bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘It all depends!’: A qualitative study of preferences for place of care and place of death in terminally ill patients and their family caregivers
Authors: Gerber Katrin , Hayes Barbara , Bryant Christina 
Published: May 2019

Background: It is often suggested that terminally ill patients favour end-of-life care at home. Yet, it is unclear how these preferences are formed, if the process is similar for patients and family caregivers, and if there are discrepancies between preferences for place of care and place of death. Understanding these nuances is essential to support people in their decision-making and ultimately provide better care at the end-of-life. Aim: To gain an in-depth understanding of how terminally ill patients and their family caregivers make decisions about preferred place of care and place of death. Design: Semi-structured interviews with patients and family caregivers, which were analysed thematically using qualitative description. Setting/participants: A total of 17 participants (8 patients and 9 caregivers) recruited from an acute palliative care hospital ward, a sub-acute hospice unit, and a palliative homecare organisation in Melbourne, Australia. Results: The process of forming location preferences was shaped by uncertainty relating to the illness, the caregiver and the services. Patients and caregivers dealt with this uncertainty on a level of thoughts, emotions, and actions. At the end of this process, patients and caregivers expressed their choices as contextual, personal, relational, conditional and flexible preferences. Conclusions: These findings suggest that in many cases end-of-life decision-making does not conclude with a clear and stable choice. Understanding the reasons for the malleability of preferences and the process of how they are formed has implications for both clinicians and researchers.
The Association Between Pregnancy-Specific Anxiety and Exclusive Breastfeeding Status Early in the Postpartum Period
Authors: Horsley Kristin , Nguyen Tuong-Vi , Ditto Blaine , Da Costa Deborah 
Published: May 2019

Background: Exclusive breastfeeding is recommended for the first 6 months of life and has significant benefits for both mother and child. Pregnancy-specific anxiety is a distinct and definable syndrome that has been identified as a robust predictor of pregnancy outcomes, but whether it is associated with exclusive breastfeeding status has not been determined. Research aims: To examine the association between pregnancy-specific anxiety in each trimester of pregnancy and exclusive breastfeeding status early in the postpartum period. Methods: Data were available from 412 women who participated in a longitudinal pregnancy cohort study. Pregnancy-specific anxiety and exclusive breastfeeding status were assessed using an online self-report questionnaire. Results: Logistic regression analyses showed that a one-unit increase in pregnancy-specific anxiety in the first ( OR = 0.94, 95% CI [0.90, 0.98]) and third ( OR = 0.95, 95% CI [0.91, 0.99]) trimester of pregnancy was associated with a 5–6% decrease in the odds of exclusive breastfeeding at 6–8 weeks postpartum. Conclusions: Pregnancy-specific anxiety was associated with lower odds of exclusive breastfeeding at 6–8 weeks postpartum. Prenatal interventions designed to increase exclusive breastfeeding duration may benefit from the incorporation of strategies that help reduce worries and concerns unique to the pregnancy experience.
The Protective Influence of Chondroitin Sulfate, a Component of Human Milk, on Intestinal Bacterial Invasion and Translocation
Authors: Burge Kathryn Y. , Hannah Lindsey , Eckert Jeffrey V. , Gunasekaran Aarthi , Chaaban Hala 
Published: May 2019

Background: Human milk is known to be protective against necrotizing enterocolitis, a devastating intestinal inflammatory disease affecting the preterm population. Although the pathogenesis of necrotizing enterocolitis is yet to be solidified, intestinal integrity dysfunction, bacterial invasion and/or translocation, and inflammation may play important roles. Glycosaminoglycans, compounds naturally prevalent in both human milk and the intestine, are thought to be anti-inflammatory and capable of altering bacterial interactions within the gut. Research aim: In this study, we aimed to evaluate the potential of chondroitin sulfate, the most prominent class of glycosaminoglycans in human milk, to protect against bacterial infection in an intestinal in vitro model. Methods: T84 cell monolayers were treated with chondroitin sulfate and cell viability was assessed across a number of doses. Monolayers were then pretreated with chondroitin sulfate and subsequently challenged with E. coli invasion and translocation to evaluate any protective role of the compound against infection. Tight junction barrier function was assessed by transepithelial electrical resistance, and cytokine levels were evaluated. Results: Chondroitin sulfate at any dose up to 750 μg/ml was not associated with any statistically significant decrease in cell viability. Additionally, chondroitin sulfate at 750 μg/ml was associated with a 75% decrease in both bacterial invasion and translocation compared to control. Conclusions: These data suggest chondroitin sulfate may protect against bacterial infection through a reduction in both invasion and translocation, importantly without attendant reduction in cell viability.
Neurologist Strategies for Optimizing the Parkinson's Disease Clinical Encounter
Authors: Schwartz Rachel , Trivedi Ranak , Gray Caroline , Lorenz Karl A. , Zulman Donna 
Published: May 2019

Objective: For patients with Parkinson's disease (PD), effective communication during neurology encounters is critical to ensuring the treatment plan maximizes quality of life. However, few research studies have engaged neurologists as key experts in identifying opportunities to optimize the clinical encounter. In this study, 16 neurologists from 4 clinic sites participated in hour-long semistructured interviews targeting opportunities to better address patients’ quality of life needs. Main Findings: Neurologists identified opportunities to meet needs across 4 domains: (1) PD patient education materials and self-management tools to facilitate clinical communication; (2) techniques for improving clinical communication, including strategies for eliciting nonmotor symptoms and contextualizing symptoms to better meet patient quality of life needs; (3) addressing system-level barriers, including time constraints and the lack of an identified specialist referral network; and (4) training in how to lead difficult conversations. Principal Conclusions: Neurologists identified specific barriers, and proposed solutions, to improving care delivery for patients with PD. Integrating practice tools to address quality of life needs, training neurologists in communication around end-of-life care, and strengthening referral networks for rehabilitation and psychosocial support hold promise for improving quality of life for patients with PD.
Soluble TNF-R1, VEGF and other cytokines as markers of disease activity in systemic lupus erythematosus and lupus nephritis
Authors: Adhya Z , El Anbari M , Anwar S , Mortimer A , Marr N , Karim M Y 
Published: May 2019

Background Current non-invasive methods of assessing disease activity in systemic lupus erythematosus (SLE) are of limited sensitivity and specificity. Testing includes acute phase markers, autoantibodies and complement levels. Although measurements of dsDNA antibodies and complement C3/C4 levels are routine, they remain of limited value. Improved blood and urine markers may help in early detection of flare, distinction between flare and chronic damage, and monitoring response to therapy. Methods A total of 87 patients with SLE were tested for the following cytokines in serum and urine: monocyte chemoattractant protein 1 (MCP-1), regulated upon activation, normal T cell expressed and secreted (RANTES), soluble tumour necrosis factor receptor 1 (sTNF-R1), interferon-inducible protein 10 (IP-10), monocyte inhibitory protein 1α (MIP-1α) and vascular endothelial growth factor (VEGF). Patients attending the Lupus Unit at St Thomas’ Hospital, London, UK were divided into active lupus nephritis (LN), inactive LN and non-renal SLE groups based on their renal pathology and SLE disease activity index (SLEDAI). Cytokine testing was performed using the FIDIS multiplex bead assay. Results The mean level of serum sTNF-R1 was higher in the active LN group compared with both inactive LN and non-renal SLE groups ( p < 0.001). For urine measurements there were significant differences between active LN and non-renal SLE for VEGF ( p = 0.016), after statistical correction for multiple testing. Both urinary and serum sTNF-R1 and IP-10 levels correlated with SLEDAI scores ( p < 0.001), while serum VEGF correlated weakly with SLEDAI ( p = 0.025). The optimum combination for differentiating active from inactive LN patients was serum VEGF, sTNF-R1, MCP-1 and glomerular filtration rate plus urinary sTNF-R1 and protein-creatinine ratio. Conclusion These results indicate that for active LN, sTNF-R1 could be a useful serum cytokine marker, with potential for VEGF in the urine. This study has confirmed the ability of the multiplex bead technique to detect cytokines in a good analytical range, including very low and high levels, in both serum and urine. Combining serum and urine markers provided additional sensitivity in distinguishing active from inactive LN.
The impact of nurse-led atrial fibrillation clinics on patient and healthcare outcomes: a systematic mixed studies review
Authors: Rush Kathy L , Burton Lindsay , Schaab Kira , Lukey Alexandra 
Published: May 2019

Background: Atrial fibrillation, the most common arrhythmia worldwide, continues to increase as the population ages. Patients with atrial fibrillation, particularly those newly diagnosed or who have multiple comorbidities, have high healthcare utilisation rates. Nurse-led atrial fibrillation clinics have developed to improve care and guidance for atrial fibrillation patients, with the potential to reduce hospital presentations and healthcare utilisation. Atrial fibrillation clinics that provide specialised and patient-centred care have improved patient symptom management, quality of life and reduced healthcare utilisation and costs. Aims: The aim of this study was to provide the first synthesis of evidence for the impact of nurse-led atrial fibrillation clinics on patient, healthcare utilisation, and quality of care outcomes. Methods: This systematic mixed studies review examined citations from three databases: Medline, CINAHL and Embase, using the search terms ‘atrial fibrillation’ and ‘clinic’, and related concepts. Seventeen moderate to high quality articles were selected. Results: Overall, atrial fibrillation clinics were more cost effective, had shorter wait times and reduced hospitalisation and emergency department visits. Symptoms and sinus rhythm restoration were comparable in the nurse-led compared to physician-led cardioversion clinics. Findings related to patient knowledge and patient satisfaction were mixed, while mortality rates were lower, and patient medication adherence was higher in nurse-led atrial fibrillation compared to usual care. Quality of life and guideline adherence was increased in patients receiving nurse-led atrial fibrillation care compared to usual care. Conclusion: Nurse-led clinics improved healthcare, patient and quality care outcomes. Future research might examine the role of technology in delivery of nurse-led clinics in rural/remote areas as well as patient experiences with nurse-led clinics.
Association between spousal diabetes status and diabetic retinopathy in Chinese patients with type 2 diabetes
Authors: Yang Mei , Liu Yu , Wen Cuihong , Wu Beirui , Wan Xu , Luan Wei , Shen Jie , Liu Wei , Ma Jing 
Published: May 2019

Purpose: To evaluate the association between spousal diabetes status and the prevalence of diabetic retinopathy in Chinese patients with type 2 diabetes. Methods: A cross-sectional community-based study was performed in 1510 patients with type 2 diabetes in Shanghai, China. Non-mydriatic digital fundus photography was used to detect diabetic retinopathy. Spousal diabetes status was assessed using a standardised interview questionnaire. Results: The prevalence of diabetic retinopathy was significantly lower in patients who had diabetic spouses, compared with those who did not (20.2% vs 29.1%, p ⩽ 0.01). The fully adjusted odds ratio for diabetic retinopathy in those had diabetic spouses was decreased by 36% (odds ratio = 0.64, 95% confidence interval = 0.42–1.00, p = 0.048). The negative correlation between spousal diabetes status and diabetic retinopathy was presented in patients with the duration of diabetes ⩾ 10 years, those with HbA1c ⩾ 7% and those not using lipid-lowering drugs (odds ratio = 0.31, 95% confidence interval = 0.13–0.74, p = 0.0082; odds ratio = 0.50, 95% confidence interval = 0.27–0.94, p = 0.031; odds ratio = 0.58, 95% confidence interval = 0.37–0.92, p = 0.021, respectively). Conclusion: We demonstrated that spousal diabetes was associated with a lower diabetic retinopathy prevalence in Chinese patients with type 2 diabetes.
Case Series: Allograft Tibiotalocalcaneal Arthrodesis Utilizing Fresh Talus
Authors: Vaughn Joshua , DeFontes Kenneth W. , Keyser Cornelia , Bluman Eric M. , Smith Jeremy T. 
Published: May 2019

Background: Talar body osteonecrosis can be a difficult condition to treat. Recent reports highlight a high rate of failure with the use of femoral head allograft. Additionally, higher rates of failure have been reported in diabetics and smokers. Our institution attempted a novel technique utilizing fresh allograft talus in attempt to improve on a reported 50% nonunion rate. Methods: Five patients who underwent tibiotalocalcaneal (TTC) fusion utilizing fresh talar allograft were clinically and radiographically reviewed to evaluate fusion rates and functional outcomes. Results: Our case series of 5 patients had a 100% union rate, including 2 former smokers and 2 diabetic patients. There were no infections or complications. Functional outcomes also improved in our series of patients postoperatively as noted by their FAAM and SF-36 scores. Conclusion: TTC fusion using fresh allograft talus has a higher union rate than reported with femoral head allograft. This case series requires further study to evaluate whether this technique can be used beyond patients with osteonecrosis of the talus. Level of Evidence: Level IV, case series.
Generation of transgenic zebrafish with 2 populations of RFP- and GFP-labeled thrombocytes: analysis of their lipids
Authors: Fallatah Weam , De Silva Imesha W. , Verbeck Guido F. , Jagadeeswaran Pudur 
Published: May 2019

AbstractZebrafish thrombocytes are similar to mammalian platelets. Mammals have young platelets (also called reticulated platelets) and mature platelets. Likewise, zebrafish have 2 populations of thrombocytes; one is DiI-C18 (DiI)+ (DP), and the other is DiI− (DN). However, the mechanism of selective thrombocyte labeling by DiI is unknown. Furthermore, there is no transgenic zebrafish line where DP and DN thrombocytes are differentially labeled with fluorescent proteins. In this study, we found that Glo fish, in which the myosin light chain 2 promoter drives the rfp gene, have a population of thrombocytes that are red fluorescent protein (RFP) labeled. We also generated transgenic GloFli fish in which DP and DN thrombocytes are labeled with RFP and green fluorescent protein (GFP), respectively. Single-cell lipid analysis showed a twofold increase in phosphatidylethanolamine (PE) and a twofold decrease in phosphatidylcholine (PC) in RFP+ thrombocytes compared with GFP+ thrombocytes, suggesting that lipid composition may be important for DiI differential labeling. Therefore, we tested liposomes prepared with different ratios of PC and PE and observed that liposomes prepared with higher amounts of PE favor DiI labeling, whereas the PC concentration had a modest effect. In liposomes prepared using only PE or PC, increased concentrations of PE resulted in increased DiI binding. These results suggest that because RFP+ thrombocytes have higher PE concentrations, DiI may bind to them efficiently, thus explaining the selective labeling of thrombocytes by DiI. This work also provides GloFli fish that should be useful in understanding the mechanism of thrombocyte maturation.
LncRNA SNHG1 contributes to sorafenib resistance by activating the Akt pathway and is positively regulated by miR-21 in hepatocellular carcinoma cells
Authors: Li Weidong , Dong Xuesong , He Changjun , Tan Gang , Li Ziyi , Zhai Bo , Feng Jing , Jiang Xian , Liu Chang , Jiang Hongchi , Sun Xueying 
Published: May 2019

Abstract
Background
Acquired resistance to sorafenib greatly limits its therapeutic efficiency in the treatment of hepatocellular carcinoma (HCC). Increasing evidence indicates that long noncoding RNAs (lncRNAs) play important roles in the resistance to anti-cancer drugs. The present study aims to explore the involvement of lncRNA SNHG1 (small nucleolar RNA host gene 1) in sorafenib resistance and how SNHG1 is associated with overexpressed microRNA-21 (miR-21) and the activated Akt pathway, which have been demonstrated to mediate this resistance in HCC cells.

Methods
Sorafenib-resistant HCC (SR-HCC) cells were generated and their sorafenib-resistant properties were confirmed by cell viability and apoptosis assays. Potential lncRNAs were screened by using multiple bioinformatics analyses and databases. The expression of genes and proteins was detected by qRT-PCR, Western blot and in situ hybridization. Gene silencing was achieved by specific siRNA or lncRNA Smart Silencer. The effects of anti-SNHG1 were evaluated in vitro and in experimental animals by using quantitative measures of cell proliferation, apoptosis and autophagy. The binding sites of miR-21 and SNHG1 were predicted by using the RNAhybrid algorithm and their interaction was verified by luciferase assays.

Results
The Akt pathway was highly activated by overexpressed miR-21 in SR-HCC cells compared with parental HCC cells. Among ten screened candidates, SNHG1 showed the largest folds of alteration between SR-HCC and parental cells and between vehicle- and sorafenib-treated cells. Overexpressed SNHG1 contributes to sorafenib resistance by activating the Akt pathway via regulating SLC3A2. Depletion of SNHG1 enhanced the efficacy of sorafenib to induce apoptosis and autophagy of SR-HCC cells by inhibiting the activation of Akt pathway. Sorafenib induced translocation of miR-21 to the nucleus, where it promoted the expression of SNHG1, resulting in upregulation of SLC3A2, leading to the activation of Akt pathway. In contrast, SNHG1 was shown to have little effect on the expression of miR-21, which downregulated the expression of PTEN, leading to the activation of the Akt pathway independently of SNHG1.

Conclusions
The present study has demonstrated that lncRNA SNHG1 contributes to sorafenib resistance by activating the Akt pathway and its nuclear expression is promoted by miR-21, whose nuclear translocation is induced by sorafenib. These results indicate that SNHG1 may represent a potentially valuable target for overcoming sorafenib resistance for HCC.
The frequency-domain airborne electromagnetic method with a grounded electrical source
Authors: Lin Jun , Kang Lili , Liu Changsheng , Ren Tongyang , Zhou Haigen , Yao Yao , Yu Shengbao , Liu Teng , Liu Peng , Zhang Ming 
Published: May 2019

For surveys in areas with difficult access, ground-based electromagnetic (EM) systems are difficult to operate, time-consuming, and expensive, whereas airborne EM (AEM) systems are unsafe and uneconomic for small survey areas. We have developed a new frequency-domain airborne electromagnetic (FAEM) system called the ground-airborne frequency-domain EM (GAFEM) system to achieve rapid data acquisition in complex terrains with high safety and low cost. The system consists of a grounded electrical source and an airborne receiver carried by an unmanned rotorcraft. The grounded electrical source transmits a [Formula: see text] pseudorandom series obtaining signals at [Formula: see text] frequencies in one flight, which can maintain the resolution without reducing efficiency. The airborne receiver based on the unmanned rotorcraft makes the system flexible, convenient, and economical to operate in areas with difficult access. The system can conduct surveys in far- and non-far-field regions and can obtain the apparent resistivity to present a quick overview of the subsurface structure. To demonstrate the GAFEM system’s effectiveness and practical detection potential, we have performed two field surveys that revealed the shallow structure with tunnels and the deep structure at source-receiver distances of 3 and 6 km, respectively. The GAFEM system effectively revealed the apparent-resistivity difference with a sufficient investigation depth at large source-receiver distances. Thus, the system can be extended to various important applications for rapid surveys or deep investigations in areas with difficult access.
Adaptive traveltime inversion
Authors: Sun Bingbing , Alkhalifah Tariq 
Published: May 2019

We have developed a method to obtain a misfit function for robust waveform inversion. In this method, called adaptive traveltime inversion (ATI), a matching filter that matches predicted data to measured data is computed. If the velocity model is relatively accurate, the resulting matching filter is close to a Dirac delta function. Its traveltime shift, which characterizes the defocusing of the matching filter, is computed by minimization of the crosscorrelation between a penalty function such as [Formula: see text] and the matching filter. ATI is constructed by minimization of the least-squares errors of the calculated traveltime shift. Further analysis indicates that the resulting traveltime shift corresponds to a first-order moment, the mean value of the resulting matching filter distribution. We extend ATI to a more general misfit function formula by computing different order moment of the resulting matching filter distribution. Choosing the penalty function in adaptive waveform inversion (AWI) as [Formula: see text], the misfit function of AWI is the second-order moment, the variance of the resulting matching filter distribution with zero mean. Because our ATI method is based on a global comparison using deconvolution, such as AWI, it can resolve the “cycle skipping” issue. We evaluate our ATI misfit function and compare it with state-of-the-art options such as least-squares inversion (L2 norm), wave-equation traveltime inversion, and AWI using schematic examples before moving to more complex examples, such as the Marmousi model. For the Marmousi model, starting with a 1D [Formula: see text] model, with data without low frequencies (no energy below 3 Hz), a meaningful estimation of the P-wave velocity model is recovered. Our ATI misfit function (first-order moment) indicates comparable performance with the AWI misfit function (the second-order moment). We also include a real data example from the Gulf of Mexico to demonstrate the effectiveness of our method.
Hebephrenia is dead, long live hebephrenia, or why Hecker and Chaslin were on to something
Authors: Barrera Alvaro , Curwell-Parry Owen , Raphael Marie-Claire 
Published: May 2019

SUMMARYSince its first description in 1863, ‘hebephrenia’ has highlighted a group of patients characterised by an early onset of illness, formal thought disorder, bizarre behaviour and incongruent emotional expression. A proportion of patients with the most severe form of mental illness have a clinical presentation that is best captured by this diagnosis. Here, we outline the construct of hebephrenia and two of its core overlapping constituent parts: bizarre behaviour and the disorganisation dimension. We argue that, despite the removal of hebephrenia (disorganised schizophrenia) from DSM-5, clinicians should consider it as a differential diagnosis, particularly in suspected personality disorder.