bluuebunny/crossref_metadata_2025_split huggingface dataset:
Range of plasma brain natriuretic peptide (BNP) levels in hemodialysis patients at a high risk of 1-year mortality and their relationship with the nutritional status: a retrospective cohort study in one institute
Authors: Kumagai Etsuko , Hosohata Keiko , Furumachi Kazuhiro , Takai Shinji 
Published: July 2020

Abstract
Background
Brain natriuretic peptide (BNP) levels are used as a marker of heart failure, which is the leading cause of morbidity and mortality in dialysis patients. BNP levels increase as renal function declines. The range of BNP levels associated with satisfactory longevity in dialysis patients currently remains unknown.

Methods
In total, 660 patients receiving maintenance hemodialysis were enrolled. BNP levels were measured at the end of the year and in a follow-up to assess 1-year mortality between 2008 and 2012. Patients were divided into six groups according to BNP levels: < 50 (reference), 50 to < 100, 100 to < 300, 300 to < 500, 500 to < 1000, and ≥ 1000 pg/mL. One-year mortality at each BNP level was analyzed using Cox’s proportional hazards model after adjustments for confounding factors.

Results
During the follow-up period, 78 (11.8%) deaths were recorded. After adjustments for confounding factors, such as gender, age, hemodialysis vintage, and primary disease, the risk of 1-year mortality was significantly high with BNP levels of 500 to < 1000 (hazard ratio [HR] 3.010; 95% confidence interval [CI] 1.065–10.729; P = 0.037) and more than 1000 pg/mL (HR 5.291; 95%CI 2.014–18.170; P = 0.0003). After adjustments for Kt/V, the risk of 1-year mortality was also significantly high with BNP levels of 500 to < 1000 (HR 3.045; 95%CI 1.065–10.929; P = 0.037) and more than 1000 pg/mL (HR 5.221; 95%CI 1.943–18.165; P = 0.0006). Following further adjustments for nutritional factors, such as albumin levels, total cholesterol levels, the normalized protein catabolic rate (nPCR), body mass index (BMI), and percent creatinine generation rate (%CGR), BNP levels of 500–1000 (HR 1.990; 95%CI 0.639–7.570; P = 0.244), and more than 1000 pg/mL (HR 2.100; 95%CI 0.663–8.105; P = 0.213) were no longer risk factors.

Conclusion
In dialysis patients, a BNP level ≥ 500 pg/mL is a risk factor for 1-year mortality. The risk associated with high BNP levels is reduced by nutritional factors, which suggests a relationship between high BNP levels and the nutritional status. In conclusion, efforts are needed to maintain BNP levels at lower than 500 pg/mL and improve the nutritional status.
Shear wave velocity by quantitative acoustic radiation force impulse in the placenta of normal and high-risk pregnancy
Authors: Hefeda Mohamed Mohamed , Zakaria Alshymaa 
Published: July 2020

Abstract
Background
Traditionally, the placental functional integrity is suggested by indirect ultrasound measurements like fetal growth, amniotic fluid index, and uterine and umbilical artery Doppler indices. Only recently the elasticity of the placenta is studied as a measure of placental consistency and biomechanical prosperities and may reflect the placental function. Shear wave velocity is the quantitative parameter of the shear wave elastography. A high-risk pregnancy is a situation which puts the mother, the fetus, or both at greater risk than a normal pregnancy.

Results
The shear wave velocity (SWV) showed no significant difference between the placenta of normal pregnancies in the second and third trimesters (0.85 ± 0.43 m/s and 0.89 ± 0.57 m/s, respectively). The placenta of patients with preeclampsia/eclampsia had high SWV in the second and third trimesters (2.13 ± 1.48 m/s and 2.23 ± 1.48 m/s) with a highly significant difference from the normal placenta (P < 0.001). The placentas with abnormal location (placenta previa) and penetration (placenta accreta) had higher SWV than the placenta of normal pregnancies. The mean SWV for placenta previa was 1.1 ± 0.74 m/s and 1.3 ± 0.81 m/s in the second and third trimesters, respectively, with a mildly significant difference with the normal placenta. The placenta accreta shows high mean SWV in the second and third trimesters (1.6 ± 0.65 m/s and 1.961.6 ± 0.65, respectively) which differed significantly (P < 0.001) from SWV in the normal placenta in the second and third trimesters.

Conclusion
Shear wave velocity measurement as the quantitative parameter of acoustic radiation force impulse (ARFI) elastography reflects the placental elasticity in normal and high-risk pregnancies. The SWV increases in conditions like hypertension, preeclampsia, maternal renal disease, and diabetes and reflects the structural and biomechanical abnormalities in such diseases. High shear wave velocity correlates with the incidence of growth restriction and abnormal Doppler parameters especially in the hypertensive disease. The virtual touch quantification (VTQ) can be used as a complementary diagnostic and prognostic tool in high-risk pregnancy.
Role of Fibroscan for early detection of hepatocellular carcinoma (HCC) in hepatitis C cirrhotic patients
Authors: Ebrahim Ahmed Elhosieny , Shehata Mona Ahmed Helmy , Abou-saif Sabry , Hamisa Manal fathy , Abd-Elsalam Sherief , Yousef Mohamed 
Published: July 2020

Abstract
Background
Liver cancer (HCC) ranks as the fifth most prevalent cancer worldwide and is ranked third as a common cause of death due to cancer. The benefit of Fibroscan in assessing the risk of developing liver cancer that was evaluated in this work was not fully demonstrated. The aim of this work was to study the role and clinical significance of Fibroscan for early detection of liver cancer in hepatitis C patients with cirrhosis.

Results
As regards binary logistic regression for predictors of HCC, it was found that Child C, AST, Fibroscan, and AFP were predictors for developing HCC. Liver stiffness values were significantly high in all groups, and the specific cutoff value for hepatocellular carcinoma detection was above 24 kPa in hepatitis C virus patients. Therefore, liver stiffness of more than 24 kPa can be considered as an independent risk factor for the development of liver cancer in HCV patients.

Conclusion
Liver stiffness of more than 24 kPa was an independent risk factor for developing new liver cancer in HCV patients.
Clinical Trials for Treatment and Prevention of HIV-Associated Malignancies in Sub-Saharan Africa: Building Capacity and Overcoming Barriers
Authors: Lin Lilie L. , Lakomy David S. , Chiao Elizabeth Y. , Strother Robert M. , Wirth Meg , Cesarman Ethel , Borok Margaret , Busakhala Naftali , Chibwesha Carla J. , Chinula Lameck , Ndlovu Ntokozo , Orem Jackson , Phipps Warren , Sewram Vikash , Vogt Samantha L. , Sparano Joseph A. , Mitsuyasu Ronald T. , Krown Susan E. , Gopal Satish 
Published: July 2020

PURPOSE The aim of this study was to review the current status of clinical trials for HIV-associated malignancies in people living with HIV in sub-Saharan Africa (SSA) and efforts made by the AIDS Malignancy Consortium (AMC) to build capacity in SSA for HIV malignancy research. METHODS All malignancy-related clinical trials in 49 SSA countries on ClinicalTrials.gov were reviewed and evaluated for inclusion and exclusion criteria pertaining to HIV status. Additional studies by AMC in SSA were compiled from Web-based resources, and narrative summaries were prepared to highlight AMC capacity building and training initiatives. RESULTS Of 96 cancer trials identified in SSA, only 11 focused specifically on people living with HIV, including studies in Kaposi sarcoma, cervical dysplasia and cancer, non-Hodgkin lymphoma, and ocular surface squamous neoplasia. Recognizing the increasing cancer burden in the region, AMC expanded its clinical trial activities to SSA in 2010, with 4 trials completed to date and 6 others in progress or development, and has made ongoing investments in developing research infrastructure in the region. CONCLUSION As the HIV-associated malignancy burden in SSA evolves, research into this domain has been limited. AMC, the only global HIV malignancy-focused research consortium, not only conducts vital HIV-associated malignancies research in SSA, but also develops pathology, personnel, and community-based infrastructure to meet these challenges in SSA. Nonetheless, there is an ongoing need to build on these efforts to improve HIV-associated malignancies outcomes in SSA.
A New Insight into the Surgical Treatment of Primary Macronodular Adrenal Hyperplasia
Authors: Yoshiaki Tanno Fabio , Srougi Victor , Almeida Madson Q , Ide Yamauchi Fernando , Morbeck Almeida Coelho Fernando , Nishi Mirian Yumie , Claudia Nogueira Zerbini Maria , Silvia Correa Soares Iracy , Adelaide Albergaria Pereira Maria , Laiz Silva Charchar Helaine , Meneses Ferreira Lacombe Amanda , Balderrama Brondani Vania , Srougi Miguel , Carlos Nahas Willian , Mendonca Berenice B , Luis Chambô José , Candida Barisson Villares Fragoso Maria 
Published: July 2020

Abstract

Purpose
This prospective study presents the results of a new approach in the treatment of primary macronodular adrenal hyperplasia (PMAH), with simultaneous total adrenalectomy of the larger adrenal gland and partial adrenalectomy of the contralateral adrenal gland (adrenal-sparing surgery).

Materials and Methods
We performed a prospective study including 17 patients with PMAH treated surgically with adrenal-sparing surgery in a tertiary referral hospital, with a median follow-up of 41 months. Clinical, hormonal, and genetic parameters were evaluated before surgery and during follow-up. All patients had at least 1 radiological examination before and after the procedure.

Results
Among the 17 patients, all but 1 patient had complete hypercortisolism control, and 12 recovered normal adrenal function after surgery. Significant improvement in clinical parameters was observed: weight loss (P = .004); reduction of both systolic (P = .001) and diastolic (P = .001) blood pressure; and reduction in the number of antihypertensive drugs (P &lt; .001). Intra-, peri-, and postoperative complications were not observed.

Conclusion
Adrenal-sparing surgery is a safe and feasible procedure to treat patients with PMAH, providing a substantial chance of hypercortisolism control without the disadvantages of lifetime corticosteroid replacement.
Common principles of early mammalian embryo self-organisation
Authors: Płusa Berenika , Piliszek Anna 
Published: July 2020

ABSTRACT
Pre-implantation mammalian development unites extreme plasticity with a robust outcome: the formation of a blastocyst, an organised multi-layered structure ready for implantation. The process of blastocyst formation is one of the best-known examples of self-organisation. The first three cell lineages in mammalian development specify and arrange themselves during the morphogenic process based on cell-cell interactions. Despite decades of research, the unifying principles driving early mammalian development are still not fully defined. Here, we discuss the role of physical forces, and molecular and cellular mechanisms, in driving self-organisation and lineage formation that are shared between eutherian mammals.
Functional Mesoporous Silica Nanomaterials for Catalysis and Environmental Applications
Authors: Singh Baljeet , Na Jongbeom , Konarova Muxina , Wakihara Toru , Yamauchi Yusuke , Salomon Carlos , Gawande Manoj B 
Published: July 2020

Abstract
Silica materials are used in a wide range of applications such as catalysis, photocatalysis, CO2 capture, and environmental remediation. These nanomaterials (NMs) have been extensively investigated since the advent of Stöber silica. However, the absence of pores and small surface area of Stöber silica limits its applications. Later, the discovery of MCM-41 type mesoporous silica using surfactants as structural directing agents became revolutionary in the field of silica NMs. This review focuses on the methods used for synthesizing mesoporous silica nanomaterials (NMs), especially mesoporous nanoparticles (NPs), and their applications in various fields including catalysis (i.e., support for nanoparticle catalysts) and environmental remediation (CO to CO2 conversion, volatile organic compound (VOC) removal, and CO2 capture). The current issues/challenges in realizing the practical applications of these conventional materials are also highlighted. This review also compares the characteristics and applications of MCM-41, SBA-15, and KCC-1 to demonstrate the effect of the morphology and pore architecture of silica on the properties of silica-based NMs. The scope for future developments in the synthesis and applications of silica materials with different pore sizes and morphologies is discussed.
The Effect of the Leaving Group in N-Heterocyclic Carbene-Catalyzed Nucleophilic Aromatic Substitution Reactions
Authors: Yasui Kosuke , Kamitani Miharu , Fujimoto Hayato , Tobisu Mamoru 
Published: July 2020

Abstract
We report here that the reactivity order of the leaving group is F &gt; Cl ≥ Br &gt; I in N-heterocyclic carbene-catalyzed CSNAr reactions of aryl halides bearing an α,β-unsaturated amide. Based on a qualitative Marcus analysis, the nature of the transition state in this catalytic CSNAr is primarily determined by the potential energy of the Meisenheimer complex, even though it is not involved as a discrete intermediate in the reaction pathway.
Survey to healthcare professionals on the practicality of AI services for healthcare
Authors: Väänänen Antti , Haataja Keijo , Toivanen Pekka 
Published: July 2020

Background:Artificial Intelligence (AI) is already in use in many fields of healthcare, and utilization of AI in state-of-the art healthcare services is growing, with many studies showing that AI can provide benefits in healthcare processes. However, there is a need for research about healthcare professionals’ willingness to use AI-based services, and their consideration about in which cases AI could provide better healthcare outcomes and reduce healthcare professionals’ workload.Methods:We studied the latest technologies and methods from current healthcare AI services’ end-users to create a survey on healthcare services, including use cases that could be beneficial for healthcare professionals. We focused on studying Information and Communication Technology (ICT) applications and services which utilize modern AI features. The purpose of our survey for healthcare professionals was to provide an analysis of the healthcare services that utilize AI features, which could provide better health outcomes from a healthcare professional and care process point of view.Results:AI features, such as health monitoring, medication management, and connected machines are considered to have high benefit in healthcare workflow. Moreover, we found that the majority (67.8%) of healthcare professionals are willing to use AI for supporting decision making or even providing independent diagnosis. In total, 28.9% of healthcare professionals are willing to use AI in a restricted manner to help professionals in care processes. Only 3.3% of respondents are not willing to use AI-based services at all.Conclusions:Our survey indicated that the willingness of healthcare professionals to use different AI in healthcare technology solutions is high.
El impacto de la secuencia visual en la comprensión simbólica de acciones en imágenes
Authors: Jauck Daniela , Peralta Olga 
Published: July 2020

ResumenLa comprensión simbólica de imágenes que representan acciones constituye un desafío cognitivo a edades tempranas. Esta investigación indaga el impacto de la presentación de la secuencia visual de acciones dirigidas hacia un fin en la comprensión simbólica de las imágenes que las representan. Niños/as de 30 a 36 meses de edad fueron asignados/as a dos condiciones en las que se manipuló la presencia o ausencia de la secuencia. Los niños/as observaron por medio de una tableta imágenes de distintas acciones; luego, debían escoger un objeto real que mostraba el resultado de cada acción. Se encontró que la presencia de la secuencia constituyó un factor clave en la comprensión de las imágenes como representaciones acciones.Palabras clave: secuencia, acciones, imágenes, comprensión simbólica temprana The impact of the visual sequence on the symbolic understanding of actions on imagesAbstract The symbolic understanding of images that represent actions constitutes a cognitive challenge at early ages. This research investigates the impact of the presentation of the visual sequence of goal directed actions on the symbolic understanding of the images representing them. Thirty-to-36 months-old children were assigned to two conditions in which the presence or absence of the sequence was manipulated. Children observed on a tablet images of different actions; afterwards they had to choose a real object that showed the result of each action. It was found that the presence of the sequence constituted a key factor on the early symbolic comprehension of the images as representations of actions.Keywords: sequence, actions, images, early symbolic understanding
Influences on childhood immunisation decision-making in London's Gypsy and Traveller communities
Authors: Ellis Nicola , Walker-Todd Ellie , Heffernan Catherine 
Published: July 2020

Aims: Uptake of childhood immunisations is lower among Gypsy, Roma and Traveller (GRT) communities than in the general UK population. This small-scale study aimed to elicit insights from GRT mothers on their interaction with health services in London around childhood immunisations. The purpose was to inform a larger piece of work by the NHS England and Improvement (London) Public Health Commissioning Team to inform their planning to improve access to vaccination services for GRT communities in London. Study design: An exploratory qualitative study using semi-structured interviews and a focus group. Methods: There was purposive sampling of mothers from any GRT background from south-west London using snowballing methods. One focus group and three interviews were conducted. A thematic analysis approach was used. Results: A total of nine women were recruited and seven participated between March and April 2018. Five themes were identified: adherence with antenatal care, self-declared parenting expertise, family support, childhood immunisations, keep children healthy but ‘they say wait on the MMR until they are talking’. Conclusion: Compliance with antenatal care, strong parenting beliefs and cohesive family support are strong influences on decision-making regarding immunisations. The women interviewed emphasised their own expertise in child rearing. This was occasionally at odds with the health advice provided by health professionals. The women widely shared their experiences of health professionals with other family and community members and this impacted on others' intention to vaccinate. These are key issues that should be considered when trying to improve uptake of immunisations in GRT families in a face-to-face manner. Equally, it warrants further exploration in a larger-scale study to see whether this reflects the wider community and in order to tailor supplementary immunisation activities to improve uptake.
Time to rethink vascular access in patients with breast cancer
Authors: McDiarmid Sheryl , Larocque Gail 
Published: July 2020

Breast cancer management is a rapidly evolving field. Diagnosis and treatment options have changed dramatically over the years, as have options for vascular access devices used to administer therapies. We now need to critically rethink vascular access device options for our breast cancer patients. Breast cancer (BC) is the most commonly diagnosed cancer among Canadian women. Although BC incidence continues to rise, the overall mortality rate in Canada is the lowest it has been for 70 years. The five-year net survival is 87%, and 83% of women are alive at 10 years. New oral therapies, shorter dose-dense treatments, and decreased use of anthracycline-base regimens are reducing the need for central venous access devices during acute treatment phases. However, these survivors go on to develop other health issues requiring routine venipuncture and insertion of vascular access devices. Breast cancer-related lymphedema (BCRL) is a chronic complication that has no cure and no proven prevention strategies. Approximately 21% of breast cancer survivors are at risk of developing BCRL. Of those patients who do develop BCRL, 70% do so within two years of surgery, 90% within three years, and another one percent per year thereafter. The literature supports axillary lymph node dissection, mastectomy, administration of chemotherapy or radiotherapy, and obesity, as risk factors for the development of BCRL. However, 40% of patients who develop BCRL have no identifiable risk factors. Broader risk reduction strategies developed are not evidence based, the most commonly cited being avoidance of needle sticks. Large cohort studies have found no significant association between blood draws and intravenous infusion in the surgical arm with the development of BCRL. Recommendations that effectively eliminate vascular access on the surgical side for the patient's entire lifetime are neither necessary nor realistic. Vascular access specialists can provide leadership by developing standardized, evidence-informed recommendations for safe vascular access and infusion practices for this patient population.
Stories of Learning: A Case Study of Norwegian Plumbers and Apprentices in TVET at the Construction Site and in a Training Agency
Authors: Lensjø Marit 
Published: July 2020

Context: Through a dual model, based on 2 years of education in upper secondary school followed by two and a half year of apprenticeship training, Norwegian plumbing education has become an integrated part of the Technical Vocational Education and Training (TVET). Competence and skills are described in national plumbing curriculum. However, there is little information on how learning and training, interaction and relations between craftsmen and apprentices take place and develops at the workplace. The objective of this article is to identify significant learning processes by studying apprentices in a training agency and in communities of plumbers at the building site. Approach: The study has an ethnographic approach, based on a combination of fieldwork and interviews with apprentices, plumbers and a vocational teacher. During one year of fieldwork I followed a group of plumbing apprentices in a training agency, and in their plumbing companies at different construction sites. As a former plumber and vocational teacher, I was able to participate as a plumber and researcher and thus I had a unique position to work along with the apprentices and plumbers. This enabled me to observe interaction, learning and training in their communities of practices as an insider.Findings: The study showed that the process of learning practical skills, a professional language and a technical rationale was time consuming, challenging and sometimes tiering. In return the apprentices discovered proficiency, gained confidence and were considered as participants in the community of plumbers. A central finding is the great value of working in a community of plumbers at the building site, combined by studying sanitary and heating technology at the training agency. Among peers at the training agency, the apprentices were challenged to build and explore complex pipe laying, and to discuss technical regulations and rationale with each other and the vocational teacher. Conclusion: Craftsmen, like plumbers, consecutively handle a variety of technical work tasks and situations. Inside practice, the plumbers are close to materials and systems on construction site, where pipes, cableways and building structures looks different from the plan and the progress on paper. As experts, the plumbers often solve problems more functional and cost effective than suggested in the blueprint. The study shows how apprentices and plumbers develop skills, tacit knowledge and professionality through involvement with relevant things and situations, and by sharing experiences and technical expertise in communities of peers and plumbers.