bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social acceptance of alcohol use in Uganda.
Authors: Ssebunnya Joshua , Kituyi Caroline , Nabanoba Justine , Nakku Juliet , Bhana Arvin , Kigozi Fred 
Published: October 2019

Abstract
Abstract: Background: Alcohol use is part of many cultural, religious and social practices, and provides perceived pleasure to many users. In many societies, alcoholic beverages are a routine part of the social landscape for many in the population. Relatively low rates were reported for Alcohol Use Disorders (AUD) in a community based survey and facility detection survey conducted in the study site contrary to findings in earlier formative studies where alcohol use was reported to be a major health problem. The aim of this study was to understand reasons for under-reporting and the low detection rate for AUDs, exploring the societal perceptions of alcohol use in the study district. Methods: The study was conducted in Kamuli District (implementation site for the PRIME project). Semi-structured interviews and focus group discussions were conducted with purposively selected participants that included local and religious leaders, lay people, health workers as well as heavy alcohol drinkers and their spouses. Interviews were tape-recorded and transcribed verbatim. The analysis followed 4 thematic areas, which include the extent and acceptability of alcohol use, patterns of alcohol use, perceived health problems associated with alcohol use and help-seeking behavior for persons with alcohol related problems. Results: The findings indicate that alcohol consumption in the study site was common and widely acceptable across all categories of people, with minimal restrictions. Society tends to overlook problems associated with alcohol use except when it is life-threatening. Help-seeking for such problems was therefore reported to be relatively rare. Conclusion: Alcohol was readily available in the community and its consumption widely acceptable with minimal restrictions to the minors. There is low recognition of alcohol use related health problems, resulting in poor help-seeking behavior. Key words: Alcohol, Kamuli, Alcohol Use Disorder, PRIME acceptability
Reduction of corticosteroid use in outpatient treatment of exacerbated COPD – Study protocol for a randomized, double-blind, non-inferiority study (The “RECUT”-Trial)
Authors: Urwyler Pascal , Boesing Maria , Abig Kristin , Cattaneo Marco , Dieterle Thomas , Zeller Andreas , Bachler Herbert , Markun Stefan , Senn Oliver , Merlo Christoph , Essig Stefan , Ullmer Elke , Schuurmans Macé , Leuppi Joerg Daniel 
Published: October 2019

Abstract
Background Chronic obstructive pulmonary disease (COPD) is a major public health issue affecting approximately four to seven percent of the Swiss population. According to current inpatient guidelines, systemic corticosteroids are important in the treatment of acute COPD exacerbations and should be given for five to seven days. Several studies suggest that corticosteroids accelerate the recovery of the FEV1 (forced expiratory volume in one second), enhance oxygenation, decrease duration of hospitalization and improve clinical outcome. However, the additional therapeutic benefit on FEV1 recovery appears to be most apparent in the first three to five days. No data are available on the minimal necessary corticosteroid dose and treatment duration in primary care patients with acute COPD exacerbations. Given that many COPD patients are treated on an outpatient basis, there is an urgent need to improve evidence about COPD management in this setting. The aim of this study is to investigate whether a three-day treatment with orally administered corticosteroids is non-inferior to a five-day treatment in acute exacerbations of COPD in a primary care setting. Methods The proposed study is a prospective, double-blind, randomized controlled trial conducted in a primary care setting, including an anticipated number of 470 patients with acutely exacerbated COPD. Participants are randomised to receive systemic corticosteroid treatment of 40 mg prednisone daily for five days (conventional arm, n = 235), or for three days, followed by two days of placebo (experimental arm, n = 235). Antibiotic treatment for seven days is given to all patients with CRP ≥ 50 mg/l, known diagnosis of bronchiectasis, or presenting with Anthonisen Type-I exacerbation. Additional treatment after inclusion is left at the discretion of the treating general practitioner. Follow-up visits are performed on days three and seven by the treating general practitioners, followed by telephone interviews on days 30, 90 and 180 after inclusion into the study. Primary endpoint is the time to next exacerbation during a six-months follow-up period, which includes re-exacerbation during index exacerbation. Discussion This study is designed to assess whether a three-day course of corticosteroid treatment is not inferior to the current conventional five-day treatment course in outpatients with exacerbated COPD regarding time to next exacerbation. Depending on the results, this trial might lead to a further reduction of cumulative corticosteroid dose in COPD patients.
Risk factors for Clostridioides difficile infection and colonization among patients admitted to an intensive care unit in Shanghai, China
Authors: Cui Yingchao , Dong Danfeng , Zhang Lihua , Wang Daosheng , Jiang Cen , Ni Qi , Wang Chen , Mao Enqiang , Peng Yibing 
Published: October 2019

Abstract
Background: Clostridioides difficile is considered the main pathogen responsible for hospital-acquired infections. This prospective study determined the prevalence, molecular epidemiological characteristics, and risk factors for C. difficile infection (CDI) and C. difficile colonization (CDC) among patients in the intensive care unit (ICU) of a large-scale tertiary hospital in China, with the aim of providing strategies for efficient CDI and CDC prevention and control.
Methods: Stool samples were collected and anaerobically cultured for C. difficile detection. The identified isolates were examined for toxin genes and subjected to multilocus sequence typing. Patients were classified into CDI, CDC, and control groups, and their medical records were analyzed to determine the risk factors for CDI and CDC.
Results: Of the 800 patients included in the study, 33 (4.12%) and 25 (3.12%) were identified to have CDI and CDC, respectively. Associations with CDI were found for fever (OR=13.993), metabolic disorder (OR=7.972), and treatment with fluoroquinolone (OR=42.696) or combined antibiotics (OR=2.856). CDC patients were characterized by prolonged hospital stay (OR=1.137), increased number of comorbidities (OR=36.509), respiratory diseases (OR=0.043), and treatment with vancomycin (OR=18.168). Notably, treatment with metronidazole was found to be a protective factor in both groups (CDI: OR=0.042; CDC: OR=0.013). Eighteen sequence types (STs) were identified. In the CDI group, the isolated strains were predominantly toxin A and toxin B positive (A+B+) and the epidemic clone was genotype ST2. In the CDC group, the dominant strains were A+B+ and the epidemic clone was ST81.
Conclusions: The prevalences of CDC and CDI in our ICU were relatively high, suggesting the importance of routine screening for acquisition of C. difficile . Future prevention and treatment strategies for CDC and CDI should consider hospital stay, enteral nutrition, underlying comorbidities, and use of combined antibiotics. Moreover, metronidazole may be a protective factor for both CDI and CDC, and could be used empirically.
Educational roles as a continuum of mentoring’s role in medicine – A systematic review and thematic analysis of educational studies from 2000 to 2018
Authors: Krishna Lalit , Renganathan Yaazhini , Tay Kuang Teck , Tan Benjamin Jia Xing , Chong Jia Yan , Ching Ann Hui , Prakash Kishore , Quek Nicholas Wei Sheng , Peh Rachel Huidi , Chin Annelissa Mien Chew , Taylor David C M , Mason Stephen , Kanesvaran Ravindran , Toh Ying Pin 
Published: October 2019

Abstract
Introduction: Recent studies have gone to great lengths to differentiate mentoring from teaching, tutoring, role modelling, coaching and supervision in efforts to better understand mentoring processes. This review seeks to evaluate the notion that teaching, tutoring, role modelling, coaching and supervision may in fact be part of the mentoring process. To evaluate this theory, this review scrutinizes current literature on teaching, tutoring, role modelling, coaching and supervision to evaluate their commonalities with prevailing concepts of novice mentoring.
Methods: A three staged approach is adopted to evaluate this premise. Stage one involves four systematic reviews on one-to-one learning interactions in teaching, tutoring, role modelling, coaching and supervision within Internal Medicine, published between 1st January 2000 and 31st December 2018. Braun and Clarke’s (2006) approach to thematic analysis was used to identify key elements within these approaches and facilitate comparisons between them.
Stage two provides an updated view of one-to-one mentoring between a senior physician and a medical student or junior doctor to contextualise the discussion.
Stage three infuses mentoring into the findings delineated in stage one.
Results: 17499 citations were reviewed, 235 full-text articles were reviewed, and 104 articles were thematically analysed. Four themes were identified – characteristics, processes, nature of relationship, and problems faced in each of the four educational roles.
Discussion: Role modelling, teaching and tutoring, coaching and supervision lie within a mentoring spectrum of increasingly structured interactions, assisted by assessments, feedback and personalised support that culminate with a mentoring approach. Still requiring validation, these findings necessitate a reconceptualization of mentoring and changes to mentor training programs and how mentoring is assessed and supported.
Health effects of nutrients and environmental pollutants in Baltic herring and salmon: a quantitative benefit-risk assessment
Authors: Tuomisto Jouni T , Asikainen Arja , Meriläinen Päivi , Haapasaari Päivi 
Published: October 2019

Abstract
Background
Dioxin health risks from fish remains a complex policy issue. Especially fatty Baltic fish, such as herring and salmon, contain relatively high concentrations of pollutants although they are otherwise healthy food. We studied the health benefits and risks of Baltic herring and salmon in four countries to identify critical uncertainties and to facilitate evidence-based discussion on the dioxin policy related to these fishes.
Methods
We performed an online survey about consumers' fish consumption and its motivation in Denmark, Estonia, Finland, and Sweden. Dioxin and methylmercury concentrations were estimated based on Finnish data. Exposure-response functions about several health endpoints were evaluated and quantified based on scientific literature. We also quantified infertility risk of men based on a recent European risk assessment about childhood dioxin exposure and its effect on sperm concentration later in life.
Results
Baltic herring and salmon contain e.g. omega-3 fatty acids and vitamin D, and the beneficial impact of these fishes on cardiovascular, mortality, and depression risk clearly outweighs risks of dioxins and methylmercury in people more than 45 years of age and in young men. The critical population subgroup is young women, who may expose their children to pollutants during pregnancy and breast feeding. However, the study suggests that even in this group the health benefits are larger or similar than health risks. Value of information analysis demonstrated that the remaining scientific uncertainties are not large. In contrast, several critical uncertainties are value judgements by nature: whether Baltic fish should be seen as primary or secondary source of nutrients; whether exceeding tolerable intake is an adverse outcome as such; and whether subgroup-specific restrictions are problematic or not.
Conclusions
Potential health risks from dioxins in Baltic fish have decreased to less than a half in ten years. The new risk assessment by European Food Safety Authority clearly increases the fraction of population exceeding the tolerable dioxin intake, but quantitative estimates of net health impacts change only marginally. Increased use of small herring (with less pollutants) is a no-regret option. Further value-based policy discussion rather than research is needed to clarify useful actions related to dioxins in fish.
The Main Infrastructure for Better Dental Implant Management: A Systematic Review on Dental Implant Registries
Authors: Author) Roya Naemi(Former Corresponding , Barikani Hamid Reza , Author) Leila Shahmoradi(New Corresponding 
Published: October 2019

Abstract
Background The importance of dental implant registry system has been well documented. However, no systematic review on the dental implant registry system can be found in the literature. Therefore, the aim of this study is to review the dental implant registry system to determine the goals, data elements, reports, data sources, capabilities and institutions that develop dental implant registry system.Methods A systematic study was conducted in PubMed, Scopus, Web of Science and Embase databases. Also, samples of dental implant registry system were searched in Google and were included into the study. For evaluating the dental implant registry system, all English language studies were examined without time limitation. Non-English studies and papers such as conference abstracts were excluded.Results The primary search identified 16905 articles. After eliminating duplicates, full texts of 53 retrieved articles were reviewed by the researchers and finally, 15 studies were included in this review. In this review, the goals of dental implant registry system were determined to be surveillance, complication management and etc. Also, the data elements of dental implant registry system were include patient information, implant information, etc.Conclusion The results of this study provide dentists and other stakeholders with useful dataset on the development of dental implant registry system. It also provides a framework of the goals, characteristics, data elements and reports, data sources, and capabilities of dental implant registry system. The establishment of dental implant registry system will allow the control of complications of dental implants in the future.Systematic review registration CRD42019126424
Demographic and socioeconomic characteristics of Canadian medical students: A cross-sectional study
Authors: Khan Rishad , Apramian Tavis , Kang Joel Hosung , Gustafson Jeffrey , Sibbald Shannon 
Published: October 2019

Abstract
Background While the importance of medical students’ demographic characteristics in influencing the scope and location of their future practice is recognized, these data are not systematically collected in Canada. This study aimed to characterize and compare the demographics of Canadian medical students with the Canadian population.Methods Through an online survey, delivered in 2018, medical students at fourteen English-speaking Canadian medical schools provided their age, sex, gender identity, ethnicity, educational background, and rurality of the area they grew up in. Respondents also provided information on parental income, occupation, and education as markers of socioeconomic status. Data were compared to the 2016 Canadian Census.Results A total of 1388 students responded to the survey, representing a response rate of 16.6%. Most respondents identified as women (63.1%) and were born after 1989 (82.1%). Respondents were less likely, compared to the Canadian Census population, to identify as black (1.7% vs 6.4%) (P<0.001) or Aboriginal (3.5% vs. 7.4%) (P<0.001), and have grown up in a rural area (6.4% vs. 18.7%) (P<0.001). Respondents had higher socioeconomic status, indicated by parental education (29.0% of respondents’ parents had a master’s or doctoral degree, compared to 6.6% of Canadians aged 45-64), occupation (59.7% of respondents’ parents were high-level managers or professionals, compared to 19.2% of Canadians aged 45-64), and income (62.9% of respondents grew up in households with income >$100,000/year, compared to 32.4% of Canadians). Assessment of non-response bias showed that our sample was representative of all students at English-speaking Canadian medical schools with respect to age, though a higher proportion of respondents were female. Additionally, there were no differences between early and late respondents with respect to ethnicity, rurality, and parental income, occupation, and education.Conclusions Canadian medical students have different socioeconomic characteristics compared to the Canadian population. Collecting and analyzing these characteristics can inform evidence-based admissions policies.
Regional differences in reasons for consultation and general practitioners’ spectrum of services – Results of a cross-sectional observational study
Authors: Schäfer Ingmar , Hansen Heike , Ruppel Thomas , Lühmann Dagmar , Wagner Hans-Otto , Kazek Agata , Scherer Martin 
Published: October 2019

Abstract
Background Among other factors, the patients’ consultation reasons and the GPs’ spectrum of services determine process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultations and performed services between urban and rural areas. Thus, the goal of the study was to investigate these factors in relation to the regional location of the GP practices.Methods We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120km around Hamburg were divided in three regional categories (urban, rural, environs) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression models via stepwise forward and backward selection.Results Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 1,032 patients per quarter (3-month period) with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultations and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038), which was statistically explained by a higher level of postgraduate training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas.Conclusions GPs in rural areas spent less time on communicative, preventive, and consultant medicine than GPs in urban areas. In contrast, GPs in rural areas more often performed services that are usually provided by ambulatory specialist care in urban areas. Depending on the analysed item, primary care in the environs was either similar to “urban areas” or to “rural areas”.
Ubiquitin-specific protease 44 inhibits cell proliferation and migration via inhibition of JNK pathway in clear cell renal cell cancer
Authors: Zhou Jiangqiao , Wang Tianyu , Qiu Tao , Chen Zhongbao , Ma Xiaoxiong , Zhang Long , Zou Jilin 
Published: October 2019

Abstract
Background: Clear cell renal cell carcinoma (ccRCC) is one of the most common malignancies. USP44 has been reported to be involved in various cancers. This study aimed to investigate the function role and molecular mechanism of USP44 in ccRCC. Methods: Data obtained from TCGA data portal and GSO database were analyzed to uncover the clinical relevance of USP44 expression and tumor development. The function of USP44 in cell proliferation and migration was assessed by cellular and molecular analysis. Results: USP44 was lowly expressed in the ccRCC cancer tissues compared to the normal tissue. Further, USP44 expression was negatively correlated with tumor stage, tumor grade, and patient survival . USP44 overexpression significantly inhibited tumor cell proliferation and migration of 786-O cell as well as Caki-1 cell. In addition, USP44 overexpression also prohibited cell proliferation by up-regulating P21, down-regulating Cyclin D1 expression, and inhibited cell migration by up-regulating MMP2 and MMP9 expression. In contrast, USP44 knockdown enhances ccRCC cell proliferation and migration. Furthermore, the USP44 function in inhibiting ccRCC cell proliferation and migration is associated with the phosphorylation level of JNK. Conclusion: In summary, this study showed that USP44 may be a marker in predicting the ccRCC progression and USP44 inhibits ccRCC cell proliferation and migration dependent on the JNK pathway.
Comparative genomic analysis of the secondary flagellar (flag-2) system in the order Enterobacterales
Authors: De Maayer Pieter , Pillay Talia , Coutinho Teresa A 
Published: October 2019

Abstract
Background The order Enterobacterales encompasses a broad range of metabolically and ecologically versatile bacterial taxa, most of which are motile by means of peritrichous flagella. Flagellar biosynthesis has been linked to a primary flagella locus, flag -1, encompassing ~ 50 genes. A discrete locus, flag -2, encoding a distinct flagellar system, has been observed in a limited number of enterobacterial taxa, but its function remains largely uncharacterized.Results and Discussion Comparative genomic analyses showed that orthologous flag -2 loci are present in 592/4,028 taxa belonging to 5/8 and 31/76 families and genera, respectively, in the order Enterobacterales. Furthermore, the presence of the outermost flag- 2 genes only in many taxa suggest that this locus was far more prevalent and has subsequently been lost through gene deletion events. The flag -2 loci range in size from ~3.4 to 81.1 kilobases and code for between five and 102 distinct proteins. The discrepancy in size and protein number can be attributed to the presence of cargo gene islands within the loci. Evolutionary analyses revealed a complex evolutionary history for the flag -2 loci, representing ancestral elements in some taxa, while showing evidence of recent horizontal acquisition in other enterobacteria.Conclusions The flag -2 flagellar system is a relatively common, but highly variable feature among members of the Enterobacterales. Given the energetic burden of flagellar biosynthesis and functioning, the prevalence of a second flagellar system suggests it plays important biological roles in the enterobacteria and we postulate on its potential role as locomotory organ or as secretion system.