bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social norms, attitudes and access to modern contraception for adolescent girls in six districts in Uganda
Authors: Bukuluki Paul , Kisaakye Peter , Houinato Maxime , Ndieli Adekemi , Letiyo Evelyn , Bazira Dan 
Published: October 2021

AbstractBackgroundSocial norms continue to be entrenched in Uganda. Understanding social norms helps to uncover the underlying drivers that influence attitudes and behavior towards contraceptive access and use. This study therefore seeks to investigate the factors that influence the social norm – access to contraception by adolescent girls – in six districts in Uganda.Data and methods:Using data from a community cross-sectional survey in six districts (Amudat, Kaberamaido, Kasese, Moroto, Tororo and Pader) in Uganda, a binary logistic regression model was fitted to examine the variation in individual beliefs and socio-economic and demographic factors on ‘allowing adolescent girls to access contraception in a community’ – we refer to as a social norm.ResultsResults demonstrate that a higher proportion of respondents hold social norms that inhibit adolescent girls from accessing contraception in the community. After controlling for all variables, the likelihood for adolescent girls to be allowed access to contraception in the community was higher among respondents living in Kaberamaido (OR = 2.58; 95 %CI = 1.23–5.39), Kasese (OR = 2.62; 95 %CI = 1.25–5.47), Pader (OR = 4.35; 95 %CI = 2.15–8.79) and Tororo (OR = 9.44; 95 %CI = 4.59–19.37), those aged 30–34 years likely (OR = 1.73; 95 %CI = 1.03–2.91). However, the likelihood for respondents living in Moroto to agree that adolescent girls are allowed to access contraception was lower (OR = 0.27; 95 %CI = 0.11–0.68) compared to respondents living in Amudat. Respondents who were not formally employed (OR = 0.63; 95 %CI = 0.43–0.91), and those who agreed that withdrawal prevents pregnancy (OR = 0.45; 95 %CI = 0.35–0.57) were less likely to agree that adolescent girls are allowed to access contraception in the community. Respondents who agreed that a girl who is sexually active can use contraception to prevent unwanted pregnancy (OR = 1.84; 95 %CI = 1.33–2.53), unmarried women or girls should have access to contraception (OR = 2.15; 95 %CI = 1.61–2.88), married women or girls should have access to contraception (OR = 1.55; 95 %CI = 0.99–2.39) and women know where to obtain contraception for prevention against pregnancy (OR = 2.35; 95 %CI = 1.19–4.65) were more likely to agree that adolescent girls are allowed to access contraception.ConclusionsThe findings underscore the need for context specific ASRH programs that take into account the differences in attitudes and social norms that affect access and use of contraception by adolescents.
Measuring social capital of hospital management boards in European hospitals: A validation study on psychometric properties of a questionnaire for Chief Executive Officers
Authors: Hammer Antje , Arah Onyebuchi A. , Mannion Russell , Groene Oliver , Sunol Rosa , Pfaff Holger , Choi Kyung-Eun 
Published: October 2021

Abstract
Background
The commitment of hospital managers plays a key role in decisions regarding investments in quality improvement (QI) and the implementation of quality improvement systems (QIS). With regard to the concept of social capital, successful cooperation and coordination among hospital management board members is strongly influenced by commonly shared values and mutual trust. The purpose of this study is to investigate the reliability and validity of a survey scale designed to assess Social Capital within hospital management boards (SOCAPO-B) in European hospitals.

Methods
Data were collected as part of the EU funded mixed-method project “Deepening our understanding of quality improvement in Europe (DUQuE)” from 210 hospitals in 7 European countries (France, Poland, Czech Republic, Germany, Portugal, Spain, and Turkey). The Chief Executive Officers (CEOs) completed the SOCAPO-B scale (six-item survey, numeric scale, 1=‘strongly disagree’ to 4=‘strongly agree’) regarding their perceptions of social capital within the hospital management board. We investigated the factor structure of the social capital scale using exploratory and confirmatory factor analyses. Internal consistency was assessed using Cronbach’s alpha, while construct validity was assessed through Pearson’s correlation coefficients between the scale items.

Results
A total of 188 hospitals participated in the DUQuE-study. Of these, 177 CEOs completed the questionnaire(172 observations for social capital) Hospital CEOs perceive relatively high social capital among hospital management boards (average SOCAPO-B mean of 3.2, SD = 0.61). The exploratory factor analysis resulted in a 1-factor-model with Cronbach’s alpha of 0.91. Pearson’s correlation coefficients between the single scale items ranged from 0.48 to 0.68.

Conclusions
The SOCAPO-B−scale can be used to obtain reliable and valid measurements of social capital in European hospital management boards, at least from the CEO’s point of view. The brevity of the scale enables it to be a cost-effective and tool for measuring social capital in hospital management boards.

Trial registration
This validation study was not registered.
Fidelity and the impact of patient safety huddles on teamwork and safety culture: an evaluation of the Huddle Up for Safer Healthcare (HUSH) project
Authors: Lamming Laura , Montague Jane , Crosswaite Kate , Faisal Muhammad , McDonach Eileen , Mohammed Mohammed A. , Cracknell Alison , Lovatt Alison , Slater Beverley 
Published: October 2021

Abstract
Background
The Patient Safety Huddle (PSH) is a brief multidisciplinary daily meeting held to discuss threats to patient safety and actions to mitigate risk. Despite growing interest and application of huddles as a mechanism for improving safety, evidence of their impact remains limited. There is also variation in how huddles are conceived and implemented with insufficient focus on their fidelity (the extent to which delivered as planned) and potential ways in which they might influence outcomes. The Huddle Up for Safer Healthcare (HUSH) project attempted to scale up the implementation of patient safety huddles (PSHs) in five hospitals – 92 wards - across three UK NHS Trusts. This paper aims to assess their fidelity, time to embed, and impact on teamwork and safety culture.

Methods
A multi-method Developmental Evaluation was conducted. The Stages of Implementation Checklist (SIC) was used to determine time taken to embed PSHs. Observations were used to check embedded status and fidelity of PSH. A Teamwork and Safety Climate survey (TSC) was administered at two time-points: pre- and post-embedding. Changes in TSC scores were calculated for Trusts, job role and clinical speciality.

Results
Observations confirmed PSHs were embedded in 64 wards. Mean fidelity score was 4.9/9. PSHs frequently demonstrated a ‘fear free’ space while Statistical Process Control charts and historical harms were routinely omitted. Analysis showed a positive change for the majority (26/27) of TSC questions and the overall safety grade of the ward.

Conclusions
PSHs are feasible and effective for improving teamwork and safety culture, especially for nurses. PSH fidelity criteria may need adjusting to include factors deemed most useful by frontline staff. Future work should examine inter-disciplinary and role-based differences in TSC outcomes.
The genome of the zoonotic malaria parasite Plasmodium simium reveals adaptations to host switching
Authors: Mourier Tobias , de Alvarenga Denise Anete Madureira , Kaushik Abhinav , de Pina-Costa Anielle , Douvropoulou Olga , Guan Qingtian , Guzmán-Vega Francisco J. , Forrester Sarah , de Abreu Filipe Vieira Santos , Júnior Cesare Bianco , de Souza Junior Julio Cesar , Moreira Silvia Bahadian , Hirano Zelinda Maria Braga , Pissinatti Alcides , Ferreira-da-Cruz Maria de Fátima , de Oliveira Ricardo Lourenço , Arold Stefan T. , Jeffares Daniel C. , Brasil Patrícia , de Brito Cristiana Ferreira Alves , Culleton Richard , Daniel-Ribeiro Cláudio Tadeu , Pain Arnab 
Published: October 2021

Abstract
Background
Plasmodium simium, a malaria parasite of non-human primates (NHP), was recently shown to cause zoonotic infections in humans in Brazil. We sequenced the P. simium genome to investigate its evolutionary history and to identify any genetic adaptions that may underlie the ability of this parasite to switch between host species.

Results
Phylogenetic analyses based on whole genome sequences of P. simium from humans and NHPs reveals that P. simium is monophyletic within the broader diversity of South American Plasmodium vivax, suggesting P. simium first infected NHPs as a result of a host switch of P. vivax from humans. The P. simium isolates show the closest relationship to Mexican P. vivax isolates. Analysis of erythrocyte invasion genes reveals differences between P. vivax and P. simium, including large deletions in the Duffy-binding protein 1 (DBP1) and reticulocyte-binding protein 2a genes of P. simium. Analysis of P. simium isolated from NHPs and humans revealed a deletion of 38 amino acids in DBP1 present in all human-derived isolates, whereas NHP isolates were multi-allelic.

Conclusions
Analysis of the P. simium genome confirmed a close phylogenetic relationship between P. simium and P. vivax, and suggests a very recent American origin for P. simium. The presence of the DBP1 deletion in all human-derived isolates tested suggests that this deletion, in combination with other genetic changes in P. simium, may facilitate the invasion of human red blood cells and may explain, at least in part, the basis of the recent zoonotic infections.
Design and user experience testing of a polygenic score report: a qualitative study of prospective users
Authors: Brockman Deanna G. , Petronio Lia , Dron Jacqueline S. , Kwon Bum Chul , Vosburg Trish , Nip Lisa , Tang Andrew , O’Reilly Mary , Lennon Niall , Wong Bang , Ng Kenney , Huang Katherine H. , Fahed Akl C. , Khera Amit V. 
Published: October 2021

AbstractBackgroundPolygenic scores—which quantify inherited risk by integrating information from many common sites of DNA variation—may enable a tailored approach to clinical medicine. However, alongside considerable enthusiasm, we and others have highlighted a lack of standardized approaches for score disclosure. Here, we review the landscape of polygenic score reporting and describe a generalizable approach for development of a polygenic score disclosure tool for coronary artery disease.MethodsWe assembled a working group of clinicians, geneticists, data visualization specialists, and software developers. The group reviewed existing polygenic score reports and then designed a two-page mock report for coronary artery disease. We then conducted a qualitative user-experience study with this report using an interview guide focused on comprehension, experience, and attitudes. Interviews were transcribed and analyzed for themes identification to inform report revision.ResultsReview of nine existing polygenic score reports from commercial and academic groups demonstrated significant heterogeneity, reinforcing the need for additional efforts to study and standardize score disclosure. Using a newly developed mock score report, we conducted interviews with ten adult individuals (50% females, 70% without prior genetic testing experience, age range 20–70 years) recruited via an online platform. We identified three themes from interviews: (1) visual elements, such as color and simple graphics, enable participants to interpret, relate to, and contextualize their polygenic score, (2) word-based descriptions of risk and polygenic scores presented as percentiles were the best recognized and understood, (3) participants had varying levels of interest in understanding complex genomic information and therefore would benefit from additional resources that can adapt to their individual needs in real time. In response to user feedback, colors used for communicating risk were modified to minimize unintended color associations and odds ratios were removed. All 10 participants expressed interest in receiving a polygenic score report based on their personal genomic information.ConclusionsOur findings describe a generalizable approach to develop a polygenic score report understandable by potential patients. Although additional studies are needed across a wider spectrum of patient populations, these results are likely to inform ongoing efforts related to polygenic score disclosure within clinical practice.
The management of type 2 diabetes before, during and after Covid-19 infection: what is the evidence?
Authors: Czupryniak Leszek , Dicker Dror , Lehmann Roger , Prázný Martin , Schernthaner Guntram 
Published: October 2021

AbstractPatients with Covid-19 place new challenges on the management of type 2 diabetes, including the questions of whether glucose-lowering therapy should be adjusted during infection and how to manage a return to normal care after resolution of Covid-19 symptoms. Due to the sudden onset of the pandemic, physicians have by necessity made such important clinical decisions in the absence of robust evidence or consistent guidelines. The risk to patients is compounded by the prevalence of cardiovascular disease in this population, which alongside diabetes is a major risk factor for severe disease and mortality in Covid-19. We convened as experts from the Central and Eastern European region to consider what advice we can provide in the setting of type 2 diabetes and Covid-19, considering the evidence before, during and after infection. We review recommendations that have been published to date, and consider the best available—but currently limited—evidence from large observational studies and the DARE-19 randomized control trial. Notably, we find a lack of guidance on restarting patients on optimal antidiabetic therapy after recovering from Covid-19, and suggest that this may provide an opportunity to optimize treatment and counter clinical inertia that predates the pandemic. Furthermore, we emphasize that optimization applies not only to glycaemic control, but other factors such as cardiorenal protection. While we look forward to the emergence of new evidence that we hope will address these gaps, in the interim we provide a perspective, based on our collective clinical experience, on how best to manage glucose-lowering therapy as patients with Covid-19 recover from their disease and return to normal care.
Pharmacology-based ranking of anti-cancer drugs to guide clinical development of cancer immunotherapy combinations
Authors: Lemaire Vincent , Shemesh Colby S. , Rotte Anand 
Published: October 2021

AbstractThe success of antibodies targeting Programmed cell death protein 1 (PD-1) and its ligand L1 (PD-L1) in cancer treatment and the need for improving response rates has led to an increased demand for the development of combination therapies with anti-PD-1/PD-L1 blockers as a backbone. As more and more drugs with translational potential are identified, the number of clinical trials evaluating combinations has increased considerably and the demand to prioritize combinations having potential for success over the ones that are unlikely to be successful is rising. This review aims to address the unmet need to prioritize cancer immunotherapy combinations through comprehensive search of potential drugs and ranking them based on their mechanism of action, clinical efficacy and safety. As lung cancer is one of the most frequently studied cancer types, combinations that showed potential for the treatment of lung cancer were prioritized. A literature search was performed to identify drugs with potential in combination with PD-1/PD-L1 blockers and the drugs were ranked based on their mechanism of action and known clinical efficacy. Nineteen drugs or drug classes were identified from an internal list of lead molecules and were scored for their clinical potential. Efficacy and safety data from pivotal studies was summarized for the selected drugs. Further, overlap of mechanisms of action and adverse events was visualized using a heat map illustration to help screen drugs for combinations. The quantitative scoring methodology provided in this review could serve as a template for preliminary ranking of novel combinations.
The phenomenon of degeneration of industrial Trichoderma reesei strains
Authors: Martzy R. , Mello-de-Sousa T. M. , Mach R. L. , Yaver D. , Mach-Aigner A. R. 
Published: October 2021

Abstract
Background
Even if the loss of production capacity of a microorganism is said to be a serious problem in various biotechnology industries, reports in literature are rather rare. Strains of the genera Trichoderma reesei are used for large-scale production of cellulases, which are needed in food and feed, textile, paper industries and biofuel production.

Results
Here, we describe the phenomenon of spontaneous degeneration of T. reesei strains during large-scale cultivation. The phenotype of the degenerated population is characterized most importantly by a loss of any cellulase formation. Interestingly, promoter regions of relevant genes had a more compact chromatin in the (cel −) strains compared to productive strains. For a systematic investigation of the phenomenon a protocol for artificially induced and lab-scaled strain degeneration was developed. This workflow allows to determine the degeneration rate and thus, to compare the occurrence of a degenerated population in differently productive strains on the one hand, and to monitor the success of any strategies to prevent or decrease the degeneration on the other hand. While highly productive strains have higher degeneration rates compared to moderate producers, the degeneration can hardly be triggered in moderate producers. The observed (cel −) phenotype is not caused by a mutation in the gene encoding the essential transactivator Xyr1. The development of a non-producing population is also not triggered by any compounds released by either producing or non-producing cells.

Conclusions
The extent of the occurrence of a degenerated strain population relates to the production capacity of the strain and goes along with chromatin condensation in relevant promoter regions.
Physical–chemical properties of cell wall interface significantly correlated to the complex recalcitrance of corn straw
Authors: Wang Yufen , Xu Xianyang , Xue Huiting , Zhang Dejian , Li Guanhua 
Published: October 2021

Abstract
Background
Tissue heterogeneity significantly influences the overall saccharification efficiency of plant biomass. However, the mechanisms of specific organ or tissue recalcitrance to enzymatic deconstruction are generally complicated and unclear. A multidimensional analysis of the anatomical fraction from 12 corn cultivars was conducted to understand the essence of recalcitrance.

Results
The results showed that leaf, leaf sheath, stem pith and stem rind of corn straw exhibited remarkable heterogeneity in chemical composition, physical structure and cell type, which resulted in the different saccharification ratio of cellulose. The high saccharification ratio ranging from 21.47 to 38.96% was in stem pith, whereas the low saccharification ratio ranging from 17.1 to 27.43% was in leaf sheath. High values of lignin, hemicelluloses, degree of polymerization and crystallinity index were critical for the increased recalcitrance, while high value of neutral detergent soluble and pore size generated weak recalcitrance. Interestingly, pore traits of cell wall, especial for microcosmic interface structure, seemed to be a crucial factor that correlated to cellulase adsorption and further affected saccharification.

Conclusions
Highly heterogeneity in cell wall traits influenced the overall saccharification efficiency of biomass. Furthermore, the holistic outlook of cell wall interface was indispensable to understand the recalcitrance and promote the biomass conversion.

Graphic abstract
Prevalence of intestinal parasites and molecular characterization of Giardia intestinalis, Blastocystis spp. and Entamoeba histolytica in the village of Fortín Mbororé (Puerto Iguazú, Misiones, Argentina)
Authors: Candela Ernesto , Goizueta Carolina , Periago M. Victoria , Muñoz-Antoli Carla 
Published: October 2021

AbstractBackgroundIntestinal parasites (IPs) are widely distributed worldwide and are one of the major contributors to gastrointestinal disease. Their prevalence is associated with poor access to water, sanitation and hygiene (WASH). The objective of this study was to identify the prevalence of IPs, including soil-transmitted helminths (STH), and their relation to socioeconomic characteristics, as well as a first approach to molecularly characterize the types ofGiardia intestinalis,Blastocystisspp. andEntamoeba histolyticapresent in an indigenous community from Puerto Iguazú, Misiones, Argentina.MethodsA cross-sectional study was conducted in the rural settlement of Fortin Mbororé between January and March 2018. Socioeconomic variables, household characteristics, and stool and blood samples were collected. Standard coprological techniques were used to analyze stool samples, and a complete hemogram was performed on the blood samples.Giardia intestinalismicroscopy-positive samples were genetically typed by the β-giardin (bg) gene. Molecular identification ofBlastocystisspp. subtypes andE. histolyticawere carried out by amplification and sequencing of a partial fragment of the small subunit ribosomal RNA gene (SSU rDNA).ResultsThe overall prevalence of IPs was 92.7%, with 72.0% specifically for hookworm. IPs were significantly more prevalent in preschool- and school-age children (P < 0.05). No formal education (P = 0.035), the presence of unimproved floors (P = 0.001) and overcrowding (P = 0.005) were significantly associated with IP infection. Hookworm was associated with anemia (P = 0.019). Molecular characterization revealed the presence ofE. histolyticasub-assemblages AII (12.5%), AIII (87.5%) and BIV (100%); one case of sub-assemblage D forG. intestinalis; and the presence of subtypes ST1 (14.8%), ST2 (14.8%) and ST3 (70.4%) ofBlastocystisspp.ConclusionsProtozoans detected in this study are transmitted mainly through water contaminated with fecal matter, evidencing the need to improve the quality of water and sanitation for the inhabitants of Fortín Mbororé. Molecular characterization showed that domestic animals can be implicated in the zoonotic transmission ofG. intestinalisandBlastocystisspp. to humans. A hyperendemic area for STH was found, with hookworm prevalence greater than 50%. Therefore, improvements in WASH as well as mass deworming programs need to be implemented in this area to control and decrease the prevalence of IPs in general and STH in particular.Graphical Abstract