bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Qualitative study of Ghanaian pediatric oncology nurses’ care practice challenges.
Authors: Nukpezah Ruth Nimota , Fomani Fatemeh Khoshnavay , Hasanpour Marzieh , Nasrabadi Alireza Nikbakht 
Published: December 2020

Abstract
Background: Pediatric cancer is a global problem, and some studies have highlighted that nurses caring for these children experience work-related challenges, which makes many children with cancer to be left with terminal diagnoses, unnecessary suffering; and also, job dissatisfaction among the nurses. But no study has explored this phenomenon among pediatric oncology nurses in Ghana. This study aims to explore and understand the challenges that the pediatric oncology nurses experience when caring for children with cancer in Ghana.Methods: An exploratory qualitative research design study was conducted from August 2019 - April 2020. The study was conducted at the Pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. The data collection instrument was a face-to-face in-depth semi-structured interview. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.Results: The results showed that the challenges that the pediatric oncology nurses experience includes: Time-consuming care, Low Job motivations, Inadequate logistics, Work stress, Reduced labor force, Low knowledge level, Absence of teamwork and the Perception of contracting cancer. Conclusions: The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer.
Antimicrobial therapy and assessing therapeutic response in culture-negative pyogenic vertebral osteomyelitis: a retrospective comparative study with culture-positive pyogenic vertebral osteomyelitis
Authors: Yu Dongwoo , Kim Sang Woo , Jeon Ikchan 
Published: December 2020

Abstract
Background: There are still controversies regarding the treatment and outcomes in culture-negative pyogenic vertebral osteomyelitis (PVO). The purpose of this study is to investigate the antimicrobial therapy, assessment of therapeutic response, and outcome of culture-negative PVO compared to culture-positive PVO.Methods: A retrospective study was performed with non-surgical lumbar PVO patients. The patients were divided into two groups based on the causative bacterial identification (CN group with culture-negative PVO and CP group with culture-positive PVO). The clinical features, use of antibiotics, laboratory data, and outcomes were compared between the two groups.Results: Seventy-three patients with 41 (56.2%) of the CN group and 32 (43.8%) of the CP group were enrolled. The CN group showed a shorter duration of parenteral antibiotics (45.88 ± 16.14 vs. 57.31 ± 24.39, p = 0.019) but a tendency of prolonged duration of total (parenteral + oral) antibiotics (101.17 ± 52.84 vs. 84.19 ± 50.29 days, p = 0.168). When parenteral antibiotics were discontinued or switched to oral antibiotics, the mean erythrocyte segmentation rate (ESR, normal range: < 25 mm/h), C-reactive protein (CRP, normal range: < 0.5 mg/dL) level, and visual analog scale (VAS) score of back pain were 42.86 ± 24.05 mm/h, 0.91 ± 1.18 mg/dL, and 4.05 ± 1.07, respectively, with no significant differences between the two groups. The recurrence rates of CN and CP groups were 7.3% (3/41) and 6.3% (2/32), respectively (p=1.000). The presence of epidural abscess was the most significant factor for the identification of causative bacteria (p = 0.002), and there was no significant relationship between the use of empirical antibiotics before tissue culture and the causative bacterial identification (p = 0.194).Conclusions: The CN group required a shorter duration of parenteral antibiotics than the CP group. Discontinuation of parenteral antibiotics or changing the administration route can be considered based on the values of ESR, CRP, and VAS score of back pain. The presence of epidural abscess was the most significant factor for the identification of causative bacteria.
Application of the PET ligand [11C]ORM-13070 to examine receptor occupancy by the α2C-adrenoceptor antagonist ORM-12741: translational validation of target engagement in rat and human brain
Authors: Shahid Mohammed , Rinne Juha O. , Scheinin Mika , Virta Jere , Marjamäki Päivi , Solin Olof , Arponen Eveliina , Sallinen Jukka , Kuokkanen Katja , Rouru Juha 
Published: December 2020

Abstract
Background: Availability of the α2C -adrenoceptor (α2C-AR) positron emission tomography (PET) tracer, [11C]ORM-13070, and the α2C-AR antagonist ORM-12741 allows probing of the roles of this G-protein coupled receptor subtype in brain function, both in healthy humans and in patients with various brain disorders. This translational study employed [11C]ORM-13070 autoradiography and PET to determine α2C-AR occupancy by ORM-12741 in rat and human brain, respectively. Results: ORM-12741 has high affinity (Ki: 0.08 nM) and potent antagonist activity (Kb: 0.04 nM) as well as selectivity (Ki estimates for the human α2A-AR and α2B-AR were 8.3 nM and 0.8 nM, respectively) for the human α2C-AR subtype. [11C]ORM-13070 had highest uptake in the basal ganglia of rat and human brain. Pretreatment with ORM-12741 inhibited [11C]ORM-13070 binding in rat striatum in a time- and dose-dependent manner at 10 and 50 µg/kg (s.c.) with an EC50 estimate of 1.42 ng/mL in rat plasma, corresponding to protein-free drug concentration of 0.23 nM. In the living human brain, time- and dose-related α2C-AR occupancy was detected with EC50 estimates of 24 ng/mL and 31 ng/mL for the caudate nucleus and putamen, respectively, corresponding to protein-free concentrations in plasma of 0.07 nM and 0.1 nM. Modelling-based maximum α2C-AR occupancy estimates were 63 % and 52 % in the caudate nucleus and the putamen, respectively. Conclusions: ORM-12741 is a selective α2C-AR antagonist which penetrates the rat and human brain to occupy α2C-ARs in a manner consistent with its receptor pharmacology. Trial registration number and date of registration: ClinicalTrial.cov NCT00829907. Registered 11 December 2008. https://clinicaltrials.gov/.
Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study
Authors: Zeng Zhi-Yong , Feng Shao-Dan , Chen Gong-Ping , Wu Jiang-Nan 
Published: December 2020

Abstract
Background: Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources.Objective: To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment.Results: During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P <0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively.Conclusions: The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.
Clinical features of anti-synthetase syndrome associated interstitial lung disease: a retrospective cohort in China
Authors: Zhan Xi , Wei YAN , Ying WANG , Qing LI , Xuhua SHI , Yanli GAO , Qiao YE 
Published: December 2020

Abstract
Background: Anti-synthetase syndrome (ASSD) is a chronic autoimmune condition characterized by antibodies directed against an aminoacycl transfer RNA synthetase (ARS) along with a group of clinical features including the classical clinical triad: inflammatory myopathy, arthritis, and interstitial lung disease (ILD). ASSD is highly heterogenous due to different organ involvement, and ILD is the main cause of mortality and function loss, which presents as different patterns when diagnosed. We designed this retrospective cohort to describe the clinical features and disease behaviour of ASSD associated ILD. Methods: Data of ASSD associated ILD were retrospectively collected in Beijing Chaoyang Hospital from 2017.12 to 2019.3. Data were obtained from the Electronic Medical Record (EMR) system. Patients were divided into 5 groups according to distinct aminoacyl tRNA synthetase (ARS) antibodies. Results: 108 consecutive patients were recruited. 33 were JO-1 positive,30 were PL-7 positive,23 were EJ positive, 13 were PL12 positive and 9 were OJ positive. The JO-1 group had a significant higher rate of mechanic's hand (57.6%) than other 4 groups. Polymyositis/ dermatomyositis (PM/DM) was diagnosed in 25 (23.1%) patients and no difference was observed among the 5 groups. The PL7 group had a higher frequency of UIP pattern (13.3%) than the other 4 groups but the difference was not significant, and the EJ group had the most frequent OP pattern(78.2%), which was significantly higher than PL7 (P<0.001) and PL12 groups (P=0.025). The median follow-up time was 10.7 months. All received prednisone treatment, with or without immunosuppressants. At 6-month-follow up, 96.3% (104/108) had a positive response to therapy, the JO1 and EJ groups had a significantly higher improvement of forced vital capacity (FVC) than the other 3 groups (P<0.05), and PL-7 group had the lowest FVC improvement (P<0.05). The JO1 and EJ groups had significantly higher anti-RO52-positive occurrence than the other 3 groups (P<0.05). Conclusion: Anti PL-7 antibody had the same frequency as anti-JO1 in ASSD-ILD, while the ILD pattern was different with distinct anti-ARS antibodies. Most ASSD-ILD had a positive response to steroids, with or without immunosuppressants. The PL-7 group had the highest occurrence of UIP pattern, and a significantly lower response to therapy.
Rehabilitation pathways in women with breast cancer in the first 12 months of the disease: a retrospective study
Authors: Falcicchio Chiara , Lallo Domenico Di , Fabi Alessandra , Bonucci Alessandro , Perrone Maria , Pace Andrea , Corti Ambra , Giacomelli Luca , Pugliese Patrizia 
Published: December 2020

Abstract
Background: Breast cancer (BC) presents important physical and psychological challenges that should be appropriately addressed through continuous, integrated and individualized rehabilitation programs after treatment. Methods: We retrospectively analyzed data from two archives of the Lazio Regional Health System Database to assess rehabilitation patterns in women diagnosed with BC in the Lazio region (Italy) in 2008.Results: Most patients (81.7%) received outpatient rehabilitative care, consisting mainly of pathology-related interventions and, more rarely, disability-related interventions (mainly motor rehabilitation and rarely cognitive or psychological therapy). Few patients followed an inpatient (1.3%) or an intensive outpatient rehabilitation program (1.0%).Conclusion: Women with BC need more adequate rehabilitation programs, which should focus more on psychosocial and cognitive interventions.
HPV Vaccination Uptake and Administration from 2006 to 2016 in a Commercially Insured Population of the United States
Authors: Prabhu Vimalanand Shrikant , Bansal Neha , Liu Zhiwen , Finalle Rodney , Sénécal Martin , Kothari Smita , Towers Kemar , Myers Evan 
Published: December 2020

Abstract
BackgroundHuman papillomavirus (HPV) infection can cause various HPV-related cancers and can be prevented through HPV vaccination. While vaccination coverage (proportion ever vaccinated) estimates are available, vaccination uptake (proportion getting their first vaccine dose in a specific year) in the United States (US) is not well-known. MethodsWe conducted a retrospective analysis of MarketScan® claims database to assess the HPV vaccination uptake in the US among the 9- to 26-years-olds from 2006 to 2016. The annual uptake was the ratio between the number of enrollees for whom a first record of an HPV vaccine was found during the year and the total number of unique enrollees of similar age and gender identified that year.ResultsUptake was below 1% among children turning 9 and 10 years old during the year. Since 2009 among female and since 2013 among males, annual uptake has been the highest in those turning 13 years old (19.7% among females and 17.6% among males in 2016). Catch-up vaccination among older adolescents and young adults increased after Advisory Committee for Immunization Practices (ACIP) recommendations, but eventually slowed down as more younger persons were vaccinated. Most young adolescents were vaccinated by pediatricians, whereas young adult women were predominantly vaccinated by obstetricians/gynecologists and young adult males by family physicians. While only about half of the adolescents had well-check visits, majority of those who initiated HPV vaccination had at least one well-check visit the same year.ConclusionUnderstanding HPV vaccination uptake can guide the development of appropriate interventions to help improve public health.
Pulmonary cavitation – an under-recognized late complication of severe COVID-19 lung disease
Authors: Zoumot Zaid , Bonilla Maria-Fernanda , Wahla Ali S. , Shafiq Irfan , Uzbeck Mateen , El-Lababidi Rania M. , Hamed Fadi , Abuzakouk Mohamed , ElKaissi Mahmoud 
Published: December 2020

Abstract
Background: Pulmonary radiological findings of the novel coronavirus disease 2019 (COVID-19) have been well documented and range from scattered ground-glass infiltrates in milder cases to confluent ground-glass change, dense consolidation, and crazy paving in the critically ill. However, lung cavitation has not been commonly described in these patients. The objective of this study was to assess the incidence of pulmonary cavitation in patients with COVID-19 and describe its characteristics and evolution. Methods: We conducted a retrospective review of all patients admitted to our institution with COVID-19 and reviewed electronic medical records and imaging to identify patients who developed pulmonary cavitation. Results: Twelve out of 689 (1.7%) patients admitted to our institution with COVID-19 developed pulmonary cavitation, comprising 3.3% (n=12/359) of patients who developed COVID-19 pneumonia, and 11% (n=12/110) of those admitted to the intensive care unit. We describe the imaging characteristics of the cavitation and present the clinical, pharmacological, laboratory, and microbiological parameters for these patients. In this cohort six patients have died, and six discharged home. Conclusion: Cavitary lung disease in patients with severe COVID-19 disease is not uncommon, and is associated with a high level of morbidity and mortality.
Insufficient physical activity level among Sahrawi adults living in a protracted refugee setting
Authors: Andersen Eivind , Kjellså Ida , Hjellset Victoria Telle , Henjum Sigrun 
Published: December 2020

Abstract
Background: The Sahrawi people fled their homes in 1975 as the conflict in Western Sahara escalated and settled down near Tindouf, Algeria, where they still live. High prevalence of overweight and obesity and type 2 diabetes had been found in this protracted refugee setting. Scaling up national policy efforts to promote physical activity (PA) is critical to reducing the prevalence of noncommunicable diseases (NCDs) in the near future. One possible barrier to the inclusion of PA in NCD prevention strategies is the lack of research on PA level, which may reduce political support and policy development for PA. Thus, the aim of this study was to investigate the PA level among adults living in Sahrawi refugee camps and socioeconomic factors associated with PA.Methods: A cross-sectional survey was carried out in 2014 in five refugee camps near Tindouf, Algeria. A total of 180 women and 175 men were included. PA was measured using the international physical activity questionnaire short form (IPAQ-SF).Results: There was a large amount of variance in reported PA for both genders, ranging from 10 min of total PA per week to above 40 hours. Forty-three percent of the participants had a low PA level (defined as not meeting the PA recommendations of 150 min of moderate to vigorous PA per day). The chi-square test of independence showed that males, those aged ≥ 60 years and people with higher education were more likely to be in the low PA level category. No significant relationship was found between PA level and BMI status. Most of the participants thought that engaging in PA would be wise, valuable, right and good but thought to a lesser degree that PA would be easy, comfortable and interesting.Conclusions: Almost half of the participants were categorised as insufficiently physically active, however, most of the Sahrawi refugees express a positive attitude towards PA. PA is a low-cost approach to reducing deaths and NCDs, government initiatives to increase PA levels in refugee camps are advised.
The role of humanities in the medical curriculum: medical students’ perspectives
Authors: Petrou Loukia , Mittelman Emma , Osibona Oluwapelumi , Panahi Mona , Harvey Joanna M , Patrick Yusuf A A , Leedham-Green Kathleen E 
Published: December 2020

Abstract
Background The humanities have long been shown to play an important role in the medical school curriculum. However, few studies have looked into the opinions of medical students on the usefulness and necessity of the humanities as well as their extracurricular involvement with them. The aim of this study was to: a) understand medical students’ attitude towards the humanities in medical education and b) assess their understanding of the necessary qualities of doctors and how interaction with the humanities affects the development of such attributes. Methods A mixed methods survey was designed to elicit demographics, engagement, interest and perspective on curricular positioning, and to explore how students ranked the qualities of a doctor. It was distributed to medical students of all year groups in the 6-year bachelor of medicine, bachelor of surgery (MBBS) course at Imperial College London. Results 109 fully completed questionnaires were received. No significant difference was found in engagement or interest in the humanities between genders. Students felt strongly that humanities subjects shouldn’t be assessed (71:18) though some felt it was necessary for engagement, while no consensus was reached on whether these subjects should be elective or not (38:31). The majority of students wanted more medical humanities to be incorporated into the traditional medical course with a preference of incorporation into the first 3 years. Junior medical students were more likely to rank empathy as a highly desirable attribute than senior students. Students provided qualitative insights into curricular positioning, assessment and value.Conclusions This study provides the perspective of medical students on how and whether the humanities should be positioned in medical education. It may be helpful to medical schools that are committed to student involvement in curriculum design.
Does respiratory co-infection facilitate dispersal of SARS-CoV-2? Investigation of a super-spreading event in an open-space office
Authors: Weissberg Dana , Böni Jürg , Rampini Silvana , Kufner Verena , Zaheri Maryam , Schreiber Peter W. , Abela Irene A. , Huber Michael , Sax Hugo , Wolfensberger Aline 
Published: December 2020

Abstract
Background: Super-spreaders are individuals infecting disproportionately large numbers of contacts. They probably play a crucial role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a super-spreading event within a team working in an open-space office and investigate factors potentially having facilitated SARS-CoV-2 transmission.Methods: In this retrospective cohort study, semi-structured telephone interviews with all team members were carried out to identify symptoms, contacts, and adherence to basic hygiene measures. During site visits, we gathered information about workplace and seating arrangements. The secondary attack rate in office and households was calculated. Potential respiratory viral co-infections were assessed by multiplex PCR. SARS-CoV-2 whole-genome sequencing was performed using a tiled-amplicon sequencing approach.Results: Of 13 team members, 11 fell ill with Coronavirus disease 2019 (COVID-19). Due to the sequence of events and full genome sequence data, one person was considered the index case for this outbreak, directly infecting 67% to 83% of the teammates. All team members reported repetitive close contacts among themselves during joint computer work, team meetings and a “Happy Birthday” serenade. Two individuals shared nuts and dates. The arrangement of the office and meeting rooms precluded sufficient adherence to physical distancing. The index case and a further individual were diagnosed with an adenovirus serotype 4 co-infection. Conclusion: We identified several environmental and behavioral factors that probably have facilitated the transmission of SARS-CoV-2. The relevance of the adenovirus co-infection remains unclear and merits further investigation.