bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the effect of Neoadjuvant chemotherapy for esophageal Cancer using the RECIST system with shorter-axis measurements: a retrospective multicenter study
Authors: Taniyama Yusuke , Murakami Kentaro , Yoshida Naoya , Takahashi Kozue , Matsubara Hisahiro , Baba Hideo , Kamei Takashi 
Published: September 2021

Abstract
Background
Evaluating the effect on primary lesions is important in determining treatment strategies for esophageal cancer. The Response Evaluation Criteria in Solid Tumors system, which employs the longest diameter for measuring tumors, is commonly used for evaluating treatment effects. However, the usefulness of these criteria in assessing primary esophageal tumors remains controversial. Thus, we evaluated this issue by measuring not only the longest diameter but also the shorter axis of the tumor.

Methods
We retrospectively reviewed data from 313 patients with esophageal cancer treated with neoadjuvant chemotherapy followed by esophagectomy at three major high-volume centers in Japan. All patients underwent contrast-enhanced computed tomography before and after chemotherapy. The longest and shortest tumor diameters were measured in each case. Treatment effects were adapted to the Response Evaluation Criteria in Solid Tumors system. Correlations between pathological and survival data were also analyzed.

Results
Inter-observer discrepancies were examined for changes in the longest diameter and shorter axis of the tumor (the intraclass correlation coefficients were 0.550 and 0.624, respectively). The shorter axis was correlated with the pathological response in the multivariate analysis (p < 0.001). The shorter axis was significantly associated with overall survival and disease-free survival (both p < 0.001), whereas this association was not observed for the longest tumor diameter.

Conclusions
This multicenter study demonstrated that the Response Evaluation Criteria in Solid Tumors system is useful for predicting pathological response and survival by incorporating the shorter axis of the primary esophageal tumor.
Alaska Native Elders’ perspectives on dietary patterns in rural, remote communities
Authors: Walch Amanda K. , Ohle Kathryn A. , Koller Kathryn R. , Alexie Lucinda , Sapp Flora , Thomas Timothy K. , Bersamin Andrea 
Published: September 2021

Abstract
Background
Given the increasing rates of childhood obesity in Alaska Native children and the understanding that the most effective interventions are informed by and reflect the cultural knowledge of the community in which they are implemented, this project sought to gather the wisdom of local Yup’ik and Cup’ik Elders in the Yukon-Kuskokwim region of Alaska around how to maintain a healthy diet and active lifestyle.

Methods
Perspectives were sought through the use of semi-structured focus groups, which were completed in person in twelve communities. All conversations were recorded, translated, transcribed, and analyzed using a qualitative approach, where key themes were identified.

Results
Elders provided a clear and consistent recollection of what their life looked like when they were young and expressed their perspectives related to maintaining a healthy and traditional lifestyle. The key themes the Elders discussed included an emphasis on the nutritional and cultural benefits of traditional foods; concerns around changing dietary patterns such as the consumption of processed foods and sugar sweetened beverages; and concerns on the time and use of screens. Elders also expressed a desire to help younger generations learn traditional subsistence practices.

Conclusions
The risk of obesity in Alaska Native children is high and intervention efforts should be grounded in local knowledge and values. The perspectives from Yup’ik and Cup’ik Elders in the Yukon-Kuskokwim Delta area of Alaska provide a better understanding on local views of how to maintain a healthy diet, physical activities, and traditional values.
Epidemiological features of hypertension among ischemic survivors in Northeast China: insights from a population-based study, 2017–2019
Authors: Jing Li , Tian Yuanmeng , Ren Guocheng , Zhang Limin , Shi Lei , Dai Dong , Xing Liying , Liu Shuang 
Published: September 2021

Abstract
Background
Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke.

Methods
Our cross-sectional study included 18,796 adults aged ≥40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization’s criteria, which requires the clinical record, computed tomography (CT) and/or magnetic resonance imaging (MRI) during the hospital stay. Hypertension was defined according to the Chinese hypertension guidelines (mean SBP ≥140 mmHg and/or mean DBP ≥90 mmHg, and/or self-reported use of anti-hypertensive medication in the past 2 weeks).

Results
Of the 986 survivors of ischemic stroke, 819 (83.1%) were identified with hypertension (535 were pre-stroke hypertension and 284 were post-stroke hypertension). Among hypertensive patients, the awareness and treatment rates were 76.8 and 66.7% respectively. Only 11.0% achieved an appropriate blood pressure (< 140 mmHg and < 90 mmHg) among those who took hypertensive medications. 16.8% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mmHg and 89.2 ± 12.3 mmHg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mmHg vs. 146.4 ± 17.5 mmHg and 90.3 ± 12.9 mmHg vs. 85.9 ± 10.1 mmHg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5 and 18.7%, and was significantly higher in rural areas than in urban areas.

Conclusions
The prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.
Do preterm-born adolescents have a poorer oral health-related quality of life?
Authors: Brogårdh-Roth Susanne , Paulsson Liselotte , Larsson Pernilla , Ekberg Ewacarin 
Published: September 2021

Abstract
Background
To evaluate oral health-related quality of life (OHRQoL) over a period of five years using the Oral Health Impact Profile (OHIP-14) questionnaire in a population of Swedish adolescents born preterm and full term.

Methods
In a longitudinal study of adolescents aged 12–14 and 17–19, changes over time in OHRQoL were measured by using OHIP-14. The OHIP-14 score, self-reported chronic illness, temporomandibular disorder (TMD pain) and subjective orthodontic treatment need were compared between 98 extremely and very preterm born (< 32 gestational week) and 93 full-term controls (≥ 37 gestational week) at two ages. The chi-square test was used for comparisons within the extremely-, very-, and full-term control groups, and to contrast the differences of mean scores of OHIP-14, the ANOVA test was used for comparisons within the study groups of extremely preterm, very preterm and full term-born adolescents.

Results
All adolescents reported a good self-perceived OHRQoL. No significant differences in the comparisons of the total mean scores were revealed between the groups, between gender or in domain-specific scores over the 5-year period. Very preterm adolescents with reported chronic illness at 12–14 years of age showed significantly higher mean scores of OHIP-14 compared with those without chronic illness (p = 0.015). At age 17–19, significantly higher mean scores of OHIP-14 were reported by very preterm adolescents with TMD pain compared to those without TMD pain (p = 0.024). Significantly higher mean scores of OHIP-14 were found among the extremely preterm (p = 0.011) and very preterm born adolescents (p = 0.031) with a subjective need of orthodontic treatment compared with those without orthodontic treatment need.

Conclusions
Poor OHRQoL measured with OHIP-14 in very preterm adolescents aged 12–14 was related to chronic illness and aged 17–19 to TMD pain. In addition, extremely and very preterm-born adolescents with subjective orthodontic treatment need at 17–19 years of age also reported poor OHRQoL. To improve the dentist–patient relationship and achieve more successful treatment results, it is important for dental clinicians to understand the impact that chronic illness, TMD pain and orthodontic treatment need has on OHRQoL in preterm-born adolescents.
Nurse-led normalised advance care planning service in hospital and community health settings: a qualitative study
Authors: Ohr Se Ok , Cleasby Peter , Jeong Sarah Yeun-Sim , Barrett Tomiko 
Published: September 2021

Abstract
Background
Advance Care Planning (ACP) by Registered Nurses (RNs) has been emerging. However, there is limited understanding about what RNs experience as they incorporate ACP into their practice. This study aimed to elicit the experiences of ACP RNs with the implementation of a normalised ACP (NACP) service in hospital and community care settings.

Methods
A qualitative descriptive study invited four ACP RNs who delivered a nurse-led NACP for a 6 months duration at two hospital and two community health care settings in New South Wales (NSW), Australia. The experiences of the ACP RNs were captured through a semi-structured interview and weekly debriefing meetings. The interview recordings were transcribed verbatim and the minutes of weekly debriefing meetings were utilized. Data were analysed by two independent researchers using thematic analysis with the Normalisation Process Theory (NPT) as a methodological framework.

Findings
The ACP RNs were females with a mean age of 43 years old. Their nursing experiences ranged 2 to 25 years but they had minimal experiences with ACP and had not attended any education about ACP previously. The following four themes were identified in the experiences of the ACP RNs; 1) Embracing NACP service; 2) Enablers and barriers related to patients and health professionals; 3) Enablers and barriers related to ACP RNs; and 4) What it means to be an ACP RN.

Conclusion
The introduction of a NACP service into existing clinical systems is complex. The study demonstrated the capacity of RNs to engage in ACP processes, and their willingness to deliver an NACP service with a raft of locally specific enablers and barriers.

Trial registration
The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record
Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review
Authors: Tan Xiu Hui , Foo Malia Alexandra , Lim Shaun Li He , Lim Marie Bernadette Xin Yi , Chin Annelissa Mien Chew , Zhou Jamie , Chiam Min , Krishna Lalit Kumar Radha 
Published: September 2021

AbstractBackgroundPoor communication skills can potentially compromise patient care. However, as communication skills training (CST) programs are not seen as a priority to many clinical departments, there is a discernible absence of a standardised, recommended framework for these programs to be built upon. This systematic scoping review (SSR) aims to gather prevailing data on existing CSTs to identify key factors in teaching and assessing communication skills in the postgraduate medical setting.MethodsIndependent searches across seven bibliographic databases (PubMed, PsycINFO, EMBASE, ERIC, CINAHL, Scopus and Google Scholar) were carried out. Krishna’s Systematic Evidence-Based Approach (SEBA) was used to guide concurrent thematic and content analysis of the data. The themes and categories identified were compared and combined where possible in keeping with this approach and then compared with the tabulated summaries of the included articles.ResultsTwenty-five thousand eight hundred ninety-four abstracts were identified, and 151 articles were included and analysed. The Split Approach revealed similar categories and themes: curriculum design, teaching methods, curriculum content, assessment methods, integration into curriculum, and facilitators and barriers to CST.Amidst a wide variety of curricula designs, efforts to develop the requisite knowledge, skills and attitudes set out by the ACGME current teaching and assessment methods in CST maybe categorised into didactic and interactive methods and assessed along Kirkpatrick’s Four Levels of Learning Evaluation.ConclusionsA major flaw in existing CSTs is a lack of curriculum structure, focus and standardisation. Based upon the findings and current design principles identified in this SSR in SEBA, we forward a stepwise approach to designing CST programs. These involve 1) defining goals and learning objectives, 2) identifying target population and ideal characteristics, 3) determining curriculum structure, 4) ensuring adequate resources and mitigating barriers, 5) determining curriculum content, and 6) assessing learners and adopting quality improvement processes.
Applying interprofessional simulation to improve knowledge, attitude and practice in hospital- acquired infection control among health professionals
Authors: Saraswathy T. , Nalliah S. , Rosliza A. M , Ramasamy S , Jalina K. , Shahar Hayati Kadir , Amin-Nordin S. 
Published: September 2021

Abstract
Background
This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

Methods
The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

Results
The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p < 0.05). Overall, using the four procedures as surrogates, the interprofessional learning approach in HAIC intervention showed improvement among the participants in the experimental group following structured instructions. The IPSS approach in HAIC clearly shows its relevance in improving learning outcomes.

Conclusions
Well-designed interprofessional simulated scenarios can be effective in skills training in improving KAP in HAIC among health professionals.
Development of a blended learning system for nurses to learn the basics of psychoeducation for patients with mental disorders
Authors: Matsuda Mitsunobu , Kohno Ayumi 
Published: September 2021

Abstract
Background
Psychoeducation should be practiced by various professionals. However, many Japanese psychiatric nurses recognize that psychoeducation should be practiced by other professionals, and show passive attitudes toward learning about evidence-based practices (EBPs), including psychoeducation. We developed a psychoeducation practitioner training program (PPTP) to nurture nurses. However, the PPTP was shown to be ineffective to help nurses achieve psychoeducation skills, although it improved their knowledge of psychoeducation and views on EBP. We developed and evaluated a revised version of the PPTP, integrating blended learning that combines e-learning and group education (BL-PPTP), to nurture nurses’ competencies to practice psychoeducation for patients with mental disorders.

Method
We trained nurses working on acute psychiatric care wards of Japanese hospitals using BL-PPTP, and compared their attitudes for evidence-based practices (EBP attitudes), preparedness for psychoeducational practice, and self-efficacy at 4 points to clarify time-course changes in each participant.

Results
Sixty-nine nurses participated, 31 withdrew, and 38 were analyzed. The time needed to complete BL-PPTP ranged from 31 to 259 days, revealing a marked individual difference. There were significant improvements in most participants’ EBP attitudes and preparedness for psychoeducational practice at the end of the program compared with the baseline.

Conclusions
BL-PPTP may be useful to nurture nurses’ competencies to practice psychoeducation. BL-PPTP developed in the present study may also help disseminate psychoeducation among nurses, and increase the quality of nursing care.
An evaluation of an influenza vaccination campaign targeting pregnant women in 27 clinics in two provinces of South Africa, 2015 – 2018
Authors: Bishop Kate , McMorrow Meredith , Meiring Susan , Walaza Sibongile , Rossi Liza , Mhlanga Sarona , Tempia Stefano , Mathunjwa Azwifarwi , Kleynhans Jackie , Appiah Grace D. , McAnerney Johanna M. , Zar Heather J. , Cohen Cheryl 
Published: September 2021

Abstract
Introduction
Despite prioritization, routine antenatal influenza vaccine coverage is < 16% in South Africa. We aimed to describe maternal influenza vaccine coverage in 27 antenatal clinics (ANCs) in Gauteng and Western Cape (WC) Provinces, where in collaboration with the Department of Health (DoH), we augmented the annual influenza vaccination programme among pregnant women.

Methods
From 2015 through 2018, 40,230 additional doses of influenza vaccine were added to the available stock and administered as part of routine antenatal care. Educational talks were given daily and data were collected on women attending ANCs. We compared characteristics of vaccinated and unvaccinated women using multivariable logistic regression.

Results
We screened 62,979 pregnant women during the period when Southern Hemisphere influenza vaccines were available (27,068 in Gauteng and 35,911 in WC). Vaccine coverage at the targeted clinics was 78.7% (49,355/62682), although pregnant women in WC were more likely to be vaccinated compared to those in the Gauteng (Odds ratio (OR) =3.7 p < 0.001). Women aged 25—29 and > 35 years were less likely to be vaccinated than women aged 18—24 years (OR = 0.9 p = 0.053; OR = 0.9 p < 0.001). HIV positive status was not associated with vaccination (OR = 1.0 p = 0.266). Reasons for not vaccinating included: vaccine stock-outs where ANCs depleted available stock of vaccines and/or were awaiting delivery of vaccines (54.6%, 6949/12723), refusal/indecision (25.8%, 3285), and current illness that contraindicated vaccination (19.6%, 2489).

Conclusion
Antenatal vaccination uptake was likely improved by the increased vaccine supply and vaccine education offered during our campaign.
Barriers and enablers to implementing ‘DEALTS2’ simulation-based train-the–trainer dementia training programme in hospital settings across England: a qualitative study
Authors: Heward Michelle , Board Michele , Spriggs Ashley , Blagden Dina , Murphy Jane 
Published: September 2021

Abstract
Background
Despite approaches to provide effective dementia training in acute care settings, little is known about the barriers and enablers to implement and embed learning into practice. We were commissioned by Health Education England to develop and evaluate a new dementia training intervention ‘Dementia Education And Learning Through Simulation 2’ (DEALTS2), an innovative simulation toolkit to support delivery of dementia training in acute care across England. This study aimed to explore barriers and enablers experienced by trainers implementing DEALTS2 and extent to which it impacted on delivery of training and staff clinical practice.

Methods
We conducted twelve one-day DEALTS2 train-the-trainer (TTT) workshops across England in 2017 for National Health Service Trust staff employed in dementia training roles (n = 199 trainers); each receiving a simulation toolkit. Qualitative data were collected through telephone interviews 6–8 months after TTT workshops with 17 of the trainers. Open ended questions informed by the Kirkpatrick model enabled exploration of implementation barriers, enablers, and impact on practice.

Results
Thematic analysis revealed six themes: four identified interrelated factors that influenced implementation of DEALTS2; and two outlined trainers perceived impact on training delivery and staff clinical practice, respectively: (i) flexible simulation and implementation approach (ii) management support and adequate resources (iii) time to deliver training effectively (iv) trainer personal confidence and motivation (v) trainers enriched dementia teaching practice (vi) staff perceived to have enhanced approach to dementia care. Trainers valued the DEALTS2 TTT workshops and adaptability of the simulation toolkit. Those supported by management with adequate resources and time to deliver effective dementia training, were likely to implement DEALTS2. Trainers described positive impacts on their teaching practice; and perceived staff had enhanced their approach to caring for people with dementia.

Conclusions
Trainers explained individual and organisational barriers and enablers during implementation of DEALTS2. The flexible simulation and implementation approach were key to supporting adherence of DEALTS2. To ensure wider implementation of DEALTS2 nationally, Trusts need to allocate appropriate time to deliver effective dementia training. Future research should measure staff behaviour change, patient perspectives of the intervention, and whether and how DEALTS2 has improved health and care outcomes.
Collection of cerebrospinal fluid in 50 adult healthy donkeys (Equus asinus): clinical complications, and cytological and biochemical constituents
Authors: Abdelhakiem Mohammed A. H. , Hussein Hussein Awad 
Published: September 2021

AbstractBackgroundDiseases of the central nervous system are a well-recognized cause of morbidity and mortality in equine. Collection and analysis of cerebrospinal fluid (CSF) give information about the type and stage of degenerative and inflammatory diseases in central nervous system (CNS). The present research aimed to assess the clinical complications of CSF collections and to establish range values of cytological and biochemical parameters of CSF in adult healthy donkeys (Equus asinus). The CSF samples were collected from fifty healthy donkeys at the lumbosacral (LS) and atlanto-occipital (AO) sites.ResultsHypothermia, tachycardia, ataxia and recumbency may develop post-puncture. Erythrocytes were noticed in 35 of 50 CSF samples. Total nucleated cell counts ranged from 0 to 6 cells/μL, and lymphocytes predominated the cells (61%). The concentration of glucose (1.2 to 5.3 mmol/L) was lower than that of serum (P < 0.05). The CSF sodium concentration (123 to 160 mmol/L) was approximately like that of serum, but potassium (1.5–3 mmol/L) was lower than that of serum (P < 0.01). Urea concentrations (1.1–2.9 mmol/L) were markedly lower than serum (P < 0.001). Concentrations of CSF total proteins, and albumin ranged from 0.1 to 0.6 g/dL, and from 0.002 to 0.013 g/dL, respectively. The albumin quotient ranged from 0.06 to 0.56.ConclusionsTransient hypothermia, tachycardia, ataxia and recumbency may develop as clinical complications of CSF puncture procedures. The collection site has no impact on the constituents in CSF. Furthermore, this study presented the range values for normal cytological and biochemical constituents of CSF in donkeys (Equus asinus) that can provide a basis in comparison when evaluating CSF from donkeys with neurologic diseases.