bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training needs for Ugandan primary care health workers in management of respiratory diseases: a cross sectional survey
Authors: Nantanda Rebecca , Kayingo Gerald , Jones Rupert , Gemert Frederik van , Kirenga Bruce 
Published: March 2020

Abstract
Background

Respiratory diseases are among the leading causes of morbidity and mortality in Uganda, but there is little attention and capacity for management of chronic respiratory diseases in the health programmes. This survey assessed gaps in knowledge and skills among healthcare workers in managing respiratory illnesses.

Methods

A cross sectional study was conducted among primary care health workers, specialist physicians and healthcare planners to assess gaps in knowledge and skills and, training needs in managing respiratory illnesses. The perspectives of patients with respiratory diseases were also sought. Data were collected using questionnaires, patient panel discussions and review of pre-service training curricula for clinicians and nurses. Survey Monkey was used to collect data and descriptive statistical analysis was undertaken for quantitative data, while thematic content analysis techniques were utilized to analyze qualitative data.
Results

A total of 104 respondents participated in the survey and of these, 76.9% (80/104) were primary care health workers, 16.3% (17/104) specialist clinicians and 6.7% (7/104) healthcare planners. Over 90% of the respondents indicated that more than half of the patients in their clinics presented with respiratory symptoms. More than half (52%) of the primary care health workers were not comfortable in managing chronic respiratory diseases like asthma and COPD. Only 4% of them were comfortable performing procedures like pulse oximetry, nebulization, and interpreting x-rays. Majority (75%) of the primary care health workers had received in-service training but only 4% of the sessions focused on respiratory diseases. The pre-service training curricula included a wide scope of respiratory diseases, but the actual training had not sufficiently prepared health workers to manage respiratory diseases. The patients were unsatisfied with the care in primary care and reported that they were often treated for the wrong illnesses.
Conclusions

Respiratory illnesses contribute significantly to the burden of diseases in primary care facilities in Uganda. Management of patients with respiratory diseases remains a challenge partially because of inadequate knowledge and skills of the primary care health workers. A training programme to improve the competences of health workers in respiratory medicine is highly recommended.
Key words: respiratory diseases, primary care, health workers, knowledge, skills
Establishment of a sentinel surveillance network for sexually transmissible infections and blood borne viruses in Aboriginal primary care services across Australia: the ATLAS project
Authors: Bradley Clare , Hengel Belinda , Crawford Katy , Elliott Salenna , Donovan Basil , Mak Donna B , Nattabi Barbara , Johnson David , Guy Rebecca , Fairley Christopher K , Wand Handan , Ward James 
Published: March 2020

Abstract
Background: Sexually transmissible infection (STI) and blood-borne virus (BBV) diagnoses data are a core component of the Australian National Notifiable Diseases Surveillance System (NNDSS). However, the NNDSS data alone is not enough to understand STI and BBV burden among priority population groups, like Aboriginal and Torres Strait Islander people, because it lacks testing, treatment and management data. Here, we describe the processes involved in establishing a STI and BBV sentinel surveillance network representative of Aboriginal Community-Controlled Health Services (ACCHS)—known as the ATLAS network—to augment the NNDSS and to help us understand the burden of disease due to STI and BBV among Aboriginal and Torres Strait Islander peoples.
Methods: Researchers invited participation from ACCHS in urban, regional and remote areas clustered in five clinical hubs across four Australian jurisdictions. Participation agreements were developed for each clinical hub and individual ACCHS. Deidentified electronic medical record (EMR) data relating to STI and BBV testing, treatment and management are collected passively from each ACCHS via the GRHANITE tm data extraction tool. These data are analysed centrally to inform 12 performance measures which are included in regular surveillance reports generated for each ACCHS and clinical hub.
Results: The ATLAS network currently includes 29 ACCHS. Regular reports are provided to ACCHS to assess clinical practice and drive continuous quality improvement initiatives internally. Data is also aggregated at the hub, jurisdictional and national level and will be used to inform clinical guidelines and to guide future research questions. The ATLAS infrastructure can be expanded to include other health services and potentially linked to other data sources using GRHANITE.
Conclusions: The ATLAS network is an established national surveillance network specific to Aboriginal and Torres Strait Islander peoples. The data collected through the ATLAS network augments the NNDSS and will contribute to improved STI and BBV clinical care, guidelines and policy program-planning.
QTL-seq Analysis of Seed Size Trait in Grape Provides New Molecular Insight on Seedlessness
Authors: Wang Li , Zhang Songlin , Jiao Chen , Li Zhi , Liu Chonghuai , Wang Xiping 
Published: March 2020

Abstract

Background

Seedlessness in grape ( Vitis vinifera ) is an important commercial trait for both the fresh and drying markets. However, despite numerous studies, the mechanisms and key genes regulating grape seedlessness are mostly unknown.

Results

In this study, we sequenced the genomes of the V. vinifera seeded cultivar ‘Red Globe’, the seedless cultivar ‘Centennial’, as well as the derived hybrids. Nonsynonymous SNPs were identified and analyzed with respect to published transcriptome data. All the DEGs containing nonsynonymous SNPs were further analyzed in terms of expression patterns, Gene Ontology and pathway enrichment. A potential QTL region associated with seed size was characterized based on SNP indices for both seedless and seeded progeny. Expression analysis of candidate genes during ovule development in multiple seeded and seedless grape cultivars further indicates their potential function in grape seed development.

Conclusion

In summary, DEGs containing nonsynonymous SNPs were mainly protein kinase, transcription factors, cytochrome P450 and other factors related to seed development, which were mainly involved in biological processes like hormone balance, seed coat and endosperm development, reproductive organ development, oxidation and reduction, senescence and cell death. Based on SNP-index and expression pattern analysis, three genes were further identified as potential seedlessness-related genes. Overall the data cast light on the differences of seed development between seeded and sedless progeny in perspective of both functional variants and expression pattern,which provides valuable candidates for future functional study.
Increasing prevalence of anticholinergic medication use in older people in England over 20 years: Cognitive Function and Ageing Study I and II
Authors: Grossi Carlota , Richardson Kathryn , Savva George , Fox Chris , Arthur Antony , Loke Yoon , Steel Nicholas , Brayne Carol , Matthews Fiona , Robinson Lousie , Myint Phyo , Maidment Ian 
Published: March 2020

Abstract
Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality, and their use should be limited in older people. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.
First evidence showing that Pepper vein yellows virus P4 protein is a movement protein
Authors: Li Sangsang , Su Xianyang , Luo Xiangwen , Zhang Yu , Zhang Deyong , Du Jiao , Zhang Zhanhong , OuYang Xian , Zhang Songbai , Liu Yong 
Published: March 2020

Abstract
Background

Plant viruses move through plasmodesmata (PD) to infect new cells. To overcome the PD barrier, plant viruses have developed specific protein(s) to guide their genomic RNAs or DNAs to path through the PD.

Results

In the present study, we analyzed the function of Pepper vein yellows virus P4 protein. Our bioinformatic analysis showed that the P4 protein contains an transmembrane domain, encompassing the amino acid residue 117-138. The P4 protein was found to target PD and form small punctates near walls. The P4 deletion mutant or the substitution mutant lost their function to produce punctates near the walls inside the fluorescent loci. The P4-YFP fusion was found to move from cell to cell in infiltrated leaves, and P4 could complement Cucumber mosaic virus movement protein deficiency mutant to move between cells.

Conclustion

Taking together, we consider that the P4 protein is a movement protein of Pepper vein yellows virus.
Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
Authors: Hao Lu , Li Shengwen , Liu Junhui , Shan Zhi , Fan Shunwu , Zhao Fengdong 
Published: March 2020

Abstract
Objective: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH), and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). Methods: We included 102 (65 males, 37 females, aged 20–66 yrs) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperatively. The presence and type of Modic changes were assessed. During surgery the herniated disc component of each patient was classified into two groups: nucleus pulposus group, hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of rLDH was assessed based on more than 2-year follow-up. Results: In total, 11 patients were lost to follow up; the other 91 were followed up during 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P<0.05). We found 2 cases of rLDH in the non-MC group (n=71); 6 cases rLDH were found in the MC group (n=28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P>0.05). rLDH was more common in patients with MCs (P<0.05). We found 5 rLDH cases in the hyaline cartilage group (n=32); 3 rLDH cases were found in the nucleus pulposus group (n=67). rLDH was more common in the hyaline cartilage group (P<0.05). Conclusions: rLDH following PELD preferentially occurs when MCs or herniated cartilage are present.
Appraising Efficiency of OpSite as Coolant in Drilling of Bone
Authors: Effatparvar Mohammad Reza , Jamshidi Nima , Mosavar Alireza 
Published: March 2020

Abstract
Background: During drilling of bone, which is common in clinical surgeries, heat generation increases local temperature in the drilling site. Transmission of excessive heat to the surrounding bone tissue can cause thermal osteonecrosis. Consequently, it may lead to failure of implants and fixation screws or delay in healing process. Using cooling is a method for limiting temperature elevation. Materials and Methods: In this study, through comparing 3 conditions of drilling without cooling, external cooling with normal saline, and external cooling with OpSite spray, the efficiency of OpSite as coolant is studied. In this regard, 2 drill bit diameters, 3 drilling speeds, and 3 drilling feed-rates are considered as drilling variables in the experiments. Results: For the whole experiments, while cooling with normal saline resulted in lower maximum temperatures than without cooling condition, OpSite had even better results and limited the temperature elevation during drilling of bone efficiently. Conclusion: OpSite spray, which has lower infection risks than normal saline on one hand and lower maximum temperature rise with all combinations of drilling parameters on the other hand, can be considered in clinical surgeries for cooling applications.
Diverting blame to stay sane - young people's strategies for dealing with the mental health effects of precarious employment: a Grounded Theory study
Authors: Toivanen Susanna , Tarantino Anna Olofsson , Emmelin Maria , Östergren Per-Olof 
Published: March 2020

Abstract
Background

Precarious employment is a risk factor for poor mental health, particularly among young adults. Knowledge about how young people maintain their mental health while in a precarious employment situation is scarce. The aim of the study was to explore the meaning of precarious employment for young adults in Sweden and their strategies for maintaining good mental health.

Methods

In-depth interviews were conducted with 15 individuals (9 men and 6 women) aged 20–39 years in a precarious employment situation. Contact persons at union offices and at specific job-coaching organizations collaborating with the Swedish public employment agency in the city of Malmö were gate openers to reach informants. Analysis was based on constructivist grounded theory, implying an emergent design where data collection and analysis go hand in hand.

Results

All informants had completed secondary school in Sweden, and one third had studied at the university level. A majority currently had jobs; however, they were mostly employed on an hourly basis and only a few had temporary full-time jobs. The analysis resulted in a core category “Diverting blame to stay sane,” which summarized an emergent coping process involving individual resources and resources represented by the individuals’ social capital. The developed theoretical model contained four main categories, “Facing reality,” ”Losing control,” “Adapting,” and “Fighting back,” related to the core category.

Conclusions

The results implied a process where the challenges created by loss of employment-based rights required a coping process where the individual’s social capital plays an important role. However, social capital is to a large extent determined by contextual factors, underlining the strong health equity aspect of precarious employment.
The hidden risk of ionizing radiation in the operating room: A survey among 258 orthopaedic surgeons in Brazil
Authors: Pires Robinson Esteves , Reis Igor Guedes Nogueira , de Faria Ângelo Ribeiro Vaz , Giordano Vincenzo , Labronici Pedro José , Belangero William Dias 
Published: March 2020

Abstract
Background: This study aims to assess orthopedic surgeon knowledge in Brazil about ionizing radiation and its health implications on surgical teams and patients.
Methods: A 15-question survey on theoretical and practical concepts of ionizing radiation was administered during the 23rd Brazilian Orthopaedic Trauma Association annual meeting. The survey addressed issues within orthopedic surgery, such as radiation safety concepts, protection, exposure, as well as the participant gender.Participants were either orthopedic surgeons or orthopedic surgery residents working at institutions in Brazil.
Results: One thousand surveys weredistributed,and 258 were answered completely (25.8% response rate).Only 5.8% of participants used basic radiation protection equipment (apron, thyroid shield, and radiation protection glasses); 47.3% used a dosimeter; 2.7% reached the annual maximum permissible radiation dose; 10.5% knew the period of increased risk to fetal gestation; 5.8% knew the maximum permissible radiation dose during pregnancy; 58.5% knew that the hands, eyes, and thyroid are the most exposed areas and at greater risk of radiation-related lesions; 25.2% knew the safe distance from a radiation-emitting tube is 3 meters or more; 44.2% knew the safest positioning of the radiation-emitting tube; 25.2% knew that smaller tubes emit greater radiation at the entrance dose to magnify the image; and 55.4% knew that the surgery team receives more scattered radiation in surgical procedures performed on obese patients.
Conclusion: This study revealed inadequate theoretical and practical knowledge about radiation exposureamong orthopaedic surgeons in Brazil. Only a minority of orthopaedic surgeons used basic radiation protection equipment (apron, thyroid shield, and radiation protection glasses). No significant differences in knowledge were found when comparing all orthopedic surgery specialties. Our findings indicate an urgent need for education to increase knowledge among orthopaedic surgeons about the hazards of ionizing radiation. Personal protection and implementation of the ALARA (as low as reasonably achievable) protocol in daily practice are important behaviors to prevent the harmful effects of ionizing radiation.
Relevance of anthropometric measurements as predictors of prevalent diabetes type II - A cross-sectional study on a Norwegian population
Authors: Hasselgren Anton , Karmacharya Biraj M , Stensdotter Ann-Katrin 
Published: March 2020

Abstract
Background The association of overweight and diabetes mellitus type 2 varies with geographical area and ethnicity, and there is incoherent evidence as to which anthropometric index best predicts prevalent diabetes mellitus type 2 in different populations. The rationale for this study was to contribute to the understanding of how anthropometric indices perform as a screening tool for diabetes mellitus type 2. Hence, the objective was to determine the predictive potential of anthropometric indices to screen prevalent diabetes mellitus type 2 in the Norwegian population.Methods This study used cross-sectional data from the Health Study in Nord-Trøndelag (HUNT) to determine the potential association of waist-to-height ratio, waist-to-hip ratio, waist-circumference and body mass index with prevalent diabetes mellitus type 2 through logistic regression analysis. Receiver Operating Characteristic (ROC) curves were used to determinate the predictive potential of the anthropometric indices. Youden’s index was applied to determinate the optimal cut-off points for each anthropometric index.Results The results suggest that the anthropometric indices performed differently within the Norwegian population with waist-to-hip ratio and waist-to-height ratio being the strongest predictors with (ROC) of 0.746 (0.735 - 0.757) and 0.741(0.730 - 0.752). The predictive potential for the investigated anthropometric indices was generally stronger for women than men.Interpretation When using anthropometric indices to screen prevalent diabetes mellitus type 2, the choice of anthropometric index and cut-off points should be considered based on country and the ethnic characteristics of the population.
Association Between Wasting and Food Insecurity Among Children Under Five Years: Findings from Nepal Demographic Health Survey 2016
Authors: Nepali Sajama , Simkhada Padam , Davies Ian Glyyn 
Published: March 2020

Abstract
Background: Wasting is a consequences of food insecurity, poor access to appropriate, inadequate caring and feeding practices. The present study assessed association between wasting and household food insecurity among under five years children, along with other socio-demographics characteristics. Methods: This study is a secondary analysis of Nepal Demographic and Health Survey 2016. The survey is cross sectional in design with use of standardized tools. The sampling frame used is an updated version of the frame from the 2011 National Population and Housing Census. The participants were children under five years of age and total children analyzed were 2414. Logistic regression was carried out to identify the odds of being wasted for children belonging to different levels of food insecure households using odds ratio and 95 percent confidence interval. Results: The prevalence of wasting increased with the level of food insecurity, from mild (9.4%) to moderate (10.8%) and to severe (11.3%). The highest proportions of wasted children were in Province 2 (14.3%), from rural areas (10.1%), born to mothers with no education (12.4%) and from a richer quintile (11.3%). Children belonging to severe food insecure households had 1.36 (95% CI 0.72-2.57) adjusted odds of being wasted and 1.38 (95% CI 0.80-2.38) crude odds of being wasted. Children born to mothers without any education had 1.84 (95% CI 1.08-3.12) crude odds of being wasted than those born to mothers with higher education in the crude analysis; however, no significant association was seen in the adjusted analysis with adjusted odds of 1.35 (95% CI 0.71-2.59). For children living in Province 1, the crude odds was 2.18 (95% CI 1.06-4.51); however on adjusting for other variables, the odds decreased to 2.06 (95% CI 1.01-4.19). Those for Province 2, the crude odds was 2.74 (95% CI 1.46-5.14) and the adjusted odds was 2.45 (95% CI 1.22-4.95). Conclusion: Considering the increment in childhood wasting as per level of food insecurity, an integrated intervention should be developed that addresses improving knowledge and behavior of community people on diet and nutrition as well as reducing the problem of food insecurity through agricultural interventions.