bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nurse-led health coaching intervention for stroke survivors and their family caregivers in hospital to home transition care in Chongqing, China: a study protocol for a randomized controlled trial
Authors: Xiao Lily , Lin Shuanglan , Chamberlain Diane 
Published: January 2020

Abstract
Background Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care. Methods This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as “participant dyads”, and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcomes are changes in self-efficacy and quality of life of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors’ functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers’ self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline. Discussion This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers.
How many words are Australian children hearing in the first year of life?
Authors: Brushe Mary E , Lynch John W. , Reilly Sheena , Melhuish Edward , Brinkman Sally A. 
Published: January 2020

Abstract
Background: There is evidence that parents from more socioeconomically disadvantaged backgrounds engage in fewer verbal interactions with their child than more advantaged parents. This leads to the so-called, ‘30 million-word gap’. Methods: We used improved technology to investigate the number of words children hear in their first year of life. Mothers were recruited into a five-year prospective cohort study and categorized into either high or low maternal education groups. Data was derived from the first two waves of the study, when the children were six and twelve months old. At both waves, children were involved in day-long audio recordings using the Language Environment Analysis software that provided automatic counts of adult words spoken to the child, child vocalizations and conversational turns. Descriptive results are presented by maternal education groups. Results: There was large variation within each maternal education group, with the number of adult words spoken to the child ranging from 2,958 to 39,583 at six months and 4,389 to 45,849 at twelve months. There were no meaningful differences between adult words, child vocalizations or conversational turns across maternal education groups at either wave of data collection. Conclusions: These results show that a word gap related to maternal education is not apparent up to twelve months of age. The large variability among both maternal education groups suggests that universal interventions that encourage all parents to talk more to their child may be more appropriate than interventions targeted towards disadvantaged families during the first year of life.
Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy
Authors: Wang Dongqing , Yu Shui , Zhai Limin , Xu Jin , Li Baosheng 
Published: January 2020

Abstract
Background: To identify the spatial patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT).Methods: We retrospectively obtained the clinicopathological characters of 123 hypopharyngeal SCC patients, and investigated the patterns of regional lymph node failure. Univariate and multivariate logistic regression were used to determine the risk factors of regional lymph node failure.Results: Forty patients (32.5% of total patients) were suffered regional lymph node failure. In these patients, the ipsilateral neck level II nodal failure account for 55.0% (22/40) followed by level III 30.0% (12/40), level VIb 15.0% (6/40), level VII 15.0% (6/40), and level IV 5.0% (2/40). In addition, 17.5% (7/40) patients suffered contralateral neck level II nodal failure and 7.5% (3/40) patients suffered level III nodal failure. The common failure levels were the II (7/46, 15.2%), III (4/46, 8.7%), VIb (4/46, 8.7%), and VII (5/46, 10.9%) for treatment by surgery. The lymph node recurrence and persistent disease at levels II (19/77, 24.7%) and III (10/77, 13.0%) remained the major cause of failure following curative intent of IMRT. The postoperative radiation significantly decreased the risk of regional lymph node failure (OR=0.082, 95% CI: 0.007–1.000, P=0.049); and the radiologic extranodal extension significantly increased the risk of regional lymph node failure (OR=11.07, 95% CI: 2.870–42.69, P<0.001).Conclusions: Whatever the treatment modality, the lymph node failure at level II and III was the most popular pattern for hypopharyngeal SCC. Moreover, for patients who underwent surgery, the nodal failure at level VIb and VII was frequent. Thus, postoperative radiation of level VIb and VII may give rise to benefit to locally advanced hypopharyngeal SCC patients.
Primary care service use by end-of-life cancer patients: a nationwide population-based cohort study in the United Kingdom
Authors: Gao Wei , Gulliford Martin , Morgan Myfanwy , Higginson Irene J 
Published: January 2020

Abstract
Background End of life(EoL) care becomes more complex and increasingly takes place in the community, but there is little data on the use of general practice(GP) services to guide care improvement. This study aims to determine the trends and factors associated with GP consultation, prescribing and referral to other care services amongst cancer patients in the last year of life. Methods A retrospective cohort study of cancer patients who died in 2000-2014, based on routinely collected primary care data(the Clinical Practice Research DataLink, CPRD) covering a representative sample of the population in the United Kingdom. Outcome variables were number of GP consultations(primary), number of prescriptions and referral to other care services(yes vs no) in the last year of life. Explanatory variables included socio-demographics, clinical characteristics and the status of palliative care needs recognised or not. The association between outcome and explanatory variables were evaluated using multiple-adjusted risk ratio(aRR). Results Of 68,523 terminal cancer patients, 70% were aged 70+, 75% had comorbidities and 45.5% had palliative care needs recognised. In the last year of life, a typical cancer patient had 43 GP consultations(Standard deviation(SD): 31.7; total=3,031,734), 71.5 prescriptions(SD: 68.0; total=5,074,178), and 21(SD: 13.0) different drugs; 58.0% of patients had at least one referral covering all main clinical specialities. More comorbid conditions, prostate cancer and having palliative care needs recognised were associated with more primary care consultations, more prescriptions and a higher chance of referral(aRRs 1.07-2.03). Increasing age was related to fewer consultations(aRRs 0.77-0.96), less prescriptions(aRR 1.09-1.44), and a higher chance of referral(aRRs 1.08-1.16) but less likely to have palliative care needs recognised(aRRs 0.53-0.89). Conclusions GPs are very involved in end of life care of cancer patients, most of whom having complex care needs, i.e. older age, comorbidity and polypharmacy. This highlights the importance of enhancing primary palliative care skills among GPs and the imperative of greater integration of primary care with other healthcare professionals including oncologists, palliative care specialists, geriatricians and pharmacists. Research into the potential of deprescribing is warranted. Older patients have poorer access to both primary care and palliative care need to be addressed in future practices.
Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis
Authors: Tenorio Carmen Hidalgo , Gálvez Juan , Martínez-Marcos Francisco Javier , Plata-Ciezar Antonio , Torre-Lima Javier De La , López-Cortés Luis Eduardo , Noureddine Mariam , Reguera José M. , Vinuesa David , García Maria Victoria , Ojeda Guillermo , Luque Rafael , Lomas José Manuel , Lepe Jose Antonio , de Alarcón Arístides 
Published: January 2020

Abstract
Background: S. aureus(SA) infective endocarditis (IE)has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistantversusmethicillin-susceptible SA (MRSA vs. MSSA) and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values >1 ug/mL to MRSA. Methods: Patients with SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. Results: We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41-7.23), invasive procedures, or recognized infection focus in the three months before IE onset (OR 2.9; 95% CI 1.14-7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64-9.5) was observed in patients with MRSA versusMSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985-1999) (OR 8.391; 95% CI (2.82-24.9); 2000-2009 (OR 6.4; 95% CI 2.92-14.06); active neoplasm (OR 6.63; 95% CI 1.7-25.5) and sepsis (OR 2.28; 95% CI 1.053-4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p= 0.32). Conclusion:MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin.Methicillin resistance does not appear to be a decisive prognostic factor for SA IE.
Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.
Authors: Iflaifel Mais HM , Lim Rosemary , Ryan Kath M , Crowley Clare 
Published: January 2020

AbstractBackground Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC. Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search undertaken for studies published in books that explained how RHC as a concept has been interpreted, what methods have been used to study it, and what factors have been important to its development. Studies were evaluated independently by two researchers. Data was synthesised using a deductive thematic approach. Results Twenty-six studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods were mainly used to study RHC. Two types of data sources have been used: direct (e.g. focus groups) and indirect (e.g. observations). Most of the tools for studying RHC were developed based on predefined resilient constructs and have been categorised into three categories: performance variability and Work As Done, cornerstone capabilities for resilience, and integration with other safety management paradigms. Tools for studying RHC currently exist but have yet to be fully implemented. Effective team relationships, trade-offs and health care ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, as well as in the methods used to study and the factors used to develop it, several questions remain to be answered before a gold standard strategy for studying RHC can confidently be identified. These include operationalising RHC assessment methods in multi-level and diverse settings and developing, testing and evaluating interventions to address the wider safety implications of RHC amidst organisational and institutional change.
Astrocyte-derived exosomes enriched with miR-873a-5p inhibit neuroinflammation via microglia phenotype modulation after traumatic brain injury
Authors: long xiaobing , Yao Xiaolong , Jiang Qian , Yang Yiping , He Xuejun , Tian Weidong , zhao kai , Zhang Huaqiu 
Published: January 2020

Abstract
Background: The interaction between astrocytes and microglia plays a vital role in the damage and repair of brain lesions due to traumatic brain injury (TBI). Recent studies have shown that exosomes act as potent mediators involved in intercellular communication. Methods: In the current study, the expression of inflammatory factors and miR-873a-5p in the lesion area and edema area was evaluated in 15 patients with traumatic brain injury. Exosomes secreted by astrocytes were detected by immunofluorescence, Western blot, and electron microscopy. A mouse model of TBI and an in vitro model of lps-induced primary microglia were established to study the protective mechanism of exosomes from miR-873a-5p-overexpressing in TBI-induced nerve injury.Results: We discovered that exosomes derived from activated astrocytes promote microglial M2 phenotype transformation following TBI. More than 100 miRNAs were detected in these astrocyte-derived exosomes. miR-873a-5p is a major component that was highly expressed in human traumatic brain tissue. Moreover, miR-873a-5p significantly inhibited LPS-induced microglial M1 phenotype transformation and the subsequent inflammation through decreased phosphorylation of ERK and NF-κB p65. This effect also greatly improved the mNSS score and attenuated brain injury in a strictly controlled cortical impact mouse model. Conclusions: Taken together, our research indicates that miRNAs in the exosomes derived from activated astrocytes play a key role in the astrocyte-microglia interaction. miR-873a-5p, as one of the main components of these astrocyte-derived exosomes, attenuated microglia-mediated neuroinflammation and improved neurological deficits following TBI by inhibiting the NF-kB signalling pathway. These findings suggest a potential role for miR-873a-5p in treating traumatic brain injury.
Urological Aspects (Dynamic Bladder and Urethral Function, Urinary Tract Stones and Calcifications) in Patients with Alkaptonuria: A Case Control Study
Authors: Suoub Mohammed , Al-Sbou Mohammed , Sawaqed Fadi 
Published: January 2020

Abstract
Background The main objective of this study is to evaluate bladder, prostate and proximal urethral dynamic function and also to evaluate urinary tract stones and calcifications in patients with alkaptonuria.Methods Thirty-eight patients were prospectively divided into two groups. Study group (A) involved 17 patients of an average age of 42 years (30–63 years). Control group (B) involved 21 patients of an average age of 37 years (31–62 years). All patients from the two groups underwent uroflowmetry assessment (peak flow rate, shape of the flow rate chart and voided volume) and ultrasonography for the kidneys and urinary bladder for two phases (full bladder and empty bladder). Finally, all patients had their prostate gland assessed in regard to calcification, prostatic stones and prostatic urethral stones.Results Group A—Bladder volume ranged between 400 and 520 cc. The peak flow rate was between 7 and 23 ml/sec, with an average of 18.6 ml/sec. Flow rate curves shape were acceptable to normal bell shape curve in 11 patients. Seven patients (41%) had prostate calcification of 5–35% of prostate size.Group B Bladder volume ranged between 290 and 510 cc. The peak flow rate was 8–27 cc/sec with an average of 20 ml/sec. Normal bill shape voiding curves were observed in 17 patients (80%). Four patients (19%) had prostate calcification of 2–12% of prostate size. Renal measurements on ultrasonography were the same in both groups.Conclusion Patients with Alkaptonuria had a slightly reduced peak urinary flow rate compared to the normal control group, but this was not statistically significant. The incidence of prostatic calcification was higher in alkaptonuria patients and they tended to develop prostate calcification at an earlier age than the control group. Regular urological assessment is recommended for all patients with alkaptonuria over the age of 30 years to detect early urological symptoms of the disease.
Cefaclor as a first-line treatment for acute uncomplicated cystitis
Authors: Koguchi Dai , Murakami Yasukiyo , Ikeda Masaomi , Dobashi Masato , Ishii Junichiro 
Published: January 2020

Abstract
Background: Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC.Methods: We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy.Results: Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n=160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n=19; 8.1% and n=18; 7.7%). Overall success rate was 94.0% (n=219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P<0.001). In the subgroup analysis, the success rate in patients with resistance to levofloxacin or cefazolin was 100% (n=24) or 93.3% (n=14). The rate in patients with resistance to both antibiotics was 60.0% (n=9), and the pathogens in the other 40.0% (n=6) of patients with treatment failure were E. coli-ESBL.Conclusion: Cefaclor showed an excellent efficacy in AUC patients, even in those with resistance to cefazolin or levofloxacin. Cefaclor has the potential to be the first-line and second-line therapies for patients with levofloxacin treatment failure.
Diagnosis of vascular invasion in pancreatic ductal adenocarcinoma using endoscopic ultrasound elastography
Authors: Yamada Kenta , Kawashima Hiroki , Ohno Eizaburo , Ishikawa Takuya , Tanaka Hiroyuki , Nakamura Masanao , Miyahara Ryoji , Ishigami Masatoshi , Hirooka Yoshiki , Fujishiro Mitsuhiro 
Published: January 2020

Abstract
Background Vascular invasion is an important criterion for resectability and deciding the therapeutic strategy for pancreatic ductal adenocarcinoma (PDAC), but imaging diagnosis is currently difficult. Endoscopic ultrasound (EUS) elastography (EG) images have band-like artifacts on the border between tumor and vessel due to different movement if the tumor is not connected to the vessel, i.e., no invasion. Based on this phenomenon, we assessed the usefulness of EUS-EG in the diagnosis of vascular invasion in PDAC. Methods The subjects were 58 out of 313 patients with PDAC who underwent EUS between January 2015 and November 2018, followed by surgery, no chemotherapy or radiotherapy, and pathological evaluation. Diagnostic accuracies of vascular invasion using dynamic computed tomography (CT), EUS B-mode and EUS-EG were compared with histopathological diagnosis. Results In 58 subjects (62 sites) who underwent both dynamic CT and EUS-B mode, the sensitivity, specificity and accuracy were 0.733, 0.787 and 0.774 on dynamic CT (62 sites); 0.733, 0.787 and 0.774 in EUS B-mode (62 sites); and 0.917, 0.889 and 0.897 in EUS-EG (39 sites). In 27 subjects (29 sites) with a tumor contacting a vessel with no vascular obstruction or stenosis on dynamic CT, the sensitivity, specificity and accuracy were 0.556, 0.750 and 0.690 on dynamic CT; 0.667, 0.700 and 0.690 in EUS B-mode; and 0.889, 0.850 and 0.862 in EUS-EG. Conclusions These results suggest that EUS combined with EG improves diagnostic performance of vascular invasion in PDAC, especially in cases of which vascular invasion cannot be clearly assessed by dynamic CT.
The efficacy of Bifidobacterium bifidum G9-1 in improving quality of life in patients with chronic constipation
Authors: Fuyuki Akiko , Higurashi Takuma , Kessoku Takaomi , Ashikari Keiichi , Yoshihara Tsutomu , Misawa Noboru , Iwaki Michihiro , Kobayashi Takashi , Ohkubo Hidenori , Yoneda Masato , Usuda Haruki , Wada Koichiro , Nakajima Atsushi 
Published: January 2020

Abstract
Background: Chronic constipation is a functional disorder that decreases patient’s quality of life (QOL). Because dysbiosis has been associated with constipation, we aimed to investigate the efficacy of Bifidobacterium bifidum G9-1 (BBG9-1) in improving QOL in constipated patients. Methods: This was a prospective, single-center, non-blinded, single-arm, feasibility trial. A total of 31 patients received BBG9-1 treatment for 8 weeks, followed by a 2-week washout period. The primary endpoint was the change in the overall Patient Assessment of Constipation of QOL (PAC-QOL) score relative to that at the baseline after probiotic administration. Secondary endpoints included changes in intestinal flora, stool consistency, frequency of bowel movement, degree of straining, sensation of incomplete evacuation, and frequency of rescue drug use. Results: The overall PAC-QOL scores and frequency of bowel movement were significantly improved after BBG9-1 administration compared to those at baseline (p < 0.05, p < 0.05, respectively). There were no statistically significant changes in other clinical symptoms. Subset analysis revealed that patients with the initial Bristol Stool Form Scale of < 4 had improvements in stool consistency, a significant increase in the frequency of their bowel movements, and a significant alleviation in their degree of straining following BBG9-1 administration. Sarcina at the genus level and Sarcina maxima at the species level were significantly increased. Functional analysis showed that butanoate metabolism increased significantly, whereas methane metabolism decreased significantly. Conclusions: BBG9-1 is safe and improves the QOL of constipated patients. The underlying improvements may be due to changes in stool consistency. Trial registration: UMIN 000029969. Registered 15 November 2017, https://www.umin.ac.jp/