bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysuria due to benign prostatic hyperplasia of the median lobe with ketamine-associated uropathy in a young male
Authors: Liao Zhangcheng , Wang Zhao , Jin Zhongyuan , Tang Zhengyan 
Published: October 2019

Abstract

Background
Benign prostatic hyperplasia (BPH) rarely occurs in children or young males. In this case report, a 29-year-old male patient diagnosed with BPH coexisting with ketamine-associated uropathy was reported to investigate the possible relationship between BPH and ketamine-associated uropathy as well as therapeutic strategies.

Case presentation
A 29-year-old male patient with a 3-year history of ketamine inhalation, complaining of dysuria with frequency and urgency, was admitted. Hydronephrosis, hydroureters, uneven bladder wall thickening and a tumour located in the outlet of the bladder were detected with computed tomography (CT). The patient agreed to cystoscopy under general anaesthesia. A spherical tumour with a diameter of approximately 2 cm was found to originate from the median lobe of the prostate and follicular lesions were diffusely distributed on the right bladder wall. The tumour and follicular lesions in the bladder were resected successfully, and pathology demonstrated BPH and chronic inflammation of the mucous membranes separately. The patient quit ketamine completely during the one-year follow-up. Dysuria was relieved completely and no tumour or follicular neoplasm recurrence was found.

Contribution
Inflammation in the urothelium, as a direct or indirect consequence of ketamine, may contribute to the development of BPH. Both surgical interventions to remove obstruction and ketamine cessation are necessary approaches.
Staged male genital reconstruction with a local flap and free oral graft: a case report and literature review
Authors: Zheng Da-chao , Xie Min-kai , Fu Shi-bo , Guo Jian-hua , Li Wen-ji , Yao Hai-jun , Wang Zhong 
Published: October 2019

Abstract

Background
Male genital skin loss is a common disease in urology. However, male genital skin loss accompanying a penile urethra defect is rarely reported. Herein, we describe a novel surgical technique using a composite local flap and oral mucosal graft to reconstruct the penis, which may provide a new solution for patients with similar conditions.

Case presentation
A 36-year-old male with a penile urethra defect and a large area of genital skin loss required urethral reconstruction. The meatus had descended to the penoscrotal junction. This procedure was divided into three stages. The first stage of the surgery involved burying the nude penile shaft beneath the skin of the left anteromedial thigh for coverage of the skin defect. The second stage consisted of releasing the penis and expanding the size of the urethral plate for further urethroplasty. The third stage consisted of reconstruction of the anterior urethra 6 months later. Postoperatively, the patient reported satisfactory voiding. The maximal flow rate (MFR) was 22.2 ml/s with no postvoiding residual urine at the 24-month follow-up visit. No edema, infection, hemorrhage, or cicatricial retraction were observed. The patient’s erectile function was satisfactory, and his international index of erectile function-5 score (IIEF-5 score) was 23 at the 24-month follow-up visit. Additionally, the presence of nocturnal penile tumescence demonstrated that he had normal erectile function.

Conclusions
This procedure is an effective surgical option for men with complete foreskin and penile urethra defects. It could also be extended as a treatment strategy when composite local or pedicle transposition flaps and free grafts are needed for specific patients.
LncRNA CACS15 regulates tongue squamous cell carcinoma cell behaviors and predicts survival
Authors: Wu Xiao , Ma Jing , Chen Jian , Huang Han 
Published: October 2019

Abstract

Background
The involvement of lncRNA CASC15 in several types of cancers has been reported, while its role in tongue squamous cell carcinoma (TSCC) is unknown. Our study aimed to investigate the clinical potentials of lncRNA CASC15 in TSCC.

Methods
The expression of CASC15 and miR-124 in tissue samples from TSCC patients and TSCC cell lines was analyzed by qPCR. Overexpression experiments were performed to analyze the interactions between CASC15 and miR-124. Survival analysis was performed to analyze the prognostic values of CASC15 and miR-124 for TSCC. Transwell assays were performed to analyze cell invasion and migration.

Results
We found that CASC15 was upregulated, while miR-124 was downregulated in TSCC tissues than in non-cancer tissues of TSCC patients. CASC15 and miR-125 expression was not significantly different among patients with different clinical stages, and patients with high level of CASC15 and low level of miR-125 showed low overall survival rate. CASC15 and miR-124 were inversely correlated in TSCC tissues, and CASC15 overexpression in TSCC cells resulted in downregulation of miR-124. In contrast, overexpression of miR-124 showed no significant effect on CASC15 expression. CASC15 overexpression resulted in the increased, while miR-124 overexpression resulted in the decreased migration and invasion rates of TSCC cells.

Conclusion
CASC15 and miR-124 predict TSCC patients’ survival and CASC15 may downregulate miR-124 to inhibit TSCC cell migration and invasion.
The study was approved by Ethics Committee of The first Affiliated Hospital of Jinzhou Medical University (20103548FAHJMU).
Effect of Nigella sativa and its bioactive compound on type 2 epithelial to mesenchymal transition: a systematic review
Authors: Nordin Abid , Kamal Haziq , Yazid Muhammad Dain , Saim Aminuddin , Idrus Ruszymah 
Published: October 2019

Abstract

Background
Nigella sativa or commonly known as black seed or black cumin is one of the most ubiquitous complementary medicine. Epithelial to mesenchymal transition (EMT) of type 2 is defined by the balance between wound healing and tissue fibrosis, which is dependent to the state of inflammation. This systematic review is conducted to provide an overview regarding the reported effect of Nigella sativa and its bioactive compound on the type 2 EMT.

Methods
A search was done in EBSCOHOST, OVID and SCOPUS database to obtain potentially relevant articles that were published between 1823 and August 2019. This review includes studies that focus on the effect of Nigella sativa and its bioactive compound on the events related to type 2 EMT.

Results
A total of 1393 research articles were found to be potentially related to the effect of Nigella sativa and its bioactive compound, thymoquinone on Type 2 EMT. After screening was done, 22 research articles met inclusion criteria and were included in this review. Majority of the studies, reported better wound healing rate or significant prevention of tissue inflammation and organ fibrosis following Nigella sativa or thymoquinone treatments. In terms of wound healing, studies included reported progression of EMT related pathological changes after treatment with Nigella sativa or thymoquinone. Alternatively, in terms of fibrosis and inflammation, studies included reported reversal of pathological changes related to EMT after treatment with Nigella sativa or thymoquinone.

Conclusion
Through this review, Nigella sativa and thymoquinone have been associated with events in Type 2 EMT. They have been shown to promote wound healing, attenuate tissue inflammation, and prevent organ fibrosis via regulation of the EMT process.
Medical electives: exploring the determinants of placement and access variables between 2010 and 2016 at the University of Auckland
Authors: McCool Judith , Curtis Elana , MacCormick Andrew D. , Cavadino Alana , Smith Michelle , Bagg Warwick 
Published: October 2019

Abstract

Background
Medical electives undertaken during sixth year at medical school provide an opportunity for students to work in an overseas or New Zealand health facility to gain exposure to a health system outside their training facility. Previous work suggests that the elective experience can be profound, exposing global health inequities, or influencing future career decisions. This study assessed patterns within elective choice by students’ socio demographic and programme entry characteristics.

Methods
A retrospective analysis of student elective records from 2010 to 2016 was undertaken using a Kaupapa Māori research framework, an approach which prioritises positive benefits for Māori (and Pacific) participants and communities. A descriptive analysis of routinely collected de-identified aggregate secondary data included demographic variables (gender, age group, ethnicity, secondary school decile, year and route of entry), and elective site. Route of entry (into medical school) is via general, MAPAS (Māori and Pacific Admissions Scheme) and RRS (Regional and Rural Scheme). Multivariable logistic regression analysis determined the odd ratios for predictors of going overseas for elective and electives taking place in a “High” (HIC) compared to “Low- and middle-income countries” (LMIC).

Results
Of the 1101 students who undertook an elective (2010–2016) the majority undertook their elective overseas; the majority spent their elective within a high-income country. Age (younger), route of entry (general) and high school decile (high) were associated with going overseas for an elective. Within the MAPAS cohort, Pacific students were more likely (than Māori) were to go overseas for their elective; Māori students were more likely to spend their elective in a HIC.

Conclusion
The medical elective holds an important, pivotal opportunity for medical students to expand their clinical, professional and cultural competency. Our results suggest that targeted support may be necessary to ensure equitable access, particularly for MAPAS students the benefit of an overseas elective.
Developing a framework for evidence-based grading and assessment of predictive tools for clinical decision support
Authors: Khalifa Mohamed , Magrabi Farah , Gallego Blanca 
Published: October 2019

AbstractBackgroundClinical predictive tools quantify contributions of relevant patient characteristics to derive likelihood of diseases or predict clinical outcomes. When selecting predictive tools for implementation at clinical practice or for recommendation in clinical guidelines, clinicians are challenged with an overwhelming and ever-growing number of tools, most of which have never been implemented or assessed for comparative effectiveness. To overcome this challenge, we have developed a conceptual framework to Grade and Assess Predictive tools (GRASP) that can provide clinicians with a standardised, evidence-based system to support their search for and selection of efficient tools.MethodsA focused review of the literature was conducted to extract criteria along which tools should be evaluated. An initial framework was designed and applied to assess and grade five tools: LACE Index, Centor Score, Well’s Criteria, Modified Early Warning Score, and Ottawa knee rule. After peer review, by six expert clinicians and healthcare researchers, the framework and the grading of the tools were updated.ResultsGRASP framework grades predictive tools based on published evidence across three dimensions: 1) Phase of evaluation; 2) Level of evidence; and 3) Direction of evidence. The final grade of a tool is based on the highest phase of evaluation, supported by the highest level of positive evidence, or mixed evidence that supports a positive conclusion. Ottawa knee rule had the highest grade since it has demonstrated positive post-implementation impact on healthcare. LACE Index had the lowest grade, having demonstrated only pre-implementation positive predictive performance.ConclusionGRASP framework builds on widely accepted concepts to provide standardised assessment and evidence-based grading of predictive tools. Unlike other methods, GRASP is based on the critical appraisal of published evidence reporting the tools’ predictive performance before implementation, potential effect and usability during implementation, and their post-implementation impact. Implementing the GRASP framework as an online platform can enable clinicians and guideline developers to access standardised and structured reported evidence of existing predictive tools. However, keeping GRASP reports up-to-date would require updating tools’ assessments and grades when new evidence becomes available, which can only be done efficiently by employing semi-automated methods for searching and processing the incoming information.
Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care
Authors: Arifin Bustanul , van Asselt Antoinette D. I. , Setiawan Didik , Atthobari Jarir , Postma Maarten J. , Cao Qi 
Published: October 2019

Abstract

Background
The number of people living with diabetes mellitus (DM) in Indonesia has continued to increase over the last 6 years. Four previous studies in U.S have found that higher DD scores were associated with worse psychological outcomes, lower health-related quality of life (HRQoL) and increased risk of T2DM complications. In this study, we aimed to firstly compare DD scores in Indonesian T2DM outpatients treated in primary care versus those in tertiary care. Subsequently, we investigated whether socio-demographic characteristics and clinical conditions explain potential differences in DD score across healthcare settings.

Methods
A cross-sectional study was conducted on Java island in three primary care (n = 108) and four tertiary care (n = 524) facilities. The participants completed the Bahasa Indonesia version of the Diabetes Distress Scale questionnaire (DDS17 Bahasa Indonesia). Ordinal regression analysis was conducted with the quartile of the summation of the DD score as the dependent variable to investigate how the association between the level of healthcare facilities and DD altered when adding different variables in the model.

Results
The final adjusted model showed that the level of healthcare facilities was strongly associated with DD (p < .001), with participants in primary care having a 3.68 times (95% CI 2.46–5.55) higher likelihood of being more distressed than the participants in tertiary care. This association was detected after including the socio-demographic characteristics and clinical conditions as model confounders.

Conclusions
This is the first study in Indonesia to compare DD scores within different healthcare facilities. We recommend a regular DD assessment, possibly closely aligned with health-literacy partner programs, especially for T2DM patients in primary care settings.
Working well: a systematic scoping review of the Indigenous primary healthcare workforce development literature
Authors: McCalman Janya , Campbell Sandra , Jongen Crystal , Langham Erika , Pearson Kingsley , Fagan Ruth , Martin-Sardesai Ann , Bainbridge Roxanne 
Published: October 2019

Abstract

Background
Strong and effective workforce models are essential for improving comprehensive Indigenous primary healthcare service (PHC) provision to Indigenous peoples in Canada, Australia, New Zealand and the USA (CANZUS nations). This review systematically scoped the literature for studies that described or evaluated models and systems that support the sustainability, capacity or growth of the Indigenous PHC workforce to provide effective PHC provision.

Methods
Eleven databases, 10 websites and clearinghouses, and the reference lists of 5 review articles were searched for relevant studies from CANZUS nations published in English from 2000 to 2017. A process of thematic analysis was utilised to identify key conditions, strategies and outcomes of Indigenous PHC workforce development reported in the literature.

Results
Overall, 28 studies were found. Studies reported enabling conditions for workforce development as government funding and appropriate regulation, support and advocacy by professional organisations; community engagement; PHC leadership, supervision and support; and practitioner Indigeneity, motivation, power equality and wellbeing. Strategies focused on enhancing recruitment and retention; strengthening roles, capacity and teamwork; and improving supervision, mentoring and support. Only 12/28 studies were evaluations, and these studies were generally of weak quality. These studies reported impacts of improved workforce sustainability, workforce capacity, resourcing/growth and healthcare performance improvements.

Conclusions
PHCs can strengthen their workforce models by bringing together healthcare providers to consider how these strategies and enabling conditions can be improved to meet the healthcare and health needs of the local community. Improvement is also needed in the quality of evidence relating to particular strategies to guide practice.
The effects of reimbursement reform of antidiabetic medicines from the patients’ perspective – a survey among patients with type 2 diabetes in Finland
Authors: Suviranta Taika , Timonen Johanna , Martikainen Janne , Aarnio Emma 
Published: October 2019

Abstract

Background
In Finland, the reimbursement rate for antidiabetic medicines other than insulins was lowered from 100 to 65% at the beginning of 2017. The objective of this study was to examine the effects of this reform experienced by patients with type 2 diabetes. The objective was also to explore if socio-economic status affects this experience.

Methods
The data were collected by conducting a survey among Finnish adults with type 2 diabetes (n = 603). The baseline survey was conducted in November–December 2016. A second follow-up survey was conducted at the end of 2017 where the participants’ experience of the reimbursement reform was surveyed with an open-ended question. Free-form inductive content analysis was used to categorize the answers. The association between the participants’ characteristics and reporting an effect caused by the reimbursement reform was studied with binomial logistic regression.

Results
285 (47.3%) participants reported an effect of some kind caused by the reimbursement reform. The most common reported effects were economic effects (32.7%) and annoyance (12.4%). Having financial difficulties in purchasing antidiabetic medicines (odds ratio (OR) 5.20, 95% confidence interval (Cl) 2.99–9.06) or not having annual deductible exceeded (OR 2.17, 95% CI 1.19–3.95), and use of certain antidiabetic medication groups at baseline were associated with reporting an effect. Socio-economic status was not associated with the likelihood of reporting an effect.

Conclusions
Almost half of the participants with type 2 diabetes reported an effect, most commonly economic effects, such as increased expenditure or difficulty in purchasing medicines, after the reimbursement reform. It is important to study the effects of reimbursement reforms also from the patients’ perspective.
Clinical determinants associated with quality of life for people who live with HIV/AIDS: a Meta-analysis
Authors: Ghiasvand Hesam , Waye Katherine M. , Noroozi Mehdi , Harouni Gholamreza Ghaedamini , Armoon Bahram , Bayani Azadeh 
Published: October 2019

Abstract

Background
During recent years, Quality of Life (QoL) is a significant assessment factor in clinical trials and epidemiological researches due to the advent of Antiretroviral Therapy (ART), Human Immunodeficiency Virus (HIV) has become a manageable,chronic disease. With regards, more attention must be paid to the QoL of infected patients. Limited evidence exists on the impact of ART on QoL among HIV infected patients. Due to lacking of a systematic approach to summarizing the available evidence on the clinical determinants of People Who Live with HIV/AIDS (PWLHs’) QoL, this study aimed to analyze the impact of clinical determinants (ART experience, CD4 count < 200, co-morbidities, time diagnosis and accessibility to cares) on QoL among PWLHs’.

Methods
This study was designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched in February 2017 to identify all past studies that discussed social and behavioral characteristics of QoL in PLWHA. To recognize effective factors on social and behavioral QoL, a meta-analysis was conducted. Polled Odds Ratios (ORs) were utilized at a 95% confidence level. Since sampling methods differed between articles in the systematic review, we evaluated pooled estimates using a random effect model. Metan, metareg, metacum, and metabias commands in STATA version 13.0 were applied to analyze the data.

Results
Our findings indicated that ART has a positive impact on QoL, with a pooled effect size at approximately 1.04 with a confidence interval between 0.42 to 1.66 which indicates this impact is not very considerable and may be relatively neutral. The pooled effect size for CD4 count on QoL was .29 (95%CI = .22–.35), indicating that there is a negative associate between CD4 count and QoL. The co-morbidity as a negative determinant for QoL among HIV/AIDS infected people. The pooled effect size implies on a relative neutral association, although the confidence interval is wide and ranges between 0.32 to 1.58. The pooled effect size is about 1.82 with confidence interval 1.27 to 2.37 which indicates a considerable positive association with lowest level of heterogeneity.

Conclusions
The results illustrated that time diagnosing and availability to hospital services had significant relationship with a higher QoL and CD4 < 200 was associated with a lower QoL. In conclusion, policy makers should set an agenda setting to provide a suitable diagnostic and therapeutic facilities to early detecting and continues monitoring the health status of People Who Live with HIV/AIDS (PWLHs’).
Rethinking obstetric violence and the “neglect of neglect”: the silence of a labour ward milieu in a South African district hospital
Authors: Lappeman Maura , Swartz Leslie 
Published: October 2019

Abstract

Background
Research into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff responses to stillbirths, we wanted to gain contextual information on how high risk pregnancies are handled in general in Khayelitsha Hospital, a district hospital in an impoverished urban setting in the Western Cape Province of South Africa. This health care system experiences an immense patient load, the poverty of the community it serves, and the numerous traumas affecting both patients and staff.

Methods
In order to obtain rich exploratory data, a qualitative research methodology was used. The primary data source was observations in the labour ward, interviewing labour ward staff (doctors, nurse, and cleaners). The secondary data source was the analysis of hospital documents, specifically those related to labour ward policy.

Results
From our numerous observations and discussions, it is clear that no one is being overtly mistreated in this hospital and patients are medically well attended to. Although we saw no physical abuse, we noted the silence in the ward. Beside medical related interactions, we also noted that there were limited interactions between the women and the health care providers.

Conclusions
Silence can be a form of neglect as it leaves the women feeling uncared for and not seen. In an overburdened health care system where both staff and patients are often overwhelmed or traumatised, silence can be a way in which a system defends itself against what it knows it cannot provide.