bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor-associated Tissue Eosinophilia Predicts Favorable Clinical Outcome in Solid Tumors: A Meta-analysis
Authors: Hu Guoming , Wang Shimin , Chen Wei , Huang Liming 
Published: July 2019

Abstract
Background: Activated eosinophils have been deemed to affect carcinogenesis and tumor progression via various mechanisms in tumor microenvironment. However, the prognostic role of tumor-associated tissue eosinophilia (TATE) in human cancers still remains controversial. Therefore, we performed the meta-analysis to better understand the role of TATE in prognosis prediction for cancer patients.
Methods: We searched PubMed and EBSCO to identify the studies evaluating the association of TATE and overall survival (OS) and/or disease-free survival (DFS) in cancer patients, then computed extracted data into hazard ratios (HRs) for OS, DFS and clinicopathological features such as lymph node metastasis etc with STATA 12.0.
Results: A total of 6125 patients from 25 published studies were incorporated into this meta-analysis. We found that the presence of TATE significantly improved OS and 5-year DFS in all types of cancers. In stratified analyses based on cancer types, pooled results indicated that eosinophils infiltrating into tumor tissue was significantly associated with better OS in oral cancer, esophageal carcinoma and colorectal cancer. In addition, TATE was significantly inversely correlated with lymph node metastasis, tumor stage and lymphatic invasion of cancer.
Conclusion: TATE leads to a favorable clinical outcome in cancer patients, implicating that it is a valuable biomarker for prognostic prediction for human cancers and clinical application of biological response modifiers or agonists promoting TATE may be the novel therapeutic strategy for patients.
The positive effect of job aids on Patent and Proprietary Medicine Vendor injectable contraceptive knowledge 9 months after training: Longitudinal results from implementation science research in Nigeria
Authors: Dwyer Sara Chace , Jain Aparna , Ishaku Salisu , Okunade Faizah , Uzomba Chiamaka , Adebayo Adedamola , Tobey Elizabeth 
Published: July 2019

Abstract
Background

To increase access to voluntary family planning services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing family planning services to drug shops has been identified as a promising practice, but more evidence is needed on how to support PPMVs in providing family planning, such as injectable services, if policy were changed.

Methods

Data were collected from 194 PPMVs in Bauchi, Cross River, Ebonyi and Kaduna states at three time points. PPMVs were trained to provide family planning counseling and injectable contraceptive services, including administration. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three outcome variables were used to represent knowledge of injectable contraceptives: intramuscular deo-medroxyprogesterone acetate (DMPA) knowledge, subcutaneous DMPA knowledge, and knowledge of 4 or more of 7 common side effects of progestin-only injectables. Unadjusted and adjusted logistic regression models were conducted for each outcome variable to determine which factors affect PPMV knowledge of injectable contraceptives 9 months after the training.

Results

PPMVs’ intramuscular and subcutaneous DMPA knowledge and side effect knowledge was low before the training and then increased immediately afterwards. Nine months following the training, intramuscular and subcutaneous DMPA knowledge decreased and side effect knowledge remained relatively the same compared to the post-training results. Results from three logistic regression models found that PPMVs who reported using at least 2 of the 3 family planning job aids provided during the training had significantly higher knowledge compared to those who reported using one or no job aids.

Conclusion

Providing PPMVs with family planning job aids as part of a larger capacity-building strategy should be considered as they may help PPMVs retain knowledge after training. These results contribute to the literature on task sharing family planning services to private sector drug shops and implications for scale-up.
Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?
Authors: Clavel Nathalie , Pomey Marie-Pascale , Ghadiri Djahanchah Philip (Sacha) 
Published: July 2019

Abstract
Background
Around the world, many healthcare organizations engage patients as a quality improvement strategy. In Canada, the University of Montreal developed a model which consists in partnering with patient advisors, providers, and managers in quality improvement. This model was introduced through its Partners in Care Programs experimented in several quality improvement teams in Quebec, Canada. Partnering with patients in quality improvement brings about new challenges for healthcare managers. Although this model is recent, little is known about how managers contribute to implementing and sustaining it using key practices.

Methods
In-depth multi-level case studies were conducted within two healthcare organizations which have implemented a Partners in Care Program in quality improvement. The longitudinal design of this research enabled us to monitor the implementation of patient partnership initiatives from 2015 to 2017. In total, 38 interviews were carried out with managers of different levels (top-level, mid-level, and front-line) involved in the implementation of Partners in Care Program. Additionally, seven focus groups were conducted with patients and providers.

Results
Our findings show that healthcare managers are engaged in four main types of practices: 1-designing the patient partnership approach for it to make sense to the entire organization; 2-structuring patient partnership to support its implementation and sustainability; 3-managing patient advisor integration in quality improvement to avoid tokenistic participation; 4-evaluating patient advisor integration to support continuous improvement. Designing and structuring patient partnership are based on traditional management practices usually used to implement quality improvement initiatives in healthcare organizations, whereas managing and evaluating patient advisor’ integration require new daily practices from managers. Our results revealed that managers of all levels, from top to front-line, are concerned with the implementation of patient partnership in quality improvement.

Conclusion
This research adds empirical support to the lack of evidence on daily managerial practices used for implementing patient partnership initiatives in quality improvement and contributes to guiding healthcare organizations and managers when integrating such approaches.
Satisfaction With Use Of Public Health And Peer Led Facilities For HIV Prevention Services By Key Populations In Nigeria
Authors: Ochonye Bartholomew , Folayan Morenike Oluwatoyin , Fatusi Adesegun O , Emmanuel Godwin , Adepoju Tomi , Ajidagba Babatunde , Jaiyebo Toluwanimi , Umoh Paul , Yusuf Ayo 
Published: July 2019

Abstract
Background

To identify the proportion of FSW, MSM and PWID who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers.

Settings

Four states in Nigeria

Methods

A mixed method approach was used to collect data from key populations in four states in Nigeria. Data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analysis was conducted for quantitative data.

Results

49.4% of the 482 respondents, and 48.7% of the 485 respondents to the question, had received HIV and sexual and reproductive health services through the public health and peer-led facilities respectively. Significantly more respondents were satisfied with the quality of services provided by peer led organisations than public health facilities. Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. There was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08).

Conclusion

Key populations had better satisfaction receiving HIV prevention services at peer led organisations than at public health facilities.
Decreased abundance of Akkermansia muciniphila after adrenocorticotropic hormone therapy in patients with West syndrome
Authors: Xu Lu , Gao Feng , Mao Shanshan , Jiang Lihua , Song Chao , Zhao Congying , Chen Dandan 
Published: July 2019

Abstract
Background

West syndrome (WS) is a severe epileptic encephalopathy of infancy. The high degree of effectiveness of adrenocorticotropic hormone (ACTH) therapy indicates that the hypothalamic-pituitary-adrenal (HPA) axis may be involved in WS, and there is substantial evidence that the gut microbiota (GM) communicates with the brain via the HPA axis. The aims of this study were to determine and compare the diversity of the GM in infants with WS and healthy infants, and in patients with WS before and after ACTH therapy.

Results

A total of 19 infants with WS and 24 healthy infants in the same age range (3–13 months) were enrolled. Fecal samples were collected and DNA was extracted and sequenced on the Illumina HiSeq platform. The between-group differences in Chao1 index (α diversity) and the abundances of GM genera were analyzed using the Wilcoxon signed-rank test; graphs were plotted using R software. There were no significant differences in the top four dominant GM genera between patients with WS and healthy infants; however, the abundance of the species Akkermansia muciniphila was significantly (P = 0.017) higher in the WS group than in healthy infants. After 2 weeks of ACTH therapy, the abundance of this bacteria was significantly (P = 0.022) and dramatically decreased.

Conclusion

The abundance of A. muciniphila was significantly higher in patients with WS than healthy infants. Further research is needed to clarify the relationship between A. muciniphila and WS pathogenesis.
A qualitative transcriptional signature to reclassify histological grade of ER-positive breast cancer patients
Authors: Li Jing , Jiang Wenbin , Zheng Hailong , Yang Jing , Cai Hao , Guo Zheng 
Published: July 2019

Abstract
Purpose Histological grade (HG) is commonly adopted as a prognostic factor for ER-positive breast cancer patients. However, HG evaluation methods, such as the pathological Nottingham grading system, are highly subjective with only 50%-85% inter-observer agreements. Specifically, the subjectivity in the pathological assignment of the intermediate grade (HG2) breast cancers, comprising of about half of breast cancer cases, results in uncertain disease outcomes prediction. Here, we developed a qualitative transcriptional signature, based on within-sample relative expression orderings (REOs) of gene pairs, to define HG1 and HG3 and reclassify pathologically-determined HG2 (denoted as pHG2) breast cancer patients.
Results From the gene pairs with significantly stable REOs in pathologically-determined HG1 (denoted as pHG1) samples and reversely stable REOs in pathologically-determined HG3 (denoted as pHG3) samples, concordantly identified from seven datasets, we extracted a signature which could determine the HG state of samples through evaluating whether the within-sample REOs match with the patterns of the pHG1 REOs or pHG3 REOs. A sample was classified into the HG3 group if at least a half of the REOs of the 10 gene pairs signature within this sample voted for HG3; otherwise, HG1. Using four datasets including samples of early stage (I–II) ER-positive breast cancer patients who accepted surgery only, we validated that this signature was able to reclassify pHG2 patients into HG1 and HG3 groups with significantly different survival time. For the original pHG1 and pHG3 patients, the signature could also more accurately and objectively stratify them into distinct prognostic groups. And the up-regulated and down down-regulated genes in HG1 compared with HG3 involved in cell proliferation and extracellular signal transduction pathways respectively.
Conclusions The transcriptional qualitative signature can provide an objective assessment of HG states of ER-positive breast cancer patients, especially for reclassifying patients with pHG2, to assist decision making on clinical therapy.
Characteristics of Adult Abdominal Cystic Lymaphangioma: a single center Chinese cohort of 12 cases
Authors: Xiao Jianchun , Shao Yuming , Zhu Shan , He Xiaodong 
Published: July 2019

Abstract
Background

Cystic lymphangioma is a kind of rare benign cystic developmental disease entity, mostly affected cervical and axial regions. Clinical features of abdominal cystic lymphangiomas (ACL) was reported among childhood but unclear for adult ACL. The purpose of this study is to demonstrate the clinical characteristics of Chinese adult ACL patients and introduce our experience of treating this disease.

Methods

We conducted a single-centered non-intervention retrospective study of 12 adult ACL patients who admitted to Peking Union Medical College Hospital (PUMCH, Beijing, China) from November 1984 to August 2017. The demographic, clinical, laboratory, imaging, histologic and therapeutic data were collected.

Results

Detailed information of 7 male and 5 female was available. The mean age at dianosis was 39.1 (17.3) years. The mean duration of follow-up was 6.9 years. Six (50%) patients were asymptomatic and abdominal pain was the leading symptom for three (25%) patients. The cysts were evaluated by ultrasound (n=8, 67%), CT (n=10, 83%) and MRI (n=4, 33%). Theraputic modalities include laparotomy (n=6, 50%), laparoscopy (n=4, 33%) and aspiration (n=2, 17%), with a variable response. Mean postoperation hospital stay was 6.8 days. Complete excision was accomplished among 8 patients and only one relapse was observed during follow-up. One partial resection patients reported disease reccurence.

Conclusions

This is the first Asian cohort of adult ACL patients. Typical imaging features could lead to timely diagnosis and treatment. Radical resection is recommended for ACL with a longer period of follow-up. The analysis of this cohort deepens our understanding of adult ACL.
Risk factors for intrahepatic cholangiocarcinoma: a systematic review and meta-analysis
Authors: Wang Shijie , Hu Bin , Li Yifei , Cai Zhibin , Zhou Yanming 
Published: July 2019

Abstract
Background

The incidence of intrahepatic cholangiocarcinoma (ICC) has increased worldwide in recent years, but the risk factors of ICC have not yet been clearly defined. The aim of this study was to identify risk factors for ICC.

Methods

A literature search was conducted in PubMed database for eligible studies published from January 2000 to November 2018. Summary odds ratio (OR) with their corresponding 95% confidence intervals (CI) were calculated using a random-effects model.

Results

Thirty-two studies (5 cohort, 27 case control) were included in this meta-analysis. Pooled estimates indicated that cirrhosis (OR=11.96, 95% CI 7.53-19.00), hepatitis B virus (HBV) infection (OR=4.09, 95% CI 3.13-5.34), hepatitis C virus (HCV) infection (OR=3.94, 95% CI 2.85-5.45), alcohol consumption (OR=2.68, 95% CI 1.97-3.66), hepatolithiasis (OR=14.94, 95% CI 6.41-34.83), choledochal cyst (OR=21.67, 95%CI 10.83-43.36), primary sclerosing cholangitis (PSC) (OR=93.91, 95%CI 43.99-200.47), diabetes mellitus (OR=1.82, 95% CI 1.57-2.11), non-alcoholic fatty liver disease (OR=2.23, 95% CI 1.65-3.02), liver fluke infection (OR=2.28, 95% CI 1.30-4.01) and smoking (OR=1.26, 95% CI 1.07-1.49) were significantly associated with ICC. Non-significant association was found between ICC and history of cholecystectomy, hypertension, coffee and aspirin.

Conclusions

Cirrhosis, HBV infection, HCV infection, alcohol consumption, hepatolithiasis, choledochal cyst, PSC, diabetes mellitus, non-alcoholic fatty liver disease, liver fluke infection and smoking are risk factors for ICC.
The predictive value of red cell distribution width for stroke severity and outcome
Authors: Shahsavarinia Kavous , Laleh Younes Ghavam , Moharramzadeh Payman , Pouraghaei Mahboob , Sadeghi-Hokmabadi Elyar , Seifar Fatemeh , Hajibonabi Farid , Khamnian Zhila , Farhoudi Mehdi , Mafi Sara 
Published: July 2019

Abstract
Objectives: In the present study, we sought to investigate the association of RDW with stroke severity and outcomes in patients who underwent anti-thrombolytic administration with tissue plasminogen activator (tPA). Results: This study was conducted during eighteen months at emergency department. During the time of study, 282 subjects were included. The categorization of RDW to <12.9 and >13 values revealed insignificant difference in stroke severity score, accounting for the mean 36-hour NIHSS of 8.19±8.2 in normal RDW values and 9.94±8.28in higher RDW group (p=0.64). In seventh day assessment, NIHSS was 6.46±7.28 in normal RDW group and was 8.52±8.35 in increased RDW group (p=0.058). Neither the thirty-six-hour, nor the seventh day and 3-month MRS demonstrated significant difference between those with normal and higher RDW values.
PHENOTYPIC CHARACTERIZATION, ANTIBIOGRAM AND RISK FACTORS OF SALMONELLA ISOLATES FROM LAYING CHICKEN, POULTRY FARM AND MARKET’S EGGS IN JIMMA TOWN, SOUTH WESTERN ETHIOPIA
Authors: Taddese Diriba , Tolosa Tadele , Deresa Benti , lakow Matios , Olani Abebe , Shumi Eshetu 
Published: July 2019

Abstract
Objectives

Salmonella is the most important causes of foodborne illness especially from poultry and poultry products. So the aim of this study was to carryout phenotypic characterization, antimicrobials susceptibility pattern and risk factors of salmonella isolates from farms and markets eggs, cloacae swabs of chickens and stool of egg collectors. A cross-sectional study was conducted from January 2018 to September 2018. Samples were, processed; salmonella was isolated, Phenotypically identified by OmniLog and antimicrobials susceptibility were carried out.

Result

Over all; 11(2.65%) of salmonella enterica were phenotipically characterized out of 415 samples from farms egg content (n=83), farms eggshell (n=83), cloacae (n=83), market eggshell (n=83) and market egg contents (n=83) with 2.4%, 0%, 2.4%, 4.8% and 3.6% prevalence, respectively. Out of isolates, 8(72.72%) displayed multidrug resistance. All isolates showed susceptibility to Gentamicin, Kanamycin and Streptomycin. Lack of separating cracked eggs, washing hand, eggs stay longer unsold, and mixing excreta with feed were associated risk factors for salmonella presence (p-value<0.05). The presence of drug resistant salmonella enterica within egg/and chicken can pose serious health problem. Good hygienic practices are important to reduce risk factors of salmonella contamination.
Non-technical skills of medical students in the course of pediatric emergency simulations are associated with their mindfulness: an observational cohort study
Authors: Chmielewski Jacek , Łuczyński Włodzimierz , Dobroch Jakub , Cebula Grzegorz , Bielecki Tomasz , Torres Kamil 
Published: July 2019

Abstract
Background

High fidelity medical simulations allow for teaching medical skills in safe and realistic conditions. Pediatric teams of emergency departments work under extreme stress, which affects high-level cognitive functions, specifically attention and memory, and increases the already high stakes for young doctors. Lapses in attention increase the risk of serious consequences such as medical errors, failure to recognize life-threatening signs and symptoms, and other essential patient safety issues. Mindfulness as a process of intentionally paying attention to each moment with curiosity, openness and acceptance of each experience without judgment can potentially contribute to improving the performance of medical teams in conditions of pediatric emergency. The aim of the study was to determine whether the actions of medical students in the course of pediatric high fidelity simulations are related to their mindfulness.

Participants and methods

A total of 166 standardized simulations were conducted among students of medicine in three simulation centers of medical universities, assessing: stress sensation, technical skills (checklists), non-technical skills (Ottawa Crisis Resource Management Global Rating Scale) and mindfulness using Five Facet Mindfulness Questionnaire.

Results

The perception of stress among students was lower and more motivating if they were more mindful. Mindfulness of students correlated positively with avoiding fixation error, but negatively with listening to and managing the team. The lowest scores among non-technical skills were noted in the area of ​​situational awareness (fixation error). In subsequent simulations of the same team, students' non-technical skills improved, although no change was noted in their technical skills.

Conclusions

The results of our research indicate the relationship between the mindfulness of medical students and their non-technical skills and the perception of stress in pediatric emergency simulations. Further research is needed to show whether mindfulness training leads to any changes in this field.

Trial registration

ClinicalTrials.gov, NCT03761355).
Evaluating the community-based medical education programme in a rural district hospital: The students’ perspectives
Authors: ADEFUYE ANTHONIO O Oladele , Benedict Matthew Abiodun , Bezuidenhout Johan , Busari Jamiu 
Published: July 2019

Abstract
Backgrounds: The adoption of community-based medical education (CBME) into the undergraduate medical curriculum is in line with the SPICE model for medical curriculum proposed by Harden and colleagues. Students are the consumers of medical education and are, thus, the ideal evaluators of the efficacy of their own course and learning environment. To evaluate the quality of the CBME programme in Botshabelo District Hospital (BDH), this study investigated student’s perceptions of their experience during their CBME training at BDH. In addition, suggestions on how to enrich students’ experience during the CBME posting was obtained from the participants.

Methods: This research was designed as a qualitative (Ethnographic) study that used a questionnaire survey to qualitatively explore the perceptions of fourth-year undergraduate medical student at BDH.

Results: Of the 120 questionnaires distributed, 84 were returned, giving a response rate of 70.0%. When asked to indicate what they liked or disliked about their CBME training, “Good educators/staff” and the “Attitude of some doctors” were the themes that scored highly (25.1% and 19.4%) in the “likes” and “dislikes” category respectively. Some of the major challenges faced during the CBME training at BDH included; Exposure to new learning environment (14.2%); Clinical practice context (12.6%) and; Language barrier (7.2%). Participants stated that they gained knowledge of how to perform certain clinical procedures and acquired core clinical skills in the areas of formulating management and managing some medical emergencies during their training at BDH. Increasing the duration of training (25.6% coverage) was suggested as a major way to enrich students’’ experience during the training at BDH.

Conclusions: Findings from this study reveal that CBME is a valuable pedagogical tool to enhance learning in undergraduate medical education and that more work is required to improve the quality of CBME training in BDH. We believe that the findings from this study will inform future planning of CBME training programmes in BDH.