bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic ability of confocal near-infrared reflectance fundus imaging to detect retrograde microcystic maculopathy from chiasm compression. A comparative study with OCT findings
Authors: Monteiro Mário L. R. , Sousa Rafael M. , Araújo Rafael B. , Ferraz Daniel , Sadiq Mohammad A. , Zacharias Leandro C. , Preti Rony C. , Cunha Leonardo P. , Nguyen Quan D. 
Published: June 2021

Purpose
To evaluate the ability of confocal near-infrared reflectance (NIR) to diagnose retrograde microcystic maculopathy (RMM) in eyes with temporal visual field (VF) loss and optic atrophy from chiasmal compression. To compare NIR findings with optical coherence tomography (OCT) findings in the same group of patients.

Methods
Thirty-four eyes (26 patients) with temporal VF loss from chiasmal compression and 41 healthy eyes (22 controls) underwent NIR fundus photography, and macular OCT scanning. VF loss was estimated and retinal layers thickness were measured on OCT. Two examiners blinded to the diagnosis randomly examined NIR images for the presence of hyporeflective abnormality (HA) and OCT scans for the presence of microcystic macular abnormalities (MMA). The total average and hemi-macular HA area and number of microcysts were determined. The groups were compared and the level of agreement was estimated.

Results
The OCT-measured macular retinal nerve fiber and ganglion cell layers were thinner and the inner nuclear layer was thicker in patients compared to controls. HA and MMA were detected in 22 and 12 patient eyes, respectively, and in 0 controls (p<0.001, both comparisons). HA was significantly more frequent than MMA in patients with optic atrophy, and agreement between HA and MMA (both total and hemi-macular) was fair (kappa range: 0.24–0.29). The mean HA area was significantly greater in the nasal than temporal hemi-macula. A re-analysis of the 14 eyes with discrepant findings allowed to confirm RMM in 20 eyes (20/34) indicating that OCT detected RMM in 12 and missed it in 8 eyes. On the other hand, NIR correctly detected 18 out of 20 eyes, overcalled 4 and missed 2.

Conclusions
RMM is a frequent finding in eyes with severe VF loss from long-standing chiasmal compression. NIR photography appears to be more sensitive than OCT for detecting RMM and may be useful as screening method for its presence.
Breast cancer awareness, risk factors and screening practices among future health professionals in Ghana: A cross-sectional study
Authors: Osei-Afriyie Sandra , Addae Albert Kwesi , Oppong Samuel , Amu Hubert , Ampofo Emmanuel , Osei Eric 
Published: June 2021

BackgroundLike many other women in the developing world, the practice of breast cancer screening among Ghanaian women is unsatisfactory. As a result, many cases are diagnosed at advanced stages leading to poor outcomes including mortalities. An understanding of the awareness and predictors of breast examination is an important first step that may guide the design of interventions aimed at raising awareness across the general population. This study aimed to explore the awareness, risk factors, and self-reported screening practices of breast cancer among female undergraduate students at the University of Health and Allied Sciences.MethodsThis cross-sectional study was conducted among 385 female undergraduate students using a pre-tested questionnaire. Data were analysed using Stata Version 13.1 and presented using descriptive and inferential statistics comprising frequency, percentage, chi-square, and binary logistic regression. Odds ratios and 95% confidence intervals were computed to quantify the association between regular Breast-Self Examination (BSE) and socio-demographic characteristics of respondents.ResultsSeventy-three per cent of the students were aware of breast cancer, with social media being the most important source of information (64.4%). The prevalence of breast cancer risk factors varied from 1% of having a personal history of breast cancer to 14.3% for positive family history of breast cancer. Current use of oral pills/injectable contraceptives was confirmed by 13.2% of participants; 20% were current alcohol users and10.1% were physically inactive. Regarding breast examination, 42.6% performed BSE; 10.1% had Clinical Breast Examination (CBE), while 2.3% had undergone mammography in the three years preceding the study. Women who did not believe to be susceptible to breast cancer (AOR: 0.04; 95%CI: 0.02–0.09) and those who did not know their risk status (AOR: 0.02; 95%CI: 0.005–0.57) were less likely to perform regular BSE compared to those who displayed pessimism. Further, women with no religious affiliation had 0.11 (95%CI: 0.02–0.55) odds of examining their breast regularly compared to Christians.ConclusionThis study demonstrated moderate awareness of the modalities of breast cancer screening and the risk factors of breast cancer among the students. However, there exists a gap between awareness and practice of breast cancer screening, which was influenced by optimism in breast cancer risk perception and religion. Awareness campaigns and education should be intensified in the University to bridge this gap.
Determinant of intention to receive COVID-19 vaccine among school teachers in Gondar City, Northwest Ethiopia
Authors: Handebo Simegnew , Wolde Maereg , Shitu Kegnie , Kassie Ayenew 
Published: June 2021

Background
Scientists across the world are working on innovating a successful vaccine that will save lives and end COVID-19 pandemic. World Health Organization (WHO) is working to make sure COVID-19 vaccines can be safely delivered to all those who need them. Indeed, the successful deployment and a sufficient uptake of vaccines is equally important. Acceptance and accessibility of such vaccine is a key indicator of vaccination coverage.

Objective
This study aimed to assess the determinants of intention to receive COVID-19 vaccine among school teachers in Gondar City.

Methods
An institution based cross-sectional study was conducted from December, 2020 to January, 2021. A total of 301 school teachers selected using stratified simple random sampling were included. Descriptive analysis such as medians, means, proportions, standard deviations and frequencies were computed. Linear regression analysis was done to identify factors associated with intention to receive COVID-19 vaccine. A p-value of less than 0.05 was used to declare statistical significance.

Results
The median intention to receive COVID-19 vaccine was 3.33 with interquartile range of 2.67–4.0. Of the participants 54.8% had scored above the median of intention to receive COVID-19 vaccine score. 54% variance in intention to receive COVID-19 vaccine was explained by the independent variables. Being affiliated with other category of religion, bachelor degree educational status, perceived susceptibility, perceived benefit, perceived barrier, and cues to action were significantly associated with the intention to receive COVID-19 vaccine.

Conclusion
The median score of intention to receive COVID-19 vaccine was 3.33. Socio-demographic and health beliefs influenced the intention to receive the COVID-19 vaccine in the study participant. Policy makers and stakeholders should focus on strong health promotion about risks of the pandemic, benefit, safety, and efficacy of vaccination.
Immunoglobulin gene rearrangement in Koreans with multiple myeloma: Clonality assessment and repertoire analysis using next-generation sequencing
Authors: Kim Miyoung , Jeon Kibum , Hutt Kasey , Zlotnicki Alyssa M. , Kim Hyo Jung , Lee Jiwon , Kim Han-Sung , Kang Hee Jung , Lee Young Kyung 
Published: June 2021

IntroductionWe assessed the applicability of next-generation sequencing (NGS)-basedIGH/IGKclonality testing and analyzed the repertoire of immunoglobulin heavy chain (IGH) or immunoglobulin kappa light chain (IGK) gene usage in Korean patients with multiple myeloma (MM) for the first time.MethodsFifty-nine bone marrow samples from 57 Korean patients with MM were analyzed, and NGS-based clonality testing that targeted theIGHandIGKgenes was performed usingIGHFR1 andIGKprimer sets.ResultsClonalIGHandIGKrearrangements were observed in 74.2% and 67.7% of samples from Korean patients with kappa-restricted MM, respectively (90.3% had one or both), and in 60.7% and 95.5% of samples from those with lambda-restricted MM, respectively (85.7% had one or both). In total, 88.1% of samples from Koreans with MM had clonalIGHand/orIGKrearrangement. Clonal rearrangement was not significantly associated with the bone marrow plasma cells as a proportion of all BM lymphoid cells.IGHV3-9(11.63%) andIGHV4-31(9.30%) were the most frequently reportedIGHVgenes and were more common in Koreans with MM than in Western counterparts.IGHD3-10andIGHD3-3(13.95% each) were the most frequent IGHD genes;IGHD3-3was more common in Koreans with MM. NoIGKrearrangement was particularly prevalent, but singleIGKV-Jrearrangements were less common in Koreans with kappa-restricted MM than in Western counterparts.IGKV4-1was less frequent in Koreans regardless of light chain type. Otherwise, the usages of theIGHV, D, and J genes and of theIGKgene were like those observed in previous Western studies.ConclusionNGS-basedIGH/IGKclonality testing ought to be applicable to most Koreans with MM. The overrepresentation ofIGHV3-9,IGHV4-31, andIGHD3-3along with the underrepresentation ofIGKV4-1and the differences inIGKgene rearrangement types suggest the existence of ethnicity-specific variations in this disease.
SARS-CoV-2 detection and genomic sequencing from hospital surface samples collected at UC Davis
Authors: Coil David A. , Albertson Timothy , Banerjee Shefali , Brennan Greg , Campbell A. J. , Cohen Stuart H. , Dandekar Satya , Díaz-Muñoz Samuel L. , Eisen Jonathan A. , Goldstein Tracey , Jose Ivy R. , Juarez Maya , Robinson Brandt A. , Rothenburg Stefan , Sandrock Christian , Stoian Ana M. M. , Tompkins Daniel G. , Tremeau-Bravard Alexandre , Haczku Angela 
Published: June 2021

Rationale
There is little doubt that aerosols play a major role in the transmission of SARS-CoV-2. The significance of the presence and infectivity of this virus on environmental surfaces, especially in a hospital setting, remains less clear.

Objectives
We aimed to analyze surface swabs for SARS-CoV-2 RNA and infectivity, and to determine their suitability for sequence analysis.

Methods
Samples were collected during two waves of COVID-19 at the University of California, Davis Medical Center, in COVID-19 patient serving and staff congregation areas. qRT-PCR positive samples were investigated in Vero cell cultures for cytopathic effects and phylogenetically assessed by whole genome sequencing.

Measurements and main results
Improved cleaning and patient management practices between April and August 2020 were associated with a substantial reduction of SARS-CoV-2 qRT-PCR positivity (from 11% to 2%) in hospital surface samples. Even though we recovered near-complete genome sequences in some, none of the positive samples (11 of 224 total) caused cytopathic effects in cultured cells suggesting this nucleic acid was either not associated with intact virions, or they were present in insufficient numbers for infectivity. Phylogenetic analysis suggested that the SARS-CoV-2 genomes of the positive samples were derived from hospitalized patients. Genomic sequences isolated from qRT-PCR negative samples indicate a superior sensitivity of viral detection by sequencing.

Conclusions
This study confirms the low likelihood that SARS-CoV-2 contamination on hospital surfaces contains infectious virus, disputing the importance of fomites in COVID-19 transmission. Ours is the first report on recovering near-complete SARS-CoV-2 genome sequences directly from environmental surface swabs.
Dilemma of physician-mothers faced with an increased home burden and clinical duties in the hospital during the COVID-19 pandemic
Authors: Nishida Sachiyo , Nagaishi Kanna , Motoya Masayo , Kumagai Ayako , Terada Noriko , Kasuga Ai , Kubota Narumi , Iesato Kotoe , Kimizuka Motonobu , Miyajima Satsuki , Koyama Masayuki , Ohnishi Hirofumi , Narimatsu Eichi , Masumori Naoya , Tsuchihashi Kazufumi , Tsukamoto Taiji , Tsuji Yoshihisa 
Published: June 2021

Purpose
Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly across the world. During the pandemic, physicians in our hospital have had to respond both to the issue of treating the patients and the increasing domestic burden associated with social disruption. The purpose of this study was to assess how much the burden on our doctors, especially female doctors, was increasing.

Material and methods
The Physicians’ Career Support Committee in Sapporo Medical University conducted a questionnaire survey. The questionnaire inquired about a wide range of subjects with regard to working style and family life during the first and second waves of the COVID-19 pandemic, and was sent to all medical/dental physicians working in Sapporo Medical University.

Results
A total of 266 (42.7%) physicians in our hospital responded to our questionnaire and the data for 264 data were analyzed. The total numbers of males, females, and others, including those who did not want to specify, were 178 (67.4%), 82 (31.0%), and 4 (1.5%), respectively. Among them, 62 (23.5%) and 23 (8.7%) answered that their domestic burden was slightly or markedly increased. The increase in the domestic burden showed a significant difference between genders (p = 0.04). Even after correction for background differences using multivariate analysis, being female (p<0.001), having child dependents (p<0.001), and treating COVID-19 patients (p = 0.03) were significantly related to an increased domestic burden. Regarding family style, 58.1% of the physician-fathers were from two-income families (i.e., families with both parents in employment), and they answered that their partner mainly cared for the children. In contrast, 97.3% of physician-mothers were from two-income families, and 94.6% of the physician-mothers had to take care of children by themselves.

Conclusion
Physician-mothers are caught in a dilemma between an increased home burden and clinical duties in the hospital, with a significantly higher ratio than physician-fathers during the pandemic. As we showed, female doctors could have not continued their careers and take responsible positions in the same way as male doctors. This is a social risk in the timing of a crisis, such as a pandemic.
Nursing students’ attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal
Authors: Thapa Pratima , Bhandari Suman Lata , Pathak Sharada 
Published: June 2021

IntroductionIn present days, the use of information technology (IT) in education is unquestionable. The mounting advancement of IT has changed the scenario of education. With the emergence of the current COVID-19 situation, it has undoubtedly provided a solution to most of our educational needs when all educational institutions remained closed due to the pandemic. This study aims to identify the nursing students’ attitude towards the practice of e-learning amidst COVID-19.MethodsA descriptive web-based cross-sectional study was conducted among nursing students with a sample size of 470. A self-administered validated questionnaire along with a standard tool to measure the attitude was used for data collection. Data were analyzed using SPSS.ResultsThe mean ± SD age of the respondents was 20.91± 1.55 years. The majority (76.4%) of the respondents used mobile for their study and 90.4% used Wi-Fi for the internet source. The main advantage of e-learning was stated as the ability to stay at home (72.1%) followed by the reduced cost of accommodation and transport (51.3%) whereas the internet problem (81.7%) was the major disadvantage followed by technical issues (65.5%). Only about 34% of the students found e-learning as effective as traditional face-to-face learning. The mean scores for the domains: perceived usefulness, intention to adapt, distant use of e-learning, ease of learning, technical support, and learning stressors were 3.1, 3.1, 3.8, 2.9, 2.9, and 2.5 respectively. Overall, 58.9% had a favorable attitude regarding e-learning. There was no significant association of overall attitude regarding e-learning with selected socio-demographic variables whereas it was positively associated with all of its six domains. All the domains were positively correlated with each other except for ease of learning with technical support and distant use, and technical support with learning stressor and distant use. Learning stressor versus distant use was negatively correlated with each other.ConclusionThough e-learning was implemented as a substitute during the pandemic, almost half of the nursing students showed a positive attitude regarding e-learning. The majority of the students had internet problems and technological issues. If e-learning can be made user-friendly with reduced technical barriers supplemented with programs that can enhance practical learning abilities, e-learning can be the vital alternative teaching method and learning in the nursing field.
Impact of urate-lowering therapy on quality of life indicators in patients with gout
Authors: Chikina M. N. , Zhelyabina O. V. , Eliseev M. S. 
Published: June 2021

Gout can have a significant impact on the quality of life (QoL) of patients.Objective: to assess the dynamics of QoL indicators and the possibility of achieving the target level of uric acid (UA) in patients with gout on febuxostat therapy, with ineffectiveness and / or contraindications to the allopurinol administration.Patients and methods. The prospective, single-center study included 80 patients with gout. The follow-up period was at least 6 months of allopurinol or febuxostat (Azurix®) therapy in doses required to achieve the target UA level. When urate-lowering therapy was initiated, allopurinol 100 mg per day was prescribed, followed by dose titration (up to maximum of 900 mg per day) until the target UA level was reached (<360 μmol/L). Patients with ineffectiveness of allopurinol and / or adverse reactions (ADRs) were transferred to febuxostat 80–120 mg per day. To prevent arthritis attacks, all patients received low doses of non-steroidal anti-inflammatory drugs or colchicine 0.5 mg per day or glucocorticoids 7,5 mg per day (in prednisolone equivqlent). At the first and last visits, patients on febuxostat completed the SF-36 questionnaire.Results and discussion. After 6 months of follow-up, 70 (88%) patients received urate-lowering therapy, of whom 51 (73%) reached the target UA level. Allopurinol dosage titration required 26 patients, of whom 14 (54%) achieved the treatment goal. Due to the ineffectiveness of allopurinol, 32 patients were switched to febuxostat, which allowed to achieve normouricemia in 69% of cases. Fifteen (68%) of 22 patients who were initiated with febuxostat due to ADRs to allopurinol also achieved the target UA level. Patients who received febuxostat and reached the target UA level improved QoL indicators: role-physical functioning, bodily pain, general health, vitality and general physical well-being (p<0.05 in all cases). Patients who did not reach the target UA level on febuxostat therapy improved such indicators as physical functioning, role-physical functioning, and bodily pain (p<0.05 in all cases). High compliance was observed in 63% of patients, treated with febuxostat and in 36% of patients, treated with allopurinol.Conclusion. In patients with ineffectiveness or intolerance to allopurinol, in 69% of cases febuxostat allows to achieve the target UA level and improving QoL and complience.
Initial drug prescription in outpatient department: principal approach
Authors: Karateev A. E. 
Published: June 2021

One of the primary tasks for a doctor when meeting a patient for the first time is to gain his affection and trust. It is not always possible during the first visit to make an accurate diagnosis and prescribe pathogenetic therapy, because this often requires a deep additional examination. However, it is imperative to demonstrate knowledge and confidence, provide psychological support and alleviate the suffering of the patient, especially in the case of rheumatic disease accompanied by severe pain. Such a patient should be immediately prescribed adequate analgesic therapy. The main tool for controlling pain in diseases of the joints and spine are non-steroidal anti-inflammatory drugs. Moreover, their prescription should be deliberate and balanced, taking into account the clinical picture and comorbid pathology.The article presents two clinical observations, illustrating the formation of a diagnostic and therapeutic concept at an outpatient appointment.
Off-label antipsychotics prescription to adolescents with acute psychotic episodes does not cause adverse drug reactions
Authors: Ivashchenko D. V. , Buromskaya N. I. , Malakhova A. D. , Tsarkova N. A. , Savchenko L. M. , Shevchenko Yu. S. , Sychev D. A. 
Published: June 2021

Antipsychotics are often used to treat children and adolescents. Because of their age, there are a lot of off-label prescribed antipsychotics in that population. However, the off-label use of medications is considered to be potentially unsafe.Objective: to evaluate whether the off-label prescription of antipsychotics outside of the approved age group increased the risk of adverse drug reactions in adolescents experiencing an acute psychotic episode.Patients and methods. We analyzed 450 charts of adolescents hospitalized due to an acute psychotic episode (only completed cases). In addition, we evaluated adverse drug reactions adjusted by off-label antipsychotics prescription outside the approved age group using the Global Trigger Tool (GTT). We also registered prescriptions with duplicates drug classes and potentially dangerous drug interactions.Results and discussion. Off-label antipsychotics prescription outside the approved age group was less frequently associated with adverse drug reactions (3.2% vs. 10.5%; p=0.013). The logistic regression analysis did not show any significant associations between the off-label antipsychotic use and increased risk of adverse drug reactions (Odds ratio=0.994 (95% confidence interval 0.572-1.726), p=0.982). Although, patients with off-label use of antipsychotics were more likely to have potentially dangerous drug interactions (35.2% vs. 16.15%; p=0.0001) and prescriptions with duplicates drug classes (39.6% vs. 15.43%; p=0.0001).Conclusion. Off-label antipsychotic prescription outside the approved age group in adolescents with acute psychotic episode does not increase the risk of adverse drug reactions. However, an increase in potentially dangerous drug interactions and prescriptions with duplicates drug classes frequency could be considered red flags. Therefore, we have concluded that the concerns about off-label antipsychotics prescription outside of approved age groups in adolescents with acute psychotic episodes were overrated.