bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work place bullying: the characteristics of victims and perpetrators at a Middle Eastern health care facility
Authors: Al-Surimi Khaled , Omar Munirah Al , Alahmary Khalid , Salam Mahmoud 
Published: December 2019

Abstract
Background: Workplace Bullying (WPB) is any form of verbal, physical or sexual harassment that an employee endures by a person or a group. In health care settings, practitioners are occasionally victims of WPB. The aim of this study was to evaluate the various characteristics of WPB incidents at a multi-regional healthcare facility in a Middle Eastern country. Methods: A cross sectional study survey was conducted in 2018, distributing a self-administrated questionnaire via private electronic mails among fulltime healthcare practitioners in multi-regional hospitals. Eligible participants were 684 practitioners who have been exposed to a WPB incident in the past five years. Factors associated with either being a victim or perpetrators were analyzed, including their age, sex, marital status, level of education, nationality, years of experience, and job title Data were analyzed using SPSS statistical software version 25, applying both descriptive and inferential statistical analysis as appropriate. Results: Majority of participants were females (89.2%), and 39.3% were <30 years old. Practitioners were nurses (49.1%), administrative staff (24.3%), physicians (14.6%), technicians (10.8%) and pharmacists (1.2%). WPB perpetrators were mainly patients (36.1%), their families/relatives (29.5%), other colleagues (27.2%) or their managers/supervisors (7.2%). The type of WPB incident was mainly a verbal abuse (98.1%), a physical harassment (11.8%) and sexual connotations (5.8%). WPB mainly occurred during day duties (80.3%) and at working stations/offices (52.6%). Higher-risk groups among nurses/allied health were mainly females, ≥30 years old, and expatriates. Among physicians and pharmacists, males, younger age groups, and locals were more prone to WPB. Nurses/allied heath were more likely to encounter WPB in offices/non-clinic areas, whereas physicians/pharmacists encountered them in patient rooms/clinics. Older practitioners (≥30 years) were mainly exposed to WPB by perpetrators who were employees, while younger practitioners encountered WPB by patients/relatives. Perpetrators who were employees committed WPB in offices/non-clinic areas, while patients/their relatives committed WPB in patient rooms/clinics. Conclusion: WPB might occur at anytime or anywhere within hospitals and by any person. This study shared the characteristics of WPB incidents that did occur in one setting and might occur in any other setting too. Analyzing the victim’s, the perpetrator’s and the setting’s characteristics provides a clear picture on the early warning signs that might predict a high-risk environment and alert hospital safety officers and hospital administration.
Building Effective Health Learning Organizational Culture: A National Study
Authors: Alonazi Wadi 
Published: December 2019

Abstract
BackgroundHospitals and healthcare institutions should be observant of the ever changing environment and be adaptive to learning practices. By adopting the steps and other components of organizational learning, hospitals and healthcare institutions can convert themselves into learning organizations and ultimately strengthen the overall healthcare system of the country. The study aimed to explore the influence of organizational learning dimensions on learning organization culture within a healthcare context.MethodIn 2019, a cross-sectional study was performed and data were collected from 1131 respondents from four categories of public learning hospitals in Saudi Arabia. A Structural equation modeling (SEM) was applied through partial least square (PLS) to estimate the relationships between the various variables.Results Organizational learning including system connections (β= 0.227, P< 0.01) and embedded systems (β= 0.186, P<0.01) have major significant relationships in building effective learning organization culture, followed by continuous learning (β= 0.142, P<0.01) and empowerment (β= 0.130, P< 0.01). Finally, team learning and collaboration (β= 0.106, P<0.01) and dialogues and inquiry (β= 0.087, P<0.01) have the lowest effect on building health organization culture.Conclusion The findings concluded that intrinsic factors like learning, dialogue and inquiry, and teamwork, have an essential role in this study, yet the most central factors toward the development of learning organization culture were extrinsic factors including system connections and embedded systems. In other words, until knowledge-sharing is embedded in health organizational systems, organizations may not maintain a high level of learning.
Perceptions and Experiences of Frontline Health Managers and Providers on Accountability in a South African Health District
Authors: Mukinda Fidele Kanyimbu , Belle Sara Van , Schneider Helen 
Published: December 2019

Abstract
Objective This study explored and described accountability as perceived and experienced by frontline health managers and providers of maternal, newborn and child health (MNCH) services in a South African health district.Methods This was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline health managers and providers in the district office and in two sub-districts, examining the meanings of accountability and related lived experiences.Results Accountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the “self”. The practice of accountability was challenged in organisational environments where impunity and unfair punishment existed alongside each other, where political connections constrained the ability to sanction and by climates of fear and blame. Accountability was enabled by open management styles, teamwork, good relationships between primary health care, hospital services and communities, investment in knowledge and skills development and responsive support systems. The interplay of these enablers and constraints varied across the facilities and sub-districts studied.Conclusions and Recommendations Providers and managers have well-established ideas about, and a language of, accountability. The lived reality of accountability by frontline managers and providers varies and is shaped by micro-configurations of enablers and constraints in local accountability ecosystems. Fairness, open leadership styles, teamwork and collaboration between primary health care and hospitals and community participation were seen as promoting accountability, enabling collective responsibility and a culture of learning rather than blame.
FEEDBACK THAT AFFECTS FIRST YEAR MEDICAL STUDENTâ€™S LEARNING IN HIGH POWER DISTANCE & COLLECTIVISM CULTURE
Authors: Triastuti Ida Ayu , Rahayu Gandes Retno , Suhoyo Yoyo 
Published: December 2019

Background: Constructive feedback is an essential component of learning for medical undergraduate. Communication culture of high-power distance and collectivism might have influence in shaping students' perception of the benefit of feedback.
Aim: This study is aimed to identify feedback characteristic which associated with students' perception of learning benefit, and further explored the mechanism feedback influence on students learning process.
Method: This is a mixed method study, with explanatory sequential approach. The setting is first-year medical undergraduate students at FK UKDW who enrolled in skill lab class (pulmonary physical examination). The first phase is a quantitative study using questionnaire on feedback characteristics and studentâ€™s perception of feedback benefits, further analysed with linear regression methods. The next phase is an interview study on selected students with semi-structured questions, and further analysed with thematic analysis.
Result: There are 82 students who returned the questionnaire. Quantitative analysis showed that feedback including comparison to standard (B=2,26; p = 0,003) and follow-up planning (B=3,47; p < 0,001) are associated with perceived benefit by students. Further interview of 11 students discovered that students have received clear and concise outline through the feedback process. On the other hand, the communication culture, poor execution of feedback process, and interconnectedness between each characteristic may influence the students' perception of benefits.
Conclusion: Feedback is beneficial for medical undergraduate students in high power distance and collectivist culture, specifically feedback with comparison to standard and follow-up planning.
New Technological Approach for Glycyrrethic Acid Oral and Topical Administration
Authors: Pagano Cinzia , Perioli Luana , Calarco Paola , Di Michele Alessandro , Tiralti Maria C. , Ricci Maurizio 
Published: December 2019

Background:
18β- glycyrrhetinic acid (Gly) is the major bioactive component of licorice roots and
rhizomes of the Glycyrrhiza glabra species. It shows many activities such as antiviral, anti-inflammatory, antioxidant,
antimicrobial, and antifungal, however, its use in the health field is very limited due to the low water solubility.

Methods:
This paper deals with the development of a new technological approach for Gly dissolution rate enhancement.
It consists of Gly intercalation (guest) in the interlamellar spaces between the inorganic spaces (host)
of the anionic clays “hydrotalcites” (HTlc) to obtain hybrids MgAl-HTlc-Gly and ZnAl-HTlc-Gly. Gly can find
applications in both systemic and local therapies, thus advantages of the use of the hybrids in these two fields
were investigated.

Results:
Gly dissolution rate from hybrids in the intestinal environment, site in which it is preferentially absorbed,
resulted enhanced (ZnAl-HTlc-Gly > MgAl-HTlc-Gly) compared to the crystalline form, thereby, making them
suitable for oral administration as dry powder in hard capsules.

:
For a local therapy, bioadhesive, vaginal emulgels loaded with the hybrids were developed. These showed suitable
mucoadhesive property to the vaginal mucosa, necessary to prolong the residence time in the application site.
The emulgel containing ZnAl-HTlc-Gly showed a faster and higher release profile than that containing MgAl-
HTlc-Gly.

Conclusions:
The obtained results suggest that Gly intercalation into HTlc, especially in ZnAl-HTlc, allows to
enhance Gly dissolution when the hybrids are formulated both as oral or topical products.
Old and New Drugs for Treatment of Advanced Heart Failure
Authors: Buttá Carmelo , Roberto Marco , Tuttolomondo Antonino , Petrantoni Rossella , Miceli Giuseppe , Zappia Luca , Pinto Antonio 
Published: December 2019

Background:
Advanced heart failure (HF) is a progressive disease with high mortality and limited
medical therapeutic options. Long-term mechanical circulatory support and heart transplantation remain goldstandard
treatments for these patients; however, access to these therapies is limited by the advanced age and multiple
comorbidities of affected patients, as well as by the limited number of organs available.

Methods:
Traditional and new drugs available for the treatment of advanced HF have been researched.

Results:
To date, the cornerstone for the treatment of patients with advanced HF remains water restriction, intravenous
loop diuretic therapy and inotropic support. However, many patients with advanced HF experience loop
diuretics resistance and alternative therapeutic strategies to overcome this problem have been developed, including
sequential nephron blockade or use of the hypertonic saline solution in combination with high-doses of furosemide.
As classic inotropes augment myocardial oxygen consumption, new promising drugs have been introduced,
including levosimendan, istaroxime and omecamtiv mecarbil. However, pharmacological agents still remain
mainly short-term or palliative options in patients with acute decompensation or excluded from mechanical
therapy.

Conclusions:
Traditional drugs, especially when administered in combination, and new medicaments represent
important therapeutic options in advanced HF. However, their impact on prognosis remains unclear. Large trials
are necessary to clarify their therapeutic potential and prognostic role in these fragile patients.
Postoperative Serum Albumin Decrease Independently Predicts Delirium in the Elderly Subjects after Total Joint Arthroplasty
Authors: Qi Jianmin , Liu Cheng , Chen Li'an , Chen Junping 
Published: December 2019

Background:
Postoperative delirium (POD), a neurobehavioral syndrome induced by dysfunction of
neural activity, is a common and serious complication. This current study aimed to investigate independent predictors
for POD in elderly subjects after total joint arthroplasty (TJA).

Methods:
Eligible elderly patients (≥65 years) who underwent elective unilateral primary hip or knee arthroplasty
under epidural anesthesia from October 2016 to January 2019 were consecutively enrolled. POD was diagnosed
following the guidance of the 5th edition of Diagnostic and Statistical Manual of Mental Disorders, (DSM V,
2013). The relative change in serum Alb (ΔAlb) was defined as the absolute value of (preoperative Alb value–
nadir value within postoperative day 2)/preoperative Alb ×100%. The predictive value of ΔAlb for POD was
evaluated by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate logistic regression
analyses were used for evaluating risk factors for POD.

Results:
A total of 328 patients were enrolled in the analysis, of which 68 (20.7%, 68/328) patients developed
POD within postoperative 7 days. ΔAlb was an effective predictor for POD with an area under the curve (AUC)
of 0.821, a sensitivity of 76.15% and a specificity of 70.59%, respectively (P<0.001). Univariate and multivariate
logistic regression analyses indicated that ΔAlb was the only independent risk factor for POD (OR: 2.43, 95%CI:
1.17–4.86, P=0.015).

Conclusions:
ΔAlb was an independent risk factor for POD in elderly subjects after TJA.
Neuroblastoma: An Updated Review on Biology and Treatment
Authors: Mallepalli Suresh , Gupta Manoj Kumar , Vadde Ramakrishna 
Published: December 2019

Background:Neuroblastoma (NB) is the second leading extracranial solid tumors of early childhood and clinically characterized by the presence of round, small, monomorphic cells with excess nuclear pigmentation (hyperchromasia).Owing to a lack of definitive treatment against NB and less survival rate in high-risk patients, there is an urgent requirement to understand molecular mechanisms associated with NB in a better way, which in turn can be utilized for developing drugs towards the treatment of NB in human.Objectives:In this review, an approach was adopted to understand major risk factors, pathophysiology, the molecular mechanism associated with NB, and various therapeutic agents that can serve as drugs towards the treatment of NB in humans.Conclusions:Numerous genetic (e.g., MYCN amplification), perinatal, and gestational factors are responsible for developing NB. However, no definite environmental or parental exposures responsible for causing NB have been confirmed to date. Though intensive multimodal treatment approaches, namely, chemotherapy, surgery &radiation, may help in improving the survival rate in children, these approaches have several side effects and do not work efficiently in high-risk patients. However, recent studies suggested that numerous phytochemicals, namely, vincristine, and matrine have a minimal side effect in the human body and may serve as a therapeutic drug during the treatment of NB. Most of these phytochemicals work in a dose-dependent manner and hence must be prescribed very cautiously. The information discussed in the present review will be useful in the drug discovery process as well as treatment and prevention on NB in humans.
Assessment of Expression of Homeobox A5 in Endometrial Cancer on the mRNA and Protein Level
Authors: Dziobek Konrad , Oplawski Marcin , Zmarzły Nikola , Gabarek Beniamin O. , Kiełbasiński Robert , Kiełbasiński Kamil , Kieszkowski Przemysław , Talkowski Karol , Boroń Dariusz 
Published: December 2019

Background:
Endometrial cancer is one of the most common gynecological cancer in the
developed countries and occurs mainly in postmenopausal women. Angiogenesis is important for cancer
formation as it provides nutrients for growing tumor mass. Most tumors do not show detectable
Homeobox A5 (HOXA5 level), suggesting its potential role as a cancer suppressor. It was demonstrated
that HOXA5 is involved in the progression of various types of cancer and the loss of its expression
correlates with higher pathological grade and poorer outcome.

Objective:
The aim of the study was to evaluate HOXA5 expression at transcriptome and protein levels.

Material and methods:
The study enrolled 45 women diagnosed with endometrial cancer and 15
without neoplastic changes. The histopathological examination allowed us to divide cancer tissue samples
according to the degree of histological differentiation: G1, 17; G2, 15; G3, 13. The expression of
the HOXA5 protein was determined by immunohistochemistry. Microarray and RT-qPCR techniques
were used to assess HOXA5 expression at the mRNA level.

Results:
The reaction to the HOXA5 protein was only visible in glandular cells in G1 endometrial cancer
and was lower compared to the control. In grades 2 and 3, reactions were noted at the limit of the
method’s sensitivity. In addition, reduced HOXA5 expression was observed at the transcriptome level.

Conclusion:
HOXA5 may become a potential complementary molecular marker, allowing early detection
of neoplastic changes in the endometrium. It also seems that detection of HOXA5 at the mRNA
and protein levels may be helpful in improving the accuracy of diagnosis and planning effective oncological
therapy.
Helicobacter pylori Reactivates Human Immunodeficiency Virus-1 in Latently Infected Monocytes with Increased Expression of IL-1β and CXCL8
Authors: Natarajan Vidhya , Moar Preeti , Kaur Urvinder S. , Venkatesh Vimala , Kumar Abhishek , Chaturvedi Rupesh , Himanshu D. , Tandon Ravi 
Published: December 2019

Background:
Helicobacter pylori are gram-negative bacteria, which colonize the human
stomach. More than 50% of the world’s population is infected by H. pylori. Based on the high prevalence
of H. pylori, it is very likely that HIV and H. pylori infection may coexist. However, the molecular
events that occur during HIV-H. pylori co-infection remain unclear. Latent HIV reservoirs are
the major obstacle in HIV cure despite effective therapy. Here, we explored the effect of H. pylori
stimulation on latently HIV-infected monocytic cell line U1.

Method:
High throughput RNA-Seq using Illumina platform was performed to analyse the change in
transcriptome between unstimulated and H. pylori-stimulated latently HIV-infected U1 cells. Transcriptome
analysis identified potential genes and pathways involved in the reversal of HIV latency using
bioinformatic tools that were validated by real-time PCR.

Results:
H. pylori stimulation increased the expression of HIV-1 Gag, both at transcription (p<0.001)
and protein level. H. pylori stimulation also increased the expression of proinflammatory cytokines
IL-1β, CXCL8 and CXCL10 (p<0.0001). Heat-killed H. pylori retained their ability to induce HIV
transcription. RNA-Seq analysis revealed 197 significantly upregulated and 101 significantly downregulated
genes in H. pylori-stimulated U1 cells. IL-1β and CXCL8 were found to be significantly upregulated
using transcriptome analysis, which was consistent with real-time PCR data.

Conclusion:
H. pylori reactivate HIV-1 in latently infected monocytes with the upregulation of IL-1β
and CXCL8, which are prominent cytokines involved in the majority of inflammatory pathways. Our results
warrant future in vivo studies elucidating the effect of H. pylori in HIV latency and pathogenesis.
Propofol Pretreatment Prevents Oxygen-Glucose Deprivation/Reoxygenation (OGD/R)-induced Inflammation Through Nuclear Transcription Factor κB (NF-κB) Pathway in Neuroblastoma Cells
Authors: Hu Fang , Jiang Jianhua , Yu Guocan , Zang Hongcheng , Sun Haoliang 
Published: December 2019

Background:
Inflammation is one of the causes of neuroblastoma progression. Propofol
attenuates inflammation by repressing nuclear transcription factor κB (NF-κB) in different diseases.
But its effect on oxygen-glucose deprivation/reoxygenation (OGD/R)-induced inflammation
is not known.

Objective:
This study investigated the role and mechanism of action of propofol on OGD/Rinduced
inflammation in mouse N2A neuroblastoma cells.

Methods:
MTT was performed on mouse neuroblastoma cells N2A to assess and select the maximum
safe dose of propofol. Next, N2A cells were pretreated with propofol and then, exposed to
the OGD condition for 3 h and reoxygenated for 6 h. The content of the inflammatory factors,
interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α), in the medium was measured
by ELISA, while their protein expression was detected by western blot and immunofluorescence.
The protein expression of P65, p-P65, IKBα and p-IKBα belonging to the NF-κB pathway was
also determined by western blot in N2A cells. To further confirm the mechanism of propofol on
OGD/R-induced inflammation in mouse N2A cells, P65 was over-expressed and the above experiments
were repeated.

Results:
Propofol did not affect cell viability of N2A cells even at the maximum concentration
used (30 µM), thus, 30 µM of propofol was selected to perform our experiments. Besides, OGD/R
induced inflammation and activation of NF-κB pathway with increased p-P65 and p-IKBα expression,
and propofol pretreatment inhibited OGD/R induced inflammation and activation of NF-κB
pathway in N2A cells. Over-expression of P56 abolished the effects of propofol on OGD/Rinduced
inflammation and activation of NF-κB pathway in N2A cells.

Conclusion:
Our work demonstrated for the first time that propofol pretreatment ameliorated
OGD/R induced inflammation via NF-κB pathway modulation in mouse neuroblastoma N2A cells,
indicating that propofol might be considered as a potential therapeutic approach to reduce inflammation
in neuroblastoma.
Integrated Protocol to Design Potential Inhibitors of Dipeptidyl Peptidase- 4 (DPP-4)
Authors: Pantaleão Simone Queiroz , Philot Eric Allison , de Oliveira Almeida Michell , Lima Angelica Nakagawa , de Sairre Mirela Inês , Scott Ana Ligia , Honorio Kathia Maria 
Published: December 2019

Background:
A strategy for the treatment of type II diabetes mellitus is the inhibition of the
enzyme known as dipeptidyl peptidase-4 (DPP-4).

Aims:
This study aims to investigate the main interactions between DPP-4 and a set of inhibitors, as
well as proposing potential candidates to inhibit this enzyme.

Method:
We performed molecular docking studies followed by the construction and validation of
CoMFA and CoMSIA models. The information provided from these models was used to aid in the
search for new candidates to inhibit DPP-4 and the design of new bioactive ligands from structural
modifications in the most active molecule of the studied series.

Result:
We were able to propose a set of analogues with biological activity predicted by the CoMFA
and CoMSIA models, suggesting that our protocol can be used to guide the design of new DPP-4 inhibitors
as drug candidates to treat diabetes.

Conclusion:
Once the integration of the techniques mentioned in this article was effective, our strategy
can be applied to design possible new DPP-4 inhibitors as candidates to treat diabetes.