bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of residents’ assessments of their postgraduate medical education learning environment: an observational study
Authors: Brand Paul L P , Rosingh H Jeroen , Meijssen Maarten A C , Nijholt Ingrid M , Dünnwald Saskia , Prins Jelle , Schönrock-Adema Johanna 
Published: November 2019

Abstract
Background. Even in anonymous evaluations of a postgraduate medical education (PGME) program, residents may be reluctant to provide an honest evaluation of their PGME program, because they fear embarrassment or repercussions from their supervisors if their anonymity as a respondent is endangered. This study was set up to test the hypothesis that current residents in a PGME program provide more positive evaluations of their PGME program than residents having completed it. We therefore compared PGME learning environment evaluations of current residents in the program to leaving residents having completed it.

Methods. This observational study used data gathered routinely in the quality cycle of PGME programs at two Dutch teaching hospitals to test our hypothesis. At both hospitals, all current PGME residents are requested to complete the Scan of Postgraduate Education Environment Domains (SPEED) annually. Residents leaving the hospital after completion of the PGME program are also asked to complete the SPEED after an exit interview with the hospital’s independent residency coordinator. All SPEED evaluations are collected and analysed anonymously. We compared the residents’ grades (on a continuous scale ranging from 0 (poor) to 10 (excellent)) on the three SPEED domains (content, atmosphere, and organization of the program) and their mean (overall department grade) between current and leaving residents.

Results. Mean (SD) overall SPEED department grades were 8.00 (0.52) for 287 current residents in 39 PGME programs and 8.07 (0.48) for 170 leaving residents in 39 programs. Neither the overall SPEED department grades (t test, p=0.53, 95% CI for difference -0.16 to 0.31) nor the department SPEED domain grades (MANOVA, F(3, 62)=0.79, p=0.51) were significantly different between current and leaving residents.

Conclusions. Residents leaving the program did not provide more critical evaluations of their PGME learning environment than current residents in the program. This suggests that current residents’ evaluations of their postgraduate learning environment were not affected by social desirability bias or fear of repercussions from faculty.
Cord blood acrylamide levels and birth size, and interactions with genetic variants in acrylamide-metabolizing genes
Authors: Hogervorst Janneke , Vesper Hubert W. , Madhloum Narjes , Gyselaers Wilfried , Nawrot Tim 
Published: November 2019

Abstract
Background Up to now, 3 epidemiological studies have shown clear inverse associations between prenatal acrylamide exposure and birth size. In addition to studying the association between acrylamide and birth size, we investigated the interaction between acrylamide and polymorphisms in acrylamide-metabolising genes, with the aim of probing the causality of the inverse relationship between acrylamide and fetal growth. Methods We investigated the association between prenatal acrylamide exposure (acrylamide and glycidamide to hemoglobin adduct levels (AA-Hb and GA-Hb) in cord blood) and birth weight, length and head circumference in 443 newborns of the ENVIRONAGE (ENVIRonmental influence ON AGEing in early life) birth cohort. In addition, we studied interaction with single nucleotide polymorphism (SNPs) in CYP2E1, EPHX1 and GSTP1, using multiple linear regression analysis. Results Compared to neonates in the lowest quartile of AA-Hb in cord blood, the body weight, length and head circumference of neonates in the highest quartile were -101 grams (95% CI: -208, 7; p for trend = 0.12), -0.13 centimetres (95% CI: -0.62, 0.36; p for trend = 0.69) and -0.41 centimetres (-0.80, -0.01; p for trend = 0.06) lower, respectively. For GA-Hb, the corresponding effect estimates were -222 grams (95% CI: -337, -108; p for trend = 0.001), -0.85 (95% CI: -1.38, -0.33; p for trend = 0.02) and -0.55 (95% CI: -0.98, -0.11; p for trend = 0.01), respectively. The associations for GA-Hb were similar or stronger in newborns of non-smoking mothers. There was no statistically significant interaction between acrylamide exposure and the studied genetic variations but there was a trend of stronger inverse associations with birth weight and head circumference among newborns with homozygous wildtypes alleles for the CYP2E1 SNPS and with variant alleles for a GSTP1 SNP (rs1138272). Conclusions Prenatal dietary acrylamide exposure, specifically in the form of its metabolite glycidamide, was inversely associated with birth weight, length and head circumference. The interaction pattern with SNPs in CYP2E1, although not statistically significant, is an indication for the causality of this association. Other studies are needed to corroborate this finding.
Perfluoroalkyl Substances Exposure in Early Pregnancy and Preterm Birth in Singleton Pregnancies: A Prospective Cohort Study
Authors: Huo Xiaona , Zhang Lin , Huang Rong , Feng Liping , Wang Weiye , Zhang Jun 
Published: November 2019

Abstract
Background: Preterm birth (PTB, < 37 completed weeks’ gestation) is one of the global public health concerns. Epidemiologic evidence on the potential impact of perfluoroalkyl substances (PFAS) on PTB is still limited and inconsistent. We aimed to investigate the associations between prenatal PFAS exposure and PTB among singleton live births. Methods: We studied 2849 mother-infant pairs in the Shanghai Birth Cohort (SBC) from 2013 to 2016. Ten PFAS in maternal plasma in early pregnancy were measured. Primary outcomes were duration of gestation, PTB, spontaneous PTB and clinically indicated PTB. A linear regression model was used to assess the associations between ln-transformed PFAS and duration of gestation (weeks). A logistic regression model was applied to estimate the risks of these outcomes within a ln-transformed continuous PFAS concentrations and across non-transformed quartiles of PFAS concentrations. A Cox proportional hazards model was also used to examine the associations by treating PFAS as continuous ln-transformed variables. Results: The incidence of overall PTB was 4.8% (95% confidence limit: 4.0% - 5.6%) in this study population. In the linear logistic regression analyses, PFAS were not associated with duration of gestation after controlling for potential confounders. In the multiple logistic model and Cox model analyses, no significant associations were observed between PFAS and overall PTB, spontaneous PTB or indicated PTB. Conclusion: Our prospective cohort study shows that maternal plasma PFAS concentrations in early pregnancy was not associated with gestational length, overall PTB, spontaneous PTB or indicated PTB.
Povidone-iodine-alcohol is superior to chlorhexidine-alcohol in its antimicrobial efficacy on the anaerobic microbial flora in surgical skin preparation of the shoulder region
Authors: Dörfel Dorothea , Daeschlein Georg , Maiwald Matthias , Müller Gerald , Hudek Robert , Assadian Ojan , Kampf Günter , Kohlmann Thomas , Harnoss Julian Camill , Kramer Axel 
Published: November 2019

Abstract
Background: Cutibacterium acnes is part of the anaerobic skin microbiome and resides in deeper skin layers. The organism is an important agent of surgical site infections (SSI), particularly in shoulder surgery, and is difficult to target with skin antisepsis. We hypothesized that prolonged preparation with an agent that penetrates deeper into the skin is more effective in shoulder surgery. Thus, we compared two different classes of antiseptics, each combined with alcohol, and each applied with two different contact times. Methods: Shoulders of 16 healthy volunteers were treated for 2.5 min (standard) or 30 min (prolonged) with alcohol-based chlorhexidine (CHG-ALC; 2% w/v CHG, 55% w/v [70% v/v] 2-propanol) or alcohol-based povidone iodine (PVP-I-ALC; 3.24% w/v PVP-I, 38.9% w/v 2-propanol, 37.3% w/v ethanol). Skin sites were sampled before, immediately after, and 3 h after treatment. Results: Aerobic skin flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after 2.5 min and immediate sampling, but not after prolonged contact times and 3-h sampling. Anaerobic flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after standard and prolonged contact times and immediate sampling, but not after 3-h sampling. None of the volunteers reported negative effects from skin antisepsis. Conclusions: PVP-I-ALC is more efficacious than CHG-ALC for topical skin antisepsis regarding the anaerobic flora on the skin of the shoulder. Standard and prolonged contact times demonstrated superiority for PVP-I-ALC for samples taken immediately, but missed significance 3 h after application. The clinical relevance of these findings should be studied with SSI as an endpoint.
Coffee intake effects on obstructive sleep apnea and type 2 diabetes control, in Tabuk City, The Kingdom of Saudi Arabia: a case-control study
Authors: Ahmed Mohammed Adam , Saleh Abdulmoneim Ahmed , Kalantan Mowffaq Mohammed , Mirghani Hyder Osman 
Published: November 2019

Abstract
Objectives: The study aimed to assess the effects of coffee intake on obstructive sleep apnea (OSA) and glycemic control among patients with diabetes mellitus.Results: There were 110 patients with diabetes and 96 healthy control subjects (matched for age and sex) attending a diabetes center in Tabuk, Saudi Arabia during the period from June 2018-October 2019. Stop-Bang questionnaire was used to assess OSA, and Epworth Sleepiness Scale to investigate daytime sleepiness. OSA and daytime sleepiness were higher among patients with diabetes compared to controls (4.34±1.61 vs. 2.86±1.24, and 8.31±4.40 vs. 6.39±3.70 respectively, P-<05), while coffee consumption was not (4.64±3.95 vs. 3.45±3.06, P->0.05). Women with diabetes were younger with short duration since the diagnosis of diabetes and consumed less coffee compared to men, P-<0.5. A negative correlation was found between coffee consumption and the duration of diabetes, while no correlation was found between coffee intake, the glycated hemoglobin, OSA, sex, and daytime sleepiness. Daytime sleepiness and OSA were commoners among patients with diabetes, they were not correlated with coffee consumption which was negatively correlated with the duration since diabetes diagnosis. Further larger multi-center studies investigating coffee intake among patients newly diagnosed with diabetes are recommended.
Extracellular vesicle-mediated amyloid transfer to neural progenitor cells: implications for RAGE and HIV infection
Authors: András Ibolya E. , Garcia-Contreras Marta , Yanick Christopher , Perez Paola , Sewell Brice , Durand Leonardo , Toborek Michal 
Published: November 2019

Abstract
Amyloid beta (Aβ) deposition was demonstrated to be elevated in the brains of HIV-infected patients and associated with neurocognitive decline; however, the mechanisms of these processes are poorly understood. The goal of the current study was to address the hypothesis that Aβ can be transferred via extracellular vesicles (ECVs) from brain endothelial cells to neural progenitor cells (NPCs) and that this process can contribute to abnormal NPC differentiation. Mechanistically, we focused on the role of the receptor for advanced glycation endproducts (RAGE) and activation of the inflammasome in these events. ECVs loaded with Aβ (Aβ-ECVs) were readily taken up by NPCs and Aβ partly colocalized with the inflammasome markers ASC and NLRP3 in the nuclei of the recipient NPCs. This colocalization was affected by HIV and RAGE inhibition by a high-affinity specific inhibitor FPS-ZM1. Blocking RAGE resulted also in an increase in ECV number produced by brain endothelial cells, decreased Aβ content in ECVs, and diminished Aβ-ECVs transfer to NPC nuclei. Interestingly, both Aβ-ECVs and RAGE inhibition altered NPC differentiation. Overall, these data indicate that RAGE inhibition affects brain endothelial ECV release and Aβ-ECVs transfer to NPCs. These events may modulate ECV-mediated amyloid pathology in the HIV-infected brain and contribute to the development of HIV-associated neurocognitive disorders.
Assessment of Oral Health-Related Photographs by Dentists and Professional Non-Dental Caregivers - A Quantitative Comparative Study
Authors: Krausch-Hofmann Stefanie , Tran Trung Dung , Declerck Dominique , Mello Johanna de Almeida , Declercq Anja , Lesaffre Emmanuel , Lepeleire Jan De , Duyck Joke 
Published: November 2019

Abstract
Background Photographs might aid professional non-dental caregivers to detect problems when inspecting the mouth of care-dependent older individuals. This study evaluated whether the assessment of oral health-related conditions presented on photographs systematically differed between dentists and professional non-dental caregivers. Methods Photographs were taken from long-term care facility residents and from patients at the Department of Dentistry of a University Hospital. The following oral health aspects were depicted: denture hygiene, oral hygiene, teeth, gums, tongue and palate/lips/cheeks. Collection continued until a pool of 20-35 photographs was available for each oral health aspect, including a variety of conditions from perfect health and hygiene to severe problems. The total pool consisted of 179 photographs. A segmented Visual Analogue Scale was applied to assess the conditions presented on the photographs. The benchmark was established by three dentists with academic-clinical expertise in gerodontology, special needs dentistry and periodontology. For each photograph they provided a collective score after reaching consensus. Photographs were assessed individually by 32 general dentists and by 164 professional non-dental caregivers. Linear mixed effects models and generalized linear mixed effects models were fitted and mean squared errors were computed to quantify differences between both groups related to the benchmark. Results For the different oral health aspects, absolute distances from the benchmark scores were 1.13 (95%CI:1.03-1.23) to 1.51 (95%CI:1.39-1.65) times higher for the caregivers than for the dentists. The odds to overestimate the condition were higher for the caregivers than the dentists for oral hygiene (OR=0.72, 95%CI=0.62-0.84) and teeth (OR=0.74; 95%CI=0.61-0.88). The odds to underestimate the condition were higher for the caregivers than the dentists for gums (OR=1.39; 95%CI:1.22-1.59) and palate/lips/cheeks (OR=1.22; 95%CI=1.07-1.40). Over all assessments, the variance in caregiver scores was 1.9 (95%CI:1.62-2.23) times higher than that for the dentists. Conclusion Small but significant systematic differences were found between dentists and non-dental caregivers regarding the assessment of oral health-related conditions presented on clinical photographs. When photographs are used to aid non-dental caregivers with the oral health assessment, these visualizations should be complemented with comments to facilitate accurate interpretation.
Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia
Authors: Edward Anbrasi , Krishnan Aparna , Ettyang Grace , Jung Younghee , Perry Henry B , Ghee Annette E , Chege Jane 
Published: November 2019

Abstract
Background Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on SBA. In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of community-oriented interventions including timed CHW services and SBA. Results Over 90% of the 3,037 women in Cambodia, 2,805 women in Kenya and 1,171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia and Kenya showed significantly higher odds of SBA (Cambodia, aOR=7.48; 95% CI: 3.87, 14.5, Kenya, aOR=0.60; 95% CI: 0.41, 0.85). The findings also indicated that older women (>24 years), in Cambodia, women with primary or secondary education in Cambodia and Kenya, women from higher wealth quintiles in Cambodia, and women with four or more ANC visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions (aOR=1.69; 95% CI: 0.92, 3.13 in Cambodia; aOR=2.12; 95% CI: 1.06, 4.26 in Kenya; aOR=6.78; 95% CI: 1.15, 13.9 in Zambia), follow up visits from the CHW following a referral or health facility visit (aOR=2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR=2.17; 95% CI 1.25, 3.75 in Kenya; aOR=1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA. Conclusions Enhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery and accelerating the sustainable development goals for maternal child and newborn health.
Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018
Authors: Amede Peter Okpeh , Adedire Elizabeth , Usman Aishat , Ameh Celestine A. , Umar Faruk S. , Umeokonkwo Chukwuma David , Balogun Muhammad Shakir 
Published: November 2019

Abstract
Background: Tuberculosis (TB) is a contagious disease and its transmissibility potential is increased in congregate settings like the prisons. TB incidence rates are five to fifty times higher among prison inmates than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its predictors in Nigerian prisons. We therefore assessed TB treatment outcomes among prison inmates in Bauchi State, Nigeria.
Method: We conducted a retrospective data analysis of inmates with TB in the five main prisons in Bauchi State. We extracted sociodemographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a standardized checklist. We estimated the TB treatment success rate (TSR) and explored the relationship between the TSR and sociodemographic and clinical characteristics. Related variables were modelled in multivariate logistic regression to identify predictors of TSR at 5% level of significance.
Results: All 216 inmates were male with mean age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 48 (22.2%) were lost to follow-up, 17 (7.9%) were transferred out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Odds of successful treatment outcome were age; 20-29 years (AOR=10.5; 95% CI: 3.2-35.1), 30-39 years (AOR=4.2; 95% CI: 1.3-13.1), pretreatment weight; 50-59 kg (AOR= 9.6; 95% CI: 1.4-65.6), ≥60 kg (AOR= 18.6; 95% CI: 2.5-140.1) and being HIV negative (AOR=3.3; 95% CI:1.4-7.8).
Conclusion: The predictors of successful TB treatment outcome were being less than 40 years of age, having a pretreatment body weight of or greater than 50 kg, imprisonment for less than 2 years, and being HIV negative. We recommended that to improve TB TSR among prison inmates; age, duration of imprisonment, weight and TB/HIV coinfection should be the major consideration during drugs adherence, psychological and nutritional counselling and a tracking system be developed by the prisons authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.
Key words: Tuberculosis, Treatment outcomes, Prison inmates, Predictors, Bauchi State, Nigeria
Incidence of subsequent primary cancers and radiation-induced subsequent primary cancers after low dose-rate brachytherapy monotherapy for prostate cancer in long-term follow-up
Authors: Vuolukka Kristiina , Auvinen Päivi , Palmgren Jan-Erik , Aaltomaa Sirpa , Kataja Vesa 
Published: November 2019

Abstract
Background As aging is the most significant risk factor for cancer development, long-term prostate cancer (PCa) survivors have an evident risk of developing subsequent primary cancers (SPCs). Radiotherapy itself is an additional risk factor for cancer development and the SPCs appearing beyond five years after radiotherapy in the original treatment field can be considered as radiation-induced subsequent primary cancers (RISPCs).Material and Methods During the years 1999-2008, 241 patients with localized PCa who underwent LDR-BT with I125 and were followed-up in Kuopio University Hospital, were included in this study. In this study the incidences and types of SPCs and RISPCs with a very long follow-up time after low dose-rate brachytherapy (LDR-BT) were evaluated.Results During the median follow-up time of 11.4 years, a total of 34 (14.1%) patients developed a metachronous SPC. The crude incidence rate of RISPC was 1.7% (n=4). Half of the SPC cases (50%) were diagnosed during the latter half of the follow-up time as the risk to develop an SPC continued throughout the whole follow-up time with the actuarial 10-year SPC rate of 7.0%. The crude death rates due to metachronous out-of-field SPCs and RISPCs were high, 50% and 50%, respectively.Conclusion The crude rate of SPC was significant, but in line with previous data. The incidence of RISPC was very low supporting the role of LDR-BT as a safe treatment option for patients with localized PCa. However, both the SPCs and the RISPCs after LDR-BT were serious diseases with high mortality rates.