bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coordinating Health Workforce Management in a Devolved Context: Lessons from Kenya
Authors: Thuku Mathew Kariuki , Muriuki Janet , Adano Ummuro , Oyucho Linet , Nelson David 
Published: February 2020

Abstract
Introduction In 2013, Kenya fully and rapidly devolved health services to 47 county governments under its new constitution. It soon became evident that the coordination mechanism to manage the health workforce at county level was inadequate. This case study describes how Kenya created an inter-county, multi-stakeholder human resources for health (HRH) coordination framework that promotes consensus, commitment, and cooperation in devolved HR management. Case Presentation Through USAID funding, IntraHealth International built the health workforce management capacity of county governments by strengthening coordination mechanisms at national and county levels. Informed by stakeholder mapping, Kenya’s 47 counties were grouped into nine clusters with similar geographic contexts and HRH challenges. Inter-county cluster HRH stakeholder coordination forums are hosted by a rotating county-led secretariat and meet quarterly to address gaps, share successes and challenges, and track implementation of action plans. They link to the national level for capacity building, policy formulation, HRH regulation, and provision of standards. Counties have assumed ownership of the forums and contributed about US$85,000 to date toward expenses. Conclusions As a mechanism for transforming Kenya’s national HRH agenda into action at the county level, the HRH coordination framework has been instrumental in 1) expediting development, customization, and dissemination of policies, 2) enabling national HRH officers to mentor their county counterparts, and 3) providing collaborative platforms for multiple stakeholders to resolve HRH challenges and harmonize HR practices nationwide. Successes catalyzed through the inter-county forums include hiring over 20,000 health workers to address shortages; expanding the national HR information system to all 47 counties; developing guidelines for sharing specialist providers; and establishing professionalized HRH units in all 47 counties. Kenya has made great strides in strengthening its health system through the HRH coordination framework, which supports standardization of county health operations with national goals while enabling national policy to address HRH gaps in the counties. Transitioning to fully local funding of inter-county forums is important for sustaining progress.
Regional AET indicating oasis water consumption and groundwater dynamics under a background of climate change
Authors: Wu Lei , Changbin Li , Xie Xuhong , He Zhibin , Wang Wanrui , Zhang Yuan , Wei Jianmei , Lv Jianan 
Published: February 2020

Abstract
Background: Development of agriculture-dominated socio-economy have led to remarkable increase of water consumption in arid regions of the world. Frequent over-exploitation of water resources resulted in widely environmental degradation in the water-scarce and eco-fragile area, especially in China’s inland river basins. The Shiyang River Basin (SYRB) is the one where the most contradictive situation was found between socio-economic development and environmental sustainability in recent decades. In this study, a case study clarifying groundwater responses to intensive oasis water utilization was conducted during the time period from 1981 to 2010.
Result: Regional AET was stepwise regressed with observed series of T, P and NDVI, the accuracy was found satisfactory. Module analysis revealed that the continuous warming had facilitated the AET rather than the other two factors (P and NDVI). The 30-year statistics revealed that total volume of oasis water utilization far exceeded mountainous discharges in the SYRB. Local abstractions offset the insufficiency and resulted in considerable drawdown of groundwater level. Dynamics of groundwater were found remarkably influenced by land surface water division, oasis scale and water consumption. Driven module calibrated upon regional averages of the above variables, suitable scale of the oasis was quantitatively discussed. Results revealed that the near-complete development of mountainous discharges, along with the over-exploitation of groundwater, have brought about degradation of the groundwater system. Groundwater level drawdown showed annual rates of 0.17 m/a and 0.31 m/a in the middle and lower reaches, respectively, during the time period from 1981 to 2010.
Conclusions: Overexploitation of water resources and its negative consequences for regional hydrology and ecology in arid regions should be considered as a warning for pursuing economic well-being at the expense of the environment. Given the huge water demand for oasis survival and the background of climatic warming, reduction of arable scale combined with water transfer from outside should be conducted. This study serves as a 30-year case example when above contradictions presented remarkably in inland river systems in the arid northwestern China.
Simultaneous detection of 37 Lactobacillus species using a real-time PCR assay based on whole-genome sequence analysis
Authors: Kim Eiseul , Yang Seung-Min , Lim Bora , Park Si Hong , Rackerby Bryna , Kim Hae-Yeong 
Published: February 2020

Abstract
Background

Lactobacillus species are used as probiotics and play an important role in fermented food production. However, use of 16S rRNA gene sequences as standard markers for the differentiation of Lactobacillus species offers a very limited scope, as several species of Lactobacillus share similar 16S rRNA gene sequences. In this study, we developed a rapid and accurate method based on comparative genomic analysis for the simultaneous identification of 37 Lactobacillus species that are commonly used in probiotics and fermented foods.

Results

To select species-specific sequences or genes, a total of 180 Lactobacillus genome sequences were compared using Python scripts. In 14 out of 37 species, species-specific sequences could not be found due to the similarity of the 16S–23S rRNA gene. Selected unique genes were obtained using comparative genomic analysis and all genes were confirmed to be specific for 52,478,804 genomes via in silico analysis; they were found not to be strain-specific, but to exist in all strains of the same species. Species-specific primer pairs were designed from the selected 16S–23S rRNA gene sequences or unique genes of species. The specificity of the species-specific primer pairs was confirmed using reference strains, and the accuracy and efficiency of the real-time polymerase chain reaction (PCR) with the standard curve were confirmed. The real-time PCR method developed in this study is able to accurately differentiate species that were not distinguishable using the 16S rRNA gene alone. This Real-time PCR method was designed to detect 37 Lactobacillus species in a single reaction. The developed method was then applied in the monitoring of 19 probiotics and 12 dairy products. The applied tests confirmed that the species detected in 17 products matched those indicated on their labels, whereas the remaining products contained species other than those appearing on the label.

Conclusions

The method developed in this study is able to rapidly and accurately distinguish different species of Lactobacillus, and can be used to monitor specific Lactobacillus species in foods such as probiotics and dairy products.
A preliminary study on the ultrasonic manifestations&nbsp;of peripulmonary lesions of non-critical novel coronavirus pneumonia (COVID-19)&nbsp;
Authors: Huang Yi , Wang Sihan , Liu Yue , Zhang Yaohui , Zheng Chuyun , Zheng Yu , Zhang Chaoyang , Min Weili , Yu Ming , Hu Mingjun 
Published: February 2020

Abstract
Background: Ultrasound is used to observe the imaging manifestations of COVID-19 in order to provide reference for real-time bedside evaluation.Purpose: To explore the ultrasonic manifestations of peripulmonary lesions of non-critical COVID-19, so as to provide reference for clinical diagnosis and efficacy evaluation.Materials and Methods: The clinical and ultrasonic data of 20 patients with clinically diagnosed non-critical COVID-19 treated in Xi'an Chest Hospital during January and February 2020 were retrospectively analyzed. Conventional two-dimensional ultrasound and color Doppler ultrasound were used to observe the characteristics of lesions. Results: All 20 patients (40 lungs and 240 lung areas) had a history of travel, residence or close contact in/with Wuhan, and 5 of them caught COVID-19 after family gatherings. Lesions tended to occur in both lungs. Lesions in the lung areas: 14 in L1+R1 area (14/40), 17 in L2+R2 area (17/40), 17 in L3+R3 area (17/40), 17 in L4+R4 area (17/40), 20 in L5+R5 area (20/40), and 28 in L6+R6 area (28/40). Lesion types: rough and discontinuous pleural line (36/240), subpleural consolidation (53/240), air bronchogram sign or air bronchiologram sign in subpleural peripleural consolidation (37/240), visible B lines (91/240), localized pleural thickening (19/240), localized pleural effusion (24/240), poor blood flow in the consolidation detected by color Doppler ultrasound (50/53).Conclusion: The non-critical COVID-19 has characteristic ultrasonic manifestations, which are visible in the posterior and inferior areas of the lung. The lesions are mainly characterized by a large number of B lines, subpleural pulmonary consolidation and poor blood flow. Lung ultrasound can provide reference for the clinical diagnosis and efficacy evaluation. Chinese Clinical Trial Registry: ChiCTR2000030032Approval for Scientific Research Project: No. 2020-S0001
Glasgow Sleep Effort Scale: Translation and Psychometric properties of the Persian Version
Authors: DoosAliVand Hoda , AhmadianVargahan Fahimeh , Charkhabi Morteza , SadeghniiatHaghighi Khosro , Dutheil Frederic , Habibi Mojtaba 
Published: February 2020

Abstract
Background: Sleep effort is a multicomponent variable associated with sleep initiation and maintenance problems. The purpose of the current study is to investigate the validity and reliability of the Glasgow Sleep Effort Scale (GSES) in Persian language. Methods: The participants consisted of two samples: a clinical group of 120 participants with insomnia disorder meeting DSM-V criteria for insomnia and a non-clinical group of 110 participants (58%) with normal sleep who completed the following measures: GSES, Pittsburg Sleep Quality Index, Insomnia Severity Index, Dysfunctional Beliefs and Attitudes about Sleep Scale-10, Pre Sleep Arousal Scale-cognitive subscale, Depression-Anxiety- Stress Scale-21 and sleep diary. Significant correlations were observed between GSES and related measures in both groups. Results: Principal component analysis indicated a single component accounted for 64.77% of total variance in clinical group. Result of the fit estimates for the one-factor unidimensional model meet the previously specified fit criteria and adequately fit the data in non-clinical group. Statistical findings showed that the GSES has good internal consistency in terms of Cronbach Alpha (.75 for clinical sample and .77 for non-clinical sample) and test- retest reliability (r =.70) for a 4 week interval. The cutoff point, sensitivity, and specificity of the scale were 6, 85% and 94.5%, respectively. Conclusions: The Persian Version of the GSES has adequate psychometric properties in both clinical and non-clinical populations and can be used in Persian speaking countries. Keywords: GSES, sleep effort, reliability, validity, insomnia, Persian scale
Psychosocial Family Interventions for Relatives of People Living with Schizophrenia in the Arab World: Systematic Review
Authors: Sawafi Aziza Saleh Al , Lovell Karina , Renwick Laoise , Husain Nusrat 
Published: February 2020

Abstract
Aim and objectives To synthesise the available evidence about culturally-adapted psychosocial family interventions in the Arab world. The review identifies the content and characteristics of these interventions, determines the strategies used to successfully adapt them to the Arab culture, assesses the feasibility and acceptability of the interventions, and evaluates the effectiveness of these interventions for service users and their families. Background Family interventions in schizophrenia are evidence based and have been adapted to different cultures to improve their effectiveness and acceptability in different settings. The Arab world has a unique set of sociocultural norms and values that cannot be ignored when developing or implementing such interventions. There is a lack of research on the feasibility of delivering family interventions for schizophrenia in the Arab region. Design: systematic review Method Five electronic databases were searched including MEDLINE, CINAHL, Cochrane Library, PsycINFO and EMBASE for articles written in Arabic and English from inception to 2019. Data were extracted and synthesised narratively. Result Five studies were retrieved from the search: two randomized control studies, two non-randomized studies and one qualitative study. There is a paucity of evidence about culturally- adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive and the implementation was feasible and acceptable. The methodological quality of the included studies was generally poor, so there is a risk of overestimating the effect of the interventions due to lack of rigour and the presence of bias. Conclusion The present review provides the foundation for future work about family interventions in the Arab world. The content and characteristics of the interventions were identified but the effectiveness cannot be determined because of the poor methodological quality. The adaptation process was comprehensive but rigor in testing adapted interventions is largely absent.
Characterization of codon usage pattern in novel coronavirus 2019-nCoV
Authors: Hou Wei 
Published: February 2020

Abstract
The outbreak of viral pneumonia in China due to a novel coronavirus 2019-nCoV poses significant threats to international health. In this study we perform bioinformatic analysis to take a snapshot of the codon usage pattern of 2019-nCoV and uncover that this novel coronavirus has a relatively low codon usage bias. The information from this research may not only be helpful to get new insights into the evolution of 2019-nCoV, but also have potential value for developing coronavirus vaccines.
Breast Cancer screening patterns in Jamaican women: review of the largest national mammography clinic
Authors: Chin Sheray N , Cornwall Derria , Mitchell Derek , McFarlane Michael , Plummer Joseph 
Published: February 2020

Abstract
Background Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica.Methods A retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data.Results 48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30 – 95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘routine mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and abnormal mammogram. Median age at first screening mammogram was 51 years (range 41-77).Conclusion Breast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer screening guidelines.
Spatio-Temporal Variability of Malaria Infection in Chahbahar County, Iran: Association with the ENSO and Rainfall Variability
Authors: Nazemosadat S. M. J , Shafiei R , Ghaedamini H , Najjari M , Nazemosadat Z , Hatam Gholamreza 
Published: February 2020

Abstract
Background: Malaria is one of the most widespread communicable diseases in the southeast of Iran particularly in Chahbahar County. Comprehensive understanding of the influence of climate on this disease is a key element for success in the environmental-based malaria elimination programs. After analyzing the spatio-temporal distribution of the disease, the relationships between the infection statistics and some important climate indices particularly the El Niño-Southern Oscillation (ENSO) and rainfall were investigated.Methods: The malaria statistics collected from various health centers were composited with the corresponding data of Southern Oscillation Index (SOI), ground-based meteorological records and satellite-based rainfall data. Non-parametric Mann-whitely test was applied to detect the significant difference between patient number between El Niño and La Niña and between the adopted wet and dry episodes.Findings: Patient number from highest to lowest was associated to summer, autumn, spring and winter, respectively. Plasmodium falciparum, Plasmodium vivax and other species were responsible for 22%, 75% and 3% of the sickness, respectively. While the outbreak of P. falciparum is in autumn; P. vivax is erupted in summer. When the epidemic statistics were collected from rural rather than urban areas, the effect of climate on the infection statistic was more obvious.Interpretation: For rural / urban areas, the infection statistics exhibited a significant decline / increase during El Niño episodes. In autumn, spring and winter, patient number has significantly increased / decreased during the dry / wet epochs, respectively. These relationships were, however, reversed during summertime of health indicators are rarely available for every population and period of interest, and available data.Funding: Shiraz University of Medical Sciences
Characterization of exosome-like vesicles derived from Cysticercus pisiformis and their immunoregulatory role in macrophages
Authors: Wang Li-Qun , Liu Ting-Li , Liang Pan-Hong , Zhang Shao-Hua , Li Tao-Shan , Li Yan-Ping , Liu Guang-Xue , Mao Li , Luo Xue-Nong 
Published: February 2020

Abstract
Background: Taenia pisiformis is one of the most common intestinal parasites in canines, and leads to serious economic losses in the rabbit breeding industry. Exosome-like vesicles from parasites play crucial roles in host-parasite interactions by transferring cargo from parasites to host cells and by modulating host immunological response through inducing production of host-derived cytokines. Nevertheless, the mechanism by which exosome-like vesicles from Cysticercus pisiformis regulate macrophage immune response remains unknown.Methods: Using ultracentrifugation, we isolated exosome-like vesicles from excretory/secretory products (ESP) of C. pisiformis. The morphology and size of purified vesicles were confirmed by transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA). The components of proteins and miRNA within these vesicles were identified by proteomic analysis and high-throughput small RNA sequencing. The biological function of targets of exosomal miRNAs was predicted by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Moreover, the expression of Th1- and Th2-type immune response associated cytokines in RAW264.7 macrophages were evaluated by qRT-PCR and ELISA. We found that exosome-like vesicles were typical cup-shaped vesicles with diameters from 30 to 150 nm. A total of 87 proteins were identified by proteomic analysis, including proteins prominently associated with exosome-like vesicles biogenesis and vesicle trafficking. 41 known miRNAs and 18 novel miRNAs were identified in the exosome-like vesicles. 11 selected miRNAs, including 7 known miRNAs (miR-71-5p, miR-10a-5p, miR-let-7-5p, miR-745-3p, miR-219-5p, miR-124-3p, and miR-4989-3p) and 4 novel miRNAs (novel-mir-3, novel-mir-7, novel-mir-8, and novel-mir-11) were validated to exist in metacestiodes and exosome-like vesicles of C. pisiformis by qRT-PCR. The functions of most targets of exosomal miRNAs were mainly associated with signal transduction and the immune system. Additionally, C. pisiformis-derived vesicles induced the production of IL-4, IL-6, IL-10, IL-13 and Arg-1, but downregulated the expression of IL-12, IFN-γ and iNOS in RAW264.7 macrophages.Conclusions: We demonstrated that proteins and miRNAs enclosed within exosome-like vesicles from C. pisiformis have immunomodulatory functions. Furthermore, exosome-like vesicles were shown to induce the macrophage Th2-type immune response in vitro. Our study suggests that exosome-like vesicles play an important role in the interaction between cysticerci and their hosts.
Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study
Authors: Redmond Patrick , Munir Khalid , Alabi Oludare , Grimes Tamasine , Clyne Barbara , Hughes Carmel , Fahey Tom 
Published: February 2020

Abstract
Background Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. Aim The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process. Design Setting Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Method Thematic analysis was undertaken using an existing theoretical framework previously applied to implementation of medicines reconciliation. Results and conclusion Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review). Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.