bluuebunny/crossref_metadata_2025_split huggingface dataset:
What are the shared decision‐making experiences of adult children in regard to their parent/s’ health care in residential aged care facilities?
Authors: Monson Ainslie , Hendricks Joyce , Sundin Deborah 
Published: March 2021

AbstractAimThis scoping literature review aimed to answer the question: What are the shared decision‐making experiences of adult children in regard to their parent/s’ health care in residential aged care facilities?BackgroundShared decision‐making has been an important patient‐centred approach to nursing care since the 1990s, yet it is becoming increasingly evident that it is still not the reality in aged care facilities fifty years on. Currently, it is not well understood how adult children participate in shared decision‐making and the types of decisions they are required to make.DesignA review of original research papers using Kable, Pich and Maslin‐Prothero 12‐step systematic approach to documenting a search strategy.MethodThe researcher screened 597 articles from four databases, published in the English language, during the period 1985–2019. The researcher used the Mixed Methods Appraisal Tool version 2011 to determine the methodological quality of the included studies. The Joanna Briggs Institute QARI data tool was used to appraise the seven selected articles and thematically analyse findings, respectively.ResultsFour themes were highlighted: communication; staffing; being involved; and staff–family relationships. Despite these themes being apparent, families have limited opportunities to participate in shared health decision‐making in regard to their parents’ care.ConclusionThe findings from this literature show how shared decision‐making is affected by the RACF environment. There is a need to find out and understand what is important from a family member's point of view to optimise shared decision‐making and nursing care of the family member in residential aged care settings.Relevance to clinical practiceThe limited findings specific to the SDM experiences of adult children of parents in RACFs in this review could help staff and RACFs to develop strategies and staff training to encourage and facilitate the implementation of shared health decision‐making with staff and families on older people's care.
Pharmacological management of an aneurysmal bone cyst in Noonan syndrome
Authors: Jadun Sarah , Beneng Kiran , Kwok Jerry , Sproat Chris , Patel Vinod 
Published: March 2021

AbstractAimNoonan syndrome is an uncommon disorder which can present with developmental delay, short stature and cardiac anomalies. Oro‐facial presentation includes giant cell lesions with secondary aneurysmal bone cysts (ABC). The current case report presents an extensive mandibular ABC managed solely by oral bisphosphonates.Material and methodsThis is a single retrospective case report.ResultsA stark regression of the ABC was evident following the use of oral bisphosphonates with reformation of mandibular integrity.ConclusionThis case reports highlights the potential value of oral bisphosphonate to manage oral pathology such as an ABC.
Photochemoprotective Potential of the Ethyl Acetate Fraction from Eugenia hiemalis Leaves and Its 2,6‐Di‐O‐galloylarbutin Isolate Against UVB‐Induced Photodamage
Authors: Iwanaga Camila C. , Ferreira Lilian A.O. , Rodrigues Camilla C.A. , Pinto Ingrid C. , Romagnolo Mariza B. , Nakamura Celso V. , Casagrande Rubia , Truiti Maria C.T. 
Published: March 2021

AbstractIntense and constant exposure to UVB radiation can lead to inflammation and oxidative stress, which are associated with many cutaneous disorders, including photoaging and skin cancer. Antioxidant plant materials that are rich in polyphenols, such as the ethyl acetate fraction (EAF) from Eugenia hiemalis leaves, and phenolic compounds represent a promising approach to protect the skin against UVB‐induced damage. The present study evaluated the photochemoprotective potential of the EAF and its 2,6‐di‐O‐galloylarbutin (1) isolate. The EAF and the phenolic antioxidant (1) reduced UVB‐induced L929 fibroblast death. The EAF prevented UVB‐induced damage in fibroblasts by inhibiting the intracellular production of reactive oxygen species and lipid peroxidation, especially in pretreated cells. Topical treatment with an emulsion with 1% EAF prevented/attenuated UVB‐induced inflammation and oxidative stress in the skin in hairless mice by controlling the increase in myeloperoxidase activity, reducing superoxide anion production, maintaining radical‐scavenging ability and ferric reducing power, and controlling the depletion of reduced glutathione and catalase levels. The EAF also inhibited the increase in epidermal thickness, mast cell infiltration, the number of sunburn cells and collagen fiber destruction that were triggered by UVB. The in vitro and in vivo results indicated that the EAF is a bioactive agent that is able to protect the skin against the harmful effects of UVB.
Comparing the physical performance of liquid barrier films
Authors: Bodkhe Rajan B. , Shrestha Shrijana B. , Unertl Karl , Fetzik Joseph , McNulty Amy K. 
Published: March 2021

AbstractBackgroundBarrier films have been used for many years to protect skin from the damaging effects of excessive moisture and mechanical injury. The performance characteristics important for these protective effects are mainly product durability and its ability to reduce the force of adhesive removal. Additionally, the moisture vapor transmission rate through the film needs to be high enough that maceration is prevented. The current study was undertaken to investigate various physical performance characteristics of six commercially available barrier films.Materials and methodsSeveral bench tests were used to simulate performance features of the barriers on skin including barrier durability, breathability (moisture vapor permeability), and the effect on adhesive dressing force of removal.ResultsResults indicated that barrier films did not perform equivalently. However, Cavilon™ No Sting Barrier Film (NSB) was shown to have significantly greater durability in the barrier integrity test than all other barriers tested and was tied for highest breathability and highest reduction in peel force from steel. No other tested barrier film performed as consistently across the different tests.ConclusionThese results may provide mechanistic understanding of how barriers such as NSB may clinically assist with the prevention of adhesive‐ and moisture‐related skin damage.
Primary bone marrow T‐cell lymphoma in a Golden Retriever
Authors: Pinard Christopher J. , Ludwig Latasha , Egan Rebecca , Tatiersky Laetitia , Brooks Melanie , Richardson Danielle , Hocker Samuel E , Bienzle Dorothee 
Published: March 2021

AbstractA 6.2‐year‐old 28‐kg (61.7 lb) intact female Golden Retriever was referred due to persistent and multiple cytopenias noted on a routine CBC prior to a mature ovariohysterectomy procedure. The patient's physical examination was unremarkable, and staging of the thorax and abdomen identified no abnormalities. At the referral hospital, moderate hypercalcemia, borderline anemia, and neutropenia were noted. Assessment of bone marrow samples by cytology, histology, immunohistochemistry, and flow cytometry indicated a T‐cell neoplasm. The patient was treated with a multi‐agent chemotherapy protocol for 6 months, which induced remission. Nine months after diagnosis, she relapsed with recurrence of hypercalcemia, cytopenias, and clinical illness. Single‐agent anthracycline (mitoxantrone) in combination with prednisone therapy was initiated for 3 months. Two months after completion, the patient relapsed again, and palliative therapy with prednisone was elected. The patient was euthanized 16 months after diagnosis due to progressive disease. Post‐mortem histopathologic evaluation showed extensive replacement of bone marrow by neoplastic cells, and infiltrates in multiple organs. The neoplasm was diagnosed as lymphoma rather than leukemia due to the lack of abnormal circulating cells throughout the course of disease. The neoplasm was detected only in marrow at the time of initial diagnosis, and the marrow was the most extensively effaced organ at the time of death. Therefore, leukemia or stage V lymphoma was considered unlikely. In patients with a cytopenia and lack of neoplastic leukocytosis or solid tissue masses, primary bone marrow lymphoma should be considered among the differential diagnoses.
Optimization of diagnostic strategy for non‐invasive cell‐free foetal RHD determination from maternal plasma
Authors: Pazourkova Eva , Zednikova Iveta , Korabecna Marie , Kralova Jana , Pisacka Martin , Novotna Michaela , Calda Pavel , Horinek Ales 
Published: March 2021

Background and objectivesThe aim of the study was to optimize routine non‐invasive prenatal detection of fetal RHD gene from plasma of RhD‐negative pregnant women (the median of gestational age was 25 weeks, range 10–38) to detect RhD materno‐fetal incompatibility and to avoid the redundant immunoprophylaxis.Materials and methodsInitially only one exon of RHD gene (exon 10) was investigated in 281 plasma samples (144 verified after delivery), in the second phase three RHD exons (5, 7, 10) were analyzed in 246 samples of plasma and maternal genomic DNA (204 verified) by real‐time PCR method. Detection of Y‐chromosomal sequence DYS‐14 and five X‐chromosomal insertion/deletion polymorphisms was used to confirm the fetal cfDNA detectability in plasma. Specific polymorphisms in RHD gene were detected by sequence‐specific primer PCR in nine samples.ResultsWhen only the RHD exon 10 was tested, 2·8% of verified samples were false positive and 3·5% false negative. With three RHD exons (5, 7, 10) and maternal genomic DNA testing, only one case was false negative (0·5%). Nine samples were inconclusive due to RHD‐positive results in maternal genomic DNA. These samples were analyzed for specific mutations in RHD gene. Combination of both methods for fetal cfDNA verification succeeded in 75% of tested group.ConclusionImplementation of analysis of three RHD exons and maternal genomic DNA to routine practice lowers dramatically the ratio of false positive and negative results. This method enables more accurate determination of fetal RHD status with the reduction of unnecessary medical care and RhD immunoprophylaxis.
Skin autofluorescence predicts cancer in subjects with type 2 diabetes
Authors: Foussard Ninon , Larroumet Alice , Rigo Marine , Mohammedi Kamel , Baillet-Blanco Laurence , Poupon Pauline , Monlun Marie , Lecocq Maxime , Devouge Anne-Claire , Ducos Claire , Liebart Marion , Battaglini Quentin , Rigalleau Vincent 
Published: March 2021

IntroductionSubjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.Research design and methodsFrom 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.ResultsThe participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2–3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ2: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).ConclusionsSkin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.
Ethnic differences in beta cell function occur independently of insulin sensitivity and pancreatic fat in black and white men
Authors: Ladwa Meera , Bello Oluwatoyosi , Hakim Olah , Shojaee-Moradie Fariba , Boselli Maria Linda , Charles-Edwards Geoff , Peacock Janet , Umpleby A Margot , Amiel Stephanie A , Bonadonna Riccardo C , Goff Louise M 
Published: March 2021

IntroductionIt is increasingly recognized that type 2 diabetes (T2D) is a heterogenous disease with ethnic variations. Differences in insulin secretion, insulin resistance and ectopic fat are thought to contribute to these variations. Therefore, we aimed to compare postprandial insulin secretion and the relationships between insulin secretion, insulin sensitivity and pancreatic fat in men of black West African (BA) and white European (WE) ancestry.Research design and methodsA cross-sectional, observational study in which 23 WE and 23 BA men with normal glucose tolerance, matched for body mass index, underwent a mixed meal tolerance test with C peptide modeling to measure beta cell insulin secretion, an MRI to quantify intrapancreatic lipid (IPL), and a hyperinsulinemic-euglycemic clamp to measure whole-body insulin sensitivity.ResultsPostprandial insulin secretion was lower in BA versus WE men following adjustment for insulin sensitivity (estimated marginal means, BA vs WE: 40.5 (95% CI 31.8 to 49.2) × 103vs 56.4 (95% CI 48.9 to 63.8) × 103pmol/m2body surface area × 180 min, p=0.008). There was a significantly different relationship by ethnicity between IPL and insulin secretion, with a stronger relationship in WE than in BA (r=0.59 vs r=0.39, interaction p=0.036); however, IPL was not a predictor of insulin secretion in either ethnic group following adjustment for insulin sensitivity.ConclusionsEthnicity is an independent determinant of beta cell function in black and white men. In response to a meal, healthy BA men exhibit lower insulin secretion compared with their WE counterparts for their given insulin sensitivity. Ethnic differences in beta cell function may contribute to the greater risk of T2D in populations of African ancestry.
Using an adaptive, codesign approach to strengthen clinic-level immunisation services in Khayelitsha, Western Cape Province, South Africa
Authors: Timothy Andrea , Coetzee David , Morgan Christopher , Kelaher Margaret , Bailie Ross Stewart , Danchin Margie 
Published: March 2021

IntroductionOptimal immunisation programme service delivery and childhood vaccine coverage remains an ongoing challenge in South Africa. Previous health systems approaches have made recommendations on how to address identified barriers but detailed local implementation studies are lacking. This study aimed to improve immunisation service delivery in children under 24 months in Khayelitsha, Western Cape Province using an adaptive, co-design approach to assess and improve childhood immunisation service delivery at the clinic level.MethodsA rapid, adaptive approach to identification of barriers and assessment of current childhood immunisation service delivery was developed with three clinics in Khayelitsha, Western Cape Province. This informed a short co-design process with key stakeholders and service providers to develop local interventions targeted at high priority barriers. Interventions were implemented for 4–6 months and evaluated using theory-based evaluation tools. Clinic service delivery, satisfaction and changes to clinic processes and parent engagement and knowledge were measured.ResultsInterventions developed included weekly community immunisation education radio sessions, daily clinic health talks, immunisation education and promotion materials and service provider and parent quality checklists. Evaluation post-intervention showed improvement in parents’/guardians’ knowledge about immunisation, parent engagement and service provider commitment to improvement in service quality. Radio sessions and immunisation education and communication materials were deemed most useful by parents and providers.ConclusionImmunisation service delivery can be strengthened using an adaptive, clinic-led assessment process which can effectively identify barriers, inform co-designed interventions and be evaluated over a short period. This approach provides a framework to guide future local participatory action research to more effectively improve childhood immunisation service delivery and other child health services in under-resourced settings.
Relationship ofPneumocystisantibody responses to paediatric asthma severity
Authors: Rayens Emily , Noble Brenda , Vicencio Alfin , Goldman David L , Bunyavanich Supinda , Norris Karen A 
Published: March 2021

BackgroundAlthough asthma is the most commonly diagnosed respiratory disease, its pathogenesis is complex, involving both genetic and environmental factors. A role for the respiratory microbiome in modifying asthma severity has been recently recognised. Airway colonisation byPneumocystis jiroveciihas previously been associated with multiple chronic lung diseases, including chronic obstructive pulmonary disease (COPD) and severe asthma (SA). Decreased incidence ofPneumocystispneumonia in HIV-infected individuals and reduced severity of COPD is associated with naturally occurring antibody responses to thePneumocystisantigen, Kexin (KEX1).Methods104 paediatric patients were screened for KEX1 IgG reciprocal end point titre (RET), including 51 with SA, 20 with mild/moderate asthma, 20 non-asthma and 13 with cystic fibrosis (CF) in a cross-sectional study.ResultsPatients with SA had significantly reducedPneumocystisKEX1 titres compared with patients with mild/moderate asthma (p=0.018) and CF (p=0.003). A binary KEX1 RET indicator was determined at a threshold of KEX1 RET=1000. Patients with SA had 4.40 (95% CI 1.28 to 13.25, p=0.014) and 17.92 (95% CI 4.15 to 66.62, p<0.001) times the odds of falling below that threshold compared with mild/moderate asthma and patients with CF, respectively. Moreover, KEX1 IgG RET did not correlate with tetanus toxoid IgG (r=0.21, p=0.82) or total IgE (r=0.03, p=0.76), indicating findings are specific to antibody responses to KEX1.ConclusionsPaediatric patients with SA may be at higher risk for chronicPneumocystisinfections and asthma symptom exacerbation due to reduced levels of protective antibodies. Plasma KEX1 IgG titre may be a useful parameter in determining the clinical course of treatment for paediatric patients with asthma.
Tumor DNA methylation profiles correlate with response to anti-PD-1 immune checkpoint inhibitor monotherapy in sarcoma patients
Authors: Starzer Angelika M , Berghoff Anna S , Hamacher Rainer , Tomasich Erwin , Feldmann Katharina , Hatziioannou Teresa , Traint Stefan , Lamm Wolfgang , Noebauer-Huhmann Iris M , Furtner Julia , Müllauer Leonhard , Amann Gabriele , Bauer Sebastian , Schildhaus Hans-Ulrich , Preusser Matthias , Heller Gerwin , Brodowicz Thomas 
Published: March 2021

BackgroundSome sarcomas respond to immune checkpoint inhibition, but predictive biomarkers are unknown. We analyzed tumor DNA methylation profiles in relation to immunological parameters and response to anti-programmed cell death 1 (anti-PD-1) immune checkpoint inhibitor (ICI) therapy in patients with sarcoma.Patients and methodsWe retrospectively identified adult patients who had received anti-PD-1 ICI therapy for recurrent sarcoma in two independent centers. We performed (1) blinded radiological response evaluation according to immune response evaluation criteria in solid tumors (iRECIST) ; (2) tumor DNA methylation profiling of >850,000 probes using Infinium MethylationEPIC microarrays; (3) analysis of tumor-infiltrating immune cell subsets (CD3, CD8, CD45RO, FOXP3) and intratumoral expression of immune checkpoint molecules (PD-L1, PD-1, LAG-3) using immunohistochemistry; and (4) evaluation of blood-based systemic inflammation scores (neutrophil-to-lymphocyte ratio, leucocyte-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio). Response to anti-PD-1 ICI therapy was bioinformatically and statistically correlated with DNA methylation profiles and immunological data.Results35 patients (median age of 50 (23–81) years; 18 females, 17 males; 27 soft tissue sarcomas; 8 osteosarcomas) were included in this study. The objective response rate to anti-PD-1 ICI therapy was 22.9% with complete responses in 3 out of 35 and partial responses in 5 out of 35 patients. Adjustment of DNA methylation data for tumor-infiltrating immune cells resulted in identification of methylation differences between responders and non-responders to anti-PD-1 ICI. 2453 differentially methylated CpG sites (DMPs; 2043 with decreased and 410 with increased methylation) were identified. Clustering of sarcoma samples based on these DMPs revealed two main clusters: methylation cluster 1 (MC1) consisted of 73% responders and methylation cluster 2 (MC2) contained only non-responders to anti-PD-1 ICI. Median progression-free survival from anti-PD-1 therapy start of MC1 and MC2 patients was 16.5 and 1.9 months, respectively (p=0.001). Median overall survival of these patients was 34.4 and 8.0 months, respectively (p=0.029). The most prominent DNA methylation differences were found in pathways implicated in Rap1 signaling, focal adhesion, adherens junction Phosphoinositide 3-kinase (PI3K)-Akt signaling and extracellular matrix (ECM)–receptor interaction.ConclusionsOur data demonstrate that tumor DNA methylation profiles may serve as a predictive marker for response to anti-PD-1 ICI therapy in sarcoma.