bluuebunny/crossref_metadata_2025_split huggingface dataset:
An exploration of person-centred approach in end-of-life care policies in England and Japan
Authors: Fang Chao , Tanaka Miho 
Published: May 2022

Abstract
Background
Increasing evidence has suggested that a person-centred approach (PCA) is beneficial not only for improving care outcomes but also for mitigating the pressure on public health systems. However, policy implementation gaps have prevented the translation of this complex framework into useful practical, ethical and moral stances for end-of-life care (EOLC). This article aims to explore the meaning and implications of person-centredness in EOLC policy discourses.

Methods
By perceiving policy documents as a medium embodied with socio-political and cultural norms, we analysed how PCA in EOLC is constructed within specific socio-cultural contexts and the implications of these contexts on resultant care. Focusing on England and Japan, we conducted a critical policy analysis to examine and compare key policy and legal documents released between 2000 and 2019 in these two post-industrial and socio-culturally distinctive countries.

Results
Our analysis found that the PCA is mobilised in policy discourses primarily through three interconnected dimensions: individual, relational and existential. While acknowledging that both countries have developed varied policy and legal mechanisms to emphasise holistic and integrated care with respect to these three dimensions, we also identified significant gaps in the pol icies both within and between England and Japan. They include ambiguity in defining patients’ best interests, fragmented support for social and family care and the neglect of existential needs.

Conclusions
This cross-cultural analysis has revealed the complex nature of discourses around PCA in English and Japanese EOLC policies, which often concentrate on the multifaceted aspects of experiences as one approaches the end of life. Despite this, we argue that a more holistic construction of PCA is needed in EOLC policies not only in England and Japan but also more broadly, to encapsulate the richness of end-of-life experiences.
Evidence-based indicators for the measurement of quality of primary care using health insurance claims data in Switzerland: update of the SQUIPRICA working group
Authors: Blozik Eva , Farcher Renato , Graber Sereina M. , Huber Carola A. ,   Swiss Quality Indicator for Primary Care (SQIPRICA) Working Group, Burgstaller Jakob , Chmiel Corinne , Huber Felix , Luchsinger Philippe , Muheim Leander , Reich Oliver , Rosemann Thomas , Scherer Martin , Schnweuwly Felix , Senn Oliver , Tapernoux Daniel 
Published: May 2022

Abstract
Background
The level of quality of care of ambulatory services in Switzerland is almost completely unknown. Since health insurance claims are the only nationwide applicable and available data source for this purpose, a set of 24 quality indicators (QI) for the measurement of quality of primary care has been previously developed and implemented. The present paper reports on an evidence-based update and extension of the initial QI set.

Methods
Established pragmatic 6-step process based on informal consensus and potential QI extracted from international medical practice guidelines and pre-existing QI for primary care. Experts rated potential QI based on strength of evidence, relevance for Swiss public health, and controllability in the Swiss primary care context. Feasibility of a preliminary set of potential new QI was tested using claims data of persons with basic mandatory health insurance at one of the largest Swiss health insurers. This test built the basis for expert consensus on the final set of new QI. Additionally, two diabetes indicators included in the previous QI set were re-evaluated.

Results
Of 23 potential new indicators, 19 of them were selected for feasibility testing. The expert group consented a final set of 9 additional QI covering the domains general aspects/efficiency (2 QI), diagnostic measures (1 QI), geriatric care (2 QI), osteoarthritis (1 QI), and drug safety (3 QI). Two pre-existing diabetes indicators were updated.

Conclusions
Additional QI relating to overuse and intersectoral care aspects extend the options of measuring quality of primary care in Switzerland based on claims data and complement the initial QI set.
Burnout and the role of authentic leadership in academic medicine
Authors: McPherson Katie , Barnard Juliana G. , Tenney Martha , Holliman Brooke Dorsey , Morrison Katherine , Kneeland Patrick , Lin Chen-Tan , Moss Marc 
Published: May 2022

Abstract
Background
Recently, there has been increasing evidence that reducing burnout in healthcare providers requires significant organizational efforts that include the integration of leadership strategies.

Methods
Focus groups were conducted across four health systems within the University of Colorado Department of Medicine in four affinity groups (administrative staff, medical trainees, research faculty, and clinical faculty). Authentic leadership theory was used for analysis to advance the understanding of the role of leadership style upon participants’ work experiences and preferences, and to identify opportunities for translation of site-specific results to other academic medical settings.

Results
Study participants from each affinity group believed their clinical leaders lacked objectivity with decision-making (lacking “balancing processing”), which contributed to their overall feeling of powerlessness. The experience of increasing work demands was salient throughout all twelve focus groups, and participants identified leadership that interacted in a more open and self-disclosing manner (“relational transparency”) as alleviating at least some of this burden. Strong preference discernable alignment between their leaders’ decision-making and their internal moral compass of values (demonstrating “internalized moral perspective”) was described, as was clinical leaders demonstrating “self-awareness” (having a self-reflective process that informs the leader’s decision-making). Comparing affinity group experiences within each authentic leadership theory construct identified the relevance of contextual factors, such as work setting and roles, upon employees’ perceptions and expectations of their leaders.

Conclusions
Use of authentic leadership theory advanced the understanding of the association between leadership traits and experiences of burnout amongst a large group of academic clinicians, researchers, trainees, and administrative staff. Leadership styles that promoted relationship transparency, openness, and support were preferred and fostering these traits may help address the demands in academic medicine, including symptoms of burnout.
A novel amino acid site of N protein could affect the PRRSV-2 replication by regulating the viral RNA transcription
Authors: Deng Hua , Xin Ning , Zeng Fancong , Wen Feng , Yi Heyou , Ma Chunquan , Huang Shujian , Zhang Guihong , Chen Yao 
Published: May 2022

Abstract
Background
Finding the key amino acid sites that could affect viral biological properties or protein functions has always been a topic of substantial interest in virology. The nucleocapsid (N) protein is one of the principal proteins of the porcine reproductive and respiratory syndrome virus (PRRSV) and plays a vital role in the virus life cycle. The N protein has only 123 or 128 amino acids, some of key amino acid sites which could affect the protein functions or impair the viral biological characteristics have been identified. In this research, our objective was to find out whether there are other novel amino acid sites of the N protein can affect N protein functions or PRRSV-2 replication.

Results
In this study, we found mutated the serine78 and serine 99of the nucleocapsid (N) protein can reduce the N-induced expression of IL-10 mRNA; Then, by using reverse genetics system, we constructed and rescued the mutant viruses, namely, A78 and A99.The IFA result proved that the mutations did not affect the rescue of the PRRSV-2. However, the results of the multistep growth kinetics and qPCR assays indicated that, compared with the viral replication ability, the titres and gRNA levels of A78 were significantly decreased compared with the wild-type. Further study showed that a single amino acid change from serine to alanine at position 78 of the N protein could abrogates the level of viral genomic and subgenomic RNAs. It means the mutation could significant decrease the viral replication efficiency in vitro.

Conclusions
Our results suggest that the serine78 of N protein is a key site which could affect the N protein function and PRRSV replication ability.
Mass spectrometry detection of inhaled drug in distal fibrotic lung
Authors: Mikolasch Theresia A. , Oballa Eunice , Vahdati-Bolouri Mitra , Jarvis Emily , Cui Yi , Cahn Anthony , Terry Rebecca L. , Sahota Jagdeep , Thakrar Ricky , Marshall Peter , Porter Joanna C. 
Published: May 2022

Abstract
Background
Currently the only available therapies for fibrotic Interstitial Lung Disease are administered systemically, often causing significant side effects. Inhaled therapy could avoid these but to date there is no evidence that drug can be effectively delivered to distal, fibrosed lung. We set out to combine mass spectrometry and histopathology with rapid sample acquisition using transbronchial cryobiopsy to determine whether an inhaled drug can be delivered to fibrotic, distal lung parenchyma in participants with Interstitial Lung Disease.

Methods
Patients with radiologically and multidisciplinary team confirmed fibrotic Interstitial Lung Disease were eligible for this study. Transbronchial cryobiopsies and endobronchial biopsies were taken from five participants, with Interstitial Lung Disease, within 70 min of administration of a single dose of nebulised ipratropium bromide. Thin tissue cryosections were analysed by Matrix Assisted Laser Desorption/Ionization-Mass Spectrometry imaging and correlated with histopathology. The remainder of the cryobiopsies were homogenised and analysed by Liquid Chromatography—tandem Mass Spectrometry.

Results
Drug was detected in proximal and distal lung samples from all participants. Fibrotic regions were identified in research samples of four of the five participants. Matrix Assisted Laser Desorption/Ionization-Mass Spectrometry imaging showed co-location of ipratropium with fibrotic regions in samples from three participants.

Conclusions
In this proof of concept study, using mass spectrometry, we demonstrate for the first-time that an inhaled drug can deposit in distal fibrotic lung parenchyma in patients with Interstitial Lung Disease. This suggests that drugs to treat pulmonary fibrosis could potentially be administered by the inhaled route.
Trial registration A prospective clinical study approved by London Camden and Kings Cross Research Ethics Committee and registered on clinicaltrials.gov (NCT03136120)
Higher resolution protein band visualisation via improvement of colloidal CBB-G staining by gel fixation
Authors: Chong Nikson Fatt-Ming , Hussain Hasnain , Hamdin Nur Ezzati , Wee David Hong-Sheng , Nisar Mehvish , Yan Wei-Jie , Lau Benjamin Yii Chung , Rahmad Norasfaliza 
Published: May 2022

AbstractBackgroundGel staining is a crucial step that allows the visualisation of proteins separated through SDS-PAGE. Colloidal Coomassie Brilliant Blue-G (CBB-G) staining is among the commonly used visualisation methods due to several factors such as compatibility with mass spectrometry (MS) analysis, sensitivity, reproducibility, and simplicity of the staining process. However, the standard colloidal CBB-G staining has a drawback: the resolution of protein bands is compromised because of diffusion of proteins during the washing step.ResultsA modification to an established colloidal CBB-G staining method, which greatly increases the resolution of protein bands, is described. The addition of a fixation step, which prevents the diffusion of proteins during the washing step, is shown to increase protein band resolution.ConclusionThe fixation step is fast, flexible, and also retains all the advantages of the standard colloidal CBB-G staining methods. As there are no drawbacks, incorporating this fixation step into the standard colloidal CBB-G staining is an easy way to improve protein visualisation in SDS-PAGE.Graphical Abstract
Can nutrition interventions tackle the global insulin affordability via improving diabetes management and reducing insulin demand?
Authors: Lu Victoria , Zhang Jiandi , Chen Guoxun 
Published: May 2022

AbstractDiabetes, a global health concern, requires insulin therapy. As insulin demand and prices rise dramatically, insulin affordability has increasingly become an issue facing patients with diabetes worldwide. To cut insulin costs, many patients ration their supply, which may have dire health consequences. This particularly affects lower-income populations, who are often forced to choose between purchasing their medications or paying for other necessities. Nutrition might be one solution for this. This commentary aims to provide comprehensive insight with historical context into intersectional components of diabetes in the global arena through analyses of insulin affordability, coupled with the critical role of nutrition intervention after searching the PubMed for relevant articles. More studies in personalized nutrition, supplementations, and dietary behaviors may develop evidence-based nutrition interventions to control diabetes. We argue that alongside price regulation, a greater focus to nutrition to address issues of food insecurity and food assistance programs may help to improve insulin affordability.
Biological applications of the NanoSuit for electron imaging and X-microanalysis of insulating specimens
Authors: Kim Ki Woo 
Published: May 2022

AbstractField emission scanning electron microscopy (FESEM) is an essential tool for observing surface details of specimens in a high vacuum. A series of specimen procedures precludes the observations of living organisms, resulting in artifacts. To overcome these problems, Takahiko Hariyama and his colleagues proposed the concept of the “nanosuit” later referred to as “NanoSuit”, describing a thin polymer layer placed on organisms to protect them in a high vacuum in 2013. The NanoSuit is formed rapidly by (i) electron beam irradiation, (ii) plasma irradiation, (iii) Tween 20 solution immersion, and (iv) surface shield enhancer (SSE) solution immersion. Without chemical fixation and metal coating, the NanoSuit-formed specimens allowed structural preservation and accurate element detection of insulating, wet specimens at high spatial resolution. NanoSuit-formed larvae were able to resume normal growth following FESEM observation. The method has been employed to observe unfixed and uncoated bacteria, multicellular organisms, and paraffin sections. These results suggest that the NanoSuit can be applied to prolong life in vacuo and overcome the limit of dead imaging of electron microscopy.
Implementation Strategies to Increase Clinical Trial Enrollment in a Community-Academic Partnership and Impact on Hispanic Representation: An Interrupted Time Series Analysis
Authors: Ledesma Vicioso Nahomy , Lin Diana , Gomez Daniel R. , Yang Jonathan T. , Lee Nancy Y. , Rimner Andreas , Yamada Yoshiya , Zelefsky Michael J. , Kalman Noah S. , Rutter Charles E. , Kotecha Rupesh R. , Mehta Minesh P. , Panoff Joseph E. , Chuong Michael D. , Salner Andrew L. , Ostroff Jamie S. , Diamond Lisa C. , Mathis Noah J. , Cahlon Oren , Pfister David G. , Zhang Zhigang , Chino Fumiko , Tsai Jillian , Gillespie Erin F. 
Published: May 2022

PURPOSE: Community-academic partnerships have the potential to improve access to clinical trials for under-represented minority patients who more often receive cancer treatment in community settings. In 2017, the Memorial Sloan Kettering (MSK) Cancer Center began opening investigator-initiated clinical trials in radiation oncology in targeted community-based partner sites with a high potential to improve diverse population accrual. This study evaluates the effectiveness of a set of implementation strategies for increasing overall community-based enrollment and the resulting proportional enrollment of Hispanic patients on trials on the basis of availability in community-based partner sites. METHODS: An interrupted time series analysis evaluating implementation strategies was conducted from April 2018 to September 2021. Descriptive analysis ofHispanic enrollment on investigator-initiated randomized therapeutic radiation trials open at community-based sites was compared with those open only at themain academic center. RESULTS: Overall, 84 patients were enrolled in clinical trials in the MSK Alliance, of which 48 (56%) identified as Hispanic. The quarterly patient enrollment pre- vs postimplementation increased from 1.39 (95% CI, –3.67 to 6.46) to 9.42 (95% CI, 2.05 to 16.78; P5 .017). In the investigator-initiated randomized therapeutic radiation trials open in the MSK Alliance, Hispanic representation was 11.5% and 35.9% in twometastatic trials and 14.2% in a proton versus photon trial. Inmatched trials open only at the main academic center, Hispanic representation was 5.6%, 6.0%, and 4.0%, respectively. CONCLUSION: A combination of practice-level and physician-level strategies implemented at community-based partner sites was associated with increased clinical trial enrollment, which translated to improved Hispanic representation. This supports the role Q:2 of strategic community-academic partnerships in addressing disparities in clinical trial enrollment.
Comprehensive Genomic Profiling of High-Risk Pediatric Cancer Patients Has a Measurable Impact on Clinical Care
Authors: Summers Ryan J. , Castellino Sharon M. , Porter Christopher C. , MacDonald Tobey J. , Basu Gargi D. , Szelinger Szabolcs , Bhasin Manoj K. , Cash Thomas , Carter Alexis B. , Castellino Robert Craig , Fangusaro Jason R. , Mitchell Sarah G. , Pauly Melinda G. , Pencheva Bojana , Wechsler Daniel S. , Graham Douglas K. , Goldsmith Kelly C. 
Published: May 2022

PURPOSE Profiling of pediatric cancers through deep sequencing of large gene panels and whole exomes is rapidly being adopted in many clinical settings. However, the most impactful approach to genomic profiling of pediatric cancers remains to be defined. METHODS We conducted a prospective precision medicine trial, using whole-exome sequencing of tumor and germline tissue and whole-transcriptome sequencing (RNA Seq) of tumor tissue to characterize the mutational landscape of 127 tumors from 126 unique patients across the spectrum of pediatric brain tumors, hematologic malignancies, and extracranial solid tumors. RESULTS We identified somatic tumor alterations in 121/127 (95.3%) tumor samples and identified cancer predisposition syndromes on the basis of known pathogenic or likely pathogenic germline mutations in cancer predisposition genes in 9/126 patients (7.1%). Additionally, we developed a novel scoring system for measuring the impact of tumor and germline sequencing, encompassing therapeutically relevant genomic alterations, cancer-related germline findings, recommendations for treatment, and refinement of risk stratification or prognosis. At least one impactful finding from the genomic results was identified in 108/127 (85%) samples sequenced. A recommendation to consider a targeted agent was provided for 82/126 (65.1%) patients. Twenty patients ultimately received therapy with a molecularly targeted agent, representing 24% of those who received a targeted agent recommendation and 16% of the total cohort. CONCLUSION Paired tumor/normal whole-exome sequencing and tumor RNA Seq of de novo or relapsed/refractory tumors was feasible and clinically impactful in high-risk pediatric cancer patients.
Effects of Metastatic Sites on Circulating Tumor DNA in Patients With Metastatic Colorectal Cancer
Authors: Bando Hideaki , Nakamura Yoshiaki , Taniguchi Hiroya , Shiozawa Manabu , Yasui Hisateru , Esaki Taito , Kagawa Yoshinori , Denda Tadamichi , Satoh Taroh , Yamazaki Kentaro , Sunakawa Yu , Kato Takeshi , Goto Masahiro , Yuki Satoshi , Nishina Tomohiro , Oki Eiji , Shinozaki Eiji , Matsuhashi Nobuhisa , Takahashi Naoki , Tsuji Akihito , Ohtsubo Koushiro , Wakabayashi Masashi , Ikeno Takashi , Hata Masayuki , Odegaard Justin I. , Yoshino Takayuki 
Published: May 2022

PURPOSELow concordance between plasma-based and tissue-based tests for determining the RAS mutational status have been reported in some but not all patients with limited-extent metastatic colorectal cancer (mCRC). In this study, we investigated the relationship between metastatic site and circulating tumor DNA (ctDNA) detection using ctDNA genotyping, an alternative to tissue genotyping for precision oncology.MATERIALS AND METHODSWe investigated the relationship between metastatic site and ctDNA detection using Guardant360, a next-generation sequencing ctDNA assay, in mCRC patients with single-organ metastasis in the SCRUM-Japan GOZILA study (UMIN000029315).RESULTSOf 1,187 patients with mCRC enrolled in GOZILA, 138 were eligible (49 with liver-only, 15 with lymph node-only, 27 with peritoneum-only, and 47 with lung-only metastases). The concordance of RAS/ BRAF status between Guaradant360 and tissue in vitro diagnostic tests was 95.9% in patients with liver-only, 80.0% in lymph node-only, 56.0% in peritoneum-only, and 65.9% in lung-only metastases. ctDNA fraction, as measured by the median maximum variant allelic fraction (max VAF), and median number of detected variants were 23.1% and five in liver-only, 6.0% and five in lymph node-only, 0.4% and three in peritoneum-only, and 0.4% and three in lung-only metastases, respectively (all P < .001, Kruskal-Wallis test). Few patients with liver-only (2.0%) and lymph node-only metastasis (13.3%) had a max VAF < 0.2%, which is required to ensure a detection limit of 95%, but max VAF was more frequently < 0.2% in patients with lung-only (27.7%) or peritoneum-only metastasis (29.6%).CONCLUSIONPatients with lung-only and peritoneum-only metastatic disease have significantly lower levels of ctDNA, suggesting decreased clinical sensitivity for subclonal variants. This observation suggests that such patients may benefit from concurrent tissue and plasma testing to provide optimal genotyping for subsequent therapy selection.
Ways to improve external structures for osteosynthesis of distal humerus fractures (early results)
Authors: Bodnya A. , Dubovik S. 
Published: May 2022

The results of the first clinical application of the developed external device for osteosynthesis of distal humerus fractures are presented. Purpose: to improve the extrafocal method of reposition and fixation of humerus shaft fractures at the level of the lower third, taking into account the anatomical and physiological features of the area damaged. Material and methods: Functional, basic fixing and repositioning capabilities of the previously used external device, its advantages and disadvantages are considered. A minimally invasive guided technique for external rod fixation in the treatment of low third humerus’ fractures is described. An improved version of the apparatus layout and transosseous osteosynthesis technology was used in 10 patients. The design of the device allows to eliminate the displacement of the humerus fragments, ensures the stability of their fixation, while maintaining the function of the elbow joint. The indications for the use of external fixation were extra-articular fractures of the humerus in the distal third - type 12A (n = 6), 12B (n =3) and 12C (n =1) according to the AO / ASIF classification. Results: The analysis of treatment outcomes showed that the technology of minimally invasive osteosynthesis allows to achieve positive results in most patients with a minimum of complications - 90.5 ± 3.3 points according to MEPS’s clinic method of assessing the function of the elbow joint. Conclusions: The developed device for transosseous osteosynthesis of distal humerus fractures, is the method of choice and can be widely used in traumatology and orthopedics.