bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Palliative Care Utilisation Among Patients With Cancer In Kwazulu-Natal, South Africa: A Cross-Sectional Study
Authors: Dlamini Minenhle S. , Hlongwana Khumbulani W. , Dlamini Siyabonga B. , Ginindza Themba G. 
Published: November 2020

Abstract
Background: Cancer remains a public health challenge in low-and-middle income countries (LMICs). Over 30% of those in need of palliative care (PC) worldwide suffer from cancer and 80% of patients with cancer in LMICs are diagnosed at advanced stages, by which time they can only benefit from PC services. The aim of this study was to determine factors influencing PC utilisation among patients with cancer in KwaZulu-Natal (KZN). Methods: A study was conducted among patients who had been diagnosed with different cancers and attending Inkosi Albert Luthuli Central Hospital, Addington Hospital, Pietermaritzburg Grey’s hospital, Msunduzi Hospice and Chatsworth Hospice, using cross-sectional mixed methods. A systematic random sampling technique was used to select the participants. Semi-structured questionnaires were administered to a total of 394 patients with cancer. The questionnaire included two open-ended questions and 59 closed-ended questions. Data from open-ended questions were manually coded and converted into themes, while the closed ended-questions were entered into the REDCap (v.8.11.7) and exported to Stata for analysis. Results: The mean (+SD) age of the 394 participants was 51.89 (+14.67) years and about 22.9% were within the 41–50 years age-group. The majority of participants were females (77.7%) and were unmarried (60.6%). Most of the participants’ racial classification was black (81.5%) and 64.5% had primary education. More than four-fifths (82.7%) were unemployed, 55.8% lived in urban areas and 24.6% had cervical cancer. The analysis of the two open-ended questions incorporated into the questionnaire revealed five major barriers preventing cancer patients from seeking PC services. These themes included lack of cancer knowledge, pursuit of alternative treatment options and long waiting periods at healthcare institutions. In addition, stigma and discrimination, lack of screening and diagnostic equipment and socio-economic barriers, contributed to the underutilisation of PC services by patients with cancer. Participants recommended that cancer awareness campaigns, healthcare services and continuous professional development (CPD) be improved.Conclusion: Cancer patients in low-to middle-income countries, such as South Africa, are still facing barriers to pursuing PC. Better education of the public could contribute to increased knowledge and awareness on cancer and PC services. Utilisation of PC could be maximised, thereby providing a better quality of life for the sufferers and their families until the end of life’s journey. The study also provides information that can be used to strengthen and/or to develop PC guidelines for addressing PC issues.
Stretchable Supercapacitor at -30 oC
Authors: Jin Xuting , Song Li , Yang Hongsheng , Dai Chunlong , xiao Yukun , Zhang Xinqun , Han Yuyang , Bai Congcong , Lu Bing , Liu Qianwen , Zhang Jiatao , Zhang Zhipan , Qu Liangti 
Published: November 2020

Abstract
At relatively low temperature (e.g, -30 oC), most flexible supercapacitors that work well at room temperature will lose their stretchability due to the poor cold intolerance of conventional electrolytes and the absence of intrinsically stretchable electrodes. Herein, an anti-freezing and highly stretchable supercapacitor (AF-SSC) was fabricated for the first time by one-step in-situ growth of polyaniline onto an organohydrogel polyelectrolyte from cross-linked polyacrylamide networks soaked by ethylene glycol/water/H2SO4. As no extra stretchable substrates (e.g. elastic fiber, polydimethylsiloxane, rubber, etc.) or predefining stretchable structures (e.g. helical, spring, wrinkle, honeycombed structures etc.) are needed in such a design, the prepared AF-SSC shows a high mechanical stretchability of 200% under -30 oC and can be repeatedly stretched for 100 cycles without significant capacitance loss. Besides, an impressive capacitance retention of 73.1% at -30 oC is achieved when the current density increases by 20 times, which is much higher than those of stretchable supercapacitors based on pseudocapacitive materials that operated at room temperature. Furthermore, the device shows an ultralong lifespan with 91.7% capacitance retention after 100000 cycles at -30 oC, outperforming all stretchable supercapacitors reported previously. With other merits of high compressibility, strong adhesion, good processability and excellent anti-drying ability, the current device is an ideal power source to drive multi-functional electronic components in real-life scenarios.
Is Muscle Weakness a Risk Factor of the Development of Rotator Cuff Tendinopathy – A Systematic Review
Authors: Kwan Cheuk-Kin , Ko Man-Chi , Fu Sai-Chuen , Ling Samuel Ka-Kin , Leong Hio-Teng , Oh Joo-Han , Yung Patrick Shu-Hang 
Published: November 2020

Abstract
BackgroundUnderlying muscle weakness may explain the inconsistency in the development of rotator cuff tendinopathy in population with similar activity levels. This systematic review aims to assess existing prospective studies to evaluate whether muscle weakness is a risk factor to the development of rotator cuff tendinopathy. MethodsA systematic search was performed using the PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy will be included. Quality assessment was performed with the Newcastle-Ottawa Quality Assessment Scale. ResultsThe search yielded 6 studies, with a total of 523 trained overhead athletes followed up for 1 season. External and internal rotation strength was described as protective factors for the development of rotator cuff tendinopathy, with an odds ratio of 0.940 (p < 0.05) and 0.946 (p < 0.01) respectively for each N/m increased in force generated. Limited range of motion of <106o for shoulder external rotation was also described as a risk factor with an odds ratio of 1.12 (p < 0.001).Imbalance between external and internal rotation strength was reported as a risk factor for shoulder injuries in 2 studies, with a relative risk of 2.57 (p < 0.05) reported in 1 of them. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in 1 study, with no odds ratio or relative risk provided. Due to insufficient data, combination into a meta-analysis was not possible. ConclusionsLimited evidence support that weakness of the external rotators, weakness in the internal rotators, and limited range of motion in external rotation are risk factors to the development of rotator cuff tendinopathy. Very limited evidence support that imbalance in external rotator and internal rotator strength, and supraspinatus weakness are risk factors for rotator cuff tendinopathies. Future cohort studies may improve on existing evidence with investigations on more muscle groups, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.
A Novel Reconstruction Device for Osteonecrotic Femoral Head Efficacy Evaluation: A Randomized-controlled Feasibility Trial
Authors: Jiang Ching-Chuan , Chiang Hongsen , Hsieh Chang-Hsun , Tsai Chia-Jung , Kuo Yu-Feng 
Published: November 2020

Abstract
BackgroundNumerous surgical treatments to preserve hip replacements have several controversies and none of these procedures are universally accepted nor have compelling evidence for osteonecrosis of the femoral head (ONFH). With developing a novel approach osteonecrotic device surgical procedure to support the regeneration of necrotic bone and articular cartilage in vivo, this will be the first randomized-controlled feasibility study to determine its safety in ONFH patients in comparison to the core decompression surgical procedure.MethodA total of 20 patients were enrolled and randomized; 10 in the osteonecrotic device group and 10 in the core decompression group. After their baseline data has been collected and their surgical procedure has been completed, the following postoperative data are then continued to 6 weeks, 3 months, 6 months, one year, and two years’ before the start of their surgery. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) were collected. ResultsAll surgical procedures were performed uneventfully with no perioperative complications. Immediate pain relief in twenty patients of both groups were observed from WOMAC and VAS, however, the osteonecrotic device group had significantly lower scores throughout all periods of the follow up overall.ConclusionOsteonecrotic device procedure is a safe surgical procedure that can provide a minimally invasive endoscopic approach for direct visual examination to the lesion site. Trial registrationClinicaltrials.gov, NCT04103944. Registered 26 September 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04103944
The Association between Poor Glycemic Control in Diabetes Mellitus and Progression of COVID-19
Authors: Estedlal AliReza , Jeddi Marjan , Heydari Seyed Taghi , Dabbaghmanesh Mohammad Hossein 
Published: November 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) is a newly recognized disease whose rapid spread has resulted in a global pandemic. In this resepct, there are several comorbidities presumed to be associated with presentation of complications in COVID-19 such as diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs). Therefore, this study aimed to explore whether DM was a risk factor influencing presentation, progression, and prognosis of COVID-19 or not.Methods: A total number of 447 patients with confirmed COVID-19 were selected from two centers for COVID-19 in the city of Shiraz, south-central Iran, from February 20 to April 29, 2020. Then, demographic data, medical history, signs and symptoms, laboratory test results, as well as chest computed tomography (CT) scan reports were collected and analyzed.Results: This study revealed that older age, HTN, and CVDs could be mostly seen in diabetic patients with COVID-19. In addition, such patients had prolonged hospital stay, lower oxygen (O2) saturation, and abnormal laboratory test results such as higher white blood cell (WBC) count, lower lymphocyte count, elevated serum tumor markers such as aspartate aminotransferase (AST), and abnormal kidney function.Conclusion: DM is an important risk factor for adverse endpoints in patients with COVID-19. In diabetic patients, proper consideration of clinical characteristics is thus of utmost importance. In addition, special clinical insight for disease prevention, good glycemic control during hospitalization, and efforts to develop a vaccine can help improve disease outcomes in this population.
Which Factors Are Associated With Positive Resection Margin in Pancreatic Ductal Adenocarcinoma for Different Surgical Procedures? Results Based on a Standard Pathological Evaluation System-retrospective Cohort Study&nbsp;
Authors: Li Bo , Guo Shiwei , Shi Xiaohan , Ni Chenming , Gao Suizhi , Li Gang , Ni Canrong , Jiang Hui , Lau Wan Yee , Jin G 
Published: November 2020

Abstract
Background/Objectives: The present study identified the independent risk factors of R1 resection in pancreaticoduodenectomy (PD) and distal pancreatosplenectomy (DP) for patients with pancreatic ductal adenocarcinoma (PDAC).Methods：Consecutive patients who were operated from December 2017 to 2018 with curative intent were analyzed retrospectively. A standardized pathological examination with digital whole-mount slide images (DWMSIs) was utilized for the resection margin status. R1 was defined as microscopic tumor infiltration within 1 mm to the resection margin. The potential risk factors of R1 resection for PD and DP were analyzed separately by univariate and multivariate logistic regression analyses. Results：For the 240 patients who underwent PD, and the 142 patients who underwent DP, the R1 resection rates were 30.8% and 35.6 %, respectively. Univariate analysis on risk factors of R1 resection for PD were tumor location, absence of tumor necrosis, N staging, TNM staging, and surgical type of PD; while those for DP were nerve invasion, T staging, and TNM staging. Multivariate logistic regression analysis showed that the risk factors of R1 resection for PD were tumor location (neck vs. head; uncinate process vs. head) and N staging, while those for DP were T staging .Conclusions：The location of tumor in the neck and uncinate process, and N1/2 staging were independent risk factors of R1 resection for PD; while those for DP were T3/4 staging.
Timing of Onset of Symptom for COVID-19 from Publicly Reported Confirmed Cases in Uganda
Authors: Ario Alex Riolexus , Mirembe Bernadette Basuta , Biribawa Claire , Bulage Lilian , Kadobera Daniel , Kyobe Henry Bosa , Kiwanuka Noah , Wamala Robert 
Published: November 2020

Abstract
Background: The incubation period for COVID-19, which is the time from exposure to symptom onset, is on average five to six days but reach 14 days. The question is, the timing of onset of various signs and symptoms of COVID-19 along the period amongst cases in Uganda is not known. Methodology: We utilized administrative data of publicly reported real-time RT-PCR laboratory COVID-19 confirmed cases in Uganda to investigate the timing of symptom onset, from 21-Marto 4-Sep-2020. Since timing of COVID-19 symptom onset is highly likely to be an interval rather than a point estimate, we generated three tertile categories of the period – 1st, 2nd, and 3rd tertiles denoting symptom presentation within 3, 4-6 and at least 7-days respectively. All signs and symptoms reported in the database were considered. We did not make any inferences about asymptomatic infection with SARS-COV-2. We analysed using frequency distributions, Chi-square test and Multinomial Logistic Regression; and controlled for age and sex.Results: We analysed a total of 420 symptomatic case-patients. The case-patients were predominantly male, 72.0% (304/420), median age of 33 years, IQR=26-41. The common symptoms of SARS-CoV-2 were: cough (47.6%), running nose (46.2%), fever (27.4%), headache (26.4%) and sore throat (20.5%). We utilized only 293 COVID-19 symptomatic cases that had clinical symptom onset date recorded for analysis of the timing of symptom onset. Most case-patients, 37.5% (109/293) - presented symptom within 3-days after laboratory confirmation, 31.4% (92/293) had symptoms in the 2nd and another 31.4% (92/293) in 3rd tertile, denoting 4-6 days and at-least 7 days after exposure, respectively. Running nose (RRR =0.45, 95% CI 0.24 - 0.84) and chest pain (RRR = 0.64, 95% CI 0.09 – 0.72) were less likely to occur in the 1st tertile and 2nd tertile rather than in the 3rd tertile. Case-patients aged ≥20yrs were less likely to have symptoms in the 1st and 2nd tertile compared to ≤20 years (p < 0.05). Conclusion: Our study provides empirical evidence for epidemiological characterization of cases by signs and symptoms along the incubation period among case-patients. This complements the current proposals for the length of active monitoring of persons exposed to SARS-CoV-2.
Use of Prophylactic Indomethacin in Preterm Infants: A Systematic Review and Meta-analysis
Authors: matary Abdulrahman Al 
Published: November 2020

Abstract
BackgroundProphylactic indomethacin has been widely used as an effective intervention for reducing mortalities and morbidities in preterm infants including the cardiopulmonary and neurodevelopmental morbidities as intraventricular hemorrhage (IVH), but many studies have reported contraindicated outcomes of its significance. Therefore, we aim to systematically review and meta-analyze the data of prophylactic indomethacin on preterm infants. MethodsOur systematic search included the following databases: Pubmed, Google Scholar, Scopus, Web of Science, The New York Academy of Medicine (NYAM), Virtual health library (VHL), and the System for Information on Grey Literature in Europe (SIGLE) to include studies that assessed the use of prophylactic indomethacin in preterm infants until August 12, 2020. ResultsThe final list of our included studies is comprised of 22 randomized trials and cohort studies. Our analysis of observational data showed that intubation in the delivery room/first day (74%), bronchopulmonary dysplasia (BPD) (33.2%), and patent ductus arteriosus (PDA) (32.2%) were the most prevalent outcomes in infants that received prophylactic indomethacin. Among all the studies outcomes, the only significant favorable outcome was lowering the rate of PDA (P< 0.001) while no significance was recorded with BPD, pulmonary hemorrhage, neurodevelopmental delays (IVH), mortality, length of hospital stays, and time spent on ventilators outcomes (P = 0.106, 0.123, 0.460, 0.340, 0.625, and 0.732, respectively). Moreover, necrotizing enterocolitis was significantly increased when applying prophylactic indomethacin in these infants (P< 0.001). Conclusion﻿The use of prophylactic indomethacin in preterm infants should be generally discouraged due to its neutral effect on most of the mortality and morbidity outcomes and the significant occurrence of its adverse events despite the positive effect on ductal closure.
Urinary CXCL10 is Associated with Acute Kidney Injury and Sepsis, and Predicts Mortality in Critically Ill Children
Authors: Huang Hui , Zhou Huiting , Wang Wenwen , Dai Xiaomei , Li Wenjing , Chen Jiao , Bai Zhenjiang , Pan Jian , Li Xiaozhong , Wang Jian , Li Yanhong 
Published: November 2020

Abstract
Background: Acute kidney injury (AKI) biomarkers are often susceptible to confounding factors, limiting their utility as a specific biomarker, in the prediction of AKI, especially in heterogeneous population. The urinary CXC motif chemokine 10 (uCXCL10), as an inflammatory mediator, has been proposed to be a biomarker for AKI in a specific setting. Whether uCXCL10 is associated with AKI and predicts AKI in critically ill patients remains unclear. The aims of the study were to investigate clinical variables potentially associated with uCXCL10 levels and determine the associations of uCXCL10 with AKI, sepsis and PICU mortality in critically ill children, as well as its predictive values of aforementioned issues. Methods: Urinary CXCL10 levels were serially measured in a heterogeneous group of children during the first week after pediatric intensive care unit (PICU) admission. AKI diagnosis was based on the criteria of Kidney Disease: Improving Global Outcomes with serum creatinine and urine output. Sepsis was diagnosed according to surviving sepsis campaign international guidelines for children. Mortality was defined as all-cause death occurring during the PICU stay.Results: Among 342 critically ill children, 52 (15.2%) developed AKI during the first week after PICU admission, and 132 (38.6%) were diagnosed as sepsis and 30 (12.3%) died during PICU stay. Both the initial and peak values of uCXCL10 remained independently associated with AKI with adjusted odds ratios (AORs) of 1.791 (P = 0.010) and 2.002 (P = 0.002), sepsis with AORs of 1.679 (P = 0.003) and 1.752 (P = 0.002), septic AKI with AORs of 3.281 (P <0.001) and 3.172 (P <0.001), and PICU mortality with AORs of 2.779 (P = 0.001) and 3.965 (P <0.001), respectively. The AUCs of the initial uCXCL10 for predicting AKI, sepsis, septic AKI, and PICU mortality were 0.63 (0.53-0.72), 0.62 (0.56-0.68), 0.75 (0.64-0.87), and 0.77 (0.68-0.86), respectively. The AUCs for prediction by using peak uCXCL10 were as follows: AKI 0.65 (0.56-0.75), sepsis 0.63 (0.57-0.69), septic AKI 0.76 (0.65-0.87), and PICU mortality 0.84 (0.76-0.91).Conclusions: Urinary CXCL10 is independently associated with AKI and sepsis, and may be a potential indicator of septic AKI and PICU mortality in critically ill children.
Do We have Arguments in Decision Making: Conservative or Surgical Treatment in Painful Degenerative Large Rotator Cuff Tears?
Authors: Vincent Karl , Gagey Olivier , Leboeuf-Yde Charlotte 
Published: November 2020

Abstract
Background and Hypotheses: The contemporary research literature indicates that there is no significant clinical difference in terms of improvement of pain and functional disability between surgical repair and rehabilitation treatment for degenerative rotator cuff tears. It could be hypothesized that rehabilitation, which is cheaper and causes few complications, is preferable for smaller lesions, whereas surgical repair might be needed for the larger lesions. The purpose of our review was to assess whether the size of the tear, particularly the large or massive, plays a major role in terms of long-term clinical results for rehabilitation compared to surgical repair.Method: We searched the literature on PubMed, Embase, PEDro, and Cochrane Library database up to March 2020 for randomized controlled clinical trials that compared long term results for surgical vs. rehabilitation concerning large or massive degenerative rotator cuff tears. A systematic, critical review process was planned using a slightly modified SIGN checklist. The review methodology followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and was submitted to PROSPERO and registered under the number CRD42020146161.Results: We found no randomized clinical trials that had dealt with this subject.Conclusion: There is no evidence that would help to choose between surgical repair or rehabilitation in case of large or massive rotator cuff degenerative tears. The reason for this is probably that large tears may be relatively painless since they often occur after retirement and therefore are relatively rarely seen in clinical practice. To obtain enough study subjects, it would therefore be necessary to study this question in multicenter randomized clinical trials.
Characterizing Common Challenges Faced by Parental Caregivers of Children With Type 1 Diabetes Mellitus in Mainland China: A Qualitative Study
Authors: Tong Huijuan , Qiu Feng , Fan Ling 
Published: November 2020

Abstract
Background: Parental caregiver psychology affects outcomes of children with Type 1 Diabetes Mellitus (T1DM). Objectives: To qualitatively examine perceptions of commo n challenges among parental caregivers of children with T1DM (T1DM Parental Caregivers). Methods: 45-60 minutes semi structured interviews were conducted with T1DM Parental Caregivers at Shengjing Hospital, China Medical University form January 2018 to Jun e 2019. Interview recordings were transcribed and coded in NVivo 11.0 to observe emergent themes. Results: Content analysis revealed 5 common themes with 14 subthemes, including persistent psychological stress (catastrophic emotions, emotional distress, a nd altered self efficacy), family function change (altered family life patterns and changes in parental role/function), challenges in daily management (technical challenges, emotional regulation, parent child conflict, and transition of care autonomy from parent to child), financial burden (cost burden of treatment and altered family economics), and lack of social support (social activity limitations and insufficient support systems). All were highly saturated across interview data. Conclusions: Young children with T1DM rely on parental caregivers for disease management and to one day become capable of autonomous self management as they age. However, both the period of emotional disturbance during initial diagnosis, psychological stresses of long term care giving, and conflict emerging from transition for parental to child responsibility for care can cause psychological effects detrimental to parental caregivers and T1DM children. This work provides compelling evidence for the role of assessment and intervention in parental caregiver psychological and emotional wellbeing in diabetes care, as well as the need for improved social and school support for children with T1DM in China. school support for children with T1DM in China.