bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study on the association of gastrointestinal symptoms in children with low lactase activity and low activity of other disaccharidases
Authors: Wasuwanich Paul , Choudry Hassan , Ingviya Thammasin , Scheimann Ann O. , AuYeung Karla J. , Karwowski Christine , Billet Susan , Nichols Buford L. , Karnsakul Wikrom 
Published: October 2020

Abstract
Background
Disaccharides such as lactose and sucrose are sugars commonly found in human diet. They are broken down by mucosal disaccharidases in the duodenum. Previous small studies found no associations between gastrointestinal (GI) symptoms and combined low disaccharidase activity. We aim to explore the associations of low activity of disaccharidase and combinations of low activity of different disaccharidases with general GI symptom presentations in a large cohort of pediatric patients.

Methods
We examined a cohort (0–21 yrs.) who have undergone esophagogastroduodenoscopy and received disaccharidase activity assay from duodenal biopsy in the time period 2010 to 2012. Disaccharidase assays tested for activity of lactase, sucrase, maltase, and palatinase. GI symptoms were grouped into four categories, abdominal pain, diarrhea, weight loss, and gastroesophageal reflux.

Results
Of the 347 subjects, we found an association between low lactase activity and abdominal pain (OR = 1.78; 95% CI = 1.07–2.97; p < 0.05). Subjects with a lactase/sucrase ratio < 0.2 were found to be associated with abdominal pain (OR = 2.25; 95% CI = 1.25–4.04; p < 0.05), Subjects with low pandisaccharidase may be correlated with abdominal pain and have a unique frequency of GI symptoms due to low frequency of diarrhea and weight loss, but they were not statistically significant.

Conclusions
Low activities of certain disaccharidase combinations may be associated with GI symptoms in subjects; a prospective study may be needed to investigate further.
Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence
Authors: Tamuzi Jacques L. , Ayele Birhanu T. , Shumba Constance S. , Adetokunboh Olatunji O. , Uwimana-Nicol Jeannine , Haile Zelalem T. , Inugu Joseph , Nyasulu Peter S. 
Published: October 2020

Abstract
Background
The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management.

Methods
We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables.

Results
After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06–2.65, P = 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12–18.10, P = 0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83–2.74, P < 0.001) and the mortality was reduced among non-TB group (P < 0.001).

Conclusion
In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.
Prevalence and diversity of enteric pathogens among cholera treatment centre patients with acute diarrhea in Uvira, Democratic Republic of Congo
Authors: Williams Camille , Cumming Oliver , Grignard Lynn , Rumedeka Baron Bashige , Saidi Jaime Mufitini , Grint Daniel , Drakeley Chris , Jeandron Aurelie 
Published: October 2020

Abstract
Background
Cholera remains a major global health challenge. Uvira, in the Democratic Republic of the Congo (DRC), has had endemic cholera since the 1970’s and has been implicated as a possible point of origin for national outbreaks. A previous study among this population, reported a case confirmation rate of 40% by rapid diagnostic test (RDT) among patients at the Uvira Cholera Treatment Centre (CTC). This study considers the prevalence and diversity of 15 enteric pathogens in suspected cholera cases seeking treatment at the Uvira CTC.

Methods
We used the Luminex xTAG® multiplex PCR to test for 15 enteric pathogens, including toxigenic strains of V. cholerae in rectal swabs preserved on Whatman FTA Elute cards. Results were interpreted on MAGPIX® and analyzed on the xTAG® Data Analysis Software. Prevalence of enteric pathogens were calculated and pathogen diversity was modelled with a Poisson regression.

Results
Among 269 enrolled CTC patients, PCR detected the presence of toxigenic Vibrio cholerae in 38% (103/269) of the patients, which were considered to be cholera cases. These strains were detected as the sole pathogen in 36% (37/103) of these cases. Almost half (45%) of all study participants carried multiple enteric pathogens (two or more). Enterotoxigenic Escherichia coli (36%) and Cryptosporidium (28%) were the other most common pathogens identified amongst all participants. No pathogen was detected in 16.4% of study participants. Mean number of pathogens was highest amongst boys and girls aged 1–15 years and lowest in women aged 16–81 years. Ninety-three percent of toxigenic V. cholerae strains detected by PCR were found in patients having tested positive for V. cholerae O1 by RDT.

Conclusions
Our study supports previous results from DRC and other cholera endemic areas in sub-Sahara Africa with less than half of CTC admissions positive for cholera by PCR. More research is required to determine the causes of severe acute diarrhea in these low-resource, endemic areas to optimize treatment measures.

Trial registration
This study is part of the impact evaluation study entitled: “Impact Evaluation of Urban Water Supply Improvements on Cholera and Other Diarrheal Diseases in Uvira, Democratic Republic of Congo” registered on 10 October 2016 at clinicaltrials.gov Identification number: NCT02928341.
Genetic variants in MIR17HG affect the susceptibility and prognosis of glioma in a Chinese Han population
Authors: Feng Jigao , Ouyang Yibin , Xu Dedong , He Qinglong , Liu Dayuan , Fan Xudong , Xu Pengxiang , Mo Yehe 
Published: October 2020

Abstract
Background
lncRNA MIR17HG was upregulated in glioma, and participated in promoting proliferation, migration and invasion of glioma. However, the role of MIR17HG polymorphisms in the occurrence and prognosis of glioma is still unclear.

Methods
In the study, 592 glioma patients and 502 control subjects were recruited. Agena MassARRAY platform was used to detect the genotype of MIR17HG polymorphisms. Logistic regression analysis was used to evaluate the relationship between MIR17HG single nucleotide polymorphisms (SNPs) and glioma risk by odds ratio (OR) and 95% confidence intervals (CIs). Kaplan–Meier curves, Cox hazards models were performed for assessing the role of these SNPs in glioma prognosis by hazard ratios (HR) and 95% CIs.

Results
We found that rs7318578 (OR = 2.25, p = 3.18 × 10− 5) was significantly associated with glioma susceptibility in the overall participants. In the subgroup with age <  40 years, rs17735387 (OR = 1.53, p = 9.05 × 10− 3) and rs7336610 (OR = 1.35, p = 0.016) were related to the higher glioma susceptibility. More importantly, rs17735387 (HR = 0.82, log-rank p = 0.026) were associated with the longer survival of glioma patients. The GA genotype of rs17735387 had a better overall survival (HR = 0.75, log-rank p = 0.013) and progression free survival (HR = 0.73, log-rank p = 0.032) in patients with I-II glioma. We also found that rs72640334 was related to the poor prognosis (HR = 1.49, Log-rank p = 0.035) in female patients. In the subgroup of patients with age ≥ 40 years, rs17735387 was associated with a better prognosis (HR = 0.036, Log-rank p = 0.002).

Conclusion
Our study firstly reported that MIR17HG rs7318578 was a risk factor for glioma susceptibility and rs17735387 was associated with the longer survival of glioma among Chinese Han population, which might help to enhance the understanding of MIR17HG gene in gliomagenesis. In subsequent studies, we will continue to collect samples and follow up to further validate our findings and further explore the function of these MIR17HG SNPs in glioma in a larger sample size.
Repetitive negative thinking is associated with subjective cognitive decline in older adults: a cross-sectional study
Authors: Schlosser Marco , Demnitz-King Harriet , Whitfield Tim , Wirth Miranka , Marchant Natalie L. 
Published: October 2020

AbstractBackgroundIn the absence of a cure or effective treatment for dementia, attention has shifted towards identifying risk factors for prevention. Subjective Cognitive Decline (SCD) describes self-perceived worsening of cognition despite unimpaired performance on neuropsychological tests. SCD has been associated with an increased dementia risk and steeper memory decline. Repetitive negative thinking (RNT) is a transdiagnostic process that manifests across several mental health disorders associated with increased vulnerability to dementia. RNT has thus been proposed as a candidate marker of risk for dementia and, relatedly, could contribute to the manifestation of SCD. We aimed to investigate the relationship between SCD and RNT alongside other proposed psychological risk/protective factors for dementia and cognitive decline.MethodsIn a cross-sectional online survey, 491 older adults (mean = 64.9 years,SD = 4.2; 63.1% female) completed measures of RNT, personality traits, purpose in life, worry, rumination, and meditation practice. SCD was assessed continuously via self-perceived cognitive function (Neuro-QoL) and categorically via endorsement (yes/no) of memory complaints. Regression models, using a stepwise backwards elimination, were built to assess associations between SCD, demographics, and all risk/protective factors.ResultsA total of 24.2% of participants reported memory complaints. In the final prediction models, RNT was the only psychological variable associated with lower self-perceived cognitive function and with a higher likelihood of memory complaints.ConclusionsThis study empirically corroborates the theoretical relationship between SCD and RNT. Longitudinal studies are needed to establish whether RNT is a prodromal symptom or an independent risk factor, and whether RNT can be a promising construct for future research on SCD and dementia risk.
Exploring attitudes of adolescents and caregivers towards community-based delivery of the HPV vaccine: a qualitative study
Authors: Ramanadhan Shoba , Fontanet Constance , Teixeira Marina , Mahtani Sitara , Katz Ingrid 
Published: October 2020

Abstract
Background
Human Papillomavirus (HPV) vaccination among adolescents is an important strategy to prevent cervical and other cancers in adulthood. However, uptake remains far below the Healthy People 2020 targets for the US. Given the barriers to population-level vaccination policies and challenges to incorporating additional action items during clinical visits, we sought to explore alternative delivery mechanisms, specifically delivery of the vaccine in community settings.

Methods
We conducted six focus groups (three with adolescents aged 11–14 who had not received the HPV vaccine and three with caregivers of adolescents meeting those criteria) from Black, Latino, and Brazilian communities in Massachusetts. We utilized a framework analysis approach that involved a multi-stage coding process employing both prefigured and emergent codes. Initial interpretations were refined through consultation with an advisory board.

Results
Adolescents and caregivers expressed a range of concerns about the HPV vaccine and also described interest in learning more about the vaccine, emphasizing the importance of a relationship with a trusted provider as a facilitator of vaccine acceptance. Regarding community-based delivery of the vaccine, reactions were mainly negative. However, adolescents and caregivers noted that receiving information in community settings that could seed a conversation with a trusted provider would be welcome. Interestingly, the notion of a trusted provider seemed to extend broadly to practitioners linked to the trusted main provider.

Conclusions
The study highlights an opportunity for increasing HPV vaccination among some racial and ethnic minority populations by leveraging trusted community organizations to provide information and seed conversations with a potentially broad group of trusted providers. A task-shifting approach, or reliance on staff with fewer formal credentials, may offer opportunities to support vaccination in resource-constrained settings.
Students’ and lecturers’ perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): a cross-sectional study
Authors: Schlenz Maximiliane Amelie , Schmidt Alexander , Wöstmann Bernd , Krämer Nobert , Schulz-Weidner Nelly 
Published: October 2020

Abstract
Background
On account of physical distancing measures, universities worldwide are strongly affected by SARS-CoV-2 (COVID-19). Thus, the dental school of Justus-Liebig-University Giessen (Germany) transferred the established “face-to-face” learning to online learning in the spring term 2020. The aim of this study was to assess the students’ and lecturers’ perspectives on the implementation of online learning due to COVID-19, using a questionnaire survey.

Methods
After the online period, all students and lecturers were asked to fill out an online questionnaire containing evaluative statements regarding handling, didactic benefit, motivation, and overall assessment. Furthermore, the questionnaire for lecturers contained additional aspects regarding knowledge gain in terms of providing online learning. Besides that, students and lecturers were asked for the amount of online learning in the future curriculum (independent of COVID-19). Data were subjected to regression analysis and T-test (p < .05).

Results
36.8% of students preferred “face-to-face” learning instead of sole online learning. An increase of know how concerning online teaching was observable for lecturers. Both, students and lecturers, want to keep up with online courses in the future curriculum. However, in terms of the optimal amount of online learning a significant difference between students’ and lecturers’ perspective was observed. While students suggested 53.2% (24.9) (mean (standard deviation)) lecturers only stated 38.6% (21.5).

Conclusions
Within the limitation of this study, students’ and lecturers’ showed a predominantly positive perspective on the implementation of online learning, providing the chance to use online learning even beyond COVID-19 in the future curriculum.
Poor level of knowledge on elderly care despite positive attitude among nursing students in Zanzibar Island: findings from a cross-sectional study
Authors: Muhsin Arafa A. , Munyogwa Mariam J. , Kibusi Stephen M. , Seif Saada A. 
Published: October 2020

Abstract
Background
It is estimated by the year 2050, 80% of the global elderly population will be from the low-and middle income countries. Elderly care requires health workers with skills associated with an understanding of the biological, psychological, social and cultural theories related to aging. Nurses with better knowledge, skills and positive attitudes towards elderly care are highly needed and critically important for better healthcare and wellbeing of the elderly population. Therefore the objective of this study was to assess the level of knowledge and attitude of nursing students towards elderly care in Zanzibar Island.

Methods
A cross-sectional study was conducted in Zanzibar involving three out of five nursing training institutions. Participants were selected by systematic random sampling. Facts on Aging Quiz 2 and Kogan’s Attitudes Toward Old People scale were used to assess the level of knowledge and attitude towards elderly care among the students respectively. Simple and multivariable logistic regressions were applied to determine the predictors of knowledge and attitude among the participants.

Results
A total of 393 students participated in this study. Only 17% (69) of the participants had good level of knowledge and about 67.9% (267) had positive attitude towards elderly care. Living in an extended family and with an elderly person at home were both associated with good level of knowledge and positive attitude towards elderly care. Furthermore, living in a rural area (adjusted odds ratio = 2.23; 95% confidence interval: 1.22, 4.10) and studying at public institution (adjusted odds ratio = 2.59; 95% confidence interval: 1.41, 4.63) were associated with positive attitude towards elderly care.

Conclusion
This study has shown that the majority of nursing students in Zanzibar have positive attitude but poor level of knowledge towards elderly care. The current findings have demonstrated that past experience with an elderly person can help in influencing good knowledge and shaping positive attitudes towards elderly care. Low level of knowledge shown in the study suggests for further research on adequacy of nursing curriculum and/or its implementation.
Use of the ankle-brachial index combined with the percentage of mean arterial pressure at the ankle to improve prediction of all-cause mortality in type 2 diabetes mellitus: an observational study
Authors: Li Yu-Hsuan , Sheu Wayne Huey-Herng , Lee I-Te 
Published: October 2020

AbstractBackgroundPeripheral artery disease (PAD) in the lower extremities is a common complication of type 2 diabetes and has been shown to be associated with mortality. The ankle-brachial index (ABI) is a simple noninvasive method to screen PAD, but this method has limited sensitivity. We hypothesized that using the percentage of mean arterial pressure (%MAP) in combination with the ABI would improve the prediction of mortality.MethodsWe retrospectively collected data from patients with type 2 diabetes who had undergone ABI and %MAP measurements at our hospital. We separated the cohort into four groups according to their ABI and %MAP values, and we examined whether these indices were associated with mortality.ResultsA total of 5569 patients (mean age, 65 ± 11 years) were enrolled. During the follow-up period (median, 22.9 months), 266 (4.8%) of the enrolled patients died. The combination of ABI and %MAP was significantly more effective than ABI alone for predicting mortality (C index of 0.62, 95% confidence interval [CI] of 0.57 to 0.65 vs. C index of 0.57, 95% CI of 0.53 to 0.62; P = 0.038). In multivariate analysis (with a reference group defined by ABI > 0.90 and %MAP ≤ 45%), the highest risk of mortality was seen in patients with ABI ≤ 0.90 and %MAP > 45% (hazard ratio = 2.045 [95% CI 1.420, 2.945], P < 0.001).ConclusionsThe use of %MAP alongside ABI appears to significantly improve the prediction of all-cause mortality in patients with type 2 diabetes.
Comparison of leucocyte profiles between healthy children and those with asymptomatic and symptomatic Plasmodium falciparum infections
Authors: Prah Diana Ahu , Amoah Linda Eva , Gibbins Matthew P. , Bediako Yaw , Cunnington Aubrey J. , Awandare Gordon A. , Hafalla Julius Clemence R. 
Published: October 2020

AbstractBackgroundThe immune mechanisms that determine whether aPlasmodium falciparuminfection would be symptomatic or asymptomatic are not fully understood. Several studies have been carried out to characterize the associations between disease outcomes and leucocyte numbers. However, the majority of these studies have been conducted in adults with acute uncomplicated malaria, despite children being the most vulnerable group.MethodsPeripheral blood leucocyte subpopulations were characterized in children with acute uncomplicated (symptomatic; n = 25) or asymptomatic (n = 67)P. falciparummalaria, as well as malaria-free (uninfected) children (n = 16) from Obom, a sub-district of Accra, Ghana. Leucocyte subpopulations were enumerated by flow cytometry and correlated with two measures of parasite load: (a) plasma levels ofP. falciparumhistidine-rich protein 2 (PfHRP2) as a proxy for parasite biomass and (b) peripheral blood parasite densities determined by microscopy.ResultsIn children with symptomaticP. falciparuminfections, the proportions and absolute cell counts of total (CD3 +) T cells, CD4 + T cells, CD8 + T cells, CD19 + B cells and CD11c + dendritic cells (DCs) were significantly lower as compared to asymptomaticP. falciparum-infected and uninfected children. Notably, CD15 + neutrophil proportions and cell counts were significantly increased in symptomatic children. There was no significant difference in the proportions and absolute counts of CD14 + monocytes amongst the three study groups. As expected, measures of parasite load were significantly higher in symptomatic cases. Remarkably,PfHRP2 levels and parasite densities negatively correlated with both the proportions and absolute numbers of peripheral leucocyte subsets: CD3 + T, CD4 + T, CD8 + T, CD19 + B, CD56 + NK, γδ + T and CD11c + cells. In contrast, bothPfHRP2 levels and parasite densities positively correlated with the proportions and absolute numbers of CD15 + cells.ConclusionsSymptomaticP. falciparuminfection is correlated with an increase in the levels of peripheral blood neutrophils, indicating a role for this cell type in disease pathogenesis. Parasite load is a key determinant of peripheral cell numbers during malaria infections.