bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond clinical food prescriptions and mobile markets: parent views on the role of a healthcare institution in increasing healthy eating in food insecure families
Authors: DeWit Emily L. , Meissen-Sebelius Emily M. , Shook Robin P. , Pina Kimberly Ann , De Miranda Evelyn Donis , Summar Michelle J. , Hurley Emily A. 
Published: July 2020

Abstract
Background: Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action. Methods: We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Our iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system.Results: Participants were 90% female, 38% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods. Conclusion: Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Findings offer critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.
A mobile app using therapeutic exercise and education for self-management in patients with hand rheumatoid arthritis. A randomized controlled trial protocol.
Authors: Rodríguez-Sánchez-Laulhé Pablo for the Management of Health Research of Seville F , Luque-Romero Luis Gabriel , Blanquero Jesús , Suero-Pineda Alejandro , Biscarri-Carbonero Ángela , Barrero-García Francisco José , Heredia-Rizo Alberto Marcos 
Published: July 2020

Abstract
Background: Therapeutic exercise is a safe and cost-effective approach to alleviate hand rheumatoid arthritis (RA) related symptoms. This study aims to investigate the differences in self-management between a smartphone app (CareHand), using hand exercises and educational advices, compared with a standard approach, on hand overall function, pain intensity, stiffness, and grip and pinch strength in patients with hand RA. Methods: The project is a prospective, longitudinal, superiority, randomized controlled trial. Fifty-eight participants with hand RA will be randomly assigned into an experimental group (CareHand app) or a control group (conventional treatment). Control intervention involves a paper sheet with exercises and recommendations, and the experimental group includes the use of a smartphone app, which provides individualized exercise programmes, self-management and educational strategies to promote adherence to treatment. Both intervention protocols will last for 3 months. The principal investigator will conduct an educational session at baseline for all participants. Primary outcome comprises the overall hand function, assessed with the Michigan Hand Outcome Questionnaire (MHQ). Secondary outcomes include self-reported functional ability with the Quick DASH questionnaire, self-reported pain intensity and morning stiffness using a Visual Analogue Scale (VAS), and hand grip and pinch strength (dynamometer). Outcome measures will be collected at baseline, and at 1 month and 3-month follow-up. Discussion: This study will evaluate the effectiveness of a telerehabilitation tool, which uses exercise and self-management strategies, compared to a conventional approach, in patients with hand RA. The smartphone app will allow to monitor the patient´s status, and to enhance patient-therapist communication. Some limitations may be related to the short follow-up duration and the lack of evaluation of psychosocial factors. Overall, this new way of promoting long-term effects in patients with a chronic rheumatic disease could be feasible and easy to implement in daily life clinical practice and current musculoskeletal care.
The relationship between immune status as measured by stimulated ex-vivo tumour necrosis factor alpha levels and the acquisition of nosocomial infections in critically ill mechanically ventilated patients.
Authors: Levin Gabrielle , Boyd J. Gordon , Day Andrew , Hunt Miranda , Maslove David , Norman Patrick , Callaghan Nicole O' , Sibley Stephanie , Muscedere John 
Published: July 2020

Abstract
Introduction: Immunological dysfunction is common in critically ill patients but its clinical significance and the optimal method to measure it are unknown. The level of tumor necrosis factor alpha (TNF-α) after ex-vivo whole blood stimulation with lipopolysaccharide (LPS) has been proposed as a possible method to quantify immunological function. We hypothesized that in a cohort of critically ill patients, those with a lower post-stimulation TNF-α level would have increased rates of nosocomial infections (NIs) and worse clinical outcomes. Methods: A secondary analysis of a phase 2 randomized, multi-centre, double-blinded placebo-controlled trial. As there was no difference between treatment and control arms in outcomes and NI rate, all the patients were analyzed as one cohort. On enrolment, day 4, 7, and weekly until day 28, whole blood was incubated with LPS ex-vivo and subsequent TNF-α level was measured. Patients were grouped in tertiles according to delta and peak TNF-α level. The primary outcome was the association between NIs and tertiles of TNF-α level post LPS stimulation; secondary outcomes included ICU and 90-day mortality, and ICU and hospital length of stay. Results: Data was available for 201 patients. Neither the post LPS stimulation delta TNF-α group nor the peak TNF-α post-stimulation group were associated with the development of NIs or clinical outcomes. Patients in the highest tertile for post LPS stimulation delta TNF-α compared to the lowest tertile were younger [61.1 years ± 15.7 vs. 68.6 years ± 12.8 standard deviations (SD) in the lowest tertile], had lower acuity of illness (APACHE II 25.0 ± 9.7 vs. 26.7 ± 6.1) and had lower baseline TNF-α (9.9 pg/mL ± 19.0 vs. 31.0 pg/mL ± 68.5). When grouped according to peak post-stimulation TNF-α levels, patients in the highest tertile had higher serum TNF-α at baseline (21.3 pg/mL ± 66.7 compared to 6.5 pg/mL ± 9.0 in the lowest tertile).Conclusion: In this prospective multicenter study, ex-vivo stimulated TNF-α level was not associated with the occurrence of NIs or clinical outcomes. Further study is required to better ascertain whether TNF levels and ex-vivo stimulation can be used to characterize immune function in critical illness and if other assays might be better suited to this task.
The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review
Authors: Vanhamel Jef , Rotsaert Anke , Reyniers Thijs , Nöstlinger Christiana , Laga Marie , Landeghem Ella Van , Vuylsteke Bea 
Published: July 2020

Abstract
Background: Strengthening HIV prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential game changer because of its high clinical efficacy and the feasibility of its provision to different key populations. Documenting the existing experience with PrEP service delivery in a variety of real-world settings will inform how its uptake and usage can be maximised. Methods: We conducted a scoping review using the five-step framework provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing the implementation of real-world PrEP service delivery models reporting on four key components: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: This review included 33 articles for charting and analysing of the results. The identified service delivery models showed that PrEP services mainly targeted people at high risk of HIV acquisition, with some models targeting specific key populations, mainly men who have sex with men. PrEP was often delivered centralised and in a clinical or hospital setting. Yet also community-based as well as home-based PrEP delivery models were reported. Providers of PrEP were mainly clinically trained health professionals, but in some rare cases community workers and lay providers also delivered PrEP. In general, in-person visits were used to deliver PrEP. More innovative digital options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied in a minority of the service delivery models in mainly high-resource settings.Conclusions: A range of possible combinations was found between all four components of PrEP service delivery models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could be expanded and optimised to respond to key populations with unmet HIV prevention needs in different settings.
Geriatric Assessment for Older Adults with Sickle Cell Disease: protocol for a prospective cohort pilot study
Authors: Oyedeji Charity I , Hall Katherine , Luciano Alison , Morey Miriam , Strouse John Joseph 
Published: July 2020

Abstract
Background: The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA).Methods/Design: We will enroll 40 adults with SCD (20 age 18-49 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, 10 to 20 days after hospitalization, and at after 12-months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events.Discussion: We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.
CD147 promotes collective invasion through cathepsin B in hepatocellular carcinoma
Authors: Wang Shi-Jie , Chao Dong , Wei Wei , Nan Gang , Li Jia-Yue , Liu Fen-Ling , Li Ling , Jiang Jian-Li , Cui Hong-Yong , Chen Zhi-Nan 
Published: July 2020

Abstract
Background

Mounting evidence suggests that solid tumors display the features of collective invasion, however, the molecular mechanisms are far from clear. This study aims to verify the role and the underlying mechanisms of CD147 in collective invasion in hepatocellular carcinoma.

Methods

Immunostaining was used to analyze human hepatocellular carcinoma specimens and three-dimensional cultures. Three-dimensional invasion model was established to mimic in vivo invasion. RNA-sequencing was used to identify downstream effectors.

Results

Human hepatocellular carcinoma undergone collective invasion and CD147 was observed to be upregulated at the invasive front of tumor cell groups. CD147 was demonstrated to promote collective invasion using the modified three-dimensional invasion model, which recapitulated the main features of collective invasion. Through transcriptome analysis and enzyme activity assay, we found that CD147 enhanced cathepsin B expression and activation. Upregulated cathepsin B in hepatocellular carcinoma cells facilitated migration and invasion, which mediated CD147-induced invasive phenotype in hepatocellular carcinoma. In terms of mechanism, we found that CD147 promoted cathepsin B transcription by activating β-catenin signaling as a result of reduced GSK-3β expression. Furthermore, we found that elevated expression of CD147 as well as cathepsin B were correlated with poor prognosis in patients with hepatocellular carcinoma.

Conclusions

CD147 promotes hepatocellular carcinoma cells collective invasion via upregulating cathepsin B expression and targeting CD147 would be valuable for the development of novel therapeutic modalities against invasion and metastasis of cancer.
The Impact of a Hospitalist Model in Perioperative Care of Elective Joint Replacement Patients: a 17 years-experience Report
Authors: Ferrari Matteo Carlo , Azzolini Elena , Strangio Giuseppe , Badalamenti Salvatore , Lagioia Michele 
Published: July 2020

Abstract
Background

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The aim of this report is to describe a 17-year experience of a hospitalist model in peri-operative co-management in more than 25,000 elective joint replacement patients.
Methods

A retrospective observational study about surgical co-management with hospitalists in a tertiary teaching referral hospital in Milan in relation to hospital lengths of stay (LOS), 30-days readmission rate, incidence of prosthetic joint infections (PJI) and patient related co-morbidities, number of medico-legal disputes and related costs, and medical customer satisfaction.
Results

Over a 17-year period LOS has been reduced from 10 to 5 days; readmission rates for total hip arthroplasty are 1.7% vs 3.7% (Italy) at 30 days; total infection rates for total knee arthroplasty are recorded at 0.8% vs 1.4% (Italy); obesity, diabetes, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) and/or smoking result as the main co-morbidity in PJI; there have been only 113 medico-legal disputes out of approximately 19,000 surgeries and we report 95% overall medical customer satisfaction.
Conclusions

This is the first paper outside the US to highlight the impact of the hospitalists on patient satisfaction and the translation of the obtained benefits into savings. The evolution of the hospitalist model in surgical settings shows promising results in terms of patients’ safety and cut of health-related direct and indirect costs.
Flexible Thermoplastic Starch Films Functionalized With Copper Particles for Packaging of Food Products
Authors: López Olivia , Villanueva María E. , Copello Guillermo J. , Villar Marcelo A 
Published: July 2020

Abstract
Biodegradable films based on thermoplastic corn starch (TPS) and copper particles with antimicrobial capacity were developed. Copper nanoparticles (Cu) and silica coated copper microparticles (Si-Cu) in the range of 0.25 to 5 % were used. Composite films were obtained by melt-mixing and subsequent thermo-compression. Particles distribution within TPS matrix and the presence of some pores and cracks, induced by Si-Cu particles, was evaluated by SEM. The presence of both fillers gave to composite films a brown pigmentation and decreased their transparency; these effects were more pronounced at higher particles concentrations. Regarding mechanical properties, copper particles at 1 and 5 % acted as reinforcing agents increasing the maximum tensile strength but their presence lead to a decrease in elongation at break, affecting films ductility. Composites inhibited the growth of Gram+ and Gram- bacteria, demonstrating their antimicrobial capacity. Copper effectively migrated to a simulant of aqueous foods and naked particles concentration in the simulant medium resulted higher than the minimum inhibitory concentration for bacteria. The characteristics and properties of developed composite films make them an interesting material for food primary packaging, mainly for meat fresh products.
Effect of ambient temperature on outpatient admission for osteoarthritis and rheumatoid arthritis in a subtropical Chinese city
Authors: Zhao Desheng , Cheng Jian , Bao Ping , Zhang Yanwu , Liang Fengjuan , Wang Hao , Wang Xu , Fang Shiyuan , Su Hong 
Published: July 2020

Abstract
Background
Current findings on the impact of weather conditions on osteoarthritis (OA) and rheumatoid arthritis (RA) are sparse and not conclusive. This study aimed to investigate the relationship between temperature change and OA/RA admission.
Methods
Daily OA/RA admission and meteorological data from 1 January 2014 to 31 December 2017 in Hefei, China, were collected. We quantified the relationship between ambient temperature and OA/RA admission using a distributed lag nonlinear model (DLNM). The effect modifications by gender and age were also examined.
Results
Sudden temperature decrease was significantly associated with RA admission (25th percentile of temperature versus 50th percentile of temperature), with the acute and largest effect at current days lag (RR: 1.063, 95%CI: 1.010–1.118). However, no association between temperature and OA admission was observed. When conducting subgroup analyses by individual characteristics, we found that females and patients aged 41–65 years were more vulnerable to temperature decrease than males, patients aged 0–40 and ≧ 66 years, respectively.
Conclusions
This study suggested that sudden temperature decrease was a risk factor for increase RA admission. Females and patients aged 41–65 years were particularly vulnerable to the effect of temperature decrease.
The Statistical shape model as a quality assurance measure in the treatment of complex midface fractures: A Case control study
Authors: Fuessinger Marc Anton , Steffen Schwarz , Mathieu Gass , Philipp Poxleitner , Leonard Brandenburg , Stefan Schlager , Christian Metzger Marc 
Published: July 2020

Abstract
BackgroundComplex bilateral midface fractures necessitate a surgically challenging procedure to preserve or restore the occlusion and the sensitive eye area. In this case control study, we aim to show the potential of a statistical shape model (SSM) for measuring the quality of the midface reconstruction, compared to the estimated preoperative situation.MethodsAn individualized SSM was postoperatively registered on 19 reconstructed complex bilateral midface fractures. Using this SSM, the distances from the simulated preoperative situation to the postoperative positions of the fracture segments were calculated. The fracture lines for Le Fort II, Le Fort III, and NOE fractures were chosen as reference points for the distance measurements.ResultsThe SSM could be registered on all 19 complex bilateral midface fractures. All analyzed fractures show a dorsal impaction (negative values) of the midface. Le Fort II fractures show deviation values of − 0.98 ± 4.6 mm, Le Fort III fractures show values of − 3.68 ± 3.6 mm, NOE type 2 fractures show values of − 0.25 ± 4.6 mm, and NOE type 1 fractures show values of − 0.25 ± 4.6 mm.ConclusionThe SSM can be used to measure the quality of the achieved reduction of complex bilateral midface fractures based on the estimated preoperative situation.Trial registrationDRKS00009719
Response To Pretransplant Downstaging Therapy Predicts Patient Outcome After Liver Transplantation For Hepatocellular Carcinoma With Portal Vein Tumor Thrombus
Authors: Yang Zhe , Wang Shuo , Sun Jingqi , Zhuang Li , Li Qiyong , Xu Xiao , Zheng Shusen 
Published: July 2020

Abstract
Background: Tumor viability and areas of necrosis after pretransplant downstaging therapy is predictive of patient outcome, but has not been evaluated in hepatocellular carcinoma (HCC) recipients with portal vein tumor thrombus (PVTT). Methods: Recurrence-free survival (RFS) and overall survival (OS) were compared among PVTT-HCC patients receiving pretransplant downstaging therapy with and without well response (radiographic tumor necrosis >50%). Multivariable predictors of well response to downstaging were identified.Results: Of 107 patients, downstaging was attempted in 48, and 15 had well response to pretransplant therapy. Compared with poor response and non-downstaged patients, well response patients had significantly superior 1-, 2-, and 3-year RFS (72%, 72%, and 72% vs 30.4%, 22.6%, and 22.6%; P = 0.002) and OS (100%, 90.9%, and 90.9% vs 66.3%, 47.7%, and 47.7%; P = 0.008). Pre-transplant alpha-fetoprotein (AFP) level <1000ng/mL and radiographic tumor necrosis >50% were independent favorable factors for lower HCC recurrence rate and better overall survival after liver transplantation (LT). Multivariable predictors of well response to downstage included well-moderate differentiated tumor on explant and multiple combined pretransplant locoregional and systematic therapies. Conclusions: For HCC patients with PVTT and receive pretransplant downstaging therapy, achieving well response is predictive of significantly better posttransplant outcomes and patients can have acceptable survival with LT after successful downstaging. Combined locoregional and systematic therapies may help to improve the responsiveness to downstaging.
Investigation of Wash Fluid Preheating on the Effectiveness of Online Compressor Washing in Industrial Gas Turbines
Authors: Agbadede Roupa , Kainga Biweri 
Published: July 2020

Abstract
This study presents an investigation of wash fluid preheating on the effectiveness of online compressor washing in industrial gas turbines. Crude oil was uniformly applied on the compressor cascade blades surfaces using a roller brush, and carborundum particles were ingested into the tunnel to create accelerated fouled blades. Demineralized water was preheated to 500C using the heat coil provided in the tank. When fouled blades washed with preheated demineralized and the one without preheating were compared, it was observed that there was little or no difference in terms of total pressure loss coefficient and exit flow angle. However, when the fouled and washed cases were compared, there was a significant different in total pressure loss coefficient and exit flow angle.