bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Modern Contraceptive Use among Adolescents in Nepal
Authors: Subedi Ranjeeta , Jahan Israt , Baatsen Pam 
Published: April 2021

In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use.Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information.A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed.
Keywords: Adolescent; barriers; contraceptive; Nepal; SRHR.
The Use of the Six English Tenses in Students’ Daily Conversation
Authors: Aditya Maulana Yusuf , Chairuddin Chairuddin 
Published: April 2021

Abstract. For English learners, there are important aspects to consider such as vocabulary, pronunciation and grammar to master their speaking skills. Speaking is used to express people’s ideas and feelings in daily life or to communicate with others both personal talks and transactional conversation. The objective of the study is to figure out how the students of SMKN 2 Bangkalan can use the six English tenses in daily conversation. The research was done within two weeks starting from 22th April to 06th May 2019. Observation and interview were performed to collect the data. Observation was made to see what was going on in the class, focusing on the students’ conversation. On the other hand, Interview was carried out to know the students’ problems in using the correct tenses in conversation, and to find out how the students solve the problems. The observation shows that in using the six English tenses, the students likely found it hard to apply the correct tenses in the conversation with their friends and the teacher. The students tended to use one tense in all situations and the tense mostly used was the simple present one. From the interview, it is found that the students do not really understand what tenses are, either the meaning or the uses.Keywords: daily conversation, tenses, observation, interview, contexts of situationAbstrak. Bagi pembelajar Bahasa Ingggris, terdapat aspek penting seperti kosakata, pengucapan dan tatabahasa yang harus diperhatikan untuk meningkatkan kemampuan berbahasa Inggrisnya. Kemampuan berbicara khususnya digunakan untuk menyampaikann semua yang ada dalam benak kita seperti misalnya ide dan perasaan dalam kehidupan sehari-hari, baik itu berupa perkataan pribadi atau pun percakapan transaksional. Tujuan utama penelitian ini adalah untuk mengetahui bagaimana murid dapat menggunakan enam kala (tenses) dalam percakapan sehari-hari sesuai dengan kontek situasi, di SMKN 2 Bangkalan. Penelitian dilakukan selama 2 minggu dimulai tanggal 22 April s/d 06 Mei 2019. Penelitian dilakukan dengan 2 langkah seperti observasi dan wawancara. Observasi dilakukan untuk mengetahui yang terjadi dalam selama proses pembelajaran dan fokus pada cara murid bercakap. Wawancara dilakukan oleh peneliti untuk mengetahui permasalahan pada murid dalam menggunakan tenses yang benar dan bagaimana murid mengatasi masalah penggunaan kala yang benar tersebut. Dari hasil observasi dapat diketahui bahwa penggunaan enam kala dalam percakapan sehari-hari dari murid adalah buruk, mereka tidak bisa mengaplikasikan kala yang sesuai dalam percakapan, baik dengan teman dan guru. Mereka cenderung menggunakan satu kala dalam percakapan dalam konteks situasi yang berbeda dan tense yang digunakan adalah Simple Present Tense.Kata kunci: percakapan, kala, observasi, wawancara, konteks situasi
Factors Influencing E-Commerce Adoption: Evaluation Using Structural Equation Modelling (SEM)
Authors: Kit-Yeng Sin  , Mun-Chong Sin  
Published: April 2021

Electronic commerce (e-commerce) has become a rapidly growing phenomenon to date. A peep into the exponential growth of the main players in this industry reveals a large reservoir of market potential for ecommerce. Nevertheless, the prevalence of e-commerce adoption has attracted attention from the government, retailers, and academicians to place specific focus on this area. As such, this study determined the correlation between Chief Executive Officer’s (CEO’s) technology knowledge, relative advantages, and competitive pressure through the lens of Tornatzky and Fleischer’s (1990) Organisational, Technological, and Environmental (OTE) model in order to probe into the adoption of e-commerce. CEOs and managers of Small and Medium Enterprises (SMEs) established in the Northern states of Malaysia were selected as the subject of analysis. A total of 283 out of 364 questionnaires distributed were valid for analysing and testing the hypotheses. Next, the gathered data were analysed using Statistical Package for the Social Sciences (SPSS) version 18.0 and Analysis of a Moment Structures (AMOS) version 16.0. The Structural Equation Modelling (SEM) was employed to assess model fit and to test hypotheses. As a conclusion, CEO’s technology knowledge and relative advantage displayed significantly positive influence upon adoption of ecommerce, whereas competitive pressure exhibited insignificant impact upon adoption of e-commerce. In precise, the insignificant influence of competitive pressure on e-commerce implementation appeared to be driven by other unseen variables worthy to be discovered. For future research, a comparison study can be conducted by selecting samples both from employers and employees, as well as other multiple variables associated with e-commerce adoption, so as to keep sampling bias at a minimum level.
Multidrug Resistance and Molecular Characterization of Streptococcus agalactiae Isolates From Dairy Cattle With Mastitis
Authors: Hernandez Luciana , Bottini Enriqueta , Cadona Jimena , Cacciato Claudio , Monteavaro Cristina , Bustamante Ana , Sanso Andrea Mariel 
Published: April 2021

Streptococcus agalactiae is a pathogen-associated to bovine mastitis, a health disorder responsible for significant economic losses in the dairy industry. Antimicrobial therapy remains the main strategy for the control of this bacterium in dairy herds and human In order to get insight on molecular characteristics of S. agalactiae strains circulating among Argentinean cattle with mastitis, we received 1500 samples from 56 dairy farms between 2016 and 2019. We recovered 56 S. agalactiae isolates and characterized them in relation to serotypes, virulence genes, and antimicrobial susceptibility. Serotypes III and II were the most prevalent ones (46% and 41%, respectively), followed by Ia (7%). In relation to the 13 virulence genes screened in this study, the genes spb1, hylB, cylE, and PI-2b were present in all the isolates, meanwhile, bca, cpsA, and rib were detected in different frequencies, 36%, 96%, and 59%, respectively. On the other hand, bac, hvgA, lmb, PI-1, PI-2a, and scpB genes could not be detected in any of the isolates. Disk diffusion method against a panel of eight antimicrobial agents showed an important number of strains resistant simultaneously to five antibiotics. We also detected several resistance-encoding genes, tet(M), tet(O), ermB, aphA3, and lnu(B) (9%, 50%, 32%, 32%, and 5%, respectively). The results here presented are the first molecular data on S. agalactiae isolates causing bovine mastitis in Argentina and provide a foundation for the development of diagnostic, prophylactic, and therapeutic methods, including the perspective of a vaccine.
Clinical Significance of Variants in the TTN Gene in a Large Cohort of Patients With Sporadic Dilated Cardiomyopathy
Authors: Xiao Lei , Li Chenze , Sun Yang , Chen Yanghui , Wei Haoran , Hu Dong , Yu Ting , Li Xianqing , Jin Li , Shi Leming , Marian Ali J. , Wang Dao Wen 
Published: April 2021

Background: Mutations in the TTN gene are the most common causes of dilated cardiomyopathy (DCM). The clinical significance of TTN gene variants remains inadequately understood.Methods: Whole-exome sequencing and phenotypic characterisation were performed, and patients were followed up for a median of 44 months.Results: We analyzed the association of the TTN variants with the clinical outcomes in a prospective study of 1,041 patients with sporadic DCM. TTN truncating variants (tTTN) were detected in 120 (11.5%) patients as compared with 2.4/10,000 East Asian populations in the Genome Aggregation Database (GnomAD; p &lt; 0.0001). Pathogenic TTN missense variants were also enriched in DCM as compared with the GnomAD populations (27.6 vs. 5.9%, p &lt; 0.0001). DCM patients with tTTN had a lower left ventricular ejection fraction (28.89 ± 8.72 vs. 31.81 ± 9.97, p = 0.002) and a lower frequency of the left bundle branch block (3.3 vs. 11.3%, p = 0.011) than those without or with mutations in other known causal genes (OCG). However, tTTN were not associated with the composite primary endpoint of cardiac death and heart transplantation during the follow-up period [adjusted hazard ratio (HR): 0.912; 95% confidence interval: 0.464–1.793; p = 0.790]. There was also no sex-dependent effect. Concomitant tTTN and pathogenic variants in OCG were present in only eight DCM patients and did not affect the outcome.Conclusion: The phenotype of DCM caused by tTTN, major causes of sporadic DCM, is not distinctly different from those caused by other causal genes for DCM.
Predicting the Likelihood of Live Birth in Assisted Reproductive Technology According to the Number of Oocytes Retrieved and Female Age Using a Generalized Additive Model: A Retrospective Cohort Analysis of 17,948 Cycles
Authors: Zhu Haiyan , Zhao Chenqiong , Xiao Peiwen , Zhang Songying 
Published: April 2021

CapsuleWe designed a predictive reference model to evaluate how many stimulation cycles are needed for a patient to achieve an ideal live birth rate using assisted reproductive technology.ObjectiveTo develop a counseling tool for women who wish to undergo assisted reproductive technology (ART) treatment to predict the likelihood of live birth based on age and number of oocytes retrieved.MethodsThis was a 6-year population-based retrospective cohort analysis using individual patient ART data. Between 2012 and 2017, 17,948 women were analyzed from their single ovarian stimulation cycle until they had a live birth or had used all their embryos. All consecutive women between 20 and 49 years old undergoing their ovarian stimulation cycles for ART in our center were enrolled. The cumulative live birth rate (CLBR) was defined as the delivery of a live neonate born during fresh or subsequent frozen–thawed embryo transfer cycles. Only the first delivery was considered in the analysis. Binary logistic regression was performed to identify and adjust for factors known to affect the CLBR independently. A generalized additive model was used to build a predictive model of CLBR according to the woman’s age and the number of oocytes retrieved.ResultsAn evidenced-based counseling tool was created to predict the probability of an individual woman having a live birth, based on her age and the number of oocytes retrieved in ART cycles. The model was verified by 10 times 10-fold cross-validation using the preprocessed data, and 100 area under the curve (AUC) values for receiver operating characteristic (ROC) curves were obtained on the test set. The mean AUC value was 0.7394. Our model predicts different CLBRs ranging from nearly 90% to less than 20% for women aged 20–49 years with at least 22 oocytes retrieved. The CLBRs of women aged 20–28 years were very similar, nearly on one trend line with a certain number of oocytes retrieved. Differences in the CLBR began to appear by the age of 29 years; these increased gradually in women aged &gt;35 years.ConclusionA predictive model of the CLBR was designed to serve as a guide for physicians and for patients considering ART treatment. The number of oocytes needed to be retrieved to achieve a live birth depends on the woman’s age.
Vildagliptin Has a Neutral Association With Dementia Risk in Type 2 Diabetes Patients
Authors: Tseng Chin-Hsiao 
Published: April 2021

Background and aimsAnimal studies suggested that vildagliptin might exert a beneficial effect on cognitive function. The present study evaluated whether the use of vildagliptin in patients with type 2 diabetes mellitus might affect dementia risk.MethodsThe database of Taiwan’s National Health Insurance was used to enroll an unmatched cohort and a propensity score-matched-pair cohort of ever and never users of vildagliptin from patients with newly diagnosed diabetes mellitus during 2002-2014. The patients should be alive on January 1, 2015 and were followed up for dementia diagnosis until December 31, 2016. Unadjusted and multivariate-adjusted hazard ratios (HR) and their 95% confidence intervals (CI) were estimated for vildagliptin ever versus never users, for cumulative duration and cumulative dose of vildagliptin therapy categorized into tertiles versus never users, and for cumulative duration and cumulative dose treated as continuous variables.ResultsThere were 355610 never users and 43196 ever users in the unmatched cohort and 40489 never users and 40489 ever users in the matched cohort. In the unmatched cohort, unadjusted HR (95% CI) was 0.929 (0.683-1.264) and the multivariate-adjusted HR (95% CI) was 0.922 (0.620-1.372). In the matched cohort, the unadjusted HR (95% CI) was 0.930 (0.616-1.402) and the multivariate-adjusted HR (95% CI) was 0.825 (0.498-1.367). None of the analyses conducted for cumulative duration and cumulative dose was significant, either being treated as tertile cutoffs or as continuous variables, in either the unmatched cohort or the matched cohort.ConclusionsThis study showed a neutral effect of vildagliptin on dementia risk.
The Small Size and Superficial Location Suggest That Laparoscopic Partial Nephrectomy Is the First Choice for the Treatment of Juxtaglomerular Cell Tumors
Authors: Ye Zixing , Fan Hua , Tong Anli , Xiao Yu , Zhang Yushi 
Published: April 2021

BackgroundJuxtaglomerular cell tumor (JGCT) is a very rare disease, and surgical resection is the only possible way to cure this tumor. Open nephrectomy and partial nephrectomy have been reported to manage JGCTs with excellent results in the previous reviews. Laparoscopic surgery has been popularized in recent years, while critical issues associated with laparoscopic surgical management have been seldom reported. We summarized the JGCTs in our center to discover the optimal surgical management and its anatomic foundation.MethodsIn this retrospective study, we enrolled a total of 14 JGCT patients. All patients received surgeries and were followed up for up to 11 years. We mainly summarized the size and location of tumors, imaging features, and surgical strategies. A descriptive statistical analysis was performed.ResultsThe JGCTs in this study had a median size of 1.35 cm and all located superficially, mainly in the cortical or subcortical area of the kidney. All 14 patients had hypertension, ten had hypokalemia, and seven had elevated plasma renin activity. Pathologically, JGCT cells were polygonal or spindle shape, with positive CD34 and vimentin immunostaining. All patients received partial nephrectomy; nine were laparoscopic, and five were open. Laparoscopic partial nephrectomy (LPN) was performed in seven out of eight patients over the last nine years. Postoperative blood pressure, serum potassium, and plasma renin activity were normal in all patients. No recurrence occurred within a median follow-up of 60 months.ConclusionThe small size and superficial location are the characteristic anatomic features of JGCT; they suggest that LPN is the preferred surgical strategy. Laparoscopic ultrasound is helpful for the intraoperative detection of small JGCTs. Longer follow-up is required to examine the biological behavior of JGCTs and the effect of LPN.
Combined Effects of Vitamin D Status, Renal Function and Age on Serum Parathyroid Hormone Levels
Authors: Niculescu Dan Alexandru , Deacu Laura Georgiana , Caragheorgheopol Andra , Popescu Nicoleta , Ghemigian Adina , Procopiuc Camelia , Rosca Roxana , Poiana Catalina 
Published: April 2021

BackgroundVitamin D status and renal function are well-known independent predictors of serum parathyroid hormone (PTH) levels. We aimed to describe the combined effects of 25-hydroxy vitamin D (25(OH)D), glomerular filtration rate (GFR) and age on serum PTH levels across the whole clinical spectrum.MethodsWe retrieved from our endocrinology center database all PTH measurement between 2012 and 2020 for which a simultaneous measurement of serum 25(OH)D, calcium and creatinine was available. Age, sex and diagnosis were available for all subjects. Intact PTH was measured using the same electrochemiluminescence assay.ResultsThere were 6,444 adults and 701 children without a diagnosis of hyper- or hypoparathyroidism or abnormal serum calcium levels. In adults with 25(OH)D≥12 ng/mL multiple regression models showed that serum PTH was negatively correlated with both 25(OH)D and GFR. Regression (-0.68 and -1.59 vs. -0.45 and -0.22 respectively), partial correlation (-0.16 and -0.35 vs. -0.12 and -0.10 respectively) and determination coefficients (0.14 vs. 0.031) were higher in CKD than in normal renal function. In subjects with 25(OH)D&lt;12 ng/mL, GFR was the only significant predictor in those with CKD (β-coefficient=-2.5, r=-0.55) and 25(OH)D was the only significant predictor in those with normal renal function (β-coefficient=-2.05, r=-0.11). Increasing age was associated with higher PTH levels only in those with normal renal function and 25(OH)D≥12 ng/mL.ConclusionsWe showed that declining vitamin D and renal function have additive effects on serum PTH in subjects without vitamin D deficiency. In vitamin D deficient subjects this dependency is stronger but is not additive anymore.
Mucosal Immunoregulatory Properties of Tsukamurella inchonensis to Reverse Experimental Food Allergy
Authors: Smaldini Paola L. , Trejo Fernando M. , Rizzo Gastón P. , Comerci Diego J. , Kampinga Jaap , Docena Guillermo H. 
Published: April 2021

The intestinal mucosa is lined by epithelial cells, which are key cells to sustain gut homeostasis. Food allergy is an immune-mediated adverse reaction to food, likely due to defective regulatory circuits. Tsukamurella inchonensis is a non-pathogenic bacterium with immunomodulatory properties. We hypothesize that the anti-inflammatory effect of dead T. inchonensis on activated epithelial cells modulates milk allergy through the restoration of tolerance in a mouse model. Epithelial cells (Caco-2 and enterocytes from mouse gut) and macrophages were stimulated with T. inchonensis and induction of luciferase under the NF-κB promoter, ROS and cytokines production were studied. Balb/c mice were mucosally sensitized with cow´s milk proteins plus cholera toxin and orally challenged with the allergen to evidence hypersensitivity symptoms. After that, mice were orally administered with heat-killed T. inchonensis as treatment and then challenged with the allergen. The therapeutic efficacy was in vivo (clinical score and cutaneous test) and in vitro (serum specific antibodies and cytokines-ELISA, and cell analysis-flow cytometry) evaluated. Heat-killed T. inchonensis modulated the induction of pro-inflammatory chemokines, with an increase in anti-inflammatory cytokines by intestinal epithelial cells and by macrophages with decreased OX40L expression. In vivo, oral administration of T. inchonensis increased the frequency of lamina propria CD4+CD25+FoxP3+ T cells, and clinical signs were lower in T. inchonensis-treated mice compared with milk-sensitized animals. In vivo depletion of Tregs (anti-CD25) abrogated T. inchonensis immunomodulation. In conclusion, these bacteria suppressed the intestinal inflammatory immune response to reverse food allergy.
Short-Term Outcomes of Refractory Diabetic Macular Edema Switch From Ranibizumab to Dexamethasone Implant and the Influential Factors: A Retrospective Real World Experience
Authors: Hsia Ning-Yi , Lin Chun-Ju , Chen Huan-Sheng , Chang Cheng-Hsien , Bair Henry , Lai Chun-Ting , Lin Jane-Ming , Chen Wen-Lu , Tien Peng-Tai , Wu Wen-Chuan , Tsai Yi-Yu 
Published: April 2021

Introduction: To evaluate the effectiveness and safety of intravitreal dexamethasone (DEX) implants in refractory diabetic macular edema (DME) treated by intravitreal ranibizumab.Materials and Methods: We retrospectively analyzed DME patients who received DEX implant treatment after being refractory to at least 3 monthly intravitreal ranibizumab injections. The main outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP).Results: Twenty-nine eyes of 26 patients who had previously received an average of 8.1 ± 4.4 ranibizumab injections were included. Patients received between one and three DEX implants during 12.4 ± 7.4 months of follow-up. The mean final CRT significantly decreased from 384.4 ± 114.4 μm at baseline to 323.9 ± 77.7 μm (p = 0.0249). The mean final BCVA was 51.4 ± 21.3 letters, which was not significant compared to baseline (44.9 ± 30.2 letters, p = 0.1149). Mean IOP did not increase significantly. All patients tolerated the treatment well without serious adverse events. Higher baseline CRT and worse BCVA correlated with better therapeutic responses.Conclusion: Switching to DEX implant is feasible and safe for treating patients of DME refractory to intravitreal ranibizumab in real world. Further larger-scale or multicenter studies would be conducted to explore different DEX treatment strategies for DME, such as first-line or early switch therapy, for better BCVA improvement.