bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of health care professionals on Governance of Hospital Quality of Care and Accreditation in the Public Hospitals of United Arab Emirates: A Qualitative Study
Authors: Ali Ghada 
Published: November 2019

Abstract
Background Hospital accreditation is frequently used as a tool for government directives for the purpose of guaranteeing patient safety or quality of care. The study aims to interview healthcare workers with a diversity of views and perceptions on accreditation experiences, performance and governance of quality of care. Methods: Semi-Structured interviews between June 2017 – Dec 2017 with 155 board members and executives from four public acute care accredited MOHAP hospitals in the United Arab Emirates was undertaken. The interviews mainly highlighted the role played by the management in overseeing the quality of care in their respective hospitals. Perceptions of interviewees’ regarding factors that have influenced their present approach to governance in this area were also elicited. Thematic analysis was utilized for the purpose of identifying the major themes extracted from the interview transcripts. Results A total of four themes emerged from the analysis including (1) Corporate (Hospital) Governance, (2) Accreditation, (3) Employees’ satisfaction, (4) Quality Management and Performance. Interviews with United Arab Emirates health care leaders emphasized on the governance role and affirmed that they had a well-structured governing body. Furthermore, the role of the leadership at their hospital was very essential in making the accreditation happen and in improving the quality of care provided to patients. Staff expressed strong support for implementation as well as development of hospital standards along with requesting for ongoing motivation and recognition. Respondents also cited the need for infrastructure, funding and technical assistance as the major obstacles. Conclusion The study demonstrated a strong support for the implementation or development of hospital standards. Implementing quality improvement programs such as accreditation leads to enhanced quality of care provided at the hospitals and better health outcomes. This study emphasizes the importance of having effective governance, top management commitment and leadership side by side for effective implementation of accreditation. Findings shows that strong governance and support from the top management were critical for implementing accreditation and improving quality of services in the government hospitals.
Potential suitable habitat of Eleusine coracana (L) Gaertn (Finger millet) under the climate change scenarios in Nepal
Authors: Luitel Dol Raj , Siwakoti Mohan , Joshi Mohan D. , Rangaswami Muniappan , Jha Pramod K. 
Published: November 2019

Abstract
Background: Finger millet is the fourth major crop in Nepal and is cultivated in a traditional integrated subsistence system. Timely rain and appropriate temperature predominately affects crop distribution and yield. Climate change is evident in Nepal and it is imperative to understand how it affects habitat suitability of finger millet. Mapping the current suitable habitat and predicting the potential changes in the future is important for maximizing production and minimizing the loss of local landraces. Results: Maxent model was used in this study to quantify the current suitable habitat and changes in the future habitat suitability of finger millet under different climate scenarios, based on representative concentration pathways (RCP)(RCP 2.6, 4.5, 6.0 and 8.5) in two different time periods (2050 and 2070AD) using climatic predictive variables and species localities. The model shows that 39.7% (58512.71km 2 ) area of Nepal is highly suitable for finger millet, with cultivation mostly between 96-2300m above sea level. Eastern and central parts of Nepal have more suitable areas than western parts. Our research clearly shows that the future climatic suitable area of finger millet would shrink by 4.3 to 8.9% in 2050 and 8.9-10.5%under different RCPs by 2070. Conclusion: Finger millet is mostly cultivated in mid-hill terraces. The substantial increase in temperature due to climate change may be one reason for decrease in habitat suitability of finger millet. This situation would further threat loss of local landraces of finger millet in the future. The findings can help in planning and policy framing for climate resilient smart agriculture practice. Key words : Climate change, finger millet, habitat suitability, Maxent model
Identification of transcription factors MYC and C/EBPβ mediated regulatory networks in heart failure
Authors: Wang Haiwei , Wang Xinrui , Xu Liangpu , Cao Hua 
Published: November 2019

Abstract
Background: Heart failure is one of leading cause of death worldwide. However, the transcriptional profiling of heart failure is unclear. Moreover, the signaling pathways and transcription factors involving the heart failure developmental progress also are largely unclear.Methods: The transcriptional profiling of heart failure was identified from integrated gene expression datasets. The enriched pathways and transcription factors were analyzed using DAVID and GSEA assay. The transcriptional networks were created by Cytoscape.Results: Compared with the normal heart tissues, we found 90 genes were particularly differentially expressed in heart failing tissues, and those genes were associated with multiple metabolism pathways and insulin signaling pathway. Metabolism and insulin signaling pathway were both inactivated in heart failing tissues. Transcription factors MYC and C/EBPβ were both negatively associated with the expression profiling of heart failing tissues in GSEA assay. Moreover, compared with normal heart tissues, MYC and C/EBPβ were down regulated in heart failing tissues. Furthermore, MYC and C/EBPβ mediated downstream target genes were decreased in heart failing tissues. MYC and C/EBPβ were positively correlated with each other. At last, we constructed the transcription factor MYC and C/EBPβ mediated regulatory networks in heart failing tissues, and identified the MYC and C/EBPβ target genes which had been reported involving the failure developmental progress by literature research. Conclusions: Our results suggested that transcription factor MYC and C/EBPβ played critical roles in heart failure developmental progress. And new heart failure treatments may be developed by targeting MYC and C/EBPβ.
The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension
Authors: Liu Yang , Lin Yao , Zhang Ming-Ming , Zheng Tong , Li Xiao-Hui , Liu Yan-Yan , Zhao Jing , Shi Lin 
Published: November 2019

Abstract
Background To investigate the relationships of plasma RAAS levels to BPV and TOD in children with essential hypertension.Methods A case-control study was conducted on 132 children diagnosed with essential hypertension, comprising 103 males and 29 females with the mean age of 11.8 ± 2.4 years. The plasma RAAS levels were measured by enhanced chemiluminescence method, and the ambulatory blood pressure was monitored for 24h, followed by calculation of the coefficients of variability (CV). Data on indicators for assessing fundus, cardiac, and renal damages. The correlations of plasma RAAS levels to BPV and TOD were studied. Comparison between groups was analyzed by SPSS 20．Results Among the 132 children, 88 cases had target organ damage. The daytime CV of systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.365, P = 0.019). Plasma AT II and aldosterone levels were significantly associated with left ventricular mass index (r = 0.316, P < 0.01; r = 0.176, P = 0.043), and plasma AT II was positively correlated with the LVMI (r = 0.316; P < 0.01).Conclusions The AT II level in children with essential hypertension affected the variability of daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage, especially the AT II. Results from this study provide an objective basis for the protection against subclinical cardiac damage in childhood hypertension.Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system
Cerebrovascular and neurological impact of chronic smoking on post traumatic brain injury outcome and recovery: an in vivo study
Authors: Sivandzade Farzane , Alqahtani Faleh , Sifat Ali , Cucullo Luca 
Published: November 2019

Abstract
Background: Traumatic Brain Injury (TBI) is among the most prevalent causes of cerebrovascular and neurological damage worldwide. To this end, tobacco smoking (TS) has been shown to promote vascular inflammation, neurovascular impairments and risk of cerebrovascular and neurological disorders through oxidative stress (OS) stimuli targeting the blood-brain barrier (BBB) endothelium among others. It has been recently suggested that premorbid conditions such as TS may exacerbate post-TBI brain damage and impact recovery. The present study aims to investigate and dissect out the pathophysiological mechanisms underlying the exacerbation of TBI in a weight-drop model following chronic TS exposure.
Methods: C57BL/6J male mice, age range 6–8 weeks were chronically exposed to TS for three weeks. Test animals were then subjected to TBI by guided vertical head weight drop using a 30 g metal weight free felling from an 80 cm distance before reaching the target. Physical activity and body weight of the mice were analyzed before TBI and 1 h, 24 h and 3 days post-injury. Finally, mice were sacrificed to collect blood and brain samples for subsequent biochemical and molecular analysis. Western blotting was applied to assess the expression of Nrf2 (a key antioxidant transcription factor) as well as tight junction proteins associated with BBB integrity including, ZO-1, Occludin, Claudin-5 from brain tissues homogenates. Levels of NF-kB (a pro-inflammatory transcript factor which antagonizes Nrf2 activity) along with pro-inflammatory cytokines IL-6, IL-10 and TNF-α were measured by ELISA on blood samples.
Results: TS promoted significantly increased inflammation and loss of BBB integrity in TBI when compared to TS-Free test mice. Additionally, mice chronically exposed to TS prior to TBI experienced a more significant weight loss, behavioral, and motor activity deficiency and slower post-TBI recovery when compared to TS-free TBI mice.
Conclusion: TS promotes a significant exacerbation of post-TBI neurovascular and neurological impairments. Whereas BBB impairment and pro-inflammatory vascular responses induced by chronic TS exposure are likely responsible for the retardation of post-traumatic recovery observed in these animals.
The role of high-mobility group box protein 1 in chronic cerebral hypoperfusion-induced vascular cognitive impairment animals
Authors: Vidyanti Amelia Nur , Hsieh Jia-Yu , Lin Kun-Ju , Fang Yao-Ching , Setyopranoto Ismail , Hu Chaur-Jong 
Published: November 2019

Abstract
Background: The molecular mechanisms of vascular cognitive impairment (VCI) are diverse and still in puzzle. VCI could be attributed to chronic cerebral hypoperfusion (CCH). CCH may cause a cascade of reactions involved in ischemia and neuro-inflammation which plays important roles in the pathophysiology of VCI. High-mobility group box protein 1 (HMGB1) is a non-histone protein that serves as a damage-associated molecular signal leading to cascades of inflammation. Increased level of HMGB1 has been established in the acute phase of CCH. However, the role of HMGB1 at the chronic phase of CCH remains elucidated.
Methods: We performed modified bilateral common carotid artery occlusion (BCCAO) in C57BL/6 mice to induce CCH. We examined the cerebral blood flow (CBF) reduction by laser doppler flowmetry, the protein expression of HMGB1 and its pro-inflammatory cytokines (TNF-a, IL-1b, and IL-6) by western blotting and immunohistochemistry. The brain pathology was assessed by 7T-animal MRI and amyloid-b accumulation was assessed by amyloid-PET scanning. We further evaluated the effect of HMGB1 suppression by injecting CRISPR/Cas9 knock-out plasmid intra-hippocampus bilaterally.
Results: There were reduction of CBF up to 50% which persisted three months after CCH. The modified-BCCAO animals developed significant cognitive decline. The 7T-MRI image showed hippocampal atrophy, although the amyloid-PET showed no significant amyloid-beta accumulation. Increased protein levels of HMGB1, TNF-a and IL-1b were found three months after BCCAO. HMGB1 suppression by CRISPR/Cas9 knock-out plasmid restored the CBF, IL-1B, TNF-alpha, IL-6, and attenuated hippocampal atrophy and cognitive decline.
Conclusion: HMGB1 plays a pivotal role in the pathophysiology of the animal model of CCH and it might be a candidate as therapeutic targets of VCI.
Occupational noise exposure and its association with incident hyperglycemia: a retrospective cohort study
Authors: Chang Ta-Yuan , Yu Tzu-Yi , Liu Chiu-Shong , Young Li-Hao , Bao Bo-Ying 
Published: November 2019

Abstract
Background: Epidemiological studies have demonstrated the association between noise exposure and diabetes, but few studies have reported the relationship between noise frequency components and fasting blood glucose. This study investigated the associations between noise levels, frequency characteristics, and the incident hyperglycemia. Methods: An industry-based cohort of 905 volunteers was enrolled and followed-up from the data of first employment to 2012. Personal noise levels and octave-band frequencies of environmental noise were measured systematically in 2012 to classify subjects’ exposure retrospectively. Cox regression models were applied to calculate the relative risk (RR) of hyperglycemia by continuous and categorical noise-exposure and frequency-component levels, adjusting for potential confounders. Results: Subjects exposed to ≥80 A-weighted decibels (dBA) had an increased RR for hyperglycemia of 1.78 (95% confidence interval [CI]: 1.11, 2.84) compared with those exposed to <70 dBA. The high-exposure groups at frequencies of 31.5 (≥33 decibel [dB]), 63 (≥44 dB), 125 (≥52 dB), 250 (≥59 dB), 500 (≥65 dB), 1000 (≥68 dB), and 2000 (≥68 dB) Hz had a significantly higher risk of hyperglycemia (all p values < 0.05) than did the low-exposure groups, and those exposed at 31.5 Hz had the highest risk (Adjusted RR=1.97, 95% CI: 1.23, 3.16). Per 5-dB increase in noise frequencies at 31.5, 63, 125, 250, 500 Hz, and 1000 Hz were associated with an elevated incidence of hyperglycemia (all p < 0.05), with the highest risk of 1.27 (95% CI: 1.10, 1.47) at 31.5 Hz (p = 0.001). Conclusions: Exposure to occupational noise may be associated with an increased incidence of hyperglycemia, with the highest risk observed at 31.5 Hz, providing a possible link between noise exposure and cardio-metabolic disease.
Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with +2.75 and +4.00 diopter add powers
Authors: Lee Jae Hyuck , Lee Hun , Lee Jin Ah , Yoo Aeri , Kim Jae Yong , Tchah Hungwon 
Published: November 2019

Abstract
Background

To evaluate the clinical outcomes of bilateral mix-and-match implantation of diffractive multifocal intraocular lenses (IOLs) with different add powers.

Methods

We retrospectively reviewed the medical records of 18 patients who underwent bilateral mix-and-match implantation of diffractive multifocal IOLs with different add powers. Multifocal IOLs with add powers of +2.75 diopters (D) and +4.00 D were implanted into the patients’ dominant and nondominant eyes, respectively. At 1 and 3-month postoperatively, monocular and binocular visual acuity was measured using logMAR charts and manifest refraction was performed. Specifically, logMAR charts were used to measure uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA). Defocus curves, contrast sensitivity, and patient satisfaction were assessed at 3-month postoperatively.

Results

Binocular logMAR measurements (mean ± standard deviation) at 3-month postoperatively were 0.01±0.04 (UDVA), 0.16±0.05 (UIVA), and 0.11±0.07 (UNVA). Postoperative spherical equivalent was -0.43±0.35 D and -0.39±0.21 D in the dominant and nondominant eyes, respectively. Defocus curves showed significant differences between -1.50 and -4.00 D among binocular, dominant, and nondominant eye measurements, except between -2.50 and -3.00 D. Eyes implanted with +2.75 and +4.00 D IOLs showed good contrast sensitivity under photopic and mesopic conditions. Over 80% of patients reported high satisfaction with their near vision.

Conclusions

Bilateral mix-and-match implantation of diffractive multifocal IOLs with add powers of +2.75 D and +4.00 D showed good near, intermediate, and far vision.
A comparison between arthroscopic and open surgery for treatment outcomes of chronic lateral ankle instability accompanied by osteochondral lesions of the talus
Authors: Xu Can , Li Mingqing , Wang Chenggong , Liu Hua 
Published: November 2019

Abstract
Background : The present study aimed to examine the efficacy and safety of concurrent arthroscopic treatment of osteochondral lesion of talus (OLT) and lateral ankle instability. It was hypothesized that the outcome of all arthroscopic surgery was no worse than that of the combined open and arthroscopic surgery for treating chronic lateral ankle instability accompanied by OLT.
Methods : All the patients diagnosed of chronic lateral ankle instability accompanied by OLT who were surgically treated between May 2015 and May2017 were targeted for inclusion. A total of 32 patients received concurrent arthroscopic treatment of OLT and lateral ankle instability, and 35 patients received arthroscopic treatment of OLT and open lateral ankle stabilization. All these patients were followed up using Karlsson Ankle Functional Score, visual analog scale (VAS) scores, Tegner activity score, and American Orthopaedic Foot and Ankle Society Score (AOFAS). The satisfaction and complication rate was evaluated and compared.
Results : At 24-month follow-up, the Karlsson score, VAS score, Tegner score and AOFAS score were significantly improved in both groups in relation to the pre-operative condition. The two groups did not differ significantly from each other in terms of functional outcomes, satisfaction and complication rate.
Conclusion : In comparison with the open lateral ankle stabilization and arthroscopic treatment of OLT, the all arthroscopic procedure showed no difference in clinical outcome at 24-month follow-up for treating chronic lateral ankle instability accompanied by OLT. With the benefits of minimal invasive arthroscopic procedure and an aggressive rehabilitation protocol, the treatment efficacy for the patients with chronic lateral ankle instability accompanied by OLT was still inferior to that for the patients with chronic ankle instability.
Trial registration : The present study was carried out with the retrospectively registered data starting from May 28, 2015
Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated OA care model: Secondary analyses from a cluster-randomised controlled trial
Authors: Moseng Tuva , Dagfinrud Hanne , Bodegom-Vos Leti van , Dziedzic Krysia , Hagen Kåre Birger , Natvig Bård , Røtterud Jan Harald , Vlieland Thea Vliet , Østerås Nina 
Published: November 2019

Abstract
Background: To address the well-documented gap between hip and knee osteoarthritis (OA) treatment recommendations and current clinical practice, a structured model for integrated OA care was developed and evaluated in a stepped-wedge cluster-randomised controlled trial. The current study used secondary outcomes to evaluate clinically important response to treatment through the Outcome Measures in Rheumatology Clinical Trials clinical responder criteria (OMERACT-OARSI responder criteria) after 3 and 6 months between patients receiving the structured OA care model vs. usual care. Secondly, the study aimed to investigate if the proportion of responders in the intervention group was influenced by adherence to the exercise program inherent in the model.
Methods: The study was conducted in primary healthcare in six Norwegian municipalities. General practitioners and physiotherapists received training in OA treatment recommendations and use of the structured model. The intervention group attended a physiotherapist-led OA education program and performed individually tailored exercises for 8-12 weeks. The control group received usual care. Patient-reported pain, function and global assessment of disease activity during the last week were evaluated using 11-point numeric rating scales (NRS 0-10). These scores were used to calculate the proportion of OMERACT-OARSI responders. Two-level mixed logistic regression models were fitted to investigate differences in responders between the intervention and control group.
Results: 284 intervention and 109 control group participants with hip and knee OA recruited from primary care in six Norwegian municipalities. In total 47% of the intervention and 35% of the control group participants were responders at 3 or 6 months combined; showing an uncertain between-group difference (OR adjusted 1.38 (95% CI 0.41, 4.67). In the intervention group, 184 participants completed the exercise programme (exercised ≥2 times/week for ≥8 weeks) and 55% of these were classified as responders. In contrast, 28% of the 86 non-completers were classified as responders.
Conclusions: The difference in proportion of OMERACT-OARSI responders at 3 and 6 months between the intervention and control group was uncertain. In the intervention group, a larger proportion of responders were seen among the exercise completers compared to the non-completers.