bluuebunny/crossref_metadata_2025_split huggingface dataset:
Underestimation of pregnancy risk among women in Vietnam
Authors: Londeree Jessica , Nguyen Nghia , Nguyen Linh H. , Tran Dung H. , Gallo Maria F. 
Published: July 2020

Abstract
Background
Addressing women’s inaccurate perceptions of their risk of pregnancy is crucial to improve contraceptive uptake and adherence. Few studies, though, have evaluated the factors associated with underestimation of pregnancy risk among women at risk of unintended pregnancy.

Methods
We assessed the association between demographic and behavioral characteristics and underestimating pregnancy risk among reproductive-age, sexually-active women in Hanoi, Vietnam who did not desire pregnancy and yet were not using highly-effective contraception (N = 237). We dichotomized women into those who underestimated pregnancy likelihood (i.e., ‘very unlikely’ they would become pregnant in the next year), and those who did not underestimate pregnancy likelihood (i.e., ‘somewhat unlikely,’ ‘somewhat likely’ or ‘very likely’). We used bivariable and multivariable logistic regression models to identify correlates of underestimating pregnancy risk.

Results
Overall, 67.9% (n = 166) of women underestimated their pregnancy risk. In bivariable analysis, underestimation of pregnancy risk was greater among women who were older (> 30 years), who lived in a town or rural area, and who reported that it was “very important” or “important” to them to not become pregnant in the next year. In multivariable analysis, importance of avoiding pregnancy was the sole factor that remained statistically significantly associated with underestimating pregnancy risk (odds ratio [OR]: 0.11; 95% confidence interval [CI], 0.05–0.25). In contrast, pregnancy risk underestimation did appear to vary by marital status, ethnicity, education or other behaviors and beliefs relating to contraceptive use.

Conclusions
Findings reinforce the need to address inaccurate perceptions of pregnancy risk among women at risk of experiencing an unintended pregnancy.
Massive open online course for Brazilian healthcare providers working with substance use disorders: curriculum design
Authors: Monteiro Erika Pizziolo , Gomide Henrique Pinto , Remor Eduardo 
Published: July 2020

Abstract
Background
Interpersonal and technical skills are required for the care of people living with substance use disorders. Considering the applicability and usability of online courses as continuing professional education initiatives, this study aimed to describe the content design process of an introductory-level healthcare-centered Massive Open Online Course (MOOC).

Methods
The content of the course was informed through needs assessment, by using three sources: (a) narrative literature review, (b) Delphi health experts panel consensus, and (c) focus groups conducted with people living with substance use disorders. The data from the empirical research phases were analyzed through qualitative Thematic Analysis.

Results
The product of this research project is the introductory-level Massive Open Online Course “Healthcare: Developing Relational Skills for the Assistance of People Living with Substance Use Disorders” which approaches health communication and empathetic relational professional skills as a means of reducing stigmatization of people living with substance use disorders.

Conclusions
Diverse strategies for designing distance education initiatives have to consider different views on the subject being approached in such courses. The product presented in this paper has the potential to be an educational tool for topics traditionally not addressed in Brazilian continuing education and can be used as a model to the design of online courses directed to the development of work-related skills for the healthcare professions.
Survey: smartphone-based assessment of cardiovascular diseases using ECG and PPG analysis
Authors: Shabaan Muhammad , Arshid Kaleem , Yaqub Muhammad , Jinchao Feng , Zia M. Sultan , Bojja Giridhar Reddy , Iftikhar Muazzam , Ghani Usman , Ambati Loknath Sai , Munir Rizwan 
Published: July 2020

AbstractA number of resources, every year, being spent to tackle early detection of cardiac abnormalities which is one of the leading causes of deaths all over the Globe. The challenges for healthcare systems includes early detection, portability and mobility of patients. This paper presents a categorical review of smartphone-based systems that can detect cardiac abnormalities by the analysis of Electrocardiogram (ECG) and Photoplethysmography (PPG) and the limitation and challenges of these system. The ECG based systems can monitor, record and forward signals for analysis and an alarm can be triggered in case of abnormality, however the limitation of smart phone’s processing capabilities, lack of storage and speed of network are major challenges. The systems based on PPG signals are non-invasive and provides mobility and portability. This study aims to critically review the existing systems, their limitation, challenges and possible improvements to serve as a reference for researchers and developers.
Assessing and reporting patient participation by means of patient preferences and experiences
Authors: Eldh Ann Catrine , Holmefur Marie , Luhr Kristina , Wenemark Marika 
Published: July 2020

Abstract
Background
Although patient participation is strongly associated with high quality of healthcare, valid means to measure and report a comprehensive notion of patient participation are scarce. The Patient Preferences for Patient Participation (4Ps) is a new healthcare practice and research tool, comprising patients’ preferences as well as experiences. The 4Ps employs 12 items for the patient to conceptualise patient participation. The aim of this paper is to describe how the two perspectives of patient participation, namely preferences and experiences, can be combined to visualise and report preference-based patient participation.

Methods
With four response alternatives in each section, the 4Ps offers sixteen possible combinations of degree of match per item. Theoretical and clinical principles fostered a tentative order of six ranks and three levels of preference-based patient participation. To test the standard, statistical analyses for ordinal data were performed, using data from a randomised controlled trial evaluating an intervention aiming to improve patient participation. Further, structures for visualising the preference-based patient participation of individuals and groups were suggested.

Results
Data from the 4Ps demonstrated the individuals’ preference-based patient participation, indicating either a match or a mismatch for each item. Mismatches represented either the experience of participation surpassing the patient’s preferences, or the patient’s preferences for patient participation not being established. At group level, the suggested approach for visualising and reporting the 4Ps demonstrated that the intervention group had a significantly higher proportion of sufficient preference-based patient participation for certain items than the control group. These results had not been identified earlier, when using the preferences and experiences of patient participation as separate measures.

Conclusions
Ways to easily acquaint stakeholders with patients’ preferences for patient participation are needed, in order for healthcare staff to better use resources to match the basic requirements of individuals and groups. While the 4Ps can guide professionals to patient participation as framed in legislations, concept analyses and by patients, a visualisation of the results is needed to capture preference-based patient participation. The proposed route to representing degree of match in preferences and experiences may also be relevant to other dimensions of quality of healthcare.
Detection of atypical porcine pestivirus in Swedish piglets with congenital tremor type A-II
Authors: Stenberg Hedvig , Jacobson Magdalena , Malmberg Maja 
Published: July 2020

AbstractBackgroundCongenital tremor (CT) type A-II is a neurological disorder characterized by tremor of the head and body of newborn piglets. The suggested causative agent of the disease is the recently found atypical porcine pestivirus (APPV). The virus has been detected in piglets suffering from congenital tremor in central Europe, South and North America and in China but no studies has so far been performed in the Nordic countries. The overarching goal of this study was to investigate if APPV is present in the brain tissue of Swedish piglets suffering from congenital tremor.From June 2017 – June 2018, 15 piglets from four Swedish farms with ongoing outbreaks of congenital tremor and 13 piglets with splay leg originating from four different farms, were investigated for presence of APPV RNA in brain tissue. Matched healthy control piglets (n = 8) were also investigated. Two APPV-specific RT-qPCR methods targeting the NS3 and NS5B region, respectively, were used. A retrospective study was performed on material from Swedish piglets with congenital tremor sampled in 2004 (n = 11) and 2011/2012 (n = 3) using the described APPV-specific RT-qPCR methods. The total number of piglets with signs of CT in this study was 29.ResultsAtypical porcine pestivirus-RNA was detected in 93% (27/29) of the piglets suffering from congenital tremor. All piglets with congenital tremor from 2004 (n = 11) and 2012 (n = 3) were PCR-positive with respect to APPV, whereas, all of the healthy controls (n = 11) were negative. The piglets with congenital tremor sampled 2017–2018 had an odds ratio of 91.8 (95% CI 3.9128 to 2153.7842, z = 2.807,P = 0.0050) to test positive for APPV by qRT-PCR compared to the healthy piglets (Fishers exact testp < 0.0001). These findings make it interesting to continue investigating APPV in the Swedish pig-population.ConclusionThis is the first description of atypical porcine pestivirus in piglets suffering from congenital tremor type A-II in Sweden and the Nordic countries. The virus has been present in the Swedish pig population since at least 2004.
Variability, repeatability and test-retest reliability of equine flash visual evoked potentials (FVEPs)
Authors: Ström L. , Bröjer J. , Ekesten B. 
Published: July 2020

AbstractBackgroundVisual evoked potentials (VEPs) are electrical potentials generated by neurons in the central nervous system in response to visual stimuli. A series of positive and negative wavelets in response to flash-stimuli (flash-VEP; FVEP) or reversing, iso-luminant patterns (pattern-VEP; PVEP) are recorded. Pathological conditions affecting the post-retinal pathways can alter overall waveform morphology, and also affect wavelet peak times and amplitudes. FVEPs have recently been described in horses, but more data on the variability within and between subjects is required, to adequately interpret results from clinical equine patients. Therefore, the purpose of this study was to describe the variability, repeatability and test-retest reliability of equine FVEPs in normal, adult horses.ResultsEquine FVEPs were recorded from one randomly selected eye in 17 horses, from both eyes in eight of these horses, and also at two separate recording sessions in six horses. N1, P2, N2 and P4 wavelets were present in 100% of the recordings in all horses, while P1, N2a, P3 and P5 were only present in some recordings. Coefficients of variation (CVs) were low for P2, N2 and P4 peak times, but higher for all amplitudes. There were no statistically significant differences comparing peak times and amplitudes between eyes or between sessions. Coefficients of repeatability (CRs) are reported for P2, N2 and P4 peak times between eyes (P2; 5 ms, N2; 18 ms, P4; 18 ms) and also between sessions (P2; 5 ms, N2; 16 ms, P4; 39 ms). Intraclass correlation coefficients (ICCs), as an estimate of test-retest reliability, was assessed to be fair to excellent for most parameters.ConclusionsThis study provides important data on variability, repeatability and test-retest reliability of FVEPs in normal, adult horses. We conclude that P2, N2 and P4 peak times should be included in the evaluation of equine FVEPs. The large inherent variability of FVEP amplitudes is likely to make them less suitable and useful for establishing a diagnosis on their own in most clinical patients, but they may occasionally provide support to a clinical diagnosis.
Comparative assessment of left atrial volume in healthy cats by two-dimensional and three-dimensional echocardiography
Authors: Rauch Janina , Fehr Michael , Beyerbach Martin , Hungerbuehler Stephan O. 
Published: July 2020

AbstractBackgroundThe left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and real-time three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Additionally, the influence of age, sex and weight on left atrial volume (LAV) was tested.ResultsOne dimensional monoplane Simpson method of discs (SMOD) in the right parasternal four chamber view (r4) and the left apical 2 chamber view (l2) as well as biplane SMOD had no significant difference for left atrial maximum volume (LAMax). They can be used as equivalent in future studies and one common reference range was set up (1.96 ± 0.54 ml). Those three methods produced significantly higher volumes than triplane echocardiography (RTTPE) and real time three dimensional echocardiography (RT3DE) using TomTec® software. LA volumetry with RTTPE and RT3DE-TomTec™ was more feasible than expected, but low RT3DE image quality was the main reason for excluding patients. Neither age nor weight had an influence on LA volume in healthy cats. Male LAV results were only slightly, but in 2D and RTTPE significantly higher than those of female cats with a range of + 10.46% to + 19.58%.ConclusionsMonoplane, biplane, triplane and real-time three dimensional echocardiography were feasible for LA volumetry in healthy cats and showed acceptable intra- and interobserver variability. One common LAMax reference range for monoplane r4, l2 and biplane SMOD was set up. Raw data can be used for LA volumes and does not need to be correlated with the cat’s weight or age. Male cats have only slightly but significantly larger atria than females in 2D and RTTPE. Therefore, under reservation, also sex related limit values were defined.
“After those nets are torn, most people use them for other purposes”: an examination of alternative bed net use in western Kenya
Authors: Santos Ellen M. , Coalson Jenna E. , Munga Stephen , Agawo Maurice , Jacobs Elizabeth T. , Klimentidis Yann C. , Hayden Mary H. , Ernst Kacey C. 
Published: July 2020

Abstract
Background
Alternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied.

Methods
A cross-sectional survey of 1217 households in an epidemic highland site and an endemic lowland site in western Kenya collected information on alternative use in three ways: direct observations, participant self-report, and participant reporting of community-level practices. LLIN misuse was defined as use of an intact net for alternative purposes and repurposing as alternatively using an old or damaged net. Associations between households with observed repurposed nets and universal access and household net use were examined.

Results
Households describe repurposing nets when they are torn and/or old. Repurposed nets were observed in 8.1% (52/643) highlands households and 33.0% (184/574) lowlands households. Repurposed nets served as chicken coops (33% highlands, 20% lowlands), fences (37% highlands, 25% lowlands), tree covers (22% lowlands), curtains (3% highlands), covering bathrooms (1.5% highlands, 9% lowlands), and washing sponges (13% lowlands). No association was found between repurposing and universal access or household net use. Misuse was rare. Of 379 repurposed nets, 4 (1.06%) were in good condition with no holes. Of 1,758 active nets, 13 (0.74%) were misused.

Conclusions
Alternative net use in this study involved repurposing rather than misuse. Repurposing was not detrimental to malaria prevention efforts in these communities. Standardized measurement of alternative net use should be used to better understand the practice and its potential impact on the success of malaria interventions.
A model of disparities: risk factors associated with COVID-19 infection
Authors: Rozenfeld Yelena , Beam Jennifer , Maier Haley , Haggerson Whitney , Boudreau Karen , Carlson Jamie , Medows Rhonda 
Published: July 2020

Abstract
Background
By mid-May 2020, there were over 1.5 million cases of (SARS-CoV-2) or COVID-19 across the U.S. with new confirmed cases continuing to rise following the re-opening of most states. Prior studies have focused mainly on clinical risk factors associated with serious illness and mortality of COVID-19. Less analysis has been conducted on the clinical, sociodemographic, and environmental variables associated with initial infection of COVID-19.

Methods
A multivariable statistical model was used to characterize risk factors in 34,503cases of laboratory-confirmed positive or negative COVID-19 infection in the Providence Health System (U.S.) between February 28 and April 27, 2020. Publicly available data were utilized as approximations for social determinants of health, and patient-level clinical and sociodemographic factors were extracted from the electronic medical record.

Results
Higher risk of COVID-19 infection was associated with older age (OR 1.69; 95% CI 1.41–2.02, p < 0.0001), male gender (OR 1.32; 95% CI 1.21–1.44, p < 0.0001), Asian race (OR 1.43; 95% CI 1.18–1.72, p = 0.0002), Black/African American race (OR 1.51; 95% CI 1.25–1.83, p < 0.0001), Latino ethnicity (OR 2.07; 95% CI 1.77–2.41, p < 0.0001), non-English language (OR 2.09; 95% CI 1.7–2.57, p < 0.0001), residing in a neighborhood with financial insecurity (OR 1.10; 95% CI 1.01–1.25, p = 0.04), low air quality (OR 1.01; 95% CI 1.0–1.04, p = 0.05), housing insecurity (OR 1.32; 95% CI 1.16–1.5, p < 0.0001) or transportation insecurity (OR 1.11; 95% CI 1.02–1.23, p = 0.03), and living in senior living communities (OR 1.69; 95% CI 1.23–2.32, p = 0.001).

Conclusion
sisk of COVID-19 infection is higher among groups already affected by health disparities across age, race, ethnicity, language, income, and living conditions. Health promotion and disease prevention strategies should prioritize groups most vulnerable to infection and address structural inequities that contribute to risk through social and economic policy.
Long-term exposure to a mixture of industrial SO2, NO2, and PM2.5 and anti-citrullinated protein antibody positivity
Authors: Zhao Naizhuo , Smargiassi Audrey , Hatzopoulou Marianne , Colmegna Ines , Hudson Marie , Fritzler Marvin J. , Awadalla Philip , Bernatsky Sasha 
Published: July 2020

Abstract
Background
Studies of associations between industrial air emissions and rheumatic diseases, or diseases-related serological biomarkers, are few. Moreover, previous evaluations typically studied individual (not mixed) emissions. We investigated associations between individual and combined exposures to industrial sulfur dioxide (SO2), nitrogen dioxide (NO2), and fine particles matter (PM2.5) on anti-citrullinated protein antibodies (ACPA), a characteristic biomarker for rheumatoid arthritis (RA).

Methods
Serum ACPA was determined for 7600 randomly selected CARTaGENE general population subjects in Quebec, Canada. Industrial SO2, NO2, and PM2.5 concentrations, estimated by the California Puff (CALPUFF) atmospheric dispersion model, were assigned based on residential postal codes at the time of sera collection. Single-exposure logistic regressions were performed for ACPA positivity defined by 20 U/ml, 40 U/ml, and 60 U/ml thresholds, adjusting for age, sex, French Canadian origin, smoking, and family income. Associations between regional overall PM2.5 exposure and ACPA positivity were also investigated. The associations between the combined three industrial exposures and the ACPA positivity were assessed by weighted quantile sum (WQS) regressions.

Results
Significant associations between individual industrial exposures and ACPA positivity defined by the 20 U/ml threshold were seen with single-exposure logistic regression models, for industrial emissions of PM2.5 (odds ratio, OR = 1.19, 95% confidence intervals, CI: 1.04–1.36) and SO2 (OR = 1.03, 95% CI: 1.00–1.06), without clear associations for NO2 (OR = 1.01, 95% CI: 0.86–1.17). Similar findings were seen for the 40 U/ml threshold, although at 60 U/ml, the results were very imprecise. The WQS model demonstrated a positive relationship between combined industrial exposures and ACPA positivity (OR = 1.36, 95% CI: 1.10–1.69 at 20 U/ml) and suggested that industrial PM2.5 may have a closer association with ACPA positivity than the other exposures. Again, similar findings were seen with the 40 U/ml threshold, though 60 U/ml results were imprecise. No clear association between ACPA and regional overall PM2.5 exposure was seen.

Conclusions
We noted positive associations between ACPA and industrial emissions of PM2.5 and SO2. Industrial PM2.5 exposure may play a particularly important role in this regard.
A minor allele of the haplotype located in the 19q13 loci is associated with a decreased risk of hyper-LDL-cholesterolemia, and a balanced diet and high protein intake can reduce the risk
Authors: Park Sunmin , Kang Suna 
Published: July 2020

Abstract
Background
Although the human chromosome 19q13 loci are reported to be associated with hyper-LDL-cholesterolemia, the haplotype of single nucleotide polymorphism (SNP) has not been studied. Therefore, the association of the haplotype in 19q13 loci with hyper-LDL-cholesterolemia was determined and their interactions with lifestyles and nutrient intakes were evaluated in 28,445 Koreans aged > 40 years.

Methods
SNPs were selected from 19q13 loci that had an association with hyper-LDL-cholesterolemia with the adjustment of confounders (age, gender, area of residence, and body mass index). Haplotype was constructed from the selected SNPs. An adjusted odds ratio of the haplotype for hyper-LDL-cholesterolemia and the interaction between haplotype and lifestyles was analyzed after adjusting for covariates.

Results
Hyper-LDL-cholesterolemia had an association with apolipoprotein E (APOE)_ rs7259620, translocase of outer mitochondrial membrane 40(TOMM40)_rs157581, poliovirus receptor-related 2(PVRL2)_rs403155, exocyst complex component 3-like 2(EXOC3L2)_ rs10406604 and CD3e molecule-associated protein (CD3EAP)_rs3212986 in 19q13. The haplotype of these SNPs had a negative association with hyper-total-cholesterolemia and hyper-LDL-cholesterolemia by 0.669 and 0.684 times, respectively, after adjusting for covariates. The incidence of cardiovascular diseases, especially myocardial infarction, had a negative association with the minor alleles. The balanced diet pattern (BD) and protein intake had a significant interaction with the haplotype: the major-allele of the haplotype exhibited a positive association with hyper-LDL-cholesterolemia, compared to the minor allele, only when combined with a high intake of BD. The participants with the minor allele exhibited a lower hyper-LDL-cholesterolemia risk compared to those with the major allele only with high protein intake.

Conclusion
The minor allele of haplotype located in 19q13 loci protected against hyper-LDL-cholesterolemia, especially with BD and high protein intake. The minor allele also had a negative association with myocardial infarction events.