bluuebunny/crossref_metadata_2025_split huggingface dataset:
An observational study of system-level changes to improve the recording of very brief advice for smoking cessation in an inpatient mental health setting
Authors: Spaducci Gilda , Richardson Sol , McNeill Ann , Pritchard Megan , Sanyal Jyoti , Healey Andy , Yates Mary , Robson Debbie 
Published: April 2020

AbstractBackgroundSmoking prevalence among people with psychosis remains high. Providing Very Brief Advice (VBA) comprising: i) ASK, identifying a patient’s smoking status ii) ADVISE, advising on the best way to stop and iii) ACT (OFFER), offering a referral to specialist smoking cessation support, increases quit attempts in the general population. We assessed whether system-level changes in a UK mental health organisation improved the recording of the provision of ASK, ADVISE, ACT (OFFER) and consent to referral to specialist smoking cessation support (ACT (CONSENT)).MethodsWe conducted a study using a regression discontinuity design in four psychiatric hospitals with patients who received treatment from an inpatient psychosis service over 52 months (May 2012–September 2016). The system-level changes to facilitate the provision of VBA comprised: A) financially incentivising recording smoking status and offer of support (ASK and ACT (OFFER)); B) introduction of a comprehensive smoke-free policy; C) enhancements to the patient electronic healthcare record (EHCR) which included C1) a temporary form to record the financial incentivisation of ASK and ACT (OFFER) C2) amendments to how VBA was recorded in the EHCR and C3) the integration of a new electronic national referral system in the EHCR. The recording of ASK, ADVISE, ACT (OFFER/CONSENT) were extracted using a de-identified psychiatric case register.ResultsThere were 8976 admissions of 5434 unique individuals during the study period. Following A) financial incentive, the odds of recording ASK increased (OR: 1.56, 95%CI: 1.24–1.95). Following B) comprehensive smoke-free policy, the odds of recording ADVICE increased (OR: 3.36, 95%CI: 1.39–8.13). Following C1) temporary recording form, the odds of recording ASK (OR:1.99, 95%CI:1.59–2.48) and recording ACT (OFFER) increased (OR: 4.22, 95%CI: 2.51–7.12). Following C3) electronic referral system, the odds of recording ASK (OR:1.79, 95%CI: 1.31–2.43) and ACT (OFFER; OR: 1.09, 95%CI: 0.59–1.99) increased. There was no change in recording VBA outcomes following C2) amendments to VBA recording.ConclusionsFinancial incentives and the recording of incentivised outcomes, the comprehensive smoke-free policy, and the electronic referral system, were associated with increases in recording individual VBA elements, but other changes to the EHCR were not. System-level changes may facilitate staff recording of VBA provision in mental health settings.
Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam
Authors: Vu Thi Hoang Lan , Bui Thi Tu Quyen , Nguyen Thi Kim Ngan , Hoang Van Minh 
Published: April 2020

Abstract
Background
This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA).

Method
This analyze used data of 3068 Vietnamese people aged 18–65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score – the indicator of individual PA – as the dependent variable.

Results
Male and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased.

Conclusion
Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.
Composition of weekly physical activity in adolescents by level of physical activity
Authors: Groffik Dorota , Fromel Karel , Badura Petr 
Published: April 2020

Abstract
Background
Physical activity (PA) in adolescence is crucial for lifelong healthy lifestyle, and attention is needed to adolescents at health risk due to insufficient PA. This study investigates the composition of weekly PA in adolescents by PA level and provides a rationale for change in their lifestyles.

Methods
The research was conducted at 66 schools in Poland between 2009 and 2016, among 949 girls and 650 boys aged 15–18 years. We used pedometers to monitor weekly PA with data assessed using the Indares web app. The participants were split into three groups by mean daily step count (lower, < 9000; middle, 9000–12,999; and higher, ≥ 13,000 steps/day), as a reliable and non-expensive indicator of PA.

Results
We did not observe statistically significant differences in composition of 7-day PA between participants with varying levels of PA, regardless of their gender (F(12,9558) = 0.60; p = 0.841; ηp2 > 0.000). The smallest differences in daily step counts by PA level were found on Mondays and the biggest on Fridays and Saturdays, in boys and girls; the differences between average school and average weekend days were most pronounced in less active girls (1677 steps/day) and boys (1886 steps/day). During the school week, the highest proportion of less active girls met the 11,000 steps/day recommendation on Fridays (21.9%), statistically significantly less than on other school days (p < 0.001). Similarly, less active boys (22.2%) had significantly less activity on Fridays than on other school days, except for Mondays (p = 0.143) Analogous pattern was apparent also in more active adolescents.

Conclusions
Less active adolescents have comparable composition of weekly PA to the more active ones but they can hardly meet the generally accepted PA recommendations. Better understanding of weekly PA composition and rates of meeting PA recommendations by day of the week can lead to more efficient interventions improving lifestyles. The recommendation of 9000 steps/day most days of the week, thus, appears appropriate for less active adolescents, as a motivating achievable goal.
Effect of mechanical ventilation versus spontaneous breathing on abdominal edema and inflammation in ARDS: an experimental porcine model
Authors: Marchesi Silvia , Hedenstierna Göran , Hata Aki , Feinstein Ricardo , Larsson Anders , Larsson Anders Olof , Lipcsey Miklós 
Published: April 2020

Abstract
Background
Mechanical ventilation (MV), compared to spontaneous breathing (SB), has been found to increase abdominal edema and inflammation in experimental sepsis. Our hypothesis was that in primary acute respiratory distress syndrome (ARDS) MV would enhance inflammation and edema in the abdomen.

Methods
Thirteen piglets were randomized into two groups (SB and MV) after the induction of ARDS by lung lavage and 1 h of injurious ventilation.
1. SB: continuous positive airway pressure 15 cmH2O, fraction of inspired oxygen (FIO2) 0.5 and respiratory rate (RR) maintained at about 40 cycles min− 1 by titrating remifentanil infusion.
2. MV: volume control, tidal volume 6 ml kg− 1, positive end-expiratory pressure 15 cmH2O, RR 40 cycles min− 1, FIO2 0.5.
Main outcomes: abdominal edema, assessed by tissues histopathology and wet-dry weight; abdominal inflammation, assessed by cytokine concentration in tissues, blood and ascites, and tissue histopathology.

Results
The groups did not show significant differences in hemodynamic or respiratory parameters. Moreover, edema and inflammation in the abdominal organs were similar. However, blood IL6 increased in the MV group in all vascular beds (p < 0.001). In addition, TNFα ratio in blood increased through the lungs in MV group (+ 26% ± 3) but decreased in the SB group (− 17% ± 3).

Conclusions
There were no differences between the MV and SB group for abdominal edema or inflammation. However, the systemic increase in IL6 and the TNFα increase through the lungs suggest that MV, in this model, was harmful to the lungs.
Effect of bisphosphonate treatment of titanium surfaces on alkaline phosphatase activity in osteoblasts: a systematic review and meta-analysis
Authors: Wehner Christian , Lettner Stefan , Moritz Andreas , Andrukhov Oleh , Rausch-Fan Xiaohui 
Published: April 2020

Abstract
Background
Bisphosphonate coating of dental implants is a promising tool for surface modification aiming to improve the osseointegration process and clinical outcome. The biological effects of bisphosphonates are thought to be mainly associated with osteoclasts inhibition, whereas their effects on osteoblast function are unclear. A potential of bisphosphonate coated surfaces to stimulate osteoblast differentiation was investigated by several in vitro studies with contradictory results. The purpose of this systematic review and meta-analysis was to evaluate the effect of bisphosphonate coated implant surfaces on alkaline phosphatase activity in osteoblasts.

Methods
In vitro studies that assessed alkaline phosphatase activity in osteoblasts following cell culture on bisphosphonate coated titanium surfaces were searched in electronic databases PubMed/MEDLINE, Scopus and ISI Web of Science. Animal studies and clinical trials were excluded. The literature search was restricted to articles written in English and published up to August 2019. Publication bias was assessed by the construction of funnel plots.

Results
Eleven studies met the inclusion criteria. Meta-analysis showed that coating of titanium surfaces with bisphosphonates increases alkaline phosphatase activity in osteoblasts after 3 days (n = 1), 7 (n = 7), 14 (n = 6) and 21 (n = 3) days. (7 days beta coefficient = 1.363, p-value = 0.001; 14 days beta coefficient = 1.325, p-value < 0.001; 21 days beta coefficient = 1.152, p-value = 0.159).

Conclusions
The meta-analysis suggests that bisphosphonate coatings of titanium implant surfaces may have beneficial effects on osteogenic behaviour of osteoblasts grown on titanium surfaces in vitro. Further studies are required to assess to which extent bisphosphonates coating might improve osseointegration in clinical situations.
Quality improvement education for medical students: a near-peer pilot study
Authors: McGeorge Elizabeth , Coughlan Charles , Fawcett Martha , Klaber Robert Edward 
Published: April 2020

Abstract
Background
Quality improvement (QI) is an essential component of modern clinical practice. Front-line professionals offer valuable perspectives on areas for improvement and are motivated to deliver change. In the UK, all junior doctors are expected to participate in QI in order to advance to the next stage of their training. However, UK undergraduates receive no standardized training in QI methods. This is perpetuated within medical schools by a lack of teaching capacity and competing priorities, and may lead to tokenistic engagement with future QI projects.

Methods
We describe a near-peer teaching programme designed to introduce students to QI methods. This pilot study was conceived and delivered in full by junior doctors and used existing resources to ensure high quality teaching content. 111 fifth-year medical students from the University of Cambridge were taught in interactive, participative workshops that encourage them to develop their own QI change ideas and projects. Core topics included the model for improvement, driver diagrams, stakeholder engagement, measurement for improvement and analysing and presenting data. Students completed surveys before and immediately after this intervention to assess their understanding of and confidence in utilizing QI methods. Questionnaires were also completed by junior doctor tutors.

Results
Analysis of questionnaires completed before and immediately after the intervention revealed statistically significant improvements in students’ self-reported understanding of QI (p < 0.05) and confidence in applying techniques to their own work (p < 0.05). Students expressed a preference for QI teaching delivered by junior doctors, citing a relaxed learning environment and greater relevance to their stage of training. Tutors reported increased confidence in using QI techniques and a greater willingness to engage with QI in future.

Conclusions
In this single-centre study, near-peer teaching produced significant improvements in students’ self-reported understanding of QI and confidence in applying QI methods. Near-peer teaching may constitute a sustainable means of teaching essential QI skills at undergraduate level. Future work must evaluate objective measures of student engagement with and competence in conducting QI.
Development and validation of data quality rules in administrative health data using association rule mining
Authors: Peng Mingkai , Lee Sangmin , D’Souza Adam G. , Doktorchik Chelsea T. A. , Quan Hude 
Published: April 2020

Abstract
Background
Data quality assessment presents a challenge for research using coded administrative health data. The objective of this study is to develop and validate a set of coding association rules for coded diagnostic data.

Methods
We used the Canadian re-abstracted hospital discharge abstract data coded in International Classification of Disease, 10th revision (ICD-10) codes. Association rule mining was conducted on the re-abstracted data in four age groups (0–4, 20–44, 45–64; ≥ 65) to extract ICD-10 coding association rules at the three-digit (category of diagnosis) and four-digit levels (category of diagnosis with etiology, anatomy, or severity). The rules were reviewed by a panel of 5 physicians and 2 classification specialists using a modified Delphi rating process. We proposed and defined the variance and bias to assess data quality using the rules.

Results
After the rule mining process and the panel review, 388 rules at the three-digit level and 275 rules at the four-digit level were developed. Half of the rules were from the age group of ≥65. Rules captured meaningful age-specific clinical associations, with rules at the age group of ≥65 being more complex and comprehensive than other age groups. The variance and bias can identify rules with high bias and variance in Alberta data and provides directions for quality improvement.

Conclusions
A set of ICD-10 data quality rules were developed and validated by a clinical and classification expert panel. The rules can be used as a tool to assess ICD-coded data, enabling the monitoring and comparison of data quality across institutions, provinces, and countries.
Qualitative exploration of perceived benefits of care and barriers influencing HIV care in trans Nzoia, Kenya
Authors: Naanyu V. , Ruff J. , Goodrich S. , Spira T. , Bateganya M. , Toroitich-Ruto C. , Otieno-Nyunya B. , Siika A. M. , Wools-Kaloustian K. 
Published: April 2020

Abstract
Background
Substantial efforts have been made to ensure people living with HIV (PLHIV) are linked to and retained in care but many challenges deter care utilization. We report perceived benefits of seeking HIV care and barriers to HIV care that were identified through a formative assessment conducted to advise the development of an alternative care model to deliver antiretroviral treatment therapy (ART) in Trans Nzoia County, Kenya.

Methods
Data were collected in 2015 through key informant interviews (KIIs), in-depth interviews (IDIs), and focus group discussions (FGDs). The study involved 55 participants of whom 53% were female. Ten KIIs provided community contextual information and viewpoints on the HIV epidemic in Trans Nzoia County while 20 PLHIV (10 male and 10 female) participated in IDIs. Twenty-five individuals living with HIV participated in four FGDs - two groups for men and two for women. Key informants were purposively selected, while every third patient above 18 years at the Kitale HIV Clinic was invited to share their HIV care experience through IDIs or FGDs. Trained research assistants moderated all sessions and audio recordings were transcribed and analyzed thematically.

Results
Findings showed that PLHIV in Trans Nzoia County used both conventional and complementary alternative care for HIV; however, public health facilities were preferred. Popular perceived benefits of adopting care were relief from symptoms and the chance to live longer. Benefits of care uptake included weight gain, renewed energy, and positive behavior change. Individual-level barriers to HIV care included lack of money and food, use of alternative care, negative side effects of ART, denial, and disclosure difficulties. At the community level, stigma, limited social support for conventional HIV treatment, and poor means of transport were reported. The health system barriers were limited supplies and staff, long distance to conventional HIV care, and unprofessional providers.

Conclusions
Diverse individual, community and health system barriers continue to affect HIV care-seeking efforts in Kenya. Appreciation of context and lived experiences allows for development of realistic care models.
Five novel PRNP gene polymorphisms and their potential effect on Scrapie susceptibility in three native Ethiopian sheep breeds
Authors: Teferedegn Eden Yitna , Yaman Yalcin , Un Cemal 
Published: April 2020

Abstract
Background
Classical scrapie susceptibility in sheep has been linked to three polymorphisms at codon 136, 154, and 171 in the prion protein gene (PRNP) whereas atypical scrapie susceptibility is related to polymorphisms at codon 141. Many other variants over the length of the PRNP have been reported. Some of the variants may play crucial roles in fighting against the emergence of a new form of scrapie disease. Scrapie surveillance, scrapie associated genotyping and PRNP characterization studies have been conducted across the globe. However, such in-depth studies have never addressed the African continent’s sheep breeds. Therefore, genotyping native Ethiopian sheep breed’s PRNP gene has socioeconomic and scientific merits. This study aimed to identify PRNP variants in three native Ethiopian sheep breeds and their potential effect on scrapie susceptibility.

Results
Five novel variants were identified in the PRNP gene of three native Ethiopian sheep breeds. Four non-synonymous heterozygous substitutions i.e. H99Q (CAC-- > CAA), H99L (CAC-- > CTA), A116E (GCA-- > GAA), A116T (GCA-- > ACA), and one synonymous N103 N (AAC-- > AAT) were detected. In addition to the novel variants, polymorphisms at codon 126,127,138,142,146,231, and 237 were also identified. The haplotype ARR was observed in Menz and Afar breeds at frequencies of 0.02 and 0.05 respectively. Neither ARR/ARR nor VRQ/VRQ genotypes were identified in the population under study.

Conclusion
Two of the novel variants at codon 99 and 103 that are placed closer to the proteinase K cleavage site and the variant at codon 116 in the palindrome region along with variants at codon 127 in glycine repeat domain may influence the conformational flexibility of prion protein. The rarity of ARR haplotype and the abundance of 141 L variant demonstrated that the present study population was less resistant to classical scrapie and less predisposed to genotype associated atypical scrapie. This study provides a valuable dataset that can be potentially integrated into selective breeding strategies during interbreeding, crossbreeding and help to take precautionary measures against scrapie.
Milk exosome-derived miRNAs from water buffalo are implicated in immune response and metabolism process
Authors: Chen Zujing , Xie Yueqin , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , Sun Jiajie 
Published: April 2020

Abstract
Background
Buffalo milk is rich in various nutritional components and bioactive substances that provide more essential health benefits to human body. Recently, exosome identified in the breast milk has been reported as a neotype nutrient and can mediate intercellular communication with exosomal miRNAs. In the present study, we therefore hypothesized that exosome-derived miRNAs from buffalo milk would play the potential physiological importance of consumption of buffalo milk.

Results
We isolated exosomes from buffalo and cow milk samples that were obtained at mid-lactation period, and the exosomal miRNA profiles were then generated using miRNA-seq. In addition, miRNAomes of pig, human and panda milk exosomes were downloaded from GEO database. Finally, a total of 27 milk exosomal miRNA profiles that included 4 buffalo, 4 cow, 8 pig, 4 human and 7 panda were analyzed using the miRDeep2 program. A total of 558 unique miRNA candidates existed across all species, and the top 10 highly expressed miRNA were evolutionarily conserved across multiple species. Functional analysis revealed that these milk enriched miRNAs targeted 400 putative sites to modulate disease resistance, immune responsiveness and basic metabolism events. In addition, a total of 32 miRNAs in buffalo milk were significantly up-regulated compared with non-buffalo milks, while 16 were significantly down-regulated. Of interest, functional analysis showed that up-regulated miRNAs were mainly related to host metabolism processes, while the predicted functions of down-regulated miRNAs were enriched in immune response.

Conclusion
In this study, we explored the exosomal miRNAome differences between milks of different animals, expanding the theoretical basis for potential applications of the miRNA-containing vesicles.
Comparison of the effects of twice-daily exenatide and insulin on carotid intima-media thickness in type 2 diabetes mellitus patients: a 52-week randomized, open-label, controlled trial
Authors: Zhang Jie , Xian Tong-Zhang , Wu Ming-Xiao , Li Chen , Pan Qi , Guo Li-Xin 
Published: April 2020

Abstract
Background
Exenatide, a glucagon like peptide 1 analog, has been suggested to reduce the cardiovascular disease risk factors, such as body weight, blood pressure and subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). This was the first randomized, open-label, controlled trial to compare the effects of exenatide versus insulin on subclinical atherosclerosis, as assessed by carotid-intima media thickness (CIMT), in patients with T2DM.

Methods
A total of 66 patients with T2DM admitted from March 10, 2015 to June 20, 2017 in the Department of Endocrinology, Beijing Hospital were randomized to receive twice-daily exenatide or aspartate 70/30 insulin for 52 weeks. The primary endpoint was change from baseline in CIMT, and secondary endpoints included changes at week 52 from baseline in body weight, glycemic markers, lipid metabolism markers, blood pressure, C-reactive protein, fibrinogen, 8-hydroxydeoxyguanosine, irisin, and brain natriuretic peptide.

Results
Exenatide more significantly reduced the CIMT from baseline compared with insulin after 52 weeks, with a mean difference of − 0.14 mm (95% interval confidence: − 0.25, − 0.02; P = 0.016). Weight and body mass index were both significantly reduced in the exenatide group over 52 weeks. Exenatide reduced total lipoprotein and low-density lipoprotein cholesterol levels more significantly than insulin at weeks 16 and 40. Correlation analyses showed that CIMT was positively correlated with low-density lipoprotein cholesterol.

Conclusions
Twice-daily exenatide could prevent atherosclerosis progression in patients with T2DM over a 52-week treatment period compared with insulin therapy.
Trial registration Chinese Clinical Trial Registry ChiCTR-1800015658