bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: A mixed method study
Authors: Mbakaya Balwani Chingatichifwe , Kalembo Fatch Welcome , Zgambo Maggie , Konyani Alice , Lungu Florence , Tveit Bodil , Kaasen Anne , Simango Modesta , Bvumbwe Thokozani 
Published: July 2020

Abstract
Background The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of the clinical learning environment by nursing and midwifery students in Malawi.Methods A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.Conclusion Although satisfaction with clinical learning environment had the highest scores, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that impacted negatively on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement.
Association of MC4R (rs17782313) with diabetes and cardiovascular disease in Korean men and women
Authors: Sull Jae Woong , Kim Gitae , Jee Sun Ha 
Published: July 2020

Abstract
Background: Diabetes is mostly assessed by the fasting glucose level. Several studies reported that serum fasting glucose levels and cardiovascular disease are associated with MC4R. Methods: A total of 4,294 subjects participated in this study. There were 1810 subjects with cardiovascular disease among the 4294 subjects. We used multivariate linear regression models and multiple logistic regression analysis. Results: Individuals with the TC/CC genotype had a 1.29-fold higher risk of diabetes than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.29; 95% CI, 1.04-1.60). For healthy subjects, the association was significant in women (OR, 1.99; 95% CI, 1.01-3.93). Men with the TC/CC genotype had a 1.21-fold higher risk of cardiovascular disease than did those with the TT genotype when adjusting for age, sex, and BMI (OR, 1.21; 95% CI, 1.04-1.41). The relationship between MC4R and cardiovascular disease was stronger in lean men (OR, 1.40; 95% CI, 1.12–1.74, p = 0.0028) than in overweight men.Conclusions: This study suggests that the rs17782313 SNP in MC4R is related to diabetes and the SNP is also associated with cardiovascular disease in lean men.
LOXL1 modulates the malignant progression of colorectal cancer by inhibiting the transcriptional activity of YAP
Authors: Hu Lin , Wang Jing , Wang Yunliang , Wu Linpeng , Wu Chao , Mao Bo , E. Maruthi Prasad , Wang Yuhong , Chin Y. Eugene 
Published: July 2020

Abstract
Background: LOX-like 1 (LOXL1) is a lysyl oxidase, and emerging evidence has revealed its effect on malignant cancer progression. However, its role in colorectal cancer (CRC) and the underlying molecular mechanisms have not yet been elucidated. Methods: LOXL1 expression in colorectal cancer was detected by immunohistochemistry, western blotting and real-time PCR. In vitro , colony formation, wound healing, migration and invasion assays were performed to investigate the effects of LOXL1 on cell proliferation, migration and invasion. In vivo , metastasis models and mouse xenografts were used to assess tumorigenicity and metastasis ability. Molecular biology experiments were utilized to reveal the underlying mechanisms by which LOXL1 modulates the Hippo pathway. Results: LOXL1 was highly expressed in normal colon tissues compared with cancer tissues. In vitro, silencing LOXL1 in CRC cell lines dramatically enhanced migration, invasion, and colony formation, while overexpression of LOXL1 exerted the opposite effects. The results of the in vivo experiments demonstrated that the overexpression of LOXL1 in CRC cell lines drastically inhibited metastatic progression and tumour growth. Mechanistically, LOXL1 inhibited the transcriptional activity of Yes-associated protein (YAP) by interacting with MST1/2 and increasing the phosphorylation of MST1/2. Conclusions: LOXL1 may function as an important tumour suppressor in regulating tumour growth, invasion and metastasis via negative regulation of YAP activity.
Diversity of plant assemblages dampens the variability of the growing season phenology in wetland landscapes
Authors: Rheault Guillaume , Lévesque Esther , Proulx Raphaël 
Published: July 2020

Abstract
Background: The functioning of ecosystems is highly variable through space and time. Climatic and edaphic factors are forcing ecological communities to converge, whereas the diversity of plant assemblages dampens these effects by allowing communities’ dynamics to diverge. This study evaluated whether the growing season phenology of wetland plant communities within landscapes is determined by the climatic/edaphic factors of contrasted regions, by the species richness of plant communities, or by the diversity of plant assemblages. From 2013 to 2016, we monitored the phenology and floristic composition of 118 wetland plant communities across five landscapes distributed along a gradient of edaphic and climatic conditions in the Province of Québec, Canada. Results: The growing season phenology of wetlands was driven by differences among plant assemblage within landscapes, and not by the species richness of each individual community (<1% of the explained variation). Variation in the growing season length of wetlands reflected the destabilizing effect of climatic and edaphic factors on green-up dates, which is opposed to the dampening effect of plant assemblage diversity on green-down dates. Conclusions: The latter dampening effect may be particularly important in the context of increasing anthropogenic activities, which are predicted to impair the ability of wetlands to adapt to fluctuating environmental conditions. Our findings suggest that stakeholders should not necessarily consider local monospecific plant communities of lower conservation value to the global functioning of wetland ecosystems.
A population pharmacokinetic model is beneficial in quantifying hair concentrations of ritonavir-boosted atazanavir: A study of HIV-infected Zimbabwean adolescents.
Authors: NGARA Bernard , Zvada Simbarashe , Chawana Tariro Dianah , Stray-Pedersen Babill , Nhachi Charles Fungai Brian , Rusakaniko Simbarashe 
Published: July 2020

Abstract
Background Adolescents experience higher levels of non-adherence to HIV treatment. Drug concentration in hair promises to be reliable for assessing exposure to antiretroviral (ARV) drugs. Pharmacokinetic modelling can explore utility of drug in hair. We aimed at developing and validating a pharmacokinetic model based on atazanavir/ritonavir (ATV/r) in hair and identify factors associated with variabilities in hair accumulation.Methods We based the study on secondary data analysis whereby data from a previous study on Zimbabwean adolescents which collected hair samples at enrolment and three months follow-up was used in model development. We performed model development in NONMEM (version 7.3) ADVAN 13. Results There is 16% / 18% of the respective ATV/r in hair as a ratio of steady-state trough plasma concentrations. At follow-up, we estimated an increase of 30% /42% of respective ATV/r in hair. We associated a unit increase in adherence score with 2% increase in hair concentration both ATV/r. Thinner participants had 54% higher while overweight had 21% lower atazanavir in hair compared to normal weight participants. Adolescents receiving care from fellow siblings had atazanavir in hair at least 54% less compared to other forms of care. Conclusion The determinants of increased ATV/r concentrations in hair found in our analysis are monitoring at follow up event, body mass index, and caregiver status. Measuring drug concentration in hair is feasibly accomplished and could be more accurate for monitoring ARV drugs exposure.
Troxerutin protects against DHT-induced polycystic ovary syndrome in rats
Authors: Gao Zixuan , Ma Xiaochen , Liu Jing , Ge Yuhang , Wang Lei , Fu Ping , Liu Zhian , Yao Ruiqin , Yan Xiaonan 
Published: July 2020

Abstract
The exact pathogenesis of polycystic ovary syndrome (PCOS), the most common neuroendocrine disorder in women of reproductive age, has not been fully elucidated. Recent studies suggested that chronic inflammation and neurotransmitter disorder involved in the progress of PCOS. Troxerutin, a natural flavonoid, was reported to possess neuroprotective effect in several disease models by inhibiting inflammation or enhancing neurotrophic factor. In this study, we investigated the possible protective effect and mechanism of troxerutin in a dihydrotestosterone (DHT)-induced rat model of PCOS. The PCOS rat models were treated with troxerutin at a dose of 150mg/kg or 300mg/kg for up to 4 weeks. Results showed that 300mg/kg troxerutin significantly decreased the body weight gain and improved the pathological changes of ovary induced by DHT. Meanwhile, the elevated gonadotrophin-releasing hormone (GnRH), gonadotrophin and testosterone in the serum of PCOS rats were reduced with the treatment of troxerutin. The expression of kisspeptin and NKB in arcuate nucleus and their receptors kiss1r and NK3r in GnRH positive neurons of median eminence were markedly decreased in troxerutin-treated rats. Of note, the GnRH inhibitory regulator GABA and stimulatory regulator glutamate were also restored to the normal level by troxerutin. The present study indicated that troxerutin may exhibit a protective effect in PCOS rat model via regulating neurotransmitter release.
The relationship between a microfinance-based healthcare delivery platform, health insurance coverage, health screenings, and disease management in rural Western Kenya
Authors: Rosenberg Molly , Amisi James Akiruga , Szkwarko Daria , Tran Dan N. , Genberg Becky , Luetke Maya , Kianersi Sina , Namae Jane , Laktabai Jeremiah , Pastakia Sonak 
Published: July 2020

Abstract
Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of these barriers. This study evaluated the association between participation in BIGPIC microfinance groups and health screening/disease management outcomes.Methods: From November 2018 to March 2019, we interviewed a sample of 300 members of two rural communities in Western Kenya, 100 of whom were BIGPIC microfinance members. We queried participants about their experiences with health screening and disease management for HIV, diabetes, hypertension, tuberculosis, and cervical cancer. We used log-binomial regression models to estimate the association between microfinance membership and each health outcome, adjusting for key covariates.Results: Microfinance members were more likely to be screened for most of the health conditions we queried, including those provided by BIGPIC [e.g. diabetes: aPR (95% CI): 3.46 (2.60, 4.60)] and those not provided [e.g. cervical cancer: aPR (95% CI): 2.43 (1.21, 4.86)]. Microfinance membership had weaker and non-statistically significant associations with health insurance uptake and disease management outcomes. Conclusions: In rural Kenya, a microfinance program integrated with healthcare delivery may be effective at increasing health screening. Interventions designed to thoughtfully and sustainably address structural barriers to healthcare will be critical to improving the health of those living in low-resource settings.
The Dignity of Burn Patients: A Qualitative Descriptive Study of Nurses and Caregivers
Authors: Tehranineshat Banafsheh , Rakhshan Mahnaz , Torabizadeh Camellia , Fararouei Mohammad , Gillespie Mark 
Published: July 2020

Abstract
Background: The essence of nursing care is preservation of patients' human dignity. The aggressive nature of severe burn injuries makes it hard to respect burn patient's existential dimensions and dignity. However, not much research has been conducted on respect for the dignity of burn patients.Purpose: The present study aims to outline the concept of maintaining the dignity of burn patients from the perspective of their caregivers. Methods: The study has a descriptive, qualitative research design. Data were collected using semi-structured, in-depth, individual interviews. Data analysis was executed using conventional content analysis. The subjects were nurses and family caregivers from the biggest burns hospital in the south-east of Iran. The participants were selected via purposeful sampling (n=20) until data saturation was reached. The study lasted from October 2017 to August 2018. Results: Three main themes emerged from the information obtained from the interviews: creating a friendly atmosphere, showing respect, and providing comprehensive support.Conclusion: Burn patients need to receive care in a friendly atmosphere where they are looked after by empathetic caregivers who give enough time to them and allow them to express their feelings and concerns. Also, patients' human values and beliefs should be respected and all aspects of their existence should be taken into account for their dignity to be preserved. Workshops designed based on the findings of the present study can help improve the quality of nursing care.
Determinants for Choice of Home Birth over Health Facility Birth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey
Authors: Moshi Fabiola Vincent , Mbotwa Christopher H. 
Published: July 2020

Abstract
Background: While evidence has shown an association between place of birth and birth outcomes, factors contributing to the choice of home birth have not been adequately investigated. In Tanzania more than 30% of deliveries occur out of health facilities with more than 95% of those deliveries are assisted by non-medical providers who are often unskilled. Birth assisted by unskilled birth attendants has been cited as a contributing factor for the high maternal and neonatal mortalities in low-resources countries. This study aimed at identifying determinants of choice for home birth over health facilities in Tanzania.Method: This study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15-49 years) who gave birth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analyses were used to determine predictors for the choice of home-based childbirth over health facility.Results: A total of 805 (35.2%) women had a home birth. After adjusting for confounders, the determinants for choice of home birth were the level of education [primary education, (AOR=0.666; p=0.001); secondary and higher education, (AOR=0.417; p<0.001)]in reference to no formal education; not owning a mobile phone, (AOR= 1.312; p=0.018); parity [parity 2-4, (AOR=1.594; p=0.004); parity 5 and above, (AOR=2.158; p<0.001)] in reference to parity 1; inadequate antenatal visits, (AOR=1.406; p=0.001); wealth index [poorest, (AOR=9.395; p<0.001); poorer, (AOR=7.701; p<0.001); middle, (AOR=5.961; p<0.001); richer, (AOR=2.557; p<0.001)] in reference to richest women and zones [Southern Highlands, (AOR=0.189; p<0.001); Southern, (AOR=0.225; p<0.001); Zanzibar, (AOR=2.55; p<0.001)] in reference to Western zone.Conclusion: A large proportion of women birth at home. Unskilled providers such as traditional birth attendants (TBAs), relatives or friends attend most of them. Predictors for home-based childbirth were lack of formal education, poor access to communication, poor uptake of antenatal visits, low socio-economic status, and geographical zone. Innovative strategies targeting these groups are needed to increase the use of health facilities for childbirth, thereby reducing maternal and neonatal mortality in Tanzania.
A linear-time algorithm that avoids inverses and computes jackknife (leave-one-out) products like convolutions or other operators in commutative semigroups
Authors: Spouge John , Ziegelbauer Joseph M. , Gonzalez Mileidy 
Published: July 2020

Abstract
Background: Data about herpesvirus microRNA motifs on human circular RNAs suggested the following statistical question. Consider independent random counts, not necessarily identically distributed. Conditioned on the sum, decide whether one of the counts is unusually large. Exact computation of the p-value leads to a specific algorithmic problem. Given elements in a set with the closure and associative properties and a commutative product without inverses, compute the jackknife (leave-one-out) products ( ).Results: This article gives a linear-time Jackknife Product algorithm. Its upward phase constructs a standard segment tree for computing segment products like ; its novel downward phase mirrors the upward phase while exploiting the symmetry of and its complement . The algorithm requires storage for elements of and only about products. In contrast, the standard segment tree algorithms require about products for construction and products for calculating each , i.e., about products in total; and a naïve quadratic algorithm using element-by-element products to compute each requires products.Conclusions: In the herpesvirus application, the Jackknife Product algorithm required 15 minutes; standard segment tree algorithms would have taken an estimated 3 hours; and the quadratic algorithm, an estimated 1 month. The Jackknife Product algorithm has many possible uses in bioinformatics and statistics.
Plasma, Urine and Tissue Concentrations of Flunixin and Meloxicam in Pigs
Authors: Nixon Emma , Mays Travis P. , Routh Patricia A. , Yeatts James L. , Fajt Virginia R. , Hairgrove Thomas , Baynes Ronald 
Published: July 2020

Abstract
Background: The objective of this study was to determine the renal clearance of flunixin and meloxicam in pigs and compare plasma and urine concentrations and tissue residues of these drugs. Urine clearance is important for livestock show animals where urine is routinely tested for these drugs. Fourteen Yorkshire/Landrace cross pigs were housed in individual metabolism cages to facilitate urine collection. This is a unique feature of this study compared to other reports. Animals into received either 2.2 mg/kg flunixin or 0.4 mg/kg meloxicam via intramuscular injection and samples analyzed by mass spectrometry. Pigs were euthanized when drugs were no longer detected in urine and liver and kidneys were collected to quantify residues.Results: Drug levels in urine reached peak concentrations between 4 and 8 h post-dose for both flunixin and meloxicam. Flunixin urine concentrations were higher than maximum levels in plasma. Urine concentrations for flunixin and meloxicam were last detected above the limit of quantification at 120 h and 48 h, respectively. The renal clearance of flunixin and meloxicam was 4.72 ± 2.98 mL/h/kg and 0.16 ± 0.04 mL/h/kg, respectively. Mean apparent elimination half-life in plasma was 5.00 ± 1.89 h and 3.22 ± 1.52 h for flunixin and meloxicam, respectively. Six of seven pigs had detectable liver concentrations of flunixin (range 0.0001-0.0012 μg/g) following negative urine samples at 96 and 168 h, however all samples at 168 h were below the FDA tolerance level (0.03 μg/g). Meloxicam was detected in a single liver sample (0.0054 μg/g) at 72 h but was below the EU MRL (0.065 μg/g). Conclusions: These data suggest that pigs given a single intramuscular dose of meloxicam at 0.4 mg/kg or flunixin at 2.2 mg/kg are likely to have detectable levels of the parent drug in urine up to 2 days and 5 days, respectively, after the first dose, but unlikely to have tissue residues above the US FDA tolerance or EU MRL following negative urine testing. This information will assist veterinarians in the therapeutic use of these drugs prior to livestock shows and also inform livestock show authorities involved in testing for these substances.
Reducing veterans' risk for suicidal behaviors: A qualitative study to inform development of the RECLAIM health promotion program
Authors: Shue Sarah , Brosmer Jayme , Matthias Marianne 
Published: July 2020

Abstract
Background: In an effort to reduce the high rate of suicide among post-9/11 veterans, a collaborative team within the Department of Veterans Affairs (VA) has developed a holistic community-based health promotion program designed to facilitate social and self-connectedness. The purpose of this study was to elicit veteran and stakeholder feedback to prepare the program for piloting and implementation.Methods: Focus groups and interviews were conducted with post-9/11 veterans and veteran stakeholders (e.g., VA clinicians) to elicit feedback regarding the health promotion program. Focus groups and interviews were audio-recorded and transcribed. Qualitative thematic analysis identified key themes emerging from the focus groups and interviews.Results: Seven focus groups (3 Veteran groups, 4 stakeholder groups) and 3 interviews (2 Veterans, 1 stakeholder) were conducted with 41 participants (14 veterans, 27 stakeholders). Overall, participants had a positive perception of the program. Thematic analysis revealed shared perspectives that provided insight into 1) enhancing program recruitment and retention, 2) the perceived ability of a health promotion program to provide more holistic, veteran-centered care, and 3) using health promotion programs to help veterans establish structure in their daily lives.Conclusions: Findings indicated an overall acceptance of the program, and participants’ perspectives on how to reduce barriers and enhance facilitators can inform the development of a larger-scale health promotion program that can be tested through future research. While discussion questions were specifically focused on the program in this study, findings can be considered more broadly for the design and implementation of related programs to effectively improve the health and wellness of post-9/11 veterans.