bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uptake and acceptability of human papillomavirus self-sampling in rural and remote Aboriginal communities: Evaluation of a nurse-led community engagement model
Authors: Dutton Tegan , Marjoram Jo , Burgess Shellie , Campbell Laurinne , Vail Anne , Callan Nichole , Jacob Sunil , Hawkes David , Saville Marion , Bailey Jannine 
Published: April 2020

Abstract
Background: Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants.Methods: Aboriginal women aged 25-69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model.Results: In total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n=46) were never-screened and one-third (n=69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women tested positive for a high risk type other than HPV 16/18 (HPV other), of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (>92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them.Conclusions: A community-based service model that respects Aboriginal Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.
Energy-dense nutrient-poor snacks and risk of non-alcoholic fatty liver disease: a case-control study in Iran
Authors: Yari Zahra , Cheraghpour Makan , Aghamohammadi Vahideh , Alipour Meysam , Ghanei Nila , Hekmatdoost Azita 
Published: April 2020

Abstract
Objective: The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire. Results: The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (p=0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR:1.94; 95% CIs: 1.16-3.26; P for trend=0.015) and adjusted (OR:2.27; 95%CIs: 1.19-4.31; P for trend=0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend=0.037) and soft drinks (OR: 1.64, P for trend=0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.
Reimagining the role of the nursing workforce in Uganda after more than a decade of ART scale-up
Authors: Zakumumpa Henry 
Published: April 2020

Abstract
Background The expanding roles and increasing importance of the nursing workforce in health services delivery in resource-limited settings is not adequately documented and sufficiently recognized in the current literature. Drawing upon the theme of 2020 as the international year of the Nurse and Midwife, we set out to describe how the role of nurses expanded tremendously in health facilities in Uganda during the era of anti-retroviral therapy (ART) scale-up that commenced in June 2004.Methods We employed a mixed-methods sequential explanatory research design. Phase One entailed a cross-sectional health facility survey (n=195) to assess the extent to which human resource management strategies (such as task shifting) were common. Phase Two entailed a qualitative multiple case-study of 16 (of the 195) health facilities for an in-depth understanding of the strategies adopted (e.g. nurse-centred HIV care). Descriptive analyses were performed in STATA (v 13) while qualitative data were analyzed by thematic approach.Results We found that nurses were the most represented cadre of health workers involved in the overall leadership of HIV clinics across Uganda. Most nurse-led HIV clinics were based in rural settings however this trend was fairly even across setting (rural/urban/peri-urban). While 181(93%) health facilities allowed non-physician cadre to prescribe ART, a number of health facilities (n=36) or 18% deliberately adopted nurse-led HIV care models. Nurses were empowered to be multi-skilled with a wide range of competencies across the HIV care continuum right from HIV testing to mainstream clinical HIV disease management. In several facilities, nursing cadre were the backbone of ART service delivery. A select number of facilities devised differentiated models of task shifting from physicians to nurses in which the latter handled patients who were stable on ART. Conclusion Overall, our study reveals a wide expansion in the scope-of-practice of nurses during ART scale-up in Uganda. Nurses were thrust in roles of HIV disease management that were traditionally the preserve of physicians. Our study underscores the importance of reforming regulatory frameworks governing nursing workforce scope-of-practice such as the need for developing a policy on task shifting which is currently lacking in Uganda.
The role of routine flexible sigmoidoscopy in patients presenting with fistula-in-ano: an observational study
Authors: Waidyasekera Ruvindu H , Jayarajah Umesh , Samarasekera Dharmabandhu Nandadeva 
Published: April 2020

Abstract
Objective: Flexible sigmoidoscopy is useful to look for an underlying aetiology in fistula-in-ano. This study was aimed to assess the yield of routine flexible sigmoidoscopy in patients presenting with fistula-in-ano. A retrospective analysis of 159 consecutive patients with fistula-in-ano who underwent routine flexible sigmoidoscopy was performed. Sigmoidoscopy findings were recorded on a standard uniform format using a computer database. Those with a known aetiology were excluded. Results: The median age was 39(range:14-74) years and the majority were males(n=128,80.5%). Forty-nine patients(30.8%) presented with a recurrent fistula-in-ano. On flexible sigmoidoscopy, internal opening was seen in only 23 patients (14.4%). Furthermore, incidental findings of haemorrhoids (n=5, 3.1%) and polyps (n=7, 4.4%) were found. One patient(0.6%) had a healed anal fissure, 5 patients(3.1%) had inflamed mucosa and 2 patients(1.3%) had ulcers. Only two patients with inflamed mucosa were diagnosed to have Crohn’s disease on histology. Therefore, flexible sigmoidoscopy was not helpful in the majority to locate the internal opening. Only two patients had evidence of an underlying aetiology, which was Crohn’s disease. However, they had recurrent complex fistulae and other associated symptoms. Therefore, flexible sigmoidoscopy may be reserved for selected group of patients with symptoms of an underlying aetiology.
Pharmacological prophylaxis versus none- pharmacological prophylaxis in prevention of clinical venous thromboembolic complications in morbid obese patients following bariatric surgery: a retrospective observational case-control study
Authors: Amini Masoud , Moein-vaziri Nader , Hosseini Babak , Vafa Leila , Haghighat Neda 
Published: April 2020

Abstract
Background: Venous thromboembolism (VTE) is a serious complication that may occur after bariatric surgery. This study aims to report the rate of clinically evident VTE using pharmacologic versus non-pharmacologic prophylaxis among morbid obese patients undergoing laparoscopic bariatric surgery who were at low risk for VTE.Methods: The laparoscopic research center database from 2017 to 2018 was queried to identify patients undergoing laparoscopic bariatric surgery. Retrospectively, each patient who met the inclusion and exclusion criteria was clinically evaluated for the presence of symptomatic VTE (DVT and PTE) during the postoperative period. VTE prophylaxis regimens were pharmacological prophylaxis or non-pharmacological prophylaxis. Results: We identified 794 patients who underwent bariatric surgery.110 patients excluded from the study based on the VTE risk factor. 371 (54.4%) patients had non-pharmacological, 313 (45.9%) patients had pharmacological prophylaxis. In the non-pharmacological group, the overall rates of DVT, and PTE were 1 (0.26%) and 1 (0.26%), respectively. In the pharmacological group, the overall rates of PTE and DVT were 2 (0.63%) and 0, respectively. Patients without pharmacological prophylaxis had no significant difference in DVT and PTE rate compared to the group which received pharmacological prophylaxis (P>0.5). Conclusions: Adequate VTE prophylaxis is achieved without pharmacological thromboprophylactic agents for lower-risk patients. Thus, an individualized prophylaxis regimen that balances efficacy and safety is suggested for each patient, based on various risk factors.
Emergence of high multidrug-resistant Escherichia coli isolates from neonates with infection
Authors: Wu Dan , Ding Yijun , Zhang Jinjing , Yao Kaihu , Gao Wei , Liu Ying , Wang Xiaojiao , Wang Yajuan 
Published: April 2020

Abstract
Background Escherichia coli (E.coli) rank one of the most common pathogens that can cause neonatal infections. The emergence of antibiotic-resistant bacteria is a major cause of treatment failure in newborn with infection. The purpose of this study was to describe the antibiotic resistance and multidrug-resistance of E.coli isolated from neonates with infection.Methods The antimicrobial susceptibility testing of the E. coli strains to selected antibiotics was assessed with the E-test technique on the Mueller-Hinton agar. The antimicrobials tests were included ceftazidime, cefuroxime, cefatriaxone, amoxicillin, amoxicillin-clavulanic acid, cefoperazone - sulbactam, meropenem, gentamicin, ciprofloxacin and sulfonamides. The minimal inhibitory concerntration (MIC) values of the antimicrobial agents selected for this study was determined by an agar dilution technique on Mueller-Hinton agar according to the Clinical and Laboratory Standards Institute recommendations. Results A total of 100 E. coli strains was isolated from phlegm (n = 78), blood (n = 10), cerebrospinal fluid (n = 5), and umbilical discharge (n = 7) of neonates hospitalized at Beijing Children’s Hospital. The highest resistance rate of E.coli was found in amoxicillin at 85%, followed by cefuroxime 65%, and cefatriaxone 60%, respectively. 6% and 5% of all isolates were resistant to amoxicillin/clavulanic acid and cefoperazone -sulbactam merely. The resistance rates to ceftazidime, gentamicin, ciprofloxacin and sulfonamides were 31%, 20%, 33%, 47%, respectively. All the isolates were susceptible to meropenem. Multidrug resistance was defined in E.coli as resistance to at least three antibiotic families. About 26% (26/100) of all the E.coli isolates were multidrug-resistant. The detection rate of ESBL-Producing E. coli was 55%. The rate in E. coli isolates from phlegm was higher than aseptic humoral. The difference was statistically significant (P < 0.05). It is worth noting that the majority of the isolates were also resistant to non-β-lactam antimicrobial agents, but the resistant rates were significantly lower than extended-spectrum β-lactamases.Conclusions: Multi-drug-resistant E.coli has become a thorny problem in clinical treatment. It is necessary to monitor E. coli resistance.
Efficiency of 123I-ioflupane SPECT as a marker of basal ganglia damage in acute methanol poisoning: a six-year prospective study
Authors: Kotikova Katerina , Zogala David , Ptacnik Vaclav , Trnka Jiri , Kupka Karel , Vaneckova Manuela , Seidl Zdenek , Diblik Pavel , Heissigerova Jarmila , Zak Ivan , Navratil Tomas , Komarc Martin , Zakharov Sergey 
Published: April 2020

Abstract
PurposeInvestigate whether 123I-ioflupane SPECT (DaT SPECT) has the potential as a marker of basal ganglia damage in acute methanol poisoning.MethodsProspective, single-centre, cohort study of patients with confirmed methanol poisoning was conducted. DaT SPECT was performed twice with semi-quantification using DaTQUANTTM and MRI-based volumetry was calculated. Specific binding ratios (SBR) of striatum, caudate nucleus, and putamen were correlated with laboratory parameters of outcome, volumetric data, and retinal nerve fibres layer (RNFL) thickness measurements.ResultsForty-two patients (mean age 46.3±4.2 y; 8 females), including 15 with putamen lesions (Group I) and 27 patients with intact putamen (Group II), underwent DaT SPECT. Volumetry was calculated in 35 of the patients assessed. SBR values for the left putamen correlated with putamen volume (r=0.665; p<0.001). Decreased bilateral SBR values were determined for the striatum and the putamen, but not for the nucleus caudate, in Group I (p<0.05). A strong correlation was observed between the SBR of the posterior putamen and arterial blood pH (r=0.574; p<0.001) and other toxicological parameters of severity of poisoning/outcome including serum lactate, glucose, and creatinine concentrations (p<0.05). The SBR of the posterior putamen positively correlated with the global RNFL thickness (p<0.05). ROC analysis demonstrated a significant discriminatory ability of SBR of the posterior putamen with AUC=0.753 (95%CI 0.604–0.902; p=0.007). The multivariate regression model demonstrated that arterial blood pH, age, and gender were the most significant factors associated with SBR of the posterior putamen.ConclusionDaT SPECT demonstrates significant potential for the diagnosis of methanol-induced basal ganglia damage.
Medicinal Plants Used for Treating Human and Livestock Ailments in Tiyo District, Arsi Zone of Oromia, Ethiopia
Authors: Aman Misbahu , Asfaw Zemede , Dalle Gemedo 
Published: April 2020

Abstract
Background Systematic documentation and promotion of indigenous knowledge associated with medicinal plants are limited. The aim of this study was to undertake ethnobotanical investigation on medicinal plants used for the treatment of human and livestock ailments and document indigenous knowledge of local communities on the preparation and administration of herbal remedies in the study area. Methods The study involved 153 informants from nine kebeles, comprising traditional healers, knowledgeable elders and local user communities. Various ethnobotanical techniques were used to collect and analyze data: semi- structured interview, guided field walk, group discussion, preference ranking, and fidelity level index. Data was analyzed using descriptive statistical analysis. Results Local communities had rich and diverse indigenous knowledge on medicinal plants, types of ailments, methods of remedy preparations and routes of applications. There were differences in this indigenous knowledge across age and sex. A total of 83 medicinal plants were documented during this study. Fifty two (62.65%) plants were used for treating human ailments, 20 species (24.10%) for treating health problems of livestock and the remaining 11 (13.25%) for treating both human and livestock ailments. The highest informant consensus was documented for the plants Allium sativum , Asparagus africanus and Azadirachta indica. Leaves were the most commonly used parts of medicinal plants accounting for 51.81% of the total followed by roots (20.48%) and barks (2.41%). Oral administration of the herbal medicine was the dominant route 66.3%, followed by dermal (22.7%) which included washing, holding on, rubbing and brushing. Smoking (8.5%) was also important. It was documented that 27 species (32.5%) were used in fresh, 13 species (15.7%) dried and 43 species (51.8%) either in dry or fresh state. Conclusion Owing to their access, curing ability, manageable charges, existence of deep indigenous knowledge and other associated cultural values, medicinal plants continued to play a significant role in meeting healthcare needs of the community in the study area. Conservation and sustainable use of the diverse medicinal plants need to be promoted. Systemic documentation and protection of the rich knowledge of local communities and further research on selected potential species was recommended as a result of this study.
Post-developmental extracellular proteoglycan maintenance in attractin-deficient mice
Authors: Azouz Abdallah , Duke-Cohan Jonathan 
Published: April 2020

Abstract
Objective: Neurodegeneration and hair pigmentation alterations in mice occur consequent to aberrations at the Atrn locus coding for the transmembrane form of attractin. Earlier results pointed to a possible involvement in intracellular trafficking/export of secretory vesicles containing proteoglycan. Here we examined kidney and liver, both heavily dependent upon proteoglycan, of attractin-deficient mice to determine whether abnormalities were observed in these tissues.Results: Histological and histochemical analysis to detect glycosylated protein identified a severe loss in attractin-deficient mice of extracellular proteoglycan between kidney tubules in addition to a loss of glycosylated material within the intratubular brush border. In the liver, extracellular matrix material was significantly depleted between hepatocytes together with swollen sinuses and aberrations in the proteoglycan-dependent space of Disse. These results are consistent with a generalized defect in extracellular proteoglycan deposition in Atrn -mutant mice and support previous reports suggesting a role for attractin in the secretory vesicle pathway.
DSG2 expression is correlated with poor prognosis and promotes early-stage cervical cancer
Authors: Qin Shuhang , Liao Yuandong , Du Qiqiao , Wang Wei , Huang Jiaming , Liu Pan , Shang Chunliang , Liu Tianyu , Xia Meng , Yao Shuzhong 
Published: April 2020

Abstract
Background: The pathogenesis and developmental mechanism of early-stage (FIGO 2009 IA2-IIA2) cervical cancer (CC) remain unclear. Seeking novel molecular biomarkers based on The Cancer Genome Atlas (TCGA) will facilitate the understanding of CC pathogenesis and help evaluate early-stage CC prognosis.Methods: To identify prognosis-related genes in early-stage CC, we analyzed TCGA mRNA-seq data and clinical data by univariate Cox and Kaplan-Meier plotter analyses. Differential expression analysis identified upregulated genes in early-stage CC. Combined with the genes correlated with unfavorable prognosis, we selected DSG2 for further investigation. To detect DSG2 expression in early-stage CC, we used immunohistochemistry (IHC), quantitative real-time PCR (qRT-PCR) and western blotting. The relationship between the expression of DSG2 and clinical features was analyzed by the chi-square test. Cox analysis was applied to assess the relationship between CC overall survival (OS) and risk factors. The correlations between DSG2 expression and CC cell line proliferation and migration were investigated with Cell Counting Kit-8 (CCK-8) and migration assays.Results: There were 416 prognosis-related genes in early-stage CC. DSG2, MMP1, CA9, HOXA1, and SERPINB3 were upregulated in early-stage CC compared with adjacent noncancerous tissue (ANT) and correlated with unfavorable prognosis. Among them, DSG2 was most significantly correlated with patient survival. Coexpression analysis indicated that DSG2 was probably involved in cell division, positive regulation of transferase activity, positive regulation of cell migration, EGFR upregulation pathway and regulation of lymphangiogenesis. IHC, qRT-PCR and western blotting showed that DSG2 expression was higher in CC than in normal tissue. Significant correlations were identified between DSG2 expression and several aggressive clinical features, including pelvic lymph node metastasis (PLNM). Multivariate Cox analysis showed that DSG2 and PLNM were independent prognostic factors for OS. DSG2 knockdown inhibited CC cell proliferation and migration.Conclusions: DSG2 is a new biomarker that promotes tumor proliferation and metastasis and is correlated with poor prognosis in early-stage CC.
Frailty prevalence and screening for frailty among elderly community-dwelling, first-time seekers of formal assistance in Norway.
Authors: Laukli Ingerid , Ormstad Heidi Kristin , Sandvik Leiv 
Published: April 2020

Abstract
Background Detection of frailty may be essential to prevent or delay disability in home-dwelling elderly who seek formal assistance for the first time. The prevalence of frailty among elderly, first-time seekers of formal assistance in Norway, is unknown. Simple tests like Short Physical Performance Battery (SPPB) or assessment of gait speed (GS) may identify frailty. The aim of this study was to investigate the prevalence of frailty in this population, and to investigate the test accuracy of GS and SPPB to detect frailty.Methods We conducted a cross-sectional study of 116 home dwelling elderly > 65 years seeking formal assistance for the first time. Frailty was assessed by an adapted version of Fried Frailty Phenotype (FFP), GS was measured over 4 meters, and physical function was assessed by the Norwegian version of SPPB. The test accuracy for frailty (FFP) of GS < 0.8 m/s, SPPB < 10 and SPPB < 10 were assessed.Results 62.1%, 29.3% and 8.6% of the participants were frail, prefrail and non-frail, respectively. No association was found between age and degree of frailty. Both GS and SPPB-scores were significantly lower in the frail group than in the prefrail group, as well as significantly lower in the prefrail group than in the non-frail group (both p < 0.001). Numbers of criteria in FFP were significantly and inversely associated with GS (p < 0.001). GS ≤ 0.8 m/s showed the best test accuracy for frailty, with a sensitivity of 0.99, specificity of 0.37, positive predictive value of 0.76 and negative predictive value of 0.93.Conclusions The present study assessed that over 90% of elderly seeking formal assistance for the first time were either frail or prefrail. This indicates that screening for frailty should be considered for this population in order to enable action to prevent or delay disability. Further, our results indicate that GS with a cut-off at ≤ 0.8 m/s may represent a feasible and easy-to-use screening tool for detecting frailty in this population.