bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes after long-term mechanical ventilation of cancer patients
Authors: Haviland Kelly , Tan Kay See , Schwenk Nadja , Pillai Manju V. , Stover Diane E. , Downey Robert J. 
Published: March 2020

Abstract
Background
The probability of weaning and of long-term survival of chronically mechanically ventilated cancer patients is unknown, with incomplete information available to guide therapeutic decisions. We sought to determine the probability of weaning and overall survival of cancer patients requiring long-term mechanical ventilation in a specialized weaning unit.

Methods
A single-institution retrospective review of patients requiring mechanical ventilation outside of a critical care setting from 2008 to 2012 and from January 1 to December 31, 2018, was performed. Demographic and clinical data were recorded, including cancer specifics, comorbidities, treatments, and outcomes. Overall survival was determined using the Kaplan-Meier approach. Time to weaning was analyzed using the cumulative incidence function, with death considered a competing risk. Prognostic factors were evaluated for use in prospective evaluations of weaning protocols.

Results
Between 2008 and 2012, 122 patients required mechanical ventilation outside of a critical care setting with weaning as a goal of care. The cumulative incidence of weaning after discharge from the intensive care unit was 42% at 21 days, 49% at 30 days, 58% at 60 days, 61% at 90 days, and 61% at 120 days. The median survival was 0.16 years (95% CI, 0.12 to 0.33) for those not weaned and 1.05 years (95% CI, 0.60 to 1.34) for those weaned. Overall survival at 1 year and 2 years was 52 and 32% among those weaned and 16 and 9% among those not weaned. During 2018, 36 patients at our institution required mechanical ventilation outside of a critical care setting, with weaning as a goal of care. Overall, with a median follow-up of 140 days (range, 0–425 days; average, 141 days), 25% of patients requiring long-term mechanical ventilation (9 of 36) are alive.

Conclusions
Cancer patients can be weaned from long-term mechanical ventilation, even after prolonged periods of support. Implementation of a resource-intensive weaning program did not improve rates of successful weaning. No clear time on mechanical ventilation could be identified beyond which weaning was unprecedented. Short-term overall survival for these patients is poor.
Helping women veterans quit smoking: a qualitative analysis of successful and unsuccessful attempts
Authors: Berg Kristin M. , Gruber Stephanie J. , Jorenby Douglas E. 
Published: March 2020

Abstract
Background
Tobacco use is the number one cause of death and disability of women in the United States, and our women Veteran population is disproportionately affected. Despite revisions to the Veterans Affairs’ approach to smoking cessation, women continue to smoke at equal or higher rates than men, are prescribed cessation medications less frequently, and are less likely to quit. In this qualitative pilot study, individual interviews with women Veterans revealed their experiences with smoking cessation attempts.

Methods
The lead author conducted semi-structured interviews with 14 women Veterans who were either current or former smokers. Participants gave a narrative account of recent quit smoking attempts. Inductive thematic analysis explored the underlying themes.

Results
Four main themes emerged as important: health and well-being, smoking as an addiction, optimism, and resilience. Health and well-being encompassed physical health, mental health, and financial stability. Women often felt that stability in these key areas made a successful attempt possible. Women with successful quit attempts were more likely to consider tobacco use as an addiction, as well as expressed optimism about their quit attempts. Women with successful quit attempts also demonstrated more resilience to lapses and relapses.

Conclusions
Women Veterans’ quit smoking attempts demonstrate four main themes: baseline health and wellbeing, acknowledging smoking as an addiction, the participant’s optimism towards quitting, and resilience. Patterns were observed within themes with respect to whether the woman was currently quit or had experienced a prolonged quit attempt in the past. Further research is needed to help women Veterans quit smoking.
A mechanistic approach to HPLC analysis, antinociceptive, anti-inflammatory and postoperative analgesic activities of panch phoron in mice
Authors: Gias Zarin Tasnim , Afsana Fatima , Debnath Polak , Alam M. Shadidul , Ena Tania Naz , Hossain Md Hemayet , Jain Preeti , Reza Hasan Mahmud 
Published: March 2020

AbstractBackgroundPanch phoron is a mixture of five spices containing an equal proportion ofFoeniculum vulgare(fennel),Trigonella foenum-graecum Linn(fenugreek),Nigella sativa(black cumin),Cuminum cyminum(cumin) andBrassica nigra(black mustard). The mixture is commonly used in Bangladeshi cuisine and possesses many pharmacological effects. In this study, we evaluated the antinociceptive and anti-inflammatory activities of aqueous panch phoron extract (PPE) in vivo, its possible mechanism of action and phytochemical analysis by High-Performance Liquid Chromatography (HPLC). We also investigated the effect of PPE on postoperative pain in mice.MethodsHPLC was carried out using LC-20A Modular HPLC system to identify the bioactive compounds present in PPE. Five groups of Swiss albino male mice (n = 6 per group) were orally treated with 10 ml/kg of distilled water or 10 mg/kg of sodium diclofenac or three doses of PPE (100 mg/kg, 300 mg/kg, 500 mg/kg). In vivo assessment was carried out by the writhing test, tail-flick test, formalin test, and carrageenan induced paw edema test. The opioid antagonist, naloxone was used in the acetic acid test to evaluate the involvement of opioid receptors. To assess the effect of PPE in postoperative pain, mice that underwent sciatic nerve surgery were measured for the paw withdrawal latency in a hot water bath.ResultsIn HPLC analysis, different types of phenolic compounds and flavonoids, including catechin hydrate, para-coumaric acid, vanillic acid, and syringic acid were detected. Treatment with PPE exhibited dose-dependent antinociceptive and anti-inflammatory activities in pain models (p < 0.05). Furthermore, naloxone did not reverse the effect of PPE in the writhing test. Mice that underwent sciatic nerve surgery showed that the paw withdrawal latency increased gradually over 7 days.ConclusionsOur results demonstrate that PPE has significant antinociceptive and anti-inflammatory activities and can provide significant postoperative analgesia.
Preferences of nursing and medical students for working with older adults and people with dementia: a systematic review
Authors: Hebditch Molly , Daley Stephanie , Wright Juliet , Sherlock Gina , Scott James , Banerjee Sube 
Published: March 2020

AbstractBackgroundA current issue in workforce planning is ensuring healthcare professionals are both competent and willing to work with older adults with complex needs. This includes dementia care, which is widely recognised as a priority. Yet research suggests that working with older people is unattractive to undergraduate healthcare students.MethodsThe aim of this systematic review and narrative synthesis is to explore the factors related to healthcare (medical and nursing) student preferences’ for working with older people and people with dementia. Searches were conducted in five databases: MEDLINE, PsycINFO, CINHAL, BNI, ERIC. Screening, data extraction and quality appraisal were conducted by two independent reviewers. A narrative, data-based convergent synthesis was conducted.ResultsOne thousand twenty-four papers were screened (139 full texts) and 62 papers were included for a narrative synthesis. Factors were grouped into seven categories; student characteristics, experiences of students, course characteristics, career characteristics, patient characteristics, work characteristics and the theory of planned behaviour.ConclusionHealth educators should review their role in cultivating student interest in working with older adults, with consideration of student preparation and the perceived value of this work. There is a lack of evidence about the career preferences of students in relation to dementia, and this warrants further research.
A systematic review of the factors – enablers and barriers – affecting e-learning in health sciences education
Authors: Regmi Krishna , Jones Linda 
Published: March 2020

AbstractBackgroundRecently, much attention has been given to e-learning in higher education as it provides better access to learning resources online, utilising technology – regardless of learners’ geographical locations and timescale – to enhance learning. It has now become part of the mainstream in education in the health sciences, including medical, dental, public health, nursing, and other allied health professionals. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, there is very limited evidence available about what works, and when and how e-learning enhances teaching and learning. This systematic review aimed to identify and synthesise the factors – enablers and barriers – affecting e-learning in health sciences education (el-HSE) that have been reported in the medical literature.MethodsA systemic review of articles published on e-learning in health sciences education (el-HSE) was performed in MEDLINE, EMBASE, Allied & Complementary Medicine, DH-DATA, PsycINFO, CINAHL, and Global Health, from 1980 through 2019, using ‘Textword’ and ‘Thesaurus’ search terms. All original articles fulfilling the following criteria were included: (1) e-learning was implemented in health sciences education, and (2) the investigation of the factors – enablers and barriers – about el-HSE related to learning performance or outcomes. Following the PRISMA guidelines, both relevant published and unpublished papers were searched. Data were extracted and quality appraised using QualSyst tools, and synthesised performing thematic analysis.ResultsOut of 985 records identified, a total of 162 citations were screened, of which 57 were found to be of relevance to this study. The primary evidence base comprises 24 papers, with two broad categories identified, enablers and barriers, under eight separate themes: facilitate learning; learning in practice; systematic approach to learning; integration of e-learning into curricula; poor motivation and expectation; resource-intensive; not suitable for all disciplines or contents, and lack of IT skills.ConclusionsThis study has identified the factors which impact on e-learning: interaction and collaboration between learners and facilitators; considering learners’ motivation and expectations; utilising user-friendly technology; and putting learners at the centre of pedagogy. There is significant scope for better understanding of the issues related to enablers and facilitators associated with e-learning, and developing appropriate policies and initiatives to establish when, how and where they fit best, creating a broader framework for making e-learning effective.
A critical review of representation in the development of global oncology curricula and the influence of neocolonialism
Authors: Giuliani Meredith , Frambach Janneke , Broadhurst Michaela , Papadakos Janet , Fazelad Rouhi , Driessen Erik , Martimianakis Maria Athina Tina 
Published: March 2020

Abstract
Background
Global curricular homogenization is purported to have a multitude of benefits. However, homogenization, as typically practiced has been found to promote largely Western ideals. The purpose of this study was to explore the issue of representation in the development of global oncology curricula.

Methods
This systematic review of global oncology curricula involved a comprehensive search strategy of eight databases from inception to December 2018. Where available, both controlled vocabulary terms and text words were used. Two investigators independently reviewed the publications for eligibility. Full global/core oncology curricular documents were included. Data analysis included exploration of representation across a number of axes of power including sex and geographic sector, consistent with a neocolonial approach.

Results
32,835 documents were identified in the search and 17 remained following application of the inclusion/exclusion criteria. Eleven of 17 papers were published from 2010 to 2018 and 13 curricula originated from Europe. The 17 curricula had 300 authors; 207 were male and most were from Europe (n = 190; 64%) or North America (n = 73; 24%). The most common curricular purposes were promoting quality patient care (n = 11), harmonization of training standards (n = 10), and facilitating physician mobility (n = 3). The methods for creation of these curricula were most commonly a committee or task force (n = 10). Over time there was an increase in the proportion of female authors and the number of countries represented in the authorship.

Conclusion
Existing global oncology curricula are heavily influenced by Western male authors and as a result may not incorporate relevant socio-cultural perspectives impacting care in diverse geographic settings.
Assessment of the impact of EHR heterogeneity for clinical research through a case study of silent brain infarction
Authors: Fu Sunyang , Leung Lester Y. , Raulli Anne-Olivia , Kallmes David F. , Kinsman Kristin A. , Nelson Kristoff B. , Clark Michael S. , Luetmer Patrick H. , Kingsbury Paul R. , Kent David M. , Liu Hongfang 
Published: March 2020

Abstract
Background
The rapid adoption of electronic health records (EHRs) holds great promise for advancing medicine through practice-based knowledge discovery. However, the validity of EHR-based clinical research is questionable due to poor research reproducibility caused by the heterogeneity and complexity of healthcare institutions and EHR systems, the cross-disciplinary nature of the research team, and the lack of standard processes and best practices for conducting EHR-based clinical research.

Method
We developed a data abstraction framework to standardize the process for multi-site EHR-based clinical studies aiming to enhance research reproducibility. The framework was implemented for a multi-site EHR-based research project, the ESPRESSO project, with the goal to identify individuals with silent brain infarctions (SBI) at Tufts Medical Center (TMC) and Mayo Clinic. The heterogeneity of healthcare institutions, EHR systems, documentation, and process variation in case identification was assessed quantitatively and qualitatively.

Result
We discovered a significant variation in the patient populations, neuroimaging reporting, EHR systems, and abstraction processes across the two sites. The prevalence of SBI for patients over age 50 for TMC and Mayo is 7.4 and 12.5% respectively. There is a variation regarding neuroimaging reporting where TMC are lengthy, standardized and descriptive while Mayo’s reports are short and definitive with more textual variations. Furthermore, differences in the EHR system, technology infrastructure, and data collection process were identified.

Conclusion
The implementation of the framework identified the institutional and process variations and the heterogeneity of EHRs across the sites participating in the case study. The experiment demonstrates the necessity to have a standardized process for data abstraction when conducting EHR-based clinical studies.
Practice of standard monitoring during anaesthesia in hospitals of North Kivu: a survey of health facilities of the health antenna of Butembo
Authors: Blaise Pascal Furaha Nzanzu , Musavuli Paulin Kambale , Ketha Joel Kambale , Sikakulya Franck Katembo , Barratt-Due Andreas , Castner Thomas , Pollach Gregor 
Published: March 2020

Abstract
Background
Standard monitoring during anaesthesia is a core element of patient safety and practice of safe anesthesia has reduced morbidity and mortality worldwide. The main objective of this study was to assess the practice of standard monitoring during anaesthesia in the hospitals of North Kivu, so as to establish a baseline overview of the situation, and orientate plans towards safe anaesthesia in the region.

Methods
This study was a cross-sectional survey of health facilities of the Health Antenna of Butembo in Democratic Republic of Congo and was conducted from October to December 2018. Questionnaires were brought to anaesthesia providers in the health facilities. The study included 1 answer from the anaesthesia practitioners who accepted to participate. The practices of standard monitoring in the health facilities were compared to WHO-WSFA guidelines. Data was captured and analyzed with Epi Info 7.

Results
Forty out of 90 health facilities (44.4%) of 10 health zones responded on the questionnaire. Twenty-three health facilities (57.5%) were from private sector and 17 (42.5%) from public sector. Sixteen health facilities (40.0%) were from the Butembo health zone. The median number of anaesthesia providers was 2 per health facility. Of all the anaesthesia providers, none were physicians, 47.5% were nurses practicing anaesthesia without any training in anaesthesia and 47.5% were nurse anaesthetists. All the health facilities were providing general anaesthesia whereas spinal anaesthesia was provided in 22 out of 40 centers (55%). Seventy percent (28/40) of the facilities were below standard according to WHO-WSFA guidelines. Only 40% (16/40) were using a pulse oximeter and 10% (4/40) declared that ECG was occasionally used.

Conclusion
The practice of standard monitoring is poor in health facilities of the Health Antenna of Butembo. Efforts should be made to improve monitoring which is a key element of safe anaesthesia.
Institutional delivery services utilization and its determinant factors among women who gave birth in the past 24 months in Southwest Ethiopia
Authors: Yoseph Metsehet , Abebe Solomon Mekonnen , Mekonnen Fantahun Ayenew , Sisay Mekonnen , Gonete Kedir Abdela 
Published: March 2020

Abstract
Background
Institutional delivery is a delivery that takes place at any medical facility staffed by skilled delivery assistance. It is estimated that using institutional delivery could reduce 16 to 33% of maternal deaths. Despite the importance of delivering at health institutions, in Ethiopia, mothers prefer to give birth at home. Therefore, the aim of this study was to compare institutional delivery service utilization and associated factors among rural and urban mothers in Mana district, Jimma Zone, Southwest Ethiopia, 2017.

Methods
A community based comparative cross sectional study was conducted in Mana district, Southwest Ethiopia from March to June, 2017. A stratified probability sampling technique was used to select a total of 1426 (713 urban, 713 rural) study participants. Data were collected from mothers who gave birth in the past 24 months by using a structured and pretested questionnaire.

Results
The overall prevalence of institutional delivery service utilization was 86.4%. Higher number of antenatal care visits, having good knowledge on the danger signs of labor, increased wealth index, primary and above educational level of the husband, mothers age below 40-year, and less than 30-min travel time to the nearby health institutions had significantly increased the rate of institutional delivery service utilization.

Conclusion
Institutional delivery service utilization is high in the study area. Maternal awareness of danger signs of labor, frequent ANC visit and better education of husband, and household wealth predicted the utilization of the service. Therefore, due attention need to be given to enhancing education, expanding health institutions and creating awareness on advantage of antenatal care follow up and danger signs to make all pregnancies delivered at health institutions.
Transcriptome analysis reveals the link between lncRNA-mRNA co-expression network and tumor immune microenvironment and overall survival in head and neck squamous cell carcinoma
Authors: Zhong Zhaoming , Hong Min , Chen Xiao , Xi Yan , Xu Yuanyuan , Kong Deyu , Deng Jun , Li Yun , Hu Rui , Sun Chuanzheng , Liang Jin 
Published: March 2020

Abstract
Background
As the sixth most common cancer worldwide, head and neck squamous cell carcinoma (HNSCC) develops visceral metastases during the advanced stage of the disease and exhibits a low five-year survival rate. The importance of tumor microenvironment (TME) in tumor initiation and metastasis is widely recognized. In addition, accumulating evidence indicates that long non-coding RNA (lncRNA) is involved in crosstalk between TME and tumor cells. However, the lncRNA-associated regulators modulating the HNSCC microenvironment and progression remain largely unknown.

Methods
The publicly available transcriptome data and matched clinical HNSCC data were collected from The Cancer Genome Atlas (TCGA). Immune scores (ISs) and stromal scores (SSs) of HNSCC TME were calculated using ESTIMATE algorithm. Weighted gene co-expression network analysis (WGCNA) was conducted to determine the co-expressed lncRNAs and protein-coding mRNAs.

Results
Results showed that the high IS HNSCC male patient subgroup exhibited improved survival. Additionally, we identified 169 lncRNAs and 825 protein-coding mRNAs that were differentially expressed in high IS HNSCC samples, with the up-regulated mRNAs displaying enrichment in immune-related biological processes. Notably, we identified a high co-expression lncRNA-mRNA module (i.e., purple module) that showed strong correlation with ISs. This module contained 79 lncRNAs and 442 mRNAs, including 26 lncRNAs and 215 mRNAs showing association between expression and male HNSCC survival. Consistently, 207 of the 215 mRNAs were up-regulated in high IS HNSCC group and were enriched in immune-related signaling pathways. Based on bioinformatics analyses and previous functional assays, certain lncRNAs (e.g., AL365361.1 and PCED1B-AS1) in the purple module likely contributed to the modification of tumor immune microenvironment (TIME) in the high IS HNSCC patients, achieved by regulating transcription of abundant immune-related genes (e.g., CCR7 and TLR8).

Conclusions
In summary, we ascertained a HNSCC male patient subgroup that displayed high ISs and good survival probability. We identified hundreds of genes with specific expression patterns in this HNSCC subgroup as well as a highly co-expressed lncRNA-mRNA module with great potential for the modulation of TIME of HNSCC. Our study provides evidence of a link between the lncRNA-associated gene network, TIME, and HNSCC progression, and highlights potential therapeutic targets for this disease.