bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran
Authors: Kiani Behzad , Hashemi Amin Fatemeh , Bagheri Nasser , Bergquist Robert , Mohammadi Ali Akbar , Yousefi Mahmood , Faraji Hossein , Roshandel Gholamreza , Beirami Somayeh , Rahimzadeh Hadi , Hoseini Benyamin 
Published: April 2021

Abstract
Background
Colorectal cancer has increased in Middle Eastern countries and exposure to environmental pollutants such as heavy metals has been implicated. However, data linking them to this disease are generally lacking. This study aimed to explore the spatial pattern of age-standardized incidence rate (ASR) of colon cancer and its potential association with the exposure level of the amount of heavy metals existing in rice produced in north-eastern Iran.

Methods
Cancer data were drawn from the Iranian population-based cancer registry of Golestan Province, north-eastern Iran. Samples of 69 rice milling factories were analysed for the concentration levels of cadmium, nickel, cobalt, copper, selenium, lead and zinc. The inverse distance weighting (IDW) algorithm was used to interpolate the concentration of this kind of heavy metals on the surface of the study area. Exploratory regression analysis was conducted to build ordinary least squares (OLS) models including every possible combination of the candidate explanatory variables and chose the most useful ones to show the association between heavy metals and the ASR of colon cancer.

Results
The highest concentrations of heavy metals were found in the central part of the province and particularly counties with higher amount of cobalt were shown to be associated with higher ASR of men with colon cancer. In contrast, selenium concentrations were higher in areas with lower ASR of colon cancer in men. A significant regression equation for men with colon cancer was found (F(4,137) = 38.304, P < .000) with an adjusted R2 of 0.77. The predicted ASR of men colon cancer was − 58.36 with the coefficients for cobalt = 120.33; cadmium = 80.60; selenium = − 6.07; nickel = − 3.09; and zinc = − 0.41. The association of copper and lead with colon cancer in men was not significant. We did not find a significant outcome for colon cancer in women.

Conclusion
Increased amounts of heavy metals in consumed rice may impact colon cancer incidence, both positively and negatively. While there were indications of an association between high cobalt concentrations and an increased risk for colon cancer, we found that high selenium concentrations might instead decrease the risk. Further investigations are needed to clarify if there are ecological or other reasons for these discrepancies. Regular monitoring of the amount of heavy metals in consumed rice is recommended.
The effect of the underlying malignancy on short- and medium-term survival of critically ill patients admitted to the intensive care unit: a retrospective analysis based on propensity score matching
Authors: Yuan Zhen-nan , Wang Hai-jun , Gao Yong , Qu Shi-ning , Huang Chu-lin , Wang Hao , Zhang Hao , Yang Quan-hui , Xing Xue-zhong 
Published: April 2021

Abstract
Background
Advances in oncology led to a substantial increase in the number of patients requiring admission to the ICU. It is significant to confirm which cancer critical patients can benefit from the ICU care like noncancer patients.

Methods
An observational retrospective cohort study using intensive care unit (ICU) admissions of Medical Information Mart for Intensive Care III from the Beth Israel Deaconess Medical Center in Boston, MA, USA between 2001 and 2012 was conducted. Propensity score matching was used to reduce the imbalance between two matched cohorts. ICU patients with cancer were compared with those without cancer in terms of patients’ characteristics and survival.

Results
There were 38,508 adult patients admitted to ICUs during the period. The median age was 65 years (IQR, 52–77) and 8308 (21.6%) had an underlying malignancy diagnosis. The noncancer group had a significant survive advantage at the point of 28-day, 90-day, 365-day and 1095-day after ICU admission compared with cancer group (P < 0.001 for all) after PSM. Subgroup analysis showed that the diagnosis of malignancy didn’t decrease 28-day and 90-day survive when patients’ age ≥ 65-year, patients in surgical intensive care unit or cardiac surgery recovery unit or traumatic surgical intensive care unit, elective admissions, patients with renal replacement therapy or vasopressor support (P > 0.05 for all).

Conclusions
Malignancy is a common diagnosis among ICU patients. Patients without cancer have a survive advantage compared with patients with cancer in the short- and medium-term. However, in selected groups, cancer critical patients can benefit from the ICU care service like noncancer patients in the short-term.
How context affects people’s willingness to register for the deceased organ donation programme
Authors: AlHajri Lamia , AlHebsi Amna , AlSuwaidi Maryam 
Published: April 2021

Abstract
Background
The deceased organ donation programme is new in the United Arab Emirates (UAE), and to improve acceptability, a broad understanding of public perspectives is thought to be helpful. Therefore, this study aims to explore the extent to which context plays a role in the willingness to register for the deceased organ donation programme in Dubai, UAE.

Methods
This study used a qualitative methodology and was gauged by the tenets of a social ecological model and lay knowledge. Audio-recorded semi-structured interviews were conducted with 17 participants. The data were subsequently analysed thematically.

Results
Four themes emerged from the dataset: fear and body integrity, family, relational ties and the identification of the recipient, religious conviction, and knowledge and personal experiences. The participants feared the whole process, were not aware of the religious outlook, and their knowledge regarding the programme was scarce. In addition, family-related factors, such as parental authority and hierarchy in the family, were also major influencers.

Conclusion
Using the social ecological model and lay knowledge helped to unravel the contextual factors that affected the willingness of participants to register for the deceased organ donation programme in Dubai, UAE, thereby enabling the development of a holistic understanding of deceased organ donation. The responses mainly stemmed from participants’ social contexts; hence, awareness campaigns should be tailored to inform people about the technical aspects and address their contextual concerns.
Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in Western New South Wales
Authors: D’Souza Charmaine , Kramadhari Nikitha , Skalkos Elizabeth , Dutton Tegan , Bailey Jannine 
Published: April 2021

Abstract
Background
Rates of skin cancer in Australia are amongst the highest in the world, with Western New South Wales (NSW) exhibiting very high prevalence. There is a large proportion of outdoor workers, including farmers, in Western NSW who have high levels of sun exposure and hence are at greater risk of developing skin cancer.

Aims
To characterise the current sun safety practices of farmers in Western NSW and explore their knowledge, attitudes and perceived barriers towards sun safety and its implementation.

Methods
A cross-sectional survey study was conducted using a self-directed questionnaire. Participants were recruited at field days held in Western NSW and through surveys distributed at general practices, local stores and online. Eligibility criteria were aged 18 years and over and currently working on a farm in the study region.

Results
Of the 144 participants, 89 (61.8%) were male with a mean age of 49 years. Knowledge of sun safety was relatively high with most questions answered correctly by greater than 80% of participants. Risk of developing skin cancer was underestimated in 58 (40.3%) participants. Of all participants, 89 (62.2%) identified one or more barriers to practicing sun safety. The most common barrier was forgetfulness in 62 (43.4%) participants. The identification of barriers was significantly associated with reduced engagement of sun safety practices (p = 0.009).

Conclusions
Knowledge of sun safety among farmers was high. There was, however, underestimation of risk of developing skin cancer. Addressing perceived barriers to implementing sun safety could improve sun safety practices in this cohort.
Online health information-seeking behaviors and skills of Chinese college students
Authors: Zhang Dangui , Zhan Weixin , Zheng Chunwen , Zhang Jinsheng , Huang Anqi , Hu Shuan , Ba-Thein William 
Published: April 2021

Abstract
Background
Seeking online health information (OHI) has become a common practice globally. The information seekers could face health risks if they are not proficient in OHI literacy. The OHI-seeking behaviors and skills of Chinese college students, the largest proportion of college students in the world, are understudied. This study was aimed to describe OHI-seeking behaviors and skills of college students in Guangdong, China.

Methods
College students in the Guangdong province with OHI-seeking experience were invited via WeChat, QQ, and Sina Weibo using QR code posters and flyers for participation in this online anonymized questionnaire-based study. Data on demographics, OHI literacy, information resources, search approaches, and behaviors were collected. The relationship between perceived OHI literacy and high-risk behaviors was investigated by bivariate logistic regression analysis.

Results
Respondents were 1203 college students with a mean age of 20.6 years, females (60.2%), and undergraduates (97.2%). They sought health information via websites (20.3%), WeChat (2.6%), or both (77.1%). Baidu was the main search engine, and baike.baidu.com (80.3%), Zhihu.com (48.4%), and Zhidao.baidu.com (35.8%) were top three among 20 searched websites for information about self-care (80.7%), general health (79.5%), disease prevention (77.7%), self-medication (61.2%), family treatment (40.9%), drugs (37.7%), western medications (26.6%), hospitals (22.7%), physicians (21.4%), and Traditional Chinese Medicine (15.6%). Despite most respondents (78%) lacked confidence in the evidence quality and satisfaction with the results, only 32.4% further consulted doctors. Many (> 50%) would recommend the retrieved information to others. About 20% experienced hacking/Internet fraud. Cronbach’s alpha for the internal consistency of OHI literacy was 0.786. Bivariate logistic regression analysis showed that students who believed they can judge the evidence level of OHI were more likely to self-diagnose (OR = 2.2, 95%CI, 1.6–3.1) and look for drug usage (OR = 3.1, 95%CI, 1.9–5.0).

Conclusions
This study reveals Chinese college students’ heavy reliance on OHI to manage their own and others’ health without sufficient knowledge/skills to identify misinformation and disinformation. The apparent risky information-seeking behaviors of Chinese college students warrant the provision of regulated, accurate, and actionable health information; assurance of cybersecurity; and health information literacy promotion in colleges by concerned authorities.
Chemotherapy in idiopathic pulmonary fibrosis and small-cell lung cancer with poor lung function
Authors: Zhang Xiyue , Li Wei , Li Chunyan , Zhang Jie , Su Zhenzhong 
Published: April 2021

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease with unclear pathogenesis. IPF is considered as a risk factor for lung cancer. Compared to other lung cancers, small-cell lung cancer (SCLC) has a lower incidence, but has a more aggressive course. Patients with IPF and SCLC have a lower survival rate, more difficult treatment, and poorer prognosis.Case presentationCase 1 was of a 66-year-old man with IPF for 5 years, who was admitted to our hospital for dyspnea. Case 2 was of a 68-year-old woman, who presented with chest pains, cough, and dyspnea. Both patients had extremely poor lung function. High-resolution computed tomography and pathology revealed that both patients had IPF and SCLC. Chemotherapy comprising nedaplatin (80 mg/m2) and etoposide (100 mg for 5 days) was initiated for both patients. Antifibrotic agents were continued during the chemotherapeutic regimen. Both patients showed improvement in their condition after treatment.ConclusionThe favorable outcomes in these 2 cases suggests that chemotherapy is worth considering in the management of patients having SCLC and IPF with poor lung function.
A comparison of postoperative outcomes after open and laparoscopic reduction of Petersen's Hernia: a multicenter observational cohort study
Authors: Min Jae-Seok , Seo Kyung Won , Jeong Sang-Ho , Kim Ki Hyun , Park Ji-ho , Yoon Ki Young , Kim Tae-Han , Jung Eun-Jung , Ju Young-tae , Jeong Chi-Young , Kim Ju-Yeon , Lee Young-Joon 
Published: April 2021

Abstract
Background
The aim of this multicenter cohort study was to compare the clinical courses between open and laparoscopic Petersen’s hernia (PH) reduction.

Method
We retrospectively collected the clinical data of patients who underwent PH repair surgery after gastrectomy for gastric cancer from 2015–2018. Forty patients underwent PH reduction operations that were performed by six surgeons at four hospitals. Among the 40 patients, 15 underwent laparoscopic PH reduction (LPH), and 25 underwent open PH reduction (OPH), including 4 patients who underwent LPH but required conversion to OPH.

Results
We compared the clinical factors between the LPH and OPH groups. In the clinical course, we found no differences in operation times or intraoperative bowel injury, morbidity, or mortality rates between the two groups (p > 0.05). However, the number of days on a soft fluid diet (OPH vs. LPH; 5.8 vs. 3.7 days, p = 0.03) and length of hospital stay (12.6 vs. 8.2 days, p = 0.04) were significantly less in the LPH group than the OPH group. Regarding postoperative complications, the OPH group had a case of pneumonia and sepsis with multi-organ failure, which resulted in mortality. In the LPH group, one patient experienced recurrence and required reoperation for PH.

Conclusion
Laparoscopic PH reduction was associated with a faster postoperative recovery period than open PH reduction, with a similar incidence of complications. The laparoscopic approach should be considered an appropriate strategy for PH reduction in selected cases.
Cystic papillary adenoma of the seminal vesicle
Authors: Heijkoop B. , Bolton D. , Katz D. , Ryan Andrew , Epstein J. , Appu S. 
Published: April 2021

Abstract
Background
Primary Seminal Vesicle (SV) tumours are a rare entity, with most SV masses representing invasion of the SV by malignancy originating in an adjacent organ, most often the prostate. Previously reported primary SV epithelial tumours have included adenocarcinoma and cystadenoma, with limited prior reports of inracystic papillary structures.

Case presentation
A 35-year-old male presented with azoospermia, intermittent macroscopic haematuria, and mild right iliac fossa and groin pain. A papillary appearing seminal vesicle mass was found on imaging and seminal vesicoscopy. The mass was robotically excised with diagnosis of benign cystic papillary adenoma made.

Conclusion
In this manuscript we describe a rare case of a benign cystic papillary adenoma of the seminal vesicle, a unique histological entity differentiated from cystadenoma of the Seminal Vesicle by its papillary component.
Semantic categorization of Chinese eligibility criteria in clinical trials using machine learning methods
Authors: Zong Hui , Yang Jinxuan , Zhang Zeyu , Li Zuofeng , Zhang Xiaoyan 
Published: April 2021

Abstract
Background
Semantic categorization analysis of clinical trials eligibility criteria based on natural language processing technology is crucial for the task of optimizing clinical trials design and building automated patient recruitment system. However, most of related researches focused on English eligibility criteria, and to the best of our knowledge, there are no researches studied the Chinese eligibility criteria. Thus in this study, we aimed to explore the semantic categories of Chinese eligibility criteria.

Methods
We downloaded the clinical trials registration files from the website of Chinese Clinical Trial Registry (ChiCTR) and extracted both the Chinese eligibility criteria and corresponding English eligibility criteria. We represented the criteria sentences based on the Unified Medical Language System semantic types and conducted the hierarchical clustering algorithm for the induction of semantic categories. Furthermore, in order to explore the classification performance of Chinese eligibility criteria with our developed semantic categories, we implemented multiple classification algorithms, include four baseline machine learning algorithms (LR, NB, kNN, SVM), three deep learning algorithms (CNN, RNN, FastText) and two pre-trained language models (BERT, ERNIE).

Results
We totally developed 44 types of semantic categories, summarized 8 topic groups, and investigated the average incidence and prevalence in 272 hepatocellular carcinoma related Chinese clinical trials. Compared with the previous proposed categories in English eligibility criteria, 13 novel categories are identified in Chinese eligibility criteria. The classification result shows that most of semantic categories performed quite well, the pre-trained language model ERNIE achieved best performance with macro-average F1 score of 0.7980 and micro-average F1 score of 0.8484.

Conclusion
As a pilot study of Chinese eligibility criteria analysis, we developed the 44 semantic categories by hierarchical clustering algorithms for the first times, and validated the classification capacity with multiple classification algorithms.
What does the patient have to say? Valuing the patient experience to improve the patient journey
Authors: Gualandi Raffaella , Masella Cristina , Piredda Michela , Ercoli Matteo , Tartaglini Daniela 
Published: April 2021

Abstract
Background
Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether and how patient experience data can more pertinently inform the design of service delivery from a patient-centred perspective when compared with other indicators. This study aims to explore whether timely patient-reported data could capture relevant issues to improve the hospital patient journey.

Methods
Between January and February 2019, a longitudinal survey was conducted in the orthopaedics department of a 250-bed Italian university hospital with patients admitted for surgery; the aim was to analyse the patient journey from the first outpatient visit to discharge. The same patients completed a paper-and-pencil questionnaire, which was created to collect timely preference, experience and main outcomes data, and the hospital patient satisfaction questionnaire. The first was completed at the time of admission to the hospital and at the end of hospitalisation, and the second questionnaire was completed at the end of hospitalisation.

Results
A total of 254 patients completed the three questionnaires. The results show the specific value of patient-reported data. Greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey. As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient.

Conclusion
By contributing to the literature on how patient-reported data could be collected and used in hospital quality improvement, this study opens the debate about the use of real-time focused data. Further studies should explore how to use patient-reported data effectively (including what the patient reports are working well) and how to improve hospital processes by profiling patients’ needs and defining the appropriate methodologies to capture the experiences of vulnerable patients. These topics may offer new frontiers of research to achieve a patient-centred healthcare system.
Integrated early childhood development services improve mothers’ experiences with prevention of mother to child transmission (PMTCT) programs in Malawi: a qualitative study
Authors: Dovel Kathryn , Kalande Pericles , Udedi Evelyn , Temelkovska Tijana , Hubbard Julie , Mbalanga Chipariro , Bruns Laurie , Mulungu Siyenunu , Gupta Sundeep , Richter Linda , Coates Thomas J. 
Published: April 2021

Abstract
Background
HIV-positive mothers who face the dual burden of HIV-positive status and motherhood, may benefit from holistic services that include early childhood development (ECD). We evaluated the acceptability and impact of integrated ECD-PMTCT interventions for mothers and their children.

Methods
We implemented an integrated ECD-PMTCT intervention in 4 health facilities in Malawi for HIV-positive mothers and their infants. WHO/UNICEF Care for Child Development (CCD) education and counseling sessions were offered during routine PMTCT visits between infant age 1.5–24 months. From June–July 2019, we conducted in-depth interviews with 29 mothers enrolled in the intervention for ≥6 months across 4 health facilities. The interview guide focused on perceived impact of the intervention on mothers’ ECD and PMTCT practices, including barriers and facilitators, and unmet needs related to the program. Data were coded and analyzed using constant comparison methods in Atlas ti.8.

Results
The vast majority of mothers believed the ECD-PMTCT intervention improved their overall experience with the PMTCT services, strengthened their relationship with providers, and excited and motivated them to attend PMTCT services during the postpartum period. Unlike prior experience, mothers felt more welcome at the health facility, and looked forward to the next visit in order to interact with other mothers and learn new ECD skills. Mothers formed new social support networks with other mothers engaged in ECD sessions, and they provided emotional and financial support to one another, including encouragement regarding ART adherence. Mothers believed their infants reached developmental milestones faster compared to non-intervention children they observed at the same age, and they experienced improved engagement in caregiving activities among male caregivers. Nearly half of women requested additional support with depression or anxiety, coping mechanisms to deal with the stresses of life, or support in building positive dynamics with their male partner.

Conclusion
The integrated ECD-PMTCT intervention improved mother’s experiences with PMTCT programs and health care providers, increased ECD practices such as responsive and stimulating parenting, and created social support networks for women with other PMTCT clients.