bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of Asha Workers in the Hope Collaborative Care Mental Health Intervention in Rural South India: A Qualitative Analysis
Authors: Bansal Stuti , Sriniva Krishnamachari , Ekstrand Maria L 
Published: June 2020

Abstract
Background:Common mental disorders are responsible for a heavy disease burden in India and are often highly co-morbid with non-communicable diseases like diabetes and cardiovascular disease, which are increasing in prevalence across India as well. There is a severe lack of mental health resources in India, particularly in rural areas. Rural health care is often dependent on ASHA workers (Accredited Social Health Activists), high school-educated village women trained as community health workers. ASHA workers have been effectively involved in a variety of interventions, including a handful targeting mental illness, but perspectives of ASHA workers have been greatly overlooked.Methods:One-on-one qualitative interviews were conducted with 15 ASHA workers, all of whom completed the parent HOPE study, a collaborative-care randomized controlled trial that aims to integrate mental health care into existing primary care systems in rural Karnataka. The 15 ASHA workers in this substudy were asked questions about their role in HOPE, as well as their perspectives on patient health, mental illness, and the HOPE study.Results:ASHA workers mostly had positive interactions with patients, including encouraging them to attend sessions, helping to explain the topics and techniques, and checking in on the patients frequently. Occasionally ASHAs had negative relationships with patients. ASHA workers were able to identify key barriers to treatment and facilitators to treatment. ASHAs claimed that their knowledge about mental illness improved because of the HOPE study, though some gaps remained in their understanding of mental illness etiology and treatment. Overall, ASHA workers viewed the HOPE study as a necessary and effective intervention, and requested that it continue and expand.Conclusions: ASHA workers are important in establishing and maintaining relationships with patients that encourage attendance and participation, and the efforts of ASHAs often help in mitigating common barriers to treatment. Our results show that the beliefs and knowledge of ASHA workers can be changed in regards to mental illness, and ASHAs can become effective advocates for patients. The perspectives of ASHA workers need to be understood in order to understand the complexities of a rural health system that relies on their work, and most effectively help patients.
Influence of maintaining apical patency in post-endodontic pain
Authors: Shubham Snigdha , Nepal Manisha , Mishra Ravish , Dutta Kishor 
Published: June 2020

Abstract
Background
The purpose of this study was to compare postoperative pain between apical patency and non-patency groups and to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.
Methods
One hundred sixty patients were included in the study. Patients were randomly divided into: Group A (n = 80) contained apical patency maintaining group and Group B (n = 80) contained those treated without maintaining apical patency. Each group was subdivided into equal number of patients treated in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single- rooted teeth (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using a numerical rating scale. Statistical analysis was done using Mann -Whitney U test and Spearman correlation.
Results
There was statistically significant difference (p < 0.05) in postoperative pain scores between the groups on 1st, 2nd and 7th day follow up. Postoperative pain in patency maintaining group was not influenced by number of visit and group of teeth treated. Whereas, vital teeth when patency was maintained in multiple visits root canal treatment post-operative pain was statistically significant (p = 0.02) in day 1 follow up. Pre-operative pain also influenced postoperative pain with statistically significant difference and positive correlation between the groups.
Conclusions
Our study concluded that maintenance of apical patency increased postoperative pain. Post-operative pain was not influenced by number of visits, and group of teeth. However, for patency group, vital tooth treated in multiple visits results in more postoperative in 1st day follow up. In addition, pre-operative pain also has influence on post-operative pain.
Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study
Authors: Lieshout Eline van , Jacobs Lilliane , Pelsma Maaike , Dijkhuizen Rick , Visser-Meily Anne 
Published: June 2020

Abstract
Background: Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with TMS treatment, and this lack of knowledge may affect optimal implementation in clinical practice. The aim of this explorative study was to gain insight in the perceived effects and experiences of the design and delivery of a TMS treatment for upper limb recovery from the perspectives of stroke patients. Methods: This qualitative study was conducted as part of a randomized controlled trial (RCT) in a specialized rehabilitation center. Data were collected through face-to-face semi-structured interviews with 13 stroke patients who completed a 10-day TMS intervention for upper limb recovery. The interviews were recorded, transcribed verbatim and analyzed using thematic analysis. Results: The major themes that emerged from the patients’ feedback were the following: physical and psychological experienced effects (receiving something, sense of purpose, and recovery as a motivator), positive experiences (comfort, power of communication and information, interest and curiosity, no burden, no unpleasant aspects), concerns (uncertainty, equipment, logistics), and likeliness to participate in an RCT (personal drive and beliefs, and altruism). Important components related to the positive experience of the design and delivery of the treatment included comfort (i.e. moment of relaxation) and the sensation of a painless treatment without side-effects. Key concerns included uncertainty and anxiety about possible negative consequences and group allocation. Conclusions: This study demonstrates that TMS is well accepted by stroke patients with an upper limb paresis. Besides the expectation of a therapeutic benefit, the patients reported various psychological effects. Positive experiences, such as the provision of a short moment of relaxation each day, could have practical implications for clinical stroke rehabilitation settings aimed at improving patient satisfaction. Explanation about and feedback from routine motor recovery progression monitoring at fixed times post-stroke is also valued by patients. Negative emotions may be limited or avoided by clear, transparent and recurrent information delivery in future trials. Trial registration: NL5952 Registered November 28, 2016.
Impact of investigator initiated trials and industry sponsored trials on medical practice (IMPACT): Rationale and study design
Authors: Nury Edris , Bischoff Karin , Wollmann Katharina , Nitschke Kai , Lohner Szimonetta , Schumacher Martin , Rücker Gerta , Blümle Anette 
Published: June 2020

Abstract
Background
The German Research Foundation (DFG) and the Federal Ministry of Education and Research (BMBF) initiated large research programs to foster high quality clinical research in the academic area. These investigator initiated trials (IITs) cover important areas of medical research and often go beyond the scope of industry sponsored trials (ISTs). The purpose of this project was to understand to what extent results of randomized controlled IITs and ISTs have an impact on medical practice, measured by their availability for decisions in healthcare and their implementation in clinical practice. We aimed to determine study characteristics influencing a trial’s impact such as type of sponsor and place of conduct.
Methods
In a quasi-experimental design, the research impact of the following sub-cohorts was compared: German IITs (funded by DFG and BMBF or by other German non-commercial organizations), international IITs (without German contribution), German ISTs, and international ISTs. Trials included were drawn from the DFG-/BMBF-Websites, the German Clinical Trials Register, and from ClinicalTrials.gov. Research impact was measured as follows: 1) proportion of published trials, 2) time to publication, 3) proportion of publications appropriately indexed in biomedical databases, 4) proportion of openly accessible publications, 5) broadness of publication’s target group, 6) citation by other research articles, especially 7) by systematic reviews or meta-analyses, 8) appearance of publications in clinical practice guidelines, and 9) identifying study characteristics influencing the impact of trials.
Results
We included 691 trials: 120 German IITs, 200 International IITs, 171 German ISTs and 200 International ISTs. The median number of participants was 150, 30% were international trials and 70% national trials, 48% drug-trials and 52% non-drug trials. Overall, 72% of the trials had one pre-defined primary endpoint, 28% two or more (max. 36).
Conclusions
The results of this project deepen our understanding of the impact of biomedical research on clinical practice and healthcare policy, add important insights for the efficient allocation of scarce research resources and may facilitate providing accountability to the different stakeholders involved.
The misalignment of Tunisia's real effective exchange rate via the BEER approach
Authors: Sassi-Tmar Amel 
Published: June 2020

Abstract
This paper adopts the methodology of error correction models on the BEER (Behavioral Equilibrium Exchange Rate) approach to express the Tunisian real effective exchange rate based on-trade openness, the money supply in terms of GDP, and GDP per capita on the period (1975–2017). Indeed, the error correction mechanism confirms one of the convergences of the REER series of its trajectory to its long-term target value and on the other hand, it reflects the success of the monetary and commercial policies exploited to absorb all unpredictable shocks capable of preventing the stability of ERER from its equilibrium value. The empirical results also show the low sensitivity of the REER to monetary and trade shocks.
Microbial adaptation in vertical soil profiles contaminated by antimony smelting plant
Authors: Xu Rui , Sun Xiaoxu , Han Feng , Xiao Enzong , Li Baoqin , Qiu Lang , Song Benru , Yang Zhaohui , Sun Weimin 
Published: June 2020

Abstract
BackgroundSoil microbes play critical roles in the biogeochemical cycling of antimony (Sb) and arsenic (As), and the effects of Sb and As contamination on soil microbiota have been well documented in surface soils (< 0.2 m). However, their effects in deep soils remain poorly understood. This study determined the depth-resolved effects of Sb and As contamination on the microbial adaptation throughout soil profiles (0–2 m) and compared contaminated soil samples to uncontaminated samples.Methods16S rRNA amplicon sequencing and shotgun metagenomic sequencing were employed to investigate the microbial community and their metabolism traits in soil profiles. Co-occurrence network analysis was used to present the pairwise interactions of microbes.ResultsAs soil depth increased, Acidobacteria (18.8%–44.7% from top to bottom, hereafter), Chloroflexi (8.7%–42.4%), Proteobacteria (11.4%–27.1%), and Thaumarchaeota (0.49%–20.17%) were the most variable phyla from surface to deep soil. A set of co-occurrence networks revealed an obvious changing pattern of microbial interactions as soil depth increased. The networks were loosely connected in the heavily contaminated surface soil but gradually recovered and were well connected in the less contaminated deep soil. Results suggested that individual species became more connected with other patterns to perform syntrophic functions in the less contaminated soil depth. Shotgun metagenomic sequencing results indicated that microbial metabolic potential also changed with soil depth. Genes encoding C metabolism pathways were negatively correlated with Sb and As concentrations. A set of arsenic-related genes was enriched by the high Sb and As contamination but reduced with soil depth. ConclusionsSoil depth-resolved characteristics are often many meters deep and their microbial diversity and community structures obviously change along their vertical soil profiles due to different nutrient contents and biomasses. The significance of this study is that it further reveals how the microbial communities and microbial physiological traits respond to different soil profiles contaminated by high concentrations of Sb and As.
A Single-Centre Retrospective Study of Systemic Reactions to Subcutaneous Immunotherapy
Authors: Robertson Kara , Montazeri Nazanin , Shelke Urvashi , Jeimy Samira , Kim Harold 
Published: June 2020

Abstract
Background: Subcutaneous immunotherapy (SCIT) is the standard approach for treating patients with sensitizations to aeroallergens. However, immunotherapy can trigger severe systemic reactions if delivered inappropriately or to high risk patients. We sought to characterize and quantify SCIT systemic reactions requiring epinephrine administration during a 6-year period in a Canadian setting following the recommendations for components and dosages published in the 2010 Canadian Society of Allergy and Clinical Immunology (CSACI) Immunotherapy Manual.Methods: A single centre retrospective chart review was performed for all patients with systemic reactions to subcutaneous immunotherapy requiring intramuscular epinephrine injection between January 2011 and October 2017. Each systemic reaction requiring epinephrine was reviewed for baseline patient characteristics, details of the reaction, and reaction severity. Research ethics approval was obtained through McMaster University.Results: 28 of 380 patients experienced a systemic reaction requiring epinephrine administration, with an incidence rate of 1 per 1,047 injection visits (0.095%). 26 of the 28 reactions occurred within the mandatory 30-minute observation period post allergen immunotherapy. Of the 28 patients that experienced a systemic reaction to SCIT, 11 patients had asthma and 5 patients had a history of possible food allergy. All of the systemic reactions occurred during injections from vial number 4, and five patients reacted to their first shot of a re-ordered serum. 10 of the 28 patients required more than one intramuscular injection of epinephrine, and 20 of 28 patients were transferred to the hospital by ambulance.Conclusions: This is the first Canadian study to review patients with systemic reactions to subcutaneous immunotherapy. Several best practice methods were employed throughout the study to optimize subcutaneous delivery of immunotherapy serum, and our recorded per injection incidence rate for systemic reactions was comparable or below the rate published in similar studies. The recommendations in the CSACI Immunotherapy Manual provide an approach to standardizing prescriptions for SCIT to maximize immunotherapy efficacy and reduce the risk of systemic reactions, though similar studies in larger multicenter settings are needed to confirm these observations. These observations provide important objective information to clinicians about the potential risks for systemic reactions in patients considering SCIT.
Differential Expression Profiles of Long Noncoding RNA and mRNA in Dexamethasone-Induced Apoptosis of Human Bone Marrow Mesenchymal Stem Cells
Authors: Li Tao , Xu Yingxing , Wang Yingzhen , Jiang Yaping 
Published: June 2020

Abstract
Background
Abnormalities in apoptosis, cell cycle, and proliferation of human bone marrow mesenchymal stem cells (hBMSCs) significantly impact bone metabolism and remodeling, and thereby cause various skeletal disorders. Long-term exposure to a high dosage of dexamethasone (Dex) induces apoptosis and inhibits proliferation of mesenchymal stromal cells (MSCs), which are probably the primary causes of osteoporosis (OP) and steroid-induced osteonecrosis of the femoral head (SONFH). However, to date, the exact mechanisms of Dex-induced apoptosis of BMSCs are still poorly defined.
Methods
A microarray was used to identify differentially expressed lncRNA and mRNA in Dex-induced apoptosis of hBMSCs, and bioinformatics was used to further explore the role of these differentially expressed lncRNAs and mRNAs by the coding and noncoding (CNC) network. Furthermore, validation of the microarray results was performed by quantitative real-time PCR (qRT-PCR) analysis.
Results
The microarray analysis identified a total of 137 differentially expressed mRNA (90 up-regulated and 47 down-regulated) and 90 differentially expressed lncRNA (61 up-regulated and 29 down-regulated) in Dex-induced apoptosis of hBMSCs. The differentially expressed mRNA and lncRNA were associated with the regulation of cell apoptosis. Meanwhile, several signaling pathways involved in the regulation of cell apoptosis, including mTOR signaling pathway, Ras signaling pathway, HIF-1 signaling pathway, NF-kappa B signaling pathway, and TGF-beta signaling pathway, also were identified in interaction net of the significant pathways (Path-Net) analysis. Furthermore, the CNC network further identified 78 core regulatory genes involved in the regulation of apoptosis. Besides, validation by qRT-PCR of the key differentially expressed mRNA and lncRNA, reported to be closely related to cell apoptosis, confirmed the reliability of the microarray dataset.
Conclusions
Collectively, we utilized microarray to identify differentially expressed lncRNA and mRNA in Dex-induced apoptotic hBMSCs, and bioinformatics to explore the interaction between the differentially expressed genes. This study demonstrates the molecular mechanisms of Dex-induced apoptosis of hBMSCs and provides a new research direction for the study of the pathogenesis of steroid-induced osteonecrosis of femoral head.
Generalised Cost-Effectiveness Analysis of 159 Health Interventions For The Ethiopian Essential Health Service Package
Authors: Teshome Getachew , Hailu Alemayehu , Stenberg Karin , Johansson Kjell Arne , Norheim Ole Frithjof , Bertram Melanie Y 
Published: June 2020

Abstract
Background: Cost effectiveness was a criterion used to revise Ethiopia’s essential health service package (EHSP) in 2019. However, there are few cost-effectiveness studies from Ethiopia or directly transferable evidence from other low-income countries to inform a comprehensive revision of the Ethiopian EHSP. Therefore, this paper reports average cost-effectiveness ratios (ACERs) of 159 health interventions used in the revision of Ethiopia’s EHSP. Methods: In this study, we estimate ACERs for 77 interventions on reproductive maternal neonatal and child health (RMNCH), infectious diseases and water sanitation and hygiene as well as for 82 interventions on non-communicable diseases. We used the standardised World Health Organization CHOosing Interventions that are Cost Effective methodology for generalised cost-effectiveness analysis. The health benefits of interventions were determined using a population state-transition model, which simulates the Ethiopian population, accounting for births, deaths and disease epidemiology. Healthy life years (HLYs) gained was employed as a measure of health benefits, and we estimated the economic costs of interventions from the health system perspective, including programme overhead and training costs. We used the Spectrum generalised cost-effectiveness analysis tool for data analysis. We did not explicitly apply cost-effectiveness thresholds, but we used US$100 and $1,000 as references to summarise and present the ACER results. Results: We found ACERs ranging from less than US$1 per HLY gained (for family planning) to about US$48,000 per HLY gained (for treatment of stage 4 colorectal cancer). In general, 75% of the interventions evaluated had ACERs of less than US$1,000 per HLY gained. The vast majority (95%) of RMNCH and infectious disease interventions had an ACER of less than US$1,000 per HLY while almost half (44%) of non-communicable disease interventions had an ACER greater than US$1,000 per HLY. Conclusion: The present study shows that several potential cost-effective interventions are available that could substantially reduce Ethiopia’s disease burden if scaled up. The use of the World Health Organization’s generalised cost-effectiveness analysis tool allowed us to rapidly calculate country-specific cost-effectiveness analysis values for 159 health interventions under consideration for Ethiopia’s EHSP.
Current situation and improvement suggestions of COVID-19 close contacts tracking investigation official letter management
Authors: Li zhiqun , Luo Lei , Jing Qinlong , Xu Jianxiong , Zhou Ziyan , Chen Jian , Huang Rende , Li Jianjie 
Published: June 2020

Abstract
Background: This study analyzes the current status of tracking investigation official letter management for 9036 COVID-19 close contacts in Guangzhou,and explains the necessity of establishing a COVID-19 close contacts tracking investigation sharing system. Method: Based on the information obtained from COVID-19's close contacts' tracking investigation official letters from January 21 to March 31 in Guangzhou, the epidemic situation map and flow chart of receiving and sending official letters were drawn, and the observation rate, sampling rate and Turn positive rate of close contacts were calculated. Results: The tracking investigation official letter involved in 31 provinces (municipalities directly under the central government, autonomous regions) and 172 cities, investigation close contacts with 9036: 309 investigation letters were received from the nonlocal case, investigation close contacts with 2790, involved in 30 provinces and 95 cities, medical observation at a rate of 100%, sampling rate 99.56%, turn positive rate was 3.76%; The city of Guangzhou issued 204 official letters of investigation, with 6,246 close contacts, covering 27 provinces and 114 cities. The medical observation rate was 100%, the sampling rate 99.63%, and turn the positive rate of 2.26%. The reply time of the investigation results is within 1-12 hours, and the other 1-3 days. As of March 31, 440 cases of covid-19 were confirmed in Guangzhou (including 92 imported cases), and the tracking coefficient of close contacts was 14.2 (6246 / 440). Conclusion: Guangzhou close contacts tracking investigation official letter management is tight, the prompt detection of the source of infection to control the epidemic situation is significant. However, due to the multiple sources and complicated process of official letters, it is suggested to establish a COVID-19 close contacts tracking and investigation sharing system.