bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mediating role of patient satisfaction and perceived quality of healthcare in the emergency department
Authors: Abidova Alina , Silva Pedro Alcântara da , Moreira Sérgio 
Published: March 2021

Abstract
The purpose of this research was to identify whether a certain set of drivers of satisfaction/perceived quality of healthcare (PQHC) could indirectly affect patients’ confidence/trust in the emergency department (ED).
Patients were seen at an ED in the public hospital in Lisbon, Portugal between January and December 2016. Data were collected between May and November 2017, using a questionnaire, by mail or e-mail. The total sample size comprised 382 patients. The data analysis included structural equation modeling to test the conceptual model with specific drivers of satisfaction/PQHC (privacy; accessibility and availability; doctors; meeting expectations; waiting time for triage [perception]; waiting time to be called back by the doctor following examinations and/or tests [perception]; information about possible delays in receiving treatment/waiting times) and with the main outcome (confidence/trust in the ED) using path analysis.
The analysis of the coefficients revealed that all the mediated paths are statistically significant (P ≤ .05). Although, altogether, the direct paths did not prove statistically significant (P > .05), the overall satisfaction with doctors (P ≤ .01) and meeting expectations (P = .01) can still directly explain the confidence/trust in the ED without the mediating role of satisfaction and PQHC. Hence, overall satisfaction with doctors and meeting expectations can influence, both directly and indirectly, confidence/trust in the ED. All other variables can only indirectly affect confidence/trust in the ED, either through PQHC or through satisfaction.
Even though there are more variables that influence confidence/trust in the ED through PQHC (1)waiting time to be called back by the doctor following examinations and/or tests [perception]; 2) privacy; 3) accessibility and availability; 4) doctors; 5) meeting expectations than through satisfaction (1)waiting time for triage [perception]; 2) information about possible delays in receiving treatment/waiting times; 3) doctors; 4) meeting expectations), we observe the strongest contribution in the mediation model through satisfaction, which reveals its dominant role over PQHC.
Effects of probiotics on gastrointestinal complications and nutritional status of postoperative patients with esophageal cancer
Authors: Liu Chao , Yang Jing , Dong Weiwei , Yuan Jinyan 
Published: March 2021

Abstract

Background:
Gastrointestinal complications and malnutrition are common problems that affect postoperative rehabilitation and survival of patients with esophageal cancer. Evidence has shown that probiotics have a positive effect on improving gastrointestinal complications and nutritional status of patients with esophageal cancer after surgery, but there is a lack of prospective studies on this topic. We designed this prospective randomized controlled trial to evaluate the effects of probiotics on gastrointestinal complications and nutritional status in patients with postoperative esophageal cancer.

Methods:
This is a prospective, randomized, double-blind, placebo-controlled trial. It was approved by the Clinical Research Ethics Committee of our hospital. 192 patients will be randomly divided into probiotics group and the placebo group in a 1:1 ratio. After operation, probiotics and placebo will be given orally for 8 weeks. The indexes of nutritional status and incidence of digestive tract complications will be recorded and the data will be analyzed by SPSS 18.0 software.

Discussion:
This study will evaluate the effect of probiotics on gastrointestinal complications and nutritional status of postoperative patients with esophageal cancer. The results of this study will provide clinical basis for the use of probiotics in postoperative treatment of esophageal cancer.

Trial registration:
OSF Registration number: D DOI 10.17605/OSF.IO/QHW86
Institutional experience of in-stent stenosis after pipeline flow diverter implantation
Authors: Wang Ting , Richard Seidu A. , Jiao He , Li Junrao , Lin Sen , Zhang Changwei , Wang Chaohua , Xie Xiaodong , You Chao 
Published: March 2021

Abstract
Pipeline embolization devices (PLEDs) are flow diverting stents that have exhibited be safe and efficient in the treatment of complex aneurysms. Nevertheless, in-stent stenosis (ISS) has been reported as one of the cardinal complications associated with PLED. The association of wall malapposition and ISS in patient treated with PLED has not been reported.
A retrospective study was conducted to identify patients with ISS after implantation of PLED as treatment for intracranial aneurysms from April 25, 2018 to April 24, 2019. Incidence of ISS and its associated causes such as sharp change of the PLED, distal wall malapposition, inconsistent compliance between parent artery as well as the PLED occlusion due to intimal hyperplasia and vessel tortuosity. Assessment of conservative treatment and retreatment outcomes of ISS were documented.
In all, 6 ISS cases were identified by 2 independent neurointerventionalists out of 118 aneurysm patients treated with PLED. Thus, the incidence rate of ISS in patients treated with PLED was as low as 5% at our institution compared to other studies. The follow-up time for detection of ISS ranged from 6 to 12 months after implantation. Several combinations of reasons such as sharp change of the PLED, distal wall malapposition, inconsistent compliance between parent arteries as well as PLED occlusion due to intimal hyperplasia and vessel tortuosity accounted for the causes of ISS during our analysis. Conservative treatment with a combination of antiplatelet during follow-ups did not resolve the ISS in our study probably due to associated underlying factors above.
Does CYP2C19 polymorphisms affect neurological deterioration in stroke/TIA patients?
Authors: Wang Jiajing , Kuang Jie , Yi Yingping , Peng Chen , Ge Yanqiu , Yin Shujuan , Zhang Xiaolin , Chen Jibiao 
Published: March 2021

Abstract

Background:
The association between cytochrome P450 2C19 (CYP2C19) polymorphisms and neurological deterioration in stroke or transient ischemic attack (TIA) patients is not completely understood. Hence, we performed a systematic review and meta-analysis of prospective cohort studies to quantify this association.

Methods:
PubMed, Cochrane Library, Excerpta Medica Database, China National Knowledge Infrastructure and WanFang databases were searched for studies published up to April 2019. Prospective cohort studies that reported an association between CYP2C19 polymorphisms and neurological deterioration in stroke/TIA patients were included. Data on risk ratio (RR) and 95% confidence intervals (CI) were extracted and pooled by the authors. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.

Results:
Twelve eligible studies were included. Twelve studies reported CYP2C19∗2, ∗3 loss-of-function alleles and 5 studies reported CYP2C19∗17 gain-of-function allele. Compared to non-carriers, carriers of CYP2C19∗2, ∗3 loss-of-function alleles had a significantly higher risk of neurological deterioration (RR, 1.63; 95%CI, 1.32–2.02). Conversely, carriers of CYP2C19∗17 gain-of-function allele had a significantly lower risk of neurological deterioration (RR, 0.520; 95%CI, 0.393–0.689) compared to non-carriers.

Conclusions:
This meta-analysis demonstrated that the carriers of CYP2C19∗2, ∗3 loss-of-function alleles have an increased risk of neurological deterioration compared to non-carriers in stroke or TIA patients. Additionally, CYP2C19∗17 gain-of-function allele can reduce the risk of neurological deterioration.
Difference in the efficacy of intravitreal dexamethasone implant before and after silicone oil removal
Authors: An Jae Hong , Kim Yu Cheol 
Published: March 2021

Abstract

Rationale:
An intravitreal dexamethasone (IV-DEX) implant is safe and effective for the treatment of macular edemas; however, the efficacy of IV-DEX implants in silicone oil (SO)-filled eyes remains controversial. There is no previous study comparing an IV-DEX implant in the same eye with and without intravitreal SO.

Patient concerns:
A 72-year-old man with proliferative diabetic retinopathy, macular edema, and rhegmatogenous retinal detachment, treated with pars plana vitrectomy with SO tamponade had refractory macular edema.

Diagnosis:
Refractory macular edema.

Intervention:
Subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation were performed; this was followed by intravitreal SO removal combined with IV-DEX implantation.

Outcomes:
The macular edema did not decrease significantly with posterior subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation; however, the edema was relieved after SO removal and a new IV-DEX implantation.

Lessons:
IV-DEX implant may be less efficacious in the treatment of macular edema in an SO-filled eye than that in a normal vitreous cavity.
Ruxolitinib in conjunction with the HLH-94 protocol for Epstein-Barr virus-related hemophagocytic lymphohistiocytosis in the intensive care unit
Authors: Huang Zoufang , Xie Jiangbo 
Published: March 2021

Abstract

Rationale:
The HLH-94 protocol is a standard induction treatment for hemophagocytic lymphohistiocytosis. However, about 30% of patients may not respond. Ruxolitinib has been clinically proven to be an effective treatment for hemophagocytic lymphohistiocytosis (HLH).

Patient concerns:
A previously healthy 14-year-old girl presented to the local hospital with a 4-day history of persistent fever and sore throat.

Diagnosis:
Clinical and laboratory tests revealed fever >38.5°C, hepatosplenomegaly, pancytopenia, hypertriglyceridemia, hypofibrinogenemia, hyperferritinemia, and an elevated interleukin-2 receptor level.

Intervention:
This patient was treated with ruxolitinib and the HLH-94 protocol.

Outcomes:
The patient's clinical and some laboratory indices improved. Unfortunately, vital signs such as respiratory function and consciousness did not improve.

Lessons:
This case report highlights the effect of using ruxolitinib in conjunction with the HLH-94 protocol. However, safety evaluation of this regimen was not performed because critically ill patient died too fast.
Recurrent monocular exudative retinal detachment as the first manifestation of squamous cell lung cancer
Authors: Zarzecki Mateusz , Saeed Emil , Mariak Zofia , Konopińska Joanna 
Published: March 2021

Abstract

Rationale:
In this report, we present an extremely rare case of recurrent monocular exudative retinal detachment without concomitant ocular metastases. This turned out to be the first symptom of squamous cell lung cancer.

Patient concerns:
A 63-year-old woman was referred to our ophthalmology clinic by her primary care physician with a complaint of deteriorating vision in her right eye that had started four months prior, without concomitant pain.

Diagnoses:
We observed a detachment in the lower part of the retina during her ophthalmoscopy. We did not find any tears, holes, or degenerative changes in the periphery of the retina of the right eye during the surgery. In addition, plaques, tumor masses, and metastases were absent. Therefore, we diagnosed her with unilateral paraneoplastic exudative retinal detachment. Imaging tests performed before surgery revealed perihilar density with a visible air bronchogram in the middle field of the left lung. This turned out to be squamous cell carcinoma.

Interventions:
Patient underwent pars plana vitrectomy and routine laboratory and imaging tests before the procedure that utilized 20-gauge instrumentation. The subretinal fluid and was drained and a tamponade using Densiron (Fluoron Co, Neu-Ulm, Germany) was applied. After ophthalmic treatment, patient underwent complex oncological treatment based on chemotherapy and radiotherapy.

Outcomes:
Despite the application of heavy silicone oil (Densiron) into the vitreous chamber, we observed a recurrence of retinal detachment in the right eye during the follow-up visit, 13 months after the first ophthalmic surgery. Following subsequent pars plana vitrectomy, the Densiron and subretinal membranes were removed. Despite oncological treatment, the patient died, twenty months after the appearance of the first ocular symptoms.

Lessons:
Exudative retinal detachment without tumor metastasis to the eyeball can be one of the first signs of lung cancer in rare cases. Multidisciplinary care and imaging methods with greater accuracy will provide comprehensive care to the patients. It will not only facilitate timely detection and treatment of lung tumors but also for a plethora of oncological diseases.
Using the health belief model to explore nursing students’ relationships between COVID-19 knowledge, health beliefs, cues to action, self-efficacy, and behavioral intention
Authors: Tsai Fu-Ju , Hu Yih-Jin , Chen Cheng-Yu , Tseng Chie-Chien , Yeh Gwo-Liang , Cheng Jin-Fong 
Published: March 2021

Abstract
Nursing educators should equip nursing students with sufficient knowledge about coronavirus disease 2019 (COVID-19), perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and behavioral intention in order to prevent the spread of COVID-19.
The purpose of this study was to use the health belief model to elucidate nursing students’ relationships between knowledge about COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and behavioral intention.
A cross-sectional survey design was adopted and purposive sampling was utilized. A total of 361 nursing students participated in the study. Quantitative analysis was employed for all data analysis.
The findings showed that the nursing students had the following mean scores on knowledge of COVID-19 9.43 [standard deviation (SD)1.19], perceived susceptibility 19.41 (SD2.68), perceived severity 20.31 (SD 4.09), perceived benefits 26.52 (SD 4.08), perceived barriers 15.17 (SD5.88), cues to action 3.30 (SD1.70), self-efficacy 17.68 (SD2.83), and behavioral intention 18.46 (SD2.33). Nursing students’ demographic background, knowledge of COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy explained 58.1% of the variance in behavioral intention (R

2
= 0.581, F = 29.775, P < .001).
Nursing educators can increase nursing students’ knowledge of COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy as effective means of health promotion to improve their behavioral intention to prevent the spread of COVID-19.
Physical Activity Measurement in Children Who Use Mobility Assistive Devices: Accelerometry and Global Positioning System
Authors: Kerfeld Cheryl I. , Hurvitz Philip M. , Bjornson Kristie F. 
Published: March 2021

Purpose:
To explore the usefulness of combining accelerometry, global positioning systems, and geographic information systems, to describe the time spent in different locations and physical activity (PA) duration/count levels by location for 4 children with cerebral palsy (CP) who use assistive devices (AD).

Methods:
A descriptive multiple-case study.

Results:
Combining the 3 instruments was useful in describing and differentiating duration by location, and amount and location of PA across differing functional levels and AD. For example, the child classified with a Gross Motor Function Classification System (GMFCS) level II exhibited large amounts of PA in community settings. In contrast, the child classified with a GMFCS level V had small amounts of PA and spent most measured time at home.

Conclusions:
Combined accelerometry, global positioning system, and geographic information system have potential to capture time spent and amount/intensity of PA relative to locations within daily environments for children with CP who use AD.
Assessment of Carfilzomib Treatment Response in Lung Transplant Recipients With Antibody-mediated Rejection
Authors: Pham Christine , Pierce Brett J. , Nguyen Duc T. , Graviss Edward A. , Huang Howard J. 
Published: March 2021

Background.
Data supporting the use of carfilzomib (CFZ) for treatment of antibody-mediated rejection (AMR) in lung transplantation in combination with plasmapheresis and intravenous immunoglobulin suggest positive outcomes through donor-specific antibody (DSA) depletion or conversion to noncomplement-activating antibodies. Herein, we describe our center’s experience treating AMR with CFZ.

Methods.
All patients treated with CFZ for AMR from 2014 to 2019 were included. The primary outcome was a positive response to CFZ was defined as: (1) loss of DSA C1q-fixing ability after last CFZ dose; (2) clearance of de novo DSA; or (3) decrease in de novo DSA mean fluorescence intensity of >3000.

Results.
Twenty-eight patients with 31 AMR episodes were treated with CFZ. A positive response was observed in 74.4% of AMR episodes and 82.1% of patients. This response was driven by loss of complement 1q fixation (70.6%), elimination of class I DSAs (78.6%), and reduction in both classes I (median 2815, 79.5% reduction from baseline) and II DSA mean fluorescence intensity (3171, 37.1%).

Conclusions.
CFZ shows potential for ameliorating AMR; however, additional studies are needed to define optimal time of administration.
Antibody evasion by the Brazilian P.1 strain of SARS-CoV-2
Authors: Dejnirattisai Wanwisa , Zhou Daming , Supasa Piyada , Liu Chang , Mentzer Alexander J. , Ginn Helen M. , Zhao Yuguang , Duyvesteyn Helen M.E. , Tuekprakhon Aekkachai , Nutalai Rungtiwa , Wang Beibei , Paesen Guido C. , López-Camacho César , Slon-Campos Jose , Walter Thomas S. , Skelly Donal , Clemens Sue Ann Costa , Naveca Felipe Gomes , Nascimento Valdinete , Nascimento Fernanda , da Costa Cristiano Fernandes , Resende Paola C. , Pauvolid-Correa Alex , Siqueira Marilda M. , Dold Christina , Levin Robert , Dong Tao , Pollard Andrew J. , Knight Julian C. , Crook Derrick , Lambe Teresa , Clutterbuck Elizabeth , Bibi Sagida , Flaxman Amy , Bittaye Mustapha , Belij-Rammerstorfer Sandra , Gilbert Sarah , Carroll Miles W. , Klenerman Paul , Barnes Eleanor , Dunachie Susanna J. , Paterson Neil G. , Williams Mark A. , Hall David R. , Hulswit Ruben J. G. , Bowden Thomas A. , Fry Elizabeth E. , Mongkolsapaya Juthathip , Ren Jingshan , Stuart David I. , Screaton Gavin R. 
Published: March 2021

SummaryTerminating the SARS-CoV-2 pandemic relies upon pan-global vaccination. Current vaccines elicit neutralizing antibody responses to the virus spike derived from early isolates. However, new strains have emerged with multiple mutations: P.1 from Brazil, B.1.351 from South Africa and B.1.1.7 from the UK (12, 10 and 9 changes in the spike respectively). All have mutations in the ACE2 binding site with P.1 and B.1.351 having a virtually identical triplet: E484K, K417N/T and N501Y, which we show confer similar increased affinity for ACE2. We show that, surprisingly, P.1 is significantly less resistant to naturally acquired or vaccine induced antibody responses than B.1.351 suggesting that changes outside the RBD impact neutralisation. Monoclonal antibody 222 neutralises all three variants despite interacting with two of the ACE2 binding site mutations, we explain this through structural analysis and use the 222 light chain to largely restore neutralization potency to a major class of public antibodies.
Phylogeography and Proline amino acid usage of Asian tiger mosquitoAedes albopictus(Skuse 1894) populations along landscape gradients in Indonesia
Authors: Wibowo Andri 
Published: March 2021

AbstractAsian tiger mosquitoAedes albopictus(Skuse 1894) is one of mosquito-borne vector that globally distributed including Southeast Asia. Despite its wide distributions, information on phylogeography and its determinant factors influencingA. albopictusgenetic diversity and speciation is still lacking, mainly in SE Asia country. Considering this, the phylogeography ofA. albopictusalong with its genetic attributes in Indonesia has been assessed. The results identify that there are 2 distinct clades ofA. albopictusphylogeography. First clade was related to the human-mediated dissemination. Relative Synonymous Codon Usage (RSCU) shows the TTG, CTG, GTG, ACG, GCG, and GGG codons were seldom represented. While GGA, CGA, and followed by TAT, CAT, CCT, TCT, AAC, and TTC codons were common. From a total of 60 codons, 40% codon has RSCU > 1and 21.6 % has RSCU < 1. The differences between west and east part populations can be observed in proline amino acid signaled by CCT and CCC codons. In this amino acid, eastA. albopictushas higher CCC than CCT codons. Since proline is functioned to provide energy for flight, then the differences of this proline related codon amongA. albopictuspopulations were related to the landscape variations in west and east parts of Indonesia with east parts have more rugged landscape and this condition is quite demanding for aerial animal distribution since it requires more flight energy.
Effects of Mutations in the Receptor-Binding Domain of SARS-CoV-2 Spike on its Binding Affinity to ACE2 and Neutralizing Antibodies Revealed by Computational Analysis
Authors: Bozdaganyan Marine E. , Sokolova Olga S. , Shaitan Konstantin V. , Kirpichnikov Mikhail P. , Orekhov Philipp S. 
Published: March 2021

AbstractSARS-CoV-2 causing coronavirus disease 2019 (COVID-19) is responsible for one of the most deleterious pandemics of our time. The interaction between the ACE2 receptors at the surface of human cells and the viral Spike (S) protein triggers the infection making the receptor-binding domain (RBD) of the SARS-CoV-2 S-protein a focal target for the neutralizing antibodies (Abs). Despite the recent progress in the development and deployment of vaccines, the emergence of novel variants of SARS-CoV-2 insensitive to Abs produced in response to the vaccine administration and/or monoclonal ones represents upcoming jeopardy. Here, we assessed the possible effects of single and multiple mutations in the RBD of SARS-CoV-2 S-protein on its binding energy to various antibodies and the human ACE2 receptor. The performed computational analysis indicates that while single amino acid replacements in RBD may only cause partial impairment of the Abs binding, moreover, limited to specific epitopes, some variants of SARS-CoV-2 (with as few as 8 mutations), which are already present in the population, may potentially result in a much broader antigenic escape. We also identified a number of point mutations, which, in contrast to the majority of replacements, reduce RBD affinity to various antibodies without affecting its binding to ACE2. Overall, the results provide guidelines for further experimental studies aiming at the identification of the high-risk RBD mutations allowing for an antigenic escape.