bluuebunny/crossref_metadata_2025_split huggingface dataset:
TAVR and Cancer: Machine Learning-Augmented Propensity Score Mortality and Cost Analysis in Over 30 Million Patients
Authors: Monlezun Dominique , Hostetter Logan , Balan Prakash , Palaskas Nicolas , Lopez-Mattei Juan , Cilingiroglu Mehmet , Iakobishvili Zaza , Ewer Michael , Marmagkiolis Konstantinos , Iliescu Cezar 
Published: November 2020

Abstract
Introduction: Cardiovascular disease (CVD) and cancer are the top mortality causes globally, yet little is known about how the diagnosis of cancer affects treatment options in patients with hemodynamically compromising aortic stenosis (AS). Patients with cancer often are excluded from aortic valve replacement (AVR) trials including both trials with transcatheter AVR (TAVR) and surgical AVR (SAVR). This study looks at how cancer may influence treatment options, and assess the outcome of cancer patients who undergo surgical or TAVR intervention. Additionally, we sought to quantitate and compare both clinical and cost outcomes for cancer and non-cancer patients. Methods: This population-based case-control study uses the most recent year available National Inpatient Sample (NIS (2016) from the United States Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ). Machine learning augmented propensity score adjusted multivariable regression was conducted based on the likelihood of undergoing TAVR versus MM and TAVR versus SAVR with model optimization supported by backward propagation neural network machine learning.Results: Of the 30,195,722 total hospital admissions, 39,254 (0.13%) TAVRs were performed, with significantly fewer performed in cancer versus non-cancer patients even in those of comparable age and mortality risk (23.82% versus 76.18%, p<0.001) despite having similar mortality. Multivariable regression in cancer patients demonstrated that mortality was similar for TAVR, MM, and SAVR, though LOS and cost was significantly lower for TAVR versus MM and comparable for TAVR versus SAVR. Patients with prostate cancer constituted the largest primary malignancy among TAVR patients including those with metastatic disease. There were no significant race or geographic disparities for TAVR mortality.Discussion: Comparison of aortic valve intervention in cancer patients with those without co-existing malignancy suggests that intervention is underutilized in the cancer population. This study suggests that as cancer patients including those with metastasis have similar clinical outcomes, patients who are symptomatic and those with higher risk aortic valve lesions should be offered the benefit of intervention. Modern techniques have reduced intervention-related adverse events, provided improved quality of life, and appear to be cost effective; these advantages should not be denied to patients on the basis of co-existing malignancy.
Co-Designing Genomics Research With A Large Group of Donor-Conceived Siblings
Authors: Nunn Jack , Crawshaw Marilyn , Lacaze Paul 
Published: November 2020

Abstract
Background: Human genomics research is growing rapidly. More effective methods are required for co-design and involving people, especially those from vulnerable sub-populations of inherently high interest to medical research. This case study documents how we worked with a large group of donor-conceived siblings who share the same sperm donor father, to explore how they might want to engage with and influence any future genomic research. Method: A participatory action research process was used to explore the views of a group of 18 known donor-conceived siblings; who are part of a larger group of up to 1000 people who share the same biological father. The discussion explored views about how the group would like to be involved in future research. Five members participated in co-design; 12 completed a pre-discussion online survey; and six participated in an online discussion forum and evaluation survey. The online discussion was led by one facilitator, supported by the study team. Results: Co-design informed the research process. Participants reported enjoying the overall experience of the surveys and discussion forum, which were perceived as inclusive and flexible. Most participants’ views regarding the value of involvement in research changed during the process, and ‘widened’ about who should be involved. Participants were supportive of future research being done with the siblings group. All who completed the final survey requested to remain part of the co-design process. Other themes in the online discussion included concerns about conflicting interests and a desire for research participation to improve the situation for people affected by assisted conception. The process informed later discussions in the sibling group about participating in a self-managed biobank and informed decision making about participating in genomics research. Conclusion: Findings from this study help inform how people from certain sub-populations should be involved in planning and defining their participation in genomic research; particularly those from more vulnerable or high-interest populations. This process provides a replicable and practical method of involving potential participants in co-designing genomics research using online discussions, with reported positive outcomes. Reporting this study using ‘Standardised data on initiatives (STARDIT)’ to report the process allows comparison with other studies.
The COVID-19 Pandemic Impact on Pediatric Surgery Residency Programs
Authors: Gunadi  , Balela Naisya , Kalim Alvin Santoso , Widitjiarso William , Fahri Fadil , Tedja Audric Kenny , Purnomo Eko , Dwihantoro Andi , Agustriani Nunik , Makhmudi Akhmad 
Published: November 2020

Abstract
Objective: The COVID-19 pandemic has had an impact not only on clinical practices but also on residency programs as an important part of hospital medical services. We investigated the impact of the COVID-19 pandemic on the pediatric surgery residency program in our institution. Results: A questionnaire was developed, consisting of 24 questions: a) the perspectives of residents about COVID-19 infection during their residency program; b) the learning process; c) academic evaluations; and d) residents' suggestions to improve the quality of their residency program during the outbreak. Most (85.7%) pediatric surgery residents agreed that elective surgeries should be postponed during the pandemic. Before the outbreak, almost all (90.5%) residents used textbooks and journals as their primary sources of learning, while during the outbreak, 71.4% of residents shifted to use online lectures either from the school or Association of Pediatric Surgeons. Interestingly, 95.2% of participants agreed that they had more time to complete their academic assignments during the pandemic. In conclusions, the pandemic has had a significant impact on the development of pediatric surgery residency programs. A comprehensive approach is needed to maintain the high standard of competence of pediatric surgery without compromising our safety from the COVID-19 infection risk.
The Changing Health Convergence for Life Expectancy and Spatial Interactions
Authors: Rodríguez Irene González , Sáez Marta Pascual , Prieto David Cantarero 
Published: November 2020

Abstract
BackgroundHealth convergence between the European Union countries and Spanish provinces is studied considering the spatial interactions among several territories. Health status measured through life expectancy in four ways: life expectancy at birth, life expectancy at age 65, disability-adjusted life expectancy and healthy life expectancy based on self-perceived health. The period analyzed differs from one indicator to another, for the period 1998-2018.MethodsTwo kinds of convergence are studied: σ-convergence, through standard deviation, and absolute β-convergence, estimating a determined regression. Furthermore, the Moran Test is performed in order to know the degree of spatial dependencies and two models of spatial regression (Spatial Lag Model and Spatial Error Model) are used to include these dependencies in the absolute β-convergence estimation.ResultsOur findings suggest that there is a convergence process, both in σ and β, between the European Union countries and between the Spanish provinces. Therefore, dispersion is reduced, and growth rates have been higher where had lower life expectancy values at the beginning. On the other hand, β-convergence is higher in women among European countries and in men among Spanish provinces, whether we consider the model without spatial dependencies or the one which include them. ConclusionIn general, there have been convergence processes (both in sigma and beta) inside Europe and Spain. Otherwise, the rise of the dispersion means that there is not a clear evidence about the trend in the following period. This study has a double contribution. First, it provides an updated vision of the health convergence. Secondly, it contributes to consider spatial econometrics in Health Economics research. These insights can be considered to reduce health population inequalities.
Evaluation of SUVlean&nbsp;Consistency&nbsp;in&nbsp;FDG&nbsp;and&nbsp;PSMA&nbsp;PET/MR&nbsp;with&nbsp;Dixon, James and Janma&nbsp;Based&nbsp;Lean Body Mass&nbsp;Correction
Authors: Zhao Jun , Xue Qiaoyi , Chen Xing , You Zhiwen , Wang Zhe , Yuan Jianmin , Liu Hui , Hu Lingzhi 
Published: November 2020

Abstract
PurposeTo systematically evaluate the consistency of various standardized uptake value (SUV) lean body mass (LBM) normalization methods in a clinical positron emission tomography/magnetic resonance imaging (PET/MR) setting.MethodsSUV of brain, liver, prostate, parotid, blood and muscle were measured in 90 18F-FDG and 28 18F-PSMA PET/MR scans and corrected for LBM using the James, Janma (short for Janmahasatian) and Dixon models. 40 dual energy X-ray absorptiometry (DXA) measurements of non-fat mass were used as the reference standard. Agreement between different methods was assessed by linear regression and Bland-Altman statistics. ResultsLBM fraction measured by DXA, James, Janma and Dixon approaches was 68.19±6.43%, 66.95±6.71%, 76.20±5.41% and 71.56±7.97% respectively. Compared to DXA, the Dixon approach presented the minimal bias when compared to the James and Janma models (bias: 0.76±7.35, -8.01±9.36, -3.33±8.26 respectively). SUV normalized by bodyweight (SUVbw) was positively correlated with Body Mass Index (BMI) in both FDG (liver: r=0.454, p<0.001) and PSMA studies (r=0.197,p=0.31), while SUV normalized by lean body mass (SUVlean) revealed a decreased dependency on BMI (r=0.22,0.08,0.14, p=0.04,0.46,0.18 for Dixon, James and Janma models respectively). Paired T-test showed significant difference between SUVlean of major organs measured using Dixon method vs James and Janma models.ConclusionSignificant systematic variation was found among SUVlean calculated using different approaches. A consistent correction method should be applied in PET/MR serial scans.
Genome-Wide Analyses of the Relict Gull (Larus Relictus) Insights Into Evolutionary Implications
Authors: Yang Chao , Li Xuejuan , Wang Qingxiong , Yuan Hao , Huang Yuan , Xiao Hong 
Published: November 2020

Abstract
BackgroundThe relict gull (Larus relictus), one of the least known Aves, was classified as vulnerable on the IUCN Red List and is a first-class national protected bird in China. Genomic resources for L. relictus are lacking, which limits the study of its evolution and its conservation.ResultsIn this study, based on the Illumina and PacBio sequencing platforms, we successfully assembled the genome of L. relictus, the first reference genome of the genus Larus. The size of the final assembled genome was 1.21 Gb, with a contig N50 of 8.11 Mb. A total of 18,454 protein-coding genes were predicted from the assembly results, with 16,967 (91.94%) of these genes annotated. The genome contained 92.52 Mb of repeat sequence, accounting for 7.63% of the assembly. The phylogenetic tree was constructed using 7,339 single-copy orthologous genes, which showed Charadriiformes located at the basal position and Philomachus pugnax as the closest relative of L. relictus. The divergence time between L. relictus and P. pugnax was ~68.44 Mya. The population dynamics of the Ordos breeding subpopulation in Hongjian Nur is a good confirmation that these birds are suffering from habitat loss and fragmentation.ConclusionsThis assembled genome will be a valuable genomic resource for a range of genomic and conservation studies of L. relictus and helps to establish a foundation for further studies investigating whether the other three breeding subpopulations have combined with the Ordos breeding subpopulation. As the species is threatened by habitat loss and fragmentation, actions to protect L. relictus are suggested to improve the fragmentation of breeding populations.
Moral neutralization: Nurses' evolution in unethical climate workplaces
Authors: Hakimi Hamideh , Joolaee Soodabeh , Farahani Mansoureh Ashghali , Rodney Patricia , Ranjbar Hadi 
Published: November 2020

Abstract
Introduction: Good quality of care is dependent on nurses’ strong clinical skills and strong moral competencies, as well. However, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The aim of the study reported on in this paper was to explore the experiences of nurses regarding negative changes in their moral practice. Materials and Methods: This was a qualitative study utilizing a inductive thematic analysis approach, which was conducted from February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. Results: The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: (1) feeling discouraged; (2) normalization; (3) giving up; (4) becoming a justifier; and (5) moral indifference. Conclusions: Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both pateints and health syetms. Some unethical behaviors in nurses can be explaiened by this process.
Professional Image of Nursing and Midwifery in East Africa: An Exploratory Analysis
Authors: Ndirangu Eunice Wambui , Sarki Ahmed , Mbekenga Columba , Edwards Grace 
Published: November 2020

Abstract
Background: Evidence suggests that there is a negative image of nursing and midwifery that does not promote these professions as attractive career options. Furthermore, there is a paucity of studies documenting how nursing and midwifery is perceived in East Africa, and where such studies exist they are country-specific. The aim of this study was to explore views regarding the image of nursing and midwifery among nurses and midwives in three East African countries, Kenya, Tanzania and Uganda.Methods: An exploratory descriptive cross-sectional study administered online using Survey Monkey Questionnaires assessed the views and perceptions of nurses and midwives regarding the image of nursing and midwifery professions. Descriptive statistics and Pearson’s Chi square tests were used to analyse the data. The semi-structured questions were analysed using content analysis. Results: A total of 551 participants took part in the study. The majority were females (61.8%), registered nurses/midwives (45.8%), and aged 30-39 years (34.2%). The majority of the respondents were from Kenya (39.7%) and Uganda (32.9%). About two-thirds of the nurses and midwives in this study perceived nursing/midwifery as both trusted and respected professions and expressed having a level of control over how their image was portrayed. Conversely, the nurses and midwives were conscious that the public had mixed responses about the nursing/midwifery professions specifically, some members of the public described nurses/midwives as professionals, knowledgeable and caring, others perceived nurses/midwives to be rude, cruel, unkind, lazy, unkempt, and maids.Conclusion: This study offers an interesting insight about the image of nursing/midwifery in East Africa. Findings from this study will inform policy makers and educators about key concepts that affect the image of nursing and midwifery in East Africa. The findings will be used to design marketing materials to help improve the image of nursing and midwifery in the region and other African countries.
Multi-locus sequence typing of Mycoplasma bovis to assess its genetic diversity from 2009-2018 in Ningxia Hui Autonomous Region, China
Authors: Guo Yanan , Luo Haifeng , Guo Shuqiang , Lei Yuanyuan , Li Yong , He Shenghu 
Published: November 2020

Abstract
Background: Mycoplasma bovis (M. bovis) is a highly contagious cattle pathogen spreading worldwide and especially in Ningxia Hui Autonomous Region in China.Results: Two types of ST, ST10and ST134, were identified in Ningxia Hui Autonomous Region. Thirty-seven strains belonged to ST10 and 28 strains belonged to ST134. ST134 was a new ST and first found in 2009 and was only widely distributed in Ningxia Hui Autonomous Region at present. The M. bovis ST10 was widely spread in many provinces in China and was widespread in Ningxia Hui Autonomous Region since 2010. It is speculated that the prevalence of M. bovis ST10 in Ningxia Hui Autonomous Region began in 2010.Conclusion: This study is the first report on the genetic diversity of M. bovis from 2009 to 2018 in Ningxia Hui Autonomous Region and provides the epidemiological information. These results may help further our understanding of the evolution of M. bovis and provide information that may be useful for the development of novel vaccines.
Comparative transcriptome analysis uncovers roles of hydrogen sulfide for alleviating cadmium toxicity in Tetrahymena thermophila
Authors: Lv Hongrui , Xu Jing , Bo Tao , Wang Wei 
Published: November 2020

Abstract
Background: Cadmium (Cd) is a nonessential heavy metal with potentially deleterious effects on different organisms. The organisms have evolved sophisticated defense system to alleviate heavy metal toxicity. Hydrogen sulfide (H2S) effectively alleviates heavy metal toxicity in plants and reduces oxidative stress in mammals. However, the function of H2S for alleviating heavy metal toxicity in aquatic organisms remains less clear. Tetrahymena thermophila is an important model organism to evaluate toxic contaminants in an aquatic environment. In this study, the molecular roles of exogenously H2S application were explored by RNA sequencing under Cd stress in T. thermophila.Results: The exposure of 30 µM Cd resulted in T. thermophila growth inhibition, cell nigrescence, and malondialdehyde (MDA) content considerably increase. However, exogenous NaHS (donor of H2S, 70 µM) significantly alleviated the Cd-induced toxicity by inhibiting Cd absorbtion, promoting CdS nanoparticles formation and improved antioxidant system. Comparative transcriptome analysis showed that the expression levels of 9152 genes changed under Cd stress (4658 upregulated and 4494 downregulated). However, only 1359 genes were differentially expressed with NaHStreatment under Cd stress (1087 upregulated and 272 downregulated). The functional categories of the differentially expressed genes (DEGs) by gene ontology (GO) revealed that the transcripts involved in the oxidation–reduction process, oxidoreductase activity, glutathione peroxidase activity, and cell redox homeostasis were the considerable enrichments between Cd stress and NaHS treatment under Cd stress. Kyoto Encyclopedia of Genes and Genomes (KEGG) indicated that the carbon metabolism, glutathione metabolism, metabolism of xenobiotics by cytochrome P450, and ABC transporters were significantly differentially expressed components between Cd stress and NaHS treatment under Cd stress in T. thermophila. The relative expression levels of six DEGs were further confirmed through quantitative real-time polymerase chain reaction (qRT-PCR). Conclusion: NaHS alleviated Cd stress mainly through inhibiting Cd absorbtion, promoting CdS nanoparticles formation, increasing oxidation resistance, enhancing detoxification, and regulation of transport in free-living unicellular T. thermophila. These findings will expand our understanding for H2S functions in the freshwater protozoa.
Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand
Authors: Suwanrath Chitkasaem , Chunuan Sopen , Matemanosak Phawat , Pinjaroen Sutham 
Published: November 2020

Abstract
AbstractBackground: The increasing worldwide rates of cesarean section are of global concern. In recent years, cesarean births upon maternal request have become a hotly debated issue. Hence, this study aimed to explore maternal reasons for cesarean preference without medical indications.Methods: A descriptive qualitative study was conducted, using in-depth interviews with 27 pregnant women who preferred cesarean birth, attending antenatal care in Songklanagarind Hospital from September 2018 to June 2019. Data were analyzed using content analysis.Results: Maternal reasons for cesarean preference were classified into six main categories: fear of childbirth, safety concerns related to health risk perceptions, negative previous birth experiences, positive attitudes toward cesarean birth, access to biased information and superstitious beliefs in auspicious birth dates. Most women had more than one reason for opting cesarean birth. Conclusion: Several reasons for cesarean birth preference have been elucidated. One striking reason was superstitious beliefs in auspicious birth dates, which are challengable for obstetricians to deal with. Obstetricians should explore the exact reasons why women request cesarean birth, so as to prevent or diminish unnecessary cesarean births.
Anemia and associated factors among adolescent girls and boys at 10-14 years in rural western China
Authors: Zhu Zhonghai , Sudfeld Christopher R. , Cheng Yue , Qi Qi , Li Shaoru , Elhoumed Mohamed , Yang Wenfang , Chang Suying , Dibley Michael J , Zeng Lingxia , Fawzi Wafaie W. 
Published: November 2020

Abstract
Background: Evidence on the anemia and associated factors among young adolescent girls and boys in rural western China is limited.Methods: We used data from a follow-up study of adolescents (10-14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the associated factors with anemia.Results: The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 65% (95% CI 7%, 87%) less likely to be anemic, compared with those of whom had <3 years. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (p-value for interaction was 0.04): males with greater than mild puberty development had 65% (95% CI 17%, 85%) reduced odds of anemia while there was no association among females (OR: 0.72, 95% CI 0.29, 1.78). Consumption of flesh foods, eggs, and having a meal frequency of three times or more per day were associated with 42% (95% CI 11%, 62%), 40% (95% CI 7%, 62%) and 32% (95% CI 4%, 52%) reduced odds of anemia, respectively.Conclusions: Anemia is a mild public health problem among young adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group.