bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction (A Case Study of Private Hospitals in Mashhad)
Authors: Kaffashpoor Azar , Sadeghian Samaneh 
Published: November 2020

Abstract
Background: The emerging ethical leadership, a unique approach in leadership viewpoint, has provided the ground for constructing and advancing individual and managerial efficiency by highlighting ethics in organizations. The present study aims to investigate the influence of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction in Private Hospitals in Mashhad.Methods: This descriptive-correlational research design stud was conducted in 2015-2016 to inspect the possible effect of ethical leadership on subjective wellbeing and job satisfaction, as dependent and mediator variables, among the Iranian private hospitals’ nurses in Mashhad. Simple random sampling method was used to select the sample of 166 nurses out of the population of 730 nurses, in total. The valid and reliable adapted version of the questionnaire designed by Yang (2014) was used to collect the data, and structural equation modeling (SEM) was used to analyze the data set.Results: The results showed that there is a positive significant correlation between ethical leadership and job satisfaction. More specifically, the findings indicated that Ethical leadership affected the subjective wellbeing of nurses through job satisfaction both directly and indirectly.Conclusions: The findings illustrated that focus on ethics and ethically-oriented leaders in hospitals, enriched by job satisfaction can lead to the nurses’ subjective wellbeing by providing them a positive climate.
Characteristics and predictors of muscle strength deficit in mechanical ankle instability
Authors: Hou Zong-chen , Miao Xin , Ao Ying-fang , Hu Yue-lin , Jiao Chen , Guo Qin-wei , Xie Xing , Zhao Feng , Pi Yan-bin , Li Nan , Zhang Zhi-yu , Jiang Dong 
Published: November 2020

Abstract
Purpose: Muscle strength training is a common strategy for treating chronic ankle instability (CAI), but the effectiveness decreases for mechanical ankle instability (MAI) patients with initial severe ligament injuries. The purpose of this study was to investigate the characteristics and the potential predictors of muscle strength deficit in MAI patients, with a view to proposing a more targeted muscle strength training strategy.Methods: A total of 220 MAI patients with confirmed initial lateral ankle ligament rupture and a postinjury duration of more than 6 months were included. All patients underwent a Biodex isokinetic examination of the ankle joints of both the affected and unaffected sides. Then, the associations between the limb symmetry index (LSI) (mean peak torque of the injury side divided by that of the healthy side) and the patients’ sex, body mass index, postinjury duration, presence of intra-articular osteochondral lesions, presence of osteophytes and ligament injury pattern (i.e., isolated anterior talofibular ligament (ATFL) injury or combined with calcaneofibular ligament injury) were analysed.Results: There was significantly weaker muscle strength on the affected side than on the unaffected side in all directions (p<0.05). The LSI in plantar flexion was significantly lower than that in dorsiflexion at 60°/s (0.87 vs 0.98, p<0.001). A lower LSI in eversion was significantly correlated with female sex (0.82 vs 0.94, p=0.016) and isolated ATFL injury (0.86 vs 0.95, p=0.012). No other factors were found to be associated with muscle strength deficits.Conclusion: MAI patients showed significant muscle strength deficits on the affected side, especially in plantar flexion. There were greater strength deficits in eversion in females and individuals with an isolated ATFL injury. Thus, a muscle strength training programme for MAI patients was proposed that focused more on plantar flexion training and eversion training for females and those with an isolated ATFL injury.
Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study.
Authors: Haesebaert Julie , Laude C. , Termoz A. , Bravant E. , Perreton N. , Bony T. , Trehard H. , Porthault S. , Derex L. , Nighoghossian N. , Schott AM. 
Published: November 2020

Abstract
Background: Public awareness of stroke symptoms is a key factor to ensure access to reperfusion strategies in due time. We designed and launched a regional theory-informed and user-centered information campaign and assessed its impact on emergency medical services (EMS) calls for stroke suspicion, time-to-call, and public attitudes and awareness concerning stroke.Methods: A controlled before-and-after study was conducted during 3 sequential time-periods in 2 separate counties. Key messages of the campaign were underpinned by stroke representations and the theory of planned behavior, and focused on recognition of stroke warning signs and the need to call EMS urgently. The campaign included posters, leaflets, adverts and films displayed in bus and subway stations, internet, social networks, and local radio. Outcome measures on behavior, attitudes, and knowledge were assessed before the launch of the campaign, at 3 months, and 12 months.Results: The number of EMS calls for stroke suspicion increased by 21% at 12 months in the intervention county and this change was significantly different to that observed in the control county (p=0.02). No significant changes were observed regarding self-reported attitudes in case of stroke. An 8% significant increase in recognizing at least 2 stroke warning signs was observed in the intervention county (p=0.04) at 3 months, while it did not change significantly in the control county (p=0.6). However, there was no significant difference in warning sign recognition between both counties (p=0.16).Conclusion: The campaign significantly improved public’s behavior of calling EMS, although stroke knowledge was not improved as much as expected. Repeating these campaigns over time might further help improve timeliness and access to reperfusion strategies.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT02846363.
Distinct mutation profiles between primary bladder cancer and circulating tumor cells warrant the use of circulating tumors cells as cellular resource for mutation follow-up
Authors: Tae-Min Kim , Yoo Jinseon , Moon Hyong Woo , Hur Kyung jae , Choi Jin Bong , Hong Sung-Hoo , Lee Ji Youl , Ha U-Syn 
Published: November 2020

Abstract
Background: While circulating tumor cells may serve as minimally invasive cancer markers for bladder cancers, the relationship between primary bladder cancers and circulating tumor cells in terms of somatic mutations is largely unknown. Genome sequencing of bladder tumor and circulating tumor cells is highlighted to identify the somatic mutations of primary bladder cancer.Methods: Bladder cancer tissue was collected by transurethral resection of the bladder and preserved by snap-freezing. Circulating tumor cells were Isolated from the blood obtained before treatment. We performed whole exome sequencing of 20 matched pairs of primary bladder cancers and circulating tumor cells to identify and compare somatic mutations of these two different genomic resources.Results: We observed that mutation abundances of primary bladder cancers and circulating tumor cells were highly variable. The mutation abundance was not significantly correlated between matched pairs. Of note, the mutation concordance between two resources was only 3 – 24% across 20 pairs examined, suggesting that the circulating tumor cell genomes of bladder cancer patients might be genetically distinct from primary bladder cancers. A relative enrichment of mutations belonging to APOBEC-related signature and a depletion of C-to-G transversions were observed for primary- and circulating tumor cells specific mutations, respectively, suggesting that distinct mutation forces might have been operative in respective lesions during carcinogenesis.Conclusions: The observed discrepancy of mutation abundance and low concordance level of mutations between genomes of primary bladder cancers and circulating tumor cells should be taken into account when evaluating clinical utility of circulating tumor cells for treatments and follow-up of bladder cancers.Trial registration: Patients were selected and registered retrospectively, and medical records were evaluated.
Efficacy and Safety of the Syrup "KalobaTUSS®" as a Treatment for Cough in Children: a randomized, double blind, placebo-controlled clinical trial
Authors: Carnevali Ilaria , Paglia Rita La , Pauletto Laura , Raso Floriana , Testa Marco , Mannucci Carmen , Sorbara Emanuela Elisa , Calapai Gioacchino 
Published: November 2020

Abstract
Background: Acute cough in children often causes discomfort to children and parents, reducing their quality of life. Despite the extensive utilization of over the counter remedies for cough, the efficacy of most of these treatments in children has not been confirmed.Methods: We conducted a randomized, double blind, placebo-controlled clinical trial of 106 children with acute cough to evaluate the efficacy and safety of KalobaTUSS®, a paediatric cough syrup based on acacia honey and from Malva sylvestris, Inula helenium, Plantago major extract, and Helichrysum stoechas extracts.Results: Children were orally treated with KalobaTUSS® or placebo for eight days. Children receiving KalobaTUSS® showed an early and significant reduction in night-time and day-time cough scores measured using a specific scale and a shorter duration of cough than children treated with the placebo.Conclusions: KalobaTUSS® is well tolerated and produces positive effects by reducing the severity and shortening the duration of cough in children (Clinicaltrials.gov no. NCT04073251).
Facilitating participation in cardiovascular preventive initiatives among people with diabetes: a qualitative study
Authors: Dahl Marie , Søndergaard Susanne Friis , Diederichsen Axel , Pouwer Frans , Pedersen Susanne S. , Søndergaard Jens , Lindholt Jes 
Published: November 2020

Abstract
Background: Type 2 diabetes (T2D) is associated with a significantly increased risk of cardiovascular disease (CVD). The DIAabetic CArdioVAscular Screening and intervention trial (DIACAVAS) was designed to clarify whether advanced imaging for subclinical atherosclerosis combined with medical treatment is an effective strategy to develop individualised treatment algorithms for Danish men and women with T2D aged 40–60. But in the DIACAVAS pilot study, the uptake was only 41%. Consequently, we explored how people experienced living with T2D to understand how to improve the uptake in initiatives targeting the prevention of CVD. Methods: We used semi-structured interviews to obtain information on how the respondents experienced having T2D. For supplementary information, we used structured interviews on e.g. socioeconomic factors. From April to October 2019, 17 participants aged 40–60 years were recruited from general practices and diabetes outpatient clinics in Denmark. Several levels of analysis were involved consistent with inductive content analysis.Results: The participants’ experiences of living with T2D fell along two continuums, from an emotional to a cognitive expression and from proactive to reactive disease management. This led to identification of four archetypal characteristics: (I) powerlessness, (II) empowerment, (III) health literacy, and (IV) self-efficacy. These characteristics indicated the importance of using different approaches to facilitate participation in cardiovascular preventive initiatives. Additionally, findings inspired us to develop a model for facilitating participation in future preventive initiatives.Conclusion: Encouraging people with T2D to participate in cardiovascular preventive initiatives may necessitate a tailored invitation strategy. We propose a model for an invitational process that takes into consideration invitees’ characteristics, including powerlessness, empowerment, health literacy and self-efficacy. This model may enhance participation in such initiatives. However, participation is a general concern, not only in relation to cardiovascular prevention. Our proposed model may be applicable in preventive services for people with T2D in general.
Haptoglobin gene diversity and incidence of uncomplicated malaria among children in Iganga, Uganda
Authors: Lwanira Catherine Nassozi , Kironde Fred , Swedberg Göte 
Published: November 2020

Abstract
BackgroundHaptoglobin (Hp) is an acute phase protein that takes part in systemic regulation of heme during Plasmodium falciparum infections. Numerous genotypes of haptoglobin have been reported in malaria endemic populations. In this study, the relationship between haptoglobin genotypes and incidence of uncomplicated malaria in a cohort of children living in a malaria-endemic area of Uganda was determined.MethodsThis is an extension of a longitudinal study comprising of 423 children aged between six months and nine years, who were actively followed up for one year. Malaria episodes occurring in the cohort children were detected and the affected children treated with national policy drug regimen. Haptoglobin genotypes were determined by an allele-specific PCR method and their frequencies were calculated. A multivariate negative binomial regression model was used to estimate the impact of haptoglobin genotypes on incidence of uncomplicated malaria in the children’s cohort. In all statistical tests, a P – value of <0.05 was considered as significant.ResultsThe prevalences of the Hp1-1, Hp2-1 and Hp2-2 genotypes in the children’s cohort were 41%, 36.2% and 22.9% respectively. The overall frequency for the Hp1 allele was 59%, while Hp2 allele occurred at a frequency of 41%. After adjustment of incidence rates for age, insecticide treated bed net (ITN) use and malaria history, the incidence of uncomplicated malaria for children carrying the Hp 2-2 genotype and those with the Hp 2-1 genotype was statistically similar (P=0.41). Also, no difference in the incidence of uncomplicated malaria was observed between children carrying the Hp 1-1 genotype and those having the Hp 2-1 genotype (P=0.84) or between Hp 2-2 Vs Hp 1-1 genotypes (P=0.50).ConclusionsThis study showed that the Hp 1-1 and Hp 2-1 genotypes each occur in nearly 4 in 10 children and the Hp 2-2 genotype occurs in 2 of every 10 children. No association with incidence of uncomplicated malaria was found. Additional studies of influence of haptoglobin genotypes on P. falciparum malaria severity are needed to understand the role of these genotypes in malarial protection.
Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo
Authors: Arinaitwe Emmanuel , Nankabirwa Joaniter I. , Krezanoski Paul , Rek John , Kamya Victor , Epstein Adrienne , Rosenthal Philip J. , Drakeley Chris , Kamya Moses R. , Dorsey Grant , Staedke Sarah G. 
Published: November 2020

Abstract
Background: The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognised as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda.Methods: Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within four weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual.Results: Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI: 0.60-0.89, p=0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52-0.83, p=0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67-1.40, p=0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31-2.46, p<0.001) and duration of travel (>7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07-3.64, p=0.03).Conclusions: Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than one week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.
Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study
Authors: Mungulluh Felix Faustin , Ruggajo Paschal , Furia Francis Fredrick 
Published: November 2020

Abstract
Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.
Association between Colic and sleep problems in infancy and subsequent development, emotional and behavioral problems: A Longitudinal study
Authors: Valla Lisbeth , Småstuen Milada Cvancarova , Andenæs Randi , Misvær Nina , Olbjørn Christine , Helseth Sølvi 
Published: November 2020

Abstract
Background: Sleep and Colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in infancy and subsequent development, emotional and behavior problems in young children. The aim of the present study was to examine whether there is an associations between infants’ crying and sleep problems at 6 months and behavioral and development problems at 18 months, 3 and 5 yearsMethods: A population-based longitudinal study, using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1999, to December 2008. A total of 86,724 children were included. Colic and sleep (sleep duration, nocturnal awakenings and easy to put to bed) was assessed by mother-reports. Z-scores were used to assess differences between groups of children (e.g. having colic or not, having a sleep problem or not). Emotional and behavioral problems were measured with items from the Child Behavior Checklist. Development problems were measured with items from The Ages and Stages Questionnaire.Results: Infants with colic scored significantly lower on development at 5 years (B=-0.10, CI [-0.14-; - 0.06]) and higher on internalizing problems both at 3years ( B=-0.15 .CI [0.11-; 0.18] ) and 5 years ( B=-0.17 .CI [0.12-; 0.21] ) than the reference population. Children who awoke frequently (≥ 3 times) and were more difficult to put to bed at 6 months scored significantly lower on development at 18 months and 3 and 5 years, and higher on internalizing behavior problems at 3 and 5 years (B=0.18 and B=0.16).Children with shorter sleep duration (≤ 10 hours) at 6 months had more internalizing behavior problems at 3 years (B=-0.14. CI [0.07; - 0.02]) and 5 years (B=-0.15 .CI [0.05-; - 0.25]) than the reference population.Conclusions: Colic and disruptive sleep early in life are risk factors for development, emotional and behavioral problems within the first five years of a child’s life. It is important to be aware that disruptive sleep and colic in infancy may have long-term negative consequences.
Host-adaptation of the rare Enterocytozoon bieneusi genotype CHN4 in Myocastor coypus (Rodentia: Echimyidae) in China
Authors: Yu Fuchang , Cao Yangwenna , Wang Haiyan , Liu Qiang , Zhao Aiyun , Qi Meng , Zhang Longxian 
Published: November 2020

Abstract
Background: Enterocytozoon bieneusi is a zoonotic gastrointestinal pathogen and can infect both humans and animals. The coypu (Myocastor coypus) is a semi-aquatic rodent, in which few E. bieneusi infections have been reported and the distribution of genotypes and zoonotic potential remains unknown.Methods: A total of 308 fresh fecal samples were collected from seven coypu farms in China to determine the infection rate and the distribution of genotypes of E. bieneusi from coypus using nested-PCR amplification of the internal transcribed spacer (ITS) region of the ribosomal RNA (rRNA) gene.Results: Enterocytozoon bieneusi was detected with an infection rate of 41.2% (n = 127). Four genotypes were identified, including three known genotypes (CHN4 (n = 111), EbpC (n = 8) and EbpA (n = 7)) and a novel genotype named CNCP1 (n = 1). Conclusions: The rare genotype CHN4 was the most common genotype in the present study, and the transmission dynamics of E. bieneusi in coypus were different from other rodents. To the best of our knowledge, this is the first report of E. bieneusi infections in coypus in China. Our study reveals that E. bieneusi in coypus may be a potential infection source to humans.