bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude and self-efficacy program intended to improve public health professionals’ ability to identify and manage perinatal depressive symptoms: A quasi-experimental study
Authors: Phoosuwan Nitikorn , Lundberg Pranee C. 
Published: December 2020

Abstract
Background: During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms.Method: The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used. Results: Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback.Conclusion: The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.
ECG-based Characteristics of Death or Re-infarction on the 12-Lead or 15-Lead ECG among UA/NSTEMI Patients: A Protocol for a Systematic Review and Meta-Analysis
Authors: Dzikowicz Dillon J , Mulligan Darcey H. , Carey Mary G. 
Published: December 2020

Abstract
BackgroundThe incidence of unstable angina/ non-ST elevation MI (UA/NSTEMI) continues to rise, and despite treatment advancements the risks of death and re-infarction persist. The electrocardiogram (ECG) remains the first assessment of myocardial ischemia caused by UA/NSTEMI, and is performed within the first 10-minutes of emergency presentation. Once ischemia is identified on the ECG, interventions are delivered timely to decrease the risk of death and re-infarction. Since the ECG informs intervention decisions, it is crucial providers understand the prognostic value of individual characteristics on the ECG. However, characteristics on ECG are limited due to low sensitivity though newer research has aimed to overcome these limitations. This is the protocol for a systematic review and meta-analysis that will assess the significance of individual characteristics on the ECG for predicting death and re-infarction among UA/NSTEMI patients, and identify remaining gaps in clinical understanding of ECG.MethodsThis is the protocol for a systematic review and meta-analysis that will be conducted to assess the prognostic value of specific characteristics on the ECG in the emergency department for predicting re-infarction and death. Electronic databases and specific journals will be searched using predefined search terms to identify relevant studies. Eligible studies will include peer-reviewed research articles with empirical findings on the risk of re-infarction and death based on individual characteristics on the ECG. To be inclusive, we will assess characteristics on both the 12-lead and 15-lead ECG. Methodological quality of will be assessed with the Newcastle-Ottawa Quality Assessment Scale and GRADE criteria. A random effects meta-analysis and exploratory meta-regression will be conducted. Citations will be managed using EndNote X9. Meta-Essentials package for Microsoft Excel and STATA will be used to compute statistics.Discussion This study will systematically evaluate and quantitatively assess the evidence available on the prognostic value of individual characteristics on the ECG for the risk of death and re-infarction among UA/NSTEMI patients. By conducting this study, we will inform clinicians about the significance of characteristics on the ECG to better inform treatment decisions for UA/NSTEMI patients. Registration This systematic review and meta-analysis is registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID CRD42020158491).
Prevalence And Predictors Of Diabetes Mellitus Among Persons Living With HIV: A Retrospective Cohort Study Conducted In 4 Public Healthcare Facilities In Kwazulu-Natal
Authors: Umar David Mohammed , Naidoo Panjasaram 
Published: December 2020

Abstract
Background: Diabetes mellitus is a chronic non-infectious medical condition which is evident by raised levels of glucose in the blood, because the body cannot produce any or enough of the hormone insulin or use insulin effectively. Diabetes, if not well managed leads to complications such as neuropathy, retinopathy, nephropathy which can be fatal. Some of the factors that predisposes to diabetes include older age, higher body mass index, heredity and hypertension. With the availability of HAART for managing HIV/AIDS infection, life span of persons living with HIV (PLWHIV) has increased significantly. With increased longevity, the aging population of PLWHIV also face chronic diseases such as diabetes in addition to HIV. The burden of both HIV and diabetes is high in South Africa, particularly in KwaZulu-Natal. Nevertheless, the prevalence of diabetes among PLWHIV in KwaZulu-Natal and its predictors is not well understood. Therefore, this study was conducted to determine the prevalence, predictors of diabetes and the outcome of managing diabetes among PLWHIV.Methods: This retrospective cohort study was conducted in four public health care facilities in KwaZulu-Natal with a total sample size of 1203 after ethical approval and informed consent were obtained. A pretested questionnaire and hospital patient charts were used to collect data. SPSS version 26 was used to analyze the data using descriptive statistics and logistic regression. Results: The prevalence of diabetes among PLWHIV was 9%. Just over 47% of those who had diabetes, had uncontrolled blood sugar, with a mean fasting blood sugar (FBS) of 11.7 mmol/L. The predictors of diabetes among PLWHIV were, male gender and older age. Male PLWHIV had 65% less chances of having diabetes and those who were between the ages of 18 and 48 years were 88% less probable to have diabetes compared to those who were older than 48 years. Conclusion: Public sector health care facilities in KwaZulu-Natal need to do much more to manage diabetes in PLWHIV in order to prevent diabetic complications and possible negative impact on the outcome of HIV management.
Interaction study of Pasteurella multocida with culturable aerobic bacteria isolated from porcine respiratory tracts using coculture in conditioned media
Authors: Hanchanachai Nonzee , Chumnanpuen Pramote , E-KOBON Teerasak 
Published: December 2020

Abstract
Background: The porcine respiratory tract harbours multiple microorganisms, and the interactions between these organisms could be associated with animal health status. Pasteurella multocida is a culturable facultative anaerobic bacterium isolated from healthy and diseased porcine respiratory tracts. The interaction between P. multocida and other aerobic commensal bacteria in the porcine respiratory tract is not well understood. This study aimed to determine the interactions between porcine P. multocida capsular serotype A and D strains and other culturable aerobic bacteria isolated from porcine respiratory tracts using a coculture assay in conditioned media followed by calculation of the growth rates and interaction parameters.Results: One hundred and sixteen bacterial samples were isolated from five porcine respiratory tracts, and 93 isolates were identified and phylogenetically classified into fourteen genera based on 16S rRNA sequences. Thirteen isolates from Gram-negative bacterial genera and two isolates from the Gram-positive bacterial genus were selected for coculture with P. multocida. From 17x17 (289) interaction pairs, the majority of 220 pairs had negative interactions indicating competition for nutrients and space, while 17 pairs were identified as mild cooperative or positive interactions indicating their coexistence. All conditioned media, except those of Acinetobacter, could inhibit P. multocida growth. Conversely, the conditioned media of P. multocida also inhibited the growth of nine isolates plus themselves.Conclusion: Negative interaction was the major interactions among the coculture of these 15 representative isolates and the coculture with P. multocida. The conditioned media in this study might be further analysed to identify critical molecules and examined by the in vivo experiments. The study proposed the possibility of using these molecules in conditioned media to control P. multocida growth.
Effect of real-time ultrasound imaging for biofeedback on trunk muscle contraction in healthy subjects: a preliminary study
Authors: Lin Shanshan , Zhu Bo , Zheng Yiyi , Huang Guozhi , Zeng Qing , Wang Chuhuai 
Published: December 2020

Abstract
Background: Real-time ultrasound imaging (RUSI) has been increasingly used as a form of biofeedback when instructing and re-training muscle contraction. However, the effectiveness of the RUSI on a single sustained contraction of the lumbar multifidus (LM) and transversus abdominis (TrA) has rarely been reported. This preliminary study aimed to determine if the use of RUSI, as visual biofeedback, could enhance the ability of activation and continuous contraction of the trunk muscles including LM and TrA.Methods: Forty healthy individuals were included and randomly assigned into the experimental group and control group. All subjects performed a preferential activation of the LM and/or TrA (maintained the constraction of LM and/or TrA for 30 seconds and then relaxed for two minutes), while those in the experimental group also received visual feedback provided by RUSI. The thickness of LM and/or TrA at rest and during contraction (Tc-max, T15s, and T30s) were extracted and recorded. The experiment was repeated three times.Results: No significant differences were found in the thickness of LM at rest (P > 0.999), Tc-max (P > 0.999), and T15s (P = 0.414) between the two groups. However, the ability to recruit LM muscle contraction differed between groups at T30s (P = 0.006), with subjects in the experimental group that received visual ultrasound biofeedback maintaining a relative maximum contraction. Besides, no significant differences were found in the TrA muscle thickness at rest (P > 0.999) and Tc-max (P > 0.999) between the two groups. However, significant differences of contraction thickness were found at T15s (P = 0.031) and T30s (P = 0.010) between the two groups during the Abdominal Drawing-in Maneuver (ADIM), with greater TrA muscle contraction thickness in the experimental group.Conclusions: RUSI can be used to provide visual biofeedback, which can promote continuous contraction, and improve the ability to activate the LM and TrA muscles in healthy subjects.
Maternal Obesity Influences Birth Weight more than Gestational Diabetes
Authors: Alfadhli Eman M 
Published: December 2020

Abstract
BACKGROUNDMaternal obesity and gestational diabetes (GDM) are commonly encountered during pregnancy. Both conditions are independently associated with unfavorable pregnancy consequences. The objective of this study was to compare the effects of obesity and GDM on birth weight, macrosomia, and other adverse pregnancy outcomes.METHODSThis cohort study involved 531 women with a singleton pregnancy attending the Maternity and Children’s Hospital, Medina, Saudi Arabia, between June 2014 and June 2015. Participants underwent a 75-g oral glucose tolerance test between 24 and 28 weeks. The International Association of Diabetes and Pregnancy Study Groups criteria were used for GDM diagnosis. BMI was assessed at the first antenatal visit, and obesity was defined as a BMI ≥30.0 kg/m2. All women were followed up until delivery. Women were divided into 4 groups: non-GDM nonobese (reference group), GDM nonobese, obese non-GDM, and obese GDM. Clinical characteristics and adverse pregnancy outcomes were compared.RESULTSThe mean age and BMI of the participants were 30.5 years and 29.3 kg/m2, respectively. GDM was diagnosed in 50.2% of the participants, and obesity was diagnosed in 47.8% of the participants. Obese women with GDM were the oldest and heaviest among all women. The mean birth weight increased in order among the four groups; it was highest in the infants in the obese GDM group, followed by those in the obese non-GDM, GDM nonobese and reference groups. Obesity and GDM alone or in combination were associated with higher rates of macrosomia and cesarean deliveries than the reference group. Neonatal intensive care unit (NICU) admission was higher in infants in the GDM nonobese and obese GDM groups. The frequency of low Apgar score was significantly higher in infants in the obese GDM group than in infants in the reference group.CONCLUSIONSMaternal obesity seems to influence birth weight more than GDM, while GDM is associated with a greater risk of admission to the NICU. The combination of both conditions is associated with the greatest risk of adverse pregnancy outcomes.
Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics
Authors: Mremi Irene , George Janeth , Rumisha Susan F. , Sindato Calvin , Mboera Leonard E.G. , Kimera Sharadhuli I. 
Published: December 2020

Abstract
Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: Three databases were searched for eligible articles: HINARI, PubMed, and advanced Google Scholar databases. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. A total of 1,809 articles were identified using key descriptors and screened at two stages, and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region, and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions, while 42 studies evaluated the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements, mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilised and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.
Exosomes derived from miR-301a-3p-overexpressing adipose-derived mesenchymal stem cells reverse hypoxia-induced erectile dysfunction in rat models
Authors: Liang Li , Zheng Dachao , Lu Chao , Xi Qinghong , Bao Hua , Li Wengfeng , Gu Yufei , Mao Yuanshen , Xu Bin , Gu Xin 
Published: December 2020

Abstract
Background: Erectile dysfunction (ED) has often been observed in patients with obstructive sleep apnea (OSA). Research on adipose-derived mesenchymal stem cells (ADSCs)-derived exosomes has shown that they have significant therapeutic effects in many diseases including ED. Methods: In this study, ED was induced in Sprague Dawley (SD) rats using chronic intermittent hypoxia (CIH) exposure. CIH-mediated influences were then measured in the corpus cavernous smooth muscle cells (CCSMCs). Results: Our data showed that miR-301a-3p-enriched exosomes treatment significantly recovered erectile function in rats and CCSMCs by promoting autophagy and inhibiting apoptosis. The treatment also significantly recovered the level of alpha Smooth Muscle Actin (α-SMA) in rats and CCSMCs. Bioinformatics predicted that Phosphatase and tensin homolog (PTEN) and Toll-like receptor 4 (TLR4) might be targets of miR-301a-3p. Conclusions: Our results indicate that PTEN-overexpression vectors or TLR4-overexpression vectors reverse the therapeutic effects achieved by miR-301a-3p in CCSMCs indicating that PTEN/hypoxia inducible factor-1 alpha (HIF-1α) and TLR4 signaling pathways play key roles in the progression of ED. The findings in this study suggest that miR-301a-3p should be considered as a new therapeutic target for treating ED associated with OSA.
Evidence for Implementation of Interventions to Promote Mental Health in the Workplace: A Systematic Scoping Review Protocol
Authors: Paterson Charlotte , Leduc Caleb , Maxwell Margaret , Aust Birgit , Amann Benedikt L. , Cerga-Pashoja Arlinda , Coppens Evelien , Couwenbergh Chrisje , O’Connor Cliodhna , Arensman Ella , Greiner Birgit A. 
Published: December 2020

Abstract
Background: Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create mental health-supportive workplaces, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve their quality and evaluation and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. Methods and analysis: A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL, Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool, and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. Discussion: This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base.
Establishment of an evaluation index system of competencies for graduating students in general practice medicine
Authors: Zhao Rui , Liu Feng , zhu kun 
Published: December 2020

Abstract
Background: The competencies of graduating students in general practice medicine have attracted attention. This study aimed to construct an evaluation index system of competencies for graduating students in general practice medicine and to promote the reform and optimization of training programs for general medicine talent in colleges.Methods: The two-round Delphi method was used to determine the evaluation index system of competencies for graduating students in general practice medicine, and the analytic hierarchy process (AHP) was used to calculate the weights of all levels of elements.Results: The evaluation index system of competencies for graduating students in general practice medicine was established with 3 primary factors, 9 secondary factors and 32 tertiary factors. The Delphi results revealed that the active coefficient of experts was 1 and the authority coefficient was 0.858. The 3 primary factors were knowledge level, job skills and professionalism with weights of 0.1532, 0.4207 and 0.4261, respectively. Among the secondary factors, the top three weight coefficients were professional ethics (0.2614), community practice (0.1526) and communication skills (0.1308). Among tertiary factors, "scientific research" exhibited the lowest value with a weight coefficient of 0.0049.Conclusion: In this study, we constructed an evaluation index system of competencies for graduating students in general practice medicine. The consensus on the content of the competencies of graduating students in general practice medicine suggests that these elements are necessary for those who will become general practitioners. This system can be used as the basis to evaluate the ability of graduating students in general practice medicine and provide guidance for the cultivation and evaluation of general medicine talent.