bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying Bowen Theory to Psychiatric Assessment and Disposition in the ED
Authors: Kerr Kathleen B. 
Published: February 2021

BACKGROUND: A number of variables have been shown to influence whether an individual who experiences an emergency psychiatric assessment is admitted to a psychiatric hospital. This study focused on the theoretical orientation of the assessing clinician as a possibly influential variable. The theoretical orientation being studied was Bowen family systems theory or Bowen theory (Bt). Overall the Bt perspective looks at the family as the primary crucible that generates symptoms but at the same time as the natural unit and the best built-in resource to deal with those symptoms. AIMS: This study examined whether the theoretical orientation of the nurse psychiatric assessor would affect her inpatient admission rate of patients seen for psychiatric evaluation in an emergency department (ED). METHOD: A clinician/researcher with extensive experience applying Bt in clinical practice worked in a Crisis Management Service providing psychiatric evaluation and disposition in a busy community hospital ED. Given Bt’s emphasis on the system rather than individual pathology, the clinician researcher hypothesized that her psychiatric hospitalization rate would be lower than the other clinical nurse specialists. A retrospective chart review analyzed 1 year of cases from all referrals that might have resulted in psychiatric hospitalizations ( n = 1,801). RESULTS: The clinician/researcher’s psychiatric hospitalization rate was significantly lower ( p = .004) than the other clinicians. CONCLUSION: An approach to psychiatric assessment in the ED applied a Bt perspective in a way that significantly reduced psychiatric hospitalizations.
COVID-19 Related Cardiovascular Comorbidities and Complications in Critically Ill Patients: A Systematic Review and Meta-analysis
Authors: Koeppen Michael , Rosenberger Peter , Magunia Harry 
Published: February 2021

Objective: This systematic-review and meta-analysis aimed to assess the prevalence of cardiovascular comorbidities and complications in ICU-admitted coronavirus disease 2019 (COVID-19) patients. Data sources: PubMed and Web of Science databases were referenced until November 25, 2020. Data extraction: We extracted retrospective and prospective observational studies on critically ill COVID-19 patients admitted to an intensive care unit. Only studies reporting on cardiovascular comorbidities and complications during ICU therapy were included. Data synthesis: We calculated the pooled prevalence by a random-effects model and determined heterogeneity by Higgins’ I2 test. Results: Of the 6346 studies retrieved, 29 were included in this review. The most common cardiovascular comorbidity was arterial hypertension (50%; 95% confidence interval [CI], 0.42-058; I2 = 94.8%, low quality of evidence). Among cardiovascular complications in the ICU, shock (of any course) was most common, being present in 39% of the patients (95% CI, 0.20-0.59; I2 = 95.6%; 6 studies). Seventy-four percent of patients in the ICU required vasopressors to maintain target blood pressure (95% CI, 0.58-0.88; I2 = 93.6%; 8 studies), and 30% of patients developed cardiac injury in the ICU (95% CI, 0.19-0.42; I2 = 91%; 14 studies). Severe heterogeneity existed among the studies. Conclusions: Cardiovascular complications are common in patients admitted to the intensive care unit for COVID-19. However, the existing evidence is highly heterogeneous in terms of study design and outcome measurements. Thus, prospective, observational studies are needed to determine the impact of cardiovascular complications on patient outcome in critically ill COVID-19 patients.
Sociodemographic inequalities in patients’ experiences of primary care: an analysis of the General Practice Patient Survey in England between 2011 and 2017
Authors: Saunders Catherine L , Flynn Sarah , Massou Efthalia , Lyratzopoulos Georgios , Abel Gary , Burt Jenni 
Published: February 2021

Objective Younger people, minority ethnic groups, sexual minorities and people of lower socioeconomic status report poorer experiences of primary care. In light of NHS ambitions to reduce unwarranted variations in care, we aimed to investigate whether inequalities in patient experience of primary care changed between 2011 and 2017, using data from the General Practice Patient Survey in England. Methods We considered inequalities in relation to age, sex, deprivation, ethnicity, sexual orientation and geographical region across five dimensions of patient experience: overall experience, doctor communication, nurse communication, access and continuity of care. We used linear regression to explore whether the magnitude of inequalities changed between 2011 and 2017, using mixed models to assess changes within practices and models without accounting for practice to assess national trends. Results We included 5,241,408 responses over 11 survey waves from 2011–2017. There was evidence that inequalities changed over time (p < 0.05 for 27/30 models), but the direction and magnitude of changes varied. Changes in gaps in experience ranged from a 1.6 percentage point increase for experience of access among sexual minorities, to a 5.6 percentage point decrease for continuity, where experience worsened for older ages. Inequalities in access in relation to socio-economic status remained reasonably stable for individuals attending the same GP practice; nationally inequalities in access increased 2.1 percentage points (p < 0.0001) between respondents living in more/less deprived areas, suggesting access is declining fastest in practices in more deprived areas. Conclusions There have been few substantial changes in inequalities in patient experience of primary care between 2011 and 2017.
Patient perceptions of the re-usable Respimat® Soft Mist™ inhaler in current users and those switching to the device: A real-world, non-interventional COPD study
Authors: Dreher Michael , Price David , Gardev Asparuh , Peeters Pascale , Arora Satish , van der Sar – van der Brugge Simone , Dekhuijzen Richard , Usmani Omar S 
Published: February 2021

The Respimat® Soft Mist™ inhaler (SMI) has recently been improved, with a re-usable device replacing the disposable version. Certain countries are currently phasing out the disposable inhaler. This study aimed to assess patient satisfaction with and preference for the re-usable device. This 4–6-week, multicentre, open-label, prospective, real-world, non-interventional study was conducted across six European countries. Patients with chronic obstructive pulmonary disease were enrolled between October and December 2019, in three cohorts: (1) currently using the re-usable Respimat SMI; (2) switched from disposable Respimat SMI at study entry; and (3) naïve to any Respimat SMI. Patients were assessed using the Patient Satisfaction and Preference Questionnaire (PASAPQ) and Ease of Handling Questionnaire. In total, 262 patients were enrolled. At follow-up, the mean PASAPQ score was 83.3/100 overall, with similar results across all three patient cohorts. Most patients were ‘satisfied’ or ‘very satisfied’ with the re-usable device. The overall score for willingness to continue using the device was 87.8/100. In total, 13 adverse events were recorded, none of which was classified as serious. This study provides real-world evidence for practitioners to start patients on Respimat re-usable, irrespective of a patient’s prior experience with this inhaler. Plain language summary: Inhalers are often used to treat patients with chronic obstructive pulmonary disease (COPD). However, there are many available, which can lead to confusion and poor inhaler technique. It is important for a patient to be happy with their inhaler. This study looked at how patients liked the re-usable Respimat® Soft Mist™ inhaler vs. their previous inhaler. It also asked whether they would be willing to continue using the device at the end of the study period.After 4–6 weeks of using the re-usable device, patients reported that they were happy with the inhaler and most would be willing to carry on using it.Overall, these results show that doctors can prescribe Respimat re-usable to patients, even if the patient has not used the inhaler before.
Exploring the Use of Two Brief Fatigue Screening Tools in Cancer Outpatient Clinics
Authors: Pearson Elizabeth J. , Drosdowsky Allison , Edbrooke Lara , Denehy Linda 
Published: February 2021

Purpose: Cancer fatigue guidelines recommend routine fatigue screening, with further assessment for people reporting moderate to severe fatigue. There is neither a gold-standard, nor a broadly accepted screening method, and knowledge about the impact of screening on care processes is limited. This study aimed to explore the feasibility of 2 fatigue screening methods and current clinical practice in cancer outpatient clinics. Methods: Hospital outpatients attending cancer clinics during 1 week completed a five-item survey: a numeric scale for current tiredness, 2 categorical pictorial scales rating tiredness last week and the impact of fatigue (Fatigue Pictogram), screening tool preference and help needed for survey completion. Participant demographics and fatigue documentation by clinical staff for that appointment were extracted from medical records. Analyses used descriptive statistics. Groups were compared using appropriate statistical tests. Results: Over 75% of participants rated their fatigue consistently as mild or significant on both screening tools. Of 1709 eligible outpatients, 533 (31%) completed the survey. Records were audited for 430 (81%) identifiable participants. Over half of the participants reported moderate or severe tiredness either “now” (237, 57%) and/or “last week” (226, 53%). Clinician documentation of fatigue seldom matched self-reports. Fatigue was rated as severe by 103 participants (24%), yet was noted in only 21 (20%) of these individuals’ clinical notes. Both screening tools were equally preferred. Conclusion: The numeric rating scale and Fatigue Pictogram are equally applicable for screening fatigue in cancer outpatient care. There is a high prevalence of clinically significant fatigue in a hospital outpatient setting that is not documented. Adequate care pathways for further management should be established alongside fatigue screening.
Revisiting Poststroke Upper Limb Stratification: Resilience in a Larger Cohort
Authors: Varley Benjamin J. , Shiner Christine T. , Johnson Liam , McNulty Penelope A. , Thompson-Butel Angelica G. 
Published: February 2021

Background Upper limb (UL) impairment in stroke survivors is both multifactorial and heterogeneous. Stratification of motor function helps identify the most sensitive and appropriate assessments, which in turn aids the design of effective and individualized rehabilitation strategies. We previously developed a stratification method combining the Grooved Pegboard Test (GPT) and Box and Block Test (BBT) to stratify poststroke UL motor function. Objective To investigate the resilience of the stratification method in a larger cohort and establish its appropriateness for clinical practice by investigating limitations of the GPT completion time. Methods Post hoc analysis of motor function for 96 community-dwelling participants with stroke (n = 68 male, 28 female, age 60.8 ± 14 years, 24.4 ± 36.6 months poststroke) was performed using the Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (F-M), BBT, and GPT. Hypothesis-free and hypothesis-based hierarchical cluster analyses were conducted to determine the resilience of the stratification method. Results The hypothesis-based analysis identified the same functional groupings as the hypothesis-free analysis: low (n = 32), moderate (n = 26), and high motor function (n = 38), with 3 exceptions. Thirty-three of the 38 participants with fine manual dexterity completed the GPT in ≤5 minutes. The remaining 5 participants took 6 to 25 minutes to place all 25 pegs but used alternative movement strategies to complete the test. The GPT time restriction changed the functional profile of the moderate and high motor function groups leading to more misclassifications. Conclusion The stratification method unambiguously classifies participants by UL motor function. While the inclusion of a 5-minute cutoff time for the GPT is preferred for clinical practice, it is not recommended for stratification purposes.
miRNA-21 may serve as a promising noninvasive marker of glioma with a high diagnostic performance: a pooled analysis of 997 patients
Authors: Zhao Xinli , Xiao Zhihong , Li Bin , Li Hongwei , Yang Bo , Li Tian , Mei Zubing 
Published: February 2021

Background: Although various serum and tissue biomarkers have been investigated for glioma diagnosis, no gold standard has been identified. miRNA-21 was demonstrated to be a promising biomarker for the diagnosis of various brain tumors, whereas there remains uncertainty concerning whether miRNA-21 could be used as a good clinical diagnostic biomarker for glioma. The current meta-analysis aimed to evaluate the diagnostic accuracy of miRNA-21 as a potent biomarker in adults with suspected glioma. Methods: The Pubmed and Embase databases were searched systematically from inception to January 2020 to identify relevant research reports. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. Summary receiver operating characteristic (SROC) curves were used to evaluate the overall diagnostic performance. Meta-regression and subgroup analyses were conducted to determine the source of heterogeneity and test the robustness of the results. Results: From 5394 citations with 997 subjects that met the inclusion criteria, 11 studies were selected. Summary estimates of the diagnostic performance of miRNA-21 were as follows: sensitivity, 0.83 [95% confidence interval (CI): 0.73–0.89]; specificity, 0.92 (95% CI: 0.85–0.96); PLR, 10.20 (95% CI: 5.10–20.30); NLR, 0.19 (95% CI: 0.12–0.31); and DOR, 54 (95% CI: 19–155). The area under the SROC curve was 0.94 (95% CI: 0.92–0.96). Deeks’s funnel plot revealed no evidence of publication bias ( p = 0.59). Meta-regression analysis suggested that study publication year could attribute to the heterogeneity. Subgroup analysis found miRNA-21 had a constant high diagnostic accuracy across different ethnicity, glioma grade, sample source, and study region. Conclusion: This meta-analysis demonstrated that miRNA-21 has high diagnostic performance and could serve as a promising noninvasive diagnostic marker for glioma. Further large prospective studies are needed to validate its diagnostic value and its prognostic significance and therapeutic effects.
Frontal Sinus Drainage in Acute Pediatric Sinusitis With Intracranial Complications
Authors: Chorney Stephen R. , Buzi Adva , Rizzi Mark D. 
Published: February 2021

Background The indication for frontal sinus drainage is uncertain when managing pediatric acute sinusitis with intracranial complications. Objective The primary objective was to determine if addressing the frontal sinus reduced need for subsequent surgical procedures in children presenting with acute sinusitis complicated by intracranial abscess. Methods A case series with chart review was performed at a tertiary children’s hospital between 2007 and 2019. Children under 18 years of age requiring surgery for complicated acute sinusitis that included the frontal sinus with noncontiguous intracranial abscess were included. Outcomes were compared among children for whom the frontal sinus was drained endoscopically, opened intracranially, or left undrained. Results Thirty-five children with a mean age of 11.1 years (95% CI: 9.9-12.3) met inclusion. Most presented with epidural abscess (37%). Hospitalizations lasted 12.9 days (95% CI: 10.2-15.5), 46% required a second surgery, 11% required three or more surgeries, and 31% were readmitted within 60 days. Initial surgery for 29% included endoscopic frontal sinusotomy, 34% had a frontal sinus cranialization and 37% did not have any initial drainage of the frontal sinus. Groups were similar with respect to demographics, severity of infection, need for repeat surgery, length of stay, and readmissions (p > .05). Further, persistence of cranial neuropathies, seizures, or major neurological sequelae after discharge were no different among groups (p > .05). Conclusion Drainage of the frontal sinus, when technically feasible, was not associated with reduced surgical procedures or increased complications and there is unclear benefit on measured clinical outcomes.
The photogeochemical cycle of Mn oxides on the Earth's surface
Authors: Lu Anhuai , Li Yan , Liu Feifei , Liu Yuwei , Ye Huan , Zhuang Ziyi , Li Yanzhang , Ding Hongrui , Wang Changqiu 
Published: February 2021

AbstractManganese (Mn) oxides have been prevalent on Earth since before the Great Oxidation Event and the Mn cycle is one of the most important biogeochemical processes on the Earth's surface. In sunlit natural environments, the photochemistry of Mn oxides has been discovered to enable solar energy harvesting and conversion in both geological and biological systems. One of the most widespread Mn oxides is birnessite, which is a semiconducting layered mineral that actively drives Mn photochemical cycling in Nature. The oxygen-evolving centre in biological photosystem II (PSII) is also a Mn-cluster of Mn4CaO5, which transforms into a birnessite-like structure during the photocatalytic oxygen evolution process. This phenomenon draws the potential parallel of Mn-functioned photoreactions between the organic and inorganic world. The Mn photoredox cycling involves both the photo-oxidation of Mn(II) and the photoreductive dissolution of Mn(IV/III) oxides. In Nature, the occurrence of Mn(IV/III) photoreduction is usually accompanied with the oxidative degradation of natural organics. For Mn(II) oxidation into Mn oxides, mechanisms of biological catalysis mediated by microorganisms (such asPseudomonas putidaandBacillusspecies) and abiotic photoreactions by semiconducting minerals or reactive oxygen species have both been proposed. In particular, anaerobic Mn(II) photo-oxidation processes have been demonstrated experimentally, which shed light on Mn oxide emergence before atmospheric oxygenation on Earth. This review provides a comprehensive and up-to-date elaboration of Mn oxide photoredox cycling in Nature, and gives brand-new insight into the photochemical properties of semiconducting Mn oxides widespread on the Earth's surface.
SP1 induced long non-coding RNA AGAP2-AS1 promotes cholangiocarcinoma proliferation via silencing of CDKN1A
Authors: Ji Hao , Wang Juan , Lu Binbin , Li Juan , Zhou Jing , Wang Li , Xu Shufen , Peng Peng , Hu Xuezhen , Wang Keming 
Published: February 2021

AbstractBackgroundLncRNA can regulate gene at various levels such as apparent genetics, alternative splicing, and regulation of mRNA degradation. However, the molecular mechanism of LncRNA in cholangiocarcinoma is still unclear. This deserves further exploration.MethodsWe investigated the expression of AGAP2-AS1 in 32 CCA tissues and two CCA cell lines. We found a LncRNA AGAP2-AS1 which induced by SP1 has not been reported in CCA, and Knockdown and overexpression were used to investigate the biological role of AGAP2-AS1 in vitro. CHIP and RIP were performed to verify the putative targets of AGAP2-AS1.ResultsAGAP2-AS1 was significantly upregulated in CCA tumor tissues. SP1 induced AGAP2-AS1 plays an important role in tumorigenesis. AGAP2-AS1 knockdown significantly inhibited proliferation and caused apoptosis in CCA cells. In addition, we demonstrated that AGAP2-AS1 promotes the proliferation of CCA.ConclusionsWe conclude that the long non-coding RNA AGAP2-AS1 plays a role in promoting the proliferation of cholangiocarcinoma.
DeepGRN: prediction of transcription factor binding site across cell-types using attention-based deep neural networks
Authors: Chen Chen , Hou Jie , Shi Xiaowen , Yang Hua , Birchler James A. , Cheng Jianlin 
Published: February 2021

AbstractBackgroundDue to the complexity of the biological systems, the prediction of the potential DNA binding sites for transcription factors remains a difficult problem in computational biology. Genomic DNA sequences and experimental results from parallel sequencing provide available information about the affinity and accessibility of genome and are commonly used features in binding sites prediction. The attention mechanism in deep learning has shown its capability to learn long-range dependencies from sequential data, such as sentences and voices. Until now, no study has applied this approach in binding site inference from massively parallel sequencing data. The successful applications of attention mechanism in similar input contexts motivate us to build and test new methods that can accurately determine the binding sites of transcription factors.ResultsIn this study, we propose a novel tool (named DeepGRN) for transcription factors binding site prediction based on the combination of two components: single attention module and pairwise attention module. The performance of our methods is evaluated on the ENCODE-DREAM in vivo Transcription Factor Binding Site Prediction Challenge datasets. The results show that DeepGRN achieves higher unified scores in 6 of 13 targets than any of the top four methods in the DREAM challenge. We also demonstrate that the attention weights learned by the model are correlated with potential informative inputs, such as DNase-Seq coverage and motifs, which provide possible explanations for the predictive improvements in DeepGRN.ConclusionsDeepGRN can automatically and effectively predict transcription factor binding sites from DNA sequences and DNase-Seq coverage. Furthermore, the visualization techniques we developed for the attention modules help to interpret how critical patterns from different types of input features are recognized by our model.