bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding breast cancer risk factors: is there any mismatch between laywomen perceptions and expert opinions
Authors: Manouchehri E. , Taghipour A. , Ebadi A. , Homaei Shandiz F. , Latifnejad Roudsari R. 
Published: March 2022

AbstractBackgroundWomen’s perception and knowledge of breast cancer signs, symptoms, and risk factors could be conducive to breast cancer risk management and interventions. The present study aimed to explore Iranian laywomen perceptions and expert opinions regarding breast cancer risk factors.MethodsThis qualitative study was conducted from March to November 2019 in Mashhad, northeast of Iran. Through purposive sampling, 24 laywomen (women with and without BC) and 10 experts of different fields including oncology, surgery, gynecology and reproductive health were selected. Data collection was carried out using semi-structured interviews, which was mainly focused on the participants’ understanding and perception of BC risk factors. The data was analyzed utilizing conventional content analysis developed by Graneheim & Lundman. Components of trustworthiness, including credibility, dependability, confirmability, and transferability were considered.ResultsThe main category of risk factors, which emerged from the lay participants’ data analysis, were “unhealthy lifestyle and habits” , “hormonal influences”, “environmental exposures”, “Individual susceptibility “and “belief in supernatural powers”. The experts had similar perspectives for certain risk factors, yet not for all. The category of “Individual history of disease” was emerged only from experts’ interviews.ConclusionIn the present study, the lay participants’ perception concerning BC risk factors was found to be a mixture of cultural beliefs and the scientific knowledge dispersed by the media, internet, and health services. Primary prevention approaches, including awareness of breast cancer risk factors, are required for women to make improved health-related choices.
PARP inhibitors chemopotentiate and synergize with cisplatin to inhibit bladder cancer cell survival and tumor growth
Authors: Bhattacharjee Sayani , Sullivan Matthew J. , Wynn Rebecca R. , Demagall Alex , Hendrix Andrew S. , Sindhwani Puneet , Petros Firas G. , Nadiminty Nagalakshmi 
Published: March 2022

Abstract
Background
Management of bladder cancer (BLCA) has not changed significantly in the past few decades, with platinum agent chemotherapy being used in most cases. Chemotherapy reduces tumor recurrence after resection, but debilitating toxicities render a large percentage of patients ineligible. Recently approved immunotherapy can improve outcomes in only a third of metastatic BLCA patients. Therefore, more options for therapy are needed. In this study, we explored the efficacy of PARP inhibitors (PARPi) as single agents or as combinations with platinum therapy.

Methods
We treated BLCA cells with PARPi (olaparib, niraparib, rucaparib, veliparib, or talazoparib) alone or as the combination of cisplatin with PARPi. We then measured their survival, proliferation, apoptosis, as well as their ability to form colonies. BLCA xenografts in male SCID mice were treated similarly, followed by the assessment of their growth, proliferation, and apoptosis.

Results
PARPi niraparib and talazoparib were effective in reducing BLCA cell survival as single agents. Combinations of Cisplatin with talazoparib and niraparib effectively reduced the survival of BLCA cells, while veliparib was not effective even at high concentrations. In vivo, the combinations of cisplatin with niraparib, rucaparib, or talazoparib reduced BLCA xenograft growth significantly.

Conclusions
We provide evidence that PARPi can be effective against BLCA as single agents or as combinatorial therapy with cisplatin.
Associations between starting and stopping volunteering and physical activity among older adults - longitudinal evidence from the German Ageing Survey
Authors: Baumbach Linda , König Hans-Helmut , Hajek André 
Published: March 2022

Abstract
Background
Physical activity (PA) contributes to healthy aging. Several studies have investigated factors influencing PA. However, population-based studies evaluating associations between volunteering and changes in PA are lacking. Our aim was to clarify whether starting and stopping to volunteer is associated with changes in physical activity in older adults.

Method
We used data from the German Ageing Survey (wave 5 and 6 in the years 2014 and 2017), which is a representative survey of community-dwelling middle-aged and older adults. We included individuals ≥ 65 years (analytical sample: n = 5,682). PA was investigated using questions from the international physical activity questionnaire (IPAQ) and converted into metabolic equivalent of tasks (METs) per week. Changes in volunteering status in groups or organizations (yes/no) and their association with changes in PA were investigated in adjusted asymmetric fixed effects models stratified by sex.

Results
We found an association, between starting to volunteer and increased physical activity in older adults in the total sample (ß = 1,078.93, p = 0.052). This change reached significance for men (ß = 1,751.54, p = 0.016), but not for women (ß = 187.25, p = 0.832) in the stratified analyses. In the total sample, there was no association between stopping volunteering and decreases in PA (ß = -285.61, p = 0.543). This also held true in the stratified analyses for men (ß = -320.76, p = 0.583) and women (ß = -158.96, p = 0.845).

Conclusion
Our study identified an association between beginning to volunteer and increased physical activity among older men. Thus, beginning to volunteer may assist older men in increasing their physical activity levels.
Cross-country evidence on the role of national governance in boosting COVID-19 vaccination
Authors: Aida Takeshi , Shoji Masahiro 
Published: March 2022

Abstract
Background
Frequent mutations of the COVID-19 virus, such as the Delta and Omicron variants, have prolonged the pandemic. Rich countries have approved the booster shots (3rd doses) of vaccine, but this causes further delay of vaccination in developing countries. This raises the risk of further mutations, which may lower the efficacy of currently available vaccines. As herd immunity by universal vaccination is essential to end the pandemic, the COVID-19 Vaccine Global Access (COVAX) facility has been established to provide developing countries with subsidized vaccines. However, a critical issue is that the developing countries also need to effectively deploy vaccines to citizens. Although this argument suggests positive effects of good national governance on vaccination coverage, to the best of our knowledge, there is no cross-country evidence on the role of national governance in increasing the coverage of COVID-19 vaccines among citizens. The goal of this study was to examine the association between the national governance and vaccination coverage among developing countries.

Methods
Using cross-country data, an ordinary least squares regression was conducted to examine the association between the national governance index and three outcomes: (1) the number of days until the administration of the first dose in the country since December 2019, (2) the number of doses per 100 citizens as of the end of July 2021, and (3) the selection of approved vaccine manufacturers. The results were compared between the model including all countries and the model excluding the member countries of Organisation for Economic Co-operation and Development (OECD).

Results
A one standard deviation increase in the national governance index was associated with 9.1 days (95%CI: -15.76, -2.43) earlier administration of vaccines in the country, and a 12.1 dose increase (95%CI: 4.76, 19.34) per 100 citizens. These associations were larger in the non-OECD sample. The results also indicated the role of governance in the selection of the administered vaccines.

Conclusion
The provision of subsidized vaccines alone is not sufficient to control the spread of infection in developing countries; logistical and administrative support should also be offered, especially in countries with poor governance.

Trial registration
Not applicable
Risk factors for reoperation due to periprosthetic joint infection after elective total hip arthroplasty: a study of 35,056 patients using linked data of the Swedish Hip Arthroplasty Registry (SHAR) and Swedish Perioperative Registry (SPOR)
Authors: Qvistgaard Maria , Nåtman Jonatan , Lovebo Jenny , Almerud-Österberg Sofia , Rolfson Ola 
Published: March 2022

Abstract
Background
In Sweden, the incidence of a prosthetic joint infection (PJI) after a planned Total Hip Arthroplasty (THA) is 1.3%, but the worldwide incidence of PJI after THA is unknown. This study explores associations between reoperation due to PJI and potential risk factors.

Methods
Primary elective THA surgery registered in both the Swedish Hip Arthroplasty Registry (SHAR) and the Swedish Perioperative Registry (SPOR) between 1 January 2015 and 31 December 2019 were included in this registry study, resulting in a total study population of 35,056 cases. The outcome variable was reoperation as the result of PJI within a year after surgery. Data were analysed using a multivariable Cox regression model.

Results
Reoperation due to PJI occurred in 460 cases (i.e., 1.3% of the study population). Each year of age increased the risk with 2% (HR 1.02 Cl 1.01, 1.03 P = < 0.001). Compared to men, women had significantly less risk for reoperation (HR 2.17 Cl 1.79, 2.53 P = < 0.001). For patients with obesity (BMI > 30), the risk increased considerably compared to underweight, normal weight, or overweight patients (HR 1.89 Cl 1.43, 2.51 P = < 0.001). The risk also increased by 6% for every 10 min of operative time (HR 1.06 Cl 1.02, 1.09 P = < 0.001). Patients having general anaesthesia had greater risk compared to those with spinal anaesthesia (HR 1.34 Cl 1.04, 1.73 P = 0.024). Finally, a lateral approach showed higher risk of reoperation than a posterior approach (HR 1.43 Cl 1.18, 1.73 P = < 0.001).

Conclusion
Recognition of the several risk factors identified in this study will be important for the perioperative management of patients undergoing THA.
Primary duodenal papilla lymphoma producing obstructive jaundice: a case report
Authors: Wang Jicai , Han Jiantao , Xu Hanbing , Tai Sheng , Xie Xingwang 
Published: March 2022

Abstract
Background
Obstructive jaundice caused by primary duodenal lymphoma is a rare disease.

Case presentation
We reported a 59-year-old man who underwent endoscopic ultrasonography for obstructive jaundice and found a duodenal papilla tumor. Light microscopy revealed a non-Hodgkin's lymphoma. Immunohistochemical staining showed that the tumor was aggressive B-cell lymphoma. We carried out molecular targeted therapy combined with CHOP regimen chemotherapy.

Conclusion
Surgery plays an important role in resolving obstructive jaundice when accurate histological diagnosis cannot be made. After diagnosis, chemotherapy should play a central role in treatment.
A pilot study of endoscope-assisted MITLIF with fluoroscopy-guided technique: intraoperative objective and subjective evaluation of disc space preparation
Authors: Lin Guang-Xun , Chen Chien-Min , Rui Gang , Kim Jin-Sung 
Published: March 2022

Abstract
Background
Adequate discectomy and endplate preparation are extremely crucial steps for spinal interbody fusion. Minimally invasive transforaminal lumbar interbody fusion MITLIF technique is safe and effective. However, concerns exist regarding sufficient disc space preparation from unilateral access. The purpose of this study, was to demonstrate our preliminary experience in objective and subjective evaluation of disc space preparation intraoperatively during endoscope-assisted MITLIF with fluoroscopy-guided, describing some of its possible advantages, and analyzing its safety and feasibility.

Methods
From March 2018 to July 2019, three patients with degenerative spinal stenosis with radiculopathy and instability underwent endoscope-assisted MITLIF with fluoroscopy-guided. Patients’ demographic data, clinical parameters, subsidence, and fusion were collected.

Results
Patients were successfully treated by endoscope-assisted MITLIF with fluoroscopy-guided at single-level or two-level. Symptoms improved postoperatively in all patients, and no complications occurred during follow-up. No cage subsidence was observed. At 6-month postoperatively, there was bony fusion observed on computed tomography in two patients.

Conclusion
Endoscope-assisted MITLIF with fluoroscopy-guided is a safe and feasible technique to improve visualization during discectomy and endplate preparation objectively and subjectively, possibly increasing fusion rate and early time to fusion.
Polyphenols in Ilex latifolia Thunb. inhibit human lung cancer cell line A549 by regulation of the PI3K-Akt signaling pathway
Authors: Chen Jing , Du Yesheng , Long Yanyan , Tao Dan , Hu Mengyu , Jiang Yong , Wan Yue , Yang Dingyi 
Published: March 2022

Abstract
Background
The leaves of the plant Ilex latifolia Thunb. can be made into Kuding tea, which is a drink rich in polyphenols. This study aimed to observe the effect of Ilex latifolia Thunb. polyphenols (ILTPs) on human lung cancer cell line A549 (A549 cells) by regulating the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway.

Methods
In vitro cultured cells were treated with ILTPs; the proliferation of A549 cells and BEAS-2B human normal lung epithelial cells (Beas-2B cells) was observed using the 3-(4,5-dimethylazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and the survival status of A549 cells was observed by fluorescence staining. The expression of A549 cells was observed by quantitative polymerase chain reaction (qPCR) assay and Western blot analysis, while the compound composition of ILTPs was detected using high-performance liquid chromatography (HPLC).

Results
The experimental results showed that the proliferation of Beas-2B cells was unaffected by treatment with 0–500 μg/mL of ILTPs, whereas the decreased proliferation of A549 cells was observed with the increasing concentrations of ILTPs. Additionally, ILTPs elevated the levels of lactate dehydrogenase (LDH) and reactive oxygen species (ROS) and promoted apoptosis in A549 cells. The results of qPCR experiments showed that ILTPs upregulated caspase-9 mRNA expression and downregulated phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), mammalian target of rapamycin (mTOR), B-cell lymphoma-2 (Bcl-2), nuclear factor-κB (NF-κB), vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1 alpha (HIF-1α), and cyclooxygenase-2 (COX-2) expression in A549 cells. The Western blot analysis results also showed that ILTPs could reduce the protein expression of PI3K and Akt. The HPLC results showed that the main compounds present in the ILTPs were rutin, kaempferol, isochlorogenic acid A, isochlorogenic acid B, and isochlorogenic acid C.

Conclusions
Thus, this study indicated that the polyphenols of I. latifolia act as a class of natural functional food materials that potently suppress cancer by exerting their inhibitory effects on A549 cell proliferation through five key polyphenolic compounds.
Educational adaptation to clinical training during the COVID-19 pandemic: a process analysis
Authors: Dzara Kristina , Pusic Martin , Carlile Narath , Krupat Edward , Alexander Erik K. 
Published: March 2022

Abstract
Background
The COVID-19 pandemic is unprecedented in terms of the extent and rapidity of the disruption forced upon formal clinical education, most notably the extensive transition of clinical skills learning to interactive video-based clinical education.

Methods
In a phenomenologic study, we used thematic analysis to explore the COVID-19 disruption to clinical training and understand processes relating to adaptation in a large academic medical center. We conducted semi-structured interviews with 14 clinical teachers and 16 trainees representing all levels of clinical learning. Interviews occurred within the initial three months of the crisis, and data were analyzed following a thematic analysis coding process.

Results
We constructed eight themes synthesizing our participants’ perceptions of the immediate unanticipated disruption, noting in the process their alignment with a change management framework. These included: urgency in adapting, with an obvious imperative for change; overcoming inconsistent involvement and support through the formation of self-organized frontline coalitions; attempts to develop strategy and vision via initially reactive but eventually consistent communication; empowering a volunteer army through co-creation and a flattened hierarchy; and efforts to sustain improvement and positive momentum with celebration of trial, error, and growth. The majority of participants found positive outcomes resulting from the tumultuous change process. Moreover, they were now more readily accepting of change, and tolerant of the ambiguous and iterative nature inherent in the education change process. Many anticipated that some innovation would, or would at least deserve to, continue post- crisis.

Conclusions
The COVID-19 pandemic afforded an opportunity to study the content and process of change during an active crisis. In this case of clinical education, our findings provide insight into the ways an academic medical system adapts to unanticipated circumstances. We found alignment with broader organizational change management models and that, compared with crisis management models (and their shorter term focus on resolving such crises), stakeholders self-organized in a reliable manner that carries the potential advantage of preserving such beneficial change.
Ethical and regulatory implications of the COVID-19 pandemic for the medical devices industry and its representatives
Authors: Blakely Brette , Rogers Wendy , Johnson Jane , Grundy Quinn , Hutchison Katrina , Clay-Williams Robyn , Richards Bernadette , Maddern Guy 
Published: March 2022

AbstractThe development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given the relatively low evidence standards currently required for regulatory approval of devices, this further indefinite reduction in standards raises serious ethical issues. Second, the pandemic has disrupted the usual operations of device representatives in hospitals, providing an opportunity to examine and refine this potentially ethically problematic practice. In this paper we explain and critically analyse the ethical implications of these two pandemic-related impacts on medical devices and propose suggestions for their management. These include an endpoint for pandemic-related adjustments to device regulation or a mechanism for continued refinement over time, together with a review of device research conducted under crisis conditions, support for the removal and replacement of emergency approved devices, and a review of device representative credentialling.
Participatory development of CURA, a clinical ethics support instrument for palliative care
Authors: van Schaik Malene Vera , Pasman H.Roeline , Widdershoven Guy , Metselaar Suzanne 
Published: March 2022

AbstractBackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care.MethodWe used aparticipatory developmentdesign. We worked together with stakeholders in a Community of Practice throughout the study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process.Phase one,Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps.Phase two,Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation.Phase three,Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments.
An exploration of young people’s, parent/carers’, and professionals’ experiences of a voluntary sector organisation operating a Youth Information, Advice, and Counselling (YIAC) model in a disadvantaged area
Authors: Hassan Shaima M. , Worsley Joanne , Nolan Lisa , Fearon Nicky , Ring Adele , Shelton Jane , McEgan David , Yameen Farheen , Khedmati Esmaeil Morasae , Kullu Cecil 
Published: March 2022

AbstractBackgroundThe present evaluation explored young people’s, parents/carers, and healthcare professionals’ perceptions of the Youth Information, Advice and Counselling (YIAC) model operated by a voluntary sector organisation in North West England. With an aim to understand the key components that contribute to enhancing the success of the YIAC model.MethodSemi-structured interviews and focus groups with young people, parents/carers, and healthcare professionals were conducted. Data were analysed using thematic analysis.ResultsFive main themes were identified from the data: 1) Accessibility and flexibility; 2) Non-clinical model and environment; 3) Staff; 4) Partnership working; and 5) Promotion of positive mental health and wellbeing.ConclusionFindings highlight the importance of non-clinical, community-based, ‘one-stop-shop’ hubs for young people in disadvantaged areas. The key components highlighted as facilitating access and engagement include: opportunity to self-refer, choice of location, timely provision of support, non-clinical environment, age appropriate services, a non-hierarchical workforce, inclusive support for family and carers, a focus on wider, often social, issues, and collaboration with partner organisations. These findings suggest that early support hubs for young people’s mental health should have consistent, long-term funding and should exist in every local area.