bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adaptability and clinical applicability of UFS-QoL in Chinese women with uterine fibroid
Authors: Xu Wei , Chen Wenzhi , Chen Jinyun , Hu Liang , Su Xueyao , Nie Yuxian , Shi Qiuling 
Published: September 2022

Abstract
Objective
To demonstrate the applicability and adaptability of uterine fibroid symptoms and quality of life (UFS-QoL) in assessing the efficacy of treatment in Chinese populations.

Methods
This is a secondary analysis of a prospective cohort study involving 20 Chinese hospitals and 2,411 Chinese women with fibroids. Patients completed UFS-QoL and short form-36 (SF-36) at pre-surgery, 6-month and 12-month post-treatments. Internal consistency of the quality of life assessed by the UFS-QoL questionnaire using Cronbach’s α coefficient (α). Principal axis factor analysis with orthogonal rotation was established to investigate relationships between items and subscales. Concurrent validity refers to the Spearman's correlation estimate of the correlation between UFS-QoL and SF-36. Using effect size and standardized response mean, the ability to detect change was evaluated by comparing pre- and post-6-month and post-12-month treatment scores.

Results
Exploratory factor analysis yielded six subscales (concern, activities, energy/mood, control, self-consciousness, and sexual function) with eigenvalues > 1 in UFS-QoL. A 63.61% total variance was explained by the test items. Ceiling effects of self-consciousness and sexual functioning subscales from UFS-QoL were > 15%. UFS-QoL showed a positive and moderate correlation with SF-36 to establish good concurrent validity. And showed good consistency reliability (Cronbach α > 0.7 in all subscales), ability to detect change after treatment. This excluded self-consciousness (α = 0.56), which demonstrated the lowest effect size (0.38) and standardized response means (0.38) 6- and 12-months post-treatment.

Conclusions
Symptom severity, activity, and mood subscales of the Chinese UFS-QoL were valid and reliable. However, the self-consciousness domain needs further investigation on cultural adaptation, such as cognitive debriefing for how Chinese interpret these questions.
Methanolic neem (Azadirachta indica) stem bark extract induces cell cycle arrest, apoptosis and inhibits the migration of cervical cancer cells in vitro
Authors: Kumar Saurav , Mulchandani Vaishali , Das Sarma Jayasri 
Published: September 2022

Abstract
Background
Cervical cancer remains one of the significant causes of mortality in women due to the limitations of current treatment strategies and their associated side effects. Investigation of alternative medicine, including phytomedicine, has shown effective anti-cancer potential with fewer side effects. Azadirachta indica (commonly known as neem) is known for its medicinal properties. The present study investigated the anti-cancer potential of methanolic neem stem bark extract (MNBE) against cervical cancer using HeLa, SiHa, and ME-180 cell lines.

Methods
Cytotoxic effect of MNBE on cultured cell lines was evaluated by MTT and clonogenic assay. The growth-inhibiting effect of MNBE was further confirmed by performing cell cycle analysis and apoptosis assay using flow cytometry. The anti-migratory effect of MNBE was evaluated by using wound healing and Boyden chamber assay. Real-time PCR was used to determine the mRNA expression, and western blot and flow cytometry was used to determine the protein levels of growth and migration-related genes.

Results
MNBE significantly suppressed the growth and survival of cervical cancer cells in a dose-dependent manner by inducing cell cycle arrest and apoptosis. In addition, the growth inhibitory effect of MNBE was specific to cervical cancer cells than normal cells. Cell cycle arrest was correlated to transcriptional downregulation of cyclin dependent kinase 1 (CDK1), cyclin A, and cyclin B. Additionally, MNBE treatment resulted in the upregulation of active caspase-3 protein and downregulation of prosurvival genes, Bcl2, and survivin at mRNA level and NFkB-p65 at the protein level. Furthermore, MNBE inhibited the migration of cervical cancer cells accompanied by modulation of migration-related genes, including zona occludens-1 (ZO-1), matrix metalloproteinase 2 (MMP2), focal adhesion kinase (FAK), N-cadherin, snail, and E-cadherin.

Conclusion
In summary, the present study provides the first evidence of MNBE in restricting cervical cancer cell growth and migration, which warrants further investigation for developing novel anti-cancer drugs.
The most significant change for Colombian medical trainees going transformative learning on cultural safety: qualitative results from a randomised controlled trial
Authors: Pimentel Juan , López Paola , Cockcroft Anne , Andersson Neil 
Published: September 2022

Abstract
Background
Cultural safety training is not yet standard in Colombian medical education. If incorporated, it could address currently adversarial interactions between health professionals and the 40% of people who use traditional medicine practices. In 2019, a randomised controlled trial tested the impact of cultural safety training for medical students using participatory serious game design. The quantitative evaluation showed improved cultural safety intentions of Colombian medical trainees. We report here a qualitative evaluation of the most significant change perceived by trial participants.

Methods
This qualitative descriptive study used the most significant change technique. We invited the trial participants engaged in clinical settings to describe stories of change in their supervised clinical practice that they attributed to the intervention. Using a deductive thematic analysis based on a modified theory of planned behaviour, two independent reviewers coded the stories and, by consensus, created themes and sub-themes.

Results
From 27 stories of change, we identified seven themes and 15 subthemes: (a) Conscious knowledge: benefits of cultural safety training, consequences of culturally unsafe behaviour, cultural diversity and cultural practices; (b) Attitudes: respect and appreciation for cultural diversity, openness, and self-awareness; (c) Subjective norms: positive perception of cultural practices and less ethnocentrism; (d) Intention to Change; (e) Agency to accept cultural diversity and to prevent culturally unsafe actions; (f) Discussion; and (g) Action: better communication and relationship with patients and peers, improved outcomes for patients, physicians, and society, investigation about cultural health practices, and efforts to integrate modern medicine and cultural health practices.

Conclusion
The narratives illustrated the transformative impact of cultural safety training on a results chain from conscious knowledge through to action. Our results encourage medical educators to report other cultural safety training experiences, ideally using patient-related outcomes or direct observation of medical trainees in clinical practice.

Trial registration
Registered on ISRCTN registry on 18/07/2019. Registration number: ISRCTN14261595.
Predictors for adoption of e-learning among health professional students during the COVID-19 lockdown in a private university in Uganda
Authors: Komuhangi Alimah , Mpirirwe Hilda , Robert Lubanga , Githinji Florence Wamuyu , Nanyonga Rose Clarke 
Published: September 2022

Abstract
Background
During the recent Coronavirus pandemic, many universities realized that the traditional delivery of educational content was not adequate in the context of imposed restrictions. Adoption of e-learning was one obvious way to foster continuity of learning. Despite its rapid implementation during the lockdown in Uganda, it was not known whether health professional students were willing to adopt e-learning as a way to foster continuity of learning. We, therefore, adopted a Technology Acceptance Model to determine the predictors for the adoption of e-learning using learner and information technology variables.

Methods
A cross-sectional study among 109 health professional students ≥18 years of age at Clarke International University was conducted. Adoption of e-learning was measured as a self-report. Data were obtained using a smart survey and descriptively summarized. The differences in the study outcome were compared using the chi-square test. The factors that independently influenced the adoption of e-learning were determined using binary logistic regression and reported as adjusted odds ratios (aORs) with a 95% confidence interval (CI).

Results
Of the 109 respondents, 71 (65.1%) adopted e-learning. Our data showed low odds of adoption of e-learning among participants in first year (aOR, 0.34: 95%CI, 0.14–0.79), low e-learning expectations (aOR, 0.01: 95%CI, 0.01–0.34), no confidence in using IT devices (aOR, 0.16: 95%CI, 0.00–0.77), no prior experience in e-learning (aOR, 0.11: 95%CI, 0.02–0.68), not considering e-learning flexible (aOR, 0.25:95%CI, 0.08–0.86) and high cost of internet (aOR, 0.13: 95%CI, 0.02–0.84).

Conclusion
We identified predictors of e-learning adoption which include having completed at least 1 year of study, high e-learning expectations, confidence in using IT devices, prior experience in e-learning, considering e-learning to be flexible and internet access. This information can be used by universities to enhance infrastructure and prepare potential e-learners.
OntoPharma: ontology based clinical decision support system to reduce medication prescribing errors
Authors: Calvo-Cidoncha Elena , Camacho-Hernando Concepción , Feu Faust , Pastor-Duran Xavier , Codina-Jané Carles , Lozano-Rubí Raimundo 
Published: September 2022

Abstract
Background
Clinical decision support systems (CDSS) have been shown to reduce medication errors. However, they are underused because of different challenges. One approach to improve CDSS is to use ontologies instead of relational databases. The primary aim was to design and develop OntoPharma, an ontology based CDSS to reduce medication prescribing errors. Secondary aim was to implement OntoPharma in a hospital setting.

Methods
A four-step process was proposed. (1) Defining the ontology domain. The ontology scope was the medication domain. An advisory board selected four use cases: maximum dosage alert, drug-drug interaction checker, renal failure adjustment, and drug allergy checker. (2) Implementing the ontology in a formal representation. The implementation was conducted by Medical Informatics specialists and Clinical Pharmacists using Protégé-OWL. (3) Developing an ontology-driven alert module. Computerised Physician Order Entry (CPOE) integration was performed through a REST API. SPARQL was used to query ontologies. (4) Implementing OntoPharma in a hospital setting. Alerts generated between July 2020/ November 2021 were analysed.

Results
The three ontologies developed included 34,938 classes, 16,672 individuals and 82 properties. The domains addressed by ontologies were identification data of medicinal products, appropriateness drug data, and local concepts from CPOE. When a medication prescribing error is identified an alert is shown. OntoPharma generated 823 alerts in 1046 patients. 401 (48.7%) of them were accepted.

Conclusions
OntoPharma is an ontology based CDSS implemented in clinical practice which generates alerts when a prescribing medication error is identified. To gain user acceptance OntoPharma has been designed and developed by a multidisciplinary team. Compared to CDSS based on relational databases, OntoPharma represents medication knowledge in a more intuitive, extensible and maintainable manner.
Medical aid to war victims in Syria in 2019: a report of organized healthcare support from a charity organization
Authors: Przepiórka Łukasz , Boguszewski Mariusz , Smuniewski Cezary , Kujawski Sławomir 
Published: September 2022

AbstractBackgroundIn 2011, a civil war started in Syria, which is on-going and has reached a death toll of over 400,000 people. Humanitarian organizations, including Aid to The Church in Need (ACN), have strived to provide help and medical support to the civilian victims.MethodsWe performed a retrospective analysis of data gathered in ACN projects in Syria in 2019. The datasets included descriptions of diseases, treatments, costs, cities, and hospitals. For each patient, we assigned the following additional categories: type of help (treatment, diagnosis, or nonmedical), type of treatment (medical or surgical), medical specialty, gross anatomic region, and presence of trauma.ResultsA total of 3835 patients benefited from ACN support in Syria in 2019. The majority of financial support went towards treatment (78.4%), while other support went towards nonmedical help (15.7%) or providing a diagnosis (5.9%). Among treatments, 66.6% were medical and 33.4% surgical. The most common medical specialty was internal medicine (48.4%), followed by public health (13.7%) and surgery (7.3%). Anatomic region was undefined in 68.3% of cases and, when defined, was most commonly the abdominal cavity and pelvis (13%). The vast majority of cases 95.1%) were not associated with trauma. Procedural costs were highest in the Valley of Christians region, and lowest in Tartous. Network graphs were used to visualize the three most common diagnoses and treatments for each medical specialty.ConclusionsThe present report describes the treatment of war victims in Syria in 2019. The patients lacked the most basic medical or surgical healthcare. Charity organizations, like ACN, constitute a valuable source of information about the healthcare of war victims. Unfortunately, the methods of describing medical treatment provided to civilian victims remain underdeveloped. Future studies will require the cooperation of healthcare providers, humanists, and social workers. The present findings can help to optimize the provision of humanitarian help by charity organizations, by tailoring projects to the specific needs of Syrian war victims.
“It’s a waste of time coming here, better go to private clinics with wider options for treatment”: patient’s perception on dental services provided in Fiji
Authors: Nair Richard D. , Mohammadnezhad Masoud 
Published: September 2022

Abstract
Background
Oral health can influence the quality of an individual’s life. Patient’s perception of the service plays a vital role in understanding the reasons as to why a patient may be satisfied or dissatisfied with the service that they accessed at a dental setting. As no studies have been done in Fiji until now, this study aimed to explore the perceptions of patients on services provided by the largest dental clinic in the Central/Eastern division in Fiji.

Method
A qualitative study was used to collect data from patients who visited the Colonial War Memorial Hospital (CWMH) dental clinic in Suva Fiji from 5th August to 31st October, 2020. All patients above the age of 18 of both genders and from any ethnicity who visited the CWMH dental clinic during the period of data collection were included the study. A total of 25 participants were interviewed for this study using the in-depth interview method till data saturation occurred. A semi-structured open-ended questionnaire was used to collect data using face-to-face in-depth interviews. The data were transcribed and analyzed using manual thematic analysis process to gather the themes and sub-themes for the results.

Results
A total of 25 patients were interviewed, with a majority (n = 14) being men and 15 were of I-Taukei background. Five themes emerging from data analysis include: Waiting time before treatment, Cost of Treatment, Accessibility of services, Privacy and confidentiality and Range of treatment options. The patients had an expectation to get the best treatment but face many hurdles while trying to get the treatment that they expect. The shortfalls on the part of this dental clinic caused an onset of negative perception among its users.

Conclusion
This study shows an overall dissatisfaction with regards to services delivery among the patients who use the CWMH dental clinic for dental care purposes. The decision makers need to look into the genuine concerns that have been raised by patients in order to create improvements in services delivery and create an array of satisfaction for its patients.
Factors related to the social network of core members of elderly care service social organizations: a cross-sectional study
Authors: Wang Zhengsheng , Zhang Xingxi , Liu Liu , Tang Ling , Zhu Ying , Bai Zhongliang , Chen Ren 
Published: September 2022

AbstractBackgroundThe social network of the core members of elderly care service social organizations could affect the performance of the organization, while studies concerning its related factors are limited. We aimed to explore factors that are associated with the social network of core members from elderly care service social organizations and provide references and suggestions for improving elderly care services.MethodsThis cross-sectional study employed a multi-stage stratified sampling method, and collected data concerning social network, demographic information and occupation. Univariate analysis and binary logistic regression were used to analyze factors that could affect the social network of the core members.ResultsOur results demonstrated that there is low social network of core members of elderly care social organizations. Out of the total membership, men (AOR = 1.708; 95%CI: 1.034–2.823), those with senior high school education (AOR = 1.923; 95%CI: 1.053–3.511), those with a college degree and above (AOR = 3.010; 95%CI: 1.591–5.692) and those that receive awards related to elderly care services (AOR = 2.260; 95%CI: 1.285–3.976) were associated with higher social network scores.ConclusionsOur data successfully characterized the social status of core members of elderly care organizations. Therefore, health care professionals and policy makers in social organizations should use this knowledge in the care and service provision to the elderly; and implement actions that would promote networking in social organizations.
Diet and irritable bowel syndrome: an update from a UK consensus meeting
Authors: Rej A. , Avery A. , Aziz I. , Black C. J. , Bowyer R. K. , Buckle R. L. , Seamark L. , Shaw C. C. , Thompson J. , Trott N. , Williams M. , Sanders D. S. 
Published: September 2022

AbstractThere has been a renewed interest in the role of dietary therapies to manage irritable bowel syndrome (IBS), with diet high on the agenda for patients. Currently, interest has focussed on the use of traditional dietary advice (TDA), a gluten-free diet (GFD) and the low FODMAP diet (LFD). A consensus meeting was held to assess the role of these dietary therapies in IBS, in Sheffield, United Kingdom.Evidence for TDA is from case control studies and clinical experience. Randomised controlled trials (RCT) have demonstrated the benefit of soluble fibre in IBS. No studies have assessed TDA in comparison to a habitual or sham diet. There have been a number of RCTs demonstrating the efficacy of a GFD at short-term follow-up, with a lack of long-term outcomes. Whilst gluten may lead to symptom generation in IBS, other components of wheat may also play an important role, with recent interest in the role of fructans, wheat germ agglutinins, as well as alpha amylase trypsin inhibitors. There is good evidence for the use of a LFD at short-term follow-up, with emerging evidence demonstrating its efficacy at long-term follow-up. There is overlap between the LFD and GFD with IBS patients self-initiating gluten or wheat reduction as part of their LFD. Currently, there is a lack of evidence to suggest superiority of one diet over another, although TDA is more acceptable to patients.In view of this evidence, our consensus group recommends that dietary therapies for IBS should be offered by dietitians who first assess dietary triggers and then tailor the intervention according to patient choice. Given the lack of dietetic services, novel approaches such as employing group clinics and online webinars may maximise capacity and accessibility for patients. Further research is also required to assess the comparative efficacy of dietary therapies to other management strategies available to manage IBS.
Unmet needs in pneumonia research: a comprehensive approach by the CAPNETZ study group
Authors: Pletz Mathias W. , Jensen Andreas Vestergaard , Bahrs Christina , Davenport Claudia , Rupp Jan , Witzenrath Martin , Barten-Neiner Grit , Kolditz Martin , Dettmer Sabine , Chalmers James D. , Stolz Daiana , Suttorp Norbert , Aliberti Stefano , Kuebler Wolfgang M. , Rohde Gernot 
Published: September 2022

Abstract
Introduction
Despite improvements in medical science and public health, mortality of community-acquired pneumonia (CAP) has barely changed throughout the last 15 years. The current SARS-CoV-2 pandemic has once again highlighted the central importance of acute respiratory infections to human health. The “network of excellence on Community Acquired Pneumonia” (CAPNETZ) hosts the most comprehensive CAP database worldwide including more than 12,000 patients. CAPNETZ connects physicians, microbiologists, virologists, epidemiologists, and computer scientists throughout Europe. Our aim was to summarize the current situation in CAP research and identify the most pressing unmet needs in CAP research.

Methods
To identify areas of future CAP research, CAPNETZ followed a multiple-step procedure. First, research members of CAPNETZ were individually asked to identify unmet needs. Second, the top 100 experts in the field of CAP research were asked for their insights about the unmet needs in CAP (Delphi approach). Third, internal and external experts discussed unmet needs in CAP at a scientific retreat.

Results
Eleven topics for future CAP research were identified: detection of causative pathogens, next generation sequencing for antimicrobial treatment guidance, imaging diagnostics, biomarkers, risk stratification, antiviral and antibiotic treatment, adjunctive therapy, vaccines and prevention, systemic and local immune response, comorbidities, and long-term cardio-vascular complications.

Conclusion
Pneumonia is a complex disease where the interplay between pathogens, immune system and comorbidities not only impose an immediate risk of mortality but also affect the patients’ risk of developing comorbidities as well as mortality for up to a decade after pneumonia has resolved. Our review of unmet needs in CAP research has shown that there are still major shortcomings in our knowledge of CAP.