bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing suitability for long-term colorectal cancer shared care: a scenario-based qualitative study
Authors: Vuong Kylie , Uebel Kerry , Agaliotis Maria , Jun Stella , Taggart Jane , Suchy Sue , Liauw Winston , Chin Melvin , Webber Kate , Harris Mark 
Published: November 2020

Abstract
Background
Shared care is the preferred model for long-term survivorship care by cancer survivors, general practitioners and specialists. However, survivorship care remains specialist-led. A risk-stratified approach has been proposed to select suitable patients for long-term shared care after survivors have completed adjuvant cancer treatment. This study aims to use patient scenarios to explore views on patient suitability for long-term colorectal cancer shared care across the risk spectrum from survivors, general practitioners and specialists.

Methods
Participants completed a brief questionnaire assessing demographics and clinical issues before a semi-structured in-depth interview. The interviews focused on the participant’s view on suitability for long term cancer shared care, challenges and facilitators in delivering it and resources that would be helpful. We conducted thematic analysis using an inductive approach to discover new concepts and themes.

Results
Interviews were conducted with 10 cancer survivors, 6 general practitioners and 9 cancer specialists. The main themes that emerged were patient-centredness, team resilience underlined by mutual trust and stronger system supports by way of cancer-specific training, survivorship care protocols, shared information systems, care coordination and navigational supports.

Conclusions
Decisions on the appropriateness of this model for patients need to be made collaboratively with cancer survivors, considering their trust and relationship with their general practitioners and the support they need. Further research on improving mutual trust and operationalising support systems would assist in the integration of shared survivorship care.
Modification of the 8th American Joint Committee on Cancer staging system for gallbladder carcinoma to improve prognostic precision
Authors: Jiang Wei , Zhao Bingqing , Li Yongcheng , Qi Dunfeng , Wang Daxing 
Published: November 2020

Abstract
Background
The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for gallbladder carcinoma (GBC) came into force since 2018. However, the prognostic precision of this staging system has not been properly assessed. This study aimed to evaluate the latest staging system and suggest modifications to improve its prognostic precision.

Methods
Data of patients with GBC was included from the Surveillance, Epidemiology and End Results (SEER) database (2004–2015) and multicenter database (2010–2017). Baseline clinicopathologic characteristics were recorded including age, sex, race, grade, T category, N category, M category and stage. The Kaplan-Meier method was used to plot survival functions. The prediction power of the AJCC 8th edition and its modified version were evaluated using the concordance index (C-index).

Results
A total of 2779 GBC patients were included in the SEER database and 591 were collected from multicenter database. While no significant difference in survival of patients was observed between stages IVA and IVB using the 8th AJCC staging system (p > 0.05), the prognosis of stage IIIA showed a slightly better outcome than stage IIIB (p = 0.046) in the SEER database. In the multicenter database, there was no significant difference between stage IIIA and stage IIIB (p > 0.05). Similarly, no significant difference in the survival of patients between stages IIIA and IIIB was observed when M0 patients with at least 6 lymph nodes (LNs) were analyzed (p > 0.05) for both SEER and multicenter database. On the other hand, a modified staging system was able to stratify patients from stage IIIA, stage IIIB and stage IV (p < 0.001). For the SEER database, the C-indexes of 8th AJCC staging system and that of its modified version were 0.709 and 0.742, respectively. For the multicenter database, the C-index of 8th AJCC staging system and that of our modified version were 0.635 and 0.679, respectively.

Conclusions
The modified 8th staging system proposed in this study can improve the prognostic precision of the 8th AJCC staging system for GBC. We therefore suggest including these modifications in the next update of AJCC staging system for GBC.
Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of Western China
Authors: Wang Chen-ran , Li Xia-yun , Zhang Lin , Wu Lin-man , Tan Ling , Yuan Fei , Guo Yao , Williams Sarah , Xu Tao 
Published: November 2020

Abstract
Background
Breastfeeding is critical to promote maternal and child health. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full term vaginally delivered neonates in the first 6 months of life.

Methods
We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to 6 months of age. Data were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects.

Results
Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25 min vs. 33 min, P <  0.01), an increased chance of successful first-time breastfeeding (OR 5.53; 95% CI 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P <  0.001), 3 months (OR 3.20; 95% CI 1.01, 10.15), and 6 months (OR 4.91; 95% CI 1.71, 14.13) of age.

Conclusions
EENC enhances breastfeeding initiation and increases exclusive breastfeeding at 6 months of age. Our evidence suggests that nationwide scale up of EENC would increase the exclusive breastfeeding rate in the first 6 months of life.
Drug-related relapses in drug reaction with eosinophilia and systemic symptoms (DRESS)
Authors: Jörg Lukas , Helbling Arthur , Yerly Daniel , Pichler Werner J. 
Published: November 2020

Abstract
Background
A drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe T cell mediated hypersensitivity reaction. Relapses of symptoms in the recovery phase are frequent and linked to the reduction of the corticosteroid treatment, to viral reactivations or to the exposure to new drugs. Here, we analyzed, how often the exposure to new drugs leads to new sensitization or drug-related relapses without detectable sensitization.

Methods
46 patients with DRESS treated in the allergy division of the Inselspital, Bern University Hospital, were retrospectively assessed. Drug-related relapses were analyzed in terms of frequency and whether a possible sensitization evaluated by skin tests and/or lymphocyte transformation tests (LTT) to the new drugs was detectable. Furthermore, drug tolerance was evaluated in a subset of patients.

Results
56 relapses were observed in 27 of 46 patients with DRESS (58.7%). 33 (58.9%) of these relapses were associated with the use of new drugs, 30 drug-related relapses were evaluated by patch test and/or lymphocyte transformation test. In 8/30 (26.7%) drug-related relapses, a sensitization to the new drug was demonstrated, suggesting the emergence of a multiple drug hypersensitivity syndrome (MDH). 14 patients experienced 22 drug-related relapses without any detectable sensitization and only 1/6 patients developed new symptoms upon reexposure.

Conclusion
Patients with DRESS frequently suffered from drug related relapses. Half of the patients with drug-related relapses developed a MDH with proven sensitizations not only to the DRESS inducing drugs, but also to newly applied drugs. When not sensitized, drugs involved in drug related relapses could be reintroduced, if needed. Here, we propose a procedure for drug testing and future management of drug-related relapses in DRESS.
Enhanced interpolation-based interference rejection combining for black-space cognitive radio in time-varying channels
Authors: Srinivasan Sudharsan , Dikmese Sener , Renfors Markku 
Published: November 2020

AbstractIn this paper, we investigate multi-antenna interference rejection combing (IRC)-based black-space cognitive radio (BS-CR) operation in time-varying channels. The idea of BS-CR is to transmit secondary user (SU) signal in the same frequency band with the primary user (PU) such that SU’s power spectral density is clearly below that of the PU, and no significant interference is inflicted on the PU receivers. We explore the effects of interpolation and mobility on the novel blind IRC technique which allows such operation mode for effective reuse of the PU spectrum for relatively short-distance CR communication. We assume that both the PU system and the BS-CR use orthogonal frequency division multiplexing (OFDM) waveforms with common numerology. In this case, the PU interference on the BS-CR signal is strictly flat-fading at subcarrier level. Sample covariance matrix-based IRC adaptation is applied during silent gaps in CR operation. We evaluate the effect of the gap length on the link performance, using known PU channel-based interference covariance estimation as reference. We also propose an interpolation-based scheme for tracking the spatial covariance in time-varying channels, demonstrating significantly improved robustness compared to the earlier scheme. The performance of the proposed IRC scheme is tested considering terrestrial digital TV broadcasting (DVB-T) as the primary service. Also joint PU and co-channel CR interference cancellation is included in the study. The resulting interference suppression capability is evaluated with different PU interference power levels, silent gap durations, data block lengths, and CR device mobilities.
Multi-level host-based intrusion detection system for Internet of things
Authors: Gassais Robin , Ezzati-Jivan Naser , Fernandez Jose M. , Aloise Daniel , Dagenais Michel R. 
Published: November 2020

AbstractThe growth of the Internet of things (IoT) has ushered in a new area of inter-connectivity and innovation in the home. Many devices, once separate, can now be interacted with remotely, improving efficiency and organization. This, however, comes at the cost of rising security vulnerabilities. Vendors are competing to create and release quickly innovative connected objects, without focusing on the security issues. As a consequence, attacks involving smart devices, or targeting them, are proliferating, creating threats to user’s privacy and even their physical security. Additionally, the heterogeneous technologies involved in IoT make attempts to develop protection on smart devices much harder. Most of the intrusion detection systems developed for those platforms are based on network activity. However, on many systems, intrusions cannot easily or reliably be detected from network traces. We propose a novel host-based automated framework for intrusion detection. Our work combines user space and kernel space information and machine learning techniques to detect various kinds of intrusions in smart devices. Our solution use tracing techniques to automatically get devices behavior, process this data into numeric arrays to train several machine learning algorithms, and raise alerts whenever an intrusion is found. We implemented several machine learning algorithms, including deep learning ones, to achieve high detection capabilities, while adding little overhead on the monitored devices. We tested our solution within a realistic home automation system with actual threats.
Development and randomized controlled trial evaluation of E-learning trainings for professionals
Authors: König Elisa , Maier Anna , Fegert Jörg Michael , Hoffmann Ulrike 
Published: November 2020

Abstract
Background
Child maltreatment and consequently child protection are highly relevant and current issues in our society. Medical institutions are widely regarded as places of healing, care and support. But they also hold risk factors to promote child maltreatment. Efforts have to be taken in order to offer help to victims by medical institutions and to reduce risk factors for child maltreatment. Therefore, health professionals in the field of child protection must be trained and sensitized for these two purposes.
The Department of Child and Adolescent Psychiatry / Psychotherapy at the University Hospital of Ulm in Germany is developing E-Learning courses directed to health professionals in order to create flexible advanced training courses for dealing with child abuse, and to increase competences in child protection. Due to their specific role in (institutional) child protection, three courses and their evaluation will be presented in this article. The aim of the studies is to examine if those online-courses are increasing knowledge and skills in child protection and how satisfied participants are with course quality.

Methods
Randomised Controlled Trials (RCT) were conducted with one wait-list control group and one group participating in the course (= intervention group). The RCTs took place from October 2016 to March 2017 for two courses, and from May 2017 to September 2017 for the other course. Data were analysed with mixed design ANOVA. For evaluation of user satisfaction, descriptive statistics are reported.

Results
For all three courses, knowledge and practical capacities on the topic of the intervention group raised significantly in comparison to the values of the control group. Furthermore, participants of the course for managers felt better prepared to meet their responsibilities in regard to institutional child protection and came up with ideas on how to implement safeguarding standards in their institution. Overall, participants were very satisfied with the structure and the content of the courses.

Conclusions
The article shows that the online-courses are an effective and well-accepted approach to train professionals in topics regarding (institutional) child protection by contributing to the participants´ abilities to create medical facilities into a place of competence and protection.
Social capital and the diffusion of learning management systems: a case study
Authors: Boland Bill 
Published: November 2020

AbstractThe diffusion and adoption process of a learning management system (LMS) at higher education institutes faces several obstacles; some of which are unique to contexts while others are shared experiences. This diffusion case study compares the adoption process of the LMS Blackboard at two universities, Texas A&M University and Monash University in Australia, investigating the factors which impacted the adoption of the innovation at each context as well as the extent to which social capital influenced the diffusion process. The study specifically examined the different adopters involved, the objections raised, the barriers encountered, and the significant factors either resulting in the success or the failure of the innovation, employing a social capital-infused theoretical framework of diffusion within organizations outlined by Frank, Zhao, and Borman (Sociol Educ 77:148–171, 2004). Primary and secondary data were analyzed and examined from three peer-reviewed, empirical articles for comparison within the study.Findings highlighted strong alignment with Rogers’ (Diffusion of innovations, 2003) diffusion of innovations theory as well as the importance of social capital maintained by Frank and colleagues (Sociol Educ 77:148–171, 2004). Though describing different adoption processes and factors, each context supported the universal idea behind diffusion theory that members of a social system communicate an innovation through social channels over time and that innovators and early adopters play a vital role in this process (Rogers, Diffusion of innovations, 2003). As higher education institutes advance further into the twenty-first century and adopt more innovations within their learning frameworks and systems, this diffusion case study stresses the importance of understanding diffusion theory, having an in-depth knowledge of the stakeholders involved in the adoption process, and creating and implementing a meticulous diffusion plan to ensure a successful diffusion and adoption process.
Screening marine algae metabolites as high-affinity inhibitors of SARS-CoV-2 main protease (3CLpro): an in silico analysis to identify novel drug candidates to combat COVID-19 pandemic
Authors: Muteeb Ghazala , Alshoaibi Adil , Aatif Mohammad , Rehman Md. Tabish , Qayyum M. Zuhaib 
Published: November 2020

AbstractThe recent dissemination of SARS-CoV-2 from Wuhan city to all over the world has created a pandemic. COVID-19 has cost many human lives and created an enormous economic burden. Although many drugs/vaccines are in different stages of clinical trials, still none is clinically available. We have screened a marine seaweed database (1110 compounds) against 3CLpro of SARS-CoV-2 using computational approaches. High throughput virtual screening was performed on compounds, and 86 of them with docking score <  − 5.000 kcal mol−1 were subjected to standard-precision docking. Based on binding energies (< − 6.000 kcal mol−1), 9 compounds were further shortlisted and subjected to extra-precision docking. Free energy calculation by Prime-MM/GBSA suggested RC002, GA004, and GA006 as the most potent inhibitors of 3CLpro. An analysis of ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) properties of RC002, GA004, and GA006 indicated that only RC002 (callophysin A, from red alga Callophycus oppositifolius) passed Lipinski’s, Veber’s, PAINS and Brenk’s filters and displayed drug-like and lead-like properties. Analysis of 3CLpro-callophysin A complex revealed the involvement of salt bridge, hydrogen bonds, and hydrophobic interactions. callophysin A interacted with the catalytic residues (His41 and Cys145) of 3CLpro; hence it may act as a mechanism-based competitive inhibitor. Docking energy and docking affinity of callophysin A towards 3CLpro was − 8.776 kcal mol−1 and 2.73 × 106 M−1, respectively. Molecular dynamics simulation confirmed the stability of the 3CLpro-callophysin A complex. The findings of this study may serve as the basis for further validation by in vitro and in vivo studies.
A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study
Authors: Eskan Mehmet Akif , Uzel Gokhan , Yilmaz Seyit 
Published: November 2020

Abstract
Background
Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.

Methods
Forty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.

Results
The overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.

Conclusions
The results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.
Complement C9 expression is associated with damaged myocardial cells in pediatric sudden death cases of fulminant myocarditis
Authors: Uno Akari Takaya , Hitosugi Masahito , Nakamura Mami , Nakanishi Tomoyuki , Mima Takahiro , Higuchi Yoshihisa 
Published: November 2020

Abstract
Background
Because disease progression is so fast in sudden death of acute fulminant myocarditis, damage of myocardial cells is not evident in routine hematoxylin and eosin staining. To understand damage to myocardial cells and the mechanism of sudden death, immunohistochemical staining was performed for two forensic autopsy cases.

Case presentation
The patients were a healthy 5-year-old girl and 8-year-old boy. They suddenly died within 2 days of appearance of flu-like symptoms. An autopsy showed accumulation of yellowish-clear pericardial fluid containing fibrin deposits, fluid blood in the heart, and congestion of visceral organs. Histologically, minor necrosis or degeneration of myocardial cells with mainly lymphocytic infiltration was observed sometimes in tissue sections. Immunohistochemically, positive complement C9 staining and negative sirtuin 1 staining were found. These findings suggested wide damage of myocardial cells, even in regions with no marked changes in myocardial cells with hematoxylin and eosin staining. These areas corresponded to those with strong accumulation of lymphocytes.

Conclusions
Immunohistochemistry for complement C9 and sirtuin 1 might become a new tool for evaluating damage of myocardial cells of fulminant acute myocarditis.