bluuebunny/crossref_metadata_2025_split huggingface dataset:
Provision and related factors of end-of-life care in elderly housing with care services in collaboration with home-visiting nurse agencies: a nationwide survey
Authors: Fukui Sakiko , Otsuki Naoko , Ikezaki Sumie , Fukahori Hiroki , Irie Saori 
Published: September 2021

Abstract
Background
Japan has the largest population of older adults in the world; it is only growing as life expectancy increases worldwide. As such, solutions to potential obstacles must be studied to maintain healthy, productive lives for older adults. In 2011, the Japanese government has started a policy to increase “Elderly Housing with Care Services (EHCS)”, which is one of a private rental housing, as a place where safe and secure end-of-life care can be provided. The government expect for them to provide end-of-life care by collaborating with the Home-Visit Nursing Agencies (HVNA). The purpose of this study is to clarify the situation of the end-of-life care provision in EHCS in collaboration with HVNA and to examine the factors that associate with the provision of the end-of-life care in EHCS.

Methods
A two-stage nationwide survey (fax and mail surveys) were conducted. Of the 5,172 HVNA of the National Association for Visiting Nurse Services members, members from 359 agencies visited EHCS. Logistic regression analysis was conducted with the provision of end-of-life care to EHCS in 2017 as the dependent variable, and the following as independent variables: characteristics of HVNA and EHCS; characteristics of residents; collaborations between HVNA and EHCS; and the reasons for starting home-visit nursing.

Results
Of the 342 HVNA who responded to the collaborations with EHCS, 21.6% provided end-of-life care. The following factors were significantly associated with the provision of end-of-life care to inmates in elderly care facilities: being affiliated with a HVNA, admitting many residents using long-term care insurance, collaborating with each other for more than three years, and started visiting-nurse services after being requested by a resident’s physician.

Conclusions
This study clarified the situation of the provision of end-of-life care in EHCS in collaboration with HVNA and the related factors that help in providing end-of-life care in EHCS.
Overcoming barriers to mental health care: multimodal trauma-focused treatment approach for unaccompanied refugee minors
Authors: van Es Carlijn M. , Sleijpen Marieke , Velu Merel E. , Boelen Paul A. , van Loon Renate E. , Veldman Marjan , Kusmallah Nebil , Ekster Paula J. C. , Mooren Trudy 
Published: September 2021

Abstract
Background
This study evaluated the feasibility of a short-term, multimodal trauma-focused treatment approach adapted specifically for unaccompanied refugee minors (URMs) in the Netherlands. This approach aims to overcome barriers to mental health care and to reduce symptoms of posttraumatic stress disorder (PTSD) and depression.

Methods
An uncontrolled study was conducted, evaluating the main request for help, treatment integrity and feasibility, and the course of symptoms of PTSD (Children's Revised Impact of Event Scale-13) and depression (Patient Health Questionnaire modified for Adolescents).

Results
In total, 41 minors were included in the study. Most participants were male (n = 27), predominately from Eritrea (75.6%) with a mean age of 16.5 (SD = 1.5). Minors mostly reported psychological problems, such as problems sleeping, and psychosocial problems, including worries about family reunification. Deviations from the approach were made to meet the current needs of the minors. Factors limiting the feasibility of the approach were often related to continuous stressors, such as news concerning asylum status.

Conclusions
The results provide a first indication that this approach partly overcomes barriers to mental health care and emphasize the added value of collaborating with intercultural mediators and offering outreach care.
Trial registration: The study was registered in the Netherlands Trial Register (NL8585), 10 April 2020, Retrospectively registered, https://www.trialregister.nl/trial/8585.
Performance of NEWS2, RETTS, clinical judgment and the Predict Sepsis screening tools with respect to identification of sepsis among ambulance patients with suspected infection: a prospective cohort study
Authors: Wallgren Ulrika M. , Sjölin Jan , Järnbert-Pettersson Hans , Kurland Lisa 
Published: September 2021

Abstract
Background
There is little evidence of which sepsis screening tool to use in the ambulance setting. The primary aim of the current study was to compare the performance of NEWS2 (National Early Warning score 2) and RETTS (Rapid Emergency Triage and Treatment System) with respect to identification of sepsis among ambulance patients with clinically suspected infection. The secondary aim was to compare the performance of the novel Predict Sepsis screening tools with that of NEWS2, RETTS and clinical judgment.

Methods
Prospective cohort study of 323 adult ambulance patients with clinically suspected infection, transported to hospitals in Stockholm, during 2017/2018. The sensitivity, specificity, and AUC (Area Under the receiver operating Curve) were calculated and compared by using McNemar´s test and DeLong’s test.

Results
The prevalence of sepsis in the current study population was 44.6% (144 of 323 patients). No significant difference in AUC was demonstrated between NEWS2 ≥ 5 and RETTS ≥ orange. NEWS2 ≥ 7 demonstrated a significantly greater AUC than RETTS red. The Predict Sepsis screening tools ≥ 2 demonstrated the highest sensitivity (range 0.87–0.91), along with RETTS ≥ orange (0.83), but the lowest specificity (range 0.39–0.49). The AUC of NEWS2 (0.73) and the Predict Sepsis screening tools (range 0.75–0.77) was similar.

Conclusions
The results indicate that NEWS2 could be the better alternative for sepsis identification in the ambulance, as compared to RETTS. The Predict Sepsis screening tools demonstrated a high sensitivity and AUCs similar to that of NEWS2. However, these results need to be interpreted with caution as the Predict Sepsis screening tools require external validation.
Trial registration: ClinicalTrials.gov, NCT03249597. Registered 15 August 2017—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03249597.
Genomic risk prediction of coronary artery disease in women with breast cancer: a prospective cohort study
Authors: Liou Lathan , Kaptoge Stephen , Dennis Joe , Shah Mitul , Tyrer Jonathan , Inouye Michael , Easton Douglas F. , Pharoah Paul D. P. 
Published: September 2021

AbstractBackgroundAdvancements in cancer therapeutics have resulted in increases in cancer-related survival; however, there is a growing clinical dilemma. The current balancing of survival benefits and future cardiotoxic harms of oncotherapies has resulted in an increased burden of cardiovascular disease in breast cancer survivors. Risk stratification may help address this clinical dilemma. This study is the first to assess the association between a coronary artery disease-specific polygenic risk score and incident coronary artery events in female breast cancer survivors.MethodsWe utilized the Studies in Epidemiology and Research in Cancer Heredity prospective cohort involving 12,413 women with breast cancer with genotype information and without a baseline history of cardiovascular disease. Cause-specific hazard ratios for association of the polygenic risk score and incident coronary artery disease (CAD) were obtained using left-truncated Cox regression adjusting for age, genotype array, conventional risk factors such as smoking and body mass index, as well as other sociodemographic, lifestyle, and medical variables.ResultsOver a median follow-up of 10.3 years (IQR: 16.8) years, 750 incident fatal or non-fatal coronary artery events were recorded. A 1 standard deviation higher polygenic risk score was associated with an adjusted hazard ratio of 1.33 (95% CI 1.20, 1.47) for incident CAD.ConclusionsThis study provides evidence that a coronary artery disease-specific polygenic risk score can risk-stratify breast cancer survivors independently of other established cardiovascular risk factors.
PAM-repeat associations and spacer selection preferences in single and co-occurring CRISPR-Cas systems
Authors: Vink Jochem N. A. , Baijens Jan H. L. , Brouns Stan J. J. 
Published: September 2021

Abstract
Background
The adaptive CRISPR-Cas immune system stores sequences from past invaders as spacers in CRISPR arrays and thereby provides direct evidence that links invaders to hosts. Mapping CRISPR spacers has revealed many aspects of CRISPR-Cas biology, including target requirements such as the protospacer adjacent motif (PAM). However, studies have so far been limited by a low number of mapped spacers in the database.

Results
By using vast metagenomic sequence databases, we map approximately one-third of more than 200,000 unique CRISPR spacers from a variety of microbes and derive a catalog of more than two hundred unique PAM sequences associated with specific CRISPR-Cas subtypes. These PAMs are further used to correctly assign the orientation of CRISPR arrays, revealing conserved patterns between the last nucleotides of the CRISPR repeat and PAM. We could also deduce CRISPR-Cas subtype-specific preferences for targeting either template or coding strand of open reading frames. While some DNA-targeting systems (type I-E and type II systems) prefer the template strand and avoid mRNA, other DNA- and RNA-targeting systems (types I-A and I-B and type III systems) prefer the coding strand and mRNA. In addition, we find large-scale evidence that both CRISPR-Cas adaptation machinery and CRISPR arrays are shared between different CRISPR-Cas systems. This could lead to simultaneous DNA and RNA targeting of invaders, which may be effective at combating mobile genetic invaders.

Conclusions
This study has broad implications for our understanding of how CRISPR-Cas systems work in a wide range of organisms for which only the genome sequence is known.
A Descriptive analysis of urine drug screen results in patients with opioid use disorder managed in a primary care setting
Authors: Sobel Halle G. , Warrington Jill S. , Francis-Fath Samuel , Crocker Abigail M. , Berger Claudia A. 
Published: September 2021

Abstract
Background
Urine drug screening (UDS) is commonly used as part of treatment for opioid use disorder (OUD), including treatment with buprenorphine-naloxone for OUD in a primary care setting. Very little is known about the value of UDS, the optimum screening frequency in general, or its specific use for buprenorphine treatment in primary care. To address this question, we thought that in a stable population receiving buprenorphine-naloxone in the primary care setting it would be useful to know how often UDS yielded expected and unexpected results.

Methods
We present a descriptive analysis of UDS results in patients treated with buprenorphine-naloxone for OUD in a primary care setting over a two-year period. An unexpected test result is:

A negative test for buprenorphine and/or

A positive test for opioids, methadone, cocaine and/or heroin.

Results
A total of 161 patients received care during the study period and a total of 2588 test results were analyzed from this population.
We found that 64.4% of the patient population (n = 104 patients) demonstrated both treatment adherence (as measured by buprenorphine positive test results) and no apparent unexpected test findings, as defined by negative tests for opioids, methadone, cocaine and heroin. Of the 161 patients, 20 results were positive for opioids, 5 for methadone, 39 for heroin and 2 for cocaine.
Analysis at the UDS level demonstrated that, of the 2588 test results, 38 (1.5%) results did not have buprenorphine. Of the 2588, 28 (1.1%) test results were positive for opioids, 8 (0.3%) were positive for methadone, 39 (1.5%) for cocaine and 2 (0.1%) for heroin.

Conclusion
Given that the majority of patients in our study had expected urine results, it may be reasonable for less frequent urine testing in certain patients.
Probabilistic Analysis of the Durability of Piles with Microcracks Under Chloride Attack
Authors: Shao Wei , Shi Danda 
Published: September 2021

AbstractA probabilistic analysis approach for estimating the durability of piles with microcracks under chloride attack is presented. The chloride ingress model is obtained by considering the time-dependent diffusion process. The equivalent diffusion coefficient is derived to investigate the crack effect by introducing the crack effect factor. The fitting formula between the chloride diffusion coefficients and crack widths is established through experimental results, and the proposed equivalent diffusion coefficient is verified by comparison with the experimental results. The probabilistic evaluation of durability of piles with microcracks is performed, and then the parametric analysis is performed to study the effect of main parameters on the failure probability and durability life. The results indicate that the chloride concentration increases rapidly as the crack width increases at the same number of cracks. The durability life greatly reduces with increasing crack density of pile. The durability life predicted by probabilistic method is always less than those by deterministic method at the same condition. The deterministic approach may underestimate the threat of reinforcement corrosion induced by chloride attack, owing to the omission of probabilistic nature of main influencing parameters.
Psychosocial support conditions in the orphanage: case study of Wolisso project
Authors: Disassa Getachew Abeshu , Lamessa Dabala 
Published: September 2021

AbstractThis study was conducted to assess the psychosocial and material services provision of Wolisso Kalehiwot Church project/center. Qualitative research design employing phenomenological approach was conducted as to reach on identifying the strengths and challenges practiced in the center. Purposive sampling techniques was used to draw ten respondents from the center (8 from orphans, 2 from staff) to respond to interview questions. The result of this study indicated that the effort made by the project is so effective in addressing the immediate need of the orphans including survival and wellbeing of these children. Consequently, the weakness in the project observed was initial recruitment problem of the orphans and unskilled staffs involving in the project and the inability to be proactive for the sustainability request for the project were seen as major. The challenges faced were identified as characteristics of the staff to handle the growing needs of the orphans, emotional instability of the children, limited access to social integration, negative attitude of the community towards institutionalization and segregation were observed as critical. Hence, institutional capacity building from both external and internal funders to maintain the projects sustainability with clear goal and policy direction is mandatory.
Rethinking labour migration: Covid-19, essential work, and systemic resilience
Authors: Anderson Bridget , Poeschel Friedrich , Ruhs Martin 
Published: September 2021

AbstractMany of the ‘essential workers’ during the Covid-19 pandemic are migrants, playing an important role for the continued functioning of basic services – notably health services, social care, and food supply chains. We argue that this role should be taken into account when assessing the impacts of migrant workers and in the design of labour migration and related public policies. Existing studies highlight how the employment of migrant workers in essential services is shaped by interests of employers, sectoral policies, and national institutions. Considerations of how migrants may affect the systemic resilience of essential services – in a pandemic or similar crises – are pervasively absent, not only in policy-making but also in research. Drawing on several disciplines, we outline the concept of systemic resilience and develop implications for the analysis and regulation of labour migration. We call for shifting the focus from the role of migrants in specific occupations and sectors in particular countries to transnational systems of production and service provision. To study how migrant workers affect systemic resilience, we propose an agenda for comparative research along three lines: comparing migrants to citizens within the same system, comparing migrants’ roles across systems, and comparing strategies for resilience adopted in different systems.
Isolation and identification of Candida spp. from immunocompromised patients
Authors: Hemaid Anas Salama Sayed , Abdelghany Mohamed Mahmoud Effat , Abdelghany Tarek Mohamed 
Published: September 2021

Abstract
Background
Candida species is considered one of the normal inhabitant commensal microbiota of the human body. However, it can also act as an opportunistic pathogen especially in hospitals (nosocomial infection) and among immunocompromised patients. The accurate, precise, rapid and reliable identification of Candida to the species level is of great importance for control and management of candidiasis.

Results
One hundred and eighteen different samples were collected (59 urine samples, 39 oral swabs, 5 vaginal swabs and 15 skin swabs) from immunocompromised patients (diabetics—pregnant women—patients underwent organ transplantation—cancer patients—burned and wounded patients) for probable existence of Candida species. Eighty-six out of 118 (72.8%) samples were typed macroscopically and microscopically and found to be Candida species. Upon streaking 86 Candida isolates on CHROMagar plates separately, 48 isolates gave green colonies, 25 isolates gave rose colonies, 10 isolates gave white colonies, 2 isolates gave pale coloured colonies and 1 isolate gave blue colonies. Forty-eight out of 86 isolates showed positive Germ tube test. API 20C assay was performed on some isolates with different coloured colonies, the results were similar to those of CHROMagar. Upon performing PCR assay on 14 isolates using ITS1 and ITS4 primers, 8 out of 14 PCR product bands appeared between 510 and 535 bp and this was difficult to differentiate among them (C. albicans, C. tropicalis, C. krusei and C. parapsilosis). Five out of 14 PCR products were found at 871 bp (C. glabrata) and the last one is negative control with no band appeared. Further molecular studies should be recommended to fully differentiate among Candida species especially those with very close bands. Antifungal activity (expressed by inhibitory zone) of zinc oxide nanoparticles in comparison with some commercially available antifungals (nystatin and Voriconazole) was carried upon the obtained Candida isolates. Zinc oxide nanoparticles with 100 μg/disc showed 9, 26, 40, 42 mm inhibitory zones for C. tropicalis, C. glabrata, C. albicans and C. parapsilosis, respectively. However, zinc oxide only showed no antifungal activity against C. krusei.

Conclusions
A sheet of identification profile for Candida should include morphotyping, biotyping and genotyping to reach a rapid, reliable and accurate diagnosis. Candida species causes a myriad of infections causing non-invasive, mucocutaneous infections and severe systemic and deep-seated disease. Repress of Candida growth by ZnONPs provides an insight towards their therapeutic application for the prevention of Candida-associated infections. Further studies on the antifungal effect of nanoparticles combined with commercially available antifungal medicines maybe recommended.
The WHO QualityRights initiative: building partnerships among psychiatrists, people with lived experience and other key stakeholders to improve the quality of mental healthcare
Authors: Moro Maria Francesca , Pathare Soumitra , Zinkler Martin , Osei Akwasi , Puras Dainius , Paccial Rodelen C. , Carta Mauro Giovanni 
Published: September 2021

SummaryPsychiatrists have an essential role to play in promoting human rights in mental healthcare. The World Health Organization's QualityRights initiative, in partnership with different stakeholders, is improving the quality of psychiatric care in different countries.
Multicenter Analysis of Genomically Targeted Single Patient Use Requests for Pediatric Neoplasms
Authors: Sabnis Himalee S. , Shulman David S. , Mizukawa Benjamin , Bouvier Nancy , Zehir Ahmet , Fangusaro Jason , Fabrizio Vanessa A. , Whitlow Chanta , Winchester Marilyn , Agresta Laura , Turpin Brian , Wechsler Daniel S. , DuBois Steven G. , Glade-Bender Julia , Castellino Sharon M. , Shukla Neerav 
Published: September 2021

PURPOSE The US Food and Drug Administration–expanded access program (EAP) uses a single patient use (SPU) mechanism to provide patient access to investigational agents in situations where no satisfactory or comparable therapy is available. Genomic profiling of de novo and relapsed or refractory childhood cancer has led to increased identification of new drug targets in the last decade. The aim of this study is to examine the SPU experience for genomically targeted therapies in patients with pediatric cancer. PATIENTS AND METHODS All genomically targeted therapeutic SPUs obtained over a 5-year period were evaluated at four large pediatric cancer programs. Data were collected on the type of neoplasm, agents requested, corresponding molecularly informed targets, and clinical outcomes. RESULTS A total of 45 SPUs in 44 patients were identified. Requests were predominantly made for CNS and solid tumors (84.4%) compared with hematologic malignancies (15.6%). Lack of an available clinical trial was the main reason for SPU initiation (64.4%). The median time from US Food and Drug Administration submission to approval was 3 days (range, 0-12 days) and from Institutional Review Board submission to approval was 5 days (range, 0-50 days). Objective tumor response was seen in 39.5% (15 of 38) of all evaluable SPUs. Disease progression was the primary reason for discontinuation of drug (66.7%) followed by toxicity (13.3%). CONCLUSION SPU requests remain an important mechanism for pediatric access to genomically targeted agents given the limited availability of targeted clinical trials for children with high-risk neoplasms. Furthermore, this subset of SPUs resulted in a substantial number of objective tumor responses. The development of a multi-institutional data registry of SPUs may enable systematic review of toxicity and clinical outcomes and provide evidence-based access to new drugs in rare pediatric cancers.