bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary lymphoepithelioma-like carcinoma
Authors: Zhou Lin , Liu Xin-Yi , He Ya , Li Lu-ting , Zhang Shao-Jin 
Published: February 2021

Abstract

Rationale:
Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare type of primary malignant lung tumor characterized by Epstein-Barr virus infection, with, to the authors’ knowledge, a total of only 500 reported cases during the past 30 years worldwide. Histologically, PLELC is similar to undifferentiated nasopharyngeal carcinoma and poorly differentiated squamous cell carcinoma. However, although PLELC accounts for <1% of all lung cancers, it has a better prognosis and is usually detected in non-smokers and individuals of Asian ancestry.

Patient concerns:
The patient presented with chest distress of no apparent cause, dizziness, headaches, and a feeling of disequilibrium without remission, as well as a pulmonary nodule incidentally detected on contrast-enhanced computed tomography (CT).

Diagnosis:
PLELC was confirmed histopathologically rather than on preoperative CT; nevertheless, CT findings still contributed to the diagnosis.

Interventions:
The patient underwent thoracoscopic wedge resection of the affected lung.

Outcomes:
The patient recovered after the lung nodule was completely removed, and was discharged. No evidence of recurrence or metastasis was found at the latest follow-up appointment 2 months after the operation.

Lessons:
PLELC is a rare bronchogenic carcinoma associated with lymphatic tissue with a favorable prognosis in most cases. With nonspecific clinical symptoms, specific radiological findings may facilitate an early diagnosis in some cases, followed by timely surgical intervention.
Acquiring sepsis competencies through simulation-based learning bundle during intermediate care unit internship
Authors: Fernández-Ros Nerea , Alegre Félix , Huerta Ana , Gil-Alzugaray Belén , Landecho Manuel F. , García Nicolás , Quiroga Jorge , Lucena Juan Felipe 
Published: February 2021

Abstract
Intermediate care units (ImCUs) have been shown as appropriate units for the management of selected septic patients. Developing specific protocols for residents in training may be useful for their medical performance. The objective of this study was to analyze whether a simulation-based learning bundle is useful for residents while acquiring competencies in the management of sepsis during their internship in an ImCU.
A prospective study, set in a tertiary-care academic medical center was performed enrolling residents who performed their internship in an ImCU from 2014 to 2017. The pillars of the simulation-based learning bundle were sepsis scenario in the simulation center, instructional material, and sepsis lecture, and management of septic patients admitted in the ImCU. Each resident was evaluated in the beginning and at the end of their internship displaying a sepsis-case scenario in the simulation center. The authors developed a sepsis-checklist that residents must fulfill during their performance which included 5 areas: hemodynamics (0–10), oxygenation (0–5), antibiotic therapy (0–9), organic injury (0–5), and miscellaneous (0–4).
Thirty-four residents from different years of residency and specialties were evaluated. The total median score (interquartile range) increased significantly after training: 12 (25) vs 23 (16), P = .001. First-year residents scored significantly lower than older residents at baseline: 10 (14) vs 14.5 (19), P = .024. However, the performance at the end of the training period was similar in both groups: 21.5 (11) vs 23 (16), P = 1.000. Internal Medicine residents scored significantly higher than residents from other specialties: 18 (17) vs 10.5 (21), P = .007. Nonetheless, the performance at the end of the training period was similar in both groups: 24.5 (9) vs 22 (13), P = 1.000.
Combining medical simulation with didactic lectures and a rotation in an ImCU staffed by hospitalists seems to be useful in acquiring competencies to manage critically ill patients with sepsis. We designed a checklist to assure an objective evaluation of the performance of the residents and to identify those aspects that could be potentially improved.
Association of non-alcoholic fatty liver disease and all-cause mortality in hospitalized cardiovascular disease patients
Authors: Saokaew Surasak , Kanchanasurakit Sukrit , Thawichai Kanitta , Duangprom Prommanee , Wannasri Monnapha , Khankham Sirintip , Kositamongkol Chayanis , Chaiyakunapruk Nathorn , Phisalprapa Pochamana 
Published: February 2021

Abstract

Background:
Controversy remains concerning the association of the all-cause mortality risk of hospitalized cardiovascular disease (CVD) patients with non-alcoholic fatty liver disease (NAFLD). This study investigated the risks of all-cause mortality among hospitalized CVD patients with NAFLD.

Methods:
We used related keywords to search for studies in 3 electronic databases: PubMed, EMBASE, and Cochrane Library. All eligible studies published up to April 2020 were reviewed. The findings of those studies reporting the mortality outcomes of hospitalized CVD patients with and without NAFLD were examined, and the various study results were pooled and analyzed using a random-effects model. A quality assessment using the Newcastle–Ottawa scale was performed on the studies selected for inclusion in a meta-analysis.

Results:
A total of 2135 studies were found, of which 3 were included in this meta-analysis. All studies were considered good quality. The mean age of the patients in the analysis was 73 years, and about half of them were men. The comorbidities reported were hypertension, diabetes mellitus, and dyslipidemia. The results showed that hospitalized CVD patients with NAFLD were at a significantly higher risk of all-cause mortality than non-NAFLD patients (adjusted hazard ratio of 2.08 [95% confidence interval, 1.56–2.59], P < .001). The included studies showed low heterogeneity (I

2
= 0.0%, P = .473), and Begg and Egger tests revealed no apparent publication bias (P = .327 and P = .682, respectively).

Conclusions:
Hospitalized CVD patients with NAFLD were at a higher risk of all-cause mortality than those without NAFLD. More studies that further explore this association are needed.
ETS1 polymorphism rs73013527 in relation to serum RANKL levels among patients with RA
Authors: Yang Bin , Luo Limei , Chen Lin , Niu Qian , Zhang Junlong , Xu Huan , Wu Yifeng , Huang Zhuochun 
Published: February 2021

Abstract
We previously identified E26 transformation specific sequence 1 (ETS1) rs73013527 single nucleotide polymorphism associated with RA susceptibility and disease activity. In the present study, we aims to further investigate the association between ETS1 rs73013527 and receptor activator of nuclear factor kappa B ligand (RANKL), an index related to bone destruction and was reported to elevate in RA.
We determined genotypes of ETS1 rs73013527, serum RANKL concentration, clinical characteristics (disease duration, disease activity score for 28 painful/swollen joints), and laboratory markers (rheumatoid factor, anti-citrullinated protein antibody, anti-keratin antibody, c-reactive protein, erythrocyte sedimentation rate) of 254 RA cases. Univariate and multivariate analysis were employed to explore the association between ETS1 rs73013527 and serum RANKL levels in RA patients.
Univariate and multivariate analysis indicated no association of serum RANKL levels with patient age, gender, clinical characteristics, and laboratory markers. Univariate analysis, not multivariate analysis indicated genotype CT/TT of ETS1 rs73013527 was significantly associated with elevated RANKL levels in RA patients.
ETS1 rs73013527 is in relation to serum RANKL levels among patients with RA. ETS1 probably might be an indirect factors involved in RANKL regulation in RA.
Different acupuncture intervention time-points for improving capacity in motor function and activities of daily living after stroke
Authors: Zhuo Yue , Deng Shifeng , Xu Ming , Zhang Yuchen , Lu Xiaoye , Wu Boyu , Zhang Hong 
Published: February 2021

Abstract

Background:
The incidence of stroke has been found in an increasing trend worldwide, resulting in significant negative effects and severe impairments to survivors in terms of motor function and activities of daily living. Acupuncture therapy has been widely used in the clinical treatment of stroke for a long time, meanwhile, the efficacy has been confirmed by many studies. However, the optimal intervention time-point of acupuncture in stroke is controversial. Therefore, the purpose of our study is to provide scientific evidence and reasonable suggestions for this issue.

Methods:
A computer-based retrieval will be employed in 7 electronic databases: EMBASE Database, PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang databases, Chinese Scientific Journals Database (VIP) and China Biological Medicine Database (CBM), from the establishment date of each database throughout October 2020. Only randomized controlled trials of acupuncture for stroke will be recruited and language is limited to English or Chinese. The outcomes we focus on include the Fugl-Meyer Assessment score and the Barthel Index. Additionally, safety assessments such as adverse events and drop-out cases may also be taken into consideration. The network meta-analysis will be performed based on the Bayesian framework and literature selection will be conducted by 2 trained reviewers. All data analysis will be calculated by Revman5.3, WinBUGS 1.4.3, Stata13.0, and R software 3.6.1. The Assessment of heterogeneity, inconsistency, subgroup, sensitivity, and publication bias will also be done under the guidelines of Cochrane Collaboration's tool.

Results:
The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusion:
This network meta-analysis will provide evidence-based references to evaluate the efficacy of different acupuncture intervention time-points during the treatment of stroke. Furthermore, it will help the clinicians to formulate appropriate medical plans and improve clinical efficacy.

Trials registration number:
INPLASY2020120060
Changes in Fatigue Levels and Sleep Measures of Hospital Nurses During Two 12-Hour Work Shifts
Authors: Cho Hyeonmi , Brzozowski Sarah , Arsenault Knudsen Élise N. , Steege Linsey M. 
Published: February 2021

OBJECTIVE
The aims of this study were to explore nurses' fatigue levels and sleep measures during two 12-hour consecutive day shifts and examine the relationships between nurses' fatigue levels within shifts and their previous-night sleep characteristics.

BACKGROUND
Monitoring changes in fatigue and sleep is important to enable effective fatigue management.

METHODS
This was a descriptive, repeated-measures study. Data were collected using surveys and actigraphy 4 times during each consecutive shift (7:00 am-7:30 pm).

RESULTS
General fatigue levels started trending up 4 hours after the start of work; highest levels were reported at 7:30 pm. Fatigue levels accumulated across consecutive shifts. Subjective sleep quality was higher the night before the 2nd shift than the night before the 1st shift. Nurses' poor sleep the night before a shift was related to increased fatigue levels during the next shift.

CONCLUSION
It is important to consider when fatigue management interventions will be most effective and to consider previous-night's sleep when monitoring fatigue.
A Qualitative Study Describing Nurses' Experiences With Presenteeism
Authors: Rainbow Jessica G. , Dudding Katherine M. , Bethel Claire 
Published: February 2021

OBJECTIVE
The aim of this study was to understand nurse awareness of coping and decision making regarding presenteeism and the consequences thereof.

BACKGROUND
Nurses report high levels of presenteeism or not being able to fully function in the workplace, but we currently lack understanding of nurse perceptions of presenteeism and its consequences.

METHODS
A qualitative descriptive method was used to evaluate the perceptions of nurses from medical surgical units at 2 different hospitals.

FINDINGS
For purposes of the study, presenteeism was defined as being present at work when not fully engaged. Most respondents experienced presenteeism in the month before data collection. Five categories of themes were identified: 1) factors leading to presenteeism, 2) awareness and symptoms of presenteeism, 3) coping with presenteeism on and off shift, 4) decision making regarding presenteeism, and 5) consequences of presenteeism.

CONCLUSIONS
Both personal and work factors contribute to presenteeism. To decrease presenteeism, healthcare leaders and systems should consider reviewing and changing sick/leave polices, unit cultures, and a lack of resources that contribute to and encourage an awareness of presenteeism, thereby decreasing nurse fatigue.
An Exploration of Factors Associated With Nurses' Perceptions of Decisional Involvement
Authors: Promes Jennifer , Barnason Susan 
Published: February 2021

OBJECTIVE
The purpose of this study was to evaluate nurses' perceptions of decisional involvement (DI).

BACKGROUND
Decisional involvement is a measure or gauge of nurses' perceived shared leadership. There has been limited research examining factors associated with actual and preferred DI.

METHODS
A descriptive, observational study design was used. A total of 189 RNs completed the Decisional Involvement Scale and Evidence-Based Practice Implementation Scale. Nurses' preferred DI (DI-P) and actual DI (DI-A) were analyzed, and DI total and subscale scores were compared based on nurses' demographic and clinical practice characteristics.

RESULTS
The DI-A and DI-P total scores were significantly different, including subscales for DI-A compared with DI-P score. Dissonance scores by subscale were highest for recruitment, governance, and support. Unit-based council (UBC) participants had significantly higher actual DI, compared with non-UBC participants. Nurses' perceptions of implementing evidence-based practice (EBP) was not significantly different by low versus high EBP implementation; nor were the scores significantly correlated with their DI-A or DI-P scores.

CONCLUSIONS
Findings indicate nurses' perceptions of DI-A and DI-P. This study provided further examination of the differences and interrelationships between DI and nurses' demographic and clinical practice characteristics. Dissonance DI scores provide opportunities for targeting interventions to engage nurses in shared leadership.
Reproduction as a Means of Evaluating Policy Models: A Case Study of a COVID-19 Simulation
Authors: Chattoe-Brown E. , Gilbert N. , Robertson D. A. , Watts C. 
Published: February 2021

AbstractThis article proposes (and demonstrates the effectiveness of) a new strategy for assessing the results of epidemic models which we designate reproduction. The strategy is to build an independent model that uses (as far as possible) only the published information about the model to be assessed. In the example presented here, the independent model also follows a different modelling approach (agent-based modelling) to the model being assessed (the London School of Hygiene and Tropical Medicine compartmental model which has been influential in COVID lockdown policy). The argument runs that if the policy prescriptions of the two models match then this independently supports them (and reduces the chance that they are artefacts of assumptions, modelling approach or programming bugs). If, on the other hand, they do not match then either the model being assessed is not provided with sufficient information to be relied on or (perhaps) there is something wrong with it. In addition to justifying the approach, describing the two models and demonstrating the success of the approach, the article also discusses additional benefits of the reproduction strategy independent of whether match between policy prescriptions is actually achieved.
Role of Heterogeneous Transmission in the Decline of COVID-19 Cases During Winter of 2020/2021 in Massachusetts
Authors: Choi Yeon-Woo , Castro Marcia C. , Eltahir Elfatih A. B. 
Published: February 2021

AbstractImportanceHeterogeneity in transmission of COVID-19 is a significant multiscale phenomenon. However, the role of this heterogeneity in shaping the overall dynamics of disease transmission is not well understood.ObjectiveTo investigate the role of heterogeneous transmission among different towns in Massachusetts in shaping the dynamics of COVID-19 transmission, especially the recent decline during winter of 2020/2021.Design, Setting, ParticipantsAnalysis of COVID-19 data collected and archived by the Massachusetts Department of Public Health.ExposuresThe entire population of the state of Massachusetts is exposed to the virus responsible for COVID-19, to varying degrees. This study quantifies this variation.Main outcome measuresWeekly observations, by town, on confirmed COVID-19 cases in Massachusetts, during the period (April 15th, 2020 to February 9th 2021).ResultsThe relative decline in COVID-19 cases, during January 12th, 2021 to February 9th, 2021, in the group of towns with higher total accumulated cases in the period before January 12th, 2021 is significantly larger than the corresponding relative decline in the group of towns with lower accumulated cases during the same period.Conclusions and RelevanceHeterogeneous nature of transmission is playing a significant role in shaping the rapid recent decline (January 12th to February 9th, 2021) in reported cases in Massachusetts, and probably around the country. These findings are relevant to how we estimate the threshold defining “herd” immunity, suggesting that we should account for effects due to heterogeneity.Key PointsQuestionDoes heterogeneity in disease transmission play a role in shaping the overall dynamics of COVID-19 in Massachusetts, including the recent decline in cases during the 2020/2021 winter.FindingsBased on analysis of data on cases in Massachusetts, the consistent and widespread decline of COVID-19 spread during winter of 2020/2021 (January 12th, 2021 to February 9th, 2021) appears to be shaped to a significant degree by the heterogeneous nature of transmission at the scale of different towns. Towns with a history of high (low) transmission rates during 2020 are experiencing a faster (slower) relative decline.MeaningWe suggest that heterogeneity in transmission of COVID-19 may impact the dynamics of disease transmission including the emergence of “herd” immunity, in line with some recent theoretical studies. This finding deserves some attention from other research groups investigating “herd” immunity, and from federal and state public health authorities concerned with the future evolution of the pandemic.
“SARS-Cov-2 testing in the United Arab Emirates: Population Attitudes and Beliefs”
Authors: AlKetbi Latifa Mohammad Baynouna , Nagelkerke Nico , Abdelbaqi Hanan , ALBlooshi Fatima , AlSaedi Mariam , Almansoori Shamsa , AlNuaimi Ruqaya , AlKhoori Amal , AlAryani Aysha , Jiziri Ahmed Al , AlMestika Naji , AlShamsi Mariam , Kayani Fatima , Alblooshi Noura , AlKhajeh Shamma , Hammadi Ibrahim Al , AlDhahei Saeed , AlFalahi Jehan 
Published: February 2021

AbstractObjectivesThe United Arab Emirates responded to the SARS-COV-2 pandemic and widely implemented test-and-trace strategy. In this cross-sectional questionnaire-based study 531 subjects presenting for SARS-COV-2 testing were recruited to study population’s beliefs and choices regarding testing and were compared to 156 who never been tested.ResultsThe community uptake in Abu Dhabi Emirate reached 90% (average of 68% overall). In the great majority it was self-motivated as 6% only had doctor referral. Those who had not taken a test were younger in age (p < 0.001), more likely performing activities such as shopping and eating out (p = 0.001), have a medical illness (p < 0.0001), and working from home (p = 0.005). The tested group reported significantly more agreement with the statement, if someone had negative result no need to stay home or wear mask. In conclusion, SARS-COV-2 testing had extensive coverage and high acceptability in the UAE. Acting on concluded beliefs and attitude are key to ensure the testing coverage efficiency and public empowerment.
Beliefs associated with Intentions of Non-Physician Healthcare Workers to Receive the COVID-19 Vaccine in Ontario, Canada
Authors: Desveaux Laura , Savage Rachel D. , Tadrous Mina , Kithulegoda Natasha , Thai Kelly , Stall Nathan M. , Ivers Noah M. 
Published: February 2021

AbstractAchieving herd immunity of SARS-CoV-2 through vaccines will require a concerted effort to understand and address barriers to vaccine uptake. We conducted a web-based survey of non-physician HCWs, informed by the Theoretical Domains Framework, measuring intention to vaccinate, beliefs and sources of influence relating to the COVID-19 vaccines, and sociodemographic characteristics. Vaccination non-intent was associated with beliefs that vaccination was not required because of good health, lower confidence that the COVID-19 vaccine would protect their family and patients, and that getting vaccinated was a professional responsibility. Vaccination non-intent was strongly associated with mistrust about how fast the vaccines were developed and vaccine safety concerns. Communication directed at non-physician HCWs should be tailored by ethnic subgroups and settings to increase salience. Messaging should leverage emotions (e.g., pride, hope, fear) to capture interest, while addressing safety concerns and confirming the low risk of side effects in contrast to the substantial morbidity and mortality of COVID-19. Emergent data about reduced transmission post-vaccination will be helpful.