bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between performance on the progress test and selection for medical residency
Authors: Ferreira Ricardo Correa , Velho Paulo Eduardo Neves Ferreira , Bicudo Angélica Maria , Passeri Silvia Maria Riceto Ronchim 
Published: October 2019

Abstract
Background: The Progress Test (PT) is a formative evaluation used to analyze student progress throughout medical undergraduate studies. Further, classificatory summative assessments are carried out by graduates of medical programs worldwide, either to acquire a practicing license or to obtain a vacancy in the Medical Residency (MR) selection processes. We aimed to identify whether PT performance is related to performance in the MR selection process.

Methods: Physicians who attended and graduated from a public university in the state of São Paulo, Brazil, between 2011 and 2014 were assessed on the basis of voluntary participation in the PTs throughout their undergraduate program, performance in the PT in their last year, performance in the multiple-choice test of MR, convocation in the first classificatory list, and approval for the MR selection. Descriptive statistics and comparison of scores were performed using student’s t-test for independent and paired samples and the Pearson correlation coefficient.

Results: Of the 424 students, 374 participated in the PTs throughout their undergraduate program and in the MR selection process. These graduates performed better in the PT than the 22 who did not go on to MR (p < 0.05). Students who participated in all the PTs throughout their undergraduate program demonstrated superior performance in MR than those 22 who did not participate regularly (p < 0.0001). Among the 374 trainees, the average performance level for the PT was lower than that for their multiple-choice test for MR, both overall (p < 0.05) and separately by year (p < 0.0001); moreover, there was a strong correlation between PT performance and performance on the multiple-choice test. There was greater approval in MR among graduates whose mean score on the multiple-choice test was above that in the PT (p < 0.0001).

Conclusions: PT performance was related to performance in the MR selection process for the study period; there was a strong correlation between student performance in the PT and the multiple-choice test in MR. Students with multiple-choice test results for MR that were below the average performance level in the PT were less frequently approved in the MR selection process.
Satisfaction With Use Of Public Health And Peer-Led Facilities For Hiv Prevention Services By Key Populations In Nigeria
Authors: Ochonye Bartholomew , Folayan Morenike Oluwatoyin , Fatusi Adesegun O , Emmanuel Godwin , Adepoju Tomi , Ajidagba Babatunde , Jaiyebo Toluwanimi , Umoh Paul , Yusuf Ayo 
Published: October 2019

Abstract
Background: The aim of the study was to identify the proportion of female sex workers, men who have sex with men, and people who inject drugs who had accessed HIV prevention services at public health facilities and peer-led facilities, their level of satisfaction with these services, and perceived barriers and challenges to accessing HIV services from public and peer-led HIV prevention service providers.
Methods: A mixed-method approach was used to collect data from key populations in the four states in Nigeria. Quantitative data collected included level of satisfaction with and barriers to use of public and peer-led facilities. In-depth interviews and focus-group discussions were conducted to explore reasons for satisfaction with and barriers to use of services. Descriptive and bivariate analyses were was conducted for quantitative data. Qualitative data were summaried, emerging themes identified, described and quotes reflecting the themes corresponding to interview questions highlighted
Results: Nine hundred sixty-seven persons responded to questions on the use of public health or/and peer-led facilities. Two hundred thirty-eight (49.4%) respondents had received HIV and sexual and reproductive health services through public health facilities, and 236 (48.7%) had received the services through peer-led facilities. Significantly more respondents were satisfied with the quality of services provided by peer-led organisations than with public health facilities with respect to service providers listening to respondent’s problems and concerns (p=0.007),privacy and confidentiality (p=0.04) and respect of rights of service recipients (p=0.04). Significantly more respondents using peer-led organisations than those using public health facilities identified no barriers to service access (p=0.003). More respondents using public health facilities than peer-led facilities identified cost of services (p=0.01), confidentiality (p=0.002), waiting time (p<0.01) and staff attitude (p=0.001) as barriers to service access. Thee was no difference in the proportion of respondents willing to discontinue their use of either facilities (p=0.08). Qualitative data revealed that concerns with access of services at the public health facility were due mainly to stigma and the effects of the same-sex prohibition law.
Conclusion: Key populations were more satisfied receiving HIV prevention services at peer-led organisations than at public health facilities.
Influence of CMTM8 polymorphisms on Lung cancer susceptibility in the Chinese Han population
Authors: Wu Jiamin , Sun Yao , Xiong Zichao , Niu Fanglin , Liu Yuanwei , Li Haiyue , Liu Jianfeng , Liu Qiufang , jin tianbo 
Published: October 2019

Abstract
Abstract
Background: Lung cancer is the leading cause of cancer-related mortality worldwide and CMTM8 is a potential tumor suppressor gene, which is down-regulated in lung cancer. The objective of this research was to assess the association of CMTM8 genetic polymorphisms with lung cancer risk in Chinese Han population.
Methods: To evaluate the correlation between CMTM8 polymorphisms and lung cancer risk, Agena MassArray platform was used for genotype determination among 509 lung cancer patients and 506 controls. Multiple genetic models, stratification analysis and haploview analysis were used by calculating odds ratio (OR) and 95% confidence intervals (CIs).
Results: Significant associations were detected between CMTM8 rs6771238 and an increased lung cancer risk (p < 0.05). In stratified analysis, rs6771238 was related to an increased risk of lung squamous cell carcinoma (p < 0.05), rs6771238 was associated with an increased risk of lung adenocarcinoma (p < 0.05), rs9835916 and rs1077868 were correlated with lung cancer staging (p < 0.05), and rs9835916 was correlated with an increased risk of lymph node metastasis in lung cancer patients (p < 0.05). Additionally, Haplotype analysis illuminated that haplotypes GG and AG were closely correlated with lung cancer staging, and haplotype AG was correlated with an increased lung cancer risk among individuals older than 50 years (p < 0.05).
Conclusions: Our study firstiy reported that the CMTM8 polymorphisms were risk factors for lung cancer in Chinese Han population. These findings also suggested the potential roles of CMTM8 in the development of lung cancer.
Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates with focus on antimicrobial resistance
Authors: Yu Xiaoling , Zhang Wen , Zhao Zhiping , Ye Chengsong , Zhou Shuyan , Wu Shaogui , Han Lifen , Han Zhaofang , YE HANHUI 
Published: October 2019

Abstract
Ba ckgrou nd The enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 is the motivation behind this investigation to study gene phenotypes and resistance-associated genes of emergence regarding the CRKP strains. In current study, seven inpatients are enrolled in the hospital with complete treatments. The carbapenem-resistant K. pneumoniae whole genome is sequenced using MiSeq short-read and Oxford Nanopore long-read sequencing technology. Prophages are identified to assess genetic diversity within CRKP genomes. Results The investigation encompassed eight CRKP strains that collected from the patients enrolled as well as the environment, which illustrate that bla KPC-2 is responsible for phenotypic resistance in six CRKP strains that K . pneumoniae sequence type (ST11) is informed. The plasmid with IncR, ColRNAI and pMLST type with IncF[F33:A-:B-] co-exist in all ST11 with KPC-2-producing CRKP strains. Along with carbapenemases, all K. pneumoniae strains harbor two or three extended spectrum β-lactamase (ESBL)-producing genes. f osA gene is detected amongst all the CRKP strains. The single nucleotide polymorphisms (SNP) markers are indicated and validated among all CRKP strains, providing valuable clues for distinguishing carbapenem-resistant strains from conventional K. pneumoniae . Co nclusions ST11 is the main CRKP type, and bla KPC-2 is the dominant carbapenemase gene harbored by clinical CRKP isolates from current investigations. The SNP markers detected would be helpful for characterizing CRKP strain from general K. pneumoniae. The data provides insights into effective strategy developments for controlling CRKP and nosocomial infection reductions.
Predicting prognosis according to preoperative chemotherapy response in patients with locally advanced lower rectal cancer
Authors: Shiraishi Takuya , Sasaki Takeshi , Ikeda Koji , Tsukada Yuichiro , Nishizawa Yuji , Ito Masaaki 
Published: October 2019

Abstract
Background: Neoadjuvant chemoradiotherapy is regarded as the standard of treatment for locally advanced lower rectal cancer, although some of these cases are systemic, and distant control may be inadequate. Neoadjuvant chemotherapy could compensate for such shortcomings, potentially yielding better survival outcomes. We aimed to stratify patients into prognostic groups on the basis of preoperative factors, including response to neoadjuvant chemotherapy.
Methods: We retrospectively analyzed patients with locally advanced lower rectal adenocarcinoma (clinical stage II/III with high-risk features of distant metastasis) who were treated with neoadjuvant chemotherapy (without radiotherapy) followed by curative resection between 2010 and 2017. Reduction in tumor volume (before vs. after neoadjuvant chemotherapy) was measured using magnetic resonance imaging, and a reduction above 60% was defined as a good response. Recurrence and overall survival were evaluated.
Results: The cohort comprised 102 patients. Good response to neoadjuvant chemotherapy was associated with better 5-year recurrence-free survival (good responders: 81.1%, poor responders: 49.0%; p =0.001) and 5-year overall survival (good responders: 94.9%, poor responders: 80.6%; p =0.06). In a multivariate analysis, extramural venous invasion on magnetic resonance imaging after neoadjuvant chemotherapy and a tumor volume reduction rate <60 were found to be significantly and independently associated with worse recurrence-free survival (hazard ratio: 2.74, 95% confidence interval: 1.36–5.50, p =0.005 and hazard ratio: 3.48, 95% confidence interval: 1.57–7.72, p =0.002, respectively). Good responders without extramural venous invasion had the best 5-year recurrence-free and overall survival (89.0% and 93.8%, respectively). Poor responders with extramural venous invasion had the worst 5-year recurrence-free and overall survival (21.4% and 50.0%, respectively).
Conclusions: Reductions in tumor volume after neoadjuvant chemotherapy were associated with a better prognosis in patients with locally advanced lower rectal cancer. Extramural venous invasion was a preoperative prognostic factor.
Prolotherapy injections and physiotherapy used singly and in combination for lateral epicondylalgia: A single-blinded randomised clinical trial.
Authors: Yelland Michael , Rabago David , Ryan Michael , Ng Shu-Kay , Vithanachchi Dinusha , Manickaraj Nagarajan , Bisset Leanne 
Published: October 2019

Abstract
Background

Lateral epicondylalgia (tennis elbow) is a common, debilitating and often treatment-resistant condition. Two treatments thought to address the pathology of lateral epicondylalgia are hypertonic glucose plus lignocaine injections (prolotherapy) and a physiotherapist guided manual therapy/exercise program (physiotherapy). This trial aimed to compare the short- and long-term clinical effectiveness, cost effectiveness, and safety of prolotherapy used singly and in combination with physiotherapy.

Methods

Using a single-blinded randomised clinical trial design, 120 participants with lateral epicondylalgia of at least six weeks’ duration were randomly assigned to prolotherapy (4 sessions, monthly intervals), physiotherapy (weekly for 4 sessions) or combined (prolotherapy+physiotherapy). The Patient-Rated Tennis Elbow Evaluation (PRTEE) and participant global impression of change scores were assessed by blinded evaluators at baseline, 6, 12, 26 and 52 weeks. Success rate was defined as the percentage of participants indicating elbow condition was either 'much improved' or 'completely recovered.’ Analysis was by intention-to-treat.

Results

88% completed the 12-month assessment. At 52 weeks, there were substantial, significant improvements compared with baseline status for all outcomes and groups, but no significant differences between groups. The physiotherapy group exhibited greater reductions in PRTEE at 12 weeks than the prolotherapy group (p = 0.014).

Conclusion

There were no significant differences amongst the Physiotherapy, Prolotherapy and Combined groups in PRTEE and global impression of change measures over the course of the 12-month trial.
Prescreening of Patient-reported Symptoms using the Edmonton Symptom Assessment System (ESAS) in Outpatient Palliative Cancer Care
Authors: Lee Garden , Kim Han Sang , Lee Si Won , Kim Eun Hwa , Lee Bori , Hu Youn Jung , Kang Beodeul , Choi Hye Jin 
Published: October 2019

Abstract
Background: Although early palliative care is associated with a better quality of life and improved outcomes in end-of-life cancer care, the criteria of palliative care referral are still elusive. Methods: We collected patient-reported symptoms using the Edmonton Symptom Assessment System (ESAS) at the baseline, first, and second follow-up visit. The ESAS evaluates ten symptoms: pain, fatigue, nausea, depression, anxiety, drowsiness, dyspnea, sleep disorder, appetite, and wellbeing. A total of 71 patients were evaluable, with a median age of 65 years, male (62%), and the Eastern Cooperative Oncology Group (ECOG) performance status distribution of 1/2/3 (28%/39%/33%), respectively. Results: Twenty (28%) patients had moderate/severe symptom burden with the mean ESAS ≥5. Interestingly, most of the patients with moderate/severe symptom burdens (ESAS ≥5) had globally elevated symptom expression. While the mean ESAS score was maintained in patients with mild symptom burden (ESAS<5; 2.7 at the baseline; 3.4 at the first follow-up; 3.0 at the second follow-up; P =0.117), there was significant symptom improvement in patients with moderate/severe symptom burden (ESAS≥5; 6.5 at the baseline; 4.5 at the first follow-up; 3.6 at the second follow-up; P <0.001). Conclusions: Advanced cancer patients with ESAS ≥5 may benefit from outpatient palliative cancer care. Prescreening of patient-reported symptoms using ESAS can be useful for identifying unmet palliative care needs in advanced cancer patients.
Prevalence of dental caries and oral health related quality of life among preschool children aged 4-6 years in Kisarawe, Tanzania.
Authors: Masumo Ray Mrisho , Ndekero Tumaini S. , Carneiro Lorna C. 
Published: October 2019

Abstract
Background Preschool years are a critical period in the development of a healthy child. The consequences of poor oral health in preschool children reach beyond dental problems, with oral health-related quality of life (OHRQoL) being associated with overall systematic health as well as one’s quality of life. The purpose of this study was to explore the level to which dental caries impacts the OHRQoL in a sample of preschooler children in Kisarawe.Methods A cross-sectional based study was conducted in 2017. A total of 1,106 preschool children completed a face-to-face interview, using a translated Kiswahili version of the Michigan Oral Health-related Quality of Life Scale–Child Version (2003), and underwent clinical oral examination using WHO (1997) criteria.Results The decayed component was the most prevalent (dft = 2.08) and the Significant Caries Index (SiC) was 5.54 double of the (dft), showing polarization of dental caries in the studied population. After adjusting for appropriate covariates, preschool children of age 5 and 6 years old were more likely to have decayed tooth [Adjusted OR = 3.02, (95% CI =2.01-4.54)] and [Adjusted OR=2.23, (95% CI= 1.55-3.20)] respectively. Preschool children without visible plaque on the buccal surface of upper anterior teeth were less likely to have decayed teeth [Adjusted OR=0.21, (95% CI=0.09-0.45)]. Regarding measurements of oral health-related quality of life using the MOHRQoL, only preschool children who reported on ‘does your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth [Adjusted OR=1.74, (95% CI=1.12-2.71)] and [Adjusted OR=1.87, (95% CI=1.11-3.15)], respectful.Conclusion The findings suggest that dental caries, affecting a significant portion of preschoolers, was associated with both poor oral hygiene and the age of the child. The MOHRQoL appear to be able to discriminate between groups, and preschool children of 4-6 years of age are reliable informants to answer the MOHRQoL in this group of Tanzanian children.
Adaptation and validation of a questionnaire measuring knowledge, awareness and practice regarding familial hypercholesterolaemia among primary care physicians in Malaysia
Authors: Azraii Ahmad Baihaqi , Ramli Anis Safura , Ismail Zaliha , Abdul-Razak Suraya , Badlishah-Sham Siti Fatimah , Mohd-Kasim Noor Alicezah , Ali Norsiah , Watts Gerald F , Nawawi Hapizah 
Published: October 2019

Abstract
Background: Primary care physicians (PCP) play an important role in early detection of Familial Hypercholesterolaemia (FH). However, knowledge, awareness and practice (KAP) regarding FH among Malaysian PCP are not well established, and there was no validated tool to assess their FH KAP. Therefore, this study aimed to adapt an FH KAP questionnaire and to determine its validity and reliability among Malaysian PCP. Methods: This cross-sectional validation study involved PCP with ≥1-year working experience in the Malaysian primary care settings. In Phase 1, the original 19-item FH KAP questionnaire was content validated and adapted by 7 experts. The questionnaire was then converted into an online survey instrument and was face validated by 10 PCP. In Phase 2, the adapted questionnaire was distributed via e-mail to 1500 PCP for self-administration. Data were collected on their KAP, demography, qualification and work experience. The construct validity was tested using known-groups validation method. PCP with postgraduate qualification (PCP-PG-Qual) were hypothesized to have better FH KAP compared with PCP without postgraduate qualification (PCP-noPG-Qual). The internal consistency reliability was tested using Kuder Richardson formula-20 (KR-20) and test-retest reliability was tested on 26 PCP using kappa statistics. Results: During content validation and adaptation, 10 items remained unchanged, 8 items were modified, 1 item was moved to demography and 7 items were added. The adapted questionnaire contained 25 items (11 knowledge, 5 awareness and 9 practice items). A total of 130 out of 1500 PCP (response rate: 8.7%) completed the questionnaire. The mean percentage knowledge score was significantly higher in PCP-PG-Qual compared to PCP-noPG-Qual (53.5, SD±13.9 vs. 35.9, SD±11.79), t(128)=6.90, p<0.001. The median percentage awareness score was significantly higher in PCP-PG-Qual compared to PCP-noPG-Qual (15.4, IqR±23.08 vs. 7.7, IqR±15.38), p=0.030. The mean percentage practice score was significantly higher in PCP-PG-Qual compared to PCP-noPG-Qual (69.2, SD±17.62 vs. 54.4, SD±19.28), t(128)=3.79, p<0.001. The KR-20 was 0.79 (moderate reliability) and average Kappa was 0.796 (substantial agreement). Conclusion: The robust validation methods and findings suggest that the adapted 25-item questionnaire is a valid and reliable tool to measure FH KAP among Malaysian PCP. This would aid to improve FH care in the community.
Molecular evolution of GDP-L-galactose phosphorylase (GGP), a key regulatory gene in plant ascorbate biosynthesis
Authors: Tao Junjie , Hao Zhuan , Huang Chunhui 
Published: October 2019

Abstract
Background Ascorbic acid (AsA) is a multi-functional molecule and plays essential roles in maintaining the normal life activities of living organisms. Although widely present in plants, the concentration of AsA varies greatly in different plant species. The GDP-L-galactose phosphorylase (GGP) is a key regulatory gene in plant AsA biosynthesis that can regulate the concentration of AsA at the transcriptional and translational levels. The function and regulation mechanisms of GGP have been well understood in previous works. However, the molecular evolutionary patterns of the gene remain unclear.Results In this study, a total of 149 homologous sequences of GGP were sampled from 71 plant species covering the major groups of Viridiplantae, including angiosperms, gymnosperms, lycophytes, bryophytes and chlorophytes, and their phylogenetic relationships, gene duplication and molecular evolution analyses were investigated. Phylogenetic analysis showed that GGP exists widely in various plants, and five major duplication events and several taxon-specific duplications were found, which led to the rapid expansion of GGP genes in seed plants, especially in angiosperms. The structure of GGP genes were more conserved in land plants, but varied greatly in green algae, indicating that GGP may have undergone great differentiation in the early stages of plant evolution. Most GGP proteins have a conserved motif arrangement and composition, suggesting that plant GGPs have similar catalytic functions. Molecular evolutionary analyses showed that plant GGP genes was predominated by strong purifying selection, indicating the functional importance and conservativeness of plant GGP genes during evolution. Most of the branches under positive selection identified by branch-site model were mainly in the chlorophytes lineage, indicating the evolutionary innovation of GGP genes also mainly occurred in the early stages of plant evolution and episodic diversifying selection contributed to the evolution of plant GGP genes.Conclusions The molecular evolutionary patterns of GGP were first systematically explored in this study. The conservative function of GGP and its rapid expansion in angiosperms may be one of the reasons for the increase of AsA content in angiosperms, enabling angiosperms to adapt to changing environments.