bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Fami-life study: protocol of a prospective observational multicenter mixed study of psychological consequences of grieving relatives in French palliative care units on behalf of the family research in palliative care (F.R.I.P.C research network)
Authors: Garrouste-Orgeas Maité , Flahault Cécile , Poulain Edith , Evin Adrien , Guirimand Frédéric , Fossez-Diaz Virginie , Perruchio Ségolène , Verlaine Catherine , Vanbésien Anne , Kaczmarek Willeme , Birkui de Francqueville Laurence , De Larivière Emmanuel , Bouquet Guillaume , Copel Laure , Verliac Virginie , Marché Véronique , Mathias Carmen , Gracia Dominique , Mhalla Alaa , Michonneau-Gandon Véronique , Poupardin Cécile , Touzet Licia , Ranchou Gaelle , Guastella Virginie , Richard Bruno , Bienfait Florent , Sonrier Marie , Michel Dominique , Ruckly Stéphane , Bailly Sébastien , Timsit Jean-François 
Published: December 2019

Abstract
Background
Grieving relatives can suffer from numerous consequences like anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and prolonged grief. This study aims to assess the psychological consequences of grieving relatives after patients’ death in French palliative care units and their needs for support.

Methods
This is a prospective observational multicenter mixed study. Relatives of adult patients with a neoplasia expected to be hospitalized more than 72 h in a palliative care unit for end-of-life issues will be included within 48 h after patient admission. End-of-life issues are defined by the physician at patient admission. Relatives who are not able to have a phone call at 6-months are excluded. The primary outcome is the incidence of prolonged grief reaction defined by an ICG (Inventory Complicate Grief) > 25 (0 best-76 worst) at 6 months after patient’ death. Prespecified secondary outcomes are the risk factors of prolonged grief, anxiety and depression symptoms between day 3 and day 5 and at 6 months after patients’ death based on an Hospital Anxiety and Depression score (range 0–42) > 8 for each subscale (minimal clinically important difference: 2.5), post-traumatic stress disorder symptoms 6 months after patient’ death based on the Impact of Events Scale questionnaire (0 best-88 worst) score > 22, experience of relatives during palliative care based on the Fami-Life questionnaire, specifically built for the study. Between 6 and 12 months after the patient’s death, a phone interview with relatives with prolonged grief reactions will be planned by a psychologist to understand the complex system of grief. It will be analyzed with the Interpretative Phenomenological Analysis. We planned to enroll 500 patients and their close relatives assuming a 25% prolonged grief rate and a 6-month follow-up available in 60% of relatives.

Discussion
This study will be the first to report the psychological consequences of French relatives after a loss of a loved one in palliative care units. Evaluating relatives’ experiences can provide instrumental insights for means of improving support for relatives and evaluation of bereavement programs.

Trial registration
NCT03748225 registered on 11/19/2018. Recruiting patients.
The combination of Radix Astragali and Radix Angelicae Sinensis attenuates the IFN-γ-induced immune destruction of hematopoiesis in bone marrow cells
Authors: Liu Juan , Wei Jie , Wang Changzhi , Meng Xiaoying , Chen Hening , Deng Peiying , Huandike Meiyier , Zhang Huijie , Li Xue , Chai Limin 
Published: December 2019

AbstractBackgroundRadix AstragaliandRadix Angelicae Sinensisare two herbs that compose Danggui Buxue Tang (an herbal formula for treatment of anemia diseases). In this study, we explored the molecular mechanism and effective targets to immune destruction of bone marrow (BM) cells treated withRadix Astragali,Radix Angelicae Sinensisor a combination of two agents. The potential synergic advantages of two herbs should also be explored.MethodsThe constituents ofRadix AstragaliandRadix Angelicae Sinensiswere analyzed by high performance liquid chromatography-electrospray ionization/mass spectrometer system BM cells were separated from limbs of BALB/c mice, and immune destruction was induced with IFN-γ. The percentages of hematopoietic stem cells (HSCs) and CD3+T cells were detected by flow cytometry. The distribution of T-bet and changes in the combination of SAP and SLAM in BM cells were observed by immunofluorescence. Western blotting was used to assay the expression of key molecules of the eIF2 signaling pathway in BM cells.ResultsSeven constituents ofRadix Astragaliand six constituents ofRadix Angelicae Sinensiswere identified. The percentages of HSCs increased significantly after treatment withRadix Angelicae Sinensis, especially at high concentrations. The percentages of CD3+T cells were significantly decreased afterRadix AstragaliandRadix Angelicae Sinensistreatment. However, the synergistic function of two-herb combinations was superior to that of the individual herbs alone. The distribution of T-bet in BM cells was decreased significantly afterRadix Angelicae Sinensistreatment. The number of SLAM/SAP double-stained cells was increased significantly afterRadix Astragalitreatment at low concentrations. The phosphorylation levels of eIF2α were also reduced afterRadix AstragaliandRadix Angelicae Sinensistreatment.ConclusionsRadix AstragaliandRadix Angelicae Sinensiscould intervene in the immunologic balance of T lymphocytes, inhibit the apoptosis of BM cells induced by immune attack, restore the balance of the T cell immune response network and recover the hematopoietic function of HSCs. The synergistic effects ofRadix AstragaliandRadix Angelicae Sinensiswere superior to those of each herb alone.
Representation learning in intraoperative vital signs for heart failure risk prediction
Authors: Chen Yuwen , Qi Baolian 
Published: December 2019

Abstract
Background
The probability of heart failure during the perioperative period is 2% on average and it is as high as 17% when accompanied by cardiovascular diseases in China. It has been the most significant cause of postoperative death of patients. However, the patient is managed by the flow of information during the operation, but a lot of clinical information can make it difficult for medical staff to identify the information relevant to patient care. There are major practical and technical barriers to understand perioperative complications.

Methods
In this work, we present three machine learning methods to estimate risks of heart failure, which extract intraoperative vital signs monitoring data into different modal representations (statistical learning representation, text learning representation, image learning representation). Firstly, we extracted features of vital signs monitoring data of surgical patients by statistical analysis. Secondly, the vital signs data is converted into text information by Piecewise Approximate Aggregation (PAA) and Symbolic Aggregate Approximation (SAX), then Latent Dirichlet Allocation (LDA) model is used to extract text topics of patients for heart failure prediction. Thirdly, the vital sign monitoring time series data of the surgical patient is converted into a grid image by using the grid representation, and then the convolutional neural network is directly used to identify the grid image for heart failure prediction. We evaluated the proposed methods in the monitoring data of real patients during the perioperative period.

Results
In this paper, the results of our experiment demonstrate the Gradient Boosting Decision Tree (GBDT) classifier achieves the best results in the prediction of heart failure by statistical feature representation. The sensitivity, specificity and the area under the curve (AUC) of the best method can reach 83, 85 and 84% respectively.

Conclusions
The experimental results demonstrate that representation learning model of vital signs monitoring data of intraoperative patients can effectively capture the physiological characteristics of postoperative heart failure.
Pathogenic Leishmania spp. detected in lizards from Northwest China using molecular methods
Authors: Zhang Jun-Rong , Guo Xian-Guang , Chen Han , Liu Jin-Long , Gong Xiong , Chen Da-Li , Chen Jian-Ping 
Published: December 2019

Abstract
Background
Leishmaniosis, a disease caused by pathogenic Leishmania parasites, remains an unresolved health problem in the New World and the Old World. It is well known that lizards can be infected by a subgenus of Leishmania parasites, i.e. Sauroleishmania, which is non-pathogenic to humans. However, evidence suggests that lizards may also harbor pathogenic Leishmania species including the undetermined Leishmania sp., discovered in our previous work. Leishmania DNA in lizard blood can be detected by using molecular methods, such as the polymerase chain reaction (PCR).

Results
Three hundred and sixteen lizards, representing 13 species of four genera, were captured for blood samples collection in Northwest China. Two reliable molecular markers (cytochrome b and heat shock protein 70 genes) were used for detection in the lizard blood samples, to confirm a widespread presence of pathogenic Leishmania parasites and the distribution pattern of Leishmania spp. in lizards from Northwest China. The PCR data indicated positive detection rate for Leishmania in all the tested lizards with an overall prevalence of 57.91% (183/316). Apart from lizard parasites like Leishmania tarentolae and Leishmania sp., several pathogenic Leishmania including L. turanica, L. tropica and L. donovani complex were identified by using phylogenetic analysis. Co-existence of different haplotypes was observed in most Leishmania DNA-positive lizards with an overall rate of 77.6% (142/183). Even mixed infections with different Leishmania species appeared to occur in the lizards with an overall rate of 37.7% (69/183).

Conclusions
Lizards can harbor pathogenic Leishmania spp. Co-existence of different haplotypes or even species of Leishmania indicates mixed infections in natural lizard host. Lizards may contribute to the spread of Leishmania parasites. The pathogenic Leishmania species detected in lizards from Northwest China may be of great eco-epidemiological importance.
Uev1A promotes breast cancer cell survival and chemoresistance through the AKT-FOXO1-BIM pathway
Authors: Wu Zhaojia , Niu Tong , Xiao Wei 
Published: December 2019

AbstractBackgroundUbiquitin-conjugating enzyme variantUEV1Ais required for Ubc13-catalyzed K63-linked poly-ubiquitination that regulates several signaling pathways including NF-κB, MAPK and PI3K/AKT. Previous reports implicateUEV1Aas a potential proto-oncogene and have shown thatUEV1Apromotes breast cancer metastasis through constitutive NF-кB activation. Ubc13-Uev1A along with TARF6 can also ubiquitinate AKT but its downstream events are unclear.MethodsIn this study, we experimentally manipulatedUEV1expression in two typical breast cancer cell lines MDA-MB-231 and MCF7 under serum starvation conditions and monitored AKT activation and its downstream protein levels, as well as cellular sensitivity to chemotherapeutic agents.ResultsWe found that overexpression ofUEV1Ais sufficient to activate the AKT signaling pathway that in turn inhibitsFOXO1andBIMexpression to promote cell survival under serum starvation conditions and enhances cellular resistance to chemotherapy. Consistently, experimental depletion of Uev1 in breast cancer cells inhibits AKT signaling and promotes FOXO1 and BIM expression to reduce cell survival under serum starvation stress and enhance chemosensitivity.ConclusionsUev1A promotes cell survival under serum starvation stress through the AKT-FOXO1-BIM axis in breast cancer cells, which unveals a potential therapeutic target in the treatment of breast cancers.
Consultative meeting that examined alignment and discrepancies between health facility and household survey data in Malawi
Authors: Battle Katherine E. , Gumbo Austin , Hamuza Gracious , Kwizombe Collins , Banda Akuzike Tauzi , Chipeta Steven , Phiri Mphatso D. , Kamanga Blessings , Kawonga Jacob , Mafuleka Taonga , Malpass Ashley , Mfune Phinias , Mhango Mathews , Munthali Lumbani , Silungwe Godfrey , Siwombo Memory , Twalibu Haroon , Zakaliya Allison , Kayange Michael , Taylor Cameron 
Published: December 2019

AbstractMalawi is midway through its current Malaria Strategic Plan 2017–2022, which aims to reduce malaria incidence and deaths by at least 50% by 2022. Malariometric data are available with health surveillance data housed in District Health Information Software 2 (DHIS2) and household survey data from two recent Malaria Indicator Surveys (MIS) and a Demographic and Health Survey (DHS). Strengths and weaknesses of the data were discussed during a consultative meeting in Lilongwe, Malawi in July 2019. The first 3 days included in-depth exploration and analysis of surveillance and survey data by 13 participants from the National Malaria Control Programme, district health offices, and partner organizations. Key indicators derived from both DHIS2 and MIS/DHS sources were analysed with three case studies, and presented to stakeholders on the fourth day of the meeting. Applications of the findings to programmatic decision-making and strategic plan evaluation were critiqued and discussed.
Nrdp1 increases neuron apoptosis via downregulation of Bruce following intracerebral haemorrhage
Authors: Zhou Changlong , Liu Qingjun , Zhao Wang , Yang Ling , Huang Zhongyan , Yang Zhao 
Published: December 2019

AbstractBackgroundNeuregulin receptor degradation protein-1 (Nrdp1) is an E3 ubiquitin ligase that plays an important role in regulating cell growth, apoptosis and oxidative stress. However, the data regarding its expression and exact mechanism in neuronal injury following ICH has not been well identified.MethodsIn this study, primary cortical neurons from C57BL/6 mice were subjected to erythrocyte lysates. Nrdp1 expression, cell apoptosis, caspase-3 and BRUCE levels were detected. In addition, inflammatory response, brain edema, and neurological injury in ICH mice were also assessed.ResultsWe found that the expression of Nrdp1 was significantly increased in neuron cells accompanied by up-regulation of active caspase-3 and decreased expression of BRUCE (an inhibitor of apoptosis protein). However, inhibiting Nrdp1 levels of neurons reduced caspase-3 activity but induced up-regulation of BRUCE. In vivo, inhibiting Nrdp1 levels increased pro-inflammatory cytokines, brain edema, and neurological injury following ICH.ConclusionsTaken together, the data suggested that Nrdp1 might play a crucial role in neuronal apoptosis via inhibiting BRUCE following ICH.
Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study
Authors: Felix Julia , Becker Christian , Vogl Matthias , Buschner Peter , Plötz Werner , Leidl Reiner 
Published: December 2019

AbstractBackgroundEvaluation of variations in pre- and postoperative patient reported outcomes (PRO) and the association between preoperative patient characteristics and health and satisfaction outcomes after total knee arthroplasty (TKA) may support shared decision-making in Germany. Since previous research on TKA health outcomes indicated valuation differences in longitudinal data, experienced-based population weights were used for the first time as an external valuation system to measure discrepancies between patient and average population valuation of HRQoL.MethodsBaseline data (n = 203) included sociodemographic and clinical characteristics and PROs, measured by the EQ-5D-3 L and WOMAC. Six-month follow-up data (n = 161) included medical changes since hospital discharge, PROs and satisfaction. A multivariate linear regression analysis was performed to evaluate the relationship between preoperative patient characteristics and PRO scores. Patient acceptable symptom state (PASS) was calculated to provide a satisfaction threshold. Patient-reported health-related quality of life (HRQoL) valuations were compared with average experienced-based population values to detect changes in valuation.ResultsOne hundred thirty-seven subjects met inclusion criteria. All PRO measures improved significantly. Preoperative WOMAC and EQ-5D VAS, housing situation, marital status, age and asthma were found to be predictors of postoperative outcomes. 73% of study participants valued their preoperative HRQoL higher than the general population valuation, indicating response shift. Preoperatively, patient-reported EQ-5D VAS was substantially higher than average experienced-based population values. Postoperatively, this difference declined sharply.Approximately 61% of the patients reported satisfactory postoperative health, being mainly satisfied with results if postoperative WOMAC was ≥82.49 (change ≥20.25) and postoperative EQ-5D VAS was ≥75 (change ≥6).ConclusionOn average, patients benefited from TKA. Preoperative WOMAC and EQ-5D VAS were predictors of postoperative outcomes after TKA. Particularly patients with high absolute preoperative PRO scores were more likely to remain unsatisfied. Therefore, outcome prediction can contribute to shared-decision making. Using general population valuations as a reference, this study underlined a discrepancy between population and patient valuation of HRQoL before, but not after surgery, thus indicating a potential temporary response shift before surgery.
Semen quality pattern and age threshold: a retrospective cross-sectional study of 71,623 infertile men in China, between 2011 and 2017
Authors: Li W. N. , Jia M. M. , Peng Y. Q. , Ding R. , Fan L. Q. , Liu G. 
Published: December 2019

Abstract
Background
The aim of this study was to provide information on the semen quality pattern of infertile men and age thresholds for semen parameters in China.

Methods
This was a retrospective cross-sectional study investigating 71,623 infertile men from the Reproductive and Genetic Hospital of CITIC Xiangya in Hunan, China, from 2011 to 2017. The Kruskal-Wallis test, Mann-Kendall test, linear regression model and joinpoint regression were used.

Results
Although erratic changes were observed in the median semen parameters (sperm concentration 40.1–52.1 × 106/ml, total sperm count 117.8–153.1 × 106, sperm progressive motility 33.4–38.1%) during the 7 years of observation, no significant decrease in semen quality was found, and 47.88% of infertile men showed normal semen parameters according to the World Health Organization (WHO) criteria. According to the joinpoint regression analysis, sperm progressive motility appeared to decrease earlier than the sperm concentration and total sperm count (at 28, 58, and 42 years of age, respectively).

Conclusions
There is no evidence of a deterioration in semen quality among infertile men in Hunan, China. Semen parameters decreased with increasing age, with turning points noted at different ages. Semen parameters are not absolute evidence for the assessment of male fertility potential. Therefore, we believe that, among semen parameters, the sperm concentration is the best predictor of fertility for ART, followed by motility. Decreased sperm motility may affect natural pregnancy, but it is not necessary for successful IVF.
‘Everything was just getting worse and worse’: deteriorating job quality as a driver of doctor emigration from Ireland
Authors: Humphries N. , McDermott A. M. , Conway E. , Byrne J-P , Prihodova L. , Costello R. , Matthews A. 
Published: December 2019

AbstractBackgroundMedicine is a high-status, high-skill occupation which has traditionally provided access to good quality jobs and relatively high salaries. In Ireland, historic underfunding combined with austerity-related cutbacks has negatively impacted job quality to the extent that hospital medical jobs have begun to resemble extreme jobs. Extreme jobs combine components of a good quality job—high pay, high job control, challenging demands, with those of a low-quality job—long working hours, heavy workloads. Deteriorating job quality and the normalisation of extreme working is driving doctor emigration from Ireland and deterring return.MethodsSemi-structured qualitative interviews were conducted with 40 Irish emigrant doctors in Australia who had emigrated from Ireland since 2008. Interviews were held in July–August 2018.ResultsRespondents reflected on their experiences of working in the Irish health system, describing hospital workplaces that were understaffed, overstretched and within which extreme working had become normalised, particularly in relation to long working hours, fast working pace, doing more with less and fighting a climate of negativity. Drawing on Hirschman’s work on exit, voice and loyalty (1970), the authors consider doctor emigration as exit and present respondent experiences of voice prior to emigration. Only 14/40 respondent emigrant doctors intend to return to work in Ireland.DiscussionThe deterioration in medical job quality and the normalisation of extreme working is a key driver of doctor emigration from Ireland, and deterring return. Irish trained hospital doctors emigrate to access good quality jobs in Australia and are increasingly likely to remain abroad once they have secured them. To improve doctor retention, health systems and employers must mitigate a gainst the emergence of extreme work in healthcare. Employee voice (about working conditions, about patient safety, etc.) should be encouraged and used to inform health system improvement and to mitigate exit.
Nurse prescribing of medicines in 13 European countries
Authors: Maier Claudia B. 
Published: December 2019

Abstract
Background
Nurse prescribing of medicines is increasing worldwide, but there is limited research in Europe. The objective of this study was to analyse which countries in Europe have adopted laws on nurse prescribing.

Methods
Cross-country comparative analysis of reforms on nurse prescribing, based on an expert survey (TaskShift2Nurses Survey) and an OECD study. Country experts provided country-specific information, which was complemented with the peer-reviewed and grey literature. The analysis was based on policy and thematic analyses.

Results
In Europe, as of 2019, a total of 13 countries have adopted laws on nurse prescribing, of which 12 apply nationwide (Cyprus, Denmark, Estonia, Finland, France, Ireland, Netherlands, Norway, Poland, Spain, Sweden, United Kingdom (UK)) and one regionally, to the Canton Vaud (Switzerland). Eight countries adopted laws since 2010. The extent of prescribing rights ranged from nearly all medicines within nurses’ specialisations (Ireland for nurse prescribers, Netherlands for nurse specialists, UK for independent nurse prescribers) to a limited set of medicines (Cyprus, Denmark, Estonia, Finland, France, Norway, Poland, Spain, Sweden). All countries have regulatory and minimum educational requirements in place to ensure patient safety; the majority require some form of physician oversight.

Conclusions
The role of nurses has expanded in Europe over the last decade, as demonstrated by the adoption of new laws on prescribing rights.