bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of death and dying on the personhood of senior nurses at the National Cancer Centre Singapore (NCCS): a qualitative study
Authors: Ho Chong Yao , Lim Nicole-Ann , Ong Yun Ting , Lee Alexia Sze Inn , Chiam Min , Gek Gillian Phua Li , Sarraf-Yazdi Shiva , Mason Stephen , Krishna Lalit 
Published: May 2022

Abstract
Background
A nurse’s role in caring for the dying is fraught with ethical, professional, and psychosocial challenges that impact how they perceive their roles as professionals. When unsupported, nurses caring for the dying experience burnout, career dissatisfaction and leave the profession. Better understanding of how caring for the dying affects the professional identity formation (PIF) of nurses will guide efforts to better support nurses.

Methods
Guided by new data on the subject, we adopt the theoretical lens of the Ring Theory of Personhood (RToP) to evaluate how caring for the dying impacts the values, beliefs, principles, professional identities and personhood of nurses. We employ Krishna’s Systematic Evidence-Based Approach (SEBA) to guide the design and piloting of the semi-structured interview tool.

Results
Analysis of interviews with eight senior nurses in Supportive, Palliative and Oncology care revealed three domains: Identity 1) Formation; 2) Conflict and 3) Refinement. Identity Formation occurs early in a nurse’s career, upon entering a new specialist field, and at the start of Supportive, Palliative and Oncology care. Identity Formation reveals significant changes to how self-concepts of professional identities are tied to individual concepts of personhood. Caring for the dying, however, resulted in Conflicts between values, beliefs, and principles within regnant concepts of personhood and their professional duties. These conflicts are captured as conflicts within (‘disharmony’) and/or between (‘dyssynchrony’) the rings of the RToP. These conflicts can result in changes to self-concepts of personhood and professional identities. Identity Refinement sees experience and timely support helping nurses attenuate the impact of difficult experiences. This reduces the risk of burnout and mitigates changes to their professional identities. Identity Refinement helps them develop a ‘rooted identity’ which remains relatively consistent in the face of adversity.

Conclusions
Ongoing Identity Construction amongst nurses, particularly in caring for the dying, underscore the host organisation’s role in ensuring structured, longitudinal, accessible, and personalised assessments and support of nurses, especially when they are prone to dyssynchrony and disharmony whilst caring for the terminally ill. Further study into assessment methods and the role of the environment is critical.
Use of a gamified website to increase pain neurophysiology knowledge and improve satisfaction and motivation among students studying for a degree in physiotherapy: a quasi-experimental study
Authors: Valenzuela-Pascual Fran , Pàmies-Fabra Judith , García-Martínez Ester , Martínez-Navarro Oriol , Climent-Sanz Carolina , Gea-Sánchez Montserrat , Virgili-Gomà Jordi , Rubí-Carnacea Francesc , Garcia-Escudero Maria , Blanco-Blanco Joan 
Published: May 2022

Abstract
Background
The scientific evidence highlights the difficulties that healthcare professionals experience when managing patients with chronic pain. One of the causes of this difficulty could be related to the acquired training and the lack of knowledge about the neurophysiology of pain. In the present study, we assessed the effectiveness of a gamified web platform in acquiring knowledge about pain neurophysiology and determining the satisfaction and motivation of students of the Degree in Physiotherapy at the University of Lleida.

Methods
A quasi-experimental study was carried out with a sample of 60 students who had access to a gamified web platform that included notes, videos, and clinical cases prepared by the teaching staff and was based on a previous study that included patients and healthcare professionals.

Results
The results show that after the intervention, there was a statistically significant increase in knowledge about the neurophysiology of pain, and the effect size was in the desired area of ​​effect. Likewise, many students considered that their motivation had increased as a result of the methodology used in the present study.

Conclusions
The results support the use of this methodology to promote knowledge about the neurophysiology of pain while improving students’ motivation.
Physicians’ knowledge and sepsis guide implementation in tertiary care hospitals in China
Authors: Han Silu , Cui Lijian , Qu Yifan , Tian Tian , Wei Bing , Wang Junyu , Yang Jun 
Published: May 2022

Abstract
Background
This study was designed to investigate the extent to which physicians involved in sepsis management understand and adopt sepsis guidelines in clinical practice. The overarching aim of this study was to generate ideas for developing more effective training methods to help physicians apply the guidelines in patient management.

Methods
Physicians working in a tertiary care hospital, primarily in the emergency and critical care departments, were recruited into the survey. They were asked to fill questionnaires which were designed to collect sepsis score, diagnostic indicators, fluid resuscitation, antibiotics choice, access to knowledge and training, as well as implementation of sepsis guidelines in clinical diagnosis and treatment.

Results
Overall, the response rate was 625/661 (94.5%). The investigate shows the basic information of all physicians who participated in the answer sheet, including their work department, professional title and whether their hospital was a teaching hospital. Significant differences were identified among the physicians in terms of method of acquiring sepsis guidelines, the impact of study guidelines on clinical diagnosis and treatment, efficiency of training methods, cognition of fluid resuscitation in patients with sepsis, the cognition of sepsis rehydration principles, selection of antibiotics for patients with sepsis, the basis for antibiotic selection, among other variables.

Conclusion
Although majority of physicians involved in tertiary care hospital understand the contents of sepsis-3 guidelines, the clinical implementation of the guidelines in the diagnosis and treatment of patients with sepsis is highly heterogeneous. Thus, there is need to develop standardized training for physicians involved in sepsis diagnosis and treatment.
Data-sharing and re-analysis for main studies assessed by the European Medicines Agency—a cross-sectional study on European Public Assessment Reports
Authors: Siebert Maximilian , Gaba Jeanne , Renault Alain , Laviolle Bruno , Locher Clara , Moher David , Naudet Florian 
Published: May 2022

Abstract
Background
Transparency and reproducibility are expected to be normative practices in clinical trials used for decision-making on marketing authorisations for new medicines. This registered report introduces a cross-sectional study aiming to assess inferential reproducibility for main trials assessed by the European Medicines Agency.

Methods
Two researchers independently identified all studies on new medicines, biosimilars and orphan medicines given approval by the European Commission between January 2017 and December 2019, categorised as ‘main studies’ in the European Public Assessment Reports (EPARs). Sixty-two of these studies were randomly sampled. One researcher retrieved the individual patient data (IPD) for these studies and prepared a dossier for each study, containing the IPD, the protocol and information on the conduct of the study. A second researcher who had no access to study reports used the dossier to run an independent re-analysis of each trial. All results of these re-analyses were reported in terms of each study’s conclusions, p-values, effect sizes and changes from the initial protocol. A team of two researchers not involved in the re-analysis compared results of the re-analyses with published results of the trial.

Results
Two hundred ninety-two main studies in 173 EPARs were identified. Among the 62 studies randomly sampled, we received IPD for 10 trials. The median number of days between data request and data receipt was 253 [interquartile range 182–469]. For these ten trials, we identified 23 distinct primary outcomes for which the conclusions were reproduced in all re-analyses. Therefore, 10/62 trials (16% [95% confidence interval 8% to 28%]) were reproduced, as the 52 studies without available data were considered non-reproducible. There was no change from the original study protocol regarding the primary outcome in any of these ten studies. Spin was observed in the report of one study.

Conclusions
Despite their results supporting decisions that affect millions of people’s health across the European Union, most main studies used in EPARs lack transparency and their results are not reproducible for external researchers. Re-analyses of the few trials with available data showed very good inferential reproducibility.

Trial registration
https://osf.io/mcw3t/
Prevalence of extended-spectrum β-lactamase-producing Enterobacterales in retail sheep meat from Zagazig city, Egypt
Authors: Abdallah H. M. , Al Naiemi N. , Elsohaby Ibrahim , Mahmoud Abdallah F. A. , Salem Gamal A. , Vandenbroucke-Grauls C. M. J. E. 
Published: May 2022

Abstract
Background
The goal of this study was to investigate the prevalence of extended-spectrum β-lactamase production in Enterobacterales isolated from retail sheep meat in Zagazig, Egypt.

Methods
One hundred random samples of sheep meat were collected from different retail butcher shops (n = 5) in the city of Zagazig, Egypt. Bacterial isolates were identified by MALDI-TOF MS and screened for antibiotic susceptibility by disk diffusion; further genotypic characterization of β-lactamase-encoding genes was performed with Real-Time PCR. E. coli strains were phylotyped with the Clermont triplex PCR method.

Results
Of the total of 101 bacterial isolates recovered from retail sheep meat samples, 93 were E. coli, six were Enterobacter cloacae and two were Proteus mirabilis. As many as 17% of these 100 samples showed ESBL phenotypes, all were E. coli. The blaCTX-M genes were detected in seven isolates (six were blaCTX-M-15 and one was blaCTX-M-14), three isolates harboured blaTEM (all were blaTEM-one), and two carried genes of the blaSHV family (both were blaSHV-12). Eight E. coli isolates expressed ESBL phenotype but no blaTEM, blaSHV or blaCTX-M genes were detected by PCR. ESBL- positive E. coli isolates were nearly equally distributed over the commensal groups A/B1 and the virulent group D.

Conclusion
Nearly one in five sheep meat samples was contaminated with ESBL-E. coli. This further corroborates the potential role played by contaminated meat in the increasing resistance rates that have been reported worldwide.
B7-H3 is eligible for predicting clinical outcomes in lung adenocarcinoma patients treated with EGFR tyrosine kinase inhibitors
Authors: Yang Ying , Huang Jun-feng , Hu Bing-qi , Zhou Jing , Wang Xian , Feng Zhen-zhong , Chen Yu-ting , Pan Fa-ming , Cheng Huai-dong , Chen Li-wen 
Published: May 2022

AbstractBackgroundNot all lung adenocarcinoma (LUAD) patients with activating epidermal growth factor receptor (EGFR) mutations respond to tyrosine kinase inhibitors (TKIs) as intended. Thus, biomarkers are needed to identify patients who benefit most from EGFR-targeted therapy. Our previous in vitro data has shown that the co-signal molecule B7-H3 determines EGFR-TKI gefitinib susceptibility ofEGFR-mutated LUAD cell lines, based on the potential crosslinking between B7-H3-induced signaling and EGFR signaling.MethodsWe detected tumoral B7-H3 expression in the original biopsy from 56 treatment-naïve LUAD patients and analyzed the association between high/low B7-H3 expression with the clinical outcomes of first-line anti-EGFR therapy. The main criteria for the analysis of response were overall response rate (ORR), disease control rate (DCR), and progression-free survival (PFS), and the secondary criterion was overall survival (OS).ResultsIn the subgroups of B7-H3 high and low expression, the ORR were 16.0% (4/25) and 74.2% (23/31) (p<0.001), and the DCR were 36.0% (9/25) and 87.1% (27/31) (p<0.001), respectively. The PFS of B7-H3 high [median 8.7, 95% confidence interval (CI) 4.0–13.4] was significantly worse than that of B7-H3 low (median not reached) [HR 6.54 (95% CI 2.18–19.60),p=0.001]. The median OS was 15.9 (95% CI 10.0–21.8) months in the B7-H3 high cohort and 25.7 (95% CI 9.0–42.4) months in the B7-H3 low subjects [HR 2.08 (95% CI 1.07–4.02),p=0.03], respectively. Both the univariate and multivariate analyses identified B7-H3 as an independent factor associated with poor PFS (p=0.001,p=0.000) and OS (p=0.03,p=0.015).ConclusionB7-H3 may serve as a potential biomarker to predict clinical outcomes inEGFR-mutated LUAD patients treated with first-line EGFR-TKIs.
Long noncoding RNAs as regulators of pediatric acute myeloid leukemia
Authors: Neyazi Sina , Ng Michelle , Heckl Dirk , Klusmann Jan-Henning 
Published: May 2022

AbstractLong noncoding RNAs (lncRNAs) are increasingly emerging as regulators across human development and disease, and many have been described in the context of hematopoiesis and leukemogenesis. These studies have yielded new molecular insights into the contribution of lncRNAs to AML development and revealed connections between lncRNA expression and clinical parameters in AML patients. In this mini review, we illustrate the versatile functions of lncRNAs in AML, with a focus on pediatric AML, and present examples that may serve as future therapeutic targets or predictive factors.
Relationship between smoking, narcissism, and impulsiveness among young women
Authors: Kertzman Semion , Kagan Alex , Vainder Michael , Lapidus Rina , Weizman Abraham 
Published: May 2022

AbstractAlthough the connection between smoking and individual differences has been recently recognized, the relationship between narcissistic personality traits and cigarette smoking has received less attention. The notion that personality traits can be associated with addictive behavior is influential in clinical practice. However, questions remain about specific interactions between smoking and personality characteristics that need empirical support to substantiate this hypothesis. This study thus identifies narcissistic and impulsive personality traits as precursors of smoking in a sample of tattooed individuals. In a cross-sectional study (N = 120), personality traits were assessed in young women (aged 18–35 years) using the narcissistic personality inventory and the Barratt Impulsivity Scale (BIS-11). The current study, using the regression analysis, has clearly demonstrated that young women who smoke have different personality characteristics as compared with women who do not smoke.
Fibrin monomer complex on postoperative day 1 is correlated with the volume of deep vein thrombosis after knee surgery
Authors: Akagawa Manabu , Kijima Hiroaki , Kimura Yoshiaki , Saito Hidetomo , Saito Kimio , Wakabayashi Ikuko , Kashiwagura Takeshi , Miyakoshi Naohisa 
Published: May 2022

Abstract
Purpose
Patients undergoing knee surgery are at high risk for deep vein thrombosis (DVT), which is infrequent but potentially life-threatening. It has not been identified how to efficiently detect high-risk DVT while minimizing bleeding complications from anticoagulation. We hypothesized that the degree of activation of thrombotic markers may correlate with the size of the thrombus. Therefore, we investigated the correlation between thrombotic markers and DVT thrombus volume in patients after knee surgery.

Methods
This retrospective study involved 29 patients who underwent around knee osteotomy or total / unicompartmental knee arthroplasty from 2018 to 2020. Fibrin monomer complex (FMC) at 1, and 7 days after surgery, and D-dimer at 4, and 7 days after surgery were investigated. In addition, the volume of DVT was estimated with ultrasonography at the 7 days after surgery. Body mass index, surgical time, and total volume of blood loss were also evaluated. Factors related to thrombus volume were examined statistically.

Results
Nine patients (31.0%) exhibited asymptomatic distal DVT, whereas 1 patient (3.4%) experienced asymptomatic proximal DVT. No patients had pulmonary embolism. Statistical analysis showed that only FMC concentration on postoperative day 1 was significantly correlated with thrombus volume (p <  0.001, 95% confidence interval 0.41 to 0.839, r = 0.679).

Conclusions
The FMC concentration was a useful early indicator of deep vein thrombosis after knee surgery. Monitoring the FMC concentration could enable selective identification of patients with a high thrombus volume, which is associated with a high risk for pulmonary embolism.
Prognostic value of cervical nodal necrosis on staging imaging of nasopharyngeal carcinoma in era of intensity-modulated radiotherapy: a systematic review and meta-analysis
Authors: Ai Qi-Yong H. , Hung Kuo Feng , So Tiffany Y. , Mo Frankie K. F. , Tsung Anthony Chin Wing , Hui Edwin P. , Ma Brigette B. Y. , Ying Michael , King Ann D. 
Published: May 2022

Abstract
Purposes
To systematically review and perform meta-analysis to evaluate the prognostic value of cervical nodal necrosis (CNN) on the staging computed tomography/magnetic resonance imaging (MRI) of nasopharyngeal carcinoma (NPC) in era of intensity-modulated radiotherapy.

Methods
Literature search through PubMed, EMBASE, and Cochrane Library was conducted. The hazard ratios (HRs) with 95% confidence intervals (CIs) of CNN for distant metastasis-free survival (DMFS), disease free survival (DFS) and overall survival (OS) were extracted from the eligible studies and meta-analysis was performed to evaluate the pooled HRs with 95%CI.

Results
Nine studies, which investigated the prognostic values of 6 CNN patterns on MRI were included. Six/9 studies were eligible for meta-analysis, which investigated the CNN presence/absence in any nodal group among 4359 patients. The pooled unadjusted HRs showed that the CNN presence predicted poor DMFS (HR =1.89, 95%CI =1.72-2.08), DFS (HR =1.57, 95%CI =1.08-2.26), and OS (HR =1.87, 95%CI =1.69-2.06). The pooled adjusted HRs also showed the consistent results for DMFS (HR =1.34, 95%CI =1.17-1.54), DFS (HR =1.30, 95%CI =1.08-1.56), and OS (HR =1.61, 95%CI =1.27-2.04). Results shown in the other studies analysing different CNN patterns indicated the high grade of CNN predicted poor outcome, but meta-analysis was unable to perform because of the heterogeneity of the analysed CNN patterns.

Conclusion
The CNN observed on the staging MRI is a negative factor for NPC outcome, suggesting that the inclusion of CNN is important in the future survival analysis. However, whether and how should CNN be included in the staging system warrant further evaluation.
Patients with hemodialysis-induced hypoxemia had a poor prognosis of COVID-19
Authors: Toda Masataro , Yoshifuji Ayumi , Fujii Kentaro , Komatsu Motoaki , Kato Ai , Tamura Ikue , Sugi Wataru , Ryuzaki Munekazu 
Published: May 2022

Abstract
Background
We experienced that some hemodialysis (HD) patients with coronavirus disease 2019 (COVID-19) exacerbated hypoxemia during HD. Though HD-induced hypoxemia has been reported, there have been no reports of HD-induced hypoxemia in patients with COVID-19 and its effect on prognosis of COVID-19.

Methods
Eleven HD patients admitted with COVID-19 from August 2020 to April 2021 were classified into the patients whose oxygen demand increased by more than 3 L/min with mask during HD (worsened group, n = 5) and others (not-worsened group, n = 6). The background, laboratory findings, severity of COVID-19 and prognosis were compared between the two groups. In addition, blood gases were measured before and after dialysis among HD patients admitted with COVID-19 on April 2021 (n = 3).

Results
There were no significant differences in backgrounds, except for a higher proportion of diabetes mellitus in worsened group (p = 0.04). Although laboratory findings were not significantly different on admission day, albumin and LDH levels 7 days after admission were significantly lower and higher in worsened group, respectively (p = 0.03 and < 0.01). The severity of COVID-19 and survival rate were significantly worse in worsened group (p = 0.01 and 0.03). The alveolar-arterial oxygen pressure difference (Aa-DO2) opened during HD in a patient with HD-induced hypoxemia, but did not open in patients without HD-induced hypoxemia.

Conclusions
There is a close relationship among HD-induced hypoxemia and poor prognosis of COVID-19. The HD-induced hypoxemia of patients with COVID-19 may be caused by ventilation/perfusion mismatching.
Repeated streptococcal peritoneal dialysis-related peritonitis following stomatitis and gingival bleeding: a case report
Authors: Fukumitsu Kento , Oka Hideaki , Iwamoto Takaki , Kondo Mika , Hirashima Yutaro , Kamimura Taro , Nakano Toshiaki , Kitazono Takanari 
Published: May 2022

Abstract
Background
Identification of the pathogenesis of peritoneal dialysis (PD)-related peritonitis is important. However, identification of endogenous peritonitis, especially hematogenous infection, is difficult, and there are few reports of endogenous peritonitis via the bloodstream. We report a case of PD-related peritonitis presumed to be caused by hematogenous infection through the oral mucosa.

Case presentation
A 65-year-old woman commenced PD at the age of 52. Over the next 13 years, she developed two episodes of streptococcal peritonitis caused by Streptococcus salivarius, a commensal bacteria of the human oral mucosa, and all episodes occurred following stomatitis and gingival bleeding in the early summer. At the age of 65, she again suffered from stomatitis followed by gingival bleeding in early summer, and 2 weeks later, developed a third case of peritonitis caused by Streptococcus salivarius. The streptococcal peritonitis improved immediately following 2 weeks of antibiotic treatment. We surmise that the patient is subject to weakened immunity in the early summer, causing repeated oral problems with gingival bleeding, and subsequently leading to oral streptococcal peritonitis.

Conclusions
Our findings suggest that oral streptococcal peritonitis following oral problems such as stomatitis and gingival bleeding results from a hematogenous infection via the oral mucosa.
Factors affecting mechanical thrombectomy outcome in acute ischemic stroke patients: an Egyptian sample
Authors: Elwan Mohammed Ezzat , Mansour Ossama Yasin , Lashin Mohamed Elsaeed , Melake Mostafa Saleh 
Published: May 2022

Abstract
Background
Stroke constitutes a major health problem worldwide, nowadays endovascular treatment is considered to be a standard of care in acute ischemic stroke patients with large vessel occlusion, accurate prediction of outcome of thrombectomy is essential for health care providers, patients and families. We studied different clinical and radiological variables that could predict functional outcome in stroke patients after thrombectomy. Thirty-four consecutive ischemic stroke patients were included, received intravenous tissue plasminogen activator (iv-tpa), then mechanical thrombectomy was done. Patients were clinically assessed at admission with National Institute of Health Stroke Scale (NIHSS) then evaluated by the Alberta Stroke Program early computerized tomography (CT) score (ASPECTS), clot burden scale (CBS) and collateral score (CS) in multiphase computerized tomography angiography (CTA) then good and poor outcomes at 3 months were defined by Modified Rankin Scale (MRS) of 0–2 and 3–6 points, respectively.

Results
Factors associated with good outcome (MRS 0–2) were lower admission NIHSS score (p < 0.037), small infarct core aspects ≥ 6 (p < 0.001), low clot burden (CBS 7–10) (p = 0.046) good collaterals (2–3) (p = 0.038) and absence of post-procedure hemorrhage (p < 0.0005).

Conclusions
Low admission NIHSS score, absence of post-procedure hemorrhage, small infarct core, low clot burden and good collaterals are reliable factors for good clinical outcome.