bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and associated factors of urinary incontinence in women living in China: a literature review
Authors: Xue Kaikai , Palmer Mary H. , Zhou Fang 
Published: October 2020

Abstract
Background
This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that can have a significant impact on women's physical and mental health and quality of life. In addition, women with UI may experience socioeconomic burdens due to UI’s effect on their ability to work and function in society. Although researchers from many countries have reported prevalence rates and associated factors for UI, little is known about the prevalence of UI in China’s large female population. Language may act as a barrier to the inclusion of published studies in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in China and in Chinese language.

Methods
The authors retrieved research studies from the Wanfang database using the following search terms: "Subject: (Female) × Subject: (Urinary incontinence) × Subject: (Prevalence) × Date: 2013 to 2019". Searches employed the China National Knowledge Infrastructure Database, VIP Database for Chinese Technical Periodicals and China Biology Medicine Database. The authors also used PubMed to search English-language studies published in Chinese journals on UI in Chinese women.

Results
This literature review includes 48 articles published between January 2013 and December 2019. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7 to 69.8%, representing 43–349 million women, respectively. For women aged 17–40 years, 41–59 years, and 60 years and older, prevalence rates ranged from 2.6–30.0, 8.7–47.7, to 16.9–61.6%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17–40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41–59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors.

Conclusions
About 43–349 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI incidence and prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17–40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
Patients’ experiences of eHealth in palliative care: an integrative review
Authors: Widberg Cecilia , Wiklund Birgitta , Klarare Anna 
Published: October 2020

Abstract
Background
With a growing world population, a longer life expectancy, and more deaths due to chronic diseases, the need for palliative care is increasing. Palliative care aims to alleviate suffering and to promote well-being for patients with progressive, incurable disease or injury. E-Health entails using of information and communication technology for healthcare provision. It is unclear to how patients experience use of eHealth technology within palliative care.

Methods
The aim of this study was to describe patients’ experiences of eHealth in palliative care. A systematic integrative review was performed using six databases: Cinahl Complete; MEDLINE; PubMed; Psychology and Behavioral Sciences Collection; Nursing and Allied Health; and PsycINFO. Twelve studies met the inclusion criteria of adult patients in palliative care, English language, published 2014–2019: comprising 397 patients. Six studies were from European countries, four from North America, one from South America and one from Oceania. Seven were feasibility or pilot studies.

Results
The findings are synthesized in the main theme: E-health applications – promoting communication on patients’ and families’ terms, and three sub- themes: usability and feasibility of eHealth applications; symptom control and individualized care; and use of eHealth applications increased sense of security and patient safety. Patients’ experiences were that eHealth promoted individualized care, sense of security, better symptom management and participation in care. Communication was facilitated by the inherent flexibility provided by technology.

Conclusions
E-Health applications seem promising in promoting equal, individualized care, and may be a tool to endorse accessibility and patient participation in palliative care settings. Indications are that eHealth communication resulted in patients and families receiving more information, which contributed to experiences of patient safety and feelings of security. At organizational and societal levels, eHealth may contribute to sustainable development and more efficient use of resources.
Nocebo effects by providing informed consent in shared decision making? Not necessarily: a randomized pilot-trial using an open-label placebo approach
Authors: Holzhüter Fabian , Hamann Johannes 
Published: October 2020

Abstract
Background
Thorough information of the patient is an integral part of the process of shared decision making. We aimed to investigate if detailed information about medication may induce nocebo (or placebo) effects.

Methods
We conducted a randomized, single-blind, pilot-study including n = 51 psychiatric in-patients aged between 18 and 80 years with a depressive disorder and accompanying sleeping disorders. In the intervention group we provided thorough information about adverse effects, while the control group received only a simple consent procedure. In both groups, patients received an open-label placebo pill instead of their sleeping medication.

Results
No statistically significant differences between the intervention group and the control group were found regarding the main outcome parameter (a visual analogue scale indicating impairment by the new pill).

Conclusion
In this study, we were not able detect an effect of informed consent vs. simple consent on the emergence of placebo or nocebo effects. This finding is contrary to most assumptions and publications about this topic.

Trial registration
Trial registration number: DRKS00017653, registered August 30th 2018. Retrosprectively registered.
Magnitude of turnover intention and associated factors among nurses working in emergency departments of governmental hospitals in Addis Ababa, Ethiopia: a cross-sectional institutional based study
Authors: Wubetie Andualem , Taye Biniyam , Girma Biruk 
Published: October 2020

Abstract
Background
Turnover intention is a probability of an employee to leave the current institution within a certain period due to various factors. It is the strongest predictor of actual turnover expected to increase as the intention increases. Emergency Department (ED) nurses are especially vulnerable to high turnover because of their increased risk of developing burnout and compassion fatigue associated with the work environment. This study is aimed to assess nurses’ intention to leave emergency departments and associated factors at selected governmental hospitals in Addis Ababa, Ethiopia.

Methods
Institutional based cross-sectional study was conducted on 102 nurses in three selected governmental hospitals, Addis Ababa from February 19 to March 31, 2018, using a structured pre-tested self-administered questionnaire. The logistic regression model was used and an adjusted odds ratio with a 95% confidence interval was calculated to identify associated factors.

Result
A total of 102 respondents were involved with a response rate of 91.1%. Among them, 79 (77.5%) respondents had the intention to leave the current working unit of the emergency department or hospital. Significant predictive factors of nurses’ intention to leave their institutions are educational status (adjusted odds ratio (OR) =4.700, 95% confidence interval (CI) = 1.033–50.772; p < 0.048), monthly income of less than 3145 Birr (adjusted OR = 6.05, 95% CI = 1.056–34.641; p < 0.043) and professional autonomy (adjusted OR = 0.191, 95% CI = 0.040–0.908; p < 0.037).

Conclusion
More than 77% of the respondents have the intention to leave their current working place of the emergency unit. Educational status, monthly income, and autonomy were significantly associated with emergency nurses’ turnover intention in three governmental hospitals. Emergency leaders and hospital managers should have made efforts to enhance nurses’ decision making for patient care activities and shared decision overwork or unit related activities.
Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context
Authors: Tran Trung Quang , Scherpbier A. J. J. A. , van Dalen Jan , Do Van Dung , Wright Elaine Pamela 
Published: October 2020

AbstractBackgroundAsian countries are making efforts to apply the partnership model in doctor-patient communication that has been used effectively in Western countries. However, notable differences between Western and Asian cultures, especially the acceptance of a hierarchical order and little attention to individuality in Asian cultures, could mean that the application of the partnership model in Vietnam requires adaptation.The study aimed to investigate whether communication models used in the Western world are appropriate in Southeast Asia, and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam.MethodsIn six provinces, collaborating medical schools collected data from 480 patients using face-to-face surveys with a structured guideline following a consultation session, and from 473 doctors using a cross-sectional survey on how they usually conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation.Using logistic regression, we examined whether doctor patient communication items and other factors were predictors of patient satisfaction.ResultsBoth patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvement. Furthermore, the doctors had higher expectations than did the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam.ConclusionThe communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needing to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.
Population genetic and biophysical evidences reveal that purifying selection shapes the genetic landscape of Plasmodium falciparum RH ligands in Chhattisgarh and West Bengal, India
Authors: Ghoshal Sharmistha , Chowdhury Pramita , Ray Sanhita , Mitra Mitashree , Kanjilal Sumana Datta , Sen Srikanta , Dasgupta Anjan Kr. , Sengupta Sanghamitra 
Published: October 2020

Abstract
Background
Reticulocyte binding protein-like homologs (RHs) are currently being evaluated as anti-erythrocytic stage vaccine targets against Plasmodium falciparum malaria. Present study explores the possible evolutionary drivers shaping the genetic organization of Pfrhs in Indian parasite population. It simultaneously evaluates a putative gain-of-function variant of PfRH5, a keystone member of PfRH family.

Methods
Receptor binding regions of Pfrh1, Pfrh2a/b, Pfrh4 and whole Pfrh5 were amplified using blood samples of P. falciparum malaria patients from Chhattisgarh and West Bengal and sequenced. Assembled sequences were analysed using MEGA7 and DnaSPv6. Binding affinities of recombinant PfRH5 proteins with basigin (BSG) were compared using in silico (CHARMM and AUTODOCK) and in vitro (Circular dichroism, fluorescence spectroscopy and isothermal titration calorimetry) methods.

Results
Pfrh1 (0.5), Pfrh2a/b (0.875), Pfrh4 (0.667) and Pfrh5 (0.778) sequence changes corresponded to low frequency (< 0.05) variants which resulted in an overall negative Tajima’s D. Since mismatch distribution of none of the Pfrh loci corroborated with the model of demographic expansion, a possible role of natural selection formulating Pfrh sequence diversity was investigated. Among the 5 members, Pfrh5 displayed very high dN/dS (5.7) ratio. Nevertheless, the model of selective sweep due to presence of any advantageous substitutions could not be invoked as polymorphic nonsynonymous sites (17/18) for Pfrh5 exceeded significantly over the divergent (62/86) ones (p = 0.0436). The majority of extant PfRH5 sequences (52/83) differed from the reference Pf3D7 allele by a single amino acid mismatch (C203Y). This non-conservative alteration was predicted to lower the total interaction energy of that PfRH5variant with BSG, compared to PfRH53D7. Biophysical evidences validated the proposition that PfRH5variant formed a more stable complex with BSG. Thermodynamic association constant for interaction of BSG with PfRH5variant was also found to be higher (Kavariant = 3.63E6 ± 2.02E6 M−1 and Ka3D7 = 1.31E6 ± 1.21E6 M−1).

Conclusions
Together, the study indicates that the genetic architecture of Pfrhs is principally shaped by purifying selection. The most abundant and ubiquitous PfRH5 variant harbouring 203Y, exhibits a greater affinity for BSG compared to PfRH53D7 possessing 203C allele. The study underscores the importance of selecting the functional allele that best represents circulating strains in natural parasite populations as vaccine targets.
DS21, a new noninvasive technology, is effective and safe for screening for prediabetes and diabetes in Chinese population
Authors: Zhu Xiaopeng , Tang Jing , Lin Huandong , Chang Xinxia , Xia Mingfeng , Wang Liu , Yan Hongmei , Bian Hua , Gao Xin 
Published: October 2020

Abstract
Background
Screening for prediabetes and asymptomatic diabetes is important for preventing development to an irreversible stage. The current diagnosis of prediabetes and diabetes is based on blood glucose or HbA1c (an invasive method). The aim of this study was to assess the efficacy and safety of DS21, a new noninvasive technology, for noninvasive screening for prediabetes and diabetes.

Methods
A total of 939 subjects were divided into a normal control group (NC, n = 308), impaired glucose regulation group (IGR, n = 312), and diabetes (DM) group (n = 319). All subjects underwent the DS21 test, and mean hands–feet, hand, and feet conductance values were analyzed. The diagnostic accuracy of the conductance value was analyzed by receiver-operating characteristic (ROC) curve.

Results
The conductance values for hands–feet, hands, and feet in the DM and IGR groups were significantly lower than those in the NC group (all P < 0.01). The area under the ROC curve (AUCROC) for distinguishing NC/IGR was highest when using hands–feet conductance values (0.766 [95% confidence interval, CI 0.730, 0.803]). However, the AUCROCs of distinguishing NC/abnormal glucose metabolism (AGM, including IGR+DM), non-diabetes (NDM)/DM, and IGR/DM were highest when using conductance values for hands at 0.782 [95% CI 0.752, 0.812], 0.688 [95% CI 0.653, 0.723] and 0.573 [95% CI 0.528, 0.617], respectively (all P < 0.01). Hand conductance of values 75.0 (sensitivity 0.769, specificity 0.660), 77.1 (sensitivity 0.718, specificity 0.695), 68.4 (sensitivity 0.726, specificity 0.555), and 58.1 (sensitivity 0.384, specificity 0.744) were recommended as the screening thresholds for NC/AGM, NC/IGR, NDM/DM, and IGR/DM, respectively. A hand conductance value 66.0 was also recommended to distinguish NC/AGM due to its high sensitivity and high PPV. No adverse events occurred in the test.

Conclusions
DS21 is fast, noninvasive, low cost, reliable and safe, which makes it a feasible device for screening for prediabetes and diabetes, especially in a large population.
Polyethylenimine-based theranostic nanoplatform for glioma-targeting single-photon emission computed tomography imaging and anticancer drug delivery
Authors: Zhao Lingzhou , Zhu Jingyi , Gong Jiali , Song Ningning , Wu Shan , Qiao Wenli , Yang Jiqin , Zhu Meilin , Zhao Jinhua 
Published: October 2020

Abstract
Background
Glioma is the deadliest brain cancer in adults because the blood–brain-barrier (BBB) prevents the vast majority of therapeutic drugs from entering into the central nervous system. The development of BBB-penetrating drug delivery systems for glioma therapy still remains a great challenge. In this study, we aimed to design and develop a theranostic nanocomplex with enhanced BBB penetrability and tumor-targeting efficiency for glioma single-photon emission computed tomography (SPECT) imaging and anticancer drug delivery.

Results
This multifunctional nanocomplex was manufactured using branched polyethylenimine (PEI) as a template to sequentially conjugate with methoxypolyethylene glycol (mPEG), glioma-targeting peptide chlorotoxin (CTX), and diethylenetriaminepentaacetic acid (DTPA) for 99mTc radiolabeling on the surface of PEI. After the acetylation of the remaining PEI surface amines using acetic anhydride (Ac2O), the CTX-modified PEI (mPEI-CTX) was utilized as a carrier to load chemotherapeutic drug doxorubicin (DOX) in its interior cavity. The formed mPEI-CTX/DOX complex had excellent water dispersibility and released DOX in a sustainable and pH-dependent manner; furthermore, it showed targeting specificity and therapeutic effect of DOX toward glioma cells in vitro and in vivo (a subcutaneous tumor mouse model). Owing to the unique biological properties of CTX, the mPEI-CTX/DOX complex was able to cross the BBB and accumulate at the tumor site in an orthotopic rat glioma model. In addition, after efficient radiolabeling of PEI with 99mTc via DTPA, the 99mTc-labeled complex could help to visualize the drug accumulation in tumors of glioma-bearing mice and the drug delivery into the brains of rats through SPECT imaging.

Conclusions
These results indicate the potential of the developed PEI-based nanocomplex in facilitating glioma-targeting SPECT imaging and chemotherapy.
Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey
Authors: Park Se-Won , Park Seong-Sik , Kim Eun-Jung , Sung Won-Suk , Ha In-Hyuk , Jung Boyoung 
Published: October 2020

Abstract
Background
No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes.

Methods
Using cross-sectional data from the 2015–2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson’s chi-square test for categorical variables or the Mann–Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders.

Results
The percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04–2.90). Significant correlations were absent among women.

Conclusions
Poor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.
Understanding the trends in international agreements on pricing and reimbursement for newly marketed medicines and their implications for access to medicines: a computational text analysis
Authors: Son Kyung-Bok 
Published: October 2020

Abstract
Background
Health systems are struggling with unprecedented drug spending and governments have devised various policy options to manage high-priced medicines. Meanwhile, some pricing and reimbursement processes are currently moving under the jurisdiction of international agreements. This study aims to understand trends in international agreements from the perspectives of pricing and reimbursement policies for newly marketed medicines.

Methods
We proposed the framework to interpret the international agreements as code and applied computational text analysis to understand international agreements as data. In particular, we selected the AUSFTA, KORUS, and TPP to assess the progress and evolution in international agreements and investigate the existing relevant content on the pricing and reimbursement of newly marketed medicines.

Results
Similar to the provisions for intellectual property, the scope of international agreements regarding pricing and reimbursement decisions are broadened and strengthened. Over time, the domain of transparency, re-naming procedural fairness, has changed significantly more than the remaining domains. Pharmaceutical companies will have more opportunities to advocate for their positions, to protect their interests in decision processes, to investigate the decisions on listings and setting the amounts of reimbursement, and to challenge these decisions.

Conclusions
Recently signed international agreements favor companies over governments with underscoring procedural fairness and timely access. However, access to affordable medicines is the goal towards which international agreements should aim. In a similar vein, substantial fairness and the accountability of companies should be discussed when negotiating agreements or adopting international agreements through domestic legislation.