bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anxiety, Perceived Stress and Coping Strategies in Nursing Students: A Cross-Sectional Correlational Descriptive Study
Authors: Onieva-Zafra María Dolores , Fernández-Muñoz Juan José , Fernández-Martínez Elia , García-Sánchez Francisco José , Abreu-Sánchez Ana , Parra-Fernández María Laura 
Published: March 2020

Abstract
Background: Clinical training is recognized as being a stressful experience for many nursing students. The levels of stress and anxiety may increase or decrease during their educational training depending on coping behavior strategies and other factors. The objective of this was to investigate the relationship between anxiety, perceived stress and coping strategies used by nursing students during their clinical training. Methods: A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman’s rho.Results: The mean age of participants was 20.71± 3.89 years (range 18-46 years). One half of the students (47.92%) indicated a moderate level of stress with a mean PSS score of 22.78 (±8.54). Veteran nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r= 0.463, p<.000) and also for trait anxiety (r=0.718, p<.000). There was also a significant relationship between the total amount of perceived stress and the following domains of the Coping Behavior Inventory: problem solving (r =-.452, p<.01), self-criticism(r =.408 p<.01), wishful thinking(r =.459, p<.01), social support(r =-.220, p<.01), cognitive restructuring(r =-.375, p<.01), and social withdrawal(r =.388, p<.01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring.Conclusions: Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs that could help prepare nursing students to cope with the challenges they are about to face during their clinical placements.
Husband’s Willingness-to-Pay for HIV and Syphilis Screening at Antenatal Care Clinic under the Thai Universal Coverage Scheme
Authors: Anunsittichai Orawan , Pongpirul Krit , Puthanakit Thanyawee , Roowicha Koranit , Kaewprasert Jirarat , Songtaweesin Wipaporn Natalie , Chaithongwongwattana Surasith 
Published: March 2020

Abstract
Background Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to determine the husband’s willingness-to-pay (WTP) for his HIV and syphilis screening tests and potential factors affecting STI screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. Methods A pilot open-ended interview was conducted among 50 participants to estimate the mean and standard deviation of WTP prices for HIV and syphilis screening tests. A questionnaire was developed to obtain demographics, STI knowledge and screening history, as well as two contingent valuation methods (bidding and payment scale), using the mean WTP prices identified from the pilot study as a starting WTP with ¼SD step-up/down. The survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. Descriptive statistics and logistic regression were used for data analysis. Results During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP prices for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the WTP prices from the bidding method. Conclusions The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.
Mental distress, perceived need and barriers to receive professional mental health care among university students
Authors: Negash Assegid , Ahmed Matloob , Medhin Girmay , Wondimagegn Dawit , Araya Mesfin 
Published: March 2020

Abstract
Context: There is limited evidence on the extent of the perceived need for professional mental health care and barriers to the delivery of mental distress services among university students in low and middle-income countries. Objective: The current study was designed to assess the prevalence of mental distress, perceived need for professional mental health care and barriers to the delivery of the service for regular undergraduate university students. Methods: A multi-stage sampling technique was used to recruit 1135 regular undergraduate university students. Symptoms of mental distress were evaluated using the Self-Reported Questionnaire (SRQ-20) and a score of eight and above was used to identify positive cases. The perceived need for professional mental health care was assessed using one question with binary responses, whereas barriers to mental health care were assessed using Barriers to Access to Care Evaluation (BACE-30) tool. The association of demographic variables with total mean scores of BACE-III sub-scales was modeled using multiple linear regression. Results: The prevalence of mental distress symptoms was 34.6% and the perceived need for professional mental health care was 70.5%. The top five barriers to receiving professional mental health service were (a) thinking the problem would get better by itself, (b) being unsure where to go to get professional care, (c) wanting to solve the problem by own, (d) denying mental health problem, and (e) preferring to get alternative forms of mental care. Conclusions: The high prevalence of mental distress, mental health care gap, and the report of barriers to professional mental health care among Ethiopian regular undergraduate students is a call for action.
A Virtual Reality based intervention for surgical patients: study protocol of a randomized controlled trial
Authors: Georgescu Raluca , Dobrean Anca , Silaghi Cristina Alina , Silaghi Horațiu 
Published: March 2020

Abstract
Background: Pain after surgery is normal, and treatments, including both pharmacological and psychological components, are fundamental for a proper postoperative care. While several trials have investigated the analgesia analgesic effect of traditional non-pharmacological treatments, such as Cognitive Behaviors Therapies, the newer ways of delivering psychological interventions for pain after surgery are scarcely investigated. The aim of this randomized controlled trial (RCT) is to determine if delivering the psychological content through Virtual Reality (VR) along with the standard pharmacological treatment return better pain relief outcomes than standard care in adults patients following surgery.
Methods: This is a protocol of a parallel RCT conducted in one community hospital. In order to test the efficacy of VR environments for reducing pain intensity, in the following day after surgery, adults (18 to 65 years) will be randomly assigned to either (1) standard treatment after surgery (control group) or (2) VR based intervention along with standard treatment. It is intended that a minimum of 27 patients be recruited in each group. For estimating the intensity of pain, both self-report and physiological measures will be used. Repeated measures of pain outcomes will be taken before and after the intervention. Moreover, for allowing an in-depth investigation on of the effect of VR environments, the primary outcome will be complemented with measures of the adverse effects, level of immersion, and level of presence in the VR environment.
Keywords: pain; postsurgical pain; virtual reality; psychological interventions; VR-based interventions;
Trial registration status: ClinicalTrials, NCT03776344 . Retrospectively registered in December 14, 2018, https://clinicaltrials.gov/ct2/show/NCT03776344 .
Efficacy of a training programme to support the application of the guideline evidence-based health information: study protocol of a randomised controlled trial
Authors: Lühnen Julia , Berger-Höger Birte , Haastert Burkhard , Hinneburg Jana , Kasper Jürgen , Steckelberg Anke 
Published: March 2020

Abstract
Background
The evidence-based guideline entitled guideline evidence-based health information emerged from the German Network for Evidence-based Medicine (DNEbM) and was published in February 2017. The guideline addresses providers of health information and its goal is to improve the quality of health information. In addition, we explored the competences of providers of health information and developed a training programme.
Aim of this study is to evaluate the efficacy of a training programme addressing providers of health information to support the application of the guideline evidence-based health information. We expected the intervention to improve the quality of health information in comparison to the provision of the guideline on its own.
Methods
The trial uses a superiority randomised control group design with ten months follow-up. 26 providers of health information (groups with up to ten members) will be enrolled to compare the intervention (guideline & training programme) with usual care ( a publicly available guideline). The 5-day training programme comprises an evidence-based medicine training module and a module to prepare the application of the guideline. The primary outcome parameter is the quality of the health information. Quality is operationalised as the extent of adherence to the guideline’s recommendations. Each provider will prepare a single health information informing a health-related decision on a topic freely chosen before randomisation. The quality of this information will be rated using the Mapping Health Information Quality (MAPPinfo) checklist. An accompanying process evaluation will then be conducted.
Discussion
The study results will show whether the efficacy of the intervention justifies implementation of the training programme to enhance health information developers’ competences in evidence-based medicine and to ensure high-quality EBHI in the long-term.
Trial registration ISRCTN registry, registration number: ISRCTN96941060, Date: 7 March 2019, URL: http://www.isrctn.com/ISRCTN96941060 Keywords
health information; guideline implementation, training programme; evidence-based medicine; guideline evidence-based health information
H19/miR-194/E2F3 regulating loop promotes gastric cancer growth and metastasis
Authors: Qin Wanxiang , Shi Ying , Zhu Dan , Chen Yaohua , Li Yuping , Cui Jian 
Published: March 2020

Abstract
Background: Gastric cancer (GC) is one of the most frequent malignant digestive tumors and second fatal cancer. This study was to investigate whether lncRNA-H19 can regulate E2F3 expression through competitive binding to microRNA-194 (miR-194), thus regulating GC growth and metastasis. Methods: H19, miR-194, and E2F3 expression levels in GC tissues and cell lines were investigated using quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR). Meanwhile, the mRNA levels of H19 and E2F3 in gastric cancer tissues were also analyzed through the GEPIA web tool. The binding condition of miR-194 with H19 and E2F3 was investigated using a dual-luciferase reporter gene assay. The regulatory effects of H19 on proliferative, migratory, and invasive abilities of AGS cells and SGC-7901 cells were detected by transwell assay and cell counting kit-8 (CCK-8). Genes involved in proliferation, migration, and invasion (PCNA, Vimentin, and N-cadherin) were determined using QRT-PCR and western blot. The regulatory interaction between H19 and miR-194, miR-194, and E2F3 were investigated using rescue experiments. Results: The results revealed that H19 was highly expressed in GC tissues and cell lines than those of controls. Downregulated H19 decreased the proliferation, migration, and invasion of AGS cells and SGC-7901 cells. H19 was demonstrated that being the molecular sponge of miR-194 in regulating the growth of the GC cells. The level of E2F3 expression was also found significantly higher in GC tissues and cell lines than those of controls. And then, the mimics of miR-194 inhibited the expression of E2F3 in the GC cells. CCK-8 assay showed decreased proliferative ability induced by miR-194 mimics were reversed by E2F3 overexpression. Transwell assays showed decreased migratory and invasive ability induced by miR-194 mimics were reversed by E2F3 overexpression. Conclusions: This study demonstrates that H19 promotes GC growth and metastasis by regulating E2F3 via competitive binding to miRNA-194.
Title: Monitoring intrapartum fetal heart rates by mothers in labour in two public hospitals: an initiative to improve maternal and neonatal healthcare in Liberia
Authors: Borzie Korpo , Jasper Noah , Southall David , MacDonald Rhona , Kola Adeyemo Abass , Dolo Obed , Magnus Asinya , Watson Diane , Casement Maire , Dahn Bernice , Jallah Wilhelmina 
Published: March 2020

Abstract
Background: In low-resource settings with few health workers, Fetal Heart Rate (FHR) monitoring in labour can be inconsistent and unreliable. An initiative to improve fetal monitoring was implemented in two public hospitals in rural Liberia; the country with the second lowest number of midwives and nurses in the world (1.007 per 10,000 of the population). The initiative assessed the feasibility of educating women in labour to monitor their own FHR and alert a midwife of changes detected.Methods: 474 women admitted in labour without obstetric complications were approached. 461 consented to participate (97%) and 13 declined. Those consenting were trained to monitor their FHR using a sonicaid for approximately one minute immediately following the end of every uterine contraction and to inform a midwife of changes. If changes were confirmed, standard clinical interventions for fetal distress (lateral tilt, intravenous fluids and oxygen) were undertaken and, when appropriate, accelerated delivery by vacuum or Caesarean section. Participants provided views on their experiences; subsequently categorized into themes. Neonatal outcomes regarding survival, need for resuscitation, presence of birth asphyxia, and treatment were recorded.Results: 461 out of 474 women gave consent, of whom 425 (92%) completed the monitoring themselves. 387 of 400 women who gave comments, reported positive and 13 negative experiences. 28 participants reported FHR changes, confirmed in 26 cases with meconium stained liquor in 17. Fetal death was identified on admission during training in one mother. 13 neonates required resuscitation, with 12 admitted to the neonatal unit. One developed temporary seizures suggesting birth asphyxia. All 26 neonates were discharged home apparently well. In 2 mothers, previously unrecognized obstetric complications (cord prolapse and Bandl’s ring with obstructed labour) accompanied FHR changes. Resuscitation was needed in 8 neonates without identified FHR changes including one of birth weight 1.3 Kg who could not be resuscitated. There were no intrapartum stillbirths in participants. Conclusions: Women in labour were able to monitor and detect changes in their FHR. Most found the experience beneficial. The absence of intrapartum stillbirths after admission and the low rate of poor neonatal outcomes are promising and warrant further investigation.
Contemporary public image of the nursing profession in Saudi Arabia
Authors: Elmorshedy Hala , AlAmrani Abrar , Hassan Mona Ahmed , Albrecht Susan Ann , New Amel Ahmed Fayed 
Published: March 2020

Abstract
Background: In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including failure to recruit high school students into nursing education; poor nursing identity, and lack of awareness about the nursing profession. Exploring the level of awareness about the nursing profession and Understanding factors that influence the nursing image is crucial for planning effective intervention programs to recruit and retain students into nursing education, and to improve nurses' sense of identity. Methods: The purpose of the present study was to explore the public image of the nursing profession. A descriptive cross-sectional study included 502 adults; 106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-demographic data, gender preference in getting nursing care, knowledge, and perceived barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0. Results: Only 32.5 % preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0-66.7)). The study highlighted a number of sociocultural barriers to pursue a nursing career including; the mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%).Conclusions: Poor knowledge and sociocultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding the underlying factors of negative public image about the nursing profession could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.
Amygdalin promotes the activity of T cells to suppress the progression of HBV-related hepatocellular carcinoma via the JAK2/STAT3 signaling pathway
Authors: Wang Ruoyu , Zhang Dong , Sun Kewei , Peng Jianping , Zhu Wenfang , Yin Sihan , Tang Dan , Wu Yunan 
Published: March 2020

Abstract
Background: Hepatitis B virus (HBV) infection is a high-risk factor of hepatocellular carcinoma (HCC). Cellular immune responses are essential for HCC development, and the CD4+ and CD8+ T subtypes are identified as the primary anti-tumor immune cells. In the study, we investigated the effect and mechanism of amygdalin in the cellular immune response in HBV-related HCC and HCC progression.Methods: The cell proliferation was examined by MTT analysis. Cells metastasis ability was detected by Invasion and migration assays. Quantification of apoptotic cells was performed with Flow cytometer assay. The protein levels of p-STAT3, STAT3, p-JAK2, JAK2, caspase-3, cleaved caspase-3 were detected by performing immunoblotting assays.Results: We demonstrate that amygdalin treatment could rescue the HBV-T cell viability and IFN-γ and TNF-αproduction. In HBV-T cells, the MFI levels of CD8+ are lower than that in NC-T cells. Moreover, the phosphorylation levels of STAT3 and JAK2 are higher in HBV-T cells, compared to those in NC-T cells, and then reduced by amygdalin treatment. Co-culture with HBV-T cells could reduce IFN-γ and TNF-α, production while increase IL-6 and IL-10 production in HepG2.2.15 cells; these alterations could be partially reversed by amygdalin pretreatment. Finally, co-culture with HBV-T cells significantly promoted the cell viability, inhibited the apoptosis, and promoted the migration of HepG2.2.15 cells, and these alterations could be partially reversed by amygdalin treatment. Conclusion: Our findings provide a rationale for further studies on the functions and mechanism of amygdalin inhibiting HBV-related HCC cell proliferation, invasion, and migration via T cell-mediated tumor immunity.
Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnant Patients
Authors: Li Rong , chen xuehai , Liu Zhongzhen , Chen Yan , Liu Chuan , Ye Lingfei , Xiao Liang , Yang Zhenjun , He Jian , Wang Wen-Jing , Qi Hongbo 
Published: March 2020

Abstract
Background: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase (AST), alanine aminotransferase (ALT) and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. We hypothesized that there was a link between gut microbiota and the progression of ICP and characterization of the potential microbiota could go a long way in the prevention and treatment of ICP.Methods: A total of 58 patients were recruited for our study; 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rRNA region of DNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota from fecal samples obtained. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different OTUs (Operational Taxonomic Units) between ICP and controls were also identified.Results: Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups; ICP patients and control group and PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.Conclusions: Our research indicated that patients with ICP have altered phylogenetic gut microbiota profiles compared to controls, and illustrated that there are significant differences in KEGG pathways.