bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased P450 aromatase levels in post-menopausal women after acute ischemic stroke
Authors: Manwani Bharti , Fall Pamela , Zhu Liang , O’Reilly Meaghan Roy , Conway Sarah , Staff Ilene , McCullough Louise D. 
Published: December 2020

Abstract
Background: Sex differences in stroke have been attributed to the neuroprotective effects of estrogen, yet most clinical trials of estrogen supplementation for stroke prevention have failed. The contribution of sex hormones to stroke outcome remains a subject of debate. Aromatization of testosterone to estradiol in neural tissue leads to sexual differentiation. Emerging data suggests aromatase activity increases in response to brain injury, and increased aromatase expression is seen in the ischemic penumbra in animal models. The objective of this study was to examine the levels of endogenous sex steroids after acute ischemic stroke and determine if levels of sex steroids were associated with acute stroke outcomes. Methods: Peripheral blood from ischemic stroke patients and controls was collected under an approved IRB within 24 hours of symptom onset. 17-β estradiol, testosterone and aromatase levels were measured in the serum of both men and women using ELISA. Hormone levels were compared in men vs. women in stroke and control groups and correlated with outcomes (NIHSS and change in the modified Rankin Scale (mRS), defined as difference of premorbid and discharge mRS) using multivariate regression. Results: We found no significant change in estradiol levels 24 hours after stroke in men (p=0.86) or women (p=0.10). In men, testosterone significantly decreased after stroke as compared with controls (1.83±0.12 vs 2.86±0.65, p=0.01). Aromatase levels were significantly higher in women after stroke as compared with controls (2.27±0.22 vs 0.97±0.22, p=0.002), but not in men (p=0.84). Estradiol levels positively correlated with change in mRS in both women (r=0.38, p=0.02) and men (r=0.3, p=0.04).Conclusions: Estradiol levels correlated with functional outcomes (change in mRS) in both men and women, at least in the acute phase (24 hours) of stroke. However, no significant change in estradiol levels is seen 24 hours post stroke in men or women. Testosterone levels decrease at 24 hours after stroke in men. As seen in animal models, aromatase levels increase after acute ischemic stroke, but this was only true for women. These indicate an active aromatization process in post-menopausal women after acute ischemic stroke.
Comparison of Risk Allele Frequencies of Single Nucleotide Polymorphisms Associated With Age-Related Macular Degeneration in Different Ethnic Groups
Authors: Shin Hyun-Tae , Yoon Byung Woo , SEO JEHYUN 
Published: December 2020

Abstract
Background: The prevalence of age-related macular degeneration (AMD) varies from 6.8% to 18.3% for all forms of AMD and from 0.6% to 2.6% for late AMD according to race, suggesting the existence of genetic differences among races. The purpose of this study was to determine the genetic causes of differences in the prevalence of AMD among individuals of different races.Methods: We collected 138 AMD-associated single nucleotide polymorphisms (SNPs) from a genome-wide association studies catalog. Their population-level allele frequencies were derived based on the 1000 Genomes Project and Korean Reference Genome Database. We used Fisher’s exact tests to assess whether the effect allele at a given SNP was significantly enriched or depleted in the database.Results: European, American, and South Asian populations showed similar heatmap patterns, whereas East Asian, and Korean populations had distinct patterns. Korean populations exhibited patterns that were different from those of the other groups; rs5754227 (SYN3), rs1626340 (TGFBR1/COL15A1), rs3750846(ARMS2/HTRA1), and rs9564692 (B3GALTL) were enriched, whereas rs2230199 (C3) and rs73036519 (EXOC3L2/MARK4) were depleted in Koreans; these SNPs are associated with late AMD. The genetic risk score calculated from allele frequencies was not less in East Asians than in Europeans.Conclusion: The prevalence of AMD is lower in Asians than in Europeans. However, our study showed that genetic risk scores in East Asians were similar to those in Europeans, which may explain why the global projected number of people with AMD by 2040 is in largest for East Asians, including Koreans.
Social Justice in Health System; a Neglected Component of Academic Nursing Education: A Qualitative Study
Authors: Habibzadeh Hosein , Jasemi Madineh , Hosseinzadegan Fariba 
Published: December 2020

Abstract
Background: In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the main factors for teaching the concept of social justice in the nursing curriculum.Method: This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data.Results: Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education.Conclusion: Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators, specially training in the area of ethical ideology and social justice.
Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China
Authors: Wu Ye , Zhang Zhen , Liao Meng , Li Qi , Tang XueLin , Liu Longqian 
Published: December 2020

Abstract
Background: To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population.Methods: One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33±4.60 years) were enrolled, the mean preoperative SE was −1.51±1.15 D (range: −1.00- −5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64±3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision.Results: No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P=0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P=0.094; BD: P=0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001). Conclusions: CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.
Clinical utility of liquid biopsy for EGFR driver, T790M mutation and EGFR amplification in plasma in patients with acquired resistance to afatinib
Authors: Oya Yuko , Yoshida Tatsuya , Asada Kazuhiro , Oguri Tetsuya , Inui Naoki , Morikawa Sayako , Ito Kentaro , Kimura Tomoki , Kunii Eiji , Matsui Takashi , Kubo Akihito , Kato Tatsuo , Abe Takashi , Tsuda Takeshi , Hida Toyoaki 
Published: December 2020

Abstract
Background: Cell-free DNA (cfDNA) genotyping in plasma using the cobas EGFR Mutation Test v2 (cobas) is the first liquid biopsy as a companion diagnosis to identify the EGFR T790M mutation (T790M) after the failure of treatment of EGFR-tyrosine kinase inhibitors (TKIs) (1st generation, gefitinib [G] and erlotinib [E] and 2nd generation, afatinib [A]). This study investigated the clinical utility of a liquid biopsy for patients who acquired resistance to afatinib.Methods: We prospectively collected plasma from 51 patients who had acquired resistance to afatinib between April 2015 and November 2016 to evaluate the frequency of T790M by cobas and digital droplet PCR (UMIN000025112). Additionally, we retrospectively reviewed 38 patients who tested by cobas in plasma after G/E failure to compare for T790M detection between A and with G/E.Results: The detection rate of EGFR-driver and T790M in plasma in patients treated with A (A group) as a first-line EGFR-TKI was lower than with G/E followed by A (G/E→A group), although the differences were not significant (EGFR-driver: 41% [A] vs. 67% [G/E→A], P=0.1867; and T790M: 8% [A] vs. 17% [G/E→A], P=0.5798). In first-line setting, the detection rate for EGFR-driver and T790M in plasma by cobas was lower in A group than in G/E group, although there was no significant difference (EGFR-driver: 34% [A] vs. 52% [G/E], P=0.2072; and T790M: 10% [A] vs. 27% [G/E], P=0.1161).Conclusion: The detection of EGFR-driver and T790M in plasma by cobas in patients treated with afatinib might be lower than with G/E in a real-world setting.
Impact of simulation-based teamwork training on COVID-19 distress in healthcare professionals
Authors: Beneria Anna , Arnedo Mireia , Contreras Sofia , Pérez-Carrasco Marcos , Garcia-Ruiz Itziar , Rodríguez-Carballeira Mónica , Raduà Joaquim , Bañeras Jordi 
Published: December 2020

Abstract
Context Non-technical skills such as leadership, communication, or situation awareness should lead to effective teamwork in a crisis. This study aimed to analyse the role of these skills in the emotional response of health professionals to the COVID-19 pandemic.Methods Before the COVID-19 outbreak, 48 doctors and 48 nurses participated in a simulation-based teamwork training program based on teaching non-technical skills through simulation. In May 2020, this group of professionals from a COVID-19 referral hospital was invited to participate in a survey exploring stress, anxiety, and depression, using the PSS-14 (Perceived Stress Scale) and the HADS (Hospital Anxiety and Depression Scale) measures. A control group that did not receive the training was included. We conducted a logistic regression to assess whether having attended a simulation-based teamwork training program modified the probability of presenting psychological distress (PSS-14>18 or HADS>12).Results A total of 141 healthcare professionals were included, 77 in the intervention group and 64 in the control group. Based on the PSS-14, 70.1% of the intervention group and 75% of the control group (p=0.342) had symptoms of stress. Having contact with COVID-19 patients [OR 4.16(1.64–10.52)]; having minors in charge [OR 2.75 (1.15–6.53)]; working as a doctor [0.39(0.16 – 0.95)], and being a woman [OR 2.94(1.09–7.91)] were related with PSS14 symptoms. Based on the HADS, 54.6% of the intervention group and 42.2% of the control group (p=0.346) had symptoms of anxiety or depression. Having contact with COVID-19 patients [OR 2.17(1.05 – 4.48)] and having minors in charge [OR 2.14(1.06 – 4.32)] were related to HADS symptoms. Healthcare professionals who attended COVID-19 patients showed higher levels of anxiety and depression [OR 2.56(1.03 – 6.36) (p=0.043)].Conclusion Healthcare professionals trained in non-technical skills through simulation tended towards higher levels of anxiety and depression and fewer levels of stress, during the COVID-19 pandemic.
4P Model for Dynamic Prediction of the Covid-19: A Statistical and Machine Learning Approach
Authors: Hasan Khandaker Tabin , Rahman Mohammed Mostafizur , Ahmmed Md. Mortuza , Chowdhury Anjir Ahmed , Islam Mohammad Khairul 
Published: December 2020

Abstract
Introduction: Around the world, scientists are racing hard to understand how Covid-19 epidemic is spreading and growing, thus trying to find ways to prevent it before medications come to pass. Many different models have been proposed so far correlating different factors. Some of them are too localized to indicate a general trend of the pandemic while some others have established transient correlations only.Methods: Hence, in this study, a 4P model has been proposed based on four probabilities (4P) which has been found to be true for all affected countries taking Bangladesh as a case. Efficiency scores have been estimated from survey analysis not only for governing authorities on managing the situation (P(G)) but also for the compliance of the citizens ((P(P)). Since the immune responses of all the people are not uniform to a specific pathogen, the probability of a person getting infected ((P(I)) after being exposed has also been estimated. And the vital one is the probability of Test Positivity ((P(T)) which is a strong indicator of how effectively the infected people are diagnosed and isolated from the rest of the group that affects the rate of growth.Results and Conclusion: All the four parameters have been fitted in a non-linear exponential model that partly updates itself periodically with everyday facts. Along with the model, all the four probabilistic parameters are engaged to train a recurrent neural network using Long-Short Term Memory neural network and the followed trial confirmed a ruling functionality of the 4Ps.
Social Listening – Revealing Parkinson’s Disease over Day and Night
Authors: Zhang Hui , Meng Fanwen , Li Xingyu , Ning Yali , Cai Meng 
Published: December 2020

Abstract
Background: Nocturnal symptoms in Parkinson’s disease are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we analyzed the characteristics and burden of nocturnal symptoms from patients’ perspectives and explored their changes over time. Overall symptoms (occurring at day or night) were collected to compare whether the unmet needs related to nocturnal symptoms and to overall symptoms are different. Methods: We used a Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in dialogues available from social media platforms in 2016 to 2018. These symptoms were classified as either overall symptoms or nocturnal symptoms. We used share of voice (SOV) of symptoms as a proportion of total dialogues per year to reflect the characteristics of symptoms. Negative sentiment score of symptoms was analyzed to find out their related burden. Results: We found the SOV for overall motor symptoms was 79% and had not increased between 2016 and 2018 (79%, p = 0.5). The SOV for non-motor symptoms was 69% and had grown by 7% in 2018 (p < 0.01). The SOV for motor complications was 9% and had increased by 6% in 2018 (p < 0.01). The SOV of motor symptoms was larger than non-motor symptoms and motor complications (p < 0.01). The SOV of non-motor symptoms was larger than motor complications (p < 0.01). For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% (p < 0.01). The SOV for nocturnal-occurring motor symptoms was higher than most non-motor symptoms. However, non-motor symptoms had the higher increases and evoked higher negative sentiment regardless of whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day. Conclusions: The growing SOV and the greater negative sentiment of nocturnal symptoms suggest management of nocturnal symptoms is an unmet need of patients. A greater emphasis on detecting and treating nocturnal symptoms with 24-hour care is encouraged.
Clinical Impact of an Analytic Tool for Predicting the Fall Risk in Inpatients: Controlled Interrupted Time Series
Authors: Cho Insook , Jin Insun , Park Hyunchul , Dykes Patricia C. 
Published: December 2020

Abstract
Background: Patient falls remain a common cause of harm in acute-care hospitals worldwide. Despite the availability of a considerable body of literature on risk factors of inpatient falls, it is a difficult, complex, and common problem requiring a great deal of nurses’ time, attention, and effort in practice. With recent rapid expansion of health care predictive analytic application along with growing availability of electronic health record data, a patient-level electronic analytic tool for predicting fall risk was developed.Objectives: The purpose of this study was to explore how an electronic analytics tool for predicting fall risk affect patient and process outcomes. Methods: A controlled interrupted time series (CITS) experiment was conducted in 12 medical-surgical nursing units at a public hospital between May 2017 and April 2019. The intervention was the provision of patient-level risk predictions generated by an analytic tool using routinely obtained from the hospital’s electronic health record system. The primary outcome was the fall rate, and secondary outcomes included fall-related injuries and predefined process indicators. Results: During the study there were 42,476 admissions, while 707 falls and 134 fall injuries occurred. Allowing for differences in the patients’ characteristics and baseline process outcomes, the fall rate was significantly low in the intervention group (1.79 vs. 2.11, t = 2.13, P = .038). The CITS analysis revealed that the immediate reduction was 29.73% in the intervention group (z = –2.06, P = .039) and 16.58% in the control group (z = –1.28, P = .200), but no ongoing effect. The injury rates did not differ significantly (0.42 vs. 0.31, t = –1.54, P = .131). Patient-level-adjusted logistic regression showed a significant group effect on falls. Process outcomes related to multifactorial interventions including risk-targeted interventions increased significantly in the intervention group over time.Conclusion: The effectiveness of IN@SIGHT was supported only by the before-after comparison. However, it demonstrated the potential to contribute to improvement of patient outcomes, leading to positive changes in process outcomes over time. Further research is needed for this new approach.
Pathological Responses to Low-Dose Irradiation and Pepleomycin in Oral Squamous Cell Carcinoma are Predictive of Locoregional Control
Authors: Katagiri Tomohiro , Ohyama Yoshio , Miyamoto Hideo , Egawa Yuki , Moriki Toshiaki , Hasegawa Kazuki 
Published: December 2020

Abstract
Background The prognosis of advanced oral cancer remains dismal. While multimodal therapy is beneficial, maintaining the quality of life of long-term survivors is important. Therefore, risk-adapted treatment regimens need to be designed. We herein investigated whether pathological responses in oral cancer patients treated with preoperative chemoradiotherapy predict locoregional recurrence.Methods We retrospectively reviewed the data of 51 oral cancer patients who received preoperative radiotherapy and concurrent pepleomycin, followed by curative surgery at our institution between January 2009 and June 2018. Each patient received preoperative external beam irradiation to the primary tumor and lymphatics (2 Gy per day for approximately 3 weeks) concurrent with pepleomycin (2.5 mg/day). Surgery was performed approximately 3-4 weeks after the completion of preoperative chemoradiotherapy. Pathological responses were defined based on the grading system of Oboshi and Shimosato.Results Eight, 22, 16, and 5 patients had Oboshi and Shimosato grades 2a, 2b, 3, and 4, respectively. Favorable pathological responses (grades 3 and 4) were observed in 41.2% of patients (21 out of 51 patients). The pathological response and number of pathological lymph node metastases were identified as signiﬁcant prognostic factors for locoregional control in the univariate analysis. Three-year locoregional control rates were 100% and 56.6% in patients with favorable and unfavorable pathological responses, respectively.Conclusions The present study demonstrated that pathological tumor responses to preoperative chemoradiotherapy are a useful predictive factor for locoregional control.
Ovarian fibrosarcoma: A single-institution experience and a review of the literature
Authors: Sun Tingting , Cheng Ning-Hai , Cao Dong-Yan , Peng Peng 
Published: December 2020

Abstract
Ovarian fibrosarcoma is an extremely rare and malignant sex cord-stromal tumor. Due to its low incidence and poor prognosis, until now, very few cases have been reported, and most of the reported cases have been sporadic. Therefore, the treatments and prognostic factors of ovarian fibrosarcoma are still debatable. Here, we report 5 cases of ovarian fibrosarcoma that presented at Peking Union Medical College Hospital over the past 20 years. The 5 patients were 41, 51, 54, 76, and 76 years of age when initial symptoms of pelvic mass or pain appeared. On ultrasound, this disease usually manifests as unilateral pelvic masses, within which uneven echo enhancement and some blood flow signals are observed. No significant increase was observed in the levels of preoperative tumor markers, such as serum CA125 and sex hormones. The final diagnosis depends on postoperative histopathological results since these tumors are easily misdiagnosed when intraoperative frozen sections are used for examination. Pathologic examinations showed that the tumor cells were spindle-shaped with moderate to severe atypia and high mitotic counts. The immunohistochemistry profile is not specific, but the positive rate of Ki-67 was consistent with the degree of malignancy and the prognosis of patients with this tumor. In addition, the tumor may also be positive for Vimentin, α-inhibin, SMA, estrogen receptor and progesterone receptor. Significant differences were observed in the surgical methods used, and no unified chemotherapy regimen has been established. The overall survival was >15, >7, >6, <1, and <1 year for each patient. After reviewing the literature, evidence-based large-scale case studies were lacking. For treatments, complete cytoreductive surgery plus regimens typically used against malignant sex cord-stromal tumors, as described in the NCCN guidelines, are recommended. Due to its low incidence, both multicenter clinical studies and molecular studies are required to provide gynecologists with a better understanding and guidance for future management of patients with ovarian fibrosarcoma.