bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal analysis of serum microRNAs as predictors of cirrhosis regression during treatment of hepatitis B virus infection
Authors: Orr Cody , Myers Rob , Li Biao , Jiang Zhaoshi , Flaherty John , Gaggar Anuj , Meissner Eric G. 
Published: April 2020

AbstractBackground and AimsMost patients with cirrhosis induced by chronic HBV infection experience fibrosis regression after long‐term antiviral treatment, while some remain cirrhotic. Fibrosis regression is associated with lower odds of developing hepatic decompensation and hepatocellular carcinoma, but mechanisms impacting differential fibrosis regression between individuals are unclear. We asked whether soluble molecules, including serum microRNAs, could serve as biomarkers of fibrosis regression.MethodsWe analysed cryopreserved sera from clinical trials in which cirrhotic HBV‐infected patients (baseline Ishak fibrosis score of 5‐6) received 240 weeks of nucleotide analogue treatment. Liver biopsies at week 240 in these trials showed 71/96 patients (74%) had fibrosis regression (Ishak ≤ 4) while 25/96 (26%) remained cirrhotic (Ishak 5‐6). We quantified inflammatory markers (CXCL10, soluble CD163) and miRNAs (n = 179) from serum at baseline, week 48 and week 240 of treatment in a sub‐cohort of patients with (n = 14) or without (n = 14) fibrosis regression.ResultsCXCL10, sCD163 and miRNAs previously associated with HBV replication and inflammation decreased during treatment but did not differ based on fibrosis regression. Two miRNAs (miR‐421 and miR‐454‐3p) had lower baseline expression in patients with subsequent fibrosis regression. In all, 27 miRNAs differed at week 240 and had higher expression in patients with fibrosis regression (eg miR‐199a‐3p, miR‐423‐3p, miR‐142‐3p, miR‐let‐7d‐5p). Several miRNAs (miR‐141‐3p, let‐7d‐5p) that correlated with regression have previously been implicated in the pathophysiology of non‐alcoholic steatohepatitis.ConclusionsIn cirrhotic patients with chronic HBV infection treated with antiviral therapy, serum miRNAs have differential expression based on fibrosis regression, suggesting potential utility as biomarkers.
What's in a name? Renaming ‘NAFLD’ to ‘MAFLD’
Authors: Fouad Yasser , Waked Imam , Bollipo Steven , Gomaa Ahmed , Ajlouni Yousef , Attia Dina 
Published: April 2020

AbstractIn medicine, language matters and the words used to name and describe a disease can have a profound impact on patients and their families. Over the last two decades, many criticisms have been voiced about the nomenclature and definition of non‐alcoholic fatty liver disease (NAFLD) in regards not only to the prominent role that alcohol plays in the definition but also on the negative impacts of the nomenclature including trivialization, stigmatization and less consideration of the disease in health policy. Recently, a consensus of international experts proposed that the disease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or ‘MAFLD’. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery. Here we review the history of, and definitions of MAFLD in the context of advancing our understanding of the pathogenesis of the disease. We also address the reasons, signals, promises, challenges and the way going forward from the name change from various stakeholder perspectives.
Reading Aloud Narrative Material as a Means for the Student's Cognitive Empowerment
Authors: Bartolucci Marco , Batini Federico 
Published: April 2020

ABSTRACTListening to stories and brain processing of narrative material activates many areas devoted not only to the linguistic processing. In this sense, it could be hypothesized that if this activity would be integrated within the school curricula, it could bring benefits in terms of understanding the text as well as in basic essential cognitive dimensions. In a series of studies with different age groups, we investigated the effects of an intensive training in narrative listening, through different tools such as the standardized tests of understanding of the text. We also used a neuropsychological battery investigating basic cognitive processes (cognitive assessment system) that are directly related to the ability of text comprehension. Results show a significant improvement in all tests for all age groups in the experimental groups, in comparison with the control groups.
Association between prenatal depressive symptoms and eczema in infants: The Born in Guangzhou Cohort Study
Authors: Wei Dongmei , Au Yeung Shiu Lun , Lu Minshan , Xiao Wanqing , Lu Jinhua , Shen Songying , Lam Kin Bong Hubert , Qiu Xiu 
Published: April 2020

AbstractBackgroundEczema is a growing threat on infants’ health, and the role of maternal depression in the risk of eczema's early onset is unclear. This study aimed to examine the associations of different exposure timing of prenatal depressive symptoms with offspring's eczema in infancy.MethodsThe study was part of the ongoing prospective Born in Guangzhou Cohort Study. Maternal depressive symptoms were assessed at both early (<20th week of gestation) and late pregnancy (≥33rd week of gestation to delivery) using the Self‐Rating Depression Scale. Information on the diagnosis of eczema was collected when the children were 1 year old. Multivariable logistic regression was used to examine the association between prenatal depressive symptoms and infants’ eczema and test for moderation by parental history of allergic diseases.ResultsIn this population, 7.7% (447/5825) of mothers experienced persistent depressive symptoms during pregnancy, 10.1% (590/5825) had depressive symptoms only at early pregnancy, and 8.4% (489/5825) of women experienced depressive symptoms only at late pregnancy. After adjusting for potential confounders, higher risks of eczema were observed in infants of mothers with persistent prenatal depressive symptoms when compared to those children without maternal depressive symptoms throughout pregnancy (OR: 1.55, 95% CI 1.19‐2.03). These associations were marginally more pronounced among children in families without parents affected by allergic diseases than in other families (P for interaction = .064 for courses of prenatal depressive symptoms).ConclusionPersistent maternal depressive symptoms during pregnancy increased the risk of infants’ eczema, especially in children without family history of allergic diseases. These associations, if proved to be causal, could be an intervention target not only to improve women's health but also to prevent offspring's eczema.
The case of missing skin: Congenital Volkmann ischemic contracture
Authors: Coerdt Kathleen M. , Guo Emily L. , Saardi Karl M. , Habeshian Kaiane A. 
Published: April 2020

AbstractCongenital Volkmann ischemic contracture (CVIC) is an exceedingly rare neonatal compartment syndrome caused by intrauterine ischemia and external compression. It presents at birth with necrotic cutaneous lesions and neurologic impairment, typically in a distal upper extremity. Diagnosis and treatment are often delayed in neonates, leading to long‐term neurologic sequelae. We present a rare case of CVIC in order to raise awareness of its presentation and management in hopes of improving outcomes.
Local Food and Civic Engagement: Do Farmers Who Market Local Food Feel More Responsible for Their Communities?
Authors: Schoolman Ethan D. 
Published: April 2020

AbstractDo farmers who participate in local food systems attach greater importance to civic engagement than farmers whose livelihood is not tied to the vitality of local markets? The literature on local food as a social movement continues to paint a picture of local food systems as contributing to, and benefiting from, rich networks of civil society groups. Yet to date, few studies have directly addressed the question of whether marketing local food is actually associated with higher levels of civic engagement among farmers. In this paper, I draw on local capitalism theory to identify two different mechanisms—depth of economic reliance on local markets, and breadth of social networks related to local food sales—that might spur farmers who market local food to feel more responsible for their communities. Then, using data from a large‐scale survey of specialty crop growers, I explore whether a relationship exists between farmer involvement with local food markets and attitudes toward civic engagement. Results suggest that while farmers strongly committed to local food markets attach greater importance to civic engagement, participation in multiple categories or kinds of local food supply chains is not necessarily associated with stronger civic values.
The Dutch Individualised Care Scale for patients and nurses – a psychometric validation study
Authors: Theys Sofie , Van Hecke Ann , Akkermans Reinier , Heinen Maud 
Published: April 2020

Aims and objectivesTranslating and psychometrically assessing the Individualised Care Scale (ICS) for patients and nurses for the Flemish and Dutch healthcare context.BackgroundIndividualised care interventions have positive effects on health outcomes. However, there are no valid and reliable instruments for evaluating individualised care for the Flemish and Dutch healthcare context.DesignPsychometric validation study.Setting and participantsIn Flemish hospitals, data were collected between February and June 2016, and in Dutch hospitals, data were collected between December 2014 and May 2015. Nurses with direct patient contact and a working experience of minimum 6 months on the wards could participate. Patient inclusion criteria were being an adult, being mentally competent, having an expected hospital stay of minimum 1 day, and being able to speak and read the Dutch language. In total, 845 patients and 569 nurses were included.MethodsThe ICS was translated into Dutch using a forward–backward translation process. Minimal linguistic adaptations to the Dutch ICS were made to use the scale as a Flemish equivalent. Omega, Cronbach’s Alpha, mean inter‐item correlations and standardised subscale correlations established the reliability and confirmatory factor analysis the construct validity of the ICS.ResultsInternal consistency using Omega (Cronbach’s Alpha) ranged from 0.83 to 0.96 (0.82–0.95) for the ICS‐Nurse and from 0.88 to 0.96 (0.87–0.96) for the ICS‐Patient. Fit indices of the confirmatory factor analysis indicated a good model fit, except for the root mean square error of approximation, which indicated only moderate model fit.ConclusionThe Dutch version of the ICS showed acceptable psychometric performance, supporting its use for the Dutch and Flemish healthcare context.Relevance to clinical practiceKnowledge of nurses’ and patients’ perceptions on individualised care will aid to target areas in the Dutch and Flemish healthcare context in which work needs to be undertaken to provide individualised nursing care.
Injuries and illnesses in Swedish Paralympic athletes—A 52‐week prospective study of incidence and risk factors
Authors: Fagher Kristina , Dahlström Örjan , Jacobsson Jenny , Timpka Toomas , Lexell Jan 
Published: April 2020

IntroductionSports‐related injuries and illnesses in Paralympic sport (SRIIPS) are a concern, but knowledge about the etiology and risk factors is limited. The aim of this study was to describe the annual incidence, type, and severity of injuries and illnesses among Swedish Paralympic athletes and to assess risk factors.MethodsSwedish Paralympic athletes (n = 107) self‐reported SRIIPS every week during 52 weeks using an eHealth application. Incidence proportions (IP) and incidence rates (IR) were used as measures of disease burden. Time‐to‐event methods (Kaplan‐Meier and Cox regression) were used to identify risk factors.ResultsThe annual IP for injury was 68% and for illness 77%. The injury IR was 6.9/1000 hours and the illness IR 9.3/1000 hours. The median time to injury was 19 weeks (95% CI: 10.5‐27.4) and to illness 9 weeks (95% CI: 1.4‐16.6). Most injuries occurred during training, and 34% were classified as severe (≥21 days of time loss). An increased injury risk was observed among athletes in team sports (HR 1.88; 95% CI: 1.19‐2.99), athletes with a previous severe injury (HR 2.37; 95% CI: 1.47‐3.83), and male athletes (HR 1.76; 95% CI: 1.06‐2.93). The most common illness type was infection (84%). Athletes in team sports (HR 1.64; 95% CI: 1.05‐2.54) and males with a previous illness (HR = 2.13; 95% CI: 1.04‐4.36) had a higher illness risk.ConclusionParalympic athletes report a high incidence of injuries and illnesses over time. This emphasizes the need to develop preventive strategies of SRIIPS and optimize medical services for this heterogeneous athlete population.
Accelerometer-Measured Physical Activity Levels and Fatigue in Older Women
Authors: Zaslavsky Oleg , Su Yan , Rillamas-Sun Eileen , Roopsawang Inthira , LaCroix Andrea Z. 
Published: April 2020

The authors examined whether the associations between physical activity (PA) levels and fatigue vary by body mass index and physical performance, and whether substituting sedentary time (ST) with low light PA, high light PA, and moderate to vigorous PA (MVPA) was associated with better mean fatigue scores. In total, 6,111 participants (aged 65 years and older) were from the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health Study. PA levels were from a hip-worn GT3X accelerometer. Overall fatigue, energy, and weariness subdomains were from the RAND-36 Vitality subscale. Isotemporal substitution models examined the time-substitution effects. Interactions were observed between MVPA and short physical performance battery performance measure (p < .05). Substituting ST with 34.3 min of MVPA was associated on average with a 1.63-point improvement in fatigue score. Substituting ST with 50.2 min of low light PA and 34.3 min of MVPA was associated on average with an energy score improvement of 1.18 and 2.06 points respectively. Substituting ST with 34.3 min of MVPA was associated on average with a 1.08-point improvement in weariness score (p < .05 for all).
Time-critical conditions: assessment of burden and access to care using verbal autopsy in Agincourt, South Africa
Authors: Fraser Andrew , Newberry Le Vay Jessica , Byass Peter , Tollman Stephen , Kahn Kathleen , D'Ambruoso Lucia , Davies Justine I 
Published: April 2020

BackgroundTime-critical conditions (TCC) are estimated to cause substantial mortality in low and middle-income countries. However, quantification of deaths and identification of contributing factors to those deaths are challenging in settings with poor health records.AimTo use verbal autopsy (VA) data from the Agincourt health and sociodemographic surveillance system in rural South Africa to quantify the burden of deaths from TCC and to evaluate the barriers in seeking, reaching and receiving quality care for TCC leading to death.MethodologyDeaths from 1993 to 2015 were analysed to identify causality from TCC. Deaths due to TCC were categorised as communicable, non-communicable, maternal, neonatal or injury-related. Proportion of deaths from TCC by age, sex, condition type and temporal trends was described. Deaths due to TCC from 2012 to 2015 were further examined by circumstances of mortality (CoM) indicators embedded in VA. Healthcare access, at illness onset and during the final day of life, as well as place of death, was extracted from free text summaries. Summaries were also analysed qualitatively using a Three Delays framework to identify barriers to healthcare.ResultsOf 15 305 deaths, 5885 (38.45%) were due to TCC. Non-communicable diseases were the most prevalent cause of death from TCC (2961/5885 cases, 50.31%). CoM indicators highlighted delays in a quarter of deaths due to TCC, most frequently in seeking care. The most common pattern of healthcare access was to die outwith a facility, having sought no healthcare (409/1324 cases, 30.89%). Issues in receipt of quality care were identified by qualitative analysis.ConclusionTCCs are responsible for a substantial burden of deaths in this rural South African population. Delays in seeking and receiving quality care were more prominent than those in reaching care, and thus further research and solution development should focus on healthcare-seeking behaviour and quality care provision.
Validity and feasibility of a self-administered home vision examination in Yueqing, China: a cross-sectional study
Authors: Ge Zhengyan , Li Linshan , Lohfeld Lynne , Lu Chunjie , Congdon Nathan , Lin Sigeng , Deng Yuxuan , Lan Yuan , Zhang Shaodan , Hou Laurence , Zhou Weihe , Cui Lele , Qu Jia , Liang Yuanbo 
Published: April 2020

ObjectiveTo investigate the validity and feasibility of a self-administered home vision examination programme in China.DesignCross-sectional study.SettingYueqing, China.ParticipantsA two-stage convenience sampling procedure was used to randomly select 600 households from 30 communities participating in the Yueqing Eye Study (YES). The aim of YES is to encourage home-based vision screening, reporting of visual acuity (VA) annually through social media and encouraging people to attend follow-up clinic appointments as a way to improve eye care access for adults with VA ≤+0.5 log of the minimum angle of resolution (logMAR).InterventionsHousehold screeners (one per household) who tested other family members’ VA completed a questionnaire on family structure, demographic information and knowledge about screening procedures. Other family members then underwent confirmatory VA testing by researchers.Outcome measuresThe completion rate of home-based VA screening, its sensitivity and specificity were used to evaluate validity. Factors that determined whether families participated in the self-VA screening were used to evaluate feasibility.Results345 (66%) of the 523 (87.2%) households with valid data form their home-based vision examinations also were retested by researchers. There was no statistically significant difference in scores on the family-administerd or researcher-administerd VA test (VA≤+0.5 logMAR, p=0.607; VA >+0.5 logMAR, p=0.612). The sensitivity and specificity of home-based vision screening were 80.5% (95% CI 70.2% to 86.9%) and 95.1% (95% CI 92.6% to 96.8%), respectively. 14.7% (77/523) of tested respondents had VA ≤+0.5 logMAR. Predictors of performing home screening for VA remaining in regression models included higher economic status (‘fair and above’ vs ‘poor’: OR 1.74; 95% CI 1.08 to 2.76; p=0.022), age (<45 years vs ≥45 years: OR 0.46; 95% CI 0.25 to 0.85; p=0.014) and living in a nuclear (OR 5.17; 95% CI 2.86 to 9.36; p<0.001) or extended family (OR 8.37; 95% CI 4.93 to 14.20; p<0.001).ConclusionSelf-administered home vision screening is reliable and highly accepted by Chinese adults.
Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study
Authors: Shi Yu , Xue Haifeng , Ma Yuanshuo , Wang Licheng , Gao Tian , Shi Lei , Wang Yang , Cui Mei , Wang Chao , Yang Xi , Liu Ming , Fan Lihua , Yan Guanyun 
Published: April 2020

ObjectivesThis study had three objectives: (1) describe the prevalence of occupational exposure among Chinese medical personnel in detail, (2) verify the partial mediating role of work environment satisfaction in the relationship between occupational exposure and job satisfaction, and (3) examine if stress symptoms moderate the relationship between occupational exposure and job satisfaction.DesignA large cross-sectional online survey was conducted in July 2018 in China.SettingA survey was conducted in 54 cities across 14 provinces of China.ParticipantsA total of 12 784 questionnaires were distributed, and 9924 healthcare workers (HCWs) completed valid questionnaires. The response rate was 77.63%.Outcome measuresA confidential questionnaire was distributed to HCWs. The relationships among and the mechanisms of the variables were explored using descriptive statistical analyses, Pearson’s correlation coefficient and multiple linear regression analysis.ResultsThe most common occupational exposures among HCWs in the past 12 months were psychosocial and organisational hazards (85.93%). Overall, physicians (93.7%) and nurses (89.2%) were the main victims of occupational exposure. Occupational exposure correlated negatively with work environment satisfaction and job satisfaction, and positively with stress symptoms. Moreover, work environment satisfaction fully mediated the relationship between occupational exposure and job satisfaction, and stress symptoms moderated the relationship between occupational exposure and job satisfaction.ConclusionThe incidence of occupational exposure among HCWs is generally high. The high frequency of psychosocial and organisational hazards among physicians and nurses should be taken seriously and dealt with in a timely manner by hospital managers. The negative impact of occupational exposure on job satisfaction must be buffered by measures to reduce stress symptoms and enhance working environment satisfaction, ultimately improving the overall quality of life of HCWs and promoting comprehensive development of the medical team.
Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial
Authors: Hong Kathryn Lauren , Babiolakis Corinne , Zile Brigita , Bullen Milena , Haseeb Sohaib , Halperin Frank , Hohl Corinne M , Magee Kirk , Sandhu Roopinder K , Tian Simon Yu , Kennedy Ashley , Lobban Trudie , Mariano Zana , Dorian Paul , Angaran Paul , Evans Marilyn , Leong-Sit Peter , Glover Benedict M 
Published: April 2020

ObjectivesThe primary objective of this study was to ascertain the reasons for emergency department (ED) attendance among patients with a history of atrial fibrillation (AF).DesignAppropriate ED attendance was defined by the requirement for an electrical or chemical cardioversion and/or an attendance resulting in hospitalisation or administration of intravenous medications for ventricular rate control. Quantitative and qualitative responses were recorded and analysed using descriptive statistics and content analysis, respectively. Random effects logistic regression was performed to estimate the OR of inappropriate ED attendance based on clinically relevant patient characteristics.ParticipantsParticipants ≥18 years with a documented history of AF were approached in one of eight centres partaking in the study across Canada (Ontario, Nova Scotia, Alberta and British Columbia).ResultsOf the 356 patients enrolled (67±13, 45% female), the majority (271/356, 76%) had inappropriate reasons for presentation and did not require urgent ED treatment. Approximately 50% of patients(172/356, 48%) were driven to the ED due to symptoms, while the remainder presented on the basis of general fear or anxiety (67/356, 19%) or prior medical advice (117/356, 33%). Random effects logistic regression analysis showed that patients with a history of congestive heart failure were significantly more likely to seek urgent care for appropriate reasons (p=0.03). Likewise, symptom-related concerns for ED presentation were significantly less likely to result in inappropriate visitation (p=0.02). When patients were surveyed on alternatives to ED care, the highest proportion of responses among both groups was in favour of specialised rapid assessment outpatient clinics (186/356, 52%). Qualitative content analysis confirmed these results.ConclusionsImproved education focused on symptom management and alleviating disease-related anxiety as well as the institution of rapid access arrhythmias clinics may reduce the need for unnecessary healthcare utilisation in the ED and subsequent hospitalisation.Trial registration numberNCT03127085