bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation via Instant Messaging-Birmingham Advance (SIMBA) model helped improve clinicians’ confidence to manage cases in diabetes and endocrinology
Authors: Melson Eka , Davitadze Meri , Aftab Manal , Ng Cai Ying , Ooi Emma , Blaggan Parisha , Chen Wentin , Hanania Thia , Thomas Lucretia , Zhou Dengyi , Chandan Joht Singh , Senthil Latha , Arlt Wiebke , Sankar Sailesh , Ayuk John , Karamat Muhammad Ali , Kempegowda Punith 
Published: July 2020

Abstract
Background: Simulation-based learning (SBL) has been increasingly used in both undergraduate and postgraduate medical training curricula. The aim of Simulation via Instant Messaging-Birmingham Advance (SIMBA) is to create a simple virtual learning environment to improve trainees’ self-reported confidence in diabetes and Endocrinology. Methods: This study was done as part of the continuous professional development for Health Education England West Midlands speciality trainees in diabetes and Endocrinology. Standardized transcripts of anonymized real-life endocrinology (endocrine session) and diabetes cases (diabetes session) were used in the simulation model. Trainees interacted with moderators through WhatsApp® in this model. All cases were then discussed in detail by a consultant endocrinologist with reference to local, national and international guidelines. Trainee acceptance rate and improvement in their self-reported confidence levels post-simulation were assessed.Results: 70.8% (n=17/24) and 75% (n=18/24) strongly agreed the simulation session accommodated their personal learning style and the session was engaging. 66.7% (n=16/24) strongly felt that the simulation was worth their time. In the endocrine session, there was a significant improvement in trainees’ confidence in the management of craniopharyngioma (p=0.0179) and acromegaly (p=0.0025). There was a trend towards improved confidence levels to manage Cushing’s disease and macroprolactinoma. In diabetes session, there was a significant improvement in trainees’ confidence to interpret continuous glucose monitor readings (p = 0.01). There was a trend towards improvement for managing monogenic diabetes, hypoglycaemic unawareness and interpreting Libre readings. Overall, there was a significant improvement in trainees’ confidence in managing cases that were discussed post-simulation. Conclusion: SIMBA is an effective learning model to improve trainees’ confidence to manage various diabetes and endocrine case scenarios. More sessions with a variety of other speciality case scenarios are needed to further assess SIMBA’s effectiveness and application in other areas of medical training.
A study of knowledge, attitudes, and practices of primary care physicians toward anticoagulant therapy in patients with non-valvular atrial fibrillation in Shanghai, China
Authors: Ye Shasha , Wang Tianhao , Liu Arthur , Yu Ying , Pan Zhigang , Gu Jie 
Published: July 2020

Abstract
Background:As a large number of Community Health Service (CHS) centers in China face the majority of patients with non-valvular atrial fibrillation (NVAF), primary care physicians (PCPs) play a primary role in the prevention of embolization. Therefore, an awareness of anticoagulant management in patients with NVAF must be brought into focus among PCPs in China. This study investigated PCPs’ knowledge, attitudes, and practices toward anticoagulant therapy in patients with NVAF, to help them understand their shortcomings regarding oral anticoagulant (OAC) therapy in preventing embolization.Method:This was a cross-sectional observational study of 462 PCPs in CHS centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program.Result:Among 462 participants, 69.3% (320/462) of females received a medical bachelor’s degree and over 50% of participants had more than 10 years of work experience. Each section for knowledge, attitude, and practice were categorized as poor (≤39.0%), fair (40.0%–69.0%), and good (≥70.0%). The level of knowledge of OAC therapy for patients with NVAF among PCPs was insufficient in over half (75.8%) of the participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of patients with NVAF.Conclusions: The knowledge and behaviors of PCPs were insufficient for OAC therapy to prevent embolization in patients with NVAF. The study also revealed that there is good potential for PCPs’ educational interventions to positively impact the care of patients with NVAF.
Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty
Authors: CHAN Gordon Chun-Kau , NG Jack Kit-Chung , CHOW Kai-Ming , Kwan Bonnie CH , KWONG Vickie Wai-Ki , PANG Wing-Fai , CHENG Phyllis Mei-Shan , LAW Man-Ching , LEUNG Chi-Bon , LI Philip Kam-Tao , Szeto Cheuk Chun 
Published: July 2020

Abstract
Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.
Biomechanical and morphological changes of rabbit corneas under collagenase type II and negative pressure: three months follow-up observation
Authors: Chen Xinyan , Qin Xiao , Yu Mengyao , Zhang Haixia , Li Lin 
Published: July 2020

Abstract
Background

To investigate biomechanical and morphological changes of rabbit cornea ectasia induced by collagenase type II and negative pressure during 3 months after treatment.

Method

Eighteen New Zealand white rabbits were randomly and evenly arranged into three groups. The left corneas were continuously treated by negative pressure suction (NP group) with 500 mmHg for 30 min once two days, three times in total. The central area of left corneas were soaked in the collagenase type II (CII group) solution (200 μL of 3 mg/ml) for 30 min. The left corneas (CP group) were disposed as CII group firstly, then applied negative pressure suction as NP group for once after 5 days. All right corneas were treated as control eyes. Corneal morphology parameters and Ocular Response Analyzer (ORA) output parameters were collected in vivo once a week for three weeks after treatment and before execution. Histology and biomechanics were tested in vitro at the third month after treatment. Paired t-test and repeated measures analysis were used to determine if there were differences in biomechanical and morphological related parameters across time.

Results

In NP group, corneal thickness and diopter changed to some extent after treatment immediately, and the elastic modulus increased and relaxation degree slowed after 3 months. In CII group, corneal diopter increased, corneal central thickness (CCT) and corneal hysteresis (CH) decreased at the second week after treatment, which showed the characters of ectatic corneas. Then the degree of ectasia decreased with time. No regular changes was found on experimental corneas in CP group.

Conclusions

Collagenase type II results in ectatic corneas around two weeks after treatment, but the degree of ectasia decreased with time, and there was no significant difference compared with the controls after 3 months. After negative pressure suction, corneal morphology changed in a short period, and elastic modulus increased and relaxation time increased after a three months recovery, indicating that the negative pressure suction do have a certain effect on corneas.
Infection of highly insecticide-resistant malaria vector Anopheles coluzzii with entomopathogenic bacteria Chromobacterium violaceum reduces its survival, blood feeding propensity and fecundity
Authors: Gnambani Edounou Jacques , Bilgo Etienne , Sanou Adama , Dabire Roch K. , Diabate Abdoulaye 
Published: July 2020

Abstract
Background: This is now a concern that malaria eradication will not be achieved without the introduction of novel control tools. Microbiological control might be able to make a greater contribution to vector control in the future. The interactions between bacteria and mosquito make mosquito microbiota really promising from a disease control perspective. Here, we studied the impact of Chromobacterium violaceum infections isolated from both larvae and adult of wild caught Anopheles gambiae s.l. mosquitoes in Burkina Faso on mosquito survival, blood feeding and fecundity propensy. Methods: To assess entomopathogenic effects of C. violaceum infection on mosquitoes, three different types of bioassays were performed in laboratory. These bioassays aimed to evaluate the impact of C.violaceum infection on mosquito survival, blood feeding and fecundity, respectively. During bioassays mosquitoes were infected through the well-established system of cotton ball soaked with 6% glucose containing C.violaceum.Results: C. violaceum kills pyrethroid resistant mosquitoes An. coluzzii (LT80 of 8.78 days ± 0.18 at 108 bacteria cell/ml of sugar meal). Interestingly, this bacterium had other negative effects on mosquito lifespan by significantly reducing (~59%, P<0.001) the mosquito feeding willingness from day 4-post infection (~81% would seek a host to blood feed) to 9- day post infection (22 ± 4.62% would seek a host to blood feed). Moreover, C. violaceum considerably jeopardized the egg laying (~16 eggs laid /mosquitoes with C. violaceum infected mosquitoes vs ~129 eggs laid / mosquitoes with control mosquitoes) and hatching of mosquitoes (A reduction of ~22 % of hatching rate with C. violaceum infected mosquitoes). Compared to the bacterial uninfected mosquitoes, mosquitoes infected with C. violaceum showed indeed significantly higher retention rates of immature eggs and follicles. Conclusion: These data showed important properties of Burkina Faso C. violaceum strains, which are highly virulent against insecticide resistant Anopheles coluzzii, and reduce both mosquito blood feeding and fecundity propensities. However, additional studies as the sequencing of C. violaceum genome and the potential toxins secreted will certainly provide useful information render it a potential candidate for the biological control strategies of malaria and other disease vectors.
An Audit Tool for Longitudinal Assessment of the Health-Related Characteristics of Urban Neighborhoods: Implementation Methods and Reliability Results
Authors: Dastidar Bonnie Ghosh , Hunter Gerald , Sloan Jennifer C , Collins Rebecca L , Richardson Andrea S , Troxel Wendy , Colabianchi Natalie , Dubowitz Tamara 
Published: July 2020

Abstract
Background: Improving the neighborhood environment may help address chronic disease and mortality. To identify neighborhood features that are predictors of health, objective assessments of the environment are used. Multiple studies have reported on cross-sectional assessments of health-related neighborhood features using direct observation. As study designs expand to better understand causation and predictors of change, there is a need to test whether direct observation methods are adequate for longitudinal assessment. To our knowledge, this is the first study to report on the reliability of repeated measurements of the neighborhood environment, and their stability, over time.Methods: The Pittsburgh Hill/Homewood Research on Neighborhood Change and Health (PHRESH) study conducted longitudinal assessments in two low-income, African American neighborhoods at three waves (years 2012, 2015, 2017). The PHRESH audit tool is a modification of earlier validated tools, with an emphasis on environment features relevant for physical activity, sleep, and obesogenic behaviors. Trained data-collector pairs conducted direct observations of a 25% sample of street segments in each neighborhood. At each wave, we audited a sub-sample of street segments twice and assessed reliability using percentage inter-observer agreement and krippendorf’s alpha statistics. Stability of these items was assessed as exhibiting moderate or high agreement at every time point. Results: Across waves, a majority (81%) of the items consistently demonstrated moderate to high agreement except for items such as public/communal space, amount of shade, sidewalk features, number of traffic lanes, garden/flower bed/planter, art/statue/monument, amount of trash, and physical disorder. The list of items with poor agreement includes features that are easy to miss (e.g. flower bed/planter), hard to assess from outside (e.g. public/communal space), or may change quickly (e.g. amount of trash). Conclusion: In this paper, we have described implementation methods, reliability results and lessons learned to inform future studies of change. We found the use of consistent methods allowed us to conduct reliable, replicable longitudinal assessments of the environment. Items that did not exhibit stability are less useful for detecting real change over time. Overall, the SSA direct observation tool is an effective and practical instrument to detect change in the neighborhood environment.
Adaptive Multi-Scale Feature Fusion Based Residual U-net for Fracture Segmentation in Coal Rock Images
Authors: Lu Fengli , Fu Chengcai , Zhang Guoying , Shi Jie 
Published: July 2020

Abstract
Accurate segmentation of fractures in coal rock CT images is important for safe production and the development of coalbed methane. However, the coal rock fractures formed through natural geological evolution, which are complex, low contrast and different scales. Furthermore, there is no published data set of coal rock. In this paper, we proposed adaptive multi-scale feature fusion based residual U-uet (AMSFFR-U-uet) for fracture segmentation in coal rock CT images. The dilated residual blocks (DResBlock) with dilated ratio (1,2,3) are embedded into encoding branch of the U-uet structure, which can improve the ability of extract feature of network and capture different scales fractures. Furthermore, feature maps of different sizes in the encoding branch are concatenated by adaptive multi-scale feature fusion (AMSFF) module. And AMSFF can not only capture different scales fractures but also improve the restoration of spatial information. To alleviate the lack of coal rock fractures training data, we applied a set of comprehensive data augmentation operations to increase the diversity of training samples. Our network, U-net and Res-U-net are tested on our test set of coal rock CT images with five different region coal rock samples. The experimental results show that our proposed approach improve the average Dice coefficient by 2.9%, the average precision by 7.2% and the average Recall by 9.1% , respectively. Therefore, AMSFFR-U-net can achieve better segmentation results of coal rock fractures, and has stronger generalization ability and robustness.
An unlabelled probe-based real time PCR and modified semi-nested PCR as molecular tools for analysis of chloroquine resistant Plasmodium vivax isolates from Afghanistan
Authors: Mosawi Sayed Hussain , Dalimi Abdolhossein , Safi Najibullah , Fotouhi-Ardakani Reza , Ghaffarifar Fatemeh , Sadraei Javid 
Published: July 2020

Abstract
Background Plasmodium vivax resistance to chloroquine (CQ) has been reported from many endemic regions in the world. Plasmodium vivax is responsible for 95% of malaria cases in Afghanistan and CQ is the first-line treatment given for treatment of vivax malaria. The pvmdr-1 and pvcrt-o (K10 insertion) genes are possible markers for CQ-resistance in P. vivax isolates. There have been no studies done on the presence or absence of molecular markers for CQ-resistance P. vivax in Afghanistan. The present work aimed to evaluate the frequency of mutations in the pvmdr-1 and K10 insertion in the pvcrt-o genes of P. vivax.
Methods
Plasmodium vivax isolates were collected from Laghman, Baghlan and Khost provinces. For investigation of polymorphisms of desired regions in pvmdr-1 and pvcrt-o genes, sequencing was applied on the PCR products. A new asymmetric qPCR and melting analysis assay based on unlabelled probe developed for scanning of K10 insertion in pvcrt-o gene.
Results
The analysis of sequencing data of the pvmdr-1 gene showed wild type Y976 and K997 and mutant M958 and L1076 in 33 isolates from three provinces. Of the 36 samples evaluated for K10 insertion in pvcrt-o , 2/18(11%), 0/10(0%) and 0/8(0%) isolates from Laghman, Baghlan and Khost province, respectively, possessed K10 insertion, confirmed by either sequencing and unlabelled probes.
Conclusion
Two samples with K10 insertion and 33 samples with pvmdr1 polymorphism, indicating on the possibility of CQ resistance in P. vivax populations in Afghanistan. Furthermore, unlabelled probes are simple and inexpensive alternative tools for screening of P. vivax mutations.
Knowledge, attitudes, and practices of primary health care physicians regarding the pre-travel counselling of patients with type 2 diabetes in Riyadh, Saudi Arabia
Authors: Alduraibi Rabia Khalid , Almigbal Turky H , Alrasheed Abdullah A , Batais Mohammed Ali 
Published: July 2020

Abstract
Background: Travel has become an integral part of Saudi life. People with diabetes face many challenges while travelling that can have detrimental effects on glycaemic control. However, no previous studies have investigated pre-travel counselling in Saudi Arabia. This study aims to assess the knowledge, attitudes and practices of primary health care (PHC) physicians regarding pre-travel counselling for patients with type 2 diabetes.Methods: This cross-sectional study was conducted in PHC centres under the Ministry of Health in Riyadh, Saudi Arabia, during the period 2018-2019. A cluster multistage random sampling technique was used to recruit physicians. The data were collected through a self-administered questionnaire.Results: Three hundred and eighty-five primary health care physicians were recruited. This study showed that more than half (57.9%) of PHC physicians had poor knowledge scores. Additionally, the following characteristics were significantly associated with poor knowledge: being younger in age, being male, being Saudi, being a general practitioner, and having limited (0-5 years) experience. A total of 183 (47.5%) subjects showed disagreement attitudes towards the importance of pre-travel counselling among patients with diabetes. Furthermore, these disagreement attitudes were significantly associated with being older and having more years of experience. The majority (62.6%) of the physicians had poor practice scores. Poor practices were detected among physicians who were younger, male, and Saudi and who had a general practitioner specialty and degree.Conclusions: It could be concluded that a gap was detected in the knowledge and practices of primary health care physicians regarding pre-travel counselling for people with type 2 diabetes. Therefore, it is necessary to create easily accessible travel medicine education programmes for Saudi PHC providers to improve the management of travellers with diabetes.Trial registrationNot applicable
Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study
Authors: zhang linyuan , liu zhiqing , wang yueting , yu chao , tang jian , sun yuehua , zhu zhen'an , xu chen , liu fengxiang 
Published: July 2020

Abstract
Background: Posterior pilon fracture (PPF) is a serious ankle injury caused by combined vertical and rotational trauma. Surgical treatment includes buttress plate (BP), anteroposterior screw (APS) and posteroanterior screw (PAS) fixation. This study aimed to compare the therapeutic effects after PPF internal fixation with BPs and APSs. Methods: From January 2015 to June 2018, 37 patients with PPFs underwent surgical treatment in our institution. The patients were divided into the BP (11 patients) and APS (26 patients) groups according to the internal fixation method. Bone healing time and postoperative complications were recorded. At the last follow-up, American Orthopedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) scores and Burwell-Charnley scores were used to evaluate ankle joint function, ankle joint pain, and fracture reduction on imaging, respectively. Results: No significant difference in bone healing time was found between the two groups (P > 0.05). Local necrosis of the posterolateral incision and chronic ankle pain occurred in 1 case each in the BP group. Chronic ankle joint pain occurred in 4 cases in the APS group. Two cases of soft tissue irritation were caused by screws that were too long. Local numbness of the posterolateral incision occurred in 1 case. At the last follow-up, no significant difference in VAS scores between the two groups at rest (P = 0.477), but a significant difference during exercise was noted (P = 0.033). AOFAS scores were better in the BP group than those in the APS group (P = 0.002). According to the Burwell-Charnley scoring system, 11 cases were anatomically reduced in the BP group. In the APS group, anatomical reduction was achieved in 19 cases and fair in 7 cases. Conclusion: Compared with APSs, BPs resulted in better reduction, ankle joint functional recovery and complication rates. BPs are recommended for internal fixation of PPFs.