bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Prison Health Care Governance and Health Equity: A Critical Lack of Evidence
Authors: McLeod Katherine E. , Butler Amanda , Young Jesse T. , Southalan Louise , Borschmann Rohan , Sturup-Toft Sunita , Dirkzwager Anja , Dolan Kate , Acheampong Lawrence Kofi , Topp Stephanie M. , Martin Ruth Elwood , Kinner Stuart A. 
Published: January 2020

The large and growing population of people who experience incarceration makes prison health an essential component of public health and a critical setting for reducing health inequities. People who experience incarceration have a high burden of physical and mental health care needs and have poor health outcomes. Addressing these health disparities requires effective governance and accountability for prison health care services, including delivery of quality care in custody and effective integration with community health services. Despite the importance of prison health care governance, little is known about how prison health services are structured and funded or the methods and processes by which they are held accountable. A number of national and subnational jurisdictions have moved prison health care services under their ministry of health, in alignment with recommendations by the World Health Organization and the United Nations Office on Drugs and Crime. However, there is a critical lack of evidence on current governance models and an urgent need for evaluation and research, particularly in low- and middle-income countries. Here we discuss why understanding and implementing effective prison health governance models is a critical component of addressing health inequities at the global level.
Anchor Institutions: Best Practices to Address Social Needs and Social Determinants of Health
Authors: Koh Howard K. , Bantham Amy , Geller Alan C. , Rukavina Mark A. , Emmons Karen M. , Yatsko Pamela , Restuccia Robert 
Published: January 2020

“Anchor Institutions”—universities, hospitals, and other large, place-based organizations—invest in their communities as a way of doing business. Anchor “meds” (anchor institutions dedicated to health) that address social needs and social determinants of health have generated considerable community-based activity over the past several decades. Yet to date, virtually no research has analyzed their current status or effect on community health. To assess the current state and potential best practices of anchor meds, we conducted a search of the literature, a review of Web sites and related public documents of all declared anchor meds in the country, and interviews with 14 key informants. We identified potential best practices in adopting, operationalizing, and implementing an anchor mission and using specific social determinants of health strategies, noting early outcomes and lessons learned. Future dedicated research can bring heightened attention to this emerging force for community health.
Comparison of State Hospital Visits With Housing and Urban Development Estimates of Homeless: Illinois, 2011–2018
Authors: Madigan Dana , Forst Linda , Friedman Lee S. 
Published: January 2020

Objectives. To assess the value of hospital records in augmenting information on homelessness counts at a state level. Methods. We used data from the Illinois Hospital Discharge Database (2011–2018) to identify outpatients and inpatients identified as affected by homelessness. We used probabilistic linkage methodology to estimate unique individuals rather than visits and compared them with US Department of Housing and Urban Development annual estimates of homelessness based on point-in-time counts. Results. Department of Housing and Urban Development point-in-time estimates indicate a substantial decline of approximately 24% in homelessness in Illinois; however, estimates of unique individuals visiting the hospital with a code for homelessness more than doubled in this same period. Conclusions. Other data sources, such as hospital records, are increasingly able to identify and report information related to homelessness. Using these additional data sources may help to augment the Department of Housing and Urban Development point-in-time estimates to provide more accurate estimates of homelessness that are used to direct resources and assess policy and support services for those affected by homelessness.
Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives.
Authors: Noel Kimberly , Messina Catherine , Hou Wei , Schoenfeld Elinor , Kelly Gerald 
Published: January 2020

Abstract
Background: Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups.Results: The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting A cohort study
Authors: Hirosawa Takanobu , Harada Yukinori , Morinaga Kohei , Takase Hiroshi , Nin Michihiro , Shimizu Taro 
Published: January 2020

Abstract
Background Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. Methods This study was a retrospective cohort study. The outpatient department and general internal medicine department of a tertiary university hospital in Japan. A total of 189 adult patients with at least 2 sets of blood cultures obtained during January 1–December 31, 2018, after excluding those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, a history of haematological cancer, or eosinophilia. The diagnostic accuracies of each univariate variable and the multivariable logistic regression models were assessed by calculating the areas under the receiver operating characteristic curves (AUROCs). The primary outcome was a positive blood culture indicating bloodstream infection. Results Severe eosinopenia (<10 cells/mm3) alone yielded little overall predictive ability (AUROC: 0.606, 95% confidence interval (CI): 0.502–0.710, P=0.035), and only moderate sensitivity (50%, 95%CI: 29–70%) and specificity (71%, 95%CI: 63–78%). The model comprising baseline variables (age, sex) and the C-reactive protein level yielded an AUROC of 0.7384, and the further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.7547 (P=0.4297) and a statistically significant net reclassification improvement (NRI) (P=0.03). However, the integrated discrimination index (IDI) (P=0.282) remained non-significant. Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection in a general internal medicine setting.
Linc01234 promotes cell proliferation and metastasis in oral squamous cell carcinoma via miR-433/PAK4 axis
Authors: Liu Deyu , Jian Xinchun , Xu Pu , Zhu Rong , Wang Yuan 
Published: January 2020

Abstract
Background: Increasing studies have demonstrated that long non-coding RNAs (lncRNAs) play an important role in tumor progression. However, the potential biological functions and clinical importance of Linc01234 in oral squamous cell carcinoma (OSCC) remain unclear. Methods: We evaluated the expression profile and prognostic value of Linc01234 in OSCC tissues by RT-qPCR. Then, functional in vitro experiments were performed to investigate the effects of Linc01234 on tumor growth, migration and invasion in OSCC. Mechanistically, RT-qPCR, bioinformatic analysis and dual luciferase reporter assays were performed to identify a competitive endogenous RNA (ceRNA) mechanism involving Linc01234, miR-433-3p and PAK4. Results: We found that Linc01234 was clearly upregulated in OSCC tissues and cell lines, and its level was positively associated with T stage, lymph node metastasis, differentiation and poor prognosis of patients with OSCC. Our results shown that Linc01234 inhibited cell proliferation and metastatic abilities in CAL27 and SCC25 cells following its knockdown. Mechanistic analysis indicated that Linc01234 may act as a ceRNA (competing endogenous RNA) of miR-433-3p to relieve the repressive effect of miR-433-3p on its target PAK4. Conclusions: Our results indicated that Linc01234 promotes OSCC progression through the Linc01234/miR-433/PAK4 axis and might be a potential therapeutic target for OSCC.
CD8-positive memory T cells in tumor-draining lymph nodes of patients with breast cancer
Authors: Vahidi Yasmin , Bagheri Mandana , Ghaderi Abbas , Faghih Zahra 
Published: January 2020

Abstract
Background: Human immunological memory is a hallmark of the adaptive immune system and plays an important role in the development of effective immune responses against tumors. In the present study, we aimed to determine the frequencies of CD8+ memory T cell subsets including stem memory T cells (TSCM) in tumor-draining lymph nodes of patients with breast cancer (BC). Methods: Mononuclear cells were obtained from axillary lymph nodes of 52 untreated patients with BC and stained for CD8, CCR7, CD45RO, CD95 markers to detect different subtypes of memory cells in the CD8+ lymphocyte population. Data were acquired on four-color flow cytometer and analyzed with CellQuest Pro software. Results: We observed that 47.65±2.66% of CD8+ lymphocytes expressed the CD45RO, a marker for memory T cells. Statistical analysis showed that the total frequency of central memory T cells (TCM) and their subset with low CD45RO expression was significantly higher in tumor-involved nodes compared to tumor-free ones (P=0.024 and P=0.017, respectively). The level of CD95 expression (based on mean fluorescence intensity) on the surface of TCM, their CD45ROhi and CD45ROlow subsets, and TSCM was higher in patients with stage II compared to those in stage I (P<0.05). In addition, the percentage of naive CD8+ T cells was significantly lower in tumor-involved lymph nodes compared to tumor-free ones (P=0.025). Conclusions: Our data collectively indicate no significant differences in the frequencies of CD8+ lymphocytes or their memory subsets in tumor-draining lymph nodes of patients with BC. However, the frequency of CD45low TCM was higher in tumor-involved nodes. Along with a decrease in the frequency of naive T cells, the higher frequency of CD45low TCM suggests that despite the immune reaction to provide a pool of effective memory cells, it is blocked in early-stage of memory cells’ differentiation (CD45ROlow), probably by tumor-derived suppressive factors. Identifying the molecular and cellular mechanisms behind this suppression can provide invaluable tools for adoptive T cell therapies in cancer.
Perspectives of General Practitioners and Nursing Staff on Acute Hospital Transfers of Nursing Home Residents in Germany: Results of two cross-sectional Studies
Authors: Fassmer Alexander Maximilian , Pulst Alexandra , Spreckelsen Ove , Hoffmann Falk 
Published: January 2020

Abstract
Background: Visits in emergency departments and hospital admissions are common among nursing home (NH) residents and they are associated with significant complications. Many of these transfers are considered inappropriate. This study aimed to compare the perceptions of general practitioners (GPs) and NH staff on hospital transfers among residents and to illustrate measures for improvement.Methods: Two cross-sectional studies were conducted as surveys among 1,121 GPs in the German federal states Bremen and Lower Saxony and staff from 1,069 NHs (preferably nursing staff managers) from all over Germany, each randomly selected. Questionnaires were sent in August 2018 and January 2019, respectively. The answers were compared between GPs and NH staff using descriptive statistics, Mann-Whitney U tests and χ2-tests.Results : We received 375 GP questionnaires (response: 34%) and 486 NH questionnaires (response: 45%). GPs estimated the proportion of inappropriate transfers higher than NH staff (hospital admissions: 35.0% vs. 25.6%, p<0.0001; emergency department visits: 39.9% vs. 20.9%, p<0.0001). The majority of NH staff and nearly half of the GPs agreed that NH residents do often not benefit from hospital admissions (NHs: 61.4% vs. GPs: 48.8%; p=0.0009). Both groups rated almost all potential measures for improvement differently (p<0.0001), however, GPs and NH staff considered most areas to reduce hospital transfers importantly. The two most important measures for GPs were more nursing staff (91.6%) and better communication between nursing staff and GP (90.9%). NH staff considered better care / availability of GP (82.8%) and medical specialists (81.3%) as most important. Both groups rated similarly the importance of explicit advance directives (GPs: 77.2%, NHs: 72.4%; p=0.1492).Conclusions : A substantial proportion of hospital transfers from NHs were considered inappropriate. Partly, the ratings of possible areas for improvement differed between GPs and NH staff indicating that both groups seem to pass the responsibility to each other. These findings, however, support the need for interprofessional collaboration.
Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease
Authors: Huang Zihan , Liu Xiang , Yang Fei , Wang Guoxin , Ge Nan , Wang Sheng , Guo Jintao , Sun Siyu 
Published: January 2020

Abstract
Background : Owing to the development of double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in recent years, direct visualization of the entire small intestinal mucosa has become possible. Because of the nonspecific symptoms and the anatomic location of the small bowel, diagnosis of isolated small bowel Crohn’s disease (CD) remains a challenge. The aim of this research was to explore the value of DBE for isolated small bowel CD in situations where routine tests cannot confirm the diagnosis. Methods : This study included patients with suspected isolated small bowel CD who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients presenting with chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic CD were excluded from this cohort. Patients with suspected isolated small bowel CD underwent DBE. Results: In 16/18 patients, pathological findings were detected by DBE. In 12 of the cases, small bowel CD was confirmed. The remaining four patients were diagnosed with small bowel inflammation, duodenal carcinoma, ileum inflammation and small bowel ulcers. However, the diagnosis of CD was confirmed in 14/18 (78%) patients by taking into account the clinical presentation, endoscopic and histological results as well as the experimental treatment. DBE assisted in the diagnosis in 86% (12/14) of the patients. Conclusions : In the diagnosis of small bowel CD, DBE is a helpful tool. Before assessment with DBE, clinical features, colonoscopy, and CT were used to initially assess the intestine. According to the lesions indicated by CT, we chose the most appropriate endoscope insertion route, and combined the endoscopic characteristics and pathological results of DBE to confirm the diagnosis.
Icotinib is as efficacious as gefitinib for brain metastasis of EGFR mutated non-small-cell lung cancer
Authors: Liu Kejun , Jiang Guanming , Zhang Ailing , Li Zhuanghua , Jia Jun 
Published: January 2020

AbstractBackground: The prognosis of non-small-cell lung cancer (NSCLC) with brain metastases is very poor. Currently, therapeutic methods for this patient population include whole-brain radiation therapy (WBRT), surgery, radiosurgery and systemic treatment. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) could be effective on cerebral metastases of mutated NSCLC. However, which EGFR-TKIs is more appropriate is still unknown. Methods: We conducted a retrospective analysis of advanced NSCLC patients with brain metastases for EGFR targeted therapy from November 2013 to April 2018 at Dongguan People’s Hospital, Southern Medical University, China. A total of 43 patients were recruit in this study. Among them, 21 cases received icotinib (125 mg, thrice a day) and 22 cases received geﬁtinib (250 mg, once a day) until disease progression or unacceptable toxicity. The primary end point of this study was intracranial PFS (iPFS). The relationships between therapeutic arms and patients characteristics were performed using Pearson’s chi-square test or Fisher’s exact test. The differences in PFS among the two arms were analyzed using Kaplan-Meier curves and log rank tests. Results: There was no significant difference of intracranial ORR (66.6% versus 59.1%, P =0.62) and DCR (85.7% versus 81.8%, P =0.73) between the two arms. The median intracranial PFS (iPFS) for icotinib and gefitinib arms were 8.4 months (95% CI, 5.4 to 11.3 months) and 10.6 months (95% CI, 6.3 to 14.8 months), respectively ( P =0.17). Adverse events of the two study arms were generally mild. None of the patients experienced dose reduction of EGFR-TKIs. Conclusions: Our study showed that icotinib and geﬁtinib had similar efficacy for brain metastasis of EGFR mutated NSCLC. Large randomized studies are suggested to further illuminate the effect of these two EGFR-TKIs on cerebral lesions of NSCLC.
Posterior only instrumented fusion provides incomplete curve control for early-onset scoliosis in type 1 neurofibromatosis
Authors: Cai Siyi , Li zhenyao , Qiu Guixing , shen Jianxiong , zhao hong , Zhao Yu , Wang Yipeng , Zhang Jianguo 
Published: January 2020

Abstract
Background: The mid-long term outcomes of posterior spinal fusion in pediatric neurofibromatosis type 1 (NF-1) patients are rarely reported, so does the effectiveness of itsorthopeidc maintenance function. This study aims to evaluate the mid-long term surgical outcomes of posterior only instrumented spinal fusion for early-onset scoliosis (EOS) in NF-1 patients. Methods: A retrospective review was performed on a cohort of 10 NF-1 patients having EOS from 2008 to 2014 in our hospital, including four male and six female patients with an age averaged at 7.8 years old when they underwent posterior only instrumented spinal fusion for their EOS. Both general clinical data and surgical specific data of the patients were collected and reviewed, and the dystrophic progression of EOS was evaluated during the follow-up. Results: The average duration of follow-up was 54 months (24 to 88 months). All patients underwent posterior only instrumented spinal fusion at 1 stage. The primary curves of EOS were thoracic in 9 cases and 1 patient had lumbar scoliosis. Preoperative major curve was significantly corrected (from 66.1 to 31.1 degrees). However, the major curve deteriorated significantly to 40.1 degrees on average at the end of the follow-up. The T1-S1 distance increased 2.8 cm on average and kept increasing at a rate of 0.6cm/year during the follow-up. Conclusions: Posterior only fusion surgery was not a good option to treat the EOS in NF-1 patients despite the relatively short segments involvement in the disease. The maintenance of orthopedic effect after treatment was not satisfactory.
Stress, stressors and related factors in clinical learning of midwifery students in Iran: a cross sectional study
Authors: Rezaei Behrooz , Falahati Juliana , Beheshtizadeh Raziyeh 
Published: January 2020

Abstract
Background: Midwifery is an emotionally challenging profession, and academic education of midwifery especially clinical learning has its own specific challenges. Midwifery students face with stressful experiences, especially related to instructor and characteristics of clinical environment, which can affect their theoretical and practical abilities. There is insufficient evidence in this field. This study aimed to explore (1) the perceived stress and stressors of midwifery students and (2) the relationships between students' stress and related factors in clinical learning environment.
Methods: A cross sectional, survey design was conducted at one university in Iran. A sample of 108 students was selected using Krejcie and Morgan table in 2016. Data was collected using Persian version of Cohen's perceived stress scale, Persian questionnaire of sources of stress and demographic form. Data was analyzed using independent t, ANOVA and correlation coefficient test (α<0.05).
Results: Participants returned 70 surveys (response rate, 64.8%). Approximately 56 % of the students perceived a high level of stress. The most common dimensions of stressors were "unpleasant emotions" and "humiliating experiences". The highest stressors were included "feeling suffering due to seeing for patients with critical situation", "instructor’s admonition in the presence of clinical staff" and "communication with instructor". The "interest in the field of study" had a negative impact on perception of stressors in dimensions of "clinical practices" and "interpersonal communication".
Conclusions: The midwifery students reported their stress in severe level, especially in dimensions of "unpleasant emotions" and "humiliating experiences". The factors associated with the instructors have caused more stress in students. These findings will highlight need for supportive strategies by the clinical instructors. In this regard, the use of experienced instructors, the development of communication skills of the instructors, increasing coping skills of the students and the creation of a supportive environment may be helpful.
Keywords: Clinical Learning Environment, Clinical Education, Clinical Preceptorship, Midwifery Education, Stress, Student, Midwifery, Instructor