bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Physical Hospital Environment and Its Effects on Palliative Patients and Their Families: A Qualitative Meta-Synthesis
Authors: Miller Elizabeth M. , Porter Joanne E. , Barbagallo Michael S. 
Published: August 2021

Aim: To review the latest qualitative literature on how the physical hospital environment affects palliative patients and their families. Background: People with a life-limiting illness may receive palliative care to improve their quality of life in hospital and may have multiple admissions as their illness progresses. Yet, despite a preference for a death at home, more than half of the dying population will receive end-of-life care in hospital. The physical hospital environment consists of ambiance, aesthetics, and architectural factors, and it is well known that the hospital’s acute wards are not a homely environment. Demand is increasing for the physical environment to be improved to better meet the needs and demands of palliative and end-of-life patients and their families. Method: Combining thematic analysis and meta-ethnography methodologies, 12 international qualitative papers were analyzed and synthesized by the three authors. Results: Findings resulted in the development of the SSAFeR Place approach that incorporates the concepts that are important to palliative and end-of-life patients and their families by describing an environment within the acute or palliative care units that feels safe, is private, customizable, and accommodates family; is a space to share with others, is homelike in ambiance and aesthetics, and is conducive for reflection. The concepts of identity, belonging, and safety are connected to the notions of home. Conclusions: To provide person-centered care and to move the focus toward the palliative approach of comfort and quality of life, attention to room size, layout, aesthetics, and ambiance is needed.
Professionalism – A Medico-Legal Perspective
Authors: Lewis Kevin 
Published: August 2021

This article examines the issue of professionalism in relation to dental practitioners, and how it impacts upon the range of medico-legal challenges they might face. It provides an overview of professionalism in a healthcare context and explores some of the characteristics that different parties would associate with it. The mismatch between these different perspectives and the relative importance that each party attaches to different aspects of professionalism, can often sit at the heart of complaints and litigation. The article also questions whether or not traditional professional values and behaviours are still relevant in a modern healthcare environment that is increasingly digital, consumerist and competitive – or conversely in such a fast-changing world, whether the need for a modern professionalism is greater than ever.
Hereditary haemorrhagic telangiectasia: A case report
Authors: Mufti Asfandyar , Sachdeva Muskaan , Maliyar Khalad , Joseph Marissa 
Published: August 2021

Background: Hereditary haemorrhagic telangiectasia is an autosomal dominant genetic disorder characterized by abnormalities in blood vessel formation. The clinical manifestations of patients affected with hereditary haemorrhagic telangiectasia include mucocutaneous telangiectasias and visceral arteriovenous malformations. Case Summary: We report the case of a 30-year-old female diagnosed with hereditary haemorrhagic telangiectasia presenting with the classic triad of recurrent epistaxis, mucocutaneous telangiectasias and family history of hereditary haemorrhagic telangiectasia with activin receptor-like kinase 1 mutation. Upon skin examination, she was noted to have telangiectasias under left naris, inner lower lip and surface of the tongue, and a vascular malformation on the right forearm. Conclusion: Although the skin involvement and epistaxis may be mild symptoms and signs of hereditary haemorrhagic telangiectasia, timely recognition of these can ensure vigilant monitoring of potential severe complications from cerebral and pulmonary visceral arteriovenous malformations.
Is Water-Only Fasting Safe?
Authors: Ogłodek Ewa , Pilis, Prof. Wiesław 
Published: August 2021

Background Water-only fasting (WF) is a practice used to improve and maintain health. Objective The aim of the study was to show whether WF performed for 8 days may be a threat to the health and/or life of people undergoing this practice. Methods Twelve middle-aged men participated in the study. During the 8-day WF, the subjects ate no food except for drinking mineral water. Before and after WF, all subjects had a series of tests performed, beginning with the level of perceived stress and somatic measurements. The concentrations of creatinine, sodium (Na+), potassium (K+), total calcium (Ca), magnesium (Mg++), urea (U), uric acid (UA) and total protein were determined in this urine and in the serum. For these substances, the values ​​of clearance, renal filtration and fractional excretion were calculated. The osmotic clearance and free water clearance as well as the amount of daily urinary excretion of creatinine, Na+, K+, Ca, Mg++, U and UA were also calculated. Moreover, the concentration of glucose in the serum and the concentration of β-hydroxybutyrate in the plasma were determined. In urine, specific gravity, pH and osmolality were also measured. Results After 8 days of WF, the study showed a significant reduction in the level of perceived stress, weight loss, changes in body composition, dehydration, increased ketogenesis, hyperuricemia, decreased serum glucose concentration, and hyponatremia. These changes were accompanied by Na+, K+ and protein sparing, decreased serum Ca and Mg++ concentrations, and reduced daily volume of more acidic urine with elevated specific gravity. Conclusions After 8 days of WF, all subjects were found to remain safe and feel the sense of well-being. However, the appearance of the above-mentioned adverse metabolic effects, despite partially effective renal compensations, suggests that the further continuation of fasting intervention by the subjects would be detrimental to their body.
Interpretation of causal relationship between quadriceps tendon Young’s modulus and gait speed by structural equation modeling in patients with severe knee osteoarthritis
Authors: Ebihara Bungo , Mutsuzaki Hirotaka , Fukaya Takashi , Iwai Koichi 
Published: August 2021

Purpose: To clarify the causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee osteoarthritis (OA) using structural equation modeling. Methods: Participants were 36 patients with knee OA (median age, 75.0 [interquartile range, 67.3–76.0] years; Kellgren-Lawrence grade 3 or 4). We measured quadriceps tendon stiffness using Young’s modulus by ShearWave Elastography. Gait speed and kinematics parameters were measured using a motion analysis system. Additional data collected for each patient included age, sex, height, body weight, body mass index, femorotibial angle, knee range of motion, knee extension torque, and pain. We performed structural equation modeling for interpretation of the causal relationship. Results: The comparative fit index of the structural equation modeling was 0.990. Quadriceps tendon Young’s modulus was a predictor of maximum knee flexion angle during the swing phase (standardized partial regression coefficients [ β] = –0.67, P < 0.001). Maximum knee flexion angle during the swing phase was a predictor of cadence and step length ( β values 0.35 and 0.55, P = 0.035 and <0.001, respectively). Cadence and step length were predictors of gait speed ( β values 0.50 and 0.63, P < 0.001 and <0.001, respectively). Conclusion: Our results showed a causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee OA. Quadriceps tendon Young’s modulus can affect gait speed through the maximum knee flexion angle during the swing phase, cadence, and step length. Adding therapeutic intervention to decrease the quadriceps tendon Young’s modulus may lead to increased gait speed.
MICA/B antibody induces macrophage-mediated immunity against acute myeloid leukemia
Authors: Alves da Silva Pedro Henrique , Xing Samantha , Kotini Andriana G. , Papapetrou Eirini P. , Song Xiaoyu , Wucherpfennig Kai W. , Mascarenhas John , Ferrari de Andrade Lucas 
Published: August 2021

Abstract
Acute myeloid leukemia (AML) is a clonal hematopoietic stem and progenitor cell malignancy characterized by poor clinical outcomes. Major histocompatibility complex class I polypeptide-related sequence A and B (MICA/B) are stress proteins expressed by cancer cells, and antibody-mediated inhibition of MICA/B shedding represents a novel approach to stimulate immunity against cancers. We found that the MICA/B antibody 7C6 potently inhibits the outgrowth of AML in 2 models in immunocompetent mice. Macrophages were essential for therapeutic efficacy, and 7C6 triggered antibody-dependent phagocytosis of AML cells. Furthermore, we found that romidepsin, a selective histone deacetylase inhibitor, increased MICB messenger RNA in AML cells and enabled subsequent stabilization of the translated protein by 7C6. This drug combination substantially increased surface MICA/B expression in a human AML line, pluripotent stem cell-derived AML blasts and leukemia stem cells, as well as primary cells from 3 untreated patients with AML. Human macrophages phagocytosed AML cells following treatment with 7C6 and romidepsin, and the combination therapy lowered leukemia burden in a humanized model of AML. Therefore, inhibition of MICA/B shedding promotes macrophage-driven immunity against AML via Fc receptor signaling and synergizes with an epigenetic regulator. These results provide the rationale for the clinical testing of this innovative immunotherapeutic approach for the treatment of AML.
Targeting RIOK2 ATPase activity leads to decreased protein synthesis and cell death in acute myeloid leukemia
Authors: Messling Jan-Erik , Agger Karl , Andersen Kasper L. , Kromer Kristina , Kuepper Hanna M. , Lund Anders H. , Helin Kristian 
Published: August 2021

AbstractNovel therapies for the treatment of acute myeloid leukemia (AML) are urgently needed, because current treatments do not cure most patients with AML. We report a domain-focused, kinome-wide CRISPR-Cas9 screening that identified protein kinase targets for the treatment of AML, which led to the identification of Rio-kinase 2 (RIOK2) as a potential novel target. Loss of RIOK2 led to a decrease in protein synthesis and to ribosomal instability followed by apoptosis in leukemic cells, but not in fibroblasts. Moreover, the ATPase function of RIOK2 was necessary for cell survival. When a small-molecule inhibitor was used, pharmacological inhibition of RIOK2 similarly led to loss of protein synthesis and apoptosis and affected leukemic cell growth in vivo. Our results provide proof of concept for targeting RIOK2 as a potential treatment of patients with AML.
Large scale genomic rearrangements in selected Arabidopsis thaliana T-DNA lines are caused by T-DNA insertion mutagenesis
Authors: Pucker Boas , Kleinbölting Nils , Weisshaar Bernd 
Published: August 2021

Abstract
Background
Experimental proof of gene function assignments in plants is based on mutant analyses. T-DNA insertion lines provided an invaluable resource of mutants and enabled systematic reverse genetics-based investigation of the functions of Arabidopsis thaliana genes during the last decades.

Results
We sequenced the genomes of 14 A. thaliana GABI-Kat T-DNA insertion lines, which eluded flanking sequence tag-based attempts to characterize their insertion loci, with Oxford Nanopore Technologies (ONT) long reads. Complex T-DNA insertions were resolved and 11 previously unknown T-DNA loci identified, resulting in about 2 T-DNA insertions per line and suggesting that this number was previously underestimated. T-DNA mutagenesis caused fusions of chromosomes along with compensating translocations to keep the gene set complete throughout meiosis. Also, an inverted duplication of 800 kbp was detected. About 10 % of GABI-Kat lines might be affected by chromosomal rearrangements, some of which do not involve T-DNA. Local assembly of selected reads was shown to be a computationally effective method to resolve the structure of T-DNA insertion loci. We developed an automated workflow to support investigation of long read data from T-DNA insertion lines. All steps from DNA extraction to assembly of T-DNA loci can be completed within days.

Conclusions
Long read sequencing was demonstrated to be an effective way to resolve complex T-DNA insertions and chromosome fusions. Many T-DNA insertions comprise not just a single T-DNA, but complex arrays of multiple T-DNAs. It is becoming obvious that T-DNA insertion alleles must be characterized by exact identification of both T-DNA::genome junctions to generate clear genotype-to-phenotype relations.
Characteristics of viral pneumonia in non-HIV immunocompromised and immunocompetent patients: a retrospective cohort study
Authors: Li Lijuan , Hsu Steven H. , Wang Chunlei , Li Binbin , Sun Lingxiao , Shi Jinying , Ren Yali , Wang Jinxiang , Zhang Xiaoqi , Liu Jiangbo 
Published: August 2021

Abstract
Background
Concerning viral pneumonia, few large-scale comparative studies have been published describing non-HIV immunocompromised and immunocompetent patients, but the epidemiological characteristics of different viruses or underlying diseases in immunocompromised hosts are lacking.

Methods
We retrospectively recruited patients hospitalised with viral pneumonia from six academic hospitals in China between August 2016 and December 2019. We measured the prevalence of comorbidities, coinfections, nosocomial infections, and in-hospital mortalities.

Results
Of the 806 patients, 370 were immunocompromised and 436 were immunocompetent. The disease severity and in-hospital mortality of immunocompromised patients were higher than those of immunocompetent patients. During the influenza season, an increased number of cases of influenza virus (IFV) infection were found in the immunocompromised group, followed by cases of cytomegalovirus (CMV) and respiratory syncytial virus (RSV) infection. During the non-influenza season, CMV was the main virus detected in the immunocompromised group, while RSV, adenovirus (AdV), parainfluenza virus (PIV), and rhinovirus (HRV) were the main viruses detected in the immunocompetent group. Pneumonia caused by Pneumocystis jirovecii (22.4%), Aspergillus spp. (14.1%), and bacteria (13.8%) were the most frequently observed coinfections in immunocompromised patients but not in immunocompetent patients (Aspergillus spp. [10.8%], bacteria [7.1%], and Mycoplasma spp. [5.3%]). CMV infection and infection with two-or-more viruses were associated with a higher in-hospital mortality rate than non-IFV infection. However, patients with IFV and non-IFV infection in immunocompromised patients had similar disease severity and prognosis.

Conclusions
Immunocompromised patients have a high frequency of coinfections, and a higher mortality rate was observed among those infected with CMV and two-or-more viruses. In addition, patients with IFV and non-IFV infection in immunocompromised patients had similar same disease severity and prognosis. The type of viral infection varied with seasons.
Prevalence and risk factors of postpartum depression in the Middle East: a systematic review and meta–analysis
Authors: Alshikh Ahmad Hoda , Alkhatib Asem , Luo Jiayou 
Published: August 2021

Abstract
Background
Postpartum depression (PPD) is a common social health problem that affects not only the mother and newborn, but extends to other family members as well as various aspects of their lives. This systematic review and meta–analysis aims to identify the prevalence and risk factors of postpartum among the women in Middle East countries.

Methods
We searched published articles from Web of Science, EMBASE, PubMed and Cochrane electronic databases to establish study articles. Articles regarding postpartum depression prevalence and associated factors among women in the Middle East were included in this systematic review and meta–analysis. A random–effect model was used for estimation of pooled postpartum depression prevalence with a 95% confidence interval (CI) and forest plot. Presence of heterogeneity was checked by Cochran's (Q) test, and funnel plots and Egger’s statistical tests were used to assess publication bias.

Results
A total of 15 studies were included in this systematic review. The studies were conducted in different countries of the Middle East between 2006 and 2020, nine of the included studies were cross–sectional studies and six were cohort studies. The overall pooled estimate of the prevalence of postpartum depression in the Middle East mothers was very high 27% (95% CI 0.19–0.35). The common risk factors reported based on our review were poor economic, pregnancy associated complications, low education, unplanned pregnancy, housewife, inadequate social support from family members and the feeding by formula. Poor economic and complication during pregnancy presented a significant relationship regarding postpartum depression in meta–analysis.

Conclusions
The prevalence of postpartum depression in the Middle East was higher than other regions of the world. In response to this, we recommend an increase of routine screening for depression during postpartum in this area. Furthermore, it might be necessary to integrate mental health with maternal health care in clinical practice during the postpartum.
TRAIL-coated leukocytes to kill circulating tumor cells in the flowing blood from prostate cancer patients
Authors: Ortiz-Otero Nerymar , Marshall Jocelyn R. , Glenn Antonio , Matloubieh Jubin , Joseph Jean , Sahasrabudhe Deepak M. , Messing Edward M. , King Michael R. 
Published: August 2021

AbstractBackgroundRadical surgery is the first line treatment for localized prostate cancer (PC), however, several studies have demonstrated that surgical procedures induce tumor cell mobilization from the primary tumor into the bloodstream.MethodsThe number and temporal fluctuations of circulating tumor cells (CTC), cancer associated fibroblasts (CAF) and CTC cluster present in each blood sample was determined.ResultsThe results show that both CTC and CTC cluster levels significantly increased immediately following primary tumor resection, but returned to baseline within 2 weeks post-surgery. In contrast, the CAF level decreased over time. In patients who experienced PC recurrence within months after resection, CTC, CAF, and cluster levels all increased over time. Based on this observation, we tested the efficacy of an experimental TNF-related apoptosis-inducing ligand (TRAIL)-based liposomal therapy ex-vivo to induce apoptosis in CTC in blood. The TRAIL-based therapy killed approximately 75% of single CTCs and CTC in cluster form.ConclusionCollectively, these data indicate that CTC cluster and CAF levels can be used as a predictive biomarker for cancer recurrence. Moreover, for the first time, we demonstrate the efficacy of our TRAIL-based liposomal therapy to target and kill prostate CTC in primary patient blood samples, suggesting a potential new adjuvant therapy to use in combination with surgery.
Prediction of the local treatment outcome in patients with oropharyngeal squamous cell carcinoma using deep learning analysis of pretreatment FDG-PET images
Authors: Fujima Noriyuki , Andreu-Arasa V. Carlota , Meibom Sara K. , Mercier Gustavo A. , Truong Minh Tam , Hirata Kenji , Yasuda Koichi , Kano Satoshi , Homma Akihiro , Kudo Kohsuke , Sakai Osamu 
Published: August 2021

Abstract
Background
This study aimed to assess the utility of deep learning analysis using pretreatment FDG-PET images to predict local treatment outcome in oropharyngeal squamous cell carcinoma (OPSCC) patients.

Methods
One hundred fifty-four OPSCC patients who received pretreatment FDG-PET were included and divided into training (n = 102) and test (n = 52) sets. The diagnosis of local failure and local progression-free survival (PFS) rates were obtained from patient medical records. In deep learning analyses, axial and coronal images were assessed by three different architectures (AlexNet, GoogLeNET, and ResNet). In the training set, FDG-PET images were analyzed after the data augmentation process for the diagnostic model creation. A multivariate clinical model was also created using a binomial logistic regression model from a patient’s clinical characteristics. The test data set was subsequently analyzed for confirmation of diagnostic accuracy. Assessment of local PFS rates was also performed.

Results
Training sessions were successfully performed with an accuracy of 74–89%. ROC curve analyses revealed an AUC of 0.61–0.85 by the deep learning model in the test set, whereas it was 0.62 by T-stage, 0.59 by clinical stage, and 0.74 by a multivariate clinical model. The highest AUC (0.85) was obtained with deep learning analysis of ResNet architecture. Cox proportional hazards regression analysis revealed deep learning-based classification by a multivariate clinical model (P < .05), and ResNet (P < .001) was a significant predictor of the treatment outcome. In the Kaplan-Meier analysis, the deep learning-based classification divided the patient’s local PFS rate better than the T-stage, clinical stage, and a multivariate clinical model.

Conclusions
Deep learning-based diagnostic model with FDG-PET images indicated its possibility to predict local treatment outcomes in OPSCCs.
Hope level and associated factors among parents of retinoblastoma patients during COVID-19 pandemic: a cross-sectional study
Authors: Zeng Changjuan , Cao Wenting , Zhao Ting , Li Li , Hou Lili 
Published: August 2021

Abstract
Background
The 2019 coronavirus disease (COVID-19) is a global public health emergency. So far, only a limited number of studies have investigated the impact of the COVID-19 pneumonia pandemic on the mental health of parents having children with cancer. This study investigated the hope, and relevant influencing factors (depression, anxiety, demographic data) among parents whose children had retinoblastoma (RB) during the COVID-19 pandemic.

Methods
A cross-sectional survey and a convenient sampling survey were conducted on 317 parents of RB children admitted to the Ninth People’s Hospital affiliated with Shanghai Jiao Tong University, School of Medicine, and Qilu Children’s Hospital of Shandong University. The survey tools included Demographic Questionnaire, Herth Hope Index (HHI), The Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaires (PHQ)-2.

Results
The hope level score of the parents of RB patients was (35.36 ± 4.42), which was at the medium level. The highest dimension of hope score was inner positive readiness and expectancy (12.07 ± 1.57), and the lowest dimension was interconnectedness with self and others (11.50 ± 1.64). The incidence rate of depression and anxiety was 29.97% (95/317) and 41.32% (131/317), respectively. Monoculus or binoculus disease, sleep status, health status, and depression /anxiety had statistically significant effects on the parental hope level (p < 0.05). Multiple linear regression analysis revealed that time since diagnosis, education level, treatment type and depression were independent influencing factors (p < 0.05), accounting for 22.60% of the variation in hope level.

Conclusion
During the COVID-19 pandemic, medical staff should formulate targeted intervention measures according to different characteristics of ocular disease, time since diagnosis, treatment type, parental educational level and emotional state in order to improve the level of parental hope.