bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uses of Quick Response Codes in Healthcare Education: A Scoping Review
Authors: Karia Chiraag Thakrar , Hughes Andrew , Carr Sue 
Published: November 2019

Abstract
Background To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context. Methods Medline, EMBASE, CINAHL, HMIC and HBE were searched using specified search terms that included ‘quick response code’ and ‘education’. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes. Results Use of QR codes in healthcare education could be broadly aligned to four common themes These included: to increase participant engagement, for simulation training, for just-in-time learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments. Conclusions The use of QR codes for healthcare education is increasing and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety, and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.
Avatar-based versus conventional vital signs display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study.
Authors: Garot Olivier , Rössler Julian , Pfarr Juliane , Ganter Michael T. , Spahn Donat R. , Nöthiger Christoph B. , Tscholl David Werner 
Published: November 2019

Abstract
Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms.Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Association Task-Load-Index (NASA TLX) questionnaire.Results In the 10-second scenarios, the median number of perceived vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a median of differences of 5 vital signs, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a median of differences of 5 points, p = 0.024. In the 30-second scenarios, vital sign perception and workload did not differ significantly.Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived cognitive workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, increase situation awareness and enhance patient safety.
Genomic and evolutionary features of two AHPND positive Vibrio parahaemolyticus strains isolated from shrimp (Penaeus monodon) of south-west Bangladesh
Authors: Ahmmed Shawon , Khan Md. Abdullah-Al-Kamran , Eshik Md. Mostavi Enan , Punom Nusrat Jahan , Islam Abul B.M.M.K. , Rahman Mohammad Shamsur 
Published: November 2019

Abstract
Background Due to its rapid lethal effect in the early stage of shrimp, acute hepatopancreatic necrosis disease (AHPND) causing great economic losses, since its first outbreak in southeast China in 2009. Vibrio parahaemolyticus, carrying the pirA and pirB toxin genes is known to cause AHPND in shrimp. The overall objective of this study was to sequence the whole genome of AHPND positive V. parahaemolyticus strains isolated from shrimp (Peneaus monodon) of south-west region of Bangladesh in 2016 and 2017 and characterize the genomic features and emergence pattern of this marine pathogen. Results Two targeted AHPND positive V. parahaemolyticus strains were confirmed using PCR with 16S rRNA, ldh, AP3 and AP4 primers. The assembled genomes of strain MSR16 and MSR17 were comprised of a total of 5,393,740 bp and 5,241,592 bp, respectively. From annotation, several virulence genes involved in chemotaxis and motility, EPS type II secretion system, Type III secretion system-1 (T3SS-1) and its secreted effectors, thermolabile hemolysin were found in both strains. Importantly, the ~69 kb plasmid was identified in both MSR16 and MSR17 strains containing the two toxin genes pirA and pirB. Antibiotic resistance genes were predicted against β-lactam, fluoroquinolone, tetracycline and macrolide groups in both MSR16 and MSR17 strains. Conclusions The findings of this research may facilitate the tracking of pathogenic and/or antibiotic-resistant V. parahaemolyticus isolates between production sites, and the identification of candidate strains for the production of vaccines as an aid to control of this devastating disease. Also, the emergence pattern of this pathogen can be highlighted to determine the characteristic differences of other strains found all over the world.
Analysis of factors related to recurrence of paediatric hepatoblastoma -A single centre retrospective study
Authors: Yang Wei , Chen Yiwei , Huang Yijin , Wang Huanmin 
Published: November 2019

Abstract
Purpose: This study was performed to identify risk factors associated with recurrence of hepatoblastoma. Methods: A retrospective study was conducted on 56 patients with hepatoblastoma from 2012 to 2015 in Beijing Children’s Hospital. PRETEXT stage, serum alpha fetoprotein (AFP) value, change trend of tumors after treatment and some other clinical characteristics were collected and analyzed. The comparison of independent variables that were not distributed normally was performed with the log-rank test. Results: 28 patients with tumor recurrence and 28 non-recurrence patients were included in this study, the median age at presentation was 46.5 (26, 71.5) months. There was a significant difference in the 3-year recurrence free survival (RFS) probability between the patients over 54 months and those younger than 54 months (p=0.007). After neoadjuvant chemotherapy, the chance of recurrence in PR patients was shown to be significantly lower than that in SD patients (p=0.004). The 3-year RFS of patients with a decrease in AFP of more than 60% after neoadjuvant chemotherapy was significantly higher than that of patients with a decrease rate of less than 60% (p=0.005). Postoperative follow-up revealed that patients whose postoperative AFP fell to normal levels within six months of the start of treatment had a three-year RFS of 68.6%, which is higher than that of patients whose AFP fell below the normal range after six months (p=0.0005). Finally, multivariate analysis by Cox regression showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors for 3-year RFS. Other clinical features were not significantly associated with tumor recurrence in this study. Conclusion: Through this study, we concluded that the prognosis of childhood HB is related to the age at presentation and the response of chemotherapy. The results of the multivariate analysis showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors. These findings can be helpful to evaluate therapeutic effects and predict prognosis. Key words: hepatoblastoma; alpha fetoprotein; risk factor
SUDDEN INTRAUTERINE UNEXPLAINED DEATH: TIME TO ADOPT UNIFORM POSTMORTEM INVESTIGATIVE GUIDELINES?
Authors: Lavezzi Anna , Piscioli Francesco , Pusiol Teresa , Jorizzo Gianfranco , Ferrero Stefano 
Published: November 2019

Abstract
Background: Worldwide approximately 2.6 million are stillborn, mostly occurring in developing countries. In the great part these deaths are inexplicable. The evenness and standardisation of the diagnostic criteria are prerequisites to understand their pathogenesis. The core goal of this article is to propose new evidence based investigative post-mortem guidelines that should be adopted in all the Institutions especially when a fetal death, after a routine autopsy procedure, is diagnosed as “unexplained”. The proposed protocol is mainly focused on the anatomopathological examination of the autonomic nervous system and in particular of the brainstem where the main centers that control vital functions are located. Methods: Updated investigative guidelines for the examination of unexplained stillbirths, prevalently focused on the histological examination of the brainstem, where the main centers that are involved in monitoring the vital functions are located, are here presented. A section of this protocol concerns the Immunohistochemical evaluation of specific functional markers such as the neuronal nuclear antigen, nicotinic acetylcholine receptors, serotonin, orexin, apoptosis and gliosis. The important role of risk factors, having regard in particular to maternal smoking and air pollution is also contemplated in these guidelines. Results: Specific morphological and/or functional alterations of vital brainstem structures have been found with high incidence in over 100 cases of unexplained fetal death sent to the “Lino Rossi Research Center” of the Milan University according to the Italian law. These alterations were rarely detected in a group of control cases. Conclusions: We hope this protocol can be adopted in all the Institutions notably for the examination of unexplained fetal deaths, in order to make uniform investigations. This will lead to identify a plausible explanation of the pathogenetic mechanism behind the unexplained fetal deaths and to design preventive strategies to decrease the incidence of these very distressing events for both parents and clinicians.
Estimating the number of usability problems affecting medical devices: modelling the discovery matrix
Authors: Vandewalle Vincent , Caron Alexandre , Delettrez Coralie , Pelayo Sylvia , Duhamel Alain , Dervaux Benoit 
Published: November 2019

Abstract
Background Usability studies of medical devices are mandatory for market access. The studies’ goal is to identify and eliminate usability problems that could cause harm the user or limit the device’s effectiveness. In practice, human factor engineers study participants under actual conditions of use and list the problems encountered. This results in a binary discovery matrix in which each row corresponds to a participant, and each column corresponds to a usability problem. One of the main challenges in usability studies is estimating the total number of problems, in order to assess the completeness of the discovery process. Today’s margin-based methods fit the column sums to a binomial model of problem detection. However, the discovery matrix actually observed is truncated because of undiscovered problems, which corresponds to fitting the marginal sums without the zeros. Margin-based methods fail to overcome the bias related to truncation of the matrix. The objective of the present study was to develop and test a matrix-based method for estimating the total number of usability problems. Methods The matrix-based method models the likelihood of the discovery matrix, and allows one to account for all the available information. It also circumvents a drawback of margin-based methods by simultaneously estimating two unknown parameters: the probability of problem detection and the total number of problems. Furthermore, the matrix-based method takes account of a heterogeneous probability of detection, which better reflects a real-life setting. As suggested in the usability literature, a logit-normal prior for the probability of detection is selected. Results We assessed the matrix-based method’s performance in a range of settings reflecting real-life usability studies and with both homogeneous and heterogeneous probabilities of problem detection. In our simulations, the matrix-based method improved the estimation of the number of problems (in terms of bias, consistency, and coverage probability of the confidence interval) in a wide range of settings. We also applied our method to real data from a usability study of infusion pumps. Conclusions Our method should be applied by regulators and device manufacturers to estimate the number of usability problems using the set of statistical routines provided.
Prevalence of depressive symptoms and associated factors among people with Tuberculosis in Ethiopia: meta-analysis
Authors: Bifftu Berhanu Boru , Tiruneh Bewket Tadesse , Guracho Yonas Deressa , Dachew Berihun Assefa 
Published: November 2019

Abstract
Tuberculosis (TB) is a chronic infectious disease caused by mycobacterium tuberculosis. Co-morbid depression among individual with TB is common public health concern that adversely affect the psychological well being of the patient. Thus, the aims of this study were to determine the magnitude of depression and its associated factors among people with TB in Ethiopia. Methods: Databases including: PubMed/Medline, SCOPUS, and HINARI were searched. Weighted inverse variance random-effects model was used to calculate the pooled prevalence of depression. The heterogeneity between studies was measured by the index of heterogeneity (I2 statistics) test. Funnel plots and Egger’s test were used to determine publication bias. Sensitivity test and subgroup analysis were also performed to identify influential study and to account for heterogeneity. Results: In this study, a total of 6430individuals with TB were included from 15 studies. The pooled prevalence of depression was 46% (95% CI; 40% -53%). Tests of heterogeneity was significant (I2= 96.33% and p <0.001). However, funnel plots and Egger’s test showed no evidence of publication bias. Being female, low income, substance use, perceived stigma, extra-pulmonary TB and treatment phase were factors associated with depressive symptoms. Conclusion: In Ethiopia, around half of the TB patients had depressive symptoms. Thus, authors’ suggest the need of mental health screening for people with TB particularly for substance users and socioeconomic disadvantage TB patients. Authors’ also suggest the needs of improving awareness of TB.
Vitamin D and 17β-estradiol upregulate each other's receptors and regulating the AMPK/NF-κB pathway to relieve depressive-like behaviors in female ovariectomized rats
Authors: Zhang Wen-yuan , Guo Yujin , Wang Ke-yi , Jiang Pei 
Published: November 2019

Abstract
Background: A deficiency of vitamin D (VD) or 17β-estradiol (E2) is associated with increased risk of mood disorders such as depression in menopausal females, but the mechanism underlying is still elusive. The present study aims to evaluate whether vitamin D and 17β-estradiol could relieve a depressive-like state through neuroinflammatory regulation in ovariectomized (OVX) rats. Methods: Female SD rats were randomly divided into four groups, namely, control (SHAM), OVX, OVX+VD, and OVX+E2. The treatment procedure was performed for 10 weeks until sacrifice. Results: The chronic administration of vitamin D and 17β-estradiol showed anti-depressive-like activity in the OVX rats. Additionally, vitamin D and 17β-estradiol upregulated each other's receptors, including VDR, ERα, and ERβ in the hippocampus of OVX rats. Vitamin D and 17β-estradiol showed neuroprotective effects by decreasing OVX-induced apoptosis and neuronal damage, regulating the AMPK/NF-κB signaling pathway, and reducing the proinflammatory cytokines (IL-1β, IL-6, and TNFα), as well as iNOS and COX-2 in the hippocampus of OVX rats. Conclusions: The present study demonstrated that vitamin D and 17β-estradiol could upregulate each other's receptors and regulate the AMPK/NF-κB pathway to relieve the OVX-induced depressive-like state. The results should stimulate translational research towards the vitamin D potential for prevention or treatment of menopause-related depression.
Association Between Developmental Dental Anomalies, Early Childhood Caries and Oral Hygiene Status of 3-5-Year-Old Children in Ile-Ife, Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Michael , Adeniyi Abiola , Tantawi Maha El , Finlayson Tracy L 
Published: November 2019

Abstract
Objectives To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3-5-year-old children resident in Ile-Ife, Nigeria.Methods We analyzed a household survey and clinical examination data collected to determine the association between ECC and maternal psychosocial wellbeing. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodnes, hypodontial, macrodontial, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status.Results Of the 918 children examined, 75 (8.2%) had DDA, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent DDA was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p<0.001) and a borderline association between ECC and hypomineralized second primary molars (p=0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91-4.56; p=0.09) and ECC (PR: 2.02; 95% CI: 0.92-4.46; p=0.08) who had DDA was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance.Conclusion For a population with a high prevalence of enamel hypoplasia and hypomineralized second primary molars, screening for these dental anomalies may be a strategic public health response to reduce the risk of children for ECC.
Two-way Messaging Therapy for Depression and Anxiety: Longitudinal Response Trajectories
Authors: Hull Thomas Derrick , Malgaroli Matteo , Connolly Philippa , Feuerstein Seth , Simon Naomi 
Published: November 2019

Abstract
Background Telemedicine is an ongoing strategy for overcoming access barriers to evidence-based psychotherapy and modes that operate outside pre-scheduled, session-based formats (e.g., two-way messaging) may further address these challenges. However, no study to date has established suitability criteria for this medium.Methods We evaluated individual response trajectories for daily two-way messaging therapy by licensed clinicians using a longitudinal design with a large outpatient sample (n = 10,718) from a telemedicine provider serving urban and rural patients in all 50 states of the US. Symptoms were measured at baseline and every three weeks for a 12 week treatment course with the nine-item Patient Health Questionnaire (PHQ-9) for depression and the seven-item Generalized Anxiety Disorder (GAD-7) for anxiety. Demographics and engagement metrics, such as word count for both patients and therapists, were also included. Growth mixture modeling identified response trajectories and predictors of membership in each trajectory.Results Two subpopulations had remission outcomes (Recovery and Acute Recovery, 30.7% of patients), while two others showed amelioration of symptoms (Depression and Anxiety Improvement, 36.9% of patients). Two subpopulations experienced marginal to no changes in symptoms (Chronic and Elevated Chronic, 32.4% of patients). Patients characterized by the greatest level of remission with treatment (Recovery and Acute Recovery groups) were reliably distinguished by patient characteristics and engagement metrics, including higher use of written communication.Conclusions Patient characteristics suggesting suitability for two-way messaging were identified and could be used for further research and treatment recommendation for individuals presenting with depression and anxiety in digital media.
Coping with Wolf-Hirschhorn Syndrome: quality of life and psychosocial features of family carers
Authors: Berrocoso Sarah , Amayra Imanol , Lázaro Esther , Martínez Oscar , López-Paz Juan Francisco , García Maitane , Pérez Manuel , Al-Rashaida Mohammad , Rodríguez Alicia Aurora , Luna Paula Maria , Pérez-Núñez Paula , Blanco Raquel , Nevado Julián 
Published: November 2019

Abstract
Background: Wolf-Hirschhorn Syndrome (WHS) is a rare, congenital disease characterized by a distinctive facial phenotype, seizures, intellectual disability and developmental delay, and pre and postnatal growth requiring lifelong care. The psychosocial status of the family caregivers of children diagnosed with WHS is unknown. This study aims to characterize the sociodemographic and psychosocial profile of WHS caregivers and analyze how these variables impact their quality of life (QoL) and well-being. Results: The sociodemographic and clinical profile of 22 Spanish caregivers of children with WHS and the characteristics of those affected have been described. Significant relationships were found between sociodemographic and psychosocial characteristics among caregivers. The impact on the parents' QoL and negative relationship with the symptomatology were assessed. The use of engagement strategies such as problem focused coping was associated with improved psychological QoL and social support. Conclusions: WHS caregivers share similarities in their profile and needs with caregivers of children with other rare diseases. Pychosocial support groups involving parents caring for children with the same disease could improve caregivers’ well-being and QoL by strengthening their social support network and using positive coping styles.