bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study
Authors: Debrah Oksana , Agyemang-Yeboah Francis , Donkoh Emmanuel Timmy , Asmah Richard Harry 
Published: October 2021

Abstract
Background
Human Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women.

Method
Women presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05.

Results
The age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016).

Conclusions
Our study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.
Effects of modified BOPPPS-based SPOC and Flipped class on 5th-year undergraduate oral histopathology learning in China during COVID-19
Authors: Wang Shan , Xu Xin , Li Fang , Fan Haixia , Zhao Eryang , Bai Jie 
Published: October 2021

Abstract
Background
Colleges and universities in China have offered courses based on online teaching platforms as required by the Ministry of Education since the beginning of the COVID-19 pandemic. This emergency action was not an expedient measure, but a powerful impetus to improve extant education and implement teaching reform. Oral histopathology is a basic subject in oral medicine education, which combines theory with practice. The course aims to improve the ability of students to observe, think, analyze and identify oral diseases.

Method
We adjusted and modified the original Bridge-In, Outcomes, Pre-assessment, Participatory Learning, Post-assessment, and Summary (BOPPPS) teaching method to fit the characteristics and needs of oral histopathology. We then combined the characteristics of Small Private Online Courses (SPOCs) and a Flipped class to complete teaching material online, and assessed the effects of such teaching using a questionnaire and interviews. Fifty 5th-year undergraduates in stomatology at the School of Stomatology of Harbin Medical University of China participated in online classes. All were in the junior second half of the semester at the beginning of 2020. Teachers investigated from various medical colleges were responsible for delivering courses associated with stomatology or ophthalmology.

Result & conclusion
The results showed that the modified BOPPPS combined with SPOC and the Flipped class improved teaching satisfaction. Modified BOPPPS combined with SPOC and the Flipped class is a useful complement to offline teaching on 5th-year undergraduate oral histopathology learning in China during COVID-19, and it can meet the multiple needs of students participating in the course.
Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial
Authors: Schwarzkopf Larissa , Dorscht Lisa , Kraus Ludwig , Luttenberger Katharina 
Published: October 2021

Abstract
Background
Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care.

Methods
Using data from the German KuS trial BPT was compared with group Cognitive Behavioral Therapy (CBT). Severity of depression symptoms at end of the intervention was operationalized via Montgomery-Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Adopting a societal perspective, direct medical costs and productivity loss were calculated based on standardized unit costs. To determine incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves (CEAC), adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) were obtained from 1000 simultaneous bootstrap replications.

Results
BPT was related to improved effects (AMDs: MADRS -2.58; PHQ-9: − 1.35) at higher costs (AMD: +€ 754). No AMD was significant. ICERs amounted to €288 per MADRS-point and €550 per PHQ-9-point. For both effect parameters about 20% of bootstrap replications indicated dominance of BPT, and about 75% larger effects at higher costs. At hypothetical willingness to pay (WTP) thresholds of €241 (MADRS) and €615 (PHQ-9) per unit of change BPT had a 50% probability of being cost-effective.

Conclusion
BPT is a promising alternate treatment strategy which – in absence of established WTP thresholds for improving symptoms of depression – cannot unambiguously be claimed cost-effective. Further studies defining subgroups that particularly benefit from BPT appear paramount to delineate recommendations for an efficient prospective roll-out to routine care.
High expression levels and the C3435T SNP of the ABCB1 gene are associated with lower survival in adult patients with acute myeloblastic leukemia in Mexico City
Authors: Olarte Carrillo Irma , García Laguna Anel Irais , De la Cruz Rosas Adrián , Ramos Peñafiel Christian Omar , Collazo Jaloma Juan , Martínez Tovar Adolfo 
Published: October 2021

Abstract
Background
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by different genetic alterations that cause changes in the normal mechanisms of differentiation, which are associated with chemoresistance. The ABCB1 gene is part of a family of ATP-binding cassette (ABC) transporter genes involved in the progression of various types of cancer. The following work aimed to evaluate the expression levels of the ABCB1 gene and the C3435T SNP with the response to first-line treatment and survival in patients with AML.

Methods
In total 135 samples were taken to isolate total RNA and DNA at the beginning of the treatment. Expression analysis by RT-qPCR and SNP C3435T assessment method were performed for real-time Polymerase chain reaction (qPCR).

Results
The expression levels impact on the survival of patients with AML compared to low or absent levels; the CC genotype was found in 22.9%, the CT genotype was found in 47.4%, and the TT genotype was found in 29.6%, the presence of the C3435T SNP, the TT genotype also impacts with a lower survival compared to CT and CC genotypes. In addition, it was shown that the dominant model significantly impacts survival.

Conclusion
In conclusion, we have found that the overexpression of the ABCB1 gene, as well as the presence of the TT genotype of the C3435T SNP, contributes to a worse prognosis in AML.
Diabetes mellitus exacerbates experimental autoimmune myasthenia gravis via modulating both adaptive and innate immunity
Authors: Zhang Peng , Yang Chun-Lin , Du Tong , Liu Yu-Dong , Ge Meng-Ru , Li Heng , Liu Ru-Tao , Wang Cong-Cong , Dou Ying-Chun , Duan Rui-Sheng 
Published: October 2021

Abstract
Background
Diabetes mellitus (DM) is a common concomitant disease of late-onset myasthenia gravis (MG). However, the impacts of DM on the progression of late-onset MG were unclear.

Methods
In this study, we examined the immune response in experimental autoimmune myasthenia gravis (EAMG) rats with DM or not. The phenotype and function of the spleen and lymph nodes were determined by flow cytometry. The serum antibodies, Tfh cells, and germinal center B cells were determined by ELISA and flow cytometry. The roles of advanced glycation end products (AGEs) in regulating Tfh cells were further explored in vitro by co-culture assays.

Results
Our results indicated clinical scores of EAMG rats were worse in diabetes rats compared to control, which was due to the increased production of anti-R97–116 antibody and antibody-secreting cells. Furthermore, diabetes induced a significant upregulation of Tfh cells and the subtypes of Tfh1 and Tfh17 cells to provide assistance for antibody production. The total percentages of B cells were increased with an activated statue of improved expression of costimulatory molecules CD80 and CD86. We found CD4+ T-cell differentiation was shifted from Treg cells towards Th1/Th17 in the DM+EAMG group compared to the EAMG group. In addition, in innate immunity, diabetic EAMG rats displayed more CXCR5 expression on NK cells. However, the expression of CXCR5 on NKT cells was down-regulated with the increased percentages of NKT cells in the DM+EAMG group. Ex vivo studies further indicated that Tfh cells were upregulated by AGEs instead of hyperglycemia. The upregulation was mediated by the existence of B cells, the mechanism of which might be attributed the elevated molecule CD40 on B cells.

Conclusions
Diabetes promoted both adaptive and innate immunity and exacerbated clinical symptoms in EAMG rats. Considering the effect of diabetes, therapy in reducing blood glucose levels in MG patients might improve clinical efficacy through suppressing the both innate and adaptive immune responses. Additional studies are needed to confirm the effect of glucose or AGEs reduction to seek treatment for MG.
Supplementation of quinoa regulates glycolipid metabolism and endoplasmic reticulum stress in the high-fat diet-induced female obese mice
Authors: An Tian , Liu Jia-Xian , Yang Xiu-yan , Lv Bo-han , Wu Yan-xiang , Jiang Guang-jian 
Published: October 2021

AbstractObjectiveTo explore the effects of the quinoa diet on glycolipid metabolism and endoplasmic reticulum (ER) stress in an obese mouse model.MethodsSix-week-old C57BL/6J female mice have received a high-fat diet (HFD) to induce obesity and subsequently were treated with a quinoa diet for 12 weeks. During this period, fasting blood glucose, body fat and insulin resistance were measured regularly. At the end of the experiment, mouse serum and liver tissue were collected. The differences in glucose and lipid metabolism were analyzed, and liver tissue pathological morphology, liver endoplasmic reticulum stress-related mRNA and protein levels, and serum oxidative stress levels were measured.ResultsQuinoa diet could significantly reduce the level of blood glucose, triglyceride, cholesterol, low-density lipoprotein, improve glucose tolerance, as well as improve histological changes of liver tissues in obese mice (P < 0.05 or < 0.01). Besides, quinoa could improve oxidative stress indicators such as GSH, and MDA (P < 0.05 or < 0.01). Furthermore, quinoa can down-regulate mRNA expression of ER stress markers eIF2α, GRP78, and CHOP in the liver of obese mice (P < 0.05 or < 0.01).ConclusionsQuinoa supplementation can improve glycolipid metabolism, regulate ER stress, and alleviate obesity in HFD-induced mice.
Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study): a superiority randomised clinical trial to evaluate the effectiveness and cost-effectiveness of invasive urodynamic investigations in management of women with refractory overactive bladder symptoms
Authors: Abdel-fattah M. , Chapple C. , Guerrero K. , Dixon S. , Cotterill N. , Ward K. , Hashim H. , Monga A. , Brown K. , Drake M. J. , Gammie A. , Mostafa A. , Bladder Health U. K. , Breeman S. , Cooper D. , MacLennan G. , Norrie J. 
Published: October 2021

Abstract
Background
Overactive bladder (OAB) syndrome is a symptom complex affecting 12–14% of the UK adult female population. Symptoms include urinary urgency, with or without urgency incontinence, increased daytime urinary frequency and nocturia. OAB has a negative impact on women’s social, physical, and psychological wellbeing. Initial treatment includes lifestyle modifications, bladder retraining, pelvic floor exercises and pharmacological therapy. However, these measures are unsuccessful in 25–40% of women (refractory OAB). Before considering invasive treatments, such as Botulinum toxin injection or sacral neuromodulation, most guidelines recommend urodynamics to confirm diagnosis of detrusor overactivity (DO). However, urodynamics may fail to show evidence of DO in up to 45% of cases, hence the need to evaluate its effectiveness and cost-effectiveness. FUTURE (Female Urgency, Trial of Urodynamics as Routine Evaluation) aims to test the hypothesis that, in women with refractory OAB, urodynamics and comprehensive clinical assessment is associated with superior patient-reported outcomes following treatment and is more cost-effective, compared to comprehensive clinical assessment only.

Methods
FUTURE is a pragmatic, multi-centre, superiority randomised controlled trial. Women aged ≥ 18 years with refractory OAB or urgency predominant mixed urinary incontinence, and who have failed/not tolerated conservative and medical treatment, are considered for trial entry. We aim to recruit 1096 women from approximately 60 secondary/tertiary care hospitals across the UK. All consenting women will complete questionnaires at baseline, 3 months, 6 months and 15 months post-randomisation. The primary outcome is participant-reported success at 15 months post-randomisation measured using the Patient Global Impression of Improvement. The primary economic outcome is incremental cost per quality-adjusted life year gained at 15 months. The secondary outcomes include adverse events, impact on other urinary symptoms and health-related quality of life. Qualitative interviews with participants and clinicians and a health economic evaluation will also be conducted. The statistical analysis of the primary outcome will be by intention-to-treat. Results will be presented as estimates and 95% CIs.

Discussion
The FUTURE study will inform patients, clinicians and policy makers whether routine urodynamics improves treatment outcomes in women with refractory OAB and whether it is cost-effective.

Trial registration
ISRCTN63268739. Registered on 14 September 2017.
Effect of alkalized urine on renal calculi in patients with gout: a protocol for a placebo-controlled, double-blinded randomized controlled trial
Authors: Jia Ertao , Zhu Haiqiong , Geng Hongling , Wang Yadong , Zhong Li , Liu Shangwen , Lin Feng , Zhang Jianyong 
Published: October 2021

Abstract
Background
The prevalence of renal calculi in patients with gout is high. Alkalized urine has been recommended by the 2020 European Association of Urology (EAU) guidelines to promote calculus dissolution. However, randomized controlled trials are lacking.

Methods
In the protocol of this randomized, placebo-controlled, double-blinded trial, patients with gout combined with renal calculi are randomized (1:1) to the placebo and sodium bicarbonate groups. The intervention would be performed for 24 weeks, the 1–12 weeks are double-blinded, and the 13–24 weeks are open-labeled. Sodium bicarbonate (1 g tid) will be performed for 24 weeks in the sodium bicarbonate group. The placebo will be performed for 12 weeks and not be performed from 13 weeks to 24 weeks in the placebo group. All subjects will be administered febuxostat (40 mg/day) for 24 weeks and receive concomitant anti-inflammatory prophylaxis therapy for 12 weeks. The primary outcome is the proportion of patients whose renal calculus volume will be reduced after 12 weeks of treatment. The secondary outcomes include the volume changes of renal calculi, uric acid changes, the proportion of patients with serum uric acid (sUA) levels < 360 μmol/L, the changes in estimated glomerular filtration rate (eGFR), the pH value of urine, and the incidence of adverse events after treatment for 12 and 24 weeks.

Discussion
This study will evaluate the efficacy and safety of sodium bicarbonate-alkalized urine on renal calculi in patients with gout.

Trial registration
ClinicalTrials.gov ChiCTR2100045183. Registered on April 7, 2021, with ChiCTR.
Time in range, especially overnight time in range, is associated with sudomotor dysfunction in patients with type 1 diabetes
Authors: Feng Zhou-qin , Guo Qing-yu , Wang Wei , Yuan Yan-yu , Jin Xu-guang , Zhou Hui , Liu Jun , Lei Hai-yan , Yang Xin-yi , Liu Jun , Lu Bin , Shao Jia-qing , Gu Ping 
Published: October 2021

Abstract
Background
Time in range (TIR) is advocated as key metric of glycemic control and is reported to be associated with microvascular complications of diabetes. Sudomotor dysfunction is among the earliest detectable diabetic peripheral neuropathy (DPN). We set about to research the relationship between TIR including overnight TIR and sudomotor function detected by SUDOSCAN with the intention of exploring the correlation of TIR including overnight TIR and early DPN in type 1 diabetes (T1D).

Methods
95 patients with T1D were enrolled. TIR including nocturnal TIR of 3.9–10.0 mmol/L was evaluated with CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC) and sudomotor dysfunction was defined as average FESC < 60µS. Logistic regressions were applied to examine the independent association of TIR and overnight TIR with sudomotor function.

Results
The overall prevalence of sudomotor dysfunction was 28.42%. Patients with sudomotor dysfunction had significantly lower TIR for the whole recorded phase and for nighttime. The sudomotor dysfunction prevalence progressively declined with the ascending tertiles of TIR and nocturnal TIR (P for trend < 0.05). Correlation analysis showed that the relationship between nocturnal TIR and FESC was stronger than that between TIR and FESC with correlation coefficients were respectively 0.362 and 0.356 (P < 0.001). Finally, logistic regression analysis indicated the independently negative relation between TIR and nocturnal TIR and sudomotor dysfunction (P < 0.05), and the correlation between nocturnal TIR and sudomotor dysfunction was more statistically significant.

Conclusions
TIR is negatively correlated with sudomotor dysfunction in T1D independent of HbA1c. Furthermore, decreased nocturnal TIR is more closely related to the impaired function of sudomotor nerves in sweat glands.
An approach to convivial urban spaces: a comparison between users’ and experts’ perception of convivial urban spaces
Authors: Shedid Mona Y. , Hefnawy Noha H. 
Published: October 2021

AbstractConvivial urban spaces are a process as well as a philosophy. They revolve around observing users in specific urban spaces to comprehend their various needs, especially their social needs. Designing urban spaces for people to promote social connections is the foundation of creating convivial urban spaces. This means that this form of urban space has been interpreted as a daily social activity and as social pleasure expressed in the physical and psychological context of people's urban space. To provide a convivial environment for all users, effective convivial urban spaces should fulfill certain important aspects. From this point of view, the paper aims to identify the main aspects of creating convivial urban spaces through their repletion in the different theories. Then, the paper will evaluate and arrange the importance of the different aspects that form convivial urban spaces from the users and experts (urban designer and architects) point of view to reach the main objective of the paper which is to create a prospected framework for the urban designer and architects to help them in future decisions in designing convivial urban spaces that fulfill users’ needs.
Thermoelectric properties of a diamond ribbon subjected to a transverse magnetic field
Authors: Chakraborty Suvendu , Ganguly Sudin , Maiti Santanu K. 
Published: October 2021

Abstract
To manufacture an efficient thermoelectric device at the nanoscale and to get its controlled performance, we suggest a finite-width diamond ribbon in the presence of a perpendicular magnetic field. Contemplating the asymmetry in transmission function in a narrow conducting channel, the possibility of a gap around the energy band center in the presence of a magnetic field is discussed here. The eigenvalue spectrum and band structures show several interesting features. The different thermoelectric quantities are evaluated following the Landauer prescription. We show that the gap is tunable by controlling the strength of the magnetic field. Near the edge of the gap, our results exhibit a favorable thermoelectric response. We believe that our analysis of the proposed model can be experimentally tested in the laboratory and hope our study helps to construct an efficient thermoelectric device at the mesoscopic level.
What Kind of Freedom Is Academic Freedom?
Authors: Scott Joan W. 
Published: October 2021

Abstract
This essay argues for a definition of academic freedom that does not confuse it with what is considered to be a human right—the individual right to free speech. This is a freedom granted in principle by the state to scholars (usually within educational institutions: schools, colleges, and universities) because their critical activity has been considered vital to the public good and because it is a self-regulated activity committed to processes of relentless questioning that require disciplined forms of reading and reasoning. Neoliberal practices have undermined the basis for this classic definition of academic freedom. The essay explores the alternatives to state-ensured academic freedom that have emerged both within and outside the university, focusing particular attention on Turkey's Solidarity Academies. It concludes by insisting that the critical function of producing knowledge for the common good must be protected by nonstate actors if the state has broken the covenant upon which academic freedom once rested.
Just What the Doctor Ordered
Authors: Schlicht Jeffrey A. , Inskip Michael , Fiatarone Singh Maria 
Published: October 2021

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