bluuebunny/crossref_metadata_2025_split huggingface dataset:
MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework
Authors: Ansbro Éimhín , Homan Tobias , Quasim Jamil , Bil Karla , Tarawneh Mohammed Rasoul , Roberts Bayard , Perel Pablo , Jobanputra Kiran 
Published: February 2020

Abstract
Background: Humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries, in response to the rising global NCD burden. Using the RE-AIM implementation framework, we evaluated a multidisciplinary, primary-level model of NCD care for Syrian refugees and vulnerable Jordanians in Irbid, Jordan. We examined the Reach, Effectiveness, Adoption and acceptance of the programme; the fidelity, adaptation and costs of Implementation; and its Maintenance over time.Methods: This mixed methods, retrospective evaluation, undertaken in 2017, comprised secondary analysis of pre-existing cross-sectional household survey data; analysis of routine cohort data from January 2015 - December 2017; provider-perspective, descriptive costing analysis of total annual, per-patient and per-consultation costs for 2015-2017; clinical audit; medication adherence survey of 300 patients; and qualitative research. The latter involved thematic analysis of individual interviews with patients, staff and stakeholders and two focus group discussions with patients.Results: The programme reached 5.9% of Syrian adults with NCDs in Irbid governorate. The cohort mean age was 54.7 years; 71% had multi-morbidity and 9.9% self-reported a disability. The programme was highly acceptable to patients, staff and stakeholders. Blood pressure and glycaemic control improved as the programme matured and within six months of patient enrolment (with a drop of 7mmHg and 26.8 mg/dL from baseline, respectively). Total costs increased in parallel with increased service complexity from INT$ 4,206,481 in 2015 to 6,739,438 in 2017. Clinical guidelines were reportedly usable and self-reported medication adherence was high. Individual and organisational challenges to programme implementation and maintenance included the impacts of war and the refugee experience on Syrian refugees’ engagement; inadequate low-cost referral options; and operating in a regulated, middle-income country. Essential programme adaptations included refinement of health education and introduction of: mental health and psychosocial services, essential referral pathways, home visit services and a social worker role.Conclusion: RE-AIM proved a valuable tool in evaluating a complex intervention in a protracted humanitarian crisis setting. This programme provided high quality, reliable, free, holistic NCD care and was highly acceptable to patients, providers and stakeholders. We propose that model simplification, cost reduction and use of technology could improve effectiveness and efficiency without reducing acceptability.
Prevalence and Correlates of Mycoplasma genitalium Infections among Patients Attending a Sexually Transmitted Infection Clinic in Guangdong, China a Cross-sectional Study
Authors: Zhang Xiaohui , Zhao PZ , Ke WJ , Wang LY , Tso Lai Sze , Chen ZY , Liao YY , Liang CM , Chen HR , Ren XQ , Huang JM , Ong JJ , Yang F , Yang Ligang 
Published: February 2020

Abstract
Background Mycoplasma genitalium (MG) is known to cause urogenital tract infections and is associated with reproductive morbidity. Although MG has been reported across many regions and population groups, it is not yet routinely tested for in China. Our study contributes to current research by reporting the prevalence and correlates of MG for patients attending a sexually transmitted infection (STI) clinic in Guangdong from Jan 2017-May 2018.Methods Urethral (489 men) and endo-cervical (189 women) samples, blood samples, and patient histories (via questionnaires) were collected. Doctors clinically diagnosed anogenital warts (GW) during the examination (n=678). Presence of MG was tested using an in-house polymerase chain reaction. We also tested all participants for herpes simplex virus-2 (HSV-2), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), syphilis and HIV. Univariate and multivariable logistic regressions were used to evaluate factors associated with MG.Results MG was detected among 7.2% (n=49) of patients (7.4% men, 6.9% women). Of 629 heterosexual patients, the MG was detected in 7.5% (47/629), and of 49 MSM, MG was detected in 4.1% (2/49). Among MG-infected patients, 10.2% were co-infected with CT, 6.1% with NG, 8.2% with HSV-2, 4.1% with syphilis and 22.4% with GW. Among 152 symptomatic patients, the prevalence of MG was 12.5% (n=19, of whom 17 were men). Being symptomatic was statistically significant for MG infection [OR=2.2(1.3~3.8)].Conclusion MG is a relatively common infection among individuals attending an STI clinic in Guangdong province. To make MG testing available and routinely screen symptomatic patients with urinary and /or cervical discharge in STI clinics in China is essential.
Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty
Authors: Wu Jian Xiang , Qing Jiang Hui , Yao Yao , Chen Dong Yang , Jiang Qing 
Published: February 2020

Abstract
Purpose: To compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients. Methods: We enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. The D-dimer and age-adjusted D-dimer cut-off was calculated by multiple logistic regression and receiver operating curve (ROC) analyses.Results: A total of 39 patients had found asymptomatic deep vein thrombosis (DVT) by ultrasonography. The age (odds ratio [OR]: 1.067; p=0.003) and D-dimer (OR:1.331; p=0.025) were related to the existence of DVT. For conventional D-dimer and age-adjusted D-dimer value, the area under the curves (AUCs) were 0.685 (0.499-0.696) and 0.795 (0.611-0.881), respectively.Conclusion: Compared to traditional D-dimer, age-adjusted D-dimer showed better performance in screening DVT, which was useful clinically.
Factors Associated with Healthy Ageing among Chinese Rural Empty Elderly Nesters and Future Focus of Health Services
Authors: Fu Liping , Wang Yuhui , He Lanping 
Published: February 2020

Abstract
Background Like most countries in the world, China is stepping into an aging society and Healthy aging (HA) faces great challenges. Chinese rural empty elderly nesters (CREEN) as the vulnerable groups of ageing populations, providing health services for CREEN needs more attention and guidance. Methods Using the method of logistic regression, four dimensions of HA among 618 respondents were separately analyzed based on the fifth public panel data of the China Health and Retirement Longitudinal Study (CHARLS). Results 41.42% respondents met the recommended good physical health (PA), ‘being literate’, ‘expectation of receiving long-term care in the future from family’, and ‘good physical health of grown children’ were significant protective factors for PA. 83.17% respondents had good daily activity level, ‘aged under 60 years’ and ‘grown children being literate’ were significant protective factors while ‘CREEN once lived with grown children’ was a significant risk factor. 59.39% respondents had good psychological health, ‘Male sex’, ‘Expectations of receiving long-term care in the future’, and ‘Physical health of grown children’ were significant protective factors. 36.73% respondents met the corresponding criteria of good social participation, ‘aged under 60 years’ was a significant protective factor while ‘CREEN once lived with grown children’ was also a significant risk factor. Conclusions For the CREEN, social participation, physical health and psychological health should be the focus and direction of providing health services. One factor could have different influence on different aspects of HA among CREEN. When health services are provided for CREEN, the second focus should assess comprehensive impact and do the long-term observation. Providing health services for CREEN should not only focus on ‘What they have’ and ‘What they don’t have’, but also focus on ‘What they have and then lose’, especially factors associated with their grown children. Those points should be the future focus of health services for CREEN.
lncRNA HOTAIR overexpression promotes hybrid epithelial/mesenchymal phenotype through suppression of c-Met Receptor Tyrosine Kinase Signaling in Hepatocellular Carcinoma Cells
Authors: Topel Hande , Bagirsakci Ezgi , Comez Dehan , Bagci Gulsun , Cakan-Akdogan Gulcin , Atabey Nese 
Published: February 2020

Abstract
Background: Epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET) are both reversible processes, and regulation of phenotypical transition is very important for progression of several cancers including hepatocellular carcinoma (HCC). Recently, it is defined that cancer cells can attain a hybrid epithelial/mesenchymal (hybrid E/M) phenotype. Cells with hybrid E/M phenotype comprise mixed epithelial and mesenchymal properties, they can be more resistant to therapeutics and also more capable of initiating metastatic lesions. However, the mechanisms regulating hybrid E/M in HCC are not well described yet. In this study, we investigated the role of the potential crosstalk between lncRNA HOTAIR and c-Met receptor tyrosine kinase, which are two essential regulators of EMT and MET, in acquiring of hybrid E/M phenotype in HCC.Methods: Expression of c-Met and HOTAIR were defined in HCC cell lines and patient tissues through HCC progression. lncRNA HOTAIR was overexpressed in SNU-449 cells and its effects on c-Met signaling were analyzed. c-Met was overexpressed in SNU-398 cells and its effect on HOTAIR expression was analyzed. Biological significance of HOTAIR/c-Met interplay was defined in means of adhesion, proliferation, motility behavior, invasion, spheroid formation and metastatic ability. Effect of ectopic HOTAIR expression on phenotype was defined with investigation of molecular epithelial and mesenchymal traits.Results: In vitro and in vivo experiments verified the pivotal role of lncRNA HOTAIR in acquisition of hybrid E/M phenotype through modulating c-Met and its membrane co-localizing partner Caveolin-1 expression, activation and membrane organization to cope with the rate limiting steps of metastasis such as survival in adhesion independent microenvironment, escaping from anoikis and resisting to fluidic shear stress (FSS) in HCC.Conclusions: Our work provides the first evidence suggesting a role for lncRNA HOTAIR in the modulation of c-Met to promote hybrid E/M phenotype. The balance between lncRNA HOTAIR and c-Met might be critical for cell fate decision and metastatic potential of HCC cells.
Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: A matched case-control study
Authors: Khalifa Nadia , Rahman Betul , Gaintantzopoulou Marianna D , Amad Suhail Al , Awad Manal M. 
Published: February 2020

Abstract
Background: Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM.Methods: This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire, as well as the Oral Health Impact Profile short form (OHIP-14) which measures OHRQoL. Clinical examinations were conducted to assess participants’ dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3mm and CAL ≥ 3mm. Linear regression models were used to identify the association between OHIP domains, clinical attachment loss, DMFT scores, and diabetes status.Results: The mean age of the participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥ 3mm compared to non-diabetic patients (10%). No significant differences in OHIP scores were observed between patients with and without diabetes. The results of the linear regression suggested that, irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetics, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetics, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetics. Conclusions: Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both groups.
Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study
Authors: Chen Changying , Du Ruofei , Wang Panpan , Wang Tao , Ma Lixia , Larcher Leon 
Published: February 2020

Abstract
Background Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to assess the health-related quality of life (HRQoL) of patients with MI after returning to work and to examine the potential influences on HRQoL. Method This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. Multiple linear regression analyses were performed to explore factors related to HRQoL in patients with MI after returning to work. Results The sample consisted of 326 patients. The mean total score of quality of life was 28.03±2.554. According to the multiple linear regression analysis, next factors were associated with HRQoL, i.e. age (P=0.039), income (P=0.000), co-morbidity (P=0.000), the time taken to return to work (P=0.003), number of stent installed (P=0.003), participation in cardiac rehabilitation (CR) (P=0.000), complete CR (P=0.000), health responsibility (P=0.000), nutrition (P=0.000), exercise (P=0.000), self-realization (P=0.000), stress response (P=0.000), objective support (P=0.000), subjective support (P=0.000), utilization of social support (P=0.028), coping (P=0.000) and yield (P=0.000). Conclusions HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a means to improve HRQoL and to facilitate patients return to society.
Modeling the Cost-effectiveness of Esophageal Cancer Screening in China
Authors: LI Yuanyuan , Du Lingbin , Wang Youqing , Gu Yuxuan , Zhen Xuemei , Hu Xiaoqian , Sun Xueshan , Dong Hengjin 
Published: February 2020

Abstract
Background

This study aimed to examine the cost-effectiveness of the standard endoscopic screening with Lugol’s iodine staining in EC screening in China.

Methods

The Markov decision analysis model with eleven states was built. Separate cohorts were conducted consisting of those aged 40 to 69 years, classified as six age groups with five years interval. Three different strategies assumed for each cohort:(1) no screening; (2) endoscopic screening with Lugol’s iodine staining with annual follow-up for Low-grade intraepithelial neoplasia; (3) endoscopic screening with Lugol’s iodine staining without follow-up. Quality-adjusted life-years (QALYs) served as effectiveness. The incremental cost-effectiveness ratio (ICER) was identified as the evaluating indicators. Sensitivity analysis was introduced to assess the robustness of the model.

Results

For aged 40-49 years, the non-screening strategies were absolutely dominated with both more costs and less QALY, while for aged 50-69 years, the screening scenarios were absolutely dominated. Screening with follow-up was the preferred strategy. Compared to non-screening, screening with follow-up saved USD 10942.57 and USD 611.73 per QALY gained for aged 40-44 and 45-49 years separately. One-way sensitivity analysis addressed that the risk ratio of the EC incidence in population after screening compared to people without screening and the utility of precancerous lesion could affect the cost-effectiveness of the screening strategy. However, the probabilistic sensitivity analysis supported the results of the base case analysis.

Conclusions

EC screening with follow-up targeting aged 40-49 years was the most cost-effective strategy.
Clinical characterization, genetic profile, and epigenetic regulation of TOX in diffuse gliomas
Authors: Hao Zhang , Fan Fan , Yuanqiang Yu , Zeyu Wang , Fangkun Liu , Ziyu Dai , Liyang Zhang , Zhixiong Liu , cheng quan 
Published: February 2020

Abstract
Background Multiple studies focusing on immune therapy towards glioblastoma (GBM) have attained great successes. TOX has been found to be closely related to immune environment surrounding tumors, while the expression of TOX has not been fully understood in gliomas. Methods Mining data from The Cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA), we analyzed 1691 WHO grade I-IV human glioma samples with transcriptome data. R language was used for most statistical analysis. Somatic mutations and somatic copy number variation (CNV) were analyzed using GISTIC 2.0.Results TOX was down-regulated in malignant gliomas, especially in the proneural and isocitrate dehydrogenase (IDH) mutant subtypes of GBM. TOX low tumours are related to loss of PTEN and amplification of EGFR, while TOX high tumours harbor mutations in IDH1 (91%). TOX was highly expressed in cellular tumour, leading edge regions. TOX was enriched in multiple immune related processes including lymphocytes migration in GBM in gene ontology and pathway analysis. Finally, TOX had negative association with the infiltration of several immune cell types in tumour microenvironment in cell lineage analysis. Conclusion TOX has the potential to be a new target for immune-therapy or a prognostic marker for GBM.
Reconstruction of lncRNA-miRNA-mRNA network based on competitive endogenous RNA reveals functional lncRNAs in melanoma
Authors: Zhu Junyou , Deng Jin , Zhang Lijun , Zhao Jingling , Zhou Fei , Liu Ning , Cai Ruizhao , Wu Jun , Shu Bin , Qi Shaohai 
Published: February 2020

Abstract
Background: Melanoma is the most dangerous skin tumor, and its pathogenesis is not fully understood. Methods: To identify the key lncRNAs in melanoma, we reconstructed a global triple network based on the ceRNA theory. GO and KEGG pathway analysis were performed using DAVID. And, we verified our findings through q(RT)-PCR assay. Results: According to ceRNA theory, 898 DEMs,53 DELs and 16 DEMis were selected to reconstruct the ceRNA network. MALAT1, LINC00943, and LINC00261 were selected as hub gene in the network. Conclusions: In this study, we found that MALAT1, LINC00943 and LINC00261 were closely associated with tumorigenesis and development of melanoma, and therefore, could be used as potential diagnostic biomarkers and therapeutic targets.
Control Group Design in a Complex Intervention Study: Challenges, Dilemmas and Possible Solutions
Authors: Mangset Margrete , Kitzmüller Gabriele , Evju Anne , Angel Sanne , Aadal Lena , Martinsen Randi , Bronken Berit Arnesveen , Kvigne Kari , Bragstad Line K. , Hjelle Ellen Gabrielsen , Sveen Unni , Kirkevold Marit 
Published: February 2020

Abstract
Background The use of a control group is one of the most critical components of an RCT. The control conditions may change over time and include assessment interviews and standard stroke treatment. Therefore, the control group should be monitored and described in as much detail as the intervention group. It is important to find ways to reduce the risk of study-induced influence on the members of the control group. The aim of this study was to explore the possible influence of the assessment interviews on the adjustment of the members of a control group in an RCT exploring psychosocial well-being following stroke. Methods Fifteen participants in the control group of the RCT, six women and nine men, aged 29-88 years, were interviewed in narrative semi-structured interviews. Ricoeur’s interpretation theory guided the analysis. Results The perceived influence of the assessment interviews on the control group varied considerably. Two different themes with subthemes were identified, describing the influence of the assessment interviews in the control group. Theme one described how participants emphasized the perceived influence of the assessment interviews that served as a safety net, enhanced their awareness and understanding, facilitated their adjustment after stroke, encouraged them to seek support, and allowed them to vent their disappointment of having been allocated to the control group. Theme two described participants’ experiences of handling their adjustment process on their own without describing any influence of the assessment interviews on their condition. These participants highlighted mild strokes, spontaneous recovery, setting own goals, support from family and friends and supporting research. Conclusions In view of the design challenges in RCTs, it seems important to explore in depth how to design assessment interviews with control group members without introducing risk of bias, and to uphold rigor and stringency in the trials.