bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T): psychometric properties measured in the context of postgraduate nursing education
Authors: Ozga Dorota , Gutysz-Wojnicka Aleksandra , Lewandowski Bogumił , Dobrowolska Beata 
Published: October 2019

Abstract
Background. The CLES+T instrument is internationally used for evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education.
Purpose. To examine the basic psychometric properties of the CLES+T in the context of clinical postgraduate nursing education in Poland.
Methods. Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland.
Results. Cronbach’s alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach’s alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52±0.63 for nursing care on the ward to 4.73±0.45 for role of the nurse teacher.
Conclusions. Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.
Traffic Police Officers’ Experience of Post-crash Care to Road Traffic Injury Victims: A Qualitative Study in Tanzania
Authors: Lukumay Gift G. , Mkoka Dickson A. , Outwater Anne H. , Ndile Menti L. , Saveman Britt-Inger 
Published: October 2019

Abstract
Background

Recently, road traffic injuries (RTIs) have become a major health problem affecting health systems in many low- and middle-income countries. Regardless of whether an ambulance is available for evacuation, police officers have been shown to arrive at the crash scene first, becoming, in effect, the first responders to RTI victims. Therefore, the study aimed to explore the experiences of traffic police officers in regard to the provision of care to RTI victims in the prehospital environment, including the role of traffic police upon arriving at the crash scene, the challenges they face, and their opinions about how to improve care to RTI victims.Method

The study used a qualitative approach in which data were obtained from 10 individual interviews and three focus group discussions. There were 41 participants, 27 of them were male and 14 were female. About half (48.7%) of the study participants were aged between 30 to 39 years. Qualitative content analysis was used to analyse all the materials.Results

Three themes emerged from the analysis. The theme “Maintain safety while saving injured victims’ lives and facilitating access to a health facility” was comprised of safety, sorting, initial help, and assisting access to hospital care. “Overwhelmed working with limited resources and support” included limited care and transport resources, police fatigue, and little or no support. “Improving supportive system and empowering frontline personnel” included the need for an emergency care system, availability of resources and an emergency medical support system, and training for police and drivers regarding victims’ first-aid care, and road safety.Conclusion

The study findings characterize an environment in which the police first responders have no knowledge or skills and no equipment and supplies to provide care to RTI victims at the scene before rushing them to definitive care. The results suggest a favorable climate for training and equipping officers so that they can deliver competent postcrash care at the scene while emergency medical services are yet to be established. However, more research will be needed to determine the efficacy of such training and its acceptability in the Tanzanian context.
Supraglottic Airway versus Endotracheal Tube During Interventional Pulmonary Procedures – A Retrospective Study
Authors: Behrens Kyle M , Galgon Richard E 
Published: October 2019

Abstract
Background: As the field of interventional pulmonology (IP) expands, anesthesia services are increasingly being utilized when complex procedures of longer duration are performed on sicker patients with high risk co-morbidities and lung pathology. Yet, evidence on the optimal anesthetic management for these patients remains lacking. Our aim was to characterize the airway management and, secondarily anesthetic maintenance patterns used for IP procedures at our institution. Methods: From 2894 identified encounters, charts of 783 patients undergoing an IP procedure with general anesthesia over a 5-year period, employing an endotracheal tube (ETT) or a supraglottic airway (SGA) for airway maintenance, were identified and reviewed after exclusions. Patients posted for a concurrent thoracic surgical procedure and those already intubated at presentation were excluded. Baseline patient demographics, procedure, proceduralist type, anesthesia maintenance modality, neuromuscular blocking drug (NMBD) use, and airway management characteristics were extracted and analyzed. Results: Inhaled general anesthesia with an ETT for airway maintenance was most commonly employed; however, SGAs were used in one-third of patients with a very low conversion rate (0.4%), and their use was associated with a significant reduction in NMBD use. Conclusions: In this large series of patients receiving general anesthesia for IP procedures, inhaled anesthetic agents and ETTs were favored. However, in appropriately selected patients, SGA use was effective for airway maintenance and allowed for a reduction in NMBD use, which may have implications in this patient population who may have an increased risk for pulmonary complications and warrants further investigation.
Clinical analysis of microbiologically proven fungal keratitis according to prior topical steroid use: A retrospective study in South Korea
Authors: Cho Chan Ho , Lee Sang-Bumm 
Published: October 2019

Abstract
Background: To compare the clinical characteristics and treatment outcomes of microbiologically proven fungal keratitis between users and non-users of prior topical steroids (PS and NPS, respectively)

Methods: Eighty-three cases with microbiologically proven fungal keratitis between January 2000 and December 2016 retrospectively. Diagnosis of fungal keratitis was made through potassium hydroxide smear, culture, PCR, or biopsy. Baseline epidemiology, predisposing factors, clinical characteristics, microbiological profiles, and treatment outcomes were evaluated and compared between the PS and NPS groups. Treatment failure was defined as any case with complications or requiring surgery. The risk factors for treatment failure were evaluated using multivariate logistic regression in the overall cohort.

Results: A total of 30 cases with PS group and 53 cases with NPS group were included. Of these, sixteen fungal isolates were identified in the PS group and 14 isolates in the NPS group. Candida was the most common organism in both groups (6 cases, respectively), while Aspergillus (4 cases) was found only in the PS group (p=0.103). No significant differences were observed in the mean age, sex, occupational distribution, epithelial defect size, hypopyon, and presenting best-corrected visual acuity (BCVA) between the two groups. Differences were observed between the PS and NPS groups in terms of previous ocular surface disease (OSD) (43.3% vs. 22.6%, p=0.048) and deep infiltration (53.3% vs. 32.1%, p=0.057). Regarding treatment outcomes, final BCVA <0.1 (60% vs. 44.2%, p=0.133), the use of voriconazole (topical 10% vs. 0%, p=0.044; systemic 23.3% vs. 1.9%, p=0.003), surgical intervention (43.3% vs. 20.8%, p=0.029), and treatment failure (46.7% vs. 22.6%, p=0.023) were more common in the PS group than in the NPS group. The significant risk factors for treatment failure were hypopyon (odds ratio [OR] 6.01, p=0.005) and deep infiltration (OR 4.38, p=0.013).

Conclusions: Previous OSD and deep infiltration were more common in the PS group compared to the NPS group. The PS group also experienced worse disease progression and treatment outcomes. These results highlight the need for paying attention to the use of steroids in clinical practice.
Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: Study protocol for a randomized controlled study
Authors: Machulska Alla , Kleinke Kristian , Eiler Tanja Joan , Grünewald Armin , Brück Rainer , Jahn Katharina , Niehaves Björn , Gethmann Carl Friedrich , Klucken Tim 
Published: October 2019

Abstract
Background: Automatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of Cognitive Bias Modification (CBM) approaches. Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple lab-training sessions. Here, we present a protocol for a randomized control design to improve CBM training efficiency and facilitate access to the training by providing mobile phone-based training sessions at home to current smokers motivated to quit smoking.
Methods: Participants (n = 100) are current smokers who smoke at least 6 cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training app aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app-training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at a six-week follow-up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, follow-up). After completion of the study, smokers in the control condition will receive access to the training app.
Discussion: This RCT is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimisation and advancement of CBM treatment for addiction.
Trial registration: Registered with Current Controlled Trials: study ID ISRCTN15690771. Registered on 20 November 2018; http://www.isrctn.com/ISRCTN15690771
Key words: Approach Bias, Cogitive Bias Modification, cigarette smoking, nicotine addiction, Randomized Control Trial, smartphone apps
Demyelinating Syndrome in Systemic Sclerosis and Neuromyelitis Optica
Authors: Deeb khaled , Eby Jessika , Labault-Santiago Jose 
Published: October 2019

Abstract
INTRODUCTION: The objective of this study is to report a case of a 44-year-old female who presented with intractable hiccups, vomiting, and later complicated with paraplegia. Imaging and sero/immunological studies were consistent with Neuromyelitis Optica (NMO) based on NMO-IgG sero-positivity and transverse myelitis on MRI. Further investigation revealed positive ANA, anti-RNA polymerase III autoantibodies, and Scl-70, leading to a concurrent diagnosis of systemic sclerosis (SSc). The coexistence of these two disease processes, namely systemic sclerosis and neuromyelitis optica, and their underlying clinical manifestations and therapeutic interventions, are seldom reported in literature and are worth reporting. CASE REPORT: The patient was treated with high dose steroids, and subsequently developed malignant hypertension and acute renal failure, later identified as steroid induced scleroderma renal crisis on renal biopsy. Although Neuromyelitis Optica spectrum disorder (NMOSD) has often been associated with various collagen and autoimmune diseases, the coexistence of NMOSD and SSc presented a challenge where patient underwent aggressive physical therapy and necessitated an intervention with Rituximab to achieve an appropriate clinical response. We have received consent forms from the participant in our study, and we have them on file in case they are requested. We have also received patient’s consent for the data presented in this article and Figure 1. CONCLUSION: This report expands on NMOSD associated autoimmune diseases. Systemic Sclerosis is an insidious disease that is often diagnosed late as not all patients often report skin manifestation. The finding suggests that patients presenting with acute neurological manifestations get tested for NMO-IgG/AQP-4 antibodies and other immunological studies based on clinical findings.
The OMACS-PIL study - a randomised controlled trial within the OMACS observational study
Authors: Culliford Lucy , Brierley Rachel , Clout Maddie , Evans Rebecca , Maishman Rachel , Phillips Dawn , Tabusa Hana , Reeves Barney , Rogers Chris A 
Published: October 2019

Abstract
Background: There has been little research to investigate whether the appearance of paper Patient Information Leaflets (PILs) used to describe research studies to potential participants influences their decision to take part. Embedding a Study Within a Trial (SWAT) is an efficient way of answering this type of methodological question. We included a randomised SWAT within a large cohort study, Outcome monitoring After Cardiac Surgery (OMACS), to address this question.
Methods: Potential participants for the OMACS study were randomised to receive one of three PILs, identical in content but with varying formatting and use of colour: PIL A (enhanced format), PIL B (hybrid format) and PIL C (standard format). Consent to OMACS was the primary outcome. Consent rates using the three different PIL formats were collected and compared.
Results: For the SWAT, 1517 PILs were sent to potential participants and 640 (42%) consented to take part in OMACS. PIL B had the highest recruitment rate, with 45% of patients consenting to participation; 40% and 41% of patients consented to participation with PIL A and C respectively. Compared to PIL C, the consent rate was 4% higher with PIL B (45% versus 41%, 95% Confidence Interval (CI) -2% to +10%, p=0.16) and 1% lower with PIL A (40% versus 41%, 95% CI -7% to +5%, p=0.72).
Conclusions: Although it not statistically significant, PIL B had the highest consent rate, and this format is being used for the remainder of the host study and will be used to inform the design of PILs for other research studies.
Incidence Of Post Dural Puncture Headache And Associated Factors Following Spinal Anaesthesia For Caesarean Delivery In Mulago National Referral Hospital
Authors: Nambooze Philo , Samuel Kizito , Kiggundu John Baptist , Kintu Andrew , Nabukenya Mary T. 
Published: October 2019

Abstract
Background Spinal anaesthesia is a cost effective anaesthesia technique commonly used for abdominal procedures like caesarean sections. The incidence of post dural puncture headaches (PDPH) which is one of the most reported complications) remains unknown in Uganda. We set out to study the incidence of PDPH and associated factors following spinal anaesthesia in mothers delivering by caesarean section in Mulago National Referral Hospital. Methods Prospective cohort study among 1294 women that received spinal anaesthesia for emergency caesarean section delivery from July 2015 to February 2016. Consecutive sampling was applied to recruit participants. Pre-tested interviewer administered questionnaires were used to collect information on demographics and associated factors. Both bivariate and multivariate logistic regressions were used with a P value of 0.05 and confidence interval of 95% being considered statistically significant. Results The incidence of PDPH was found to be 48.8% (n=239/1294) (95%CI: 46.0-51.6). Significant factors associated with PDPH were history of spinal anaesthesia OR 1.3 95% CI (1.0-1.6) p=0.04 and loss more than 500mls of blood during surgery OR 2.2, 95% CI (1.1-4.2) P=0.02. Conclusion Results from our study indicate high incidence of PDPH women undergoing spinal anesthesia for Caesarean section. Prior exposure to spinal anesthesia and blood loss of more than 500mls are the major associated factors. There is need to objectively screen women at risk for PDPH prior to caesarean section and institute appropriate interventions.
Women’s experience of unplanned out-of-hospital birth in paramedic care
Authors: Flanagan Belinda , Lord Bill , Reed Rachel , Crimmins Gail 
Published: October 2019

Abstract
Background Healthcare literature describes predisposing factors, clinical risk, maternal and neonatal clinical outcomes of unplanned out-of-hospital birth; however, there is little quality research available that explores the experiences of mothers who birth prior to arrival at hospital. Methods This study utilised a narrative inquiry methodology to explore the experiences of women who birth in paramedic care. Results The inquiry was underscored by twenty-two narrative interviews of women who birthed in paramedic care in Queensland, Australia between 2011-2016. This data identified factors that contributed to the planned hospital birth occurring in the out-of-hospital setting. Women in this study began their story by discussing previous birth experience and their knowledge, expectations and personal beliefs concerning the birth process. Specific to the actual birth event, women reported feeling empowered, confident and exhilarated. However, some participants also identified concerns with paramedics practice; lack of privacy, poor interpersonal skills, and a lack of consent for certain procedures. Conclusions This study identified several factors and a subset of factors that contributed to their experiences of the planned hospital birth occurring in the out-of-hospital setting. Women described opportunities for improvement in the care provided by paramedics, specifically some deficiencies in technical and interpersonal skills.
Perioperative predictors of early silent coronary graft occlusion after direct myocardial revascularisation
Authors: Semchenko A. , Musurivskaya T. , Rosseykin E. 
Published: October 2019

Background. The condition of the coronary grafts is the most important determinant of prognosis after direct myocardial revascularisation. Previous studies mainly aimed at exploring the long-term patency and causes of coronary graft occlusions; identification of patients at risk for asymptomatic graft occlusion in the early postoperative period remains an unresolved issue.Aim. The purpose of this study was to define perioperative predictors of early asymptomatic coronary graft occlusion after direct myocardial revascularisation.Methods. This retrospective study included 201 patients with coronary artery disease who underwent microscope-assisted coronary artery (CA) bypass surgery in 2013–2018. All patients underwent 64-slice computed tomography angiography 7 days after surgery. The patients were categorised into two groups: those with confirmed patency of all coronary grafts (n = 153; group I) and those with occlusion of at least one graft (n = 48; group II). The perioperative predictors of early asymptomatic coronary graft occlusion were analysed using logistic regression.Results. The total graft patency was 91.7% among a total of 650 coronary grafts that were examined. The frequencies of mammary and venous graft occlusions were comparable (8.4% and 8.2%, respectively). No differences were noted in the conduit types or the revascularised areas of the myocardium between the two groups. Multivariate regression analysis revealed that diffuse CA lesions (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.36–5.52; p = 0.005), lesion diameter of CA of <1.5 mm (OR, 2.86; 95% CI, 1.34–6.71; p = 0.007) and hyperglycaemia (glucose >7.8 mmol/l) during the first postoperative day (OR, 4.22; 95% CI, 1.70–10.5; p = 0.002) were independent predictors of early coronary graft occlusion. History of percutaneous coronary intervention (OR, 0.32; 95% CI, 0.11–0.97; p = 0.045) and increased baseline glomerular filtration rate (OR, 0.96; 95% CI, 0.93–0.98; p = 0.002) were associated with a reduced risk of early graft occlusion.Conclusion. The frequency of early asymptomatic occlusion after microscope-assisted coronary artery bypass surgery was comparable between the venous and mammary grafts and did not depend on the anatomical zone of myocardial revascularisation. Diffuse CA lesions, target CA diameter of <1.5 mm and hyperglycaemia (>7.8 mmol/L) during the first postoperative day were associated with an increased risk of early silent graft occlusion, whereas increased baseline glomerular filtration rate and history of percutaneous coronary intervention were protective for the early patency of coronary bypass grafts.
Received 24 June 2019. Revised 23 August 2019. Accepted 29 August 2019.
Funding: The study did not have sponsorship.
Conflict of interest: Authors declare no conflict of interest.
Unraveling the Inhibition of Intestinal Glucose Transport by Dietary Phenolics: A Review
Authors: Pico Joana , Martínez Mario M. 
Published: October 2019

Background:Glucose transport across the intestinal brush border membrane plays a key role in metabolic regulation. Depending on the luminal glucose concentration, glucose is mainly transported by the sodium- dependent glucose transporter (SGLT1) and the facilitated-transporter glucose transporter (GLUT2). SGLT1 is apical membrane-constitutive and it is active at a low luminal glucose concentration, while at concentrations higher than 50 mM, glucose is mainly transported by GLUT2 (recruited from the basolateral membrane). Dietary phenolic compounds can modulate glucose homeostasis by decreasing the postprandial glucose response through the inhibition of SGLT1 and GLUT2.Methods:Phenolic inhibition of intestinal glucose transport has been examined using brush border membrane vesicles from rats, pigs or rabbits, Xenopus oocytes and more recently Caco-2 cells, which are the most promising for harmonizing in vitro experiments.Results:Phenolic concentrations above 100 µM has been proved to successfully inhibit the glucose transport. Generally, the aglycones quercetin, myricetin, fisetin or apigenin have been reported to strongly inhibit GLUT2, while quercetin-3-O-glycoside has been demonstrated to be more effective in SGLT1. Additionally, epigallocatechin as well as epicatechin and epigallocatechin gallates were observed to be inhibited on both SGLT1 and GLUT2.Conclusion:Although, valuable information regarding the phenolic glucose transport inhibition is known, however, there are some disagreements about which flavonoid glycosides and aglycones exert significant inhibition, and also the inhibition of phenolic acids remains unclear. This review aims to collect, compare and discuss the available information and controversies about the phenolic inhibition of glucose transporters. A detailed discussion on the physicochemical mechanisms involved in phenolics-glucose transporters interactions is also included.