bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are we equipped with serving the right care? Implications for program responses regarding gender-based violence
Authors: Tin Khaing Nwe , Oung Myitzu Tin , Yin Su Su , Htet Kyaw Ko Ko , Hein Kyaw Thu , Einda Hla Mya Thway , Than Kyu Kyu 
Published: November 2019

Abstract
Background Globally, 35% of women have experienced gender-based violence (GBV) which seriously affects all aspects of women’s health. While health sector must play a key role in response, there are many barriers for GBV survivors to access health services, especially in developing countries including Myanmar. Limitations of health sector in provision of quality services to GBV survivors, healthcare providers’ knowledge, attitude, experience and service availability and readiness, should be explored as an initial step for the improvement of health care response to GBV survivors.Methods This study was a cross-sectional descriptive study conducted in four purposively selected townships with higher number GBV cases. Face-to-face interviews were done to all health care providers (n=233) from public health facilities using a structured questionnaire. The findings were described as frequency and percentage for categorical data and mean and standard deviation for continuous data.Results Lady Health Visitors and Midwives were mainly involved (88.0%). About two-thirds had heard GBV without probing. Types of violence they mostly described were physical (81.1%) and sexual violence (8.5%). One-third wanted women to be patient to their partners’ violence to maintain family ties. Nearly two-third assumed conflict between husband and wife was not a matter that someone should involve. About 70% had given care to GBV survivors and they provided only injury treatment (76.1%). A quarter of them experienced sexual violence cases, but only 4.9% and 1.2% provided emergency contraception and Sexually Transmitted Infection treatment. Although nearly two third mentioned about psychological counseling in GBV management, only 20% provided counseling services to survivors. Absence of standard GBV management guideline, trained and skilled staff for GBV and counseling room at health facilities were issues mostly stated by the respondents.Conclusions Inadequate knowledge, misconceptions and unfavorable attitudes of GBV among health care providers might deter the effectiveness of GBV management at the health sector. In addition, poor management practice together with no standard management guideline, limited skilled staff, inadequate drug supplies and absence of counseling facilities indicated insufficient readiness to provide quality health care responses to GBV surviours in Myanmar.
Factors associated with Trifluridine/Tipiracil (TAS-102) effectiveness in patients with refractory metastatic colorectal cancer: real-life data from the Czech Republic.
Authors: Grell Peter , Dvorak Josef , Vocka Michal , John Stanislav , Pitauerova Helena , Buchler Tomas , Selingerova Iveta , Borilova Simona , Petruzelka Lubos , Vyzula Rostislav , Kiss Igor , Obermannova Radka 
Published: November 2019

Abstract
Background: Trifluridine/tipiracil (TAS-102) is effective in refractory metastatic colorectal cancer (mCRC). Currently, no predictive biomarkers are established and used in clinical practice. Methods: We analyzed data of 160 patients treated with TAS-102 in real clinical practice in the Czech Republic. Different factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated. Results: Median PFS was 3.3 months, and median OS 10.2 months. Factors significantly associated with PFS and/or OS were: ECOG performance status (PS), time from diagnosis of mCRC > 24 months, initiation of treatment > 3 months from last fluoropyrimidine, number of metastatic sites, baseline CRP level, WBC count, neutrophils count, monocytes count, neutrophil to lymphocyte ratio, development of neutropenia, thrombocytopenia, diarrhea, required dose reduction and cycle delay. We developed a scoring system TAScore from factors available at the beginning of treatment. One point each was assigned to the following factors (PS, diagnosis of mCRC > 24 months, initiation of TAS-102 > 3 months from fluoropyrimidine, baseline CRP, WBC, monocytes count < 0.5 × 10 9 /L) and patients were divided into 3 groups: high risk group (0 to 1 point), intermediate (2 to 3), favorable with 4 or more points. OS according to risk group was: 5.7 months for high risk, 8.7 for intermediate, 12.8 for favorable (P < 0.001). TAScore was also associated with PFS (P < 0.001). Conclusions : TAS-102 is effective in patients with refractory mCRC. We propose simple scoring system TAScore to help with precise patient selection at the beginning of TAS-102 treatment.
Practice and its associated factors of evidence-based care during second and third stage of labour at tertiary teaching hospital in the Philippines, a descriptive mixed methods study
Authors: Masuda Chisato , Ferolin Shirley Kristine , Masuda Ken , Smith Chris , Matsui Mitsuaki 
Published: November 2019

Abstract
Background Evidence-based practice is one of key components of quality maternal care. However, previous studies have identified gaps between evidence and actual practices at maternity in the Philippines. This study aims to describe practice of evidence-base intrapartum care and its associated factors in a tertiary teaching hospital.Methods A mix-methods study was conducted, which consists of direct observation of intrapartum practices during the second and third stages; semi-structured interviews and focus group discussions with care providers to confirm the reasons to perform episiotomy or fundal pressure and their perception. Descriptive statistics, and univariate and multivariate logistic regressions were used to analyse the relationship between observed practices and maternal, neonatal and environmental factors. Qualitative data was extracted and categorised to identify themes on the decision-making process of practices.Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices, such as intramuscular or intravenous oxytocin use in the second stage (14.1%) and lack of foetal heart rate monitoring (57.1%) were also observed. 92.0% of primiparas received episiotomy and 31.2% of all deliveries received fundal pressure. Following factors were associated with implementation of episiotomy; primipara (adjusted Odds Ratio 62.3 [16.3-237.1]), duration of the second stage more than 30 minutes (aOR 4.6 [1.2-17.7]) and assisted vaginal delivery (aOR 15.0 [1.2-192.0]). Factors associated with fundal pressure were; primipara (aOR 3.0 [1.4-6.7]), augmentation with oxytocin (aOR 3.3 [1.5-7.0]) and assisted vaginal delivery (aOR 4.8 [1.3-18.0]). Healthcare providers believe these practices can prevent laceration or proceed delivery. 17.1% of women got OASIS in this study. Assisted vaginal delivery (aOR 6.0 [1.6-22.4]), baby’s weight more than 3500g (aOR 7.8 [1.7-36.6]), episiotomy (aOR 26.4 [2.3-299.0]) and fundal pressure (aOR 6.2 [2.1-18.2]) were associated with OASIS.Conclusions Our study found potentially harmful practices were still conducted and they contributed to the occurrence of OASIS. The perception of these practices was divergent with the current evidence, empirical knowledge had more influence. Scientific evidence and its underlying knowledge should be understood among providers to improve practices.
Effectiveness of sodium fluoride varnish to prevent dental caries in school children between age of 6 and 7 years: A randomised controlled trial in a low resource setting
Authors: Jayasinghe Rasika Manori , Senanayake Sameera , Kularatna Sanjeewa 
Published: November 2019

Abstract
Background
Dental caries among children is a significant public health problem world over with multiple factors playing a major role as risk factors in initiation and contnuation of the disease. Fluoride varnish application is an effective intervent in preventing dental caries. Objective of this study was to evaluate the effectiveness of six monthly application of sodium fluoride varnish in prevention of dental caries in deciduous teeth, permanent incisors and molars in children between six and seven years in a low resource setting, Sri Lanka.

Method
This was a double-blind, randomized controlled trial (NCT02877888). The study population was school children aged six to seven years, living in a district of Sri Lanka. Recruited children were randomly assigned to either a treatment (n=161) or to control group (n=162) using block randomization. Children in the treatment group received fluoride varnish professionally applied every 6 months combined with counselling on maintenance of oral hygiene and diet for a period of 2 years. The control group was only subjected to counselling on maintenance of oral hygiene and diet. Caries examinations were conducted using the International Caries Detection and Assessment System (ICDAS). The primary outcome studied was the number of new caries in the two study groups.

Results
At the baseline assessment, the propotion of students with dental caries was higher in the intervention groupl (80.9%) compared to the control group (48.4%). Similarly the mean number of teeth with dental caries in a student was higher in the intervention group (1.35). At each time interval, the mean number of new dental caries was significantly lower in the intervention group. When independent effect of the intervention on development of new dental caries was assessed, application of fluoride varnish every 6 months for a period of 2 years was significantly associated with less number of new dental caries compared to controls.

Conclusion
Implementation of fluoride varnish application in a low resource setting is an effective method of preventing dental caries among children. A national level programme would contribute to the reduction of prevalence of dental caries in this age group.
Trial registration: NCT02877888
Changes in children’s oral-health-related quality of life following dental treatment under general anesthesia in the United Arab Emirates
Authors: Alantali Kholoud , Halabi Manal Al , Hussein Iyad , Hassan Amar , El-Tatari Ahmed , Kowash M.B. 
Published: November 2019

Abstract
Background Early Childhood Caries (ECC) is the most common childhood disease in preschool children which often require dental treatment under Dental General Anaesthesia (DGA). Aim: To assess the effect of DGA on United Arab Emirates (UAE) children and their families’ Oral Health Related Quality of Life (OHRQoL). Design: A cross sectional study, using a DGA pre-and post-survey to evaluate changes in OHRQoL. A total of 173 parents completed Early Childhood Oral Health Impact Scale (ECOHIS) before and after their children (mean age 4.6 years) underwent DGA by a pediatric dentist in Al-Ain, UAE from 1st March 2017 to 28th February 2018. The ECOHIS and its effect size (ES) served to evaluate children's OHRQoL, the Wilcoxon signed-rank and the Kruskal-Wallis tests were used for statistical analyses. Results: The mean dmft of the children prior to the treatment was 13.8+3.07. Children’s pain and eating problems and parents feeling upset and guilty were the most frequently reported impacts at baseline. The ECOHIS scores decreased significantly (p < 0.001) after DGA, revealing a large ES for the child (2.19) and family (2.79) sections of the ECOHIS. Conclusions: DGA treatment resulted in significant improvement in all child and family physical, psychological and social aspects of OHRQoL.
Data Quality of Request Forms for Lumbar Spine Radiography in a Tertiary Care Hospital in Sri Lanka
Authors: Wettasinghe Mihiri Chami , Rosairo Shanthini , Wickramasinghe Nuwan Darshana 
Published: November 2019

Abstract
Objective: To assess the data quality of request forms for lumbar spine X-ray received by a tertiary care hospital in the Central Province, Sri Lanka.
Results: A total number of 185 lumbar spine X-ray request forms received by the Department of Radiology were analysed. Data quality was assessed on the aspects of completeness, accuracy and legibility.
Completeness was assessed for different sections separately and altogether eight sections in the request forms were analyzed. Out of the 185 request forms, 138 (74.5%) had complete entries for all the eight sections. Thirteen (7.0%) requests failed to provide the clinical history. Five request forms (2.7%) failed to provide the sex and the age of the patient. Thirty two (17.3%) did not provide details on the region of examination.
Accuracy was assessed in relation to the clinical history and region of examination. In the 172 requests, which gave a clinical history, 167 (97.1%) provided relevant clinical histories for requesting lumbar spine X-rays. Five requests (2.9%) provided irrelevant history and five (2.9%) requests contained non-standard abbreviations.
Five (2.7%) referrals were not readable by the radiologists.
Hence, the data quality of lumbar spine X-ray request forms received by the Department of Radiology needs further improvement.
The correlation between MRI findings and clinical prognosis in children with purulent meningitis
Authors: Kong Lei , Li Di , Guo Xin , Liu Linlin , Liu Gang , Liu Yue 
Published: November 2019

Abstract
Background: To explore the correlation between magnetic resonance imaging (MRI) findings and clinical prognosis in children with purulent meningitis.
Methods : Forty-nine cases of children with purulent meningitiswere collected from January 2016 to December 2018 in Beijing Children's Hospital. According to the Glasgow Outcome Scale（GOS), there were 35 patients with good prognosis and 14 patients with poor prognosis. All patients were scanned by MRI. We used Chi-square test and Logistic regression to analyse the correlation between MRI features and clinical prognosis in children with purulent meningitis.
Results : Among the two groups, the poor prognosis group had the worst imaging performance, while the good prognosis group had the lighter imaging performance. Chi-square test showed that the imaging signs of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia had statistical significance between the two groups (P < 0.05). Multivariate logistic regression analysis showed that the signs of cerebral edema, subdural effusion were risk factor for poor prognosis (P < 0.001).
Conclusion : There are many complications and sequelae in children with purulent meningitis. The MRI findings of cerebral edema, cerebral hemorrhage, subdural effusion, hydrocephalus, venous sinus thrombosis, cerebral hernia suggest poor prognosis. It is instructive to clinical treatment and prognosis.
Stakeholder Opinion on the proposal to introduce ‘Treat and Referral’ into the Irish Emergency Medical Service.
Authors: Power Brian , Bury Gerard , Ryan John 
Published: November 2019

Abstract
Background: The Irish ambulance services have traditionally transported all patients following an emergency (112/999) call, regardless of acuity, to an ED. A proposal to introduce Treat and Referral, an established care pathway in some jurisdictions, is under active consideration in Ireland. This will present a significant change. Stakeholder engagement is recognised as an essential component of management of such change. This study has conducted a multicentre, cross-sectional survey exploring opinions on the introduction of Treat and Referral among key Irish stakeholders; consultants in emergency medicine, paramedics and advanced paramedics. Methods: Public-sector consultants in emergency medicine, registered paramedics and advanced paramedics, in Ireland at the time of the study, were invited to complete an on-line survey. Results: A significant finding was that 90% of both cohorts (EM consultants and PHECC practitioners) support written after-care instructions being given to referred patients, that > 83% agree that Treat and Referral will reduce unnecessary ambulance journeys and that 70% are in favour of their own family member being offered Treat and Referral. Consensus was reached between respondents that Treat and Referral would improve care and increase clinical judgement of practitioners. Differences were identified in relation to the increased availability of ambulances locally, that only adults should be included, and that research was required to extend Treat and Referral beyond the index conditions. There was no consensus on whether GPs should be directly informed. Conclusions: This study identified that the Irish healthcare practitioners surveyed are supportive of the introduction of Treat and Referral into Ireland. It also affords healthcare policymakers the opportunity to address the concerns raised, in particular the clinical level which will be targeted for inclusion in this extended scope of practice.
Association between physical activity pain and injuries in children
Authors: Greca João Paulo de Aguiar , Korff Thomas , Ryan Jennifer 
Published: November 2019

Abstract
Background Children are advised to engage in physical activity to improve health. However, recent literature suggests an association between weight bearing activities, e.g. walking, and excessive joint loading in lower limbs of children. Excessive stress in joints of children may lead to pain or even cause injuries. The aim of this study was to investigate the relationship between pain, injury and physical activity in children.Methods This study had a cross-sectional design. 112 children aged 8-12 yr. (68 with normal weight, 38 with overweight or obesity) participated in the study. Moderate and vigorous physical activity were assessed using accelerometry over 7 days. Questionnaires were used to report pain (over 7 days) and injuries (over 12 months). Linear regression and negative binomial models were used to examine association between moderate activity, vigorous activity, and pain and injuries, respectively. Models were adjusted for potential confounders. Effect modification according to weight status was explored.Results There was no association between moderate physical activity and pain (β=0.0004, 95% CI -0.007 to 0.008; p=0.915) or between vigorous physical activity and pain (β=0.0069, 95% CI -0.08 to 0.22; p=0.354). Similarly, no association was found between moderate physical activity and injuries (Rate Ratio [RR]=1.00, 95% CI 0.99 to 1.01; p=0.995) or vigorous physical activity and injuries (RR=1.00, 95% CI 0.99 to 1.02; p=0.798). There was no evidence that associations between physical activity and pain or physical activity and injuries, respectively, differed according to weight status.Conclusions Although paediatric obesity is linked to a higher incidence of pain and injuries in children, this study did not find that moderate and vigorous physical activity are associated with pain or injuries in children, regardless of their weight status.
How common are Chinese patients with multimorbidity involved in decision making and having a treatment plan? a cross-sectional study
Authors: Lee Kam Pui , Wong Samuel Yeung Shan , Yip Benjamin Hon Kei , Wong Eliza Lai Yi , Chan Dicken , Chau Patsy , Luk Lawrence , Yeoh Eng-kiong 
Published: November 2019

Abstract
Background Creating a treatment plan (TP) through shared decision making (SDM) with healthcare professionals, is of paramount importance for patients with multimorbidity. This study aims to estimate the prevalence of SDM and TP in patients with multimorbidity, and study the association between SDM/TP with demographics and patients’ confidence to manage their diseases.Method This cross-sectional study used an internationally recognized survey. 1,032 patients aged 60 or above with multimorbidity, were recruited from a specialist outpatient clinic, general outpatient clinic (GOPC) and a geriatric day hospital. The proportion of patients reported to have SDM and TP were estimated. Associations between the presence of SDM/TP and patients’ demographic data, and the confidence level to manage their illnesses, were then studied using logistic regression.Results The prevalence of SDM and TP were 35.8% and 82.1%, respectively. The presence of TP was associated with receiving healthcare from the same doctor or in the same facilities, and being recruited from GOPC. Presence of SDM (OR 1.381, p=0.054) and TP(OR 2.195, p<0.0001) were associated with enhanced confidence in dealing with diseases.Conclusion Most people with multimorbidity had TP in Hong Kong, but fewer patients had SDM.Practice implications: Ways to promote SDM in HK are needed.
The clinicopathological features and prognostic value of lymphovascular invasion in patients with upper tract urinary carcinoma after radical nephroureterectomy: an updated systematic review and meta-analysis.
Authors: Zhang Lijin , Wu Bin , Zha Zhenlei , Zhao Hu , Yuan Jun , Feng Yejun 
Published: November 2019

Abstract
Background and Purpose: Although the prognostic value of lymphovascular invasion (LVI) for upper tract urinary carcinoma (UTUC) have been described. There is lack of consensus regarding the prognostic factor of LVI in UTUC. The aim of present study was to evaluate the current evidence regarding the contemporary role of LVI through systematic review and meta-analysis according to the updated literatures.
Materials and Methods: In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE was performed for all reports published until July 2019 that included detailed results on the predictors of LVI.
Results: Our meta-analysis included thirty one eligible studies containing 14,653 UTUC patients (81-1,363 per study). According to our final results, there was a significant correlation of LVI with worse cancer-specific survival (CSS) (HR=1.62, 95 % CI: 1.49-1.76, p < 0.001), overall survival (OS) (HR=1.55, 95 % CI: 1.41-1.71, p < 0.001), recurrence-free survival (RFS) (HR=1.46, 95 % CI: 1.32-1.61, p < 0.001), cancer-specific mortality (CSM) (HR=1.25, 95 % CI: 1.00-1.56, p = 0.047) and recurrence(HR=1.23, 95 % CI: 1.03-1.48, p = 0.026). In addition, LVI was also correlated with advanced TNM stage (III/IV vs. I/II: OR = 7.63, 95% CI: 5.60–10.39, p < 0.001), higher tumor grade (3 vs. 1/2: OR = 5.61, 95% CI: 3.71–8.48, p < 0.001), lymph node metastasis (yes vs. no: OR = 4.95, 95% CI: 3.66–6.71, p < 0.001), carcinoma in situ (yes vs. no: OR = 1.92, 95% CI: 1.36–2.70, p < 0.001) and positive surgical margin (yes vs. no: OR = 4.38, 95% CI: 2.71–7.07, p < 0.001), but not related to gender (male vs. female: OR = 0.98, 95% CI: 0.80–1.19, p = 0.825) and multifocality (multifocal vs. unifocal: OR = 1.10, 95% CI: 0.82–1.47, p = 0.539). The funnel plot test indicated that no significant publication bias in the meta-analysis.
Conclusions: This study demonstrated that LVI was associated with more aggressive clinicopathological features and could serve as a poor prognostic factor for patient with UTUC after radical nephroureterectomy.