bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study
Authors: Andersson Ingrid , Eklund Anna Josse , Nilsson Jan , Bååth Carina 
Published: April 2022

Abstract
Background
With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective.

Methods
A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question.

Results
The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual.

Conclusion
Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.
Financial burden of catastrophic health expenditure on households with chronic diseases: financial ratio analysis
Authors: Jung Hyunwoo , Kwon Young Dae , Noh Jin-Won 
Published: April 2022

Abstract
Background
The financial status of households is vulnerable to chronic diseases which entail high medical expenses and income loss. Financial strain can be assessed by four indicators: a household surplus indicator, the liquid asset/debt ratio, a solvency indicator, and a liquidity indicator. We investigated the association between catastrophic health expenditure (CHE) and financial ratio indicators in households with chronic diseases in South Korea.

Methods
This study applied thresholds to the financial ratios to determine the financial strain. We conducted multiple logistic regression analyses to determine whether CHE is associated with financial strain. Furthermore, we analyzed the relationship between CHE and basic financial indicators, absolute finance size, using multiple linear regression.

Results
When CHE occurred, all financial ratio indicators deteriorated. However, this was not due to decreases in the absolute size of wealth and income, but rather the relative balance between finances. In particular, the loss of liquid assets was a major factor in the deterioration. In addition, all types of labor-related income deteriorated; only private transfer income increased.

Conclusions
This study revealed that CHE in households with chronic diseases negatively impacts household finances. It was found that financial coping strategies are only resource consuming.
Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians’ engagement in the research process
Authors: Flenady Tracy , Dwyer Trudy , Kahl Julie , Sobolewska Agnieszka , Reid-Searl Kerry , Signal Tania 
Published: April 2022

Abstract
Background
There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians’ engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme.

Methods
This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed.

Results
The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators’ skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey.

Conclusion
This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians’ engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians’ increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.
Zika virus-induced TNF-α signaling dysregulates expression of neurologic genes associated with psychiatric disorders
Authors: Kung Po-Lun , Chou Tsui-Wen , Lindman Marissa , Chang Nydia P. , Estevez Irving , Buckley Benjamin D. , Atkins Colm , Daniels Brian P. 
Published: April 2022

Abstract
Background
Zika virus (ZIKV) is an emerging flavivirus of global concern. ZIKV infection of the central nervous system has been linked to a variety of clinical syndromes, including microcephaly in fetuses and rare but serious neurologic disease in adults. However, the potential for ZIKV to influence brain physiology and host behavior following apparently mild or subclinical infection is less well understood. Furthermore, though deficits in cognitive function are well-documented after recovery from neuroinvasive viral infection, the potential impact of ZIKV on other host behavioral domains has not been thoroughly explored.

Methods
We used transcriptomic profiling, including unbiased gene ontology enrichment analysis, to assess the impact of ZIKV infection on gene expression in primary cortical neuron cultures. These studies were extended with molecular biological analysis of gene expression and inflammatory cytokine signaling. In vitro observations were further confirmed using established in vivo models of ZIKV infection in immunocompetent hosts.

Results
Transcriptomic profiling of primary neuron cultures following ZIKV infection revealed altered expression of key genes associated with major psychiatric disorders, such as bipolar disorder and schizophrenia. Gene ontology enrichment analysis also revealed significant changes in gene expression associated with fundamental neurobiological processes, including neuronal development, neurotransmission, and others. These alterations to neurologic gene expression were also observed in the brain in vivo using several immunocompetent mouse models of ZIKV infection. Mechanistic studies identified TNF-α signaling via TNFR1 as a major regulatory mechanism controlling ZIKV-induced changes to neurologic gene expression.

Conclusions
Our studies reveal that cell-intrinsic innate immune responses to ZIKV infection profoundly shape neuronal transcriptional profiles, highlighting the need to further explore associations between ZIKV infection and disordered host behavioral states.
Radioiodine treatment outcome by dosimetric parameters and renal function in hyperthyroidism
Authors: Nilsson Joachim N. , Elovsson Rebecca , Thor Daniel , Calissendorff Jan , Ardenfors Oscar 
Published: April 2022

Abstract
Background
Hyperthyroidism has been treated with radioiodine therapy for eight decades, with known benefits and side-effects. No consensus exists on which activity dosage and pre-therapeutic measurements are required for optimal treatment, balancing risk of incomplete response, therapy-induced hypothyroidism and radiation exposure. A retrospective analysis was performed to assess these questions.

Methods
Data was collected on radioiodine treatment outcomes for 904 patients treated for Graves' disease or toxic nodular goitres at our institution during 2016–2020. The prescribed absorbed doses were 120 Gy (Graves’ disease), 200 Gy (toxic multinodular goitre) and 300 Gy (solitary toxic adenoma). Univariate analysis and multivariate regression modelling were used to find factors linked to treatment outcome.

Results
The cure rate of hyperthyroidism after one administration of radioiodine was 79% for Graves' disease, 94% for toxic multinodular goitre and 98% for solitary toxic adenoma. Thyroid mass, uptake and effective half-life were all significantly associated with cure in Graves’ disease, but not in toxic multinodular goitre. The rates of therapy-induced hypothyroidism were 20% and 29% for toxic multinodular goitre and solitary toxic adenoma. Neither the cure rate nor the hypothyroidism rate was found to be superior among patients with individualised effective half-life measurements in toxic nodular goitres. Poor renal function was associated with dubious iodine uptake measurements but was not found to correlate with worse outcome.

Conclusions
Multiple measurements of individual iodine uptake for kinetics estimation may be unnecessary, and a population-based value can be used instead. Patients with renal impairment had similar outcome as other patients, but with a higher risk of dubious uptake measurements.
Effectiveness of modified Buzhong Yiqi decoction in treating myasthenia gravis: study protocol for a series of N-of-1 trials
Authors: Weng Senhui , Li Jinghao , Chen Benshu , He Long , Zhong Zhuotai , Huang Linwen , Zhang Shijing , Liu Fengbin , Jiang Qilong 
Published: April 2022

Abstract
Background
Myasthenia gravis (MG) is an acquired autoimmune disease with high heterogeneity. The disease is chronic, relapsing repeatedly and progressive with acute exacerbation occasionally. Although the treatment of MG has developed, it is still unsatisfactory and has some unexpected side effects. Traditional Chinese medicine (TCM) has shown great potential in MG treatment, including relief of muscle weakness syndrome, improvement of patient’s quality of life, and reduction of side effects of western medicine. The purpose of this study is to evaluate the effectiveness of modified Buzhong Yiqi decoction (MBYD) as an add-on therapy for MG through a small series of N-of-1 trials.

Methods
Single-centre, randomized, double-blind, 3 crossover N-of-1 trials will be conducted to enroll patients with MG diagnosed as spleen-stomach deficiency syndrome or spleen-kidney deficiency syndrome in TCM. Each N-of-1 trial has 3 cycles of two 4-week periods containing the MBYD period and placebo period. The wash-out interval of 1 week is prior to switching each period. Primary outcome: quantitative myasthenia gravis (QMG). Secondary outcomes: the following scales: myasthenia gravis composite (MGC), myasthenia gravis activities of daily living profile (MG-ADL), myasthenia gravis quality of life (MG-QOL); the level of CD4+FoxP3+Treg cells and cytokines (IL-4, IL-17A, INF-γ, TGF-β) in the peripheral blood; the alterations of the composition of gut microbiota; reduction of the side effects of western medicine.

Discussion
Used by WinBUGS software, we will conduct a hierarchical Bayesian statistical method to analyze the efficacy of MBYD in treating MG in individuals and populations. Some confounding variables such as TCM syndrome type and potential carryover effect of TCM will be introduced into the hierarchical Bayesian statistical method to improve the sensitivity and applicability of the trials, and the use of prior available information within the analysis may improve the sensitivity of the results of a series of N-of-1 trials, from both the individual and population level to study the efficacy of TCM syndrome differentiation. We assumed that this study would reveal that MBYD is effective for MG and provide robust evidence of the efficacy of TCM to treat MG.

Trial registration
Chinese Clinical Trial Register, ID: ChiCTR2000040477, registration on 29 November 2020.
Assessing gait, balance, and muscle strength among breast cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): study protocol for a randomized controlled clinical trial
Authors: Teran-Wodzinski Patricia , Haladay Douglas , Vu Tuan , Ji Ming , Coury Jillian , Adams Alana , Schwab Lauren , Visovsky Constance 
Published: April 2022

Abstract
Background
Chemotherapy-induced peripheral neuropathy (CIPN) is a common and understudied consequence of taxane chemotherapy for breast cancer treatment. CIPN symptoms include numbness combined with tingling sensations, persistent shooting, stabbing, or burning pain even in the absence of painful stimuli, lower extremity muscle weakness, and impaired balance. CIPN symptoms often persist for a long time after completion of chemotherapy, causing significant loss of functional abilities and increased risk of falls. Persistent CIPN caused by taxanes represents a therapeutic challenge due to the limited treatment options. Resistance exercise has shown promising results; however, the effect of exercise on CIPN remains understudied. This study aims to assess the effects of exercise on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to an educational attention control condition.

Methods
A sample of 312 women who completed taxane-based chemotherapy for breast cancer and have symptomatic neuropathy is recruited from a community-dwelling sample. Participants are randomized to either a 16-week Home-Based Physical Activity Intervention or an Educational Attention control group. The home-based intervention protocol consists of targeted lower extremity stretches, followed by 10 min each of gait/balance and 10 min of resistive training accessed by hyperlink or DVD. An Exercise Diary records quantitative exercise data. The gait assessment includes temporospatial parameters and lower extremity joint angles using APDM motion sensors. Participants’ balance is assessed using the Sensory Organization Test (SOT) performed using a NeuroCom Balance Master. Isometric strength of hip, knee, and ankle flexor and extensor muscles is assessed using an isokinetic dynamometer, Biodex BX Advantage. In addition, we assess neuropathy symptoms using the FACT-Taxane Additional Concerns Subscale and nerve conduction velocity of the sural and peroneal nerve action potentials. Outcomes are assessed at baseline (prior to randomization) and 16 weeks.

Discussion
There are currently no evidence-based interventions that address the functional declines associated with CIPN. If successful, this program is simple and easy to implement in the standard of care for individuals with CIPN. Gait and balance training have the potential to reduce physical dysfunction associated with CIPN and reduce the burden of disease in cancer survivors.

Trial registration
ClinicalTrials.gov NCT04621721. Registered on August 3, 2020. ClincialTrials.gov is a primary registry of the World Health Organization International Clinical Trials Registry Platform (WHO ICTEP) network and includes all items from the WHO Trial Registration data set in Trial registration.
Conducting a randomised controlled trial of a psychosocial intervention for adolescents with type 1 diabetes during COVID-19: recommendations to overcome the challenges complicated by inconsistent public health guidelines on research
Authors: Pembroke Sinead , Rogerson Shauna , Coyne Imelda 
Published: April 2022

AbstractSince the beginning of the COVID-19 pandemic, there has been very little guidance in Ireland and abroad, around the conduct of research, and randomised controlled trials (RCTs) in particular. This has led to inconsistent interpretations of public health guidelines for the conduct of research in hospitals. Consequently, challenges have arisen for researchers conducting RCTs, in relation to recruitment and retention. These challenges are amplified for RCTs of psychosocial interventions, where communication and physical contact play a major role in administering the RCT. Therefore, learning from other research studies is important. This study addresses the challenges in administering an RCT of a psychosocial intervention in two paediatric outpatient diabetes clinics in Dublin Ireland, including recommendations to overcome these. Recommendations include the following: (1) recognise research as an essential service; (2) hospital management should implement guidelines to ensure a consistent approach to the conduct of research during pandemics; (3) ensure that there is a mechanism for the provision of clear and effective communication before the clinic visit with patients, to reassure them and gain their trust; and (4) trial managers should make time to check in with their team every day, as they would do if they were in the office.
The SPIRIT Checklist—lessons from the experience of SPIRIT protocol editors
Authors: Qureshi Riaz , Gough Alexander , Loudon Kirsty 
Published: April 2022

AbstractCrystal clear RCT protocols are of paramount importance. The reader needs to easily understand the trial methodology and know what is pre-planned. They need to know there are procedures in place if there are, for instance, protocol breaches and protocol amendments are required, there is loss to follow-up and missing data, and how solicited and spontaneous reported adverse events are dealt with. This plan is important for the trial and for the results that will be published when the data is analysed. After all, individuals have consented to participate in these trials, and their time and their well-being matter. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) provides guidance to structure RCT protocols and ensures all essential information is included. But sadly, not all trialists follow the guidance, and sometimes, the information is misunderstood. Using experience peer-reviewing for Trials over the last 2 years, we have prepared information to assist authors, peer reviewers, editors, and other current and future SPIRIT protocol editors to use the SPIRIT guidance and understand its importance.
Propagation characteristics of sporadic E and medium-scale traveling ionospheric disturbances (MSTIDs): statistics using HF Doppler and GPS-TEC data in Japan
Authors: Matsushima Ryo , Hosokawa Keisuke , Sakai Jun , Otsuka Yuichi , Ejiri Mitsumu K. , Nishioka Michi , Tsugawa Takuya 
Published: April 2022

AbstractWe carried out a statistical analysis of the propagation characteristics of Es and Medium-Scale Traveling Ionospheric Disturbances (MSTIDs) by combining data of HF Doppler (HFD) sounder and Total Electron Content (TEC) obtained from the GPS receivers of GEONET (GPS-TEC) for 4 years from 2014 to 2017. We made use of Es reflection data from the HFD receivers in Sugito, Saitama (36.0°N, 139.7°E), Fujisawa, Kanagawa (35.3°N, 139.5°E), and Sugadaira, Nagano (36.4°N, 138.3°E) in Japan. By using this triangle observation, we succeeded in deriving the horizontal speed and direction of the motion of Es. In addition, we estimated the phase velocity of MSTIDs observed in the simultaneously obtained maps of GPS-TEC with the same triangle observation procedure. The speeds of Es and MSTIDs were commonly less than 100 m/s in most cases and their propagation direction was predominantly southwestward. This result is consistent with the statistical characteristics of nighttime MSTIDs observed in the previous studies. More importantly, good correspondence between the propagation characteristics of the two phenomena at two different altitudes confirms that Es and MSTIDs move in tandem with each other, further suggesting that Es in the E region plays an important role in the generation and propagation of MSTIDs in the F region.
Graphical Abstract
Acute aortic thrombosis in the ascending aorta after cisplatin-based chemotherapy for esophageal cancer: a case report
Authors: Sato Noriaki , Mishima Takehito , Okubo Yuka , Okamoto Takeshi , Shiraishi Shuichi , Tsuchida Masanori 
Published: April 2022

Abstract
Background
The risk of thrombus development is considered to be increased by malignant tumors and chemotherapy. In addition, thrombosis of the ascending aorta is rare. We report a case of ascending aortic thrombectomy in a patient with esophageal cancer who developed ascending aortic thrombus after starting neoadjuvant chemotherapy, including operative findings and surgical treatment.

Case presentation
A 63-year-old man with esophageal cancer was administered chemotherapy comprising cisplatin plus 5-fluorouracil. A week after completing 1 cycle of chemotherapy, computed tomography angiography showed acute aortic thrombosis at the ascending aorta. The risk of embolization appeared high because the thrombosis was floating, so we performed emergency ascending aortic thrombectomy. The postoperative course was good and uncomplicated. A month after this surgery, the patient underwent surgery for esophageal cancer. As of 1 year after the cancer surgery, neither cancer nor thrombosis has recurred.

Conclusion
We describe a case of acute aortic thrombosis in the ascending aorta after cisplatin-based chemotherapy, that was treated by aortic thrombectomy. The treatment strategy should depend on thrombus location and the condition of the patient, but surgical treatment should be considered where possible to achieve better prognosis.
Biocontrol mechanisms of endophytic fungi
Authors: Adeleke Bartholomew Saanu , Ayilara Modupe Stella , Akinola Saheed Adekunle , Babalola Olubukola Oluranti 
Published: April 2022

Abstract
Background
Scientific approaches into modern agricultural systems, as opposed to the use of synthetic pesticides in food production, became important by exploring endophytic fungi capable of protecting plants against pathogens for maximum crop productivity.

Main body
Diverse endophytic microbes colonizing the internal tissue of plants exhibit beneficial and pathological effects on plants. The beneficial endophytic fungi assisted plants in the control of pathogenic endophytic fungi in plants due to their ability to directly or indirectly promote plant health. Inefficient agricultural practices and environmental factors contribute to the disease emergence in plants. Endophytic fungi employed diverse mechanisms in phytopathogen control by activating and inducing plant resistance through gene expression, synthesis of fungi-derived metabolite compounds, and hormonal signaling molecules. The mutual coexistence between endophytic fungi and host plants remains an important mechanism in disease suppression. An in-depth understanding and selection of beneficial endophytic fungi and interaction between pathogens and host plants are important in managing challenges associated with the endophyte biocontrol mechanisms.

Conclusion
Research findings on the use of endophytic fungi as bioinoculants are advancing, and understanding endophytic fungi antibiosis action through the synthesis of biocontrol agents (BCAs) can, however, be explored in integrated plant disease management. Therefore, in this review, the biocontrol mechanism of endophytic fungi against plant pathogens was highlighted.