bluuebunny/crossref_metadata_2025_split huggingface dataset:
An integrative review to identify how nurses practicing in inpatient specialist palliative care units uphold the values of nursing
Authors: Moran Sue , Bailey Maria , Doody Owen 
Published: July 2021

Abstract
Background
Caring for individuals and their families with a life-limiting, symptomatic illness and those who are dying has long been an integral role of palliative care nurses. Yet, over the last two decades, the specialty of palliative care has undergone significant changes in technology and medical treatments which have altered both the disease trajectory and the delivery of palliative care. To date, there is little evidence as to the impact of these medical and nursing advancements on the role of nurses working in palliative care and how in clinical practice these nurses continue to uphold their nursing values and the philosophy of palliative care.

Methods
An integrative review was conducted searching seven academic databases from the time period of January 2010 – December 2019 for studies identifying research relating to the role of the palliative care nurse working in specialist palliative care units and hospices. Research articles identified were screened against the inclusion criteria. Data extraction was completed on all included studies and the Crowe Critical Appraisal Tool was utilized to appraise the methodological quality and thematic analysis was performed guided by Braun and Clarke’s framework. The review was conducted and reported in lines with PRISMA guidelines.

Results
The search yielded 22,828 articles of which 7 were included for appraisal and review. Four themes were identified: (1) enhancing patient-centred care (2) being there (3) exposure to suffering and death (4) nursing values seen but not heard. The findings highlight that while palliative care nurses do not articulate their nurse values, their actions and behaviors evident within the literature demonstrate care, compassion, and commitment.

Conclusion
These findings suggest that there is a need for nurses working in specialist palliative care units to articulate, document, and audit how they incorporate the values of nursing into their practice. This is pivotal not only for the future of palliative nursing within hospice and specialist palliative care units but also to the future of palliative care itself. To make visible the values of nursing further practice-based education and research is required.
Risk factors for radiation-induced lung injury in patients with advanced non-small cell lung cancer: implication for treatment strategies
Authors: Sha Sha , Dong Jigang , Wang Maoyu , Chen Ziyu , Gao Peng 
Published: July 2021

Abstract
Background
The radiation-induced lung injury (RILI) in patients with advanced non-small cell lung cancer (NSCLS) is very common in clinical settings; we aimed to evaluate the risk factors of RILI in NSCLS patients, to provide insights into the treatment of NSCLS.

Methods
NSCLC patients undergoing three-dimensional conformal radiotherapy (3D-CRT) in our hospital from June 1, 2018, to June 30, 2020, were included. The characteristics and treatments of RILI and non-RILI patients were analyzed. Logistic regression analyses were conducted to assess the risk factors of RILI in patients with NSCLC.

Results
A total of 126 NSCLC patients were included; the incidence of RILI in NSCLC patients was 35.71%. There were significant differences in diabetes, smoke, chronic obstructive pulmonary disease (COPD), concurrent chemotherapy, radiotherapy dose, and planning target volume (PTV) between the RILI group and the non-RILI group (all P < 0.05). Logistic regression analyses indicated that diabetes (OR 3.076, 95%CI 1.442~5.304), smoke (OR 2.745, 95%CI 1.288~4.613), COPD (OR 3.949, 95%CI 1.067~5.733), concurrent chemotherapy (OR 2.072, 95%CI 1.121~3.498), radiotherapy dose ≥ 60 Gy (OR 3.841, 95%CI 1.932~5.362), and PTV ≥ 396 (OR 1.247, 95%CI 1.107~1.746) were the independent risk factors of RILI in patients with NSCLC (all P < 0.05).

Conclusions
RILI is commonly seen in NSCLS patients; early targeted measures are warranted for patients with those risk factors; future studies with larger sample sizes and different areas are needed to further elucidate the influencing factors of RILI in the treatment of NSCLS.
Molecular characteristics and clinical outcomes of complex ALK rearrangements identified by next-generation sequencing in non-small cell lung cancers
Authors: Xia Peiyi , Zhang Lan , Li Pan , Liu Enjie , Li Wencai , Zhang Jianying , Li Hui , Su Xiaoxing , Jiang Guozhong 
Published: July 2021

Abstract
Background
Complex kinase rearrangement, a mutational process involving one or two chromosomes with clustered rearrangement breakpoints, interferes with the accurate detection of kinase fusions by DNA-based next-generation sequencing (NGS). We investigated the characteristics of complex ALK rearrangements in non-small cell lung cancers using multiple molecular tests.

Methods
Samples of non-small cell lung cancer patients were analyzed by targeted-capture DNA-based NGS with probes tilling the selected intronic regions of fusion partner genes, RNA-based NGS, RT-PCR, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH).

Results
In a large cohort of 6576 non-small cell lung cancer patients, 343 (5.2%) cases harboring ALK rearrangements were identified. Fourteen cases with complex ALK rearrangements were identified by DNA-based NGS and classified into three types by integrating various genomic features, including intergenic (n = 3), intragenic (n = 5) and “bridge joint” rearrangements (n = 6). All thirteen cases with sufficient samples actually expressed canonical EML4-ALK fusion transcripts confirmed by RNA-based NGS. Besides, positive ALK IHC was detected in 13 of 13 cases, and 9 of 11 cases were positive in FISH testing. Patients with complex ALK rearrangements who received ALK inhibitors treatment (n = 6), showed no difference in progression-free survival (PFS) compared with patients with canonical ALK fusions n = 36, P = 0.9291).

Conclusions
This study firstly reveals the molecular characteristics and clinical outcomes of complex ALK rearrangements in NSCLC, sensitive to ALK inhibitors treatment, and highlights the importance of utilizing probes tilling the selected intronic regions of fusion partner genes in DNA-based NGS for accurate fusion detection. RNA and protein level assay may be critical in validating the function of complex ALK rearrangements in clinical practice for optimal treatment decision.
Identification of hub genes in rheumatoid arthritis through an integrated bioinformatics approach
Authors: Wu Rui , Long Li , Zhou Qiao , Su Jiang , Su Wei , Zhu Jing 
Published: July 2021

Abstract
Background
Rheumatoid arthritis (RA) is a common chronic autoimmune disease characterized by inflammation of the synovial membrane. However, the etiology and underlying molecular events of RA are unclear. Here, we applied bioinformatics analysis to identify the key genes involved in RA.

Methods
GSE77298 was downloaded from the Gene Expression Omnibus (GEO) database. We used the R software screen the differentially expressed genes (DEGs). Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway were analyzed by using the DAVID online tool. The STRING database was used to analyze the interaction of differentially encoded proteins. PPI interaction network was divided into subnetworks using MCODE algorithm and was analyzed using Cytoscape. Gene set enrichment analysis (GSEA) was performed to identify relevant biological functions. qRT-PCR analysis was also performed to verify the expression of identified hub DEGs.

Results
A total of 4062 differentially expressed genes were selected, including 1847 upregulated genes and 2215 downregulated genes. In the biological process, DEGs were mainly concentrated in the fields of muscle filament sliding, muscle contraction, intracellular signal transduction, cardiac muscle contraction, signal transduction, and skeletal muscle tissue development. In the cellular components, DEGs were mainly concentrated in the parts of cytosol, Z disk, membrane, extracellular exosome, mitochondrion, and M band. In molecular functions, DEGs were mainly concentrated in protein binding, structural constituent of muscle, actin binding, and actin filament binding. KEGG pathway analysis shows that DEGs mainly focuses on pathways about lysosome, Wnt/β-catenin signaling pathway, and NF-κB signaling pathway. CXCR3, GNB4, and CXCL16 were identified as the core genes that involved in the progression of RA. By qRT-PCR analysis, we found that CXCR3, GNB4, and CXCL16 were significantly upregulated in RA tissue as compared to healthy controls.

Conclusion
In conclusion, DEGs and hub genes identified in the present study help us understand the molecular mechanisms underlying the progression of RA, and provide candidate targets for diagnosis and treatment of RA.
In vivo and in vitro mutagenicity of perillaldehyde and cinnamaldehyde
Authors: Honma Masamitsu , Yamada Masami , Yasui Manabu , Horibata Katsuyoshi , Sugiyama Kei-ichi , Masumura Kenichi 
Published: July 2021

Abstract
Background
Perillaldehyde and cinnamaldehyde are natural substances found in plants that are used as flavoring ingredients. Due to the α,β-unsaturated aldehydes in their structures, these compounds are expected to be DNA reactive. Indeed, several reports have indicated that perillaldehyde and cinnamaldehyde show positive in in vitro and in vivo genotoxicity tests. However, their genotoxic potentials are currently disputed. To clarify the mutagenicity of perillaldehyde and cinnamaldehyde, we conducted in silico quantitative structure–activity relationship (QSAR) analysis, in vitro Ames tests, and in vivo transgenic rodent gene mutation (TGR) assays.

Results
In Ames tests, perillaldehyde was negative and cinnamaldehyde was positive; these respective results were supported by QSAR analysis. In TGR assays, we treated Muta™ Mice with perillaldehyde and gpt-delta mice with cinnamaldehyde up to the maximum tested doses (1000 mg/kg/day). There was no increase in gene mutations in the liver, glandular stomach, or small intestine following all treatments except the positive control (N-ethyl-N-nitrosourea at 100 mg/kg/day).

Conclusions
These data clearly show no evidence of in vivo mutagenic potentials of perillaldehyde and cinnamaldehyde (administered up to 1000 mg/kg/day) in mice; however, cinnamaldehyde is mutagenic in vitro.
Impact of lung-RADS classification system on the accurate diagnosis of pulmonary nodular lesions in oncology patients
Authors: Ahmed Hoda Abdel Kareem , FarghalyAmin Mohamed 
Published: July 2021

Abstract
Background
Lung assessment is highly recommended in the management of oncology patients as it is the commonest affected site in metastatic dissemination. The low-dose CT with nodule reporting system based on Lung Reporting and Data System (lung-RADS) is a promising non-invasive tool for the characterization of incidentally detected pulmonary nodules. The authors aimed to assess the accuracy of the “lung-RADS” classification system as a non-invasive tool for the characterization of any newly developed pulmonary nodules among oncology patients. Ethics committee approval and informed written consent were obtained from the studied patients. A non-contrast LDCT study was performed on all patients with a nodule reporting system based on the lung-RADS classification system applied for evaluation of each detected pulmonary nodule. Diagnoses were established using the help of either histopathology or follow-up clinical results as a gold standard.

Results
In this prospective study, we enrolled 187 known malignancy patients with 200 suspicious newly developed pulmonary nodules. Their mean patient age was 48.4 ± 9.7 years. The studied 200 pulmonary nodular lesions were categorized using a nodule reporting system based on the lung-RADS into 6 sub-groups with 122 lesions found to be malignant and 78 lesions were of benign etiology, which showed a high sensitivity of 92.08%, specificity of 78.79%, and accuracy of 85.50% with 81.58% positive predictive value and 90.70% negative predictive value in the diagnosis of pulmonary nodules in cancer patients.

Conclusion
Low-density CT with a nodule reporting system based on the lung-RADS classification system was found to be an accurate non-invasive tool to characterize and to risk stratify pulmonary nodules in oncology patients.
Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults
Authors: Van Ginderdeuren Eva , Bassett Jean , Hanrahan Colleen F. , Van Rie Annelies 
Published: July 2021

Background
The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease.

Methods
At a primary care clinic in Johannesburg, a differential white blood cell count and TST was performed in adults starting antiretroviral treatment (ART) without symptoms suggestive of active TB.

Results
Of 259 participants, 171 had valid results of whom 30% (51/171) were TST positive and the median MLR was 0.18 (IQR 0.13–0.28). The MLR distribution differed between CD4 count categories (p < 0.01), with a broader range of values in TST negative participants with a low CD4 count (≤ 250 cells/mm3), likely reflecting HIV immunosuppression. MLR was associated with a positive TST (OR 0.78 per 0.1 increase, 95% CI 0.59, 0.97) in bivariate analysis but not in multivariate regression analysis (aOR 0.83 for every 0.1 increase, 95% CI 0.60, 1.08).

Conclusion
In ART-naïve adults without symptoms suggestive of active TB, MLR was not independently associated with TST positivity and is thus unlikely to be a useful alternative to TST. Future research should focus on development of a cheap, simple and accurate biomarker to identify those people benefiting most from preventive TB therapy.
Ethical and practical considerations for interventional HIV cure-related research at the end-of-life: A qualitative study with key stakeholders in the United States
Authors: Kanazawa John , Gianella Sara , Concha-Garcia Susanna , Taylor Jeff , Kaytes Andy , Christensen Christopher , Patel Hursch , Ndukwe Samuel , Rawlings Stephen , Hendrickx Steven , Little Susan , Brown Brandon , Smith Davey , Dubé Karine 
Published: July 2021

Background
A unique window of opportunity currently exists to generate ethical and practical considerations presented by interventional HIV cure-related research at the end-of-life (EOL). Because participants would enroll in these studies for almost completely altruistic reasons, they are owed the highest ethical standards, safeguards, and protections. This qualitative empirical ethics study sought to identify ethical and practical considerations for interventional HIV cure-related research at the EOL.

Methods and findings
We conducted 20 in-depth interviews and three virtual focus groups (N = 36) with four key stakeholder groups in the United States: 1) bioethicists, 2) people with HIV, 3) HIV care providers, and 4) HIV cure researchers. This study produced six key themes to guide the ethical implementation of interventional HIV cure-related research at the EOL: 1) all stakeholder groups supported this research conditioned upon a clearly delineated respect for participant contribution and autonomy, participant understanding and comprehension of the risks associated with the specific intervention(s) to be tested, and broad community support for testing of the proposed intervention(s); 2) to ensure acceptable benefit-risk profiles, researchers should focus on limiting the risks of unintended effects and minimizing undue pain and suffering at the EOL; 3) only well-vetted interventions that are supported by solid pre-clinical data should be tested in the EOL translational research model; 4) the informed consent process must be robust and include process consent; 5) research protocols should be flexible and adopt a patient/participant centered approach to minimize burdens and ensure their overall comfort and safety; and 6) a participant’s next-of-kin/loved ones should be a major focus of EOL research but only if the participant consents to such involvement.

Conclusions
To our knowledge, this empirical ethics study generated the first ethical and practical considerations for interventional HIV cure-related research at the EOL. The ethical complexities of such research must be considered now. We must navigate this ethical conundrum so that we are good stewards of the participants’ extremely altruistic gifts by maximizing the impact and social value of this research. We hope that this study will serve as the foundation for future research and discussion on this topic.
The patient satisfaction in primary care consultation—Questionnaire (PiC): An instrument to assess the impact of patient-centred communication on patient satisfaction
Authors: Stark Stefanie , Worm Lukas , Kluge Marie , Roos Marco , Burggraf Larissa 
Published: July 2021

Background
Primary care consultation is significantly influenced by communication between the General Practitioner (GP) and their patients. Hypothesising that patient satisfaction can be tested based on an expectation-experience comparison, the aim of this article is to discuss the influence of communication on patient satisfaction.

Methods
A standardised questionnaire was developed striving for a universal primary care survey tool that focuses on patient satisfaction in the context of patient-centred-communication. The sample consisted of 14 German GPs with 80 patients each (n = 1120). Due to the inclusion in an overarching cluster-randomised-study (CRT), the medical practices to be examined were divided into intervention and control groups. The intervention was developed as a reflective training on patient-centred communication.

Results
The results in the present sample show no correlation between patient-centred-communication and patient satisfaction. There are also no significant differences between the intervention and control group.

Discussion
The results raise the question to what extent patient satisfaction can be shaped significantly through patient-centred-communication. The presented project represents part of the basic research in general medical care research and contributes to the transparent processing of theoretical assumptions. With the results described here, communication models with a focus on patient centredness can be evaluated with regard to their practical relevance and transferability.
Improved DEMATEL-ISM integration approach for complex systems
Authors: Chen Jih-Kuang 
Published: July 2021

Purpose
Decision Making Trial and Evaluation Laboratory (DEMATEL) and Interpretive Structural Modeling (ISM) are commonly used separately, but also may be combined per their common characteristics to identify causal relationships and hierarchical structure among factors in complex systems with a relatively small computational burden. The purpose of this study is to establish an improved DEMATEL-ISM integration approach to remedy the disadvantages of the traditional DEMATEL-ISM integration method. A case study was conducted to compare the proposed improved integration approach against the traditional integration method, and to validate its feasibility and effectiveness.

Methods
The proposed improved DEMATEL-ISM integration approach has two main parts: a threshold determination via maximum mean de-entropy (MMDE) method and an additional transitivity check process. The factors influencing China’s rural-urban floating population’s willingness to participate in social insurance was analyzed as a case study.

Results
The traditional and improved methods show notable differences in the hierarchical factor structure and the inner influence relationship among factors that they respectively reveal. The traditional integration approach results in some irrationality, while the improved approach does not.

Originality
This study confirms the importance of proper threshold determination and reachability matrix transitivity checking during DEMATEL-ISM integration. The improved approach includes a scientific threshold determination method based on the MMDE method, plus a transitivity check of the reachability matrix with necessary corrections to ensure its soundness. It can be straightforwardly operated at a relatively low computational burden while providing accurate analysis results.
Infection control, occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers from variants of concern: A 14-month observational study using surveillance data
Authors: Yassi Annalee , Grant Jennifer M. , Lockhart Karen , Barker Stephen , Sprague Stacy , Okpani Arnold I. , Wong Titus , Daly Patricia , Henderson William , Lubin Stan , Kim Sing Chad 
Published: July 2021

Background
We evaluated measures to protect healthcare workers (HCWs) in Vancouver, Canada, where variants of concern (VOC) went from <1% VOC in February 2021 to >92% in mid-May. Canada has amongst the longest periods between vaccine doses worldwide, despite Vancouver having the highest P.1 variant rate outside Brazil.

Methods
With surveillance data since the pandemic began, we tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates, and vaccine uptake in all 25,558 HCWs in Vancouver Coastal Health, by occupation and subsector, and compared to the general population. Cox regression modelling adjusted for age and calendar-time calculated vaccine effectiveness (VE) against SARS-CoV-2 in fully vaccinated (≥ 7 days post-second dose), partially vaccinated infection (after 14 days) and unvaccinated HCWs; we also compared with unvaccinated community members of the same age-range.

Findings
Only 3.3% of our HCWs became infected, mirroring community rates, with peak positivity of 9.1%, compared to 11.8% in the community. As vaccine coverage increased, SARS-CoV-2 infections declined significantly in HCWs, despite a surge with predominantly VOC; unvaccinated HCWs had an infection rate of 1.3/10,000 person-days compared to 0.89 for HCWs post first dose, and 0.30 for fully vaccinated HCWs. VE compared to unvaccinated HCWs was 37.2% (95% CI: 16.6–52.7%) 14 days post-first dose, 79.2% (CI: 64.6–87.8%) 7 days post-second dose; one dose provided significant protection against infection until at least day 42. Compared with community infection rates, VE after one dose was 54.7% (CI: 44.8–62.9%); and 84.8% (CI: 75.2–90.7%) when fully vaccinated.

Interpretation
Rigorous droplet-contact precautions with N95s for aerosol-generating procedures are effective in preventing occupational infection in HCWs, with one dose of mRNA vaccination further reducing infection risk despite VOC and transmissibility concerns. Delaying second doses to allow more widespread vaccination against severe disease, with strict public health, occupational health and infection control measures, has been effective in protecting the healthcare workforce.
Reinigungsarbeit zwischen Professionalisierung und ökonomischem Druck
Authors: Clement Ute , Yalçın Serhat 
Published: July 2021

Zusammenfassung
Betrachtet man die Beschäftigtenzahlen, so ist die Gebäudereinigung mit fast 700.000 Beschäftigten das größte Handwerk Deutschlands. Auch deshalb ist die Frage, welche Chance Professionalisierungsbestrebungen in diesem Bereich haben, von hoher Bedeutung. Als Zwischenergebnis unseres Forschungsprojekts „Arbeitsfelder der Ankunft“ (gefördert von der Hans-BöcklerStiftung) beschreiben wir sektorale Veränderungen und kontrastieren sie mit zentralen Merkmalen der Beruflichkeit, um zu zeigen, wie Liberalisierungstendenzen im Handwerk, hoher Kostendruck und Schwächen hinsichtlich des beruflichen Selbstverständnisses Professionalisierungsprozesse behindern.