bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between velocity‐specific exercise and isometric exercise on neck muscle functions and performance: a randomised clinical trial
Authors: Tsang Sharon MH , Chan Kenneth TK , Ho Parco LT , Kwok Jacky CY , Tse Daniel HT , Tsoi Henry HT 
Published: January 2021

Abstract
Background
Evidence has shown that velocity-specific exercise results in additional benefits for peripheral joint muscles by promoting their functions, however, its effects on spinal muscles are yet to be investigated. This study aimed to examine the feasibility and effects of velocity-specific exercise compared to isometric exercise on cervical muscle functions and performance in healthy individuals.

Methods
Thirty healthy adults were randomised to practise either the velocity-specific exercise (VSE, n = 15) or isometric exercise (IE, n = 15) for 6 weeks. Functions and performance of the cervical extensors and flexors were assessed pre- and post-program, by analyzing the peak torque and electromyography during the isokinetic testing, and cross-sectional area of the deep cervical muscles at rest. The self-reported level of difficulty and post-exercise soreness during the exercise were recorded to evaluate the feasibility and safety of the two exercise programs.

Results
Both VSE and IE exercises resulted in significant improvement of the muscle functions and performance while there were no between-group differences at reassessment of the (a) cross-sectional area of longus colli and semispinalis capitis; (b) EMG amplitude in sternocleidomastoid and cervical erector spinae, and (c) peak torque values. Further analysis revealed that degree of correlation between extension torque and EMG amplitude of cervical erector spinae increased in both groups. However, significant correlation was found only in VSE group post-program. There were no significant differences for the level of difficulty and post-exercise soreness found between two groups.

Conclusions
Both velocity-specific and isometric exercises significantly promoted cervical muscle functions and performance. The present study confirms that velocity-specific exercise can be practised safely and it also contributes to a greater enhancement in neuromuscular efficiency of the cervical extensors. These findings indicate that the velocity-specific exercise can be considered as a safe alternative for training of the cervical muscles. Further study is recommended to examine its benefit and application for promoting the muscle functions and recovery in symptomatic individuals.
Thymic rebound hyperplasia post-chemotherapy mistaken as disease progression in a patient with lymphoma involving mediastinum: a case report and reflection
Authors: Qiu Lei , Zhao Yi , Yang Yang , Huang He , Cai Zhen , He Jingsong 
Published: January 2021

Abstract
Background
Chemotherapy can cause thymic atrophy and reduce T-cell output in cancer patients. However, the thymus in young adult patients has regenerative potential after chemotherapy, manifesting as thymic hyperplasia which can be easily mistaken as residual disease or recurrence in patients suffering lymphoma.

Case presentation
This study reports a case of lymphoma in a young female adult who was initially diagnosed with an anterior mediastinal mass, and was found to have soft tissue occupying the anterior mediastinum repeatedly after chemotherapy, suggesting a lymphoma residue or disease progression. From discussions by a multi-disciplinary team (MDT), the anterior mediastinal mass of the patient was considered unknown and might be thymus tissue or tumor tissue, and it was eventually identified as thymus tissue via histopathology.

Conclusions
The anterior mediastinal mass appearing after chemotherapy in patients with lymphoma can be considered as enlarged thymus, and such phenomenon is frequent in young adult patients who undergo chemotherapy or autologous hematopoietic stem cell transplantation. Additionally, detection of thymic output cells in peripheral blood might be a feasible approach to differentiate thymic hyperplasia from lymphoma.
Impact of a specialised palliative care intervention in patients with advanced soft tissue sarcoma – a single-centre retrospective analysis
Authors: Brandes F. , Striefler J. K. , Dörr A. , Schmiester M. , Märdian S. , Koulaxouzidis G. , Kaul D. , Behzadi A. , Thuss-Patience P. , Ahn J. , Pelzer U. , Bullinger L. , Flörcken A. 
Published: January 2021

Abstract
Background
Soft tissue sarcomas (STS) account for less than 1% of all malignancies. Approximately 50% of the patients develop metastases with limited survival in the course of their disease. For those patients, palliative treatment aiming at symptom relief and improvement of quality of life is most important. However, data on symptom burden and palliative intervention are limited in STS patients.

Aim
Our study evaluates the effectiveness of a palliative care intervention on symptom relief and quality of life in STS patients.

Design/setting
We retrospectively analysed 53 inpatient visits of 34 patients with advanced STS, admitted to our palliative care unit between 2012 and 2018.
Symptom burden was measured with a standardised base assessment questionnaire at admission and discharge.

Results
Median disease duration before admission was 24 months, 85% of patients had metastases. The predominant indication for admission was pain, weakness and fatigue. Palliative care intervention led to a significant reduction of pain: median NRS for acute pain was reduced from 3 to 1 (p < 0.001), pain within the last 24 h from 5 to 2 (p < 0.001) and of the median MIDOS symptom score: 18 to 13 (p < 0.001). Also, the median stress level, according to the distress thermometer, was reduced significantly: 7.5 to 5 (p = 0.027).

Conclusions
Our data underline that specialised palliative care intervention leads to significant symptom relief in patients with advanced STS. Further efforts should aim for an early integration of palliative care in these patients focusing primarily on the identification of subjects at high risk for severe symptomatic disease.
Medical students’ awareness of health issues, attitudes, and confidence about caring for lesbian, gay, bisexual and transgender patients: a cross-sectional survey
Authors: Arthur Sophie , Jamieson Abigail , Cross Harry , Nambiar Kate , Llewellyn Carrie D. 
Published: January 2021

Abstract
Background
Lesbian, gay, bisexual and transgender (LGBT) patients have an increased incidence of a range of health problems, and face many barriers to accessing healthcare. Our research aimed to explore the awareness of health issues and attitudes of medical students towards LGBT patients’ health including barriers to health services, their attitudes towards inclusion of LGBT content in the curriculum and their confidence with providing care for their LGBT patients in the future.

Methods
Medical students were recruited to take part in a cross-sectional survey. We used a 28-item survey to explore views about the undergraduate medical curriculum.

Results
252 surveys were analysed from 776 eligible participants. Attitudes towards LGBT patients were positive but awareness and confidence with respect to LGBT patients were variable. Confidence discussing sexual orientation with a patient significantly increased with year of study but confidence discussing patient gender identity did not. The majority of participants (n = 160; 69%) had not received specific training on LGBT health needs, and 85% (n = 197) wanted to receive more training.

Conclusions
Increasing the amount of LGBT teaching in undergraduate medical curricula could help to increase the quality of doctor-patient interactions, to facilitate patients’ disclosure of sexual orientation and gender identity in healthcare and increase the quality of healthcare.
How can WhatsApp® facilitate the future of medical education and clinical practice?
Authors: Salam Muhammed Aizaz us , Oyekwe George Chukwuemeka , Ghani Sami Ahmad , Choudhury Regwaan Imtiaz 
Published: January 2021

AbstractAs part of the modern generation of medical students and prospective future doctors of the United Kingdom’s Nation Health Service (NHS), we have grown up in an age where smartphones and instant messaging applications (IMAs) are ubiquitous across all aspects of society. With IMAs being so familiar, we recognise their scope for facilitating our learning of the pre-registration syllabus and how their practical nature could potentially revolutionise healthcare worldwide. It is, therefore, rational to further investigate the benefits of incorporating such technology into these respective settings. In this article, we will further expand on some of the advantages highlighted by E. Colman & E. O’Connor that IMAs, particularly WhatsApp, have in the academic environment which resonate with us. We illustrate our views on IMAs being incorporated into health systems globally through exemplifying the NHS, using reviewed literature.
Perspectives of organizational identity in a health higher education institution: a mixed-method analysis
Authors: de Miranda Junior Ubirajara José Picanço , Novaes Maria Rita Carvalho Garbi , Santos Henrique Batista Araújo , Tatsch João Fellipe Santos , Ferreira Rafael Sanches , Vieira Wilton Paulo de Freitas Martins , Lapão Luís Velez 
Published: January 2021

Abstract
Background
Among the processes to be experienced by any organization during its establishment is the formation of an organizational identity. This process can be understood as the activity and event through which an organization becomes unique in the mind of its members. An organizational identity leads to an identification and both are directly associated with the success of an institution. This study is about a public higher education institution in health in its early years, with distinctive characteristics in the country where it is situated. In spite of having been successful in the graduation of its students it has fragile institutional bases, lack of autonomy and internal problems common to other institutions of this type. Thus, this study was conducted to understand how this institution defined itself among its own members, the elements of its identity and what justified its relative success despite its weaknesses.

Methods
A mixed-method approach was used to evaluate how a representative portion of this organization identifies with it. For the qualitative study two focus groups were conducted with transcripts submitted to content analysis proposed by Bardin, culminating in results from which a Likert scale-based questionnaire was elaborated and applied to 297 subjects.

Results
There were six central elements of the organizational identity made evident by the focus groups: political / ideological conflict; active teaching and learning methodologies; location / separation of campuses; time of existence; teaching career; political-administrative transformations. The quantitative analysis revealed in more detail the general impressions raised in the focus groups. Most results were able to demonstrate distinct identifications of the same identity with its exposed weaknesses.

Conclusions
Lack of autonomy, administrative and structural shortcomings and ideological or political conflicts presented themselves as problems capable of destabilizing the identity of a public higher education institution. On the other hand, one way to combat such problems is through the development of the institution itself, particularly by becoming more active and useful to the community and seeking in a common interest to the higher administration agencies.
What impact does postgraduate clinical training have on empathy among Japanese trainee dentists?
Authors: Yoshida Toshiko , Watanabe Sho , Kono Takayuki , Taketa Hiroaki , Shiotsu Noriko , Shirai Hajime , Nakai Yukie , Torii Yasuhiro 
Published: January 2021

AbstractBackgroundEnhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients’ medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees’ empathy from cognitive, behavioral, and patients’ perspective.MethodsThis study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.ResultsNo significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85–134] vs. 108.34 [range, 69–138];p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88–118) vs. 101.06 (range, 71–122;p = 0.283) and female 109.17 (range, 85–134) vs. 111.20 (range, 69–138;p = 0.170). Similarly, there was no difference in the SPs’ evaluation of trainees’ communication (10.73 vs. 10.38,p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14,p = 0.000).ConclusionsOverall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists’ empathy levels. Providing regular education support in this area may help trainees foster their empathy.
Malpractice claimed calls within the Swedish Healthcare Direct: a descriptive – comparative case study
Authors: Björkman Annica , Engström Maria , Winblad Ulrika , Holmström Inger K. 
Published: January 2021

Abstract
Background
Medical errors are reported as a malpractice claim, and it is of uttermost importance to learn from the errors to enhance patient safety. The Swedish national telephone helpline SHD is staffed by registered nurses; its aim is to provide qualified healthcare advice for all residents of Sweden; it handles normally about 5 million calls annually. The ongoing Covid-19 pandemic have increased call volume with approximate 30%. The aim of the present study was twofold: to describe all malpractice claims and healthcare providers’ reported measures regarding calls to Swedish Healthcare Direct (SHD) during the period January 2011–December 2018 and to compare these findings with results from a previous study covering the period January 2003–December 2010.

Methods
The study used a descriptive, retrospective and comparative design. A total sample of all reported malpractice claims regarding calls to SHD (n = 35) made during the period 2011–2018 was retrieved. Data were analysed and compared with all reported medical errors during the period 2003–2010 (n = 33).

Results
Telephone nurses’ failure to follow the computerized decision support system (CDSS) (n = 18) was identified as the main reason for error during the period 2011–2018, while failure to listen to the caller (n = 12) was the main reason during the period 2003–2010. Staff education (n = 21) and listening to one’s own calls (n = 16) were the most common measures taken within the organization during the period 2011–2018, compared to discussion in work groups (n = 13) during the period 2003–2010.

Conclusion
The proportion of malpractice claims in relation to all patient contacts to SHD is still very low; it seems that only the most severe patient injuries are reported. The fact that telephone nurses’ failure to follow the CDSS is the most common reason for error is notable, as SHD and healthcare organizations stress the importance of using the CDSS to enhance patient safety. The healthcare organizations seem to have adopted a more systematic approach to handling malpractice claims regarding calls, e.g., allowing telephone nurses to listen to their own calls instead of having discussions in work groups in response to events. This enables nurses to understand the latent factors contributing to error and provides a learning opportunity.
Work activities of primary health care nurses in Poland: National Survey Results
Authors: Marcinowicz Ludmila , Wojnar Danuta , Terlikowski Slawomir Jerzy 
Published: January 2021

Abstract
Background
In some countries, including Poland, nurses have acquired autonomy from being a designated “ancillary staff” to “professional staff” only in recent decades. No prior published studies have examined, however, whether the actual nursing practice in primary health care (PHC) has evolved with the advancement of education and professional autonomy. The aim of this study is to assess the scope of practice of a PHC nurses and their actual work activities.

Methods
A cross-sectional study design using an investigator-developed survey was conducted in Poland, in 2018. The survey was sent to professionally active PHC nurses in Poland. Of the 225 questionnaires distributed, 202 (89.8%) were returned.

Results
Out of 44 work activities examined, the most often performed activity was administering medications. Less frequent activities included recognizing patients’ nursing needs and health problems and monitoring, assessing, and interpreting basic vital signs. A correlation was found between the length of work experience and the following three activities: performing nursing care, issuing referrals for specific diagnostic tests, and ordering of specific treatments, medications, and nutritional supplements. The longer was the work experience, the more often the nurses performed nursing care (r = 0.15; p = 0.035) but less often issued referrals for diagnostic tests (r = − 0.24; p = 0.001) or orders within their scope of practice (r = − 0.23; p = 0.002).

Conclusion
While nurses in general are most likely to carry out physician orders, junior nurses tend to be more likely to work toward professional autonomy and pursuing new challenges. PHC nurses in Poland perform work associated more with carrying out physicians’ orders and less with what they were prepared to do. Engaging nursing students in interprofessional education, dissemination of nursing research, and advocacy of nursing professional organizations on behalf of the profession may be an effective strategy to overcome the current barriers for PHC nurses to work the top of their license.
Body mass index and waist circumference in relation to the risk of 26 types of cancer: a prospective cohort study of 3.5 million adults in Spain
Authors: Recalde Martina , Davila-Batista Veronica , Díaz Yesika , Leitzmann Michael , Romieu Isabelle , Freisling Heinz , Duarte-Salles Talita 
Published: January 2021

Abstract
Background
A high body mass index (BMI) has been associated with increased risk of several cancers; however, whether BMI is related to a larger number of cancers than currently recognized is unclear. Moreover, whether waist circumference (WC) is more strongly associated with specific cancers than BMI is not well established. We aimed to investigate the associations between BMI and 26 cancers accounting for non-linearity and residual confounding by smoking status as well as to compare cancer risk estimates between BMI and WC.

Methods
Prospective cohort study with population-based electronic health records from Catalonia, Spain. We included 3,658,417 adults aged ≥ 18 years and free of cancer at baseline between 2006 and 2017. Our main outcome measures were cause-specific hazard ratios (HRs) with 99% confidence intervals (CIs) for incident cancer at 26 anatomical sites.

Results
After a median follow-up time of 8.3 years, 202,837 participants were diagnosed with cancer. A higher BMI was positively associated with risk of nine cancers (corpus uteri, kidney, gallbladder, thyroid, colorectal, breast post-menopausal, multiple myeloma, leukemia, non-Hodgkin lymphoma) and was positively associated with three additional cancers among never smokers (head and neck, brain and central nervous system, Hodgkin lymphoma). The respective HRs (per 5 kg/m2 increment) ranged from 1.04 (99%CI 1.01 to 1.08) for non-Hodgkin lymphoma to 1.49 (1.45 to 1.53) for corpus uteri cancer. While BMI was negatively associated to five cancer types in the linear analyses of the overall population, accounting for non-linearity revealed that BMI was associated to prostate cancer in a U-shaped manner and to head and neck, esophagus, larynx, and trachea, bronchus and lung cancers in an L-shaped fashion, suggesting that low BMIs are an approximation of heavy smoking. Of the 291,305 participants with a WC measurement, 27,837 were diagnosed with cancer. The 99%CIs of the BMI and WC point estimates (per 1 standard deviation increment) overlapped for all cancers.

Conclusions
In this large Southern European study, a higher BMI was associated with increased risk of twelve cancers, including four hematological and head and neck (only among never smokers) cancers. Furthermore, BMI and WC showed comparable estimates of cancer risk associated with adiposity.
Deciphering molecular mechanisms underlying chemoresistance in relapsed AML patients: towards precision medicine overcoming drug resistance
Authors: Levin May , Stark Michal , Ofran Yishai , Assaraf Yehuda G. 
Published: January 2021

AbstractBackgroundAcute myeloid leukemia (AML) remains a devastating disease with a 5-year survival rate of less than 30%. AML treatment has undergone significant changes in recent years, incorporating novel targeted therapies along with improvements in allogeneic bone marrow transplantation techniques. However, the standard of care remains cytarabine and anthracyclines, and the primary hindrance towards curative treatment is the frequent emergence of intrinsic and acquired anticancer drug resistance. In this respect, patients presenting with chemoresistant AML face dismal prognosis even with most advanced therapies. Herein, we aimed to explore the potential implementation of the characterization of chemoresistance mechanisms in individual AML patients towards efficacious personalized medicine.MethodsTowards the identification of tailored treatments for individual patients, we herein present the cases of relapsed AML patients, and compare them to patients displaying durable remissions following the same chemotherapeutic induction treatment. We quantified the expression levels of specific genes mediating drug transport and metabolism, nucleotide biosynthesis, and apoptosis, in order to decipher the molecular mechanisms underlying intrinsic and/or acquired chemoresistance modalities in relapsed patients. This was achieved by real-time PCR using patient cDNA, and could be readily implemented in the clinical setting.ResultsThis analysis revealed pre-existing differences in gene expression levels between the relapsed patients and patients with lasting remissions, as well as drug-induced alterations at different relapse stages compared to diagnosis. Each of the relapsed patients displayed unique chemoresistance mechanisms following similar treatment protocols, which could have been missed in a large study aimed at identifying common drug resistance determinants.ConclusionsOur findings emphasize the need for standardized evaluation of key drug transport and metabolism genes as an integral component of routine AML management, thereby allowing for the selection of treatments of choice for individual patients. This approach could facilitate the design of efficacious personalized treatment regimens, thereby reducing relapse rates of therapy refractory disease.