bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why do Older Women with Invasive Breast Cancer Avoid Surgery? A Qualitative Analysis of Factors Influencing the Decision of Patients and Physicians
Authors: Angarita Fernando A. , Hoppe Ethan , Ko Gary , Lee Justin , Vesprini Danny , Hong Nicole Look 
Published: February 2021

Abstract
Purpose: Limited data exists about why older women (≥70 years old) with breast cancer avoid surgery. This study aimed to identify physician- and patient-perceived attitudes that influence the decision to avoid surgery among older women with invasive breast cancer.Methods: Semi-structured in-depth interviews were conducted with multidisciplinary breast cancer specialists and with older women with breast cancer who declined surgery. Transcripts were iteratively coded using a theoretical framework to guide identification of common themes. Thematic comparison was performed between patients and physicians. Results: Ten breast cancer specialists and eleven patients participated. Physicians believed older women declined surgery because they did not perceive their breast cancer as a life-threatening ailment compared to other medical comorbidities. Physicians did not discuss breast reconstruction, as it was perceived to be unimportant. Treatment side effects, length of treatment, impact on quality of life, and minimal survival benefit strongly influenced a patient’s decision to decline surgery. Patients valued independence and quality of life over quantity of life. Patients felt empowered to participate in the decision-making process but appreciated having support. Both groups had congruent beliefs with respect to age impacting treatment decision, cosmesis playing a minor factor in treatment decisions, and importance of quality of life; however, they were discordant in their perceptions about the amount of support that patients have from their families.Conclusion: The decision to avoid surgery in older women stems from a variety of individual beliefs. Acknowledging patient values early in treatment planning may facilitate a patient-centered approach to treatment decision making.
Effect of 8 Weeks of Vitamin D Supplementation and Water-Based Exercise on Cardiometabolic Profile in Women With Type 2 Diabetes
Authors: Salarinia Mona , Azizi Mohammad , Tahmasebi Worya , Khalvandi Hadi 
Published: February 2021

Abstract
BackgroundSince type 2 diabetes is the most common metabolic disease, it is necessary to know the factors affecting on the complications of this disease. The aim of this study was to investigate the Effect of 8 weeks of vitamin D supplementation and water exercise on cardiometabolic profile in women with type 2 diabetes.Methods40 women with type 2 diabetes participated in this study voluntarily and randomly divided to four groups: 1) vitamin D+ water exercise, 2) vitamin D, 3) water exercise, and 4) control groups. Water exercise groups (groups 1 and 3) performed 3 sessions of water training per week during 8 weeks (15 minutes of warm-up, 45 to 60 minutes of main activity with a Borg scale of 14 and 10 minutes of cooling). Vitamin D groups (groups 1 and 2) received 50,000 (IU) vitamin D supplements once a week. Levels of fasting blood sugar (FBS), insulin, hemoglobin A1c (HbA1c), C- reactive protein (CRP) levels, as well as lipid protein profile (triglyceride, total cholesterol, high and low density lipoproteins (LDL and HDL)) were measured before and after intervention. Insulin resistance was also obtained by calculating HOMA-IR.ResultsWeight, waist circumference, and body fat mass were significantly decrease after intervention in Vitamin D+ water exercise group (P= 0.001, 0.001, 0.032, and 0.013 respectively), as well as CRP, glycemic and lipid profile were significantly improved after intervention in water exercise group.ConclusionThe results of the present study showed that water exercise plus vitamin D supplementation had synergism beneficial effects on anthropometric indices and cardiometabolic status of type 2 diabetic patients and can be used as a non-pharmacological and non-invasive method to reduce complications of type 2 diabetes. Iranian Clinical Trials Registry number: IRCT20201223049811N1, data of registration: 12.01.2021; https://en.irct.ir/trial/53230
4D printing of reconfigurable metamaterials and devices
Authors: Manen Teunis van , Janbaz Shahram , Jansen Kaspar , Zadpoor Amir 
Published: February 2021

Abstract
Shape-shifting materials are a powerful tool for the fabrication of reconfigurable materials. Upon activation, not only a change in their shape but also a large shift in their material properties can be realized. As compared with the 4D printing of 2D-to-3D shape-shifting materials, the 4D printing of reconfigurable (i.e., 3D-to-3D shape-shifting) materials remains challenging. That is caused by the intrinsically 2D nature of the layer-by-layer manner of fabrication, which limits the possible shape-shifting modes of 4D printed reconfigurable materials. Here, we present a novel single-step production method for the fabrication and programming of 3D-to-3D shape-changing materials, which requires nothing more than a simple modification of widely available fused deposition modeling (FDM) printers. This simple modification allows the printer to print on curved surfaces. We demonstrate how this modified printer can be combined with novel design strategies to achieve unprecedented levels of complexity and versatility in the 3D-to-3D shape-shifting behavior of our reconfigurable materials and devices. We showcase the potential of the proposed approach for the fabrication of deployable medical devices including deployable bifurcation stents that are otherwise extremely challenging to create.
Possible Neuropathic Pain in Patients With Osteoarthritis of the Knee Before and After Total Knee Arthroplasty
Authors: Hasegawa Masahiro , Tone Shine , Naito Yohei , Sudo Akihiro 
Published: February 2021

Abstract
Background: Although osteoarthritis (OA) is traditionally considered to be nociceptive, our objective was to examine neuropathic pain in the knees of OA patients using the pain DETECT questionnaire (PDQ).Methods: A total of 180 knees in 158 consecutive patients who underwent total knee arthroplasty (TKA) were enrolled. The prevalence of neuropathic pain, unclear pain and nociceptive pain was determined before and after TKA. Knee pain was evaluated using a numerical rating scale (NRS). All patients were evaluated preoperatively and 6 months postoperatively. Neuropathic pain and unclear pain were grouped together as possible neuropathic pain. The relationship between possible neuropathic pain and pain intensity was evaluated.Results: Before TKA, neuropathic pain and unclear pain were found in 10 and 30 knees, respectively. The remaining 140 knees were categorized as nociceptive pain. After TKA, the numbers of knees with neuropathic and unclear pain decreased to one and five, respectively. The prevalence of possible neuropathic pain decreased significantly from 22.2% to 3.3% (p < 0.001) after surgery. Among the six knees with possible neuropathic pain postoperatively, four had possible neuropathic pain preoperatively as well, while the remaining two patients had been classified as nociceptive pain preoperatively (p = 0.021). Knees with postoperative possible neuropathic pain had higher postoperative NRS scores than those with nociceptive pain (p = 0.011).Conclusions: The prevalence of possible neuropathic pain decreased significantly after TKA, however, preoperative possible neuropathic pain might affect the presence of persistent postoperative pain.
Designing A New Suitable Support System for Deep Virgin Coal Mining Blocks of Godavari Valley Coalfield
Authors: Shankar Vikram , Kumar Dheeraj , Subrahmanyam Duvvuri Satya 
Published: February 2021

Abstract
Importance of support system in mine design gained pace after modern way of approach took birth through many variants. A suitable support system is designed for deep virgin coal mining blocks of Godavari valley coalfield in India. This is achieved by measuring stress state by sophisticated method followed by geotechnical hazard mapping for identifying potential roof instability, predict hazards in advance and integrating the above parameters for analyze effects on stress due to different mining geometries by using numerical modelling technique. The three-dimensional numerical analysis study pours much light on effects causing instability than the 2D program. The results show that the stresses at an angle to the Level galleries are adverse. The level gallery/dip-raise may be oriented at 200 to 400 to reduce roof problems.
Supremacy of Magnetic Behaviour in n-Heptane Based M Doped Barium Ferrite (BaFe2O4) Nanoparticles (M: Co, Ni and Mn)
Authors: R Dilip , R Jayaprakash 
Published: February 2021

Abstract
The M doped BaFe2O4 (M- Co, Ni and Mn) nanoparticles were synthesized through auto combustion method by using n-heptane as a surfactant. And also the weight percentage (wt%) of metals such as cobalt, nickel and manganese (10 wt%, 8 wt% and 6 wt%) in BaFe2O4 was optimized. The prominent orientation (212) and (311) of M doped BaFe2O4 is confirmed from XRD especially in 10 wt% of respective metals. The addition of metal doped in barium ferrite specific vibration on 770 and 445 cm− 1 in FTIR spectra indicated the formation of M doped BaFe2O4. The influence of n-heptane as a surfactant on morphological change occurred in different metal doped was visualized from FESEM and TEM images. The different morphologies such as spherical, hexagonal platelets and small rectangular bar shaped were observed only by the inclusion of barium ferrite at surfactant medium. The analysis of EDX spectrum reflected the atomic percentage of elemental presence in the samples of M doped barium ferrite. Magnetic properties of these samples were studied by VSM. It revealed that 28.41 emu/g saturation magnetization (Ms) with 1655.64 Oe coercivity (Hc) and also induced ferromagnetic behaviour. The variation of dielectric constant indicated from dielectric study.
The Responses of Soil Microbial to Changed Rainfall and Increased Temperature in Desert Grassland in Northern China
Authors: Zhang Yi , Xie Ying-Zhong , Ma Hong-Bin , Zhang Juan , Jing Le , Wang Yu-Tao , Li Jianping 
Published: February 2021

Abstract
Background: The study evaluates how rainfall change and temperature increase affect microbial communities in the desert grassland of Ningxia Autonomous Region, China to explore the soil microbial community and the relationships among the soil microbial community, chemical properties, soil respiration (SR) and plant biomass under the climate change. We established the field experiment with five levels of rainfall by rainout shelters and two levels of temperature by Open-Top Chamber (OTC). Results: The effect of temperature to soil microbial communities is not significant, but with the continuous increase of rainfall, the microbial community gradually increases. Soil microbial diversity negatively correlated with soil CO2 flux. The α-diversity of microbial communities positively correlated with above-living biomass (ALB) and soil temperature (ST), but negatively correlated with root biomass (RB). Conclusions: Both rainfall and temperature’s rising do not promote the soil community α-diversity, but it can promote soil microbial community β-diversity. Soil microbial communities show resistance to rainfall changing. Soil respiration (SR) will limit soil microbial diversity. Soil organic carbon (SOC), soil total nitrogen (STN), and soil total phosphorus (STP) will promote soil microbial abundance and diversity. ALB and ST will promote the soil α-diversity, but the effect of RB to soil microbial is opposite. These findings maybe provide a reliable theoretical basis for formulating a reasonable response strategy in desert steppe ecosystems.
Family-Centered Approach to Monitoring Children’s Development in a Paediatric Outpatient Setting: Feasibility Study from Pakistan
Authors: Rasheed Muneera A. , Mughis Waliyah , Elahi Kinza N , Hasan Babar S. 
Published: February 2021

Abstract
Background: The purpose of the study was to design and test the feasibility of a recent guideline of family-centered psychosocial support as an approach to developmental monitoring in a pediatric outpatient setting.Methods: The patient experience team at a private tertiary care hospital leveraged an on-going patient and family-centric initiative in the service to implement the intervention. The intervention delivery model was designed using the theory of change model and entailed the following i) the service providers: paediatricians but with support from psychology trainee volunteers to address time constraints; ii) monitoring form: Survey of Well-Being of Young Children (SWYC) being feasible and designed for regular developmental monitoring as parent report; iii) family support intervention: the Care for Child Development module to enhance parent-child interactions given team’s successful experience with inpatient children; iv) timing: utilize wait time to also enhance families’ experience and v) reinforcement: reinforced by the paediatrician in the consultation visit to capitalize on the established rapport and relationship with families. All families with children under 5 years 5 months of age in selected clinics (acute care, complex care, developmental issues) were eligible. The study was evaluated for acceptability and implementation feasibility. Families were interviewed about their experience; trainees provided a written narrative while physicians provided feedback on email. These were thematically analyzed using an inductive approach.Results: A total 182 families were administered the SWYC with 54% children detected for further review on cognitive milestones and 76% on social-emotional milestones. Forty-eight families were interviewed regarding their experience with the intervention. They reported the monitoring process to be useful and important for them as parents indicating acceptability. Paediatricians and trainees found the intervention to be important for parents and children’s health also requesting further understanding about child’s functioning. The trainees further expressed the experience to be significant for their own learning.Conclusion: The authors conclude that the intervention model for a family-centric approach to monitoring was acceptable to the families and the service providers. The intervention when implemented using a robust behaviour change framework can enhance feasibility.
High crop yield losses induced by potential HONO sources —— a case study in the North China Plain
Authors: Zhang Jingwei , Ran Haiyan , Guo Yitian , Xue Chaoyang , Liu Xingang , Qu Yu , Sun Yele , Zhang Qiang , Mu Yujing , Chen Yong , Wang Jing , An Junling 
Published: February 2021

Abstract
Nitrous acid (HONO) is a major source of hydroxyl radicals in the troposphere through its photolysis, and can significantly influence ozone (O3) levels, thereby causing considerable crop yield losses. Previous studies have assessed relative crop yield losses by using exposure-response equations with observed or simulated O3, however, the contribution of enhanced O3 due to potential HONO sources to the crop yield losses has never been quantified. In this study, for the first time, we evaluated the crop yield losses caused by potential HONO sources in the North China Plain (NCP), which is one of the major grain-producing areas in China suffering from heavy O3 pollution, by using the Weather Research and Forecasting/Chemistry (WRF-Chem) model during the wheat and maize growing seasons of 2016. HONO simulations were significantly improved after including six potential HONO sources. The potential HONO sources produced a daily maximum 8-h O3 enhancement of 8.1/8.2 ppb during the wheat/maize growing seasons, respectively, and led to ~11.4%/3.3% relative yield losses for wheat/maize, respectively, corresponding to approximately US$3.78/0.66 billion losses, respectively, in NCP in 2016. Potential HONO sources play a significant role in O3 formation and may induce high crop yield losses globally.
Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi.
Authors: HAKIZIMANA SONIA , Odjidja Emmanuel Nene 
Published: February 2021

Abstract
Background With a fertility rate of 5.4 children per woman, Burundi ranked as seventh country with the highest fertility rate in the world. Family planning is an effective way of achieving desirable family size, appropriate birth spacing and significant reduction in unintended pregnancies. Furthermore, family planning has been linked to improvements in maternal health outcomes. Yet, in spite of the overwhelming evidence on the benefits of family planning and despite high knowledge and free services, utilisation is low especially in rural communities with conservative people. Employing a mixed methods approach, this study first quantifies contraceptive prevalence and second, explores the contextual multilevel factors associated with low family planning utilisation among community members.Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n=132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes.Results The overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29 (aOR 5.04 (95% CI 2.09 – 10.27 p=0.038)), those that have completed secondary school and having four or less children were significantly associated with use of family planning (aOR 1.72 (95%1.35 – 2.01) p=0.002). Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion Given that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use.
Online art therapy in elementary schools during COVID-19: results from a randomized cluster pilot and feasibility study and impact on mental health.
Authors: Malboeuf-Hurtubise Catherine , Léger-Goodes Terra , Mageau Geneviève A. , Taylor Geneviève , Herba Catherine , Chadi Nicholas , Lefrançois David 
Published: February 2021

Abstract
Background: Emerging literature on the current COVID-19 crisis suggests that children may experience increased anxiety and depression as a result of the pandemic. To prevent such school and mental health-related problems, there is a timely need to develop preventive strategies and interventions to address potential negative impacts of COVID-19 on children’s mental health, especially in school settings. Results from previous child clinical research indicate that art-based therapies, including mindfulness-based art therapy, have shown promise to increase children’s well-being and reduce psychological distress. Objective: The goal of the present pilot and feasibility study was to compare the impact of an emotion-based directed drawing intervention and a mandala drawing intervention, on mental health in elementary school children (N=22), in the context of the COVID-19 pandemic. Both interventions were group-based and delivered online and remotely. A pilot study using a randomized cluster design was implemented to evaluate and compare both interventions in relation to child anxiety, depression, inattention and hyperactivity symptoms. Results: Analyses of covariance revealed a significant effect of the type of drawing intervention on levels of inattention, after controlling for baseline levels. Participants in the emotion-based directed drawing group showed lower inattention scores at post-test, when compared to participants in the mandala group. Post-hoc sensitivity analyses showed significant decreases in pre-to-post scores for levels of hyperactivity for the complete sample. Conclusion: Overall, results from this pilot and feasibility study showed that both an emotion-based directed drawing intervention and a mandala drawing intervention may be beneficial to improve mental health in elementary school children, in the context of the current COVID-19 pandemic. From a feasibility standpoint, results indicate that the implementation of both interventions online and remotely, through a videoconference platform, is feasible and adequate in school-based settings. Further work incorporating larger sample sizes, longitudinal data and ensuring sufficient statistical power is warranted to evaluate the long-term impact of both interventions on children’s mental health.
Clinical and Hemodynamic Characterization Super Responders to IV Prostacyclin in Pulmonary Arterial Hypertension
Authors: Conger Adrienne K , Halliday Steven J , Pugh Meredith E , Robbins Ivan M , Hemnes Anna R 
Published: February 2021

Abstract
Background: Parenteral prostacyclins are the only therapy proven to extend survival in pulmonary arterial hypertension (PAH), yet at the bedside clinicians have no tools to predict which patients are most likely to benefit from this medication class. Methods: We retrospectively analyzed all PAH patients treated with IV epoprostenol therapy at our center from 1/1/1996 to 12/31/2016. We analyzed survival in patients and defined the 90 th percentile of survival. Patients were divided into those who survived past this point (super responders) and those who had had an event prior to this time point after initiation of iv epoprostenol (usual responders). Results: The median survival after IV epoprostenol initiation was 4.32 years, and the 90 th percentile of event-free survival was 11.09 years. Fourteen patients met criteria for super responder and 45 had a survival <90 th percentile, comprising the usual responder group. Super responders tended to be younger, have longer six-minute walk distances and higher mean pulmonary arterial pressure (p<0.05 for all). In follow up, super responders continued to have a higher six-minute walk distance and were more likely to have achieved normal or only mildly impaired right ventricular function, though no differences in hemodynamics were observed. Conclusions: There may be a super responder phenotype that can be defined in patients with PAH by >90 th percentile of survival. Super responders were more likely that usual responders to be younger and were more likely to have achieved favorable right ventricular function at follow up, however, differences in hemodynamics were not observed.