bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of neuron‐specific enolase, neutrophil‐to‐lymphocyte‐ratio and lymph node metastasis for distant metastasis in small cell lung cancer
Authors: Xia Xiaofang , Li Kejie , Wu Ruoqi , Lv Qiyuan , Deng Xia , Fei Zhenghua , Zou Changlin , Yang Xujing 
Published: August 2020

AbstractObjectiveTo investigate the value of neuron‐specific enolase (NSE), neutrophil‐to‐lymphocyte ratio (NLR) and lymph node metastasis in predicating distant metastasis in patients with limited‐stage small cell lung cancer (LD‐SCLC).MethodsClinical pathological data of LD‐SCLC patients in the First Affiliated Hospital of Wenzhou Medical University between August 2009 and October 2017 were retrospectively analyzed. The age, gender, smoking, TNM, NSE, NLR, chemotherapy cycle, radiotherapy, surgery and new metastasis of lymph nodes of 47 cases with distant metastasis and 47 cases without distant metastasis in 1 year were compared. Finally, factors influencing distant metastasis were determined as the predictors. The receiver operating characteristic (ROC) curve model was established based on logistic regression analysis of the factors obtained.ResultsDistant metastasis mainly involved brain (17/47), liver (17/47) and bone (17/47). Univariate analysis showed that patients with new lymph node metastasis, high NSE, pretreatment hilar lymph node metastasis and NLR were more prone to have distant metastasis. Multivariate analysis showed that new lymph node metastasis, high NSE, NLR and pretreatment hilar lymph node metastasis were independent predictors. The predictive model established using these predictors had an AUC of 0.872 (95%CI: 0.803‐0.941), a sensitivity of 76.60% and a speciality of 80.85%.ConclusionThe new lymph node metastasis, NLR and NSE are predictors of distant metastasis, and thus, may have a profound impact on treatment decision making. Patients with lower NLR and NSE expression levels and less new metastasis of lymph nodes have a lower distant metastasis rate.
EBUS‐TBNA versus EUS‐B‐FNA for the evaluation of undiagnosed mediastinal lymphadenopathy: The TEAM randomized controlled trial
Authors: Madan Karan , Mittal Saurabh , Madan Neha Kawatra , Tiwari Pavan , Jain Deepali , Arava Sudheer , Hadda Vijay , Mohan Anant , Garg Pramod , Guleria Randeep 
Published: August 2020

AbstractBackgroundEndobronchial Ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is a standard of care modality for the evaluation of mediastinal lymphadenopathy. Transesophageal Bronchoscopic Ultrasound‐Guided Fine Needle Aspiration (EUS‐B‐FNA), wherein one introduces the EBUS bronchoscope through the esophageal route, is also a safe and efficacious diagnostic modality for sampling the mediastinal lymph nodes. The objective of this study was to compare the diagnostic yield and patient comfort with these two available approaches.MethodsWe randomized subjects with predominant subcarinal or lower left paratracheal mediastinal lymph node enlargement to either EBUS‐TBNA or EUS‐B‐FNA (50 to each group). Co‐Primary objectives were the comparison of adequate and diagnostic aspirates between groups. Key secondary objectives were a comparison of Operator rated cough and Operator rated procedural comfort on Visual Analog scale (VAS), procedure duration and complications between the groups.ResultsBaseline characteristics were comparable between the groups. The proportion of adequate (EBUS‐TBNA 46/50; 92% and EUS‐B‐FNA 48/50;96%, P = 0.4) and diagnostic aspirates (EBUS‐TBNA 38/50; 76% and EUS‐B‐FNA 36/50;74%, P = 0.4) were similar between the two groups. Operator rated cough was significantly less, and Operator rated patient comfort significantly higher with the EUS‐B‐FNA approach. Procedure duration was significantly shorter with EUS‐B‐FNA [18.1(14.4) minutes versus 16.4 (49.6) minutes, P < 0.001]. Minor complications occurred in one patient in the EBUS‐TBNA group and none in the EUS‐B‐FNA group.ConclusionDuring the endosonographic evaluation for undiagnosed mediastinal lymphadenopathy located at predominantly the subcarinal or lower left paratracheal stations, EUS‐B‐FNA as compared with EBUS‐TBNA provides greater patient comfort with a similar diagnostic yield.
Evaluating resilience as a predictor of outcomes in lung transplant candidates
Authors: Bui Yvonne Tran , Hathcock Matthew A. , Benzo Roberto P. , Budev Marie M. , Chandrashekaran Satish , Erasmus David B. , Lease Erika D. , Levine Deborah J. , Thompson Karin L. , Johnson Bradley K. , Jowsey‐Gregoire Sheila G. , Kennedy Cassie C. 
Published: August 2020

AbstractBackgroundResilience represents the capacity to adapt to adversity. Resilience can improve following behavioral interventions. We examined lung transplant candidates’ resilience as a novel predictor using the Connor‐Davidson Resilience Scale (RISC‐10).MethodsWaitlisted candidates at six centers were mailed questionnaires from 9/16/2015 to 10/1/2019. Follow‐up surveys were collected annually and post‐transplant. Outcomes were recorded through February 17, 2020. Primary outcome was pre‐transplant death/delisting. Analyses included t test or chi‐square for group comparisons, Pearson's correlation coefficients for strength of relationships, and Cox proportional‐hazard models to evaluate associations with outcomes, adjusting for age, sex, and mood.ResultsParticipation was 55.3% (N = 199). Baseline RISC‐10 averaged 32.0 ± 5.6 and did not differ by demographics, primary transplant diagnosis, or disease severity markers. RISC‐10 did not correlate to the commonly utilized Psychosocial Assessment of Candidates for Transplant [PACT] or Stanford Integrated Psychosocial Assessment for Transplantation [SIPAT] tools. Scores < 26.3 (representing > 1 standard deviation below population average) occurred in 16% and were associated with pre‐transplant death or delisting, adjusted Hazard Ratio of 2.60 (95% Confidence Interval 1.23‐5.77; P = .01).ConclusionOne in six lung candidates had low resilience, predicting increased pre‐transplant death/delisting. RISC‐10 did not correlate with PACT or SIPAT; resilience may represent a novel risk factor.
The Stagnant Export Upgrading in Northeast China: Evidence from Value‐added Tax Reform
Authors: Du Yan , Yang Mengkai , Li Jing , Li Yunong 
Published: August 2020

AbstractChina's 2004 value‐added tax (VAT) pilot reform in the Northeast region, which changed the VAT from production type to consumption type, introduced a sizable tax credit for fixed investment in manufacturing industries, leading to more investment and higher productivity at firm level. This paper, however, uses difference‐in‐difference estimation and finds a negative structural effect; that is, the VAT pilot reform leads to a reduction in the export sophistication of Northeast cities relative to other cities in China, and the results hold for a battery of robustness checks. It is found that resources are reallocated towards less‐sophisticated industries. As the products with higher export sophistication are more skill and research and development (R&D) intensive, the shortfalls of skilled labor and R&D spending hinder the upgrading process. With a new round of revitalization plans in the Northeast, policymakers should be cautious with similar structural effects and focus on increasing skilled labor supply and R&D investment.
Assessment in the Service of Student Learning: Three Cases in Point
Authors: Bond Lloyd 
Published: August 2020

AbstractThree examples of extant testing practices (i.e., a classroom instructor's use of a simple pre‐post design, the practice of teaching to the test, and the think aloud verbal protocol) are discussed to illustrate the contention that assessment in the service of testing and learning does not necessarily involve radically different assessment practices. It is demonstrated that activities already familiar to teachers and assessment specialists can powerfully inform student learning and teaching practice.
Age‐related changes in oral motor‐control strategies during unpredictable load demands in humans
Authors: Almotairy Nabeel , Kumar Abhishek , Welander Nadia , Grigoriadis Anastasios 
Published: August 2020

To investigate age‐related changes in oral motor strategies in response to unpredictable load demands. Sixty‐five healthy children (aged 3–17 yr) were divided into five age‐groups based on their dental eruption stages and compared with a group of healthy adults (aged 18–35 yr). Each participant was asked to perform a standardized motor control task involving ‘pulling’ and ‘holding’ a force transducer with the anterior teeth. Different loads were attached to the force transducer in an unpredictable manner. The temporal force profile was divided into two time‐segments (an initial segment and a later segment). The peak force and peak force rate during the initial time‐segment, and the holding force and intra‐trial variability (coefficient of variation) during the later time‐segment, were measured. The results showed no differences in the peak force, peak force rate, holding force, and force variability in children compared with adults. However, the trends in the data evaluated using a segmented regression analysis showed that a breakpoint (abrupt change) consistently occurred in the late‐mixed dentition group (age 9–11 yr) for most of the outcome variables. The results indicate that while the motor control strategies in children appear to be similar to those in adults, there is a shift in the oral motor developmental trend during the late‐mixed dentition stage.
A Qualitative Study to Assess the Content Validity of the 24‐Hour Migraine Quality of Life Questionnaire in Patients with Migraine
Authors: Speck Rebecca M. , Collins Ethan M. , Lombard Louise , Ayer David W. 
Published: August 2020

ObjectiveA concept elicitation, cognitive debriefing, and usability study was undertaken to: (1) explore migraine symptoms and day‐to‐day impacts; (2) determine the comprehensiveness and comprehensibility of the previously developed 24‐Hour Migraine Quality of Life Questionnaire electronic patient‐reported outcome (24‐Hr MQoLQ ePRO) items, and the appropriateness and understanding of the recall period, response options, and instructions; and (3) assess the usability on an electronic hand‐held device.MethodsEleven United States English‐speaking people with episodic migraine were recruited to participate in one‐on‐one interviews, which followed methods appropriate for concept elicitation, cognitive debriefing, and usability testing. Interviews were audio‐recorded, transcribed, and analyzed following the constant comparative method.ResultsParticipants had a mean age of 42 years, and 8 were female. Through spontaneous mention or probing, all concepts of the 24‐Hr MQoLQ ePRO were endorsed by a majority of the participants. Cognitive interviewing confirmed the 24‐Hr MQoLQ ePRO instructions were clear, meaningful, and important to assess as symptoms and day‐to‐day impacts experienced as a result of migraine. Overall impressions of the ePRO device were overwhelmingly favorable, and the ePRO device was preferred to paper and pencil by all participants. Participant responses regarding the level of headache pain that would be acceptable in order to continue to go about daily activities ranged from 3 to 6, on a scale of 0 to 10, with 0 being “no headache” and 10 being “the worst headache.”ConclusionsThe 24‐Hr MQoLQ ePRO is content‐valid and appropriate for inclusion in future acute treatment for migraine studies designed to measure the symptoms and health‐related quality of life of migraine.
An understanding of spirituality and spiritual care among people from Chinese backgrounds: A grounded theory study
Authors: Niu Yanping , McSherry Wilfred , Partridge Martin 
Published: August 2020

AbstractAimTo investigate the meaning of spirituality and spiritual care among people from Chinese backgrounds living in England.DesignStrauss and Corbin’s grounded theory design was used.MethodTwenty‐five participants were recruited from Chinese community centres after which data saturation was reached in September 2016. In‐depth interviews in Chinese were carried out. Transcribed digital recordings were translated into English. Data analysis followed the techniques of open coding, axial coding, and selective coding, using NVivo11. Data collection and analysis were conducted simultaneously.ResultsThree themes emerged from the data which provide an understanding of spirituality and spiritual care in the study context: ‘essence and nature of life’, ‘driving forces’, ‘self‐support’.ConclusionThis study provides an understanding of spirituality and spiritual care from a Chinese cultural perspective. From a Daoist tradition, spirituality is seen as essence and driving force in the human body. From a Confucian viewpoint, it appears that patients saw themselves or the ‘self’ as a supporting resource.ImpactThe knowledge gained from this study has potential to support nurses and healthcare practitioners to identify the spiritual needs of people from Chinese backgrounds and to remove some of the Chinese misconceptions Chinese people hold about spiritual care by explaining what these concepts could mean. It could also improve cultural awareness for student nurses around what constitutes spiritual care. Further research is recommended among the wider community of health and social care workers to explore spirituality and spiritual care among people from Chinese backgrounds living in England.
Associations between sarcopenia and white matter alterations in older adults with diabetes mellitus: A diffusion tensor imaging study
Authors: Tamura Yoshiaki , Shimoji Keigo , Ishikawa Joji , Tachibana Aya , Kodera Remi , Oba Kazuhito , Toyoshima Kenji , Chiba Yuko , Tokumaru Aya M , Araki Atsushi 
Published: August 2020

AbstractAims/IntroductionOlder adults with diabetes mellitus are susceptible to sarcopenia. Diffusion tensor imaging studies have also shown that patients with diabetes have altered white matter integrity. However, the relationship between these structural changes in white matter and sarcopenia remains poorly understood.Materials and MethodsThe study included 284 older patients (aged ≥65 years) who visited the Tokyo Metropolitan Geriatric Hospital Frailty Clinic. We used diffusion tensor imaging to measure fractional anisotropy (FA) and mean diffusivity (MD) to evaluate changes in white matter integrity. We investigated the associations between sarcopenia, or its diagnostic components, and FA or MD in seven white matter tracts considered to be associated with sarcopenia according to the patients’ diabetes status.ResultsWe found significantly low FA or high MD values in the bilateral anterior thalamic radiations (ATR) and right inferior fronto‐occipital fasciculus (IFOF) of patients with Asian Working Group for Sarcopenia 2019‐defined sarcopenia, in all patients and those with diabetes. Using binominal regression analyses, we associated low FA values in the left ATR and right IFOF with sarcopenia in all patients and those with diabetes, after adjusting for age, gender, HbA1c, blood pressure, cognitive function, physical activity, depression, nutritional status, and inflammation.ConclusionsWhite matter alterations in left ATR and right IFOF are associated with the prevalence of sarcopenia in patients with diabetes. Specific changes to the left ATR and right IFOF tracts could play critical roles in the occurrence of sarcopenia in patients with diabetes.
Can insurance alter poverty dynamics and reduce the cost of social protection in developing countries?
Authors: Janzen Sarah A. , Carter Michael R. , Ikegami Munenobu 
Published: August 2020

AbstractThis paper develops a dynamic theoretical model to assess the impact of asset insurance on poverty and the cost of social protection in developing countries. We analyze the model under two technological assumptions: a standard, globally concave production technology, and a fixed cost technology that creates a non‐convex production set and admits the possibility of multiple equilibria and a poverty trap. Under both assumptions, the introduction of an asset insurance market reduces poverty and the costs of social protection. Under the non‐convex production set, there is a strong public finance case for insurance premium subsidies that target poor and vulnerable households and bring them into the insurance market. While the challenges of making microinsurance markets work are multiple, this analysis suggests the potential gains to solving these challenges are substantial.
Investigating prescribing errors in the emergency department of a large governmental hospital in Jordan
Authors: Abdel-Qader Derar H , Al Meslamani Ahmad Z , El-Shara' Asma' A , Ismael Najlaa Saadi , Albassam Abdullah , Lewis Penny J , Hamadi Salim , Abbas Hazim Saleem , Al Mazrouei Nadia , Mohamed Ibrahim Osama 
Published: August 2020

Abstract

Background
Although prescribing errors (PEs) are the most common type of medication errors and cause morbidity and mortality, they have been rarely studied.

Objective
The study aimed to investigate PEs incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.

Setting
This study was conducted in the emergency department of the largest governmental hospital in Jordan.

Method
This was a retrospective observational 4-week study. A validated definition of PEs was adopted, and errors were identified by direct observation of all prescriptions. Structured interviews with doctors to assess the causes of errors were conducted within three days of the prescription date; the severity of PEs was rated by a committee.

Main outcome measure
Prescribing errors incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.

Results
For 1330 patients, 3470 medication orders were recorded. Almost one in five patients had PEs (n = 288, 21.65%), and the total number of medication orders for patients who had errors was 610. The PEs incidence was 12.5% (95% CI 11.4%–3.5% (n = 450/3597)). Analgesics were the most common medications associated with PEs (232/610, 38.03%). The top two types of PEs detected were wrong drug (165/450, 36.6%) and wrong dose (142/450, 31.5%) respectively. Most PEs were clinically significant errors (342/450, 76%). Doctors refused pharmacists' interventions on their orders in 132 (45.8%) prescriptions. The most common cause of errors was poor skills of doctors in electronic prescribing system (266/450, 59%). Predictors of PEs were the following: drug with multiple dosage forms (OR 2.998; 95% CI 1.41–6.34; P = 0.004) and a prescription with polypharmacy (OR 1.685; 95% CI 1.25%–2.26%; P = 0.001).

Conclusion
A national approach for observing, intervening on and correcting PEs is necessary to improve patient safety.
Effects of silymarin supplementation during transition and lactation on reproductive performance, milk composition and haematological parameters in sows
Authors: Jiang XiaoJun , Lin Sen , Lin Yan , Fang ZhengFeng , Xu ShengYu , Feng Bin , Zhuo Yong , Li Jian , Che LianQiang , Jiang XueMei , Wu De 
Published: August 2020

AbstractSilymarin has been shown to be a multiple‐functional plant extract having antioxidant, hepatoprotective, hypolipidemic, antihypertensive, antidiabetic and anti‐obesity effects. In recent years, the galactagogue effects of silymarin in animals and humans have also been revealed. This research was conducted to test whether dietary inclusion of silymarin during transition and lactation could impact reproductive performance of sows and to explore the underlying mechanisms. From day 108 of gestation to weaning, sows were randomly assigned to receive dietary treatment of silymarin (40 g/day) or not and were designated as control group (CGP, n = 55) or treatment group (TGP, n = 55). The results showed that piglets’ average daily gain and average weaning weight were higher in TGP than CGP sows. In comparison with the CGP sows, the TGP sows had higher serum concentrations of catalase (CAT) on day 18 of lactation and glutathione peroxidase (GSH‐Px) on day 7 of lactation. The TGP sows had lower concentration of TNF‐α on day 7 of lactation and significantly lower concentration of IL‐1β on day 18 of lactation than CGP sows. There was significantly higher serum concentration of PRL on day 7 of lactation in sows consuming silymarin than sows from the CGP group. On day 18 of lactation, the protein and urea contents in milk were significantly increased while the serum urea concentration was significantly decreased in TGP sows. In summary, our results indicate that silymarin supplementation during transition and lactation can increase circulating concentrations of PRL transiently, reduce oxidative stress, increase feed intake and enhance protein metabolism, thereby significantly increasing milk yield of sows and subsequently improving growth performance of their offsprings.
Functional traits: Adaption of ferns in forest
Authors: Jin Dong‐Mei , Zhou Xi‐Le , Schneider Harald , Wei Hong‐Jin , Wei Hong‐Yu , Yan Yue‐Hong 
Published: August 2020

AbstractFerns that evolved from 400 million years ago show various functional traits and ecological strategies in extant species, over 80% of which belong to the youngest order Polypodiales. How the functional traits and strategies of ferns have changed during their evolutionary history remains unexplored. Here, we measured functional traits that are sensitive to environmental light and water availability in 345 fern species across fern phylogeny, and reconstructed their evolutionary histories. We found that ferns, mainly Polypodiales, have developed diversified functional traits in response to forest environments. Terrestrial species, especially Thelypteridaceae and Athyriaceae in eupolypods II, since the late Jurassic period, have shown decreased leaf mass per area (LMA) and area‐based leaf nitrogen (Narea), but increased mass‐based leaf nitrogen (Nmass) compared with early‐derived polypods. Epiphytic species, mainly those in Polypodiaceae, have shown reductions in Nmass and individual leaf area (Area) since the late Cretaceous period. The adaption of functional traits of Polypodiales to forest environment may have played a crucial role in fern radiation since the late Jurassic period. Integrative analysis of functional traits, especially numerical ones, may shed new light on plant evolution.