bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Biomarkers with Therapeutic And prognostic Value in Skin Cutaneous Melanoma
Authors: Wang Guangwen , Ling Yonghuo , Zhuang Qianru , Li Yingbang , Bai Yunpeng , Huang Yisheng , Huang Wendong 
Published: July 2020

Abstract
Background

The morbidity and mortality of skin cutaneous melanoma (SKCM), the most deadly type of skin cancer, are on the rise worldwide. Through in-depth study of the tumor microenvironment (TME) of SKCM, this study further identified biomarkers with therapeutic and prognostic value.
Methods

The gene expression profiles and clinical data of SKCM patients were downloaded from The Cancer Genome Atlas database. Then we calculated the immune score and stromal score of patients with skin melanoma by using the estimate algorithm, and divided all patients into the high/low immune/stromal score groups and discussed the correlation between them and clinical characteristics.Then, limma R package was used to screen out the differential genes in the high/low immune/ stromal score groups, and the heat map of the differential genes was drawn. At the same time, the functional enrichment analysis of the differential genes was carried out. The protein‒protein interaction (PPI) network of different genes was constructed by using STRING and Cytoscape, and the key genes related to the prognosis of cutaneous melanoma were further selected. Finally, kinase target, co expression genes and immune infiltrating cells of key genes were discussed.
Results

Patients in the low-immune/stromal score group had poorer survival outcome. The immune and stromal scores are associated with specific clinicopathologic variables (age, tumor grade, tumor stage) in SKCM. In total, 914 DEGs (909 upregulated and 5 downregulated genes) were screened from the gene expression profiles of patients with high immune and stromal scores. Functional enrichment analysis demonstrated a correlation between DEGs and the tumor microenvironment, tumor immune response and RCC tumorigenesis.Kaplan-Meier survival curves showed that 15 out of the 914 identified tumor microenvironment related genes are involved in the prognosis of SKCM. Finally CXCR8 and CCR5 were selected as the hub genes. A positive correlation was obtained between the expression of CXCR8/CCR5 and the abundance of six immune cells.
Conclusions

We studied the tumor microenvironment of SKCM, and finally screened out the biomarkers with therapeutic and prognostic effects.
Collaborative Chronic Care Model Implementation within Outpatient Behavioral Health Care Teams: Qualitative Results from a Multisite Trial using Implementation Facilitation
Authors: Sullivan Jennifer L , Kim Bo , Miller Christopher , Elwy A. Rani , Drummond Karen , Connolly Samantha , Riendeau Rachel , Bauer Mark 
Published: July 2020

Abstract
Background: This paper reports on a qualitative evaluation of a hybrid II stepped-wedge trial using implementation facilitation to implement team-based care in the form of the Collaborative Chronic Care Model (CCM) in interdisciplinary outpatient mental health teams. The objective of this study was to compare the alignment of sites’ clinical processes with the CCM elements at baseline (Time 1) and after 12 months of implementation facilitation (Time 2) from the perspective of providers.Methods: We conducted semi-structured interviews to assess the extent to which six CCM elements were in place: work role redesign, patient self-management support, provider decision support, clinical information systems, linkages to community resources, and organizational/leadership support. Interviews were transcribed and a priori CCM elements were coded using a directed content analysis approach at Time 1 and 2. We sought consensus on, and compared, the extent to which each CCM element was in place at Times 1 and 2.Results: We conducted 27 and 31 telephone interviews at Times 1 and 2, respectively, with outpatient mental health providers at nine participating sites. At Time 1 and Time 2, three CCM elements were most frequently present across the sites: work role redesign, patient self-management support, and provider decision support. The CCM elements with increased implementation from Time 1 to Time 2 were: work role redesign, patient self-management support, and clinical information systems. For two CCM elements, linkages to community resources and organizational/leadership support, some sites had increased implementation at Time 2 compared to Time 1, while others had reductions.Conclusions: Sites increased the extent of implementation on several CCM elements. The most progress was made in the CCM elements where sites had CCM-aligned processes already in place at Time 1. Teams made progress on elements they could more easily control, such as work role redesign. Our results suggest that maximizing the benefits of CCM-based outpatient mental health care may require targeting resources and training toward specific CCM elements—especially in the use of clinical information systems and linking with community resources. Trial Registration: Clinical Trials NCT02543840Registered 7 September 2015.
Can a Complex Vocational Rehabilitation Intervention Be Delivered With Fidelity? Fidelity Assessment in the Fresh Feasibility Trial
Authors: Holmes Jain Anne , Fletcher-Smith Joanna Clare , Merchán-Baeza Jose Antionio , Phillips Julie , Radford Kathryn 
Published: July 2020

Abstract
Background:Determining whether complex rehabilitation interventions are delivered with fidelity is important as differences can occur between sites, therapists delivering the intervention and over time; threatening trial outcomes and increasing the risk of Type II and Type III errors. Aims: to (1) evaluate implementation fidelity of vocational rehabilitation delivered in FRESH, a multi-centre feasibility randomised controlled trial; and (2) understand factors affecting delivery. Methods:Mixed methods evaluation. Fidelity was measured quantitatively using intervention case report forms, fidelity checklists and clinical records. Qualitative data from mentoring records, interviews with the intervention therapists, participants and their employers and NHS staff at each site explored moderators of implementation fidelity. The quantitative and qualitativedata informed data collection tools and analysis. Data were examined against a logic model and benchmarked against an earlier cohort study. Results:Analysis of 38 clinical records (one per participant), 699 content CRFs (42-248 per therapist) and 12 fidelity checklists suggest intervention was delivered as intended. The core intervention process was followed in each case despite therapist variation. Qualitative data from clinical records, fidelity checklists, 183 mentoring records and 38 interviews (4 therapists, 15 trial participants, 6 employers and 13 NHS staff) explained factors affecting intervention fidelity. Fidelity moderators were similar across sites. Facilitators included therapists’ community rehabilitation experience, expert mentoring, and ability to individually tailor intervention. Barriers involved a lack of access to NHS systems no backfill and limited line-manager support. Factors that both helped or hindered intervention delivery were effective communication with participants, intervention acceptability, participants’ changing needs and interagency working. Different fidelity measures answered different questions. Fidelity checklists determined whether intervention processes were followed and explained moderators. Interviews provided insights into acceptability. Adherence was determined by content forms. Mentoring records described implementation barriers and how they were overcome.Conclusions:Mixed methods fidelity assessments enable trialists to identify factors likely to affect intervention fidelity in a definitive trial and longer-term clinical implementation. Mentoring provided insight into engagement and fidelity deviations that could be addressed in real-time, facilitating fidelity and offering a window on trial processesTrial registration: ISRCTN Registry, ISRCTN38581822 (Registered: 02/01/2014) (https://doi.org/10.1186/ISRCTN38581822)
Motherhood and Decision-Making Among Women Living with HIV: A Systematic Review with Qualitative Research Synthesis.
Authors: Huertas-Zurriaga Ariadna , Palmieri Patrick Albert , Edwards Joan E. , Cesario Sandra K. , Alonso-Fernandez Sergio , Pardell-Dominguez Lidia , Dominguez-Cancino Karen A. , Leyva-Moral Juan M. 
Published: July 2020

Abstract
Objective: To explain the reproductive decision-making process of women living with HIV according to their experiences.Design: Systematic review with qualitative research synthesis. Studies were assessed with the Critical Appraisal Skills Programme and the JBI Checklist for Qualitative Research. The protocol was registered with PROSPERO, and the results reported in adherence with the PRISMA statement and the ENTREQ recommendations.Setting: Studies with qualitative data from member countries of the Organization for Economic Co-operation and Development were selected to maintain consistency in the conditions of women living with HIV, including socioeconomic, human rights, and access to health services.Participants: Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among women living with HIV were searched in multiple databases, including CINAHL, EMBASE, MEDLINE (through PubMed), Scopus, Social Science Citation Index, Web of Science, Google Scholar, and the Spanish databases Cuidatge, Cuiden Enfispo, and SciELO.Results: From the 4,198 articles identified and assessed, 18 were included for analysis and synthesis with 1,333 participants from 10 countries. Three meta‐categories were constructed from 15 themes that emerged from 45 subthemes to give new meaning to the phenomena of reproductive decision-making for women living with HIV as 1) Shattered identity, 2) Barriers, inequities, and misinformation, and 3) Coping, resiliency, and support.Key Conclusions: Reproductive decision-making is a complex process with multiple challenges that women living with HIV encounter with knowledge deficiencies and limited social support. Decisions need to be taken judiciously by women living with HIV in collaboration with clinicians within the context of a supportive health system. Implications for practice: An integrated approach to care with comprehensive multidisciplinary counseling are needed to support women living with HIV as they engage in reproductive decision-making. Clinicians require professional development as well as evidence-based clinical guidelines and educational resources to support person-centered care for these women, and their families.
Identification of Novel Hub Genes Through Expression Profiles Analysis in Adrenocortical Carcinoma
Authors: Yao Chenhe , Zhao Xiaoling , Shang Xuemeng , Jia Binghan , Dou Shuaijie , Ye Weiliang , Yang Yuemei 
Published: July 2020

Abstract
Background: Adrenocortical carcinoma (ACC) is a heterogeneous and rare malignant tumor associated with a poor prognosis. The molecular mechanisms of ACC remain elusive and more accurate biomarkers for the prediction of prognosis are needed.Methods: In this study, integrative profiling analyses were performed to identify novel hub genes in ACC to provide promising targets for future investigation. Three gene expression profiling datasets in the GEO database were used for the identification of overlapped differentially expressed genes (DEGs) following the criteria of adj.P.Value<0.05 and |log2 FC|>0.5 in ACC. Novel hub genes were screened out following a series of processes: the retrieval of DEGs with no known associations with ACC on Pubmed, then the cross-validation of expression values and significant associations with overall survival in the GEPIA2 and starBase databases, and finally the prediction of gene-tumor association in the GeneCards database.Results: Four novel hub genes were identified and two of them, TPX2 and RACGAP1, were positively correlated with the staging. Interestingly, co-expression analysis revealed that the association between TPX2 and RACGAP1 was the strongest and that the expression of HOXA5 was almost completely independent of that of RACGAP1 and TPX2. Furthermore, the PPI network consisting of four novel genes and seed genes in ACC revealed that HOXA5, TPX2, and RACGAP1 were all associated with TP53. Conclusions: This study identified four novel hub genes (TPX2, RACHAP1, HXOA5 and FMO2) that may play crucial roles in the tumorigenesis and the prediction of prognosis of ACC.
TEK Suppresses Lung Adenocarcinoma Cell Phenotypes by Interacting with miR-19a-3p
Authors: Peng Tao , Yang Fan , Sun Zhanwen , Yan Jie 
Published: July 2020

Abstract
Background: We identified TEK as a key gene that that participates in lung adenocarcinoma cell migration and adhesion, and miR-19a-3p a potential upstream regulator of TEK. Both TEK and miR-19a-3p have been reported during lung cancer development. However, how TEK/miR-19a-3p interactome regulates lung adenocarcinoma remains unraveled. We herein aim to report a novel TEK/miR-19a-3p interactome in lung adenocarcinoma.Methods: The mRNA and protein expression of TEK in tissues and cell lines were determined using qPCR and Western blot, respectively. CCK-8 assay, EDU assay, flow-cytometry cell apoptosis assay, scratch assay, and cell-to-extracellular matrix adhesion assay were performed to detect the proliferation, apoptosis, migration, and adhesion of A549 and H1975 cell lines. Results：Both mRNA and protein levels of TEK were down-regulated in tumor tissues and cell lines. Compared with the control, the transfection of TEK overexpression plasmids into H1975 and A549 cells led to the significant inhibition of cancerous phenotypes. On the other hand, miR-19a-3p promoted lung adenocarcinoma cancerous cell phenotypes by downregulating TEK.Conclusions: TEK can be a potential LUAD tumor suppressor by interacting with miR-19a-3p. This novel interactome can be used as a novel therapy target for LUAD.
Observational Study of Compliance With Infection Control Practices Among Healthcare Workers in Subsidized and Private Residential Care Homes
Authors: Au Jessie Kit Ling , Suen Lorna Kwai Ping , Lam Simon Ching 
Published: July 2020

Abstract
Background
The elderly population in Hong Kong is rapidly growing, and the need for residential care homes (RCHs) is increasing. The frail and the vulnerable elderly population is prone to being infected with micro-organisms as the immunity system begins to deteriorate. Furthermore, the residents in RCHs are at high risk of healthcare-associated infections (HAIs) due to the confined living environment and individual co-morbidities. In relation to this, infection control practice (ICP) is the crucial and effective prevention of HAIs. This study aimed to observe the daily ICP of healthcare workers in RCHs settings.
Methods
An observational study was conducted to observe daily ICP among healthcare workers in private and subsidized RCHs. Each RCH was separated into different units by location (common area and bedroom area) and nature of residents for successive days. The ICP episodes were observed until 200 opportunities in each unit. The ICP episodes were recorded by an electronic tool called “eRub,” which is the checklist of ICP based on international guidelines.
Results
The most frequent observed ICP episodes were hand hygiene (n = 1053), the use of gloves (n = 1053), and respiratory protection (n = 1053). The overall compliance of hand hygiene was poor, which only 15% performed during the “five moments for hand hygiene.” Furthermore, the observations showed that 77.9% improperly performed the use of gloves, and 31.8% failed to wear a mask during the care provision for the elderly. However, the results showed that most healthcare workers can wear the mask in a proper way when they should. Generally, the personal care workers were the worst in hand hygiene and use of gloves compared with the other types of healthcare workers.
Conclusions
Despite the fact that the practice of hand hygiene, the use of gloves and respiratory protection were the important elements of ICP, overall compliance to these elements was still poor. Personal care workers had the most frequent contact with the residents, but they had the worst compliance rate. Hence, continued monitoring and training among healthcare workers is needed, particularly personal care workers, in this healthcare service setting.
A Simple Noninvasive Model to Predict Significant Fibrosis in Children With Chronic Hepatitis B
Authors: Zhang Kang-Ling , Chen Xiu-Qi , Lv Zi-Li , Huang Li , Yun Xiang , Yang Mei-Xiong , Tang Qing , Shan Qingwen 
Published: July 2020

Abstract
Objectives: to develope a noninvasive model for significant fibrosis in children with chronic hepatitis B (CHB).Methods: A total 116 CHB pediatric patients who had undergone liver biopsy were included in the study. Blood routine examination, coagulation function, liver biochemistry, viral serology and viral load were analyzed. Receiver operating characteristic (ROC) curve analysis was used to analyze sensitivity and specificity of all possible cut-off values.Results: Based on the correlation and difference analysis, 7 available clinical parameters [Total bile acid (TBA), Gamma-glutamyl transpeptidase(GGT), Aspartate transaminase(AST), Direct bilirubin to total bilirubin ratio (D/T), Alanine aminotransferase(ALT), Prealbumin (PA),and Cholinesterase（CHE）] were included for modeling analysis. A model to predict significant liver fibrosis (Ishak fibrosis score ≥2) was derived using the two best parameters (PA and GGT) The original model was . After mathematical calculation, the G index 600×GGT/PA2 predicts significant fibrosis with an area under the receiving operating characteristics (AUROC) curve of 0.733，95% IC (0.643-0.811). The area under the receiver operating characteristic curve (AUROC) of G index (0.733,) was higher than that of APRI (0.680) and FIB-4(0.601) to predict significant fibrosis in children with CHB. If the G index's values outside 0.28-1.16, 52% of children with CHB could avoid liver biopsy with an overall accuracy of 75%.Conclusions: The G index can predict and exclude significant fibrosis in children with HBV, which may reduce the liver biopsy need for children with CHB.
Three-Dimensional Construction of Micrometer Level in Rat Stomach by Synchrotron Radiation
Authors: Tao Qiang , Gao Chen-Chen , Tong Xue-Hong , Yuan Shi-Zhen , Xu Jingdong 
Published: July 2020

Abstract
Background: The structural changes of gastric mucosa are considered as an important window of early gastric lesions. This article shows an imaging method of the stomach that does not use imaging agents. X-ray phase-contrast images of different stages of gastric development were taken using micrometer level X-ray in-line phase-contrast imaging (XILPCI) technique on synchrotron radiation facility. The aim of the study was to demonstrate that the imaging technique is an appropriate method for micron imaging of the gastric structures.Methods: The stomachs of 4-, 6- and 12-week-old rats were removed and cleaned. XILPCI has 1000 times greater soft tissue contrast than that of X-ray traditional absorption radiography. The projection images of the rats’ stomachs were recorded by an XILPCI charge coupled device (CCD) at 9 μm image resolution.Results: The X-ray in-line phase-contrast images of the different stages of rat gastric specimens clearly showed the gastric architectures and the details of the gastro-duodenal region. 3-dimensional stomach anatomical structure images were reconstruction. Conclusion: The reconstructed gastric 3D images can clearly display the internal structure of the stomach. XILPCI may be a useful method for medical research in the future.
Carbon ion reirradiation compared to intensity-modulated re-radiotherapy for recurrent head and neck cancer (CARE): a randomized controlled trial
Authors: Held Thomas , Lang Kristin , Regnery Sebastian , Weusthof Katharina , Hommertgen Adriane , Jäkel Cornelia , Tonndorf-Martini Eric , Krisam Johannes , Plinkert Peter , Zaoui Karim , Freudlsperger Christian , Moratin Julius , Krauss Jürgen , Harrabi Semi B. , Herfarth Klaus , Debus Jürgen , Adeberg Sebastian 
Published: July 2020

Abstract
Background
Intensity-modulated re-radiotherapy (reIMRT) has been established as a standard local treatment option in patients with non-resectable, recurrent head and neck cancer (rHNC). However, the clinical outcome is unfavorable and severe toxicities (≥ grade III) occurred in 30–40% of patients. The primary aim of the current trial is to investigate carbon ion reirradiation (reCIRT) compared to reIMRT in patients with rHNC regarding safety/toxicity as well as local control, overall survival (OS), and quality of life (QoL).
Methods
The present trial will be performed as a single center, two-armed, prospective phase II study. A maximum of 72 patients will be treated with either reIMRT or reCIRT to evaluate severe (≥ grade III) treatment-related toxicities (randomization ratio 1:1). The primary target value is to generate less than 35% acute/subacute severe toxicity (≥ grade III), according to the Common Terminology Criteria for Adverse Events v5.0, within 6 months after study treatment. The total dose of reirradiation will range between 51–60 Gy or Gy (RBE), depending primarily on the radiotherapy interval and the cumulative dose to organs at risk. Individual dose prescription will be at the discretion of the treating radiation oncologist. The local and distant progression-free survival 12 months after reirradiation, the OS, and the QoL are the secondary endpoints of the trial. Explorative trial objectives are the longitudinal investigation of clinical patient-related parameters, tumor parameters on radiological imaging, and blood-based tumor analytics.
Discussion
Recent retrospective studies suggested that reCIRT could represent a feasible and effective treatment modality for rHNC. This current randomized prospective trial is the first to investigate the toxicity and clinical outcome of reCIRT compared to reIMRT in patients with rHNC.
Trial registration:
ClinicalTrials.gov; NCT04185974; December 4th 2019; https://clinicaltrials.gov/ct2/show/record/NCT04185974.