bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of Sustainable Complex Interventions in Health Care Services: The Triple C Model
Authors: Khalil Hanan , Kynoch Kate 
Published: October 2020

Abstract
Background The changing and evolving healthcare means organisations are under increasing pressure to deliver value-based, high quality care to patients through enabling access, reducing costs and improving outcomes. These factors result in an increased pressure to deliver efficient and beneficial interventions to improve patient care and ensure sustainability beyond the scope of the implementation of such interventions. This paper discusses the development of a triple C model for implementation that ensures sustainability of complex interventions in health care services. Methods In order to develop the proposed implementation model, we adapted the formal tradition of theory building that is described in sociology. Firstly, through a review of the literature on complex interventions and the available implementation models used to embed these interventions. Secondly, devising a framework that encompassed these findings into a simple and workable model that can be easily embedded into everyday practice. This proposed model uses clear, systemic explanation, adds to the current knowledge in this area and is fit for purpose, providing healthcare workers with a simple easy-to-follow framework to embed practice change. Results A three-stage implementation model was devised based on the findings of the literature and named the Triple C model (Consultation, Collaboration and Consolidation). The three stages are interconnected and overlap to ensure sustainability is considered at all levels of the project ensuring its greater success. This model considers the sustainability within any implementation project. Sustainability of interventions are a key consideration for continuous and successful change in any health care organisation. A set of criteria were developed for each of the three stages to ensure adaptability and sustainment of interventions are maintained throughout the life of the intervention.Conclusion Ensuring sustainability of interventions requires continuing effort and embedding the need for sustainability throughout all stages of an implementation project. The Triple C model offers a new approach for healthcare clinicians to ensure sustainability of organizational change.
Embedding Active Pedagogies into Pre-Service Teacher Education: Implementation Considerations and Recommendations
Authors: Lander Natalie , Mazzoli Emiliano , Cassar Samuel , Symington Naomi , Salmon Jo 
Published: October 2020

Abstract
Purpose: The physical activity levels of children in Australia are critically low and correlate with reduced academic achievement and poor health outcomes. Schools provide an ideal setting for physical activity interventions to help children move more. Instead of targeting in-service teachers, this study embedded an evidence-based active pedagogy program called Transform-Ed! into pre-service teacher education. Methods: Surveys, interviews and focus group discussions were conducted with key stakeholders, lecturers and pre-service teachers involved with the 12-week program. The design, implementation and evaluation of the study were systematically guided by all five dimensions of the RE-AIM framework – reach, effectiveness, adoption, implementation, and maintenance. Linear mixed models, descriptive analysis and a framework approach were used to analyse the data. Results: Significant improvements were observed in pre-service teachers’ willingness, confidence, and competence to implement physically active pedagogic strategies following the intervention. Pre-service teacher perceived effectiveness of such strategies on student outcomes also significantly increased and perceived barriers decreased. High adherence was consistently reported and the program was maintained by all lecturers. Four key themes spanning multiple dimensions and participant levels informed recommendations for program scalability: an ‘inter-systemic approach’, a ‘co-design’ approach, ‘embedded in professional practice’ and ‘evidence of impact’ on teacher practice. Anchored in real-world settings and tethered by implementation science, Transform-Ed! could have the potential to advance the capability of teachers and transform the learning experience and physical and academic outcomes of future primary school students.
Effect of patellar tendon release on squatting characteristics of tibiofemoral joint after total knee arthroplasty: a simulation analysis
Authors: Wang Jian-ping , Wang Shihua , Yang Yongqiang , Guo Dong , Liu Jinlai , Chen Xu , Wang Yangqing , Chen Jiwu , Li Yu 
Published: October 2020

Abstract
BackgroundThe objective of this paper was to study the patellar tendon release’s effect on the squat movement characteristics of the tibiofemoral joint after TKA (total knee arthroplasty).MethodsThe dynamic FEM(finite element model) of the human knee joint with 30% release of the upper end, lower end and both ends of the patellar tendon after TKA was established respectively, and the knee tibiofemoral joint of the squat movement simulation analysis.ResultsThe results of simulation show that in the release of three different parts, comparing with the results of no release simulation, the average of lateral translation, superior translation, posterior translation, and the adduction of the femur relative to the tibia decreased by 20%, 17%, 17%, and 12%, respectively.ConclusionThe average of external rotation of the femur relative to the tibia increased 24%. By comparing the data after patellar tendon release and no release one, it can be concluded that the flexion degree of femur relative to the tibia was 4° on average more than no release. Moderate release of the patellar tendon during TKA surgery is beneficial to improve the range of motion (ROM) of the femur relative to the tibia.
Taurine Decreases Cellular Cholesterol Level in HepG2 Cells Partly through Upregulating Calcineurin
Authors: Guo Junxia , Gao Ya , Zhao Yuxing , Zhang Jing , Zhang Yanzhen , Chen Wen 
Published: October 2020

Abstract
Objective: Taurine exerts cholesterol-lowering effect through inducing CYP7A1 and promoting the biotransformation of cholesterol into bile acids in livers, but its molecular mechanism remains unclear. Taurine also suppresses the expression of MCIP1, a calcineurin inhibitory protein. Here we aimed to explore whether calcineurin involves in the cholesterol-lowering effect and upregulation of CYP7A1 by taurine. Methods: High cellular cholesterol conditions were obtained by incubating with 0.2mM cholesterol contained DMEM in HepG2 cells. FK506, a calcineurin inhibitor, was used to depress cellular calcineurin. CnAb-/- cells are the HepG2 cells of which calcineurin was knocked down. Taurine was cultured in wild type, high-cholesterol conditions, calcineurin inhibition or deficiency HepG2 cells respectively for 24h or 48h. The levels of intracellular total cholesterol were determined by an enzymatic method and the expressions of CYP7A1, calcineurin, MEK1/2, c-Jun/p-c-Jun and SHP-1 were detected by western blotting. Results: High cellular cholesterol conditions in HepG2 cells were established and resulted in increased CYP7A1 and calcineurin expression. Taurine exhibited the decreasing-cholesterol effects on HepG2 cells regardless of whether cells with high cholesterol conditions or inhibited / deleted intracellular calcineurin. However, the extent of decreasing cholesterol after calcineurin repression or deficiency was much less than that of controls. Taurine could induce the expression of CYP7A1 but this induction was abolished when the cellular calcineurin was inhibited or deleted. Taurine was able to suppress MEK1/2, p-c-Jun and SHP-1, which are several key molecules in one inhibitory pathway of CYP7A1 transcription, whereas this suppression on MEK1/2 but not p-c-Jun or SHP-1 was reversed after completely knocking down calcineurin. Conclusions: Calcineurin was found to be required partly in taurine-decreasing cholesterol effect through inhibiting MEK1/2 which resulted in CYP7A1 upregulation.
&nbsp;the Impact of Watershed Land Use on River Water Quality: Implication for Planning in the Case of Kebena River Watershed, Addis Ababa, Ethiopia
Authors: Asnake Kalkidan , Worku Hailu , Argaw Mekuria 
Published: October 2020

Abstract
Background: The impact of watershed land-use on surface water quality, especially in urbanized areas, has been investigated in numerous studies in developed countries, however, the issue is one of the under researched areas in developing cities of Africa. To study the impact of watershed land-use on surface water quality, we used the main land use types of the Kebena watershed from aerial photograph and collected river water samples during the dry and wet seasons for two consecutive years at different points from the river course. We calculated the share of each land use using ArcGIS and tested the water quality during each season. The variations in water quality parameters relating to the different land use types of the sub-watersheds were analyzed using ANOVA. Results: Kebena watershed is mainly covered by 39.14% forest, 32.51% built-up area and 27.25% cultivated land. At sub-catchment level, Denkaka, (agriculture dominated) sub-catchment with 44.90 % cultivated land, Little Kebena, (forest dominated) sub-catchment, with 60.87% forest cover and Ginfle (urban dominated) sub-catchment with 90.44% built-up area were identified. The variations in water quality parameters relating to the different land use types of Kebena watershed revealed the significantly high seasonal relationship between the concentration of the water quality indicators during the dry season at (P<0.001, P<0.05). Furthermore, there is a strong positive relationship between the urban and forest dominated sub-catchments and water quality indicators during both the wet and dry seasons than agriculture dominated sub-catchment.Conclusion: Integrating watershed planning with land use planning, therefore, becomes one of the vital tools to address water quality problems in a holistic manner to further prioritize restoration and protection strategies for specific sub-catchments. Thus, in the urban dominated sub-catchment, relocating riverfront communities, providing a well-designed sewage system, applying appropriate storm water management schemes, are some of the important measures while providing wide river buffers with various vegetation cover are necessary to minimize pollutants influx to the river from the agriculture dominated sub-catchment. Furthermore, in the forested sub-catchment, applying preventive measures to retain and enhance connectivity of the existing natural green spaces through open space planning, development and management schemes is crucial.
Integrative Networks by BRWD3 Regulates Cytoskeleton Organization and Cell Motility
Authors: Li Junlin , Yu Yan , Cui Jihong , Wang Yan , Ding Kefan , Li Hongling , Zhang Kejin , Gao Xiaocai 
Published: October 2020

Abstract
BackgroundEukaryotic cytoskeleton forms and keeps cell shape, transports intracellular particles and organelles, determines cell motility and other important cellular events. A large number of regulators of cytoskeleton organization have been identified, but the detailed regulatory mechanism still remains obscure. Previous reports suggest that BRWD3 may be a regulator of cytoskeleton organization in Drosophila melanogaster, and influences cell shape. Therefore, we investigated the molecular network of BRWD3 regulating cytoskeleton organization.ResultsIn this study, we observed the alteration of cell shape, cell motility, and proliferation when BRWD3 was knocked down in MCF-7 and MDA-MB-231 cell lines. The cells were rounded, cell motility decreased when BRWD3 was knocked down. Using chromatin immunoprecipitation combining with sequencing, we found that BRWD3 influenced the cytoskeleton organization, cell shape, and cell motility through regulating expression of the cytoskeleton associative genes including ARF1, ABI2, ARPC3, ARPC1A, RHOC, MEF2C, and VIM.ConclusionsA molecular network by BRWD3 is sketched to elucidate that BRWD3 may not only regulate actin filament but also regulate microtubule and intermediate filament-based cytoskeleton organization. These efforts provide an overview of a BRWD3 network regulating cytoskeleton organization, cell shape and motility, and allow a better understanding of cytoskeleton (re)organization and pathogenesis of mental retardation X-linked 93 and relative carcinomas.
A Hybrid Computational Framework for Intelligent Inter-continent SARS-CoV-2 Sub-strains Characterization and Prediction
Authors: Ekpenyong Moses , Edoho Mercy , Inyang Udoinyang , Uzoka Faith-Michael , Ekaidem Itemobong , Moses Anietie , Emeje Martins , Tatfeng Youtchou , Udo Ifiok , Anwana Enoabasi , Etim Oboso , Joseph Geoffery , Dan Emmanuel 
Published: October 2020

Abstract
Whereas accelerated attention beclouded early stages of the coronavirus spread, knowledge of actual pathogenicity and origin of possible sub-strains remained unclear. By harvesting the Global initiative on Sharing All Influenza Data (GISAID) database (https://www.gisaid.org/), between December 2019 and August 20, 2020, a total of 157 human SARS-CoV-2 (complete) genome sequences processed by gender, across 6 continents of the world, were analyzed. We hypothesized that data speaks for itself and can discern true and explainable patterns of the disease. Identical genome diversity and pattern correlates analysis performed using a hybrid of biotechnology and machine learning methods corroborate multiple emergence of SARS-CoV-2 sub-strains and explained the diversity of the SARS-CoV-2. Interestingly, some viral sub-strains progressively transformed into new sub-strain clusters indicating varying amino acid and strong nucleotide association derived from same origin. A novel approach to cognitive knowledge mining from enriched genome datasets and output targets labeling, helped intelligent prediction of emerging or new viral sub-strains.
Association of Gestational Weight Gain with Cesarean Section: A Prospective Birth Cohort Study in Southwest China
Authors: Huang Lujiao , Zhang Ju , Sun Hong , Dong Hongli , Li Run , Cai Congjie , Gao Yan , Wu Cheng , Lan Xi , Zeng Guo 
Published: October 2020

Abstract
Background: Cesarean section (CS) is a rising public health issue globally, which is even worse in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range.Methods: We retrieved data from a prospective birth cohort conducted in Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as categorical variable according to the Institute of Medicine (IOM) recommendation, just as the majority of previous studies did. In the other analysis, we directly incorporated the GWG as continuous variable and natural cubic splines was used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on multivariate meta-analysis was conducted to examine whether the stratum specific estimation agreed with each other.Results: A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG respectively. When stratified by pre-pregnancy BMI, we further found that BMI may be an effect modifier with a higher risk of excessive GWG seen in the underweight women. By applying a flexible spline regression, the optimal GWG in term of reducing CS based on our data were more stringent than that of IOM recommendation, which were 9-12 kg for underweight women, <20 kg for normal weight women and <10 kg for overweight/obese women. Conclusion: These results suggested a more stringent recommendation should be applied in Southwest China, and more attention should be given to those underweight women.
A Predictive Model for Estimating Risk of Harm and Aggression in Inpatient Mental Health Clinics.
Authors: Blasioli Emanuele , Hassini Elkafi , Bieling Peter J. 
Published: October 2020

Abstract
Background: Serious mental illness is a major risk factor for aggression and violence. The aim of the present study was to develop and test an algorithm to predict inpatient aggressions that involve a risk of harm to self or others.Methods: This work is based on a retrospective study aimed to investigate the prediction of risk of harm and aggressions at St. Joseph’s Healthcare Hamilton, between 2016 and 2017. An analysis of the risk factors most strongly associated with harmful incidents is, followed by the description of the process involved in the development of a predictive model which estimates the risk of harm. Results: The efficiency of the model developed is finally evaluated, showing an overall accuracy of 75%: the specificity to identify episodes considered not at risk of harm is equal to 91.85%, whereas the sensitivity to identify episodes considered harmful is equal to 28.57%. a﻿Conclusions: The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting.
Characterisation and structural analysis of glyoxylate cycle enzymes of Teladorsagia circumcincta.
Authors: Umair Saleh , Bouchet Charlotte , Palevich Nikola , Simpson Heather 
Published: October 2020

Abstract
A 1332 bp full length cDNA encoding Teladorsagia circumcincta isocitrate lyase (TciICL) and a 1575 bp full length cDNA encoding T. circumcincta malate synthase (TciMS) were cloned, expressed in Escherichia coli and the recombinant proteins purified. The predicted TciICL protein of 444 amino acids was present as a single band of about 52 kDa on SDS-PAGE and the recombinant TciMS of 525 amino acids formed a single band about 62 kDa. Multiple alignments of the combined bifunctional TciICL MS protein sequence with homologues from other nematodes showed that the greatest similarity (89-92%) to the homologues of Ancylostoma ceylanicum, Haemonchus contortus and Haemonchus placei and 71-87% similarity to the other nematode sequences. The 3-dimensional structures, binding and catalytic sites were determined for TciICL and TciMS and shown to be highly conserved. Substrate and metal ion binding sites were identified and were completely conserved in other homologues. TciICL was confirmed as a functional enzyme. At 30 °C, the optimum pH was pH 7.5, the Vmax was 275 ± 23 nmoles.min-1.mg-1 protein and the apparent Km for the substrate isocitrate was 0.7 ± 0.01μM (mean ± SEM, n = 3). Addition of 10 mM metal ions (except Mg2+) or 1 mM inhibitors reduced the recombinant TciICL activity by 60-90%. Antibodies in both serum and saliva from field-immune, but not nematode-naïve, sheep recognised recombinant TciICL in ELISA, supporting similar antigenicity to that of the native enzyme.
Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index
Authors: Trilling Bertrand , Brind'Amour Alexandre , Hamad Raphael , Tremblay Jean-Francois , Dubé Pierre , Mitchell Andrew , Sidéris Lucas 
Published: October 2020

Abstract
Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to present the results of a planned two-step surgical strategy to decrease postoperative morbidity and improve resectability of patients with very high PCI.Methods All patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were included. Data was retrospectively reviewed and analyzed. The first surgery included a complete CRS of the inframesocolic compartment and omentectomy. HIPEC was delivered at the second surgery, after complete CRS of the supramesocolic compartment. Postoperative morbidity was assessed using the Clavien-Dindo classification and survival results were also collected. Results Eight patients underwent the two-step approach. Seven had a low-grade disease and one had a high-grade disease. The median PCI was 33 (29-39) and the median time between the two procedures was 111 days. One patient was deemed unresectable at the second surgery. The rate of major morbidity was 0% for the first step and 25% for the second step, with no mortality. Median follow-up was 53.8 months. Conclusion A two-step surgical management for low-grade PMP patients with very high PCI is safe and feasible, with acceptable postoperative morbidity and no compromise on oncological outcomes.
Two giant connected retroperitoneal schwannomas: A rare case report
Authors: Yang Tao , Cao Lanqing , Li Wei , Zhang Kai , Zhu Yuecheng , Liu Tongjun , Li Jiannan 
Published: October 2020

Abstract
Background：There are few reports of large retroperitoneal schwannomas and few guidelines for the diagnosis and surgical treatment.Case presentation：A 40-year-old female came to our department due to abdominal pain for 1 day and there are no other specific symptoms. There were no abnormalities in the patient's tumor markers. Plain computer tomography (CT) scan of the whole abdomen revealed two mass soft tissue density shadows behind the peritoneum, with uneven internal density, cystic low-density shadows and patchy calcification shadows. The larger mass was about 12.0 cm × 12.3 cm in size. Then tumors were completely excised by a reasonable surgical approach while the surrounding organs closely related to the tumor were preserved. Postoperative pathology confirmed that the tumor was benign schwannoma. In the 18-month follow-up, the patient had no recurrences and was asymptomatic.Conclusion：We summarize the diagnosis and treatment of a rare giant retroperitoneal schwannoma. Laparotomy for the management of retroperitoneal giant schwannomas may be a safe and effective method.