bluuebunny/crossref_metadata_2025_split huggingface dataset:
The perspectives of family caregivers of people with Alzheimer´s disease regarding advance care planning in China: a qualitative research
Authors: Chen Linghui , Yin Guo , Lin Siting , Li Yuanxia 
Published: July 2022

AbstractObjectivesAdvance care planning (ACP) enables people to define goals and preferences for future medical treatment and care. Despite universal recognition of the importance of ACP for people with Alzheimer´s disease (AD) internationally, there is little support for its implementation in China. The viewpoint of family caregivers is crucial in making clinical decisions about AD. Therefore, it’s critical to understand the family caregivers’ perspectives on ACP in order to promote its practice among people with AD in China.MethodsSeventeen family caregivers of people with AD were purposively selected in three communities in Guangzhou. Semi-structured interviews were conducted to collect data and the data were analyzed using the thematic analysis.ResultsThree main themes were extracted: ①Attitudes toward ACP including positive and negative attitudes; ②Social pressure influencing ACP decision; ③Behavioral willingness of the implementation of ACP.ConclusionsAttitudes, social pressure, and behavioral willingness characterized the behavioral intentions of family caregivers of people with Alzheimer’s disease. It is recommended to strengthen efforts to publicity of advance care planning and promote legislation in China.
Inequality in health opportunities in Indonesia: long-term influence of early-life circumstances on health
Authors: Aizawa Toshiaki 
Published: July 2022

Abstract
Background
This study explores inequality of opportunity in terms of the health of adult Indonesian people, associated with household and parental circumstances in childhood and adolescence.

Methods
Exploiting the longitudinal nature of the Indonesian Family Life Survey, this study measures inequalities relating to being underweight, overweight, hypertensive and diabetic across adult Indonesians aged between 20 and 35 through the dissimilarity index. This study explores their determinants by decomposing the observed inequality levels into contributing factors. Moreover, this study sheds light on the underlying mechanisms through which early-life circumstances influence the health of grown-up respondents, by estimating the intermediate effects of early-life circumstances on current lifestyles.

Results
For all health conditions, health risks are unequally distributed (all p<0.01). Demographic factors and parental health are major contributors to inequalities relating to being underweight, overweight and hypertensive. Family structure and parental occupation are major contributors to inequality in diabetes. The greater part of this inequality is explained by the indirect pathways through which early-life circumstances mediate current diet and exercise habits.

Conclusions
The results suggest that such interventions that compensate for disadvantaged early-life circumstances would be essential in reducing future health risks and mitigating health inequality.
Safety and feasibility of the transoral endoscopic thyroidectomy vestibular approach with neuroprotection techniques for papillary thyroid carcinoma
Authors: Chen Zhen-Xin , Song Ya-Min , Chen Jing-Bao , Zhang Xiao-Bo , Pang Feng-Shun , Lin Zhan-Hong , Yang Li-Ming , Cai Bei-Yuan , Qin You 
Published: July 2022

Abstract
Background
This study aimed to evaluate the feasibility and safety of the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) with neuroprotection techniques for the surgical management of papillary thyroid carcinoma (PTC).

Methods
Patients with PTC who underwent TOETVA between December 2016 and July 2020 were included in this study, and their relevant clinical characteristics, operational details, and surgical outcomes were reviewed and extracted from their medical records for further analysis.

Results
A total of 75 patients successfully underwent TOETVA with zero conversions. Unilateral lobectomy with isthmectomy and total thyroidectomy were completed for 58 and 17 patients, respectively, all using our unique neuroprotective procedure and ipsilateral central neck dissection (CND). The mean number of retrieved lymph nodes versus positive lymph nodes was 6.8 ± 3.7 vs. 1.5 ± 2.3. Postoperative complications included three cases of transient superior laryngeal nerve (SLN) palsy (4.0%), five cases of transient recurrent laryngeal nerve (RLN) palsy (6.7%), 14 cases of transient hypoparathyroidism (18.7%), two cases of numb chin (2.7%) and two cases of flap perforation (2.7%). The follow-up period for patients with PTC lasted for 15.6 ± 10.9 months, during which no other complications or tumor recurrence were observed.

Conclusion
TOETVA can be safely performed for patients with PTC with satisfactory results during the short-term follow-up period. Our neuroprotection techniques can be integrated into TOETVA, which is worth recommending for PTC patients who desire better cosmetic surgical outcomes.
Reasonable requests: echocardiography referral forms as a measure of coherent clinical communication
Authors: Kotzé C. , Parrish A. 
Published: July 2022

Abstract
Background
Well performed clinical communication is a cornerstone of collaborative care in medicine but may be confounded by inconsistent intentions of the messenger and biased interpretation by the recipient. A comparison of the findings of electronic echocardiography reports with clinician-completed standardised request forms provided an opportunity to assess communication quality.

Aim
The study aimed to determine clinician aptitude to complete written echocardiography referral forms by assessing the completeness, appropriateness, accuracy, and coherency of the reported clinical findings, conclusions and requests made on the referral forms. The study explored factors that may influence the quality of communication through this referral medium.

Methods
A retrospective cohort study was conducted on patients who underwent trans-thoracic echocardiography imaging at Cecilia Makiwane Hospital in East London over 26 months. Paper echocardiography request forms that recorded the requesting clinician’s findings on examination, the provisional clinical diagnosis, and the specific echocardiographic information sought, were compared with the actual findings on echocardiography.

Results
Of 613 request forms reviewed, 97 cases were excluded due to illegibility or because they lacked analysable information or requester details, leaving 516 forms suitable for study. No pathology was found on echocardiography in 31%. Of the murmurs expected from the echocardiography findings, only half were recorded on the request form (sensitivity and positive predictive value both 52%.). Only 35% of request forms that mentioned a mitral systolic murmur gave a working diagnosis of mitral regurgitation and only 38% of request forms that mentioned an aortic systolic murmur considered aortic stenosis. Clinically suspected cardiomyopathy (CMO) had a PPV of 43% and echocardiographic CMO was missed clinically in 41%. Apex beat displacement reported clinically was not associated with echocardiographic LV dilatation in 65% of cases. One-third (34%) of forms reporting murmurs did not request valve function assessment and 17% considering cardiomyopathy did not request left ventricular function assessment.

Conclusion
Echocardiography request forms highlight vulnerabilities in clinical communication. Specifically, important clinical features were missing and more concerningly, included when unlikely to be present. There was a lack of concordance between recorded clinical findings and postulated diagnoses. Clinicians sometimes appeared unclear about the value or appropriateness of the requested assistance. Greater emphasis on teaching examination and communication skills may foster safer and more efficient use of scarce resources.
Cost-minimisation analysis of plasma exchange versus IVIg in the treatment of autoimmune neurological conditions
Authors: Klemencic Kozul Tara , Yudina Anna , Donovan Carley , Pinto Ashwin , Osman Chinar 
Published: July 2022

Abstract
Background
Plasma exchange (PLEX) is an effective treatment for antibody-mediated neurological disorders and has been shown to be equally efficacious to intravenous immunoglobulin (IVIg) with comparable adverse event profiles. IVIg has traditionally been the preferred treatment option due to its ease of use. However, advancing technology has allowed PLEX to be performed with a centrifugal system via peripheral access as opposed to central access via a membrane filter.

Methods
We prospectively collected data from a cohort of patients who underwent PLEX at the Wessex Neurological Centre, UK, to perform a cost-minimisation analysis comparing PLEX to IVIg, the standard of care, between May 2019 and May 2020. Data obtained included indication, admission type (inpatient, daycase or intensive care), access (peripheral or central), number of PLEX cycles, exchange volume, patient weight, complications and clinical outcomes. The cost of PLEX delivered in an outpatient setting for an average 80kg person was calculated and compared to the equivalent cost of delivering IVIg by means of a cost-minimization model.

Results
The provision of PLEX was roughly half as costly when compared to what it would have been for IVIg (£886 per exchange vs £1778 per infusion or £4432 per cycle of 5 exchanges vs £8890 per cycle of 5 infusions). Our cohort included a total of 44 patients who received a total of 357 PLEX exchanges during the 12-month period (the majority of which were in a daycase setting). We calculated an annual cost saving for PLEX over IVIg of £318,589. The robustness of this result was confirmed by a one-way deterministic sensitivity analysis, showing the cost-effectiveness of PLEX.

Conclusion
Our findings demonstrate that PLEX is more cost-effective than IVIg in this setting. Our study supports the economic case for development of plasma exchange centres in regional neurology units, a case made all the more relevant in the context of constrained supplies of IVIg.
Family caregivers’ preparedness to support the physical activity of patients at risk for hospital readmission in rural communities: an interpretive descriptive study
Authors: Fox Mary T. , Butler Jeffrey I. , Sidani Souraya , Nguyen An 
Published: July 2022

Abstract
Background
Physical activity in the post-discharge period is important to maximize patient recovery and prevent hospital readmission. Healthcare providers have identified family caregivers as potential facilitators of patients’ engagement in physical activity. Yet, there is very little research on family caregivers’ perspectives on their preparedness to support the physical activity of patients, particularly those at risk for hospital readmission in rural communities. Accordingly, this study explored the challenges related to family caregivers’ preparedness to support the physical activity of a recently discharged, rural-dwelling relative at risk for hospital readmission.

Methods
In this interpretive descriptive study, semi-structured interviews were conducted by telephone with 16 family caregivers. Interview transcripts were analyzed using thematic analysis.

Results
Participants were predominantly women (n = 14; 87.5%) with an average age of 49 years (range 26–67) who were the primary caregivers of a relative who had been hospitalized for a medical illness (n = 12; 75%) and was at high risk for hospital readmission. Four themes were identified: 1) family caregivers generally felt unprepared to support their relative’s physical activity, 2) some family caregivers believed that rest was more important than physical activity to their relative’s recovery, 3) insufficient physical activity preparation led to family caregiver-relative conflicts, and 4) to defuse these conflicts, some family caregivers wanted healthcare providers to be responsible for promoting physical activity.

Conclusions
Despite assertions that family caregivers are a potential source of support for patient physical activity, our findings indicate that family caregivers are largely unprepared to assume that role and that more work needs to be done to ensure they can do so effectively. We suggest that healthcare providers be conscious of the potential for family caregiver-patient conflict surrounding physical activity, assess family caregivers’ ability and willingness to support physical activity, educate them on the hazards of inactivity, and provide physical activity instructions to family caregivers and patients conjointly. Preparing family caregivers to support their relative’s physical activity is particularly important given the current emphasis on early discharge in many jurisdictions, and the limited formal healthcare services available in rural communities.
The testis-specific E3 ubiquitin ligase RNF133 is required for fecundity in mice
Authors: Nozawa Kaori , Fujihara Yoshitaka , Devlin Darius J. , Deras Ricardo E. , Kent Katarzyna , Larina Irina V. , Umezu Kohei , Yu Zhifeng , Sutton Courtney M. , Ye Qiuji , Dean Laura K. , Emori Chihiro , Ikawa Masahito , Garcia Thomas X. , Matzuk Martin M. 
Published: July 2022

AbstractBackgroundUbiquitination is a post-translational modification required for a number of physiological functions regulating protein homeostasis, such as protein degradation. The endoplasmic reticulum (ER) quality control system recognizes and degrades proteins no longer needed in the ER through the ubiquitin–proteasome pathway. E2 and E3 enzymes containing a transmembrane domain have been shown to function in ER quality control. The ER transmembrane protein UBE2J1 is a E2 ubiquitin-conjugating enzyme reported to be essential for spermiogenesis at the elongating spermatid stage. Spermatids fromUbe2j1KO male mice are believed to have defects in the dislocation step of ER quality control. However, associated E3 ubiquitin-protein ligases that function during spermatogenesis remain unknown.ResultsWe identified four evolutionarily conserved testis-specific E3 ubiquitin-protein ligases [RING finger protein 133 (Rnf133); RING finger protein 148 (Rnf148); RING finger protein 151 (Rnf151); and Zinc finger SWIM-type containing 2 (Zswim2)]. Using the CRISPR/Cas9 system, we generated and analyzed the fertility of mutant mice with null alleles for each of these E3-encoding genes, as well as double and triple knockout (KO) mice. Male fertility, male reproductive organ, and sperm-associated parameters were analyzed in detail. Fecundity remained largely unaffected inRnf148,Rnf151, andZswim2KO males; however,Rnf133KO males displayed severe subfertility. Additionally,Rnf133KO sperm exhibited abnormal morphology and reduced motility. Ultrastructural analysis demonstrated that cytoplasmic droplets were retained inRnf133KO spermatozoa. AlthoughRnf133andRnf148encode paralogous genes that are chromosomally linked and encode putative ER transmembrane E3 ubiquitin-protein ligases based on their protein structures, there was limited functional redundancy of these proteins. In addition, we identified UBE2J1 as an E2 ubiquitin-conjugating protein that interacts with RNF133.ConclusionsOur studies reveal that RNF133 is a testis-expressed E3 ubiquitin-protein ligase that plays a critical role for sperm function during spermiogenesis. Based on the presence of a transmembrane domain in RNF133 and its interaction with the ER containing E2 protein UBE2J1, we hypothesize that these ubiquitin-regulatory proteins function together in ER quality control during spermatogenesis.
Perioperative oxygen therapy: a protocol for an overview of systematic reviews and meta-analyses
Authors: Elfeky Adel , Chen Yen-Fu , Grove Amy , Hooper Amy , Wilson Anna , Couper Keith , Thompson Marion , Uthman Olalekan , Court Rachel , Tomassini Sara , Yeung Joyce 
Published: July 2022

Abstract
Background
Oxygen is routinely given to patients during and after surgery. Perioperative oxygen administration has been proposed as a potential strategy to prevent and treat hypoxaemia and reduce complications, such as surgical site infections, pulmonary complications and mortality. However, uncertainty exists as to which strategies in terms of amount, delivery devices and timing are clinically effective. The aim of this overview of systematic reviews and meta-analyses is to answer the research question, ‘For which types of surgery, at which stages of care, in which sub-groups of patients and delivered under what conditions are different types of perioperative oxygen therapy clinically effective?’.

Methods
We will search key electronic databases (MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, CENTRAL, Epistemonikos, PROSPERO, the INAHTA International HTA Database and DARE archives) for systematic reviews and randomised controlled trials comparing perioperative oxygen strategies.
Each review will be mapped according to type of surgery, surgical pathway timepoints and clinical comparison. The highest quality reviews with the most comprehensive and up-to-date coverage of relevant literature will be chosen as anchoring reviews. Standardised data will be extracted from each chosen review, including definition of oxygen therapy, summaries of interventions and comparators, patient population, surgical characteristics and assessment of overall certainty of evidence. For clinical outcomes and adverse events, the overall pooled findings and results of subgroup and sensitivity analyses (where available) will be extracted. Trial-level data will be extracted for surgical site infections, mortality, and potential trial-level effect modifiers such as risk of bias, outcome definition and type of surgery to facilitate quantitative data analysis. This analysis will adopt a multiple indication review approach with panoramic meta-analysis using review-level data and meta-regression using trial-level data. An evidence map will be produced to summarise our findings and highlight any research gaps.

Discussion
There is a need to provide a panoramic overview of systematic reviews and meta-analyses describing peri-operative oxygen practice to both inform clinical practice and identify areas of ongoing uncertainty, where further research may be required.

Systematic review registration
PROSPERO CRD42021272361
Analysis of stochastic neutral fractional functional differential equations
Authors: Siva Ranjani Alagesan , Suvinthra Murugan , Balachandran Krishnan , Ma Yong-Ki 
Published: July 2022

AbstractThis work deals with the large deviation principle which studies the decay of probabilities of certain kind of extremely rare events. We consider stochastic neutral fractional functional differential equation with multiplicative noise and show large deviation principle for its solution processes in a suitable Polish space. The existence and uniqueness results are presented using the Picard iterative method, which is indeed essential for further analysis. The establishment of Freidlin–Wentzell type large deviation principle is solely based on the variational representation developed by Budhiraja and Dupuis in which the weak convergence technique is used to show the sufficient condition. Examples are provided to emphasize the theory.
Existence of positive solutions for a singular third-order two-point boundary value problem on the half-line
Authors: Bao Yongdong , Wang Libo , Pei Minghe 
Published: July 2022

AbstractIn this paper, we consider the following singular third-order two-point boundary value problem on the half-line of the form$$ \textstyle\begin{cases} x'''+\phi (t)f(t,x,x',x'')=0, \quad 0< t< +\infty , \\ x(0)=0, \qquad x'(0)=a_{1},\qquad x'(+\infty )=b_{1}, \end{cases} $${x‴+ϕ(t)f(t,x,x′,x″)=0,0<t<+∞,x(0)=0,x′(0)=a1,x′(+∞)=b1,where$\phi \in C[0,+\infty )$ϕ∈C[0,+∞),$f\in C([0,+\infty )\times (0,+\infty )\times \mathbb{R}^{{2}},\mathbb{R})$f∈C([0,+∞)×(0,+∞)×R2,R)may be singular at$x=0$x=0, and$a_{1}$a1,$b_{1}$b1are positive constants. Using the Leray–Schauder nonlinear alternative and the diagonalization method together with the truncation function technique, we obtain the existence and qualitative properties of positive solutions for the problem. As applications, an example is given to illustrate our result.
A sumoylation program is essential for maintaining the mitotic fidelity in proliferating mantle cell lymphoma cells
Authors: Hanel Walter , Lata Pushpa , Youssef Youssef , Tran Ha , Tsyba Liudmyla , Sehgal Lalit , Blaser Bradley W. , Huszar Dennis , Helmig-Mason JoBeth , Zhang Liwen , Schrock Morgan S. , Summers Matthew K. , Chan Wing Keung , Prouty Alexander , Mundy-Bosse Bethany L. , Chen-Kiang Selina , Danilov Alexey V. , Maddocks Kami , Baiocchi Robert A. , Alinari Lapo 
Published: July 2022

Abstract
Background
Mantle cell lymphoma (MCL) is a rare, highly heterogeneous type of B-cell non-Hodgkin’s lymphoma. The sumoylation pathway is known to be upregulated in many cancers including lymphoid malignancies. However, little is known about its oncogenic role in MCL.

Methods
Levels of sumoylation enzymes and sumoylated proteins were quantified in MCL cell lines and primary MCL patient samples by scRNA sequencing and immunoblotting. The sumoylation enzyme SAE2 was genetically and pharmacologically targeted with shRNA and TAK-981 (subasumstat). The effects of SAE2 inhibition on MCL proliferation and cell cycle were evaluated using confocal microscopy, live-cell microscopy, and flow cytometry. Immunoprecipitation and orbitrap mass spectrometry were used to identify proteins targeted by sumoylation in MCL cells.

Results
MCL cells have significant upregulation of the sumoylation pathway at the level of the enzymes SAE1 and SAE2 which correlated with poor prognosis and induction of mitosis associated genes. Selective inhibition of SAE2 with TAK-981 results in significant MCL cell death in vitro and in vivo with mitotic dysregulation being an important mechanism of action. We uncovered a sumoylation program in mitotic MCL cells comprised of multiple pathways which could be directly targeted with TAK-981. Centromeric localization of topoisomerase 2A, a gene highly upregulated in SAE1 and SAE2 overexpressing MCL cells, was lost with TAK-981 treatment likely contributing to the mitotic dysregulation seen in MCL cells.

Conclusions
This study not only validates SAE2 as a therapeutic target in MCL but also opens the door to further mechanistic work to uncover how to best use desumoylation therapy to treat MCL and other lymphoid malignancies.