bluuebunny/crossref_metadata_2025_split huggingface dataset:
Young women’s autonomy and information needs in the schools-based HPV vaccination programme: A qualitative study
Authors: Fisher Harriet , Evans Karen , Ferrie Jo , Yates Julie , Roderick Marion , Audrey Suzanne 
Published: May 2020

Abstract
Background Until 2019, the English schools-based human papillomavirus (HPV) vaccination programme was offered only to young women aged 12 to 13 years to reduce HPV-related morbidity and mortality. The aim of this study is to explore the extent to which young women were able to exercise autonomy within the HPV vaccination programme and how this was influenced by the content and form of information provided. Methods Recruitment was facilitated through a healthcare organisation, schools and community organisations in a local authority in the south-west of England. Researcher observations of the delivery of the HPV vaccination session were carried out in three schools. Semi-structured interviews took place with 53 participants (young women, parents of adolescent children, school staff and immunisation nurses) during the 2017/18 and 2018/19 programme years. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was undertaken, assisted by NVivo software. Results Young women’s active participation and independence within the HPV vaccination programme was constrained by the setting of vaccination and the primacy of parental consent procedures. The authoritarian school structure influenced the degree to which young women were able to actively participate in decisions about the HPV vaccination programme. Young women exercised some power, either to avoid or receive the vaccine, by intercepting parental consent forms and procedures. Reliance on leaflets to communicate information led to unmet information needs for young women and their families. Communication may be improved by healthcare professional advocacy, accessible formats of information, and delivery of educational sessions. Conclusions Strategies to improve communication about the HPV vaccine may increase young people’s autonomy in consent procedures, clarify young people’s rights and responsibilities in relation to their health care services, and result in higher uptake of the HPV vaccination programme. Trial registration: ISRCTN registry number 49086105
The Magnitude and associated factors of Helicobacter pylori infection among adult dyspeptic patients attending Bokoji Hospital, Southeast Ethiopia
Authors: Kenea Dagaga Goboto , Negawo Mesfin , Lemessa Firaol Kitila , Tejineh Solomon 
Published: May 2020

Abstract
Background: Helicobacter pylori infection is the most common chronic bacterial infection and there were approximately 4.4 billion individuals with H pylori infection worldwide. Among those, hundreds of millions of people develop peptic ulcer disease during their lifetime and still tens of millions might progress to gastric cancer. Hence, early information is very important to prevent upper gastrointestinal complications. Consequently, the current study aimed to assess the magnitude and associated risk factors of Helicobacter pylori infection among adult dyspeptic patients attending Bokoji hospital, Southeast Ethiopia.Methods: A hospital-based cross-sectional study involving 348 adult dyspeptic patients attending Bokoji hospital was carried out from July 16 to October 31, 2019. About 50 mg of fresh stool and 60 µl of capillary blood were collected from each dyspeptic patient and analyzed for detection of Helicobacter pylori antigens, presence of intestinal parasites and ABO blood grouping respectively. Data were entered using Epi Info 7 and Statistical analysis was done using SPSS version 21 and a p-value less than 0.05 was considered as statistically significant.Results: The overall magnitude of Helicobacter pylori infection was 47.7%. The magnitude of H. pylori infection was almost two times higher in patients who do not have a habit of handwashing after toilet visit than those who wash their hand's habit of handwashing after visiting toilet (AOR 2.241, 95% CI (1.410, 3.563) and alcohol drinking habit (AOR 1.796, 95% CI (1.087, 2.968). Conclusions: The magnitude of H. pylori was high in the study area and associated with handwashing habits after toilet use and alcohol drinking habits. Therefore, the community could be educated on the handwashing habit to minimize H. pylori infections.
Moderate, Rather Than Vigorous Exercise Benefits Plasma Amino Acids Profile in Patients With Nonalcoholic Fatty Liver Disease
Authors: Li Jia , Shi Xiulin , Huang Yinxiang , Huang Caoxin , Chen Zhen , Zhao Yan , Chen Zhong , Li Xuejun 
Published: May 2020

Abstract
Backgrounds: Exercise benefits nonalcoholic fatty liver disease (NAFLD), and amino acids (AAs) are close associated with the development and progression of NAFLD. However, it is unclear whether AAs profile changes following long term exercise training.Methods: NAFLD participants (n=220) were recruited and randomly assigned to control group, moderate exercise group, and vigorous exercise group with a 6-month followed-up. Clinical characteristics were carefully calculated and plasma AAs concentrations were determined using a validated ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method. Results: At baseline, AAs concentrations were close associated with clinical characteristics in NAFLD, particularly, the sum of branched chain amino acids (BCAAs) were positively associated with intrahepatic triglyceride (IHTG) content (r=0.18, P=0.007). After 6 month exercise intervention, IHTG content was reduced by both exercise intensities without a significant difference (P=0.45). Compared to control, several AAs concentrations altered, and different exercise intensity showed inversely impact on histidine, serine, glutamine, valine, tyrosine and tryptophan concentrations changes, particularly, moderate exercise was much more efficient on BCAAs decreasing than vigorous exercise with a significant difference (P=0.0008). Conclusions: Several AAs were close associated with IHTG content in NAFLD patients, and 6 month moderate exercise was more efficient on AAs concentrations alteration, especially BCAAs decreasing than vigorous exercise. Trial registration number: NCT01418027
Sensory Gating and Suppression of Subjective Peripheral Sensations During Voluntary Muscle Contraction
Authors: Takahara Terumasa , Yamaguchi Hidetaka , Seki Kazutoshi , Onodera Sho 
Published: May 2020

Abstract
Background: During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the somatosensory evoked potential (SEP) amplitude decreases. This depression of sensory input during voluntary muscle contraction has been demonstrated by many studies using electrophysiological methods. However, the association between the electrophysiological response of the sensory system during exercise and subjective peripheral sensation (SPS) is still unclear. The aim of this study was to investigate changes in spinal excitability, SEP, and SPS during voluntary muscle contraction.Results: The appearance rate of the F-wave was significantly higher during muscle contraction than rest, whereas no significant difference was observed in F-wave latency between muscle contraction and rest. Furthermore, the P25 amplitude of SEP was significantly lower during muscle contraction than rest, whereas the N20 amplitude of SEP exhibited no significant differences. The SPS was significantly lower during muscle contraction than rest.Conclusions: We conclude that sensory gating, which is found in the P25 component of SEP during muscle contraction, is one of the neurophysiological mechanisms underlying the suppression of SPS.
The rs28757157 and rs59429575 polymorphisms in CYP19A1 are associated with lung cancer in Chinese Han population
Authors: Zhang Chan , Cheng Yujing , Chen Wanlu , Li Qi , Dai Run , Wang Yajie , Yang Tonghua 
Published: May 2020

Abstract
Background: Lung cancer is the leading cause of cancer death globally. Recent studies have revealed that the CYP19A1 gene played a crucial role in cancer initiation and development. Objectives: The aim of this study was to assess the association of CYP19A1 genetic polymorphisms with the risk of lung cancer in Chinese Han population. Method: This study randomly recruited 507 lung cancer patients and 505 healthy controls. The genotypes of four SNPs of CYP19A1 gene were identified by Agena MassARRY technique. Genetic model analysis was used to assess the association between genetic variation and lung cancer risk. Odds ratio (OR) values and 95% confidence intervals (CIs) were provided for the evaluation of the lung cancer risk effect. Results: Rs28757157 and rs59429575 polymorphisms of CYP19A1 were significantly correlated with the risk of lung cancer. In stratified analysis, rs28757157 was associated with increased cancer risk in males and smoker. Meanwhile, rs59429575 was identified as a risk biomarker in female and lung adenocarcinoma patients (p < 0.05). While rs28757157 exerted protective role among people with a BMI greater than 24 (p = 0.033). Conclusions: This study identified two new SNPs (rs28757157 and rs59429575) of CYP19A1 associated with lung cancer in Chinese Han population. These findings provide data support for further functional studies of CYP19A1 in lung cancer.
Immediate Postpartum Haemorrhage at the Libreville University Hospital Centre: Epidemiological Profile of Women
Authors: WOROMOGO SYLVAIN HONORE , Ledaga Nathalie Ambouda , Yagata-Moussa Felicite-Emma , Ossouka Liela Agnes Okoyi , Tekem Vicky Noel Simo , Ango Eliane Okira , Kouanang Alain Jepang 
Published: May 2020

Abstract
Introduction In Gabon, the frequency of maternal deaths directly related to Immediate PostPartum Haemorrhage (IPPH) is 15 to 25%, despite the different means that World Health Organization (WHO) has made available to the providers of the Emergency Obstetrical and Neonatal Care (EmONC). The objective of this study was to determine the prevalence and epidemiological characteristics of IPPH in order to improve its management and reduce the rate of maternal deaths.Methods An analytical retrospective study involved 42,728 records, whose data were collected using a chart collection form on the basis of information contained in partograms and other patient records. The description of the sample is made using numbers and proportions. The relationship between the etiologies of IPPH and certain characteristics of the women was established using the ORs with their 95% confidence interval. The difference was significant if p < 0.05.Results The prevalence of IPPH was 1.6%. The 20-39 age group was the most represented. Multiparous women accounted for 67.2%. Delivery hemorrhages accounted for 65.5% of IPPH. The main factors associated with delivery hemorrhages were multiparity (p<0.001), preterm and postterm (p<0.001), and child weight >4,000 g (p<0.001). Those associated with genital track injuries were young maternal age, multiparity (p<0.001).ConclusionsThe prevalence of IPPH was 1.6%. The most common etiology was hemorrhage from delivery. Multiparity remains the most common risk factor and the young age of the patients. It is important to improve management through better assessment of blood loss in the immediate postpartum as well as capacity building of health providers on EmONC.
Impact of a multimedia website with patient experiences of multiple sclerosis (PExMS) on immunotherapy decision-making: study protocol for a pilot randomised controlled trial in a mixed-methods design
Authors: Barabasch Anna , Riemann-Lorenz Karin , Kofahl Christopher , Scheiderbauer Jutta , Eklund Desiree , Kleiter Ingo , Kasper Jürgen , Köpke Sascha , Lezius Susanne , Zapf Antonia , Rahn Anne Christin , Heesen Christoph 
Published: May 2020

Abstract
Background: A variety of management options (e.g. immunotherapies, lifestyle interventions, and rehabilitation) are available for people with relapsing-remitting multiple sclerosis (RRMS). Besides coping with the diagnosis, people with MS (pwMS) have to make complex decisions such as deciding about immunotherapies. In addition to factual information, reports of patient experiences (PEx) may support patients in decision-making. The added value of PEx in decision-making is not clear and controlled studies are rare. Therefore, systematic methods are necessary to develop and analyse PEx. As there are no evaluated PEx for MS in Germany, we are currently creating a website presenting PEx structured according to topics and illustrated by video, audio and text files. We aim to determine the feasibility of an intervention using PEx and evaluate whether PEx may help pwMS in their immunotherapy decision-making processes as a supplement to evidence-based information.Methods: This project will follow the Medical Research Council framework for development and evaluation of complex interventions. After the development of a website with PEx, a randomised controlled pilot trial (pilot RCT) will be conducted in 2-3 MS centres, clinics or rehabilitation centres including 55 pwMS and accompanied by a process evaluation. Patients with a RRMS diagnosis considering immunotherapy are eligible. The primary outcome is decision self-efficacy. Secondary outcomes include preparation for decision-making, decisional conflict, risk knowledge, confidence in active participation, affective forecasting, social support and self-reported impact of eHealth on its users. Participants will be randomly assigned either to i) an intervention group with a four weeks access to an evidence-based patient information resource and the PExMS-website as an adjunct or to ii) the control group with access to evidence-based information alone. A 6-members advisory panel involving representatives of pwMS, researchers, and neurologists, who accompany the whole project will mentor this pilot RCT.Discussion: The intervention was developed with systematic methods, created with active patient involvement and in critical appraisal by an expert advisory panel. The study is innovative as it contributes to the controversial evidence on the use of PEx in the context of evidence-based patient information.Trial registration: ClinicalTrials.gov (Identifier: NCT04236544).
Does Teaching Clinical Ethics to Medical Students Improve Knowledge, Attitude, and Practice of Medical Ethics Among Clinicians? An Observational Study in a Tertiary Care Hospital in Nepal.
Authors: Shrestha Carmina , Joshi Jasmin , Shrestha Ashma , Karki Shuvechchha , Acharya Sajan , Joshi Suchita 
Published: May 2020

Abstract
Background: The importance of doctors being aware of medical ethics has been highlighted in a number of studies. Our first study (Study-1) aims to assess the knowledge, attitude, and practices of medical ethics among clinicians at Patan Academy of Health Sciences (PAHS). We then follow up with the effect of teaching clinical ethics to medical students (Study-2). The purpose of this study is to assess the awareness regarding appropriate ethical principles, application of medical ethics and the effect of teaching medical ethics to students. Methods: There are two studies presented: Study-1 is a cross-sectional questionnaire-based study. A total of 72 participants, selected by simple random sampling, included doctors working as interns, medical officers and consultants in six departments of PAHS. Study-2 was a follow-up, cross-sectional online questionnaire-based comparative study conducted at PAHS to compare KAP of medical ethics among medical officers with and without formal medical ethics training. We used the validated questionnaire from our previous study. All graduates of PAHS 2016 and all medical officers employed at PAHS at the time of study who had graduated from other medical schools that did not include Medical Ethics in their core curriculum were included. Results: Study-1: A positive correlation between Knowledge(p = 0.088), Attitude (p = 0.002), Practice of medical ethics(p = 0.000), and years of practice was found. No significant difference in KAP of medical ethics between MBBS graduates from Nepal and abroad (p = 0.190) was found. The majority scored poorly in issues concerning autonomy. The follow-up study found a statistically significant difference (p = 0.000) in the knowledge between the doctors who were taught medical ethics and those who were not. Conclusions: Doctors find it easier to discuss ethical dilemmas with their colleagues rather than department heads. The KAP of the consultants were found to be better than that of the interns and medical officers. Autonomy is the least understood ethical principle. ‘Medical Ethics’ as a part of the core curriculum in medical schools would improve ethical practice.
LIP4 gene expression from Candida viswanathii strain
Authors: Teixeira Ronan C. , Daude Matheus M. , Oliveira Nayra M. L. de , Almeida Alex Fernando , Barreto Horllys G. 
Published: May 2020

Abstract
Background : Lipases are hydrolases that catalyze the cleavage of triglyceride esters bonds, releasing glycerol and free fatty acids. Candida genus can produce distinct isoforms of lipase, among of them, Candida viswanathii strain is a potential lipase producer using hydrophobic carbons sources in which produced high level of enzyme under submerged cultivation using olive oil as carbon sources. This enzyme has commercially attractive due to characteristics desired in the industries processes. The genes responsible for encoding the lipases comprise a family called LIP gene. C. viswanathii not have its genome sequenced and are not available in annotated form through the GenBank nucleotide sequence database for lipase production. The aim of this work was understanding at molecular level the effect of carbon sources to lipase production, to identify and to analyses the gene expression of CvLIP4 from C. viswanathii on different culture media. Results : In silico analysis was carried out with LIP4 gene from Candida species. Degenerate primers were designed and evaluated for expression in different conditions. CvLIP4 expression was evaluated using carbon sources glucose, tributyrin, triolein and olive oil. Triolein and olive oil were strong inducer for CvLIP4 gene expression, while tributyrin was a weak inducer and glucose was strong repressor. Conclusions : These results will contribute to further studies about regulation of the lipase genes expression from C. viswanathii and heterologous expression of this enzyme to improve the catalytic conditions in industries processes.
Development and External Validation of a Nomogram for Early Predicting in-hospital Mortality of Patients with SARS-CoV-2 Pneumonia: A Two-Center, Retrospective Analysis
Authors: Luo Miao , Lu Junlin , Liu Jing , Xia Shuli , Wei Shuang 
Published: May 2020

Abstract
Background At present, the death cases with SARS-CoV-2 pneumonia are continuing to increase globally. However, the information on death cases and predictive methods are substantial lacking. We aimed to develop a nomogram, which was validated by both internal and external cohorts, for early predicting mortality in hospitalized patients with SARS-CoV-2 pneumonia.Methods We retrospectively collected data on 1,540 patients confirmed SARS-CoV-2 pneumonia from two hospitals. Multivariate logistic regression analysis was performed to examine factors associated with in-hospital mortality. We investigated the mortality related risk factors and their weights, thereafter designed and validated a predictive nomogram model to facilitate early discrimination of in-hospital death. We assessed the nomogram performance by examining calibration (calibration plots and Hosmer–Lemeshow calibration test) and discrimination (AUROC). We also plotted survival curves and decision curves to evaluate the clinical usefulness of the nomogram.Results In the 1,540 patients from two centers, 248 cases died (16.1%). In the predictive nomogram calculated by a multivariate logistic regression analysis, eight independent risk factors associated mortality included age ≥ 60 years (odd ratio(OR) = 2.840; 95%CI, 1.467–5.495; P = 0.002), respiratory rate ≥ 30 breaths per minute (OR = 3.308; 95%CI, 1.408–7.770; P = 0.006), neutrophil count ≥ 7 × 109/L (OR = 3.084; 95%CI, 1.667–5.707; P < 0.001), lymphocyte count ≤ 0.8 × 109/ L (OR = 4.688; 95%CI, 2.500-8.791; P < 0.001), d-dimer ≥ 1.5 µg/mL(OR = 2.159; 95%CI, 1.169–3.989; P = 0.014), lactate dehydrogenase ≥ 350U/L(OR = 4.385; 95%CI, 2.299–8.362; P < 0.001), procalcitonin ≥ 0.1 ng/mL(OR = 4.972; 95%CI, 2.537–9.746; P < 0.001), and presence of myocardial injury (OR = 2.289; 95%CI, 1.260–4.160; P = 0.007) on admission. Calibration curves showed good fitting of the nomogram model with no statistical significance (P = 0.740) by Hosmer-Lemeshow test. This predictive nomogram had better predictive ability than CURB-65 score in training set (AUROC = 0.956 vs 0.828,P < 0.001). The good predictive performance of the nomogram is suggested by calibration, discrimination, and survival curve analysis, whether in the training, internal or external validation set. The decision curve analysis showed that predicting mortality risk applying this nomogram would be better than having all patients or none patients.Conclusions This nomogram is a reliable prognostic method that can accurately and early predict in-hospital mortality in patients with SARS-CoV-2 pneumonia. It can guide clinicians to improve their abilities to evaluate patient prognosis, enhance patient stratification, make earlier and reasonable decisions.Trail registration: This is a retrospective observational study without a trial registration number.
Prognostic Value of Baseline Clinical and HRCT Findings in 101 Patients with Severe COVID-19 in Wuhan, China
Authors: Cao Yukun , Han Xiaoyu , Gu Jin , Li Yumin , Liu Jia , Alwalid Osamah , Cui Yue , Zhang Xin , Zheng Chuansheng , Fan Yanqing , Wu Hanping , Shi Heshui 
Published: May 2020

Abstract
Background It has been reported that patients with severe Coronavirus disease 2019 (COVID-19) had high mortality rate, but the information about prognostic factors for these patients is unknown. The aim of this study was to assess the prognostic value of baseline clinical and high resolution CT (HRCT) findings in patients with severe COVID-19.Methods In this retrospective, two-center study, we included two groups of inpatients with severe COVID-19 who had been discharged or had died in Jin Yin-tan hospital and Wuhan union hospital between January 5, 2020, and February 22, 2020. Cases were confirmed by real-time polymerase chain reaction. Demographic, clinical, laboratory data, and HRCT data were collected and compared between discharged and deceased patients. Univariable and multivariable logistic regression models were used to assess predictors of mortality risk in these patients.Results 101 patients were included in this study, of whom 66 were discharged and 35 died in the hospital. The mean age was 56.6 ± 15.1 years and 67 (66.3%)were men. Of the 101 patients, hypertension (38, 37.6%), cardiovascular disease (21,20.8%), diabetes (18,17.8%), and chronic pulmonary disease (16,15.8%) were the most common coexisting conditions. The multivariable regression analysis showed older age (OR:1.142, 95%CI:1.059–1.231, p༜0.001), acute respiratory distress syndrome (ARDS) (OR:10.142, 95%CI:1.611–63.853, p = 0.014), reduced lymphocyte count (OR:0.004, 95%CI: 0.001–0.306, p = 0.013), and elevated HRCT score (OR:1.276, 95%CI:1.002–1.625, p = 0.049) to be independent predictors of mortality risk on admission in severe COVID-19 patients.Conclusions These initial data indicate that older age, ARDS, lymphocytopenia and elevated HRCT score on admission were strong predictors of mortality risk in severe COVID-19 patients.