bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of dementia on informal care: a systematic review of family caregivers’ perceptions
Authors: Lindeza Patrícia , Rodrigues Mário , Costa João , Guerreiro Manuela , Rosa Mario Miguel 
Published: October 2020

IntroductionCaregivers play a major role in providing all the support and care in daily activities for their relatives with dementia. To fully describe the influence of dementia caregiving on family caregivers’ life, we conducted a systematic review including caregivers’ perceptions about the positive and negative aspects of caring and the expressed factors.Materials and methodsWe conducted a systematic review including articles from January 1998 to July 2020. Qualitative studies reporting family caregivers’ perceptions about their experiences and the effects/impact of dementia caregiving were eligible. Two authors extracted the data independently, and the analysis focused on the positive and negative aspects of dementia caregiving in caregivers’ life.ResultsEighty-one studies with 3347 participants were included in this review. The positive aspects of caregiving in caregivers’ life encompass personal accomplishment and strengthening relationships, which were enhanced by good medical counselling/formal care support and family/friends support. The negative aspects included emotional and social aspects experienced by caregivers. Other factors such as inappropriate medical/formal care support, illness progression and the costs of dementia contributed to negative appraisal.Discussion and implicationsThe findings provide insights into the holistic experience of caring for a person with dementia revelling the major positive and negative aspects underlying the caregiver role. The evidence emphasises the need ‘to focus on positive aspects’ and targeted interventions aimed at reducing the negative impact of caregiving, which has serious consequences on caregivers’ quality of life. A multicomplex intervention for dementia informal caregiving should be developed, committing the society to promote mental health, address these community needs and improve the quality of life of the person with dementia and their family caregivers.
FDA Approval Summary: Tucatinib for the Treatment of Patients with Advanced or Metastatic HER2-positive Breast Cancer
Authors: Shah Mirat , Wedam Suparna , Cheng Joyce , Fiero Mallorie H. , Xia Huiming , Li Fang , Fan Jianghong , Zhang Xinyuan , Yu Jingyu , Song Pengfei , Chen Wei , Ricks Tiffany K. , Chen Xiao Hong , Goldberg Kirsten B. , Gong Yutao , Pierce William F. , Tang Shenghui , Theoret Marc R. , Pazdur Richard , Amiri-Kordestani Laleh , Beaver Julia A. 
Published: October 2020

Abstract
On April 17, 2020, the FDA approved tucatinib in combination with trastuzumab and capecitabine for the treatment of patients with advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received one or more prior anti-HER2-based regimens in the metastatic setting. This was the first new molecular entity evaluated under Project Orbis, an FDA Oncology Center of Excellence initiative, which supports concurrent review of oncology drugs by multiple global health authorities. Approval was based on the HER2CLIMB trial, which randomized patients to receive tucatinib or placebo with trastuzumab and capecitabine. Tucatinib demonstrated efficacy compared with placebo in progression-free survival [PFS; HR: 0.54; 95% confidence interval (CI): 0.42–0.71; P &lt; 0.00001] and overall survival (OS; HR: 0.66; 95% CI, 0.50–0.87; P = 0.00480). Patients with either treated and stable or active brain metastases made up 48% of the study population. PFS in patients with brain metastases confirmed benefit (HR: 0.48; 95% CI, 0.34–0.69; P &lt; 0.00001). The benefit in patients with brain metastases allowed for inclusion of this specific population in the indication. Important safety signals included diarrhea and hepatotoxicity which are listed under Warnings and Precautions. This article summarizes the FDA thought process and data supporting the favorable benefit–risk profile and approval of tucatinib.
Development of a Portable Tool to Identify Patients With Atrial Fibrillation Using Clinical Notes From the Electronic Medical Record
Authors: Shah Rashmee U. , Mutharasan R. Kannan , Ahmad Faraz S. , Rosenblatt Anna G. , Gay Hawkins C. , Steinberg Benjamin A. , Yandell Mark , Tristani-Firouzi Martin , Klewer Jake , Mukherjee Rebeka , Lloyd-Jones Donald M. 
Published: October 2020

Background:
The electronic medical record contains a wealth of information buried in free text. We created a natural language processing algorithm to identify patients with atrial fibrillation (AF) using text alone.

Methods and Results:

We created 3 data sets from patients with at least one AF billing code from 2010 to 2017: a training set (n=886), an internal validation set from site no. 1 (n=285), and an external validation set from site no. 2 (n=276). A team of clinicians reviewed and adjudicated patients as AF present or absent, which served as the reference standard. We trained 54 algorithms to classify each patient, varying the model, number of features, number of stop words, and the method used to create the feature set. The algorithm with the highest F-score (the harmonic mean of sensitivity and positive predictive value) in the training set was applied to the validation sets. F-scores and area under the receiver operating characteristic curves were compared between site no. 1 and site no. 2 using bootstrapping. Adjudicated AF prevalence was 75.1% at site no. 1 and 86.2% at site no. 2. Among 54 algorithms, the best performing model was logistic regression, using 1000 features, 100 stop words, and term frequency-inverse document frequency method to create the feature set, with sensitivity 92.8%, specificity 93.9%, and an area under the receiver operating characteristic curve of 0.93 in the training set. The performance at site no. 1 was sensitivity 92.5%, specificity 88.7%, with an area under the receiver operating characteristic curve of 0.91. The performance at site no. 2 was sensitivity 89.5%, specificity 71.1%, with an area under the receiver operating characteristic curve of 0.80. The F-score was lower at site no. 2 compared with site no. 1 (92.5% [SD, 1.1%] versus 94.2% [SD, 1.1%];
P
<0.001).

Conclusions:
We developed a natural language processing algorithm to identify patients with AF using text alone, with >90% F-score at 2 separate sites. This approach allows better use of the clinical narrative and creates an opportunity for precise, high-throughput cohort identification.
China, Responsibility to Protect, and the Case of Syria
Authors: Gegout Catherine , Suzuki Shogo 
Published: October 2020

Abstract
Will the rise of China, an authoritarian, party-state with a poor record of protecting its citizens’ human rights, undermine humanitarian intervention? This question has been particularly pertinent since China’s “assertive turn” in foreign policy. Drawing on the case of Chinese reactions to the humanitarian crisis in Syria, this article argues that China’s attitude toward humanitarian intervention remains ambiguous and contradictory. While China has at times prevented the UN Security Council from threatening sanctions on Syria, it has not necessarily denied that a humanitarian crisis exists. The article shows that the People’s Republic of China is beginning to act more as a norm maker than norm taker, and is offering its own vision of humanitarian intervention, coined as “responsible protection.”
<p><strong><em>Nepenthes diabolica</em></strong><strong> (Nepenthaceae)<em>, </em>a new species of toothed pitcher plant from Central Sulawesi</strong></p>
Authors: BIANCHI ANDREA , LEE CHIEN C. , GOLOS MICHAL R. , MEY FRANÇOIS S. , MANSUR MUHAMMAD , MAMBRASAR YASPER MICHAEL , ROBINSON ALASTAIR S. 
Published: October 2020

Nepenthes diabolica, a new species of tropical pitcher plant from Central Sulawesi, is described and illustrated. It is a high-montane, terrestrial to epiphytic taxon, distinguished by its elaborately flanged peristome and rufous, woolly pitcher indumentum. N. diabolica is a member of section Tentaculatae, showing morphological affinities with N. hamata. Nevertheless, the two species can be distinguished by morphological characters as well as by ecology and geography. A diagnostic key to the species of section Tentaculatae is provided. Owing to its highly restricted range, small number of recorded individuals, and desirability among plant collectors, the conservation status of N. diabolica is assessed as Critically Endangered under the IUCN criteria. Finally, N. hamata, until now based on lost types and mixed paratypes, is lectotypified using recently uncovered original material.
Identification of plasticity-controlled creep and fatigue failure mechanisms in transversely loaded unidirectional thermoplastic composites
Authors: Erartsın Ozan , Drongelen Martin van , Govaert Leon E. 
Published: October 2020

In continuous fiber-reinforced thermoplastics, the macroscopic failure mode in transverse long-term failure is dominated by a brittle crack-growth mechanism. Neat thermoplastic matrices, on the other hand, generally display also a plasticity-controlled mechanism in long-term loading at elevated stress levels and/or temperature. This failure mechanism requires a different approach to lifetime prediction than crack growth; hence, it is important to identify it in the long-term performance of composites. In this study, we demonstrate the presence of the plasticity-controlled failure mechanism in long-term failure of transversely loaded unidirectional (UD) thermoplastic composites made of glass/iPP, carbon/PEEK and carbon/PEKK. The main method used is to compare the lifetime in cyclic loading to that in static loading at the same level of maximum stress, where an increase in lifetime is characteristic for plasticity controlled failure, and, vice versa, a decrease is indicative for fatigue crack growth. In addition, the applicability of a lifetime prediction method common to plasticity-controlled failure of neat thermoplastics is evaluated for the composites investigated. The results of this study indicate that the plasticity-controlled failure was present in composites, although the extent to which the effects are present varied depending on the materials investigated. Glass/iPP showed the most explicit evidence of the plasticity-controlled failure over the entire load range experimentally covered. Its long-term failure was delayed with a decrease in the stress ratio and lifetime was predicted well using the principles of plasticity-controlled failure.
Risk Factors for Complications Associated With Minimally Invasive Medial Displacement Calcaneal Osteotomy
Authors: Coleman Michelle M. , Abousayed Mostafa M. , Thompson John M. , Bean Bryan A. , Guyton Gregory P. 
Published: October 2020

Background: Few studies have reported the outcomes following minimally invasive medial displacement calcaneal osteotomy (MDCO) for correction of pes planovalgus deformities. Methods: Charts were retrospectively reviewed for consecutive patients who underwent minimally invasive MDCO procedures by a single surgeon from 2013 to 2019 with more than 3 months of follow-up. A total of 160 consecutive patients who underwent 189 minimally invasive MDCO procedures were included in the study. Median follow-up was 12 months (interquartile range, 7-25 months). Results: Osteotomy healing complications were present in 7% of cases during the 6-year study period. A 12-month case cluster of osteotomy healing complications was observed. Healing complication rates were 28% during the cluster and 0.7% outside of the cluster. No definitive cause was found for the case cluster, although heat osteonecrosis from the burr was suspected to be involved. Osteotomy healing complications were significantly associated with higher American Society of Anesthesiologists (ASA) classification, female sex, current tobacco use, and higher body mass index (BMI). Healing complications were not associated with osteotomy technique or fixation type. Other complications included wound dehiscence (3%), surgical site infection (2%), transient nerve symptoms (6%), and persistent nerve symptoms (2%). Nerve symptoms were significantly associated with an increased number of concomitant procedures. Conclusion: Patients with higher ASA classification, current tobacco use, and higher BMI were at higher risk for osteotomy healing complications after minimally invasive MDCO procedures. Patients were also more likely to develop nerve complications with more extensive surgical procedures. Level of Evidence: Level IV, retrospective case series.
The switch from etanercept originator to SB4: data from a real-life experience on tolerability and persistence on treatment in joint inflammatory diseases
Authors: Bruni Cosimo , Gentileschi Stefano , Pacini Giovanni , Baldi Caterina , Capassoni Marco , Tofani Lorenzo , Bardelli Marco , Cometi Laura , Cantarini Luca , Nacci Francesca , Vietri Michele , Bartoli Francesca , Fiori Ginevra , Frediani Bruno , Matucci-Cerinic Marco 
Published: October 2020

Aims: Switching from originator to biosimilar is part of current practice in inflammatory rheumatic musculoskeletal diseases (iRMDs) such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondylarthritis (axSpA), with evidences derived from both etanercept (ETN) to SB4-switching randomized controlled trials and real-life registries. We investigated the safety and treatment persistence of ETN/SB4 in a multi-iRMD cohort derived from two rheumatology departments in our region. Methods: Adult patients with iRMDs, treated with ETN for at least 6 months and switched to SB4 in stable clinical condition, were eligible for this retrospective evaluation. Retrospective data on adverse events, loss of efficacy and persistence on treatment were collected until latest available follow-up. Results: A total of 220 patients (85 RA, 81 PsA, 33 axSpA, 14 juvenile idiopathic arthritis and seven other conditions; 142 females, mean age 58 ± 7 years, disease duration 12 ± 4 years, ETN duration 7 ± 4 years) were enrolled, with median follow-up of 12.1 (9.7–15.8) months. A total of 50 patients (22.7%) presented with at least one adverse event, with 36 (16.4%) disease flares and 30 (13.6%: 11 for safety and 19 loss of efficacy) SB4 withdrawals. Cumulative SB4 treatment persistence was 99.1%, 88.6% and 64.6% at 6, 12 and 18 months respectively. Back-switch to ETN was performed in 17/30 cases, the remaining cases were managed with change of biologic disease modifying or conventional synthetic anti-rheumatic drug. Age was the only significant predictor of SB4 interruption at 6 months. Conclusion: Our real-life data confirm the safety profile of switching from ETN to SB4, with slightly higher treatment persistence rates compared with other real-life registries.
The Effect of Abdominal Massage on Enteral Complications in Geriatric Patients
Authors: Çetinkaya Onur , Ovayolu Özlem , Ovayolu Nimet 
Published: October 2020

Introduction and Purpose Geriatric patients, who are fed by nasogastric tube (NG), may suffer from complications. Therefore, this study was conducted to evaluate the effect of abdominal massage on Gastric residual volume (GRV), distension, vomiting, and defecation in geriatric patients, who were hospitalized in intensive care unit and fed by NG. Methods The quasi-experimental study was conducted in intensive care units. The researcher applied abdominal massage to patients in the intervention group (n = 30) twice a day for 15–20 minutes before feeding. The data of the study were collected by using a questionnaire and a parameter questionnaire. Results GRV decreased significantly in the intervention group and increased significantly in the control group ( p < 0.05). The frequency of defecation significantly increased in intervention group ( p < 0.05). It was found that there was no positive effect of abdominal massage on vomiting ( p > 0.05). Conclusion It was observed that while abdominal massage reduced high GRV and distension incidence, it increased the incidence of defecation.
A method for analysis of nuisance dust from integrated steel works: chemical and mineralogical characteristics of contributing sources
Authors: Small James A. , van Hoek Corrie J. G. , Schollbach Katrin , Moosavi-Khoonsari Elmira , van der Does Frank J. L. , Melzer Stefan , de Jong Tako P. R. , de Bie Tilly , Versfeld Rob A. , de Roo Michiel , van der Laan Sieger R. 
Published: October 2020

Abstract
Background
Integrated steelmaking is known to emit coarse airborne ‘nuisance’ dust (10–100 µm) to the production site and in the local environs. We present a method to quantitatively analyse the provenance, mineralogical and chemical attributes of the constituent particles in nuisance dust related to the integrated steelworks of Tata Steel, IJmuiden, the Netherlands. The dust is characterised per particle, using scanning electron microscopy with energy-dispersive spectrometry (SEM–EDS) microanalysis, and in bulk with quantitative X-ray diffraction (XRD) analysis. Based on mineralogical characteristics, particles in the dust are sorted into populations that can be related in detail to industrial processes and subsequent atmospheric weathering influence. The method is illustrated by application to a nuisance dust complaint sample from the neighbouring town Wijk aan Zee containing a large contribution of several dust sources from the integrated steelworks.

Results
Besides a background contribution from urban and natural dust, diverse sources from the integrated steelworks are identified in the nuisance dust sample, derived from coke-making, iron-ore agglomeration processes and blast furnace ironmaking, steelmaking slag processing, process fluxes, as well as steelmaking refractory materials. The most voluminous of these in the sample are directly verified by comparison with a set of reference source materials. The abundances, mineralogical and chemical attributes of the various dust particle populations in the sample are quantitatively examined including, specifically, the occurrence of the potentially toxic elements Mn and V. These elements occur with highest concentrations in dust derived from steelmaking converter slag: V is housed in dilute form (solid solution) in the phases di-calcium silicate and brownmillerite, and Mn chiefly in Mg–Fe-oxide (Mg-wustite ((Mg,Mn,Fe)O) and its oxidation product ((Mg,Mn,Fe)(Fe,Mn)2O4)).

Conclusions
By treating nuisance dust as a particulate, multi-phase, multi-source material, the outlined method provides crucial information for toxicological evaluation and for mitigation of emissions, which is not obtainable by bulk chemical analyses alone. It also helps address the lack of adequate monitoring options for deposits of nuisance dust from integrated steel production, necessary to evaluate the relationship between deposition and monitored emissions that are regulated by the European Industrial Emissions Directive and by local permits based on this legislation.
A novel nomogram to predict the overall survival in esthesinoeroblastoma
Authors: Jiang Lijie , Lin Tengjiao , Zhang Yu , Gao Wenxiang , Deng Jie , Xu Zhaofeng , Luo Xin , Huang Zhaoqi , Chen Fenghong , Shi Jianbo , Lai Yinyan 
Published: October 2020

Abstract
Background
Increasing evidence indicates that the pathology and the modified Kadish system have some influence on the prognosis of esthesioneuroblastoma (ENB). However, an accurate system to combine pathology with a modified Kadish system has not been established.

Methods
This study aimed to set up and evaluate a model to predict overall survival (OS) accurately in ENB, including clinical characteristics, treatment and pathological variables. We screened the information of patients with ENB between January 1, 1976, and December 30, 2016 from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program as a training cohort. The validation cohort consisted of patients with ENB at Sun Yat-sen University Cancer Center and The First Affiliated Hospital of Sun Yat-sen University in the same period, and 87 patients were included. The Pearson’s chi-squared test was used to assess significance of clinicopathological and demographic characteristics. We used the Cox proportional hazards model to examine univariate and multivariate analyses. The model coefficients were used to calculate the Hazard ratios (HR) with 95% confidence intervals (CI). Prognostic factors with a p-value < 0.05 in multivariate analysis were included in the nomogram. The concordance index (c-index) and calibration curve were used to evaluate the predictive power of the nomogram.

Results
The c-index of training cohort and validation cohort are 0.737 (95% CI, 0.709 to 0.765) and 0.791 (95% CI, 0.767 to 0.815) respectively. The calibration curves revealed a good agreement between the nomogram prediction and actual observation regarding the probability of 3-year and 5-year survival. We used a nomogram to calculate the 3-year and 5-year growth probability and stratified patients into three risk groups.

Conclusions
The nomogram provided the risk group information and identified mortality risk and can serve as a reference for designing a reasonable follow-up plan.
The quality of Cochrane systematic reviews of acupuncture: an overview
Authors: Ji Zhaochen , Zhang Junhua , Menniti-Ippolito Francesca , Massari Marco , Fauci Alice Josephine , Li Na , Yang Fengwen , Zhang Mingyan 
Published: October 2020

Abstract
Background
Many systematic reviews of clinical trials on acupuncture were performed within the Cochrane Collaboration, the evidence-based medicine (EBM) most recognized organization. Objective of the article was to systematically collect and identify systematic reviews of acupuncture published in the Cochrane Library and assess their quality from a methodological perspective.

Methods
A comprehensive literature search was performed in the Cochrane Database of Systematic Reviews to identify the reviews of acupuncture conducted until June 2019. The methodological quality of the included reviews was assessed using the AMSTAR 2 checklist, an evaluation tool for systematic reviews.

Results
Out of a total of 126 eligible reviews, 50 systematic reviews were included. According to the AMSTAR 2, 52% of Cochrane Systematic Reviews (CSRs) were of low quality, due to the presence of one or more weaknesses in at least one of the domains defined as critical for the methodological quality assessment. The less satisfied critical domain was inadequate investigation and discussion of publication bias. Declaration of potential sources of conflict of interest, and funding of the authors of the review and of the included studies were other important weaknesses.

Conclusions
The main methodological flaws in the included CSRs were related to topics of relatively new concern in the conduction of systematic reviews of the literature. However, both, lack of attention about retrieval of negative studies, and statements about conflict of interests are crucial point for the evaluation of therapeutic interventions according to EBM methodology.