bluuebunny/crossref_metadata_2025_split huggingface dataset:
Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico
Authors: Lazcano-Ponce Eduardo , Angeles-Llerenas Angelica , Rodríguez-Valentín Rocío , Salvador-Carulla Luis , Domínguez-Esponda Rosalinda , Astudillo-García Claudia Iveth , de León Eduardo Madrigal , Katz Gregorio 
Published: March 2020

Abstract
Background Paternalism/overprotection limits communication between the healthcare professionals and patients and does not promote shared therapeutic decisions. In developed countries, communication patterns have been regulated to promote autonomy, whereas in developing countries, they reflect the physician’s personal choice. The goal of this work was contribute to knowledge of communication patterns used in the clinical practice in Mexico, and identify the determinants that favor a low paternalist/autonomist doctor-patient relationship. Methods A self-report study of communication patterns within a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were performed to analyze paternalism and associated factors. Results A high prevalence (68.7% [95% CI 60.0-70.5) of paternalism was observed among mental healthcare professionals in Mexico. The main determinants of low paternalism/autonomism were the medical specialty (OR 1.67 [95% CI 1.16-2.40]) and the sex, whereby female physicians were more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomism (OR 12.13 [95% CI 7.71-19.05]). Finally, a modification effect of age strata on association between communication pattern or speciality and low paternalism/autonomism was observed. Conclusions Among mental healthcare professionals in Mexico, an elevated paternalism prevailed. Sex, medical specialty, and a pattern of open communication were closely associated with low paternalism/autonomism. Strengthening the competencies of health professionals and promoting explicit communication could contribute to achieving a transition towards a more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
Consumption of melatonin supplement improves cardiovascular disease risk factors and new anthropometric indices (as predictors of obesity) in type 2 diabetes mellitus patients: A double–blind, randomized, placebo-controlled trial
Authors: Bazyar Hadi , Javid Ahmad Zare , Behbahani Hossein Bavi , Moradi Fardin , Poode Bahman Moradi , Amiri Parichehr 
Published: March 2020

Abstract
Background: Diabetes mellitus is a common chronic disease. Dyslipidemia and hypertension are two complications may develop in diabetic patients if hyperglycemia, insulin resistance, and weight gain are not controlled. The objective of this study was to investigate the effects of melatonin supplementation on some cardiovascular disease risk factors and new anthropometric indices in patients with type 2 diabetes mellitus (T2DM).Materials and Methods: In this double-blind, randomized, placebo-controlled trial, 50 T2DM patients were randomly allocated to intervention and control groups. The intervention and control groups received either 2 tablets melatonin or placebo (250 mg) once a day for 8 weeks. Mean arterial pressure (MAP), pulse pressure (PP), atherogenic index of plasma (AIP), body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), lipid accumulation product (LAP), conicity index, and waist to height ratio (WHR) were evaluated in all patients pre and post-intervention.Results: Melatonin supplementation for 8 weeks significantly decreased the mean levels of MAP, PP, BAI, AVI, conicity index, and WHR post intervention (p <0.05). Also, the mean changes of MAP, PP, BAI, AVI, and Conicity index were significantly lower in the intervention group compared with the control group (p <0.05). A significant increase (p <0.001) was observed in the mean levels of ABSI in the intervention group. The mean changes of ABSI was significantly greater in the intervention group compared with the control group (p <0.001).Conclusions: Consumption of melatonin supplement may be effective in controlling arterial pressure and new anthropometric indices (as predictors of obesity) in T2DM patients.Trial registration: This trial was registered in the Iranian Registry of Clinical Trials website at 2019/5/17. (IRCT20190303042905N1).
Status of Water, Sanitation and Hygiene in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda.
Authors: Kayiwa Denis , Mugambe Richard K. , Mselle Jane Sembuche , Isunju John Bosco , Ssempebwa John C. , Wafula Solomon Tsebeni , Ndejjo Rawlance , Kansiime Winnie K , Nalugya Aisha , Wagaba Brenda , Zziwa Jude. B. , Bwire Constance , Buregyeya Esther , Radooli Martin Othieno , Kimbugwe Ceaser , Namanya Emily , Bateganya Najib Lukooya , McGriff Joanne A. , Wang Yuke , Ssekamatte Tonny , Habib Yakubu 
Published: March 2020

Abstract
Background: Improved Water, Sanitation and Hygiene (WASH) services in Health Care Facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of hospital acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improved staff morale. Despite these benefits, there is limited evidence on the status of WASH in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the status of WASH within HCFs in the GKMA in order to inform policy and WASH programming.Methods: A cross-sectional study was conducted in 60 HCFs. The status of WASH in the study facilities was assessed using a validated WASH Conditions (WASHCon) tool comprising of structured interviews, HCF observations and microbial water quality analysis. Data were analysed using Stata 14 software and R software. The relationships between WASH status and HCF characteristics were assessed using Fishers’ exact tests.Results: Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH status respectively. About 48.3% (28/58) had a limited water supply status, 84.5% (49/58) had limited sanitation status, 50.0% (29/58) had limited environmental cleanliness status, 56.9% (33/58) had limited hand hygiene status and 51.7% (30/58) had limited waste management status. Overall, there were significant differences in water supply status by ownership of the HCF and level of HCF. There was a significant statistical difference in WASH status between public and private not for profit facilities (p = 0.021). A significant difference was also observed in WASH status between hospitals and lower levels HCFs (p = 0.004). Conclusion: Majority of the HCFs in the GKMA had limited access to all WASH service domains i.e. water supply, sanitation, hand hygiene, environmental cleanliness and healthcare waste management. We recommend deliberate increased investments in WASH for healthcare services, especially for sanitation and hand hygiene provisions which were in the poorest state. Improvements in WASH conditions will not only minimize the risk of transmission of HAIs but also associated costs.
Socio-cultural and economic barriers, and facilitators influencing men’s involvement in antenatal care including HIV testing: A qualitative study from urban Blantyre, Malawi
Authors: Sakala Doreen , Kumwenda Moses K. , Conserve Donaldson F. , Ebenso Bassey , Choko Augustine Talumba 
Published: March 2020

Abstract
BackgroundMale partner involvement in antenatal care (ANC) is associated with positive maternal and neonatal outcomes. However, only a handful of men attend ANC with their partners. This study aimed to understand the underlying barriers and facilitators influencing men’s ANC attendance including HIV testing in Blantyre, Malawi.MethodsData were collected during a formative qualitative study of a cluster-randomised trial. Six focus group discussions (FGDs) with 42 men and women and 20 in-depth interviews (IDIs) were conducted at three primary health centres in urban Blantyre, Malawi. FGD participants were purposively sampled with IDI participants subsequently sampled after FGD participation. Thematic analysis was used to analyse the data.ResultsThe economic requirement to provide for their families exerted pressure on men and often negatively affected their decision to attend ANC together with their pregnant partners despite obvious benefits. Peer pressure and the fear to be seen by peers queueing for services at ANC, an environment traditionally viewed as a space for women and children made men feel treated as trespassers and with some level of hostility rendering them feeling emasculated when they attend ANC. Health system problems associated with overall organization of the ANC services, which favours women created resistance among men to be involved. An association between ANC and HIV testing services discouraged men from attending ANC because of their fear of testing HIV-positive in the presence of their partners. The availability of a male friendly clinic offering a private, quick, supportive/sensitive and flexible service was considered to be an important incentive that would facilitate male men’s ANC attendance. Men described compensation to cover transport and opportunity cost for attending the clinic as a motivator to attending ANC services and accepting an HIV test. ConclusionPeer and economic influences were the most influential barriers of men attending ANC and testing for HIV with their pregnant partners. Addressing these socio-economic barriers and having a male friendly clinic are promising interventions to promote male ANC attendance in this setting.
Locally implemented prevention programs may reverse weight trajectories in half of children with overweight/obesity amid low child-staff ratios: Results from a four-year prospective study in France
Authors: Constant Aymery , Boulic Gaëlle , Lommez Agnes , Chaillou Raphaëlle , Guy-Grand Bernard , Raffin Sandrine 
Published: March 2020

Abstract
Background The aim of the present study was to prospectively assess 4-year changes in the weight status of children between school-based prevention programs locally implemented in French municipalities with the same organizational support, and focused on experiential learning interventions promoting healthy eating and physical activity. Methods Using a body mass index chart established by the International Obesity Task Force, school nurses assessed first-grade children for weight status (normal, overweight, obesity) several weeks before the launch of each program in 2011, and 4 years later, together with the BMI z-score measuring overweight/obesity severity. Child-staff ratios (CSRs) by occupation (canteen seervice/extracurriculars) and training session (healthy eating/physical activity) were computed in each municipality. Results During the 4-year follow-up period, weight status improved in half of the children with overweight/obesity, and worsened in 6.6% of children with over/normal weight. In children who remained overweight, the BMI z-score diminished over time. Estimates of the positive 4-year weight change increased with age and were significantly higher in low-to-moderate CSR multicomponent programs ( City3 and City4 ) compared to moderate CSR single-intervention programs (reference: City1 ). The high-to-moderate CSR multicomponent program ( City2 ) had a similar effect as the reference. The estimated negative weight change decreased with age. Conclusions Training ancillary school staff to experiential-focused interventions for healthy eating and physical activity in locally implemented school-based programs contributed positively to preventing childhood obesity without interfering with educational activities. However, low CSRs seem to be pivotal for optimal outcomes, especially in schools in deprived areas.
Noninfectious mixed cryoglobulinaemic glomerulonephritis associated with monoclonal gammopathy of undetermined significance
Authors: Flavell Adam , Fullinfaw Robert , Smith Edward R , Holt Steve , Finlay Moira , Barbour Thomas 
Published: March 2020

Abstract
Background

Cryoglobulins are cold-precipitable immunoglobulins that may be found in association with systemic vasculitis including cryoglobulinaemic glomerulonephritis (CGN). Type 1 cryoglobulins consist of isolated monoclonal immunoglobulin (mIg), whereas mixed cryoglobulins are typically immune complexes comprising either monoclonal (type 2) or polyclonal (type 3) Ig with rheumatoid activity against polyclonal IgG. Only CGN related to type 1 cryoglobulins has been clearly associated with monoclonal gammopathy of undetermined significance (MGUS) using the conventional serum-, urine- or tissue-based methods of paraprotein detection.

Methods

We retrospectively assessed our patient cohort of CGN related to mixed (type 2 or 3) cryoglobulins for those with a monoclonal band on serum protein electrophoresis (SPEP), with exclusion of infectious cases and those involving malignant clonal plasma cell or B cell disorders.

Results

We identified four patients with a median age of 54 years, including three women. Two patients had type 2 cryoglobulinaemia, one had type 3 cryoglobulinaemia, and one lacked definitive typing of the serum cryoprecipitate. The serum monoclonal band identified on SPEP was IgM-κ in all four cases. Treatments included corticosteroids, cyclophosphamide, plasma exchange, and rituximab. At median 3.5 years’ follow-up, no patient had developed a haematological malignancy or advanced chronic kidney disease. Other potential causes of mixed cryoglobulinaemia were also present in our cohort, notably primary Sjögren’s syndrome in three cases.

Conclusions

Our study raises questions regarding the attribution of causation to MGUS, and the role of clonally directed therapies outside the setting of haematological malignancy.
Contemporary pressures on school-based research: A cautionary tale for school leaders
Authors: Smith Megan , Thrupp Martin , Barrett Patrick 
Published: March 2020

Abstract
School-based research has historically played an important role within the education system contributing to our understanding of the organisation and practice of formal education. Supported by relevant literature, this article reports on current challenges in conducting school-based research in Aotearoa New Zealand as experienced by one researcher. It suggests that conducting school-based research is becoming increasingly difficult, with possible explanations for this being the divergent workflows of researcher and school-based participant(s), the volume of demands on teachers and schools, and restricted roles for teachers and parents, which increase the risk of research fatigue. The article argues that although school-based research is rarely an immediate priority for school leaders, it is imperative that they support it if they want to be informed by its insights for policy and practice.
Prediction of flow-control devices' noise with modified acoustic perturbation equations
Authors: Fenini Luca , Malavasi Stefano 
Published: March 2020

Abstract
Fluid-dynamic noise emissions produced by flow-control devices inside ducts are a concerning issue for valve manufacturers and pipeline management. This work proposes a modified formulation of Acoustic Perturbation Equations (APE) that is applicable to industrial frameworks where the interest is addressed to noise prediction according to international standards. This formulation is derived from a literature APE system removing two terms allowing for a computational time reduction of about 20%. The physical contribution of the removed terms is discussed according to the literature. The modified APE are applied to the prediction of the noise emitted by an orifice. The reliability of the new APE system is evaluated by comparing the Sound Pressure Level (SPL) and the acoustic pressure with the ones returned by LES and literature APE. The new formulation agrees with the other methods far from the orifice: moving over nine diameters downstream of the trailing edge, the SPL is in accordance with the other models. Since international standards characterize control devices with the noise measured 1 m downstream of them, the modified APE formulation provides reliable and faster noise prediction for those devices with outlet diameter, d, such that 9d &lt; 1 m.
Drinking water quality and consumer perceptions at the point-of-use in San Rafael Las Flores, Guatemala
Authors: Marcillo C. E. , García Prado G. , Copeland N. , Krometis L. H. 
Published: March 2020

Abstract
Limited information is available describing point-of-use (POU) water quality in rural Guatemala. Source water quality in eastern Guatemala is of concern given underlying volcanic geology that can leach arsenic and the presence of large-scale mining, which can potentially exacerbate exposure. On-premise piped POU water in the rural community of San Rafael las Flores was sampled in 31 households to characterize a suite of metallic ions and E. coli, along with a survey of water uses and perceptions. Samples were analyzed via standard laboratory methods in the United States and an arsenic quick kit in the field. Fourteen household samples contained arsenic &gt;9 μg/L and 13% of households exceeded at least one Guatemalan and US health-based water quality standard. Survey results revealed widespread dissatisfaction with water quality and service: most participants did not drink their POU water, fearing illness, and instead purchased bottled water or collected from untreated springs. Ideally, establishment of baseline water quality and an understanding of local concerns will facilitate collaborative partnerships and interventions that build community trust in appropriate water infrastructure while identifying surrounding land use impacts. This work represents the first Guatemalan study that quantifies POU contamination while concurrently examining user perceptions, preferences, and concerns.
Phytochemical and Pharmacological Insight on Sesamol: An Updated Review
Authors: Singh Namrata , Kushwaha Poonam , Gupta Amresh , Prakash Om , Swarup Shivam , Usmani Shazia 
Published: March 2020

Background:
Nowadays, sesamol has emerged as an effective adjuvant therapeutic
agent in the anticipation and therapy of various diseases. Sesamol, a natural phenolic compound is
a major lignan isolated from the seeds of Sesamum indicum and sesame oil. Sesame oil is well
known for its nutritional as well as their health-promoting properties.

Methods:
Several studies revealed that sesamol possesses significant antifungal, anti-inflammatory,
antioxidant, and free radical scavenging, anticancer, neuroprotective, cardioprotective, antiaging,
hepatoprotective and antidiabetic activity, etc.

Results:
The present review highlights the potential of sesamol as a novel medicinal agent for the
treatment of numerous types of ailment.

Conclusion:
This review article also provides a brief idea about its uses, ethnomedicinally and
commercially important analytical techniques, and its pharmacological activities.
Melatonin a Promising Candidate for DNA Double-Stranded Breaks Reduction in Patients Undergoing Abdomen-Pelvis Computed Tomography Examinations
Authors: Eskandari Ali , Mahmoudzadeh Aziz , Shirazi Alireza , Esmaely Farid , Carnovale Carla , Cheki Mohsen 
Published: March 2020

Background and Objective:
Cancer incidence is 24% higher in children and young adults exposed to
Computed Tomography (CT) scans than those unexposed. Non-repairing of ionizing radiation-induced DNA
Double-Strand Breaks (DSBs) can initiate carcinogenesis. In the present study, we aimed to investigate the
radioprotective potential of melatonin against DSBs in peripheral blood lymphocytes of patients undergoing
abdomen-pelvis CT examinations.

Methods:
This double-blind, placebo-controlled clinical trial was conducted on thirty patients. These patients
were divided into two groups; group one (control) patients who have undergone the CT examination received a
single oral dose of placebo, while in group two, patients received a single oral dose of 100mg melatonin. In both
the groups, blood samples were collected 5-10min before and 30 minutes after the CT examination. The
lymphocytes from these samples were isolated and DSBs were analyzed using γH2AX immunofluorescence
microscopy.

Results:
Compared to the control group, the use of melatonin 1h before the CT examination caused a significant
reduction in γH2AX-foci, indicating a reduction in DSBs. In addition, no side effect was observed in patients
following 100mg melatonin administration.

Conclusion:
For the first time, this study has shown that melatonin has protective effects against radiationinduced
genotoxicity in peripheral blood lymphocytes of patients undergoing abdomen-pelvis CT examinations.
Therefore, melatonin can be considered as a promising candidate for reducing DSBs in patients undergoing
abdomen-pelvis CT examinations.
A Multiview Model for Detecting the Inappropriate Use of Prescription Medication: Machine Learning Approach
Authors: Zhuo Lin , Cheng Yinchu , Liu Shaoqin , Yang Yu , Tang Shuang , Zhen Jiancun , Zhao Junfeng , Zhan Siyan 
Published: March 2020

Background
The inappropriate use of prescription medication has recently garnered worldwide attention, but most national policies do not effectively provide for early detection or timely intervention.

Objective
This study aimed to develop and assess the validity of a model that can detect the inappropriate use of prescription medication. This effort combines a multiview and topic matching method. The study also assessed the validity of this approach.

Methods
A multiview extension of the latent Dirichlet allocation algorithm for topic modeling was chosen to generate diagnosis-medication topics, with data obtained from the Chinese Monitoring Network for Rational Use of Drugs (CMNRUD) database. Topic mapping allowed for calculating the degree to which diagnoses and medications were similarly distributed and, by setting a threshold, for identifying prescription misuse. The Beijing Regional Prescription Review Database (BRPRD) database was used as the gold standard to assess the model’s validity. We also conducted a sensitivity analysis using random samples of validated prescriptions and evaluated the model’s performance.

Results
A total of 44 million prescriptions were used to generate topics using the diagnoses and medications from the CMNRUD database. A random sample (15,000 prescriptions) from the BRPRD was used for validation, and it was found that the model had a sensitivity of 81.8%, specificity of 47.4%, positive-predictive value of 14.5%, and negative-predictive value of 96.0%. The model showed superior stability under different sampling proportions.

Conclusions
A method that combines multiview topic modeling and topic matching can detect the inappropriate use of prescription medication. This model, which has mediocre specificity and moderate sensitivity, can be used as a primary screening tool and will likely complement and improve the process of manually reviewing prescriptions.