bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sociodemographic determinants of knowledge and attitude in the primary prevention of cervical cancer among University Tunku Abdul Rahman (UTAR) students in Malaysia: preliminary study of HPV vaccination
Authors: Tusimin Maiza , Yee Chek Lo , Razak Nur Zarifah Syahmi Abdul , Zainol Mohamad Izwan , Minhat Halimatus Sakdiah , Rejali Zulida 
Published: November 2019

Abstract

Background
Cervical cancer is the third most common cancer affecting women around the world in which the Human Papillomavirus (HPV) is the one of the recognized causative agent affecting women health. In response to this health issue, the Malaysian government had officially implemented the HPV immunisation programme for secondary schoolchildren in 2010 at the age of 13 years old and above. The purpose of this study is to investigate the sociodemographic determinants of knowledge and attitude among students of Universiti Tunku Abdul Rahman (UTAR) towards the HPV vaccination programme.

Methods
A cross-sectional study was conducted using self-administered questionnaires, recruiting 374 UTAR’s students as the respondents by using convenience sampling method. Respondents were categorized as having good/poor level of knowledge and positive/negative attitude towards HPV vaccination.

Results
Over half of the respondents were females (64.5%) and the majority were aged 20 years old and below (55.8%). Generally, 54.7% of the total respondents had a high level of knowledge towards HPV vaccine while 57.5% of the total respondents showed a negative attitude towards HPV vaccine. Female respondents aged 20 years old and below showed good knowledge (56.4%) and a more positive attitude (55.8%) towards HPV vaccine. Students from the Faculty of Medicine and Health Sciences (FMHS) exhibited higher knowledge (67.3%) and positive attitude (62.4%) as compared to the Faculty of Accountancy and Management (FAM) which showed only 32.7% of knowledge and 37.6% of positive attitude towards the HPV vaccination.

Conclusion
The majority of UTAR students possess good knowledge regarding HPV vaccination. Nonetheless, they demonstrated a negative attitude towards HPV vaccination, depicting the necessity to impart and further intensify the sense of health awareness among all students, especially among male students. The judicious use of social media apart from the conventional mass media should be an advantage as to enhance the practice of HPV vaccination among them and thereafter minimize the health and economic burdens of cervical cancer.
Omentopexy with Glubran®2 for reducing complications after laparoscopic sleeve gastrectomy: results of a randomized controlled study
Authors: Pilone Vincenzo , Tramontano Salvatore , Renzulli Michele , Romano Mafalda , Monda Angela , Albanese Alice , Foletto Mirto 
Published: November 2019

Abstract

Background
Gastric fistulas, bleeding, and strictures are commonly reported after laparoscopic sleeve gastrectomy (LSG), that increase morbidity and hospital stay and may put the patient’s life at risk. We report our prospective evaluation of application of synthetic sealant, a modified cyanoacrylate (Glubran®2), on suture rime, associated with omentopexy, to identify results on LSG-related complications.

Methods
Patients were enrolled for LSG by two Bariatric Centers, with high-level activity volume. Intraoperative recorded parameters were: operative time, estimated intraoperative bleeding, conversion rate. We prospectively evaluated the presence of early complications after LSG during the follow up period. Overall complications were analyzed. Perioperative data and weight loss were also evaluated. A control group was identified for the study.

Results
Group A (treated with omentopexy with Glubran®2) included 96 cases. Control group included 90 consecutive patients. There were no differences among group in terms of age, sex and Body Mass Index (BMI). No patient was lost to follow-up for both groups. Overall complication rate was significantly reduced in Group A. Mean operative time and estimated bleeding did not differ from control group. We observed three postoperative leaks in Group B, while no case in Group A (not statistical significancy). We did not observe any mortality, neither reoperation. Weight loss of the cohort was similar among groups. In our series, no leaks occurred applying omentopexy with Glubran®2.

Conclusion
Our experience of omentopexy with a modified cyanoacrylate sealant may lead to a standardized and reproducible approach that can be safeguard for long LSG-suture rime.

Trial registration
Retrospective registration on clinicaltrials.gov PRS, with TRN NCT03833232 (14/02/2019).
Safety and effectiveness of a novel generator algorithm for bipolar vessel sealing: a randomised controlled chronic animal study
Authors: Kraemer Bernhard , Tsaousidis Christos , Kruck Stephan , Schenk Martin , Scharpf Marcus , Kommoss Stefan , Brucker Sara , Nuessle Daniela , Enderle Markus D. , Biber Ulrich 
Published: November 2019

Abstract

Background
Electrosurgical vessel sealers are gradually replacing conventional techniques such as ligation and clipping. Algorithms that control electrosurgical units (ESU), known as modes, are important for applications in different surgical disciplines. This chronic porcine animal study aimed to evaluate the safety and effectiveness of the novel thermoSEAL electrosurgical vessel sealing mode (TSM). The BiClamp® mode (BCM) of the renowned VIO® 300 D ESU served as control. BCM has been widely available since 2002 and has since been successfully used in many surgical disciplines. The TSM, for the novel VIO® 3 ESU, was developed to reduce sealing time and/or thermal lateral spread adjacent to the seal while maintaining clinical success rates. The primary aim of this study was to investigate the long-term and intraoperative seal quality of TSM.

Methods
The BiCision® device was used for vessel sealing with TSM and BCM in ten German Landrace pigs which underwent splenectomy and unilateral nephrectomy during the first intervention of the study. The seals were cut with the BiCision® knife. Ninety-nine arteries, veins and vascular bundles were chronically sealed for 5 or 21 days. Thereafter, during the second and terminal intervention of the study, 97 additional arteries and veins were sealed. The carotid arteries were used for histological evaluation of thermal spread.

Results
After each survival period, no long-term complications occurred with either mode. The intraoperative seal failure rates, i.e. vessel leaking or residual blood flow after the first sealing activation, were 2% with TSM versus 6% with BCM (p = 0.28). The sealing time was significantly shorter with TSM (3.5 ± 0.69 s vs. 7.3 ± 1.3 s, p < 0.0001). The thermal spread and burst pressure of arteries sealed with both modes were similar (p = 0.18 and p = 0.61) and corresponded to the histological evaluation. The measured tissue sticking parameter was rare with both modes (p = 0.33). Tissue charring did not occur. Regarding the cut quality, 97% of the seals were severed in the first and 3% in the second attempt (both with TSM and BCM).

Conclusions
The novel TSM seals blood vessels twice as fast as the BCM while maintaining excellent tissue effect and clinical success rates.

Trial registration
Not applicable.
Clinical and morphological effects of hyperbaric oxygen therapy in patients with interstitial cystitis associated with fibromyalgia
Authors: Bosco Gerardo , Ostardo Edoardo , Rizzato Alex , Garetto Giacomo , Paganini Matteo , Melloni Giorgio , Giron Giampiero , Pietrosanti Lodovico , Martinelli Ivo , Camporesi Enrico 
Published: November 2019

Abstract

Background
Interstitial Cystitis (IC) is a debilitating disorder of the bladder, with a multifactorial and poorly understood origin dealing with microcirculation repeated damages. Also Fibromyalgia (FM) is a persistent disorder whose etiology is not completely explained, and its theorized alteration of pain processing can compromise the quality of life. Both these conditions have a high incidence of conventional therapeutic failure, but recent literature suggests a significant beneficial response to Hyperbaric Oxygen Therapy (HBOT). With this study, this study we evaluated the effects of HBOT on quality of life, symptoms, urodynamic parameters, and cystoscopic examination of patients suffering from both IC and FM.

Methods
We structured an observational clinical trial design with repeated measures (questionnaires, urodynamic test, and cystoscopy) conducted before and 6 months after a therapeutic protocol with hyperbaric oxygen for the treatment of patients suffering from both IC and FM. Patients were exposed to breathing 100% oxygen at 2 atm absolute (ATA) in a multiplace pressure chamber for 90 min using an oro-nasal mask. Patients undertook a cycle of 20 sessions for 5 days per week, and a second cycle of 20 sessions after 1 week of suspension.

Results
Twelve patients completed the protocol. Changes after HBOT were not significant, except for hydrodistension tolerance (mean pre-treatment: 409.2 ml; mean post-treatment: 489.2 ml; p < 0.05). A regression of petechiae and Hunner’s ulcers was also noted 6 months after the completion of HBOT.

Conclusions
Our study showed no improvement of symptoms, quality of life, and urodynamic parameters, except for hydrodistension, and a slight improvement in cystoscopic pattern. However, to date, we could not demonstrate the significance of overall results to justify the use of HBOT alone in patients with IC and FM. This observation suggests that additional studies are needed to better understand if HBOT could treat this subset of patients.

Trial registration
NCT03693001; October 2, 2018. Retrospectively registered.
Predicting skilled delivery service use in Ethiopia: dual application of logistic regression and machine learning algorithms
Authors: Tesfaye Brook , Atique Suleman , Azim Tariq , Kebede Mihiretu M. 
Published: November 2019

AbstractBackgroundSkilled assistance during childbirth is essential to reduce maternal deaths. However, in Ethiopia, which is among the six countries contributing to more than half of the global maternal deaths, the coverage of births attended by skilled health personnel remains very low. The aim of this study was to identify determinants and develop a predictive model for skilled delivery service use in Ethiopia by applying logistic regression and machine-learning techniques.MethodsData from the 2016 Ethiopian Demographic and Health Survey (EDHS) was used for this study. Statistical Package for Social Sciences (SPSS) and Waikato Environment for Knowledge Analysis (WEKA) tools were used for logistic regression and model building respectively. Classification algorithms namely J48, Naïve Bayes, Support Vector Machine (SVM), and Artificial Neural Network (ANN) were used for model development. The validation of the predictive models was assessed using accuracy, sensitivity, specificity, and area under Receiver Operating Characteristics (ROC) curve.ResultsOnly 27.7% women received skilled delivery assistance in Ethiopia. First antenatal care (ANC) [AOR = 1.83, 95% CI (1.24–2.69)], birth order [AOR = 0.22, 95% CI (0.11–0.46)], television ownership [AOR = 6.83, 95% CI (2.52–18.52)], contraceptive use [AOR = 1.92, 95% CI (1.26–2.97)], cost needed for healthcare [AOR = 2.17, 95% CI (1.47–3.21)], age at first birth [AOR = 1.96, 95% CI (1.31–2.94)], and age at first sex [AOR = 2.72, 95% CI (1.55–4.76)] were determinants for utilizing skilled delivery services during the childbirth. Predictive models were developed and the J48 model had superior predictive accuracy (98%), sensitivity (96%), specificity (99%) and, the area under ROC (98%).ConclusionsFirst ANC and contraceptive uses were among the determinants of utilization of skilled delivery services. A predictive model was developed to forecast the likelihood of a pregnant woman seeking skilled delivery assistance; therefore, the predictive model can help to decide targeted interventions for a pregnant woman to ensure skilled assistance at childbirth. The model developed through the J48 algorithm has better predictive accuracy. Web-based application can be build based on results of this study.
Investigation of the methylerythritol 4-phosphate pathway for microbial terpenoid production through metabolic control analysis
Authors: Volke Daniel Christoph , Rohwer Johann , Fischer Rainer , Jennewein Stefan 
Published: November 2019

Abstract

Background
Terpenoids are of high interest as chemical building blocks and pharmaceuticals. In microbes, terpenoids can be synthesized via the methylerythritol phosphate (MEP) or mevalonate (MVA) pathways. Although the MEP pathway has a higher theoretical yield, metabolic engineering has met with little success because the regulation of the pathway is poorly understood.

Results
We applied metabolic control analysis to the MEP pathway in Escherichia coli expressing a heterologous isoprene synthase gene (ispS). The expression of ispS led to the accumulation of isopentenyl pyrophosphate (IPP)/dimethylallyl pyrophosphate (DMAPP) and severely impaired bacterial growth, but the coexpression of ispS and isopentenyl diphosphate isomerase (idi) restored normal growth and wild-type IPP/DMAPP levels. Targeted proteomics and metabolomics analysis provided a quantitative description of the pathway, which was perturbed by randomizing the ribosome binding site in the gene encoding 1-deoxyxylulose 5-phosphate synthase (Dxs). Dxs has a flux control coefficient of 0.35 (i.e., a 1% increase in Dxs activity resulted in a 0.35% increase in pathway flux) in the isoprene-producing strain and therefore exerted significant control over the flux though the MEP pathway. At higher dxs expression levels, the intracellular concentration of 2-C-methyl-d-erythritol-2,4-cyclopyrophosphate (MEcPP) increased substantially in contrast to the other MEP pathway intermediates, which were linearly dependent on the abundance of Dxs. This indicates that 4-hydroxy-3-methylbut-2-en-1-yl diphosphate synthase (IspG), which consumes MEcPP, became saturated and therefore limited the flux towards isoprene. The higher intracellular concentrations of MEcPP led to the efflux of this intermediate into the growth medium.

Discussion
These findings show the importance of Dxs, Idi and IspG and metabolite export for metabolic engineering of the MEP pathway and will facilitate further approaches for the microbial production of valuable isoprenoids.
Diagnostic performance of CareStart™ malaria HRP2/pLDH test in comparison with standard microscopy for detection of uncomplicated malaria infection among symptomatic patients, Eastern Coast of Tanzania
Authors: Bwire George M. , Ngasala Billy , Kilonzi Manase , Mikomangwa Wigilya P. , Felician Fatuma F. , Kamuhabwa Appolinary A. R. 
Published: November 2019

Abstract

Background
CareStart™ malaria HRP2/pLDH (Pf/pan) combo test is one of the several rapid diagnostic tests (RDT) approved for diagnosis of malaria at the point of care in Tanzania. However, there are limited studies on the diagnostic performance of RDT after wide scale use in primary health care facilities in Tanzania. Therefore, this study was carried out to determine the diagnostic performance of RDT when compared with blood smear (BS) microscopy as a reference standard.

Methods
A cross-sectional study was conducted between March and August 2019 at Kibiti Health Centre, Pwani region, Tanzania. Blood samples for malaria tests were collected from patients with malaria symptoms. Diagnostic performance parameters of RDT, i.e. sensitivity, specificity, positive and negative likelihood ratios (LR+/−), diagnostic accuracy and predictive values were determined using contingency table. An agreement between RDT and microscopy was statistically determined by Cohen’s kappa test.

Results
Of 980 patients screened, 567 (57.9%) were found to be malaria positive by RDT, whereas 510 patients (52%) were positive by microscopy. Of the 510 microscopy-positive patients, 487 (95.5%) were infected with Plasmodium falciparum. The geometric mean parasite density was 2921parasites/µl, whereas majority (68.6%) of patients had parasite density greater than 10,000/µl. The sensitivity, specificity, positive and negative predictive values of CareStart™ were 99.8%, 87.6%, 89.8%, and 99.8%, respectively. The LR+ and LR− were 8.0 and 0.002, respectively. The diagnostic accuracy was 0.5. There was a strong agreement between the results obtained using CareStart™ and BS microscopy (kappa = 0.863, P < 0.0001).

Conclusion
CareStart™ malaria HRP2/pLDH (Pf/pan) had high sensitivity and strong agreement with microscopy results. However, moderate specificity of RDT resulted in a substantial number of patients with false positive malaria test. Wherever available, microscopy should be used to confirm RDT test results.
Barriers and facilitators to the implementation of brief interventions targeting smoking, nutrition, and physical activity for indigenous populations: a narrative review
Authors: Fazelipour Mojan , Cunningham Frances 
Published: November 2019

AbstractObjectiveThis narrative review aimed to identify and categorize the barriers and facilitators to the provision of brief intervention and behavioral change programs that target several risk behaviors among the Indigenous populations of Australia, Canada, and New Zealand.MethodsA systematic database search was conducted of six databases including PubMeD, Embase, CINAHL, HealthStar, PsycINFO, and Web of Science. Thematic analysis was utilized to analyze qualitative data extracted from the included studies, and a narrative approach was employed to synthesize the common themes that emerged. The quality of studies was assessed in accordance with the Joanna Briggs Institute’s guidelines and using the software SUMARI – The System for the Unified Management, Assessment and Review of Information.ResultsNine studies were included. The studies were classified at three intervention levels: (1) individual-based brief interventions, (2) family-based interventions, and (3) community-based-interventions. Across the studies, selection of the intervention level was associated with Indigenous priorities and preferences, and approaches with Indigenous collaboration were supported. Barriers and facilitators were grouped under four major categories representing the common themes: (1) characteristics of design, development, and delivery, (2) patient/provider relationship, (3) environmental factors, and (4) organizational capacity and workplace-related factors. Several sub-themes also emerged under the above-mentioned categories including level of intervention, Indigenous leadership and participation, cultural appropriateness, social and economic barriers, and design elements.ConclusionTo improve the effectiveness of multiple health behavior change interventions among Indigenous populations, collaborative approaches that target different intervention levels are beneficial. Further research to bridge the knowledge gap in this topic will help to improve the quality of preventive health strategies to achieve better outcomes at all levels, and will improve intervention implementation from development and delivery fidelity, to acceptability and sustainability.
A prospective study of acute kidney injury in the intensive care unit: development and validation of a risk prediction model
Authors: Wang Qi , Tang Yi , Zhou Jiaojiao , Qin Wei 
Published: November 2019

Abstract
Background
Acute kidney injury (AKI) has high morbidity and mortality in intensive care units (ICU). It can also lead to chronic kidney disease (CKD), more costs and longer hospital stay. Early identification of AKI is important.

Methods
We conducted this monocenter prospective observational study at West China Hospital, Sichuan University, China. We recorded information of each patient in the ICU within 24 h after admission and updated every two days. Patients who reached the primary outcome were accepted into the AKI group. Of all patients, we randomly drew 70% as the development cohort and the remaining 30% as the validation cohort. Using binary logistic regression we got a risk prediction model of the development cohort. In the validation cohort, we validated its discrimination by the area under the receiver operator curve (AUROC) and calibration by a calibration curve.

Results
There were 656 patients in the development cohorts and 280 in the validation cohort. Independent predictors of AKI in the risk prediction model including hypertension, chronic kidney disease, acute pancreatitis, cardiac failure, shock, pH ≤ 7.30, CK > 1000 U/L, hypoproteinemia, nephrotoxin exposure, and male. In the validation cohort, the AUROC is 0.783 (95% CI 0.730–0.836) and the calibration curve shows good calibration of this prediction model. The optimal cut-off value to distinguish high-risk and low-risk patients is 4.5 points (sensitivity is 78.4%, specificity is 73.2% and Youden’s index is 0.516).

Conclusions
This risk prediction model can help to identify high-risk patients of AKI in ICU to prevent the development of AKI and treat it at the early stages.
Trial registration TCTR, TCTR20170531001. Registered 30 May 2017, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=2573
Super short operations on both gene order and intergenic sizes
Authors: Oliveira Andre R. , Jean Géraldine , Fertin Guillaume , Dias Ulisses , Dias Zanoni 
Published: November 2019

Abstract

Background
The evolutionary distance between two genomes can be estimated by computing a minimum length sequence of operations, called genome rearrangements, that transform one genome into another. Usually, a genome is modeled as an ordered sequence of genes, and most of the studies in the genome rearrangement literature consist in shaping biological scenarios into mathematical models. For instance, allowing different genome rearrangements operations at the same time, adding constraints to these rearrangements (e.g., each rearrangement can affect at most a given number of genes), considering that a rearrangement implies a cost depending on its length rather than a unit cost, etc. Most of the works, however, have overlooked some important features inside genomes, such as the presence of sequences of nucleotides between genes, called intergenic regions.

Results and conclusions
In this work, we investigate the problem of computing the distance between two genomes, taking into account both gene order and intergenic sizes. The genome rearrangement operations we consider here are constrained types of reversals and transpositions, called super short reversals (SSRs) and super short transpositions (SSTs), which affect up to two (consecutive) genes. We denote by super short operations (SSOs) any SSR or SST. We show 3-approximation algorithms when the orientation of the genes is not considered when we allow SSRs, SSTs, or SSOs, and 5-approximation algorithms when considering the orientation for either SSRs or SSOs. We also show that these algorithms improve their approximation factors when the input permutation has a higher number of inversions, where the approximation factor decreases from 3 to either 2 or 1.5, and from 5 to either 3 or 2.