bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contraceptive Needs and Fertility Intentions of Women With Breast Cancer in Cape Town, South Africa: A Qualitative Study
Authors: Harries Jane , Constant Deborah , Cairncross Lydia , Moodley Jennifer 
Published: July 2020

Abstract
Background:
No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18–49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.
Methods:
Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach.
Results:
Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs.
Conclusions:
Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient- provider communication and counseling could address knowledge gaps.
Risk factors for mechanical failure of proximal femoral nail anti-rotation (PFNA–II) in the treatment of intertrochanteric fractures (AO/OTA 31-A1, A2)
Authors: Nie Shaobo , Ji Hui , li ming , yang di , Qi Yeqing , lei mingxing , tang peifu , zhang zhuo , Zhang Licheng 
Published: July 2020

Abstract
Background: Intertrochanteric fracture is associated with severe morbidity and mortality. The results of postoperative implant failure are catastrophic. The aim of this study was to determine risk factors for implant failure in intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA–II) through the assessment of early therapeutic effects.Methods: A single-center retrospective study was conducted on a continuous series of 123 intertrochanteric fracture patients treated with PFNA-II between Dec 2018 and Oct 2019. Perioperative medical and imaging data were collected. The patients were divided into two groups according to whether implant failure of not. The differences in reduction quality, nail length and tip apex distance (TAD) were analyzed to determine the risk factors of implant failure.Results: A total of 80 patients were enrolled, with an average age of 80.2 years old. There were 6 patients with implant failure. There was no significant difference in demographic index between the two groups. The reduction quality of failure group was good, accept and poor with each 2 patients, and that of the non-failure group was 35, 35 and 4 patients respectively. The difference of reduction quality between the two groups was statistically significant. The risk of postoperative implant failure in patients with poor reduction quality was 8.75 times that of patients with good and acceptable reduction from the Logistic regression analysis（OR=8.75，95%CI 1.215-62.99）. The differences in nail length, ASA and bone quality were not statistically significant. Conclusion: Reduction quality is a risk factor of implant failure in intertrochanteric fractures treated with PFNA-II. Even if the medial femoral cortex is anatomically reduced, there will be a triangular void area between the nail and the medial femur, which are prone to coxa vara and implant failure. Therefore, good reduction is the key to treat intertrochanteric fracture.
Habitual Dietary Intakes of Fat were Associated with Apelin Gene Expression in Visceral and Subcutaneous Adipose Tissues
Authors: Yuzbashian Emad , Zarkesh Maryam , Asghari Golaleh , Hedayati Mehdi , Mirmiran Parvin , Khalaj Alireza , Safarian Mohammad 
Published: July 2020

Abstract
Background: The aim of the present study was to investigate the association of habitual intake of total fatty acids, saturated-, monounsaturated-, polyunsaturated fatty acids, n-3, n-6, and n-9 fatty acids with apelin gene expression in visceral and subcutaneous adipose tissue. Methods: We obtained visceral and subcutaneous adipose tissues from 179 participants (71 non-obese and 105 obese), who had undergone open abdominal surgery. Dietary intake information was gathered with a valid and reliable food frequency questionnaire. The mRNA expression of apelin gene was analyzed by Real-Time PCR. Results: Apelin gene expression was found to be more increased in subcutaneous and visceral adipose tissues in obese than in non-obese participants. Dietary intake of n-3 and polyunsaturated fatty acids was associated with apelin gene expression in subcutaneous and visceral adipose tissues among all categories of weight status after adjusting for total energy intake. Among obese individuals, visceral adipose tissue apelin mRNA levels were associated with total fat intake. Conclusion: Higher apelin gene expression in adipocytes had an association with habitual intake of total fat and n-3 fatty acids in obese and non-obese individuals, indicating a determinative role of quality and quantity of fatty acid intake in a regular diet in adipose tissue adipokine.
BTG1 inhibits malignancy as a novel prognosis signature in endometrial carcinoma
Authors: Li Yibing , Huo Jianing , He Junjian , Zhang Yunzheng , Ma Xiaoxin 
Published: July 2020

Abstract
Background Endometrial carcinoma (EC) is one of the three major malignant tumors of the female reproductive system. In recent years, the incidence and mortality rate of EC have increased. B-cell translocation gene 1 (BTG1) is an anti-proliferation gene that regulates the occurrence and development of a variety of tumors, but there is no research regarding this gene in EC. Methods Based on The Cancer Genome Atlas (TCGA) database, we used a variety of bioinformatics tools and databases to explore the expression and prognosis of BTG1. We verified expression and prognosis of BTG1 in EC using qRT-PCR and analyzed the relevant clinicopathological parameters. We functionally enriched BTG1 and related genes in EC patients through the bioinformatics website and analyzed miRNA targets of BTG1 and interacting protein networks. Cell proliferation, wound healing, transwell invasion, and cell apoptosis assays were used to detect the effects of BTG1 on the malignant biological behavior of endometrial carcinoma cells (ECCs). The effect of BTG1 on the epithelial-to-mesenchymal transition (EMT) process was detected using western blot. Results We analyzed the expression and prognosis of BTG1 based on TCGA and found that low expression of BTG1 was associated with poor EC prognosis. The qRT-PCR suggested that BTG1 had low expression in EC. BTG1 expression was significantly correlated with overall survival (OS) shortening. Clinicopathological analysis suggested that expression of BTG1 was related to invasion depth and the International Federation of Gynecology and Obstetrics (FIGO) stage. EC pathological tissue type, fertility history, lymphatic metastasis, menopause, estrogen receptor (ER), progesterone receptor (PR), and age of diagnosis were not related. Functional enrichment analysis showed that BTG1 plays an important role in regulating embryonic development, tumorigenesis, apoptosis, and cell cycle. Biological behavior experiments suggest that BTG1 inhibits proliferation, migration, and invasion of ECCs, and promotes apoptosis of ECCs. Western blot indicated that BTG1 inhibited the EMT process of ECCs. Conclusions BTG1 plays an important role in the occurrence and development of EC. BTG1, as a tumor suppressor gene, shows low expression in EC, which can inhibit malignant biological behavior and EMT process of ECCs. In addition, BTG1 can be used as a potential prognostic biomarker for EC.
Health risks among women desiring pregnancy within one year: a cross-sectional study in Maharashtra India
Authors: Gothankar Jayashree Sachin , Doke Prakash , Palkar Sonali , Chutke Amruta , Patil Archana , Pore Prasad , Narula Arvinder Pal Singh , Deshpande Aniruddha , Bhuyan Khanindra , Karnataki Madhusudan , Shrotri Aparna 
Published: July 2020

Abstract
Background Health of women during preconception phase though critical is comparatively ignored period in her life cycle. Presence of health risks are judged as hazardous to well-being of women and her forthcoming progeny. The objective of the study was to measure the prevalence of health risks and its comparison between blocks.Methods A cross sectional study was conducted in two tribal and two non-tribal blocks in Nasik district, Maharashtra, India. Currently married women desiring conception within one year were included as study participants. Sample size was estimated to be 6,951. Data was collected by trained Accredited Social Health Activists using validated interview schedule. Anthropometric measures of women were recorded in standard manner. Body Mass Index criteria were used to assess the nutritional status.Results Mean age of women was 23.19 ± 3.71 years and 16% of them were adolescents. Illiteracy rate was higher in tribal than non-tribal women. Commonest reported occupation was farming. Despite being high parity and gravida status more tribal women desired pregnancy. Substance abuse was high among tribal women. Majority of women consumed meal with family members or with husband. Although 35% of women had low consumption of protein and calorie, yet most of them perceived to have abundant food.Conclusion Health risks namely younger age, illiteracy, farming with moderate to high-intensity work, high parity, low consumption of protein and calories and undernutrition were found to be prevalent and the risks were significantly more among tribal women. “Continuum of care” must include preconception care.
Trends in 10-Year Cardiovascular Disease Risk Among Adults in The United States From 1999–2016
Authors: Yang Fang , Pu Liyuan , Sun Mengzi , Wang Min , Li Shuo , Sun Chong , Wang Xiaowei , Guo Feng , Guo Xuecan , Li Jiagen , Yao Yan , Tao Yuchun , Jin Lina 
Published: July 2020

Abstract
Objective: People have high 10-year cardiovascular disease (CVD) risk should take measures to prevent CVD. Thus, to know which subgroups of the population have high CVD risk is important. This study found out trends and risk factor of CVD risk in the US population.Methods: The population aged 30 years and older who were not diagnosed with CVD came from the National Health and Nutrition Examination Surveys (NHANES) in this study, n=35196. Logistic regression models were used to analyze the trends of CVD risk and estimate association between risk factor and CVD risk.Results: The estimated rate of CVD risk > 10% changed from 1999 to 2016 (from 42.2% to 47.7% for males, from 24.7% to 23.9% for females). The estimated rate increased in males over time (P for trend =0.001), while it was stable in females. Males who did not participate in vigorous recreational activity, the estimated rate of CVD risk> 10% significantly increased (P for trend <0.001). The estimated rate of CVD risk >10%, 20% and 30% increased with BMI level in males in the multivariable-adjusted model; the odds ratios and 95% confidence intervals (OR [95% CI] ) of obesity was 1.63 [1.41, 1.88] for CVD risk >10%, 1.69[1.45, 1.48] for CVD risk >20%, and 1.56[1.30, 1.87)] for CVD risk >30%. Conclusions: The rate of CVD risk >10% had an increasing trend in American males adults, who did not participate in vigorous recreational activity. In addition, lower annual household income, higher weight status and do not participate in vigorous recreational activity increased the CVD risk.
The Burden of Stroke in The Municipality of Chongqing, China, From 1990 To 2016
Authors: Yang Shiya , Ran Sha , Liu Ping , Wu Zuocheng , Yu Dong , Zhang Weiwei , Ding Xianbin , Liu Shiwei 
Published: July 2020

Abstract
Background: The burden of stroke varies substantially across regions in China. However, comprehensive comparisons between regions are lacking. This study aims to analyze variations in stroke burden in the municipality of Chongqing, Western China, from 1990-2016. Methods: Data on prevalence, years lived with disability (YLDs), mortality, years of life lost (YLLs), and disability-adjusted life years (DALYs) by age, sex, location, and year were extracted from the 2016 Global Burden of Disease Study (GBD 2016) of China between 1990-2016. The datasets were compared to examine the temporal trends in stroke burden in the last two decades.Results: In 2016, there were 670,438 cases of stroke, 41,022 deaths, and 847,437 DALYs due to stroke in Chongqing. Age-standardized mortality and DALY rates of IS and HS were higher in men whereas age-standardized prevalence rates of IS were higher in women. From 1990 to 2016, age-standardized prevalence rates of overall stroke increased by 33.29%, whereas mortality rates and DALYs decreased by 34.51% and 34.79%, respectively. YLLs were the main contributor to DALYs; however, the YLL/YLD ratio decreased over time. During the study period, the overall burden of stroke decreased, whereas the prevalence rate of IS increased in all age groups.Conclusions: Despite a decrease in mortality rates, the increase in the prevalence of stroke in Chongqing stresses the need to allocate more health resources. Special attention should be paid to discrepancies in the estimation of the type of stroke according to gender and age to determine mechanisms that explain the causes of stroke.
COVID-19 Pandemic Readiness Status of West Africa
Authors: Lokossou Virgil Kaussi , Kaburi Basil Benduri , Bandoh Delia Akosua , Ouendo Edgard-Marius , Ouédraogo Aboubacar , Aseidu-Bekoe Franklin , Akoriyea Samuel Kaba , Sombié Issiaka , Johnson Ermel , Somé Donmozoun Télesphore , Kenu Ernest 
Published: July 2020

Abstract
Background

From the onset of COVID-19 pandemic in late December 2019, countries have been stepping up their pandemic preparedness and response activities in accordance with WHO recommendations. Informed by the recent lessons learned from the West Africa Ebola Virus Disease outbreak, and subsequent investments made in public health emergency preparedness and response in the Economic Community of West African States (ECOWAS) region, the West Africa Health Organisation (WAHO) is providing regional leadership in the COVID-19 pandemic preparedness and response. We assessed the COVID-19 pandemic readiness status of West Africa.
Methods

We conducted survey of all 15 ECOWAS member states between February 27 and March 15, 2020. We purposively selected a minimum of two respondents from each of the 15 ECOWAS member states – interviewing 37 in all using an interviewer-administered questionnaire based on the nine item WHO national capacity review tool for novel corona virus (nCOV). We also reviewed reports of COVID-19 pandemic preparedness meetings and trainings organized by WAHO. We performed a thematic analysis on the data and described the strengths and weaknesses of the ongoing pandemic readiness efforts of West Africa.
Results

Overall, the strengths of pandemic readiness of the region were: capacity to test 86.7% (13/15) of member states; functional incident management systems (100%); rapid response teams 100%, and at least two of the three tiers of field epidemiology workforce (100%). Within the region also, there existed good cross-border collaborations among member states, active participation of health ministers of member states in regional coordination meetings and decision making. Member states described the numbers of qualified biomedical scientists/technicians, field epidemiologists, risk communicators, and COVID-19 case management teams as inadequate. None of the member states had stockpiles of COVID-19 test kits, laboratory supplies, and personal protective equipment.
Conclusion

ECOWAS member states are taking appropriate COVID-19 pandemic preparedness measures in all pillars towards a regional response. Rather than a total lack, there are insufficiencies in numbers of skilled workforce, logistics, and supplies. Governments of member states are supportive of the coordination and technical direction of WAHO and WHO.
‘It benefits patient care’: The value of practice-based IPE in healthcare curriculums
Authors: O'Leary Noreen , Salmon Nancy , Clifford Amanda M. 
Published: July 2020

Abstract
Background
Practice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE have been integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge will generate important insights into how practice-based IPE is perceived and experienced. This learning can be applied, both locally and beyond, by stakeholders seeking to embed practice-based IPE in their placement curriculums.
Methods
A qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede’s cultural dimensions, informed data analysis and interpretations.
Results
The overarching theme was establishing the value of practice-based IPE, illustrated in three sub-themes: articulating expectations, conceptualising practice-based IPE and integrating interprofessionalism. First, overt articulation of practice-based IPE learning outcomes within regulatory standards and assessment processes would enhance its value within practice education. Second, clearer conceptualisation of what constitutes practice-based IPE is required. Participants indicated varying conceptualisations regarding why and how to implement practice-based IPE. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve meaningful practice-based IPE. Third, integrating interprofessionalism at placement sites is required. Varying levels of professional engagement were noted, perpetuating stereotypes. Creating educator networks and embedding practice-based IPE in organisational strategy enhances its status and broadens engagement.
Conclusions
Adoption of these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally. National and international longitudinal stakeholder data is needed to refine what type of practice-based IPE is most impactful on future collaborative practice.
Prevalence and Risk Factors of Coronary Heart Disease in Chinese Patients with type 2 Diabetes Mellitus, 2013-2018
Authors: Wang Chenchen , Xie Zuoling , Huang Xi , Wang Zheng , Shangguan Haiyan , Wang Shaohua 
Published: July 2020

Abstract
Background: Coronary heart disease (CHD) is the most common cause of death in patients with type 2 diabetes (T2DM). We aim to estimate the prevalence of CHD and cardiovascular risk factors in Chinese diabetic inpatients.Methods: A total of 66536 diabetic inpatients from 2013 to 2018 were investigated, demographic and clinical data were gathered from 30693 patients with T2DM. The age-standardized prevalence of CHD was calculated on the basis of data from Chinese population census in 2010. Multiple imputation was used to impute missing values and logistic regression analysis was used to analyze the risk factors.Results: The crude prevalence of CHD was estimated to be 23.5% and a standardized prevalence was 13.9% (16.0% in men and 11.9% in women). More than half of diabetic patients with CHD have 4 or above of the 5 traditional risk factors, which is much higher than 38.96% of diabetic patients (p<0.01). Multivariate regression analysis showed that diabetes duration, hypertension, smoking, underweight, overweight, obesity, hypoglycemia were significantly associated with a higher risk of CHD (all p<0.05). The odds ratio of CHD in patients having 3, 4, or 5 CHD risk factors were 2.35 (95%CI 1.81- 3.04), 2.96 (95%CI 2.28- 3.85), and 5.29 (95%CI 4.04- 6.93), compared with diabetes patients without any other risk factors.Conclusions: The prevalence of CHD was rather high in Chinese T2DM inpatients, aggregation of CHD risk factors was more seriously, hierarchical CHD prevention strategies based on risk factors are needed for them.