bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality improvement initiative to improve the duration of kangaroo mother care for twin preterm neonates born at a tertiary care hospital in resource‐limited settings
Authors: Arora Pihu , Kommalur Anitha , Devadas Sahana , Kariyappa Mallesh , Rao Suman P N 
Published: February 2021

AimKangaroo mother care (KMC) can be challenging in multiple births and more so in resource‐limited settings. This study aims at increasing the mean duration of KMC with early initiation in twin preterm neonates born at a tertiary care hospital using a quality improvement (QI) initiative.MethodsBarriers for poor KMC practice in twin preterm neonates born at the tertiary care hospital were analysed and baseline data were collected over a period of 4 months using a predesigned proforma. A QI team was formed and suggested solutions were prioritised through focus group discussions in the form of Plan‐Do‐Study‐Act (P‐D‐S‐A) cycles. Each cycle was of one‐month duration and three cycles were implemented, followed by the sustenance phase studied at 1‐month post‐implementation.ResultsThere were a total of 238 twin deliveries in the study period, of which 169 twin pairs were included in the study. At the end of implementation, the average day of initiation of KMC improved from 8th to 3rd day of life and the duration of KMC increased significantly from an average of 2.70 h/infant/day to 7.88 h/infant/day.ConclusionThis QI project focused on the improvement of KMC practice in twin preterm neonates in a tertiary care hospital where results were achieved with maximal utilisation of available hospital resources and low‐cost interventions. This study design is generalizable to other hospitals in resource‐limited settings where family participatory care can be strengthened to overcome the challenges of KMC in multiple births.
Computer tomography‐assisted visualization of the movement triggered by frost in Ostrinia nubilalis overwintering in maize stalks
Authors: Keszthelyi Sándor , Binder Antal , Csóka Ádám , Pónya Zsolt , Donkó Tamás 
Published: February 2021

AbstractThe damage of the European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), causes is mainly determined by the success of its overwintering. The aim of our study was to assess the consequences of the artificial cooling on the movement and survival ability of overwintering larvae of O. nubilalis by using computer‐assisted tomography. The in situ movement of the examined larvae in icy media of different thickness (5, 15, and 30 cm) and during freezing periods of 5, 10, 20, 40, and 60 min was determined in maize stalks using CT and the positioner‐laser of the CT apparatus. It has been found that the thickness of the ice had a significant effect on the displacement of the overwintering larvae, however, the impact of the duration of freezing on the moving of the larvae could not be proven statistically. Enhanced larvae activity due to thinner ice layers (5, 15 cm) were of exponential type, which was more pronounced just prior to the freezing point. In contrast, thicker ice covering (30 cm) caused complete immobility. According to our results, the diapausing larvae were still able to move and albeit it appeared to be capable of surviving the direct impact of extreme cold, it could even leave its overwintering place as a result of low temperature. Furthermore, the maize stalk tissue contributes to the survival‐success of the larvae as it seems to act as a temperature‐buffer moderating the severe impact that low temperature exerts on living tissue.
Explicit and Implicit Hopelessness and Self‐injury
Authors: Gray Nicola Susan , Knowles James , George Danielle , Harvey Alex , Powell Rachel , Zadeh Mehrnaz Vazirian , Wansing Carlotta , Snowden Robert J. 
Published: February 2021

AbstractObjectiveThis study examined the relationship between explicit and implicit measures of hopelessness and self‐injurious behavior (defined here as self‐harming or suicidal actions and thoughts).MethodA community sample of 267 participants completed explicit measures of hopelessness (Beck's Hopelessness Scale and a Feeling Thermometer), an implicit measure of hopelessness (Hopelessness Implicit Association Test), and a self‐report measure of their history of self‐injurious behavior.ResultsThe results showed that high levels of hopelessness, measured both explicitly or implicitly, were associated with a past and recent history of self‐injury. However, there was also an interaction between the implicit and explicit measures such that explicit hopelessness was more strongly predictive of self‐injury in people with high levels of implicit hopelessness.ConclusionThe findings show that the implicit measurement of hopelessness can help predict past and recent self‐injury beyond what explicit measures of hopelessness currently achieve and could be used in the assessment of risk of both self‐harming and suicidal behaviors.
MATRA‐A: A study on massive transfusion
Authors: Ünlü Aytekin , Yılmaz Soner , Akbasli Izzet Turkalp , Karaagac Akyol Tulay , Akkapulu Nezih , Tumer Murat , Ertugrul Oruc Nigar , Balas Sener , Goral Seniz , Topcuoglu Pervin , Tanriseven Mustafa , Sayin Selim , Eryilmaz Mehmet 
Published: February 2021

BackgroundWe use massive transfusion in various clinical conditions and it is associated with high mortality. Although some massive transfusion protocols improve patient outcomes, the clinical circumstances requiring it are not well defined.MethodsMATRA‐A is a multicenter retrospective study. Six University and Training Research Hospitals in Ankara participated in the study. We collected clinical data on patients (>18 years) who received massive transfusions (≥10 units/24 h) from 2017 through 2019.ResultsOverall, 167 (0·27% of transfused patients) received a massive transfusion of 2586 units of red blood cells (1·5% of total RBCs transfused). The median interquartile range values for RBCs, fresh frozen plasma (FFP) and platelets were 13 (11–176), 16 (9–33) and 4 (0–11), respectively. Surgical patients received 90% of massive transfusions. The most common clinical indications for massive transfusion were cardiovascular diseases (42·6%), trauma (20·3%) and malignancies (11%). FFP: RBC: Platelets ratio was 1·9:1:0·5. The overall and trauma‐related mortality rates were 57·4% and 61·8%, respectively. The hospital mortality rates of trauma patients that received high vs. low ratio (FFP: RBCs > 1:1·5 vs. ≤1:1·5) transfusions were 47·6% and 86·6% and the difference was statistically significant (P = 0·03).ConclusionCardiovascular diseases and trauma occasion are the most common causes of massive transfusion. It is infrequent in clinical settings and is associated with high mortality rates. Additionally, in massively transfused trauma patients, a high FFP:RBCs ratio seems to be associated with increased survival. Focused prospective studies are required to define the areas that need improvement on a national scale.
Amlodipine as adjuvant therapy to current chelating agents for reducing iron overload in thalassaemia major: a systematic review, meta‐analysis and simulation of future studies
Authors: Elfaituri Muhammed Khaled , Ghozy Sherief , Ebied Amr , Morra Mostafa Ebraheem , Hassan Osama Gamal , Alhusseiny Ahmed , Abbas Alzhraa Salah , Sherif Nourin Ali , Fernandes Juliano Lara , Huy Nguyen Tien 
Published: February 2021

Background and ObjectivesIron overload in thalassaemia is a crucial prognostic factor and a major cause of death due to heart failure or arrhythmia. Therefore, previous research has recommended amlodipine as an auxiliary treatment to current chelating agents for reducing iron overload in thalassaemia patients.Materials and MethodsA systematic review and meta‐analysis of the results of three randomized clinical trials evaluating the use of amlodipine in thalassaemia patients through 12 databases were carried out.ResultsOur final cohort included 130 patients. Insignificant difference in decreasing liver iron concentrations was found between amlodipine and control groups {weighted mean difference = −0·2, [95% confidence interval = (−0·55–0·15), P = 0·26]}. As regards serum ferritin, our analysis also showed no significant difference in serum ferritin between amlodipine and control groups {weighted mean difference [95% confidence interval = −0·16 (−0·51–0·19), P = 0·36]}. Similarly, there was insignificant difference in cardiac T2* between amlodipine and control groups {weighted mean difference [95% confidence interval = 0·34 (−0·01–0·69), P = 0·06]}.ConclusionsDespite the growing evidence supporting the role of amlodipine in reducing iron overload in thalassaemia patients, our meta‐analysis did not find that evidence collectively significant. The results of our simulation suggest that when more data are available, a meta‐analysis with more randomized clinical trials could provide more conclusive insights.
Aero-Thermal Aspects of Film Cooled Nozzle Guide Vane Endwall—Part 1: Aerodynamics
Authors: Alqefl Mahmood H. , Nawathe Kedar P. , Chen Pingting , Zhu Rui , Kim Yong W. , Simon Terrence W. 
Published: February 2021

Abstract
The first-stage turbine of a modern gas turbine is subjected to high thermal loads which lead to a need for aggressive cooling schemes to protect its components from melting. Endwalls are particularly challenging to cool due to the complex system of secondary flows near them that wash the protective film coolants into the mainstream. This paper shows that without including combustor cooling, the complex secondary flow physics is not representative of modern engines. Aggressive injection of all cooling flows upstream of the passage is expected to interact and change passage aerodynamics and, subsequently, mixing and transport of coolants. This study describes, experimentally, the aero-thermal interaction of cooling flows near the endwall of a first-stage nozzle guide vane passage. The test section involves an engine-representative combustor–turbine interface geometry, combustor coolant flow, and endwall film cooling flow injected upstream of a linear cascade. The approach flow conditions represent flow exiting a cooled, low-NOx combustor. This first part of this two-part study aims to understand the complex aerodynamics near the endwall through detailed measurements of passage three-dimensional velocity fields with and without endwall film cooling. The aerodynamic measurements reveal a dominant vortex in the passage, named here as the Impingement Vortex, that opposes the passage vortex formed at the airfoil leading edge plane. This Impingement Vortex completely changes our description of flow over a modern film cooled endwall.
Peer-Assisted Lifestyle (PAL) intervention: a protocol of a cluster-randomised controlled trial of a health-coaching intervention delivered by veteran peers to improve obesity treatment in primary care
Authors: Wittleder Sandra , Smith Shea , Wang Binhuan , Beasley Jeannette M , Orstad Stephanie L , Sweat Victoria , Squires Allison , Wong Laura , Fang Yixin , Doebrich Paula , Gutnick Damara , Tenner Craig , Sherman Scott E , Jay Melanie 
Published: February 2021

IntroductionAmong US veterans, more than 78% have a body mass index (BMI) in the overweight (≥25 kg/m2) or obese range (≥30 kg/m2). Clinical guidelines recommend multicomponent lifestyle programmes to promote modest, clinically significant body mass (BM) loss. Primary care providers (PCPs) often lack time to counsel and refer patients to intensive programmes (≥6 sessions over 3 months). Using peer coaches to deliver obesity counselling in primary care may increase patient motivation, promote behavioural change and address the specific needs of veterans. We describe the rationale and design of a cluster-randomised controlled trial to test the efficacy of the Peer-Assisted Lifestyle (PAL) intervention compared with enhanced usual care (EUC) to improve BM loss, clinical and behavioural outcomes (aim 1); identify BM-loss predictors (aim 2); and increase PCP counselling (aim 3).Methods and analysisWe are recruiting 461 veterans aged 18–69 years with obesity or overweight with an obesity-associated condition under the care of a PCP at the Brooklyn campus of the Veterans Affairs NY Harbor Healthcare System. To deliver counselling, PAL uses in-person and telephone-based peer support, a tablet-delivered goal-setting tool and PCP training. Patients in the EUC arm receive non-tailored healthy living handouts. In-person data collection occurs at baseline, month 6 and month 12 for patients in both arms. Repeated measures modelling based on mixed models will compare mean BM loss (primary outcome) between study arms.Ethics and disseminationThe protocol has been approved by the Institutional Review Board and the Research and Development Committee at the VA NY Harbor Health Systems (#01607). We will disseminate the results via peer-reviewed publications, conference presentations and meetings with stakeholders.Trial registration numberNCT03163264; Pre-results.
Open-label placebo for insomnia (OPIN): study protocol for a cohort multiple randomised controlled trial
Authors: Colagiuri Ben , Sharpe Louise , Ambarchi Zahava , Glozier Nick , Bartlett Delwyn , Costa Daniel S J , Scott Amelia 
Published: February 2021

IntroductionInsomnia is a prevalent sleep disorder that causes substantial personal and societal harm. There is evidence that placebo interventions can reduce insomnia symptoms, but this research has involved deceptively administering the placebo under the guise of a real medication (conventional placebo, CP), which has obvious ethical constraints. Open-label placebo (OLP) treatment, in which a placebo is administered with full disclosure that there are no active ingredients, has been proposed as a method of using the placebo effect ethically, but the efficacy and acceptability of OLP for insomnia is currently unknown.Methods and analysisThis study uses a cohort multiple randomised controlled trial design to compare OLP, CP and no treatment for insomnia. Two-hundred and sixty-seven participants with self-reported insomnia symptoms (Insomnia Severity Index, ISI ≥10) will be recruited into an observational study and have their sleep monitored over a 2-week period. Participants will then be randomised to one of three groups: invite to OLP, invite to CP described deceptively as a new pharmacological agent, or no invite/observational control. Those in OLP and CP accepting the invite receive identical placebos for a 2-week treatment period while sleep is monitored in all participants. The primary outcome is ISI at the end of the treatment period. Secondary outcomes include treatment uptake and clinically significant response rates, objective and subjective sleep parameters, fatigue, mood, expectancy, treatment satisfaction and side effects. Predictors of uptake and responses to OLP and CP will be explored.Ethics and disseminationThe trial has been approved by The University of Sydney Human Research Ethics Committee. Written informed consent is obtained from every participant. OLP and CP participants accepting the invite undergo an additional consent process. Results will be disseminated via peer-reviewed conference proceedings and publications.Trial registration numberACTRN12620001080910.
Living with COVID-19: a phenomenological study of hospitalised patients involved in family cluster transmission
Authors: Liu Wei , Liu Jia 
Published: February 2021

ObjectivesTo describe experiences of hospitalised patients with COVID-19 following family cluster transmission of the infection and the meaning of these experiences for them.DesignA descriptive phenomenological design was used to construct themes depicting patients’ experiences of living with COVID-19.SettingThis study was conducted in a major teaching hospital in Wuhan, China, in March 2020.ParticipantsFourteen patients involved in family cluster transmission of COVID-19 were recruited into the study. The participants consisted of seven males and seven females. Data were collected through semistructured, in-depth, face-to-face interviews. Interviews were transcribed verbatim and analysed using Colaizzi’s approach.ResultsSix themes emerged from data analysis during two distinct phases of patients going through COVID-19: the early outbreak phase and the later hospitalisation phase. Early in the outbreak, patients experienced life imbalances between individual well-being and family responsibilities. While facing widespread prejudice and rejection, patients dealt with the heavy toll that the illness had left on their body and mind. After being hospitalised, patients described feelings of living with uncertainty, sadness, fear of death and concerns about family, while simultaneously hoping for a better life after recovery.ConclusionsOur findings suggest that living with COVID-19 is an emotionally and physically challenging experience for patient participants in the study. Psychological evaluations need to be routinely carried out with patients in a public health crisis. Interprofessional and interorganisational collaborative efforts should be made to examine the physical and psychological sequelae of COVID-19, as well as investigate outcomes of existing intervention programmes.
Understanding vehicular routing behavior with location-based service data
Authors: Xu Yanyan , Clemente Riccardo Di , González Marta C. 
Published: February 2021

AbstractProperly extracting patterns of individual mobility with high resolution data sources such as the one extracted from smartphone applications offers important opportunities. Potential opportunities not offered by call detailed records (CDRs), which offer resolutions triangulated from antennas, are route choices, travel modes detection and close encounters. Nowadays, there is not a standard and large scale data set collected over long periods that allows us to characterize these. In this work we thoroughly examine the use of data from smartphone applications, also referred to as location-based services (LBS) data, to extract and understand the vehicular route choice behavior. Taking the Dallas-Fort Worth metroplex as an example, we first extract the vehicular trips with simple rules and reconstruct the origin-destination matrix by coupling the extracted vehicular trips of the active LBS users and the United States census data. We then present a method to derive the commonly used routes by individuals from the LBS traces with varying sample rate intervals. We further inspect the relation between the number of routes and the trip characteristics, including the departure time, trip length and travel time. Specifically, we consider the travel time index and buffer index for the LBS users taking different number of routes. Empirical results demonstrate that during the peak hours, travelers tend to reduce the impact of traffic congestion by taking alternative routes. Overall, the proposed data analysis framework is cost-effective to treat sparse data generated from the use of smartphones to inform routing behavior. The potential in practice is to inform demand management strategies, by targeting individual users while generating large scale estimates of congestion mitigation.
In Vivo Imaging of Methionine Aminopeptidase II for Prostate Cancer Risk Stratification
Authors: Xie Jinghang , Rice Meghan A. , Chen Zixin , Cheng Yunfeng , Hsu En-Chi , Chen Min , Song Guosheng , Cui Liyang , Zhou Kaixiang , Castillo Jessa B. , Zhang Chiyuan A. , Shen Bin , Chin Frederick T. , Kunder Christian A. , Brooks James D. , Stoyanova Tanya , Rao Jianghong 
Published: February 2021

Abstract

Prostate cancer is one of the most common malignancies worldwide, yet limited tools exist for prognostic risk stratification of the disease. Identification of new biomarkers representing intrinsic features of malignant transformation and development of prognostic imaging technologies are critical for improving treatment decisions and patient survival. In this study, we analyzed radical prostatectomy specimens from 422 patients with localized disease to define the expression pattern of methionine aminopeptidase II (MetAP2), a cytosolic metalloprotease that has been identified as a druggable target in cancer. MetAP2 was highly expressed in 54% of low-grade and 59% of high-grade cancers. Elevated levels of MetAP2 at diagnosis were associated with shorter time to recurrence. Controlled self-assembly of a synthetic small molecule enabled design of the first MetAP2-activated PET imaging tracer for monitoring MetAP2 activity in vivo. The nanoparticles assembled upon MetAP2 activation were imaged in single prostate cancer cells with post-click fluorescence labeling. The fluorine-18–labeled tracers successfully differentiated MetAP2 activity in both MetAP2-knockdown and inhibitor-treated human prostate cancer xenografts by micro-PET/CT scanning. This highly sensitive imaging technology may provide a new tool for noninvasive early-risk stratification of prostate cancer and monitoring the therapeutic effect of MetAP2 inhibitors as anticancer drugs.

Significance:
This study defines MetAP2 as an early-risk stratifier for molecular imaging of aggressive prostate cancer and describes a MetAP2-activated self-assembly small-molecule PET tracer for imaging MetAP2 activity in vivo.
Activated ALK Cooperates with N-Myc via Wnt/β-Catenin Signaling to Induce Neuroendocrine Prostate Cancer
Authors: Unno Kenji , Chalmers Zachary R. , Pamarthy Sahithi , Vatapalli Rajita , Rodriguez Yara , Lysy Barbara , Mok Hanlin , Sagar Vinay , Han Huiying , Yoo Young A. , Ku Sheng-Yu , Beltran Himisha , Zhao Yue , Abdulkadir Sarki A. 
Published: February 2021

Abstract

Neuroendocrine prostate cancer (NEPC) is an aggressive subtype of prostate cancer with poor prognosis, and there is a critical need for novel therapeutic approaches. NEPC is associated with molecular perturbation of several pathways, including amplification of MYCN. Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase involved in the pathogenesis of neuroblastoma and other malignancies where it cooperates with N-Myc. We previously identified the first case of ALK F1174C-activating mutation in a patient with de novo NEPC who responded to the ALK inhibitor, alectinib. Here, we show that coactivation of ALK and N-Myc (ALK F1174C/N-Myc) is sufficient to transform mouse prostate basal stem cells into aggressive prostate cancer with neuroendocrine differentiation in a tissue recombination model. A novel gene signature from the ALK F1174C/N-Myc tumors was associated with poor outcome in multiple human prostate cancer datasets. ALK F1174C and ALK F1174C/N-Myc tumors displayed activation of the Wnt/β-catenin signaling pathway. Chemical and genetic ALK inhibition suppressed Wnt/β-catenin signaling and tumor growth in vitro in NEPC and neuroblastoma cells. ALK inhibition cooperated with Wnt inhibition to suppress NEPC and neuroblastoma proliferation in vitro and tumor growth and metastasis in vivo. These findings point to a role for ALK signaling in NEPC and the potential of cotargeting the ALK and Wnt/β-catenin pathways in ALK-driven tumors. Activated ALK and N-Myc are well known drivers in neuroblastoma development, suggesting potential similarities and opportunities to elucidate mechanisms and therapeutic targets in NEPC and vice versa.

Significance:
These findings demonstrate that coactivation of ALK and N-Myc induces NEPC by stimulating the Wnt/β-catenin pathway, which can be targeted therapeutically.