bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration of Palliative Care in Services for Children with Life Limiting Neurodevelopmental Disabilities and Their Families: A Delphi Study
Authors: Guerin Suzanne , Kiernan Gemma , Courtney Eileen , McQuillan Regina , Ryan Karen 
Published: September 2020

Abstract
Background: The aim of this study was to explore expert professionals’ opinions on service provision to children under six with life-limiting neurodevelopmental disabilities (LLNDD), including the goals of care and the integration and coordination of palliative care in general and specialist services. Methods: A Delphi design was used with three questionnaire rounds, one open-ended and two closed response rounds. Primary data collected over a six-month period from expert professionals with five years’ (or more) experience in pediatric, intellectual disability and/or palliative care settings. Ratings of agreement and prioritization were provided with agreement expressed as a median (threshold = 80%) and consensus reported as interquartile ranges. Stability was measured using non-parametric tests. Results: Primary goals of care were achievement of best possible quality of life, effective communication and symptom management. Service integration and coordination were considered inadequate, and respondents agreed that areas of deficiency included palliative care. Improvement strategies included a single care plan, improved communication and key worker appointments. Conclusions: The findings suggest that services do not serve this group well with deficiencies in care compounded by a lack of information on available services and sub-optimal communication between settings. Further research is needed to develop an expert-based consensus regarding the care of children with LLNDD.
Adoption Rates of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes
Authors: Kose Ilker , Rayner John , Birinci Suayip , Ulgu Mustafa Mahir , Yilmaz Ismayil , Guner Seyma 
Published: September 2020

Abstract
Background: Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods: EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion: Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.
Impact of low skeletal muscle mass index and perioperative blood transfusion on the prognosis for HCC following curative resection
Authors: Bekki Tomoaki , Abe Tomoyuki , Amano Hironobu , Hattori Minoru , Kobayashi Tsuyoshi , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio 
Published: September 2020

Abstract
Background

This study aimed to assess the prognostic factors including low skeletal muscle mass index (SMI) and perioperative blood transfusion for patients with hepatocellular carcinoma (HCC) following curative surgery.

Methods

This study included 139 patients with HCC who underwent hepatectomy between 2005 and 2016. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS) and recurrence-free survival (RFS).

Results

Low SMI was significantly related with poor OS, while blood transfusion had a strong impact on RFS. The male ratio and body mass index in the low SMI group were significantly higher than those in the high SMI group. There were no significant differences in age, virus etiology, laboratory data, liver function, tumour makers, and operative variables between the groups. Tumour factors such as tumour diameter, tumour number, poor differentiation, and intrahepatic metastasis (IM) did not significantly differ between the two groups. Operation time, intraoperative blood loss volume, and recurrence ratio were significantly higher in the blood transfusion group than in the non-transfusion group. IM was associated with poor OS and RFS.

Conclusions

Low SMI and blood transfusion were independently related with long-term prognosis in patients with HCC following curative surgery.
Tunicamycin promotes metastasis through upregulating endoplasmic reticulum stress indu​ced GRP78 expression in thyroid carcinoma
Authors: Zhao Guohong , Kang Jianqin , Xun Guanghui , Wei Jing , Wang Xiaoguang , Jing Xiaorui , Zhang Lan , Yang Aili , Wang Kai , Wang Jue , Wang Li , Hou Junfeng , Liu Qingquan , Jiao Kai , Gao Bin 
Published: September 2020

Abstract
Background: Thyroid cancer (TC) is the most common type of endocrine malignancy and its incidence is increasing over years. Conventional surgery, radiotherapy and chemotherapy are difficult to improve the significant effects of it due to aggression and metastasis of poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC), and these are regarded as the most malignant types of TC. Glucose-regulated protein (GRP78) is the key molecule of tumor growth, apoptosis and metastasis. However, the underlying mechanisms of GRP78 in TC still require discussion. This study aimed to explore the role of GRP78 and its potential mechanism in TC.Results: GRP78 expression was increased in TC tissues when compared with adjacent normal tissues. Besides, down-regulation of GRP78 significantly inhibited the metastatic and proliferative ability of ATC cells in in vitro studies. In addition, tunicamycin-induced ER stress up-regulated the expression of GRP78, PERK and XBP1 as well as reversed the metastatic ability of GRP78 in ATC cells. Bioinformatics and statistical analysis of gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways for RNA-sequencing data with regard to si-GRP78 and si-control showed that GRP78 might regulate the ability of metastasis through extracellular matrix (ECM) remodeling in ATC cells, as well as the expression of ECM components such as COL1A1 and MMP13, which were highly relevant to ATC cells. The analysis of GEPIA database confirmed that high genomic amplification of MMP13 and COL1A1 in TC tissues showed correlation with TNM stage. Further western blotting analysis showed that MMP13 might be the target of GRP78 in ATC cells and ER stress could activate the expression of MMP13 that is suppressed by GRP78 depletion.Conclusions: GRP78 acts as an important regulator of metastasis under ER stress. In addition, the function of GRP78 might be mediated by ECM remodeling in ATC cells, implicating it as a therapeutic target in TC.
Gut Microbiota Composition and Metabolomic Profiles of Wild and Captive Chinese Monals (Lophophorus lhuysii)&nbsp;
Authors: Jiang Dandan , He Xin , Valitutto Marc , Chen Li , Xu Qin , Yao Ying , Hou Rong , Wang Hairui 
Published: September 2020

Abstract
Background：The Chinese monal (Lophophorus lhuysii) is an endangered bird species, with a wild population restricted to the mountains of southwest China, and only one known captive population in the world. We investigated the fecal microbiota and metabolome of wild and captive Chinese monals to explore differences and similarities in nutritional status and digestive characteristics. An integrated approach combining 16S ribosomal RNA (16S rRNA) gene sequencing and ultra-high performance liquid chromatography (UHPLC) based metabolomics were used to examine the fecal microbiota composition and the metabolomic profile of Chinese monals. Results: The results showed that the alpha diversity of gut microbes in the wild group were significantly higher than that in the captive group and the core bacterial taxa in the two groups showed remarkable differences at phylum, class, order, and family levels. Metabolomic profiling also revealed differences, mainly related to galactose, starch and sucrose metabolism, fatty acid, bile acid biosynthesis and bile secretion. Furthermore, strong correlations of metabolite types and bacterial genus were detected. Conclusions: There were remarkable differences in the gut microbiota composition and metabolomic profile between wild and captive Chinese monals. This study has established a baseline for a normal gut microbiota and metabolomic profile for wild Chinese monals, thus allowing us to evaluate if differences seen in captive organisms have an impact on their overall health and reproduction.
Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: Post-hoc analysis from a randomized controlled trial
Authors: Zhao Shuang , Hu Shangying , Xu Xiaoqian , Zhang Xun , Pan Qinjing , Chen Feng , Zhao Fang-Hui 
Published: September 2020

Abstract
Background: It is widely acknowledged that HPV prophylactic vaccine could prevent new infections and their associated lesions among women who were predominantly HPV-naive at vaccination. Yet there still remains uncertainty about whether HPV vaccination could benefit to individuals who had undergone surgery for cervical disease. Methods: This post-hoc analysis intends to focus on intent-to-treat participants who underwent excision treatment at baseline and the follow-up period in a phase II/III, double-blind, randomized trial (ClinicalTrials.gov, number NCT00779766) conducted in Jiangsu province, China. We evaluate the impact of HPV vaccination on preventing women from subsequent infection and cervical lesions (LSIL+ and CIN2+) after excision treatment. Results: 168 (vaccine, n=87; placebo, n=81) performed excisional treatment in this clinical trial. We observed a significant effect of vaccination on acquiring 14 high-risk HPV (HR-HPV) infection after treatment (vaccine efficacy: 27.0%; 95% CI 4.9%, 44.0%). The vaccine efficacy against new infections after treatment for 14 HR-HPV infection was estimated as 32.0% (95%CI 1.8%, 52.8%), and was 41.2% (95%CI -162.7%, 86.8%) for HPV16/18 infection. The accumulative clearance rates of the vaccine group and placebo group were 88.9% and 81.6% for HPV16/18 infection (P=0.345), 63.4%, 48.7% for 14 HR-HPV infection (P=0.062), respectively. No significant difference was observed on the persistent rate of HPV16/18, 14 HR-HPV infection and occurrence rate of LSIL+ between the two groups. Conclusions: No significant evidence from this study showed that HPV-16/18 AS04-adjuvanted vaccine could lead to viral faster clearance or have any effect on the rates of persistent infection among women who had excision treatment. However, the vaccine may still benefit post-treatment women with “primary prophylactic” effect. Further research is required in clarifying the effect of using the prophylactic HPV vaccine as therapeutic agents. ClinicalTrials.gov Identifier: NCT00779766Date and status of trial registration: October 24, 2008 Completed; Has Results
Clinical course and outcome of patients with acute pulmonary embolism rescued by veno-arterial extracorporeal membrane oxygenation: a retrospective review of 21 cases
Authors: Chen Yen-Yu , Chen Yin-Chia , Wu Chia-Chen , Yen Hsu-Ting , Huang Kwan-Ru , Sheu Jiunn-Jye , Lee Fan-Yen 
Published: September 2020

Abstract
Background: Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly being utilized in patients with massive pulmonary embolism (PE). However, the efficacy and the safety remain uncertain. This study aimed to investigate clinical courses and outcomes in ECMO-treated patients with acute PE.Methods: Twenty-one patients with acute PE rescued by ECMO from January 2012 to December 2019 were retrospectively analysed. Clinical features, laboratory biomarkers, and imaging findings of these patients were reviewed, and the relationship with immediate outcome and clinical course was investigated.Results: Sixteen patients (76.2%) experienced refractory circulatory collapse requiring cardiopulmonary resuscitation (CPR) or ECMO support within 2 hours after the onset of cardiogenic shock, and none could receive definitive reperfusion therapy before ECMO initiation. Before or during ECMO support, more than 90% of patients had imaging signs of right ventricular (RV) dysfunction. In normotension patients, the computed tomography (CT) value was a valuable predictor of rapid disease progression compared with cardiac troponin I level. Ultimately, in-hospital death occurred in 10 patients (47.6%) and 90% of them died of prolonged CPR-related brain death. Cardiac arrest was a significant predictor of poor prognosis (p = 0.001). Conclusions: ECMO appears to be a safe and effective circulatory support in patients with massive PE. Close monitoring in intensive care unit is recommended in patients with RV dysfunction and aggressive use of ECMO may reduce the risk of sudden cardiac arrest and improve clinical outcome.
Ten years of research and publications about hospice and palliative care in Mainland China: a bibliometric study
Authors: Jin Shuang , Liu Shuo , Li Jiaojiao , Ning Xiaohong , Liu Xiaohong 
Published: September 2020

Abstract
Objectives: Research is a fundamental element in the sustainable development of hospice and palliative care. Mainland China is facing increasing demand for hospice and palliative care and has launched related policies over the past decade. However, the state of research and publications in this field in China remains largely unknown. This study aimed to provide an overall picture of hospice-and palliative care -related research and publications in Mainland China of the last decade.Methods: We searched Web of Science, Scopus, PubMed, CINAHL, OVID, and China National Knowledge Infrastructure for hospice-and palliative care -related publications in English and Chinese for 2010–2019. We analyzed the production, citations and impacts, publishing journals, region and institution of origin, publication types and topics.Results: A total of 3224 publications were identified, and 636 of them were published in high-quality journals. The production and impacts showed a clear increase—especially after 2016. However, there is no specialized journal of hospice and palliative care in Mainland China. The publications scattered among various journals. The regional disparity between East and Western China in production was conspicuous and closely linked to economic factors. The most prosperous cities in Mainland China, Beijing and Shanghai, were the most productive regions. The hospice providers in the first five pilot regions had no collaboration with leading universities in their publications. Hospice and palliative care for cancer patients was the most common publication topic; some essential topics were rarely explored.Conclusions: Research and publications about hospice and palliative care in Mainland China is developing faster than before; however, it remains at an early stage and should be promoted in terms of interregional equity. Collaboration among different disciplines, institutes, and regions should be encouraged.
Predicting COVID-19 Preventive Behaviors based on&nbsp;Protection Motivation Theory in Hormozgan, Iran
Authors: Rad Roghayeh Ezati , Mohseni Shokrollah , Takhti Hesamaddin Kamalzadeh , Azad Mehdi Hassani , Shahabi Nahid , Aghamolaei Teamur , Norozian Fatemeh 
Published: September 2020

Abstract
Background: The present research aimed to predict the preventive behaviors of COVID-19 in the light of the Protection Motivation Theory (PMT).Methods: The present cross-sectional research was conducted in 2 months (March 2020-April 2020) in Hormozgan Province of Iran. The research population comprised all residents above 15 years of age. They received an online questionnaire survey in two parts, demographic information along with PMT constructs. To analyze the data, independent t-test and one-way anova test, Multiple linear regression and the statistical technique of path analysis and structural equation modeling was used. All statistical calculations and hypothesis testing were performed using spss21 and Amos21 software and a significant level of hypothesis testing was considered to be 0.05Results: A total number of 2,032 subjects participated in this research, the mean age of whom was 34.84±9.8 (R=15-98). The majority of participants were between 31 - 40 years old, female (60.4%), married (72%), urban residents (87.3%), holding a Bachelor’s degree or higher (58.8%) and employed (58.8%). Statistically significant positive correlation coefficients were estimated between preventive behaviors of COVID-19 and perceived vulnerability (r=0.192, p<0.001), perceived severity (r=0.092, p<0.001), response efficacy (r=0.398, p<0.001) ,self efficacy (r=0.497, p<0.001) and protection motivation (r=0.595, p<0.001). Statistically significant negative correlations were found between behavior and maladaptive behavior rewards (r=-0.243, p<0.001) and perceived costs (r=-0.121, p<0.001). Conclusions: The present findings showed that maladaptive behavior reward and fear predicted protective behaviors negatively; response efficacy and self-efficacy predicted protective behaviors positively. The effect of self-efficacy was the strongest among all. The information provided in this research can contribute to policy-making in the country.
Long-term outcomes of moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for prostate cancer confined to the pelvis: A single center retrospective analysis
Authors: Yao Lihong , Shou Jianzhong , Wang Shulian , Song Yongwen , Fang Hui , Lu Ningning , Tang Yuan , Chen Bo , Qi Shunan , Yang Yong , Jing Hao , Jin Jing , Yu Zihao , Li Yexiong , Liu Yue-Ping 
Published: September 2020

Abstract
Background: There is an increasing application of moderately hypofractionated radiotherapy for prostate cancer. We presented our outcomes and treatment-related toxicities with moderately hypofractionated (67.5 Gy in 25 fractions) radiotherapy for a group of advanced prostate cancer patients from China.Methods: From November 2006 to December 2018, 246 consecutive patients with prostate cancer confined to the pelvis were treated with moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions). 97.6% of the patients received a different duration of androgen deprivation therapy. Failure-free survival (FFS), prostate cancer-specific survival (PCSS), overall survival (OS), and cumulative grade ≥2 late toxicity were evaluated using the Kaplan-Meier actuarial method. Prognostic factors for FFS, PCSS, and OS were analyzed.Results: The median follow-up time was 74 months (range: 6-150 months). For all patients, the 5- and 10-year FFS rates were 80.0% (95%CI: 74.7%-85.7%) and 63.5% (95%CI: 55.4%-72.8%). The failure rates for the intermediate, high-risk, locally advanced, and N1 groups were 6.1%, 13.0%, 18.4%, and 35.7%, respectively (P = 0.003). Overall, 5- and 10-year PCSS rates were 95.7% (95%CI: 93.0%-98.5%) and 88.2% (95%CI: 82.8%-93.8%). Prostate cancer-specific mortality rates for the high-risk, locally advanced, and N1 groups were 4.0%, 8.2%, and 23.8%, respectively (P＜0.001). Overall, 5- and 10-year actuarial OS rates were 92.4% (95%CI: 88.8%-96.1%) and 72.7% (95%CI: 64.8%-81.5%). High level prostate-specific antigen and positive N stage were significantly associated with worse FFS (P＜0.05). Advanced T stage and positive N stage emerged as worse predictors of PCSS (P＜0.05). Advanced age, T stage, and positive N stage were the only factors that were significantly associated with worse OS (P＜0.05). The 5-year cumulative incidence rate of grade ≥ 2 late GU and GI toxicity was 17.8% (95%CI: 12.5%-22.7%) and 23.4% (95%CI: 17.7%-28.7%), respectively. Conclusions: Moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for this predominantly high-risk, locally advanced, or N1 in Chinese patients demonstrates encouraging long-term outcomes and acceptable toxicity. This fractionation schedule deserves further evaluation in similar populations.
Long-Term Ocular Biometric Variations After Scleral Buckling Surgery in Macula on Rhegmatogenous Retinal Detachment.
Authors: Albanese Giuseppe Maria , Cerini Alberto , Visioli Giacomo , Marenco Marco , Gharbiya Magda 
Published: September 2020

Abstract
BACKGROUNG: Myopic shift and biometric ocular changes have been previously observed after scleral buckling (SB) surgery in retinal detachment, but long term-term outcomes had not yet been explored. The purpose of present study is to evaluate long term ocular biometric changes in patients with primary macula-on rhegmatogenous retinal detachment (RRD) treated with scleral buckling.METHODS: in this retrospective, observational study, we reviewed the medical records of patients undergoing SB surgery for macula-on RRD. Ocular biometry was performed before and at the most recent visit after surgery. Axial length (AXL), anterior chamber depth (ACD), anterior corneal astigmatism and spherical equivalent in treated eyes were compared before and after surgery as well as with those of fellow eyes.RESULTS: 34 eyes of 17 patients with a mean age of 57.0 ± 8.9 years were included. The mean follow-up duration was 50.9 ± 21.9 months (median 53.0; range, 12 to 82 months). A significant postoperative AXL increase of 0.83 mm and a concomitant myopic shift of 1.35 diopters was observed in the operated eyes (p < 0.0001). The preoperative axial length was the only predictive factor of axial length change after surgery (B = 0.152, 95% CI 0.059 to 0.245, β = 0.668, P = 0.003). Compared to fellow eyes, a postoperative ACD shallowing of 0.1 mm was found in operated eyes (p < 0.05), while there were no long-term changes of anterior corneal astigmatism.CONCLUSIONS: we show that the preoperative axial length is the only predictive factor of AXL increase after SB surgery. Scleral encircling induces a concomitant long-term shallowing of the AC, therefore fourth generation intraocular lens (IOL) power calculation formulae, should be used for patients requiring cataract surgery after SB.