bluuebunny/crossref_metadata_2025_split huggingface dataset:
'We always support each other – no matter what': a qualitative analysis of work-related psychosocial demands, stressors and resources in general practice teams
Authors: Tsarouha Elena , Preiser Christine , Weltermann Birgitta , Junne Florian , Seifried-Dübon Tanja , Stuber Felicitas , Hartmann Sigrid , Wittich Andrea , Rieger Monika A , Rind Esther , Consortium IMPROVEjob- 
Published: July 2020

Abstract
Background Work-related stress has been associated with poor psychological and physical outcomes. A better understanding of work-related psychosocial demands, risks and resources can therefore contribute to the prevention of work-related stress. Compared to the general population, medical staff have reported a higher prevalence of chronic stress. Using general practices as an example for small enterprises, this study aims to gain a deeper understanding of work-related psychosocial demands, stressors and resources in the primary care setting. Methods We applied an ethnographic design, comprising a combination of participating observations, individual interviews with physicians (N = 6) and focus group discussion with practice assistants and administrative staff (N = 19) in five general practices in Germany. Access to the practice teams was established via a university general practice network. A grounded theory approach was applied to analyze all data. Results Our results identified specific psychosocial demands, stressors and resources exemplified mainly along two typical tasks in GP practices: the issuing of medical prescriptions and blood sampling. Main psychosocial risks included factors related to work content and tasks (e.g. incompleteness of task), organization of work (e.g. frequent interruptions), and the working environment (e.g. noise). Work-related resources comprised staff’s influence on aspects related to work organization (e.g. scope for action) and social support (e.g. positively perceived teamwork). These factors did not occur in isolation but were closely interrelated with each other.Conclusion Although work processes in general practices are complex and required to comply with legal regulations, the specific organization of work processes is the responsibility of the general practitioner. Therefore, there are opportunities for practice owners and practice teams to establish working procedures in ways that reduce psychosocial risks and strengthen work-related resources.
Identifying Integration and Differentiation in a Hospital’s Logistical System: A social network analysis of a case study
Authors: Ham Annelies van der , Merode Frits Van , Ruwaard Dirk , Raak Arno Van 
Published: July 2020

Abstract
Background
Integration, the coordination and alignment of tasks, has been promoted widely in order to improve the performance of hospitals. Both organization theory and social network analysis offer perspectives on integration. This exploratory study research aims to understand how a hospital’s logistical system works, and in particular to what extent there is integration and differentiation. More specifically, it first describes how a hospital organizes logistical processes; second, it identifies the agents and the interactions for organizing logistical processes, and, third, it establishes the extent to which tasks are segmented into subsystems, which is referred to as differentiation, and whether these tasks are coordinated and aligned, thus achieving integration.

Methods
The study is based on case study research carried out in a hospital in the Netherlands. All logistical tasks that are executed for surgery patients were studied. Using a mixed method, data were collected from the Hospital Information System (HIS), documentation, observations and interviews. These data were used to perform a social network analysis and calculate the network metrics of the hospital network.

Results
This paper shows that 23 tasks are executed by 635 different agents who interact through 31,499 interaction links. The social network of the hospital demonstrates both integration and differentiation. The network appears to function differently from what is assumed in literature, as the network does not reflect the formal organizational structure of the hospital, and tasks are mainly executed across functional silos. Nurses and physicians perform integrative tasks and two agents who mainly coordinate the tasks in the network, have no hierarchical position towards other agents. The HIS does not seem to fulfill the interactional needs of agents.

Conclusions
This exploratory study reveals the network structure of a hospital. The cross-functional collaboration, the integration found, and position of managers, coordinators, nurses and doctors suggests a possible gap between organizational perspectives on hospitals and reality. This research sets a basis for further research that should focus on the relation between network structure and performance, on how integration is achieved and in what way organization theory concepts and social network analysis could be used in conjunction with one another.
Global targetome analysis reveals critical role of miR-29a in pancreatic stellate cell mediated regulation of PDAC tumor microenvironment
Authors: Dey Shatovisha , Liu Sheng , Factora Tricia D , Taleb Solaema , Riverahernandez Primavera , Udari Lata , Zhong Xiaoling , Wan Jun , Kota Janaiah 
Published: July 2020

Abstract
Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive forms of malignancies with a nearly equal incidence and mortality rates in patients. Pancreatic stellate cells (PSCs) are critical players in PDAC microenvironment to promote the aggressiveness and pathogenesis of the disease. Dysregulation of microRNAs (miRNAs) have been shown to play a significant role in progression of PDAC. Earlier, we observed a PSC-specific downregulation of miR-29a in PDAC pancreas, however, the mechanism of action of the molecule in PSCs is still to be elucidated. The current study aims to clarify the regulation of miR-29a in PSCs and identifies functionally important downstream targets that contribute to tumorigenic activities during PDAC progression. Methods In this study, using RNAseq approach, we performed transcriptome analysis of paired miR-29a overexpressing hPSC cells and controls. Enrichment analysis was performed with the identified differentially expressed genes (DEGs). miR-29a targets in the dataset were identified, which were utilized to create network interactions. Western blots were performed with the top candidate miR-29a targets in hPSC cells transfected with miR-29a mimic or scramble control. Results RNAseq analysis identified 202 differentially expressed genes, which included 19 downregulated direct miR-29a targets. Translational repression of eight key pro-tumorigenic and -fibrotic targets namely IGF-1, COL5A3, CLDN1, E2F7, MYBL2, ITGA6 and ADAMTS2 by miR-29a was observed in PSCs. Using pathway analysis, we find that miR-29a modulates effectors of IGF-1-p53 signaling in PSCs that may hinder carcinogenesis. We further observe a regulatory role of the molecule in pathways associated with PDAC ECM remodeling and tumor-stromal crosstalk, such as INS/IGF-1, RAS/MAPK, laminin interactions and collagen biosynthesis. Conclusions Together, our study presents a comprehensive understanding of miR-29a regulation of PSCs, and identifies essential pathways associated with PSC-mediated PDAC pathogenesis. The findings suggest an anti-tumorigenic role of miR-29a in the context of PSC-tumor cell crosstalk and advocates for the potential of the molecule in PDAC targeted therapies.
Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia
Authors: Martini Ross P , Yanez N David , Treggiari Miriam , Tekkali Praveen , Soelberg Cobin , Aziz Michael F 
Published: July 2020

Abstract
Background : Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff.

We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.

Methods : We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.

Results : 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).

Conclusions : The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery.

ClinicalTrials.gov ID NCT02450929
Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study
Authors: Ginja Samuel , Jackson Katherine , Newham James J , Henderson Emily J , Smart Debbie , Lingam Raghu 
Published: July 2020

Abstract
Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women - depression and anxiety.Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage.Results: 295 participants provided valid data. Women in rural areas (n=130) were mostly comparable to their urban counterparts (n=165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 95% CI 1.03 to 2.72, p=.038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p=.078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p=.070).Conclusions: Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.
The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence
Authors: Monaghesh Elham , Hajizadeh Alireza 
Published: July 2020

Abstract
Purpose: The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak.Methods: This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results: Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions: The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.
Impact of Pre-appointment contact and Short Message Service alerts in reducing ‘Did Not Attend’ (DNA) rate on rapid access new patient breast clinics: A DGH perspective
Authors: Kiruparan Pasupathy , Kiruparan Nanthesh , Debnath Debasish 
Published: July 2020

Abstract
Background: Failure to attend the clinic without prior intimation, known as “Did Not Attend” (DNA) is a significant global issue. There have been no published studies attempting to reduce DNA rates in breast clinics. We aimed to assess the impact of contacting patients prior to clinic attendance and Short Message Service (SMS) reminder on DNA rates in rapid access new patient breast clinics, evaluate ‘Could Not Attend’ (CNA) rate, and explore any correlation between age, sex, clinic days and sessions.Methods: Initially, DNAs at the rapid access new patient breast clinics between 01/04/2018 and 31/03/2019 at a district general hospital in the North-West of England was assessed (Cycle 1). Changes were introduced in terms of contacting patients prior to offering appointments, followed by SMS reminders nearer the clinic dates. Subsequently, DNA was reassessed between 01/10/2019 and 31/03/2020 (Cycle 2). Results: Following implementation of changes, DNA rate reduced from 8.2% to 4.1% (p<0.00001). CNA rates were 0.9% (Cycle 1) and 1.1% (Cycle 2) [p=0.36]. Evening clinics had the lowest DNA rates throughout. DNA patients in cycle 2 were significantly older than those in cycle 1 (p=0.002). Conclusions: Contacting patients prior to clinic appointments and sending SMS reminders helped reduce DNA rates significantly in rapid access new patient breast clinics. Scheduling clinic sessions with least DNA rates, such as evening clinics, should be contemplated. One should be cautious of mobile phone technology that conveys SMS, which can potentially disadvantage the older age group. This model could be considered across the board to improve DNA rates.
Characterization of a Monanema nematode in Ixodes scapularis
Authors: Tokarz Rafal , Tagliafierro Teresa , Lipkin W. Ian , Marques Adriana R 
Published: July 2020

Abstract
Background Metagenomic studies have revealed the presence of a filarial nematode in Ixodes scapularis. The phylogeny of this agent, and its potential for human infection, are unknown.Methods We used existing metagenomic data from I. scapularis to determine the phylogeny of this tick-associated nematode and employed quantitative PCR to determine if the presence of this agent had an effect on the burden of Borrelia burgdorferi. We also developed a Luciferase Immunoprecipitation System assay using the Av33 antigen as a target to investigate the presence of antibodies against this nematode in 128 serum specimens from patients with Lyme disease and babesiosis. To demonstrate assay utility, we used 15 sera from patients with onchocerciasis as controls.Results We show that this agent is a new species in the genus Monanema and its presence in vector ticks does not impact the burden of B. burgdorferi. We did not detect IgG antibodies to this agent in 127 of 128 sera from patients with Lyme disease or babesiosis. One sample had reactivity above the threshold, but at the low-level equivalent to the least reactive onchocerciasis sera. This low positive signal could be a result of cross-reacting antibodies, antibodies from a previous infection with a filarial nematode, or, less likely, a exposure to the Ixodes scapularis-associated nematode. Conclusions We found no evidence that this nematode contributes to the spectrum of human tick-borne infections.
A New Scoring System for Predicting Extent of Resection in Medial Sphenoid Wing Meningiomas Based on Three-dimensional Multimodality Fusion Imaging
Authors: Wang Zilan , Liang Xiaolong , Yang Yanbo , Gao Bixi , Wang Ling , You Wanchun , Chen Zhouqing , Wang Zhong 
Published: July 2020

Abstract
Background: Three-dimensional (3D) multimodality fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively.Methods: We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors’ location, volume, cavernous sinus involvement, vascular encasement and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated.Results: The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = .772, P < .001). The scoring system had good predictive capacity with an accuracy of 69.60%.Conclusions: We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging.Trial registration: Retrospectively registered.
Reverse transcriptase inhibition potentiates target therapy in BRAF-mutant melanomas: effects on cell proliferation, apoptosis, DNA-damage, ROS induction and mitochondrial membrane depolarization
Authors: Fattore Luigi , Malpicci Debora , Milite Ciro , Castellano Sabrina , Sbardella Gianluca , Botti Gerardo , Ascierto Paolo Antonio , Mancini Rita , Ciliberto Gennaro 
Published: July 2020

Abstract
Target therapies based on BRAF and MEK inhibitors (MAPKi) have changed the therapeutic landscape for metastatic melanoma patients bearing mutations in the BRAF kinase. However, the emergence of drug resistance imposes the necessity to conceive novel therapeutic strategies capable to achieve a more durable disease control. In the last years, retrotransposons laying in human genome have been shown to undergo activation during tumorigenesis, where they contribute to genomic instability. Their activation can be efficiently controlled with reverse transcriptase inhibitors (RTIs) frequently used in the treatment of AIDS. These drugs have demonstrated anti-proliferative effects in several cancer models, including also metastatic melanoma. However, to our knowledge no previous study investigated the capability of RTIs to mitigate drug resistance to target therapy in BRAF-mutant melanomas. In this short report we show that the non-nucleoside RTI, SPV122 in combination with MAPKi strongly inhibits BRAF-mutant melanoma cell growth, induces apoptosis, and delays the emergence of resistance to target therapy in vitro. Mechanistically, this combination strongly induces DNA double-strand breaks, mitochondrial membrane depolarization and increased ROS levels. Our results shed further light on the molecular activity of RTI in melanoma and pave the way to their use as a novel therapeutic option to improve the efficacy of target therapy.
Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - A multi-centric clinical study of GD-2008-ALL protocol
Authors: Li Xin-Yu , Li Jia-Qiang , Luo Xue-Qun , Wu Xue-Dong , Sun Xin , Xu Hong-Gui , Li Chang-Gang , Liu Ri-Yang , Sun Xiao-Fei , Chen Hui-Qin , Lin Yu-Deng , LI Chi-Kong , Fang Jian-Pei 
Published: July 2020

Abstract
Background The prognosis of childhood acute lymphoblastic leukemia (ALL) is optimistic with a 5-year event-free survival (EFS) rate of 70%-85%. However, the major causes of mortality are chemotherapy toxicity, infection and relapse. The Guangdong(GD)-2008-ALL collaborative protocol was carried out to study the effect of reduced intensity on treatment related mortality(TRM) based on Berlin-Frankfurt-Münster (BFM) 2002 backbone treatment. The study was designed to elucidate weather the reduced intensity is effective and safe for children with ALL. Methods The clinical data was obtained from February 28, 2008 to June 30, 2016. A total of 1,765 childhood ALL cases from 9 medical centers were collected and data was retrospectively analyzed. Patients were stratified into 3 groups according to bone marrow morphology, prednisone response, age, genotype, and karyotype information: standard risk (SR), intermediate risk (IR) and high risk (HR). The dose of cyclophosphamide (CTX), Cytarabine (Ara-c) and 6-mercaptopurine (6-MP) during CAM induction for the SR group was half that of the BFM 2002 and was reduced to 2 weeks.Results The 5-year and 8-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) were 83.5±0.9% and 83.1±1.0%, 71.9±1.1% and 70.9±1.2%, and 19.5±1.0% and 20.5±1.1%, respectively. The 2-year treatment-related mortality (TRM) was 5.2±0.5%. The 5-year and 8-year OS were 90.7±1.4% and 89.6±1.6% in the SR group, while the 5-year and 8-year EFS were 81.5±1.8% and 80.0±2.0%. In the SR group, 74 (15.2 %) patients measured minimal residual disease (MRD) on Day 15 and Day 33 of induction therapy. Among them, 7 patients (9.46%) were MRD positive (≥ 0.01%) on Day 33. The incidence of relapse in the MRD Day33 positive group (n=7) was 28.6%, while in the MRD Day33 negative group (n=67) was 7.5% (p=0.129).Conclusions The results of GD-2008-ALL protocol are outstanding for reducing TRM in childhood ALL in China with excellent long term EFS. This protocol provided the evidence for further reducing intensity of induction therapy in the SR group according to the risk stratification. MRD levels on Day 15 and Day 33 are appropriate indexes for stratification.