bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-delivery of Dacarbazine and All-Trans Retinoic Acid (ATRA) Using Lipid Nanoformulations for Synergistic Antitumor Efficacy Against Malignant Melanoma
Authors: Li Chenyang , Han Xiuping 
Published: May 2020

AbstractMalignant melanoma is a highly aggressive skin cancer responsible for 80% of mortality, and the overall median survival in patients with metastatic melanoma is only 6–9 months. Combination treatment through the simultaneous administration of dual drugs in a single nanocarrier has been demonstrated to be elegant and effective in combatting cancer. Herein, we employ a combination therapy based on dacarbazine (DBZ), FDA approved drug for melanoma and all-trans retinoic acid (ATRA), promising anticancer agents loaded on lipid nanoformulations (RD-LNF) as a new treatment strategy for malignant melanoma. We have successfully encapsulated both the drugs in lipid nanoformulations and showed a controlled release of payload over time. We demonstrated that the simultaneous delivery of DBZ and ATRA could effectively reduce cell proliferation in a concentration-dependent manner. The combinational nanoparticles significantly reduced the colony formation ability of B16F10 melanoma cells. Flow cytometer analysis showed that RD-LNF induced a greater proportion of apoptosis cells with significant inhibition of cell cycle progression and cell migration. These results suggest the promising potential of RD-LNF in the treatment of malignant melanoma with high efficacy.
Keeping up with the information explosion: a surge in consumption of data on pediatric SARS-CoV-2 infection by pediatric emergency physicians
Authors: Feldman Oren , Boukai Amit , Shavit Itai 
Published: May 2020

AbstractPEM-Database.org is an unaffiliated, not-for-profit website, dedicated to the field’s advancement of pediatric emergency medicine. PEM-Database published the first early access pediatric-related SARS-CoV-2 articles on March 13th, two days following the World Health Organization’s declaration of a global pandemic. Over the following 2 weeks, the number of PEM-Database entries increased dramatically. This surge expresses interest by pediatric emergency medicine physicians in data on pediatric SARS-CoV-2 infection.
Fast-track breeding system to introduce CTV resistance of trifoliate orange into citrus germplasm, by integrating early flowering transgenic plants with marker-assisted selection
Authors: Endo Tomoko , Fujii Hiroshi , Omura Mitsuo , Shimada Takehiko 
Published: May 2020

AbstractBackgroundGlobal warming will expand the range of new and invasive pathogens in orchards, and subsequently increase the risk of disease epidemics and economic losses. The development of new resistant plant varieties can help to reduce the impact of pathogens, however, the breeding speed can be extremely slow, due to the growth rates of the plants, and the availability of resistance genes. Citrus trees are suffering immense damage from serious diseases such as citrus canker (XCC), huanglongbing (HLB), and citrus tristeza virus (CTV). A fast-track breeding system, that aimed at shortening the duration for disease resistance breeding by incorporating the resistance genes from related species to commercial varieties, has been developed using the integration of precocious transgenic trifoliate orange with the overexpression ofCiFTand MAS. It was applied here to incorporate CTV resistance of trifoliate orange into citrus germplasm.ResultsOne generation of backcrossed breeding, that would normally take at least 5 years, was achieved in a single year by fast-track breeding system. Linkage analysis using the corresponding DNA markers revealed that CTV resistance and T-DNA integrated regions were found in different linkage groups, and they were independently segregated in the BC progenies. The CTV resistant null segregants, in which the T-DNA integrated region was removed from their genome, were feasibly obtained by MAS in each generation of the BC progenies, and their CTV resistance was confirmed by immunological analysis. Several BC3null segregants, whose genetic backgrounds had been substituted into citrus germplasm, except for the haplotype block of CTV resistance, were successfully obtained. CGH and NGS analyses revealed that the T-DNA integrated region was safely segregated out in null segregants.ConclusionFast-track breeding systems are expected to shorten the required breeding time by more than one-fifth in comparison with conventional cross breeding techniques. Using this system, we obtained BC3–8, whose genetic background was successfully substituted except for the CTV resistance locus, and could be a novel mandarin breeding material. The fast-track breeding system will be useful to introduce important traits from related species to citrus germplasm while also drastically reducing the time required for breeding.
Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study
Authors: Zhao Xin-Ying , Xu Xuan-Xuan , Yin Hai-Sen , Hu Qin-Ming , Xiong Tao , Tang Yuan-Yan , Yang Ai-Ying , Yu Bao-Ping , Huang Zhi-Ping 
Published: May 2020

Abstract
Background
Since December 2019, the 2019 coronavirus disease (COVID-19) has expanded to cause a worldwide outbreak that more than 600,000 people infected and tens of thousands died. To date, the clinical characteristics of COVID-19 patients in the non-Wuhan areas of Hubei Province in China have not been described.

Methods
We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital.

Results
Of the 91 patients diagnosed with COVID-19, 30 cases (33.0%) were severe and two patients (2.2%) died. The severe disease group tended to be older (50.5 vs. 42.0 years; p = 0.049) and have more chronic disease (40% vs. 14.8%; p = 0.009) relative to mild disease group. Only 73.6% of the patients were quantitative polymerase chain reaction (qPCR)-positive on their first tests, while typical chest computed tomography images were obtained for each patient. The most common complaints were cough (n = 75; 82.4%), fever (n = 59; 64.8%), fatigue (n = 35; 38.5%), and diarrhea (n = 14; 15.4%). Non-respiratory injury was identified by elevated levels of aspartate aminotransferase (n = 18; 19.8%), creatinine (n = 5; 5.5%), and creatine kinase (n = 14; 15.4%) in laboratory tests. Twenty-eight cases (30.8%) suffered non-respiratory injury, including 50% of the critically ill patients and 21.3% of the mild patients.

Conclusions
Overall, the mortality rate of patients in Jingzhou was lower than that of Wuhan. Importantly, we found liver, kidney, digestive tract, and heart injuries in COVID-19 cases besides respiratory problems. Combining chest computed tomography images with the qPCR analysis of throat swab samples can improve the accuracy of COVID-19 diagnosis.
Performance of malaria microscopy external quality assessment and networking among health facilities in west Amhara region, Ethiopia
Authors: Tegegne Banchamlak , Ejigu Kefale , Alemu Getaneh , Fetene Yeshimebet , Endaylalu Kindye , Melese Mulatu 
Published: May 2020

Abstract
Background
Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. However, test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous monitoring of the performance of laboratories is of pivotal importance in order to make timely correction.

Methods
A facility based cross-sectional study was conducted from July 2017 to July 2019 to assess malaria microscopy performance among thirty malaria diagnostic laboratories in west Amhara region. Thirty slides were collected from participating laboratories every quarter. Collected slides were taken to Amhara Public Health Institute reference laboratory and re-checked by malaria microscopists who were blind to the results from health facilities. Percentage of test agreement, rates of false positive, false negative and species misdiagnosis were calculated using Excel 2010.

Results
Among a total of 6689 slides re-checked, results of 6146 slides were the same with that of participating laboratories. The test agreement was 97.31 and 94.6% for parasite detection and species identification, respectively. Variations in the overall performance of individual laboratories were seen within a range of 81.55 to 97.27% test agreement. Results of 543 (8.12%) slides were discordant, of which 363 (5.4%), 93 (1.4%) and 87 (1.3%) slides were due to species misdiagnosis, false positive and false negative results, respectively.

Conclusion
There was good test agreement between participated laboratories and Amhara Public Health Institute. More accurate performance is expected as the country is tracking to malaria elimination. Hence, further strengthening the external quality assurance program is recommended.
Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors
Authors: Guo Hong-tao , Bi Xue-han , Lei Ting , Lv Xiao , Yao Guang , Chen Yao , Liu Chang 
Published: May 2020

Abstract
Background
For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients.

Methods
A total of 301 cervical cancer patients were included in the present study from March 2006 to March 2016. There were 156 patents who received adjuvant chemotherapy, while the rest of 145 patents did not receive it. The survival analysis including Overall survival (OS) and disease-free survival (DFS) was assessed by using the Kaplan-Meier method. Cox proportional hazards regression was done to detect factors in predicting the tumor prognosis.

Results
In patients with high pre-treatment SCC-Ag level, those who received adjuvant chemotherapy acquired better prognosis than patients who did not receive it. Particularly, a lower rate of distant metastasis was found in the group of adjuvant chemo-radiotherapy than that in the group of adjuvant radiotherapy. As for patients with low pre-treatment SCC-Ag level, we observed no differences in both the OS and DFS between patients who were given and not given with adjuvant chemotherapy. In the multivariable analysis, adjuvant chemotherapy was significantly correlated with DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level.

Conclusion
Preoperative SCC-Ag can be a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors.
Measuring upper limb function and patient reported outcomes after major breast cancer surgery: a pilot study in an Asian cohort
Authors: Chan Kai Siang , Zeng Ding , Leung Joelle Hoi Ting , Ooi Belinda Si Yin , Kong Kit Teng , Yeo Yi Heng , Goo Jerry Tiong Thye , Chia Clement Luck Khng 
Published: May 2020

Abstract
Background
Breast cancer is the most common cancer in women worldwide. Major breast cancer surgery especially with axillary lymph node dissection (ALND), is associated with upper limb functional decline. Majority of studies are conducted in Western population and may not be applicable to Asians. This pilot study aims to evaluate whether major breast surgery results in upper limb functional impairment in a cohort of Asian women with breast cancer.

Methods
This is a prospective cohort study of 41 patients who underwent 44 major breast surgeries from April 2018 to August 2019. Main inclusion criteria were patients over 21 years of age undergoing major breast surgery for breast cancer. Major breast surgery was defined as wide local excision (WLE) or mastectomy. Main exclusion criteria were patients with pre-existing neurological or rheumatological co-morbidities affecting upper limb function or previous trauma with resulting deformities to the upper limbs. Patients underwent early rehabilitation from post-operative day 1. Shoulder flexion and abduction active range of motion (AROM) and QuickDASH disability score were assessed 1 week before surgery, post-operative week 2 and week 6. Baseline demographics and peri-operative data were also collected.

Results
Median age was 62.5 years. There were 16 (36.4%) wide local excisions and 28 (63.6%) simple mastectomies. Two (4.5%) cases had neoadjuvant chemotherapy. Fifteen (34.1%) cases had ALND. At post-operative week 6, shoulder flexion was comparable to baseline (p = 0.775), while abduction improved from baseline (p = 0.016). However, QuickDASH disability score was significantly worse at post-operative week 6 compared to baseline (median score 2.5 vs 0, p = 0.027). Subgroup analysis of patients with ALND demonstrated significantly worse QuickDASH disability score at post-operative week 6 (p = 0.010) but not for patients with only sentinel lymph node biopsy (p = 0.396).

Conclusion
This pilot study in an Asian cohort found that patients were able to regain AROM of shoulder after major breast surgery at post-operative week 6 but had a worse QuickDASH disability score, especially in the subgroup with ALND. Aggressive and early rehabilitation should be encouraged. However, a longer follow-up is required to evaluate long term functional outcomes.
Predictors of dopamine agonist resistance in prolactinoma patients
Authors: Vermeulen Elle , D’Haens Jean , Stadnik Tadeusz , Unuane David , Barbe Kurt , Van Velthoven Vera , Gläsker Sven 
Published: May 2020

Abstract
Background
Surgical resection of prolactinomas resistant to dopamine agonists is frequently incomplete due to fibrotic changes of the tumour under pharmacological therapy. In order to identify a subgroup of patients who may benefit from early surgery, we thought to investigate possible predictive factors of pharmacological resistance of prolactinomas to dopamine agonists.

Methods
We retrospectively analyzed a database of a Belgian tertiary reference center for patients with pituitary tumours from 2014 to 2016. The groups of interest were patients with dopamine agonist responsive and resistant prolactinomas. The possible predictive factors, including MRI findings, endocrinological parameters, response of tumour and patient factors for dopamine agonist resistance were investigated.

Results
We included 69 patients of whom 52 were women (75,4%) and 17 were men (24,6%). Rate of dopamine agonist resistance was 15.9%. We identified four significant predictors of dopamine agonist resistance: male gender, a large tumour volume, prolonged time to prolactin normalization and presence of a cystic, hemorrhagic and/or necrotic component. In addition, symptoms due to mass effect, high baseline prolactin level and a high contrast capture on MRI are factors that can be taken into consideration.

Conclusion
We identified predictive factors for pharmacological resistance and developed a scoring system for patient specific prediction of resistance to dopamine agonists. This scoring system may have impact on the timing and decision of surgery in prolactinoma patients after further prospective evaluation.
Confidence, attitudes, beliefs and determinants of implementation behaviours among physiotherapists towards clinical management of low back pain before and after implementation of the BetterBack model of care
Authors: Schröder Karin , Öberg Birgitta , Enthoven Paul , Kongsted Alice , Abbott Allan 
Published: May 2020

Abstract
Background
Implementing clinical guidelines is challenging. To facilitate uptake, we developed a model of care (BetterBack Model of Care) and an implementation strategy to support management of low back pain in primary care. The aim of this study was to evaluate physiotherapists´ confidence, attitudes and beliefs in managing patients with low back pain before and after a multifaceted implementation of the BetterBack Model of Care. A further aim was to evaluate determinants of implementation behaviours among physiotherapists.

Methods
This clinical trial was an experimental before and after study within a hybrid type 2 effectiveness-implementation trial. The primary outcome was Practitioner Self-Confidence Scale (PCS), secondary outcomes were the Pain Attitude and Beliefs Scale for Physiotherapists (PABS-PT) and Determinants of Implementation Behaviour Questionnaire (DIBQ). Data was analysed using repeated measures ANOVA and pairwise comparisons.

Results
One hundred sixteen physiotherapists answered a questionnaire before, directly after, as well as 3 and 12 months after implementation of the Model of Care. PCS improved over time with a large effect size post implementation (ηp2 = 0.197, p < 0.001). Changes in PABS-PT were only significant after 12 months with higher biopsychosocial orientation, (ηp2 = 0.071, p < 0.01) and lower biomedical orientation, (ηp2 = 0.136, p < 0.001). Directly after the workshop, after 3 and 12 months, physiotherapists had high ratings on all DIBQ domains, (scores > 50) implying that all were potential facilitators of the implementation. However, after 3 months, all domains had significantly decreased except for organisation, social influence and patient expectation domains. However, after 12 months, organisation and social influence domains had significantly decreased while domains such as knowledge, skills and beliefs about capabilities returned to initial levels.

Conclusions
Physiotherapists´ confidence and biopsychosocial orientation increased after implementation and may have the potential to improve management of low back pain in primary care. The implementation behaviour showed mostly facilitating patterns but changed over time, pinpointing a need to repeatedly monitor these changes. This can inform the need for changes of implementation efforts in different phases and support sustainability strategies.

Trail registration
ClinicalTrials.gov NCT03147300 3 May 2017, prospectivly registered.
Health care seeking behavior among presumptive tuberculosis patients in Ethiopia: a systematic review and meta-analysis
Authors: Gamtesa Dinka Fikadu , Tola Habteyes Hailu , Mehamed Zemedu , Tesfaye Ephrem , Alemu Ayinalem 
Published: May 2020

Abstract
Background
Health seeking behavior is one of the challenges affecting tuberculosis (TB) control program because of its high risk to prolonged diseases transmission and poor treatment outcome. Although there are few primary studies that reported diversified magnitudes of health seeking behavior among presumptive TB patients in Ethiopia, there is no review study that attempted to summarize the available evidence. Thus, this review was aimed to estimate the proportion of health care seeking behavior from health facility and to summarize the reasons why individuals with presumptive TB are not seeking health care in Ethiopia.

Method
A systematic review and meta-analysis study was conducted on primary studies that reported proportion of health seeking behavior among presumptive TB patients. Electronic databases: PubMed, Google Scholar and Science Direct were searched to retrieve studies published in English language from Ethiopia without restricting publication year. In addition, bibliographies of included studies were also screened to retrieve potential studies. The keywords “health seeking”, “health seeking behavior”, “TB suspects” and “presumptive TB” were used both in Medical Subject Heading (MeSH) and free text. Random effects meta-analysis model was used to estimate the pooled proportions of health care seeking and not seeking behaviors. Stata version 14 was used for data analysis.

Result
Five studies which involved 3230 patients with presumptive TB were included into this review. The pooled estimated proportion of health care seeking behavior among presumptive TB patients from health facilities was 65% (95% CI, 54–76%), while the pooled proportion of not seeking health care from any sources was 17% (95% CI;6–27%). In addition, 18% (95% CI; 5–30%) of presumptive TB patients were seeking health care from inappropriate sources. Being female, younger age, low income status, absence of previous TB treatment history, low education status were the risk factors that associated with low health care seeking behavior.

Conclusion
Considerable proportion of patients with presumptive TB were not seeking health care from health facilities or seeks care from inappropriate sources in Ethiopia. Implementing efforts that could improve health care seeking behavior is vital to prevent prolonged disease transmission through immediate treatment commencement.
Perceived organizational culture and its relationship with job satisfaction in primary hospitals of Jimma zone and Jimma town administration, correlational study
Authors: Mesfin Dereje , Woldie Mirkuzie , Adamu Ayinengida , Bekele Fitsum 
Published: May 2020

Abstract
Background
The concept of Organizational Culture (OC) which refers to the pattern of values, norms, beliefs, attitudes and assumptions may not be articulated through verbal language. However, it shapes the way people behave and the way things get done in an organization. The management of organizational culture is increasingly viewed as necessary part of health system reform. Major cultural transformation of an organization must be secured alongside structural and procedural changes in order to achieve desired quality and performances improvements in health systems. It is therefore essential to understand organizational culture, job satisfaction level of the health workers and the link between them.

Methodology
Facility based cross sectional study was conducted in four primary hospitals of Jimma zone and town administration. A self-administered questionnaire was used to collect the data. The collected data were checked for completeness, entered and documented into Epi-data version 3.1 and Exported to SPSS version 21 for analysis. Finally descriptive statistics, Paired t-test and multiple linear regression analysis were used to assess the relationship between organizational culture and job satisfaction and the results were presented using tables and charts.

Result
It was indicated from the finding that, the dominant existing organizational culture typology in the primary hospitals was Hierarchy culture (MS = 22.31, ±2.82).and the preferred organizational culture typology was Innovative culture (MS = 26.09, ±4.72). The health workers had low to medium level of job satisfaction where only (29.40%) of the health workers were very satisfied with their hospital physical working environment. Existing perceived clan culture had positive and significant correlation with health workers’ satisfaction in relation to work relation dimension (r = .16, p < 0.002).

Conclusion
while acknowledging all limitation of observational study we reached to the conclusion that an employees of the respective primary hospitals would prefer to work in environment characterized by innovative and clan culture and their satisfaction level is medium so that the managers should undertake major cultural transformation and must work to improve the job satisfaction level of health workers within their respective hospitals.