bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to obtaining reliable results from evaluations of teaching quality in undergraduate medical education
Authors: Zhang Zemiao , Wu Qi , Zhang Xinping , Xiong Juyang , Zhang Lan , Le Hong 
Published: September 2020

AbstractBackgroundMedical education is characterized by numerous features that are different from other higher education programmes, and evaluations of teaching quality are an integral part of medical education. Although scholars have made extensive efforts to enhance the quality of teaching, various issues unrelated to teaching that interfere with the accuracy of evaluation results remain. The purpose of this study is to identify the barriers that prevent objective and reliable results from being obtained during the evaluation process.MethodsThis study used mixed methods (3 data sources) to collect opinions from different stakeholders. Based on purposive sampling, 16 experts familiar with teaching management and 12 s- and third-year students were invited to participate in interviews and discussions, respectively. Additionally, based on systematic random sampling, 74 teachers were invited to complete a questionnaire survey. All qualitative data were imported into NVivo software and analysed using thematic analysis in chronological order and based on grounded theory. Statistical analyses of the questionnaire results were conducted using SPSS software.ResultsSixty-nine valid questionnaires (93.24%) were recovered. A total of 29 open codes were extracted, and 14 axial codes were summarized and divided into four selective codes: evaluation preparation, the index system, the operation process, and the consequences of evaluation. The main barriers to obtaining reliable evaluation results included inadequate attention, unreasonable weighting, poor teaching facilities, an index without pertinence and appropriate descriptions, bad time-points, incomplete information on the system, lagged feedback, and disappointing result application. Almost all participants suggested lowering the weight of students as subjects, with a weight of 50–60% being appropriate. Students showed dissatisfaction with evaluation software, and the participants disagreed over the definition of good teaching and the management of student attendance.ConclusionsThis study reveals the difficulties and problems in current evaluations of teaching in medical education. Collecting data from multiple stakeholders helps in better understanding the evaluation process. Educators need to be aware of various issues that may affect the final results when designing the evaluation system and interpreting the results. More research on solutions to these problems and the development of a reasonable evaluation system is warranted.
The role of 3D printed models in the teaching of human anatomy: a systematic review and meta-analysis
Authors: Ye Zhen , Dun Aishe , Jiang Hanming , Nie Cuifang , Zhao Shulian , Wang Tao , Zhai Jing 
Published: September 2020

Abstract
Background
Three-dimensional (3D) printing is an emerging technology widely used in medical education. However, its role in the teaching of human anatomy needs further evaluation.

Methods
PubMed, Embase, EBSCO, SpringerLink, and Nature databases were searched systematically for studies published from January 2011 to April 2020 in the English language. GRADEprofiler software was used to evaluate the quality of literature. In this study, a meta-analysis of continuous and binary data was conducted. Both descriptive and statistical analyses were used.

Results
Comparing the post-training tests in neuroanatomy, cardiac anatomy, and abdominal anatomy, the standardized mean difference (SMD) of the 3D group and the conventional group were 1.27, 0.37, and 2.01, respectively (p < 0.05). For 3D vs. cadaver and 3D vs. 2D, the SMD were 0.69 and 1.05, respectively (p < 0.05). For answering time, the SMD of the 3D group vs. conventional group was – 0.61 (P < 0.05). For 3D print usefulness, RR = 2.29(P < 0.05). Five of the six studies showed that satisfaction of the 3D group was higher than that of the conventional group. Two studies showed that accuracy of answering questions in the 3D group was higher than that in the conventional group.

Conclusions
Compared with students in the conventional group, those in the 3D printing group had advantages in accuracy and answering time. In the test of anatomical knowledge, the test results of students in the 3D group were not inferior (higher or equal) to those in the conventional group. The post-training test results of the 3D group were higher than those in the cadaver or 2D group. More students in the 3D printing group were satisfied with their learning compared with the conventional group. The results could be influenced by the quality of the randomized controlled trials. In a framework of ethical rigor, the application of the 3D printing model in human anatomy teaching is expected to grow further.
“If you are on duty, you may be afraid to come out to attend to a person”: fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective
Authors: Etiaba Enyi , Manzano Ana , Agbawodikeizu Uju , Ogu Udochukwu , Ebenso Bassey , Uzochukwu Benjamin , Onwujekwe Obinna , Ezumah Nkoli , Mirzoev Tolib 
Published: September 2020

Abstract
Background
Maternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of security in the provision and use of maternal health services in primary healthcare facilities in Nigeria.

Methods
Study was carried out in Anambra state, Nigeria. Qualitative data were initially collected from 35 in-depth interviews and 24 focus groups with purposively identified key informants. Information gathered was used to build a programme theory that was tested with another round of interviews (17) and focus group (4) discussions. Data analysis and reporting were based on the Context-Mechanism-Outcome heuristic of Realist Evaluation methodology.

Results
The presence of a male security guard in the facility was the most important security factor that facilitated provision and uptake of services. Others include perimeter fencing, lighting and staff accommodation. Lack of these components constrained provision and use of services, by impacting on behaviour of staff and patients. Security concerns of facility staff who did not feel safe to let in people into unguarded facilities, mirrored those of pregnant women who did not utilize health facilities because of fear of not being let in and attended to by facility staff.

Conclusion
Health facility security should be key consideration in programme planning, to avert staff and women’s fear of crime which currently constrains provision and use of maternal healthcare at health facilities.
The Framework Convention on Tobacco Control in Slovakia and in Finland: one law, two different practices?
Authors: Pavlikova Barbara , van Dijk Jitse P. 
Published: September 2020

AbstractBackgroundThe Framework Convention on Tobacco Control (FCTC) was ratified in 2004 in Slovakia and in 2005 in Finland. The aim of this study was to compare the implementation of the FCTC in the national laws and policies regarding smoking in Finland and Slovakia.MethodsIn this case study the following areas are compared: the legal framework; the monitoring system and health promotion; treatment; and policies aimed at reducing tobacco consumption. We report on these in this order after a short historical introduction.ResultsThe legal frameworks are similar in Slovakia and in Finland. Finland far exceeds the minimum legal requirements. Slovakian regulations reflect the FCTC requirements; however, social tolerance is very high. In Finland the monitoring system and health promotion are aimed more at tobacco consumption. Slovakia does not follow the surveillance plans recommended by WHO so strictly; often there are no current data available. No additional documents regarding the FCTC have been adopted in Slovakia. The financial contribution to treatment is very low. Slovakian tobacco control policy is more focused on repression than on prevention, in contrast to Finland. Smoking bans meet European standards. Excise duties rise regularly in both countries.ConclusionImplementation of the FCTC is at different levels in the compared countries. Finland has a clear plan for achieving the goal of a smoking-free country. Slovakia meets only the minimum standard required for fulfillment of its international obligations. Its policy should become more transparent by making more up-to-date data available.
Diagnostic reliability of clinical signs in cows with traumatic reticuloperitonitis and abomasal ulcers
Authors: Braun Ueli , Nuss Karl , Warislohner Sonja , Reif Christina , Oschlies Carina , Gerspach Christian 
Published: September 2020

Abstract
Background
Clinical signs of traumatic reticuloperitonitis and abomasal ulcer are often similar making the disorders difficult to differentiate. The goal of our study was to compare the frequency of individual clinical signs of cows with traumatic reticuloperitonitis and cows with abomasal ulcers and determine their diagnostic significance. The frequency of the findings “rectal temperature, heart rate, respiratory rate, demeanour, signs of colic, arched back, abdominal guarding, bruxism, scleral vessels, rumen motility, foreign body tests, percussion auscultation, swinging auscultation and faecal colour” of cows with traumatic reticuloperitonitis (TRP, n = 503) and cows with type 1 (U1, n = 94), type 2 (U2, n = 145), type 3 (U3, n = 60), type 4 (U4, n = 87) and type 5 (U5, n = 14) abomasal ulcer were compared, and the reliability indices “diagnostic sensitivity and specificity, positive and negative predictive values and positive likelihood ratio” were calculated. A total of 182 healthy cows served as controls (control group).

Results
None of the cows in the control group had colic, rumen atony or melena, 99% had no abnormalities in demeanor and appetite and did not have a rectal temperature of ≤38.6 or >  40.0 °C, a heart rate >  100 bpm or a respiratory rate >  55 breaths per min, and 95% did not have an arched back or bruxism. The control group was therefore ideal for comparative purposes. Many signs such as mild increase in rectal temperature, scleral congestion and positive foreign body test were non-diagnostic because they occurred in healthy as well as in ill cows. Likewise, differentiation of cows with TRP and abomasal ulcer was not possible based on single clinical variables; a detailed history and a comprehensive assessment of all clinical findings were required for this.

Conclusions
The findings of the present study serve as a guide for the veterinarian in the differentiation of cows with traumatic reticuloperitonitis and abomasal ulcer.
Phenotypic variability and population structure analysis of Tanzanian free-range local chickens
Authors: Mushi James R. , Chiwanga Gaspar H. , Amuzu-Aweh Esinam N. , Walugembe Muhammed , Max Robert A. , Lamont Susan J. , Kelly Terra R. , Mollel Esther L. , Msoffe Peter L. , Dekkers Jack , Gallardo Rodrigo , Zhou Huaijun , Muhairwa Amandus P. 
Published: September 2020

Abstract
Background
Free-range local chickens (FRLC) farming is an important activity in Tanzania, however, they have not been well-characterized. This study aimed to phenotypically characterize three Tanzanian FRLCs and to determine their population structure. A total of 389 mature breeder chickens (324 females and 65 males) from three popular Tanzanian FRLC ecotypes (Kuchi, Morogoro-medium and Ching’wekwe) were used for the phenotypic characterization. Progenies of these chickens were utilized to assess population structure. The ecotypes were collected from four geographical zones across Tanzania: Lake, Central, Northern and Coastal zones. Body weights and linear measurements were obtained from the mature breeders, including body, neck, shanks, wingspan, chest girth, and shank girth. Descriptive statistics were utilized to characterize the chickens. Correlations between the linear measurements and differences among the means of measured linear traits between ecotypes and between sexes were assessed. A total of 1399 progeny chicks were genotyped using a chicken 600 K high density single nucleotide polymorphism (SNP) panel for determination of population structure.

Results
The means for most traits were significantly higher in Kuchi relative to Ching’wekwe and Morogoro-medium. However, shank length and shank girth were similar between Kuchi and Morogoro-medium females. All traits were correlated with the exception of shank girth in Morogoro-medium. Admixture analyses revealed that Morogoro-medium and Ching’wekwe clustered together as one population, separate from Kuchi.

Conclusions
Phenotypic traits could be used to characterize FRLCs, however, there were variations in traits among individuals within ecotypes; therefore, complementary genomic methods should be considered to improve the characterization for selective breeding.
Epidemiological characterization of Mycobacterium caprae strains isolated from wildlife in the Bieszczady Mountains, on the border of Southeast Poland
Authors: Orłowska Blanka , Krajewska-Wędzina Monika , Augustynowicz-Kopeć Ewa , Kozińska Monika , Brzezińska Sylwia , Zabost Anna , Didkowska Anna , Welz Mirosław , Kaczor Stanisław , Żmuda Piotr , Anusz Krzysztof 
Published: September 2020

Abstract
Background
The majority of animal tuberculosis (TB) cases reported in wildlife in Poland over the past 20 years have concerned the European bison inhabiting the Bieszczady Mountains in Southeast Poland: an area running along the border of Southeast Poland. As no TB cases have been reported in domestic animals in this region since 2005, any occurrence of TB in the free-living animals inhabiting this area might pose a real threat to local livestock and result in the loss of disease-free status. The aim of the study was to describe the occurrence of tuberculosis in the wildlife of the Bieszczady Mountains and determine the microbiological and molecular characteristics of any cultured strains. Lymph node samples were collected for analysis from 274 free-living animals, including European bison, red foxes, badgers, red deer, wild boar and roe deer between 2011 and 2017. Löwenstein–Jensen and Stonebrink media were used for culture. Molecular identification of strains was performed based on hsp65 sequence analysis, the GenoType®MTBC (Hain Lifescience, Germany) test, spoligotyping and MIRU-VNTR analysis.

Results
Mycobacterium caprae was isolated from the lymph nodes of 21 out of 55 wild boar (38.2%; CI 95%: 26.5%, 51.4%) and one roe deer. Since 2014, no new TB cases have been reported in the Bieszczady European bison population.

Conclusions
The identification of TB in wild boar in the Bieszczady is an alarming phenomenon, which requires further investigation. The Bieszczady mountains are a precious, unique area, home to many protected species. However, it is also the only area in Poland where TB cases have been reported in free-living animals. The occurrence of TB in wild boar inhabiting this area might pose a real threat to local livestock and many of the protected species (for example European bison that can share feeding places with wild boar). Given this situation, ongoing monitoring of the prevalence of TB should be conducted, and protective measures should be considered.
Influence of bacterial organic selenium on blood parameters, immune response, selenium retention and intestinal morphology of broiler chickens
Authors: Dalia A. M. , Loh T. C. , Sazili A. Q. , Samsudin A. A. 
Published: September 2020

Abstract
Background
Several studies indicated that dietary organic selenium (Se) usually absorbed better than an inorganic source, with high retention and bioavailability. Dietary Se as an antioxidant element affects the immune system and hematological status in animals. Therefore, the aim of this study was to evaluate the effect of dietary supplementation of bacterial selenium as an organic source on hematology, immunity response, selenium retention, and gut morphology in broiler chickens.

Results
The present results revealed that supplementation of inorganic Se was associated with the lowest level of RBC, HB, and PCV with significant difference than ADS18-Se. In the starter stage, both T2 and T5 were associated with the significantly highest IgG level compared to the basal diet, while all supplemented groups showed higher IgM levels compared to the control group. In the finisher phase, all Se supplemented groups showed significant (P ˂ 0.05) increases in IgG, IgA, and IgM levels compared to T1. Birds fed bacterial-Se showed high intestinal villus height and better Se retention more than sodium selenite. The organic selenium of ADS18 had a superior action in improving Se retention compared to ADS1 and ADS2 bacterial Se.

Conclusions
Bacterial organic Se had a beneficial effect on the villus height of small intestine led to high Se absorption and retention. Thus, it caused a better effect of Se on hematological parameters and immunity response.
Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study
Authors: Lee Eun Young , Han Kyungdo , Kim Da Hye , Park Yong-Moon , Kwon Hyuk-Sang , Yoon Kun-Ho , Kim Mee Kyoung , Lee Seung-Hwan 
Published: September 2020

Abstract
Background
Metabolic syndrome (MetS) status changes over time, but few studies have investigated the relationship between the extent or duration of exposure to MetS and the risk of cardiovascular disease (CVD). We investigated the cumulative effects of MetS and its components on the risk of myocardial infarction (MI) and stroke.

Methods
From the Korean National Health Insurance database, 2,644,851 people who received annual health examinations from 2010 to 2013 were recruited. Exposure-weighted scores for MetS during this 4-year period were calculated in two ways: cumulative number of MetS diagnoses (MetS exposure score, range: 0–4) and the composite of its five components (MetS component exposure score, range: 0–20). The multivariable Cox proportional-hazards model was used to assess CVD risk according to the exposure-weighted scores for MetS.

Results
MetS was identified at least once in 37.6% and persistent MetS in 8.2% of subjects. During the follow-up (median, 4.4 years), 10,522 cases of MI (0.4%) and 10,524 cases of stoke (0.4%) occurred. The risk of MI and stroke increased gradually with increasing exposure scores of MetS and its components (each P for trend < 0.0001). The hazard ratio [(HR) (95% CI)] of MI and stroke were 5.27 (4.20–6.62) and 3.90 (3.09–4.93), respectively, in those with a score of 20 compared with those with a MetS component exposure score of 0. People fulfilling only two MetS components out of 20 already had 22% increased risk of MI, and those with three MetS components had 24% increased risk of stroke. These associations were consistent in the subgroup and sensitivity analyses.

Conclusions
A dose–response relationship between the cumulative exposure to metabolic disturbances and incident MI or stroke was evident. Even minimal exposure to MetS components was sufficient to increase the risk of CVD significantly, highlighting the importance of intensive risk management for the prevention of CVD.
Heterogeneity of antidiabetic treatment effect on the risk of major adverse cardiovascular events in type 2 diabetes: a systematic review and meta-analysis
Authors: D’Andrea Elvira , Kesselheim Aaron S. , Franklin Jessica M. , Jung Emily H. , Hey Spencer Phillips , Patorno Elisabetta 
Published: September 2020

Abstract
Background
We explored whether clinically relevant baseline characteristics of patients with type 2 diabetes can modify the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RA) or sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on the risk of major adverse cardiovascular events (MACE).

Methods
We investigated Medline and EMBASE through June 2019. We included randomized clinical trials reporting the effect of GLP-1 RA or SGLT-2i on MACE in subgroups of patients with type 2 diabetes, identified through key baseline factors: established cardiovascular disease; heart failure; chronic kidney disease; uncontrolled diabetes; duration of diabetes; hypertension; obesity; age; gender and race. Hazard ratios (HRs) and 95% confidence intervals (CIs) from trials were meta-analyzed using random-effects models.

Results
Ten trials enrolling 89,790 patients were included in the analyses. Subgroup meta-analyses showed a 14% risk reduction of MACE in patients with established cardiovascular disease [GLP1-RA: HR, 0.86 (95% CI, 0.80–0.93); SGLT-2i: 0.86 (0.80–0.93)], and no effect in at-risk patients without history of cardiovascular events [GLP1-RA: 0.94 (0.82–1.07); SGLT-2i: 1.00 (0.87–1.16)]. We observed a trend toward larger treatment benefits with SGLT-2i among patients with chronic kidney disease [0.82 (0.69–0.97)], and patients with uncontrolled diabetes for both GLP1-RA or SGLT-2i [GLP1-RA: 0.82 (0.71–0.95); SGLT-2i: 0.84 (0.75–0.95)]. Uncontrolled hypertension, obesity, gender, age and race did not appear to modify the effect of these drugs.

Conclusions
In this exploratory analysis, history of cardiovascular disease appeared to modify the treatment effect of SGLT2i or GLP1-RA on MACE. Chronic kidney disease and uncontrolled diabetes should be further investigated as potential effect modifiers.
MicroRNA-585 inhibits human glioma cell proliferation by directly targeting MDM2
Authors: Chen Wangsheng , Hong Lan , Hou Changlong , Wang Yibin , Wang Fei , Zhang Jianhua 
Published: September 2020

Abstract
Background
MicroRNAs (miRNAs) are important regulators for cancer cell proliferation. miR-585 has been shown to inhibit the proliferation of several types of cancer, however, little is known about its role in human glioma cells.

Methods
miR-585 levels in human glioma clinical samples and cell lines were examined by quantitative real-time PCR (qRT-PCR) analysis. Cell proliferation was measured by Cell Counting Kit-8 (CCK-8) and EdU incorporation assays in vitro. For in vivo investigations, U251 cells were intracranially inoculated in BALB/c nude mice and xenografted tumors were visualized by magnetic resonance imaging (MRI).

Results
miR-585 expression is downregulated in human glioma tissues and cell lines compared with non-cancerous counterparts. Additionally, miR-585 overexpression inhibits and its knockdown promotes human glioma cell proliferation in vitro. Moreover, miR-585 overexpression also inhibits the growth of glioma xenografts in vivo, suggesting that miR-585 may act as a tumor suppressor to inhibit the proliferation of human glioma. Furthermore, miR-585 directly targets and decreases the expression of oncoprotein murine double minute 2 (MDM2). More importantly, the restoration of MDM2 via enforced overexpression markedly rescues miR-585 inhibitory effect on human glioma cell proliferation, thus demonstrating that targeting MDM2 is a critical mechanism by which miR-585 inhibits human glioma cell proliferation.

Conclusions
Our study unveils the anti-proliferative role of miR-585 in human glioma cells, and also implicates its potential application in clinical therapy.