bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivery of a Mental Health First Aid training package and staff peer support service in secondary schools: A mixed-methods implementation study of the WISE intervention
Authors: Fisher Harriet , Harding Sarah , Bell Sarah , Copeland Lauren , Evans Rhiannon , Powell Jillian , Araya Ricardo , Campbell Rona , Ford Tamsin , Gunnell David , Murphy Simon , Kidger Judi 
Published: November 2019

Abstract
Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The intervention tested delivery of a Mental Health First Aid (MHFA) training package to at least 16 percent of staff, a short mental health awareness session to all teachers, and development of a staff peer-support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings from an embedded process evaluation to assess the extent of successful intervention implementation.Methods: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. Results: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the two-day standard MHFA training course, and a further 146 (11.1%) staff completed the one-day MHFA for Schools and Colleges training. In seven (58.3%) schools the required eight percent of staff completed the MHFA training packages. A one-hour mental health awareness raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer-support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study. Teachers reported limited use of the peer support service during follow-up. At the second peer-supporter feedback meeting, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership. Conclusion: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach.
Molecular Evolution, Genome-Wide Characterization and Codon Bias Analysis of the SBP-Box Family in Cucumis sativus
Authors: You Yue , Zheng Yuanting , Wang Jian , Li Sujuan , Shao Jianfeng , Qi Guoan , Xu Fei , Wang Gangjun , Chen Zhonghua , Xu Shengchun 
Published: November 2019

Abstract
Background: SQUAMOSA promoter binding protein (SBP)-box genes encode a group of transcription factors which extensively play essential roles in plant development and stress responses. However, the SBP-box gene family has not been well characterized in cucumber (Cucumis sativas). Results: In present study, 15 putative SBP-box genes were identified distributing on 4 chromosomes of cucumber. Evolutionary analysis showed that the green plant SBP family originated from a common ancestor. Phylogenic analysis divided CuSBPs into 6 groups similar to those of Arabidopsis and rice. Intron-exon and motif structure within each group shared common features according to evolutionary study. Expression pattern analysis of transcriptional data about flowering and resistance to powdery mildew demonstrated conserved SBP-box genes function in vegetative-to-reproductive transition and potential roles in other regulatory pathways. Moreover, codon bias analysis explained the mutation and selection pressure exerted on genes. Conclusions: This study comprehensively characterized cucumber CuSBP gene families, which would provide a foundation to explore the functions of CuSBPs for improving yield, quality and stress tolerance of cucumber in the future.
Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.
Authors: Ngunyi Yannick Lechedem , Halle-Ekane Gregory , Tendongfor Nicholas , Mbivnjo Etheldreda Leinyuy , Mbarga Armel Evouna , Nembulefack Derick , Abonge Clifford Lo-oh , Egbe Thomas Obinchemti 
Published: November 2019

Abstract
Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP.Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.
Association of CYP19A1 Polymorphism with Genetic Susceptibility to Lung Cancer in Chinese population:a case-control study
Authors: Li Anqi , Li Meng , He Ruiqing , Dang Wenhui , Li Yang , Jin Tianbo , Zhang Ning , Zhang Shanshan , Chen Mingwei 
Published: November 2019

Abstract
Background Lung cancer is a kind of cancer with high morbidity and mortality related to genetic factors. Many studies have shown that CYP19A1 gene polymorphism is associated with a variety of cancers, but there are few studies on lung cancer at present. The aim of the study was to explore the correlation between CYP19A1 polymorphisms and lung cancer risk in Chinese population.Methods We enrolled 510 lung cancer patients as the case group and 504 healthy people as the control group. Five single nucleotide polymorphisms determined in CYP19A1 gene were genotyped by MassARRAY, and correlation analysis was performed by Chi square test and logistic regression model.Results The genotypes of rs4646 (OR=0.77, p=0.010), rs6493487 (OR=0.76, p=0.006) and rs17601876 (OR=0.69, p=1.15E-04) in CYP19A1 gene were linked to decreasing the risk of lung cancer, while the rs1062033 (OR=1.49, p=0.029) was linked to increasing lung cancer risk. In gender-stratified analysis, female patients with the GG genotype of the rs6493487 (OR=0.31, p=0.037) and male patients with the rs17601876 (OR=0.52, p=0.012) had lower lung cancer risk. In age-stratified analysis, for patients ≥58 years, decreased lung cancer risk was correlated with the genotypes of rs4646 (OR=0.66, p=0.021), rs6493487 (OR=0.65, p=0.021) and rs17601876 (OR=0.39, p=0.001), and increased risk was associated with the GG genotype of rs1062033 (OR=2.09, p=0.003). In pathologic type-stratified analysis, the AA genotype of rs17601876 (OR=0.41, p=0.048) was associated with decreased risk of small cell lung cancer, and the AA genotype of rs4646 (OR=0.41, p=0.027), the GA genotype of rs6493487 (OR=0.65, p=0.024) and the AA genotype of rs17601876 (OR=0.34, p=0.005) were linked to decreased risk of squamous cell carcinoma.Conclusion CYP19A1 polymorphisms are associated with lung cancer risk, especially in elderly patients and patients with pathologic types of small cell lung cancer and squamous cell carcinoma.
Metabolomics Study of Browning Mechanism in Eggplant Fruits
Authors: Liu Xiaohui , Zhang Shengmei , Shang Jing , Zhang Aidong , Zhu Zongwen , Wu Xuexia , Zha Dingshi 
Published: November 2019

Abstract
Background: Fresh-cut fruits and vegetables is a emerging type of fruits and vegetables processing products for consumers to eat immediately or for the catering industry. Enzymatic browning is one of the crucial problems compromising the flavor and texture of fresh-cut fruit and vegetables. Eggplant is a common vegetable, which is favored by consumers. Accordingly, we used an untargeted metabolomics approach based on liquid chromatography-mass spectrometry (LC-MS) to explore the browning mechanism in peeled eggplant ( Solanum melongena L . ). Results: Metabolomics revealed several hundred differential metabolites, including lipids, phenols, sugars and fatty acids. The content of these metabolites changed dynamically as the peeled time increased. The content of polyphenols, especially chlorogenic acid, increased significantly, suggesting that the main substrate for enzymatic browning in eggplant is chlorogenic acid. Furthermore, all the differential metabolite were mapped to KEGG pathway, revealing significant differences in linoleic acid metabolism, tyrosine metabolism ，glutathione metabolism, pentose phosphate pathway, tropane, piperidine and pyridine alkaloid biosynthesis, phenylpropanol metabolism and glycosylphosphatidylinositol(GPI)-anchor biosynthesis over time. Therefore, we speculate that some metabolic pathways that are closely connected with respiration, glycolysis, ATP synthesis, and phenolic synthesi are disturbed after peeling, under the action of enzymes, eventually leading to browning. Conclusions: We established an untargeted metabolomics method based on LC-MS technology to explain the mechanism of eggplant browning, which may lay the foundation for better understanding the mechanism of browning during the fruits and vegetables deeply processing, and furnish new ideas and perspectives for understanding fruit and vegetable browning in the future.
An Ontology-Based Medical Information Management System for Electronic Claim Processing Systems
Authors: Kose Ilker 
Published: November 2019

Abstract
Background The electronic claim processing (ECP) systems in healthcare insurance require, naturally, comprehensive, and secure management of medical information. Even though the state of the art ECP systems can read the payment rules written in plain-text, there are hundreds of rules (each including tens of conditions) in a conventional ECP system. The conditions of the rules, in turn, refer to thousands of medical entities and concepts. Although domain experts can manage the plain-text payment rules, the length and complexity of the rules yield a lack of understandability and an increase in-rule and inter-rule inconsistencies. Hence, a more efficient and straightforward system is required. This study aims to make the medical data bank that is used for the claim management system more efficient by using ontology. Method We proposed ontology- based on the medical information management system (ONTMIMS) in healthcare insurance- to simplify the payment rules. 1,312 sets of diagnosis and health services are included in ONTMIMS. The development of the ontology compromises four stages: i) specification and conceptualization; ii) formalization; iii) implementation; and, iv) evaluation. Protégé and Apache Jena library are conducted as tools, and the ONTMIMS is used in a real-life ECP system. Results The experiments indicated that ONTMIMS increased the understandability from 35.1% to 64.9%. Distinguishing in-rule inconsistencies increased from 65% to 82.5%, and distinguishing inter-rule inconsistencies increased from 78.8% to 85%. Conclusions Ontology, as in many other studies, is very useful in representing and processing information. That is the first study using ontology in ECP systems used in health insurance institutions. The results showed that ontology increased the in-rule and inter-rule consistency and made the rule sentences more understandable by the domain experts.
Association between demographics, socioeconomic status and metabolic syndrome in American adults: a cross-sectional study
Authors: Liu Yang , Jiang Liyan , Zeng Mengru 
Published: November 2019

Abstract
Background Evidence regarding the association between demographics, socioeconomic status and metabolic syndrome is limited. We aim to investigate whether demographics and socioeconomic status are correlated with metabolic syndrome using data from National Health and Nutrition Examination Survey through 2013/2014 to 2015/2016.Methods A total of 4313 selected participants were included in this cross-sectional study. The independent variables were demographics (age, gender,and race/ethnicity) and socioeconomic status (the ratio of family income to poverty). The dependent variable was metabolic syndrome. The covariates included data release cycle, education level, marital status, dietary data, health insurance, average alcoholic drinks, current smoking, sedentary activity hours, physical activity minutes, and body mass index. Logistic regression analysis was used to evaluate the association between demographics, socioeconomic status and metabolic syndrome.Results In fully-adjusted models, we found that age was positively associated with metabolic syndrome (OR:1.05, 95%CI:1.04-1.05); compared with the male group, female was positively associated with metabolic syndrome in participants with body mass index under 25 kg/m 2 (OR:1.84, 95%CI:1.07-3.18) whereas it was negatively associated with metabolic syndrome in those with body mass index equal to or greater than 30 kg/m 2 (OR:0.62, 95%CI:0.48-0.81); compared with Mexican American, non-Hispanic Asian and other race/ethnicity were positively associated with metabolic syndrome in participants with body mass index under 25 kg/m 2 (OR: 7.30, 95%CI: 1.50-35.62 and OR: 6.09, 95%CI: 1.25-29.74, respectively) while non-Hispanic Black was negatively associated with metabolic syndrome in participants with body mass index equal to or greater than 25 kg/m 2 and less than 30 kg/m 2 (OR:0.58, 95%CI:0.36-0.92); there was no significant association between the ratio of family income to poverty and metabolic syndrome.Conclusions Among the population of nationally representative non-pregnant American adults, there is a correlation between demographics and metabolic syndrome whereas no correlation between socioeconomic status and metabolic syndrome after multivariates adjustment. Healthcare interventions targeting those with metabolic syndrome including older individuals, obese males, along with females, non-Hispanic Asian and other race/ethnicity with BMI under 25 kg/m 2 are required to address these disparities.
Analyzing Big Tobacco’s global youth marketing strategies in Nigeria using the theory of triadic influence
Authors: Isip Ukoabasi , Calvert John Robert 
Published: November 2019

Abstract
Background Major transnational tobacco companies (TTCs) have identified Nigeria, the seventh most populous country in the world, as a market with a major revenue potential given its high youth population and growing gross domestic product (GDP). This research analyses tobacco industry-related strategies and activities targeting youth (aged 15 to 24 years) in Nigeria as existing, but most importantly, future tobacco users. Nigeria is the focus of this study because the tobacco industry has viewed it as a major emerging market since the 1990s. Successful marketing in Nigeria could provide the industry with a template for similar initiatives in other emerging markets in low- and middle-income countries.Methods The research began with a systematic review of secondary literature to determine how the tobacco industry has targeted youth globally. It then used the theory of triadic influence as a heuristic framework to categorize the various industry strategies. Quotations from internal tobacco industry documents were organized into the three streams of the theory of triadic influence: biology/personality, social and cultural/environmental streams. A total of 12 interviews were conducted with 6 policymakers and governmental officials, 2 civil society organization representatives, a high school principal, a journalist and 2 researchers to investigate how the tobacco industry had targeted youth in Nigeria.Results The findings indicate that TTCs have actively targeted youth in Nigeria since the 1990s, focusing on changing behaviour through the biology/personality, social and environmental/ cultural streams.Conclusion The study recommends that Nigeria implement and vigorously enforce its 2015 National Tobacco Control Bill.
Reliability of Optic Disc Edema Area in Estimating the Severity of Papilledema in Patients with POEMS Syndrome
Authors: Liu Ling-shan , Zhang Xiao , Zhao Hao , Gao Xue-min , Zhou Dao-bin , Dai Rongping , Li Jian 
Published: November 2019

Abstract
Background Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes (POEMS) syndrome is a rare paraneoplastic syndrome involving multisystem. Optic disc edema (ODE) is the most common ocular manifestation in patients with POEMS syndrome and serves as an independent prognostic factor. However, parameters previously used to estimate its severity were inconvenient and costly. This study was designed to bring forward a novel and practical parameter, optic disc edema area, to evaluate ODE in patients with this disease and applied it to assess effectiveness of lenalidomide and dexamethasone in respect of ODE.Results Forty-one treatment-naive patients with POEMS syndrome were enrolled in this single-center prospective study and treated with lenalidomide and dexamethasone. They received ocular examination to determine optic disc edema (ODE) area and other optic manifestations. Meanwhile, serum VEGF was measured before and after treatment. Among 41 enrolled patients, 38 received complete ocular examinations, and 25 of which had ODE at initial visit. Binocular mean ODE area of patients with ODE was significantly related to ODE grade (r=0.620, p =0.003) and peripheral retinal thickness (r=0.760, p =0.000) before treatment. Serum VEGF was significantly higher in patients with ODE than their counterparts ( p =0.025) and positively correlated with binocular mean ODE area (r=0.460, p =0.036). After treatment, ODE area, along with serum VEGF, decreased markedly ( p =0.000).Conclusion ODE area was a reliable index to evaluate ODE severity and could precisely reflect ODE improvement through systemic treatment. Additionally, it was related to serum VEGF, a key factor in disease pathogenesis, which suggests its potential capability of indicating the overall severity of this disease. Trial registration: Clinicaltrials, NCT01816620. Registered March 22 2013, https://clinicaltrials.gov/ct2/show/NCT01816620.
A simple model established by blood markers predicting overall survival after radical resection of gastric cancer
Authors: Zhang Li-xiang , Wei Zhi-jian , Han Wen-xiu , Xu A-Man 
Published: November 2019

Abstract
The prognostic prediction after radical resection of gastric cancer patients has not been well established. We aimed to establish a prognostic model based on a new score system, which included another clinical routine serum marker. Methods 904 patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2011 were included. Univariate and multivariate analyses were used to screen for prognostic risk factors. The construction of the nomogram is based on the Cox proportional hazard regression model. The construction of the new scoring model is analyzed by the receiver operator characteristic curve (ROC curve) and then compared with other clinical indicators. Results Multivariate analysis showed that TNM stage, CEA, SII and age were independent prognostic factors. The new score system had a higher AUC value than other risk factors, and the C-index of the nomogram was highly consistent for evaluating survival of gastric cancer patients in The validation groups and training group. Conclusions Based on the serum markers and other clinical indicators, we developed a precise model to predict the prognosis of gastric cancer patients after radical surgery. This score system can provide effective help for surgeons and patients.
Water security and environmental security in a national and regional context: envisioning environmental diplomacy for cooperation
Authors: Hassan Mabroor , Afridi Manzoor Khan , Irfan Khan Muhammad 
Published: November 2019

Abstract
Water insecurity anticipates the ample threat to livelihood, economy, development, environment, peace, security, and poverty reduction efforts in South Asia. This study has attempted the analysis of accords, treaties, and water policies in the region to assess the relationship of water security, environmental security, and conflict in a national (Pakistan) and regional (South Asia) context using multi-criteria decision analysis (MCDA). Twenty-four technical, economic, social, environmental, and political criteria have been selected to present the relationship logically in terms of obligations of international water laws. The results express various gaps in the selected criteria which were the probable cause of environmental damage, conflicts, and mistrust. Moreover, environmental diplomacy has been endorsed as a tool for dispute settlement due to its non-aggressive and flexible characteristics. Dispute settlement and cooperation on shared water resources can foster sustainable development, poverty reduction, and environmental sustainability.