bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Framework for Design of Conversational Agents to Support Health Self-Care for Older Adults
Authors: Morrow Daniel G. , Lane H. Chad , Rogers Wendy A. 
Published: October 2020

Objective We examined the potential of conversational agents (CAs) to support older adults’ self-care related to chronic illness in light of lessons learned from decades of pedagogical agent research, which investigates the impact and efficacy of CAs for a wide range of learners. Background The role of CAs in education (i.e., pedagogical agents) has been long studied, but their potential for supporting self-care has received less attention, especially for older adults. Methods We reviewed work on pedagogical agents and considered how it informs the design of CAs for older adults. We propose a framework for designing CAs to support older adult self-care, which organizes a review of work in this area and integration with the pedagogical agent literature. Results Our review of the pedagogical agent literature revealed an evolution from teaching machines to interactive, social systems that influence student motivational as well as learning outcomes. To integrate this review with work on CAs and self-care, we developed a framework that specifies how self-care goals evolve with stages of an illness, communication goals that support self-care at each stage, patient needs, and requirements for CAs to support these needs. The review identified an agenda for future research on CA functions and features that help older adults accept need for self-care, establish self-care, and sustain self-care over time. Conclusions Integrating insights from the pedagogical agent literature with research on developing CAs for self-care defines an agenda for developing and evaluating CAs to help older adults manage illness.
Tactile Vigilance Is Stressful and Demanding
Authors: DeLucia Patricia R. , Greenlee Eric T. 
Published: October 2020

Objective The primary aims of the study were to replicate the vigilance decrement in the tactile modality, examine whether a decrease in sensitivity is associated with the decrement, and determine whether tactile vigilance is stressful and demanding. Background When people monitor occasional and unpredictable signals for sustained durations, they experience a decline in performance known as the vigilance decrement, which has important practical consequences. Prior studies of the vigilance decrement focused primarily on visual vigilance and, to a lesser degree, on auditory vigilance. There are relatively few studies of tactile vigilance. Method Participants monitored vibrotactile stimuli that were created from a tactor, for 40 min. Results Sensitivity declined, self-report ratings of distress increased, and ratings of task engagement decreased, during the vigil, and perceived workload was moderately high. Conclusion Monitoring tactile signals is demanding and stressful and results in a decrement in signal detection. Application Monitoring tactile signals may result in a decrement in tasks requiring discrimination, such as monitoring lane position with the use of rumble strips; these require discrimination between current road vibration and increased vibration when the car drifts out of its lane and crosses over the strip.
Quality of Life After Thyroidectomy for Hashimoto Disease in Patients With Persistent Symptoms
Authors: Thatipamala Priyanka , Noel Julia E. , Orloff Lisa 
Published: October 2020

Objectives: To determine whether thyroidectomy improves quality of life in patients with Hashimoto thyroiditis with persistent symptoms despite biochemical euthyroidism. Methods: A retrospective cohort study was conducted of patients undergoing thyroidectomy for Hashimoto thyroiditis at our institution between 2014 and 2018. The following variables were collected: age, race, body mass index, preoperative symptoms, preoperative thyroid peroxidase antibody titer, thyroglobulin antibody titer, thyroid-stimulating hormone, free thyroxine, specimen weight, and histologic presence of thyroiditis. Outcomes included general health score on the Short Form 36 (SF-36) Health and responses to a questionnaire addressing postoperative disease management. Results: A total of 19 patients were included in the study, 18 of whom were female with a mean age of 48 years. The majority of patients were Caucasian. There were no significant differences between the postoperative general health scores of the patients with Hashimoto thyroiditis and scores from a healthy control population (66.9 vs 74.1; 95% CI: −16.9 to +2.5, P = .16). There were also no differences between groups within the 7 SF-36 subscores. Elevation in preoperative thyroperoxidase antibody correlated with lower reported postoperative energy levels ( r = −0.63, P = .016) and emotional well-being ( r = −.55, P = .041); 87.5% of respondents reported being moderately or extremely happy with their decision to proceed with surgery. Conclusions: Quality of life in patients with Hashimoto thyroiditis who undergo thyroidectomy is equivalent to the general population, and the majority are satisfied with surgery. Thyroidectomy is a consideration for patients with persistent symptoms despite optimization on medical therapy.
A Retrospective Study of Lymph Node Yield in Lateral Neck Dissection for Papillary Thyroid Carcinoma
Authors: Issa Khalil , Stevens Madelyn N. , Sun Yuhui , Thomas Samantha , Collins Alissa , Cohen Jonathan , Esclamado Ramon M. , Rocke Daniel J. 
Published: October 2020

Objective: Lateral neck dissection (LND) is important in managing papillary thyroid carcinomas (PTCs). This study aimed to evaluate the relationship between lymph node yield (LNY) for LND and patient outcomes, specifically postoperative serum thyroglobulin levels (sTG) and radioiodine uptake on thyroid scan, and to estimate a threshold LNY to signify adequate LND. Methods: Patients diagnosed with PTC who underwent LND from 2006 to 2015 at a single institution were included. Linear regression with restricted cubic splines was used to characterize the association of LNY with outcomes. Outcomes were log-transformed to achieve a more symmetric distribution prior to regression. For nonlinear associations, a Monte Carlo Markov Chain procedure was used to estimate a threshold LNY associated with postoperative outcome. This threshold was then used to define high LNY versus low LNY in the subsequent analyses. Results: In total, 107 adult patients were included. There was a significant relationship between LNY and postoperative sTG level ( P = .004), but not radioiodine uptake ( P = .64). An LNY of 42.96 was identified, which was associated with the maximum change in sTG level. No association was found between LNY groups (LNY ≥ 43 vs < 43) and radioiodine uptake, risk of complication, or longer operative times (all P > .05). High LNY was associated with a decrease in log(sTG) (estimate = −1.855, P = .03), indicating that adequacy of LND is associated with an 84.4% decrease in sTG. Conclusion: These results suggest an association between LNY and postoperative sTG level, with an estimated threshold of 43 nodes. This has implications for adequate therapeutic LND; additional work is needed to validate thresholds for clinical practice.
Accuracy of resting metabolic rate prediction equations among healthy adults in Trinidad and Tobago
Authors: Nichols Selby , George Dennora , Prout Patrice , Dalrymple Nequesha 
Published: October 2020

Background: Over 50% of adults in Latin America and the Caribbean have a body mass index (BMI) ≥ 25 suggesting excess energy intakes relative to energy expenditure. Accurate estimation of resting metabolic rate (RMR), the largest component of total energy requirements, is crucial to strategies aimed at reducing the prevalence and incidence of overweight and obesity. Aim: We evaluated the accuracies of established and locally developed RMR prediction equations (RMRP) among adults. Methods: Four hundred adult volunteers ages 20 to 65 years had RMR measured (RMRM) with a MedGem® indirect calorimeter according to recommended procedures. RMRP were compared to RMRM with values ± 10% of RMRM deemed accurate. Anthropometry was measured using standard procedure. Linear regression with bootstrap analyses was used to develop local RMRP equations based on anthropometric and demographic variables. The University of the West Indies Ethics Committee approved the study. Results: Males had higher mean absolute RMR ( p < 0.001) but similar mean age-adjusted measured RMR per kg of body (20.9 vs. 21.5 kcals/day; p = 0.1) to females. The top performing established anthropometry-based RMRP among participants by sex, physical activity (PA) level and BMI status subgroups were Mifflin-St Jeor, Owen, Korth, Harris–Benedict, and Livingston, while Johnstone, Cunningham, Müller (body composition (BC)), Katch and McArdle, Mifflin-St Jeor (BC) were the most accurate BC-based RMRP. Locally developed RMRP had accuracies comparable to their top-ranked established RMRP counterparts. Conclusions: Accuracies of established RMRP depended on habitual PA level, BMI status, BC and sex. Furthermore, locally developed RMRP provide useful alternatives to established RMRP.
Investigating Patient Trust in Doctors: A Cross-Sectional Survey of Out-Patient Departments in Fiji
Authors: Chandra Swastika , Ward Paul , Mohammadnezhad Masoud 
Published: October 2020

Background Despite evidence on the positive impact of trust in a doctor-patient relationship on health outcomes, there are limited studies conducted in Pacific Island Countries including Fiji. This study was conducted to assess the current level of patient trust in doctors and investigate its determinants in Fiji. Method: A random sample of 410 participants attending the outpatient services completed the self-administered structured questionnaire. The response rate was 91% (N=375) and data was analyzed using descriptive statistics and analytic analysis using logistic regression. Result: Mean age of participants was 38years (±15yrs). The majority of patients had partial trust in their doctors compared to full trust (61.6% vs 38.4%). More than half of the participants perceived doctor’s communication behavior as fair rather than good (53.6% vs 45.6%). Those over 50 years (OR 1.96; p=0.007, 95% CI: 1.198–3.226) and those who perceived doctors’ communication behavior as good (OR 8.48; p=0.0001, 95% CI: 5.257–13.709) were significantly more likely to have full trust in the doctors. Conclusion: This study reveals that age and communication are determinants of trust in Fiji. In view of the current perception of the doctors’ communication behavior, Fiji’s Ministry of Health and Medical Services should implement policies to give equal importance to the communication skills of the doctors together with their clinical skills and enforce it in the medical schools.
Depressive disorders in the Arabian Gulf Cooperation Council countries: a literature review
Authors: Alzahrani Owiss 
Published: October 2020

Objective To determine the contributions from the six Arabian Gulf Cooperation Council (GCC) countries to the national scientific literature on depressive disorders. Methods This literature review identified all of the published studies on all major depressive disorders as cited on the PubMed® and APA PsycInfo® databases from inception to 31 December 2016 from the six GGC countries. Data were extracted using a standardized form. The study compared the volume of research production between the countries by calculating an index that allowed for the country population size. Results A total of 28 studies met the inclusion criteria. Saudi Arabia headed the list of publications (10 articles) followed by the United Arab Emirates ( n = 6), Kuwait ( n = 5), Qatar ( n = 3); and Bahrain and Oman produced two articles each. Only six out of the 28 (21.4%) studies included a random sample or adopted good sampling strategies. The majority of studies (24 of 28; 85.7%) were cross-sectional in design. Only one study clearly stated the use of the DSM-4 criteria for diagnosis. Conclusion The scientific literature published by the GCC countries on depressive disorders is scant and lacking scientific depth. These findings should be considered as a wake-up call for public health researchers, mental health workers and policymakers.
Fucoxanthin may inhibit cervical cancer cell proliferation via downregulation of HIST1H3D
Authors: Ye Guoliu , Wang Lingling , Yang Kang , Wang Caizhi 
Published: October 2020

Objective To investigate the role of fucoxanthin, reported to have significant anticancer effects, and histone Cluster 1 H3 Family Member D (HIST1H3D; implicated in tumorigenesis) in cervical cancer. Methods The half maximal inhibitory concentration (IC50) of fucoxanthin against HeLa and SiHa cervical cancer cells was determined. Differentially expressed genes (DEGs) in SiHa cells treated with IC50 fucoxanthin were screened by high-throughput techniques and subjected to signal enrichment. Following identification of HIST1H3D as a candidate gene, HIST1H3D-knockdown models were created via transfection with a short hairpin HIST1H3D payload. Impacts on cell proliferation, cell-cycle distribution, colony formation, and apoptosis were studied. Results The fucoxanthin IC50 was 1 445 and 1 641 µM (Hela and SiHa cells, respectively). Chip results revealed 2 255 DEGs, including 943 upregulated and 1 312 downregulated genes, in fucoxanthin-treated versus untreated SiHa cells. Disease and function analysis indicated that these DEGs are primarily associated with cancer and organismal injuries and abnormalities, and online integrated pathway analysis showed that the DEGs were mainly enriched in p53 signalling. HIST1H3D was significantly downregulated in response to fucoxanthin. Inhibition of HIST1H3D mRNA significantly reduced cell proliferation and colony formation, significantly augmented the percentage of apoptotic HeLa and SiHa cells, and cells were arrested in G0/G1 cell cycle phase. Conclusion The results suggest that HIST1H3D may be an oncogene in cervical carcinogenesis and a potential fucoxanthin target in treating cervical cancer.
Pain perception in women with menstrually-related migraine
Authors: Linstra Katie M , Ibrahimi Khatera , van Casteren Daphne S , Wermer Marieke JH , Terwindt Gisela M , MaassenVanDenBrink Antoinette 
Published: October 2020

Background Cyclic hormonal fluctuations influence migraine incidence and severity. Previously, we described reduced menstrual cyclicity in estradiol levels and dermal blood flow reaction to capsaicin in female migraineurs. It is unclear whether pain perception in women with migraine is influenced by the menstrual cycle. Methods Women with menstrually-related migraine (n = 14), healthy age-matched controls (n = 10) and postmenopausal women (n = 15) were asked to grade trigeminal and non-trigeminal painful stimuli on a numeric pain rating scale on menstrual cycle day 19–21 (mid-luteal) and day 1–2 (early follicular). Results In women with menstrually-related migraine, trigeminal pain remained low throughout the cycle. Controls showed increased trigeminal pain during the mid-luteal phase compared to the early follicular phase. Changes throughout the cycle were significantly different between women with MRM and controls. Conclusion The compromised menstrual cyclicity of pain perception in women with menstrually-related migraine parallels our earlier findings on estradiol levels and dermal blood flow.
Clinical characteristics of pre-attack symptoms in cluster headache: A large series of Korean patients
Authors: Cho Soohyun , Cho Soo-Jin , Lee Mi Ji , Park Jeong Wook , Chu Min Kyung , Moon Heui-Soo , Chung Pil-Wook , Sohn Jong-Hee , Kim Byung-Su , Kim Daeyoung , Kim Jae-Moon , Chung Jae Myun , Oh Kyungmi , Ahn Jin-Young , Chung Chin-Sang , Kim Byung-Kun 
Published: October 2020

Background Previous studies have reported notable differences in demographic and clinical features of cluster headache between Western and Asian populations, including lower prevalence of the chronic type and in women. Recently, prodromal symptoms of migraine and pre-attack symptoms of cluster headache have drawn attention regarding their potential pathophysiological implications and pre-emptive treatment. However, pre-attack symptoms of cluster headache have not been studied in the Asian population. Methods A total of 136 patients with cluster headache (21 first-onset, 110 episodic, and five chronic cases) were recruited in this multi-center study between October 2018 and December 2019. We evaluated the characteristics of pre-attack symptoms in a current bout using a structured questionnaire. Univariable and multivariable logistic regression analyses were performed to evaluate the factors associated with presence of pre-attack symptoms. Results Pre-attack symptoms were reported in 71.3% of our patients with cluster headache. When present, pre-attack symptoms occurred at a median of 20 minutes (range 1–120) before the attack. The prevalence of local and painful, local and painless sensory, autonomic, and general symptoms was 58.8%, 14.7%, 11.0%, and 30.1%, respectively. Multivariable logistic regression analysis revealed that higher number of bouts was associated with higher prevalence of pre-attack symptoms (OR = 1.464, p = 0.044). Conclusions Pre-attack symptoms were frequently observed in Korean patients with cluster headache, which was consistent with previous Western studies.
Characterization of autoantibodies and cytokines related to cutaneous lupus erythematosus
Authors: Hu Feng-qiu , Zhang Yu-ping , Yin Jing , Tang Zeng-qi , Han Yan-fang , Shi Zhen-rui , Tan Guo-zhen , Wang Liangchun 
Published: October 2020

Objective To investigate the profiles of anti-RPLP0, anti-galectin3 antibodies, interferon-α (IFN-α), interferon-λ1(IFN-λ1) and interleukin-17A/F(IL-17A/F) in the subtypes of cutaneous lupus erythematosus (CLE) including acute CLE (ACLE), subacute CLE (SCLE) and discoid lupus erythematosus (DLE). Methods Serum levels of autoantibodies and cytokines were determined by enzyme-linked immunoabsorbent assay (ELISA). Lupus lesions were evaluated by cutaneous lupus erythematosus disease area and severity index (CLASI). Results Serum anti-RPLP0, anti-galectin3 antibodies and IFN-λ1 were higher in systemic lupus erythematosus (SLE) patients with skin lesions than those without skin lesions, compared to healthy controls. IFN-α, IL-17A and IL-17F was elevated in all patients regardless of skin lesions. The two antibodies, IFN-α and IL-17A were positively correlated with the CLASI score in all patients with CLE. In addition, serum IL-17A was positively correlated to the CLASI score of ACLE, SCLE and DLE, while anti-RPLP0 and anti-galectin3 antibodies were only correlated to the score of SCLE and IL-17F to DLE. Conclusion Serum anti-RPLP0, anti-galectin3 antibodies, IFN-α, IFN-λ1 and IL-17A/F are associated with the occurrence of lupus skin lesions regardless of the systemic complications, whereas the profiles of these inflammatory mediators vary with the subtypes of lupus skin lesions.
Attitudes of Front-Line Nurses Toward Hospice Care During the COVID-19 Pandemic
Authors: Liu Qinghua , Tao Jing , Gao Lianlian , He Xifei , Wang Yuping , Xia Wenlin , Huang Lihong 
Published: October 2020

Objective: The aim of this study was to understand the attitudes of front-line clinical nurses toward hospice care in the fight against the COVID-19 pandemic, to provide a source of reference for hospice care education and training in hospitals treating patients with COVID-19. Method: Front-line nurses from a designated COVID-19 hospital in Wuhan, China, participated. Participants completed the Chinese versions of the General Information Questionnaire, the Frommelt Attitudes Toward Care of the Dying Scale, the Jefferson Scale of Empathy, and the General Self-Efficacy Scale. Results: A total of 149 questionnaires were included in the analysis. The median total hospice care attitudes score was median 102.00(interquartile range, 95.5-120.50). The nurses’ attitudes toward hospice care were significantly associated with their age, knowledge of hospice care, level of empathy, and self-efficacy. Conclusion: The attitudes of front-line nurses toward hospice care need to be improved. Hospital departments should establish an effective public health emergency strategy, provide training to increase front-line nurses’ knowledge and practical experience of hospice care, cultivate nurses’ empathy, and enhance their sense of self-efficacy, in order to improve the quality of hospice care for patients and their families.
Temozolomide-induced aplastic anaemia: Case report and review of the literature
Authors: Gilbar Peter J , Pokharel Khageshwor , Mangos Hilda M 
Published: October 2020

Introduction Temozolomide (TMZ) is an oral alkylating agent principally indicated for neurological malignancies including glioblastoma (GBM) and astrocytoma. Most common side effects are mild to moderate, and include fatigue, nausea, vomiting, thrombocytopenia and neutropenia. Severe or prolonged myelosuppression, causing delayed treatment or discontinuation, is uncommon. Major haematological adverse effects such as myelodysplastic syndrome or aplastic anaemia (AA) have rarely been reported. Case report We report a 68-year old female with GBM treated at a tertiary hospital with short-course radiotherapy and concurrent temozolomide following craniotomy. On treatment completion she was transferred to our hospital for rehabilitation. She was thrombocytopenic on admission. Platelets continued falling with significant pancytopenia developing over the next two weeks. Blood parameters and a markedly hypocellular bone marrow confirmed the diagnosis of very severe AA, probably due to TMZ. Management and outcome Treatment consisted of repeated platelet transfusions, intravenous antibiotics, antiviral and antifungal prophylaxis, and G-CSF 300 mcg daily. Platelet and neutrophil counts had returned to normal at 38 days following the completion of TMZ treatment. Discussion Whilst most cases of AA are idiopathic, a careful drug, occupational exposure and family history should be obtained, as acquired AA may result from viruses, chemical exposure, radiation and medications. Temozolomide-induced AA is well documented, though only 12 cases have been described in detail. Other potential causes were eliminated in our patient. Physicians should be aware of this rare and potentially fatal toxicity when prescribing. Frequent blood tests should be performed, during and following TMZ treatment, to enable early detection.