bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives of HIV specialists and cardiologists on the specialty referral process for people living with HIV: a qualitative descriptive study
Authors: Muiruri Charles , Corneli Amy , Cooper Linda , Dombeck Carrie , Gray Shamea , Longenecker Chris T. , Meissner Eric G. , Okeke Nwora Lance , Pettit April C. , Swezey Teresa , Vicini Joseph , Bloomfield Gerald S. 
Published: May 2022

AbstractBackgroundCardiology care may be beneficial for risk factor management in people living with HIV (PLWH), yet limited information is available about the referral process from the perspectives of HIV specialists and cardiologists.MethodsWe conducted 28 qualitative interviews at academic medical centers in the United States from December 2019 to February 2020 using components of the Specialty Referral Process Framework: referral decision, entry into referral care, and care integration. We analyzed the data using applied thematic analysis.ResultsReasons for cardiology referral most commonly included secondary prevention, uncontrolled risk factors, cardiac symptoms, and medication management. Facilitators in the referral process included ease of referral, personal relationships between HIV specialists and cardiologists, and close proximity of the clinic to the patient’s home. Barriers included lack of transportation, transportation costs, insurance coverage gaps, stigma, and patient reluctance.ConclusionsOur results will inform future studies on implementation strategies aimed at improving the specialty referral process for PLWH.Trial RegistrationClinicalTrials.gov Identifier:NCT04025125.
Evaluating the reasons for nonattendance to outpatient consultations: is waiting time an important factor?
Authors: Zykienė Bernadeta , Kalibatas Vytenis 
Published: May 2022

Abstract
Background
Nonattendance is a common problem worldwide. Important factors for nonattendance are a queue or the waiting time until the planned service.

Aims
The aims of this study were to identify the reasons for nonattendance to planned consultations, assess the waiting time from registration to access to an outpatient specialist consultation, and identify the associations between the reasons for nonattendance and the waiting time until the planned outpatient specialist consultation.

Methods
A cross-sectional study based on a phone questionnaire was conducted among patients not attending a planned consultation at the outpatient department of the Lithuanian University of Health Sciences Kaunas Hospital in Kaunas, Lithuania. A total of 972 phone calls were made, and 389 telephone surveys were completed.

Results
The mean respondents’ waiting time until the planned outpatient consultation was 15.13 ± 10 days. The highest proportion of nonattendance was observed when the wait time was between 6 and 17 days.
More often, the patients did not attend the planned outpatient consultation due to worsened health status (24.69%), unidentified personal problems (14.91%), work-related problems (13.62%) and being unaware about the appointment (11.82%). A longer waiting time was significantly associated with the following reasons for nonattendance: work-related problems, health problems solved at another health care institution, unidentified personal problems and unknown reasons for nonattendance. The highest proportions of nonattending patients had consultations registered with neurologists (17.0%), traumatologists (11.3%) and cardiologists (10.5%).

Conclusions
Patients did not identify the long waiting time until outpatient specialist consultation among the main reasons for nonattendance. The issue of waiting time is not an important aspect of nonattendance.
Integrated investigation of DNA methylation, gene expression and immune cell population revealed immune cell infiltration associated with atherosclerotic plaque formation
Authors: Yin Yihong , Xie Zhaohong , Chen Dong , Guo Hao , Han Min , Zhu Zhengyu , Bi Jianzhong 
Published: May 2022

Abstract
Background
The clinical consequences of atherosclerosis are significant source of morbidity and mortality throughout the world, while the molecular mechanisms of the pathogenesis of atherosclerosis are largely unknown.

Methods
In this study, we integrated the DNA methylation and gene expression data in atherosclerotic plaque samples to decipher the underlying association between epigenetic and transcriptional regulation. Immune cell classification was performed on the basis of the expression pattern of detected genes. Finally, we selected ten genes with dysregulated methylation and expression levels for RT-qPCR validation.

Results
Global DNA methylation profile showed obvious changes between normal aortic and atherosclerotic lesion tissues. We found that differentially methylated genes (DMGs) and differentially expressed genes (DEGs) were highly associated with atherosclerosis by being enriched in atherosclerotic plaque formation-related pathways, including cell adhesion and extracellular matrix organization. Immune cell fraction analysis revealed that a large number of immune cells, especially macrophages, activated mast cells, NK cells, and Tfh cells, were specifically enriched in the plaque. DEGs associated with immune cell fraction change showed that they were mainly related to the level of macrophages, monocytes, resting NK cells, activated CD4 memory T cells, and gamma delta T cells. These genes were highly enriched in multiple pathways of atherosclerotic plaque formation, including blood vessel remodeling, collagen fiber organization, cell adhesion, collagen catalogic process, extractable matrix assembly, and platelet activation. We also validated the expression alteration of ten genes associated with infiltrating immune cells in atherosclerosis.

Conclusions
In conclusion, these findings provide new evidence for understanding the mechanisms of atherosclerotic plaque formation, and provide a new and valuable research direction based on immune cell infiltration.
Exploring factors influencing chiropractors’ adherence to radiographic guidelines for low back pain using the Theoretical Domains Framework
Authors: To Daphne , Hall Amanda , Bussières André , French Simon D. , Lawrence Rebecca , Pike Andrea , Patey Andrea M. , Brake-Patten Debbie , O’Keefe Lino , Elliott Barbara , De Carvalho Diana 
Published: May 2022

Abstract
Background
The inappropriate use of lumbar spine imaging remains common in primary care despite recommendations from evidence-based clinical practice guidelines to avoid imaging in the absence of red flags. This study aimed to explore factors influencing ordering behaviours and adherence to radiographic guidelines for low back pain (LBP) in chiropractors in Newfoundland and Labrador (NL), Canada.

Methods
We conducted two focus groups in December 2018 with chiropractors in different regions of NL (eastern, n = 8; western, n = 4). An interview guide based on the Theoretical Domains Framework (TDF) served to identify perceived barriers to, and enablers of, target behaviours of guideline adherence and managing LBP without X-rays. We conducted thematic analysis of chiropractors’ statements into relevant theoretical domains, followed by grouping of similar statements into specific beliefs. Domains key to changing radiographic guideline adherence, LBP imaging behaviours, and/or informing intervention design were identified by noting conflicting beliefs and their reported influence on the target behaviours.

Results
Six of the 14 TDF domains were perceived to be important for adherence to radiographic guidelines and managing non-specific LBP without imaging. Participating chiropractors reported varying levels of knowledge and awareness of guidelines for LBP imaging (Knowledge). Many chiropractors based their decision for imaging on clinical presentation, but some relied on “gut feeling” (Memory, attention, and decision processes). While chiropractors thought it was their role to manage LBP without imaging, others believed ordering imaging was the responsibility of other healthcare providers (Social/professional role and identity). Contrasting views were found regarding the negative consequences of imaging or not imaging LBP patients (Beliefs about consequences). Communication was identified as a skill required to manage LBP without imaging (Skills) and a strategy to enable appropriate imaging ordering behaviours (Behavioural regulation). Chiropractors suggested that access to patients’ previous imaging and a system that facilitated better interprofessional communication would likely improve their LBP imaging behaviours (Behavioural regulation).

Conclusion
We identified potential influences, in six theoretical domains, on participating chiropractors’ LBP imaging behaviours and adherence to radiographic guidelines. These beliefs may be targets for theory-informed behaviour change interventions aimed at improving these target behaviours for chiropractors in NL.
Effect of different types of oil intake on the blood index and the intestinal flora of rats
Authors: Xu Yan , Zhu Wenzheng , Ge Qingfeng , Zhou Xiaoyan 
Published: May 2022

AbstractDietary fat is an important part of human diet and has a close relationship with human health. However, it is still unclear how gut microbiota in adolescent responds to dietary fats at a normal dose. In this study, fat-free group (BC) was used as blank control group, we explored blood index and gut microbiota structure in growing rat(aged 1 months) after feeding a normal dose of 16.9% stewed lard(SL), refined lard(RL), fish oil(FO) and soybean oil(SO) for 6 weeks, respectively. The results showed that compared with RL group, SL group showed reduced fasting blood sugar and blood lipid levels and improved nutrient absorption capacity of the intestine. The blood indexes of glucose (Glu), total cholesterol (TC) and total triglyceride (TG) in FO treatment group were relatively low. The abundance of Bacteroidetes in the BC group decreased, and the abundance of Firmicutes increased. The Firmicutes/Bacteroidetes ratio of the FO group was relatively low, and the Firmicutes/Bacteroidetes ratio of the SL group and the SO group was lower than that of the RL group. The abundance of Bacteroidaceae in the SL group was increased. Research results showed that fat-free diets will increase the risk of obesity to a certain extent; compared with refined lard, stewed lard, soybean oil and fish oil can reduce the risk of obesity to a certain extent. The present study could find that the addition and types of dietary fat will affect the abundance and diversity of rat intestinal flora, and provide some information for nutritional evaluation about these dietary lipids.
A pixel analysis technique and unmanned aircraft system for horizontal displacement in the landslide potential area
Authors: Liu Che-Hsin , Ho Jui-Yi , Chu Chung-Ray , Chang Chih-Hsin , Chen Hongey 
Published: May 2022

Abstract Quantitative horizontal displacement in the landslide potential area is necessary for mitigating casualties, property damage, and economic loss. Focusing on a sliding within a deep-seated landslide potential area located in Guanghua area in northern Taiwan, this study employed an unmanned aerial system (UAS) to capture and produce seven high-precision orthomosaics from February 23 to March 26, 2021. Through particle image velocimetry (PIV) method, these orthomosaics were used to assess the two-dimensional land surface displacement in the sliding-movement region. The results revealed substantial displacement in the study region within the monitoring period. The direction of displacement was consistent with the slope aspect in the region. To evaluate the suitability of the proposed model, the coefficient of efficiency was chosen to determine the goodness-of-fit between the observed and calculated two-dimensional displacement in situ land surface displacement extensometer. The result showed that coefficient of efficiency was up to 0.998. In addition, the greatest displacement was observed in the vegetated section located at the bottom of the sliding-movement region. This section also had the highest slope, and its maximum tree-crow displacement exceeded 9 m. PIV facilitated easy identification of the range and boundaries of the sliding area. This noncontact monitoring technique overcame the limitations of single-point displacement assessment, obviating the time-consuming, costly processes involved in conventional monitoring methods. The achieved results obtained by proposed method gave a worthy support for an accurate understanding and evaluation of the landslide processes in the watershed. The technique can also be applied to other critical infrastructure sites, allowing hazard risk reduction.
Pain in midlife women: a growing problem in need of further research
Authors: Pavlović Jelena M. , Derby Carol A. 
Published: May 2022

AbstractMore than 10% of American adults experience some level of daily pain, and nearly 40 million (17.6%) experience episodes of severe pain annually. Women are particularly impacted by both episodic and chronic pain with higher prevalence and a greater level of pain-related disability compared to men. Midlife is a critical period for women during which the frequency of pain complaints begins to increase. Although pain is known to be influenced and controlled by sex hormones, it has not been widely recognized as a symptom of the menopausal transition outside of the menopause research community. The recent thematic series in this journal has specifically highlighted pain related conditions including rheumatoid arthritis, migraine and abdominal pain for which the significance among midlife women is not typically recognized. The studies presented in this thematic series present a small fraction of relevant, understudied questions regarding pain and its impact on women in midlife. Addressing the gaps in knowledge will require longitudinal studies that consider the emergence of pain symptomatology in relation to midlife trajectories of other symptoms and health determinants, as well as further study of new and emerging therapies.
Rapid enlargement of pulmonary benign metastasizing leiomyoma with fluid-containing cystic change: a case report
Authors: Yanagihara Takahiro , Kobayashi Naohiro , Kawamura Tomoyuki , Kikuchi Shinji , Goto Yukinobu , Ichimura Hideo , Sato Yukio 
Published: May 2022

Abstract
Background
Pulmonary benign metastasizing leiomyoma (PBML) is a rare disease that can occur in women with a history of uterine leiomyoma. Despite its benign histological features, like a malignancy, leiomyomas can on rare occasion spread to the lung. Typically, PBML presents with asymptomatic multiple solid lung nodules with slow tumor progression, following hysterectomy. Here, we present an atypical case with rapid enlargement of PBML with fluid-containing cystic change.

Case presentation
We experienced a case of a 49-year-old woman with bilateral lung nodules following hysterectomy. Two nodules in the right lung had cystic change with fluid in the tumors. Hormone therapy was initiated after surgical biopsy of the left lung confirmed a diagnosis of PBML. However, the cystic component of right upper lobe lesion enlarged rapidly over the following 7 months, and, considering the risk of malignant transformation or tumor rupture, right upper lobectomy was performed. Pathologically, the fluid-containing tumor was diagnosed as PBML.

Conclusion
Given the risk of rapid progression, we should carefully consider the surgical indications of fluid-containing PBML.
Bitcoin price change and trend prediction through twitter sentiment and data volume
Authors: Critien Jacques Vella , Gatt Albert , Ellul Joshua 
Published: May 2022

AbstractTwitter sentiment has been shown to be useful in predicting whether Bitcoin’s price will increase or decrease. Yet the state-of-the-art is limited to predicting the price direction and not the magnitude of increase/decrease. In this paper, we seek to build on the state-of-the-art to not only predict the direction yet to also predict the magnitude of increase/decrease. We utilise not only sentiment extracted from tweets, but also the volume of tweets. We present results from experiments exploring the relation between sentiment and future price at different temporal granularities, with the goal of discovering the optimal time interval at which the sentiment expressed becomes a reliable indicator of price change. Two different neural network models are explored and evaluated, one based on recurrent nets and one based on convolutional networks. An additional model is presented to predict the magnitude of change, which is framed as a multi-class classification problem. It is shown that this model yields more reliable predictions when used alongside a price trend prediction model. The main research contribution from this paper is that we demonstrate that not only can price direction prediction be made but the magnitude in price change can be predicted with relative accuracy ( 63%).
Residents as teachers in Neurology: a Germany-wide survey on the involvement of neurological residents in clinical teaching
Authors: Biesalski Anne-Sophie , Tönges Lars , von Kirchbauer Isabelle , Gülke Eileen , Eisenberg Hanna , Ippen Franziska Maria , Schmidt-Graf Friederike 
Published: May 2022

Abstract
Background
Residents play an important role in the clinical training of medical students, spending up to 25% of their daily work teaching. In the US medical curriculum didactic courses for residents already exist and their role as a teacher is firmly anchored. In Germany, there are no fixed regulations or residents-as-teachers-programs. The aim of this study was to evaluate the activities of neurological residents in clinical teaching.

Methods
We conducted a prospective cross-sectional online survey among neurological residents in Germany. The evaluation was carried out descriptively and by means of text analysis.

Results
138 residents from 39 German neurological university hospitals answered the survey. Nearly half of them needed the teaching activity as part of their career planning. The residents are mostly involved in practical courses. More than 80% stated, that they enjoy teaching. 64% stated that there were no preparatory courses for teaching at their hospital/university. 78.4% of the respondents received no or merely insufficient feedback for their own teaching and 62.5% had only little or even no knowledge about the university curriculum.

Conclusions
By teaching medical students, residents play an outstanding role in recruiting students for neurology and, simultaneously, teaching leads an improvement in the residents’ own learning. To encourage young neurologists as teachers and—at the same time as learners—Clinic directors and universities should promote residents-as-teachers programs in neurology and reward the residents’ teaching activities.
Lessons Learnt From the First Year of a First-of-Its-Kind Breast Cancer Patient Psychosocial Support Group in Ethiopia and Promising Practices for Initiation and Implementation of Survivor Support Programs in Low-Resource Settings
Authors: Deressa Biniyam Tefera , Bekele Etsegenet , Hussen Rahima , Lott Breanne 
Published: May 2022

PURPOSE Psychosocial support helps cancer patients adjust to diagnosis and treatment and improve their overall well-being. With few resources committed to cancer prevention and treatment in Ethiopia, patients’ and survivors’ mental health needs are frequently disregarded, resulting in low quality of life. In October 2020, a support group for breast cancer (BC) patients was formed at Adama Hospital Medical College (AHMC), the first of its kind in Ethiopia. Here, we reflect on lessons learnt from the first year of implementation and share promising practices for establishing such groups in low-resource settings. METHODS The founder and facilitators of the AHMC BC patient and survivor support group describe the program and critically reflect on its impact, challenges to implementation, lessons learned, and ideas for further improvement. Ng and Colombani’s framework for selecting best practices in public health (2015) is used to organize key themes. RESULTS One Saturday each month, 20-30 patients and survivors gather with a traditional Ethiopian coffee ceremony. Participants report feelings of empowerment, hope, and confidence, a stronger sense of interconnectedness with others, and increased engagement in social activities. One notable success was the advocacy opportunity for the women to speak with hospital administrators and Ministry of Health officials at a BC Awareness Month celebration this year. Implementation challenges include a lack of funding, lack of a trained psychologist, and ethical uncertainty about distress caused when members die (not uncommon as patients typically present with advanced stage disease). Clinicians have learned important lessons about patients’ lay beliefs and consequently, patient counseling has been improved to incorporate topics of diet, sexuality, and pregnancy. CONCLUSION A first-of-its-kind BC patient and survivor support group improves perceived psychosocial well-being and quality of life for women in Ethiopia. The low-cost program shares promising practices for survivor support groups and patient-centered cancer treatment in low-resource contexts.
Metronomic Dosing for Pancreatic Cancer Combination Therapy Treatment Association With Reduced Neutropenia
Authors: Gill Sharoon , Killian Rakesh 
Published: May 2022

PURPOSE Metronomic dosing for pancreatic cancer combination therapy treatment association with reduced neutropenia. METHODS This research aims to evaluate the use of combination therapy for shrinking tumor size in patients with metastatic pancreatic cancer using gemzar/paclitaxel combination therapy for treatment. Patients with pancreatic cancer were treated and observed in a cancer outpatient clinic. Gemzar/Paclitaxel combination therapy was used in lower than recommended dose. Patients were educated on the risk of neutropenia associated with combination chemotherapy. Labs were repeated every month to assess the tumor size, metastasis of tumor growth to other organs and neutropenia associated with combination chemotherapy. RESULTS Patient in the clinic undergoing chemotherapy showed that using gemzar/paclitaxel combination therapy has reduced chance of neutropenia when used with low dose intervals in metastatic pancreatic cancer. CONCLUSION We observed that using metronomic dosing in patients using combination therapy for pancreatic cancer shows decreased neutropenia compared to others who did not receive metronomic dosing on combination treatment with gemzar/paclitaxel. While neutropenia is decreased, patients also have decline in the metastasis of the tumor to other organs and shrinkage in the size of tumor.