bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative measurements of prostatic zones by MRI and their dependence on prostate size: possible clinical implications in prostate cancer
Authors: Sellers Jake , Wagstaff Rachel G. , Helo Naseem , de Riese Werner T. W. 
Published: April 2021

Aim: Many studies support an inverse relationship between benign prostate hypertrophy (BPH) size and incidence of prostate cancer (PCa), but the causal link between these conditions is poorly understood. Recent studies suggest that a growing transition zone (TZ) in the prostate may induce pressure on the outer peripheral zone (PZ), leading to atrophy of the glandular tissue where PCa often originates, providing a possible explanation for this interaction. To further investigate this phenomenon, our pilot study uses magnetic resonance imaging (MRI) to examine quantitative zonal changes in a consecutive cohort of prostates. Methods: MRI scans of male patients [ n = 204, 61.57 ± 13.90 years, average body mass index (BMI) 29.05 kg/m2] with various prostate sizes were analyzed statistically to identify possible associations between prostate parameters, such as total prostate volume (TPV) and peripheral zone thickness (PZT). Results: TPV and PZT demonstrated a weak, inverse correlation ( r = −0.21, p = 0.002). However, when examining the plotted data, the relationship between TPV and PZT was significantly different when the cohort was divided into two groups; lower TPV: ⩽87.5 ml ( n = 188, TPV xˉ = 36.01 ± 18.18 ml), and higher TPV: >87.5 ml ( n = 17, TPV xˉ = 125.69 ± 41.13 ml). Average PZT differed significantly between these groups (z = −3.5554, p = 0.0004). Conclusions: PZT was significantly different for patients with lower versus higher TPVs, suggesting that, above a certain point of BPH growth, the PZ is unable to withstand pressure from an expanding TZ, supporting the notion that growing BPH causes compression of the PZ glandular tissue, and, therefore, BPH may be protective against PCa.
Paraneoplastic ganglioradiculoneuritis in a cat with a plasma cell tumour
Authors: Marsh Oliver , Destri Alessandra , Di Palma Stefano , Mari Lorenzo , De Risio Luisa , Stabile Fabio 
Published: April 2021

Case summary An 8-year-old neutered female domestic longhair cat was presented for investigation of a 48 h history of lethargy and pelvic limb ataxia. MRI of the spinal cord and vertebral column (C1 to sacrum) and brain was unremarkable. Lumbar cerebrospinal fluid analysis revealed pleocytosis and increased protein concentration. Thoracic radiographs and abdominal ultrasound were unremarkable. Anti-inflammatory doses of prednisolone were administered. Clinical deterioration occurred over the following 2 days, with the development of lower motor neuron deficits in both thoracic limbs. On repetition of the MRI, bilateral enlargement, T2-weighted hyperintensity, and marked contrast enhancement of the C7, C8 and T1 nerve roots, spinal nerves and brachial plexuses were observed. Infectious disease testing was negative. An immune-mediated inflammatory process was suspected and immunosuppressive doses of prednisolone were commenced. The clinical signs improved transiently, but marked deterioration occurred after 2 weeks. The patient was euthanased and a post-mortem examination was performed. A lymphocytic inflammatory infiltrate was detected in the C7, C8 and T1 nerve roots and dorsal root ganglia, and neoplastic plasma cells were identified in multiple organs. A diagnosis of non-cutaneous extramedullary plasmacytoma with multiorgan involvement and paraneoplastic ganglioradiculoneuritis was reached. Relevance and novel information Paraneoplastic ganglioradiculoneuritis in association with a plasma cell neoplasia has not been previously reported in the cat and should be considered as a differential diagnosis for cats with clinical or imaging evidence of an inflammatory process affecting the nerve roots, spinal nerves or brachial plexuses.
Implementing online patient feedback in a ‘special measures’ acute hospital: A case study using Normalisation Process Theory
Authors: Baines Rebecca , Underwood Frazer , O’Keeffe Kim , Saunders Jessica , Jones Ray B 
Published: April 2021

Objective Online patient feedback is becoming increasingly prevalent on an international scale. However, limited research has explored how healthcare organisations implement such feedback. This research sought to explore how an acute hospital, recently placed into ‘special measures’ by a regulatory body implemented online feedback to support its improvement journey. Methods Semi-structured interviews were conducted with eleven key stakeholders involved in the implementation and/or use of online patient feedback. Data was analysed using deductive thematic analysis with Normalisation Process Theory used as the analytical framework. Research findings are translated into the Engage, Support and Promote (ESP) model, a model of rapid feedback adoption. Results Participants viewed the implementation of online feedback as an opportunity to learn, change and improve. Factors found to facilitate implementation were often linked to engagement, support and promotion. Although less frequently described, barriers to implementation included staff anxieties about time pressures, moderation processes and responding responsibilities. Such anxieties were often addressed by activities including the provision of evidence based responder training. Overall, staff were overwhelmingly positive about the value of online feedback with 24 impacts identified at an individual and organisational level, including the ability to boost staff morale, resilience and pride. Conclusions The rapid implementation of online patient feedback can be achieved in a ‘special measures’ organisation. However, the difficulties of implementing such feedback should not be underestimated. In order to embed online feedback, staff members need to be engaged and feel supported, with opportunities to provide, respond and invite patient feedback frequently promoted to both patients and staff members.
Challenges to state control of territory: Comparative analysis of Yemen, Afghanistan and Myanmar
Authors: Korishetti Sumedha 
Published: April 2021

States around the world have lost control over their territory to armed non-state actors, including states like Yemen, Afghanistan and Myanmar in the Asian region. This article aims to understand why these states are unable to exercise control over all of their territory. The study identifies and examines four major challenges faced by states in maintaining control over their territory – lack of state legitimacy and effectiveness, strategic motives of armed non-state actors, socio-economic motives of armed non-state actors and external intervention. A comparative analysis of the cases of Yemen, Afghanistan and Myanmar illustrates the wide relevance of these challenges faced by the states with respect to territorial control.
Cassia Abbreviata Enhances Glucose Uptake and Glucose Transporter 4 Translocation in C2C12 Mouse Skeletal Muscle Cells
Authors: Kamga-Simo F. D. Y. , Kamatou G. P. , Ssemakalu C. , Shai L. J. 
Published: April 2021

Background. This study aim at assessing C. abbreviata aqueous extracts for its potential to exhibit anti-diabetic activity in skeletal muscle cells. In addition to the toxicological and glucose absorption studies, the action of C. abbreviata extracts on some major genes involved in the insulin signaling pathway was established. Methods. The in vitro cytotoxic effects C. abbreviata was evaluated on muscle cells using the MTT assay and the in vitro glucose uptake assay conducted using a modified glucose oxidase method described by Van de Venter et al. (2008). The amount of GLUT-4 on cell surfaces was estimated quantitatively using the flow cytometry technique. Real time quantitative PCR (RT-qPCR) was used to determine the expression of GLUT-4, IRS-1, PI3 K, Akt1, Akt2, PPAR-γ. Results. Cytotoxicity tests revealed that all extracts tested at various concentrations were non-toxic (LC50 > 5000). Aqueous extracts of leaves, bark and seeds resulted in a dose-dependent increase in glucose absorption by cells, after 1 h, 3 h and 6 h incubation period. Extracts of all three plant parts had the best effect after 3 h incubation, with the leaf extract showing the best activity across time (Glucose uptake of 29%, 56% and 42% higher than untreated control cells after treatment with 1 mg/ml extract at 1 h, 3 h and 6 h, respectively). All extracts, with the exception 500 µg/ml seed extract, induced a two-fold increase in GLUT-4 translocation while marginally inducing GLUT-10 translocation in the muscle cells. The indirect immunofluorescence confirmed that GLUT-4 translocation indeed occurred. There was an increased expression of GLUT-4, IRS1 and PI3 K in cells treated with insulin and bark extract as determined by the RT-qPCR. Conclusion. The study reveals that glucose uptake involves GLUT-4 translocation through a mechanism that is likely to involve the upstream effectors of the PI3-K/Akt pathway.
Family perceptions of quality of end of life in LGBTQ+ individuals: a comparative study
Authors: Kemery S. Alexander 
Published: April 2021

Background: Members of the lesbian, gay, bisexual, transgender, and queer community have encountered discrimination and stigmatization related to sexual orientation and/or gender identity both within healthcare establishments and in the larger community. Despite the literature describing inequities in healthcare, very little published research exists on the experiences of lesbian, gay, bisexual, transgender, and queer patients and family members in hospice care. Methods: A quantitative comparative descriptive design explored the difference in end-of-life experiences between a lesbian, gay, bisexual, transgender, and queer and non-lesbian, gay, bisexual, transgender, and queer cohort. One hundred and twenty-two family members of individuals who have died while under hospice care in the past 5 years completed the Quality of Dying and Death Version 3.2a Family Member/Friend After-Death Self-Administered Questionnaire. Results: Comparison of the experiences of the lesbian, gay, bisexual, transgender, and queer cohort ( n = 56) and non-LGBTQ cohort ( n = 66) yielded varying results, with the LGBTQ cohort experiencing lower quality end of life in some Quality of Dying and Death measures and no statistically significant difference from the non-LGBTQ cohort in others. Discussion: The findings from this study in combination with previously published works on lesbian, gay, bisexual, transgender, and queer health support the position that hospice providers must take concrete steps to ensure that professional caregivers and office staff are qualified to meet the needs of this marginalized population.
Insights into phylogenetic relationships and genome evolution of subfamily Commelinoideae (Commelinaceae Mirb.) inferred from complete chloroplast genomes
Authors: Jung Joonhyung , Kim Changkyun , Kim Joo-Hwan 
Published: April 2021

Abstract
Background
Commelinaceae (Commelinales) comprise 41 genera and are widely distributed in both the Old and New Worlds, except in Europe. The relationships among genera in this family have been suggested in several morphological and molecular studies. However, it is difficult to explain their relationships due to high morphological variations and low support values. Currently, many researchers have been using complete chloroplast genome data for inferring the evolution of land plants. In this study, we completed 15 new plastid genome sequences of subfamily Commelinoideae using the Mi-seq platform. We utilized genome data to reveal the structural variations and reconstruct the problematic positions of genera for the first time.

Results
All examined species of Commelinoideae have three pseudogenes (accD, rpoA, and ycf15), and the former two might be a synapomorphy within Commelinales. Only four species in tribe Commelineae presented IR expansion, which affected duplication of the rpl22 gene. We identified inversions that range from approximately 3 to 15 kb in four taxa (Amischotolype, Belosynapsis, Murdannia, and Streptolirion). The phylogenetic analysis using 77 chloroplast protein-coding genes with maximum parsimony, maximum likelihood, and Bayesian inference suggests that Palisota is most closely related to tribe Commelineae, supported by high support values. This result differs significantly from the current classification of Commelinaceae. Also, we resolved the unclear position of Streptoliriinae and the monophyly of Dichorisandrinae. Among the ten CDS (ndhH, rpoC2, ndhA, rps3, ndhG, ndhD, ccsA, ndhF, matK, and ycf1), which have high nucleotide diversity values (Pi > 0.045) and over 500 bp length, four CDS (ndhH, rpoC2, matK, and ycf1) show that they are congruent with the topology derived from 77 chloroplast protein-coding genes.

Conclusions
In this study, we provide detailed information on the 15 complete plastid genomes of Commelinoideae taxa. We identified characteristic pseudogenes and nucleotide diversity, which can be used to infer the family evolutionary history. Also, further research is needed to revise the position of Palisota in the current classification of Commelinaceae.
Integrated early childhood development policy in Iran: a qualitative policy process analysis
Authors: Atashbahar Omolbanin , Sari Ali Akbari , Takian Amirhossein , Olyaeemanesh Alireza , Mohamadi Efat , Barakati Sayyed Hamed 
Published: April 2021

AbstractBackgroundIntegrated early childhood development (IECD) is a comprehensive approach to optimal development of children in different developmental domains from fetal stage to eight years of age. The aim of this study was to identify the factors affecting the process of policy-making for early childhood development and to clarify how these factors affect decision-making and create challenges in this regard.MethodIn a qualitative study, we used two main data sources including document analyses and interviews. Using purposive sampling, forty semi-structured interviews with policymakers and informants in the fields related to children were conducted in Tehran from October 2017 to June 2018. Also, 62 national and 10 international relevant documents were reviewed. A deductive-inductive approach was used to analyze the data. We used the MAXQDA11 software for data management.Resultswe identified 13 themes and 29 subthemes related to the stages of policymaking process including: Agenda setting (problem stream, policy stream, politics stream), Policy formulation (formulation and approval process, policy sustainability, mechanisms of stakeholders’ participation in policymaking), Policy implementation (conceptual ambiguity, intersectoral and trans-sectoral issues, structural capacities, mobilization of resources), and Policy evaluation (continuous and routine data registry system, comprehensiveness of indexes). We propose 19 policy recommendations to improve the situation.ConclusionAs a multidisciplinary and multi-sectoral field with different domains, early childhood development (ECD) requires a more active role on the part of policymakers in governmental levels in supporting the related policies. Unless policymakers change their approach to decrease nonintegrated and non-comprehensive policymaking for ECD, child development will be compromised, which endangers the eventual sustainability of the society since improved IECD policy-making process improves developmental outcomes in children. In this regard, attention should be paid to the role of reinforcing intersectoral collaboration through incorporating it in the missions and the evaluation items of organizations, creating commitment in high organizational levels, and developing an inter-ministerial policymaking framework that clearly specifies the roles and responsibilities of every single sector and their interactions and collaborations.
Factors associated with coverage of vitamin a supplementation among Bangladeshi children: mixed modelling approach
Authors: Marjan Nahyatul , Rahman Atikur , Rois Rumana , Rahman Azizur 
Published: April 2021

AbstractBackgroundVitamin A deficiency (VAD) is a prominent and widespread public health problem in developing countries, including Bangladesh. About 2% of all deaths among under-five children are attributable to VAD. Evidence-based information is required to understand the influential factors to increase vitamin A supplementation (VAS) coverage and reduce VAD. We investigated the potential factors affecting VAS coverage and its significant predictors among Bangladeshi children aged 6 to 59 months using the VAS clustered data extracted from the latest Bangladesh Demographic and Health Survey 2014.MethodsData were analysed using mixed logistic regression (MLR) modelling approach in the generalised linear mixed model framework. The MLR model performs better than logistic regression for analysing the clustered data because of its minimum Akaike information criterion value. The likelihood ratio test showed that the variance component was significant. Therefore, the clustering effect among children was inevitable to use.ResultsVAS coverage among under-five children was 63.6%, which is not optimal and below the WHO’s recommendation and the country’s target of 90%. Children aged 25 to 36 months (AOR = 2.07, 95% CI: 1.711 to 2.513), who had higher educated mothers (AOR = 1.37,p = 0.033, 95% CI: 1.026–1.820) and fathers (AOR = 1.32,p = 0.027, 95% CI: 1.032–1.683), whose mothers had media exposure (AOR = 1.22,p = 0.006, 95% CI: 1.059–1.408) and NGO membership (AOR = 1.24,p = 0.002, 95% CI: 1.089–1.422) were more likely to consume VAS.ConclusionThe relevant authorities should create proactive awareness programs for highly vulnerable local communities, specifically targeted to educate the children’s mothers about the necessity and benefits of childhood nutrition.
Factors influencing physical activity in adults with cystic fibrosis
Authors: Hurley Nicola , Moyna Niall M. , Kehoe Bróna , McCaffrey Noel , Redmond Karen , Hardcastle Sarah J. 
Published: April 2021

Abstract
Background
Physical activity (PA) is a well-documented and accepted adjunct therapy for the maintenance and improvement of long-term health in cystic fibrosis (CF). Although the benefits of PA for CF populations are well-established, adherence to PA programmes within this population remains low. This study aimed to investigate the factors that influence engagement in physical activity, and to explore exercise preferences, among adults with cystic fibrosis (CF).

Methods
Semi-structured telephone interviews were conducted. Participants were twenty-one adults (mean age 35 years, SD ± 8) with an established diagnosis of CF, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data.

Results
Four main themes emerged: barriers, motives, value of exercise-related outcomes, and exercise preferences. The main barriers included: low energy levels, time, the weather, and exercise-related confidence. Enjoyment and perceived competence underpinned autonomous motivation. Participants who self-identified as being regularly active valued personally identified exercise-related outcomes such as, accomplishment and affect regulation. Participants indicated a preference for home-based physical activity programs compared to gym- or facility-based programs.

Conclusion
Interventions aimed at promoting physical activity among adults with CF should involve programs that foster autonomous motivation, enjoyable activities, personally identified outcomes, competence and that can be conducted from the home environment.

Clinical implications
To increase physical activity participation among adults with CF, interventions that can be conducted from the home environment, that pay attention to the patients’ personally-valued exercise outcomes may be required.
The importance of intervertebral disc material model on the prediction of mechanical function of the cervical spine
Authors: Komeili Amin , Rasoulian Akbar , Moghaddam Fatemeh , El-Rich Marwan , Li Le Ping 
Published: April 2021

Abstract
Background
Linear elastic, hyperelastic, and multiphasic material constitutive models are frequently used for spinal intervertebral disc simulations. While the characteristics of each model are known, their effect on spine mechanical response requires a careful investigation. The use of advanced material models may not be applicable when material constants are not available, model convergence is unlikely, and computational time is a concern. On the other hand, poor estimations of tissue’s mechanical response are likely if the spine model is oversimplified. In this study, discrepancies in load response introduced by material models will be investigated.

Methods
Three fiber-reinforced C2-C3 disc models were developed with linear elastic, hyperelastic, and biphasic behaviors. Three different loading modes were investigated: compression, flexion and extension in quasi-static and dynamic conditions. The deformed disc height, disc fluid pressure, range of motion, and stresses were compared.

Results
Results indicated that the intervertebral disc material model has a strong effect on load-sharing and disc height change when compression and flexion were applied. The predicted mechanical response of three models under extension had less discrepancy than its counterparts under flexion and compression. The fluid-solid interaction showed more relevance in dynamic than quasi-static loading conditions. The fiber-reinforced linear elastic and hyperelastic material models underestimated the load-sharing of the intervertebral disc annular collagen fibers.

Conclusion
This study confirmed the central role of the disc fluid pressure in spinal load-sharing and highlighted loading conditions where linear elastic and hyperelastic models predicted energy distribution different than that of the biphasic model.