bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review.
Authors: Bartlett Andrew , Um Irene S , Luca Edward J , Krass Ines , Schneider Carl R 
Published: March 2020

Abstract
Background: In healthcare, preceptors act as a role model and supervisor, thereby facilitating the socialisation and development of the preceptee into a professional fit to practice. To ensure a consistent approach to every preceptorship experience, preceptor competencies should be measured or assessed to ensure that the desired outcomes are achieved. Defining these would ensure quality management and could inform development of an preceptor competency framework. This review aimed to evaluate the evidence for preceptor competencies and assessment in health professions.Methods: This study followed the PRISMA ScR scoping review guidelines. A database search was conducted in Embase, Medline, CINAHL and IPA in 2019. Articles were included if they defined criteria for competency, measured or assessed competency, or described performance indicators of preceptors. A modified GRADE CERQual approach and CASP quality assessment were used to appraise identified competencies, performance indicators and confidence in evidence.Results: Forty one studies identified 17 evidence-based competencies, of which 11 had an associated performance indicator. The competency of preceptors was most commonly measured using a preceptee completed survey (moderate to high confidence as per CERQual), followed by preceptor self-assessment, and peer-assessment. Preceptee outcomes as a measure of preceptor performance had good but limited evidence.Conclusions: Competencies with defined performance indicators allow for effective measurement and may be modifiable with training. To measure preceptor competency, the preceptor perspective, as well as peer and preceptee assessment is recommended. These findings can provide the basis for a common preceptor competency framework in health professions.
No differences in the body fat after violating core bioelectrical impedance measurement assumptions
Authors: Randhawa Arshdeep , Jamnik Veronica , Fung Michael , Fogel Adam , Kuk Jennifer L. 
Published: March 2020

Abstract
Objective: It is unclear to what degree acutely violating bioelectrical impedance analysis (BIA) measurement assumptions will alter the predicted percent fat mass (%FM) and whether this differs by sex or body mass index (BMI). Methods: %FM was assessed under control, dehydration, exercise, water, meal intake and non-voided bladder conditions with three BIA devices (Tanita: BC-418, TBF-314, & Omron HBF-306CN) (n=40). Results: For all BIA devices, there were no differences in the %FM values between the control and the other conditions in men or women (-1.9 to 0.4%, p >0.05). Across the three devices and five conditions, 97% of %FM tests returned values within 5% of control (2 tests), and 86% of tests were within 2% of control despite violating an assumption. The errors were greatest with dehydration and females were more likely to have a %FM difference greater than 2% than males with dehydration using the hand-to-foot device (Tanita TBF-314: 59% versus 9%). There were no differences in %FM between control and the conditions when examined by BMI category (overweight: -2.8 to 0.1% and normal weight: -1.7 to 0.5%; BMI*trial, p=0.99). Conclusion: %FM estimates were similar despite acutely violating the preliminary measurement BIA assumptions across a range of different BMIs. The minor variations in %FM are smaller than what would be expected with day-to-day variability or weight loss intervention, but may be larger in women than men.
Comparative analysis, applications, and interpretation of electronic health record-based stroke phenotyping methods
Authors: Thangaraj Phyllis , Kummer Benjamin R , Lorberbaum Tal , Elkind Mitchell S.V. , Tatonetti Nicholas P 
Published: March 2020

Abstract
Background: Accurate identification of acute ischemic stroke (AIS) patient cohorts is essential for a wide range of clinical investigations. Automated phenotyping methods that leverage electronic health records (EHRs) represent a fundamentally new approach cohort identification without current laborious and ungeneralizable generation of phenotyping algorithms. We systematically compared and evaluated the ability of machine learning algorithms and case-control combinations to phenotype acute ischemic stroke patients using data from an EHR.Materials and Methods: Using structured patient data from the EHR at a tertiary-care hospital system, we built and evaluated machine learning models to identify patients with AIS based on 75 different case-control and classifier combinations. We then estimated the prevalence of AIS patients across the EHR. Finally, we externally validated the ability of the models to detect AIS patients without AIS diagnosis codes using the UK Biobank.Results: Across all models, we found that the mean AUROC for detecting AIS was 0.963±0.0520 and average precision score 0.790±0.196 with minimal feature processing. Classifiers trained with cases with AIS diagnosis codes and controls with no cerebrovascular disease codes had the best average F1 score (0.832±0.0383). In the external validation, we found that the top probabilities from a model-predicted AIS cohort were significantly enriched for AIS patients without AIS diagnosis codes (60-150 fold over expected). Conclusions: Our findings support machine learning algorithms as a generalizable way to accurately identify AIS patients without using process-intensive manual feature curation. When a set of AIS patients is unavailable, diagnosis codes may be used to train classifier models.
Repeated intraocular lens dislocation followed by haptic deformation and loss of tension: a case report
Authors: ma xinqi , zhou ming , wen jiajie , ouyang yujia , long chongde 
Published: March 2020

Abstract
Background: Intraocular lens (IOL) dislocation is a rare but serious postoperative complication of intraocular lens implantation, so far, there is no report describing late intraocular lens dislocation caused by a deformed haptic piercing through the iris. Case report: A 29-year-old male developed IOL dislocation one and a half years after IOL implantation in his right eye. The eye examination showed that haptic pierced the iris at 10 o'clock in his right eye, according to intraoperative exploration, the haptic was deformed and became less elastic, the patient underwent the surgery of IOL reposition for various factors, but finally did not achieve a satisfactory outcome. Conclusion: Late IOL dislocation followed by haptic deformation is difficult to detect unless there are serious complications. When the position of IOL haptics is not in a plane with its optical surface, it should be highly vigilant that the function of the haptics may be abnormal. IOL replacement should be performed as soon as possible for the IOL dislocation caused by the loss of haptic tension.
Comparative study of a nano-bacterial rat kidney stone model and the traditional ethylene glycol rat kidney stone model
Authors: Qian Biao , wang Jingshen , Hao Zhiqiang , Wang Yuan , Yang Heng , Li Yongle , Tan Minghui , Zhang Guoxi , Zou Xiaofeng 
Published: March 2020

Abstract
Objective To Compare a nanobacterial (NB) rat kidney stone model and the traditional ethylene glycol (EG) rat kidney stone model to assess its significance. Methods Ninety Wistar male rats were randomly divided into three groups. After the first week of modeling, three rats of every groups were randomly selected to measure the biochemical blood and urine markers. After the sacrifice, the renal tissues were observed to assess the pathological changes. The expression levels of CaSR and Claudin-14 protein were detected by kinds of technology. Results The biochemical metabolic indices of rats in NB group began to increase at the third week and decreased to normal at the 9th week. In the EG group they began to increase at the second week and did not return to normal later. At the 7th week, the creatinine levels of rats in the EG group were higher than in the NB group, and the difference was statistically significant. The formation rates of kidney stones in the NB group and EG group were 52.4 and 66.7%, respectively, but the difference of the two rates was not statistically significant. The protein expression CaSR and Claudin-14 in the EG group began to strengthen at 3rd week, and at 4th week in the NB group. CaSR was continuously expressed in the NC group, but Claudin-14 was not expressed. Conclusion The formation of stones in the NB group began slightly later. CaSR and Claudin-14 proteins play a role in the formation of kidney stones.
A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure
Authors: Douglas Flora , MacIver Emma , Yuill Chris 
Published: March 2020

Abstract
Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. However, while international evidence outside of the UK indicates that food insecurity adversely affects individual’s health condition management capability, little is known about how those so affected manage their condition(s) in this high-income country context. Methods :A qualitative investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. notions of the support they might wish to receive from them. Interview audio recordings were fully transcribed and thematically analysed.Results : Twenty individuals living with a wide range of self-reported health conditions, and being supported by a local poverty alleviation social enterprise took part. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in)visibility of participants’ economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system.Conclusions :This study, the first of its kind in the UK, indicated that participants’ health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK.
Uptake of oral-based HIV self-testing among Key Populations taking HIV pre-exposure prophylaxis in central Uganda
Authors: Bosco Matovu John , Tusiime Jayne Byakika , Mayega Roy William , Nalubega Sylivia 
Published: March 2020

Abstract
Introduction: HIV incidence is higher among key populations such as sex workers, fishermen and men who have sex with men. HIV self-testing among key populations taking HIV Pre-Exposure Prophylaxis has not been studied in Uganda yet it could be an alternative testing approach for these population categories. We assessed the uptake of oral based HIV self-testing among key populations enrolled on Pre-Exposure Prophylaxis in Uganda. Methods : A mixed methods cross-sectional study was conducted on 366 key populations attending Pre-Exposure Prophylaxis clinics at MARPI Mulago and Kasensero HC II Uganda, during May-August 2018. Respondents aged 15 years and above with no prior history of HIV self-testing were issued with “Oraquick” HIV rapid diagnostic test (kit) for self-testing. Data were collected using an interviewer administered structured questionnaire and through in depth interviews of selected respondents. A chi square test was performed to determine association between socio demographic, economic factors and propensity to uptake HIV self-testing. Logistic regression was used to determine the predictors of HIV self-testing uptake. Thematic analysis was performed to explore factors that promote and inhibit HIV self-testing uptake. Results : HIV self-testing acceptability was 100% (365/365) with 73% (n=265) of respondents willing to pay for a kit. Of these, 85%(n=227) would pay not more than 1.4USD. Sixty-six percent (n=243) of respondents had high propensity to uptake HIV self-testing. Predictors of uptake were clinic location (rural vs urban) (aOR = 17.63 95% CI 8.44 – 36.81, p<0.001); Key Population category (female sex worker’s vs others) aOR= 4.36 (95% CI: 1.63 – 11.66, p=0.003) and education level ( < primary vs post primary) aOR=0.38 (95% CI: 0.20 – 0.73). Using an oral fluid based kit “Oraquick” was reported to be free of pain, convenient, easy to use and time saving. A multimodal approach to distributing HIV self-testing kits was suggested by respondents. Conclusion HIV self-testing can be an alternative to the conventional routine 3 monthly follow up HIV screening for key populations on Pre-Exposure Prophylaxis. Kits’ distribution may employ several models. Majority of key populations would afford the kits at a cost not more than 1.4USD.
Cumulative evidence of helmet effects on bicycle injuries
Authors: Chen Siyu , Ou Shan , Cui Huijie , Tang Mingshuang , Wang Yutong , Zhang Min , Bai Ye , Song Bing , Gu Dongqing , Wang Xin , Yin Zhiyong , Liu Guodong 
Published: March 2020

Abstract
Background: With widely-used use of bicycles, studies of helmet effects on bicycle injuries were intensively conducted after the problem of bicycle injuries emerged. This study aims to justify whether current evidence is sufficient to manifest the effects of helmets. Methods：We exhaustively searched the articles in the databases of Medline, Scopus, and Embase by the term of (helmet* AND (cycl* OR bicycle* OR bike*)) AND injur* by the time of April 10, 2019. The meta-analysis and SSA (study sequential analysis) were conducted. Results：A total of 55 studies are eligible for meta-analysis. The OR (odds ratio) of helmet effect on head injuries compared with other injuries is 0·50 (0·43, 0·59) and effect of helmets on serious head injuries compared with other injuries are protective with OR of 0·34 (0·28, 0·43). Compared with control injuries, the OR of helmet effect on facial injuries is 0·63 (0·45, 0·88). Helmets is not associated with protective effects of neck injuries and OR is 0·98 (0·82, 1·17). SSA results of head injuries, serious head injuries, and face injuries showed, the cumulative Z-curve crossed both the conventional and the trial sequential monitoring boundary. SSA results of neck injuries showed the cumulative Z-curve does not cross both the conventional and the trial sequential monitoring boundary. Conclusions：The helmet has protection effects on head injuries, serious head injuries, and face injuries. The SSA showed the current evidence was sufficient to support the results. More studies of helmet promotion are warranted in the future. Key words: helmet; bicycle injuries; head injuries; face injuriesKey words: helmet; bicycle injuries; head injuries; face injuries
A lower apatinib dose provides equivalent efficacy and reduced toxicity: A phase II, single-arm study of apatinib and oral etoposide in metastatic breast cancer
Authors: Hu Nanlin , Zhu Anjie , Si Yiran , Yue Jian , Wang Xue , Wang Jiayu , Ma Fei , Yuan Peng , Xu Binghe 
Published: March 2020

Abstract
Introduction : The effectiveness of antiangiogenic drugs in metastatic breast cancer is still unclear. Apatinib is a small tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor 2 (VEGFR-2). We performed this clinical trial to evaluate the efficacy and safety of apatinib and oral etoposide in patients with HER2-negative locally advanced or metastatic breast cancer(MBC).Methods : Patients with HER2-negative MBC previously treated with anthracycline and taxanes and failed ≥1 prior chemotherapy regimens were recruited. The starting dose of apatinib was 500 mg and 425 mg in patients with Eastern Cooperative Oncology Group (ECOG) scores of 0-1 and 2, respectively. The etoposide capsules were given at 50 mg/m 2 on days 1 to 10 for 21 days. The primary end point was progression-free survival (PFS) which is assessed every 6 weeks (RECIST v1.1). Secondary end points included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety.Results : Thirty-one eligible patients were enrolled. The median follow-up time was 11 months. The median PFS for all patients was 6.93 months (95% confidence interval (CI), 5.97–7.90), and 6.93 months(95% CI 5.27-8.60) and 6.56 months (95% CI 1.41-11.73) for patients with apatinib 425mg and 500mg once daily, respectively. The ORR was 35.5% (11/31). The DCR was 87.1% (27/31). The median OS was 20.37 months (95% CI, 11.39–29.34). The median PFS of patients who had hypertension and proteinuria was longer than that for those without hypertension and proteinuria. The most common grade 3/4 treatment-related adverse events(AE) were hypertension (12/31, 38.71%), fatigue (3/31, 9.68%), thrombocytopenia (3/31, 9.68%).Conclusion : Apatinib combined with etoposide capsules is effective and tolerable in heavily pretreated, metastatic HER2-negative breast cancer patients. A lower apatinib dose provide equivalent efficacy and reduced toxicity.Trial registration : ClinicalTrails, NCT03535961, Registered 24 May 2018, https://clinicaltrials.gov/ct2/show/NCT03535961?cond=apatinib+etoposide+breast+cancer&draw=2&rank=1
Intensity of metastasis screening and survival outcomes in patients with breast cancer
Authors: Cheun Jong Ho , Jung Jigwang , Lee Eun-Shin , Rhu Jiyoung , Lee Han-Byoel , Lee Kyung-Hun , Kim Tae-Yong , Han Wonshink , Im Seock-Ah , Noh Dong-Young , Moon Hyeong-Gon 
Published: March 2020

Abstract
Background Previous randomized trials, performed decades ago, showed no survival benefit of intensive screening for distant metastasis in breast cancer. However, recent improvements in targeted therapies and diagnostic accuracy of imaging have again raised the question of the clinical benefit of screening for distant metastasis. Therefore, we investigated the association between the use of modern imaging and survival of patients with breast cancer who eventually developed distant metastasis.Methods We retrospectively reviewed data of 398 patients who developed distant metastasis after their initial curative treatment between January 2000 and December 2015.Results Patients in the less-intensive surveillance group (LSG) had significantly longer relapse-free survival than did patients in the intensive surveillance group (ISG) (8.7 vs. 22.8 months; p = 0.002). While the ISG showed worse overall survival than the LSG did (50.2 vs. 59.9 months; p = 0.015), the difference was insignificant after adjusting for other prognostic factors. Among the 200 asymptomatic patients whose metastases were detected on imaging, the intensity of screening did not affect overall survival. A small subgroup of patients showed poor survival outcomes when they underwent intensive screening. Patients with HR-/HER2+ tumors and patients who developed lung metastasis in the LSG had worse overall survival than those in the ISG did.Conclusions Highly intensive screening for distant metastasis in disease-free patients with breast cancer was not associated with significant survival benefits, despite the recent improvements in therapeutic options and diagnostic techniques.
Combined Texture Analysis of MR images and Glypican-3 to Identify the Differentiated Degree of Hepatocellular Carcinoma: a retrospective study
Authors: Feng Mengmeng , Zhang Mengchao , Liu Yuanqing , Jiang Nan , Meng Qian , Wang Jia , Yao Ziyun , Dai Hui 
Published: March 2020

Abstract
BACKGROUND To explore the clinical value of texture analysis of MR images (multiphase Gd-EOB-DTPA-enhanced MRI and T2 weighted imaging (T2WI) and the glypican-3 (GPC-3) to identify the differentiated degree of hepatocellular carcinoma (HCC). METHOD In this retrospective study, 104 participants were enrolled (GPC-3 data obtained in 51 participants). Each participant performed preoperative Gd-EOB-DTPA-enhanced MR scanning. Texture analysis was calculated by MaZda and then using the B11 program for data analysis and classification. The performance of texture features and GPC-3 in identifying the differentiated degree of HCC was assessed by receiver operating characteristic (ROC) analysis. RESULTS There were no statistically significances for the expression of GPC-3 between poorly-, well- and moderately-differentiated HCC. The area under the curve (AUC) of the combined texture features between poorly- and well-differentiated HCC, poorly- and moderately-differentiated HCC, moderately- and well-differentiated HCC was 0.812, 0.879 and 0.808 respectively. With GPC-3 combined, the AUC was increased to 0.868, while accuracy was decreased, in poorly- verse well-differentiated HCC, and the AUC and accuracy were the same as those without GPC-3 combined in poorly- verse moderately-differentiated HCC. Although the AUC was increased to 0.818 with GPC-3 combined in moderately- verse well-differentiated HCC, there were no statistical significance for the value change (p>0.05). CONCLUSION S Texture analysis of Gd-EOB-DTPA-enhanced MRI and T2WI are valuable in identifying the differentiated degree of HCC. There is no significant effect of GPC-3 in identifying the differentiated degree of HCC, suggesting the promising value of texture analysis of MR images in the precise presurgical diagnosis of HCC.
Physical Exposure during Patient Transfer and Risk of Back Injury &amp; Low-back Pain: Prospective Cohort Study
Authors: Vinstrup Jonas , Jakobsen Markus D , Madeleine Pascal , Andersen Lars L 
Published: March 2020

Abstract
BackgroundWork-related musculoskeletal disorders (MSDs) are more common among healthcare workers compared with most other professions. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly used assistive devices and to investigate associations between accumulated physical exposure during patient transfer and risk of MSDs.MethodsBy applying an exposure matrix based on measure¬ments of electromyography and trunk flexion on a large (n=1285) prospective cohort, intensity of low-back pain (LBP) and risk of back injury at 1-year follow-up were modelled using a linear model and logistic regressions, respectively. The cohort was divided into groups based on physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure.ResultsExposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p=0.0085). No differ-ence was found between the moderate and high exposure groups (p=0.2967). Likewise, we find no associations between physical exposure and risk of back injury at 1-year follow-up, with a prevalence of 11%, 13% and 11% for the three groups, respectively. ConclusionsLow physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associ¬ated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the prevalence of MSDs among healthcare workers.