bluuebunny/crossref_metadata_2025_split huggingface dataset:
The H2FPEF and HFA-PEFF Algorithms for Predicting Exercise Intolerance and Abnormal Hemodynamics in Heart Failure with Preserved Ejection Fraction
Authors: Amanai Shiro , Harada Tomonari , Kagami Kazuki , Yoshida Kuniko , Kato Toshimitsu , Wada Naoki , Obokata Masaru 
Published: September 2021

Abstract
Exercise intolerance is a primary manifestation of patients with heart failure with preserved ejection fraction (HFpEF) and is associated with abnormal hemodynamics and poor quality of life. Two multiparametric scoring systems have been proposed to diagnose HFpEF. This study sought to determine the performance of the H2FPEF and HFA-PEFF scores for predicting exercise capacity and echocardiographic measures of intracardiac pressures during exercise. Patients with HFpEF (n = 83) and control subjects without HF (n = 104) underwent bicycle exercise echocardiography. In a subset, simultaneous expired gas analysis was performed to measure peak oxygen consumption (VO2). The H2FPEF score was obtainable in all patients while the HFA-PEFF score could not be calculated in 23 patients (feasibility 88%). Both H2FPEF and HFA-PEFF scores were correlated with higher E/e’ ratio (r = 0.49 and r = 0.46), lower systolic tricuspid annular velocity (r=-0.44 and =-0.24), and lower cardiac output (r=-0.28 and r=-0.24) during peak exercise. Peak VO2 and exercise duration decreased with increasing the H2FPEF score (r=-0.40 and r=-0.32), and the H2FPEF score predicted reduced aerobic capacity (AUC 0.71, p = 0.0005), but the HFA-PEFF score did not (p = 0.07). These data provide new insights into the role of the H2FPEF and HFA-PEFF scores for predicting exercise intolerance and abnormal hemodynamics in patients HFpEF.
Thymoquinone Improved Nonylphenol-Induced Memory Deficit and Neurotoxicity Trough its Antioxidant and Neuroprotective Effects
Authors: Lotfi Mandana , Kazemi Sohrab , Ebrahimpour Anahita , Pourabdolhossein Fereshteh , Satarian Seyed Leila , Eghbali Atiyeh , Moghadamnia Ali Akbar 
Published: September 2021

Abstract
Nonylphenol (NP) as a well-known endocrine-disrupter chemical (EDCs), has several harmful effects on the CNS such as neuroendocrine disruption, cognitive impairment, and neurotoxicity. Thymoquinone (TQ) is a main bioactive compound in the black seeds of nigella sativa (NS) possesses antioxidant, anti-inflammatory, and neuroprotective properties. This study was designed to assess the neuroprotective effect of TQ against NP-induced memory deficit and neurotoxicity in rats. To induce memory impairment, NP (25mg/kg) was used as gavage in male Wistar rats for 21 days. TQ i.p. injection at doses 2.5, 5, and 10mg/kg was done in NP-treated animals at the same time. Morris Water Maze (MWM) test was performed to assess spatial memory. The rats` hippocampus tissues were isolated for histopathological testes. Biochemical, molecular and cellular tests were done for proving more details. The results showed TQ at dose 5 mg/kg significantly improved NP-induced memory impairment. Histological data proved that TQ decreased the number of necrotic cells in the hippocampus which was increased in NP-treated animals. Biochemical analysis showed that the levels of glutathione (GSH) and total antioxidant capacity (TAC) were significantly increased in TQ treated groups compared to the NP group. The molecular analysis has shown that NP increased GFAP and decreased α-Syn expression level and TQ treatment did the reverse. In vitro study in astrocytes isolated from mice brain proved that TQ significantly increased cell viability in cytotoxicity induced by NP. This study strongly indicates that TQ has therapeutic and neuroprotective effects on NP-induced neurotoxicity through reduction of oxidative damages and neuroinflammation.
Cryoablation Using Liquid Nitrogen for Metastatic Lung Cancers
Authors: Nomori Hiroaki , Yamazaki Ikuo , Adachi Takuya , ME Masaya Kanno 
Published: September 2021

Abstract
AimsTo identify factors that were associated with local control after cryoablation for metastatic lung tumors and to compare preserved pulmonary function according to tumor number.MethodsWe retrospectively evaluated 68 patients with 121 metastatic lung tumors that were treated with cryoablation using liquid nitrogen during 2013–2019. Primary outcome was whether local control was related with tumor size, histology, location, and distance to a vessel with a diameter of ≥3 mm. Secondary outcome was whether preserved pulmonary function varied according to number of treated tumors. ResultsMedian follow-up period was 32 months (range: 4–87 months).Histological types were carcinomas in 95 tumors and sarcoma in 26 tumors. Multivariate analysis revealed that local control was significantly associated with tumor size (p<0.001), histology (p<0.001), and distance from a vessel with a diameter of ≥3 mm (p=0.03). Among tumors with a diameter of ≥2.2 cm, poorer local control was observed for sarcomas (p<0.001) and tumors that were ≤3 mm from the vessel (p=0.009), although these relationships were not significant among tumors with a diameter of <2.2 cm (p=0.44 and p=0.16). Relative to cryoablation for a single tumor, cryoablation for multiple tumors was associated with significantly lower preservation of pulmonary function (p=0.002). Conclusion﻿Poor local control after cryoablation was significantly associated with tumor size ≥2.2 cm, sarcoma histology, and tumors that were ≤3 mm from a vessel with a diameter of ≥3 mm. Preserved pulmonary function declined significantly with an increasing number of treated tumors.
Identification of barriers and facilitators in providing medication-assisted treatment for opioid users in Central Asia and China
Authors: Sultan Aysel , Michels Ingo Ilja , Stöver Heino 
Published: September 2021

Abstract
Implementation of medication-assisted treatment (MAT) for opioid users in Asia has been slow to develop and is currently under-researched in the international drug policy field. On the basis of a systematic literature review and expert interviews, this article explores the barriers and facilitators in provision of MAT in Central Asian countries and Public’s Republic China. To review the dynamics since 2011, we conducted a systematic literature review to complement informal expert interviews, and synthesize our results with the available statistical data and grey literature. Our review includes 42 selected articles and reports, and maps out the recent developments in MAT and related research in Kazakhstan, Kyrgyzstan, and China. The implications of this study suggest a need for future research to design better methods for successful scaling-up of access and integration of MAT for opioid users.
Pan-cancer characterization of GDF15 as a potential prognosis and immunological biomarker
Authors: Li Xiaolei , Huai Qian , Zhu Cheng , Du Yishan , Ma Fang , Zhang Xu , Dai Hanren , Wang Hua 
Published: September 2021

Abstract
Background
Growth/differentiation factor 15 (GDF15) is a member of the TGF-b superfamily whose expression is increased in response to cellular stress and disease. Although emerging cell-or animal-based evidence supports the relationship between GDF15 and cancers, systematic pan-cancer analysis of GDF15 remains unavailable. Thus, we aimed to explore the prognostic and immunological roles of GDF15 across different types of tumors.
Methods
A comprehensive analysis of GDF15 in 33 types of cancer was performed based on the TCGA database. This involved an analysis of mRNA expression profiles, genetic alterations, methylation, prognostic values, immune infiltration analysis, potential biological pathways. Moreover, both the gain and loss of function strategies were used to assess the function of GDF15 in cell lines of hepatocellular carcinoma (HCC).
Results
GDF15 is highly expressed in most types of cancers, and there is a significant correlation between the expression of GDF15 and the prognosis of cancer patients. We have observed that GDF15 promotes the proliferation and invasion of HCC cell lines. Subsequently, methylation analyses suggested that high GDF15 expression likely resulted from hypomethylation, and immune infiltration analysis showed that GDF15 may have an impact on the changes in the tumor microenvironment. Moreover, enrichment analysis revealed that TGF-beta signaling and metabolism pathways were involved in the functional mechanisms of GDF15.
Conclusions
Our unpresented pan-cancer analysis of GDF15 offers a relatively comprehensive overview of the oncogenic roles of GDF15 in multiple human cancers. GDF15 may prompt HCC cellular proliferation, invasion and metastasis. All of these provides solid basement and will promote more advanced understanding the role of GDF15 in tumorigenesis and development from the perspective of clinical tumor samples and cells.
Exploring educational service quality and improvement priorities from the viewpoints of health sciences students using the SERVQUAL model
Authors: Al-Rabia Mohammed , Fasfous Ismail , Eldigre Mohamed , Aldarmahi Ahmed , Alzahrani Sami , Atwa Hani 
Published: September 2021

Abstract
Background
In higher education institutes, there are competitive and tussling environments to provide students with a high educational and service quality. Service quality is the key to meet or exceed student expectations. The quality of health systems, therefore; would be directly dependent on the quality of medical sciences education. In the current study, the modified SERVQUAL model was applied to assess the quality of the educational service provided at King Abdulaziz University (KAU) in Saudi Arabia.
Methods
This is a descriptive, cross-sectional study that was conducted within the Faculties of Medicine, Applied Medical Sciences, Dentistry, and Pharmacy. Through applying the modified SERVQUAL model, the gap between students' perceptions and expectations was calculated and correlated with other demographic data. The ratio of students’ perception to their expectation was calculated as a probe of student satisfaction in the current educational services to enable prioritizing items for improvement.
Results
The response rate was 89% (n = 266). Out of the 266 participants, 87% were females and 13% were males. Comparisons between the gap values of male and female students showed a significant difference in the assurance and responsiveness dimensions of the educational service quality at KAU. The results showed that all items have negative gap values (except item 24). The findings showed a significant difference of students’ opinion in SERVQUAL dimensions among different Faculties except in empathy.
Conclusion
The findings of this study showed that all dimensions were not up to the expectations of students. Reliability dimension and its items should be given the highest priority for improvement based on gap, ratio, and service improved matrix. The findings of this study will be very useful for the higher management to design the University Strategic Plan with well-defined direction and priorities for the improvement processes based on SERVQUAL outcomes.
Internet addiction and related psychosocial factors among Pakistani population during Covid19
Authors: Lakhdir Maryam Pyar Ali , Hameed Ayesha Nasir , Hasnani Fauzia Basaria , Angez Meher , Nawaz Muhammad Talha , Khan Malik Muhammad Hamza , Peerwani Ghazal , Nathwani Apsara Ali , Azam Syed Iqbal 
Published: September 2021

Abstract
Background

Internet addiction has surfaced as a significant concern to public health in these unprecedented Covid19 times due to social distancing and lockdown. This study aims to determine the burden of internet addiction and related psychosocial factors among the Pakistani population amidst COVID-19
Methods

An analytical cross-sectional survey was broadcasted on internet via google form link which was completed by 1145 Pakistani residents. The outcome variable was Internet addiction and was assessed using the "Young's Internet Addiction Test" (IAT). In addition, symptoms of depression, anxiety, and stress were evaluated using the "Depression, Anxiety, and Stress Scale-21" (DASS-21). The multinomial logistic regression was applied, and adjusted odds ratio along with 95% confidence intervals were reported for significant factors associated with Internet addiction.
Results

The majority of participants were females and youth (between ages 20–24 years). The prevalence of problematic-internet-users (PIU) and addictive-internet-users (AIU) was 27.3% and 11.3%, respectively. The odds of extremely severe anxiety among AIU were approximately three times (Adj OR: 2.6 (1.1–7.1) followed by the odds of having extremely severe depression was 3.14 (95% C.I.: 1.53–6.44) times greater among PIUand odds of extremely severe stress being about five times higher among AIU (Adj OR: 5.42 (1.66–17.68)) as compared to normal-internet-user (NIU).
Conclusion

Amid Covid 19, the burden of internet addiction was discovered to have surged among the Pakistani populace. This study found that gender, marital status, depression, stress, anxiety, work situation, and mood changes amidst the pandemic are significantly associated with problematic and addictive internet use.
Implementation Strategies to Support Evidence-Informed Symptom Management Among Outpatient Oncology Nurses: A Scoping Review Protocol
Authors: Teggart Kylie , Bryant-Lukosius Denise , Neil-Sztramko Sarah E. , Ganann Rebecca 
Published: September 2021

Abstract
Introduction:

Despite the availability of clinical practice guidelines for cancer symptom management, cancer care providers do not consistently utilize them in practice. Oncology nurses in outpatient settings are well-positioned to use established guidelines to inform symptom assessment and management; however, issues concerning inconsistent implementation persist. This scoping review aims to identify and describe the components of implementation strategies that have been used to enhance the adoption, implementation, and sustainability of symptom management guidelines among specialized and advanced oncology nurses in cancer-specific outpatient settings. Factors influencing guideline implementation will also be identified.
Methods and analysis:

This scoping review will follow Joanna Briggs Institute methodology. Electronic databases CINAHL, Embase, Emcare, MEDLINE(R), and grey literature sources will be searched for studies published in English since the year 2000. Primary studies and grey literature reports of any design that include specialized or advanced oncology nurses practicing in cancer-specific outpatient settings will be eligible. Sources describing implementation strategies to enhance the adoption, implementation, and sustainability of cancer symptom management guidelines and/or factors influencing implementation will be included. Two reviewers will independently screen for eligibility and extract data. Data extraction will be guided by the Consolidated Framework for Implementation Research (CFIR). Data will be analyzed descriptively and synthesized according to CFIR constructs. Results will be presented through tabular/diagrammatic formats and narrative summary.
Ethics and dissemination:

Ethics approval is not required for this scoping review. Planned knowledge translation activities include a national conference presentation, peer-reviewed publication, academic social media channels, and dissemination within local oncology nursing and patient networks.
Hybride Gesellschaften im Verhältnis Schweiz-Deutschland
Authors: Kollruss Thomas 
Published: September 2021

Grundsätzlich treten im Staatenverhältnis Schweiz-Deutschland keine hybriden Gesellschaften auf, da die Rechtsformen und die jeweiligen steuerlichen Einordnungsmethodiken weitgehend korrespondieren. Jedoch sind vorgeschaltete hybride Gesellschaften mit einer Betriebsstätte in der Schweiz möglich. Sie können für ausländische Investoren attraktiv sein und steuerliche Vorteile mit sich bringen. Der vorliegende Beitrag befasst sich mit der Einordnung und Besteuerung von hybriden Gesellschaften im Verhältnis Schweiz-Deutschland und insbesondere mit dem in der Literatur bisher kaum beachteten Sonderfall der vorgeschalteten hybriden Gesellschaft mit schweizerischer Betriebsstätte.
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En principe, les sociétés hybrides ne sont pas traitées dans le cadre des relations entre la Suisse et l’Allemagne car les formes juridiques et les méthodes de classification fiscale des deux pays sont largement équivalentes. Cependant, les sociétés hybrides existantes et qui ont un établissement stable en Suisse sont tout de même admises. D’ailleurs, elles peuvent se révéler attrayantes pour les investisseurs étrangers souhaitant profiter d’avantages fiscaux. Cet article traite d’un sujet encore peu abordé dans la littérature scientifique. Il présente la classification et l'imposition des sociétés hybrides dans les relations entre la Suisse et l'Allemagne et, en particulier, le cas spécifique de la société hybride déjà constituée avec un établissement stable en Suisse.
Applicability of Cytological Grading of Carcinoma Breast
Authors: Pachori Saroj , Chaturvedi Kriti , Pachori Geeta , Tiwari Tarun , Jain Disha 
Published: September 2021

Background: In India breast cancer incidence is on rise and large number of cases occur before 50 years of age. Early diagnosis and proper treatment are known to increase the survival of the patients. As fine needle aspiration cytology is widely used as a preliminary mode for the diagnosis of breast malignancies, adding a reliable grading system in reporting shall aid in planning the management options.
Methods: It’s a prospective study done on 100 cases of breast malignancies from June 2018 to May 2020 in department of Pathology JLNMC, Ajmer. Cytology smears were stained with H&E and Geimsa and graded according to Robinson’s cytological grading system while their corresponding histopathological sections were stained with H&E and graded as per Elston and Ellis modification of Scarff Bloom & Richardson grading system and the results were compared.
Result: Out of 100 cases of breast cancer evaluated in cytology 29% were grade I, 56% were grade II and 15% were grade III. On histopathological evaluation 25% were grade I, 54% were grade II while 21% were grade III. A highly significant association between the two grading systems was observed with coefficient of correlation 0.831, p value of <0.001 and concordance rate 80%.
Conclusion: There is high degree of concordance between the Robinson’s and Elston and Ellis modification of Scarff Bloom & Richardson grading system. Robinson’s method is an easy and quick and reliable method to grade carcinomas of breast, hence it should be included in cytology reporting of breast carcinomas.
A controlled clinical study of the effects of the Ni-Ti Memoria® Leaf Spring Activated Expander
Authors: Manzella Kevin S. , Warunek Stephen , Conley R. Scott , Al-Jewair Thikriat 
Published: September 2021

Abstract

Objective
To evaluate the dental effects of the Ni-Ti Memoria® Leaf Spring Activated Expander (MLSAE) in adolescent orthodontic patients presenting with maxillary transverse constriction.

Methods
This retrospective controlled clinical study included 22 patients consecutively treated with the Ni-Ti MLSAE (mean age = 12.72 ± 3.07; range = 6–16 yrs). The sample was compared with 22 untreated controls from the University of Michigan Growth Study. Controls were matched by gender, CVM stage and inter-first molar width. Digital dental casts were obtained at pretreatment, one week, monthly and post-expansion time-points. Maxillary dental arch measurements of inter-canine, interpremolar, inter-first molar, arch depth, arch perimeter and molar angulation were evaluated using 3Shape’s OrthoAnalyzer software. Data were analysed using paired sample and modified Student’s t-tests.

Results
Total mean expansion duration was 4.2 ± 1.23 months. Significant increases were observed between baseline and final inter-canine, inter-first and second premolars, inter-first molar, and arch perimeter measurements within the treatment group. No significant differences were found within the controls. Between group analyses showed statistically significant differences between the treatment and control groups for all variables except for arch depth and molar angulation. Average changes for inter-canine, inter-first premolar, inter-second premolar, inter-first molar, and arch perimeter were 1.04, 5.65, 5.80, 4.70 and 2.15 mm, respectively.

Conclusions
The Ni-Ti MLSAE is capable of obtaining adequate expansion in patients, 6–16 years of age, without causing significant dental tipping. It should be considered a slow expansion device that allows for calibrated expansion at a rate of 1–1.5 mm per month when following the suggested protocol.
Mandibular advancement appliance effects on obstructive sleep apnoea: a prospective threedimensional computed tomography study
Authors: Ghoneima Ahmed , Bodkin Cynthia , Stewart Kelton , Perlow Mark J. , Starbuck John , Kula Katherine 
Published: September 2021

Abstract

Background
The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity.

Methods
Forty-seven male subjects were classified into two groups comprising12 controls and 35 suffering from OSA. The OSA group was further divided into three subgroups based on their apnoea-hypopnoea index (AHI). All subjects completed an Epworth questionnaire and an overnight home sleep test before (T1) and at the end of the study (T2). OSA subjects were provided with a custom-made EMA appliance. Cone beam computed tomographic images were obtained for each subject at T1 and T2. Airway parameters were measured and summarised by grouping. The differences in the measurements T1 – T2 were compared using repeated measures analysis of variance (rmANOVA) and p ≤ 0.05 was considered statistically significant.

Results
The use of the EMA produced a statistically significant increase in the nasopharyngeal, oropharyngeal, MCA, and total airway volume. Although sleep apnoea patients reported a reduction in snoring time, particularly in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores.

Conclusion
EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, specifically in the moderate and severe cases.