bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of interleukin 2, interleukin 12, and interferon-γ with intervertebral disc degeneration in Iranian population
Authors: Hanaei Sara , Abdollahzade Sina , Sadr Maryam , Mirbolouk Mohammad Hossein , Fattahi Ehsan , Khoshnevisan Alireza , Rezaei Nima 
Published: June 2020

Abstract
Background: Intervertebral disc degeneration (IVDD) is an age-related degenerative disease, presenting with low back pain or radicular pain. The inflammatory changes would occur in discs in the process of IVDD. Therefore, the inflammatory and anti-inflammatory cytokines, as well as their respective genes, have been proposed to play roles in pathophysiology of disease. This study has been conducted to elucidate the role of IL-2, IL-12, and IFN-γ single nucleotide polymorphisms (SNP) in this disease.Method: 76 patients who were diagnosed with IVDD and 140 healthy controls who complied with eligibility criteria were included. A total volume of 5cc peripheral blood was obtained from each participant to investigate the IL-2 +166G/T, IL-2 -330G/T, IL-12 -1188A/C, and IFN-γ +847A/T SNPs through PCR-SSP method.Results: The ‘TG’ and ‘TT’ genotypes of IL-2 -330G/T polymorphism were significantly more common among patients and healthy controls respectively. The ‘GT’ and ‘TT’ haplotypes of IL-2 (comprised of -330G/T, and +166G/T SNPs) were also more common among patients and controls respectively.Conclusion: This study indicated the significant role of IL-2 genotypes and haplotypes in IVDD. These SNPs were differently distributed in patients and controls. Therefore, alteration in the structure of IL-2 gene could play an important role in pathophysiology of IVDD.
Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial
Authors: Rego Ryan Trevor Titus , Watson Samuel , Ishengoma Philbert , Langat Philemon , Otieno Hezekiah Pireh , Lilford Richard 
Published: June 2020

Abstract
Background Text messaging systems are used to collect data on symptom prevalence. Using a text messaging system, we evaluated the effects of question load, question frequency, and financial incentive on response rates and reported infant diarrhoea rates in an infant diarrhoea survey. Methods We performed a factorial cross-over randomised controlled trial of an SMS surveying system for infant diarrhoea surveillance with treatments: financial incentive (yes/no), question load (1-question/3-question), and questioning frequency (daily/fortnightly). Participants progressed through all treatment combinations over eight two-week rounds. Data were analysed using multivariable logistic regressions to determine the impacts of the treatments on the response rates and reported diarrhoea rates. Attitudes were explored through qualitative interviews.Results For the 141 participants, the mean response rate was 47%. In terms of percentage point differences (ppd), daily questioning was associated with a lower response rate than fortnightly (-1·2[95%CI:-4·9,2·5]); high (3-question) question loads were associated with a lower response rate than low (1-question) question loads (-7·0[95%CI:-10·8,-3·1]); and financial incentivisation was associated with a higher response rate than no financial incentivisation (6·4[95%CI:2·6,10·2]). The mean two-week diarrhoea rate was 36·4%. Daily questioning was associated with a higher reported diarrhoea rate than fortnightly (29·9[95%CI:22·8,36·9]); with little evidence for impact by incentivisation or question load. Conclusions Close to half of all participants responded to the SMS survey. Daily questioning evoked a statistically higher rate of reported diarrhoea, while financial incentivisation and low (1-question) question loads evoked higher response rates than no incentive and high (3-question) question loads respectively.Trial RegistrationThe protocol was registered on ISRCTN on the 20th of March 2019 under number ISRCTN11410773.
Expanding Medical Student Interaction In Neurology With A Redesigned Student Interest Group In Neurology (SIGN) Chapter
Authors: Gummi Rohit , Smith Ross , Govindarajan Raghav 
Published: June 2020

Abstract
Background: SIGN chapters across the country provide opportunities for medical students to participate in clinical, research, and service activities in neurology. Despite these, enrollment in SIGN chapters has been traditionally low.Methods: Following changes were introduced: an open board style SIGN chapter executive committee with greater active engagement of first and second year students, new types SIGN chapter activities including journal club articles, hands on workshop (example EMG), celebration/cause events (example ALS walk). In addition, a free neurology clinic was introduced. Activities were planned in consultation with office of medical education, and were organized during ‘down times’. Data on student enrollment, activities successfully carried out, students interested in neurology residency, number of neurology-related research projects with student involvement were collected prior to changes and compared to values after changes were introduced.Results: Post intervention, student engagement in neurology activities and projects increased significantly. There were also significantly more students engaged in neurology related research projects and significantly more students reported interest in neurology. However, a similar increase in applications to neurology residency was not yet observed.Conclusions: An open chapter with early engagement and involvement of first and second year medical students, creating a variety of chapter activities with greater hands on involvement, planned in conjunction with office of medical education has reinvigorated our SIGN chapter.
Application of magnesium sulphate as a " multimodal general anesthesia" protocol in patients undergoing hysteroscopy: a randomized controlled study
Authors: Gao Peng-fei , Lin Jing-yan , Wang Shun , Zhang Yun-feng , Wang Guo-qiang , Xu Qi , Guo Xiao 
Published: June 2020

Abstract
Background: The purpose of the study was to applicate magnesium sulphate as a " multimodal general anesthesia" protocol to reduce perioperative opioids requirements in patients undergoing hysteroscopy.Methods: 70 patients scheduled for hysteroscopy were randomly divided into 2 groups. Patients in Group M received intravenous magnesium sulfate 50 mg/kg in 100 ml of isotonic saline over 15 min before fentanyl injection and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group received an equal volume of normal saline as placebo. All patients were anesthetized under a BIS guided monitored anesthesia care with propofol and fentanyl. Intraoperative hemodynamic variables were recorded and postoperative pain scores were assessed with verbal numerical rating scale (VNRS) 1 min, 15 min, 30 min, 1 hour, and 4 hours after recovery of consciousness. The primary outcome of our study was total amount of intraoperative and postoperative analgesics administered.Results: Postoperative serum magnesium concentrations in Group C were significantly decreased than preoperative levels (0.86 ± 0.06 to 0.80 ± 0.08 mmol/L, P=0.001) while there was no statistical change in Group M (0.86 ± 0.07 to 0.89 ± 0.07 mmol/L, P=0.129). Bradycardia did not occur in either group and the incidence of hypotension was comparable between the two groups. Total dose of fentanyl given to patients in Group M was less than the one administered to Group C [100 (75-150) vs 145 (75-175) μg, median (range); P < 0.001]. Fewer patients in Group M required additional analgesics postoperatively. In addition, patients receiving magnesium displayed lower VNRS scores at 15 min, 30 min, 1 hour, and 4 hours postoperatively. Conclusions: Intravenous infusion of magnesium sulphate significantly reduces postoperative pain and perioperative opioid requirements without increasing the risk of cardiovascular side effects. Meanwhile, it was beneficial to maintain a stable serum magnesium concentration after the procedure.Trial registration: www.chictr.org.cn ChiCTR1900024596 date of registration: July 18th 2019.
A Study of Pre-hospital Emergency Care Personnel's Perception of Ethical Dilemmas in the Field: a qualitative study
Authors: Bijani Mostafa , Mohammadi Fateme , Hatami Mahmood 
Published: June 2020

Abstract
Background Due to their unpredictable and critical working conditions, pre-hospital emergency care personnel experience difficult and complicated situations in the field presenting them with various ethical dilemmas which affect their clinical decisions. Lack of studies on the ethical dilemmas which pre-hospital emergency care personnel face necessitates more research into these ethical challenges and dilemmas. The present study aims to determine pre-hospital emergency care personnel's perception of the ethical dilemmas they face in the field. Methods The present study is a work of qualitative research with a content analysis approach. Data were collected through semi-structured, in-depth interviews and field notes. The collected data were analyzed using conventional content analysis. The participants were 25 pre-hospital emergency care personnel members in Iran who met the inclusion criteria. They were selected via purposeful sampling which was continued to saturation point. The study lasted from February to May 2020. Results Two main themes—paradox in decision-making and patients' ethics and values—with 8 categories were extracted from the collected data. Conclusion The results of the present study show that, in the field, pre-hospital emergency care personnel confront various ethical dilemmas which create paradoxes in their professional performance and ethical decisions. Yet, they should make the best ethical decision and provide care combined with respect for patients' ethical identities and beliefs to achieve satisfactory medical care results. To provide high-quality care, pre-hospital emergency care personnel must be provided with a proper cultural, professional, and organizational environment which is free of ethical distress.
Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia
Authors: Li Qiu-Mei , Wang Feng , Wu Zhe-Ming , Liu Zhen , Zhan Chuan , Chen Bing-Heng , Sima Jing , Stieger Knut , Li Shao-Wei 
Published: June 2020

Abstract
Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey.Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.Results: 21 Eyes from sixteen patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was −0.56 D ± 0.49 SD, wherein, 10 eyes (47.6%) were within ± 0.50 D of the desired emmetropia and 19 eyes (90.5%) were within ± 1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, without any difficulty in daily activity. Thirteen patients (81%) did not need spectacles at all distances, while the other 3 patients (19%) used spectacles for near-distance related visual activity. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.Conclusions: Trifocal IOL implantation after myopia excimer laser correction could restore good distance, intermediate visual acuity and acceptable near visual acuity, and provide accurate refractive outcomes as well as high spectacles independence rate.
Identifying maternal needs following childbirth: comparison between pregnant women and recent mothers
Authors: Slomian Justine , Reginster Jean-Yves , Emonts Patrick , Bruyère Olivier 
Published: June 2020

Abstract
Background

The postnatal period is associated with new needs for mothers. Four categories of needs were highlighted in our previous study: for information, for psychological support, for the sharing of experiences and for practical and material support. The aims of this study were as follows: (1) to validate these 4 needs by comparing recent mothers’ needs with the needs of pregnant women and (2) to compare these needs between primiparous and multiparous women.
Methods

The 4 needs previously identified were investigated by online self-report questionnaires completed by women in their last trimester of pregnancy and by mothers who had a child between 0 and 6 months of age.
Results

The 4 needs were largely present during the postpartum period. The need for information seemed to be more present during pregnancy (92.4%) than during the postpartum period (84.6%, p = 0.03), but women used the Internet significantly more often to search for information after childbirth (54.8%) than during pregnancy (41.2%, p < 0.0001). The needs for psychological support and to share experiences seemed to be closely linked. Even if the global satisfaction with psychological support was fairly high, it weakened after childbirth (p < 0.05). Feelings of loneliness (p < 0.0001) and depression scores (p = 0.01) were also higher during the postpartum period than during pregnancy. Not surprisingly, primiparous women felt less reassured in their roles as mothers and more stressed during the postpartum period than multiparous women (p < 0.0001). Finally, the need for practical support was also more pronounced during the postpartum period than during pregnancy (p = 0.01).
Conclusion

All mothers seem to meet the 4 identified needs during the postpartum period but at different levels of intensity. Trying to meet these needs could offer an opportunity to improve mothers’ quality of life.
A cross-sectional study investigating the relationship between handgrip strength with multimorbidity in Korean adults: Findings from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-VII (2014–2017)
Authors: Lee Mee-Ri , Jung Sung Min 
Published: June 2020

Abstract
Background
To date research investigating the associations between handgrip strength and multimorbidity when stratifying by age and sex is limited. Furthermore, this is the first study in a Korean population, and the first to include adults ≥ 19 years of age. Here we investigated the associations between handgrip strength and multimorbidity in Korean adults aged ≥ 19 years.
Methods
In this cross-sectional study data from the Korean National Health and Nutrition Examination Survey were used. Multimorbidity was defined as having two or more chronic diseases. A total of 19,779 participants were eligible for the study (8,730 male and 11,409 female). We grouped and analysed participants based on age and sex (men and women aged 19–49 years, men and women aged 50–80 years) and examined the associations between handgrip strength and multimorbidity using multivariate logistic regressions using stratification by age, sex and body mass index (BMI).
Results
Multivariate logistic regressions revealed a significant inverse association irrespective of sex, between relative handgrip strength and multimorbidity. Participants with the lowest handgrip strength had a significantly higher odds ratio (OR) of multimorbidity (men aged 19–49 years: 3.76 and aged 50–80 years: 2.11; women aged 19–49 years: 1.52 and aged 50–80 years: 2.15) when compared to those with highest handgrip strength after adjusting for confounding variables. The highest OR was observed in men aged 19–49 years with a BMI ≥ 25 kg/m2.
Conclusion
In the current study we observed a significant inverse relationship between handgrip strength and multimorbidity in males and females with two or more chronic diseases. Male participants with a low handgrip strength aged between 19–49 years with a BMI ≥ 25 kg/m2 may be at greater risk of multimorbidity. This study highlights the need for further longitudinal studies to investigate the effects of increasing handgrip strength combined with weight loss, as an effective strategy to reduce the incidence of multimorbidity
Bone Impaction Grafting with Trabecular Metal Augments in Large Defects in Young Patients: Unravelling A New Perspective in Surgical Technique
Authors: Torre-Escurero Basilio De la , Gómez-González Eva , Álvarez-Villar Slavador , Bujan Julia , Ortega Miguel A 
Published: June 2020

Abstract
Background: Acetabular reconstruction with bone impaction grafting in large defects has yielded conflicting results. Methods: This was a retrospective study of a case series of five patients with a young age (≤50 years) at the time of surgery who had large acetabular defects reconstructed by bone impaction grafting and trabecular metal augments. The mean follow-up was 79 months. We describe the surgical technique in detail.Results: Improvement was significant on the WOMAC and SF-36 scales (p < 0.05). The radiographs taken at the last follow-up examination showed no migration of the polyethylene cup (p = 0.31) or differences in the abduction angle (p = 0.27) compared to the radiographs from the immediate postoperative period. One patient presented two dislocation episodes as a complication.Conclusion: The combination of trabecular metal augments with the bone impaction grafting technique in young patients with large acetabular defects provides satisfactory results in the long term and restores the bone stock.
A designathon to co-create community-driven HIV self-testing services for Nigerian youth: findings from a participatory event
Authors: Tahlil Kadija M , Obiezu-Umeh Chisom , Gbajabiamila Titi , Nwaozuru Ucheoma , Oladele David , Musa Adesola Z , Idigbe Ifeoma , Okwuzu Jane , David Agatha N , Bamidele Tajudeen A , Airhihenbuwa Collins O , Rosenberg Nora E , Tang Weiming , Ong Jason J , Conserve Donaldson F , Iwelunmor Juliet , Ezechi Oliver , Tucker Joseph D 
Published: June 2020

Abstract
Background
Youth are at high risk for HIV, but are often left out of designing interventions, including those focused on adolescents. We organized a designathon for Nigerian youth to develop HIV self-testing (HIVST) strategies for potential implementation in their local communities. A designathon is a problem-focused event where participants work together over a short period to create and present solutions to a judging panel.
Methods
We organized a 72-hour designathon for youth (14–24 years old) in Nigeria to design strategies to increase youth HIVST uptake. Proposals included details about HIVST kit service delivery, method of distribution, promotional strategy, and youth audience. Teams pitched their proposals to a diverse seven-member judging panel who scored proposals based on desirability, feasibility, potential impact and teamwork. We examined participants’ socio-demographic characteristics and summarized themes from their HIVST proposals.
Results
Forty-two youth on 13 teams participated in the designathon. The median team size was 3 participants (IQR: 2–4). The median age was 22.5 years (IQR: 21–24), 66.7% were male, 47.4% completed tertiary education, and 50% lived in Lagos State. Themes from proposals included HIVST integration with other health services, digital marketing and distribution approaches, and engaging students. Judges identified seven teams with exceptional HIVST proposals and five teams were supported for further training.
Conclusions
The designathon provided a structured method for incorporating youth ideas into HIV service delivery. This approach could differentiate HIV services to be more youth-friendly in Nigeria and other settings.
Ethical challenges of the healthcare transition to adult Antiretroviral therapy (ART) clinics for HIV infected adolescents and young people in Uganda
Authors: Mbalinda Scovia Nalugo , Bakeera-Kitaka Sabrina , Amooti Derrick Lusota , Magongo Eleanor Namusoke , Musoke Philippa , Dan Kaye K 
Published: June 2020

Abstract
Introduction Many HIV infected adolescents require transfer of care from paediatric/ adolescent clinics to adult ART clinics. Transition is beset with factors that hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a successful transition. The purpose of this study was to analyse the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Method We conducted 18 focus group discussions among 191 adolescents attending 9 different health facilities in Uganda. We explored facilitators and barriers regarding adolescent transitioning to adult HIV clinics. Thematic data analysis was used to analyze the data. The Silences Framework guided the data analysis and interpretation. The principles of Bioethics and the four-boxes ethics framework for clinical care (Patient autonomy, Medical indications, Context of care and Quality of life) were used to analyze the ethical issues surrounding the transition to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of both privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort; and contextual factors are critical to successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition to ensure retention in HIV care, facilitate long-term self-care, provide ongoing holistic healthcare and support in order to promote health and wellbeing, and build trust in the healthcare system. Identifying what facilitates successful transitions, and the gaps that interventions can target, may ensure HIV-infected youth remain healthy across the healthcare transition.