bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis on mental health status and needs of health care workers in designated medical institutions of tuberculosis during the epidemic period of COVID-19
Authors: Fang Xue-Hui , Wu Li , Lu Lun-Shan , Kan Xiao-Hong , Wang Hua , Xiong Yan-Jun , Ma Dong-Chun , Wu Guo-Cui 
Published: June 2020

Abstract
Background Coronavirus disease 2019 (COVID-19) has spread rapidly in China and other overseas areas, which has aroused widespread concern. The sharp increase in the number of patients has led to great psychological pressure on health care workers. The purpose of this study is to understand their mental health status and needs, so as to provide a scientific basis for alleviating the psychological pressure of health care workers.Methods Using a cross-sectional study design, 511 health care workers were randomly selected from two designated tuberculosis medical institutions in Anhui Province. The basic situation, perceived social support, depression level, loneliness and COVID-19 related knowledge were collected and analyzed by questionnaire.Results There were 139 people in epidemic prevention and control positions (27.20%). Depression level: female was higher than male; nurse was higher than doctor; middle and junior job titles were higher than senior titles; junior college degree or below were higher than bachelor's degree, master's degree and above; isolation ward, fever clinic and pre-check triage were significantly higher than those of non-prevention and control positions (P < 0.05). Loneliness scores: doctors were higher than that of medical technicians, and isolation ward, fever clinic and pre-check triage were higher than those of non-prevention and control positions (P < 0.05). Social support: doctors were lower than that of medical technicians, and isolation ward, fever clinic and pre-check triage were significantly lower than those of non-prevention and control positions (P < 0.05). The score of social support was negatively correlated with depression and loneliness (P < 0.001), while depression was positively correlated with loneliness (P < 0.001). Health care workers most want to receive one-to-one psychological counseling (29.75%), and provide crisis management (24.07%). The awareness rate of health care workers on COVID-19's knowledge was relatively high.Conclusions The psychological problems of health care workers, especially women, nurses with low educational background, low professional title, and staff in the epidemic prevention and control positions are relatively serious. We should focus on this population, and take targeted intervention measures.
Family Witnessed Resuscitation: Staff Opinion
Authors: de Mingo-Fernández Eva , Belzunegui-Eraso Ángel , Jiménez-Herrera María 
Published: June 2020

Abstract
BACKGROUNDSince the 1980s, the controversial issue of family presence during cardiopulmonary resuscitation has been studied, as well as to identify the perceptions, opinions and beliefs of health professionals, patients and family members, as well as to identify benefits, barriers and design training and protocols for its implementation. In 2008, Twibell et al. designed a questionnaire that measured nurses’ perceptions of Risks-Benefits and Self-Confidence in the face of Family Presence during Cardiopulmonary Resuscitation.MethodsThe objective is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale (FPRB-FPSC) instrument by Twibell et al. For this purpose were used a questionnaire on paper and online self-administered, semi-structured, translated cross-culturally. Statistical tests were performed for the validity of the questionnaire. 541 health workers were invited to answer. The results were analysed by factor analysis with varimax rotation (maximum likelihood method), in addition to ANOVA, contingency tables and Student’s t-test to observe associations between different variables. The study was approved by the institutional review board of the Consorci Sanitari del Garraf, and by the Ethic Comitee clinical research of the Fundació Unió Catalana Hospitals.Results 237 health workers answered the survey (69% women), of whom 167 were nurses. Health care providers who have experienced CPR barely reach 13%, with the majority being men and the elderly. Regarding the invitation to the FPDR, it barely reaches 5% and regarding the willingness to include the FP in the advance directives, 66% of the health workers are in favour. Health personnel identify similar barriers and factors that favour Family Presence.The correlation between the two measured scales, FPRB-FPSC, is significant and has a moderate intensity of the relationship (r = 0.65 and α <0.001).ConclusionsThe Family Presence during Cardiopulmonary Resuscitation generates controversy in health personnel, observing a trend along with generational change, as younger professionals tend to accept the Family Presence more. The psychometric properties of the questionnaire indicate high validity and reliability. Risk-Benefit perception and trust are related to healthcare staff who consider the Family Presence beneficial.
Systematic Review of cost-effectiveness models in prostate cancer: exploring new developments in testing and diagnosis
Authors: Keeney Edna , Thom Howard , Turner Emma , Martin Richard M , Morley Josie , Sanghera Sabina 
Published: June 2020

Abstract
Background
There is currently no formal prostate cancer screening programme in the UK. Early detection using age-based prostate-specific antigen (PSA) testing is unlikely to be cost-effective due to limited mortality benefit and harms associated with overdetection. However, the discovery of new prostate cancer specific biomarkers and more accurate diagnostic strategies (e.g. magnetic resonance imaging (MRI)) could improve the outcomes of screening. A systematic review was conducted to assess the evidence base on cost-effectiveness of such innovations and areas for further development.
Methods
To identify model-based economic evaluations of screening and diagnostic tests for prostate cancer, a systematic review of the literature using the NHS Economic Evaluation Database, Medline, EMBASE, HTA databases, NICE guidelines, and UK National Screening Committee guidance was carried out, between 2009 and 2019. Relevant data were extracted on study type, model inputs, modelling methods and cost-effectiveness conclusions and the results narratively synthesized.
Results
Sixteen studies were included in the review. Seven studies compared the cost-effectiveness of new urinary or blood biomarkers compared to each other or the PSA test and found the biomarkers e.g. the Prostate Health Index (PHI) and SelectMDx, to be the most cost-effective. Seven studies compared newer prostate biopsy methods, including MRI-guided, to TRUS guided biopsy and found MRI-guided methods to be most cost-effective. The newer detection methods showed a reduction in unnecessary biopsies and overtreatment. However, there was uncertainty around the most cost-effective pathway of follow-up strategies (MRI/biomarkers) in men who have a negative initial biopsy. Many studies did not model stage or grade of cancer, cancer progression or the entire testing, screening and treatment pathway. Very few studies fully accounted for uncertainty in their analysis.
Conclusions
This review brings together the cost-effectiveness literature for novel screening and testing methods used in the diagnosis of prostate cancer. Several limitations of the published models were identified. The models generally either compared new biomarkers or new imaging techniques which highlights the importance of future work in this area, as biomarkers and imaging are likely to be used in combination.
Unleashing the Indirect Influence of FDI in Environmental Degradation via Financial Development and Economic Growth. New Evidence from Asian Countries
Authors: Qamri Ghulam Muhmmad , Sheng Bing , Khan Rana Ejaz Ali , Hanim Wasisfah 
Published: June 2020

Abstract
Background:Scholars in developed and emerging economies have widely tested the interactions between foreign direct investment, financial development, economic growth and environmental degradation. Despite a number of empirical and review studies, it is not yet wrap up either the associations are negative, positive, direct or indirect. Additionally, minor attention is given to the indirect role of foreign direct investment in environmental degradation; perhaps no study has yet demonstrated the mediating role of financial development and economic growth between foreign direct investment and environmental degradation in Asian economies. Referring to the fragmented outputs and consequences as well as lacking the indirect role, the present study examines the influence of foreign direct investment on environmental degradation with the mediating role of financial development and economic growth. Results:Secondary data of 21 Asian countries from 1980-2018 were gathered from World Bank Indicators and then performed STATA to test the paths. Our findings are slightly different from the studies conducted in developed economies. The results indicate that foreign direct investment significantly improves environmental quality by deteriorating environmental pollution. It also significantly improves economic growth in the selected regions. Surprisingly, our study shows that foreign direct investment has a significant negative influence on financial development in the Asian regions. Both financial development and economic growth significantly negatively influence environmental degradation in Asian regions. However, financial development partially mediates while economic growth does not play any mediating role between foreign direct investment and environmental degradation in the Asian countries. Trade openness and population growth as control factors do not show any significant role in the model. Conclusions:This research recommends policymakers to focus on the inflow of foreign direct investment in order to enhance economic growth and environmental quality. It is strongly suggested for policymakers to attenuate the political intervention (e.g. ensure the political stability) in the inflow of foreign direct investment, so financial resources can be impartially distributed in the industrial sector and thus the nations will have an effective financial development system. Other implications have described.
Association Between Obstetric and Medical Risk Factors With Stillbirths in 4 Tertiary Hospitals in a Low Income Country
Authors: Gwako George Nyakundi , Obimbo Moses Madadi , Gichangi Peter Bundi , Kinuthia John , Onesmus Gachuno W , Bosire Alex Nyakundi , Were Fredrick 
Published: June 2020

Abstract
Background

The burden of stillbirth in Africa is high. The burden of stillbirth in Kenya is unknown, and very few studies have investigated the association between medical and obstetric risk factors and the occurrence of stillbirth in a Kenyan setting. The aim of this study was to evaluate the association between obstetric and medical risk factors with stillbirths in Nairobi, Kenya. This information is key to the healthcare system while formulating policies and interventions to mitigate preventable stillbirths.
Methods

This was a case-control study conducted in four Kenyan hospitals between August 2018 and April 2019. Two hundred and fourteen women with stillbirths and 428 with livebirths > 28 weeks were enrolled and evaluated. Data was collected via interviews and data abstraction from medical records. The outcome variables were stillbirth and livebirth; the exposure variables were sociodemographic characteristics, medical and obstetric risk factors. Sociodemographic characteristics were compared using the two-sample t-test for continuous variables and Chi-square or Fisher's exact tests for categorical variables. The association between the medical and obstetric risk factors with stillbirth was assessed using univariate and multivariate analysis using logistic regression. Statistical significance was defined as a two-tailed p-value of ≤0.05.
Results

Mothers with obstetric complications had higher odds of stillbirth: pre-eclampsia (OR 9.1, 95% CI 2.6–32.5, P = 0.001), eclampsia (OR 9.2, 95% CI 2.6–32.5, P = 0.001), placenta previa (OR 8.6 95% CI 2.8–25.9, P = 0.001), abruptio placenta (OR 6.9 95% CI 2.2–21.3, P = 0.001), early preterm delivery 28-34weeks (OR 9.5, 95% CI 5.7–16), late preterm delivery between 34–37 weeks (OR 2.0 95% CI 1.3–3.3) and previous preterm birth (OR 4.7, 95% CI 1.2–18.7, P = 0.01). Women with gestational diabetes mellitus had a 11fold higher likelihood of a stillbirth, OR 11.5 95% CI 2.5–52, P = 0.001). There was no association between intrauterine growth restriction (IUGR), multiple gestation, congenital anomalies, previous stillbirth, previous abortion, HIV and anaemia with stillbirth.
Conclusion:

Our findings reiterate the significance of medical and obstetric complications in association with stillbirth in a Kenyan urban setting. Proper antepartum care and surveillance to identify and manage medical and obstetric conditions with a potential of causing stillbirth are recommended.
Measuring the Quality of Nursing Clinical Placements. Development of the Placement Evaluation Tool (PET): A Mixed Methods Co-design Project
Authors: Cooper Simon , Cant Robyn , Waters Donna , Luders Elise , Henderson Amanda , Willetts Georgina , Tower Marion , Searl Kerry Reid , Ryan Colleen , Hood Kerry 
Published: June 2020

Abstract
Background: The quality of nursing clinical placements has been found to vary. Placement evaluation tools for nursing students are available but lack contemporary reviews of clinical settings. Therefore, the aim of this study was to develop a feasible, valid and reliable clinical placement evaluation tool applicable to nursing student placements in Australia and beyond.Methods: An exploratory mixed methods co-design project. Phase 1 included a literature review; expert rating of potential question items and Nominal Group Technique meetings with a range of stakeholders for item development. Phase 2 included on-line pilot testing of the Placement Evaluation Tool (PET) with 1,263 nursing students, across all year levels at six Australian Universities and one further education college in 2019-20, to confirm validity, reliability and feasibility.Results: The PET included 19-items (rated on a 5-point agreement scale) and one global satisfaction rating (a 10-point scale). Placements were generally positively rated. The total scale score (19 items) revealed a median student rating of 81 points from a maximum of 95 and a median global satisfaction rating of 9/10. Criterion validity was confirmed by item correlation: Intra-class Correlation Co-efficient ICC = .709; scale total to global score r = .722; and items to total score ranging from .609 to .832. Strong concurrent validity was demonstrated with the Clinical Learning Environment and Supervision Scale (r= .834). Internal reliability was identified and confirmed in two subscale factors: Clinical Environment (Cronbach’s alpha = .94) and Learning Support (alpha = .96). Based on the short time taken to complete the survey (median 3.5 minutes) and students’ comments, the tool was deemed applicable and feasible.Conclusions: The PET was found to be valid, reliable and feasible. Use of the tool as a quality assurance measure is likely to improve education and practice in clinical environments. Further international evaluation of the instrument is required to fully determine its psychometric properties.
Responses of Forest Carbon and Water Coupling to Thinning Treatments Across Multiple Spatial Scales
Authors: Wang Yi , Campo Antonio D. del , Wei Xiaohua , Liu Wanyi , Li Qiang 
Published: June 2020

Abstract
BackgroundWater-use efficiency (WUE) represents the coupling of forest carbon and water. Little is known about the responses of WUE to thinning at multiple spatial scales. The objective of this research was to use field measurements to understand short-term effects of two thinning treatments (T1: 4,500 stems ha-1; and T2: 1,100 stems ha-1) and the control (C: 27,000 stems ha-1) on WUE (the ratio of leaf photosynthesis to leaf transpiration, or tree growth to tree transpiration, or net stand above-ground biomass (AGB) accumulation to stand transpiration) and the intrinsic WUE (WUEi, the ratio of leaf photosynthesis to stomatal conductance or the net stand AGB accumulation to canopy conductance) in a 16-year old natural lodgepole pine forest. Leaf-level measurements were conducted in 2017, while tree- and stand-level measurements were conducted in both 2016 (the normal year) and 2017 (the drought year).ResultsThere was no significant effect of thinning on the tree- and stand-level WUE in 2016, while in 2017, only T2 exhibited significantly higher tree-level WUE (0.63 mm2 kg-1) than the C (0.06 mm2 kg-1), and the stand-level WUE values were significantly higher in the thinned stands, with the means of 0.34, 0.61 and 0.7 kg m-3 for the control, T1 and T2, respectively. Stand-level WUEi was, however, significantly higher in the unthinned stands than in the thinned stands. In contrast, the leaf-level WUE values were not significantly different from each other, while the leaf-level WUEi was statistically higher in C than in the thinned stands. Thinning changed the WUE-VPD relationships at tree and stand levels, but not at the leaf level.Conclusions The effects of thinning on forest carbon and water coupling differed with the spatial scales and the metrics (WUE or WUEi) of water use efficiency. Lacking consistent reponses of WUE metrics to thinning treatments across the spatial scales suggests that caution must be exercised when transferring and modeling WUE from one spatial scale to others. Both tree-level and stand-level WUE values in the more heavily thinning stands were significantly promoted under the drough condition, demonstrating that thinning can improve WUE and consequently support forests to cope with the drought effects.
Clinical features and outcomes of combined hepatocellular carcinoma and cholangiocarcinoma versus hepatocellular carcinoma versus cholangiocarcinoma after surgical resection: A propensity score matching analysis
Authors: Lin Chih-Wen , Lin Hung-Yu , Hung Chao-Ming , Hsieh Pei-Min , Wu Tsung-Chin , Yeh Jen-Hao , Hsiao Pojen , Huang Ya-Ling , Li Yu-Chan , Wang Ya-Chih , Shu Chih-Wen , Chen Yaw-Sen 
Published: June 2020

Abstract
Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups.Methods: We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan–Meier analysis.Results: In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7–61.2], 62.3 months (CI: 42.1–72.9), and 36.2 months (CI: 15.4–56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM.Conclusion: The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.
Recruitment And Retention Of Participants From Socioeconomically Deprived Communities: Lessons From The Awareness And Beliefs About Cancer (ABACus3) Randomised Controlled Trial
Authors: Kolovou Vasiliki , Moriarty Yvonne , Gilbert Stephanie , Quinn-Scoggins Harriet , Townson Julia , Padgett Louise , Owen Sioned , Buckle Peter , Edwards Adrian , Hepburn Julie , Lau Mandy , Matthews Maura , Mitchell Caroline , Neal Richard , Playle Rebecca , Robling Michael , Smits Stephanie , Trubey Robert , Wood Fiona , Brain Kate 
Published: June 2020

Abstract
Background
Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successfully recruit and retain our trial participant sample.
Methods
Community and healthcare settings in areas of high socioeconomic deprivation were identified by lay advisors who recruited participants opportunistically or by appointment. Follow-up was done by telephone or post at 2-weeks and 6-months after recruitment, and all participants were offered financial incentives. Qualitative interviews were conducted with lay advisors regarding their experience and reflections.
Results
The lay advisors identified and contacted 107 potential recruitment venues across South and West Yorkshire and South East Wales of which 41.1% (n = 42) were opened for recruitment. A total of 234 participants were recruited, with 91% (n = 212) retention at 2-weeks and 85% (n = 199) at 6-months. Community settings yielded 75% (n = 176) of participants. Participants had a mean age of 61.3 years and 63.3% (n = 148) were female, with 66% (n = 154) resident in the most deprived geographical areas. Lay advisors described recruitment as intensive, although engaging participants was easier in community settings.
Conclusions
The ABACus3 trial achieved recruitment and high retention with a population that is often “hard to reach” or entirely missed in health research. Strategies were specifically tailored to engage the venues and adult residents of highly deprived areas. Future studies recruiting adults living in the most deprived areas might benefit from community recruitment and from collaborating with local gatekeepers who are key to engagement.