bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Multiple Sclerosis‑Related Quality of Life among Iranian Patients Using the MSQOL-54 Tool: A cross-sectional study
Authors: Namazi Niloofar , Ziaei Shadi , Afzal Golnaz , Barati Saghar , Mohebbi Rezvaneh , Mir Mahshad , Esmaily Hadi , Mehralian Gholamhossein 
Published: December 2020

Abstract
BackgroundThe main objectives of this study were to assess quality of life (QoL), consumption patterns of dietary supplements, as well as physical/mental health status in patients with multiple sclerosis (MS). The present study also aimed to determine the association between demographic characteristics and physical as well as mental health composite (PHC and MHC) scores using the Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaire.MethodsThis cross-sectional study was conducted on a group of patients with MS (n=382) referring to Shahid Kazemi Pharmacy, based in the city of Tehran, Iran, as a national pharmacy providing specialized pharmaceutical care to these individuals from February 2019 to March 2020 via the implementation of the MSQoL-54 questionnaire. ResultsA total number of 382 patients with MS participated in this study, including 89 (23.3%) men and 293 (76.7%) women, aged 40±10.9 years old (range: 18-84 years old). The overall score of the MSQoL-54 questionnaire was also by 41.58, and that was 69.60 and 62.99 from 100 for PHC and MHC, respectively. Conclusions The study results demonstrated that advanced age, longer disease duration, and lower levels of education were significantly associated with lower QoL. Trial registration IR.SBMU.PHARMACY.REC.1398.240.
Can Non-Invasive Assessment of Liver Fibrosis Be Used As A Predictor of Prognosis for HCC Patients with HBV-Related Cirrhosis?
Authors: Mu Siyu , Xu Lin 
Published: December 2020

Abstract
Backgroud: Most liver cancer patients have backgroud of HBV-related liver cirrhosis. We are still not sure whether non-invasive assessments of liver fibrosis can be used as predictors of prognosis. In this study, we investigate the relationship between aspartate aminoytransferase (AST)-to-platelet(PLT) ratio index (APRI) and the prognosis of hepatocellular carcinoma (HCC) patients with liver cirrhosis.Methods: The clinical data of HCC patients with cirrhosis who received hapatectomy in our hospital were analyzed retrospectively. Receiver Operating Characteristic (ROC) curve was used to determine APRI cut-off value to predict the prognosis. Kaplan-Meier survival (Log-rank test) and Cox regression analyses were used for univariate and multivariate analysis of the prognosis in all patients, and the differences were compared between the APRI high-value and low-value groups. Independent sample t test was used to compare the differences of clinical data between the APRI high-value and low-value groups.Results: The cut-off value was determined as 0.61 according to the ROC curve, and the high-value group was defined as APRI ≥ 0.61, while the low-value group was defined as APRI<0.61. By the end of follow-up data, the proportion of patients died from liver failure in high-value group was higher than that in low-value group (χ2 =5.232, P=0.022). The results of survival analysis showed that the maximum of tumor diameter >0.5cm, multiple tumors, invasion of liver capsule, vascular tumor thrombus, AFP>20ng/ml and APRI ≥ 0.61were independent risk factors influencing the disease free survival (DFS) time after resection for HCC patients with cirrhosis (P<0.05). The 1-year, 2-year, and 5-year disease free survival rates of APRI low-value and high-value groups were 79.4%, 61.4%, 43.7% and 71.4%, 51.6%, 27.0%. The recurrence rate of APRI low-value and high-value groups were 20.5%, 38.1%, 54.1% and 28.0%, 47.1%, 69.8%, respectively (P=0.000). APRI value of patients with portal hypertension (PH) and Child-pugh B class were higher than those without PH and Child-pugh A class (P<0.05).Conclusion: HCC patients with liver cirrhosis whose APRI ≥ 0.61 had worse prognosis after resection.
Gastric Electrical Stimulation Increases The Proliferation of Interstitial Cells of Cajal and Alters Enteric Nervous System in Diabetic Rats
Authors: Wang Cai , Zhang Hui , Zhao Le , Gao Tao , Liu Xia , Chen Yan 
Published: December 2020

Abstract
Background: Lack of interstitial cells of Cajal (ICC) and neuropathy were the most possible pathological mechanisms of diabetic gastroparesis. Gastric electrical stimulation (GES) is a promising way to treat gastroparesis. The aims of the present study were to explore the impact of GES on ICC together with enteric neurons in diabetic rats and the possible mechanisms involved.Methods: Sixty rats were randomized into the normal rats, diabetic rats (DM), diabetic rats with sham GES (DM+SGES), and three diabetic rats with GES (DM+GES1, DM+GES2 and DM+GES3). The proliferation of ICC and expressions of 5-HT2B, nNOS, CHAT, PGP9.5 and GDNF were evaluated by immunofluorescence staining or Western blot. The expressions of 5-HT in blood and tissue were determined by ELISA.Results: (1) The proliferation of ICC was hardly observed in the DM group together with the DM+SGES group but increased in the three DM+GES groups. (2) The expression of 5-HT2B was decreased in the DM group and enhanced in the DM+GES groups. Similarly, the expressions of 5-HT in the blood and distal stomach tissue were increased in the DM+GES groups. (3) Both nNOS labeled neurons and CHAT positive neurons were reduced in myenteric plexus of the DM group, while plenty of these neurons were observed the DM+GES groups. (4) The expression of GDNF protein in the diabetic rats was down-regulated, while GES increased the expression of GDNF.Conclusion: GES improves the proliferation of ICC possibly related with 5-HT/5-HT2B signal pathway, and alters enteric nervous system 52 partly though the GDNF expression.
Effects of Sub-Atmospheric Pressure and Dissolved Oxygen Concentration on Lesions Generated in Ex Vivo Tissues by High Intensity Focused Ultrasound
Authors: He Min , Zhong Zhiqiang , Zeng Deping , Gong Xiaobo , Wang Zhibiao , Li Faqi 
Published: December 2020

Abstract
BackgroundAcoustic cavitation plays an important role in the medical treatment using high intensity focused ultrasound (HIFU), but unnecessarily strong cavitation also could deform the morphology and enlarge the size of lesions. It is known that the increase of ambient hydrostatic pressure (Pstat) can control the acoustic cavitation but the question how decrease of Pstat and dissolved oxygen concentration (DOC) influences the strength of cavitation has not been thoroughly answered.MethodsEx vivo bovine liver tissues were immersed in degassed water with different DOC of 1.0 mg/L, 1.5 mg/L and 2.0 mg/L. Ultrasound (US) of 1 MHz and the spatial and temporal average intensity (Isata) of 6500 W/cm2 was used to expose two groups of in vitro bovine livers for two seconds; one group was under atmospheric pressure (Pstat = 1 bar) and the other was under sub-atmospheric pressure (Pstat = 0.1 bar). Acoustic cavitation was detected by a passive cavitation detector (PCD) during the exposure process. Echo signals at the focal zone of HIFU were monitored by B-mode ultrasound imaging before and after exposure.ResultsThe results demonstrated a significant difference of broadband acoustic emissions from the cavitation bubbles, echo signals on B mode image, morphology of lesions under various condition of ambient pressure and DOC. The lesion volume in tissue was increased with the increase of ambient pressure and DOC.ConclusionCavitation could be suppressed through sub-atmospheric pressure and low DOC level in liver tissue, which could provide a method of controlling cavitation in HIFU treatment to avoid unpredictable lesions.
Awareness of Colorectal Cancer and Associated Factors Among Adult Patients in Jimma, South-West Ethiopia.
Authors: Hamza Abdulmenan , Argaw Zeleke , Gela Debela 
Published: December 2020

Abstract
Background: Colorectal cancer (CRC) is the first commonest diagnosed cancer in men and the fourth commonest in women in Ethiopia. The most significant factors that may increase the risk of having CRC were modifiable. However, little is known about the awareness of CRC and associated factors among adult patients in study area. Therefore, the study aimed to assess the awareness of CRC and associated factors among adult patients in Jimma, South-West Ethiopia, 2020. Methods: The institution-based quantitative cross-sectional study design was conducted among 422 patients from March 8 to April 30, 2020. The study participants were recruited by a systematic random sampling method and data was collected semi-structured interviewer-administered questionnaires. Descriptive, bivariate, and multivariate logistic regression was implemented. The statistical level of significance was stated at p-value < 0.05. Result: A 100% response rate in this study was recorded. More than half (57.6%) of the study participants had low awareness of colorectal cancer. Smoking (78.2%) and bloody stool (49.3%) were the most known risk factors and symptoms. There is a significant association between awareness of colorectal cancer with gender, residency, monthly income, level of education, information sources, and heard about CRC. Conclusion: Overall awareness of patients towards CRC was inadequate. Participants with high levels of education and females had better awareness, however; the overall awareness of them was insufficient. Therefore, there is a need for awareness campaigns and health education for promoting colorectal cancer awareness.
Human Breast Milk Assessed by the Deuterium Dose Mother Technique with Less Than 30 g Deuterium Using the Agilent 4500S for Fourier Transform Infrared Spectroscopy: A Pilot Study in the Democratic Republic of Congo
Authors: Murhima’Alika Christine Chimanuka , Balemba Ghislain Maheshe , Mapendo Daniella Bugugu , Kapapa Aminata , Munthali Grace , Owino Victor , Wilmet Michèle Dramaix , Donnen Philippe , Balaluka Ghislain Bisimwa 
Published: December 2020

Abstract
Background: Good breastfeeding practice is essential in preventing malnutrition in children. The deuterium method is the best technique for assessing human breast milk output. We investigated whether deuterium doses < 30 g can be used to assess human breast milk using saliva and the new Agilent 4500S for Fourier transform infrared spectroscopy (FTIR). Methods: In a cross-sectional study, the breastmilk output of lactating mothers was evaluated using four different doses of deuterium in the Miti-Murhesa Health Zone (Democratic Republic of Congo). Lactating mothers of infants aged 3-23 months were recruited and assigned to a dosage group. Weight, height, and mid-upper arm circumference were measured and the body mass index calculated as weight/height2. Body composition (fat mass, free fat mass, total body water, and breastmilk output) was assessed using standard deuterium dilution methods. One-way ANOVA was used to compare the means in different groups and the chi² test to compare proportions. Results: Seventy-five lactating mothers were included in the study: 19 received 6 g, 20 received 10 g, 18 received 15 g, and 18 received 20 g deuterium. The mean ± standard deviation infant age was 10.6 ± 5.2, 11.1 ± 4.4, 10.9 ± 4.4, and 11.0 ± 3.9 months, respectively (p=0.076). We found no difference in the age and anthropometric parameters of the lactating mothers in the different groups. The mean ± standard deviation breast milk output rate was 796.6 ± 292.4, 260.8± 23.2, 749.8 ± 244.2, and 733.6 ± 207.1 g/d in the 6 g, 10 g, 15 g, and 20 g groups, respectively (p=0.883). Conclusions: The different doses of deuterium administered to lactating mothers resulted in similar breast milk output values. Thus, it is possible to evaluate human breast milk with deuterium doses <30 g when using the Agilent 4500S.
Leveraging Phone Based Mobile Technology to Improve Data Quality at Health Facilities in Rural Malawi: A Best Practice Project
Authors: Tizifa Tinashe Alinafe , Nkhono William , Mtengula Spencer , Vugt Michele van , Munn Zachary , Kabaghe Alinune Nathanael 
Published: December 2020

Abstract
Background: To further reduce malaria burden, identification of areas with highest burden for targeted interventions needs to occur. Routine health information has the potential to indicate where and when clinical malaria occurs the most. Developing countries mostly use paper-based data systems however they are error-prone as they require manual aggregation, tallying and transferring of data. We piloted the use of electronic data capture (EDC) using a cheap and user friendly software in rural Malawian primary healthcare setting to improve the quality of health records. Methodology: We used audit and feedback tools from Joanna Briggs Institute’s (Practical Application of Clinical Evidence System and Getting Research into Practice) in four primary healthcare facilities. Using this approach, we identified the best available evidence for a malaria information system (MIS). Baseline audit of the existing MIS was conducted in the facilities based on available best practice for MIS; this included ensuring data consistency and completeness in MIS by sampling 25 random records of malaria positive cases. Implementation of an adapted evidence-based EDC system using tablets on an OpenDataKit platform was done. We then conducted an end line audit following implementation. Users had interviews on experiences and challenges concerning EDC at the beginning and end of the survey.Results: The existing MIS was paper-based, occupied huge storage space, had some data losses due to torn out papers and were illegible in some facilities. The existing MIS did not have documentation of necessary parameters such as malaria deaths and treatment within 14 days. Training manuals and modules were absent. One health center solely had data completeness and consistency at 100% of the malaria-positive sampled records. Data completeness and consistency rose to 100% with readily available records containing information on recent malaria treatment. Interview findings at the end of the survey showed that EDC was acceptable among users and they agreed that the tablets and the OpenDataKit were easy to use, improved productivity and quality of care. Conclusions: Improvement of data quality and use in the Malawian rural facilities was achieved through the introduction of EDC using OpenDataKit. Health workers in the facilities showed satisfaction with the use of EDC. (Word limit: 350 words, current: 349)
Delayed Exercise Therapy after acute Ankle Sprain Increases Functional Ankle Instability – The Later, the Worse: A Retrospective Analysis.
Authors: Raeder Christian , Tennler Janina , Praetorius Arthur , Ohmann Tobias , Schoepp Christian 
Published: December 2020

Abstract
Background:The lateral ankle sprain (LAS) is one of the most common injuries in everyday life and sports. Approximately 20-40% of patients with a LAS develop a chronic ankle instability (CAI). The underlying mechanisms for CAI have not yet been clearly clarified. An inadequate rehabilitation after LAS can be speculated, since the LAS is often handled as a minor injury demanding less treatment Therefore, the aim of this retrospective study was to first determine the CAI rate depending on age and sex and second, to identify possible risk factors for developing CAI. Methods:Between 2015 and 2018 we applied the diagnostic code “sprain of ankle” (ICD S93.4) to identify relevant cases from the database of the BG Klinikum Duisburg, Germany. Patients received a questionnaire containing the Tegner-Score as well as the patient-related outcome measures including the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Disability Index. Additionally, there were questions about the cause of accident, time points of therapy onset, as well as the number of recurrent sprains. There was a total of 647 completed datasets which were separated into a CAI and a COPER group according to a CAIT cut-off score of <24.Results:The overall CAI rate was 17.3%. We identified a higher risk for CAI in females and within the age segment of 41 to 55 years. A later therapy onset (>4 weeks) after acute LAS significantly worsens ankle function in CAIT (p<.05). There was a significantly higher CAIT score in patients having no recurrent sprain compared to patients having 1-3 recurrent sprains (p<.001) or 3-5 recurrent sprains (p<.001).Conclusion:Females and older age groups have a higher risk for developing CAI which implies to perform specific prevention programs improving ankle function following LAS. A delayed onset of exercise therapy seems to be an important risk factor for the development of CAI. A further risk factor, suggested by literature, is the number of recurrent sprains that could be also confirmed by our data. Therefore, we recommend an early onset of functional exercise therapy after acute LAS in the future to minimize the development of CAI.
Development of in Vitro Resistance to Daptomycin in Enterococcus Faecium and Estimation of Its Fitness Cost
Authors: Zeng Weiliang , Chen Tao , Wu Qing , Xu Ye , Yu Kaihang , Zhang Ying , Liu Shixing , Cao Jianming , Zhou Tieli 
Published: December 2020

Abstract
BackgroundDaptomycin has broad-spectrum antibacterial activity against Gram-positive pathogens, but recent studies have revealed cases where daptomycin has failed to treat multidrug-resistant bacteria, such as vancomycin-resistant Enterococcus faecium. However, the resistance evolution of E. faecium to daptomycin in vitro and fitness cost remain unclear. In this study, we sought to analyze the resistance development and mechanism of E. faecium to datomycin, and futher to investigate the relationship between daptomycin resistance and fitness cost.MethodsTo investigate the development of daptomycin resistance in E. faecium, 6 daptomycin-susceptible (DAP-S) clinical isolates, including 3 vancomycin-resistant E. faecium (VRE) and 3 vancomycin-susceptible E. faecium (VSE), were exposured to daptomycin in vitro by serial passage experiment. Then the different resistance mechanisms of daptomycin-resistant (DAP-R) mutants were analyzed by polymerase chain reaction (PCR), cytochrome C binding assay and transmission electron microscopy. Furthermore, we also estimated the changes of fitness cost among each highly DAP-R mutants by bacterial growth curve measurement, in vitro competition experiments, infection model of Galleria mellonella larvae and biofilm formation assays.ResultsIn vitro, a total of 21 DAP-R mutants with minimal inhibitory concentration (MIC) of 4 to 512 μg/mL were obtained, and these mutants carried more than one mutation of LiaFSR and YycFG system encoding genes. More positive charges were detected among highly DAP-R mutants than parent isolates, and the cell walls of SC1174-D and SC1762-D mutants were remarkly thicker than those of the parent isolates. In comparison with parent isolates, besides, the growth, competition ability and virulence were significantly reduced, while the biofilm formation capacity was markedly elevated among each highly DAP-R mutants.ConclusionsOur findings suggest that E. faecium isolates are able to rapidly acquire DAP resistance in vitro through different dynamic resistance mechanisms, which often accompany by significant fitness cost. Intriguingly, DAP and glycopeptide antibiotics may present collateral-sensitivity during E. faecium acquired DAP resistance in vitro.
Practical Experience of Humanistic Care Among Medical Staff in Stroke Wards: A Qualitative Research Study Conducted in China
Authors: Li Min , Zhu Wenjing , Yang Ziqing , Luo Qing , Chen Huang , Duan Yan , Chen Ken , Xie Hongzhen 
Published: December 2020

Abstract
BackgroundAs a special patient group, stroke patients have a significant attachment to humanistic care. There are, however, still many problems in clinical practice. Medical staff in stroke wards are the main providers of humanistic care. Finding out the opinions of staff that provide the medical service is vitally important for stroke patients that need access to curative and humanistic care.ObjectiveThe aim of the study was to explore the psychological experiences of doctors, nurses and physiotherapists during the implementation of humanistic care in a stroke ward.MethodMedical staff including doctors, nurses and physiotherapists were selected from stroke wards in general hospitals (minimum level two) from 13 cities within six provinces in China. A purposive sampling method was used until no new data were generated (n=18). Semi-structured interviews were conducted by using a phenomenological research method. The Colaizzi seven-step method was used for analysis.ResultThe end user’s experience incorporated four themes: (1) Gradually improving the perception of humanistic caring in a stroke ward. (2) Required improvement of consciousness and ability of humanistic care implementors in a stroke ward. (3) Main problems and contradictions associated with implementing humanistic care in stroke wards. (4) Critical needs of staff in a stroke ward.ConclusionSteady advances have been made in the prevention and treatment of stroke in China. Care behaviour of staff in stroke wards has gradually improved. Nevertheless, while implementing humanistic care in stroke wards, the consciousness and ability of medical staff needs to be improved, in addition to the practical problems and contradictions affecting the development of humanistic care. In order to improve the level of humanistic care in stroke wards, attention should be paid to the overall improvement of the personal qualities of medical staff in stroke wards and the integration of a humanistic management mode.
Pre-treatment Controlling Nutritional Status (CONUT) Score and Carcinoembryonic Antigen Level Provide Tumour Progression and Prognostic Information in Gastric Cancer ： A Retrospective Study
Authors: chen xiuqing , wu peiwen , shen ximei , yang liyong 
Published: December 2020

Abstract
BackgroundThis study explores the role of combining the controlling nutritional status (CONUT) score and the carcinoembryonic antigen (CEA) level on predicting tumour stage and prognosis in gastric cancer (GC) patients.MethodsA total of 682 GC patients were included in this retrospective study. CONUT scores and CEA levels were combined to establish a new scoring system: CONUT-CEA score. Cut-off values for distinguishing patients between stage IV and non-stage IV were established by receiver operating characteristic curves. Cut-off values for predicting prognosis were determined by maximum x2 method.ResultsThe CONUT and CEA cut-off values for discriminating stage IV patients from non-stage IV patients were 2.0 and 5.58 ng/ml, respectively. Logistic regression model demonstrated that high CONUT-CEA score was related to advanced tumour stage. Among non-stage IV patients, CONUT and CEA cut-off values of 2.0 and 9.50 ng/ml predicted overall survival (OS), respectively. The Cox proportional risk model revealed that high CONUT-CEA score was notable related to decreased OS (2 vs 0: hazard ratios (HR) =2.358, 95% confidence intervals (CI)=1.412–3.940, P=0.001) and decreased disease-free survival (2 vs 0: HR=1.980, 95% CI=1.072–3.656, P=0.003). ConclusionsThe CONUT-CEA score may be a good biomarker for predicting tumour stage and prognosis in GC patients.