bluuebunny/crossref_metadata_2025_split huggingface dataset:
Titles: Facilitators and Barriers of Active Participation of caregivers of Children with Cerebral Palsy in their Rehabilitation: An Exploratory Study
Authors: Isah Auwal , Abdullahi Auwal 
Published: October 2019

Abstract
Background : Cerebral Palsy (CP) is a group of permanent disorders of movement and posture, attributed to non-progressive disturbance that occurred in the developing fetal or infant brain. The condition results in long term disability in carrying out activities of daily living (ADL). Thus, it most times required active participation of the caregivers of the children affected in their rehabilitation. Objective: The aim of the study was to explore the facilitators and barriers of active participation of caregivers in the rehabilitation of these children. Materials and Methods: The study design used was qualitative indepth interview. The participants consisted of caregivers of children with CP attending Hasiya Bayero Paediatric Specialists Hospital, Kano. The caregivers were sampled and interviewed by one of the researchers until theoretical saturation was attained. A note taker wrote down and recorded responses of the participants using a tape recorder. The data generated from the interview was then transcribed, coded and analyzed using matrix analysis using constant comparative analysis. Results: Forty caregivers with mean age, 27.17±4.46 years participated in the study. The results of the study showed that, the factors that facilitate active participation of caregivers of children with CP in the rehabilitation of their children are improvement in the child’s condition, family support, improvement in the conditions of other children with CP, encouragement from the therapist managing the child, empathy, and cooperation of the child during home programs. The barriers are number of children the caregiver has, caregiver’s occupation and financial resources. Conclusion: Therapists need to help reinforce these facilitators, and devise strategies to help caregivers overcome barriers during rehabilitation of children with CP. For example, since lack of finance is one of the barriers to the caregivers’ active participation in the rehabilitation of their children, there should be a policy on CP rehabilitation that will make rehabilitation services accessible to all children with CP. Similarly, since family support is a facilitator, sharing caregiving rehabilitation tasks among member of the family could help facilitate caregiver activation participation in the rehabilitation of their children with CP.
Co-producing childbirth knowledge: A qualitative study of birth stories in antenatal sessions
Authors: de Quattro Leah 
Published: October 2019

Abstract
Background Birth stories surround pregnant women. Existing research on childbirth knowledge suggests that personal accounts from family and friends play a foundational role upon which other information builds. However, among the handful of studies that specifically address the educational role of birth stories, stories appeared to have little impact on knowledge creation. This paper engages with this discussion by exploring how birth stories contributed to the co-construction of birth knowledge within the specific context of antenatal sessions. Findings draw from the pilot study of a project which seeks to understand how participants use collective approaches to co-produce birth knowledge. Method Research data drew from participant observation of group-led Homebirth sessions (25 participants) and teacher-led National Childbirth Trust classes (18 participants). The researcher analysed transcripts using template analysis, a form of thematic content analysis, with principles from feminist ethnography and narrative analysis. Results Storytelling proved central to mother-to-mother antenatal group practices, providing not only information, but also a means for understanding. This educational work took place through various mechanisms: Stories (re)shaped expectations, shared practical techniques, navigated different truth claims and approaches to knowledge, and helped build supportive communities of parents. These findings emerged more prominently in group-led sessions compared to teacher-led sessions. Conclusion Compared to teacher-led norms, storytelling and other collective approaches to antenatal education provide additional resources to childbearing women. As dialogic, complex and flexible learning tools, stories offer uniquely diverse, credible and supportive messages. The next phase of this project will further investigate these findings, explore informal collective practices, and seek to evaluate the impact of collective knowledge on childbirth experiences.
Neuromuscular shoulder activity during exercises with different combinations of stable and unstable weight mass
Authors: Baritello Omar , Khajooei Mina , Engel Tilman , Kopinski Stephan , Quarmby Andrew , Mueller Steffen , Mayer Frank 
Published: October 2019

Abstract
Background Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass affects the muscular activity of the shoulder stabilizers (ST). Aim of the study was to analyzed the neuromuscular activity of the dynamic ST under four combinations of stable and unstable weight mass during three shoulder exercises. It was hypothesized that a combined condition of weight with unstable mass would elicit significantly greater activation due to the increased stabilization demand.
Methods Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 sec.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different training conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root mean square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR: U.TA/L.TA; U.TA/SA) and contraction (CR: concentric/eccentric) ratios were analyzed (paired t-test;Bonferroni adjusted α=0.008)
Results PWG showed significantly greater activation for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p>0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles.
Conclusion Higher weight generated greater muscle activation whereas an unstable weight mass behavior raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an unstable weight mass increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
Metagenomic next-generation sequencing for mixed pulmonary infection diagnosis
Authors: Wang Jiahui , Han Yelei , Zhou Yang , Feng Jing 
Published: October 2019

Abstract
Background. Metagenomic next-generation sequencing (mNGS) is emerging as a promising technique for pathogens detection. However, reports on the application of mNGS in mixed pulmonary infection remain scarce.
Methods. From July 2018 to March 2019, 55 cases were enrolled in this retrospective analysis. Cases were classified into mixed pulmonary infection (36 [65.5%]) and non-mixed pulmonary infection (19 [34.5%]) according to primary diagnoses. The performances of mNGS and conventional test on mixed pulmonary infection diagnosis and pathogen identification were compared.
Results. The sensitivity of mNGS in mixed pulmonary infection diagnose was much higher than that of conventional test (97.2％ vs 13.9％; P< 0.01) , but the specificity was the opposite (63.2％ vs 94.7％; P= 0.07) . The positive predictive value of mNGS was 83.3% (95% CI: 68.0-92.5%) , and the negative predictive value was 92.3% (95% CI: 62.1-99.6%) . A total of 5 (9.1%) cases were identified as mixed pulmonary infection by both conventional tests and mNGS, however, the pathogens identification results were consistent between these two methods in only 1(1.8%) case. In summary, the pathogens detected by mNGS in 3 (5.5%) cases were consistent with those by conventional test, and only 1(1.8%) case was mixed pulmonary infection. According to our data, mNGS had a broader spectrum for pathogen detection than conventional tests. In particular, application of mNGS improved the diagnosis of pulmonary fungal infections. Within the 55 cases, mNGS detected and identified fungi in 31 (56.4%) cases, of which only 10 (18.2%) cases were positive for the same fungi by conventional test. The most common pathogen detected was H uman cytomegalovirus in our study, which was identified in 19(34.5%) cases of mixed pulmonary infection . Human cytomegalovirus and Pneumocystis jirovecii, which were detected in 7(12.7%) cases, were the most common co-pathogens in the group of mixed pulmonary infection.
Conclusions. mNGS is a promising technique to detect co-pathogens in mixed pulmonary infection, with potential benefits in speed and sensitivity.
Moderating Role of Job Satisfaction on Turnover Intention and Burnout among Workers in Primary Care Institutions: A Cross-Sectional study
Authors: Chen Xuyu , Ran Li , Zhang Yuting , Yang Jinru , Yao Hui , Zhu Sirong , Tan Xiaodong 
Published: October 2019

Abstract
Background: Global countries are suffering from a shortage of health professionals. Turnover intention is closely related to job satisfaction and burnout, making good use of these relationship could alleviate the crisis. The research aims to examine the mediating role of job satisfaction in the relationship between burnout and turnover intention. Methods: This research was conducted in Huangpi, China. Convenience sampling methods and self-administereded questionnaires were used. 1370 of valid samples were collected with 97.72% effective rate. Descriptive analyses were conducted to describe social demographic factors. The structural equation model (SEM) was performed to adjust model fitting, and the mediation effect test was carried out by using the bootstrap method. Sobel-Z test was used to verify the significance of mediation effect. Results: The mean age was 36.98 (SD=9.84). The fitting indices of hypothetical model is not good. After the adjustments, c 2 /df =5.590, GFI=0.932, AGFI=0.901, CFI=0.977, NFI=0.973, IFI=0.977, TLI=0.970, RESEA=0.058. The revised model fitted well, and the SEM was put up by using the bootstrap method. The mediating effect is partial, and Soble-Z test indicates that the mediation effect is significant. Burnout is negatively correlated with job satisfaction (p<0.01) and the standardized path coefficient is -0.41. Job satisfaction is also negatively correlated with turnover intention (p<0.01) and the standardized path coefficient is -0.18. Burnout is positively correlated with turnover intention (p<0.01) and the standardized path coefficient is 0.83. Conclusions: Job satisfaction is a mediating variable that affects the relationship between burnout and turnover intention. The mediating effect was a partial mediating effect and has a low impact of 7.4%. Improving treatment and giving more promotion opportunities for workers to improve job satisfaction, conducting career planning courses and paying attention to employee psychological health to reduce job burnout. The above measures may be helpful to reduce employee turnover rate and alleviating the current situation of shortage of health personnel in China.
Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory
Authors: Mccrorie Carolyn , Benn Jonathan , Johnson Owen , Scantlebury Arabella 
Published: October 2019

Abstract
Background
Global evidence suggests benefits of introducing electronic health record (EHR) systems to improve patient care. However, implementing EHR into healthcare organisations is complex and in the United Kingdom (UK), uptake has been slow. More research is needed to explore factors influencing successful implementation. This study explored staff expectations for change and outcome following procurement of a commercial EHR system by a large academic acute NHS hospital in the UK.
Methods
Qualitative interviews were conducted with 14 members of hospital staff who represented a variety of user groups across different specialities within the hospital. The four components of Normalisation Process Theory (Coherence, Cognitive participation, Collective action and Reflexive monitoring) provided a theoretical framework to interpret and report study findings.
Results
Health professionals had a common understanding for the rationale for EHR implementation (Coherence). There was variation in willingness to engage with and invest time into EHR (Cognitive participation) at an individual, professional and organisational level. Collective action (whether staff feel able to use EHR) was influenced by context and perceived user-involvement in EHR design and planning of the implementation strategy. When appraising EHR (Reflexive monitoring), staff anticipated short and long-term benefits. Staff perceived that quality and safety of patient care would be improved with EHR implementation, but that these benefits may not be immediate. Some staff perceived that use of the system may negatively impact patient care. The findings indicate that preparedness for EHR use could mitigate perceived threats to the quality and safety of care.
Conclusions
Health professionals looked forward to reaping the benefits from EHR use. Variations in level of engagement suggest early components of the implementation strategy were effective, and that more work was needed to involve users in preparing them for use. A clearer understanding as to how staff groups and services differentially interact with EHR as they go about their daily work was required. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EHR implementation to reduce concerns for quality and safety of patient care and improve the chance of successful implementation.
The Prognostic Significance of Different Bleeding Classifications in Off-pump Coronary Artery Bypass Grafting
Authors: Xi Ziwei , Gao Yanan , Yan Zhenxian , Zhou Yujie , Liu Wei 
Published: October 2019

Abstract
Background: Perioperative bleeding during cardiac surgery are known to make patients susceptible to adverse outcomes and several bleeding classifications have been developed to stratify the severity of bleeding events. Further validation of different classifications was needed. The aim of present study was to validate and explore the prognostic value of different bleeding classifications in patients undergoing off-pump coronary artery bypass grafting (OPCAB).
Methods: Data on baseline and operative characteristics of 3,988 patients who underwent OPCAB in Beijing Anzhen Hospital from February 2010 to December 2014 were available. The primary endpoint was a composite of in-hospital death and nonfatal postoperative myocardial infarction (MI). The secondary endpoint was postoperative acute kidney injury (AKI). We explored the association of major bleeding defined by the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Bleeding Academic Research Consortium (BARC) classification and Study of Platelet Inhibition and Patient Outcomes (PLATO) with primary endpoints by multivariable logistic regression analysis and investigated their significance of adverse event prediction using goodness-of-fit tests of -2 log likelihood.
Results: In-hospital mortality was 1.23% (n=49) and postoperative MI was observed in 4.76% (n=190) of patients, AKI in 24.69% (n=985). The incidence of the primary outcome was 5.99% (n=239). Multivariable logistic regression analysis showed that BARC type 4 (OR=2.64, 95% CI: 1.66–4.19, P<0.001), UDPB class 4 (OR=3.52, 95% CI: 2.05–6.02, P<0.001) and E-CABG class 2-3 (class 2: OR=2.24, 95% CI: 1.36–3.70, P=0.001; class 3: OR=12.65, 95% CI: 2.74–18.43, P=0.002) bleeding but not PLATO bleeding were associated with an increased risk of in-hospital death and postoperative MI. Major bleeding defined by all the four classifications mentioned above was an independent risk factor of AKI after surgery. Inclusion of major bleeding defined by these four classifications improved the predictive performance of the multivariable model with baseline characteristics.
Conclusions: Bleeding assessed by BARC, E-CABG and UDPB classifications were significantly associated with poorer immediate outcomes. These classifications seemed to be valuable tool in the assessment of prognostic effect of perioperative bleeding.
A Systematic review: Comparative Analysis of the Effects of Propofol and Sevoflurane on Postoperative Cognitive Function in Elderly Patients with Lung Cancer
Authors: Sun Haitao , Zhang Guohua , Ai Bolun , Zhang Huimin , kong xiangyi , Lee Wan-Ting , Yan Tao , Zheng Hui , Sun Li 
Published: October 2019

Abstract
Background The potential risk for cognitive-impairment following surgery and anesthesia is a common concern, especially in the elderly and more fragile patient. The risk for various neurocognitive effects is thus an area of importance. The independent impact of surgery and anesthesia is still not known. Likewise, the independent effect of different drugs used during anesthesia is a matter of debate as is the number and amounts of drugs used and the "depth of anesthesia". So, understanding the drug-related phenomenon and mechanisms for postoperative cognitive impairment is essential. This meta-analysis aims to compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function in elderly patients with lung-cancer.
Methods This study is a meta-analysis for controlled-clinical-studies. Public - available online databases were searched to identify eligible randomized placebo-controlled trials or prospective cohort studies concerning the effects of propofol and sevoflurane on postoperative cognitive function. The primary endpoints are postoperative mini-mental state examination (MMSE) scores at various time points; the secondary endpoint is the serum S100beta concentration 24 hours after surgery. Standard mean differences (SMDs) along with 95% confidence intervals (CIs) were extracted and analyzed using random or fixed effects models. Analyses regarding heterogeneity, risk of bias assessment, and sensitivity were performed.
Results We searched 1626 eligible publications and 14 studies of 1404 patients were included in the final analysis. The majority of included studies had been undertaken in Asian populations. Results suggested that propofol has a greater adverse effect on cognitive function in the elderly patients with lung cancer than sevoflurane. There were significant differences in issues of MMSE 6h (11 studies; SMD -1.391, 95% CI -2.024, -0.757; p < 0.001), MMSE 24h (14 studies; SMD -1.106, 95% CI -1.588, -0.624; p < 0.001), MMSE 3d (11 studies; SMD -1.065, 95% CI -1.564, -0.566; p < 0.001), MMSE 7d (10 studies; SMD -0.422, 95% CI -0.549, -0.295; p < 0.001), and serum S100beta concentration at 1 day after surgery (13 studies; SMD 0.746, 95% CI 0.475, 1.017; p < 0.001).
Conclusion Propofol has a more significant adverse effect on postoperative cognitive function in elderly patients with lung cancer than sevoflurane.
Pattern of nucleotide variants of TP53 and their correlation with the expression of p53 and its downstream proteins in a Sri Lankan cohort of breast and colorectal cancer patients
Authors: Manoharan Vahinipriya , Karunanayake Eric Hamilton , Tennekoon Kamani Hemamala , De Silva Sumadee , Imthikab Ahamed Ilyas Ahamed , De Silva Kanishka , Angunawela Preethika , Lunec John , Vishwakula Sameera 
Published: October 2019

Abstract
Background
Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka.

Methods

30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53. We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients.

Results

Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS; three of them were on codon 12 and one was on codon 61.

Conclusion

The prevalence of pathogenic somatic TP53 variants was 31% and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5 – 8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.