bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preemptive analgesic effectiveness of single dose intravenous ibuprofen in infants undergoing cleft palate repair: a randomized controlled trial
Authors: Peng Zhe Zhe , Wang Yan Ting , Zhang Ma Zhong , Zheng Ji Jian , Hu Jie , Zhou Wan Ru , Sun Ying 
Published: October 2021

Abstract
Background
Correction surgery for cleft palate is recommended between 9 and 18 months of age. Patients suffer from acute pain after palatoplasty. Clinicians are hesitant to use opioids for analgesia concerning the potential high risk of respiratory adverse events. Intravenous ibuprofen perhaps be a suitable adjuvant to pain relief. We try to assess whether preoperative administration of intravenous ibuprofen can decrease opioid requirements following cleft palate repair in infants.

Methods
This single center prospective randomized clinical trial was performed from February to April 2021 at Department of Anesthesiology in Shanghai Children’s Medical Center. Forty patients ASA I-II, aged 9–24 months with isolated cleft palate and undergoing palatoplasty were randomized in a 1:1 ratio to receive either a single dose of 10 mg/kg ibuprofen intravenously or normal saline at induction. Children and infants postoperative pain scale (CHIPPS) was used for pain assessment. Those patients CHIPPS pain score equal or higher than 4 received analgesic rescue with titrating intravenous fentanyl 0.5 μg/kg and repeated in 10 min if required. The primary outcome was the amount of postoperative fentanyl used for rescue analgesia in postanesthesia care unit (PACU).

Results
Patients (n = 20 in each group) in IV-Ibuprofen group required less postoperative fentanyl than those in placebo group (p<0.001). There was no significant difference between two groups in first rescue analgesia time (p = 0.079) and surgical blood loss (p = 0.194). No incidence of obvious adverse events had been found within the first 24 h after surgery in both groups.

Conclusions
Preemptive intravenous administration ibuprofen 10 mg/kg at induction had a significant opioid sparing effect in early postoperative period without obvious adverse effects in infants undergoing palatoplasty.

Trial registration
CHICTR, CTR2100043718, 27/02/2021 http://www.chictr.org.cn/showproj.aspx?proj=122187
Subjective burdens among informal caregivers of critically ill patients: a cross-sectional study in rural Shandong, China
Authors: Fu Wenhao , Li Jiajia , Fang Feng , Zhao Dan , Hao Wenting , Li Shixue 
Published: October 2021

Abstract
Background
Informal caregivers are the main source of care for the critically ill, especially after discharge or during the terminal stages at home. However, the concern for informal caregivers is often overshadowed by critically ill patients. The purpose of this study is to determine the influencing factors of the subjective burden of informal caregivers and to seek solutions accordingly.

Methods
Between July and August 2019, a cross-sectional study was conducted in Shandong, China, focusing on family caregivers and critically ill patients. Subjective caregiver burden was measured by the Chinese version of Zarit Burden Interview (ZBI). The stress process model was used to identify conditions relevant to the caregiving burden and to assess their impact on family caregivers.

Results
554 samples were selected for analysis. The average scores of Zarit Caregiver Burden Interview (ZBI) scores in this study was 30.37±19.04 (n=554). ZBI scores of older, less educated, and spouse caregivers were significantly lower (4.12; 95%CI, 0.42 to 7.81; P =0.029). Objective and subjective burdens increased proportionally. Secondary role stress factors included the higher out-of-pocket (OOP) costs of critical diseases and lower household income, both of which increased caregivers’ subjective burdens (1.28; 95%CI, -0.06 to 2.63; p=0.062). Formal medical aid systems played a positive role in reducing subjective caregiving burdens (-7.31; 95%CI, -13.23 to -1.40; p=0.016).

Conclusions
Health policies should address both the direct medical burdens and the intangible psychological burdens of critical diseases.
The dignity of burn patients: a qualitative descriptive study of nurses, family caregivers, and patients
Authors: Tehranineshat Banafsheh , Rakhshan Mahnaz , Torabizadeh Camellia , Fararouei Mohammad , Gillespie Mark 
Published: October 2021

Abstract
Background
As an ethical principle, showing respect for human dignity is a professional duty of all nurses. The aggressive nature of severe burn injuries makes it hard to respect the existential values and dignity of burn patients. However, only a few studies have been conducted on the preservation of the dignity of burn patients. The purpose of this study is to identify and describe burn patients’ dignity as perceived by nurses, family caregivers, and burn patients.

Methods
The present study has a descriptive, qualitative research design. Nurses, family caregivers and patients in the biggest burns hospital in the south of Iran were selected via purposeful sampling from October 2017 to August 2018 (n = 25). Data were collected using semi-structured, in-depth, individual interviews. Thereafter, data analysis was performed through conventional content analysis.

Results
Three main themes were extracted from the information obtained in the interviews: empathic communication, showing respect, and providing comprehensive support.

Conclusion
The care provided to burn patients should be combined with effective communication, spending time with them, and attending to their repetitive requests, so that they can freely express their feelings and concerns. In addition, the patients’ human values and beliefs should be respected and all aspects of their existence should be taken into account to preserve their dignity. Workshops designed based on the findings of the present study can help with improving the quality of burn nursing care.
Exploring utilisation of the allied health assistant workforce in the Victorian health, aged care and disability sectors
Authors: Huglin J. , Whelan L. , McLean S. , Greer K. , Mitchell D. , Downie S. , Farlie M. K. 
Published: October 2021

Abstract
Background
Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. Previous studies have indicated that AHAs may be underutilised in some contexts. This study aims to identify factors contributing to the effective utilisation of AHAs across health, aged care and disability sectors and possible pathway elements that may optimise AHA careers in Victoria.

Methods
Using an interpretive description approach data collection included a workforce survey and semi structured interviews (individual and group). Data analysis included descriptive statistics, independent t-tests and thematic analysis. Participants included allied health assistants, allied health professionals and allied health leaders in the health, aged care or disability sectors; educators, managers or student of allied health assistance training; and consumers of Victorian health, disability or aged care services.

Results
The literature scan identified numerous potential barriers to and enablers of AHA workforce utilisation. A total of 727 participants completed the survey consisting of AHAs (n = 284), AHPs & allied health leaders (n = 443). Thirteen group and 25 individual interviews were conducted with a total of 119 participants. Thematic analysis of the interview data identified four interrelated factors (system, training, individual and workplace) in pre-employment training and workplace environments. These factors were reported to contribute to effective utilisation of the AHA workforce across health, aged care and disability sectors. Study findings were also used to create a conceptual diagram of potential AHA career pathway elements.

Conclusion
This study identified pre-employment and workplace factors which may contribute to the optimal utilisation of the AHA workforce across Victorian health, aged care and disability sectors. Further study is needed to investigate the transferability of these findings to national and global contexts, and testing of the conceptual model.
WEE1 promotes endometriosis via the Wnt/β-catenin signaling pathway
Authors: Shi Liya , Xue Xue , Tian Hui , Ye Hongjuan , Wang Hui , Wang Rongxiang , Liu Yu , Zhang Caixia , Chen Qiuju , Sun Lihua 
Published: October 2021

Abstract
Background
Endometriosis, the presence of active endometrial tissue outside the lining membrane of the uterine cavity, is a common disease in women of childbearing age. The ectopic endometrium has some characteristics of tumor tissue, including invasive and migratory abilities. In addition, endometriosis is associated with inflammation and reduced cellular apoptosis.

Methods
Western blot analysis, qPCR, immunohistochemistry, immunofluorescence microscopy, Transwell assay, wound healing assay, and TUNEL staining.

Results
Interleukin-1β (IL-1β) induced WEE1 expression in endometrial stromal cells (ESCs), suggesting that WEE1 may be upregulated during the endometriosis-induced inflammatory response. Overexpression of WEE1 in cultured ESCs promoted ESC migration while inhibiting apoptosis, whereas WEE1 knockdown reduced ESC migration while promoting apoptosis. Inhibition of WEE1 attenuates fibrosis in ESCs and female C57BL/6 J mice. This pro-fibrotic effect of WEE1 was significantly decreased by treatment with the Wnt/β-catenin inhibitor XAV939, suggesting that WEE1 acts via the Wnt/β-catenin signaling pathway.

Conclusion
Our study demonstrates that WEE1 promotes ESC migration and fibrosis via the Wnt/β-catenin signaling pathway. Thus, WEE1 may serve as a potential therapeutic target for the treatment of endometriosis.
Implantation of an attachment tube preserves knee extension after nonunion of Felix IV fracture: a case report
Authors: Richter Alena , Windhagen Henning , Ettinger Max 
Published: October 2021

Abstract
Background
While commonly utilized to fix tissue and muscles to megaprostheses to restore function and stability after tumor surgery, an attachment tube was used as a synthetic reconstruction of the knee joint’s extension mechanism after nonunion of Felix IV C fracture. Fixation of the tibial fragment, and therefore its osteointegration, is complicated after total knee arthroplasty, causing tibial tubercle dislocation.

Case presentation
A 61-year-old German patient presented to our clinic with Felix IV C fracture, persistent knee pain, and reduced knee extension strength. In this special case, mobilization and reattachment of the tibial tubercle was not possible because of necrosis and underlying tibial component. Therefore, we covered the defect with cement and used an polyethylene terephthalate tube for knee extension system augmentation. Follow-up after 10 months demonstrated a good clinical result.

Conclusion
The management of Felix IV C fractures is complicated by the underlying prosthesis resulting in redislocation of the fragment and persistent symptoms of pain and reduced functionality. We here present a new surgical technique to treat periprosthetic fracture complicated by tibial tubercle dislocation. Good clinical and radiologic results on follow-up after 10 months indicate the use of attachment tubes as a suitable surgical technique to restore knee joint extension and to reduce knee pain after dislocated Felix IV C fracture.
Unfounded claims about productivity beyond density for reindeer pastoralism systems
Authors: Stien Audun , Tveraa Torkild , Ims Rolf Anker , Stien Jennifer , Yoccoz Nigel Gilles 
Published: October 2021

AbstractWe point out problems with the article Productivity beyond density: A critique of management models for reindeer pastoralism in Norway by Marin and co-workers published in Pastoralism in 2020. In our opinion, there are several misleading claims about the governance of the reindeer pastoralist system in Norway, the Røros model for herd management and density dependence in reindeer herds in their article. We point out the errors in their empirical re-evaluation of previous work on the relationship between reindeer densities and the productivity and slaughter weights in herds. These errors have a significant bearing on their conclusions. We agree that weather variability has a substantial impact on reindeer body mass growth, fecundity and survival, but disagree with Marin et al. when they argue that reindeer densities are of minor importance for reindeer productivity and animal welfare.
Responses of soil microbial communities to freeze–thaw cycles in a Chinese temperate forest
Authors: Sang Changpeng , Xia Zongwei , Sun Lifei , Sun Hao , Jiang Ping , Wang Chao , Bai Edith 
Published: October 2021

Abstract
Background
Freeze–thaw events are common in boreal and temperate forest ecosystems and are increasingly influenced by climate warming. Soil microorganisms play an important role in maintaining ecosystem stability, but their responses to freeze–thaw cycles (FTCs) are poorly understood. We conducted a field freeze–thaw experiment in a natural Korean pine and broadleaf mixed forest in the Changbai Mountain Nature Reserve, China, to determine the dynamic responses of soil microbial communities to FTCs.

Results
Bacteria were more sensitive than fungi to FTCs. Fungal biomass, diversity and community composition were not significantly affected by freeze–thaw regardless of the stage. Moderate initial freeze–thaw resulted in increased bacterial biomass, diversity, and copiotrophic taxa abundance. Subsequent FTCs reduced the bacterial biomass and diversity. Compared with the initial FTC, subsequent FTCs exerted an opposite effect on the direction of change in the composition and function of the bacterial community. Soil water content, dissolved organic carbon, ammonium nitrogen, and total dissolved phosphorus were important factors determining bacterial community diversity and composition during FTCs. Moreover, the functional potentials of the microbial community involved in C and N cycling were also affected by FTCs.

Conclusions
Different stages of FTCs have different ecological effects on the soil environment and microbial activities. Soil FTCs changed the soil nutrients and water availability and then mainly influenced bacterial community composition, diversity, and functional potentials, which may disturb C and N states in this temperate forest soil. This study also improves our understanding of microbial communities regulating their ecological functions in response to climate change.
Stigma toward people with COVID-19 among the Lebanese population: a cross-sectional study of correlates and mediating effects
Authors: Haddad Chadia , Bou Malhab Sandrella , Malaeb Diana , Sacre Hala , Saadeh Danielle , Mourtada Vanessa , Salameh Pascale 
Published: October 2021

AbstractIntroductionStigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma.MethodsA cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19.ResultsMore than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta =  −.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score.ConclusionOur main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.
The relative effect of student, family and school-related factors on math achievement by location of the school
Authors: Tomul Ekber , Önder Emine , Taslidere Erdal 
Published: October 2021

AbstractThis study aims to examine the relative effects of student, family and school-related characteristics on 4th grade students’ math achievement according to location of the school in Turkey. The data of 6435 students studying at 260 primary schools were analyzed using TIMSS-2015 database. The dependent variable of the study was students’ math scores and 19 factors constituting the student, family and school-related characteristics were the independent variables. The location of the school was classified as urban, suburban, medium-size city and village. The data was analyzed via single level multiple linear regression. The results revealed that the entire models explained the largest amount of variance (52%) in the schools located in the villages and the least amount of variance (44%) in those located in the urban area. Although all of the student, family and school-related characteristic sets were found to be significantly related with the achievement, the student-related characteristics explained the largest amount of variance in achievement. Students’ confidence in math contributed almost the highest amount of variance, and the early numeracy tasks, absenteeism in school, parents’ highest education level, parents’ highest occupation level, early numeric activities before school explained small amounts of variance in students’ math achievement in the schools of all locations.
PARP Inhibition in Prostate Cancer With Homologous Recombination Repair Alterations
Authors: von Werdt Alexander , Brandt Laura , Schärer Orlando D. , Rubin Mark A. 
Published: October 2021

PURPOSE With the broad use of next-generation sequencing assays, it has become clear that mutations in DNA repair genes are more commonly found than previously reported. In advanced prostate cancer patients with BRCA1/2 or ATM mutations, poly (ADP-ribose) polymerase inhibition (PARPi) causes an increased overall survival advantage compared with patients without these mutations. This review explores the advantages and limitations of PARPi treatment and its use beyond BRCA1/2-altered tumors. Furthermore, it discusses the benefits of current biomarkers and what role functional biomarkers and organoids may play in addressing the involvement of homologous recombination repair mutations in tumor development and progression. METHODS A systematic review was conducted in MEDLINE, National Library of Medicine, and ClinicalTrials.gov to identify studies published between January 1, 2016, and August 31, 2021. The search strategy incorporated terms for PARPi, BRCA, DNA damage, homologous recombination, organoids, patient-derived organoids, biomarker AND prostate cancer, breast cancer, ovarian cancer. RESULTS A total of 261 records remained after duplicate removal, 69 of which were included in the qualitative synthesis. CONCLUSION To improve the outcome of targeted therapy and increase sensitivity of tumor detection, patients should be repeatedly screened for DNA repair gene alterations and biomarkers. Future clinical studies should explore the use of PARPi beyond BRCA1/2 mutations and focus on finding new synthetically lethal interactions.
Long-Term Efficacy of T3 Analogue Triac in Children and Adults With MCT8 Deficiency: A Real-Life Retrospective Cohort Study
Authors: van Geest Ferdy S , Groeneweg Stefan , van den Akker Erica L T , Bacos Iuliu , Barca Diana , van den Berg Sjoerd A A , Bertini Enrico , Brunner Doris , Brunetti-Pierri Nicola , Cappa Marco , Cappuccio Gerarda , Chatterjee Krishna , Chesover Alexander D , Christian Peter , Coutant Régis , Craiu Dana , Crock Patricia , Dewey Cheyenne , Dica Alice , Dimitri Paul , Dubey Rachana , Enderli Anina , Fairchild Jan , Gallichan Jonathan , Garibaldi Luigi R , George Belinda , Hackenberg Annette , Heinrich Bianka , Huynh Tony , Kłosowska Anna , Lawson-Yuen Amy , Linder-Lucht Michaela , Lyons Greta , Monti Lora Felipe , Moran Carla , Müller Katalin E , Paone Laura , Paul Praveen G , Polak Michel , Porta Francesco , Reinauer Christina , de Rijke Yolanda B , Seckold Rowen , Menevşe Tuba Seven , Simm Peter , Simon Anna , Spada Marco , Stoupa Athanasia , Szeifert Lilla , Tonduti Davide , van Toor Hans , Turan Serap , Vanderniet Joel , de Waart Monique , van der Wal Ronald , van der Walt Adri , van Wermeskerken Anne-Marie , Wierzba Jolanta , Zibordi Federica , Zung Amnon , Peeters Robin P , Visser W Edward 
Published: October 2021

AbstractContextPatients with mutations in thyroid hormone transporter MCT8 have developmental delay and chronic thyrotoxicosis associated with being underweight and having cardiovascular dysfunction.ObjectiveOur previous trial showed improvement of key clinical and biochemical features during 1-year treatment with the T3 analogue Triac, but long-term follow-up data are needed.MethodsIn this real-life retrospective cohort study, we investigated the efficacy of Triac in MCT8-deficient patients in 33 sites. The primary endpoint was change in serum T3 concentrations from baseline to last available measurement. Secondary endpoints were changes in other thyroid parameters, anthropometric parameters, heart rate, and biochemical markers of thyroid hormone action.ResultsFrom October 15, 2014 to January 1, 2021, 67 patients (median baseline age 4.6 years; range, 0.5-66) were treated up to 6 years (median 2.2 years; range, 0.2-6.2). Mean T3 concentrations decreased from 4.58 (SD 1.11) to 1.66 (0.69) nmol/L (mean decrease 2.92 nmol/L; 95% CI, 2.61-3.23; P &lt; 0.0001; target 1.4-2.5 nmol/L). Body-weight-for-age exceeded that of untreated historical controls (mean difference 0.72 SD; 95% CI, 0.36-1.09; P = 0.0002). Heart-rate-for-age decreased (mean difference 0.64 SD; 95% CI, 0.29-0.98; P = 0.0005). SHBG concentrations decreased from 245 (99) to 209 (92) nmol/L (mean decrease 36 nmol/L; 95% CI, 16-57; P = 0.0008). Mean creatinine concentrations increased from 32 (11) to 39 (13) µmol/L (mean increase 7 µmol/L; 95% CI, 6-9; P &lt; 0.0001). Mean creatine kinase concentrations did not significantly change. No drug-related severe adverse events were reported.ConclusionsKey features were sustainably alleviated in patients with MCT8 deficiency across all ages, highlighting the real-life potential of Triac for MCT8 deficiency.