bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study
Authors: Jokhio Abdul Hakeem , Rizvi Raheela Mohsin , MacArthur Christine 
Published: April 2020

Abstract
Background
Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate “the prevalence of pelvic organ prolapse” associated factors, duration and impact on women’s quality of life in rural Pakistan.

Methods
A cross-sectional study was conducted with a three stage random sampling strategy. Three health centers were selected and selected Lady Health Workers from each health center interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health center on women who reported symptoms of prolapse to verify and grade pelvic organ prolapse using Baden-Walker classification system.

Results
Among the 5064 women interviewed (95.8% response rate), 521 women had clinically confirmed POP, a prevalence of 10.3% (95% CI 9–11%). Among women with POP 37.8% had grade III or IV prolapse. Women with four or more children had the highest proportion of pelvic organ prolapse (75%) followed by women aged 36–40 years (25%).Among women with POP, 60.8% reported their quality of life as greatly or moderately affected; 44.3% had it for more than 5 years; and 78.7% never consulted a doctor.

Conclusions
Pelvic organ prolapse is highly prevalent in rural Pakistan, impacts on women’s everyday lives and remains mainly untreated. Measures should be taken to provide health care services to reduce this burden of disease among women.
Quality of life, psychological distress and violence among women in close relationships: a population-based study in Finland
Authors: Hisasue Tomomi , Kruse Marie , Raitanen Jani , Paavilainen Eija , Rissanen Pekka 
Published: April 2020

Abstract
Background
The aim of this study was to examine associations between exposure to violence, quality of life, and psychological distress. Women aged 19–54 years who had been exposed to violence by someone in a close relationship were compared with women unexposed to violence in Finland. We also aimed to investigate associations between different forms of violence (physical, sexual, emotional, or any combination of these) with quality of life and psychological distress.

Methods
We selected a sample of 22,398 women who had returned self-completed questionnaires from a Finnish population-based health survey between 2013 and 2016. Exposure to violence during the past year was assessed through specific questions from the survey. The EUROHIS-QOL 8-item index was used to measure quality of life, and ordinary least square regressions were fitted. The mental health inventory (MHI-5) was used to measure psychological distress. We investigated associations with multivariate logistic regression analysis.

Results
Among women in Finland, the prevalence of exposure to violence in any type of close relationship during the past year was 7.6%. Women who had been exposed to violence had significantly worse scores of the EUROHIS-QOL 8-item index, and psychological distress was significantly worse (p < 0.001), compared with unexposed women. Strong associations were found between combinations of violence and both quality of life (coefficient − 0.51, p < 0.001) and mental health (odds ratio 4.16, 95% confidence interval 3.44–5.03). Compared with women who had been exposed to violence by a stranger, women who had been exposed to violence by someone in a close relationship had significantly lower quality-of-life scores (p < 0.001).

Conclusions
This study found that experience of close relationship violence had a negative influence on both quality of life and psychological distress among women in the general Finnish population. Comparison with victims of violence by strangers shows that some of the lower quality-of-life scores among victims are driven by the perpetrator and victim being in a close relationship. Preventive policies in primary care settings aimed at screening and educating young people should be considered as an early form of intervention to reduce the negative mental health consequences of violence.
Using rapid cycle deliberate practice to improve primary and secondary survey in pediatric trauma
Authors: Yan Diana Hou , Slidell Mark B , McQueen Alisa 
Published: April 2020

AbstractBackgroundOptimal performance of the primary and secondary survey is the foundation of Advance Trauma Life Support care. Despite its importance, not all primary surveys completed at level 1 pediatric trauma centers are performed according to established guidelines (Gala et al., Pediatr Emerg Care 32:756–762, 2016, Carter et al., Resuscitation 84:66–71, 2013). We hypothesize that rapid cycle deliberate practice (RCDP) will improve surgical residents’ confidence in performing the primary and secondary survey.MethodsWe developed a curriculum to teach surgical interns the principles of performing the primary and secondary survey using RCDP. Surveys distributed after each session assessed the impact of the curriculum on learner confidence and perception that this curriculum would benefit patient care. Questions were scored on a 5-point Likert scale. Sixteen surgical interns participated during intern orientation and 100% of the participants completed the post curriculum survey.ResultsThirteen (81%) of participants agreed or strongly agreed that the simulation would impact future performance in the pediatric trauma bay. The curriculum also significantly improved the confidence of our learners to perform trauma surveys (p < 0.001).ConclusionThis curriculum improves the confidence of junior surgical residents in learning the primary and secondary survey. Most learners enjoyed the session and felt that the curriculum would positively impact their performance.
Need for cognitive closure, tolerance for ambiguity, and perfectionism in medical school applicants
Authors: Gärtner Julia , Bußenius Lisa , Prediger Sarah , Vogel Daniela , Harendza Sigrid 
Published: April 2020

AbstractBackgroundPhysicians have to deal with uncertainty on a daily basis, which requires high tolerance for ambiguity. When medical decisions have to be made in ambiguous situations, low levels of need for cognitive closure and high levels of adaptive perfectionism are beneficial. It might be useful to measure such personality traits during medical school selection processes. In our study, we explored the expression of need for cognitive closure, tolerance for ambiguity, and perfectionism in medical school applicants who participated in a multiple mini-interview selection process with respect to the final decision of admission or rejection.MethodsAfter participating in the multiple mini-interview procedure (HAM-Int) at Hamburg Medical School in August 2019, 189 medical school applicants filled out a questionnaire including the Multidimensional Perfectionism Scale by Hewitt and Flett (MPS-H), the Multidimensional Perfectionism Scale by Frost (MPS-F), the Tolerance for Ambiguity Scale (TAS), the 16-Need for Cognitive Closure Scale (16-NCCS), and sociodemographic data. After the final admission decision, the scores of need for cognitive closure, tolerance for ambiguity, and perfectionism of admitted and rejected applicants were compared. We also assessed the predictive power of need for cognitive closure and age for the admission decision in a binary logistic regression model.ResultsCompared to the admitted applicants, the rejected applicants showed a significantly higher need for cognitive closure (p = .009). A high need for cognitive closure correlated significantly positively with maladaptive perfectionism (p < .001) and significantly negatively with tolerance for ambiguity (p < .001). Low need for cognitive closure and older age were associated with a positive admission decision.ConclusionsRegarding the personality traits need for cognitive closure, tolerance for ambiguity, and perfectionism we identified interesting differences and correlations of relevance for physicians’ daily work in medical school applicants who were admitted or rejected after participating in a multiple mini-interview selection procedure. Further studies are needed to investigate these characteristics and their development longitudinally in medical students and to correlate them with students’ medical performance.
LncRNA MSC-AS1 aggravates nasopharyngeal carcinoma progression by targeting miR-524-5p/nuclear receptor subfamily 4 group A member 2 (NR4A2)
Authors: Yao Hongchao , Yang Like , Tian Linli , Guo Yan , Li Yushan 
Published: April 2020

Abstract
Background
Nasopharyngeal carcinoma (NPC) is a subtype of head and neck cancer with dismal prognosis and high relapse rate. The role of long non-coding RNAs (lncRNAs) in NPC has become a research hotspot in recent years. This study aimed to interrogate the function and mechanism of lncRNA MSC antisense RNA 1 (MSC-AS1) in NPC.

Methods
MSC-AS1 level in NPC tissues and cells were detected by RT-qPCR. Function of MSC-AS1 in NPC cells was assessed by CCK-8, EdU, TUNEL, caspase-3 activity, and transwell invasion assay. Interaction of microRNA-524-5p (miR-524-5p) with MSC-AS1 and nuclear receptor subfamily 4 group A member 2 (NR4A2) was determined by RIP and luciferase reporter assays.

Results
MSC-AS1 was upregulated in NPC tissues and cells. Functional assays indicated that MSC-AS1 exacerbated cell proliferation, hindered apoptosis, and facilitated invasion and epithelial-to-mesenchymal transition (EMT) in NPC. Mechanistically, MSC-AS1 sequestered miR-524-5p to upregulate NR4A2 expression in NPC cells. Finally, NR4A2 was conformed as an oncogene in NPC, and overexpressed NR4A2 could restore MSC-AS1 knockdown-mediated inhibition on NPC progression.

Conclusions
Our study firstly showed that lncRNA MSC-AS1 aggravated NPC progression by sponging miR-524-5p to increase NR4A2 expression, indicating MSC-AS1 as a novel target for the lncRNA-targeted therapy in NPC.
Analysis of the susceptibility of lung cancer patients to SARS-CoV-2 infection
Authors: Kong Qi , Xiang Zhiguang , Wu Yue , Gu Yu , Guo Jianguo , Geng Fei 
Published: April 2020

AbstractRecent studies have reported that COVID-19 patients with lung cancer have a higher risk of severe events than patients without cancer. In this study, we investigated the gene expression of angiotensin I-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) with prognosis in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). Lung cancer patients in each age stage, subtype, and pathological stage are susceptible to SARS-CoV-2 infection, except for the primitive subtype of LUSC. LUAD patients are more susceptible to SARS-CoV-2 infection than LUSC patients. The findings are unanimous on tissue expression in gene and protein levels.
Comparison of Ferguson’s δ and the Gini coefficient used for measuring the inequality of data related to health quality of life outcomes
Authors: Wang Hsien-Yi , Chou Willy , Shao Yang , Chien Tsair-Wei 
Published: April 2020

Abstract
Background
Ferguson’s δ and Gini coefficient (GC) are defined as contrasting statistical measures of inequality among members within populations. However, the association and cutting points for these two statistics are still unclear; a visual display is required to inspect their similarities and differences.

Methods
A simulation study was conducted to illustrate the pertinent properties of these statistics, along with Cronbach’s α and dimension coefficient (DC) to assess inequality. We manipulated datasets containing four item lengths with two number combinations (0 and 33%) in item length if two domains exist. Each item difficulty with five-point polytomous responses was uniformly distributed across a ± 2 logit range. A simulated response questionnaire was designed along with known different structures of true person scores under Rasch model conditions. This was done for 20 normally distributed sample sizes. A total of 320 scenarios were administered. Four coefficients (Ferguson’s δ, GC, test reliability Cronbach’s α, and DC) were simultaneously calculated for each simulation dataset. Box plots were drawn to examine which of these presented the correct property of inequality on data. Two examples were illustrated to present the index on Google Maps for securing the discriminatory power of individuals.

Results
We found that 1-Ferguson’s δ coefficient has a high correlation (0.95) with GC. The cutting points of Ferguson’s δ, GC, test reliability Cronbach’s α, and the DC are 0.15, 0.50, 0.70, and 0.67, respectively. Two applications are shown on Google Maps with GCs of 0.14 and 0.42, respectively. Histogram legends and Lorenz curves are used to display the results.

Conclusion
The GC is recommended to readers as an index for measuring the extent of inequality (or lower discrimination power) in a given dataset. It can also show the study results of person measures to determine the inequality in the health-related quality of life outcomes.
Pharmaceutical care in Chinese public tertiary hospitals: findings from the 4th National Healthcare Improvement Initiative Survey
Authors: Li Mingshuang , Cao Man , Sun Jing , Jiang Yu , Liu Yuanli 
Published: April 2020

Abstract
Background
Pharmaceutical care has been playing an increasingly critical role in Chinese hospitals. However, evidence about the most recent development of pharmaceutical care in China is limited. This study analyzed the current situation of pharmaceutical care and the capacities of pharmacists in Chinese public tertiary hospitals.

Methods
All on-duty pharmacists of 143 public tertiary hospitals responded to the Likert-5 pre-set online questionnaire about their pharmaceutical care capacities in eight aspects, and their respective hospitals valued pharmaceutical care in clinical practice from March 18 to 31, 2019. This study measured the appraisals of the responding pharmacists as positive (“strongly agree” and “agree”) or negative (“neither agree nor disagree,” “strongly disagree,” and “disagree”) results. The study performed a descriptive analysis of the responding pharmacists and unconditional multivariate binary logistic regression analysis to predict the influencing factors of the pharmacists’ appraisals of pharmaceutical care. The dependent variable was transformed into binary categories and assigned 1 = positive response and 0 = negative response. The independent variables included the identifications of sample hospitals and the characteristics of the responding pharmacists.

Results
The survey retrieved 10 815 valid responded questionnaires. 74.5%, 67.5%, and 65.0% of the responding pharmacists made a positive self-appraisal of their abilities of communication with patients and doctors, reviewing prescriptions, and communication with particular patients, respectively. 65.5% had a positive appraisal of their respective hospitals to conduct active monitoring of the clinical use of new medicines, and 68.9% admitted that their respective hospitals valued the clinical pharmaceutical care. The doctor’s degree and senior academic rank of the responding pharmacists, as well as maternal and child hospitals, were predictors of higher appraisals of the responding pharmacists about their pharmaceutical care capacities, and their respective hospitals valued pharmaceutical care (all ORs > 1.5, P < 0.05).

Conclusions
The study suggested that there is a need to strengthen the pharmacy education, training, and staffing of pharmacists with improved professional skills to offer value-added specialized pharmaceutical care in Chinese public hospitals. Patient-centered and inter-disciplinary interactions in medical practice should be promoted. There is also a need for public hospitals to provide a platform for the achievement of the professional values of high-quality pharmacists at different carrier development stages.
Novel alterations in corneal neuroimmune phenotypes in mice with central nervous system tauopathy
Authors: Jiao Haihan , Downie Laura E. , Huang Xin , Wu Mengliang , Oberrauch Sara , Keenan Ryan J. , Jacobson Laura H. , Chinnery Holly R. 
Published: April 2020

Abstract
Background
Tauopathy in the central nervous system (CNS) is a histopathological hallmark of frontotemporal dementia (FTD) and Alzheimer’s disease (AD). Although AD is accompanied by various ocular changes, the effects of tauopathy on the integrity of the cornea, which is densely innervated by the peripheral nervous system and is populated by resident dendritic cells, is still unknown. The aim of this study was to investigate if neuroimmune interactions in the cornea are affected by CNS tauopathy.

Methods
Corneas from wild type (WT) and transgenic rTg4510 mice that express the P301L tau mutation were examined at 2, 6, 8, and 11 months. Clinical assessment of the anterior segment of the eye was performed using spectral domain optical coherence tomography. The density of the corneal epithelial sensory nerves and the number and field area of resident epithelial dendritic cells were assessed using immunofluorescence. The immunological activation state of corneal and splenic dendritic cells was examined using flow cytometry and compared between the two genotypes at 9 months of age.

Results
Compared to age-matched WT mice, rTg4510 mice had a significantly lower density of corneal nerve axons at both 8 and 11 months of age. Corneal nerves in rTg4510 mice also displayed a higher percentage of beaded nerve axons and a lower density of epithelial dendritic cells compared to WT mice. From 6 months of age, the size of the corneal dendritic cells was significantly smaller in rTg4510 compared to WT mice. Phenotypic characterization by flow cytometry demonstrated an activated state of dendritic cells (CD86+ and CD45+ CD11b+CD11c+) in the corneas of rTg4510 compared to WT mice, with no distinct changes in the spleen monocytes/dendritic cells. At 2 months of age, there were no significant differences in the neural or immune structures between the two genotypes.

Conclusions
Corneal sensory nerves and epithelial dendritic cells were altered in the rTg4510 mouse model of tauopathy, with temporal changes observed with aging. The activation of corneal dendritic cells prior to the gradual loss of neighboring sensory nerves suggests an early involvement of corneal immune cells in tau-associated pathology originating in the CNS.
Treatment adherence amongst drug users attending public and private methadone maintenance clinics in a northern province of Vietnam
Authors: Le Tuan Anh , Ha Giang Hai , Le Mai Quynh Thi , Tran Lien My Hoang , Pham Duyen Thanh Thi , Tran Ninh Hai Thi , Vu Giang Thu , Nguyen Long Hoang , Pham Hai Quang , Nguyen Cuong Tat , Tran Tung Hoang , Pham Kiet Tuan Huy , Tran Bach Xuan , Latkin Carl A. , Ho Cyrus S. H. , Ho Roger C. M. 
Published: April 2020

Abstract
Background
Methadone maintenance treatment (MMT) has been proven to be effective in improving health status and the quality of life of illicit drug users. Due to the quick expand of methadone program, socialization through co-payment service is a critical to the success of it. In Nam Dinh, Vietnam, MMT has been used in public clinics and one private clinic. Such effectiveness of this treatment has been found to depend largely on adherence to treatment. This study aims to explore the compliance rate and its influencing factors among drug users between public and private clinics in Nam Dinh province, Vietnam.

Methods
A cross-sectional study was conducted on 395 participants from January to September in 2018 in three MMT clinics in Nam Dinh, Vietnam. We applied the convenience sampling technique to recruit respondents. Data on socioeconomics characteristics, MMT adherence (measured by Visual Analogue Scale – VAS) and level of social/family support were collected.

Results
43.3% of participants reported complete adherence to the MMT program during the time of research. Significant factors affect MMT adherence among illicit drug users including family income, history of drug rejections, concurrence in drug usage, far distance from MMT clinics, and having only peer. Patients in MMT private clinic had higher complete adherence than that of public MMT (OR = 1.82, 95% CI = 1.13; 2.94). Having contacts with peer drug users associated with a higher rate of incomplete adherence (OR = 2.83, 95% CI = 1.39; 5.73).

Conclusions
The findings support the establishment of private MMT clinics alongside public ones, while further researches to determine the optimal dose and ways to reduce the impact of peer drug user’s influence are encouraged to be conducted.
NDRG2 gene expression pattern in ovarian cancer and its specific roles in inhibiting cancer cell proliferation and suppressing cancer cell apoptosis
Authors: Kang Fenhong , Wang Yanlong , Luo Yaping , Zhang Yongjun 
Published: April 2020

Abstract
Background
The cancer cell metastasis and the acquisition of chemotherapy resistance remain huge challenge for ovarian cancer treatment. Previously, N-myc downstream-regulated gene 2 (NDRG2) serves as a tumor suppressor for many cancers. Here, we attempted to investigate the specific roles of NDRG2 in ovarian cancer.

Methods
The expression levels of NDRG2 were detected by qRT-PCR or Immunoblotting. CCK-8 assay was employed to examine the cell viability of ovarian cancer cells. The colony formation ability was determined by colony formation assay. Flow cytometry analyses were performed to detect the cell apoptosis and cell cycle. Xenograft tumor assay was performed to detect the in vivo function of NDRG2.

Results
We revealed that NDRG2 mRNA expression and protein levels were downregulated within both ovarian cancer tissues and cell lines. The overexpression of NDRG2 dramatically inhibited the cell viability and colony formation and tumor growth, whereas promoted the cell apoptosis, cell cycle arrest in G1 phase within ovarian cancer cells. More importantly, NDRG2 overexpression significantly enhanced the suppressive roles of cisplatin (DDP) in ovarian cancer cell viability. On the contrary, NDRG2 silence exerted opposing effects on ovarian cancer cells.

Conclusions
In summary, we provide a solid experimental basis demonstrating the tumor-suppressive effects of NDRG2 in inhibiting the cell proliferation, enhancing the cell apoptosis, eliciting the cell cycle arrest in G1 phase, and promoting the suppressive effects of DDP on the viability of ovarian cancer cells. NDRG2 administration presents a potent adjuvant treatment for ovarian cancer therapy.