bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soluble IL-2R as a predictor of familial breast cancer
Authors: Gonda Kenji , Horita Shoichiro , Maejima Yuko , Takenoshita Seiichi , Shimomura Kenju 
Published: May 2020

Abstract
Background: The incidence of breast cancer has been increasing annually, and breast cancer-related diseases, such as breast cancer in the young, ovarian cancer, prostate cancer, and pancreatic cancer, have clearly and steadily increased in number and have become common among the family members of patients with breast cancer. Accordingly, an increase in the incidence of familial breast cancer (FBC) is anticipated in the future. Interleukin (IL)-2 is one of the cytokines that activate cytotoxic T lymphocytes (CTLs), which are important for cancer immunity. To identify the markers of increased risk for FBC, soluble IL-2 receptor (sIL-2R) levels and immunologic factors were investigated in patients with FBC and non-familial breast cancer (NFBC).Methods: Of the 106 untreated breast cancer patients who gave consent to participate in this study, 24 had FBC and 82 had NFBC. There were 11 healthy individuals included in this study. Serum and peripheral blood mononuclear cells were collected from all patients for measurement of sIL-2R, IL-10, Vascular endothelial growth factor (VEGF), IL-17, regulatory T cells (Tregs), Myeloid derived suppressor cells (MDSCs), neutrophil to lymphocyte ratio (NLR), white blood cell (WBC) and C-reactive protein (CRP) levels. Prognosis was assessed and compared according to sIL-2R levels (low vs. high). Tissue samples from postoperative patients with high sIL-2R levels were stained with programmed cell death ligand 1 (PD-L1) and Cluster of Differentiation (CD) 8.Results: sIL-2R level was significantly higher and had significantly stronger correlation with IL-10, VEGF, IL-17, Tregs, MDSCs levels, NLR, WBC count and CRP in FBC, than in NFBC. In cases with high sIL-2R levels, Tregs and MDSCs levels were significantly higher and the overall survival (OS) and disease free survival (DFS) rates were significantly worse in FBC than in NFBC. Among the FBC cases with high sIL-2R levels, triple negative breast cancer tissues stained well for PD-L1and CD8.Conclusions: Compared with NFBC, FBC was associated with higher sIL-2R level, Th2 predominance, and less aggressive cancer immunosuppressive cells. In the present study, sIL-2R was identified as a biomarker that can predict the prognosis of FBC. The ability to prospectively identify patients who are less likely to have NFBC is a vital step in improving the overall survival of this population.
Psychometric properties of the North American version of the Flodén ATODAI (Attitudes Toward Organ Donor Advocacy Instrument): a validation study
Authors: Flodén Anne , Stadtler Maria , Collazo Stephanie E Jones , Mone Tom , Ash Rick , Fridlund Bengt 
Published: May 2020

Abstract
Background: Intensive and critical-care nurses are the key to successful donor management in the critical-care setting. No studies measuring attitudes toward organ donor advocacy existed before 2011, when the 51-item Swedish “Attitudes Toward Organ Donor Advocacy Scale” was developed. The aim of this study was to translate, adapt and establish the psychometric properties of the North American version of the Flodén ATODAI (Attitudes Toward Organ Donor Advocacy Instrument) in terms of validity and reliability. Methods: A multi-step approach was used: Initial translation; Back-translation; Review and synthesis of these translations; Expert panel (N=7) rated the prefinal version of the instrument for content validity index (CVI); International panel made adjustments guided by the expert panel. Reliability testing with test and retest of the adjusted 46-item version was conducted using intraclass correlation coefficient (ICC), weighted kappa (ҡ Weight), sign test, and Cronbach’s alpha coefficient (α), (N=50); and finally Delphi technique procedure with a preselected Delphi panel (N=15).Results: The CVI was determined to be greater than the 0.05 significance level. Item level (I-CVI) ranged 0.82-1.0, with a mean of 0.97. Scale level (S-CVI) on the entire instrument was 0.97. Test-retest procedure was performed to estimate stability. In total, 34 of the items had good-to-high ICC. Accepting an ICC of >0.70 resulted in a total of 24 items. Homogeneity reliability was estimated by α and was calculated for these items where α=0.90. In total, 20 of the items had a substantial or almost perfect ҡ Weight and 23 showed a moderate ҡ Weight. None of the items showed systematical differences. The Delphi technique procedure was used on the 22 items with ICC <0.70 resulted in adjustments establishing that consensus was achieved.Conclusions: Undertaking this multi-step, cross-cultural adaptation procedure has effectively ensured that the 46-item Flodén ATODAI [North America version] produces valid and reliable measurements.
The construction of a conceptual framework explaining the relation between barriers to change of management of neuropsychiatric symptoms in nursing homes: a qualitative study using focus groups
Authors: Teunenbroek Charlotte Frederike van , Verhagen Kim , Smalbrugge Martin , Persoon Anke , Zuidema Sytse U. , Gerritsen Debby L. 
Published: May 2020

Abstract
Background. Several efforts have been made to change management of neuropsychiatric symptoms (NPS) in nursing homes, however only few were successful. Numerous barriers to change in healthcare were identified, yet only one conceptual model is known to study their interrelationships . Unfortunately, this model does not discuss specific barriers encountered in nursing home practice. The aim of this study is to explore perceived barriers to change in the management of NPS in nursing homes and to construct a conceptual framework providing insight into the relative importance and interrelationships of these barriers when improving quality of care.Methods. Four focus groups were conducted in different dementia special care units of one Dutch nursing home. Participants were either nursing staff, treatment staff or relatives of residents. Qualitative thematic analysis was conducted according to the five phases defined by Braun & Clarke. Finally, a conceptual framework showing the interrelations of barrier-themes was constructed using text fragments of the focus groups. Results. We constructed a conceptual framework consisting of eight themes of barriers explaining the extent to which change in NPS-management can be achieved: 'organizational barriers', 'personal barriers', 'deficiency of staff knowledge', 'suboptimal communication', 'inadequate (multidisciplinary) collaboration', 'disorganization of processes', 'reactive coping' and 'differences in perception'. Addressing 'organizational barriers' and 'deficiency of staff knowledge' is a precondition for change. 'Suboptimal communication' and 'inadequate (multidisciplinary) collaboration' play a key role in the extent of change achieved via the themes 'differences in perception' and 'disorganization of processes'. Furthermore, 'personal barriers' influence all themes - except 'organizational barriers' - and may cause 'reactive coping', which in turn may lead to 'difficulties to structure processes'. Conclusions. A conceptual framework was created explaining the relationships between barriers towards achieving change focused on improving management of NPS in nursing homes. After this framework has been confirmed and refined in additional research, it can be used to study the interrelatedness of barriers to change, and to determine the importance of addressing them for achieving change in the provided care.
Anti-Müllerian hormone predictive levels to determine the likelihood of ovarian hyper-response in infertile women with polycystic ovarian morphology
Authors: Sene Azadeh Akbari , Ashrafi Mahnaz , Alaghmand-Fard Nasim , Mohammadi Neda , Alisaraie Mona Mortezapour , Alizadeh Ahad 
Published: May 2020

Abstract
The authors have withdrawn this preprint due to author disagreement.
Development of the “POP” scoring system for predicting obstetric and gynecological diseases in the emergency department: A retrospective cohort study
Authors: OKADA ASAMI , Okada Yohei , Fujita Hiroyuki , Iiduka Ryoji 
Published: May 2020

Abstract
Background: Obstetric and gynecological (OBGY) diseases are among the most important differential diagnoses for young women with acute abdominal pain. However, there are few established clinical prediction rules for screening OBGY diseases in emergency departments (EDs). This study aimed to develop a prediction model for diagnosing OBGY diseases in the ED.Methods: This single-center retrospective cohort study included female patients with acute abdominal pain who presented to our ED. We developed a logistic regression model for predicting OBGY diseases and assessed its diagnostic ability. This study included young female patients aged between 16 and 49 years who had abdominal pain and were examined at the ED between April 2017 and March 2018. Trauma patients and patients who were referred from other hospitals or from the OBGY department of our hospital were excluded.Results: Out of 27,991 patients, 740 were included. Sixty-five patients were diagnosed with OBGY diseases (8.8%). The "POP" scoring system (past history of OBGY diseases +1, no other symptoms +1, and peritoneal irritation signs +1) was developed. Cut-off values set between 0 and 1 points, sensitivity at 0.97, specificity at 0.39, and negative likelihood ratio (LR-) of 0.1 (95% CI: 0.02-0.31) were considered to rule-out, while cut-off values set between 2 and 3 points, sensitivity at 0.23 (95% CI 0.13-0.33), specificity at 0.99 (95% CI 0.98-1.00), and positive likelihood ratio (LR+) of 17.30 (95% CI: 7.88-37.99) were considered to rule-in.Conclusions: Our "POP" scoring system may be useful for screening OBGY diseases in the ED. Further research is necessary to assess the predictive performance and external validity of different data sets.
GC×GC-HRMS nontarget fingerprinting of organic micropollutants in urban freshwater sediments
Authors: Lübeck Josephine Susanne , Alexandrino Guilherme Lionello , Christensen Jan H 
Published: May 2020

Abstract
Background Sediments are sinks for organic micropollutants, which are traditionally analysed by gas chromatography-mass spectrometry (GC-MS). Although GC-MS and GC-MS/MS (tandem MS) are preferred for target screening, they provide only limited chromatographic resolution for nontarget screening. In this study, a comprehensive two-dimensional GC-high-resolution MS method (GC×GC-HRMS) was developed for nontarget screening and source identification of organic micropollutants in sediments from an urban lake and channel in Copenhagen, Denmark. The GC×GC-HRMS data were processed by pixel-based chemometric analysis using baseline subtraction, alignment, normalisation, and scaling before principal component analysis (PCA) of the pre-processed GC×GC-HRMS base peak ion chromatograms (BPCs). The analysis was performed to identify organic micropollutants of high abundance and relevance in the urban sediments, to identify pollution sources. Tentative identifications were based on match factors and retention indices and tagged according to the level of identification confidence. Results The channel contained both significantly higher concentrations of micropollutants and a higher diversity of compounds compared to the lake. The PCA models were able to isolate distinct sources of chemicals such as a natural input (viz. a high relative abundance of mono-, di- and sesquiterpenes) and a weathered oil fingerprint (viz. alkanes, naphthenes and alkylated polycyclic aromatic hydrocarbons). A dilution effect of the weathered oil fingerprint was observed in lake samples that were close to the channel. Several benzothiazole-like structures were identified in lake samples close to a high-traffic road which could indicate a significant input from asphalt or tire wear particles. Conclusions Several chemical fingerprints of different sources were described in urban freshwater sediments in Copenhagen using a pixel-based chemometric approach of GC×GC-HRMS chromatograms. Various micropollutants of anthropogenic origin were identified. Tailored pre-processing and careful interpretation of the identification results is inevitable and still requires further research for an automated workflow.
Medicinal plant use practice in four ethnic communities (Gurage, Mareqo, Qebena and Silti), South Central Ethiopia
Authors: Teka Alemtshay , Asfaw Zemede , Demissew Sebsebe , Damme Patrick Van 
Published: May 2020

Abstract
Background: Ethnic groups throughout the world have developed their own cultures expressed in the form of customs, taboos and traditional healthcare systems. Traditional medicine system is one of the widespread cultures known throughout the world which is very much tied to cultural practices of the community or ethnic group. Medicinal plant treasure found in Gurage and Silti Zones remained poorly characterized and understood. Therefore, this study was conducted in four ethnic groups: three from Gurage zone (Gurage, Qebena and Mareqo) and one from Silti zone (Silti) which have lived in close proximity and contact for many centuries in the respective Zones. In the present study unique and shared cultural elements in connection to traditional herbal medicine were examined through investigation of the diversity of medicinal plants. Moreover, attempts have been made to determine similarities among the society in the medicinal plants they have used in general and in medicinal plant species considered culturally most important.Methods: In a study that involved 320 randomly sampled informants semi-structured interviews, focus group discussions, participant observation were used and qualitative and quantitative data were collected. Descriptive statistics, rank order priority (ROP), informant consensus factor, jaccard similarity coefficient and clustering were used for data analysis. Results: A total of 244 medicinal plant species and a fungal species used to treat human and/or livestock ailments were documented. The number of plants (80 plants, 33 %) with ROP value greater than 50% is considerably smaller than that of plants with ROP < 50% (164, 67 %). Jaccard similarity index and clustering analysis for all cited plants, among the respective studied districts, indicated that grouping generally followed the existing ethnic origin. On the contrary, clustering based on culturally important medicinal plant species (80 plant species, score ROP ≥ 50%) showed the influence of proximity and geographical orientation rather than ethnic relation. Conclusions: Culturally most important plants (80 spp.) are widely used and best shared with nearby communities and this could imply current (new) knowledge being practiced in the community. This knowledge must be documented and better utilized in a modern way including modernized use of traditional medicinal plants.
Physiological Effects of the Combined Stresses of Freezing-thawing, Acid Precipitation and Deicing Salt on Alfalfa Seedlings
Authors: Bao Guozhang , Tang Wenyi , An Qirui , Liu Yaoxin , Tian Jiaqi , Zhao Nan , Zhu Saning 
Published: May 2020

Abstract
Background: Frequent freeze-thaw phenomena, together with widely used deicing salt and intense acid precipitation, often occur in northeastern China, causing damage to various aspects of plants, such as the permeability of biological membranes, osmotic adjustment, and photosystems. Aiming to explore the resistance of alfalfa to freezing-thawing (F), acid precipitation (A) and deicing salt (D), this study used Medicago sativa cv. Dongmu-70 as the experimental material, and the contents of malondialdehyde (MDA), soluble protein, soluble sugars, proline and chlorophyll were evaluated.Results: As the temperature decreased, the MDA content in the seedlings of the group under combined stress (A-D-F) increased and was significantly higher than that of group F (by 69.48~136.40%). Compared with those in the control (CK) group, osmotic substances such as soluble sugars and proline in the treatment groups were higher, while the soluble protein content was lower. The chlorophyll contents in the seedlings of the treatment groups were lower than those of the CK group; however, the chlorophyll content displayed a non-significant change during the free-thaw cycle.Conclusion: Injury to the permeability of the biological membranes and photosystems of alfalfa results from stress. Moreover, alfalfa maintains osmotic balance by adaptively increasing the potential of osmotic substances such as soluble sugars and proline. Furthermore, the influence of stress from freezing-thawing and deicing salt is highly substantial, but the combined stresses of acid precipitation with the two factors mentioned above had little effect on the plants.
Misconceptions about transmission, symptoms and prevention of HIV/AIDS among adolescents in Ebonyi state, South-east Nigeria
Authors: Agu Ifunanya Clara , Mbachu Chinyere Ojiugo , Okeke Chinyere , Eze Irene , Agu Chibuike , Ezenwaka Uchenna , Ezumah Nkoli , Onwujekwe Obinna 
Published: May 2020

Abstract
Objectives: Nigeria has the second largest number of adolescents and young people living with HIV/AIDS in the world. Misconceptions about HIV/AIDS contribute to spread of HIV, and constrain uptake of preventive services. This paper explored misconceptions about HIV/AIDS among adolescents in south-east Nigeria. A qualitative study was conducted in six urban and rural local government areas of Ebonyi state. Data were collected through twelve focus group discussions (FGD) with unmarried adolescents aged 13-18 who were either attending school or out-of-school. The FGDs were conducted using a pre-tested topic guide. Data were coded manually and analyzed using a thematic framework approach.Results: There are persistent misconceptions about transmission of HIV/AIDS through mosquito bites and sharing of personal belongings. Some adolescents had inaccurate notions that a HIV infected person could be identified through changes in physical features such as abdominal swelling and longer fingernails. A few of them also reported that HIV could be treated with antibiotics. These misconceptions were expressed by both male and female adolescents. Adolescents have some mistaken beliefs about HIV/AIDS which constrain them from taking necessary preventive measures. Hence, the need to target adolescents with health education interventions on HIV/AIDS.
The Relationship between Personality Dimensions, Spirituality, Coping Strategies and Clinical Clerkship Satisfaction among Intern Nursing Students: A Cross-sectional Study
Authors: Rezapour-Mirsaleh Yasser , Aghabagheri Mahdi 
Published: May 2020

Abstract
Background: The clinical clerkship is a crucial stage in nursing training and dissatisfaction at this stage may cause a nurse quit in future. This study aimed to evaluate the relationship among personality dimensions, spirituality, coping strategies and clinical clerkship satisfaction in intern nursing students. Methods: This was a correlational, cross-sectional study. A total of 293 participants were selected using cluster random sampling. All participants were provided with standard questionnaires including personality dimensions (NEO_FFI), spirituality, coping strategies (WoCQ), and satisfaction with clinical clerkship. Data analyzed using Pearson correlation and hierarchical multiple regression.Results: The results showed that spirituality, problem-focused coping and extraversion (of personality dimensions) played a significant role in predicting clinical clerkship satisfaction among intern nursing students (p<.01). Regression analysis showed openness, extraversion, and spirituality could significantly predict problem-focused coping style in intern nursing students (p<.05). However, personality dimensions and spirituality were not good predictors for emotion-focused coping among intern nursing students.Conclusion: Personality dimensions, coping strategies and, in particular, spirituality are good predictors of clinical clerkship satisfaction among intern nursing students.
Smoking is associated with pneumonia development in lung cancer patients
Authors: Heo Jung Won , Yeo Chang Dong , Park Chan Kwon , Kim Sung Kyoung , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kang Hye Seon 
Published: May 2020

Abstract
Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019­–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.