bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Sex and Gender in the Selection of Alzheimer Patients for Clinical Trial Pre-screening
Authors: Rosende-Roca Maitee , Abdelnour Carla , Esteban Ester , Tartari Juan Pablo , ALARCON EMILIO , Martinez-Atienza Juliana , González-Pérez Antonio , Lafuente Asunción , Buendia Mar , Pancho Ana , Aguilera Nuria , Ibarria Marta , Diego Susana , Jofresa Sara , Hernández Isabel , López Rogelio , Gurruchaga Miren Jone , Tárraga Lluís , Marquié Marta , Valero Sergi , Ruiz Agustín , Boada Mercè 
Published: January 2021

Abstract
Background: Alzheimer disease (AD) is a progressive neurodegenerative disorder affecting the elderly with a prevalence of 7.1% in women and 3.3% in men aged 55 or older. Sex-related patterns have been reported in prognosis, biomarker status and risk factors. Despite this, the interaction of sex has received limited attention, with AD trials persistently recruiting lower numbers of women than the population distribution and a lack of information on the sex-disaggregated effects of anti-dementia therapies. This is the first study aiming to identify the role of sex in the selection for screening in AD clinical trials.Methods: This cross-sectional study provides a comprehensive analysis of screening eligibility according to a set of pre-selection criteria currently applied at Fundació ACE memory clinic for a more efficient trial screening process. A cohort of 6,667 women and 2,926 men diagnosed with AD dementia (55%) or mild cognitive impairment (45%) was analyzed. We also assessed the frequencies of men and women effectively screened for trial enrolment over a period of 10 years.Results: Women showed a significantly lower chance of being eligible for screening than men (OR=1.26; p<0.01). This imbalance was confirmed by a lower frequency of women screened for enrolment compared to the study population (63.0% vs 69.5%). Education was revealed as the key criterion contributing to this unbalance, with men showing over twice the chance of being screened compared with women (OR=2.25, p<0.01). Education-based differences were greater in earlier born patients, but the gap narrowed and achieved balance with increasing year of birth. Comorbidity was the most limiting criterion with sex differences in frequencies and significant discrimination against the selection of men (OR=0.86, p<0.01).Conclusions: The large number of low-educated elderly women with AD demands for a sex-focused approach in clinical research. New assessment tools insensitive to education level should be develop to enable a proportional representation of women. Although this gender education gap is mostly inexistent in developed countries, economic or cultural factors may lead to different scenarios in other regions. Overlooking the impact of sex may lead to a handicap in AD research with a direct adverse impact on women’s health.
Routine Health Information Use for Decision-making and Associated Factors among Managers Working at Public Hospitals in North Shewa Zone of Oromia Regional State, Ethiopia: A Mixed-Method Study
Authors: Tulu Gemechu , Demie Takele Gezahegn , Teshome Tesfalem 
Published: January 2021

Abstract
Background: Routine health information systems (RHIS) are vital for the acquisition of data for health sector planning, monitoring, and evaluation, patient management, health education, resource allocation, disease prioritization, and decision-making. Routine health information use for decision-making is low in Ethiopia. Thus, the study aimed to assess level of routine health information use and its associated factors among managers working at public hospitals in North Shewa, Ethiopia.Methods: A facility-based cross-sectional study design with both quantitative and qualitative data collection methods was conducted from May to June 2020. A total of 102 randomly selected managers working in public hospitals in North Shewa were included in the quantitative study while six in-depth interviews were performed for the qualitative method. Quantitative data were collected using a structured self-administered questionnaire and interview guide by trained data collectors, cleaned, coded, and entered into Epi-info version 7.1 software and transferred into SPSS version 23 software for Window for further statistical analysis. Both bivariable and multivariable logistic regression analyses were performed. In the multiple logistic regression analysis, a less than 0.05 P-value was considered statistically significant. The odds ratio along with a 95% confidence interval (CI) were estimated to measure the strength of the association. Thematic analysis was done for key informant interview data.Result: In this study, the level of routine health information use for decision-making was 71.6% (95% CI: 61.8%, 79.4%). According to the multivariable logistic regression analysis, training on health information system (AOR = 0.28, 95% CI: 0.08-0.98) and supportive supervision (AOR = 0.27, 95% CI: 0.09-0.78) were found significantly associated with the use of routine health information for decision-making. Moreover, the lack of staff motivation and computer and data analysis skills were the major reasons for not using routine health information.Conclusions: Three-fourth of the managers working at public hospitals used routine health information for decision-making. Training on health information system and supportive supervision were factors associated with the use of routine health information. Therefore, training of managers and the provision of supportive supervision were highly recommended to improve the use of routine health information managers for decision-making at public health institutions.
Development and Characterization of Nb3Sn/Al2O3 Superconducting Multilayers for High-performance Radio-Frequency Applications
Authors: Sundahl Chris , Makita Junki , Welander Paul , Su Yi-Feng , Kametani Fumitake , Xie Lin , Zhang Huimin , Gurevich Alex , Eom Chang-Beom , Li Lian 
Published: January 2021

Abstract
Superconducting radio-frequency (SRF) resonator cavities provide extremely high quality factors > 1010 at 1-2 GHz and 2K in large linear accelerators of high-energy particles. The maximum accelerating field of SRF cavities is limited by penetration of vortices into the superconductor. Present state-of-the-art Nb cavities can withstand up to 50 MV/m accelerating gradients and magnetic fields of 200-240 mT which destroy the low-dissipative Meissner state. Achieving higher accelerating gradients requires superconductors with higher thermodynamic critical fields, of which Nb3Sn has emerged as a leading material for the next generation accelerators. To overcome the problem of low vortex penetration field in Nb3Sn, it has been proposed to coat Nb cavities with thin film Nb3Sn multilayers with dielectric interlayers. Here, we report the growth and multi-technique characterization of stoichiometric Nb3Sn/Al2O3 multilayers with good superconducting and RF properties. We developed an adsorption-controlled growth process by co-sputtering Nb and Sn at high temperatures with a high overpressure of Sn. The cross-sectional scanning electron transmission microscope images show no interdiffusion between Al2O3 and Nb3Sn. Low-field RF measurements suggest that our multilayers have quality factor comparable with cavity-grade Nb at 4.2 K. These results provide a materials platform for the development and optimization of high-performance SIS multilayers which could overcome the intrinsic limits of the Nb cavity technology.
Secondary Analysis on Malaria RDTs in WHO Product Testing from Round 5 to 8 on False Negative Results in Testing Sample
Authors: Xu Biao , Tu Bo , Chu Fang , Jalloh Mohamed , Mu Jinsong , Zheng Junjie , Chen Weiwei 
Published: January 2021

Abstract
Background

with the widespread use of malaria rapid diagnostic tests (RDTs) in clinical practice, they also show their own challenges. Compared with most of the attention focusing on false positive results in WHO product testing, the same important false negative results attract insufficient focus.

Method

data of 129 malaria RDTs in the summary of WHO rounds 5 to 8 product testing was secondary analyzed in 5 aspects including low parasite density, improper RDTs storage, operation and interpretation, P. falciparum (Pf) with pfhrp2/3 genes deletion, inter-lot variation.

Results

First, the percentage of tests that achieved a panel detection score (PDS) < 80% at a low parasite density was 20-25% for Pf, and substantially higher for P. vivax (Pv). Second, Some Pv- and Pf- detecting products showed an increasing deterioration with increase of storage temperature. Third, approximately 20-27% products’ performances were unsatisfied in blood safety and instruction quality; and 30-35% test bands of the RDTs for Pf were barely visible, and the ones for Pv returned a higher proportion of weak band intensity. Fourth, different Lots of each test products may produce inconsistent results. Fifth, many malaria RDTs obtained a low PDS (< 50%) and a high false negative rate (> 50%) when testing Pf with deletion of pfhrp2/3 gene.

Conclusion

the malaria RDTs currently widely used were overestimated and could cause false negative results in practice. The clinicians should be aware of these shortcomings in order to draw more accurate diagnosis and treatment.
Factors Affecting Addiction Severity Index (ASI) among Clients Enrolled in Methadone Maintenance Treatment (MMT) Program in Myanmar
Authors: Tun Sun , Balasingam Vicknasingam , Singh Darshan Singh 
Published: January 2021

Abstract
Background: Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social-functioning. Understanding factors that undermine clients’ social-functioning during MMT treatment is vital for improving treatment compliance and quality of life. Method: A total of 210 respondents who were presently enrolled in formal MMT program in Myanmar were recruited from five cities through stratified random sampling for this cross-sectional study. The Addiction Severity Index (ASI) was used to objectively assess respondents social-functioning in the last 30 days. Higher ASI scores denotes poorer social-functioning. Result: Respondents total ASI scores in the respective domains were; employment (47.4%), alcohol (44.4%), drug use (7.2%), legal (49.2%) and social-family relationship (10.7%). Those reported to have never injected drugs in the last 30 days had lower ASI scores than those who reported injection drug use (p=0.026). After identifying the differences in ASI total scores, we found there are significant associations in the clients’ Hepatitis C status, age category, frequency of heroin injection, quality of life score, marital status, current leisure status with family/friend, current history of injection in the last 30 days, income status, satisfaction with current marital status, as well as reported drug and alcohol use (p<0.05). Stepwise binary logistic regression showed alcohol and higher frequency of heroin injection is associated with higher ASI scores. Meanwhile, older age respondents, those who had leisure time with family, and satisfied with current marital status had lower ASI scores (p<0.05). Conclusion: Our results indicate that those enrolled in MMT program in Myanmar faced many challenges in their daily social-functioning. Treatment providers must take heed of these apparent impediment to ensure clients chequered social-functioning do not undermine their treatment compliance. Trial registration: NA
Influence of dietary and lifestyle factors on blood pressure control among adult hypertensive patients under care in Uganda
Authors: Nakalega Patience Annet , Mugenyi Levicatus , Nuwabaine Lilian , Amperiize Mathius , Tabusibwa Barbara Kirunda 
Published: January 2021

Abstract
Background Hypertension is an important worldwide public-health challenge because of its high prevalence and for being a risk factor for cerebrovascular, cardiovascular and chronic renal disease. Despite these risk factors, blood pressure control among hypertensive patients is still poor. Objectives To assess dietary and lifestyle factors associated with uncontrolled blood pressure control among a series of Ugandan hypertensive patients under care at a Kiruddu hospital.Methods A cross sectional study involving 271 adult hypertensive patients attending general outpatient hypertensive clinic were enrolled. We collected data on dietary and lifestyle factors, social demographics, BMI, comorbidities, and adherence to hypertensive medication. Dietary factors were based on recommended DASH diet including nine food items salt; grains; fruits; vegetables; nut/seeds, and legumes; dairy; meat; fat; and sweets. Questionnaires on alcohol intake, smoking status and level of physical activity were also administered. An average of the previous two Blood pressure readings were recorded while weight and height were measured for each subject at enrolment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model.Results The mean age of study participants was 57 years (SD ± 0.76 years), with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption (less than 7days/week): 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21).Conclusion The proportion of hypertensive patients with uncontrolled BP was high (44.7%). Consumption of raw salt, inadequate fruit consumption being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, many of the factors that impact on the control of blood pressure are fortunately modifiable.
Transmission frequency of covid-19 through pre-symptomatic and asymptomatic patients in AJK: A report of 201 cases
Authors: Mahmood Majid , Ilyas Noor-ul-ain , Khan Muhammad , Hasrat Muhammad 
Published: January 2021

Abstract
Background: Corona virus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, declared as “once-in-a-century” pandemic, has affected about entire human population. Till now, the most promising control strategy is to block the transmission which will never be effective without completely knowing the transmission patterns.Methods: This was a retrospective case to case study aiming to estimate and calculate the transmission rate of COVID-19 through pre-symptomatic and asymptomatic patients. Contact history of included positive cases during the period of 24 hours before appearance of symptoms and infection confirmation for symptomatic and asymptomatic cases respectively was traced for disease transmission. Results: Overall, a total of 201 cases had contacted with 7168 people in last 24 hours with an average of 35.66 contacts per patient ranging from a minimum of 4 to maximum of 87 contacts (Meetings). Out of 7168 meeting persons, the infection was traced in 64 (0.89%) persons. For 155 symptomatic patients, a total of 5611 contacting persons were traced before appearance of symptoms (pre-symptomatic) in last 24 hours with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people and remaining 5548 (98.88%) were remained uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within last 6 hours before the onset of symptoms while only 1 was traced from 6-12 hours before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 hours before their infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Conclusion: The study concludes that the risk of pre-symptomatic transmission of infection is low (1.12%) and it becomes very rare in contacts made longer than 6 hours before onset of symptoms. The infection transmission is traced as long as about 9 hours before the appearance of clear symptoms in the patients but the incidence was as low as about 0.02% of the total contacts in that period. Transmission frequency by asymptomatic patients is also rare (0.06%) in the studied population.
Elevated Liver Enzymes and Incident Type Two Diabetes Mellitus Risk in Yemeni Patients&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Authors: Dahman Lotfi S. Bin , Barahman Omer M. , Humam Mariam A. , Musiaan Nabil S. , Daakik Ahmed M. 
Published: January 2021

Abstract
Liver disease is a major cause of morbidity and mortality in patients with type two diabetes mellitus (T2DM). This case-control study was aimed to assess the association between liver enzymes and incident T2D in Yemeni patients. The present study comprising 142 T2D patients and 142 healthy control subjects were recruited from the diabetic outpatient clinic of Ibn-Sina hospital in Mukalla during the period from 1st January to 30th May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Also, anthropometric and blood pressure measurements were taken from each participant. T2D patients had significantly higher FBG (P= <0.0001), total cholesterol (P= <0.0001), LDL-C (P= <0.0001), and GGT (P= <0.0001) while, HDL-C was significantly lower in T2D patients (P= 0.021). In correlation analysis, serum GGT levels were positively associated with systolic BP (r= 0.134; P= 0.025), diastolic BP (r= 0.218; P= <0.001), FBG (r= 0.216; P= <0.0001), total cholesterol (r= 0.196; P= 0.0001), triglyceride (r= 0.123; P= 0.038), and LDL-C (r= 0.209; P= <0.0001). Also, serum ALT and GGT levels were significantly associated with increased incident T2D risk (P= 0.006 for ALT and 0.022 for GGT) and the odds ratio at 95% CI comparing highest versus lower tertiles of ALT and GGT were 2.75(2.01-3.48) and 1.17(1.83-6.42) respectively. In conclusion, higher levels of ALT and GGT are positively associated with increased blood glucose levels and may be used as the predictive biomarkers in developing higher risk of diabetes. Thus, routine screening of ALT and GGT in T2D patients is recommended for the early detection of liver disorders.
Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results
Authors: Wu Qin , Shi Lei , Chen Rui , Xing Quansheng 
Published: January 2021

Abstract
Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases.Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received two-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract.Results All operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure was performed in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of hospital stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during a median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases.Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.
The meaning of postpartum sexual health for women living in Spain: A phenomenological inquiry.
Authors: Pardell-Dominguez Lidia , Palmieri Patrick Albert , Dominguez-Cancino Karen A. , Camacho-Rodriguez Doriam E. , Edwards Joan E. , Watson Jean , Leyva-Moral Juan M. 
Published: January 2021

Abstract
Background: Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum period, a woman transitions to mother, as well as partner-to-parent and couple-to-family. There are new realities in life in the postpartum period, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain).Methods: This was a phenomenological study with a purposive sample of primiparous women. Data was collected through semi-structured interviews until saturation. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis.Results: Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. Returning to sexual health led women to engage in experiential learning through trial and error. Most participants reported reduced libido, experienced altered body image, and recounted resumption of sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a meaningful relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model.Conclusion: Evidence-based practices should incorporate the best evidence from research, consider the postpartum sexual health experiences and preferences of the woman, and use clinician expertise in discussions that include the topic of postpartum sexual health to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women. Clinicians need to be authentically present, engage in active communication, and individualize their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through meta-synthesis.