bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of On-site CT-derived Fractional Flow Reserve on the Management of Decision Making for Patients with Stable Chest Pain (TARGET Trial): Objective, Rationale and Design
Authors: yang junjie , shan dongkai , wang zhiqiang , dong mei , ma xiang , hu xinyang , zeng hesong , chen yundai 
Published: January 2020

Abstract
Background: The diagnostic accuracy of CT-derived Fractional Flow Reserve (CT-FFR) in clinical application has been well validated. This advanced technology focus on evaluating anatomical stenosis and functional ischemia simultaneously. However, the effect of CT-FFR on the management of decision making has not been fully evaluated in randomized controlled design. Method/design: TARGET study is a pragmatic, multicentre, prospective, open-label and randomized controlled trial evaluating the effect of a CTA/CT-FFR strategy (Group A) versus usual care (Group B) on intermediate-to-high risk patients with suspected CAD who undergo clinically indicated diagnostic evaluation. A total sample size of 1216 subjects will be enrolled and followed up for 12 months. This study will be performed in 6 Chinese hospitals, and the primary endpoint is the planned ICA without significant obstructive CAD within 90 days. The secondary endpoints include major adverse cardiovascular event, quality of life, medical expenditure, and cumulative radiation exposure during 1-year follow-up. Conclusion: The study will provide information to patients, health care providers and other stakeholders in China about which strategy could be more effective in the management of intermediate-to-high risk patients with suspect CAD. Trial registration: ClinicalTrials.gov, NCT03901326, Registered on 03 April 2019.
Association of Subclinical Hypothyroidism and Dyslipidemia in Children and Adolescents
Authors: Habib Ashkan , Habib Asadollah 
Published: January 2020

Abstract
Background: Correlation of higher levels of TSH and dyslipidemia in children is controversial. This study was designed to assess the relation between lipid profile components and TSH levels in children. Method: This cross-sectional study was performed in a growth assessment clinic in Shiraz. Children aged between 2 to 18 years that came to the clinic from January till April 2018 were considered. TSH levels equal or above 5 and lower than 10 mIU/L with normal FT4 were considered as subclinical hypothyroidism. Results: 666 children were euthyroid while 181 had subclinical hypothyroidism. Mean total cholesterol in euthyroid children was 160.50 ± 29.070 mg/dl and in SH group 161.39 ± 28.694 mg/dl (P=0.713). Mean LDL-C in euthyroid children was 90.96 ± 24.996 mg/dl and in SH group 89.10 ± 23.852 mg/dl (P=0.369). Mean HDL-C in euthyroid children was 47.94 ± 10.560 mg/dl and in SH group 49.04 ± 10.361 mg/dl. (P=0.211). Mean non HDL-C in euthyroid children was 112.56 ± 27.696 mg/dl and in SH group 112.35 ± 28.136 mg/dl. (P=0.929). Mean triglyceride in euthyroid children was 104.98 ± 54.934 mg/dl and in SH group 113.83 ± 91.342 mg/dl (P=0.215). There was no significant difference in mean serum total cholesterol, LDL, HDL, non-HDL and triglyceride levels between euthyroid and subclinical hypothyroid. Adjusted correlation was not significant between TSH levels and any lipid profile component. Conclusion: By comparing the results of this study with other studies, it is evident that lipid disorder in subclinical hypothyroid children does not have a specific pattern.
Community health worker motivation to perform systematic household contact tuberculosis investigation in a high burden metropolitan district in South Africa
Authors: Kigozi Gladys , Heunis Christo , Engelbrecht Michelle 
Published: January 2020

Abstract
BackgroundSouth Africa faces a chronic shortage of professional health workers. Accordingly, community health workers (CHWs) are being employed to mitigate the ongoing deficiencies. In addition to facilitating linkages between communities and primary health care (PHC) facilities, CHWs are entrusted with a range of crucial tuberculosis (TB), HIV/AIDS and maternal health services. As increased access to quality service delivery hinges upon their motivation, this study investigated CHWs’ motivation to deliver systematic household contact TB investigation (SHCI).MethodsIn 2017, a cross-sectional survey was conducted among CHWs enrolled in the ward-based PHC outreach teams in the Mangaung Metropolitan District. Descriptive, exploratory factor analysis and multiple linear regression analysis were conducted to establish the dimensions, levels and determinants of CHW motivation. Statistical significance was determined at p ≤ 0.05.ResultsOut of 235 participants, the majority were female (89.2%). Participants’ median age was 39 (inter-quartile range: 33-45) years. Job satisfaction, burnout and team commitment characterised CHW motivation or lack thereof, together explaining 56.04% of the total variance, with a mean score of 51.59 (standard deviation: 5.14) out of 64. The full scale showed satisfactory internal consistency (Cronbach α: 0.734). The individual sub-scales also had acceptable internal consistency (Cronbach α—job satisfaction: 0.83; burnout: 0.83; and team commitment: 0.73). CHW category (i.e. formal — with at least phase 1 of standardised training vs. informal — with non-standardised training) and TB SHCI training and knowledge significantly influenced CHW motivation. Formal CHWs scored twice higher (β = 2.020; p = 0.009) than informal CHWs on the motivation scale. Motivation scores increased by 0.841 (p = 0.007) times with every unit increase in CHW TB SHCI knowledge. Scores were more than twice lower (β = -2.289; p = 0.003) among CHWs who did not attend TB SHCI training than those who did.ConclusionThe high mean score implies that the CHWs were motivated to perform TB SHCI. The TB programme in the Free State should ensure sustained CHW motivation to effect improved access to quality TB SHCI service provision. To this end, the TB programme should pay close attention to the CHWs’ formalisation, TB knowledge and training.
MicroRNA-21 inhibitor (miR-21i) and Simvastatin-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles for synergistic anticancer effect in Gastric Cancers
Authors: Liu Yuxia , Yang Bin , Zhang Lirong , Cong Xianling , Liu Hongyu , Yu Mengxi , Song Bin 
Published: January 2020

Abstract
In this study, we have successfully developed a simvastatin (SMV) and miR-21i-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles (NP) to enhance the therapeutic efficacy in gastric cancers. The nanoparticles were characterized for in vitro physicochemical and biological assays and pharmacokinetic study was performed in rats. CLSM/FACS results clearly showed the ability of SMV/miR-21i-loaded PLGA/PEI NP (PPN-S21i) to deliver the combinational therapeutics of SMV and miR-21i to the cancer cells. Combination of SMV+miR-21i showed significantly lower cell viability compared to that of free SMV. Our results clearly highlight the importance of simultaneous interaction of SMV+miR-21i and that it could significantly decrease the cell proliferation in BGC-823, SGC-7901 and HGC-27 gastric cancer cells while it was significantly less cytotoxic to normal gastric mucosa cells (GES-1). Cell apoptosis of SMV+miR-21i was significantly higher compared to that of individual drug or miRNA. Finally, pharmacokinetic analysis revealed that PPN-S21i significantly prolonged the blood circulation time of SMV compared to that of free SMV indicating the potential of carrier system. Overall, results clearly indicate that the combination of SMV+miR-21i (gene + drug therapy) might provide a valuable strategy for the clinical management of gastric cancers.
Immunogenicity analysis of conserved fragments in Plasmodium ovale merozoite surface protein 4
Authors: Juliette Uwase , Chu Ruilin , Kassegne Kokouvi , Lei Yao , Shen Feihu , Fu Haitian , Sun Yifan , Xuan Yinghua , Cao Jun , Cheng Yang 
Published: January 2020

Abstract
Background: An effective vaccine to control and eradicate malaria, one of the most serious global infectious diseases, is an urgent need. Plasmodium merozoite surface protein 4 (MSP4) has been listed as a blood-stage subunit vaccine candidate for malaria. Plasmodium ovale infection is also a source of malaria burden in tropical regions where it is sometimes mixed with other Plasmodium species. However, little is known about P. ovale MSP4. Methods: The msp4 gene was amplified through polymerase chain reaction using genomic DNA extracted from blood samples of 46 patients infected with P. ovale and then sequenced. Open reading frames predicted as immunogenic peptides consisting of 119 and 97 amino acids of P. ovale curtisi MSP4 (PocMSP4) and P. ovale wallikeri MSP4 (PowMSP4), respectively, were selected for protein expression. Recombinant proteins (rPoMSP4) were expressed in Escherichia coli, purified, analyzed, and immunized in BALB/c mice. The specificity of anti-MSP4-immunoglubulin (Ig) G antibodies was evaluated by Western blot and enzyme-linked immunosorbent assays, and cellular immune responses were analyzed via lymphocyte proliferation assays.Results: Full peptide sequences of PocMSP4 and PowMSP4 were completely conserved in all clinical isolates, except in the epidermal growth factor-like domain at the carboxyl terminus where only one mutation was observed in one P. ovale wallikeri isolate. Furthermore, we successfully expressed the truncated pocmsp4 and powmsp4 and purified as ~32 kDa proteins. Our results showed that PocMSP4 and PowMSP4 induced high antibody responses with end-point titers ranging from 1:2,560,000 to 1:10,000 in all immunized mouse groups and with high IgG avidity to PocMSP4 (80.5%) and PowMSP4 (92.3%). Furthermore, rPocMSP4 and rPowMSP4 cross-reacted with anti-PowMSP4-specific or anti-PocMSP4-specific antibodies. Additionally, anti-PoMSP4 IgG antibodies showed broad immuno-specificity in reacting against rPoMSP1 and rPoAMA1. Lastly, PocMSP4- and PowMSP4-immunized mice induced cellular immune responses with PocMSP4 (36%) and PowMSP4 cells (15.8%) as observed through splenocyte proliferation assays. Conclusion: Our study suggested conservation in PoMSP4 protein sequences with high immunogenicity. Furthermore, PocMSP4- and PowMSP4-immunized mice induced cellular immune responses, suggesting that both humoral and cellular immune responses play crucial roles in the protection against any antigen.
Revisiting the Plant CLE Gene Family with a New Method for Predicting and Clustering Short Amino Acid Sequences
Authors: Zhang Zhe , Liu Lei , Kucukoglu Melis , Tian Dongdong , Larkin Robert M. , Shi Xueping , Zheng Bo 
Published: January 2020

Abstract
Background: The CLV3 / ESR-RELATED ( CLE ) gene family encodes small secreted peptides (SSPs) and plays vital roles in plant growth and development through cell-to-cell communication. The prediction and classification of CLE genes is challenging because of their low sequence similarity. Results: We developed a machine learning-aided method for predicting CLE genes by using a CLE motif-specific residual score matrix and a novel clustering method based on the Euclidean distance of the 12 amino acid residues from CLE motifs in a site-weight dependent manner. In total, 2156 CLE candidates—including 627 novel candidates—were predicted from 69 plant species. The results from our CLE motif-based clustering are consistent with previous reports using the entire pre-propeptide. Characterization of CLE candidates provided systematic statistics on protein lengths, signal peptides, relative motif positions, amino acid compositions of different parts of the CLE precursor proteins, and decisive factors of CLE prediction. The approach taken here provides information on the evolution of the CLE gene family and provides evidence that the CLE and IDA/IDL genes share a common ancestor. Conclusions: Our new approach is applicable to SSPs or other proteins with short conserved domains and hence, provides a useful tool for gene prediction, classification and evolutionary analysis.
Enhancement of nursing students’ moral competencies through support the formation of professional identity
Authors: Haghighat sahar , borhani fariba , ranjbar hadi 
Published: January 2020

Abstract
Background: Moral care provision is an essential part of nursing work. Nursing schools are responsible for developing moral competencies in nursing students. The aim of this study was to assess the relationship between the formation of professional identity and development of morality in nursing students. Methods: This study was designed as a descriptive-correlational study. The study population consisted of nursing students who were enrolled in nursing schools at the time of the study. Two hundred and twenty-one nursing students completed the study tools. The research tools were a demographic questionnaire, Moral Development Scale for Professionals (MDSP), and Professional Identity Scale for Nursing Students (PISNS). Results: The mean (SD) of MDSP and PISNS scores were 45.69±5.90 and 55.61±12.75, respectively. There was a significant statistical relationship between MSDP and PISNS scores (p<0.05). A significant equation was found (f (2, 218) = 16.68, p<0.001) with an R2 of 0.113. The MSDP scores increased 0.136 for each score of PISNS, and married students had 2.452 scores higher than single students. Conclusions: There was a significant correlation between the formation of professional identity and development of morality in nursing students. By supporting the formation of professional identity, nursing schools can help the development of moral competencies in nursing students.
Premature aging of circulating T cells predicts all-cause mortality in hemodialysis patients
Authors: Xiang Fangfang , Chen Rongyi , Cao Xuesen , Shen Bo , Chen Xiaohong , Ding Xiaoqiang , Zou Jianzhou 
Published: January 2020

Abstract
Background Patients with end-stage renal disease (ESRD) exhibit a premature aging phenotype of the immune system, which is recently concerned as a significant factor for increased risk of various morbidities. Nevertheless, there are few dates explicating the relevancy of T cell senescence to mortality. In this study, we prospectively studied the predictive value of T cell senescence for mortality in hemodialysis patients. Methods Patients who had been on hemodialysis treatment for at least 6 months were enrolled. T cell senescence determined by differentiation status was evaluated by flow cytometry. Survival outcomes were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed to evaluate the prognostic impact of T cell premature aging and other clinical factors on all-cause mortality. Results A total of 466 patients (277 man and 169 women) were enrolled in this study. Decreased number of naïve T cell, as the most prominent feature of T cell senescence, did not change in parallel with age in these patients. Decreased absolute count of T cell, naïve T cell, CD4 + naïve T cell were independently associated with all-cause mortality. Decreased percentage of T cell and increased percentage of CD8 + central-memory T cell were also independently associated with all-cause mortality. After including all the T cell parameters in one regression model, only decreased count of naïve T cell was significantly associated with increased mortality in these patients. Conclusions Aging-associated T cell changes are aggravated in ESRD patients. For the first time, our study demonstrates that naïve T cell depletion is a strong predictor of all-cause mortality in HD patients.
Potential molecular mechanism of the NPPB gene in post-ischemic heart failure with and without T2DM
Authors: Guan Yao-Zong , Yin Rui-Xing , Deng Guo-Xiong , Zheng Peng-Fei , Liu Chun-Xiao , Wei Bi-Liu 
Published: January 2020

Abstract
Background This study aimed to investigate natriuretic peptide B ( NPPB ) co-expression genes and the pathways involved in post-ischemic heart failure (HF) among patients both with and without type 2 diabetes mellitus (T2DM). Methods The microarray dataset of GSE26887 was examined to detect the genes that co-expressed with NPPB from 19 post-ischemic HF patients’ peripheral blood samples (7 with T2DM and 12 without T2DM). NPPB co-expression genes were then screened using the R packet. Further, using online analytical tools, we determined the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, Gene Ontology (GO) annotation, and protein-protein interaction (PPI) network of the co-expression genes. The modules and hub genes of the PPI network were then identified using the Cytoscape software. Results In patients with T2DM, a total of 41 biological processes (BP), 20 cellular components (CC), 13 molecular functions (MF), and 41 pathways were identified. Further, a total of 61 BPs, 16 CCs, 13 MFs, and 22 pathways in patients without T2DM were identified. In both groups of patients, 17 BPs, 10 CCs, 6 MFs, and 13 pathways were enriched. We also identified 173 intersectional co-expression genes (63 positive, 106 negative, and 4 differently co-expressed in patients with and without T2DM, respectively) in both types of patients, which enriched in 16 BPs, 8 CCs, 3 MFs, and 8 KEGG pathways. Moreover, the PPI network (contained 237 edges and 170 nodes) with the top module significantly enriched in 4 BPs (the tricarboxylic acid metabolic process, citrate metabolic process, tricarboxylic acid cycle, and aerobic respiration) and 3 pathways (the citrate cycle, malaria parasite metabolic pathway, and AGE-RAGE signaling pathway in diabetic complications) was constructed. Conclusions This study used genome-wide co-expression genes to identify the potential functions and mechanisms of the NPPB gene in post-ischemic HF with and without T2DM. Our findings may elucidate the functions and roles of NPPB in patients with post-ischemic HF and facilitate HF management.
Low-arginine and low-protein diets induce hepatic lipid accumulation through different mechanisms in growing rats
Authors: Otani Lila , Nishi Hiroki , Koyama Ayaka , Akasaka Yuta , Taguchi Yusuke , Toyoshima Yuka , Yamanaka Daisuke , Hakuno Fumihiko , Jia Huijuan , Takahashi Shin-Ichiro , Kato Hisanori 
Published: January 2020

Abstract
Background Dietary protein deficiency and amino acid uimbalance cause hepatic fat accumulation. We previously demonstrated that only arginine deficiency as well as total amino acid deficiency in a diet caused significant hepatic triglyceride (TG) accumulation in young Wistar rats. In this study, we explored the mechanisms of this fatty liver formation using these two models. Methods A low-total-amino acid diet (equivalent to 5% protein) and a low-arginine diet (solely the arginine content alone is as low as the low-total-amino acid diet) to the rats for 2 weeks. Results There was substantially greater hepatic TG accumulation in the low-arginine group than in the low-total-amino acid group. The low-total-amino-acid diet potentiated insulin signals in the liver and enhanced de novo lipogenesis. By contrast, the low-arginine diet inhibited hepatic very-low-density lipoprotein secretion, without affecting hepatic insulin signaling and lipogenesis. Conclusions We conclude that, although the arginine intake of the low-arginine group was as low as that of the low-total-amino-acid group, these two diets developed a fatty liver via completely different mechanisms. The potentiation of insulin signaling and resultant increases in fatty acid synthesis seem to drive the effects of a low-protein diet, whereas lower VLDL secretion may be the main causes of low-arginine diet-induced TG accumulation in the liver.
Effect of Education on Preventive Home Accident Practices by Mothers with Toddlers: Using the Theory of Planned Behavior
Authors: Amini Roya , Kalvandi Narges , Khodaveisi Masoud , Tapak Leili 
Published: January 2020

Abstract
Background Home accidents are one of the causes of death and disability in toddlers. This study aimed to determine the effect of education on preventive home accident practices by mothers with toddlers with regard to the Theory of Planned Behavior (TPB). Methods This research was a quasi-experimental study conducted on 116 mothers referred to comprehensive health centers (58 mothers per experimental and control groups), who were selected using cluster sampling method. Data were collected by a researcher-made TPB questionnaire, and then educational intervention was performed based on the TPB in four 45-60 minute sessions for the experimental group. After two months, the data were recollected from the two groups and analyzed by SPSS software version 16. Results Comparing the scores of knowledge, TPB constructs (i.e., attitude, perceived behavioral control, behavioral intention, and subjective norms), and preventive home accident practices of mothers revealed no statistically significant difference between the two groups at the beginning of the study. After having the intervention, there was a significant difference between the two groups of mothers regarding knowledge, TPB constructs (except for subjective norms), and preventive home accident practices for toddlers (p <0.001). Conclusion Preventive home accident practices adopted by mothers with toddlers enhanced after applying the TPB ; hence, this theory-based education can be used as a proper theoretical framework for toddlers’ home accident prevention.
Feeding Practices in 6-23-Month-Old Children With Chronic Cholestatic Liver Diseases: A Mixed Method Study
Authors: Zhang Yuxia , Chen Xiao , Wang Jianshe , Lu Yi , Xie Xinbao , Gu Ying , Latour Jos M. 
Published: January 2020

Abstract
Background Children with chronic cholestatic liver diseases have a high risk of malnutrition. However, nutritional management does not receive attention with limited evidence to improve these practices. This study aimed to evaluate feeding status of children with chronic cholestatic liver disease, aged 6-24 months, and to explore the experiences of parents’ feeding behaviors. Methods A mixed-method study was conducted among parents of 74 children with chronic cholestatic liver diseases. The Infant and young Child Feeding Index (ICFI) was used to collect quantitative data of feeding behaviors. In-depth interviews with parents were performed to generate qualitative information. Multivariate analysis was conducted to identify predictors of feeding practice. Qualitative data were analyzed using thematic analysis. Results Only 16.2% children had qualified feeding practice. In terms of dairy products, the rate of breast-feeding, medium-chain-triglyceride formula-feeding, and regular formula-feeding was 25.7%, 39.2% and 44.6% respectively. The complementary feeding rate was 68.8%, and the time of adding complementary food was 6.9±1.7 months. Consumption of food from animal sources is sub-optimal, 66.7% of children aged 6-8 months and 45.5% of children aged 9-11 months had carbohydrate as single source of complementary food and had no intake of flesh foods, eggs or bean products, while in the age group 12-24 months, 52% of children had eggs less than 2 days/week, 60% had flesh foods less than 2 days/week, and 60% had no intake of bean products. Literacy of primary care provider was significantly related with inappropriate feeding practice (Adjusted OR 5.52; 95% CI 1.29, 23.66). The result of the interviews indicated that parents generally had limited feeding knowledge and thought that the intake of animal source products such as flesh foods, eggs and oil would be a burden to the liver, and cause damage to the liver function. Conclusion Parents had limited feeding knowledge and the feeding practices in 6-24-month-old children diagnosed with chronic cholestatic liver diseases did not follow current nutritional guidelines. Appropriate intervention targeting social and cultural family circumstances should therefore be included in the disease management in order to improve children’s clinical outcomes.