bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic bilateral central neck dissection should be evaluated based on prospective randomized study of 581 PTC patients
Authors: Yan Shouyi , Yu Jiafan , Zhao Wenxin , Wang Bo , Zhang Liyong 
Published: January 2022

Abstract
Background
Prophylactic central lymph node dissection (PCND) was a basic consensus for patients with papillary thyroid carcinoma (PTC) in China. However, unilateral or bilateral central lymph node dissection (CND) was still controversial. This study aimed at investigating the safety and long-term benefit for the patients undergone with bilateral central lymph node dissection (BCCD).

Methods
581 patients were enrolled and divided randomly into the test and control groups according to range of CND. 285 patients were prospectively assigned to undergo thyroid lobectomy plus BCND in the test group, other 296 patients were assigned to undergo thyroid lobectomy plus ipsilateral central lymph node dissection (ICND) in the control group.

Results
We found that the numbers of total LN and pN1a in the test group were more than that of the control group (p = 0.002,0.004), but there was no difference in the number of metastasized lymph nodes (p = 0.857) and tumor recurrence (p = 0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P = 0.010), and the numbers of transient laryngeal nerve palsy were more than that(p = 0.033). Meanwhile, we further found that pathological tumor size larger than 1 cm and tumor side lymph node metastasis were independent risk factors for contralateral central lymph node metastasis(p = 0.002,0.001).

Conclusion
BCND may be an alternative for patients with tumor sizes larger than 1 cm, but it would significantly increase the rate of transient vocal cord palsy, parathyroid auto transplantation and decreased PTH, but the risk of permanent complications was similar to the ICND group.
Verbalizing spiritual needs in palliative care: a qualitative interview study on verbal and non-verbal communication in two Danish hospices
Authors: Voetmann Sara Stage , Hvidt Niels Christian , Viftrup Dorte Toudal 
Published: January 2022

AbstractDenmark is considered one of the World’s most secular societies, and spiritual matters are rarely verbalized in public. Patients report that their spiritual needs are not cared for sufficiently. For studying spiritual care and communication, twelve patients admitted to two Danish hospices were interviewed. Verbal and non-verbal communication between patients and healthcare professionals were identified and analysed. Methodically, the Interpretative Phenomenological Analysis was used, and the findings were discussed through the lenses of existential psychology as well as philosophy and theory of caring sciences. Three themes were identified: 1. When death becomes present, 2. Direction of the initiative, and 3. Bodily presence and non-verbal communication. The encounter between patient and healthcare professional is greatly influenced by sensing, decoding, and interpretation. A perceived connection between the patient and the healthcare professional is of great importance as to how the patient experiences the relationship with the healthcare professional.The patient’s perception and the patient’s bodily experience of the healthcare professional are crucial to whether the patient opens up to the healthcare professional about thoughts and needs of a spiritual nature and initiates a conversation hereabout. In this way we found three dynamically connected movements toward spiritual care: 1. From secular to spiritual aspects of care 2. From bodily, sensory to verbal aspects of spiritual care and 3. From biomedical to spiritual communication and care. Thus, the non-verbal dimension becomes a prerequisite for the verbal dimension of spiritual communication to develop and unfold. The behaviour of the healthcare professionals, characterised by the way they move physically and the way they touch the patient, was found to be just as important as verbal conversation when it comes to spiritual care. The healthcare professional can create a connection to the patient through bodily and relational presence. Furthermore, the healthcare professionals should let their sensing and impressions guide them when meeting the patient in dialog about matters of a spiritual nature. Their perception of the patient and non-verbal communication are a prerequisite for being able to meet patient’s spiritual needs with care and verbal communication.
Neuroprotective effects of Lippia javanica (Burm.F.) Spreng. Herbal tea infusion on Lead-induced oxidative brain damage in Wistar rats
Authors: Suleman Zubair , Engwa Godwill A. , Shauli Mathulo , Musarurwa Hannibal T. , Katuruza Ndinashe A. , Sewani-Rusike Constance R. 
Published: January 2022

AbstractBackgroundThoughLippia javanica (Burm.f.) Sprengantioxidant activity has been demonstrated, its effect in protecting the brain from lead (Pb)-induced oxidative damage is unknown. This study investigated the effect ofL. javanicaagainst Pb-induced oxidative stress, inflammation, apoptosis and acetylcholinesterase activity in rat’s brain.MethodsL. javanicaherbal tea infusion was prepared, its phytochemical constituent was revealed by liquid chromatography-Mass spectrometer (LC-MS) and was administered simultaneously with Pb. Four groups of male Wistar rats (n = 5/group) were used: control received distilled water; Pb-acetate group received 50 mg Pb/ Kg bodyweight (bw), treatment group received 50 mg Pb/ Kg Pb-acetate + 5 ml/kg bwL. javanicaandL. javanicagroup received 5 ml/Kg bw ofL. javanicatea infusion only. After 6 weeks of treatment, oxidative status, acetylcholinesterase activity, inflammation and apoptosis was assessed in brain tissue which was also histologically examined.ResultsMean brain and heart weight was reduced (p < 0.05) while liver and spleen weights were increased (p < 0.05) in Pb exposed animals but were prevented byL. juvanicatreatment. Treatment withL. javanicaincreased(p < 0.05)overall brain antioxidant status (glutathione and superoxide dismutase activities) and reduced lipid peroxidation (p < 0.05) compared to the Pb exposed animals. Pro-inflammatory cytokine tumour necrotic factor-alpha, pro-apoptosis Bax protein and anticholinesterase activity were reduced (p < 0.05) in Pb-L. javanicatreated animals compared to the Pb exposed group. Histological examination confirmed neuroprotective effects ofL. javanicaas evidenced by reduced apoptosis/necrosis and inflammation-induced vacuolization and oedema in the hippocampus. TheL. javanicatreatment alone had no detrimental effects to the rats. LC-MS analysis revealedL. javanicato be rich in phenolics.ConclusionsThis study demonstrated thatL. javanica,rich in phenolics was effective in reducing Pb-induced brain oxidative stress, inflammation, apoptosis, acetylcholinesterase activity and neuronal damage.
Protective effects of Quercus acuta Thunb. fruit extract against UVB-induced photoaging through ERK/AP-1 signaling modulation in human keratinocytes
Authors: Hong Ji-Ae , Bae Donghyuk , Oh Kyo-Nyeo , Oh Dool-Ri , Kim Yujin , Kim Yonguk , Jeong Im So , Choi Eun-jin , Lee Seul-gi , Kim Moonjong , Jeong Changsik , Choi Chul Yung 
Published: January 2022

AbstractBackgroundQuercus acutaThunb. (Fagaceae)orJapanese evergreen oak is cultivated as an ornamental plant in South Korea, China, Japan, and Taiwan and used in traditional medicine. The acorn or fruit ofQuercus acutaThunb. (QAF) is the main ingredient of acorn jelly, a traditional food in Korea. Its leaf was recently shown to have potent xanthine oxidase inhibitory and anti-hyperuricemic activities; however, there have been no studies on the biological activity of QAF extracts. Solar ultraviolet light triggers photoaging of the skin, which increases the production of reactive oxygen species (ROS) and expression of matrix metalloproteinase (MMPs), and destroys collagen fibers, consequently inducing wrinkle formation. The aim of this study was to investigate the effect of water extracts of QAF against UVB-induced skin photoaging and to elucidate the underlying molecular mechanisms in human keratinocytes (HaCaT).MethodsIn this study, we used HPLC to identify the major active components of QAF water extracts. Anti-photoaging effects of QAF extracts were evaluated by analyzing ROS procollagen type I in UVB-irradiated HaCaT keratinocytes. Antiradical activity was determined using 2,2-diphenyl-1-picrylhydrazyl and 2,20-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) assays. The expression of MMP-1 was tested by western blotting and ELISA kits. QAF effects on phosphorylation of the MAPK (p38, JNK, and ERK) pathway and transcription factor AP-1, which enhances the expression of MMPs, were analyzed by western blots.ResultsWe identified two major active components in QAF water extracts, gallotannic acid and ellagic acid. The QAF aqueous extracts recovered UVB-induced cell toxicity and reduced oxidative stress by inhibiting intracellular ROS generation in HaCaT cells. QAF rescued UVB-induced collagen degradation by suppressing MMP-1 expression. The anti-photoaging activities of QAF were associated with the inhibition of UVB-induced phosphorylation of extracellular signal-regulated kinase (ERK) and activator protein 1 (AP-1). Our findings indicated that QAF prevents UVB-induced skin damage due to collagen degradation and MMP-1 activation via inactivation of the ERK/AP-1 signaling pathway. Overall, this study strongly suggests that QAF exerts anti-skin-aging effects and is a potential natural biomaterial that inhibits UVB-induced photoaging.ConclusionThese results show that QAF water extract effectively prevents skin photoaging by enhancing collagen deposition and inhibiting MMP-1 via the ERK/AP-1 signaling pathway.
Optimization for ultrasonic-microwave synergetic extraction of total iridoid glycosides and screening of analgesic and anti-inflammatory active fractions from patrinia scabra Bunge (Valerianaceae)
Authors: Ma Quhuan , Lu Yanmei , Deng Yi , Hu Xiaodong , Li Wanyu , Jia Hongzhen , Guo Yuer , Shi Xiaofeng 
Published: January 2022

Abstract
Background
Patrinia scabra Bunge is a well-known herbal medicine for its favorable treatment on inflammatory diseases owing to its effective ingredients, in which iridoid glycoside plays an extremely significant role. This article aimed to improve the content of total iridoid glycosides in crude extract through a series optimization of extraction procedure. Moreover, considering that both pain and inflammation are two correlated responses triggered in response to injury, irritants or pathogen, the article investigated the anti-inflammatory and analgesic activities of P. scabra to screen out the active fraction.

Method
P. scabra was extracted by ultrasonic-microwave synergistic extraction (UMSE) to obtain total iridoid glycosides (PSI), during which a series of conditions were investigated based on single-factor experiments. The extraction process was further optimized by a reliable statistical method of response surface methodology (RSM). The elution fractions of P. scabra extract were prepared by macroporous resin column chromatography. Through the various animal experiment including acetic acid-induced writhing test, formalin induced licking and flinching, carrageenan-induced mice paw oedema test and xylene-induced ear edema in mice, the active fractions with favorable analgesic and anti-inflammatory effect were reasonably screen out.

Results
The content of PSI could reach up to 81.42 ± 0.31 mg/g under the optimum conditions as follows: ethanol concentration of 52%, material-to-liquid ratio of 1:18 g/mL, microwave power at 610 W and extraction time of 45 min. After gradient elution by the macroporous resin, the content of PSI increased significantly. Compared with other concentrations of elution liquid, the content of PSI in 30 and 50% ethanol eluate was increased to reach 497.65 and 506.90 mg/g, respectively. Owing to the pharmacology experiment, it was reasonably revealed that 30 and 50% ethanol elution fractions of P. scabra could relieve pain centrally and peripherally, exhibiting good analgesic and anti-inflammatory activities.

Conclusion
Patrinia scabra possessed rich iridoids and exhibited significant analgesic and anti-inflammatory activities.
Student well-being during dedicated preparation for USMLE Step 1 and COMLEX Level 1 exams
Authors: Tackett Sean , Jeyaraju Maniraj , Moore Jesse , Hudder Alice , Yingling Sandra , Park Yoon Soo , Grichanik Mark 
Published: January 2022

Abstract
Background
Nearly all U.S. medical students engage in a 4–8 week period of intense preparation for their first-level licensure exams, termed a “dedicated preparation period” (DPP). It is widely assumed that student well-being is harmed during DPPs, but evidence is limited. This study characterized students’ physical, intellectual, emotional, and social well-being during DPPs.

Methods
This was a cross-sectional survey sent electronically to all second-year students at four U.S. medical schools after each school’s respective DPP for USMLE Step 1 or COMLEX Level 1 in 2019. Survey items assessed DPP characteristics, cost of resources, and perceived financial strain as predictors for 18 outcomes measured by items with Likert-type response options. Open-ended responses on DPPs’ influence underwent thematic analysis.

Results
A total of 314/750 (42%) students completed surveys. DPPs lasted a median of 7 weeks (IQR 6–8 weeks), and students spent 70 h/week (IQR 56–80 h/week) studying. A total of 62 (20%) reported experiencing a significant life event that impacted their ability to study during their DPPs. Most reported 2 outcomes improved: medical knowledge base (95%) and confidence in ability to care for patients (56%). Most reported 9 outcomes worsened, including overall quality of life (72%), feeling burned out (77%), and personal anxiety (81%). A total of 25% reported paying for preparation materials strained their finances. Greater perceived financial strain was associated with worsening 11 outcomes, with reported amount spent associated with worsening 2 outcomes. Themes from student descriptions of how DPPs for first-level exams influenced them included (1) opportunity for synthesis of medical knowledge, (2) exercise of endurance and self-discipline required for professional practice, (3) dissonance among exam preparation resource content, formal curriculum, and professional values, (4) isolation, deprivation, and anguish from competing for the highest possible score, and (5) effects on well-being after DPPs.

Conclusions
DPPs are currently experienced by many students as a period of personal and social deprivation, which may be worsened by perceived financial stress more than the amount of money they spend on preparation materials. DPPs should be considered as a target for reform as medical educators attempt to prevent student suffering and enhance their well-being.
Deep Q-networks with web-based survey data for simulating lung cancer intervention prediction and assessment in the elderly: a quantitative study
Authors: Chen Songjing , Wu Sizhu 
Published: January 2022

Abstract
Background
Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer. We employed Deep Q-Networks (DQN) to respond to this gap. The aim was to quantitatively predict lung cancer optimal intervention strategy and assess intervention effect in aged 65 years and older (the elderly).

Methods
We screened lung cancer high risk with web-based survey data and conducted simulative intervention. DQN models were developed to predict optimal intervention strategies to prevent lung cancer in elderly men and elderly women separately. We assessed the intervention effects to evaluate the optimal intervention strategy.

Results
Proposed DQN models quantitatively predicted and assessed lung cancer intervention. DQN models performed well in five stratified groups (elderly men, elderly women, men, women and the whole population). Stopping smoking and extending quitting smoking time were optimal intervention strategies in elderly men. Extending quitting time and reducing smoked cigarettes number were optimal intervention strategies in elderly women. In elderly men and women, the maximal reductions of lung cancer incidence were 31.81% and 24.62% separately. Lung cancer incidence trend was deduced from the year of 1984 to 2050, which predicted that the difference of lung cancer incidence between elderly men and women might be significantly decreased after thirty years quitting time.

Conclusions
We quantitatively predicted optimal intervention strategy and assessed lung cancer intervention effect in the elderly through DQN models. Those might improve intervention effects and reasonably prevent lung cancer.
Comparing machine learning algorithms for predicting COVID-19 mortality
Authors: Moulaei Khadijeh , Shanbehzadeh Mostafa , Mohammadi-Taghiabad Zahra , Kazemi-Arpanahi Hadi 
Published: January 2022

AbstractBackgroundThe coronavirus disease (COVID-19) hospitalized patients are always at risk of death. Machine learning (ML) algorithms can be used as a potential solution for predicting mortality in COVID-19 hospitalized patients. So, our study aimed to compare several ML algorithms to predict the COVID-19 mortality using the patient’s data at the first time of admission and choose the best performing algorithm as a predictive tool for decision-making.MethodsIn this study, after feature selection, based on the confirmed predictors, information about 1500 eligible patients (1386 survivors and 144 deaths) obtained from the registry of Ayatollah Taleghani Hospital, Abadan city, Iran, was extracted. Afterwards, several ML algorithms were trained to predict COVID-19 mortality. Finally, to assess the models’ performance, the metrics derived from the confusion matrix were calculated.ResultsThe study participants were 1500 patients; the number of men was found to be higher than that of women (836 vs. 664) and the median age was 57.25 years old (interquartile 18–100). After performing the feature selection, out of 38 features, dyspnea, ICU admission, and oxygen therapy were found as the top three predictors. Smoking, alanine aminotransferase, and platelet count were found to be the three lowest predictors of COVID-19 mortality. Experimental results demonstrated that random forest (RF) had better performance than other ML algorithms with accuracy, sensitivity, precision, specificity, and receiver operating characteristic (ROC) of 95.03%, 90.70%, 94.23%, 95.10%, and 99.02%, respectively.ConclusionIt was found that ML enables a reasonable level of accuracy in predicting the COVID-19 mortality. Therefore, ML-based predictive models, particularly the RF algorithm, potentially facilitate identifying the patients who are at high risk of mortality and inform proper interventions by the clinicians.
Demand for community-based Case Management in Austria - a qualitative analysis
Authors: Gessl Alessandra Schirin , Flörl Angela , Schulc Eva 
Published: January 2022

Abstract
Background
The number of people with complex nursing and care needs living in their own homes is increasing. The implementation of Case and Care Management has shown to have a positive effect on unmet care needs. Research on and implementation of Case and Care Management in the community setting in Austria is limited. This study aimed to understand the changes and challenges of changing care needs by mobile nurses and to evaluate the need for Case Management in mobile care organizations by investigating the evolution of mobile care nurses‘task profiles and the challenges in working in a dynamic field with changing target groups and complexifying care needs.

Methods
A qualitative study with reductive-interpretative data analysis consisting of semi-structured focus groups was conducted. Community care nurses, head nurses, and managers of community mobile care units as well as discharge managers of a community hospital (n = 24) participated in nine qualitative, semi-structured focus groups. The recorded focus groups were transcribed and analyzed using qualitative content analysis.

Results
The analysis revealed three main categories: the complexity of the case, innerinstitutional frameworks, and interinstitutional collaboration, which influence the perception of need for further development in the direction of Case and Care Management. Feelings of overwhelmedness among nurses were predominantly tied to cases that presented with issues beyond healthcare such as legal, financial, or social that necessitated communication and collaboration across multiple care providers.

Conclusions
Care institutions need to adapt to changing and increasingly complex care needs that necessitate cooperation between organizations within and across the health and social sectors. A key facilitator for care coordination and the adequate service provision for complex care needs are multidisciplinary institutional networks, which often remain informal, leaving nurses in the role of petitioner without equal footing. Embedding Case and Care Management in the community has the potential to fill this gap and facilitate flexible, timely, and coordinated care across multiple care providers.
Translation and psychometric properties of the MISSCARE survey-Persian version
Authors: Hosseini Zeinab , Raisi Leila , Maghari Amirhossein , Karimollahi Mansoureh 
Published: January 2022

Abstract
Background
Providing safe and high-quality nursing care is an essential task of nursing. Nurses may be unable to provide patients with all of the necessary care for numerous reasons, such as an increase in the number of patients and a low number of nursing staff. Moreover, they may have to omit, postpone, or incompletely perform a series of care, referred to as missed nursing care. The purpose of this study was to translate and conduct psychometric testing of the MISSCARE Survey.

Method
In this study, we accurately translated the MISSCARE Survey. Its acceptability, construct validity, and internal consistency were analyzed. This cross-sectional study was conducted in the summer of 2020 in educational hospitals in Ardabil, Iran. The participants were 300 nurses who worked in educational hospitals and were randomly selected.

Results
Participants in this study included 300 nurses from five units, including general medicine (13.3%), COVID-19 (45.0%), surgery (18.7%), critical care unit (6.3%), and intensive care unit (16.7%), who worked various shifts, of whom 84.7% were female. The total content validity in Part A was 0.944, and that in Part B was 0.969. Part A was divided into three domains (necessary care, secondary care, and supportive care), and Part B was divided into five domains (communication, labor resources, material resources, responsibility, and unpredictable situations). In both parts, the chi-square index was < 3, and the RMSEA index was < 0.08. The internal consistency measured by Cronbach’s alpha was 0.933 for Part A and 0.910 for Part B for the Persian version of the MISSCARE Survey.

Conclusion
Based on the outcomes of this research, it can be concluded that the Persian version of the MISSCARE Survey is valid for use in Iranian hospitals and can be used to identify missed care and the reasons behind it. Nursing managers can also use it to improve the situation and provide the highest-quality care.