bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decentralising NCD management in rural southern Africa: evaluation of a pilot implementation study
Authors: Sharp Ashley , Riches Nick , Mims Annastesia , Ntshalintshali Sweetness , McConalogue David , Southworth Paul , Pierce Callum , Daniels Philip , Kalungero Muhindo , Ndzinisa Futhi , Elston Ekta , Okello Valephi , Walley John 
Published: January 2020

Abstract
Background
The prevalence of non-communicable diseases, and associated morbidity and mortality, is increasing rapidly in low and middle-income countries where health systems often have limited access and lower quality of care. The intervention was to decentralise uncomplicated non-communicable disease (NCD) care from a hospital to nurse practitioners in health centres in a poor rural district in Eswatini, southern Africa. The objective of this study was to assess the feasibility and impact of decentralised care for NCDs within nurse-led clinics in order improve access and inform healthcare planning in Eswatini and similar settings.

Methods
In collaboration with the Eswatini Ministry of Health, we developed and implemented a package of interventions to support nurse-led delivery of care, including: clinical desk-guide for hypertension and diabetes, training modules, treatment cards and registries and patient leaflets. Ten community clinics in the Lubombo Region of Eswatini were randomly selected to be trained to deliver NCD care for a period of 18 months. Observational data on follow-up rates, blood pressure (BP), glucose etc. were recorded and evaluated. We compared blood pressure and blood glucose measurements between the first and fourth visits and fitted a linear mixed effects model.

Results
One thousand one hundred twenty-five patients were recruited to the study. Of these patients, 573 attended for at least 4 appointments. There was a significant reduction in mean BP among hypertensive patients after four visits of 9.9 mmHg systolic and 4.7 mmHg diastolic (p = 0.01), and a non-significant reduction in fasting blood glucose among diabetic patients of 1.2 mmol/l (p = 0.2). Key components of NCD care were completed consistently by nurses throughout the intervention period, including a trend towards patients progressing from monotherapy to dual therapy in accordance with prescribing guidelines.

Conclusions
The findings suggest that management of diabetes and hypertension care in a rural district setting can be safely delivered by nurses in community clinics according to a shared care protocol. Improved access is likely to lead to improved patient compliance with treatment.
Using mobile phones to improve community health workers performance in low-and-middle-income countries
Authors: Feroz Anam , Jabeen Rawshan , Saleem Sarah 
Published: January 2020

Abstract
Background
In low-and-middle-income countries community health workers are the core component of the PHC system as they act as a liaison between the communities and the healthcare facilities. Evidence suggests that the services offered by these workers have helped in the decline of maternal and child morbidity and mortality rates and the burden of communicable and non-communicable diseases. However, the coverage and the overall progress towards achieving the SDG targets is very sluggish. The recent consensus concerning this current pace of progress, is that it relates to financial and human resources constraints. CHWs are overburdened as they are expected to accomplish more although they may not obtain the required support to perform their duties. The health systems of LMICs, have given very little attention to the work environment of CHWs; which has negatively affected CHWs productivity, and quality of services. This debate is intended to explore the potential of mobile phone technology in LMICs for improving CHWs performance and effectiveness.

Discussion
To improve CHWs productivity, some studies involved the use of mobile phones for data collection and reporting, while other studies used mobile technology for patient to provider communication, patient education, CHWs supervision, and monitoring and evaluation. A wide range of benefits exists for using mobile phones including reduction in CHWs workload, improvement in data collection, reporting and monitoring, provision of quality healthcare services, supportive supervision, better organization of CHWs tasks and improvement in community health outcomes. However, a number of studies suggests that CHWs encounter unique challenges when adopting and using mobile health solutions for health service delivery such as, lack of CHWs training on new mHealth solutions, weak technical support, issues of internet connectivity and other administrative challenges. Future research efforts should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs.

Conclusion
Future research efforts and policy dialogue should be directed to explore health system readiness for adopting sustainable mHealth solutions to improve CHWs workflows in LMICs.
Effects of high-flow nasal cannula in patients with persistent hypercapnia after an acute COPD exacerbation: a prospective pilot study
Authors: Pisani Lara , Betti Sara , Biglia Carlotta , Fasano Luca , Catalanotti Vito , Prediletto Irene , Comellini Vittoria , Bacchi-Reggiani Letizia , FERS Stefano Nava 
Published: January 2020

Abstract
Background
Persistent hypercapnia after COPD exacerbation is associated with excess mortality and early rehospitalization. High Flow Nasal cannula (HFNC), may be theoretically an alternative to long-term noninvasive ventilation (NIV), since physiological studies have shown a reduction in PaCO2 level after few hours of treatment.
In this clinical study we assessed the acceptability of HFNC and its effectiveness in reducing the level of PaCO2 in patients recovering from an Acute Hypercapnic Respiratory Failure (AHRF) episode. We also hypothesized that the response in CO2 clearance is dependent on baseline level of hypercapnia.

Methods
Fifty COPD patients recovering from an acute exacerbation and with persistent hypercapnia, despite having attained a stable pH (i.e. pH > 7,35 and PaCO2 > 45 mmHg on 3 consecutive measurements), were enrolled and treated with HFNC for at least 8 h/day and during the nighttime

Results
HFNC was well tolerated with a global tolerance score of 4.0 ± 0.9. When patients were separated into groups with or without COPD/OSA overlap syndrome, the “pure” COPD patients showed a statistically significant response in terms of PaCO2 decrease (p = 0.044). In addition, the subset of patients with a lower pH at enrolment were those who responded best in terms of CO2 clearance (score test for trend of odds, p = 0.0038).

Conclusions
HFNC is able to significantly decrease the level of PaCO2 after 72 h only in “pure” COPD patients, recovering from AHRF. No effects in terms of CO2 reduction were found in those with overlap syndrome. The present findings will help guide selection of the best target population and allow a sample size calculation for future long-term randomized control trials of HFNC vs NIV.

Trial registration
This study is registered with www. clinicaltrials.gov with identifier number NCT03759457.
Acute and sub-acute toxicity of Echinops kebericho decoction in rats
Authors: Deyno Serawit , Abebe Abiy , Tola Mesfin Asefa , Hymete Ariya , Bazira Joel , Makonnen Eyasu , Alele Paul E. 
Published: January 2020

AbstractBackgroundEchinops keberichois widely used for treatment of a variety of diseases including infectious, non-infectious disease and fumigation during child birth. Antibacterial, antimalarial, anti-leshimania, anti-diarrheal and insect repellent activities have been elucidated. Its toxicity profile is not yet investigated and thus this study was to investigate acute and sub-acute toxicity ofE. keberichodecoctions.MethodsAcute toxicity study was performed in female Wistar albino rats with single oral dose and followed up to 14 days. The sub-acute oral dose toxicity studies were conducted in rats of both sexes in accordance with the repeated dose 28-day oral toxicity study in rodent OECD guidelines. Physical observations were made regularly during the study period while body weight was measured weekly. Organ weight, histopathology, clinical chemistry and hematology data were collected on the 29th day. Results were presented as mean ± standard deviation. One-way analysis of variance (ANOVA) was performed if assumptions were met; otherwise Kruskal-Wallis analysis was performed.ResultOral administration ofE. keberichodecoction showed no treatment-related mortality in female rats up to the dose of 5000 mg/kg. In sub-acute toxicity studies, no significant treatment-related abnormalities were observed compared to negative controls. Food consumption, body weight, organ weight, hematology, clinical chemistry, and histopathology did not show significant variation between controls and treatment groups. However, creatinine, relative lung weight, triglycerides, and monocytes were lower in treated compared to control groups. Significant variations between male and female groups in food consumption, relative organ weight, hematology, clinical chemistry were observed. Histolo-pathology of high-dose treated groups showed fatty liver.ConclusionEchinops keberichoshowed LD50of greater than 5000 mg/kg in acute toxicity study and is well tolerated up to the dose of 600 mg/kg body weight in sub-acute toxicity study.
Xiao-ai-ping injection adjunct with platinum-based chemotherapy for advanced non-small-cell lung cancer: a systematic review and meta-analysis
Authors: Feng Fanchao , Huang Jingyi , Wang Zhichao , Zhang Jiarui , Han Di , Wu Qi , He Hailang , Zhou Xianmei 
Published: January 2020

Abstract
Background
Xiao-ai-ping injection (XAPI), as patented Chinese medicine, has shown promising outcomes in non-small-cell lung cancer (NSCLC) patients. This meta-analysis investigated the efficacy and safety of XAPI in combination with platinum-based chemotherapy.

Methods
A comprehensive literature search was conducted to identify relevant studies in Pubmed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Wangfang Database, VIP Database, and Chinese Biology Medical Database from the date of their inception to September 2018. The RevMan 5.3 software was applied to calculate the risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI).

Results
We included and analyzed 24 randomized controlled trials. The meta-analysis showed that XAPI adjunctive to platinum-based chemotherapy had better outcomes in objective tumor response rate (ORR) (RR: 1.27, 95% CI, 1.14–1.40); improved Karnofsky performance scores (KPS) (RR: 1.70, 95% CI, 1.48–1.95); reduction in occurrence of grade 3/4 leukopenia (RR: 0.49, 95% CI, 0.38–0.64), anemia (RR: 0.63, 95% CI, 0.46–0.87) and thrombocytopenia (RR: 0.53, 95% CI, 0.38–0.73), nausea and vomiting (RR: 0.57, 95% CI, 0.36–0.90); and enhanced immune function (CD8+ [MD: 4.96, 95% CI, 1.16–8.76] and CD4+/CD8+ [MD: 2.58, 95% CI, 1.69–3.47]). However, it did not increase dysregulated liver and kidney function, diarrhea, constipation, and fatigue. Subgroup analysis of ORR and KPS revealed that dosage, treatment duration, and methodological quality did not affect the outcome significantly.

Conclusions
Our meta-analyses demonstrated that XAPI in combination with platinum-based chemotherapy had a better tumor response, improved the quality of life, attenuated adverse side effects, and enhanced immune function, which suggests that it might be used for advanced NSCLC. Moreover, low dosage (< 60 ml/d) and long-term treatment of XAPI might be a choice for advanced NSCLC patients.
Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia
Authors: Wondmieneh Adam , Alemu Wudma , Tadele Niguse , Demis Asmamaw 
Published: January 2020

Abstract
Background
Unsafe medication practices are the leading causes of avoidable patient harm in healthcare systems across the world. The largest proportion of which occurs during medication administration. Nurses play a significant role in the occurrence as well as preventions of medication administration errors. However, only a few relevant studies explored the problem in Ethiopia. Therefore, this study aimed to assess the magnitude and contributing factors of medication administration error among nurses in tertiary care hospitals, Addis Ababa, Ethiopia, 2018.

Methods
We conducted a hospital-based, cross-sectional study in Addis Ababa, Ethiopia. The study involved 298 randomly selected nurses. We used adopted, self-administered survey questionnaire and checklist to collect data via self-reporting and direct observation of nurses while administering medications. The tools were expert reviewed and tested on 5% of the study participants. We analyzed the data descriptively and analytically using SPSS version 24. We included those factors with significant p-values (p ≤ 0.25) in the multivariate logistic regression model. We considered those factors, in the final multivariate model, with p < 0.05 at 95%Cl as significant predictors of medication administration errors as defined by nurse self-report.

Result
Two hundred and ninety eight (98.3%) nurses completed the survey questionnaire. Of these, 203 (68.1%) reported committing medication administration errors in the previous 12 months. Factors such as the lack of adequate training [AOR = 3.16; 95% CI (1.67,6)], unavailability of a guideline for medication administration [AOR = 2.07; 95% CI (1.06,4.06)], inadequate work experience [AOR = 6.48; 95% CI (1.32,31.78)], interruption during medication administration [AOR = 2.42, 95% CI (1.3,4.49)] and night duty shift [AOR = 5, 95% CI (1.82, 13.78)] were significant predictors of medication administration errors at p-value < 0.05.

Conclusion and recommendation
Medication administration error prevention is complex but critical to ensure the safety of patients. Based on our study, providing a continuous training on safe administration of medications, making a medication administration guideline available for nurses to apply, creating an enabling environment for nurses to safely administer medications, and retaining more experienced nurses may be critical steps to improve the quality and safety of medication administration.
Enhancement of 1,3-propanediol production from industrial by-product by Lactobacillus reuteri CH53
Authors: Ju Jung-Hyun , Wang Dexin , Heo Sun-Yeon , Kim Min-Soo , Seo Jeong-Woo , Kim Young-Min , Kim Dae-Hyuk , Kang Soon-Ah , Kim Chul-Ho , Oh Baek-Rock 
Published: January 2020

Abstract
Background
1,3-propanediol (1,3-PDO) is the most widely studied value-added product that can be produced by feeding glycerol to bacteria, including Lactobacillus sp. However, previous research reported that L. reuteri only produced small amounts and had low productivity of 1,3-PDO. It is urgent to develop procedures that improve the production and productivity of 1,3-PDO.

Results
We identified a novel L. reuteri CH53 isolate that efficiently converted glycerol into 1,3-PDO, and performed batch co-fermentation with glycerol and glucose to evaluate its production of 1,3-PDO and other products. We optimized the fermentation conditions and nitrogen sources to increase the productivity. Fed-batch fermentation using corn steep liquor (CSL) as a replacement for beef extract led to 1,3-PDO production (68.32 ± 0.84 g/L) and productivity (1.27 ± 0.02 g/L/h) at optimized conditions (unaerated and 100 rpm). When CSL was used as an alternative nitrogen source, the activity of the vitamin B12-dependent glycerol dehydratase (dhaB) and 1,3-propanediol oxidoreductase (dhaT) increased. Also, the productivity and yield of 1,3-PDO increased as well. These results showed the highest productivity in Lactobacillus species. In addition, hurdle to 1,3-PDO production in this strain were identified via analysis of the half-maximal inhibitory concentration for growth (IC50) of numerous substrates and metabolites.

Conclusions
We used CSL as a low-cost nitrogen source to replace beef extract for 1,3-PDO production in L. reuteri CH53. These cells efficiently utilized crude glycerol and CSL to produce 1,3-PDO. This strain has great promise for the production of 1,3-PDO because it is generally recognized as safe (GRAS) and non-pathogenic. Also, this strain has high productivity and high conversion yield.
MAP7 promotes migration and invasion and progression of human cervical cancer through modulating the autophagy
Authors: Zhang Li , Liu Xudong , Song Lina , Zhai Hui , Chang Chaohua 
Published: January 2020

Abstract
Background
Microtubule-associated proteins 7(MAP7) was reported to be engaged into the function of neuronal function. The function of MAP7 in human cervical cancer (CC) was unknown. We aimed to uncover the function and mechanism of MAP7 on CC.

Methods
We applied qRT-PCR, western blot and immunochemistry to detect the expression difference between normal tissue and CC. In vitro, we establish MAP7 stable knocking down and overexpression cell lines and investigated the function and underlying mechanism of MAP7 in CC.

Results
Both mRNA and protein of MAP7 were upregulated in CC compared with the normal tissue. MAP7 was correlated with the clinical stage and tumor size and lymph node metastasis. MAP7 promotes the invasion and migration of CC cell lines. We next detected EMT pathway and autophagy associated pathway. MAP7 promotes the EMT through modulating the autophagy.

Conclusion
Taken above, our results showed that MAP7 promotes the migration and invasion and EMT through modulating the autophagy.
Efficacy and safety of Guhong injection for treating coronary microvascular disease: study protocol for a randomized controlled trial
Authors: Jieqin Zhuang , Shuling Liu , Hairong Cai , Xingzhen Dai , Yanhong Chen , Zilin Jin , Bojun Chen 
Published: January 2020

Abstract
Background
Coronary microvascular disease (CMVD) can be described as one of the cardiovascular diseases with normal coronary angiography but evidence of myocardial ischemia or microcirculatory lesions, often presenting as angina pectoris attacks. Coronary artery microtubular dysfunction is one of the pathogenic features of coronary heart disease, but its occurrence and development and the current CMVD-intervention therapy needs further research. Chinese traditional medicine (TCM) has advantages for the treatment of cardiovascular diseases. Hence, this article describes an ongoing randomized controlled clinical trial based on the theory of TCM for the purpose of evaluating the efficacy and safety of Guhong injection versus placebo in patients with CMVD.

Methods/design
This is a multicenter, randomized, parallel-arm, open-label, double-blind, placebo-controlled clinical trial. A total of 260 eligible patients will be allocated and randomly assigned, in a ratio of 1:1, to either the experimental group or the control group. The treatment course is 10 consecutive days, and with an 8-week follow-up. The primary outcome is therapeutic efficacy. Secondary outcomes include the quantitative score of TCM syndromes (a series of TCM symptoms and signs of coronary heart disease), the average frequency of anginal attacks, electrocardiogram (ECG) changes, inflammatory response, endothelial function indicators and myocardial metabolites.

Discussion
This trial is strictly designed in accordance with principles and regulations issued by the China Food and Drug Administration (CFDA). The results should provide high-quality evidence on the efficacy and safety of Guhong injection in the treatment of CMVD.

Trial registration
Chinese Clinical Trials Registry, ID: ChiCTR1900022902. Registered on 27 April 2019.
Effects of fungal infection on the survival of parasitic bat flies
Authors: Szentiványi Tamara , Estók Péter , Pigeault Romain , Christe Philippe , Glaizot Olivier 
Published: January 2020

AbstractBackgroundParasites are able to alter numerous aspects of their hosts’ life history, behaviour and distribution. One central question in parasitology is to determine the degree of impact that parasites have on their hosts. Laboulbeniales (Fungi: Ascomycota) are ectoparasitic fungi of arthropods. Even though these fungi are widely distributed, little is known about their ecology and their possible physiological effects on their hosts. We used a highly specific bat fly-fungi association to assess the effect of these fungal parasites on their dipteran hosts.MethodsWe collected bat flies (Diptera: Nycteribiidae) belonging to two species,Nycteribia schmidliiandPenicillidia conspicuafrom their bat hostMiniopterus schreibersii(Chiroptera: Miniopteridae). We experimentally tested the effect of infection on the lifespan of bat flies.ResultsThe prevalence of Laboulbeniales fungi was 17.9% inN. schmidliiand 64.8% inP. conspicua. Two fungi species were identified,Arthrorhynchus eucampsipodaeandA. nycteribiae, both showing strict host specificity withN. schmidliiandP. conspicua, respectively. We found that fungal infection reduced by half the survival rate ofP. conspicuaregardless of sex, whereasN. schmidliiwas not affected by the infection. Moreover, the intensity of infection showed negative correlation with the lifespan ofP. conspicua.ConclusionsTo our knowledge, this is the first indication that fungal infection can alter bat fly survival and thus may play a significant role in the population dynamics of these bat ectoparasites.