bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Course for Patients With Trisomy 13 and 18 Pursuing Life-Prolonging Therapies Versus Comfort-Directed Care
Authors: Milligan Michelle C. Perry , Jackson Laura E. , Maurer Scott H. 
Published: December 2020

Background: Care for infants with Trisomy 13 and 18 is evolving with more children being offered medical and surgical interventions. Parents and clinicians of children diagnosed with trisomy 13 and 18 would benefit from understanding how parental goals of care correlate with the subsequent clinical course of children with these conditions. Objective: To describe and compare parental goals of care (GOC) and clinical course in infants with trisomy 13 and 18. Design: Single center, retrospective (2013-19) analysis of electronic health record repository at a birthing center and a tertiary care hospital. Measurements: ICD-9/10 codes were used to identify patients with trisomy 13 or 18 born between 2013-2019. Their records were abstracted for their diagnosis, hospitalization days, interventions, GOC, death location and length of life. Result: Twenty-eight total patients were identified; trisomy 13, mosaic trisomy 13 and trisomy 18 were diagnosed in 9, 2 and 17 patients respectively. Among the 26 patients with complete trisomy 13 or 18, 8 had life-prolonging and 18 had comfort care goals at birth/diagnosis. Life-prolonging goals were not associated with longer life (p = 0.36) but were associated with more mean hospital days (70 vs. 12, p = 0.01), ICU days (66 vs. 9, p = 0.009), intubation (7/8 vs 7/18, p = 0.04), and death in ICU (7/7 vs. 10/17, p = 0.02). Zero patients underwent cardiac surgery. Conclusion: Parental GOC did not affect length of life in children with complete trisomy, but did alter treatment intensity. This may inform decision making for patients with trisomy 13 or 18.
Telepharmacy in oncology care: A scoping review
Authors: Vo Anh Thu , Gustafson Diana L 
Published: December 2020

Introduction Telepharmacy has the potential to enhance pharmacy services in oncology care, especially in remote areas. This scoping review explored the range, critical benefits and barriers of using telepharmacy services in oncology care. Methods The scoping review followed the Arksey and O’Malley’s five-stage framework to identify available evidence. PubMed, CINAHL, Embase, PsycINFO, Ovid MEDLINE and Scopus databases were searched for original research published between 2010 and 2020. The five dimensions of the Alberta Quality Matrix for Health were used to analyse reported outcomes. Results Eligible articles ( n = 21) were analysed. Telepharmacy in oncology care was used for follow-up, monitoring and counselling, intravenous chemotherapy and sterile compounding, expanding availability of pharmacy services, and remote education. Telepharmacy obtained high acceptability among cancer patients ( n = 5) and healthcare professionals ( n = 5), and increased accessibility of pharmaceutical services to underserved cancer populations ( n = 2). Commonly cited effectiveness and safety outcomes were improved patient adherence ( n = 5), increased pharmacy services ( n = 3) and early identification of medication-related problems ( n = 5). Telepharmacy improved efficiency in staffing and workload ( n = 3), and increased cost savings ( n = 3). A shortage of resources ( n = 5), technical problems ( n = 4) and prolonged turnaround time ( n = 4), safety concerns ( n = 2) and patient willingness to pay ( n = 1) were identified barriers to implementing telepharmacy in oncology care. Discussion Despite evidence pointing to the advantages and opportunities for expanding oncology pharmacy services through telepharmacy, certain challenges remain. Further research is needed to investigate safety concerns and patient willingness to pay for telepharmacy services.
Increased Expression of TXNIP Facilitates Oxidative Stress in Nasal Epithelial Cells of Patients With Chronic Rhinosinusitis With Nasal Polyps
Authors: Lin Hai , Ba Guangyi , Tang Ru , Li Mingxian , Li Zhipeng , Li Dawei , Ye Haibo , Zhang Weitian 
Published: December 2020

Background Oxidative stress plays crucial roles in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Thioredoxin-interacting protein (TXNIP) is essential in the process of triggering oxidative stress. However, its role and mechanism in CRSwNP remain unclear. The present study sought to explore the role and mechanism of TXNIP in the pathogenesis of CRSwNP. Methods Western blotting, real-time PCR and immunohistochemistry (IHC) were employed to assess TXNIP, thioredoxin (TRX) expression in nasal tissue samples from patients with CRSwNP and control subjects. MDA level and SOD activity in nasal tissue homogenates were measured using MDA and SOD Assay Kit. To evaluate the role and mechanism of TXNIP in CRSwNP, human nasal epithelial cells (HNECs) were cultured and stimulated using TXNIP siRNA, with or without N-acetylcysteine (NAC, an ROS scavenger). Western blotting, real-time PCR, ROS detecting dye DCFH-DA, MDA and SOD Assay Kit were performed to assess the effects and mechanisms of stimulators on the cells. Results We found significantly increased levels of TXNIP and decreased levels of TRX protein, mRNA, positive cells, increased MDA level and decreased SOD activity in CRSwNP patients compared with control subjects. In vitro study, significantly altered levels of TXNIP, TRX, MDA, SOD and ROS in HNECs were found following treatment of TXNIP siRNA with or without NAC on HNECs. Conclusion TXNIP expression was increased and TRX expression was decreased in CRSwNP at both protein and mRNA levels. MDA levels were increased and SOD activities were decreased in CRSwNP. TXNIP may have negative association with TRX, and then decrease SOD activities and increase MDA levels, resulting in the upregulation of ROS and oxidative stress in HNECs, which may play a pivotal role in the pathogenesis of CRSwNP. Future studies are expected to further explore the role and mechanism of TXNIP in CRSwNP.
Sacroiliac Joint Degeneration After Lumbopelvic Fixation
Authors: Nakashima Hiroaki , Kanemura Tokumi , Satake Kotaro , Ito Kenyu , Tanaka Satoshi , Segi Naoki , Ouchida Jun , Kagami Yujiro , Ando Kei , Kobayashi Kazuyoshi , Imagama Shiro 
Published: December 2020

Study Design: Retrospective Study. Objectives: Sacroiliac buttress screws (SBS) and S2 alar iliac screws (SAI) are used as distal screws in cases with long fusion to the pelvis. Distal fixation ends, whether exceeding the sacroiliac joint (SIJ), may affect postoperative degenerative changes in the SIJ. The aim of this study was to investigate SIJ degeneration after lumbosacral and lumbopelvic fixation, using SBS and SAI in degenerative spine diseases, respectively. Methods: This study included 70 patients aged ≥50 years with lumbosacral fusion (>3 levels). They were divided into 2 groups (SBS 20 and SAI 50 cases) based on the type of distal screws. Radiographical and clinical data were reviewed with a minimum 2-year follow-up. Radiographical SIJ degeneration was analyzed using computed tomography; clinical outcomes were evaluated using visual analog scale (VAS) and Japanese Orthopaedic Association Back Pain Questionnaire (JOABPEQ). Results: No significant differences were observed in patients’ preoperative characteristics between the 2 groups. The incidence of SIJ degeneration, including osteophyte formation (30.0% and 8.0%, p = 0.03), intraarticular air (75.0% and 16.0%, p < 0.001), and subchondral cyst (20.0% and 2.0%. p = 0.02) in SBS and SAI groups, respectively, at the follow-up, was significantly higher in the SBS group. Although SIJ degenerative changes were significantly different between the SBS and SAI groups, there was no significant difference in VAS and JOABPEQ scores between the groups at 2 years post-surgery. Conclusions: Lumbosacral fusion can cause SIJ degeneration, which is more frequent when SBS are used in fixation to the sacrum.
Incidence and Risk Factors for Neurological Deterioration in Posterior Corrective Surgeries for Severe Angular Kyphotic Deformities: A 10-Year Institutional Retrospective Study
Authors: Kalidindi Kalyan Kumar Varma , Sath Sulaiman , Sharma Jeevan Kumar , Vishwakarma Gayatri , Chhabra Harvinder Singh 
Published: December 2020

Study Design: Retrospective case-control study. Objective: Neurological deficit is one of the dreaded complications of kyphotic deformity correction procedures. There is inconsistency in the reports of neurological outcomes following such procedures and only a few studies have analyzed the risk factors for neurological deficits. We aimed to analyze the factors associated with neurological deterioration in severe kyphotic deformity correction surgeries. Methods: We performed a retrospective study of 121 consecutive surgically treated severe kyphotic deformity cases (49 males, 56 females) at a single institute (May 1st 2008 to May 31st 2018) and analyzed the risk factors for neurological deterioration. The demographic, surgical and clinical details of the patients were obtained by reviewing the medical records. Results: 105 included patients were divided into 2 groups: Group A (without neurological deficit) with 92 patients (42 males, 50 females) and Group B (with neurological deficit) with 13 patients (7 males, 6 females) (12.4%). Statistically significant difference between the 2 groups was observed in the preoperative sagittal Cobbs angle (p < 0.0001), operative time (p = 0.003) and the presence of myelopathic signs on neurological examination (p = 0.048) and location of the apex of deformity (p = 0.010) but not in other factors. Conclusions: Preoperative Sagittal Cobbs angle, presence of signs of myelopathy, operative time and location of apex in the distal thoracic region were significantly higher in patients with neurological deterioration as compared to those without neurological deterioration during kyphotic deformity correction surgery. Distal thoracic curve was found to have 4 times more risk of neurological deterioration compared to others.
The Expression of Intimacy and Sexuality in Persons With Dementia
Authors: D’cruz Migita , Andrade Chittaranjan , Rao T. S. Sathyanarayana 
Published: December 2020

Sexuality in dementia is infrequently addressed. Dementia is characterized by a progressive deterioration in all domains of functioning, including loss of sexual function. However, the diagnosis of dementia does not mean an immediate or complete cessation of sexuality in the person, or a loss of the ability to consent to sexual activity with a partner. A discussion of sexuality in dementia occurs infrequently in clinical care for several reasons. These include (a) a discomfort in discussing sexuality in older adults, (b) the fear of causing social or cultural offense, and (c) the assumption that the cessation of the reproductive period implies the end of sexual life in older adults. There is also a tendency to focus on the preservation of cognition and independence, with relative neglect of the need for physical and emotional intimacy or quality of life. Patients with dementia are more likely to be sexually active than not. The most common change is a lack or loss or sexual desire. Inappropriate sexual behaviors occur in a minority of patients (28%) and can be usually managed with behavioral measures, with the use of pharmacotherapy for symptomatic management in refractory cases. Other clinical and ethical concerns in dementia include the capacity to consent to sexual intimacy, the formation of new relationships, sexuality in long-term residential facilities, and vulnerability to sexual abuse. Dementia care guidelines recommend a low threshold of suspicion for abuse, with a focus on patient safety. These must, however, be counterweighed by respect for patient autonomy and wishes.
Knowledge, attitude and self-efficacy program intended to improve public health professionals’ ability to identify and manage perinatal depressive symptoms: a quasi-experimental study
Authors: Phoosuwan Nitikorn , Lundberg Pranee C. 
Published: December 2020

Abstract
Background
During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms.

Method
The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used.

Results
Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback.

Conclusion
The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.
Attitudes towards using electronic health records of patients with psoriasis and dermatologists: a cross-sectional study
Authors: Klein Toni Maria , Augustin Matthias , Kirsten Natalia , Otten Marina 
Published: December 2020

Abstract
Background
Electronic health records (EHRs) offer various advantages for healthcare delivery, especially for chronic and complex diseases such as psoriasis. However, both patients’ and physicians’ acceptability is required for EHRs to unfold their full potential. Therefore, this study compares patients’ and physicians’ attitudes towards using EHRs in routine psoriasis care.

Methods
For the purpose of this study, a questionnaire was developed based on literature research and analyses of previously conducted focus groups. Participants completed either a paper-based or an electronic version of the questionnaire. Patient recruitment took place at an dermatological outpatient clinic and via several online pathways (patient associations, and social media). Physicians were recruited via a mailing list of a dermatological association and at a dermatological conference. Patients’ and physicians’ responses were compared using χ2 tests and Fisher’s exact tests.

Results
The study consisted of 187 patients and 44 dermatologists. Patients compared to physicians rated almost all potential EHR uses as significantly more important and expected significantly more potential benefits from EHRs.

Conclusions
Patients showed positive expectations towards using EHRs, whereas there was more scepticism in the physician sample. This aligns with previous findings. These differences illustrate the necessity to involve all stakeholders, especially patients and physicians, into the process of developing and implementing EHRs.
Comparing different wavelet transforms on removing electrocardiogram baseline wanders and special trends
Authors: Chen Chao-Chen , Tsui Fuchiang Rich 
Published: December 2020

Abstract
Background
Electrocardiogram (ECG) signal, an important indicator for heart problems, is commonly corrupted by a low-frequency baseline wander (BW) artifact, which may cause interpretation difficulty or inaccurate analysis. Unlike current state-of-the-art approach using band-pass filters, wavelet transforms can accurately capture both time and frequency information of a signal. However, extant literature is limited in applying wavelet transforms (WTs) for baseline wander removal. In this study, we aimed to evaluate 5 wavelet families with a total of 14 wavelets for removing ECG baseline wanders from a semi-synthetic dataset.

Methods
We created a semi-synthetic ECG dataset based on a public QT Database on Physionet repository with ECG data from 105 patients. The semi-synthetic ECG dataset comprised ECG excerpts from the QT database superimposed with artificial baseline wanders. We extracted one ECG excerpt from each of 105 patients, and the ECG excerpt comprised 14 s of randomly selected ECG data. Twelve baseline wanders were manually generated, including sinusoidal waves, spikes and step functions. We implemented and evaluated 14 commonly used wavelets up to 12 WT levels. The evaluation metric was mean-square-error (MSE) between the original ECG excerpt and the processed signal with artificial BW removed.

Results
Among the 14 wavelets, Daubechies-3 wavelet and Symlets-3 wavelet with 7 levels of WT had best performance, MSE = 0.0044. The average MSEs for sinusoidal waves, step, and spike functions were 0.0271, 0.0304, 0.0199 respectively. For artificial baseline wanders with spikes or step functions, wavelet transforms in general had lower performance in removing the BW; however, WTs accurately located the temporal position of an impulse edge.

Conclusions
We found wavelet transforms in general accurately removed various baseline wanders. Daubechies-3 and Symlets-3 wavelets performed best. The study could facilitate future real-time processing of streaming ECG signals for clinical decision support systems.
Skeletal dysplasia-like syndromes in wild giraffe
Authors: Brown Michael Butler , Wells Emma 
Published: December 2020

Abstract
Objective
Skeletal dysplasias, cartilaginous or skeletal disorders that sometimes result in abnormal bone development, are seldom reported in free-ranging wild animals. Here, we use photogrammetry and comparative morphometric analyses to describe cases of abnormal appendicular skeletal proportions of free-ranging giraffe in two geographically distinct taxa: a Nubian giraffe (Giraffa camelopardalis camelopardalis) in Murchison Falls National Park, Uganda and an Angolan giraffe (Giraffa giraffa angolensis) on a private farm in central Namibia.

Results
These giraffe exhibited extremely shortened radius and metacarpal bones relative to other similarly aged giraffe. Both giraffe survived to at least subadult life stage. This report documents rare occurrences of these apparent skeletal dysplasias in free-ranging wild animals and the first records in giraffe.
Cognitive impact of COVID-19: looking beyond the short term
Authors: Miners Scott , Kehoe Patrick G. , Love Seth 
Published: December 2020

AbstractCOVID-19 is primarily a respiratory disease but up to two thirds of hospitalised patients show evidence of central nervous system (CNS) damage, predominantly ischaemic, in some cases haemorrhagic and occasionally encephalitic. It is unclear how much of the ischaemic damage is mediated by direct or inflammatory effects of virus on the CNS vasculature and how much is secondary to extracranial cardiorespiratory disease. Limited data suggest that the causative SARS-CoV-2 virus may enter the CNS via the nasal mucosa and olfactory fibres, or by haematogenous spread, and is capable of infecting endothelial cells, pericytes and probably neurons. Extracranially, SARS-CoV-2 targets endothelial cells and pericytes, causing endothelial cell dysfunction, vascular leakage and immune activation, sometimes leading to disseminated intravascular coagulation. It remains to be confirmed whether endothelial cells and pericytes in the cerebral vasculature are similarly targeted. Several aspects of COVID-19 are likely to impact on cognition. Cerebral white matter is particularly vulnerable to ischaemic damage in COVID-19 and is also critically important for cognitive function. There is accumulating evidence that cerebral hypoperfusion accelerates amyloid-β (Aβ) accumulation and is linked to tau and TDP-43 pathology, and by inducing phosphorylation of α-synuclein at serine-129, ischaemia may also increase the risk of development of Lewy body disease. Current therapies for COVID-19 are understandably focused on supporting respiratory function, preventing thrombosis and reducing immune activation. Since angiotensin-converting enzyme (ACE)-2 is a receptor for SARS-CoV-2, and ACE inhibitors and angiotensin receptor blockers are predicted to increase ACE-2 expression, it was initially feared that their use might exacerbate COVID-19. Recent meta-analyses have instead suggested that these medications are protective. This is perhaps because SARS-CoV-2 entry may deplete ACE-2, tipping the balance towards angiotensin II-ACE-1-mediated classical RAS activation: exacerbating hypoperfusion and promoting inflammation. It may be relevant thatAPOEε4 individuals, who seem to be at increased risk of COVID-19, also have lowest ACE-2 activity. COVID-19 is likely to leave an unexpected legacy of long-term neurological complications in a significant number of survivors. Cognitive follow-up of COVID-19 patients will be important, especially in patients who develop cerebrovascular and neurological complications during the acute illness.
Sustainability in the automotive industry, importance of and impact on automobile interior – insights from an empirical survey
Authors: Wellbrock Wanja , Ludin Daniela , Röhrle Linda , Gerstlberger Wolfgang 
Published: December 2020

AbstractSustainability is currently one of the main issues in all media and in society as a whole and is increasingly discussed in science from different sides and areas. Especially for the automotive industry, sustainability becomes more and more important due to corporate scandals in the past and topics such as electric motors, lightweight construction and CO2 emission reduction are key issues. Although the focus is primarily on other components, the interior cannot be neglected either in terms of sustainability. Interior is the most frequently seen part of the car by the driver. Therefore, e.g. the use of natural fibres especially for premium brands can only be considered in connection with highest standards regarding practical and aesthetical aspects. Consequently, the following research question arises: How do the three pillars of sustainability (economical, ecological and social issues) influence interior development at premium brand manufacturers and how do customers accept sustainable solutions? The focus of the paper is exclusively on premium brands due to the higher spread of sustainability effects compared to volume brands. A quantitative study is carried out to determine the expectations on the customer side regarding more sustainability in the automotive industry in general and in the interior sector in particular and to derive corresponding challenges and potentials for original equipment manufacturers.
Effects of Lorentz violation in the Bose-Einstein condensation
Authors: Furtado J. , Ramos A. C. A. , Assunção J. F. 
Published: December 2020

Abstract
In this paper we study the corrections emergent from a Lorentz-violating CPT-odd extension of the complex scalar sector to the Bose-Einstein condensation and to the thermodynamics parameters. We initially discuss some features of the model to only then compute the corrections to the Bose-Einstein condensation. The calculations are done by computing the generating functional, from which we extract the thermodynamics parameters. We also obtain a Lorentz-violating correction for the critical temperature T

c
that sets the Bose-Einstein condensation.