoms?
Authors: erbaba hulya - , Ciftci Esra - Karaca 
Published: September 2020

Abstract
BackgroundDemographic features such as low income, low education, and living in a crowded or single-parent family increase young girls' premenstrual and menstrual symptoms such as pain, anxiety, and bleeding and negatively affect their healthy lifestyle. The purpose of the study was to analyze the relationship between healthy lifestyle behaviors and menstrual symptoms among young girls and their sociodemographic characteristics. MethodsThis descriptive study was conducted on 1,130 students from four high schools providing full-time education in the Beylikduzu district of Istanbul between February 3, 2020, and March 1, 2020. Volunteer students whose families gave consent participated in the study. A personal identification form, the Menstrual Symptom Scale and the Healthy Lifestyle Behavior Scale-II (HLBS-II) were used to collect data in the study. All statistical analyses were performed using SPSS Statistics version 23.ResultsIt was found that economic status and painful menstruation negatively affected healthy lifestyle behaviors, while living with one’s nuclear family positively affected healthy lifestyle behaviors; furthermore, chronic disease, painful menstruation, and family types other than the nuclear family negatively affected menstrual symptoms. ConclusionsPoor economic status and painful menstruation negatively affected healthy lifestyle behaviors, and chronic disease, painful menstruation and family type other than the nuclear family negatively affected menstrual symptoms.
Associations between depressive symptoms and geriatric syndromes in community-dwelling older adults in Japan: a cross-sectional study
Authors: Imaoka Masakazu , Nakao Hidetoshi , Nakamura Misa , Tazaki Fumie , Hida Mitsumasa , Omizu Tomoko , Imai Ryota , Takeda Masatoshi 
Published: September 2020

Abstract
Background
It is estimated that 7.2% of community-dwelling older adults in worldwide have major depression. This cross-sectional study aimed to investigate the relationship between geriatric syndromes and depressive symptoms.
Methods
Data were obtained from 363 older adults (mean age 73.6 ± 6.6 years; women = 75.8%) who participated in a community-based health check. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15). Depression was defined as a GDS-15 score of ≥ 5. Further, geriatric syndromes in participants—such as frailty, sarcopenia, and locomotive syndrome—were assessed.
Results
There was a 28.1% prevalence of depressive symptoms. In a logistic regression analysis with depressive symptoms as the dependent variable, both pre-frailty (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.09–3.01) and frailty (OR 5.45, 95% CI 2.23–13.31) were found to be significantly higher in the depressive group.
Conclusions
Our findings suggest that depressive symptoms are associated with frailty and pre-frailty in community-dwelling older adults in Japan.