bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships between changes in HIV risk perception and condom use in east Zimbabwe 2003-2013: Population-based longitudinal analyses
Authors: Schaefer Robin , Thomas Ranjeeta , Maswera Rufurwokuda , Kadzura Noah , Nyamukapa Constance , Gregson Simon 
Published: July 2019

Abstract
Background: Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception.

Methods: Data on sexually active, HIV-negative adults (15-54 years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated.

Results: 1988 males and 3715 females participated in ≥2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR]=1.39, 95% confidence interval [CI]=0.85-2.28, PAF=3.39%; females: aOR=1.41 [1.06-1.88], PAF=6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR=1.76 [1.12-2.78]; females: aOR=1.23 [0.93-1.62]).

Conclusions: Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.
A Global Health Capstone: An Innovative Educational Approach in a Global Health Competency-Based Curriculum
Authors: Chamberlain Stacey , Gonzalez Nicole , Dobiesz Valerie , Edison Marcia , Lin Janet , Weine Stevan 
Published: July 2019

Abstract
Background

Global health educational programs for medical and public health professionals have grown substantially in recent years. The University of Illinois Chicago College of Medicine (UICOM) began a global medicine (GMED) program for selected students in 2012 and has since graduated four classes. As part of the four-year curriculum, students complete a longitudinal global health capstone project. This paper describes the global health capstone project with the aims of understanding whether longitudinal capstone projects are feasible, how mentorship of capstones could be strengthened, and how participation in a capstone might contribute to students’ attainment of global health competencies.

Methods

The authors reviewed the final capstone projects for 35 graduates to assess features of the capstones including whether the projects were longitudinal, faculty-mentored, or involved original research. In addition, the authors assessed the attainment of each of 11 global health competency domains identified by the Consortium of Universities for Global Health (CUGH). Student reflection papers were reviewed for themes related to capstone completion.

Results

Of the 35 capstones, 19 (54%) were longitudinal, and 21 (60%) had subject matter-focused faculty mentorship. Twenty-six projects involved original research (74%) and 25 involved international travel (71%). Nine projects led to a conference abstract/presentation (26%) while five led to a publication (14%). Overall, capstone projects addressed 9 out of 11 (82%) CUGH competency domains. In their reflection papers, students identified factors that facilitated capstone completion (e.g. strong mentorship), barriers to capstone completion (e.g. difficulty identifying a capstone project), and key benefits of the capstone process (e.g. strengthened research skills).

Conclusions

A longitudinal capstone model is feasible, provides an impactful opportunity for research and career mentorship, and can teach targeted global health competencies. Further refinement of the capstone process is needed to strengthen mentorship and target more global health competencies, and additional assessment tools are needed.
Effect of stress coping ability and working hours on burnout among residents
Authors: Kijima Saori , Tomihara Kazuya , Tagawa Masami 
Published: July 2019

Abstract
Background

Burnout (BO) among residents leads to interruptions in training and even to exit from programs. Despite the implementation of working hour restrictions in the U.S. in 2013, the high rate of BO remains a serious problem. Therefore, we analyzed Japanese residents’ BO, training conditions, and associated factors, especially stress coping ability, with the aim of providing support for residents and evidence-based guidelines for working environments.

Methods

In total, 37 teaching hospitals were randomly selected, and all residents in the third and fifteenth months of a residency program at these hospitals were targeted for this research. We analyzed the residents’ BO rates, associated factors, and interactions using response data from a self-administered questionnaire consisting of the Japanese versions of the Maslach Burnout Inventory (MBI) and the Sense of Coherence (SOC) scale, as well as items asking about their training environments, gender, and age.

Results

Overall, 48 (49.5%) of 97 residents in 18 teaching hospitals (62 and 35 in the third and fifteenth months, respectively) whose average working hours were 63.3 hours per week were judged as having BO, among whom, 33 (53.2%) and 15 (42.9%) had BO in the third and fifteenth months, respectively. Logistic regression analysis indicated that working hours and 10 items on the SOC scale (SOC10) were significant factors of BO.

Two-way analysis of variance revealed that working hours was a significant variable for the MBI-emotional exhaustion score and SOC10 in the third and fifteenth months, respectively. Regarding the MBI-cynicism and professional efficacy scores, the SOC10 was a significant variable in both the third and fifteenth months. In addition, the high SOC group (SOC10>45) showed higher personal efficacy under longer working hours.

Conclusion

About half of the Japanese residents were judged as having BO as early as the third month of training under regulations of working 40 hours per week. Individual stress coping ability and working hours were found to be significant factors for BO. Residents with high stress coping ability exhibited more personal efficacy with more working experiences, which suggests that the SOC scale could be a valuable tool to help foster a suitable training environment.
Generalizability of a Progress Clinical Skills Examination and the Assessment of the Growth in Clinical Skills in a Medical School Curriculum with Early Clinical Experiences
Authors: Laird-Fick Heather S , Chang Chi , Wang Ling , Parker Carol , Malinowski Robert , Emery Matthew , Solomon David 
Published: July 2019

Abstract
Background

This study evaluates the generalizability of an eight-station progress clinical skills examination and assesses the growth in performance for six clinical skills domains among first- and second-year medial students over four time points during the academic year.

Methods

We conducted a generalizability study for longitudinal and cross-sectional comparisons and assessed growth in six clinical skill domains via repeated measures ANOVA over the first and second year of medical school.

Results

The generalizability of the examination domain scores was low but consistent with previous studies of data gathering and communication skills. Variations in case difficulty across administrations of the examination made it difficult to assess longitudinal growth. It was possible to compare students at different training levels and the interaction of level of training and growth. Second-year students outperformed first-year students, but first-year students’ clinical skills performance grew faster than second-year students narrowing the gap in clinical skills over the students’ first year of medical school.

Conclusions

Case specificity limits the ability to assess longitudinal growth in clinical skills through progress testing. Providing students with early clinical skills training and authentic clinical experiences appears to result in the rapid growth of clinical skills during the first year of medical school.
Clinical Features of Actinomycosis: A 20-year Experience of A Single Institute in Southern China
Authors: Xu Yu-yuan , Zhang Jian , Lu Ai-li , Peng Jie , Xu Xu-wen 
Published: July 2019

Abstract
Background

Actinomycosis is a rare indolent infectious disease with nonspecific clinical presentations that delay diagnosis. Although actinomycosis is thought to be more prevalent in developing countries, data from developing countries are scanty. This study was to reveal the current situation of actinomycosis in developing countries and the difference from that in developed countries.

Methods

Patients fulfilling the inclusion criteria for actinomycosis from Nanfang Hospital in southern China between January 2003 and December 2018 were retrospectively analyzed. We described clinical characteristics, diagnostic procedures, differential diagnosis, and management of actinomycosis of clinical significance.

Results

Thirty-one patients were included in this study. Disease was diagnosed predominately in the orocervicofacial (n=14), cardiothoracic (n=11), abdominopelvic (n=5), soft tissue (n=1). Diagnosis was obtained from either histopathology (n=29, 94%) or microbiology (n=2, 6%). Only one-thirds of patients presented with general symptoms such as fever, weight loss. Ten was lost to follow-up, and median duration of antibiotics was 93.5 days (interquartile range 28–300), whereas the median follow-up time was 34 months (interquartile range 9–132). Ten patients receiving complete resection of the lesion were cured without postoperative use of antibiotic. Only one patients relapsed during the follow-up period.

Conclusions

Actinomycosis is a rare disease even in developing countries, and both misdiagnosis and missed diagnosis are common. Diagnosis was often delayed and obtained from histopathology postoperatively in developing countries. Hence, clinicians should be aware of this disease in patients with high riks factors. In the future, specific molecular methods may help to improve early diagnosis and treatment.
A Comparative Analysis of DWI and Ultrasound in Thyroid Nodules
Authors: Kong Wei dan , Yue Xiu hui , Ren Ji liang , Tao Xiao feng 
Published: July 2019

Abstract
Background

Diffusion weighted imaging and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. To evaluate the value of diffusion weighted imaging and ultrasound in differentiing benign and malignant thyroid nodules
Methods

A total of 100 patients with 137 nodules were enrolled. who underwent both diffusion weighted imaging and ultrasound before operation. T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The value of ADC,signal intensity ratio (SIR) of benign and malignant thyroid nodules were analyzed by two independent sample t test. The sensitivity, specificity and accuracy of DWI and ultrasound were compared and analyzed by chi-square test.

Results

There was no significant difference in signal intensity ratio between benign and malignant thyroid nodules. The ADC value had significant difference. When the threshold value was 1.12 ×10-3 mm2/s, the maximum area under the curve was 0.944,The sensitivity, specificity and accuracy were 84.9%, 92.2% and 87.6% respectively. The sensitivity and specificity of ultrasound diagnosis were 90.1%, 80.4% and 86.9% respectively.

Conclusion

Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and ADC value has high specificity in differentiating thyroid nodules, but there is no statistical difference in sensitivity and specificity between the two. DWI and Ultrasound have their own advantages in differentiating benign and malignant thyroid nodules.
Tumor-associated fibroblasts expression in esophageal squamous cell carcinoma and may descend from mesenchymal stem cells
Authors: Yang Weilin , Bella Amos Ela , Xu Bo , Zou Jianyong , Zhu Haoshuai , Su Chunhua , Xiang Andy Peng , Wang Tao , Chen Zhenguang 
Published: July 2019

Abstract
Tumor-associated fibroblasts (TAFs) play a pivotal role in cancer proliferation, invasion and metastasis. The expression of TAFs in esophageal squamous cell carcinoma (ESCC) tissues remain unclear. We investigated the relevance of TAFs in ESCC, and then culture mesenchymal stem cells (MSC) by ESCC microenvironment induced their conversion into TAFs to assess whether MSC are precursors of TAFs. We detected the expression of TAFs surface markers, including α-SMA, and S100A4 in esophageal squamous cell cancer tissues by using immunohistochemistry, and evaluated associations with clinicopathological features. In order to verify whether MSC is one of the TAFs sources, we used culture supernatant from ESCC tumor cells to culture and induce MSC to transform into TAFs. TAFs surface markers, α-SMA and S100A4, were expressed in ESCC tissues, and their expressions correlated with tumor differentiation and clinical TNM stage. Real-time-PCR analysis and Western-Blot analysis confirmed MSC conversion into TAFs. Our study demonstrated that TAFs existence in esophageal carcinoma, and their expression was also closely related to metastasis and poor prognosis. Furthermore, we confirmed the conversion from MSC to TAFs and surmised MSC may be the precursors of TAFs.
Prevalence and Associated Factors of Bronchial Asthma among Adult Patients in Debre Berhan Referral Hospital, Ethiopia 2018: A cross-sectional study
Authors: Tegegnework Sisay , Muhamud Sindew , Demelash Alebachew 
Published: July 2019

Abstract
Objective

Bronchial asthma is one of the major public health challenges throughout the world that negatively impact patients, families and community. The objective of this study was to assess the prevalence and associated risk factors of bronchial asthma among adult patients in Debre Berhan Referral Hospital. A hospital based cross-sectional study design was used among 257 study participants. A systematic sampling technique was used to select the study participants. Data were collected by using pre-tested and structured questionnaire. The data was analyzed by SPSS version 20.0. Both bivariate and multivariate logistic regression model was used to identify the predictors of asthma.

Results

Prevalence of bronchial asthma among adult patients was 29.6%. Being an urban resident (AOR: 1.5: 95%CI: 1.3 - 3.9), income of household less than 1000 EBr/ month (AOR: 1.7: 95%CI: 1.6 - 4.1), having family history of asthma (AOR: 2.7: 95%CI: 1.3 - 5.8), and presence of vermin at the house of patients’ (AOR: 2.4: 95%CI: 1.2 – 4.7) were significantly associated with bronchial asthma. The authors concluded that the prevalence of bronchial asthma among adult patients was high. Therefore, educational program about the risk factors and preventive measures of asthma is highly recommended.
Lower serum 25-hydroxyvitamin D3 concentration is associated with higher pain and disability in subjects with low back pain: a case-control study
Authors: Pishgahi Alireza , Dolatkhah Neda , Shakouri Seyed Kazem , Hashemian Maryam , Amiri Atefeh , Reihany Morteza Delkhosh , Jahanjou Fatemeh 
Published: July 2019

Abstract
Objectives: Low back pain (LBP) is a common medical problem worldwide. The aim of this study is to evaluate the association between serum levels of 25-hydroxivitamin D3 and functional disability in patients suffering from LBP in a sample of Azeri middle-aged subjects, North West of Iran.
Results: In this case-control study, 63 eligible patients with LBP and 55 healthy subjects enrolled in the study. Peripheral venous blood was taken for evaluating the serum Level of 25-hydroxivitamin D3. We recognized factors related with LBP by multiple regression analyses. The average plasma level of vitamin D in case group was significantly lower than that of the matched controlled group (26.25±15.95 vs. 34.20±14.92, p-value < 0.01 respectively). Subjects with vitamin D deficiency or insufficiency were more likely to exhibit LBP than subjects with normal vitamin D level [(OR= 2.388, 95% CI (1.114 to 5.119)]. According to the partial correlation analysis, there was a reverse correlation between plasma level of vitamin D with functional disability measured by Modified Oswestry Questionnaire (r = -.307, p = .017) and also with pain intensity according to Visual analogue Scale (VAS) score (r = -.268, p = .040) whilst controlling for age, sex and body mass index (BMI).
The effects of anethum graveolens (dill) powder supplementation on glycemic control, lipid profile, some antioxidants and inflammatory markers, and gastrointestinal symptoms in type 2 diabetic patients: a double-blind, placebo-controlled trial
Authors: Haidari Fatemeh , Zakerkish Mehrnoosh , Borazjani Fatemeh , Angali Kambiz Ahmadi , Amoochi Golnaz 
Published: July 2019

Abstract
Background: The objective of this study was to investigate the effects of anethum graveolens (dill) powder supplementation on glycemic control, lipid profile, some antioxidants and inflammatory markers, and gastrointestinal symptoms in type 2 diabetic patients.
Material and methods: In this study, 42 type 2 diabetic patients were randomly allocated to intervention and control groups and received either 3 gr dill powder or placebo (3 capsules 1 gr) three per day. Fasting blood sugar (FBS), insulin, homeostatic model assessment of insulin resistance (HOMA- IR), lipid profile, hs-C-reactive protein (hs-CRP), total antioxidant capacity (TAC), malondialdehyde (MDA) and gastrointestinal symptoms were measured in all subjects at baseline and post-intervention.
Results: The dill powder supplementation significantly decreased the mean serum levels of insulin, HOMA-IR, LDL-C and MDA in the intervention group in compare with baseline (p < 0.05). Also, the mean serum levels of HDL and TAC was significantly increased in the intervention group in compare with baseline (p < 0.05). Colonic motility disorders was the only gastrointestinal symptom that its frequency was significantly reduced by supplementation (P = 0.01). The mean changes of insulin, LDL-c and MDA were significantly lower in intervention group in compare with control group (p < 0.05). In addition, the mean changes of HDL was significantly higher in intervention group in compare with control group (p < 0.05).
Conclusion: It is recommended that dill powder supplementation may be effective in control of the glycemic, lipid, stress oxidative and gastrointestinal symptoms in type 2 diabetic patients.
Increased long-term risk of dementia in patients with carbon monoxide poisoning: A systematic review and meta-analysis of cohort studies
Authors: Zhang Meixian , Wei Ho-Shan , Chien Ching-Wen , Tung Tao-Hsin 
Published: July 2019

Abstract

Background

It has long been known that carbon monoxide poisoning is associated with cognitive dysfunction but whether carbon monoxide poisoning is a risk factor for incident dementia is still inconclusive. Our objective was to assess whether carbon monoxide poisoning increases the incidence of dementia.

Methods

We conducted a systematic review and meta analysis of cohort studies examining the risk of dementia in people with carbon monoxide poisoning. We searched the Cochrane Library, PubMed, and EMBASE from inception to 31 March 2019. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Only cohort study with an enough follow-up period was included, which reported the association between carbon monoxide poisoning and incidence of dementia in adults. Exposure was carbon monoxide poisoning; primary outcomes were incident all-cause dementia, Alzheimer’s disease and cognitive disorder. Summary estimates were obtained using random effects meta-analysis.

Results

Thirty-three full texts were initially searched, but only three studies met our inclusion criteria, and they were comprised of 134,563 participants who were initially free of dementia. The follow-up period ranged from 9 to 12 years. We found that CO poisoning increased the risk of dementia incidence [adjusted hazard ratio 2.61, 95% confidence interval (CI) 1.56 to 4.36, P = 0.0003]. Subgroup analysis showed that the increased dementia risk was significant in males but not in females, and the highest risk was in young age group, followed by in middle age group, but not in the old one (P > 0.05).

Conclusions

This meta-analysis suggests that overall the evidence from prospective cohort studies supported a link between carbon monoxide exposure and an increased dementia risk, although all the included studies were limited to Taiwanese population. Further studies that provide data for different ethnic groups are needed to clarify whether a subgroup of patients with carbon monoxide exposure has an elevated risk of dementia.