bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes of Israeli Medical Students Towards the Medical Treatment of Uninsured Migrants
Authors: Mor Zohar , Cadesky Adam , Halleluyan Ran , Sheffer Rivka 
Published: February 2020

Abstract
Background: Undocumented migration to developed countries poses practical concerns, as migrants are not medically insured. This cross-sectional study aims to appraise the attitudes of Israeli medical students towards the uninsured migrant population. Methods: Participants from five medical schools in Israel completed anonymous questionnaires in Hebrew, based on the "Medical Students’ Attitudes Toward the Underserved" (MSATU), which assessed students' attitudes regarding the professional responsibility and societal expectations towards the migrants. It also evaluated students' views of the migrants as eligible for expensive medical procedures. Results: A total of 891 students completed the survey with a median age of 28 years. The majority were Jews (N=816, 91.6%) and singles (N=681, 68.5%). Participants in the pre-clinical years were likely to be female and unmarried compared to those in clinical training. They also demonstrated higher scores on professional responsibilities and societal expectations than students in clinical training, but no significant differences were found in their views on expensive medical services. Students of minorities (non-Jews and migrants) scored higher on professional responsibilities and societal expectations. The scores for professional responsibilities and societal expectations decreased as students progressed in their medical training (Spearman coefficient p=0.04 and p=0.01, respectively). This trend was more apparent in males rather than females. Conclusion: MSATU scores declined as students progressed through medical school, with females maintaining more favorable attitudes than males. Medical schools should attempt to maintain the enthusiasm and idealism that students possess as they enter medical training and provide clinical experience with migrant populations that allows for cross-cultural communication.
Implementation of an interactive organ donation education program for Dutch lower-educated students: a process evaluation
Authors: Steenaart Esther , Crutzen Rik , de Vries Nanne K 
Published: February 2020

Abstract
Background As organ donation registration rates remain low, especially among lower-educated people, it is important to support this group in making their registration decision. To prepare lower-educated students in the Netherlands for making a well-informed decision, an interactive educational program was developed. We aim to understand both the (quality of) implementation as well as to contextualize the effect of this program in a lower-educated school setting.
Methods The process evaluation was part of a Cluster Randomized Controlled Trial, in which 11 schools for Intermediate Vocational Education throughout the Netherlands participated. Teachers who taught a course on Citizenship delivered three intervention elements (i.e. video fragments and discussion, quizzes with tailored feedback and an exercise filling out a registration form) to their students. Implementation was assessed by interviews with teachers, questionnaires from students, logbooks from teachers and user data from Google Analytics.
Results The program was well received and implemented, but on-the-spot adaptations were made by teachers to fit their students better. Within the lower-educated target group, differences between students are high in terms of active participation, reading abilities, knowledge and attention span. The program fit well within their regular teaching activities, but the topic of organ donation is not always prioritized by teachers.
Conclusions We see opportunities to disseminate the program on a larger scale and reach a group that has been neglected in organ donation education before. Within the program, there are possibilities to increase the effectiveness of the program, such as alternative delivery methods for the elements with a lot of text, the addition of booster sessions and guidelines for teachers to adapt the program to students of different levels within Intermediate Vocational Education. Moreover, in order to have an impact on a national level, strategies need to be employed to reach high numbers of students and, therefore, support on a higher level is needed (both within schools and at policy level).
Trial registration: Dutch Trial Register, NTR6771. Registered on 24 October 2017. https://www.trialregister.nl/trial/6557
Clinical Performance Evaluation of the Idylla™ Egfr Mutation Test on Formalin-Fixed Paraffin-Embedded Tissue of Non-Small Cell Lung Cancer
Authors: Delgado-Garcia Mercedes , Weynand Birgit , Izquierdo Lourdes Gómez , Barrera María José Hernández , Lobo Ángela María Blanco , Rodríguez Mar Varela , Guiu Xavier Matias , Nadal Ernest , Lobo Bélgica Márquez , Alarcão Ana , Casado Enrique de Álava , Biscuola Michele , Delgado-García Mercedes 
Published: February 2020

AbstractBackground:detection of epidermal growth factor receptor (EGFR)mutations in exons 18-21 is recommended in all patients with advanced Non-small-cell lung carcinoma due to the demonstrated efficiency of the standard therapy with tyrosine kinase inhibitors inEGFR-mutated patients. Therefore, choosing a suitable technique to testEGFRmutational status is crucial to warrant a valid result in a short turnaround time using the lowest possible amount of tissue material.The Idylla™EGFRMutation Test is a simple, fast and reliable method designed for the detection ofEGFRmutations from formalin-fixed paraffin-embedded samples. The aim of this study was the Clinical Performace Evaluation of the Idylla™ EGFR Mutation Test on the Idylla™ System.Methods:EGFR mutational status was determined on 132 archived formalin-fixed paraffin-embedded tissue sections with Idylla™technology. Results were compared with the results previously obtained by routine method in the reference lab (Therascreen®EGFRRGQ PCR v2, Qiagen in Molecular Pathology lab, Hospital Universitario Virgen del Rocío de Sevilla).Results:the overall agreement between results obtained with the Idylla™EGFRMutation Test and the Comparator test method was 95.38% (with 1-sided 95% lower limit of 91.7%) showing Positive Diagnostic Agreement of 93.22% and Negative Diagnostic Agreement of 97.18%, with a Limit Of Detection ≤5%.Conclusions:the Idylla™EGFRMutation Test passed its clinical validity performance characteristics for accuracy.
Application of Loop-Mediated Isothermal Amplification combined with colorimetric and lateral flow dipstick visualization as the potential point-of-care testing for Corynebacterium diphtheriae
Authors: Zasada Aleksandra Anna , Wiatrzyk Aldona , Czajka Urszula , Brodzik Klaudia , Formińska Kamila , Mosiej Ewa , Prygiel Marta , Krysztopa-Grzybowska Katarzyna , Wdowiak Karol 
Published: February 2020

Abstract
Background Diphtheria outbreaks occurred in endemic areas and imported and indigenous cases are reported in UE/EEA. Because of the high infectiveness and severity of the disease, early and accurate diagnosis of each suspected case is essential for the treatment and management of the case and close contacts. The aim of the study was to establish simple and rapid testing methods based on Loop-Mediated Isothermal Amplification (LAMP) assay for the detection of Corynebacterium diphtheriae and differentiation between toxigenic and non-toxigenic strains. Methods Corynebacterium diphtheriae and Corynebacterium ulcerans isolates from the National Institute of Public Health-National Institute of Hygiene collection were used for the development of LAMP assay for the diagnosis of diphtheria and nontoxigenic C. diphtheriae infections. Various colorimetric methods for visualization of results were investigated. Sensitivity and specificity of the assay were examined using a collection of DNA samples from various gram-positive and gram-negative bacteria. Results The LAMP assay for tox and dtxR genes was developed. The sensitivity and specificity of the assay were calculated as 100%. The detection limit was estimated as 1.42 pg/µl concentration of DNA template when the reaction was conducted for 60 min. However, the detection limit was lowered 10 times for every 10 minutes of reduction in the time of incubation during the reaction. Positive results were successfully detected colorimetrically using hydroxynaphthol blue, calcein, QuantiFluor, and lateral flow Milenia HybriDetect dipsticks. Conclusion The assay developed in the study might be applied for point-of-care testing of diphtheria and other C. diphtheriae infections as well as for other infections caused by diphtheria-toxin producing Corynebacterium species. It is highly sensitive, specific, inexpensive, easy to use, and suitable for low-resource settings.
Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia
Authors: Kasahun Gebremicheal Gebreslassie , Gebretekle Gebremedhin Beedemariam , Gecho Yohannes Hailemichael , Woldemariam Aynalem Abraha , Fenta Teferi Gedif 
Published: February 2020

Abstract
Background: With the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden.Objective: The purpose of the study was to examine the level of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.Methods: A hospital based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.Results: A total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (±SD) age was 48±13.2years. The distribution of cancer was mostly concentrated among 35-44 (30.4%) age group category. Breast (36.9 %) and Cervical (16.5%) cancers accounted the largest proportion. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure shared the highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support (43.0%) were the main coping strategies.Conclusion: A substantial number of patients with cancer are exposed to CHE with considerable medical expenditure. Hence, efficient mobilization of the health insurance scheme is urgently needed to ensure financial risk protection and realize universal health coverage for patients with cancer.
Decomposing the educational inequalities in the factors associated with severe acute malnutrition among under-five children in Low- and Middle-Income Countries
Authors: Fagbamigbe Adeniyi Francis , Kandala Ngianga- Bakwin , Uthman Olalekan 
Published: February 2020

Abstract
Background: Low- and Middle-Income Countries (LMIC) have remained plagued with the burden of severe acute malnutrition (SAM). The decomposition of the educational inequalities in SAM across individual, neighbourhood and national level characteristics in LMIC have not been explored. This study aims to decompose educational-related inequalities in the development of SAM among under-five children in LMIC and identify the risk factors that contribute to the inequalities.
Methods: We pooled successive secondary data from the Demographic and Health Survey (DHS) conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers was the main exposure variable. The explanatory variables cut across the individual-, household- and neighbourhood-level factors of the mother-child pair. Oaxaca-Blinder decomposition method was used at p=0.05.
Results: Mothers with no formal education ranged from 0.1 % in Armenia and Kyrgyz to as much as 86.1 % in Niger. The overall prevalence of SAM in the group of children whose mothers had no education was 5.8 % compared with 4.2 % among those whose mothers were educated, this varied within each country. Fourteen countries (Cameroon(p<0.001), Chad(p<0.001), Comoro(p=0.047), Burkina Faso(p<0.001), Ethiopia(p<0.001), India(p<0.001), Kenya(p<0.001), Mozambique(p=0.012), Namibia(p=0.001), Nigeria(p<0.001), Pakistan(p<0.001), Senegal(p=0.003), Togo(p=0.013), and Timor Leste(p<0.001) had statistically significant pro-illiterate inequality while no country showed statistically significant pro-literate inequality. We found significant differences in SAM prevalence across child’s age(p<0.001), child’s sex(p<0.001), maternal age(p=0.001), household wealth quintile(p=0.001), mother’s access to media(p=0.001), birth weight(p<0.001) and neighbourhood socioeconomic status disadvantage(p<0.001). On the average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type.
Conclusions: SAM is prevalent in most LMIC with wide educational inequalities explained by individual, household and community-level factors. Promotion of women education should be strengthened as better education among women will close the gaps and reduce the burden of SAM generally. We recommend further studies of other determinate causes of inequalities in severe acute malnutrition in LMIC.
Comparison of bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity of hyperlipidemic acute pancreatitis(HLAP)
Authors: Nie Lan , Cheng Yi , Yao Fei , Wu Ru Shuo , Li Ming , Zhang Junjun , Wu Ming qing , Long Hui , Fang Ming Xiang 
Published: February 2020

Abstract
Background: In recent years, the incidence of hyperlipidemic acute pancreatitis(HLAP) is rapidly increasing. It is important for clinicians to identify the severity at early stage of HLAP. AIMS: The goal of this paper was to compare bedside index for severity in acute pancreatitis(BISAP) and modified CT severity index(MCTSI) for predicting the severity and local complications of HLAP. Methods: We collected 167 patients with HLAP, including 133 cases of Mild acute pancreatitis(MAP), 34 cases of Moderately severe acute pancreatitis(MSAP) and Severe acute pancreatitis(SAP). The study retrospectively analyzed the clinical characteristics of two groups(MAP group,MSAP and SAP group) of patients. Correlation analysis was demonstrated by Spearman,s test. In addition,the accuracy was investigated through the study of the receiver operating characteristic(ROC) curve to predict the severity of HLAP by BISAP and MCTSI score. Results：There are significantly statistical differences(P<0.05) in Triglycerides(TG), Total cholesterols(TC), Hospitalization days, Fatty liver and Local complications between two groups. However, there are no statistical differences(P>0.05) in Gender, Age,Serum amylase, Alanine aminotransferase(ALT), Aspertate aminotransferase(AST), Hypertension, Type2 diabetes and Hyperuricemia. The Area Under the Curve(AUC) of BISAP and MCTSI in predicting the severity of HLAP respectively were 0.89、0.78, sensitivity were 73.5%、79.4%, specificity were95.5%、60.2%, positive predictive value(PPV) were 80.6%、33.8%, negative predictive value(NPV) were 93.4%、92.0%. Furthermore, the AUC respectively were 0.73、0.87, sensitivity were 37.5%、90.1%, specificity were 93.2%、78.6%, PPV were 77.4%、72.5%, NPV were 70.6%、93.1% in predictionig local complications. Conclusion：Compared to MCTSI score, BISAP score may be a better prognostic scoring system for predicting the severity of HLAP in view of accuracy and easiness. Keywords: Hyperlipidemic acute pancreatitis; Triglycerides; BISAP score; MCTSI score; Severe acute pancreatitis
DJ-1 exerts anti-inflammatory effects and regulates NLRX1-TRAF6 via SHP-1 in stroke
Authors: Peng Li , Zhou Yang , Jiang Ning , Wang Tingting , Zhu Jin , Chen Yanlin , Li Linyu , Zhang Jinyan , Yu Shanshan , Zhao Yong 
Published: February 2020

Abstract
Background : Acute inflammation developed by reactive astrocytes after cerebral ischemia/reperfusion (I/R) injury is important in protecting the resultant lesion. Our previous study demonstrated the abundant expression of DJ-1 in reactive astrocytes after cerebral I/R injury. Here, we show that DJ-1 negatively regulates the inflammatory response by facilitating the interaction between SHP-1 and TRAF6, thereby inducing NLRX1 dissociation from TRAF6. Methods : We used oxygen-glucose deprivation/reoxygenation (OGD/R) in vitro in primary astrocyte cultures and transient middle cerebral artery occlusion/reperfusion (MCAO/R) in vivo to mimic ischemic reperfusion insult. Results: The inhibition of DJ-1 expression increased the expression of the inflammatory cytokines TNF-α, IL-1β, and IL-6. DJ-1 knockdown facilitated the interaction of NLRX1 with TRAF6. However, the loss of DJ-1 attenuated the interaction of SHP-1 with TRAF6. In subsequent experiments, a SHP-1 inhibitor altered the interaction of SHP-1 with TRAF6 and facilitated the interaction of NLRX1 with TRAF6 in DJ-1-overexpressing astrocytes. Conclusion: This finding suggests that DJ-1 exerts a SHP-1-dependent anti-inflammatory effect and induces the dissociation of NLRX1 and TRAF6 in cerebral I/R injury. Thus, DJ-1 may be an efficacious therapeutic target for the treatment of I/R injury.
The impact of Clonorchis sinensis infection on immune response in mice with type II collagen-induced arthritis
Authors: li xiangyang , Yang Ying , Qin Su-Ping , Kong Fan-Yun , Yan Chao , Cheng Wan-Peng , Pan Wei , Yu Qian , Hua Hui , Zheng Kui-Yang , Tang Ren-Xian 
Published: February 2020

Abstract
Background: Clonorchis sinensis infection could trigger strong immune responses in mice and humans. However, whether the C.sinensis infection has an impact on arthritis is unknown. Here we investigated the effect of C.sinensis infection on type II collagen-induced arthritis in BALB/c mice.
Results: The mice were firstly infected with 45 C.sinensis metacercariae by oral gavage. Four weeks later, arthritis in mice was induced by type II collagen. Joint inflammation with severe redness and swelling in hind paws was observed in type II collagen-induced arthritis (CIA) mice. Besides, the physical activity was significantly reduced, but the respiratory exchange ratio was increased in CIA mice. Compared with CIA mice, C.sinensis infection could increase the severity of arthritis in CIA mice, based on the results of disease score and pathological changes. Compared to CIA mice, increased neutrophils and Ly6C hi monocytes, decreased B cells and CD4 + T cells, were found in C.sinensis infected CIA mice. Besides these, C.sinensis infected mice also displayed significantly higher levels of serum IL-4 and IL-17 than those in CIA mice.
Conclusions: Taken together, our data suggest that C.sinensis infection have a bad effect on arthritis, and could induce the abnormality of the immune response in mice with CIA.
Women’s Economic Empowerment, Participation in Decision-Making and Exposure to Violence as Risk Indicators for Early Childhood Caries
Authors: Folayan Morenike Oluwatoyin , Tantawi Maha El , Vukovic Ana , Schroth Robert , Gaffar Balgis , Al-Batayneh Ola B. , Amalia Rosa , Arheiam Arheiam , Obiyan Mary , Daryanavard Hamideh 
Published: February 2020

Abstract
Objectives In view of the association between early childhood caries [ECC] and maternal social risk factors, this study tried to determine if there were associations between indicators of processes, outputs and outcomes of women’s empowerment, and the prevalence of ECC. Methods In this ecological study, indicators measuring the explanatory variables - economic empowerment, decision-making and violence against women - were selected from the Integrated Results and Resources Framework of the UN-Women Strategic Plan 2018-2021 and WHO database. Indicators measuring the outcome variables - the prevalence of ECC for children aged 0 to 2 years, and 3 to 5 years - were extracted from a published literature. The general linear models used to determine the association between the outcome and explanatory variables were adjusted for economic level of countries. Regression estimates (B), 95% confidence intervals and partial eta squared (η 2 ) were calculated. Results Countries with more females living under 50% of median income had higher prevalence of ECC for 3 to 5-year olds (B= 1.82, 95% CI= 0.12, 3.52). Countries with higher percentage of women participating in their own health care decisions had higher prevalence of ECC for 0 to 2-year-olds (B= 0.85, 95% CI= 0.03, 1.67). Countries with higher percentage of women participating in decisions related to visiting family, relatives and friends had higher prevalence of ECC for 3 to 5-year-olds (B= 0.67, 95% CI= 0.03, 1.32). None of the indicators for violence against women was significantly associated with the prevalence of ECC. Conclusion Empowerment of women is a welcome social development that may have some negative impact on children’s oral health. Changes in policies and norms are needed to protect children’s oral health while empowering women.
Impact of cutaneous adverse events on the quality of life in patients receiving anticancer agents: Results from an observational, cross-sectional study
Authors: Oh Hae-Jin Suh , Menéndez Ángeles Flórez , Santos Víctor Sacristán , Ribeiro Francisca Fernández , Vilanova-Trillo Lucía , Figueiras Manuel Constenla , Ferreiros Manuel Pereiro 
Published: February 2020

Abstract
Background: despite the growing interest in cutaneous adverse events (CAEs) and their management in oncology patients, they are often under-reported and there are no extensive data on their impact on quality of life. Health care professionals should pay attention to this issue in order to minimize its negative impact on quality of life (QoL) and improve patient outcome. The aim of this study was to evaluate the impact of CAEs on QoL in patients receiving anticancer drugs and to determine differences in QoL between conventional chemotherapy versus targeted therapies. Methods: 114 cancer patients with CAEs were included in this observational, cross-sectional study. Patient-reported outcomes instruments (FACT-G, DLQI and SKINDEX-16) were used. Results: Mean (SD) score in FACT-G was 65.3 (13.4), while in DLQI it was 8.4 (5) and in SKINDEX-16 it was 30.8 (16.9), showing a moderate impact on QoL. No significant differences in QOL indices according to the type of treatment (conventional chemotherapy vs targeted therapy) were observed Conclusions: CAEs had a moderate impact on QoL in cancer patients, evaluated with three different PRO instruments, but having more severe or two or more CAEs had a significant negative impact on QoL. No differences between conventional chemotherapy and targeted therapy were observed.