bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study of old patients’ experiences of the quality of the health services in hospital and 30 days after hospitalization
Authors: Lilleheie Ingvild , Debesay Jonas , Bye Asta , Bergland Astrid 
Published: July 2019

Abstract
Background

The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions (multimorbidity). The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that health care systems must prepare for a change in the focus of clinical care for older people. The WHO defines health care quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which health care quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions.

This study explores experiences of the quality of the health services in hospital and the first 30 days at home after discharge by patients over 80 years of age.

Method

We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically.

Results

The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants.

Conclusion

According to the WHO, to deliver quality health care, services must include all six of the dimensions listed above. Our findings show that they do not. Health care focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.
Patient Satisfaction with Clinical Laboratory Services and Associated Factors among Adult Patients attending Outpatient Departments at Debre Markos Referral Hospital, Northwest Ethiopia
Authors: Alelign Asmamaw , Belay Yihalem Abebe 
Published: July 2019

Abstract
Objectives: There is limited evidence on patient satisfaction with clinical laboratory services in Northwest Ethiopia. This study aimed to assess patient satisfaction with clinical laboratory services and associated factors among adult patients attending outpatient department at Debre Markos hospital, Northwest Ethiopia. Cross-sectional study was conducted among 391 patients from April 09-16, 2019 using interviewer-administered questionnaire. Systematic random sampling technique was used. Data were entered into Epi-Data 3.1, and analyzed using SPSS 20. Binary logistic regression analysis was employed. Variables having p-value < 0.05 were considered as statistically significant.
Results: Overall level of patient satisfaction towards clinical laboratory services was 48.3%. Patients with no occasion of missing laboratory results [AOR: 2.10; 95% CI (1.13, 3.83)], had diplomas and above educational level [AOR: 0.38; 95% CI (0.15, 0.96)], and who reported no place in the laboratory to put personal things [AOR: 0.37; 95% CI (0.21, 0.54)] were significantly associated with patient satisfaction. Hospital administration and laboratory department in Debre Markos hospital should strengthen their effort to improve patient satisfaction focusing on educated patients, missing laboratory results, and the availability of places to put personal things in the blood drawing room.
Key words: Debre Markos hospital; Patient satisfaction; Laboratory services
A shared susceptibility locus in p53 for both gastric cancer and esophageal cancer in a northwestern Chinese population
Authors: Cao Juan , Chen Zhiqiang , Chen Jing , You Yanjie , Tian Chaoyong , Yu Jia , Zhang Hongfei , Yang Jingwen , Yang Wenjun 
Published: July 2019

Abstract
Background Upper gastrointestinal cancers are the leading causes of cancer-related deaths in Northwest China and share many similarities in terms of histological type, risk factors and genetic variants. We hypothesized that shared common genetic SNPs among eight SNPs in the p53 pathway existed among Ningxia gastric cancer (GC) and esophageal cancer (EC) patients. Methods A total of 180 GC cases, 113 EC cases and 358 cancer-free control subjects from a high-incidence area for upper gastrointestinal cancers in Ningxia, China, were enrolled in this study. The genotyping of 8 SNPs was performed using PCR direct sequencing. P53 expression in GC and EC tissues was examined using the S-P immunohistochemical method. Multiple logistic regression analyses were used to estimate the association between genotypes and GC or EC risks. Kaplan-Meier and multivariate Cox regression analyses were carried out to evaluate the associations between genetic variants and overall survival. Result rs1042522 was a common genetic locus shared by both Ningxia GC and EC patients. Compared with the rs1042522 Pro allele, the rs1042522 Arg allele increased the GC risk by 1.810 times and the EC risk by 2.285 times. Additionally, patients who carried the rs1042522 Arg allele and who also smoked or consumed alcohol had an increased risk for GC and EC. Cox survival analysis showed that neither p53 nor rs1042522 had an effect on the prognosis of GC and EC patients. Conclusion rs1042522 was a common genetic locus responsible for susceptibility shared by both northwestern GC and EC Chinese patients. Tobacco smoking and alcohol drinking further enhanced the cancer risk in our study.
Alterations of plasma glutamine and surgical stress in gastric cancer surgery
Authors: Hayashi Tsutomu , Aoyama Toru , Yamamoto Hiroshi , Yamada Takanobu , Sato Tsutomu , Rino Yasushi , Masuda Munetaka , Cho Haruhiko , Tsuburaya Akira , Ogata Takashi , Yoshikawa Takaki 
Published: July 2019

Abstract
Background: The plasma glutamine levels are known to decrease after major surgery, which is related to a negative clinical outcome. However, the influence of surgical stress on the decrease in the plasma glutamine concentration is unclear. The aim of this study was to evaluate the change in glutamine in relation to the types of gastrectomy and approaches as well as the amount of surgical stress evaluated by serum interleukin-6(IL-6) as an objective indicator.
Methods: This was a prospective observational study. The eligibility criteria were (1) gastric adenocarcinoma of the stomach confirmed by pathology and (2) patients scheduled to receive gastrectomy with lymphadenectomy for gastric cancer. Blood samples were taken at 7 AM on the day of surgery and at 12 h after surgery to measure the plasma glutamine and interleukin-6 (IL-6) levels.
Results: Between May 2011 and December 2011, 81 consecutive patients were enrolled in this study. The plasma glutamine level was significantly decreased in all patients, regardless of distal or total gastrectomy and laparoscopic or open surgery. No significant differences were observed in the IL-6 level between total and distal gastrectomy patients or between patients treated via a laparoscopic or open approach. Decreases in the plasma glutamine level were positively correlated with the logarithmically transformed-plasma IL-6 (logIL6) (r =0.471, p<0.001) overall.
Conclusions: Decreases in the glutamine concentration depended on the amount of surgical stress. When conducting a clinical trial to evaluate glutamine administration, personalized adjustment may be key to avoiding glutamine depletion in response to surgical stress.
Therapeutic Effect of Exogenous Treg Cells on Collagen-Induced Arthritis and Rheumatoid Arthritis
Authors: Li Shutong , Wang Hongxing , Wu Hui , Zhang Guoqing , Chang Xiaotian 
Published: July 2019

Abstract
Background

Regulatory T (Treg) cells have anti-inflammatory and anti-autoimmune functions. The proportion and functions of Treg cells are perturbed in rheumatoid arthritis (RA) patients.

Methods

Human Treg cells were induced to amplify in vitro and cocultured with RA synovial fibroblast cells (RASFs). The proliferation and apoptosis of RASFs were determined by the cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Human Treg cells were also injected to collagen-induced arthritis (CIA) rats via the tail vein. Changes in lymphocyte subtypes and cytokines in the peripheral blood and spleen were observed by flow cytometry.

Results

After coculture with the Treg cells, the proliferation of RA synovial fibroblast cells decreased (p<0.01), and the rate of apoptosis increased (p=0.037). The human Treg cells were injected into the tail veins of collagen-induced arthritis (CIA) rats. The severity of the CIA was reduced (p<0.01) following the injection, the percentages of rat endogenous Treg cells in the peripheral blood and spleen increased significantly (p=0.007 and p<0.01, respectively), and the proportion of B cells decreased (p=0.031). The levels of interleukin IL-5 and IL-6 and the Th1/Th2 ratio in the peripheral blood were significantly decreased (p=0.013, 0.009 and 0.012, respectively). The number of NK cells and the levels of IL-4, IL-13, TNF-α, IFN-γ and GM-CSF in the peripheral blood and spleen did not change significantly.

Conclusion

These results suggest that exogenous Treg cells play a therapeutic role in RA and CIA. Treg cell treatment could serve as a therapy for RA.
Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis
Authors: Liu Jing , Dong Yi , Wang Yan 
Published: July 2019

Abstract
Background

This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery.

Methods

All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively.

Results

Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: -0.26 to -0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: -0.21 to -0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P<0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence.

Conclusions

Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.
Sequential dual-site High-Definition transcranial Direct Current Stimulation (HD-tDCS) treatment in chronic subjective tinnitus: study protocol of a double-blind, randomized, placebo-controlled trial
Authors: Cardon Emilie , Rompaey Vincent Van , Jacquemin Laure , Mertens Griet , Vermeersch Hanne , Joossen Iris , Beyers Jolien , Vanderveken Olivier , de Heyning Paul Van , Topsakal Vedat , Gilles Annick 
Published: July 2019

Abstract
Background

Chronic tinnitus is a highly prevalent symptom, with many patients reporting considerable effects of tinnitus on quality of life. No clear evidence-based treatment options are currently available. While counseling-based methods are valuable in some cases, they are not sufficiently effective for all tinnitus patients. Neuromodulation techniques such as high-definition transcranial direct current stimulation (HD-tDCS) are proposed to have positive effects on tinnitus severity but, to date, these effects have not been proven conclusively. The proposed trial will investigate the hypothesis that chronic tinnitus patients receiving HD-tDCS will report a positive effect on the impact of tinnitus on daily life, as compared to patients receiving sham stimulation.

Methods

This study proposes a randomized, double-blind, placebo-controlled trial with parallel group design. A total of 100 chronic tinnitus patients will be randomly allocated to an experimental group or a sham group, with allocation stratified according to gender and tinnitus severity. Patient and researcher will be blinded to the patient’s allocation. Patients will undergo six sessions of sequential dual-site HD-tDCS of the left temporal area and the right dorsolateral prefrontal cortex. Evaluations will take place at baseline, immediately following treatment, and at three and six months after the start of the therapy. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Secondary outcome measures include audiological measurements, cortical auditory evoked potentials, the Repeatable Battery for the Assessment of Neuropsychological Status adjusted to test Hearing impaired individuals (RBANS-H), and supplementary questionnaires probing tinnitus severity and additional symptoms. By use of a linear regression model, the effects of HD-tDCS compared to sham stimulation will be assessed.

Discussion

The objective of this study is to evaluate whether HD-tDCS can reduce the impact of tinnitus on daily life in chronic tinnitus patients. To date, published trials on the effects of HD-tDCS on tinnitus suffer from a lack of standardization, and few randomized controlled trials exist. The proposed study will be the first adequately powered trial to investigate the effects of sequential dual-site HD-tDCS on tinnitus severity.
Effect of short-term blood pressure variability on functional outcome after intra-arterial treatment in acute stroke patients with large-vessel occlusion
Authors: Zhang Tianli , Wang Xiaolong , Wen Chao , Zhou Feng , Gao Shengwei , Zhang Xiaodong , Lin Shiqin , Shi Jing , Li Weirong 
Published: July 2019

Abstract
Background: Endovascular treatment (EVT) is advocated for acute ischemic stroke with large-vessel occlusion (LVO), but perioperative periods are challenging.This study investigated the relationship between post-EVT short-term blood pressure variability (BPV) and early outcomes in LVO patients.
Methods: We retrospectively reviewed 72 LVO patients undergoing EVT between June 2015 and June 2018. Hourly systolic and diastolic blood pressures (SBP and DBP, respectively) were recorded in the first 24 hours post-EVT. BPV were evaluated as standard deviation (SD), coefficient of variation (CV), and successive variation (SV) separately for SBP and DBP. Three-month functional independence was defined as a modified Rankin Scale (mRS) score of 0-2.
Results: For 58.3% patients with favorable outcomes, median National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT scores on admission were 14 and 8, respectively. The maximum SBP ([154.3±16.8] vs. [163.5±15.6], P=0.02), systolic CV ([8. 8%±2.0%] vs. [11.0%±1.8%], P<0.001), SV ([11.4±2.3] vs. [14.6±2.0], P<0.001), and SD ([10.5±2.4] vs. [13.8±3.9], P<0.001) were lower in patients with favorable outcomes. On multivariable logistic regression analysis, systolic SV (OR: 4.273, 95% CI: 1.030 to 17.727, P=0.045) independently predicted unfavorable prognosis. The area under the curve was 0.868 (95% CI: 0.781 to 0.955, P<0.001), and sensitivity and specificity were 93.3% and 73.8%, respectively, showing excellent value for 3-month poor-outcome predictions.
Conclusions: Decreased systolic SV following intra-arterial therapies result in favorable 3-month outcomes. Systolic SV may be a novel predictor of functional prognosis in LVO patients.
Investigating the Balance Status of Nutrients in Wheat Plant Using Isometric Log Ratio and Field Validation of Balances
Authors: Geikloue Abolfazl , Reyhanitabar Adel , Najafi Nosratollah 
Published: July 2019

Nutrient status of plants is determined by using critical nutrient range and nutrient ratios. The obtained data may not be generally error‐free due to the nature of compositional data is not taken into account Here, nutrient status of wheat (Triticum aestivumL.) in Entisols and Aridisols soils is investigated by isometric log ratio (ILR) technique. Leaf samples collected from 96 fields at booting stage. To validate the obtained ILR balances, two separate filed experiments were conducted employing a factorial experiment based on CRBD design with three replications. Concentrations of N, P, K, Ca, Mg, Zn, Fe, Mn, Cu, and B in the flag leaf tissue were determined at both fields. Nutrients were arranged into ad hoc balances and computed ILR and classified into four groups as balanced, misbalanced, high and low yielders by receiver operating characteristic (ROC) curve. The ROC classification applied to the data from survey fields and validation test respectively showed 4.67 and 4.02 as the critical Mahalanobis distance and 5034 and 6559 kg ha−1as yield cut‐off for separating balanced and imbalanced samples at area under curve (AUC = 0.83 and 0.88). Comparing nutrient balance between reference (TN) and nonreference (TP) groups in the survey fields by Tukey's test showed that the balances of [Fe,Mn,Zn,Cu|B,Mg,Ca,K,P,N], [B|Mg,Ca,K,P,N], [Mg,Ca,K|P,N], [Mg,Ca|K], and [Mn|Zn,Cu] were negative. The [Fe|Mn,Zn,Cu] and [Zn|Cu] balances were positive. In the low yielding of survey fields, the balances of [Fe|Mn,Zn,Cu], [Mn|Zn,Cu], [Zn|Cu], [Fe,Mn,Zn,Cu|B,Mg,Ca,K,P,N], and [Ca,Mg|K] were imbalanced, but they become balanced through fertilizer treatments in the validation test.Core IdeasNutrient balances can be interpreted simultaneously using pan balance approach.The values of isomeric log ratio represent the balances between two or more nutrients.Mahalanobis distance was set as a criterion for nutrient misbalance.
Managing Tillage Operation and Manure to Restore Soil Carbon Stocks in Wheat–Maize Cropping System
Authors: Khan Ahmad , Fahad Shah , Khan Aziz , Saud Shah , Adnan Muhammad , Wahid Fazli , Noor Muhammad , Nasim Wajid , Hammad Hafiz Mohkum , Bakhat Hafiz Faiq , Ahmad Shakeel , Habib ur Rehman Muhammad , Wang Depeng , Sönmez Osman 
Published: July 2019

Increasing soil organic matter (SOM) contents improve the resilience of productive soil for future sustainability particularly in poor soil (<1% SOM). This study sought to elucidate how tillage and N fertilizer sources affect soil bulk density, soil organic carbon (SOC) and soil total N (TN) in 0‐ to 20‐cm soil depth. Treatments included minimum till (MT), conventional till (CT), deep till (DT), and twelve N treatments (60 and 120 kg urea N ha−1, 10 and 20 Mg farmyard manure [FYM] ha−1, 10 Mg soybean residue [SR] ha−1and their combinations along with a control). The experiment was designed in randomized complete block design with split plot arrangement. Soil bulk density increased for DT toward the end of the experiment than CT or MT. The sequestration rates of SOC of MT was 22% higher than DT. The FYM retuned more SOC than SR, however SR returned more TN than FYM. Application of FYM as well as SR sequestered more C than urea or control. Conclusively, SOC returned was increased with 10 Mg FYM ha−1along with 30 kg urea N ha−1but TN with 10 Mg SR ha−1in CT plots. This practice can therefore increase soil quality and productivity, and thus is considered a sustainable approach for soils deficient in organic matter.Core IdeasMinimum tillage improved C stock than shallow or deep tillage.The addition of urea increased SOC contents in SR plots than FYM.C Stocks in FYM and SR fertilized plots was about 3‐ to 4‐fold greater than control.Soybean residue build N stock principally in less plowed plots.
Catalytic activity of CuxMnxFe3-2xO4/multi-walled carbon nanotubes (0 ≤ x ≤ 0.1) nanocomposites for p-nitrophenol degradation in catalyst/H2O2 system
Authors: Yu Jiye , Tian Xiaojun , Liu Mingwang , Jia Zhenzhen , Fang Hongqin , Liu Yunfang , Yu Changyuan 
Published: July 2019

Abstract
Heterogeneous Fenton oxidation has become a very important wastewater-treatment method and its catalyst is crucial for good treatment effect. In order to improve the catalytic properties, the Cu and Mn elements were doped for CuxMnxFe3-2xO4/multi-walled carbon nanotubes (CuxMnxFe3-2xO4/MWCNTs) nanocomposites (0 ≤ x ≤ 0.1) by co-precipitation method. The structure, morphology and surface properties of the nanocomposites were characterized by X-ray powder diffractometer (XRD), N2-physisorption analysis, transmission electron microscope (TEM), and X-ray photoelectron spectroscopy (XPS). The CuxMnxFe3-2xO4/MWCNTs nanocomposites were used as heterogeneous Fenton catalysts for p-nitrophenol (p-NP) degradation. The catalytic performances of the Cu and/or Mn doped nanocomposites have remarkable improvement compared with Fe3O4/MWCNTs nanocomposite, especially for both Cu and Mn doped catalyst. For CuxMnxFe3-2xO4/MWCNTs nanocomposites, the catalytic performance increases with increasing x value and reaches a maximum at 0.075 of x value. At optimal condition, the p-NP conversion rate reaches 96.4% in 10 min for Cu0.075Mn0.075Fe2.85O4/MWCNTs nanocomposite. However, the mentioned rate for Fe3O4/MWCNTs catalyst is only 14.5%. The chemical oxygen demand (COD) removal rates in 120 min for Cu0.075Mn0.075Fe2.85O4/MWCNTs and Fe3O4/MWCNTs catalysts are 82.7% and 67.3%, respectively. Furthermore, the p-NP conversion and COD removal rates of Cu0.075Mn0.075Fe2.85O4/MWCNTs nanocomposite still keep at 94.4% and 70.3% after five-time reuse, respectively. This catalyst shows good reusability for p-NP degradation and is very easy to recover from the treated water.