bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of Protein C level and Activated Partial Thromboplastin Time among neonates suffering of sepsis-Omdurman Maternity Hospital, Sudan.
Authors: AHMED ALBARA , Mohammed Babiker , Nasr Abdelhalim M , Elhag Wafa I , Abass Awadelkareem 
Published: April 2020

Abstract
Objectives: The study aimed to assess Activated Partial Thromboplastin Time (APTT) and Protein C (PC) among Sudanese neonates with sepsis (Cases) in Omdurman maternity hospital, Sudan compared with healthy neonates (controls) for recognizing haemostatic alteration in APTT and PC, considering the gender, gestational age, delivery mode among both groups, case group categorized additionally regarding; sepsis onset, outcome, and Gram stain typing of the causative agent. Results: A total of 100 neonates divided equally into septic cases and healthy controls, died neonates were constituted 10 (20%) while 40 (80%) were recovered among case group. APTT showed significant prolongation in septic neonates compared to controls (mean; 47.8 and 37.5 sec for cases and controls, respectively) P. value was 0.00. Among case group; dead neonates showed significant prolongation compared recovered (mean; 61.5 and 44.4sec) P.value 0.00. PC showed significant decrease in dead neonates compared to recovered (mean; 25.4 and 36.2% for dead and improved) p value 0.04. APTT&PC can be useful as marker of neonatal sepsis mortality.Insignificant difference in PC reported between case and control group. None of the gender, gestational age, delivery mode, sepsis onset, and causative agent showed significant correlation with APTT and PC.
Antibiotic-induced alterations and repopulation dynamics of yellowtail kingfish microbiota
Authors: Legrand Thibault Philippe Raymond Albert , Catalano Sarah R. , Wos-Oxley Melissa L. , Wynne James W. , Weyrich Laura S. , Oxley Andrew P.A. 
Published: April 2020

Abstract
Background The use of antibiotics in aquaculture is a common infection treatment and is increasing in some sectors and jurisdictions. While antibiotic treatment can negatively shift gut bacterial communities, recovery and examination of these communities in fish of commercial importance is not well documented. Examining the impacts of antibiotics on farmed fish microbiota is fundamental for improving our understanding and management of healthy farmed fish. This work assessed yellowtail kingfish (Seriola lalandi) skin and gut bacterial communities after an oral antibiotic combination therapy in poor performing fish that displayed signs of enteritis over an 18-day period. In an attempt to promote improved bacterial re-establishment after antibiotic treatment, faecal microbiota transplantation (FMT) was also administered via gavage or in the surrounding seawater, and its affect was evaluated over 15 days post-delivery. Results Antibiotic treatment greatly perturbed the global gut bacterial communities of poor-performing fish – an effect that lasted for up to 18 days post treatment. This perturbation was marked by a significant decrease in species diversity and evenness, as well as a concomitant increase in particular taxa like an uncultured Mycoplasmataceae sp., which persisted and dominated antibiotic-treated fish for the entire 18-day period. The skin-associated bacterial communities were also perturbed by the antibiotic treatment, notably within the first 3 days; however, this was unlike the gut, as skin microbiota appeared to shift towards a more ‘normal’ (though disparate) state after 5 days post antibiotic treatment. FMT was only able to modulate the impacts of antibiotics in some individuals for a short time period, as the magnitude of change varied substantially between individuals. Some fish maintained certain transplanted gut taxa (i.e. present in the FMT inoculum; namely various Aliivibrio related ASVs) at Day 2 post FMT, although these were lost by Day 8 post FMT. Conclusion As we observed notable, prolonged perturbations induced by antibiotics on the gut bacterial assemblages, further work is required to better understand the processes/dynamics of their re-establishment following antibiotic exposure. In this regard, procedures like FMT represent a novel approach for promoting improved microbial recovery, although their efficacy and the factors that support their success requires further investigation.
Is high dose intravenous acetaminophen affect liver function in premature neonates with patent ductus arteriosus?
Authors: Bahrami Reza , Ezzatabadi Aida , Mehdizadegan Nima , Mohammadi Hamid , Amoozgar Hamid , Edraki Mohammad Reza 
Published: April 2020

Abstract
Objectives
The aim of this study was to collect consistent data on the efficacy and safety and evaluation hepatotoxicity of intravenous acetaminophen for the treatment of PDA in preterm infants.
Methods
This is an observational longitudinal prospective study on 46 preterm infants with PDA who treated with high dose of acetaminophen and evaluated with echocardiography and serum liver enzymes at Hafez and Zeinabiyeh hospitals from January 2016 to December 2019.
Result
Forty-six preterm infants with PDA treated with intravenous acetaminophen. Rate of closure of PDA was 82.6. There was no significant difference after treatment regarding AST, ALT, Albumin, total and direct bilirubin (P value > 0.05) and no adverse side effects were observed in association with intravenous acetaminophen.
Conclusion
High dose of acetaminophen is an effective and safe therapeutic option without hepatotoxic side effect for PDA closure.
Health Variations Among Breast-Cancer Patients from Different Disease States: Evidence from China
Authors: Qing Yang , Zhang wei , Yu Xuexin 
Published: April 2020

Abstract
Background To obtain health utility data for different disease status of breast cancer in China in order to obtain important parameters in health economics modeling. To explore the feasibility of establishing a breast cancer health utility mapping model in China.Methods Multivariate regression models, including linear regression model, ordinal logistic regression model and Tobit model, were employed to analyz. Subgroup analyses were performed to analyze variations in sub-dimensional health attributes derived from FACT-B and EQ-5D-5L. A mapping function was used to estimate health utility from quality of life.Results 446 breast cancer patients with different disease states were analyzed. The utility of breast cancer patients with P state(without cancer recurrence and metastasis), R state(with cancer recurrence within a year), S state(with primary and recurrent breast cancer for the second year and above) and M state(metastasis cancer) were 0.81 (SD ±0.23), 0.90 (SD ±0.12), 0.78 (SD ±0.31), and 0.74 (SD ±0.27), respectively. All scores, including the FACT-B domain, showed a positive correlation( p <0.001). Multivariate analysis suggested that patients in R and M state had lower scores in overall quality of life (R,β = -9.45, p < 0.01; M, β = -6.72, P <0.05). Patients in M state had a lower probability of achieving higher health utility compared with patients in P state (β = -0.11, p < 0.05). Estimated health utilities derived from quality of life, using mapping function, were significantly correlated with directly measured health utilities ( p <0.001).Conclusions We obtained the health utility and HRQoL scores of Chinese breast cancer patients with different disease states. Mapping health utilities from quality of life in four disease states could be a plausible approach in health economic analysis, while the mapping function may need further revise.
Defining Ambulatory Care Sensitive Conditions for adults in Portugal
Authors: Sarmento João , Rocha João Vitor Muniz , Santana Rui 
Published: April 2020

Abstract
BackgroundAmbulatory Care Sensitive Conditions (ACSCs) are health conditions for which adequate management, treatment and interventions delivered in the ambulatory care setting could potentially prevent hospitalization. Which conditions are sensitive to ambulatory care varies according to the scope of health care services and the context in which the indicator is used. The need for a country-specific validated list for Portugal has already been identified, but currently no national list has been developed yet. MethodsA modified web-based Delphi panel approach was designed, in order to determine which conditions can be considered ACSCs in the Portuguese adult population. The selected experts were general practitioners and internal medicine physicians identified by the most relevant Portuguese scientific societies. Experts were presented with previously identified ACSC and asked to select which could be accepted in the Portuguese context. They were also asked to identify other conditions they considered relevant. We estimated the number of ACSC hospitalizations in 2017 in Portugal according to the identified conditions. ResultsAfter three rounds the experts agreed on 34 of the 45 initially proposed items. Fourteen new conditions were proposed and four achieved consensus, namely uterine cervical cancer, colorectal cancer, thromboembolic venous disease and voluntary termination of pregnancy. In 2017 136626 hospitalizations were for ACSC (16.1% of all hospitalizations). This represents a rate of 1,540 per 100,000 adults. The most frequent diagnosis were pneumonia, chronic obstructive pulmonary disease/chronic bronchitis, heart failure, hypertensive disease, colorectal cancer, atrial fibrillation, urinary tract infections and complications of diabetes mellitus. ConclusionsNew ACSC where identified. It is expected that this list could be used henceforward by epidemiologic studies, health services research and for healthcare management purposes.
A description of the influenza vaccination program for health care workers in Vietnam
Authors: Ha Nga , Nguyen Thoa Thi Minh , Nguyen Tung Xuan , Tran Phu Dac , Nguyen Hang Minh , Ha Van Thi Cam , Lafond Kathryn E. , Seward Jane F. , McFarland Jeffrey W. , Chu Susan Y. 
Published: April 2020

Abstract
Background: In 2017, the Vietnam Ministry of Health conducted a demonstration project to introduce seasonal influenza vaccination to health care workers. A total of 11,000 doses of influenza vaccine, single-dose prefilled syringes, were provided free to HCWs at 29 selected hospitals, clinics, and research institutes in four provinces: Hanoi, Khanh Hoa, Dak Lak and Ho Chi Minh City. Methods: Before the campaign, a workshop was organized to discuss an implementation plan including technical requirements, cold chain, uptake reporting, and surveillance for adverse events following immunization. All sites distributed communication materials and encouraged their staff to register for vaccination. Following immunization sessions, sites sent reports on uptake and adverse events following immunization. Left-over vaccine was transferred to other sites to maximize vaccine use. Results: The average uptake was 57% for all health care workers, with 11 sites achieving 90% and above. These 11 sites were small with less than 500 staff, including 5 primary hospitals, 3 preventive medicine units, and 2 referral hospitals. Among the six biggest sites with over 1,000 staff, four sites had the lowest uptake (14%-47%). Most of the high-uptake sites were from the central to the south; only one site, a referral hospital, was from the north. After redistribution of left-over vaccine, only 130 vaccine doses (1.2%) were not used and destroyed. Based on factors that affected uptake, including registration levels, differing communication strategies, availability of vaccination, and commitment by health facility leaders, we recommended ways to increase health care worker coverage; recommendations to improve reporting adverse events following immunization were also made.Conclusions: The project demonstrated that it was feasible to conduct influenza vaccination campaigns among health care workers in Vietnam. Improvements in promotion of registration, more intense pre-planning, especially at larger facilities, and wider, more consistent availability of communication materials will result in increased efficiency and coverage in this program’s future expansion.
A Framework of Evidence-Based Decision-Making in Health System Management: Applying Best-Fit Framework Synthesis
Authors: Shafaghat Tahereh , Bastani Peivand , Nasab Mohammad Hasan Imani , Bahrami Mohammad Amin , Kavosi Zahra , Montazer Mahsa Roozrokh Arshadi , Zarchi Mohammad Kazem Rahimi 
Published: April 2020

Abstract
Background: Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. In recent years, efforts have been made to create more comprehensive guidelines for evidence-based decision-making (EBDM), thus the purpose of the present study was developing a framework for EBDM to make the best decisions concerning to scare resources and too many needs. Methods: The present basic-applied research was a secondary study carried out using qualitative research method in 2019. A Systematic Scoping Review (SSR) was done for the comprehensive review of the existing published studies in this area. This method, according to Arksey and O’Malley approach, consists of five main stages and one optional stage. Results: Based on the SSR, 3751 studies from 7 databases were found, and due to the full-text screening of the studies, 30 final studies were selected for extracting the components and steps of EBDM in Health System Management (HSM). After collecting, synthesizing, and categorizing key information, the framework of EBDM in HSM is developed in the form of four general scopes of inquiring, inspecting, implementing and integrating, which includes 10 main steps and 56 sub-steps. Conclusions: The present framework tries to present a sequential systematic map to achieve evidence-based decision and policy making specially for under developed and developing countries which mostly suffer from applying update and applied evidences in their decision-making process. At the same time, it seems that the present framework tries to synthesize and integrate the fragmented elements of the other models and in this way can be tested by developed countries to improve their EBDM cycle.
A longitudinal study of the turning points and trajectories in therapeutic relationship development
Authors: Horton Ayana , Hebson Gail , Holman David 
Published: April 2020

Abstract
Background The therapeutic relationship refers to the interpersonal relationship between the healthcare professional and patient (Peplau, 1997). The importance of the therapeutic relationship is widely recognised across healthcare professions (e.g., nurses - Peplau, 1997; physicians - Weeger & Farin, 2017; psychotherapists - Martin et al, 2000; occupational therapists - Weiste, 2018; physiotherapists- Fuentes et al, 2014). Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories. Methods Data collection was based on the Retrospective Interview Technique (RIT) and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.
Waiting times in emergency departments: a resource allocation or an efficiency issue?
Authors: Vainieri Milena , Panero Cinzia , Coletta Lucrezia 
Published: April 2020

Abstract
Background: In recent years, the flow of patients to emergency departments (ED) in Western countries has steadily increased, generating overcrowding and extended waiting times. Scholars have identified four main causes for this phenomenon, related to continuity of primary care services; availability of specific clinical pathways for chronic patients; ED’s personnel endowment; and organization of the ED. This study aims to provide a logical diagnostic framework to support managers in investigating specific solutions to be applied to their EDs to cope with high ED waiting times. The framework is based on the ED waiting times and ED admission rate matrix. It is applied to Tuscan EDs as illustrative example. Methods: To provide the factors to be analysed once the EDs are positioned into the matrix, a list of issues is identified. The matrix is applied to Tuscan EDs. Data are collected from the Tuscan performance evaluation system, integrated with specific data on Tuscan EDs’ personnel. The Tuscan ED matrix, descriptive statistics for each quadrant and Spearman’s rank correlation analysis among waiting times, admission rates and a set of performance indicators were conducted to help managers to read the phenomena that they need to investigate. Results: The combined reading of the correlations and waiting times–admission rates matrix shows that there are no optimal rules for all the EDs in managing admission rates and waiting times, but solutions have to be found considering mixed and personalized strategies. Conclusions: The waiting times–admission rates matrix provides a tool able to support managers in detecting problems related to the management of ED services. In particular, using this matrix, healthcare managers can be facilitated in the identification of possible solutions for their specific situation.
Implementing Continuity of Midwife Carer – Just a Friendly Face? A Realist Evaluation
Authors: McInnes Rhona Jean , Arbuckle Alix Aitken , Lake Suzanne , Martin Caroline J Hollins , MacArthur Juliet 
Published: April 2020

Abstract
BACKGROUND: Good quality midwifery care saves the lives of women and babies. Continuity of midwife carer (CMC), a key component of good quality midwifery care, results in better clinical outcomes, higher care satisfaction and enhanced caregiver experience. However, CMC uptake has tended to be small scale or transient. We used realist evaluation in one Scottish health board to explore implementation of CMC as part of the Scottish Government 2017 maternity plan. METHODS: Participatory research, quality improvement and iterative data collection methods were used to collect data from a range of sources including facilitated team meetings, local and national meetings, quality improvement and service evaluation surveys, audits, interviews and published literature. Data analysis developed context-mechanism-outcome configurations to explore and inform three initial programme theories, which were refined into an overarching theory of what works for whom and in what context.RESULTS: Trusting relationships across all organisational levels are the context in which CMC works. However, building these relationships during implementation requires good leadership and effective change management to drive whole system change and foster trust across all practice and organisational boundaries. Trusting relationships between midwives and women were valued and triggered a commitment to provide high quality care; CMC team relationships supported improvements in ways of working and sustained practice, and relationships between midwives and providers in different care models either sustained or constrained implementation. Continuity enabled midwives to work to full skillset and across women’s care journey, which in turn changed their perspective of how they provided care and of women’s care needs. In addition to building positive relationships, visible and supportive leadership encourages engagement by ensuring midwives feel safe, valued and informed.CONCLUSION: Leadership that builds trusting relationships across all practice and organisational boundaries develops the context for successful implementation of CMC. These relationships then become the context that enables CMC to grow and flourish. Trusting relationships, working to full skill set and across women’s care journey trigger changes in midwifery practice. Implementing and sustaining CMC within NHS organisational settings requires significant reconfiguration of services at all levels, which requires effective leadership and cannot rely solely on ground-up change.
Immunoinformatic based identification of cytotoxic T lymphocyte epitopes from the Indian isolate of SARS-CoV-2
Authors: Mulpuru Viswajit , Mishra Nidhi 
Published: April 2020

Abstract
The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has turned into a pandemic with about a million confirmed cases worldwide. Being an airborne infection, it can be highly fatal to populous countries like India. This study sets to identify potential cytotoxic T lymphocyte (CTL) epitopes in the SARS-CoV-2 Indian isolate which can acts act as an effective vaccine candidate for the majority of the Indian population. The immunogenicity and the foreignness of the epitopes towards the human body have to studies to further confirm their candidacy. The top-scoring epitopes were subjected to molecular docking studies to study their interactions with the corresponding human leukocyte antigen (HLA) system. The CTL epitopes were observed to bind at the peptide-binding groove of the corresponding HLA system, indicating their potency as a vaccine candidate. The identified epitopes can be subjected to further studies for the development of SARS-CoV-2 vaccine.