bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing strategies to attract, retain and support midwives in rural fragile settings: participatory workshops with health system stakeholders in Ituri Province, Democratic Republic of Congo
Authors: Baba Amuda , Martineau Tim , Theobald Sally , Sabuni Paluku , Nobabo Marie Muziakukwa , Alitimango Ajaruva , Katabuka John Kisembo , Raven Joanna 
Published: November 2020

AbstractBackgroundMidwifery plays a vital role in the quality of care as well as rapid and sustained reductions in maternal and newborn mortality. Like most other sub-Saharan African countries, the Democratic Republic of Congo experiences shortages and inequitable distribution of health workers, particularly in rural areas and fragile settings. The aim of this study was to identify strategies that can help to attract, support and retain midwives in the fragile and rural Ituri province.MethodsA qualitative participatory research design, through a workshop methodology, was used in this study. Participatory workshops were held in Bunia, Aru and Adja health districts in Ituri Province with provincial, district and facility managers, midwives and nurses, and non-governmental organisation, church medical coordination and nursing school representatives. In these workshops, data on the availability and distribution of midwives as well as their experiences in providing midwifery services were presented and discussed, followed by the development of strategies to attract, retain and support midwives. The workshops were digitally recorded, transcribed and thematically analysed using NVivo 12.ResultsThe study revealed that participants acknowledged that most of the policies in relation to rural attraction and retention of health workers were not implemented, whilst a few have been partially put in place. Key strategies embedded in the realities of the rural fragile Ituri province were proposed, including organising midwifery training in nursing schools located in rural areas; recruiting students from rural areas; encouraging communities to use health services and thus generate more income; lobbying non-governmental organisations and churches to support the improvement of midwives’ living and working conditions; and integrating traditional birth attendants in health facilities. Contextual solutions were proposed to overcome challenges.ConclusionMidwives are key skilled birth attendants managing maternal and newborn healthcare in rural areas. Ensuring their availability through effective attraction and retention strategies is essential in fragile and rural settings. This participatory approach through a workshop methodology that engages different stakeholders and builds on available data, can promote learning health systems and develop pragmatic strategies for the attraction and retention of health workers in fragile remote and rural settings.
Feasibility study: one year fortnightly follow-up of the evolution of supra-spinatus degeneration via text-messages
Authors: Vincent Karl , Gagey Olivier , Leboeuf-Yde Charlotte 
Published: November 2020

AbstractBackgroundThe clinical follow-up of patients for degeneration of the supraspinatus tendon is limited by the lack of objective assessment of pain evolution over time. We therefore tested a new method to collect follow-up data on patients treated either by surgical cuff repair or rehabilitation.ObjectivesWe report the feasibility this method in terms of recruitment of clinicians and patients and their compliance.MethodsIn this multicenter longitudinal observational study, between September 2015 and March 2019, patients consulting either for surgical repair or rehabilitation were examined at baseline and after twelve months by their clinician, including the Mini-DASH questionnaire. Fortnightlys, during one year, patients were asked about number of days their shoulder problem affected their daily life, number of nights woken up from shoulder pain, and present pain score, using text-messages for sending and responding to questions. A system administrator supervised responses and non-compliant subjects were contacted and assisted with the procedure. The CONSORT statement for pilot studies was followed.ResultsFour of 11 invited clinicians accepted participation and collected data till the end. Of the 410 patients we originally planned for, 252 were included in the study, but complete data for the clinicians’ follow-up at 12 months were missing for 30. Of the 222 subjects with SMS data files, 190 (85%) provided at least 80% of their fortnightly messages. All three SMS messages were answered equally often. In total, 160 study subjects answered at least 80% of timesandhad clinical data at twelve months, i.e. 39% of the intended study sample and 72% of the 222 subjects with SMS data.ConclusionThe most important difficulty of this study was the enrolment and compliance of clinicians. The collection of SMS data was less successful than in previous studies, but French people accepted well this new method which is much easier and specific than collecting data through clinical records. The quality of the SMS data was acceptable. However, because of the limited number of complete datasets, only a limited number of questions from the original study protocol can be answered.
A simplified method to isolate rice mitochondria
Authors: Xu Yanghong , Li Xiaoyi , Huang Jishuai , Peng Leilei , Luo Dinghui , Zhang Qiannan , Dan Zhiwu , Xiao Haijun , Yang Fang , Hu Jun 
Published: November 2020

Abstract

Background
Mitochondria play critical roles in plant growth, development and stress tolerance. Numerous researchers have carried out studies on the plant mitochondrial genome structure, mitochondrial metabolism and nuclear-cytoplasmic interactions. However, classical plant mitochondria extraction methods are time-consuming and consist of a complicated ultracentrifugation procedure with expensive reagents. To develop a more rapid and convenient method for the isolation of plant mitochondria, in this study, we established a simplified method to isolate rice mitochondria efficiently for subsequent studies.

Results
To isolate rice mitochondria, the cell wall was first disrupted by enzymolysis to obtain the protoplast, which is similar to animal mitochondria. Rice mitochondria were then isolated with a modified method based on the animal mitochondria isolation protocol. The extracted mitochondria were next assessed according to DNA and protein levels to rule out contamination by the nucleus and chloroplasts. Furthermore, we examined the physiological status and characteristics of the isolated mitochondria, including the integrity of mitochondria, the mitochondrial membrane potential, and the activity of inner membrane complexes. Our results demonstrated that the extracted mitochondria remained intact for use in subsequent studies.

Conclusion
The combination of plant protoplast isolation and animal mitochondria extraction methods facilitates the extraction of plant mitochondria without ultracentrifugation. Consequently, this improved method is cheap and time-saving with good operability and can be broadly applied in studies on plant mitochondria.
The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives
Authors: Caton Lauren , Yuan Mina , Louie Dexter , Gallo Carlos , Abram Karen , Palinkas Lawrence , Brown C. Hendricks , McGovern Mark 
Published: November 2020

Abstract

Background
The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding.

Methods
Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n = 16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants.

Results
Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns.

Conclusions
Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.
Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis
Authors: Hasnain Md Golam , Attia John R. , Akter Shahinoor , Rahman Tabassum , Hall Alix , Hubbard Isobel J. , Levi Christopher R. , Paul Christine L. 
Published: November 2020

Abstract

Background
Despite being one of the few evidence-based treatments for acute ischemic stroke, intravenous thrombolysis has low implementation rates—mainly due to a narrow therapeutic window and the health system changes required to deliver it within the recommended time. This systematic review and meta-analyses explores the differential effectiveness of intervention strategies aimed at improving the rates of intravenous thrombolysis based on the number and type of behaviour change wheel functions employed.

Method
The following databases were searched: MEDLINE, EMBASE, PsycINFO, CINAHL and SCOPUS. Multiple authors independently completed study selection and extraction of data. The review included studies that investigated the effects of intervention strategies aimed at improving the rates of intravenous thrombolysis and/or onset-to-needle, onset-to-door and door-to-needle time for thrombolysis in patients with acute ischemic stroke. Interventions were coded according to the behaviour change wheel nomenclature. Study quality was assessed using the QualSyst scoring system for quantitative research methodologies. Random effects meta-analyses were used to examine effectiveness of interventions based on the behaviour change wheel model in improving rates of thrombolysis, while meta-regression was used to examine the association between the number of behaviour change wheel intervention strategies and intervention effectiveness.

Results
Results from 77 studies were included. Five behaviour change wheel interventions, ‘Education’, ‘Persuasion’, ‘Training’, ‘Environmental restructuring’ and ‘Enablement’, were found to be employed among the included studies. Effects were similar across all intervention approaches regardless of type or number of behaviour change wheel-based strategies employed. High heterogeneity (I2 > 75%) was observed for all the pooled analyses. Publication bias was also identified.

Conclusion
There was no evidence for preferring one type of behaviour change intervention strategy, nor for including multiple strategies in improving thrombolysis rates. However, the study results should be interpreted with caution, as they display high heterogeneity and publication bias.
Clinical decision support improves the appropriateness of laboratory test ordering in primary care without increasing diagnostic error: the ELMO cluster randomized trial
Authors: Delvaux Nicolas , Piessens Veerle , Burghgraeve Tine De , Mamouris Pavlos , Vaes Bert , Stichele Robert Vander , Cloetens Hanne , Thomas Josse , Ramaekers Dirk , Sutter An De , Aertgeerts Bert 
Published: November 2020

Abstract

Background
Inappropriate laboratory test ordering poses an important burden for healthcare. Clinical decision support systems (CDSS) have been cited as promising tools to improve laboratory test ordering behavior. The objectives of this study were to evaluate the effects of an intervention that integrated a clinical decision support service into a computerized physician order entry (CPOE) on the appropriateness and volume of laboratory test ordering, and on diagnostic error in primary care.

Methods
This study was a pragmatic, cluster randomized, open-label, controlled clinical trial.

Setting
Two hundred eighty general practitioners (GPs) from 72 primary care practices in Belgium.

Patients
Patients aged ≥ 18 years with a laboratory test order for at least one of 17 indications: cardiovascular disease management, hypertension, check-up, chronic kidney disease (CKD), thyroid disease, type 2 diabetes mellitus, fatigue, anemia, liver disease, gout, suspicion of acute coronary syndrome (ACS), suspicion of lung embolism, rheumatoid arthritis, sexually transmitted infections (STI), acute diarrhea, chronic diarrhea, and follow-up of medication.

Interventions
The CDSS was integrated into a computerized physician order entry (CPOE) in the form of evidence-based order sets that suggested appropriate tests based on the indication provided by the general physician.

Measurements
The primary outcome of the ELMO study was the proportion of appropriate tests over the total number of ordered tests and inappropriately not-requested tests. Secondary outcomes of the ELMO study included diagnostic error, test volume, and cascade activities.

Results
CDSS increased the proportion of appropriate tests by 0.21 (95% CI 0.16–0.26, p < 0.0001) for all tests included in the study. GPs in the CDSS arm ordered 7 (7.15 (95% CI 3.37–10.93, p = 0.0002)) tests fewer per panel. CDSS did not increase diagnostic error. The absolute difference in proportions was a decrease of 0.66% (95% CI 1.4% decrease–0.05% increase) in possible diagnostic error.

Conclusions
A CDSS in the form of order sets, integrated within the CPOE improved appropriateness and decreased volume of laboratory test ordering without increasing diagnostic error.

Trial registration
ClinicalTrials.gov Identifier: NCT02950142, registered on October 25, 2016
APOE2: protective mechanism and therapeutic implications for Alzheimer’s disease
Authors: Li Zonghua , Shue Francis , Zhao Na , Shinohara Mitsuru , Bu Guojun 
Published: November 2020

AbstractInvestigations of apolipoprotein E (APOE) gene, the major genetic risk modifier for Alzheimer’s disease (AD), have yielded significant insights into the pathogenic mechanism. Among the three common coding variants,APOE*ε4increases, whereasAPOE*ε2decreases the risk of late-onset AD compared withAPOE*ε3. Despite increased understanding of the detrimental effect ofAPOE*ε4, it remains unclear howAPOE*ε2confers protection against AD. Accumulating evidence suggests thatAPOE*ε2protects against AD through both amyloid-β (Aβ)-dependent and independent mechanisms. In addition,APOE*ε2has been identified as a longevity gene, suggesting a systemic effect ofAPOE*ε2on the aging process. However,APOE*ε2is not entirely benign;APOE*ε2carriers exhibit increased risk of certain cerebrovascular diseases and neurological disorders. Here, we review evidence from both human and animal studies demonstrating the protective effect ofAPOE*ε2against AD and propose a working model depicting potential underlying mechanisms. Finally, we discuss potential therapeutic strategies designed to leverage the protective effect ofAPOE2to treat AD.
Prevalence and social determinants of psychological distress among people who use drugs in Cambodia
Authors: Saing Chan Hang , Prem Kiesha , Uk Ponha , Chann Navy , Chhoun Pheak , Mun Phalkun , Tuot Sovannary , Yi Siyan 
Published: November 2020

Abstract

Background
People who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges. However, studies on mental health among people who use drugs in resource-constrained countries are scarce. This study sheds light on the prevalence and correlates of psychological distress among people who use drugs in Cambodia.

Methods
We conducted this cross-sectional study in the capital city and 11 provinces in 2017. The Respondent Driven Sampling method was adapted to recruit 1677 people who used drugs for face-to-face interviews using a structured questionnaire. Psychological distress was measured using the General Health Questionnaire (GHQ-12). A total score of GHQ-12 > 2 indicated high psychological distress. We performed a multiple logistic regression analysis to identify factors associated with psychological distress.

Results
We included 1598 participants in the analyses, with a mean age of 28.6 years (SD = 7.8). Of the total, 42% had high psychological distress – 50% in women and 37% in men. The adjusted odds of having high psychological distress were significantly higher among participants who were 25–34 years old and 35 years and above, had been to a drug rehabilitation center, had been insulted by family members, and had been sexually harassed/abused by someone when they were growing up. The odds of having high psychological distress were significantly lower among participants who were male, lived in their own dwelling, reported injecting as the mode of the first drug use, and had someone taking care of them when they got sick.

Conclusions
This study documents a high prevalence of psychological distress among people who use drugs in Cambodia. Intervention programs that attempt to address mental health problems among people who use drugs in resource-limited settings should be gender- and age-sensitive and target more marginalized subpopulations. Mental health services can be integrated into HIV and harm-reduction programs for people who use drugs.
A comprehensive overview of metaplastic breast cancer: clinical features and molecular aberrations
Authors: Reddy Tejaswini P. , Rosato Roberto R. , Li Xiaoxian , Moulder Stacy , Piwnica-Worms Helen , Chang Jenny C. 
Published: November 2020

Abstract
Metaplastic breast cancer (MpBC) is an exceedingly rare breast cancer variant that is therapeutically challenging and aggressive. MpBC is defined by the histological presence of at least two cellular types, typically epithelial and mesenchymal components. This variant harbors a triple-negative breast cancer (TNBC) phenotype, yet has a worse prognosis and decreased survival compared to TNBC. There are currently no standardized treatment guidelines specifically for MpBC. However, prior studies have found that MpBC typically has molecular alterations in epithelial-to-mesenchymal transition, amplification of epidermal growth factor receptor, PI3K/Akt signaling, nitric oxide signaling, Wnt/β-catenin signaling, altered immune response, and cell cycle dysregulation. Some of these molecular alterations have been studied as therapeutic targets, in both the preclinical and clinical setting. This current review discusses the histological organization and cellular origins of MpBC, molecular alterations, the role of radiation therapy, and current clinical trials for MpBC.
The rescue intervention strategy for asthma patients under severe air pollution: a protocol for a single-centre prospective randomized controlled trial
Authors: Yang Xiaoyu , Huang Junjun , Hu Yan , Guo Cuiyan , Wang Xi , Yang Zhao , Zhou Tianyu , Wang Guangfa 
Published: November 2020

Abstract

Background
Asthma is a common chronic airway inflammatory disease. Exacerbations of asthma not only accelerate the progression of the disease but also increase the incidence of hospitalization and death. Studies have shown that air pollution is a high-risk factor for asthma exacerbations. However, few treatment strategies have been recommended to reduce the risk of severe air pollution-related asthma exacerbations.

Methods/design
This is a single-centre, prospective, randomized and standard treatment parallel control clinical trial. Seventy-two asthma patients in the nonexacerbation stage according to GINA guidelines 2017 will be recruited and randomized into the rescue intervention strategy (RIS) group and control group. Original treatments for the participants will include no use of inhaled medicine, the use of short-acting β-agonists (SABA) on demand or the use of budesonide/formoterol (160 μg/4.5 μg/dose, 1–2 dose/time, b.i.d.). The rescue intervention strategy for the RIS group will be budesonide/formoterol plus the original treatment until the severe pollution ends (air quality index, AQI < 200). The control group will maintain the original treatment. The follow-up observation period will last 1 year. The primary outcome is the frequency of asthma exacerbations per year. Secondary outcomes include the mean number of unplanned outpatient visits, emergency visits, hospitalizations, medical costs and mortality caused by asthma exacerbations per patient per year.

Discussion
The results of this trial will provide a novel strategy to guide clinical practice in decreasing the risk of asthma exacerbations under severe air pollution.

Trial registration
ChiCTR ChiCTR1900026757. Registered on 20 October 2019—retrospectively registered
Glucose metabolism-related gene polymorphisms as the risk predictors of type 2 diabetes
Authors: Li Cuilin , Yang Yuping , Liu Xin , Li Zhongyu , Liu Hong , Tan Qiuhong 
Published: November 2020

AbstractType 2 diabetes mellitus (T2DM) is a complex polygenic metabolic disease characterized by elevated blood glucose. Multiple environmental and genetic factors can increase the risk of T2DM and its complications, and genetic polymorphisms are no exception. This review is mainly focused on the related genes involved in glucose metabolic, including G6PC2, GCK, GCKR and OCT3. In this review, we have summarized the results reported globally and found that the genetic variants of GCK and OCT3 genes is a risk factor for T2DM while G6PC2 and GCKR genes are controversial in different ethnic groups. Hopefully, this summary could possibly help researchers and physicians understand the mechanism of T2DM so as to diagnose and even prevent T2DM at early time.
Draft genome assembly of Passalora sequoiae a needle blight pathogen on Leyland cypress
Authors: Copes Warren E. , Ibarra Caballero Jorge , Babiker Ebrahiem , Stewart Jane E. , Orner Valerie A. , Windham Alan S. , Arias Renee S. 
Published: November 2020

Abstract

Objective
Passalora sequoiae (family Mycosphaerellaceae) causes a twig blight on Leyland cypress that requires numerous fungicide applications annually to minimize economic losses for ornamental plant nursery and Christmas tree producers. The objective was to generate a high-quality draft assembly of the genome of P. sequoiae as a resource for primer development to investigate genotype diversity.

Data description
We report here the genome sequence of P. sequoiae 9LC2 that was isolated from Leyland cypress ‘Leighton Green’ in 2017 in southern Mississippi, USA. The draft genome was obtained using Pacific Biosciences (PacBio) SMRT and Illumina HiSeq 2500 sequencing. Illumina reads were mapped to PacBio assembled contigs to determine base call consistency. Based on a total of 44 contigs with 722 kilobase (kb) average length (range 9.4 kb to 3.4 Mb), the whole genome size was estimated at 31,768,716 bp. Mapping of Illumina reads to PacBio contigs resulted in a 1000 × coverage and were used to confirm accuracy of the consensus sequences.