bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dignity in Care at the End of Life in a Nursing Home: an Ethnographic Study
Authors: Holmberg Bodil , Godskesen Tove 
Published: March 2022

Abstract
Background: Nursing homes (NHs) are populated by the frailest older people with multiple physical or mental conditions and palliative care needs. Although dignity is a commonly used concept, it has been claimed to be complex, ambiguous, and multivalent. Nevertheless, dignity is a core value of end-of-life care and is why this study aimed to explore aspects of dignity in older persons’ everyday lives in a NH.Design: A focused ethnographic study design. Methods: Data consisted of 170 hours of fieldwork, including observations (n=39) with residents (n=19) and assistant nurses (n=22) in a NH in a Swedish urban area. Open interviews were undertaken with residents several times (in total, n=35, mean 70 minutes/resident). To study dignity and dignity-related concerns, we used the Chochinov model of dignity to direct the deductive analysis.Results: The study showed that residents suffered from illness-related concerns that inhibited their possibilities to live a dignified life at the NH. Their failing bodies were the most significant threat to their dignity, as loss of abilities was constantly progressing. Together with a fear of becoming more dependent, this caused feelings of angst and loneliness. The most dignity-conserving repertoire came from within themselves. Their self-knowledge had provided them with tools to distinguish what was still possible from what they just had to accept. Socially, the residents’ dignity depended on assistant nurses’ routines and behaviour. Their dignity was violated by long waiting times, lack of integrity in care, and deteriorating routines, but also by distanced and sometimes harsh encounters with assistant nurses. As the residents oin this study cherished autonomy and self-determination, while still in need of much help, these circumstances placed them in a vulnerable situation. Conclusions: To protect residents’ dignity, NHs need to apply a palliative care approach to provide holistic care that comprises attending to personal, bodily, social, spiritual and psychological needs to increase well-being and prevent suffering.
Predictors for the restoration of the sagittal spinal malalignment in patients with lumbar stenosis after short-segment decompression and fusion surgery
Authors: Huang Rufeng , Pan Fumin , Zhu Weiguo , Kong Chao , Lu Shibao , Wang Shuaikang 
Published: March 2022

Abstract
Objective: To explore the predictors for the restoration of the sagittal spinal malalignment in the elderly patients with lumbar spinal stenosis (LSS) after short-segment decompression and fusion surgery.Methods: We retrospectively reviewed 82 LSS patients with sagittal malalignment (SVA≥50mm or PT≥20° or PI-LL≥20°) who underwent short-segment decompression and fusion surgery between January 2019 and March 2021. Patients’ characteristic, radiographic and paravertebral muscle parameters were assessed. The patients were divided into group A (postoperative malalignment) and B (postoperative alignment) according to whether the postoperative restoration of the sagittal alignment was achieved.Results: There existed more males in group B than in group A (p=0.002). The age of group A (73.36±8.02) was greater than that of group B (69.08±6.07, p=0.009). Preoperative PT in group A (27.40±5.82) was greater than that in group B (19.30±7.32, p<0.001). The functional cross-sectional area (fCSA) in group A (28.73±4.23) was lower than that in group B (36.94±7.81, p<0.001). And the fatty infiltration rate (FI) of group A (27.16%±5.58%) was higher than that of group B (22.61%±5.81%, p=0.001). The fCSA was negatively correlated with the postoperative PT and PTr (p<0.05).Conclusion: Stronger lumbar paravertebral muscles, smaller preoperative PI, PT or PI-LL, male and younger age are the predictors for the restoration of the sagittal spinal malalignment in the elderly LSS patients after short-segment decompression and fusion surgery.
Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) for adolescents (15-18 years) from grades 10-12: validity and reliability evidence of the Psychological and Social modules using Mokken Scale Analysis
Authors: Mota João , Martins João , Onofre Marcos 
Published: March 2022

Abstract

Background
Aims of this study were to assess construct validity (dimensionality, measurement invariance, convergent and discriminant validity) and reliability of the previously developed Psychological and Social modules of the Portuguese Physical Literacy Assessment – Questionnaire (PPLA-Q).
Methods
Mokken Scale Analysis was used in a final sample of 508 Portuguese adolescents (Mage= 16, SD = 1 years) studying in public schools in Lisbon. A retest subsample of 73 students, collected 15 days after baseline, was used to calculate Intraclass Correlation Coefficient (ICC).
Results
The 8 scales in the 2 modules can be interpreted as moderate to strong Mokken scales with H coefficient ranging from .47 to .66; 4 of these scales had an interpretable Invariant Item Ordering (HT>.30). Results suggest that all scales function similarly in male and female adolescents, except for the Physical Regulation scale which has shown evidence of a sex bias. All scales had good total score reliability (ρ > .80, ranging from .83 to .94); regarding test-retest reliability: 3 scales had good to excellent reliability (ICC95%CI ranging from .72 to .95), and 5 scales presented moderate to good reliability (ICC95%CI ranging from .51 to .85). Scales score correlated as theoretically expected, with low to moderate across domain correlations providing support of convergent and discriminant validity.
Conclusions
Evidence supports the construct validity and reliability of the psychological and social modules of the PPLA-Q to assess the psychological and social domains of Physical Literacy in the Portuguese PE context for grade 10–12 (15–18 years) adolescents.
Quantifying Uncertainties in CERES/MODIS Downwelling Radiation Fluxes in the Global Tropical Oceans
Authors: Thandlam Venugopal 
Published: March 2022

Abstract
The Clouds and the Earth's Radiant Energy System (CERES) program using the Moderate Resolution Imaging Spectroradiometer (MODIS) (CM) has been updated with a launch of new satellites and made newly upgraded radiation data available. Here we study the spatial and temporal variability of daily averaged synoptic 1-degree (SYN1deg) CM version 3 (CMv3) (old) and version 4 (CMv4) (new) downwelling shortwave (QS) and longwave radiation (QL) data in the global tropical oceans spanning 30oS-30oN available during 2000–2017. Daily in situ data from Global Tropical Moored Buoy Array (GTMBA) has been used to validate the CM data during 2000–2015. Both QS and QL in CMv4 show significant enhancements with improved bias, root-mean-square error, and standard deviations (standard deviation) compared to CMv3. Furthermore, long term trend analysis shows that QS has been increasing in the southern hemisphere with 1 Wm− 2 per annum. In contrast, the northern hemisphere shows an annual decreasing trend of -0.7 Wm− 2. Both QS and QL shows similar spatial trend pattern. However, QL spatial patterns in CMv3 and CMv4 differ largely with an opposite trend (0.5 Wm− 2) in the Indian Ocean, Indo-Pacific warm pool region and southern hemisphere. These annual trends in QS and QL could cause Sea Surface Temperature (SST) to change in the tropical oceans with a magnitude of -0.2 to 0.3oC per annum. These results stress the importance of accurate radiative flux data, and CMv4 data can be used as a better alternative radiation data to force standalone ocean models than reanalysis products. They may also be helpful to produce hybrid data by correcting reanalysis or other model-simulated data.
A novel human monogenic obesity trait: severe early-onset childhood obesity caused by aberrant expression of agouti-signaling protein (ASIP): a case report
Authors: Körner Antje , Kempf Elena , Stein Robert , Hanschkow Martha , Hilbert Anja , Jamra Rami Abou , Kühnapfel Andreas , Tseng Yu-Hua , Stäubert Claudia , Schöneberg Torsten , Kuhnen Peter , Rayner William , Zeggini Eleftheria , Kiess Wieland , Blüher Matthias , Landgraf Kathrin 
Published: March 2022

Abstract
In a patient with extreme childhood obesity, we identified a heterozygous tandem duplication at the ASIP (agouti-signaling protein) gene locus causing ubiquitous, ectopic ASIP expression. The mutation places ASIP under control of the ubiquitously active itchy E3 ubiquitin protein ligase (ITCH) promoter, driving the ubiquitous generation of ASIP as evidenced in patient-derived induced pluripotent stemm cells for all germ layers. The patient´s phenotype of early-onset obesity, overgrowth, red hair, and hyperinsulinemia is concordant with that of mutant mice ubiquitously expressing the homolog agouti. ASIP represses melanocyte-stimulating hormone-mediated activation of as an inverse agonist of the melanocortin receptors, thereby affecting eating behavior, energy expenditure, adipocyte differentiation, and pigmentation, as observed in the index patient. Furthermore, we identified another patient with the identical mutation, ectopic ASIP expression and a similar phenotype. Thus, human obesity caused by ubiquitous ASIP expression is a novel monogenic trait, potentially treatable by melanocortin receptor agonists.
Evaluation of CD39, CD73, HIF-1α, and their related miRNAs expression in decidua of preeclampsia cases compared to healthy pregnant women
Authors: Yousefi Mehdi , Yousefzadeh Yousef , Soltani-Zangbar Mohammad Sadegh , Kalafi Ladan , Tarbiat Ali , Farid Sima Shahmohammadi , Aghebati-Maleki Leili , Dolati Sanam , Parhizkar Forough , Danaii Shahla , Taghavi Simin , Jadidi-Niaragh Farhad , Kafil Hossein Samadi , Mahmoodpoor Ata , Heris Javad Ahmadian , Hojjat-Farsangi Mohammad 
Published: March 2022

Abstract
The Preeclampsia (PE) molecular mechanisms are not fully revealed and different biological processes are involved in the pathogenesis of PE. We aimed to evaluate adenosine and hypoxia-related signaling molecules in PE patients in the current study. Decidua tissue and peripheral blood samples were taken from 25 healthy pregnant and 25 PE women at delivery time. CD39, CD73, and Hypoxia-inducible factor-alpha (HIF-α) were evaluated in mRNA and protein level using real-time PCR and western blotting techniques, respectively. Also, miR-30a, miR-206, and miR-18a expression were evaluated by real-time PCR. At last, secretion levels of IGF and TGF-β in the taken serum of blood samples were measured by ELISA. Our results revealed that Expression of CD39 is decreased in PE cases versus healthy controls at mRNA and protein levels (p = 0.0003 for both). CD73 and HIF-α showed an increased level of expression in PE patients at RNA and protein status (p = 0.0157 and p < 0.0001 for protein evaluation of CD73 and HIF-α, respectively). The miRNA-30a (p = 0.0037) and miR-206 (p = 0.0113) showed elevated expression in the decidua of the PE group. The concentration of secreted IGF-1 (p = 0.0002) and TGF-β (p = 0.0101) in serum samples of PE cases compared to the healthy group were decreased and increased, respectively. In conclusion, our results showed that aberrant expression of molecules that are involved in ATP catabolism and the hypoxic conditions is observed in PE cases and involved in their hypertension and inflammation could be served as PE prognosis by more confirming in comprehensive future studies.
Clinical Characteristics and Prognosis of Patients with Glioblastoma with Infratentorial Leptomeningeal Dissemination
Authors: Kawauchi Daisuke , Ohno Makoto , Honda-Kitahara Mai , Miyakita Yasuji , Takahashi Masamichi , Yanagisawa Shunsuke , Tamura Yukie , Kikuchi Miyu , Ichimura Koichi , Narita Yoshitaka 
Published: March 2022

Abstract
Objective: Leptomeningeal dissemination (LMD) is a severe complication of glioblastoma (GBM) and has become a more common and indispensable clinical proposition with improved patient prognosis. Although infratentorial leptomeningeal dissemination (ITD) of GBM is rare, it is clinically significant as it may largely influence patient prognosis. Here, we investigated the clinical characteristics and prognosis of patients with ITD.Methods: Data of patients with newly diagnosed isocitrate dehydrogenase (IDH)-wildtype GBM treated at our institution between October 2008 and December 2018 were reviewed. ITD was defined as the dissemination of GBM, which first emerged as a supratentorial tumor, and later disseminated in the infratentorial region as the first recurrent site.Results: Of 160 patients with newly diagnosed IDH-wildtype GBM, seven (4.4%) were classified as having ITD. ITD lesions were in the fourth ventricle in two patients, extra-cerebellum or extra-brainstem in two, and intra-cerebellum in three. The primary symptoms of ITD were gait disturbance (85.7%, n=6), nausea and vomiting (28.6%, n=2), cerebellar mutism (14.3%, n=1), and none (14.3%, n=1). In four cases (57.1%), symptoms were confirmed before ITD discovery.The median progression-free survival (PFS) and overall survival of the patients were 12.2 and 19.7 months, respectively. Radiotherapy was performed in five patients, and all the patients received chemotherapy. The PFS and overall survival rates from ITD diagnosis were 2.9 and 7.1 months, respectively. Patients with favorable prognoses were younger and had higher Karnofsky performance status (KPS) scores.Conclusions: Radiotherapy or molecular-targeted therapy may be effective in some cases of ITD and may contribute to extending survival. Carefully checking the infratentorial region of patients with GBM during follow-up and rapidly treating ITD before their KPS score starts declining are crucial.
The Diagnostic Accuracy of PIK3CA Mutations by circulating tumor DNA (ctDNA) in Breast Cancer: An Individual Patient Data Meta-analysis
Authors: Galvano Antonio , Castellana Luisa , Gristina Valerio , Mantia Maria La , Insalaco Lavinia , Barraco Nadia , Perez Alessandro , Cutaia Sofia , Calò Valentina , Russo Tancredi Didier Bazan , Incorvaia Lorena , Mirisola Mario Giuseppe , Rolfo Christian , Bazan Viviana , Russo Antonio 
Published: March 2022

Abstract
Background
The circulating tumor DNA (ctDNA) diagnostic accuracy for detecting Phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutations in breast cancer is under discussion. We aimed to compare plasma and tissue PIK3CA alterations, encompassing factors that could affect the results.
Methods
Two reviewers selected studies from different databases until December 2020. We considered Breast cancer patients with matched tumor tissue and plasma ctDNA. We performed metaregression and subgroup analyses to explore sources of heterogeneity concerning tumor burden, diagnostic technique, sample size, sampling time, biological subtype, and hotspot mutation. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the related area under the curve (AUC) were elaborated for the overall population and each subgroup.
Results
The pooled analysis was carried out on 25 cohorts for a total of 1966 patients. The overall ctDNA sensitivity and specificity were 0.73 (95% CI: 0.70–0.77) and 0.87 (95% CI: 0.85–0.89). The AUC was 0.93. Pooled concordance, negative predictive value (NPV) and positive predictive value (PPV) values were 0.87 (95% CI: 0.82–0.92), 0.86 (95% CI: 0.81–0.90), and 0.89 (95% CI: 0.81–0.95) with pooled PLR, NLR, and DOR of 7.94 (95% CI: 4.90–12.86), 0.33 (95% CI: 0.25–0.45), and 33.41 (95% CI: 17.23–64.79). The pooled results consistently favored next-generation sequencing (NGS)- over polymerase chain reaction (PCR)-based methodologies. Metaregression and subgroup analyses highlighted sampling time as a possible major cause of heterogeneity.
Conclusions
These findings reliably estimate the high ctDNA accuracy for the detection of PIK3CA mutations. A ctDNA-first approach for the assessment of PIK3CA mutational status by NGS may accurately replace tissue tumor sampling, representing the preferable strategy at diagnosis of metastatic BC in patients who present with visceral involvement and at least two metastatic lesions, primarily given low clinical compliance or inaccessible metastatic sites.
Paravalvular Septate Abscess Presented By Complete Atrioventricular Block; Impressive Echocardiographic Images of Rare Pathology
Authors: Kuş Görkem 
Published: March 2022

Abstract
Paravalvular abscess is a serious complication of prosthetic valve endocarditis with various clinical presentations. In this report, we present a case of paravalvular septate abscess with demonstrative echocardiography images and complete atrioventricular block (a.v.) one month after aortic valve replacement. Transthoracic echocardiography was performed when complete av block was detected in the electrocardiography of the patient who presented with the complaint of fatigue and shortness of breath. Then transesophageal echocardiography was performed due to suspicious paravalvular abscess around the mechanical aortic valve in transthoracic echocardiography. In transesophageal echocardiography, paravalvular septate abscess image was detected. In patients with prosthetic valves, newly developing av block should be a warning for paravalvular abscess. Paravalvular Septate Abscess Presented By Complete Atrioventricular Block; Impressive Echocardiographic Images Of Rare Pathology
Extremely Severe Intractable Binge Eating Disorder: a Case Report With a Successful Alternative Therapy by Traditional Chinese Medicine
Authors: Zhang Yong , Xiao Z. M. , Lu Z. N. , Wu X. 
Published: March 2022

Abstract
BackgroundBinge eating disorder(BED) is the most common eating disorder that mainly affects young women. BED often occurs in the patients with psychiatric disorders and relates to the impairment in psychosocial functioning (home, work, personal life, or social life). Psychotherapy is the first-line treatment for the BED patients. However, only 50% of BED patients can benefit from psychotherapy and pharmacotherapy has less effect than psychotherapy. Here, we report a case with extremely severe BED, whose discomforts were almost disappeared after taking only herbal formula based on Traditional Chinese Medicine(TCM) for 2 months.Case presentationThe case reported was a man aged 73 years who fitted the diagnosis of extremely severe BED. He ate a lot every meal, didn’t stop eating until he felt the extreme discomfort of abdominal distension, and ate more than ten meals every day. Only could an enema every day improve his constipation and the extreme discomfort of abdominal distension. He was transferred to dozens of hospitals because of the disease and had tried a variety of treatments, which had no effect on him. Here, we described in detail his medical history and treatment process. At last, his clinical symptoms were controlled and had no side-effect.Conclusion Besides psychotherapy and pharmacotherapy, herbal formula based on TCM can be an alternative therapy for severe intractable BED patients.Level of evidence Level V, case report.
Intraoperative Challenge of Removing a Tibia Intramedullary Nail With the Herzog's Bend Facing Anteriorly- a Case Report
Authors: Rajappa Srinivasan , Veeraraghavan Raghav Ravi 
Published: March 2022

Abstract
Background:Intramedullary nailing of tibial shaft fractures is a very standard procedure. Removal of implant is done many times for reasons such as infection, breakage, nonunion and in situations where patient demands it. Complications during removal of tibia nail have been described. We report a case wherein an arthrotomy of the knee was necessary because of wrongly inserted nail with the Herzog bend(apex) facing anteriorly.Case presentation: 48 year old gentleman had undergone intramedullary nailing of the right tibia two years ago for treatment of a closed mid-shaft fracture. The fracture healed uneventfully, and the patient returned to all pre-injury activities. He visited us two years after surgery requesting removal of implant. There was difficulty in attaching the extraction jig as the mouth of the nail was facing posteriorly and the complete insertion of the jig was not allowed by the patella. Revisiting the X-ray intraoperatively, we found that the Herzog bend was facing anteriorly. Following this the nail was removed using a medial parapatellar approach.Discussion and conclusions: The studies published regarding removal of the tibia nail usually mentions the complications associated with the implant design or the patient factor. The implant design complicating the removal could be due to the non-slotted distal portion in the older generation nails. We had a complication due to the iatrogenic erroneous implantation of the tibial nail which was only found intra-operatively. The use of medial parapatellar approach was a useful method which helped us in insertion of the extraction jig and thereby helping in removal of the nail.
Adaptive finite-time event-triggered command filtered control for nonlinear systems with unknown control directions
Authors: Qi Xiaojing , Liu Wenhui 
Published: March 2022

Abstract
In this article, we study an adaptive finite-time event-triggered command filtered control problem based on output feedback for nonstrict-feedback nonlinear systems with unknown direction control gains. Firstly, the unknown nonlinear continuous functions in the systems are approached by fuzzy logic systems, and the coordinate transformation and Nussbaum function technique are introduced to settle the problem caused by the unknown direction control gains in the systems. Then, in order to lighten the communication load between the controller and the actuator, a finite-time adaptive event-triggered control algorithm is designed by means of backstepping technique. It is proved that the tracking and observer errors are adjusted around zero with a small neighborhood in a finite time and all the signals in the closedloop systems are bounded. In addition, the command filtering technology based on error compensation system with fractional power is constructed to avoid the complexity explosion issue in the backstepping design process. Finally, the simulation examples are included to verify the availability and superiority of the control approach.
Self-assembled DNA nanostructure containing oncogenic miRNA-mediated cell proliferation by downregulation of FOXO1 expression
Authors: Kar Avishek , Kumari Kanchan , Mishra Sandip K. , Subudhi Umakanta 
Published: March 2022

Abstract
FOXO1 transcription factor is not only limit the cell cycle progression but also promote cell death as a tumor suppressor protein. Though the expression of FOXO1 is largely examined in breast cancer, the regulation of FOXO1 by miRNA is yet to be explored. In the current study, self-assembled branched DNA (bDNA) nanostructures containing oncogenic miRNAs were designed and transfected to MCF7 cell lines to decipher the FOXO1 expression. bDNA containing oncogenic miRNA 27a, 96 and 182 synergistically downregulate the expression of FOXO1 in MCF7 cells. The down-regulation is evident both in mRNA and protein level suggesting bDNA having miRNA sequences can selectively bind to mRNA and inhibit translation. Secondly, the downstream gene expression of P21 and P27 are also significantly downregulated in presence of miR-bDNA nanostructures. The cell proliferation activity was progressively increased in presence of miR-bDNA nanostructure which confirms the reduced tumor suppression activity of FOXO1 and the downstream gene expression. This finding can be explored to design novel bDNA structures which can downregulate the tumor suppressor protein in normal cells and induce cell proliferation activity to identify early phase markers of cancer.