bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chlamydia infection, PID, and infertility: further evidence from a case–control study in China
Authors: Liu Lijun , Li Changchang , Sun Xuewan , Liu Jie , Zheng Hepeng , Yang Bin , Tang Weiming , Wang Cheng 
Published: July 2022

Abstract
Background
Chlamydia trachomatis infection and pelvic inflammatory disease (PID) are well-known risk factors for female infertility. But there is limited evidence from China. This study aimed to further explore the associations between previous/current chlamydial infection, PID, and infertility in China.

Methods
We performed a 1:2 matched case–control study with two control groups: pregnant controls and non-pregnant controls in China in 2019. Women diagnosed with infertility were selected as cases (n = 255). Controls were selected based on the following criteria: Pregnant women who were documented in the selected hospitals were chosen as Pregnant controls (n = 510), and people who sought health care in Obstetric/Gynecologic clinics, Family Planning clinics, Dermatology and STD Department or Urological department were selected as Non-pregnant controls (n = 510). Infertility induced by male factors and people who used antibiotics in the vagina within two weeks were excluded. The first-stream specimen of urine samples was tested for chlamydia by nucleic acid amplification testing (NAAT). Conditional logistic regression was used to estimate the association.

Results
The prevalence of previous chlamydial infection and PID were significantly higher in cases (2.4%, 17.3%) than in controls (Non-pregnancy: 0.4%, 3.0%; Pregnancy: 0.4%, 9.0%). The current chlamydial infection rates were 5.9%, 7.3%, and 7.1% in infertile, pregnant, and non-pregnant women, respectively. After adjusting for confounders, PID largely elevated the risk of infertility (using non-pregnant controls: adjusted OR = 2.57, 95% CI 1.51, 4.39; using pregnant controls: adjusted OR = 6.83, 95% CI 3.47, 13.43). And the positive association between PID and tubal infertility was more obvious for both groups. For current chlamydial infection, none of the odds ratios were significant at the 0.05 level, while small sample size limited the evaluation of an association between prior chlamydial infection with infertility.

Conclusions
Previous PID was indicated to largely increase the risk of infertility, especially tubal infertility. And there should be continuing emphasis on highly sensitive and specific biomarker for prior chlamydial infection.
Effectiveness of life skills training based on self-care on mental health and quality of life of married Afghan women in Iran
Authors: Shovaz Fatemeh Abbasi , Zareei Mahmoodabadi Hassan , Salehzadeh Maryam 
Published: July 2022

Abstract
Background
One of the major issues that immigrants, especially Afghan women face, is their self-care disability. This will cause problems in their mental health and quality of life. The aim of this study was to evaluate the effectiveness of life skills training based on self-care on mental health and quality of life of married Afghan women living in Taft.

Methods
This quasi-experimental study was conducted using a pretest posttest design with control group. Statistical population was all married Afghan women living in Taft (Yazd province) of whom 60 women were selected using purposive sampling and were randomly allocated to two groups of 30 as experimental and control groups. The experimental group received 8 sessions of life skills training based on self-care. General Health Questionnaire (GHQ) and Quality of Life of the World Health Organization Questionnaire (WHOQ-BREF) were used to collect data. Multivariate analysis of covariance (MANCOVA) was used to analyze the data.

Results
Results showed that following the intervention, the mean scores of quality of life (p < 0.0001) and mental health (p < 0.019) in the experimental group increased in the posttest compared to the pretest and the effect of intervention was significant.

Conclusion
Results suggested that providing a training opportunity for Afghan women to learn life skills based on self-care, enables them to realize their strengths and weaknesses and improve their quality of life and mental health.
Impact of Infectious Diseases training in the perception of antibiotic resistance and rational use of antibiotics among Spanish medical students – a cross-sectional study
Authors: Yuste José Ramón , Matteo Andrés Blanco-Di , Gruber Fernando 
Published: July 2022

Abstract
Background
Antibiotic resistance is one of the main public health problems worldwide. One key tool to optimize antibiotic prescription is medical training. The aim of this study is to compare the impact of training in infectious diseases on students’ knowledge of the antibiotic resistance problem and the rational use of antibiotics.

Methods
We performed a cross-sectional study in the medical school of the University of Navarra. We conducted an anonymous in situ survey of students in each year of training. Data were analyzed grouping the students as follows: GROUP 1: first three years of education, no training in Clinical Microbiology (CM) or in Infectious Diseases (ID); GROUP 2: fourth-year students, training in CM but not ID; GROUP 3: Fifth and sixth-year students who have completed the training in CM and ID. Chi-square test (or Fisher’s exact test when appropriate) was performed to evaluate potential associations. Wilcoxon’s test was used to compare the median correct answers between groups. We used Spearman’s test for correlation between year of training and performance in questionnaire.

Results
A total of 994 students respond to the survey, 80.4% of the eligible students. Almost all students who had completed infectious diseases training perceive antibiotic resistance as an important problem in comparison with students who had not completed the formation (99.5% in group 3 vs 94.5% in group 1, p = 0.02). Knowledge of antibiotic stewardship underwent a statistically significant change after training in infectious diseases (from 9.2% in group 1 to 52.2% in group 3, p < 0.001). In the training questions block we also found an increase in the average number of correct answers (21.4% in group 1 vs 44.7% in group 3, p < 0.001). When comparing the results of subgroups 3A and 3B we found a significant loss of knowledge as we moved away from training (49% vs 40.9%, p < 0.001).

Conclusions
The training of medical students is the key to improving both perception and knowledge of infectious diseases. However, we have an opportunity for educational improvement as far as infectious diseases are concerned, regarding both the acquisition of knowledge and its loss as time lapses after training.
The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study
Authors: Zhang Juxia , Shields Linda , Ma Bin , Yin Yuhuan , Wang Jiancheng , Zhang Rong , Hui Xueke 
Published: July 2022

Abstract
Background
Clinical practice is a core component of nurse education. It is believed that nursing students’ clinical placement experiences can affect their learning outcomes, satisfaction, as well as influence their choice of future career. To examine nursing students’ perception of clinical learning environment and mentoring in hospital where they perform their clinical placement and the connection of these factor with intention to work as a nurse once graduated.

Methods
Nursing students enrolled in clinical practice at least 6 months in hospitals in China were surveyed between January–March 2021. Percentages, frequencies, mean, standard deviation, t-test, ANOVA, and regression analysis were used to analyse the data.

Results
Of the five scales in the CLES+T, ‘Leadership style of the ward manager’ scored the highest mean while ‘Pedagogical atmosphere at the ward’ scored the lowest. Nursing students with lower educational level, those supervised by fixed preceptor, and those intent to be a nurse in the future were significantly more satisfied with the CLES+T. Most of the nursing students are intent to work as a nurse in the future. CLES+T total scores and sub-dimensions (Premises of nursing on the ward) have significantly effectiveness on the intention to be a nurse in the future.

Conclusions
Given the significant correlation of between learning environments and nursing students intention to be a nurse in the future, ward managers need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections among students through effective feedback mechanisms, which can enable students to experience a better clinical learning environment and meaningful experiences to build their professional roles and competencies, thus helping to enhance students’ willingness to pursue nursing careers in the future.
Analyzing patient experiences using natural language processing: development and validation of the artificial intelligence patient reported experience measure (AI-PREM)
Authors: van Buchem Marieke M. , Neve Olaf M. , Kant Ilse M. J. , Steyerberg Ewout W. , Boosman Hileen , Hensen Erik F. 
Published: July 2022

AbstractBackgroundEvaluating patients’ experiences is essential when incorporating the patients’ perspective in improving healthcare. Experiences are mainly collected using closed-ended questions, although the value of open-ended questions is widely recognized. Natural language processing (NLP) can automate the analysis of open-ended questions for an efficient approach to patient-centeredness.MethodsWe developed the Artificial Intelligence Patient-Reported Experience Measures (AI-PREM) tool, consisting of a new, open-ended questionnaire, an NLP pipeline to analyze the answers using sentiment analysis and topic modeling, and a visualization to guide physicians through the results. The questionnaire and NLP pipeline were iteratively developed and validated in a clinical context.ResultsThe final AI-PREM consisted of five open-ended questions about the provided information, personal approach, collaboration between healthcare professionals, organization of care, and other experiences. The AI-PREM was sent to 867 vestibular schwannoma patients, 534 of which responded. The sentiment analysis model attained an F1 score of 0.97 for positive texts and 0.63 for negative texts. There was a 90% overlap between automatically and manually extracted topics. The visualization was hierarchically structured into three stages: the sentiment per question, the topics per sentiment and question, and the original patient responses per topic.ConclusionsThe AI-PREM tool is a comprehensive method that combines a validated, open-ended questionnaire with a well-performing NLP pipeline and visualization. Thematically organizing and quantifying patient feedback reduces the time invested by healthcare professionals to evaluate and prioritize patient experiences without being confined to the limited answer options of closed-ended questions.
Impact of bisphenol-A on the spliceosome and meiosis of sperm in the testis of adolescent mice
Authors: Wang Yongjie , Wu Yanyan , Zhang Shilei 
Published: July 2022

Abstract
Background
Bisphenol-A (BPA) has estrogenic activity and adversely affects humans and animals' reproductive systems and functions. There has been a disagreement with the safety of BPA exposure at Tolerable daily intake (TDI) (0.05 mg/kg/d) value and non-observed adverse effect level (5 mg/kg/d). The current study investigated the effects of BPA exposure at various doses starting from Tolerable daily intake (0.05 mg/kg/d) to the lowest observed adverse effect level (50 mg/kg/d) on the testis development in male mice offspring. The BPA exposure lasted for 63 days from pregnancy day 0 of the dams to post-natal day (PND) 45 of the offspring.

Results
The results showed that BPA exposure significantly increased testis (BPA ≥ 20 mg/kg/d) and serum (BPA ≥ 10 mg/kg/d) BPA contents of PND 45 mice. The spermatogenic cells became loose, and the lumen of seminiferous tubules enlarged when BPA exposure at 0.05 mg/kg/d TDI. BPA exposure at a low dose (0.05 mg/kg/d) significantly reduced the expression of Scp3 proteins and elevated sperm abnormality. The significant decrease in Scp3 suggested that BPA inhibits the transformation of spermatogonia into spermatozoa in the testis. The RNA-seq proved that the spliceosome was significantly inhibited in the testes of mice exposed to BPA. According to the RT-qPCR, BPA exposure significantly reduced the expression of Snrpc (BPA ≥ 20 mg/kg/d) and Hnrnpu (BPA ≥ 0.5 mg/kg/d).

Conclusions
This study indicated that long-term BPA exposure at Tolerable daily intake (0.05 mg/kg/d) is not safe because low-dose long-term exposure to BPA inhibits spermatogonial meiosis in mice testis impairs reproductive function in male offspring.
Associations between glycated hemoglobin and the risks of incident cardiovascular diseases in patients with gout
Authors: Li Likang , Lip Gregory Y. H. , Li Shuai , Adachi Jonathan D. , Thabane Lehana , Li Guowei 
Published: July 2022

Abstract
Background
Evidence for the relationship between glycated hemoglobin (HbA1c) levels and risk of cardiovascular diseases (CVD) in patients with gout remained sparse and limited. This study aims to explore the associations between HbA1c levels and risks of incident CVD in patients with gout.

Methods
We included patients with gout who had an HbA1c measurement at baseline from the UK Biobank. CVD events were identified from through medical and death records. We used multivariable Cox proportional hazards model with a restricted cubic spline to assess the potential non-linear effect of HbA1c on CVD risk.

Results
We included a total of 6,685 patients (mean age 59.7; 8.1% females) with gout for analyses. During a mean follow-up of 7.3 years, there were 1,095 CVD events documented with an incidence of 2.26 events per 100 person-years (95% confidence interval [CI]: 2.13–2.40). A quasi J-shaped association between HbA1c and risk of CVD was observed, with the potentially lowest risk found at the HbA1c of approximately 5.0% (hazard ratio [HR] = 0.65, 95% CI: 0.53–0.81). When compared with the HbAlc level of 7%, a significantly decreased risk of CVD was found from 5.0 to 6.5%, while an increased risk was observed at 7.5% (HR = 1.05) and 8.0% (HR = 1.09). Subgroup analyses yielded similar results to the main findings in general.

Conclusions
Based on data from a nationwide, prospective, population-based cohort, we found a quasi J-shaped relationship between HbA1c and risk of CVD in patients with gout. More high-quality evidence is needed to further clarify the relationship between HbA1c and CVD risk in patients with gout.
Musculoskeletal pain and its effect on daily activity and behaviour in Icelandic children and youths with juvenile idiopathic arthritis: a cross-sectional case-control study
Authors: Oskarsdottir Svanhildur Arna , Kristjansdottir Audur , Gudmundsdottir Judith Amalia , Kamban Solrun W. , Licina Zinajda Alomerovic , Gudmundsdottir Drifa Bjork , Gudjonsdottir Bjorg 
Published: July 2022

Abstract
Background
Juvenile idiopathic arthritis is characterised by recurring episodes of acute inflammation, with joint swelling in one or more joints, often accompanied by pain. These episodes can now be controlled better than in the past because of a new category of medications. However, despite more stable disease activity, pain may continue to cause problems in the children with juvenile idiopathic arthritis and can reduce their performance of routine physical activities and participation in social or school activities.

Aim
To evaluate the prevalence of pain, pain intensity, pain behaviour, and pain interference in Icelandic children with juvenile idiopathic arthritis compared with healthy peers.

Methods
A cross-sectional, case-control study including 8-18 years old children; 28 with juvenile idiopathic arthritis and 36 in a control group. The children answered questions on pain experienced during the last 7 days, painful areas of the body and pain frequency. They completed short form versions of the Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires on pain intensity, pain behaviour, and pain interference.

Results
Significantly more children with juvenile idiopathic arthritis had pain compared with the control group (p = 0.02). Children with JIA also had a greater number of painful body areas (p = 0.03), more pain intensity (p = 0.009), and showed more pain behaviour (p = 0.006), and pain interference (p = 0.002). Children with juvenile idiopathic arthritis who had pain, experienced more pain interference (p = 0.023) than their peers who had pain. However, the groups did not differ in terms of pain intensity (p = 0.102) and pain behaviour (p = 0.058).

Conclusion
The research results indicate that pain experience was different between children with juvenile idiopathic arthritis and the control group. The results suggest that further research of the role of pain management on functional outcomes in children with juvenile idiopathic arthritis is needed.
Breast cancer combined with contralateral neck lymph node metastasis: a case report
Authors: Zhong Xiaoxiao , Ding Fengjiao , Qian Liyuan , Wu Wei , Wen Yanguang , Ding Boni 
Published: July 2022

Abstract
Background
Contralateral neck lymph node metastasis is rare in primary breast cancer. Its clinical staging and treatment principles lack authoritative guidelines. A case of a 30-year-old breast cancer patient with contralateral neck lymph node metastasis is presented. The clinical treatment is discussed in combination with current research.

Case presentation
A 30-year-old woman presented with a right breast mass for 5 months and left neck lymph node enlargement for 5 days. Mammography showed a 33 mm*14.3 mm mass in the inner quadrant of the right breast. The ultrasound showed several hypoechoic nodules on the left side of the neck. Rapid intraoperative pathological examination diagnosed a right breast malignant tumor and poorly differentiated carcinoma of the left cervical lymph nodes. Then, right mastectomy was performed immediately. The patient was scheduled to undergo chemotherapy, molecular targeted therapy, radiotherapy and endocrine therapy after the operation. The long-term efficacy remains to be seen.

Conclusion
The infrequent presentation of breast cancer with metastasis to the contralateral neck lymph node can be challenging for standard therapies.
Preclinical evaluation of a commercially available biofilm disrupting wound lavage for musculoskeletal trauma
Authors: Whitely Michael E. , Helms Sarah M. , Muire Preeti J. , Lofgren Alicia L. , Lopez Rebecca A. , Wenke Joseph C. 
Published: July 2022

Abstract
Background
Treatment of open fractures remains a significant challenge in trauma care as these fractures are accompanied by extensive soft tissue damage, exposing the wound site to contaminants and increasing infection risk. Formation of biofilm, a capsule-like environment that acts as a barrier to treatment, is a primary mode by which infecting pathogens persist at the wound site. Therefore, a pressing need exists to identify irrigation methods that can disrupt biofilm and expose pathogens to treatment. This study aims to evaluate the antibiofilm wound lavage, Bactisure™, in comparison with saline for care of severe musculoskeletal wounds and elucidate potential effects on antibiotic treatment success.

Methods
UAMS-1 Staphylococcus aureus biofilms were formed in vitro and treated with Bactisure™ wound lavage or sterile normal saline, alone, or in combination with sub-biofilm inhibitory levels of vancomycin. Characterization methods included quantification of biofilm biomass, quantification of viable biofilm bacteria, and biofilm matrix imaging. For in vivo assessment, a delayed treatment model of contaminated open fracture was used wherein a critical-sized defect was created in a rat femur and wound site inoculated with UAMS-1. Following a 6 h delay, wounds were debrided, irrigated with lavage of interest, and antibiotic treatments administered. Bacterial enumeration was performed on bone and hardware samples after two weeks.

Results
An immediate reduction in biofilm biomass was observed in vitro following antibiofilm lavage treatment, with a subsequent 2- to 3- log reduction in viable bacteria achieved after 24 h. Furthermore, biofilms treated with antibiofilm lavage in combination with vancomycin exhibited a minor, but statistically significant, decrease in viable bacteria compared to irrigation alone. In vivo, a minor, not statistically significant, decrease in median bioburden was observed for the antibiofilm lavage compared to saline when used in combination with antibiotics. However, the percentage of bone and hardware samples with detectable bacteria was reduced from 50 to 38%.

Conclusions
These results suggest that the antibiofilm wound lavage, Bactisure™, may hold promise in mitigating infection in contaminated musculoskeletal wounds and warrants further investigation. Here, we proposed multiple mechanisms in vitro by which this antibiofilm lavage may help mitigate infection, and demonstrate this treatment slightly outperforms saline in controlling bioburden in vivo.
A clinicopathologic study of malignancy in VCP-associated multisystem proteinopathy
Authors: Shmara Alyaa , Perez-Rosendahl Mari , Murphy Kady , Kwon Ashley , Smith Charles , Kimonis Virginia 
Published: July 2022

Abstract
Background
Valosin containing protein (VCP) is an important protein with many vital functions mostly related to the ubiquitin–proteasome system that provides protein quality control. VCP-associated inclusion body myopathy with Paget disease of bone and frontotemporal dementia, also termed VCP disease and multisystem proteinopathy (MSP 1), is an autosomal dominant disorder caused by monoallelic variants in the VCP gene on human chromosome 9. VCP has also been strongly involved in cancer, with over-activity of VCP found in several cancers such as prostate, pancreatic, endometrial, esophageal cancers and osteosarcoma. Since MSP1 is caused by gain of function variants in the VCP gene, we hypothesized our patients would show increased risk for developing malignancies. We describe cases of 3 rare malignancies and 4 common cancers from a retrospective dataset.

Results
Upon surveying 106 families with confirmed VCP variants, we found a higher rate of rare tumors including malignant peripheral nerve sheath tumor, anaplastic pleomorphic xanthoastrocytoma and thymoma. Some of these subjects developed cancer before displaying other classic VCP disease manifestations. We also present cases of common cancers; however, we did not find an increased rate compared to the general population. This could be related to the early mortality associated with this disease, since most patients die in their 50–60 s due to respiratory failure or cardiomyopathy which is earlier than the age at which most cancers appear.

Conclusion
This is the first study that expands the phenotype of VCP disease to potentially include rare cancers and highlights the importance of further investigation of the role of VCP in cancer development. The results of this study in VCP disease patients suggest that patients may be at an increased risk for rare tumors. A larger study will determine if patients with VCP disease develop cancer at a higher rate than the general population. If that is the case, they should be followed up more frequently and screened for recurrence and metastasis of their cancer.