bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-life outcomes with or without early palliative care: a propensity score matched, population-based cancer cohort study
Authors: Seow Hsien , Sutradhar Rinku , Burge Fred , McGrail Kimberlyn , Guthrie Dawn M , Lawson Beverley , Oz Urun Erbas , Chan Kelvin , Peacock Stuart , Barbera Lisa 
Published: February 2021

ObjectivesTo investigate whether cancer decedents who received palliative care early (ie, >6 months before death) and not-early had different risk of using hospital care and supportive home care in the last month of life.Design/settingWe identified a population-based cohort of cancer decedents between 2004 and 2014 in Ontario, Canada using linked administrative data. Analysis occurred between August 2017 to March 2019.ParticipantsWe propensity-score matched decedents on receiving early or not-early palliative care using billing claims. We created two groups of matched pairs: one that had Resident Assessment Instrument (RAI) home care assessments in the exposure period (Yes-RAI group) and one that did not (No-RAI group) to control for confounders uniquely available in the assessment, such as health instability and pain. The outcomes were the absolute risk difference between matched pairs in receiving hospital care, supportive home care or hospital death.ResultsIn the No-RAI group, we identified 36 238 pairs who received early and not-early palliative care. Those in the early palliative care group versus not-early group had a lower absolute risk difference of dying in hospital (−10.0%) and receiving hospital care (−10.4%) and a higher absolute risk difference of receiving supportive home care (23.3%). In the Yes-RAI group, we identified 3586 pairs, where results were similar in magnitude and direction.ConclusionsCancer decedents who received palliative care earlier than 6 months before death compared with those who did not had a lower absolute risk difference of receiving hospital care and dying in hospital, and an increased absolute risk difference of receiving supportive home care in the last month of life.
Comparative efficacy and side-effect profile of ketamine and esketamine in the treatment of unipolar and bipolar depression: protocol for a systematic review and network meta-analysis
Authors: Zhan Zhiqing , Wang Xichao , Chen Qing , Xiao Zhidai , Zhang Bin 
Published: February 2021

IntroductionDespite a range of antidepressant drugs and therapies, approximately one-third of patients fail to achieve meaningful recovery, prompting the urgent need for more effective treatment for depression. Several open-label studies randomised controlled trials (RCTs) and meta-analyses have been conducted to confirm the therapeutic efficacy and side effects of ketamine and esketamine. Esketamine is (S)- enantiomer of ketamine; however, there is limited evidence comparing esketamine and ketamine in treating unipolar and bipolar depression have been published so far.Methods and analysisWe will include all double-blind RCTs comparing efficacy and side-effect profile of ketamine and esketamine in the treatment of unipolar and bipolar depression. Our primary outcomes will be study-defined response at endpoint assessment; dropouts due to adverse events and other adverse drug reactions. Published studies will be retrieved through relevant database searches. Reference selection and data extraction will be independently completed by two investigators, resolving inconsistencies by consensus or a discussion with the third investigator. For each outcome, we will undertake a network meta-analysis to synthesise all evidence. Local and global methods will be used to evaluate consistency. We will assess the quality of evidence contributing to network estimates with the Confidence in Network Meta-Analysis web application.Ethics and disseminationThis work does not require ethics approval as it will be based on published studies. This review will be published in peer-reviewed journals.PROSPERO registration numberCRD42020201559.
Effects of general versus regional anaesthesia on circadian melatonin rhythm and its association with postoperative delirium in elderly patients undergoing hip fracture surgery: study protocol for a prospective cohort clinical trial
Authors: Yuan Yi , Song Yanan , Wang Geng , Jia Yunyang , Zhou Yang , Mi Xinning , Jia Xixi , Wang Xiaoxiao , Liu Chang , Li Yue , Shi Chengmei , Han Yongzheng , Guo Xiangyang , Zhang Wenchao , Li Zhengqian 
Published: February 2021

IntroductionPostoperative delirium (POD) is a common neurological complication after hip fracture surgery and is associated with high morbidity and mortality in elderly patients. Although the specific mechanism of POD remains unclear, circadian rhythm disruptions have recently drawn increased attention. To date, only limited postoperative time points of plasma melatonin level measurements were recorded in previous studies, and such data cannot represent a comprehensive melatonin rhythm. The process of anaesthesia (either general anaesthesia (GA) or regional anaesthesia (RA)) is known to influence the melatonin rhythm. However, how these two anaesthesia methods differently affect the postoperative melatonin rhythm is still unknown. Therefore, we hypothesise that RA may attenuate the disruption of the melatonin rhythm, which might decrease the incidence of POD in elderly patients undergoing hip surgery.Methods and analysisIn this prospective cohort clinical trial, 138 patients scheduled for hip fracture surgery will be divided into two groups to receive either GA or RA. The primary aim is to compare the circadian rhythm of melatonin secretion between the two groups and explore its association with the incidence of POD.Ethics and disseminationThe study has been approved by the Medical Science Research Ethics Committees of Beijing Jishuitan Hospital (JLKS201901-04). The results of the study will be published in peer-reviewed international journals.Trial registration numberChiCTR1900027393.
Cross-disciplinary perspectives on the transition to remote education
Authors: Houghton Natasha , Houstoun Will , Yates Sophie , Badley Bill , Kneebone Roger 
Published: February 2021

The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning—through simulation or direct patient contact—is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely.The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.
LKB1/STK11 Is a Tumor Suppressor in the Progression of Myeloproliferative Neoplasms
Authors: Marinaccio Christian , Suraneni Praveen , Celik Hamza , Volk Andrew , Wen Qiang Jeremy , Ling Te , Bulic Marinka , Lasho Terra , Koche Richard P. , Famulare Christopher A. , Farnoud Noushin , Stein Brady , Schieber Michael , Gurbuxani Sandeep , Root David E. , Younger Scott T. , Hoffman Ronald , Gangat Naseema , Ntziachristos Panagiotis , Chandel Navdeep S. , Levine Ross L. , Rampal Raajit K. , Challen Grant A. , Tefferi Ayalew , Crispino John D. 
Published: February 2021

Abstract

The myeloproliferative neoplasms (MPN) frequently progress to blast phase disease, an aggressive form of acute myeloid leukemia. To identify genes that suppress disease progression, we performed a focused CRISPR/Cas9 screen and discovered that depletion of LKB1/Stk11 led to enhanced in vitro self-renewal of murine MPN cells. Deletion of Stk11 in a mouse MPN model caused rapid lethality with enhanced fibrosis, osteosclerosis, and an accumulation of immature cells in the bone marrow, as well as enhanced engraftment of primary human MPN cells in vivo. LKB1 loss was associated with increased mitochondrial reactive oxygen species and stabilization of HIF1α, and downregulation of LKB1 and increased levels of HIF1α were observed in human blast phase MPN specimens. Of note, we observed strong concordance of pathways that were enriched in murine MPN cells with LKB1 loss with those enriched in blast phase MPN patient specimens, supporting the conclusion that STK11 is a tumor suppressor in the MPNs.

Significance:
Progression of the myeloproliferative neoplasms to acute myeloid leukemia occurs in a substantial number of cases, but the genetic basis has been unclear. We discovered that loss of LKB1/STK11 leads to stabilization of HIF1a and promotes disease progression. This observation provides a potential therapeutic avenue for targeting progression.
This article is highlighted in the In This Issue feature, p. 1307
The Effects of Time Pressure on Temporal Overestimation Due to Threat
Authors: Tipples Jason , Lupton Michael , George David 
Published: February 2021

Abstract
How does emotion change the way we perceive time? Studies have shown that we overestimate the duration of faces that express anger of fear – an effect that has been explained as due the speeding of a pacemaker that resides within an internal clock. Here, we test the idea that attending longer to facial threat leads to an overestimation of time. Seventy participants (16 male) estimated the duration of angry, fearful and neutral expressions under conditions designed to either reduce attention to time (by emphasising speedy responses) or lengthen attention to time (by emphasising accuracy). Results were modelled using Bayesian Multilevel Logistic Regression. The results replicate previous findings: speed emphasis reduced temporal sensitivity and led to both a higher overall proportion of long responses and faster reaction times. Facial threat attenuated the drop in temporal sensitivity due to speed instructions supporting the idea that people prolong attention to threat (even when they are not directly instructed to do so). We relate the findings to research into attention bias to threat and more broadly to models of perceptual decision making.
Molecular investigation of a RSV outbreak in a geriatric hospital
Authors: Hababou Yohan , Taleb Assia , Recoing Amélie , Moreau Frédérique , Simon Isabelle , Muller de Schongor Florence , Gault Elyanne , Rameix-Welti Marie-Anne 
Published: February 2021

Abstract
Background
Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce.

Methods
RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed.

Results
Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak’s cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died.

Conclusions
This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.
Effects of health education on spousal knowledge and participation in birth preparedness in Farafenni Regional Hospital, The Gambia: a randomized trial
Authors: Tunkara- Bah Haddy , Adeyemo Florence O. , Okonofua Friday E. 
Published: February 2021

Abstract
Background
The Gambia is a male-dominant society in which the cultural norms empower husbands to decide when and where their wives seek care, yet they are not always involved in maternal health care services. Therefore, the purpose of this study was to design and measure the effects of antenatal health education on spousal participation in birth preparedness in Farafenni and satellite villages.

Methods
The study used a quasi-experimental design, and the participants were 300 spouses of pregnant women attending their antenatal care booking at Farafenni Hospital. A multistage sampling method was used to select the study participants who were then equally distributed to the intervention and comparison groups. Pre-test data were collected from both groups. Thereafter, the intervention group was exposed to two health education sessions on obstetric danger signs and birth preparedness. The post-test data were collected immediately before discharge of the participants’ wives after institutional delivery or within 2 weeks post-delivery for those who did not accompany their wives to the health care institution, or whose wives delivered at home. IBM SPSS version 21 software was used to analyze the data.

Results
The differences between the demographic characteristics of participants in the intervention and comparison groups were not statistically significant except for the highest level of education achieved. After controlling for the demographic variables, the health education administered to the intervention group effectively increased knowledge on birth preparedness among them (F (1, 255) = 376.108, p < .001). Every unit increase in the intervention led to a unit increase in the spouses’ knowledge on birth preparedness (β = 0.789, p <  0.001). Furthermore, the participants in the intervention group had higher mean score (M = 4.4; SD = 0.8) on participation in birth preparedness than those in the comparison group (M = 0.9; SD = 0.8). The spouses in the intervention group were four times more likely to be prepared for the delivery of their wives after being exposed to the health education than those in the comparison group (F (1, 255) = 522.414, p < .001).

Conclusion
The study provides evidence that educating men on maternal health care can improve their level of participation in birth preparedness.

Trial registration
Name of Registry: Pan African Clinical Trial Registry (www.pactr.org). Registry Number:PACTR202004752273171. Date of Registration: 19th April 2020. Retrospectively Registered.
A 4-gene signature predicts prognosis of uterine serous carcinoma
Authors: Chen Hui , Li Lingjun , Qin Ping , Xiong Hanzhen , Chen Ruichao , Zhang Minfen , Jiang Qingping 
Published: February 2021

Abstract
Background
Uterine serous carcinoma (USC) is an aggressive type of endometrial cancer that accounts for up to 40% of endometrial cancer deaths, creating an urgent need for prognostic biomarkers.

Methods
USC RNA-Seq data and corresponding patients’ clinical records were obtained from The Cancer Genome Atlas and Genotype-Tissue Expression datasets. Univariate cox, Lasso, and Multivariate cox regression analyses were conducted to forge a prognostic signature. Multivariable and univariable cox regression analysis and ROC curve evaluated the prediction efficiency both in the training and testing sets.

Results
We uncovered 1385 genes dysregulated in 110 cases of USC tissue relative to 113 cases of normal uterine tissue. Functional enrichment analysis of these genes revealed the involvement of various cancer-related pathways in USC. A novel 4-gene signature (KRT23, CXCL1, SOX9 and ABCA10) of USC prognosis was finally forged by serial regression analyses. Overall patient survival (OS) and recurrence-free survival (RFS) were significantly lower in the high-risk group relative to the low-risk group in both the training and testing sets. The area under the ROC curve of the 4-gene signature was highest among clinicopathological features in predicting OS and RFS. The 4-gene signature was found to be an independent prognostic indicator in USC and was a superior predictor of OS in early stage of USC.

Conclusions
Our findings highlight the potential of the 4-gene signature as a guide for personalized USC treatment.
Reasons for explantation of phakic intraocular lenses and associated perioperative complications: cross-sectional explant registry analysis
Authors: Yildirim Timur M. , Khoramnia Ramin , Son Hyeck-Soo , Mayer Christian S. , Łabuz Grzegorz , Munro Donald J. , Auffarth Gerd U. 
Published: February 2021

Abstract
Background
We discuss the safety, since their introduction, of phakic intraocular lenses (pIOLs) to correct refractive errors in healthy eyes. We investigated the reasons for pIOL explantation and the associated perioperative complications.

Methods
This retrospective, cross-sectional study included 69 pIOLs, explanted at a single tertiary center between July 2005 and March 2020: 34 angle-supported (G1), 28 iris-fixated (G2) and seven posterior chamber (G3) pIOLs. Case data including the reason for explantation was taken from the patient records. Intra- and postoperative complications were evaluated for an association with the pIOL.

Results
The mean duration in the eye was 10.4 (0.2–28) years. Cataractogenesis and subsequent surgery that required pIOL explantation was the reason in 42% of all cases. In 22%, cataract in combination with endothelial damage prompted explantation, with 26, 18 and 14% for G1, G2 and G3 respectively. The second most common reasons were corneal damage alone in the angle-supported group (26%), IOL subluxation in the iris-fixated group (18%), and photopic disturbance in the posterior chamber group (29%). In 68% of all explantations, the surgical course was unremarkable, while in the remaining cases perioperative complications were associated with the lens in 45.7%.

Conclusion
Overall, the need for cataract surgery was the most common reason for pIOL explantation. Corneal complications were more frequent in the angle-supported pIOLs and their removal was associated with higher rates of complication compared to the other groups.
Integrated analysis of differentially expressed genes and construction of a competing endogenous RNA network in human Huntington neural progenitor cells
Authors: Tan Xiaoping , Liu Yang , Zhang Taiming , Cong Shuyan 
Published: February 2021

Abstract
Background
Huntington's disease (HD) is one of the most common polyglutamine disorders, leading to progressive dyskinesia, cognitive impairment, and neuropsychological problems. Besides the dysregulation of many protein-coding genes in HD, previous studies have revealed a variety of non-coding RNAs that are also dysregulated in HD, including several long non-coding RNAs (lncRNAs). However, an integrated analysis of differentially expressed (DE) genes based on a competing endogenous RNA (ceRNA) network is still currently lacking.

Methods
In this study, we have systematically analyzed the gene expression profile data of neural progenitor cells (NPCs) derived from patients with HD and controls (healthy controls and the isogenic controls of HD patient cell lines corrected using a CRISPR-Cas9 approach at the HTT locus) to screen out DE mRNAs and DE lncRNAs and create a ceRNA network. To learn more about the possible functions of lncRNAs in the ceRNA regulatory network in HD, we conducted a functional analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) and established a protein–protein interaction (PPI) network for mRNAs interacting with these lncRNAs.

Results
We identified 490 DE mRNAs and 94 DE lncRNAs, respectively. Of these, 189 mRNAs and 20 lncRNAs were applied to create a ceRNA network. The results showed that the function of DE lncRNAs mainly correlated with transcriptional regulation as demonstrated by GO analysis. Also, KEGG enrichment analysis showed these lncRNAs were involved in tumor necrosis factor, calcium, Wnt, and NF-kappa B signaling pathways. Interestingly, the PPI network revealed that a variety of transcription factors in the ceRNA network interacted with each other, suggesting such lncRNAs may regulate transcription in HD by controlling the expression of such protein-coding genes, especially transcription factors.

Conclusions
Our research provides new clues for uncovering the mechanisms of lncRNAs in HD and can be used as the focus for further investigation.
Quantitative proteomics analysis of Mycoplasma pneumoniae identifies potential macrolide resistance determinants
Authors: Li Shaoli , Xue Guanhua , Zhao Hanqing , Feng Yanling , Yan Chao , Cui Jinghua , Xie Xianghui , Yuan Jing 
Published: February 2021

AbstractMycoplasma pneumoniae is one of the leading causes of community-acquired pneumonia in children and adolescents. Because of the wide application of macrolides in clinical treatment, macrolide-resistant M. pneumoniae strains have become increasingly common worldwide. However, the molecular mechanisms underlying drug resistance in M. pneumoniae are poorly understood. In the present work, we analyzed the whole proteomes of macrolide-sensitive and macrolide-resistant strains of M. pneumoniae using a tandem mass tag-labeling quantitative proteomic technique, Data are available via ProteomeXchange with identifier PXD022220. In total, 165 differentially expressed proteins were identified, of which 80 were upregulated and 85 were downregulated in the drug-resistant strain compared with the sensitive strain. Functional analysis revealed that these proteins were predominantly involved in protein and peptide biosynthesis processes, the ribosome, and transmembrane transporter activity, which implicates them in the mechanism(s) of resistance of M. pneumoniae to macrolides. Our results provide new insights into drug resistance in M. pneumoniae and identify potential targets for further studies on resistance mechanisms in this bacterium.
Weighted average current method for active damping control based on grid voltage feed-forward
Authors: Li Shengqing , Li Xinluo , Lee Xiaobao 
Published: February 2021

AbstractIn the weak current network environment, the existence of power network impedance will reduce the current control stability margin of LCL grid connected inverter, the stability margin will gradually deteriorate as the inductive component of the power network impedance increases, leading to system instability. In this paper, an improved weighted average current control strategy is proposed, which is based on the active damping control of the voltage feedforward of the charged network. In the new control strategy, with the zero-pole cancellation method, a new weighting coefficient related only to the parameters of LCL filter is obtained, which reduces the order of the system, suppresses the influence of power network impedance, and improves the stabilization of the system, getting better inverter output current quality. Then the influence of power network impedance on the control system of grid connected inverter is analyzed, and the feed-forward control of grid voltage is improved to improve the stability of inverter in weak current network. The Bode diagram analysis and MATLAB simulation results proved that the proposed control strategy is feasible.