bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levels, patterns and determinants of using reversible contraceptives for limiting family planning in India: evidence from National Family Health Survey, 2015–16
Authors: Rahaman Margubur , Singh Risha , Chouhan Pradip , Roy Avijit , Ajmer Sumela , Rana Md Juel 
Published: April 2022

Abstract
Background
Demand for family planning is predominantly for birth limiting rather than birth spacing in India. Despite several family planning programmes in India, the use of reversible contraception for limiting family planning has been stagnant and largely depends on female sterilization. Though many researchers have examined patterns and determinants of using modern contraception for total family planning, studies on patterns and determinants of contraceptive use for birth limiting are limited in India. This paper examines the patterns of contraceptive use for liming demand and its determinants in India.

Methods
The National Family Health Survey-4, 2015–16 data was used. Bivariate chi-square significant test and multivariate binary logistic regression model used to accomplish the study objectives.

Results
Majority of women (86.5%) satisfied limiting demand (SLD) in India; the SLD was found significantly low among the women’s age 15–19 years (53.1%) and parity 0 (42%). The satisfied limiting demand by modern reversible contraception (mrSLD) was found significantly high in age group 15–19 years (49.1%), Muslims (30.6%) and North-east region (45.4%). The satisfied limiting demand by traditional contraception (tSLD) was almost three times higher in North-east region (26.1%) than national average of India (8.7%). The women’s years of schooling, wealth status, religion and presence of son child found to be significant determinants of mrSLD. The likelihood of tSLD was found significantly high among the women who had no son child (AOR = 1.41; 95% CI:1.34, 1.48), Muslim (AOR = 1.78; 95% CI:1.70, 1.87). A considerable regional variability in levels of SLD, mrSLD and tSLD was found in India.

Conclusion
Public investment in family planning is required to promote and provide subsidized modern reversible contraception (MRC) services, especially to women from North-east region, Muslim, Scheduled tribe, poor household and who had no son child. Improving the quality and availability of MRC services in public health centre will be helpful to increase SLD among the above mentioned women. Besides, the promotion of MRC will be supportive to overcome the issues of sterilization regrets in India.
Assessing distinguishable social skills in medical admission: does construct-driven development solve validity issues of situational judgment tests?
Authors: Mielke Ina , Breil Simon M. , Amelung Dorothee , Espe Lia , Knorr Mirjana 
Published: April 2022

Abstract
Background
Social skills are important for future physicians and are therefore increasingly considered in selection processes. One economic assessment method from which different social skills can be inferred are Situational Judgment Tests (SJTs) in which applicants are asked to rate behavioral responses in context-relevant situations. However, traditional SJTs have so far failed to distinctively measure specified constructs. To address this shortcoming in the medical admission context, we applied a construct-driven approach of SJT development in which test development was deductively guided by agency and communion as target constructs.

Method
The final version of the construct-driven SJT includes 15 items per construct with three behavioral responses. Medical school applicants (N = 1527) completed the construct-driven SJT, a traditional SJT, and an aptitude test under high-stakes condition as part of their application. A subsample (N = 575) participated in a subsequent voluntary online study with self-report measures of personality and past behavior.

Results
The proposed two-factor structure and internal consistency of the construct-driven SJT was confirmed. Communal SJT scores were positively associated with self-reported communal personality and communal behavior, yet effects were smaller than expected. Findings for agentic SJT scores were mixed with positive small associations to self-reported agentic personality scores and agentic behavior but unexpected negative relations to communal self-reported measures.

Conclusions
Results suggest that construct-driven SJTs might overcome validity limitations of traditional SJTs, although their implementation is challenging. Despite first indicators of validity, future research needs to address practical points of application in high-stakes settings, inclusion of other constructs, and especially prediction of actual behavior before the application of construct-driven SJTs for selection purposes in medical admission can be recommended.
Ethical decision-making climate, moral distress, and intention to leave among ICU professionals in a tertiary academic hospital center
Authors: Silverman Henry , Wilson Tracey , Tisherman Samuel , Kheirbek Raya , Mukherjee Trishna , Tabatabai Ali , McQuillan Karen , Hausladen Rachel , Davis-Gilbert Melissa , Cho Eunsung , Bouchard Kerri , Dove Samantha , Landon Julie , Zimmer Michele 
Published: April 2022

AbstractBackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units (ICUs). Our aim was twofold: (1) to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and (2) determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire (EDMCQ) and the Measure of Moral Distress for Healthcare Professionals (MMD-HP) tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians (p < 0.05). They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/Pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units (3.54 ± 0.66 vs. 3.43 ± 0.81 vs. 3.30 ± 0.69; respectively; bothp ≤ 0.05) and also demonstrated lower moral distress scores (bothp < 0.05) and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated (r = −0.58,p < 0.001); moral distress and "intention to leave" was positively correlated (r = 0.52,p < 0.001); and ethical climate and “intention to leave” were negatively correlated (r = −0.50,p < 0.001).ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care.
Cost-effectiveness of a mental health drop-in centre for young people with long-term physical conditions
Authors: Clarke Harrison , Morris Walter , Catanzano Matteo , Bennett Sophie , Coughtrey Anna E. , Heyman Isobel , Liang Holan , Shafran Roz , Batura Neha 
Published: April 2022

Abstract
Background
Paediatric patients being treated for long-term physical health conditions (LTCs) have elevated mental health needs. However, mental health services in the community are difficult to access in the usual course of care for these patients. The Lucy Project – a self-referral drop-in access point—was a program to address this gap by enrolling patients for low-intensity psychological interventions during their treatment for LTCs. In this paper, we evaluate the cost-effectiveness of the Lucy Project.

Methods
Using a pre-post design, we evaluate the cost-effectiveness of the intervention by calculating the base-case incremental cost-effectiveness ratio (ICER) using outcomes data and expenses recorded by project staff. The target population was paediatric patients enrolled in the program with an average age of 9 years, treated over a time horizon of 6 months. Outcome data were collected via the Paediatric Quality of Life Inventory, which was converted to health utility scores using an instrument found in the literature. The QALYs were estimated using these health utility scores and the length of the intervention. We calculate a second, practical-case incremental cost-effectiveness ratio using streamlined costing figures with maximum capacity patient enrolment within a one-year time horizon, and capturing lessons learned post-trial.

Results
The base-case model showed an ICER of £21,220/Quality Adjusted Life Years (QALY) gained, while the practical model showed an ICER of £4,359/QALY gained. The practical model suggests the intervention garners significant gains in quality of life at an average cost of £309 per patient. Sensitivity analyses reveal use of staff time was the greatest determinant of the ICER, and the intervention is cost-effective 75% of the time in the base-case model, and 94% of the time in the practical-case model at a cost-effectiveness threshold of £20,000/QALY gained.

Conclusions
We find the base-case intervention improves patient outcomes and can be considered cost-effective according to the National Institute for Health and Care Excellence (NICE) threshold of £20,000—£30,000/QALY gained, and the practical-case intervention is roughly four times as cost-effective as the base-case. We recommend future studies incorporate a control group to corroborate the effect size of the intervention.
Information needs of patients undergoing bariatric surgery in Germany: a qualitative study
Authors: Breuing Jessica , Könsgen Nadja , Doni Katharina , Neuhaus Annika Lena , Pieper Dawid 
Published: April 2022

Abstract
Background
Obesity is a worldwide problem with different treatment options. Bariatric surgery is an effective treatment for severe obesity; however, it leads to drastic changes (e.g., changes in everyday life and eating behavior) for patients, which may lead to information needs. Our aim was to identify the information needs of patients undergoing bariatric surgery and to explore the information provision within the healthcare process of bariatric surgery in Germany.

Methods
We conducted a qualitative study (n = 14 single, semi-structured telephone interviews) between April 2018 and April 2019. The interview guide was designed prior to the interviews and consisted of four main sections (demographic information, pre-/postoperative healthcare provision, information needs). The interviews were transcribed verbatim and analyzed using qualitative content analysis with MAXQDA software.

Results
There were unmet information needs with two factors (time: pre/postoperative and categories of information: general/specific) to be considered. Due to the patients’ description of information, we categorized information into general (different surgical procedures, general nutritional information) and specific (occurring simultaneously with a problem) information. Most patients felt well informed concerning general information. However, it was pointed out that it was not possible to provide complete information preoperatively, as the need for information only arises when there are postoperative (specific) problems. In addition, there seems to be a high demand for specific postoperative information regarding nutrition and nutrition-related problems. However, patients stated that postoperative nutritional counseling is not reimbursed by health insurance funds. The information conveyed in support groups and the exchange of experiences are highly valued by patients. However, some patients describe the information provided within the support groups as unfiltered, frightening or exaggerated.

Conclusion
Overall, there were unmet information needs. Reimbursement by health insurance funds could increase the use of postoperative nutritional counseling and thus serve existing information needs. Support groups enable an exchange of experiences and therefore offer low-barrier access to information. Cooperation between support groups and healthcare professionals in information provision could be an approach to improving existing information needs or to avoiding the development of information gaps. Furthermore, the development and implementation of a digital solution for (postoperative) information dissemination could be helpful.
Alpha-1-antichymotrypsin as a novel biomarker for diagnosis, prognosis, and therapy prediction in human diseases
Authors: Jin Yanxia , Wang Weidong , Wang Qiyun , Zhang Yueyang , Zahid Kashif Rafiq , Raza Umar , Gong Yongsheng 
Published: April 2022

AbstractThe glycoprotein alpha-1-antichymotrypsin (AACT), a serine protease inhibitor, is mainly synthesized in the liver and then secreted into the blood and is involved in the acute phase response, inflammation, and proteolysis. The dysregulation of AACT and its glycosylation levels are associated with tumor progression and recurrence, and could be used as a biomarker for tumor monitoring. In this review, we summarized the expression level, glycosylation modification, and biological characteristics of AACT during inflammation, neurodegenerative or other elderly diseases, and tumorigenesis, as well as, focused on the biological roles of AACT in cancer. The aberrant expression of AACT in cancer might be due to genetic alterations and/or immune by bioinformatics analysis. Moreover, AACT may serve as a diagnostic or prognostic biomarker or therapeutic target in tumors. Furthermore, we found that the expression of AACT was associated with the overall survival of patients with human cancers. Decreased AACT expression was associated with poor survival in patients with liver cancer, increased AACT expression was associated with shorter survival in patients with pancreatic cancer, and decreased AACT expression was associated with shorter survival in patients with early lung cancer. The review confirmed the key roles of AACT in tumorigenesis, suggesting that the glycoprotein AACT may serve as a biomarker for tumor diagnosis and prognosis, and could be a potential therapeutic target for human diseases.
Prognostic value and biological function of LRRN4 in colorectal cancer
Authors: Xu Cheng , Chen Yulin , Long Feiwu , Ye Junman , Li Xue , Huang Qiaorong , Yao Dejiao , Wang Xiaoli , Zhao Jin , Meng Wentong , Mo Xianming , Lu Ran , Fan Chuanwen , Zhang Tao 
Published: April 2022

Abstract
Background
Several nervous and nerve-related biomarkers have been detected in colorectal cancer (CRC) and can contribute to the progression of CRC. However, the role of leucine-rich repeat neuronal 4 (LRRN4), a recently identified neurogenic marker, in CRC remains unclear.

Methods
We examined the expression and clinical outcomes of LRRN4 in CRC from TCGA-COREAD mRNA-sequencing datasets and immunohistochemistry in a Chinese cohort. Furthermore, colony formation, flow cytometry, wound healing assays and mouse xenograft models were used to investigate the biological significance of LRRN4 in CRC cell lines with LRRN4 knockdown or overexpression in vitro and in vivo. In addition, weighted coexpression network analysis, DAVID and western blot analysis were used to explore the potential molecular mechanism.

Results
We provide the first evidence that LRRN4 expression, at both the mRNA and protein levels, was remarkably high in CRC compared to controls and positively correlated with the clinical outcome of CRC patients. Specifically, LRRN4 was an independent prognostic factor for progression-free survival and overall survival in CRC patients. Further functional experiments showed that LRRN4 promoted cell proliferation, cell DNA synthesis and cell migration and inhibited apoptosis. Knockdown of LRRN4 can correspondingly decrease these effects in vitro and can significantly suppress the growth of xenografts. Several biological functions and signaling pathways were regulated by LRRN4, including proteoglycans in cancer, glutamatergic synapse, Ras, MAPK and PI3K. LRRN4 knockdown resulted in downregulation of Akt, p-Akt, ERK1/2 and p-ERK1/2, the downstream of the Ras/MAPK signaling pathway, overexpression of LRRN4 leaded to the upregulation of these proteins.

Conclusions
Our results suggest that LRRN4 could be a biological and molecular determinant to stratify CRC patients into distinct risk categories, and mechanistically, this is likely attributable to LRRN4 regulating several malignant phenotypes of neoplastic cells via RAS/MAPK signal pathways.
Changing transmission dynamics among migrant, indigenous and mining populations in a malaria hotspot in Northern Brazil: 2016 to 2020
Authors: Wetzler Erica Anne , Marchesini Paola , Villegas Leopoldo , Canavati Sara 
Published: April 2022

Abstract
Background
Roraima state is the northernmost state in Brazil and the primary border-crossing point between Brazil and Venezuela. The uncontrolled surge of malaria in Venezuela, coupled with mass migration of Venezuelans to neighbouring countries and the upward trend in informal mining in the state, pose a serious threat to the broader region, especially to migrant, indigenous and mining populations, jeopardizing malaria elimination efforts. This study describes changes in the epidemiological profile of malaria in Roraima state related to time, place and populations at risk from 2016 to 2020.

Methods
De-identified malaria surveillance data were obtained from the Malaria Epidemiological Surveillance System from 2016 to 2020. Pearson’s chi-square tested differences between imported and autochthonous cases. Multivariable logistic regression was used to identify risk factors for imported versus autochthonous cases by demographic characteristics.

Results
Odds of being an imported case were higher for Plasmodium falciparum cases (AOR = 2.08). However, as the number of cases from Venezuela decreased in 2020 following closure of the border, the proportion of P. falciparum cases increased markedly, from 6.24% in 2019 to 18.50% in 2020. Over the 5-year period, the odds of being an imported case among miners were about nine times higher than the general population (AOR = 8.99). The proportion of total malaria cases that were among indigenous people increased from 33.09% in 2016 to 54.83% in 2020. Indigenous children had a higher burden of malaria with over 40% of cases in children 0 to 9 years old, compared to 8% in non-indigenous children 0 to 9 years old. In some municipalities, place of infection differed from place of notification, with a large proportion of cases in these municipalities reporting in Boa Vista.

Conclusions
Malaria remains a serious threat in Roraima state, especially among high-risk populations, such as miners, migrants, and indigenous people. As malaria cases have increased among indigenous people and miners, and the proportion of P. falciparum cases has increased, elimination efforts require understanding of these risk factors to tailor interventions appropriately. Furthermore, cross-border surveillance systems need to be urgently strengthened at formal and unofficial border points, especially since the border with Venezuela reopened in July 2021.
Low prevalence of Plasmodium falciparum parasites lacking pfhrp2/3 genes among asymptomatic and symptomatic school-age children in Kinshasa, Democratic Republic of Congo
Authors: Nundu Sabin S. , Arima Hiroaki , Simpson Shirley V. , Chitama Ben-Yeddy Abel , Munyeku Yannick Bazitama , Muyembe Jean-Jacques , Mita Toshihiro , Ahuka Steve , Culleton Richard , Yamamoto Taro 
Published: April 2022

AbstractBackgroundLoss of efficacy of diagnostic tests may lead to untreated or mistreated malaria cases, compromising case management and control. There is an increasing reliance on rapid diagnostic tests (RDTs) for malaria diagnosis, with the most widely used of these targeting thePlasmodium falciparumhistidine-rich protein 2 (PfHRP2). There are numerous reports of the deletion of this gene inP. falciparumparasites in some populations, rendering them undetectable byPfHRP2 RDTs. The aim of this study was to identifyP. falciparumparasites lacking theP. falciparumhistidine rich protein 2 and 3 genes (pfhrp2/3) isolated from asymptomatic and symptomatic school-age children in Kinshasa, Democratic Republic of Congo.MethodsThe performance ofPfHRP2-based RDTs in comparison to microscopy and PCR was assessed using blood samples collected and spotted on Whatman 903™ filter papers between October and November 2019 from school-age children aged 6–14 years. PCR was then used to identify parasite isolates lackingpfhrp2/3genes.ResultsAmong asymptomatic malaria carriers (N = 266), 49%, 65%, and 70% were microscopy,PfHRP2_RDT, andpfldh-qPCR positive, respectively. The sensitivity and specificity of RDTs compared to PCR were 80% and 70% while the sensitivity and specificity of RDTs compared to microscopy were 92% and 60%, respectively. Among symptomatic malaria carriers (N = 196), 62%, 67%, and 87% were microscopy,PfHRP2-based RDT,pfldh-qPCR and positive, respectively. The sensitivity and specificity of RDTs compared to PCR were 75% and 88%, whereas the sensitivity and specificity of RDTs compared to microscopy were 93% and 77%, respectively. Of 173 samples with sufficient DNA for PCR amplification ofpfhrp2/3, deletions ofpfhrp2andpfhrp3were identified in 2% and 1%, respectively. Three (4%) of samples harboured deletions of thepfhrp2gene in asymptomatic parasite carriers and one (1%) isolate lacked thepfhrp3gene among symptomatic parasite carriers in the RDT positive subgroup. No parasites lacking thepfhrp2/3genes were found in the RDT negative subgroup.ConclusionPlasmodium falciparumhistidine-rich protein 2/3 gene deletions are uncommon in the surveyed population, and do not result in diagnostic failure. The use of rigorous PCR methods to identifypfhrp2/3 gene deletions is encouraged in order to minimize the overestimation of their prevalence.