bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘She taught me’: factors consumers find important in nurse practitioner and pharmacist prescriber services
Authors: Officer Tara N. , Cumming Jackie , McBride-Henry Karen 
Published: March 2021

Abstract
Background
Advanced practitioner services, such as those nurse practitioners and pharmacist prescribers provide, are an opportunity to improve health care delivery. In New Zealand, these practitioners remain underutilised, despite research suggesting they offer safe and effective care, and considerable international literature recording patient satisfaction with these roles. This study aimed to explore factors underlying consumer satisfaction with primary health care nurse practitioner and pharmacist prescriber services.

Methods
As part of a larger realist evaluation, 21 individuals receiving advanced practitioner services participated in semi-structured interviews. These interviews were transcribed and coded against context–mechanism–outcome configurations tested and refined throughout the research.

Results
Study findings emphasise the importance of consumer confidence in the provider as a mechanism for establishing advanced practitioner roles. Underlying this confidence is a recognition that these practitioners work in a more accessible manner, engage at the individual’s ‘level’, and operate with passion.

Conclusions
This research offers learnings to re-engineer service delivery within primary health care to make best use of the entire health care team by including consumers in the design and introduction of new roles.
Cost effectiveness of outpatient lumbar discectomy
Authors: Linhares Daniela , Fonseca João A. , Ribeiro da Silva Manuel , Conceição Filipe , Sousa António , Sousa-Pinto Bernardo , Neves Nuno 
Published: March 2021

Abstract
Background
Microdiscectomy is the most commonly performed spine surgery and the first transitioning for outpatient settings. However, this transition was never studied, in what comes to cost-utility assessment. Accordingly, this economic study aims to access the cost-effectiveness of outpatient lumbar microdiscectomy when compared with the inpatient procedure.

Methods
This is a cost utility study, adopting the hospital perspective. Direct medical costs were retrieved from the assessment of 20 patients undergoing outpatient lumbar microdiscectomy and 20 undergoing inpatient lumbar microdiscectomy Quality-adjusted life-years were calculated from Oswestry Disability Index values (ODI). ODI was prospectively assessed in outpatients in pre and 3- and 6-month post-operative evaluations. Inpatient ODI data were estimated from a meta-analysis. A probabilistic sensitivity analysis was performed and incremental cost-effectiveness ratio (ICER) calculated.

Results
Outpatient procedure was cost-saving in all models tested. At 3-month assessment ICER ranged from €135,753 to €345,755/QALY, higher than the predefined threshold of €60,000/QALY gained. At 6-month costs were lower and utilities were higher in outpatient, overpowering the inpatient procedure. Probabilistic sensitivity analysis showed that in 65% to 73% of simulations outpatient was the better option. The savings with outpatient were about 55% of inpatient values, with similar utility scores. No 30-day readmissions were recorded in either group.

Conclusion
This is the first economic study on cost-effectiveness of outpatient lumbar microdiscectomy, showing a significant reduction in costs, with a similar clinical outcome, proving it cost-effective.
Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes
Authors: Jiang Zhisheng , Luo Jing , Xu Mengqing , Cong Zhuangzhuang , Ji Saiguang , Diao Yifei , Xu Yang , Shen Yi 
Published: March 2021

Abstract
Objective
To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.

Methods
The clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups.

Results
There was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05).

Conclusions
Early oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.
Elafin promotes tumour metastasis and attenuates the anti-metastatic effects of erlotinib via binding to EGFR in hepatocellular carcinoma
Authors: Wang Chenwei , Liao Yadi , He Wei , Zhang Hong , Zuo Dinglan , Liu Wenwu , Yang Zhiwen , Qiu Jiliang , Yuan Yichuan , Li Kai , Zhang Yuanping , Wang Yongjin , Shi Yunxing , Qiu Yuxiong , Gao Song , Yuan Yunfei , Li Binkui 
Published: March 2021

Abstract
Background
Elafin is a serine protease inhibitor critical for host defence. We previously reported that Elafin was associated with the recurrence of early-stage hepatocellular carcinoma (HCC) after surgery. However, the exact role of Elafin in HCC remains obscure.

Methods
HCC tissue microarrays were used to investigate the correlation between Elafin expression and the prognosis of HCC patients. In vitro migration, invasion and wound healing assays and in vivo lung metastasis models were used to determine the role of Elafin in HCC metastasis. Mass spectrometry, co-immunoprecipitation, western blotting, and immunofluorescence staining assays were performed to uncover the mechanism of Elafin in HCC. Dual-luciferase reporter and chromatin immunoprecipitation assays were employed to observe the transcriptional regulation of Elafin.

Results
Elafin expression was frequently increased in HCC tissues compared to normal tissues, and high Elafin expression in HCC tissues was correlated with aggressive tumour phenotypes and a poor prognosis in HCC patients. Elafin dramatically enhanced the metastasis of HCC cells both in vitro and in vivo by interacting with EGFR and activating EGFR/AKT signalling. Moreover, Elafin attenuated the suppressive effects of erlotinib on HCC metastasis. Besides, Elafin was transcriptionally regulated by Sp1 in HCC cells. Clinically, Elafin expression was positively correlated with Sp1, Vimentin, and EGFR signalling in both our HCC tissue microarrays and TCGA database analysis.

Conclusions
Upregulation of Elafin by Sp1 enhanced HCC metastasis via EGFR/AKT pathway, and overexpression of Elafin attenuated the anti-metastatic effects of erlotinib, suggesting a valuable prognostic biomarker and therapeutic target for HCC.
Iatrogenic injury to long thoracic nerve following thoracotomy for right thoracic scoliosis in Marfan syndrome: a case report
Authors: Safaei Saeid , Mirbolook Ahmadreza , Azimi Parisa , Athari Mirbahador , Hamzehzadeh Farhad , Yazdanian Taravat 
Published: March 2021

Abstract
Background
Patients with Marfan syndrome commonly require spinal deformity surgery. The purpose of this case report is to present a rare thoracotomy complication. We present the management of such a patient.

Case summary
In a known case of Marfan syndrome, an 18-year-old Persian man was admitted to our hospital with scoliosis. The patient underwent radiological examinations, and thoracic scoliosis of 70° was diagnosed. A right thoracotomy for anterior spinal fusion from the sixth rib and posterior spinal fusion were performed successfully. Two months later, he was readmitted because of winging of the right scapula due to serratus anterior palsy. Electromyography and nerve conduction velocity confirmed long thoracic nerve injury. Conservative treatment was provided. Ultimately, the patient recovered completely in the last follow-up visit 6 months after the surgery.

Discussion
This is the first report of ipsilateral winged scapula after thoracotomy. Attention needs to be paid to surgical techniques in patients with Marfan syndrome.
Breeding biology of a relictual Maghreb Magpie (Pica mauritanica) population in Tunisia
Authors: Nefla Aymen , Ouni Ridha , Selmi Slaheddine , Nouira Saïd 
Published: March 2021

AbstractBackgroundThe Maghreb Magpie (Pica mauritanica) is an endemic North African species. Available knowledge on this species is limited to historic descriptive data with no ecological information provided. Populations continue to dramatically decline in Tunisia, where only one relic population survives. Investigating the breeding biology of this species is essential for conservation purposes. The purpose of this study was to increase our understanding of the Tunisian relic population and provide detailed data on breeding biology over two breeding seasons (2017 and 2018).MethodsThis study occurred on a private farm of 650 ha, located 10 km from Dhorbania village at Kairouan Governorate, in central Tunisia. Active nests were monitored weekly during egg laying period and twice a week during hatching period. The Ivlev’s electivity index was used to assess whether the frequency of use of nesting trees and bushes matched their availability in the study area. We recorded nest measurements and positions, and compared them using Wilcoxon signed-rank test. Variations of breeding parameters as number of eggs laid, hatchlings, and fledglings over years were performed using Mann–WhitneyU-test andχ2tests. We used a Generalized Linear Mixed Model (GLMM) to investigate how egg volume varied with clutch size and laying date.ResultsWe investigated clutch size, egg size, hatching and fledging success, and evaluated how these parameters varied according to laying date and nest characteristics. Clutch size averaged 5.00 ± 0.19 but was significantly greater in 2017. Hatching success was 2.78 ± 0.34 eggs hatched per nest and fledging success reached 1.69 ± 0.30 young/nest. Causes of nest failure included the depredation of nestlings by shrikes, cobras and rats (e.g.Lanius meridionalis,Naja hajeandRattus rattus), death of parents by the Black-shouldered Kite (Elanus caeruleus) and nest parasitism by the Great Spotted Cuckoo (Clamator glandarius). Clutch size, brood size and fledgling success were unaffected by laying date, nest volume and nest elevation. Egg volume decreased with laying date but was unaffected by clutch.ConclusionOur study provides the first and only detailed data on reproductive parameters of the Maghreb Magpie in its entire geographic range (North Africa). Information gleaned from this study provides valuable information for monitoring and long-term conservation plans of the endangered Tunisian Magpie population. Additionally, our data provide an avenue of large-scale comparative studies of the reproductive ecology of the magpie complex.
Contamination within trials of community-based public health interventions: lessons from the HENRY feasibility study
Authors: Stamp Elizabeth , Schofield Holly , Roberts Victoria Laurina , Burton Wendy , Collinson Michelle , Stevens June , Farrin Amanda , Rutter Harry , Bryant Maria 
Published: March 2021

Abstract
Introduction
Contamination occurs when participants allocated to trial control arms receive elements of the active intervention. Randomisation at cluster level, rather than individual level, may reduce or eliminate contamination, avoiding the dilution of intervention effectiveness that it may cause. However, cluster randomisation can result in selection bias and may not be feasible to deliver. We explored the extent of contamination in a qualitative study nested within a feasibility study of HENRY (Health, Exercise and Nutrition for the Really Young); a UK community-based child obesity prevention programme. We aimed to determine the nature and impact of contamination to inform a larger planned trial and other trials in community based public health settings.

Method
We invited participants to take part in the nested qualitative study who were already involved in the HENRY feasibility study. Semi-structured interviews/focus groups were conducted with children’s centre managers (n=7), children’s centre staff (n=15), and parents (n=29). Data were transcribed and analysed using an integrative approach. First, deductively organised using a framework guided by the topic guide and then organised using inductive thematic analysis.

Results
Potential for contamination between treatment arms was recognised by all stakeholder groups. Staff within the intervention centres presented the greatest risk of contamination, predominantly because they were often asked to work in other children centre’s (including control group centres). ‘Sharing of best practice’ by staff was reported to be a common and desirable phenomenon within community based settings. Parental sharing of HENRY messages was reported inconsistently; though some parents indicated a high degree of knowledge transfer within their immediate circles.

Conclusions
The extent of contamination identified has influenced the design of a future effectiveness trial of HENRY which will be clustered at the centre level (with geographically distinct clusters). The common practice of knowledge sharing amongst community teams means that this clustering approach is also likely to be most suitable for other trials based within these settings. We provide recommendations (e.g. cluster randomisation, training intervention facilitators on implications of contamination) to help reduce the impact of contamination in public health intervention trials with or without clustering, whilst enabling transfer of knowledge where appropriate.

Trial registration
ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017
Foot-ankle functional outcomes of using the Diabetic Foot Guidance System (SOPeD) for people with diabetic neuropathy: a feasibility study for the single-blind randomized controlled FOotCAre (FOCA) trial I
Authors: Cruvinel Júnior Ronaldo H. , Ferreira Jane S. S. P. , Beteli Raquel I. , Silva Érica Q. , Veríssimo Jady L. , Monteiro Renan L. , Suda Eneida Y. , Sacco Isabel C. N. 
Published: March 2021

Abstract
Background
Diabetic neuropathy dramatically affects musculoskeletal structure and function of the lower limbs by impairing their muscle strength and mobility. Specific muscle strengthening through physiotherapy strategies appears to be promising; however, adherence to physiotherapy treatment is low in people with chronic diseases. Thus, an internet-based foot-ankle exercise program was created as a potential telerehabilitation alternative for people with diabetes to improve their self-monitoring and self-care management. This study assessed the feasibility, safety, acceptability, and changes in foot health and neuropathy symptoms in people with diabetes after 12 weeks of the intervention program with the Sistema de Orientação ao Pé diabético - Diabetic Foot Guidance System (SOPeD).

Methods
Fourteen individuals were recruited and randomized to either the usual care (control group) or usual care plus an internet-based foot-ankle exercise program through SOPeD (intervention group) three times per week for 12 weeks. For feasibility, we assessed contact and recruitment rates per week; program adherence, determined as completing over 70% of the 36 sessions; and participant satisfaction and safety assessed through a questionnaire and scored on a 5-point Likert scale. We assessed changes in neuropathy symptoms and foot health and functionality from baseline to 12 weeks estimating differences or median of differences and 95% confidence intervals in the intervention group.

Results
In 24 weeks, of the 822 patients in the database, 192 were contacted, 65 were assessed for eligibility, and 20 were considered eligible. The recruitment rate was 0.83 participants per week. Fourteen out of the 20 eligible participants agreed to participate, resulting in recruitment success of 70%. Adherence to the program was 66.7%, and there was no dropout. Participants’ median level of satisfaction was 5.0 (IQR: 4.5–5.0) and perceived safety was 5.0 (IQR: 5.0–5.0).

Conclusion
The internet-based foot-ankle exercise program using SOPeD is feasible, satisfactory, and safe. Although this study had moderate adherence and a zero-dropout rate, recruitment needs to be improved in the larger trial.

Trial registration
ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.
The value of endobronchial cryotherapy in the management of malignant endobronchial obstruction in patients with inoperable NSCLC: a prospective analysis of clinical and survival outcomes
Authors: Rashad Alaa , Badawy Mohamed Shahat , Ali Mohammed Mustafa , Mansour Haggagy , Abdel-Bary Mohamed 
Published: March 2021

Abstract
Background
Malignant endobronchial obstruction (MEBO) is the most debilitating complication in non-small cell lung cancer (NSCLC). The therapeutic role of cryotherapy and its impact on survival has not been well addressed. This is to clarify whether the combination of endobronchial cryotherapy (EBCT) and chemoradiotherapy (CRT) improved symptoms, respiratory functions, performance status, and survival outcomes in inoperable NSCLC with symptomatic MEBO compared to that obtained by CRT alone.

Results
A prospective cohort study included 60 cases presented to Qena University Hospital, Egypt, between December 2016 and May 2019. They were divided into two groups. Group A included 30 patients who were managed with EBCT plus CRT. Group B included 30 patients who were managed with CRT alone. The outcomes assessed were symptoms relief, respiratory function tests (RFT), performance status, and survival outcomes at baseline and 4 weeks of follow-up. Group A patients showed a highly significant improvement in symptoms (cough, dyspnea, and hemoptysis), RFT, 6MWD test, and arterial blood gases, compared to group B. The mean Karnofsky score increased from 57.33±5.67% at baseline to 60.67±6.39% post-EBCT (P=0.036); group A was significantly improved compared to group B (P=0.04). The Kaplan-Meier median survival for all patients was 9.7±0.4 months (95% CI= 8.86–10.54), and group A cases (10.77±0.44 months, 95% CI= 9.9–11.6) was significantly longer than that of group B cases (8.6±0.68 months, 95% CI= 7.3–9.97; T test = 2.631, P=0.011).

Conclusion
The use of EBCT with CRT for the management of MEBO in symptomatic patients with inoperable NSCLC is an efficient and safe procedure. EBCT improves clinical outcomes, RFT, performance status, and median survival.

Trial registration
ClinTrial.Gov registration: NCT04710459 on 4/3/2021.
The role of loneliness in the development of depressive symptoms among partnered dementia caregivers: Evidence from the English Longitudinal Study of Aging
Authors: Saadi J. P. , Carr E. , Fleischmann M. , Murray E. , Head J. , Steptoe A. , Hackett R. A. , Xue B. , Cadar D. 
Published: March 2021

AbstractBackgroundDepressive symptoms are highly prevalent among partnered dementia caregivers, but the mechanisms are unclear. This study examined the mediating role of loneliness in the association between dementia and other types of care on subsequent depressive symptoms.MethodsProspective data from partnered caregivers were drawn from the English Longitudinal Study of Aging. The sample consisted of 4,672 partnered adults aged 50–70 living in England and Wales, followed up between 2006–2007 and 2014–2015. Caregiving was assessed across waves 3 (2006–2007), 4 (2008–2009), and 5 (2010–2011), loneliness at wave 6 (2012–2013), and subsequent depressive symptoms at wave 7 (2014–15). Multivariable logistic regression models were used to assess the association between caregiving for dementia and depressive symptoms compared to caregiving for other illnesses (e.g., diabetes, coronary heart disease (CHD), cancer, and stroke). Binary mediation analysis was used to estimate the indirect effects of caregiving on depressive symptoms via loneliness.ResultsCare for a partner with dementia was associated with higher odds of depressive symptoms at follow-up compared to those not caring for a partner at all (odds ratio [OR] = 2.6, 95% confidence intervals [CI]: 1.4, 5.1). This association was partially mediated by loneliness (34%). Care for a partner with other conditions was also associated with higher odds of depressive symptoms compared to non-caregiving partners (OR = 1.7, 95% CI: 1.2, 2.5), but there was no evidence of an indirect pathway via loneliness.ConclusionLoneliness represents an important contributor to the relationship between dementia caregiving and subsequent depressive symptoms; therefore, interventions to reduce loneliness among partnered dementia caregivers should be considered.
A “metaphorical” nonlinear multimode fiber laser approach to weakly dissipative Bose-Einstein condensates
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Authors: Kalashnikov V. L. , Wabnitz S. 
Published: March 2021

Abstract
We demonstrate the stabilization of two-dimensional nonlinear wave patterns by means of a dissipative confinement potential. Our analytical and numerical analysis, based on the generalized dissipative Gross-Pitaevskii equation, makes use of the close analogy between the dynamics of a Bose-Einstein condensate and that of mode-locked fiber laser, operating in the anomalous dispersion regime. In the last case, the formation of stable two-dimensional patterns corresponds to spatiotemporal mode locking, using dissipation-enhanced mode cleaning. We analyze the main scenarios of pattern destabilization, varying from soliton dissolution to its splitting and spatiotemporal turbulence, and their dependence on graded dissipation.
Quantum degeneracy and phase-space density in superradiant semiconductor heterostructures at room temperature
Authors: Vasil'ev Peter P. , Penty Richard V. 
Published: March 2021

Abstract
We investigate the fulfilment of the quantum degeneracy criterium in bulk GaAs/AlGaAs heterostructures operated under the superradiant emission generation at room temperature. The e-h density has been evaluated by analysing both spontaneous window emission from above the samples and amplified spontaneous emission radiated from their edges. The maximum experimental value of the phase-space density is 1.31 at

. It is supposed that resonant photons with energies at the band gap establish coherence within the e-h ensemble and facilitate the build-up of a macroscopic wave packet from overlapped wave functions of collectively paired electrons and holes. As a result, the photon-mediated “stimulated” condensation of e-h pairs in phase space can take place at room temperature.