bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool
Authors: Pigoga Jennifer , Joiner Anjni Patel , Chowa Phindile , Luong Jennifer , Mhlanga Masitsela , Reynolds Teri , Wallis Lee 
Published: February 2020

Abstract
Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.
Parental drinking and adolescent binge drinking: Findings from a nationwide high school survey in Japan
Authors: Inoura Satoshi , Shimane Takuya , Kitagaki Kunihiko , Wada Kiyoshi , Matsumoto Toshihiko 
Published: February 2020

Abstract
Background:Alcohol problems in parents have been revealed as one factor affecting adolescent alcohol misuse, but there are few studies on how parental drinking affects adolescent alcohol misuse in the general population. The findings of previous studies are inconsistent with respect to the influence of parental drinking according to parental structure. Binge drinking among adolescents has received much attention. In this study, we aimed to examine the relationship between parental drinking in parents and binge drinking among high school students in Japan.Methods:We performed a secondary analysis of the Nationwide High School Survey on Drug Use and Lifestyle 2018, Japan. A total of 46,848 valid surveys from high school students of 78 schools were included for analysis. Logistic regression analysis was conducted with binge drinking as the dependent variable. We established nine groups, classified according to parental drinking by parental structure (e.g., both parents, single parent, neither parent at home) as the independent variable, after adjusting with demographic factors and lifestyle factors as covariates. Binge drinking was defined as five or more alcoholic drinks for male adolescents or four or more alcoholic drinks for females on the same occasion within 2 hours. Results: In the fully adjusted models, the risk of binge drinking in adolescents whose parents do not drink (adjusted odds ratio (AOR): 0.541, 95% confidence interval (CI): 0.411–0.711) and whose father drinks but mother does not (AOR: 0.696, 95% CI: 0.575–0.844) were significantly lower than that in adolescents whose parents drink. This risk was significantly higher among students with neither parent living at home (AOR: 3.746, 95% CI: 2.290–6.127). Conclusion:Our findings suggest that adolescents whose parents do not drink and whose father drinks but mother does not are less likely to engage in binge drinking. Adolescents who did not live with either parent may have greater risk of binge drinking. This research revealed that parental drinking affects binge drinking among adolescents in the general population. Engaging parents, including mothers and non-parental family members, in future programs and interventions is important, to prevent adolescent alcohol misuse.
Understanding magnetic resonance imaging in multiple sclerosis (UMIMS) and accompanying process evaluation: study protocol for a double-blind, randomized controlled trial using an evidence-based patient information website
Authors: Schiffmann Insa , Freund Magalie , Vettorazzi Eik , Stellmann Jan-Patrick , Heyr-Borchelt Susanne , D'Hooghe Marie , Häußler Vivien , Rahn Anne C. , Heesen Christoph 
Published: February 2020

Abstract
Background: While Magnetic Resonance Imaging (MRI) plays a major role in the lives of people with multiple sclerosis (pwMS), studies have shown that MRI-specific knowledge in pwMS is limited. Moreover, poor knowledge was associated with negative feelings towards MRI (e.g. anxiety concerning MRI scan). Because information sources about MRI in MS for pwMS are not available, we designed and evaluated an evidence-based online educational platform about MRI in MS called “Understanding MRI in MS” (UMIMS). Based on a pilot study in 104 subjects, an educational intervention was found to be feasible and effective. We hypothesize, that MRI-specific knowledge can be increased by using UMIMS and that, subsequently, negative feelings towards MRI will be reduced and shared decision making competences increased.Methods: This randomized, controlled, double-blinded trial will recruit n=120 pwMS. The intervention group will receive access to UMIMS. The control group will get access to a specifically developed control website, which visually imitates UMIMS, and contains the standard information available by several MS self-help organisations. The change in MRI-specific knowledge assessed via the MRI-risk knowledge questionnaire (MRI-RIKNO) after the intervention is the primary endpoint at 2 weeks. Several secondary endpoints will be assessed at different timepoints throughout the study, e.g. emotions towards MRI, autonomy preferences, threat by MS and shared decision-making competences. The study includes a process evaluation.Discussion: The aim of this randomized, controlled, double-blind trial recruiting n=120 pwMSis to assess the effect of the evidence-based online educational tool “UMIMS” on MRI-specific knowledge.Additonally, secondary endpoints (e.g. emotions towards MRI) will be assessed and a process evaluation will be included.Trial registration: Clinicaltrials.gov, NCT03872583, registration date: 13th March 2019.
How to choose kinematic or mechanical alignment individually according to preoperative characteristics of patients?
Authors: Luan Chong , Xu Dong-Tan , Chen Ning-Jie , Wang Fei-Fei , Tian Kang- Song , Wei Chao , Wang Xian-Bin 
Published: February 2020

Abstract
Background Making decision in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA).Methods We reviewed 296 patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a portable navigation system from 2016 to 2018 in our prospectively maintained database. The minimum followup was 1 year. Clinical outcomes including range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS. Results ROM and KSS at the 1-year followup didn’t differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05), Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05). Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.
Job satisfaction of medical interns: a qualitative study using Herzberg’s hygiene motivation theory
Authors: Isaacs Anton , Raymond Anita , Jacob Angela , Hawkings Philippa 
Published: February 2020

Abstract
Background: Human resource management policies and practices are not well understood and implemented in some health care settings. Besides affecting client outcomes, poor management practices can adversely affect the health and wellbeing of healthcare professionals such as nurses and doctors. The junior most doctors in the medical hierarchy of a hospital are interns. Owing to long working hours and heavy workloads, internship can be quite a stressful experience resulting in unprofessional and unethical behaviours as well as increased number of medical errors. Although there is an abundance of research on the difficulties faced by interns, there is a paucity of research highlighting their job satisfaction. Identifying factors that influence interns’ job satisfaction could inform better working conditions for interns as well as improve client outcomes and overall hospital performance. Methods: Job satisfaction was explored by one-to-one semi-structured interviews with 12 senior interns within the theoretical framework of Herzberg’s ‘hygiene-motivation’ or ‘two factor theory’. Data were analysed thematically. Results: Reasons for job satisfaction included feeling supported in the work place as well as getting quality supervision, teaching and clinical exposure. Reasons for job dissatisfaction included poor access to administration, unduly stressful working situations, lack of support for mental health and wellbeing and poorly organised teaching sessions. The results of this study closely align with Herzberg’s motivation hygiene theory showing that reasons for job satisfaction are mostly different from reasons for job dissatisfaction. Conclusion: The internship experience, together with the people they are influenced by, can determine a doctor’s future career pathway. It is therefore vital for internship coordinators and hospital managers to facilitate a positive internship experience. The findings have implications for human resource management policy and practice in hospitals.
Laparoscopic surgery for diverticular colovesical fistula: Single–center experience of 11 cases
Authors: Kitaguchi Daichi , Enomoto Tsuyoshi , Ohara Yusuke , Owada Yohei , Hisakura Katsuji , Akashi Yoshimasa , Takahashi Kazuhiro , Ogawa Koichi , Shimomura Osamu , Oda Tatsuya 
Published: February 2020

Abstract
Objective: Laparoscopic surgery for diverticular colovesical fistula (CVF) is technically challenging, and the incidence of conversion to open surgery (COS) is high. The aims of this study were to review our experience with laparoscopic surgery for diverticular CVF and to identify preoperative risk factors for COS. Results: This was a single institution, retrospective, observational study of 11 patients who had undergone laparoscopic sigmoid colon resection with fistula resection for diverticular CVF from 2014 to 2019. Preoperative magnetic resonance imaging (MRI) was utilized to evaluate fistula location in the bladder, patency of the rectovesical pouch, and estimated contact area between the sigmoid colon and bladder. The relationship between preoperative variables and incidence of COS was analyzed between completed laparoscopy and COS groups. The overall incidence of postoperative morbidity (Clavien–Dindo classification Grade II or higher) was 36% (4/11). Severe morbidity, reoperation, and mortality were not observed. The incidence of COS was 27% (3/11). Posterior bladder fistulas were significantly associated with COS ( p = 0.006 ). CVFs located on the posterior bladder appears to be a risk factor for COS. Identifying the risk factors for COS preoperatively could help guide the intraoperative course.
Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving Universal Health Coverage in Tanzania
Authors: Kapologwe Ntuli Angyelile , Meara John G , Kengia James T. , Sonda Yusuph , Gwajima Dorothy , Alidina Shehnaz , Kalolo Albino 
Published: February 2020

Abstract
Background: Infrastructure development and upgrading to support safe surgical services in primary health care facilities is an important step in the journey towards achieving Universal Health Coverage (UHC). This study aimed to understand the public sector's efforts to improve the infrastructure of primary health facilities between 2005 and 2019. We assessed the construction rates, geographic coverage, and physical status of each facility, surgical safety and services rendered in public primary health facilities. Methods : Data was collected from existing policy reports, the Services Availability and Readiness Assessment (SARA) tool (physical status), the Health Facility Registry (HFR), implementation reports on infrastructure development from the 26 regions and 185 district councils across the country and Comprehensive Emergence Obstetric Care (CEMONC) signal functions assessment tool. Data was descriptively analyzed so as to understand the distribution of primary health facilities and their status (old, new, upgraded, under construction, renovated and equipped), and the service provided, including surgical servic­es. Results: Of 5,072 (in which 518 are Health Center and 4,554 are Dispensaries) existing primary health care facilities, the majority (46%) had a physical status of A (good state), 33% (1,693) had physical status of B (minor renovation needed) and the remaining facilities had physical status of C up to F (needing urgent major renovation or complete reconstruction). Only 33% (1,673) of all health facilities had water and 5.1% had telecommunication system. Between 2015 and 2019, a total of 419 (8.3%) health facilities (Consisting of 350 health centers and 69 District Hospitals) were either renovated or constructed and equipped to offer safe surgery facilities. Of all Health Centers only 115 (22.2%) were offering the CEMONC. Of these 115 health facilities, only 20 (17.4%) were offering the CEMONC with all 9-signal functions and only 17.4% were offering Blood transfusion services. Conclusion: Despite the achievements in infrastructure development and upgrading, still there is a high demand for good physical statuses and functioning of primary health facilities with capacity to offer essential and safe surgical services in the country also as an important strategy towards achieving UHC. Key Words: Infrastructure, primary health facilities, safe surgery and Universal Health Coverage
Clinical characteristics of adult T-cell leukemia/lymphoma infiltration in the gastrointestinal tract
Authors: Miike Tadashi , Kawakami Hiroshi , Kameda Takuro , Yamamoto Shojiro , Tahara Yoshihiro , Hidaka Tomonori , Kubuki Yoko , Yorita Kenji , Akiyama Yutaka , Arimura Yasuji , Kubota Yoshimasa , Kataoka Hiroaki , Shimoda Kazuya 
Published: February 2020

Abstract
Background: Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell malignancy caused by human T-cell lymphotropic virus type 1 (HTLV-1). The clinical course of ATLL is very heterogeneous, and many organs, including the gastrointestinal (GI) tract, can be involved. However, there are few detailed reports on ATLL infiltration in the GI tract. We investigated the clinical characteristics of ATLL infiltration in the GI tract.Methods: This retrospective observational single center study included 40 consecutive ATLL patients who underwent GI endoscopy. The patients’ demographic and clinical characteristics and endoscopic findings were analyzed retrospectively. Patients with ATLL who were diagnosed via histological examination, were divided into two groups based on GI tract infiltration.Results: Multivariate analysis revealed that the absence of skin lesions was significantly associated with GI infiltration (P < 0.05). Furthermore, the infiltration group tended to have similar macroscopic lesions in the upper and lower GI tracts.Conclusions: The absence of skin lesions and characteristic endoscopic findings may aid in detecting ATLL infiltration in the GI tract.
Equity and efficiency of health resource allocation of Chinese Medicine in mainland China: 2013 to 2017
Authors: Li Zhengjun , Yang Lili , Bian Yaoyao 
Published: February 2020

Abstract
Background: In this study, we aimed to measure the equity, efficiency and productivity of traditional Chinese medicine (TCM) health resource allocation and utilization in mainland China trend from 2013 to 2017. Methods: The data were download from the China Health Statistical Yearbook (2018) and the China Statistical Yearbook (2018). The equity and efficiency of TCM health resource allocation was evaluated by Lorenz curve, Gini coefficient (G) and Theil index (T) were applied to evaluate. The efficiency and productivity of TCM health resource utilization were assessed by Data Envelopment Analysis (DEA)-based Malmquist productivity index (MPI). Results: The TCM health resource had an increasing trend every year. The equity allocated by population (Gs range from 0.1 to 0.3) was better than that by geographic region (Gs more than 0.5). Ts in the intra-groups were higher than that in the inter-groups. Most provinces (29 out of 31) had negative productivity changes, which suggested a deterioration in productivity. However, the middle region with higher scale sizes had more redundant inputs. Moreover, the low technological development (all technical values lower than 1.00) might obstacle the productive progress. Conclusion: The equity of TCM health allocated by population was better than that by the geography region. The intra-regional difference was the main reasons of the sources of inequity. The equity of TCM resource allocation was middle region ＞ eastern region ＞ western region. The productivity in more than 97% provinces are inefficient. The frequency distribution of Sech ( score ＞ 1) increased since 2015. However, the frequency distribution of Techch (score ＞ 1) decreased year by year. The slow technological progress and low scale size might the major reason for the low productivity. Keywords: TCM health resource, Equity, Efficiency, Productivity
Regulation of [Ca2+]i Oscillations and Mitochondrial Activity by Various Calcium Transporters in Mouse Oocytes
Authors: Wang Feng , Li Ang , Meng Tie-Gang , Wang Li-Juan , Hou Yi , Schatten Heide , Sun Qing-Yuan , Ou Xiang-Hong 
Published: February 2020

Abstract
Oocyte activation inefficiency is one of the reasons for female infertility and Ca 2+ functions play a critical role in the regulation of oocyte activation. We used various inhibitors of Ca 2+ channels and pumps located on the plasma membrane, the endoplasmic reticulum or both, including sarcoplasmic/endoplasmic reticulum Ca 2+ ATPases (SERCAs, the main Ca 2+ pumps which decrease the intracellular Ca 2+ level by reaccumulating Ca 2+ into the sarcoplasmic reticulum), transient receptor potential (TRP) ion channel subfamily member 7 (TRPM7, a Ca 2+ /Mg 2+ -permeable non-selective cation channel), T-type Ca 2+ channels and calcium channel Orai1, to investigate their roles in[Ca 2+ ] i oscillation patterns and mitochondrial membrane potential during oocyte activation by real-time recording. Our results show that SERCAs, TRPM7 and T-type Ca 2+ channels are important for initiation and maintenance of [Ca 2+ ] i oscillations, which is required for mitochondrial membrane potential changes during oocyte activation, as well as for subsequent pronuclear formation and transition to embryo development, while the function of calcium channel Orai1 is not confirmed. Increasing the knowledge of these transporters may provide a theoretical basis for improving oocyte activation in human assisted reproduction clinics.
Antiviral Disinfection In The Medical Area
Authors: Trzcińska Agnieszka 
Published: February 2020

Abstract
Hospital-acquired infections (HAIs) are a serious public health problem. This problem affects hundreds of millions of people every year, leading to many serious health complications. Disinfection is an important element in the prevention and control of viral infections, which is the basis of sanitation and hygiene processes in medical facilities such as hospitals, outpatient clinics, dental offices, etc. The disinfection is a complex process, the efficacy of which is influenced by many factors. The disinfectant, apart from the fact that it requires competent and proper use, also has to meet certain criteria, including the wide range of biocidal activity confirmed by well-known and well-designed research methods.
1. Introduction. 2. Disinfection. 3. The effectiveness of the disinfection process. 4. Requirements for disinfectants. 5. Testing of virucidal activity of disinfectants. 6. Antiviral disinfection – practical aspects
Maqashid Syari’ah Menjawab Tantangan Post-Truth Era: Urgensi Hifẓ Al-‘Aql Sebagai Penyaring Informasi
Authors: Al Wasim Arif 
Published: February 2020

<em>The development of information technology has an impact on the spread of false news, false data, and hate speech, which is difficult to control. Truth mixed with badness will be ambiguous and biased. This is the most visible symptom or symptom of the post-truth era. In this context, the concept of hifẓ al-‘aql in the maqāṣid syarī'ah can be used as a solution to deal with the negative symptoms above.</em> <em>This research is focused on how far the concept of hifẓ al-qaql can be used as an information filter. The data's research is library research. The data collection method uses the documentation method, which is: collecting, then analyzing the data collected. After that, data analysis is carried out by means of data reduction, presentation of data in narrative form, and concluding.</em> <em>This study concludes that the concept of hifẓ al-‘aql can be extended to mental and intellectual functions. The meaning of hifẓ al-‘aql is expanded by making reason as a guide, and controller for rationality (‘aqlaniyah). This expansion of meaning emphasizes that filtering information before it is conveyed to others is a must, and worthy of worship. Vice versa, the spread of news and hate speech received without verification is an action that is contrary to the principle of hifẓ al-qaql, prohibited acts, and has syar'i consequences. </em>