bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences and views of different key stakeholders on the feasibility of treating cancer-related fatigue
Authors: Canella Claudia , Mikolasek Michael , Rostock Matthias , Guckenberger Matthias , Jenewein Josef , Linka Esther , Six Claudia , Stoll Sarah , Stupp Roger , Witt Claudia M. 
Published: May 2020

Abstract
Background
Although cancer-related fatigue (CRF) has gained increased attention in the past decade, therapy remains a challenge. Treatment programs are more likely to be effective if the needs and interests of the persons involved are well represented. This can be achieved by stakeholder engagement.
In this paper, different key stakeholders’ experiences and views on the feasibility of treating CRF in the context of supportive care in hospital environments are analyzed.

Method
In a qualitative study with the aim of developing an integrative treatment program for CRF, a total of 22 stakeholders (6 medical oncologists, 5 nurses, 9 patients, 1 patient family member, 1 representative of the Swiss Cancer League) were interviewed either in a face-to-face (n = 12) or focus group setting (n = 2). For data analyses, the method of qualitative content analysis was used.

Results
The stakeholders referred to different contextual factors when talking about the feasibility of treating CRF in the context of supportive care in hospital environments. These included: assessment, reporting and information; treatability; attitude; infrastructure, time-management, costs and affordability; and integrative approach.

Conclusions
Key factors of a feasible treatment approach to CRF are a coherent, cost effective integrative treatment program facilitated by an interdisciplinary team of health care providers. Furthermore, the treatment approach should be patient orientated, adopting an individualized approach. The major challenges of making the integrative treatment program feasible for CRF are resources and interprofessional collaboration.
Association of Helicobacter pylori babA2 gene and gastric cancer risk: a meta-analysis
Authors: Kpoghomou Marce-Amara , Wang Jinchen , Wang Tianpei , Jin Guanfu 
Published: May 2020

Abstract
Background
The association of Helicobacter pylori (H. pylori) babA2 gene with gastric cancer (GC) was reported by several studies, but results were inconsistent. This meta-analysis was performed to investigate the relationship between H. pylori babA2 gene and GC risk.

Methods
Case-control studies involving the association between H. pylori babA2 gene and GC risk were systematically identified from PubMed databases. A meta-analysis was used to pool studies and to estimate odds ratios (ORs) with 95% confidence intervals (CIs) of H. pylori babA2 gene associated with GC risk.

Results
Twenty studies were identified with a total of 1289 GC cases and 1081 controls. H. pylori babA2 gene was associated with an increased risk of GC by 2.05 fold (95% CI, 1.30–3.24, P = 0.002). In subgroup analysis, we found that H. pylori babA2 gene was significantly associated with GC risk in Asian population (OR = 2.63, 95% CI: 1.36–5.09 P = 0.004) but not in South American population (OR = 1.35, 95% CI: 0.69–2.64, P = 0.379).

Conclusions
This meta-analysis indicates that H. pylori babA2 gene may be associated with increased risk of GC, especially in Asian population.
Interobserver reproducibility and interocular symmetry of the macular ganglion cell complex: assessment in healthy children using optical coherence tomography
Authors: Muñoz-Gallego Alicia , De la Cruz Javier , Rodríguez-Salgado Martín , Torres-Peña José L. , Sambricio Javier , Ortueta-Olartecoechea Ana , Tejada-Palacios Pilar 
Published: May 2020

Abstract
Background
Assessment of interobserver reproducibility and interocular symmetry using optical coherence tomography (OCT)–based measurements of the macular ganglion cell complex (GCC) in healthy children facilitates interpretation of OCT data. We assessed the interobserver reproducibility and interocular symmetry of GCC and evaluated candidate determinants.

Methods
This was a cross-sectional study performed in a primary and tertiary health-care setting. A total of 126 healthy participants aged 5 to 18 years were eligible. GCC scans were performed by 4 operators using the Topcon 3D OCT-2000 device. Intraclass correlation coefficients (ICCs) were used to estimate reproducibility and symmetry. Cut-off points for symmetry were defined as the 95th percentile of the absolute interocular difference for 6 GCC parameters. Percentile distributions of interocular difference were generated based on age and difference in absolute interocular spherical equivalent (SE).

Results
The reproducibility ICC ranged from 0.96 to 0.98 for all 6 GCC parameters. Cut-off points for interocular symmetry of the superior and inferior quadrants and total macular retinal nerve fibre layer thickness (mRNFL) and macular ganglion cell layer-inner plexiform layer thickness were 3.5, 4.5, 3.0, 3.0, 2.5, and 2.5 μm respectively. A positive association was observed between the absolute interocular difference of SE and superior and total mRNFL symmetry values (p = 0.047 and p = 0.040, respectively).

Conclusions
OCT measurements of GCC in healthy children show excellent reproducibility. Interocular differences in SE should be assessed when mRNFL differences exceed the 95% cut-off. These findings can contribute to establish reference values for interocular symmetry in paediatric GCC parameters.
Pathology features and the results of treatment of two cases of posterior choroidal leiomyoma
Authors: Zhou Nan , Wei Wenbin , Xu Xiaolin 
Published: May 2020

Abstract
Background
Posterior choroidal leiomyoma is an extremely rare tumor, to our knowledge, less than 10 cases reported in the literature. The definite diagnosis can be confirmed by immunohistochemistry, and local resection is preferable to enucleation for the posterior choroidal leiomyoma.

Case presentation
Two adult Asian women presented with progressive vision loss in their right eyes. Ophthalmic examination revealed an amelanotic dome-shaped choroidal mass located in the fundus with yellowish exudative retinal detachment. Clinical differential diagnosis of a nonpigmented choroidal neoplasm mainly includes amelanotic melanoma, atypical hemangioma, metastatic carcinoma, as well as the rare posterior choroidal leiomyoma. Considering the choroidal lesion was more likely to be a benign tumor, then we performed the treatment of local resection by pars plana vitrectomy and the histopathological examination confirmed the diagnosis of choroidal leiomyoma. The best corrected visual acuity of the patients was more than 20/100 on 6-month follow-up.

Conclusions
From these two posterior choroidal neoplasm cases, we were able to demonstrate local resection by the 23 to 25-gauge mircoinvasive vitrectomy for excision of intraocular tumors is a feasible treatment for choroidal leiomyoma.
Influence of virtual reality on visual parameters: immersive versus non-immersive mode
Authors: Yoon Hyeon Jeong , Kim Jonghwa , Park Sang Woo , Heo Hwan 
Published: May 2020

Abstract

Background
To investigate the differences in refraction, accommodative factors, visual parameters, and subjective symptoms after using two types of virtual reality (VR) content with different depths of perception.

Methods
Twenty-three volunteers, who played VR games in two modes (immersive and non-immersive) for 30 min, were enrolled. Visual parameters were examined before and after using VR. Accommodative factors were measured using static and dynamic methods. Subjective symptoms were assessed using a questionnaire. Differences according to VR content were compared, and correlations between each visual parameter were analyzed.

Results
There were no changes in refraction or accommodative factors after use of the VR. However, there was a significant increase in the near point of accommodation (NPA), the near point of convergence (NPC), and subjective symptom scores after using the immersive mode. Correlation analysis revealed a positive correlation between baseline values of near exophoria and mean accommodative lag of the dominant eye, and also revealed a negative correlation between NPA and mean accommodative lag in the non-dominant eye.

Conclusions
The use of VR for 30 min increased NPA and NPC, especially after the immersive mode was used. In addition, higher exophoria and smaller NPA is associated with increased accommodative lag after using VR.
A case of severe flare reaction observed in HLA B27 associated acute anterior uveitis
Authors: Kim Jae-Ik , Park Choul Yong 
Published: May 2020

Abstract
Background
Anterior chamber flare reaction refers to the light reflection from the protein in aqueous humor. We report a case of very severe flare reaction observed in human leukocyte antigen (HLA)- B27 associated acute anterior uveitis (AAU).

Case presentation
An age 43 male patient visited the uveitis clinic complaining of decreased visual acuity in the right eye which developed 1 week before. The detailed ophthalmic examination revealed very severe flare reaction in the anterior chamber with diffuse conjunctival hyperemia in the right eye. Pupil margin and iris details were barely observable. Oral prednisolone 20 mg daily with topical 1% prednisolone acetate (Pred Forte, Allergan, CA) every 2 h and 1% topical cyclopentolate (Cyclogyl, Alcon, TX) three times daily were immediately prescribed. The next day, the flare reaction of the right eye decreased significantly and inflammatory cells in the anterior chamber were visible. Detailed fundus examination revealed no inflammatory signs on the retina and ciliary body. Later, the blood test revealed positive HLA B27 and autoantibodies against lupus anticoagulant with mild elevation of C reactive protein. There were no signs for ankylosing spondylitis. Continued treatment and tapering of topical 1% prednisolone acetate for 4 weeks led to the complete resolution of the anterior uveitis.

Conclusions
We experienced HLA-B27 AAU with the feature of a very severe flare reaction. Conventional uveitis treatment was successful to acquire the complete resolution of the inflammation.
Clustering of health-related behaviours and its relationship with individual and contextual factors in Portuguese adolescents: results from a cross-sectional study
Authors: dos Santos Constança Soares , Picoito João , Loureiro Isabel , Nunes Carla 
Published: May 2020

Abstract
Background
Health behaviours are shaped early in life and tend to occur in complex specific patterns. We aimed to characterise these patterns among Portuguese adolescents and their association with individual and contextual factors.

Methods
This study was based in the Portuguese 2009/10 survey of Health Behaviour in School-Aged Children Study, comprising 4036 adolescents. Individuals were grouped using two-step cluster analysis based on 12 behaviours regarding diet, physical activity, screen use and substance use. The association between clusters and individual and contextual factors was analysed using multinomial regression.

Results
The median age was 13,6, and 54% were female. Overweight and obesity were highly prevalent (25%). We identified four behavioural clusters: “Active screen users”, “Substance users”, “Healthy” and “Inactive low fruit and vegetable eaters”. Sociodemographics varied across clusters. The “Substance users” and “Active screen users” clusters were associated with poor family communication, academic performance and school attachment and violent behaviours, and the “Inactive low fruit and vegetable eaters” were associated with lower socioeconomic status.

Conclusion
The understanding of these health-compromising patterns and their social determinants is of use to Public Health, allowing tailored health-promoting interventions. Further research is needed to understand how cluster membership evolves and its influence on nutritional status.
The association between new graphic health warning labels on tobacco products and attitudes toward smoking among south Korean adolescents: a national cross-sectional study
Authors: Hwang Ji-eun , Cho Sung-il 
Published: May 2020

Abstract
Background
Graphic health warning labels (GHWLs) on tobacco products are more effective than text warnings for communicating the risk of smoking. The implementation of GHWLs can prevent adolescents from initiating smoking. Therefore, this study examined the association between GHWLs newly implemented on December 23, 2016, in South Korea and attitudes toward smoking among adolescents.

Methods
This post-implementation cross-sectional analysis examined the responses of 62,276 students (31,624 boys and 30,652 girls) who participated in the 2017 Web-based Korean Youth Risk Behavior Survey, which was completed anonymously as a self-administered questionnaire by middle and high school students. Multinomial logistic regression was applied to explore the attitudes toward smoking among the youth (13–18 years old) who have been exposed to GHWLs in order to identify relationship of exposure to the GHWLs with smoking initiation and awareness of the danger of smoking.

Results
Six months after implementation, 69.4% of adolescents reported having been exposed to GHWLs in the previous 30 days. Among those exposed to GHWLs both boys and girls in grade 7 were significantly more likely than grade 12 high school students to decide not to start smoking (boys: AOR = 3.96, 95% CI 3.31–4.75, p < 0.001; girls: AOR = 2.76, 95% CI 2.32–3.30, p < 0.001) and to think that smoking was dangerous to their health (boys: AOR = 3.01, 95% CI 2.52–3.58, p < 0.001; girls: AOR = 2.42, 95% CI 2.03–3.88, p < 0.001) after seeing GHWLs. These associations were greater for adolescents who had experienced smoking-prevention education or had been exposed to anti-tobacco advertisements. However, those who smoked, used e-cigarettes, or experienced secondhand smoking were significantly less likely to decide not to smoke and to view smoking as dangerous.

Conclusions
To maintain the perception of the harm of tobacco from childhood through adolescence, the government should implement both comprehensive tobacco controls, including smoking-prevention education in schools, and measures to encourage a smoke-free environment in homes.
Acceptability and feasibility of a behavioral and mobile health intervention (COMBIND) shown to increase uptake of prevention of mother to child transmission (PMTCT) care in India
Authors: Suryavanshi Nishi , Kadam Abhay , Kanade Savita , Gupte Nikhil , Gupta Amita , Bollinger Robert , Mave Vidya , Shankar Anita 
Published: May 2020

Abstract
Background
A cluster-randomized trial recently demonstrated that an integrated behavioral and mobile technology intervention improved uptake of key components of a Prevention of Mother to Child Transmission (PMTCT) Option B+ program, among HIV- infected pregnant/breastfeeding women in India. To guide scale-up and optimize programmatic implementation, we conducted a mixed-methods evaluation of the feasibility and acceptability of this intervention.

Methods
The COMmunity Home Based INDia (COMBIND) study, was conducted in four districts of Maharashtra, India and randomized 119 integrated counseling and testing centers (ICTC) and their outreach workers (ORWs) to the COMBIND intervention, an integrated mHealth application that allowed digital data capture, PMTCT educational videos, SMS alerts for missed visits and reminder for visits, combined with personal empowerment and motivational interviewing training for ORWs. This qualitative evaluation was done through 15 in-depth interviews (IDIs) with ORWs and 15 IDIs with HIV-infected pregnant/breastfeeding women from the intervention arm. Utilizing a concurrent nested mixed-method evaluation approach, we assess the feasibility and acceptability of the study intervention.

Results
All 30 participants reported that the PMTCT videos were essential in providing easy to understand information on critical aspects of HIV and necessary care related to PMTCT practices. A majority of the ORWs reported that the personal empowerment training with motivational interviewing skills training increased their confidence, motivation and gave them the tools for effectively supporting their clients. The mHealth application improved their working style as it facilitated targeted PMTCT information support, systemized data capture, streamlined their health education delivery practice and provided a sense of work satisfaction. The SMS appointment alerts improved retention in HIV care for mother and baby to the smaller proportion that had access to their phones. Despite reported improvements in knowledge and communication, few ORWs reported that structural challenges such as limited drug stocks, lack of HIV kits or unavailability of trained staff at ICTC, may hamper the uptake of PMTCT services, thus resulting in limited significant impacts of COMBIND on PMTCT outcomes.

Conclusion
This study found that COMBIND intervention is scalable, feasible, beneficial and very well accepted by ORWs and patients, however structural challenges in goods and services remain.
Returning to care after incarceration with HIV: the French Guianese experience
Authors: Huber F. , Vandentorren S. , Merceron A. , Bonifay T. , Pastre A. , Lucarelli A. , Nacher M. 
Published: May 2020

Abstract
Background
HIV prevalence in correctional facilities may be 2 to 10 times higher than in the general adult population. Antiretroviral therapy (ART) interruption is frequent after an incarceration. This, in combination with post-release high-risk behaviors, may have detrimental consequences on the epidemic. Although return to care after release from correctional facilities has been described in many North American settings, data from South America seemed scarce.
French Guiana is the only French territory located in South America. In 2014, HIV prevalence was estimated at 1.2% among pregnant women and oscillated around 4% in the only correctional facility.

Method
HIV-infected adults released from the French Guiana correctional facility between 2007 and 2013 were included in a retrospective cohort survey. The first objective was to describe the cascade of care in the 4 years following release. The secondary objectives were to describe contacts with care and to identify factors associated with return to HIV care, 1 year after release.

Results
We included 147 people, mostly males (81.6%). The median time before the first ambulatory consultation was 1.8 months. Within 1 year after release, 27.9% came for unscheduled emergency consultations, 22.4% were hospitalized. Within 4 years after release, 40.0–46.5% were in care, 22.4% archieved virological success.
Being on ART when incarcerated was associated with HIV care (aIRR: 2.0, CI: 1.2–3.0), whereas being HIV-diagnosed during the last incarceration was associated with poor follow-up (aIRR: 0.3, CI: 0.1–0.9).

Conclusion
The risk of HIV-follow-up interruption is high, after an incarceration with HIV. ART supply should be sufficient to cover the timespan following release, several months if possible. Those not on ART at the time of incarceration may require special attention, especially those newly HIV-diagnosed while in custody. Comprehensive programs are necessary to support ex-offenders to stay on ART after incarceration.
Medical schools in India: pattern of establishment and impact on public health - a Geographic Information System (GIS) based exploratory study
Authors: Sabde Yogesh , Diwan Vishal , Mahadik Vijay K. , Parashar Vivek , Negandhi Himanshu , Trushna Tanwi , Zodpey Sanjay 
Published: May 2020

AbstractBackgroundIndian medical education system is on the brink of a massive reform. The government of India has recently passed the National Medical Commission Bill (NMC Bill). It seeks to eliminate the existing shortage and maldistribution of health professionals in India. It also encourages establishment of medical schools in underserved areas. Hence this study explores the geographic distribution of medical schools in India to identify such under and over served areas. Special emphasis has been given to the mapping of new medical schools opened in the last decade to identify the ongoing pattern of expansion of medical education sector in India.MethodsAll medical schools retrieved from the online database of Medical Council of India were plotted on the map of India using geographic information system. Their pattern of establishment was identified. Medical school density was calculated to analyse the effect of medical school distribution on health care indicators.ResultsPresence of medical schools had a positive influence on the public health profile. But medical schools were not evenly distributed in the country. The national average medical school density in India amounted to 4.08 per 10 million population. Medical school density of provinces revealed a wide range from 0 (Nagaland, Dadra and Nagar Haveli, Daman and Diu and Lakshadweep) to 72.12 (Puducherry). Medical schools were seen to be clustered in the vicinity of major cities as well as provincial capitals. Distance matrix revealed that the median distance of a new medical school from its nearest old medical school was just 22.81 Km with an IQR of 6.29 to 56.86 Km.ConclusionsThis study revealed the mal-distribution of medical schools in India. The problem is further compounded by selective opening of new medical schools within the catchment area of already established medical schools. Considering that medical schools showed a positive influence on public health, further research is needed to guide formulation of rules for medical school establishment in India.
Delays in diagnosing pulmonary tuberculosis within a context of medium incidence, Medellín, Colombia, 2017: an operational research
Authors: Rodríguez-Márquez Iader , Montes Fernando , Upegui Luz D. , Montoya Nilton , Vargas Nelly E. , Rojas Abelardo , Valencia Gloria C. , Álvarez Claudia M. , Uribe Leonardo , Ochoa Jesús 
Published: May 2020

Abstract
Background
Delay in tuberculosis (TB) diagnosis is one of the first obstacles for controlling the disease. Delays generate greater deterioration of the health of the patients and increase the possibilities of transmission and infection at home and in the community. The aim of the study was to identify profiles and individual variables associated with patient delays and health care system delays in patients with pulmonary tuberculosis (PTB) in Medellín, Colombia, a city that notifies 1400 new cases per year.

Methods
A retrospective cohort study in adults with PTB was conducted from May to September of 2017. Sociodemographic, health care-seeking behaviour, and clinical variables were measured. The outcomes were patient delay and health care system delay. The data were obtained from records of the local TB program, and a questionnaire was applied by the health care team that performs routine field visits. Simple correspondence analysis was used to identify groups (profiles), and their characteristics. Cox’s proportional hazards model was carried out to identify the variables associated with the delays.

Results
The study included 183 patients. The total delay median was 101 days (IQR: 64–163). Patient delay was of 35 days (IQR: 14–84), the profile with greater delay belonged to consumers of psychoactive substances. The health care system delay was of 27 days (IQR: 7–89), the attributes of the profile with greater delay were being a female, having more than two consultations before the diagnosis, and having prescribed antibiotics. Basic-medium educational level [HRa = 0.69; 95% CI (0.49–0.97)] and having a TB home contact [HRa = 0.68; 95% CI (0.48–0.96)] were associated with greater patient delay. Having negative acid-fast bacilli (AFB) smear [HRa = 0.64; 95% CI (0.45–0.92)] and more than two consultations before the diagnosis [HRa = 0.33; 95% CI (0.22–0.49)] was associated with greater health care system delay.

Conclusions
Data from epidemiological surveillance allowed locating risk groups with delays in TB diagnosis which requires the prioritisation of the local TB control program to promote early detection and prevention of adverse outcomes.