bluuebunny/crossref_metadata_2025_split huggingface dataset:
Access to internet, smartphone usage, and acceptability of mobile health technology among cancer patients
Authors: Potdar Rashmika , Thomas Arun , DiMeglio Matthew , Mohiuddin Kamran , Djibo Djeneba Audrey , Laudanski Krzysztof , Dourado Claudia M. , Leighton John Charles , Ford Jean 
Published: November 2019

Abstract
Purpose: The use of mobile health (mHealth) technologies to augment patient care, enables providers to communicate remotely with patients enhancing the quality of care and patient engagement. Few studies addressed barriers to its implementation, especially in medically underserved populations. Methods: A cross-sectional study of 151 cancer patients was conducted at an academic medical center in the United States. A trained interviewer performed structured interviews regarding the barriers and facilitators of patients’ current and desired utilization of technology for healthcare services. Results: Of the 151 participants, 35.8% were male and ages ranged from 21-104 years. Only 73.5% of participants currently have daily access to internet, and 68.2% currently own a smartphone capable of displaying mobile applications. Among all participants, utilization of a daily mHealth application was significantly higher in patients with a college-level degree (OR; 2.78, p<0.01) and lower in older patients (OR; 0.05, p<0.01). Differences in utilization when adjusted for current smartphone use and daily access to internet were nonsignificant. Among smartphone users, the desire to increase cancer knowledge was associated with a higher likelihood of utilizing a mHealth application (OR; 261.53, p<0.01). Conclusion: The study suggests the access to mobile technology is the predominant determinant of utilization. Healthcare organizations should consider these factors when launching patient engagement platforms.
Factors associated with work-private life conflict and leadership qualities among line managers of health professionals in Swiss acute and rehabilitation hospitals – a cross-sectional study
Authors: Peter Karin Anne , Halfens Ruud JG , Hahn Sabine , Schols Jos MGA 
Published: November 2019

Abstract
Background: The workforce shortage of health professionals is a current concern, with a high level of work-related stress being an important reason why health professionals leave their career prematurely. In particular, incompatibility between work and private life and a lack of leadership qualities among line managers are important factors in health professionals’ satisfaction and health at work. This study therefore aimed to identify key associated factors of work-private life conflicts and of poor managerial leadership quality among health professionals. Methods: This study is based on a cross-sectional survey in 26 Swiss acute and rehabilitation hospitals, consisting of 3398 health professionals from various disciplines. For data analysis, multilevel models (with hospitals as the second level variable) were performed for ‘work-private life conflict’ and ‘quality of leadership’, considering significant main effects (using AIC) and significant interactions (using BIC) of potential explanatory variables. Results: The main findings of this study reveal that the compatibility of health professionals’ work and private life is associated with topics of shift planning, specifically regarding their influence on shift planning (possibility of exchanging shifts, β=-2.87, p=0.000), the extent to which their individual preferences are considered (e.g. working in one specific shift only, β=6.31, p=0.000), the number of shifts per weekend (β=1.38, p=0.002) and the number of hours per week (β=0.13, p=0.000) they had to work. In addition, high quantitative demands (β=0.25, p=0.000) as well as being required to hide their emotions (β=0.16, p=0.000) and poor social community at work (β=-0.12, p=0.000) were also related to a severe work-private life conflict. Regarding managerial leadership, health professionals perceived the leadership qualities of their direct line manager as better if they received more social support (β=0.61, p=0.000) and rewards (β=0.41, p=0.000) at work. Conclusions: These study results show key components of improving the compatibility of work and private life as well as managerial leadership qualities among health professionals and can help top executives working in acute or rehabilitation hospitals to develop appropriate interventions.
The excessive use of cesarean section and its contribution factors in Shanghai, China
Authors: Xiao Yuyin , Shi Chenshu , Zeng Wu , Dong Minye , Lu Chunling , Liu Yiting , Zhang Jun , Li Guohong 
Published: November 2019

Abstract
Objectives: This study proposes a mathematical analysis framework to estimate the proportion of cesarean section (CS) with non-medical indications and of CS cases correctly diagnosed, examine the excessive use of CS, and investigate its contributing factors in Shanghai. Design and Settings A mathematical model (C-model), developed by the World Health Organization, was employed to estimate the expected proportion of women having CS based on clinical indicators. Cases in which CS occurred but vaginal delivery (VD) was recommended instead by the C-model were regarded as "Suspicious CS". Cases that are “CS of suspected non-medical indications” were identified and used for categorical principal component analysis to explore causes of "Suspicious CS". A Bayesian model was used to calculate the proportion of correctly diagnosed CS. The use of CS and medical conditions were collected from 5,686 pregnant women delivered in twenty public hospitals with obstetrics departments in 2016, which were randomly selected in Shanghai. The excessive use of CS in Shanghai and the cost of "CS suspected non-medical indications" were estimated. Results 43.96% of pregnant women performed CS in Shanghai in 2016, much higher than the expected CS rate of 30.13% according to the C-model. A total of 1271 CS cases were classified as “Suspicious CS”, representing 22.35% of the sample. There were 784 cases classified as “CS of suspected non-medical indications”, including CS caused by fetal heart rate abnormality/fetal distress and cesarean delivery on maternal request (CDMR), accounting for 13.79% of the sample. Based on Bayes estimation, only 42.5% of pregnant women who had CS were medically necessary. If the CS with non-medical indications were appropriately controlled, the hospitalization costs in the whole year in Shanghai would drop by about US$ 60 million (408 million RMB). Conclusion The study provides empirical evidence on non-medical indications of CS in Shanghai, and uses a mathematical model to estimate the excessive use of CS. The high rate of CS in Shanghai was associated with non-medical indications. Establishing clinical standards of CS, especially in relations to abnormal fetal heart rate/fetal distress, would help reduce CS without medical indications, which would significantly lower medical expenses of hospitalization.
ADL Recovery Trajectory after Discharge and its Predictors among Baseline-Independent Older Inpatients
Authors: Li Xiuyue , Zheng Tingting , Guan Yaqi , Li Hui , Zhu Kexin , Shen Lu , Yin Zhiqin 
Published: November 2019

Abstract
Background Among the previous studies about the ADL recovery and its predictors,the researches and resources used to study and protect the baseline-independent older patients from being permanently ADL-dependent was few. We aimed to describe the level of activities of daily living (ADL) at discharge and ADL change within 6 months after discharge in older patients who were ADL-independent before admission but became dependent because of acute illness, and to identify the predictors of early rehabilitation,so as to provide the basis to early intervention. Methods Stratified cluster sampling was used to recruit 520 hospitalised older patients who were ADL-independent from departments of internal medicine at two tertiary hospitals from August 2017 to May 2018. Demographics, clinical data, and ADL status at 1, 3, and 6 months after discharge were collected. Data were analysed using descriptive statistics, Student’s t-test,Pearson’s chi-square test,Spearman’s correlation analysis, binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis. Results There were 403 out of 520 patients completing the 6-month follow-up, and 229 (56.8%) regained independence at 6 months after discharge. There was an overall increasing trend in ADL with time. The recovery rate was the highest within the first month after discharge, gradually declined after 1 month, and changed less obviously from 3 to 6 months after discharge (P<0.001). ADL score at discharge (OR=1.034, P<0.001), age (OR=0.269, P=0.001), post-discharge residence (OR=0.390, P<0.05), and cognition status at discharge(OR=1.685, P<0.05) were predictors of ADL recovery. The area under the curve of the four predictors combined was 0.763 (P<0.001). Conclusion Studying ADL recovery rate and its predicting indicators of the baseline independent inpatients at different time points provide a theoretical reference for the formulation of nursing plans and allocation of care resources.
Rapid direct identification of positive paediatric blood cultures by MALDI-TOF MS technology and its clinical impact in the paediatric hospital setting.
Authors: Samaranayake Waniganeththi Arachchige Manori Piyumal , Dempsey Suzanne , Howard-Jones Annaleise R , Outhred Alexander Conrad , Kesson Alison Margaret 
Published: November 2019

Abstract
Objective: Rapid diagnostic tools are imperative for timely clinical decision making, particularly in bacteraemic patients. This study evaluated the performance of a fast, inexpensive novel in house method for processing positive blood cultures for immediate identification of microorganisms by MALDI-TOF mass spectrometry (Vitek MS bioMérieux). We prospectively analyzed the clinical impact of such method on the management of pediatric patients.Result: In total, 360 positive blood cultures were included in this study. Among 318 mono-microbial cultures, in-house method achieved correct identification in 270 (85%) cultures to the species level, whilst 43 (13.5%) gave no identification, and 7 (2.2%) gave discordant identifications. Identification of Gram-negative organisms was accurate to both species and genus level in 99% of isolates, and for Gram positives accuracy was 84% to genus and 81% to species level overall, with accuracy of 100% for Staphylococcus aureus and Enterococcus to the species level. Assessment of the potential impact of direct MALDI-TOF identification in sixty sequential cases revealed a clear clinical benefit in 35.5% of cases. Benefits included timely antibiotic rationalization, change of medical intervention, and early confirmation of contamination. This study demonstrates a highly accurate in-house method with considerable potential clinical benefits for paediatric care.
Anxiety related disorders in adolescents in the United Arab Emirates: a population based cross-sectional study
Authors: Al-Yateem Nabeel , Issa Wegdan Bani , Rossiter Rachel C , Al-Shujairi Arwa , Radwan Hadia , Awad Manal , Fakhry Randa , Altayeb Ibrahim 
Published: November 2019

Abstract
Background Anxiety disorders are common among children and adolescents. However, there is a paucity of up-to-date data on the prevalence and correlates of anxiety-related disorders among children and adolescents in the United Arab Emirates (UAE).Methods We conducted a cross sectional study to determine the prevalence of specific anxiety-related disorders (e.g., generalized anxiety disorder, panic disorder, separation anxiety, social anxiety) in the UAE, and identify correlations between these disorders and adolescents’ demographic variables. Participants were 968 adolescents aged 13–18 years attending secondary schools across the UAE. Convenience sampling was used to recruit participants. We collected demographic information and data about participants’ anxiety levels. Anxiety was assessed using the Arabic and English versions of the Screen for Child Anxiety Related Disorders scale. Univariate analyses (independent sample t -tests and analysis of variance) were performed to evaluate factors affecting participants’ anxiety scores. Chi-square tests were used to compare proportions of anxiety disorders between boys and girls.Results Participants’ mean age was 16±1.8 years, and 65.8% were female. The overall prevalence of anxiety disorders was 28%, with this being significantly higher in girls (33.6%) than boys (17.2%) (p<.0001). Participants aged <16 years had higher generalized anxiety, separation anxiety, and social anxiety scores compared with those aged ≥16 years (p≤.05). Those from households with a maid had significantly higher generalized anxiety, panic disorder, separation anxiety, and significant school avoidance scores than those without a maid (p≤.05). In addition, participants from middle and low economic backgrounds had higher separation anxiety scores compared with children from high economic backgrounds (p≤.05). The multivariate analysis showed the main risk factors for anxiety were gender and caregiver.Conclusions We found a high incidence of anxiety-related disorders among school-aged adolescents in the UAE, with girls being more affected than boys. This suggests that age-appropriate initiatives are urgently needed to reduce the high rate of anxiety-related disorders. It may also be necessary to further investigate the two main risk factors for anxiety identified in this study (being female and non-parental caregivers).
Let us say what we need ourselves: report of the interview of mental health service users with schizophrenia in South-West Nigeria.
Authors: Oyelade Oyeyemi Olajumoke , Nkosi Nokuthula Gloria 
Published: November 2019

Abstract
Schizophrenia is one of the, most chronic mental illnesses that subjects’ individuals who are suffering from dictatorship and control by close associates/friends, family and health professionals. The productivity of individuals who have schizophrenia is also reduced, due to the debilitating effect of the illness. In some countries, the right of such individuals is protected by laws guiding their treatment, however in the majority of the low-middle income countries (64%), Nigeria included, there are no Mental Health Acts that protect the rights of individuals in such categories. Without law or guidance, individual health professionals engage in trial and error, subjective ideas, or dictatorship. However, in a situation where recovery has been achieved, which is a function of remission of symptoms, there is a need for mental health service users to take part in their care. When a mental health service users’ voice is heard and appreciated, there is a high tendency for quick improvement, and this makes rehabilitation goals achievable. This study, therefore, describes the rehabilitation activities for individuals with schizophrenia in South-West Nigeria.
A descriptive qualitative approach and semi-structured interviews were used to gather information from mental health service users at the eight clinics of the two tertiary psychiatric institutions in South-West Nigeria. Twenty-nine mental health service users were interviewed. The results of the interview were analysed independently by both researchers through a content analysis approach, using NVIVO version 11. The results of the analysis were compared, and an agreement reached on the conclusion.
This study revealed that there was no uniform approach to rehabilitation of individuals with schizophrenia in South-West Nigeria, and instances of dictatorship and dependence by professional on the choice of activities were eminent. For the few who were able to make an informed decision, the mental health service users did better on what they chose to do themselves than what the family and health professionals suggested. However, when the mental health service users, did what they felt was best for them; this indicated a certain level of rehabilitation. This study, therefore, encourages the development of practice guidelines for the rehabilitation of individuals with schizophrenia in Nigeria.
Study investigating executive function in schizophrenia patients and their unaffected siblings
Authors: Xu Feifei , He Kongliang , Bai Xiaomeng , Wang Lu , Xiao Guixian , Yu Fengqiong , Chen Xingui , Hu Panpan , Zhu Chunyan , Wang Kai 
Published: November 2019

Abstract
Background: Schizophrenia (SCZ) is a serious genetic mental illness. Most research indicates that executive impairment has a certain genetic predisposition. The shared neuropathological characteristics of patients with schizophrenia and their siblings might reveal intermediate phenotypes in behavior that could be used to further characterize the illness. Methods: Our study involved 32 schizophrenia patients, 32 unaffected siblings,and 33 healthy controls. The three groups underwent a computerized version of the Wisconsin Card Sorting Test (WCST) and a battery of cognitive neuropsychological assessments. These tests evaluated executive function and several cognitive domains. Results: In this study, the WCST results demonstrate that the total correct (TC), total error (TE), perseverative response (PR) and perseverative error (PE) scores in the SZ group were significantly lower than those in the HC group (TC (p=0.011), TE (p<0.001), PR (p=0.007) and PE (p=0.002)), and compared to the unaffected siblings, we found significant differences in TE (p=0.003). Moreover, significant differences were observed between the unaffected siblings and healthy controls as follows: TC (p=0.034), TE (p=0.008), PR (p=0.016) and PE (p=0.013). Conclusion: The schizophrenia patients and their siblings performed worse in the WCST test than the healthy controls. This result supports the claim that the development of functional impairment is not unique to schizophrenia patients and that unaffected siblings may have a certain level of abnormal brain function.Neurological abnormalities lead to abnormal functioning in siblings and patients,suggesting that genetics plays a considerable role in such results.
Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP: A Retrospective Study
Authors: Fu Lin , Chan Yau Kei , Li Junhua , Nie Li , Li Na , Pan Weihua 
Published: November 2019

Abstract
Background: To investigate the long term surgical outcomes of cataract surgery in severe and end glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors. Methods: A retrospective study of severe and end stage glaucoma patients who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Twenty patients (24 eyes) were included. The mean age was 64.6 ± 11.0 years and the mean followed up duration was 21.4 ± 7.3 months. The final visual acuity was significantly improved from 0.93±0.72 to 0.70±0.74, within 14 (58.3%) eyes improved, 5 (20.8%) eyes kept unchanged, and 5 (20.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with greater final visual acuity improvement (r = -0.545, r = -0.501, r = 0.521 respectively). Moreover, the final number of medications were reduced from 1.1 ± 0.9 to 0.2 ± 0.5 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 13.2 ± 3.9 (6.8-25.9) mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was reduced to 7 (29.2%) eyes compared to 11 (45.8%) eyes at baseline. Moreover, the number of eyes without the use of medications was increased from 6 (25%) preoperatively to 20 (83.3%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage glaucoma patients and the number of eyes came off medications increased by 58.3% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the visual acuity changes after cataract surgery.
Serum levels of cytokines in infants treated with Conbercept for retinopathy of prematurity
Authors: Cheng Yong , Zhu Xuemei , Linghu Dandan , Jia Zhongxu , Xu Yongsheng , Liang Jianhong 
Published: November 2019

Abstract
Background: To determine the serum concentrations of cytokines in infants with retinopathy of prematurity (ROP), and to evaluate the changes of serum vascular endothelial growth factor (VEGF) concentration who received intravitreal Conbercept (IVC). Methods: Case series study. Forty infants with ROP treated with IVC 0.25 mg and ten full-term infants with congenital cataract were included. Blood samples were collected before and 1 week, and 4 weeks after IVC. Serum levels of 45 types of cytokines were measured by multiplex bead assay. Results: In the ROP group, significantly higher concentrations of VEGF-A, VEGF-D, macrophage inflammatory protein 1 beta (MIP-1β), interferon-inducible protein-10 (IP-10), regulated on activation, normal T Cell expressed and secreted (RANTES), eotaxin, TNF-α, IL-18, EGF, SCF, PIGF-1, and β-NGF were measured, while lower concentrations of monocyte chemotactic protein-1 (MCP-1) and hepatocyte growth factor (HGF) were observed; when compared with the control group. No significant differences were detected in serum concentrations of VEGF-A and VEGF-D in ROP patients between baseline and 1 week, and 4 weeks after IVC treatment.Conclusion: Besides angiogenic factors, several inflammatory cytokines were associated with ROP. IVC 0.25 mg in ROP patients did not induce circulatory VEGF suppression at 1 week after injection.
Pterygium: Glutathione, Nitric Oxide Production and N-Acetylcysteine Treatment
Authors: Parra Fidelina , Kormanovski Alexandre , Guevara-Balcazar Gustavo , Castillo-Hernández Maria del Carmen , Franco-Vadillo Antonio , Toledo-Blas Mireille , Jarillo-Luna Adriana , Lara-Padilla Eleazar 
Published: November 2019

Abstract
Background There was not investigated the participation of glutathione (GSH), endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) in pterygium pathogenesis and the effects of the precursor of GSH synthesis N-acetylcysteine in treatment prior to surgery.Methods The levels of eNOS, NO, 3-nitrotyrosine, reduced and oxidized GSH (GSSG) and catalase were measured in tissue homogenates of 120 patients with primary or recurrent pterygium, and systemic or topical pretreatment with N-acetylcysteine, compared to control group.Results A decrease in eNOS, NO, 3-nitrotyrosine, and GSH oxidation degree (GSSG%) was observed in primary pterygium, which remained decreased in other pathological groups in case of GSSG% and 3-nitrotyrosine. The levels of GSH and catalase increased in recurrent pterygium, even more, they increased in the group with systemic treatment, while topical treatment did not affect them, compared with control or primary pterygium groups. High positive correlation in groups of the study was observed between behavior of eNOS with NO or GSSG%, while GSH showed it with GSSG or catalase. Women showed a higher level of GSH and catalase in primary pterygium group, lower its level and a higher level of NO in recurrent pterygium. It was observed in women positive correlation in groups of study of GSSG% with 3-nitrotyrosine alone, while in men with NO.Conclusions Study data do not contradict the assumption about the following possible sequence of events in pathogenesis of the primary pterygium: decrease in the activity of eNOS and consequently of NO, decrease in S-nitrosation of GSH, possible modulation of the intracellular level of GSH through synthesis and/or mobilization from other tissues.