bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction of a patient decision aid for the treatment of uncomplicated urinary tract infection in primary care
Authors: VINCENT Yves-Marie , FRACHON Adèle , BUFFETEAU Clotilde , CONORT Guillaume 
Published: December 2020

Abstract
Background: Uncomplicated urinary tract infection (uUTI) is very common among women in primary care. The risk of developing pyelonephritis remains low after uUTI, nonetheless, empiric antibiotic therapy is frequently prescribed for symptomatic purposes. This may lead to adverse effects and antibiotic resistance. Furthermore, patients may express the will to limit the use of antibiotics. Some European countries recommend discussing a delayed prescription with the patient and developing a shared decision. The aim of this study is to create a patient decision aid (PtDA) used in primary care settings to make a shared decision between practitioners and women about whether or not to treat uUTI with antibiotics.Methods: We followed the steps recommended by the International Patient Decision Aids Standards, with a scoping phase, a design phase (including focus groups and literature review), and an alpha-testing phase. A steering group, made of patients and physicians, met throughout the study to develop a prototype PtDA.Results: The information included in the PtDA is the definition of uUTI, information on the options, their benefits, risks, and consequences, based on a review of the literature. The results of the focus group made possible to determine the patient's values and preferences to consider in decision-making, including: the discomfort felt, the impact on daily life, patients’ perceptions of antibiotics, and the position relative to the risk of adverse effect. The choices in presentation, organisation and design are the result of the work of the steering group, improved by feedback from alpha testing. We confirmed the need for shared decision-making and the equipoise in this situation.Conclusions: We developed a PtDA to be used in primary care for sharing decision on the use of antibiotic in uUTI. It needs to be validated in a beta-testing phase, with complementary advice from peers, and then tested in a clinical study comparing its use with the systematic prescription approach.
Physical Exercise for Individuals with Dementia: potential benefits perceived by Formal Caregivers
Authors: Sampaio Arnaldina , Marques-Aleixo I , Seabra A , Mota J , Carvalho J 
Published: December 2020

Abstract
Background: The social and economic impact of dementia for the development of accessible and sustainable care for individuals with dementia (IwD). Physical exercise has been seen as a beneficial non-pharmacological therapy in the prevention and management of dementia, and possible benefits may not only impact on participants, but also indirectly on their caregivers. Thus, this quasi-experimental non-randomized study aimed to analyze the effects of an exercise intervention on functional capacity, behavioural and psychological symptoms in dementia (BPSD) and quality of life of institutionalized older adults with dementia, perceived by their formal caregivers. Methods: Sixty-four institutionalized older adults (from both genders, aged 65–93 yrs. old), clinically diagnosed with dementia, were divided into two groups: control group (CG, continued with usual care, n= 26) and exercise group (EG, 6-month supervised multicomponent exercise intervention, n= 38). Nine caregivers (female, aged 28-47 yrs old) from nine different nursing homes, reported about their distress related to BPSD and proxy-reported about participants’ functional capacity (Katz index), quality of life (QoL-AD), BPSD (NPI) before and after 6 months of an exercise intervention (aerobic, muscular resistance, flexibility and postural exercises). Results: A two-way ANOVA, with repeated measures, revealed significant group and time interactions on Total Katz index and QoL-AD. The CG's performance functional capacity and quality of life score worsen over time while in EG maintains these values after the exercise intervention. Moreover, formal caregiver´s distress triggered by apathy and disinhibition increased in CG while after 6 months of an exercise intervention no alterations were seen regarding these distress causes in EG. No significant main effects were observed for total NPI score or NPI distress.Conclusions: Overall results show that after the exercise intervention, IwD from the EG, was capable of preserving the functional capacity, quality of life and neuropsychiatric symptoms were attenuate, contributing to a lower load of distress for the caregivers.Trial registration: clinicaltrials.gov, NCT04095962. Retrospectively registered on 19 September 2019, https://clinicaltrials.gov/ct2/show/NCT04095962
The emotional and social burden of heart failure: integrating physicians’, patients’, and caregivers’ perspectives through Narrative Medicine
Authors: Testa Marco , Cappuccio Antonietta , Latella Maura , Napolitano Silvia , Milli Massimo , Volpe Massimo , Marini Maria Giulia 
Published: December 2020

Abstract
Background: The TRUST (The Roadmap Using Story Telling) project used a Narrative Medicine (NM) framework to assess the perspectives of people with heart failure (HF), their informal caregivers and HF specialists of the impact of heart failure (HF) on the daily life of patients and their carers. Methods: Italian HF specialists participated on a voluntary basis, completing their own narratives, and inviting patients and their caregivers to write anonymously about their experiences, all on a dedicated online platform. The narratives were analyzed according to standard NM methodology. Results: 82 narratives were collected from patients, 61 from caregivers, and 104 from HF specialists. Analysis of the three points of view revealed the extent of the burden of illness on the entire family, particularly that of the caregiver. The impact was mainly experienced as emotional and social limitations in patients’ and their caregivers’ daily lives. The analysis of all three points of view highlighted a strong difference between how HF is perceived by patients, caregivers, and HF specialists. Conclusions: This NM project illustrates the complex issues of living with HF and gave insights to integrate three different perspectives into the HF pathway of care.
MHC class I evolution; from Northern pike to salmonids
Authors: Grimholt Unni , Lukacs Morten 
Published: December 2020

Abstract
Background: Salmonids are of major importance both as farmed and wild animals. With the changing environment comes changes in pathogenic pressures so understanding the immune system of all salmonid species is of essence. Major histocompatibility complex (MHC) genes are key players in the adaptive immune system signalling infection to responding T-cells populations. Classical MHC class I (MHCI) genes, defined by high polymorphism, broad expression patterns and peptide binding ability, have a key role in inducing immunity. In salmonids, the fourth whole genome duplication that occurred 94 million years ago has provided salmonids with duplicate MHCI regions, while Northern Pike, a basal sister clade to salmonids, represent a species which has not experienced this whole genome duplication. Results: Comparing the gene organization and evolution of MHC class I gene sequences in Northern pike versus salmonids displays a complex picture of how many of these genes evolved. Regional salmonid Ia and Ib Z lineage gene duplicates are not orthologs to the Northern pike Z lineage sequences. Instead, salmonids have experienced unique gene duplications in both duplicate regions as well as in the Salmo and Oncorhynchus branch. Species-specific gene duplications are even more pronounced for some L lineage genes. Conclusions: Although both Northern pike as well as salmonids have expanded their U and Z lineage genes, these gene duplications occurred separately in pike and in salmonids. However, the similarity between these duplications suggest the transposable machinery was present in a common ancestor. The salmonid MHCIa and MHCIb regions were formed during the 94 MYA since the split from pike and before the Oncorhynchus and Salmo branch separated. As seen in tetrapods, the non-classical U lineage genes are diversified duplicates of their classical counterpart. One MHCI lineage, the L lineage, experienced massive species-specific gene duplications after Oncorhynchus and Salmo split approximately 25 MYA. Based on what we currently know about L lineage genes, this large variation in number of L lineage genes also signals a large functional diversity in salmonids.
Radiofrequency ablation combined with conductive fluid-based dopants (saline normal and colloidal gold): Computer modeling and ex vivo experiments.
Authors: Castro-Lopez Dora Luz , Berjano Enrique , Romero-mendez Ricardo 
Published: December 2020

Abstract
Background: The volume of the coagulation zones created during radiofrequency ablation (RFA) is limited by the appearance of roll-off. Doping the tissue with conductive fluids, e.g. gold nanoparticles (AuNPs) could enlarge these zones by delaying roll-off. Our goal was to characterize the electrical conductivity of a substrate doped with AuNPs in a computer modeling study and ex vivo experiments to investigate their effect on coagulation zone volumes. Methods: The electrical conductivity of substrates doped with normal saline or AuNPs was assessed experimentally on agar phantoms. The computer models, built and solved on COMSOL Multiphysics, consisted of a cylindrical domain mimicking liver tissue and a spherical domain mimicking a doped zone with 2, 3 and 4 cm diameters. Ex vivo experiments were conducted on bovine liver fragments under three different conditions: 1) non-doped tissue (ND Group), 2 mL of 0.9% NaCl (NaCl Group), and 2 mL of AuNPs 0.1 wt% (AuNPs Group). Results: The theoretical analysis showed that adding normal saline or colloidal gold in concentrations lower than 10% only modifies the electrical conductivity of the doped substrate with practically no change in the thermal characteristics. The computer results showed a relationship between doped zone size and electrode length regarding the created coagulation zone. There was good agreement between the ex vivo and computational results in terms of transverse diameter of the coagulation zone.Conclusions: Both the computer and ex vivo experiments showed that doping with AuNPs can enlarge the coagulation zone, especially the transverse diameter and hence enhance sphericity.
Improvement in BMI z-score following adenotonsillectomy in adolescents aged 12-18 years: a retrospective cohort study
Authors: Nathan Keren , Livnat Galit , Feraru Liat , Pillar Giora 
Published: December 2020

Abstract
Background: obstructive sleep apnea (OSA) is associated with different patient characteristics according to age groups. OSA in babies and in prepubertal children is usually accompanied by a failure to thrive (FTT) and underweight. Adenotonsillectomy (T&A) is the first line of treatment for obstructive sleep apnea (OSA) in childhood. In the adult population and partly in adolescents OSA is commonly associated with obesity and the metabolic syndrome. In adolescents with OSA managed with a T&A the change in BMI was only occasionally studied. Thus, we peruse to examine the BMI z-score change following T&A in adolescents. Methods: in Israel, Clalit Health Services is the largest health care organization with the largest patient registry (more than 50% of the population). From the Clalit registry, 242 adolescents aged 12-18 who underwent T&A between 2006-2015 were retrospectively studied. BMI z-score changes from up to 3 months prior to T&A were compared to BMI measures in the following 3 years post T&A.Results: there were changes to all directions with overall small increase, not statistically significant (P=0.26) in BMI Z-score with a median of 0.79 prior to and 0.835 following T&A. Overweight children (n=74) tended to reduce their BMI z-score from 1.508 to 1.48 following T&A (p=NS), and in obese children (n=33) BMI z-score decreased from 2.288 to 2.000 accordingly (P=0.06, 2 tailed). Interestingly thin individuals (n=6) increased their BMI z-score following T&A from -2.4 to -0.59 (p=0.046).Conclusions: adolescents managed with T&A show variable changes in their BMI z-score following the procedure. In this regard their BMI z-score change is closer to the change seen in adults treated for OSA and not young children. The changes observed show trend to normalize the BMI z-score such that overweight children tend to decrease their BMI z-score while thin individuals tend to increase it.
MRI Study on Tibial Nerve of the Ankle Canal and Its Branches:A method of multiplanar reconstruction with 3D-FIESTA-C sequences
Authors: Zhang Yan , He Xucheng , Li Juan , Ye Ju , Han Wenjuan , Zhou Shanshan , Zhu Jianzhong , Wang Guisheng , Chen Xiaoxia 
Published: December 2020

Abstract
Background: The display of tibial nerve and its branches in the ankle canal is helpful for the diagnosis of local lesions and compression, and also for clinical observation and surgical planning. The aim of this study was to investigate the feasibility of three-dimensional dual-excitation balanced steady-state free precession sequence (3D-FIESTA-C) multiplanar reformation (MPR) display of tibial nerve and its branches of the ankle canal.Methods: The subjects were 20 healthy volunteers (40 ankles), aged 22-50, with no history of ankle joint disease. 3D-FIESTA-C sequence was used in the 3.0t magnetic resonance equipment for imaging. During the scanning, each foot was at a 90-degree angle to the tibia. The tibial nerve of the ankle canal and its branches were displayed and measured at the same level through multiplanar reformation.Results: Most of the tibial nerve bifurcation points were located in the ankle canal (57.5%), few (42.5%) were located at the proximal end of the ankle canal, and none was found away from the distal end. The bifurcation between the medial plantar nerve and the lateral plantar nerve is on the line between the tip of the medial malleolus and the calcaneus, and it’s angle is between 6° and 35°. In MPR images, the display rates of both the medial calcaneal nerve and the subcal caneal nerve were 100%, and the starting point of the subcal caneal nerve was always at the distal end of the starting point of the medial calcaneal nerve. In 55% of cases, there were more than 2 medial calcaneal nerve innervations.Conclusion: The 3D-FIESTA-C MPR can display the morphological features and positions of tibial nerve and its branches and the bifurcation point’s projection position on the body surface can be marked. This method not only benefited the imaging diagnosis of tibial nerve and branch-related lesions of the ankle canal, but also provided a good imaging basis to plan the clinical operation of the ankle canal and avoid surgical injury.
The effect of inhaling mother’s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial
Authors: Rad Zahra Akbarian , Aziznejadroshan Parvin , Amiri Adeleh Saebi , Ahangar Hemmat Gholinia , Valizadehchari Zahra 
Published: December 2020

Abstract
Background: Non-pharmacologic pain relief in preterm infant is an important measure. Familiar odors for neonates have soothing effects in some researches. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother’s breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants.Methods: This single-blind randomized clinical trial was performed in the neonatal intensive care unit of Babol Rouhani Hospital, Iran from February 2019 to March 2020. Ninety preterm infants who must to be receive the HB vaccine, were randomly assigned into three groups of MBMO (A), another mother’s BMO (B) and control with distilled water(C). Oxygen saturation(SaO2), blood pressure(BP) and heart rate(HR) were recorded by electronic monitoring and premature infant pain profile (PIPP) were determined through video recording in tree groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing data, and P<0.05 was considered significant.Results: No significant differences were seen between tree groups in mean± SD of HR, BP, Sao2 before intervention, (P>0.05). After intervention, the mean heart rate in group A, B and C was 146. 6±14.3, 153.70±17.5 and 155.70±17.7 respectively, (P=0.01). There was no significant difference between groups in the mean of SaO2, systolic and diastolic blood pressure after intervention (P>0.05). The mean PIPP score in groups A, B and C was 6.6±1.3, 10 ±2 and 11.4±1.9 respectively, (P<0.001).Conclusions: Stimulation with MBMO is effective in reducing the pain of preterm infants, so it can be used in less invasive procedures such as needling.Trial registration: IRCT, IRCT20190220042771N1. Registered 18 May 2019- Retrospectively registered, https://en.irct.ir/trial/37646
Incidence and risk factors for trocar-site incisional hernia detected by clinical and ultrasound examination. A prospective observational study​
Authors: Ciscar Ana , Badia Josep Maria , Novell Francesc , Bolivar Santiago , Mans Esther 
Published: December 2020

Abstract
BACKGROUND: Trocar site incisional hernia (TSIH) is the most frequent complication associated with laparoscopic surgery. Few studies currently describe its incidence or risk factors. The aim of this report is to determine the real incidence of TSIH and to identify risk factors. METHODS: A cross-sectional prospective study was performed including consecutive patients who underwent a laparoscopic procedure during a four months period. All the patients were assessed both clinically (TSIHc) and by an ultrasonographic examination (TSIHu). The main variable studied was the incidence of TSIH. A multivariate analysis was performed to identify risk factors. RESULTS: 76 patients were included. 27.6% of patients were clinically diagnosed as having TSIH (TSIHc) but only 23.7% of those cases were radiologically confirmed (TSIHu). In the logistic regression analysis, age > 70 years (OR 3.462 CI 1.14 - 10.515, p = 0.028) and body mass index (BMI) ≥30 Kg / m2 (OR 3.313 CI 1.037-10.588, p = 0.043) were identified as risk factors for TSIH. The size of the trocar also showed statistically significant differences (p <0.001). Mean follow-up time was 34 months.CONCLUSIONS: TSIH is under-diagnosed due to the lack of related symptomatology and the inadequacy of the postoperative follow-up period. We detected discrepancies between the clinical and ultrasonographic examinations. TSIHu should be considered as the gold standard for the diagnosis of TSIH. Risk factors such as age, BMI and size of the trocar were confirmed. Patients should be followed-up for a minimum of 2 years.
Effects of Quran Recitation on the Reduction of Preoperative Anxiety in Elective Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Gavgani Vahideh Zarea , Ghojazadeh Mortaza , Sadeghi-Ghyassi Fatemeh , Khodapanah Tahmineh 
Published: December 2020

Abstract
Background: Anxiety is a common reaction among patients undergoing surgery. This study aim to assess effectiveness of Quran recitation on reducing the preoperative anxiety.Methods: A systematic review of the citations in the Medline, EMBASE, Cochrane Library, PsycInfo, Arab World Research Source and other relevant databases was performed to collect the data. Randomized clinical trials about the effect of Quran recitation on the reduction of preoperative anxiety in elective surgery were included without any Language and date restriction. Interventions with self-reading/self-recitation were excluded. The Cochran’s Q statistic and the (I2) with 50 percent threshold was used for calculation of the heterogeneity and inconsistency index. Subgroup analysis was conducted based on the type of surgery. The funnel plot has been used to evaluate the possibility of the publication bias.Results:Twelve studies were included in the qualitative synthesis and nine studies included in the quantitative synthesis. Our meta-analysis showed a significant reduction in the anxiety level with Quran recitation. The heterogeneity of the included studies was statistically significant (Q=23.05, I2=65.29, P=0.003). The pooled effect size of the anxiety was d=−8.893; 95% CI=[−10.763 to −7.022] (P < 0.001). The subgroup analysis showed that Quran recitation has a beneficial effect on reducing anxiety in both major and minor surgeries.There was no publication bias (t=0.907, P=0.39) in the studies.Conclusion: Quran recitation can be considered as a non-invasive and peaceful intervention to reduce preoperative anxiety in elective surgery.
Usability evaluation of an integrated Electronic Medication Management System implemented in an Oncology setting using the Unified Theory of the Acceptance and Use of Technology.
Authors: dabliz racha , Poon Simon K. , Ritchie Angus , Burke Rosemary , Penm Jonathan 
Published: December 2020

Abstract
Background: Medication management processes in an Oncology setting are complex and difficult to examine in isolation from interrelated processes and contextual factors. This qualitative study aims to evaluate the usability of an Electronic Medication Management System (EMMS) implemented in a specialised oncology unit using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. Methods: The study was conducted in a 12-bed outpatient Oncology unit of a major teaching hospital six months following implementation of a commercial EMMS. In-depth semi-structured interviews were conducted with doctors, nurses and pharmacists using the system to assess usability. The UTAUT framework was used to analyse the results, which facilitated evaluation of interrelated aspects and provided a structured summary of user experience and usability factors. Results: Direct cross-comparison between user groups illustrated that doctors and pharmacists were generally satisfied with the facilitating conditions (hardware and training), but had divergent perceptions of performance (automation, standardised protocols and communication and documented) and effort (mental and temporal demand). In counterpoint, nurses were generally satisfied across all constructs. Prior experience using an alternative EMMS influenced performance and effort expectancy and was related to early dissatisfaction with the implemented system. Furthermore, whilst not originally designed for the healthcare setting, the flexibility of the UTAUT allowed for translation to the hospital environment. Conclusion: Nurses demonstrated overall satisfaction with the EMMS, whilst doctors and pharmacists perceived some usability problems, particularly related to restricted automaticity and system complexity, which hindered user uptake and EMMS success. The study demonstrates the feasibility and utility of the UTAUT framework to evaluate usability of an EMMS for multiple user groups in the Oncology setting.