bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation strategies for the patient safety reporting system using Consolidated Framework for Implementation Research: a retrospective mixed-method analysis
Authors: Koike Daisuke , Ito Masahiro , Horiguchi Akihiko , Yatsuya Hiroshi , Ota Atsuhiko 
Published: March 2022

Abstract
Background
Healthcare-related adverse events occur because of complex healthcare systems. The patient safety reporting system is a core component of patient safety initiatives in hospitals. However, hospital management often encounters a cultural barrier with its implementation and struggles to overcome the same. Implementation science would be useful for analysing implementation strategies. This study determines the effects of the implemented strategy on an increase in the number of patient safety reports and the determinants of successful implementation, using the implementation framework.

Methods
Mixed method analysis was performed in Fujita Health University Hospital (FHUH), a large volume hospital in Japan. We identified strategies to implement the patient safety reporting system by scrutinising internal documents using the Consolidated Framework for Implementation Research (CFIR). The electronic reporting systems developed in 2004 in the FHUH and the number of reports were analysed using the staff data and hospital volumes.

Results
Reports (n = 110,058) issued between April 2004 and March 2020 were analysed. The number of reports increased from 2004 to 2008 and from 2013 to 2019, reaching 14,037 reports per year. Between 2009 and 2012, the FHUH experienced a stagnation period where the number of reports were not increasing. From the qualitative materials, we identified 74 strategies which contributed to the implementation of the patient safety reporting system. Among these, the domain of ‘intervention characteristics’ in the CFIR contained 12 strategies, ‘outer settings’ contained 20, ‘inner settings’ contained 21, ‘characteristics of individuals’ contained 8, and ‘process’ contained 13. There were two concentrated periods of the implemented strategies, the number was 17 in 2007 and 10 in 2016. These concentrated periods preceded a remarkable increase in the number of patient safety reports.

Conclusions
A safety culture had been fostered in FHUH in the study period. A relationship between number of strategies and development of a reporting culture was observed. The intensity of adequate strategies was needed for implementation of patient safety reporting system. Therefore, the implementation framework is useful for analysing patient safety initiatives for safety culture.
Multimodal ocular imaging of known and novel corneal stromal disorders in dogs
Authors: Park Sangwan , Sebbag Lionel , Moore Bret A. , Casanova M. Isabel , Leonard Brian C. , Daley Nicole L. , Steele Kirsten A. , Li Jennifer Y. , Murphy Christopher J. , Thomasy Sara M. 
Published: March 2022

Abstract
Background
Imaging features obtained with Fourier-domain optical coherence tomography (FD-OCT) and in vivo confocal microscopy (IVCM) for corneal stromal disorders have been sparsely reported in dogs. This case report is a compilation of imaging features for three cases of different stromal disorders of the canine cornea which have not yet been reported elsewhere.

Case presentation
Lipid deposition in case 1 appeared as needle-shaped hyperreflective lines along the collagen lamellae, which correlated histologically with lipid clefts. In case 2, glycosaminoglycan accumulation by mucopolysaccharidosis type 1 caused diffuse stromal hyperreflectivity and depletion of keratocytes on IVCM and was associated with secondary corneal degeneration presumed to be calcium deposition. In case 3, posterior corneal stromal opacities in the absence of ocular inflammation were identified. Hyperreflective particles were scattered in the middle and posterior corneal stroma on FD-OCT. With IVCM, hyperreflective deposits were identified within keratocytes and the number of enlarged keratocytes containing hyperreflective deposits increased towards the posterior stroma. The bilateral, non-inflammatory nature and unique appearance with IVCM is most consistent with a posterior stromal dystrophy reminiscent of pre-Descemet corneal dystrophy described in humans.

Conclusions
In vivo multimodal corneal imaging facilitated instantaneous microstructural analysis and may be valuable in the differential diagnosis of corneal stromal disorders in veterinary clinical practice. The non-specific nature of imaging findings occurs in some conditions such as mucopolysaccharidosis, thus in vivo corneal imaging should be complemented with other gold standard methods of definitive diagnosis.
Susceptibility to malaria during the prevention of re-establishment phase in Sri Lanka
Authors: Jeevatharan Hamsananthy , Wickremasinghe Rajitha 
Published: March 2022

AbstractBackgroundSri Lanka eliminated malaria in November 2012 and was certified malaria-free by the World Health Organization (WHO) in September 2016 but is facing a challenge to prevent re-establishment of malaria. Influx of travellers from malarious countries and the presence of malaria vectors in formerly endemic areas make the country both receptive and vulnerable. Susceptibility to malaria, the predisposition of populations to be infected by malaria parasites, is influenced by biologic and generic factors such as the age-sex composition, socio economic status, and the migration history of the population. The aim of this study was to assess susceptibility to malaria during the prevention of re-establishment phase in Sri Lanka.MethodsA national survey was conducted among 3454 households. A multistage cluster sampling technique was used to select the households. Susceptibility was assessed based on pre-defined variables by interviewing heads of households using an interviewer-administered questionnaire. Basic socio-demographic information, travel history, history of fever and past malaria infections in the preceding three years were collected. Data were analysed using SPSS version 20 package.ResultsThe percentage of the population who had been overseas within the last 3 years in the urban sector (4.5%, n = 99) was higher than that of the rural (2.8%, n = 288) and estate sectors (0.2%, n = 2) (p < 0.001); it also declined with the wealth index up to the 4th quintile with a slight rise in the 5th quintile (p < 0.001). The likelihood of travel overseas was 1.75 times (95% CI: 1.38–2.22) higher for urban residents as compared rural estate residents; it was 1.46 times (95% CI: 1.16–1.92) higher for persons from the upper wealth index quintile as compared to persons from the 1st and 2nd quintiles after controlling for sex, age and area of residence. 177 persons had fever within the past 2 weeks of the survey. There was no association between presence of fever within the last 2 weeks and sector or travel abroad.ConclusionsUrban residents, upper socioeconomic class persons and males are more likely to travel overseas and bring the parasite into the country. Social vulnerability and risk of re-establishment of malaria can be assessed by combining susceptibility with resilience and receptivity.
Supervised consumption site enables cost savings by avoiding emergency services: a cost analysis study
Authors: Khair Shahreen , Eastwood Cathy A. , Lu Mingshan , Jackson Jennifer 
Published: March 2022

Abstract
Background and aims
We report on a cost analysis study, using population level data to determine the emergency service costs avoided from emergency overdose management at supervised consumption services (SCS).

Design
We completed a cost analysis from a payer’s perspective. In this setting, there is a single-payer model of service delivery.

Setting
In Calgary, Canada, ‘Safeworks Harm Reduction Program’ was established in late 2017 and offers 24/7 access to SCS. The facility is a nurse-led service, available for client drop-in. We conducted a cost analysis for the entire duration of the program from November 2017 to January 2020, a period of 2 years and 3 months.

Methods
We assessed costs using the following factors from government health databases: monthly operational costs of providing services for drug consumption, cost of providing ambulance pre-hospital care for clients with overdoses who could not be revived at the facility, cost of initial treatment in an emergency department, and benefit of costs averted from overdoses that were successfully managed at the SCS.

Results
The proportion of clients who have overdosed at the SCS has decreased steadily for the duration of the program. The number of overdoses that can be managed on site at the SCS has trended upward, currently 98%. Each overdose that is managed at the SCS produces approximately $1600 CAD in cost savings, with a savings of over $2.3 million for the lifetime of the program.

Conclusion
Overdose management at an SCS creates cost savings by offsetting costs required for managing overdoses using emergency department and pre-hospital ambulance services.
Validation of a novel quality of life questionnaire: the Digestion-associated Quality of Life Questionnaire (DQLQ)
Authors: Beke Matthew , Burns Alyssa M. , Weir Sydney , Solch Rebecca J. , Judkins Taylor C. , Nieves Carmelo , Langkamp-Henken Bobbi 
Published: March 2022

Abstract
Background
Few health-related quality of life (QOL) questionnaires are designed specifically for healthy populations and are specific to gastrointestinal (GI) symptoms even though healthy individuals may frequently experience gas, bloating, constipation, diarrhea, and abdominal pain. The purpose of this study was to develop and validate a tool that could assess the impact of GI symptoms on digestion-associated QOL in otherwise healthy individuals.

Methods
After a review of current literature and with input from experienced GI researchers, a 24-item questionnaire was created. The questionnaire was reduced to 9 items with input from focus groups comprised of healthy adults experiencing GI-related symptoms and through variability analysis. The Digestion-associated QOL Questionnaire (DQLQ) was designed to be sensitive to the physical and mental well-being changes that may occur due to GI symptoms. The DQLQ was assessed for internal consistency reliability (Cronbach’s alpha; McDonald’s omega), test–retest reliability (intraclass correlation coefficient, ICC), and construct validity (Pearson correlations) in a study with healthy, academically stressed, undergraduate students. Convergent validity was evaluated by correlating the DQLQ with gastrointestinal symptom rating scale (GSRS) scores. Divergent validity was assessed by correlating DQLQ scores with stress scores, and bowel satisfaction scores.

Results
A total of 594 students (age 18–30 years) completed the DQLQ. Internal consistency reliability was favorable (n = 594; α = 0.84, ω = 0.84). A high level of agreement and correlation between DQLQ scores was found with the test–retest reliability analysis (n = 273; ICC = 0.89). The questionnaire was shown to have good convergent validity through correlation with the GSRS (n = 594; r = 0.54). Divergent validity was also shown to be appropriate by correlating DQLQ scores with stress (n = 592; r = 0.13, p < 0.005), and bowel satisfaction (n = 592; r = 0.18, p < 0.001) scores.

Conclusion
The DQLQ is a reliable and valid questionnaire for assessing digestion-associated QOL in healthy individuals.
Development and validation of the health-related quality of life instrument for Chinese infertile couples: a mixed-methods study protocol
Authors: Shi Zhao , Mao Zhuxin , Nie Hongwei , Geng Ling , Chen Gang , Li Shunping 
Published: March 2022

Abstract
Background
Infertility and its treatment have negative impacts on a couple’s marital relationship, sexual life, psychological state and interpersonal relationships, causing personal distress. Health-related quality of life (HRQoL) has become an important component of health outcomes. HRQoL instruments developed in western culture are not always appropriate for use in China due to cultural differences. Probably due to the unique concept of fertility in China, infertility patients can be looked down upon and the family may feel shameful. This study aims to develop a HRQoL instrument for infertile couples based on the Chinese social and cultural setting.

Methods
Complementary mixed methods will be used to develop a new HRQoL instrument for Chinese infertile couples. The study consists of four stages: the first stage will involve a systematic review and qualitative interviews to construct draft candidate items. In the second stage, quantitative research [e.g., exploratory factor analysis (EFA), item response theory (IRT)] and cognitive interviews will be used for item selection. The third stage will be instrument validation, in which classical test theory (CTT) and IRT will be applied. In the final stage, the minimal clinically important difference (MCID) will be calculated by using distribution-based methods and anchor-based methods (e.g., logistic regression, receiver operating characteristic curve).

Discussion
The new HRQoL instrument for Chinese infertile couples will be developed, which will provide a standard and effective HRQoL instrument in clinical outcome assessment and health outcome measurement.
LncRNA MSTO2P promotes colorectal cancer progression through epigenetically silencing CDKN1A mediated by EZH2
Authors: Guo Mengjun , Zhang Xiling 
Published: March 2022

Abstract
Background
Pseudogene-derived long non-coding RNAs (lncRNAs) have been reported to act as key regulatory factors of cancers. However, the study focused on pseudogene misato family member 2 (MSTO2P) in the occurrence and development of colorectal cancer (CRC) remains unclear.

Methods
CCK-8, colony formation, and transwell assays clarified HT-29 and SW480 cell proliferation and invasion. Furthermore, flow cytometry was carried out to detect cell cycle and cell apoptosis. Subcellular localization assay indicated the location of MSTO2P in HT-29 cells. RIP and CHIP assays clarified the relationship of MSTO2P with target protein and gene in HT-29 cells.

Results
MSTO2P expression was upregulated in CRC tissues and cells. Functional experiments revealed that inhibition of MSTO2P suppressed HT-29 and SW480 cell proliferation and invasion, and promoted cell cycle arrest and cell apoptosis. Besides, MSTO2P epigenetically down-regulated cyclin-dependent kinase inhibitor 1A (CDKN1A) via binding to the enhancer of zeste homolog 2 (EZH2) in the nucleus. At last, rescue experiments proved the anti-tumor effect of inhibition of MSTO2P was partially recovered due to the knockdown of CDKN1A in HT-29 cells.

Conclusion
LncRNA MSTO2P promoted colorectal cancer progression through epigenetically silencing CDKN1A mediated by EZH2.
Cytokine-induced killer cells mediated pathways in the treatment of colorectal cancer
Authors: Fayyaz Farimah , Yazdanpanah Niloufar , Rezaei Nima 
Published: March 2022

AbstractCytokine-induced killer (CIK) cell therapy is a type of adoptive immunotherapy that due to its high proliferation rate and anti-tumor characteristics, is being investigated to treat various solid tumors. Since advanced colorectal cancer (CRC) has high mortality and poor survival rates, and the efficacy of chemotherapy and radiotherapy is limited in treatment, the application of CIK cell therapy in CRC has been evaluated in numerous studies. This review aims to summarize the clinical studies that investigated the safety and clinical efficacy of CIK cell therapy in CRC. Therefore, 1,969 enrolled CRC patients in the clinical trials, of which 842 patients received CIK cells in combination with chemotherapy with or without dendritic cell (DC) infusions, were included in the present review. Furthermore, the signaling pathways involved in CIK cell therapy and novel methods for improving migration abilities are discussed.
Multi-use physical activity trails in an urban setting and cardiovascular disease: a difference-in-differences analysis of a natural experiment in Winnipeg, Manitoba, Canada
Authors: McGavock Jonathan , Hobin Erin , Prior Heather J. , Swanson Anders , Smith Brendan T. , Booth Gillian L. , Russell Kelly , Rosella Laura , Isaranuwatchai Wanrudee , Whitehouse Stephanie , Brunton Nicole , Burchill Charles 
Published: March 2022

Abstract
Objective
To determine if expansion of multi-use physical activity trails in an urban centre is associated with reduced rates of cardiovascular disease (CVD).

Methods
This was a natural experiment with a difference in differences analysis using administrative health records and trail-based cycling data in Winnipeg, Canada. Prior to the intervention, each year, 314,595 (IQR: 309,044 to 319,860) persons over 30 years without CVD were in the comparison group and 37,901 residents (IQR: 37,213 to 38,488) were in the intervention group. Following the intervention, each year, 303,853 (IQR: 302,843 to 304,465) persons were in the comparison group and 35,778 (IQR: 35,551 to 36,053) in the intervention group. The natural experiment was the construction of four multi-use trails, 4-7 km in length, between 2010 and 2012. Intervention and comparison areas were based on buffers of 400 m, 800 m and 1200 m from a new multi-use trail. Bicycle counts were obtained from electromagnetic counters embedded in the trail. The primary outcome was a composite of incident CVD events: CVD-related mortality, ischemic heart disease, cerebrovascular events and congestive heart failure. The secondary outcome was a composite of incident CVD risk factors: hypertension, diabetes and dyslipidemia.

Results
Between 2014 and 2018, 1,681,125 cyclists were recorded on the trails, which varied ~ 2.0-fold across the four trails (2358 vs 4264 counts/week in summer months). Between 2000 and 2018, there were 82,632 CVD events and 201,058 CVD risk events. In propensity score matched Poisson regression models, the incident rate ratio (IRR) was 1.06 (95% CI: 0.90 to 1.24) for CVD events and 0.95 (95%CI: 0.88 to 1.02) for CVD risk factors for areas within 400 m of a trail, relative to comparison areas. Sensitivity analyses indicated this effect was greatest among households adjacent to the trail with highest cycling counts (IRR = 0.85; 95% CI: 0.75 to 0.96).

Conclusions
The addition of multi-use trails was not associated with differences in CVD events or CVD risk factors, however the differences in CVD risk may depend on the level of trail use.

Trial registration
Trial registration number: NCT04057417.
Trend change in delayed first antenatal care visit among reproductive-aged women in Ethiopia: multivariate decomposition analysis
Authors: Alamneh Asaye , Asmamaw Achenef , Woldemariam Mehari , Yenew Chalachew , Atikilt Getaneh , Andualem Minwuyelet , Mebrat Amare 
Published: March 2022

Abstract
Background
Early first antenatal care visit is a critical health care service for the well-being of women and newborn babies. However, many women in Ethiopia still start their first antenatal care visit late. We aimed to examine the trend in delayed first antenatal care visit and identify the contributing factors for the trend change in delayed first antenatal care visits in Ethiopia over the study period 2000–2016.

Method
We analyzed the data on reproductive-aged women from the four consecutive Ethiopian Demographic and Health Surveys to determine the magnitude and trend of delayed first antenatal care visit. A weighted sample of 2146 in 2000, 2051 in 2005, 3368 in 2011, and 4740 women in 2016 EDHS were involved in this study. All statistical analysis was undertaken using STATA 14. Multivariate logistic decomposition analysis was used to analyze the trends of delayed first antenatal care visit over time and the contributing factors to the change in delayed first antenatal care visit.

Results
The prevalence of delayed first antenatal care visit in Ethiopia decreased significantly from 76.8% (95% CI 75.1−78.6) in 2000 to 67.3% (95% CI 65.9−68.6) in 2016. Decomposition analysis revealed that 39% of the overall change in delayed first antenatal care visit overtime was due to differences in women’s composition, whereas 61% was due to women’s behavioral changes. In this study, residence, husband's education, maternal occupation, ever told about pregnancy complications, cesarean delivery and family sizes were significantly contributing factors for the decline in delayed first antenatal care visit over the study periods.

Conclusion
The prevalence of delayed first antenatal care visit in Ethiopia among women decreased significantly over time. More than halves (61%) decline in delayed first antenatal care visits was due to women’s behavioral changes. Public health interventions targeting rural residents, poor household economic status and improving awareness about pregnancy-related complications would help to reduce the prevalence of delayed first antenatal care visit.
A descriptive, cross-sectional study of postpartum education: midwives’ self-reported knowledge and teaching of postpartum complications in Ghana
Authors: Adams Yenupini Joyce , Sladek Lynn 
Published: March 2022

Abstract
Background
Obstetric complications remain the leading causes of maternal deaths. Since it is not always possible to ascertain which women will develop complications and which women will not, all women who have a baby should be educated about warning signs of complications. In this study, we assessed postpartum education provided by midwives, midwives’ knowledge to teach patients about complications and their skills to manage postpartum complications.

Methods
Descriptive, cross-sectional study of 245 midwives in four hospitals in Tamale, Ghana, using an electronic questionnaire. Data analyzed in Stata 16 software using descriptive, bivariate, and multivariate statistics.

Results
Majority of midwives were female (98%). Mean age of midwives was 32 years. Most midwives spent 6 to 15 min teaching patients on warning signs of complications (61.89%). Mode of discharge education was mostly individual (83.13%). Most midwives reported no reference materials given to patients (66.39%). About 93.45% of midwives strongly agreed or agreed it is their responsibility to teach all patients, regardless of risk factors, about warning signs of complications. However, midwives did not always teach patients about complications. The majority of midwives felt they were knowledgeable or very knowledgeable to teach patients about hemorrhage (95.08%), infection (94.67%), preeclampsia/ eclampsia (90.95%), and hypertension (89.35%). Similarly, most midwives felt they had the skills to manage these same four obstetric complications. Unsurprisingly, most midwives were more likely to always educate their patients about hemorrhage, infection, preeclampsia/ eclampsia, and hypertension—the complications they were more knowledgeable about. Many midwives felt not knowledgeable about and not competent to manage postpartum depression, cardiac events, pulmonary embolism, and venous thrombosis. In the same regard, many midwives did not teach patients about the life-threatening complications they were least knowledgeable about.

Conclusions
Midwives did not always teach patients about complications. Most midwives felt knowledgeable to teach and manage hemorrhage, infection, and preeclampsia/hypertension but not cardiac events, pulmonary embolism, and venous thrombosis. Additional training of midwives on life-threatening complications such as pulmonary embolism and cardiac events is recommended.