bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability of quality indicators for the management of endometrial, cervical and ovarian cancer: results of an online survey
Authors: Luyckx Annemie , Wyckmans Leen , Bonte Anne-Sophie , Trinh Xuan Bich , van Dam Peter A. 
Published: July 2020

Abstract
Background
Measuring quality indicators (QI’s) is a tool to improve the quality of care. The aim of this study was to evaluate the acceptability of 36 QI’s, defined after a literature search for the management of endometrial, cervical and ovarian cancer. Relevant specialists in the field of interest were surveyed.

Methods
To quantify the opinions of these specialists, an online survey was sent out via mailing to members of gynaecological or oncological societies. The relevance of each QI was questioned on a scale from one to five (1 = irrelevant, 2 = less relevant, 3 = no opinion/neutral, 4 = relevant, 5 = very relevant). If a QI received a score of 4 or 5 in 65% or more of the answers, we state that the respondents consider this QI to be sufficiently relevant to use in daily practice.

Results
The survey was visited 238 times and resulted in 53 complete responses (29 Belgian, 24 other European countries). The majority of the specialists were gynaecologists (45%). Five of the 36 QI’s (13,9%) did not reach the cut-off of 65%: referral to a tertiary center, preoperative staging of endometrial cancer by MRI, preoperative staging of cervical cancer by positron-emission tomography, incorporation of intracavitary brachytherapy in the treatment of cervical cancer, reporting ASA and WHO score for each patient. After removing the 5 QI’s that were not considered as relevant by the specialists and 3 additional 3 QI’s that we were considered to be superfluous, we obtained an optimized QI list.

Conclusion
As QI’s gain importance in gynecological oncology, their use can only be of value if they are universally interpreted in the same manner. We propose an optimized list of 28 QI’s for the management of endometrial, cervical and ovarian cancer which responders of our survey found relevant. Further validation is needed to finalize and define a set of QI’s that can be used in future studies, audits and benchmarking.
Development and validation of a tool to assess the risk of QT drug-drug interactions in clinical practice
Authors: Berger Florine A. , van der Sijs Heleen , Becker Matthijs L. , van Gelder Teun , van den Bemt Patricia M. L. A. 
Published: July 2020

Abstract
Background
The exact risk of developing QTc-prolongation when using a combination of QTc-prolonging drugs is still unknown, making it difficult to interpret these QT drug-drug interactions (QT-DDIs). A tool to identify high-risk patients is needed to support healthcare providers in handling automatically generated alerts in clinical practice. The main aim of this study was to develop and validate a tool to assess the risk of QT-DDIs in clinical practice.

Methods
A model was developed based on risk factors associated with QTc-prolongation determined in a prospective study on QT-DDIs in a university medical center inthe Netherlands. The main outcome measure was QTc-prolongation defined as a QTc interval > 450 ms for males and > 470 ms for females. Risk points were assigned to risk factors based on their odds ratios. Additional risk factors were added based on a literature review. The ability of the model to predict QTc-prolongation was validated in an independent dataset obtained from a general teaching hospital against QTc-prolongation as measured by an ECG as the gold standard. Sensitivities, specificities, false omission rates, accuracy and Youden’s index were calculated.

Results
The model included age, gender, cardiac comorbidities, hypertension, diabetes mellitus, renal function, potassium levels, loop diuretics, and QTc-prolonging drugs as risk factors. Application of the model to the independent dataset resulted in an area under the ROC-curve of 0.54 (95% CI 0.51–0.56) when QTc-prolongation was defined as > 450/470 ms, and 0.59 (0.54–0.63) when QTc-prolongation was defined as > 500 ms. A cut-off value of 6 led to a sensitivity of 76.6 and 83.9% and a specificity of 28.5 and 27.5% respectively.

Conclusions
A clinical decision support tool with fair performance characteristics was developed. Optimization of this tool may aid in assessing the risk associated with QT-DDIs.

Trial registration
No trial registration, MEC-2015-368.
Improving shared decision-making in vascular surgery by implementing decision support tools: study protocol for the stepped-wedge cluster-randomised OVIDIUS trial
Authors: de Mik S. M. L. , Stubenrouch F. E. , Legemate D. A. , Balm R. , Ubbink D. T. 
Published: July 2020

Abstract
Background
Shared decision-making improves the quality of patient care. Unfortunately, shared decision-making is not yet common practice among vascular surgeons. Thus, decision support tools were developed to assist vascular surgeons and their patients in using shared decision-making. This trial aims to evaluate the effectiveness and implementation of decision support tools to improve shared decision-making during vascular surgical consultations in which a treatment decision is to be made.

Methods
The study design is a multicentre stepped-wedge cluster-randomised trial. Eligible patients are adult patients, visiting the outpatient clinic of a participating medical centre for whom several treatment options are feasible and who face a primary treatment decision for their abdominal aortic aneurysm, carotid artery disease, intermittent claudication, or varicose veins. Patients and vascular surgeons in the intervention group receive decision support tools that may help them adopt shared decision-making when making the final treatment decision. These decision support tools are decision aids, consultation cards, decision cards, and a practical training. Decision aids are informative websites that help patients become more aware of the pros and cons of the treatment options and their preferences regarding the treatment choice. Consultation cards with text or decision cards with images are used by vascular surgeons during consultation to determine which aspect of a treatment is most important to their patient. In the training vascular surgeons can practice shared decision-making with a patient actor, guided by a medical psychologist. This trial aims to include 502 vascular surgical patients to achieve a clinically relevant improvement in shared decision-making of 10 out of 100 points, using the 5-item OPTION instrument to score the audio-recordings of consultations.

Discussion
In the OVIDIUS trial the available decision support tools for vascular surgical patients are implemented in clinical practice. We will evaluate whether these tools actually improve shared decision-making in the consultation room. The stepped-wedge cluster-randomised study design will ensure that at the end of the study all participating centres have implemented at least some of the decision support tools and thereby a certain level of shared decision-making.

Trial registration
Netherlands Trial Registry, NTR6487. Registered 7 June 2017. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6487
Normalizing inconvenience to promote childhood vaccination: a qualitative implementation evaluation of a novel Michigan program
Authors: Lillvis Denise F. , Willison Charley , Noyes Katia 
Published: July 2020

Abstract
Background
In 2015, Michigan implemented a rule requiring parents to attend an education session at a local health department (LHD) prior to waiving mandatory child vaccinations. This study utilizes Normalization Process Theory (NPT) to assess program implementation, identifying potential threats to fidelity and sustainability.

Methods
We conducted 32 semi-structured interviews with individuals involved in these education programs across 16 LHDs. Participating LHDs were selected from a stratified, representative sample. One interviewer conducted all interviews using a semi-structured interview guide; two authors coded and analyzed the interview transcripts according to the NPT framework (i.e, sense-making, engagement, collective action, and reflexive monitoring).

Results
There was a lack of consensus about who the stakeholders of this new rule and its resulting program were (sense-making). Perhaps as a result, most LHDs did not solicit advice from key stakeholder groups (i.e., schools, health care providers, community stakeholders) in their planning (engagement). While most interviewees identified providing education and information as the goal, some identified the more challenging goal of persuading vaccine hesitant parents to immunize their children. There was also some variation in perception of who held health educators accountable for meeting the goals of the waiver education program (collective action). Formal program evaluation by LHDs was rare, although some held informal staff debriefings. Additionally, sessions that went particularly well or poorly were top-of-mind (reflexive monitoring).

Conclusions
The immunization waiver education program may be at risk of not becoming fully embedded into routine LHD practice, potentially compromising its long-term effectiveness and sustainability. Managers at the local and state level should maintain oversight to ensure that the program is delivered with fidelity. As the program relies on sustaining inconvenience to encourage parents to immunize their children, any shortcuts taken will undermine its success.
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources
Authors: Calegari Rafael , Fogliatto Flavio S. , Lucini Filipe R. , Anzanello Michel J. , Schaan Beatriz D. 
Published: July 2020

Abstract
Background
Surgical theater (ST) operations planning is a key subject in the healthcare management literature, particularly the scheduling of procedures in operating rooms (ORs). The OR scheduling problem is usually approached using mathematical modeling and made available to ST managers through dedicated software. Regardless of the large body of knowledge on the subject, OR scheduling models rarely consider the integration of OR downstream and upstream facilities and resources or validate their propositions in real life, rather using simulated scenarios. We propose a heuristic to sequence surgeries that considers both upstream and downstream resources required to perform them, such as surgical kits, post anesthesia care unit (PACU) beds, and surgical teams (surgeons, nurses and anesthetists).

Methods
Using hybrid flow shop (HFS) techniques and the break-in-moment (BIM) concept, the goal is to find a sequence that maximizes the number of procedures assigned to the ORs while minimizing the variance of intervals between surgeries’ completions, smoothing the demand for downstream resources such as PACU beds and OR sanitizing teams. There are five steps to the proposed heuristic: listing of priorities, local scheduling, global scheduling, feasibility check and identification of best scheduling.

Results
Our propositions were validated in a high complexity tertiary University hospital in two ways: first, applying the heuristic to historical data from five typical ST days and comparing the performance of our proposed sequences to the ones actually implemented; second, pilot testing the heuristic during ten days in the ORs, allowing a full rotation of surgical specialties. Results displayed an average increase of 37.2% in OR occupancy, allowing an average increase of 4.5 in the number of surgeries performed daily, and reducing the variance of intervals between surgeries’ completions by 55.5%. A more uniform distribution of patients’ arrivals at the PACU was also observed.

Conclusions
Our proposed heuristic is particularly useful to plan the operation of STs in which resources are constrained, a situation that is common in hospital from developing countries. Our propositions were validated through a pilot implementation in a large hospital, contributing to the scarce literature on actual OR scheduling implementation.
The gut bacterial diversity of sheep associated with different breeds in Qinghai province
Authors: Chang Jianjun , Yao Xiaoting , Zuo Chenxiang , Qi Yuxu , Chen Dekun , Ma Wentao 
Published: July 2020

Abstract
Background
Gut microbiota play important roles in their co-evolution with mammals. However, little is understood about gut bacterial community of Tibetan sheep compared with other sheep breeds. In this study, we investigated the gut bacterial community in 4 different sheep breeds living in the Qinghai-Tibetan Plateau (QTP) of China using high-throughput sequencing (HTS) technique.

Results
The results suggested that bacterial community abundance and breeds diversity of Tibetan sheep (TS) were significantly lower than that of the other three breeds of sheep [Dorset sheep (DrS), Dorper sheep (DrS) and Small Tail Han sheep (STHS)] (p < 0.05). Principal coordinates analysis (PCoA) and nonmetric multidimensional scaling (NMDS) analysis indicated that microbiome composition of TS was significantly different from that of other three sheep breeds (p < 0.01). Firmicutes was the most predominant microbial phylum in the gut, followed by Bacteroidetes. The gut bacterial community of TS showed higher proportions of phylum Spirochaetes, Proteobacteria and Verrucomicrobia, compared to the other three sheep breeds, but the Deferribacteres was absent in TS. At the genus level, Treponema, Succinivibrio, 5-7 N15 and Prevotella showed significantly higher abundance in TS than in the other three sheep breeds (p < 0.05).

Conclusions
In this study, we first employed HTS to understand the gut microbiomes among different sheep breeds in QTP of China.
LncRNA ANRIL/miR-7-5p/TCF4 axis contributes to the progression of T cell acute lymphoblastic leukemia
Authors: Li Gang , Gao Lan , Zhao Jing , Liu Dejun , Li Hui , Hu Min 
Published: July 2020

Abstract
Background
Antisense non-coding RNA in the INK4 locus (ANRIL) is of great importance in cell biological behaviors, and ANRIL functions in many kinds of cancers including leukemia. However, the mechanism of ANRIL in the progression of T-cell acute lymphoblastic leukemia (T-ALL) has not been clarified clearly.

Methods
qRT-PCR was performed to detect ANRIL expression in T-ALL samples. T-ALL cell lines (MOLT4, CCRF-CEM and KOPT-K1) were used as the cell models. The function of ANRIL on T-ALL cells was investigated by CCK-8 assays, Transwell assays, and apoptosis experiments in vitro. qRT-PCR, Western blot, luciferase reporter assay and RIP assay were used to confirm the interactions between ANRIL and miR-7-5p, miR-7-5p and its target gene transcription factor 4 (TCF4).

Results
ANRIL was significantly up-regulated in T-ALL samples. Its knockdown markedly inhibited viability, migration and invasion of T-ALL cells, but its overexpression exerted the opposite effects. TCF4 was proved to be a target gene of miR-7-5p. ANRIL down-regulated miR-7-5p via sponging it and in turn up-regulated TCF4.

Conclusions
LncRNA ANRIL can modulate malignant phenotypes of T-ALL cells, possibly by regulating miR-7-5p/TCF4 axis, and it serves as a potential therapeutic target for T-ALL.
Pathophysiology and neurologic sequelae of cerebral malaria
Authors: Schiess Nicoline , Villabona-Rueda Andres , Cottier Karissa E. , Huether Katherine , Chipeta James , Stins Monique F. 
Published: July 2020

AbstractCerebral malaria (CM), results from Plasmodium falciparum infection, and has a high mortality rate. CM survivors can retain life-long post CM sequelae, including seizures and neurocognitive deficits profoundly affecting their quality of life. As the Plasmodium parasite does not enter the brain, but resides inside erythrocytes and are confined to the lumen of the brain’s vasculature, the neuropathogenesis leading to these neurologic sequelae is unclear and under-investigated. Interestingly, postmortem CM pathology differs in brain regions, such as the appearance of haemorragic punctae in white versus gray matter. Various host and parasite factors contribute to the risk of CM, including exposure at a young age, parasite- and host-related genetics, parasite sequestration and the extent of host inflammatory responses. Thus far, several proposed adjunctive treatments have not been successful in the treatment of CM but are highly needed. The region-specific CM neuro-pathogenesis leading to neurologic sequelae is intriguing, but not sufficiently addressed in research. More attention to this may lead to the development of effective adjunctive treatments to address CM neurologic sequelae.
Predictors of health workers’ knowledge about artesunate-based severe malaria treatment recommendations in government and faith-based hospitals in Kenya
Authors: Machini Beatrice , Zurovac Dejan , Amboko Beatrice , Malla Lucas , Snow Robert W. , Kipruto Hillary , Achia Thomas N. O. 
Published: July 2020

Abstract
Background
Health workers’ knowledge deficiencies about artesunate-based severe malaria treatment recommendations have been reported. However, predictors of the treatment knowledge have not been examined. In this paper, predictors of artesunate-based treatment knowledge among inpatient health workers in two hospital sectors in Kenya are reported.

Methods
Secondary analysis of 367 and 330 inpatient health workers randomly selected and interviewed at 47 government hospitals in 2016 and 43 faith-based hospitals in 2017 respectively, was undertaken. Multilevel ordinal and binary logistic regressions examining the effects of 11 factors on five knowledge outcomes in government and faith-based hospital sectors were performed.

Results
Among respective government and faith-based health workers, about a third of health workers had high knowledge of artesunate treatment policies (30.8% vs 32.9%), a third knew all dosing intervals (33.5% vs 33.3%), about half knew preparation solutions (49.9% vs 55.8%), half to two-thirds knew artesunate dose for both weight categories (50.8% vs 66.7%) and over three-quarters knew the preferred route of administration (78.7% vs 82.4%). Eight predictors were significantly associated with at least one of the examined knowledge outcomes. In the government sector, display of artesunate administration posters, paediatric ward allocation and repeated surveys were significantly associated with more than one of the knowledge outcomes. In the faith-based hospitals, availability of artesunate at hospitals and health worker pre-service training were associated with multiple outcomes. Exposure to in-service malaria case-management training and access to malaria guidelines were only associated with higher knowledge about artesunate treatment policy.

Conclusion
Programmatic interventions ensuring display of artesunate administration posters in the wards, targeting of health workers managing adult patients in the medical wards, and repeated knowledge assessments are likely to be beneficial for improving the knowledge of government health workers about artesunate-based severe malaria treatment recommendations. The availability of artesunate and focus on improvements of nurses’ knowledge should be prioritized at the faith-based hospitals.
Psychometric testing of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (FACT/GOG-Ntx) subscale in a longitudinal study of cancer patients treated with chemotherapy
Authors: Cheng Hui Lin , Lopez Violeta , Lam Simon Ching , Leung Anthony Kwun To , Li Yu Chung , Wong Kam Hung , Au Joseph Siu Kie , Sundar Raghav , Chan Alexandre , De Ng Terrence Rong , Suen Lorna Kwai Ping , Chan Choi Wan , Yorke Janelle , Molassiotis Alex 
Published: July 2020

Abstract
Background
The aim of this study was to evaluate the psychometric properties of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group—Neurotoxicity (FACT/GOG-Ntx) subscale in a longitudinal study of cancer patients treated with chemotherapy.

Methods
Patients were assessed with the FACT/GOG-Ntx subscale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Scale 20 (EORTC QLQ-CIPN20), National Cancer Institute -Common Terminology Criteria for Adverse Events (NCI-CTCAE), and light touch test using 10 g monofilament for up to ten assessment points from baseline (prior to initiation of first chemotherapy), after the end of each cycle (up to 6 cycles, 3 weeks per cycle), and at 6, 9, and 12 months after starting chemotherapy. Psychometric analyses included internal consistency reliability, convergent validity, factorial validity, sensitivity to change and responsiveness (minimal clinically important difference, MCID).

Results
Cronbach’s alpha coefficients of the FACT/GOG-Ntx subscale were 0.82–0.89 across assessment points. The subscale strongly correlated with the EORTC QLQ-CIPN20 (r = 0.79–0.93) but low-to-moderately correlated with the NCI-CTCAE sensory (rs = 0.23–0.45) and motor items (rs = 0.15–0.50) as well as the monofilament test (rs = 0.23–0.47). The hypothesized 4-factor structure of the FACT/GOG-Ntx subscale was not confirmed at assessment points (χ2/df = 2.26–8.50; all P < 0.001). The subscale exhibited small-to-moderate sensitivity to change (r = 0.17–0.37). The MCIDs were between 1.38 and 3.68.

Conclusion
The FACT/GOG-Ntx subscale has satisfactory reliability, validity, sensitivity to change and responsiveness to evaluate CIPN in cancer patients. Future research is needed to explore the factorial structure of the FACT/GOG-Ntx subscale as the published four-factor structure was not supported in this study.
Psychometric evaluation of Azeri version of the head and neck cancer specific quality of life questionnaire (EORTC QLQ-H&N43)
Authors: Davudov Mahammad M. , Rahimov Chingiz , Harirchi Iraj , Mirzajani Zoheir , Amiraliyev Namig , Amiraliyev Kanan , Rustamova Narmin , Zebardast Jayran , Montazeri Ali 
Published: July 2020

Abstract
Background
Oral cancer surgery can have a deep effect on the quality of life in the patient both in terms of functional and psychological aspects. This study aimed to translate and validate the European Organization for Research and Treatment of Cancer head and neck cancer specific quality of life questionnaire (EORTC QLQ-H&N43) in Azerbaijan.

Methods
Forward-backward translation was applied in order to translate the EORTC QLQ-H&N43 from English into Azeri. Then, a sample of patients with oral cancer attending a teaching hospital affiliated to Azerbaijan Medical University completed the EORTC QLQ-C30 (the core cancer specific questionnaire), and the EORTC QLQ-H&N43. To evaluate psychometric properties of the QLQ-H&N43, known groups validity, convergent and divergent validity was performed. Internal consistency reliability was examined by estimating the Crornbach’s alpha coefficient.

Results
Ninety-six patients with confirmed diagnosis of oral cancer were entered into the study. The mean age of patients was 59.6 (SD = 10.7) years and 36 patients (37.5%) diagnosed as having stage IV and 10 patients (10.5%) were metastatic. The results obtained from comparing quality of life scores among these patients showed that the questionnaire was able to differentiate among patients who differed in stage and metastasis lending support to its validity. In addition convergent and divergent validity showed satisfactory results. The internal consistency of the multi-item scales as assessed by the Cronbach’s alpha coefficient showed acceptable results (alpha ranging from 0.66 to 0.78).

Conclusion
The findings suggest that in general the Azeri version of EORTC QLQ-H&N43 has satisfactory internal consistency reliability and validity, but additional psychometric evaluation is needed to draw firm conclusions.