bluuebunny/crossref_metadata_2025_split huggingface dataset:
HPV knowledge, burden and genital wart location among heterosexually identified versus homosexually identified men who have sex with men in Lima, Peru: cross-sectional results from a cohort study
Authors: Galea Jerome T , León Segundo R , Peinado Jesús , Calvo Gino , Zamora Jonathan , Sánchez Hugo , Brown Brandon J 
Published: October 2017

ObjectivesThe relationship between sexual practices, identity and role among Latino men who have sex with men (MSM) and HIV risk is the subject of ongoing investigation but less is known about how these aspects of sexuality relate to human papilloma-virus (HPV), an independent risk factor for HIV. This observational study investigated the relationship between HPV and sexual practices, identity and role as well as other sexually transmitted infection (STI)/HIV risk factors among HIV-negative heterosexually and homosexually identified Peruvian MSM.SettingCommunity-based clinic for MSM in Lima, Peru.Participants756 subjects were screened based on inclusion criteria of: born anatomically male; age ≥18 years; had any anal intercourse with a man during the previous 12 months; residing in metropolitan Lima; HIV negative; willing to commit to twice-yearly clinic visits for 24 months; had not participated in an HIV or HPV vaccine study. 600/756 participants met the inclusion criteria and were enrolled, of whom 48% (284) identified as homosexual and 10% (57) as heterosexual, the basis of the analyses performed.ResultsCompared with homosexually identified MSM, heterosexually identified MSM had completed fewer years of formal education and were less likely to have: anogenital HPV or visible anal warts; given oral sex to a man; or used a condom with their most recent female sexual partner (all p<0.05). Conversely, heterosexually identified MSM were more likely to have: visible penile warts; used a condom during last anal intercourse; smoked cigarettes; had transactional sex; and used drugs during sex in the previous month (all p<0.01). There was no difference found between heterosexually and homosexually identified MSM by syphilis or high-risk HPV prevalence.ConclusionsHPV burden, wart type (penile vs anal) and select HIV/STI risk behaviours differed between heterosexually and homosexually identified Peruvian MSM. Understanding the implications of these differences can lead to tailored HIV/STI prevention interventions for heterosexually identified MSM.Trial registration numberNCT01387412.
Does the behavioural type-specific approach for type 2 diabetes promote changes in lifestyle? Protocol of a cluster randomised trial in Japan
Authors: Adachi Misa , Yamaoka Kazue , Watanabe Mariko , Nemoto Asuka , Tango Toshiro 
Published: October 2017

IntroductionType 2 diabetes (T2D) is a significant problem, and lifestyle modifications including self-management are important. We have developed a structured individual-based lifestyle education (SILE) programme for T2D. With attention now being paid to techniques to change behaviour, we recently developed a behavioural type-specific SILE (BETSILE) programme. We aimed to evaluate the effectiveness of the BETSILE programme compared with the SILE programme for reducing glycated haemoglobin (HbA1c) in patients with T2D and special behavioural types by a cluster randomised controlled trial.Methods and analysisThis is a 6-month cluster randomised controlled trial with two intervention arms (BETSILE vs SILE) provided in a medical care setting by randomising registered dietitians for patients with T2D aged 20–79 years. Patients’ behavioural types were classified into four types (BT1 to BT4) using an assessment sheet. We will perform independent trials for BT1 and BT2. The primary endpoint is a change from the baseline HbA1c value at 6 months. Differences between the SILE and BETSILE groups will be primarily analysed following the intention-to-treat principle. Crude and multivariate adjusted effects will be examined after adjusting for covariates, using a general linear mixed-effects model for continuous variables and a logistic regression mixed-effects model for dichotomous variables. Sample sizes needed were calculated assuming effect sizes of 0.42 and 0.33 for BT1 and BT2, respectively, an intraclass correlation of 0.02, a significance level of 5% (two-sided), a power of 80%, and equal allocation of clusters to the two arms, with each cluster having three BT1 patients for the SILE and BETSILE arms and six BT2 patients for the SILE and BETSILE arms. We will need 16 dietitians for each arm, and a total 288 patients will be required.Ethics and disseminationThis study has been approved by the Medical Ethical Committee of Teikyo University (No.15–222). Findings will be disseminated widely through peer-reviewed publications, etc.Trial registration numberUMIN 000023087; Pre-results.
ШЛЯХИ РЕФОРМУВАННЯ СИСТЕМИ ВИЩОЇ МЕДИЧНОЇ ОСВІТИ В УКРАЇНІ В СУЧАСНИХ УМОВАХ
Authors: Linchevskyi O. V. , Chernenko V. M. , Piatnytskyi Yu. S. , Bulakh I. Ye. 
Published: October 2017

Пошук стандартів вищої медичної освіти є оптимальною стратегією досягнення концептуально нового рівня якості підготовки майбутніх фахівців, основою якого є підготовка медичних працівників відповідно до загальноприйнятих міжнародних норм викладання з урахуванням особливостей та інтересів національної системи охорони здоров’я. Серед першочергових завдань діяльності вищих навчальних закладів та закладів післядипломної освіти у новому навчальному році будуть приведення змісту комп’ютерних програм для атестації інтернів та слухачів у відповідність до положень сучасних протоколів лікування та стандартів діагностики; приведення навчально-методичного забезпечення навчального процесу у відповідність до змісту сучасних стандартів вищої освіти, сучасних протоколів лікування та стандартів діагностики тощо.
КОНТРОЛЬ ЕФЕКТИВНОСТІ ЗАСВОЄННЯ ПРАКТИЧНИХ НАВИЧОК ВИПУСКНИКАМИ ДОНЕЦЬКОГО НАЦІОНАЛЬНОГО МЕДИЧНОГО УНІВЕРСИТЕТУ ЗА СПЕЦІАЛЬНІСТЮ «МЕДИЦИНА»
Authors: Dumanskyi Yu. V. , Kondratenko P. H. , Konkova M. V. , Kietinh O. V. 
Published: October 2017

У статті розглянуто особливості впровадження симуляційних технологій у педагогічний процес та здійснення контролю засвоєння практичних навичок студентами, опираючись на досвід створення та використання у практично-орієнтованому навчанні центру симуляційної медицини, що дозволяє забезпечити якісну практичну підготовку майбутніх лікарів та суттєво підвищити ефективність засвоєння практичних навичок випускниками Донецького національного медичного університету за спеціальністю «Медицина».
ОРГАНІЗАЦІЙНЕ ЗАБЕЗПЕЧЕННЯ ПІСЛЯДИПЛОМНОЇ ОСВІТИ МЕДИЧНИХ СПЕЦІАЛІСТІВ У ДЗ «ЗАПОРІЗЬКА МЕДИЧНА АКАДЕМІЯ ПІСЛЯДИПЛОМНОЇ ОСВІТИ МОЗ УКРАЇНИ»
Authors: Nykonenko O. S. , Shapoval S. D. , Dmytriieva S. M. , Hrytsun T. O. 
Published: October 2017

У статті висвітлено досвід впровадження сучасних освітніх технологій, що сприяють подальшому розвитку й удосконаленню післядипломної освіти та безперервного професійного розвитку лікарів і є важливою умовою реалізації положень освітньої реформи в Україні. Показано, що використання інформаційних ресурсів у практичній діяльності викладачів підвищує пізнавальну активність і навчальну мотивацію, дозволяє максимально ефективно сформувати особисте освітнє середовище учасників навчального процесу.
СТРАТЕГІЯ АКТИВІЗАЦІЇ НАВЧАЛЬНОГО ПРОЦЕСУ В СУЧАСНИХ СИСТЕМАХ ПЕРЕДАВАННЯ ЗНАНЬ
Authors: Voronenko Yu. V. , Mintser O. P. 
Published: October 2017

У статті розглянуто та обґрунтовано нову концепцію передавання знань у системі післядипломної медичної освіти, засновану на активізації та адаптації системи передавання знань, можливості розроблення та впровадження освітніх стандартів. Робота побудована на даних, отриманих при дослідженні підготовки 450 лікарів-інтернів до ліцензійного інтегрованого іспиту «Крок-3», у процесі навчання яких використовувалася система управління навчанням «Ilias». Визначено можливість реалізації головного педагогічного принципу диференціації (індивідуалізації) в процесі навчання, зокрема дистанційного, при введенні в навчальні програмні середовища адаптивних та інтелектуальних технологій.
СУЧАСНІ ПІДХОДИ ДО ПІДГОТОВКИ ЛІКАРІВ-ІНТЕРНІВ ОРТОПЕДІВ-ТРАВМАТОЛОГІВ В УМОВАХ СИМУЛЯЦІЙНОГО ТРЕНІНГОВОГО ЦЕНТРУ
Authors: Zaporozhan S. Y. , Shulhai A. H. , Tsviakh A. I. , Hospodarskyi A. Ya. , Kopytchak I. R. , Sydorenko V. M. 
Published: October 2017

Мета роботи – проаналізувати підготовку лікарів-інтернів ортопедів-травматологів в умовах симуляційного тренінгового центру, розглянути сучасні підходи до застосування симуляційних технологій та окреслити перспективи подальшого впровадження набутих практичних навичок у повсякденну роботу.Основна частина. Вивчення хірургічної патології лікарями-інтернами в симуляційному тренінговому центрі ґрунтується на базових принципах організації навчального процесу та здійснюється поетапно: викладення лекційного матеріалу, відпрацювання індивідуальних практичних навичок, обробка та аналіз лікарями-інтернами результатів власної активності й ефективності проведеної роботи, самоаналіз та елементи зворотного зв’язку. Можливість виконувати етапи оперативного лікування та практичні навички необхідну кількість разів до повного їх відпрацювання, створення рівних умов для всіх лікарів-інтернів та індивідуальний підхід до процесу навчання дозволяють краще підготувати лікаря-інтерна до самостійної операційної діяльності.Висновок. Використання симуляційних технологій у навчальному процесі лікарів-інтернів ортопедів-травматологів полегшує засвоєння теоретичного матеріалу, дає можливість набути необхідний практичний досвід роботи, а також об’єктивно оцінити їхні професійні знання, комунікативні та спеціальні навички.
Polo‐Like Kinase 2 is Dynamically Regulated to Coordinate Proliferation and Early Lineage Specification Downstream of Yes‐Associated Protein 1 in Cardiac Progenitor Cells
Authors: Mochizuki Michika , Lorenz Vera , Ivanek Robert , Della Verde Giacomo , Gaudiello Emanuele , Marsano Anna , Pfister Otmar , Kuster Gabriela M. 
Published: October 2017

Background

Recent studies suggest that adult cardiac progenitor cells (
CPC
s) can produce new cardiac cells. Such cell formation requires an intricate coordination of progenitor cell proliferation and commitment, but the molecular cues responsible for this regulation in
CPC
s are ill defined.

Methods and Results

Extracellular matrix components are important instructors of cell fate. Using laminin and fibronectin, we induced two slightly distinct
CPC
phenotypes differing in proliferation rate and commitment status and analyzed the early transcriptomic response to
CPC
adhesion (<2 hours). Ninety‐four genes were differentially regulated on laminin versus fibronectin, consisting of mostly downregulated genes that were enriched for Yes‐associated protein (
YAP
) conserved signature and TEA domain family member 1 (TEAD1)‐related genes. This early gene regulation was preceded by the rapid cytosolic sequestration and degradation of
YAP
on laminin. Among the most strongly regulated genes was polo‐like kinase 2 (
Plk2
).
Plk2
expression depended on
YAP
stability and was enhanced in
CPC
s transfected with a nuclear‐targeted mutant
YAP
. Phenotypically, the early downregulation of
Plk2
on laminin was succeeded by lower cell proliferation, enhanced lineage gene expression (24 hours), and facilitated differentiation (3 weeks) compared with fibronectin. Finally, overexpression of Plk2 enhanced
CPC
proliferation and knockdown of Plk2 induced the expression of lineage genes.

Conclusions

Plk2 acts as coordinator of cell proliferation and early lineage commitment in
CPC
s. The rapid downregulation of Plk2 on
YAP
inactivation marks a switch towards enhanced commitment and facilitated differentiation. These findings link early gene regulation to cell fate and provide novel insights into how
CPC
proliferation and differentiation are orchestrated.
Impact of Sustained Use of a Multifaceted Computerized Quality Improvement Intervention for Cardiovascular Disease Management in Australian Primary Health Care
Authors: Patel Bindu , Peiris David , Usherwood Tim , Li Qiang , Harris Mark , Panaretto Kathryn , Zwar Nicholas , Patel Anushka 
Published: October 2017

Background

We evaluated a multifaceted, computerized quality improvement intervention for management of cardiovascular disease (
CVD
) risk in Australian primary health care. After completion of a cluster randomized controlled trial, the intervention was made available to both trial arms. Our objective was to assess intervention outcomes in the post‐trial period and any heterogeneity based on original intervention allocation.

Methods and Results

Data from 41 health services were analyzed. Outcomes were (1) proportion of eligible population with guideline‐recommended
CVD
risk factor measurements; and (2) the proportion at high
CVD
risk with current prescriptions for guideline‐recommended medications. Patient‐level analyses were conducted using generalized estimating equations to account for clustering and time effects and tests for heterogeneity were conducted to assess impact of original treatment allocation. Median follow‐up for 22 809 patients (mean age, 64.2 years; 42.5% men, 26.5% high
CVD
risk) was 17.9 months post‐trial and 35 months since trial inception. At the end of the post‐trial period there was no change in
CVD
risk factor screening overall when compared with the end of the trial period (64.7% versus 63.5%,
P
=0.17). For patients at high
CVD
risk, there were significant improvements in recommended prescriptions at end of the post‐trial period when compared with the end of the trial period (65.2% versus 56.0%,
P
<0.001). There was no heterogeneity of treatment effects on the outcomes based on original randomization allocation.

Conclusions

CVD
risk screening improvements were not observed in the post‐trial period. Conversely, improvements in prescribing continued, suggesting that changes in provider and patient actions may take time when initiating medications.

Clinical Trial Registration

URL
:
http://www.anzctr.org.au
. Unique identifier: 12611000478910.
Impact of Regional Systems of Care on Disparities in Care Among Female and Black Patients Presenting With ST‐Segment–Elevation Myocardial Infarction
Authors: Hinohara Tomoya T. , Al‐Khalidi Hussein R. , Fordyce Christopher B. , Gu Xiangqiong , Sherwood Matthew W. , Roettig Mayme L. , Corbett Claire C. , Monk Lisa , Tamis‐Holland Jacqueline E. , Berger Peter B. , Burchenal J. E. B. , Wilson B. Hadley , Jollis James G. , Granger Christopher B. 
Published: October 2017

Background

The American Heart Association Mission: Lifeline STEMI (
ST
‐segment–elevation myocardial infarction) Systems Accelerator program, conducted in 16 regions across the United States to improve key care processes, resulted in more patients being treated within national guideline goals (time from first medical contact to device: <90 minutes for direct presenters to hospitals capable of performing percutaneous coronary intervention; <120 minutes for transfers). We examined whether the effort reduced reperfusion disparities in the proportions of female versus male and black versus white patients.

Methods and Results

In total, 23 809 patients (29.3% female, 82.3% white, and 10.7% black) presented with acute STEMI between July 2012 and March 2014. Change in the proportion of patients treated within guideline goals was compared between sex and race subgroups for patients presenting directly to hospitals capable of performing percutaneous coronary intervention (n=18 267) and patients requiring transfer (n=5542). The intervention was associated with an increase in the proportion of men treated within guideline goals that presented directly (58.7–62.1%,
P
=0.01) or were transferred (43.3–50.7%,
P
<0.01). An increase was also seen among white patients who presented directly (57.7–59.9%,
P
=0.02) or were transferred (43.9–48.8%,
P
<0.01). There was no change in the proportion of female or black patients treated within guideline goals, including both those presenting directly and transferred.

Conclusion

The
STEMI
Systems Accelerator project was associated with an increase in the proportion of patients meeting guideline reperfusion targets for male and white patients but not for female or black patients. Efforts to organize systems of
STEMI
care should implement additional processes targeting barriers to timely reperfusion among female and black patients.
Diffusion-weighted MRI combined with susceptibility-weighted MRI: added diagnostic value for four common lateral ventricular tumors
Authors: Yu Yuanlin , Zhang Hua , Xiao Zebin , She Dejun , Xing Zhen , Yang Xiefeng , Cao Dairong 
Published: October 2017

Background Diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) are reliable imaging modalities for brain tumors. However, the role of DWI and SWI in the diagnosis of common lateral ventricular tumors has not been systematically evaluated. Purpose To evaluate the diagnostic performance of DWI and SWI in common lateral ventricular tumors. Material and Methods Fifty-two patients with histopathologically confirmed lateral ventricular tumors were included in this study (18 with central neurocytomas, nine with ependymomas, seven with high-grade gliomas, and 18 with meningiomas). The relative minimum apparent diffusion coefficient (rADCmin) and relative average apparent diffusion coefficient (rADCave) measured by DWI and the intratumoral susceptibility signal intensity (ITSS) of hemorrhage acquired by SWI were calculated. These quantitative parameters were evaluated using the Mann–Whitney U test, receiver operating characteristic curve, and logistic regression analyses. Results The rADCmin and rADCave ratios of central neurocytomas were significantly lower than those of the other neoplasms. The rADCmin and rADCave ratios of ependymomas and the rADCave ratio of high-grade gliomas were significantly higher than those of meningiomas. The ITSS score of meningiomas was significantly lower than those of the other tumors, while the score of central neurocytomas was obviously lower than those of ependymomas and high-grade gliomas. The combination of the rADC ratio with the ITSS showed no significant difference, except in discriminating between meningiomas and high-grade glioma-ependymomas. Conclusion The rADC ratios and ITSS may be useful for differentiating common lateral ventricular tumors. The diagnostic performance may be improved with the use of the rADC ratios and ITSS scores.
Management of tennis elbow: a survey of UK clinical practice
Authors: Bateman Marcus , Titchener Andrew G. , Clark David I. , Tambe Amol A. 
Published: October 2017

Background Tennis elbow is a common condition in the UK but there are no guidelines on how best to manage the condition. The purpose of the present study was to establish the current UK practice in managing patients with chronic tennis elbow. Methods A cross-sectional online survey of UK surgeons and therapists was conducted in June 2017. Results In total, 275 responses were received, the majority from consultant surgeons and experienced physiotherapists. In total, 81% recommended exercise-based physiotherapy as the first-line intervention. Second-line treatments varied widely, with corticosteroid injections being the most popular (27%), followed by shockwave therapy, platelet-rich plasma injection, surgery, acupuncture and a wait-and-see policy. Conclusions There is wide variability of treatments offered when physiotherapy fails patients with tennis elbow. The majority of second-line interventions lack evidence to support their use and, in the case of corticosteroid injections, may even be harmful in the long term. There is a clear need for national guidance based on best evidence to aid clinicians in their treatment approach.
Differential Impact of Genetic Loci on Age at Thelarche and Menarche in Healthy Girls
Authors: Busch Alexander S , Hagen Casper P , Assens Maria , Main Katharina M , Almstrup Kristian , Juul Anders 
Published: October 2017

Abstract

Context
Recent genetic studies have identified genetic variants associated with age at pubertal onset. Whereas genome-wide association studies reported associations of several hundred genetic variants with timing of self-reported age at menarche, a recent clinical study focused on genetic variation affecting follicle-stimulating hormone action and clinically determined age at thelarche. The observations appear to be incongruent, as effect sizes varied substantially among the studies. Alternatively, this may point to a differential impact of specific genetic loci on distinct pubertal events.

Objective
To investigate whether top-candidate genetic variants exhibit a different impact on timing of thelarche vs menarche, respectively.

Design
Cross-sectional and longitudinal study of healthy girls.

Setting
Population-based study in the Copenhagen area.

Patients or Other Participants
Girls (1478) were followed through puberty and genotyped for FSHB c.−211G&gt;T (rs10835638), FSHR c.−29G&gt;A (rs1394205), FSHR c.2039A&gt;G (rs6116), LIN28B (rs7759938), INHA (rs4141153), MKRN3 (rs12148769), TMEM38B (rs10453225), and ZNF483 (rs10980921).

Main Outcome Measures
Clinical pubertal staging and anthropometric data.

Results
We observed an association of LIN28B (rs7759938) with age at thelarche (P &lt; 0.001, effect size: 0.27 year, 95% confidence interval: 0.12 to 0.42) and age at menarche (P = 0.005, 0.17 year, 0.05 to 0.29). FSHB c.−211G&gt;T (rs10835638) and FSHR c.−29G&gt;A (rs1394205) minor allele count was associated with age at thelarche (P = 0.004, 0.19 year, 0.06 to 0.31) but not with age at menarche (P = 0.97; all adjusted for body mass index z scores).

Conclusion
Our results indicate a differential impact of specific genetic loci on age at thelarche and menarche in healthy girls.
Long-Term Survivorship in Multiple Endocrine Neoplasia Type 2B Diagnosed Before and in the New Millennium
Authors: Raue Friedhelm , Dralle Henning , Machens Andreas , Bruckner Thomas , Frank-Raue Karin 
Published: October 2017

Abstract

Context
Recent long-term outcomes and survival data are lacking for patients with multiple endocrine neoplasia type 2B (MEN2B).

Objectives
To analyze long-term MEN2B outcomes and define prognostic factors.

Design, Setting, and Participants
Retrospective comparative study of 75 patients with MEN2B from two German tertiary referral centers. Patients diagnosed and treated before and after 2000 were compared for demographic, biochemical, surgical, and outcome parameters.

Intervention
Surgery.

Main Outcome measure
Long-term survival.

Results
We identified seven familial and 68 de novo cases of MEN2B; 61 exhibited the RET M918T genotype (2 others exhibited A883F and E768D/L790T mutations). Surgery was performed at a mean age of 16.4 ± 11.2 years. The tumor stages at diagnosis for 71 patients were stage I, 15%; stage II, 6%; stage III, 35%; and stage IV, 44%. The mean follow-up was 9.6 ± 9.0 years. The outcomes were 15 (20%) cured, 9 (12%) with minimal residual disease, 19 (25%) with metastatic disease, and 10 (13%) unknown. Medullary thyroid cancer (MTC) caused 22 deaths (29%) 7.3 ± 6.2 years after diagnosis (mean age, 22.9 ± 10.7 years). The overall survival rates at 5, 10, and 20 years were 85%, 74%, and 58%, respectively. After 2000 (vs before 2000), significantly more patients had stage I and II (32% vs 11%) and more were cured (43% vs 20%), with a higher survival trend (P = 0.058). The only prognostic factor was tumor stage at diagnosis.

Conclusions
Patients with MEN2B developed MTC at an early age with wide ranging aggressiveness, but the outcome was generally better after 2000 than before 2000.