bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Exclusive Breastfeeding Practice and its Association with Maternal Employment in Ethiopia: A Systematic Review and Meta-Analysis, 2020
Authors: WAKE GETU ENGIDA , MITTIKU YOHANNES MOGES 
Published: December 2020

Abstract
Background: Exclusive breastfeeding is defined as the practice of providing only breast-milk for an infant for the first 6 months of life without addition of any other food or water, which recommends initiation of breastfeeding within one hour of life and continued breastfeeding for up to 2 years of age or more. There are highly variable findings regarding the prevalence of exclusive breastfeeding in Ethiopia. Maternal employment is the most important factor contributing to the low practice of exclusive breastfeeding. The purpose of this review was to estimate the pooled prevalence of exclusive breastfeeding and its association with maternal employment in the context of Ethiopia.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this systematic review and meta-analysis. The databases such as; PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, and Web of Science were systematically searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal. Results: Forty-five studies were included in the final analysis after reviewing 751 studies in this meta-analysis yielding the pooled prevalence of EBF 60.42% (95% CI: 55.81-65.02%) in Ethiopia. The subgroup analysis showed the highest prevalence reported in a study conducted in SNNP and Tigray( 87.84%), a study published during (2015-2016) (64.60 %), and among studies with a sample size of less than 500 (64.15%). Those employed mothers were 57% less likely to practice exclusive breastfeeding in comparison to unemployed mothers in Ethiopia [OR] 0.43; 95% CI (0.31, 0.61).Conclusions: Maternal employment was significantly associated with the practice of exclusive breastfeeding in comparison to their counterparts. The prevalence of exclusive breastfeeding in Ethiopia is low in comparison to the global recommendation. Based On our findings, we recommended that the Ethiopian government should increase legislated paid maternity leave after delivery beyond current paid maternity leave and implement policies that empower women and create a conducive environment for mothers to practice exclusive breastfeeding in the workplace.
Performance of the QPLEXTM Alz plus assay, a novel multiplex kit for screening cerebral amyloid deposition
Authors: Park Jong-Chan , Jung Keum Sim , Kim Jiyeong , Jang Ji Sung , Kwon Sunghoon , Byun Min Soo , Yi Dahyun , Byeon Gihwan , Jung Gijung , Kim Yu Kyeong , Lee Dong Young , Han Sun-Ho , Mook-Jung Inhee 
Published: December 2020

Abstract
Background: Alzheimer's disease (AD) is an irreversible neurodegenerative disease characterized by the hallmark finding of cerebral amyloid deposition. Many researchers have tried to predict the existence of cerebral amyloid deposition by using easily accessible blood plasma samples, but the effectiveness of such strategies remains controversial. Methods: We developed a new multiplex kit, the QPLEXTM Alz plus assay kit, which uses proteomics-based blood biomarkers to prescreen for cerebral amyloid deposition. A total of 300 participants who underwent Pittsburgh compound B (PiB)-positron emission tomography (PET) which allows imaging of cerebral amyloid deposition were included in this study. We compared the levels of QPLEXTM biomarkers between patients who were classified as PiB-negative or PiB-positive, regardless of their cognitive function. Logistic regression analysis followed by receiver operating characteristic (ROC) curve analysis was performed. The kit accuracy was tested using a randomized sample selection method. Results: The results obtained using our assay kit reached 89.1% area under curve (AUC) with 80.0% sensitivity and 83.0% specificity. Further validation of the QPLEXTM Alz plus assay kit using a randomized sample selection method showed an average accuracy of 81.5%. Conclusions: Our QPLEXTM Alz plus assay kit provides preliminary evidence that it can be used as blood marker to predict cerebral amyloid deposition but independent validation is needed.
A Real-Time PCR Assay for Rapid Identification of Inducible and Acquired Clarithromycin Resistance in Mycobacterium abscessus
Authors: Sharma Meenu Kaushal , La Yanni , Janella Debra , Soualhine Hafid 
Published: December 2020

Abstract
Background: Mycobacterium abscessus is a rapidly growing mycobacteria involved in severe infections of the lung, skin, or soft tissue. Macrolides such as clarithromycin are the recommended first line drugs for treatment of M. abscessus infections. However, M. abscessus has dual mechanisms of resistance to macrolides, making treatment by macrolides difficult. A functional erm(41) gene confers for inducible resistance while acquired mutations on the 23S rRNA rrl gene confer for constitutive resistance.Methods: We have developed a real-time PCR assay to detect both inducible and acquired resistance to clarithromycin, and compared the results to traditional erm(41) and rrl sequencing and phenotypic susceptibility testing using Sensititre™ plates. Results: Of the total 126 M. abscessus isolates tested, truncated erm(41) was found in 23/126 (18.3%) of the samples, 27/126 (21.4%) had a T28C mutation in erm(41), and 2/126 (1.6%) had an acquired A2058C mutation in rrl. The phenotypic results correlated with the expected sequencing results in 121/126 samples (96%). Phenotypic testing compared to real-time PCR resolved 2 of these discrepancies by showing the existence of both erm(41) alleles in the isolates that sequencing missed. One culture was found to be mixed with two M. abscessus subsp. as per hsp65 sequencing and 2 isolates had discordance between molecular and phenotypic results. It was presumed that 3 isolates showed discrepancy between sequencing and real-time PCR, but one culture was mixed and other 2 detected both alleles by real-time PCR leading to 100% concordance when compared to sequencing.Conclusion: In conclusion, real-time PCR is more accurate for detection of both acquired and induced clarithromycin resistance, specifically when mixed genic profiles are present in a sample.
Profile of Children Referred to Primary Health Care Physiotherapy: A Longitudinal Observational Study in Norway
Authors: Evensen Kari Anne I , Sellæg Siw , Stræte Anne-Cath , Hansen Anne E. , Meisingset Ingebrigt 
Published: December 2020

Abstract
Background: Physiotherapy services are an important part of the primary health care services for children, serving a broad spectrum of children referred from different sources and for a variety of reasons. There is limited knowledge about their characteristics and outcome. The aim of this study was to describe the profile, i.e. referral patterns, baseline demographical and clinical characteristics, as well as treatment outcome at follow-up six months after baseline in children receiving physiotherapy in primary care. Methods: Children referred to primary care physiotherapy in a municipality in Norway were invited to participate in this longitudinal observational study. The children’s demographics, referral source, causes of referral, functional diagnoses, influence on their daily activities, main goals and planned treatments were registered at baseline. Goal attainment and treatment compliance were registered at follow-up maximum six months after baseline. Results: The physiotherapists registered baseline characteristics for 148 children. Parent-reported data at baseline were available for 101 (68.2%) of these children. Children were mainly referred from child health care centres (n=74; 50.0%), hospital (n=25; 16.9%) and kindergarten (n=22; 14.9%). The most frequent causes of referral were concerns for motor development (n=50; 33.8%), asymmetry (n=40; 27.0%) and orthopaedic conditions (n=25; 16.9%). Eighty-one (54.7%) children were below the age of one year. There was partly agreement between causes of referral and the physiotherapists’ functional diagnoses. Parents of 69 (71.1%) children reported that their child’s daily activities were little to not at all influenced by the problem or complaint for which they were referred. Follow-up data was registered for 64 children. The main treatment goal was achieved in 37 (57.8%) and partly achieved in 26 (40.6%) children and the treatment was carried out as planned in 55 (87.3%) children. Conclusions: The large variation in the profile of children receiving primary health care physiotherapy in Norway shows how primary health care PT’s can contribute to fulfil the broad purpose of the primary health care services.Trial registration: ClinicalTrials.gov Identifier: NCT03626389. Registered on August 13th 2018 (retrospectively registered).
Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study
Authors: Larsen Annette Bævre , Hermann Monica , Graue Marit 
Published: December 2020

Abstract
Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.
Altered gut microbiota correlate with different immune response to HAART in HIV-infected individuals
Authors: Xie Yirui , Sun Jia , Wei Li , Jiang Haiyin , Hu Caiqin , Yang Jiezuan , Huang Ying , Ruan Bing , Zhu Biao 
Published: December 2020

Abstract
Background: Although gut microbiota dysbiosis has been reported in HIV infected individuals recently, the relationship between the gut microbiota and immune activation in patients with different immune responses to highly active antiretroviral therapy (HAART) is still not well understood. Gut microbiota and immune activation were studied in 36 non-HIV-infected subjects (healthy controls) and 58 HIV-infected individuals, including 28 immunological responders (IR) and 30 immunological non-responders (INR) (≥500 and <200 CD4+ T-cell counts/µl after 2 years of HIV-1 viral suppression respectively) without comorbidities. Results: Metagenome sequencing revealed that HIV-infected immunological responders and immunological non-responders could not recover completely from the gut microbiota dysbiosis. At a 97% similarity level, the relative abundances of Fusobacterium, Ruminococcus gnavus and Megamonas were greater, whereas Faecalibacterium, Alistipes, Bifidobacterium, Eubacterium rectale and Roseburia were more depleted in the IR and INR groups than those in the healthy controls. Ruminococcaceae and Alistipes were positively correlated with nadir and current CD4+ T-cell counts, but negatively correlated with CD8+CD57+ T-cell counts. Inflammation markers and translocation biomarkers (LPS) levels were positively correlated with the abundances of genera Ruminococcus and Fusobacterium but were negatively correlated with the genus Faecalibacterium. The relative abundances of Escherichia-Shigella and Blautia were significantly higher in the IR than those in the INR group. Escherichia-Shigella were negatively correlated with the CD4/CD8 ratio but positively correlated with the amount of CD8+CD57+ T-cells. Roseburia and Blautia were negatively associated with nadir CD4+ T-cell and positively associated with CD8+CD57+ T-cell counts. Conclusions: Gut microbiota dysbiosis may be one of the factors contributing to different immune responses and treatment outcomes to HAART.
Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China
Authors: Hu Jiajin , Liu Yilin , Wei Xiaotong , Li Lin , Gao Ming , Liu Yang , Ma Yanan , Wen Deliang 
Published: December 2020

Abstract
Background: The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.Methods: This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length z-scores (WFLZ), weight-for-age z-scores (WFAZ), and length-for-age z-scores (LFAZ) at birth, 1, 3, 6, 8, and 12 months of age.Results: Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. When stratified analysis by maternal pre-pregnancy body mass index (BMI) status, the association was pronounced in normal-weight [β:0.28 SD units (95% CI: 0.11–0.45)] and overweight/obese women [β: 0.34 SD units (95% CI: 0.09–0.58)] but not in underweight women (P for interaction <0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.36 SD units (95% CI: 0.11– 0.61)], remained significant at 1 [β: 0.22 SD units (95% CI: 0.03–0.41)] and 3 [β:0.19 SD units (95% CI: 0.01–0.37)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ.Conclusions: Maternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association between GDM status and offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. Increased public health efforts to prevent GDM in normal-weight and overweight/obese pre-pregnancy mothers are recommended to control offspring overweight or obesity.
The Effect of Driver Variables on the Estimation of Bivariate Probability Density of Peak Loads in Long-Term Horizon
Authors: Kaheh Zohreh , Shabanzadeh Morteza 
Published: December 2020

Abstract
It is evident that developing more accurate forecasting methods is the pillar of building robust multi-energy systems (MES). In this context, long-term forecasting is also indispensable to have a robust expansion planning program for modern power systems. While very short-term and short-term forecasting are usually represented with point estimation, this approach is highly unreliable in medium-term and long-term forecasting due to inherent uncertainty in predictors like weather variable in long terms. Accordingly, long-term forecasting is usually represented by probabilistic forecasting values which are based on probabilistic functions. In this paper, a self-organizing mixture network (SOMN) is developed to estimate the probability density function (PDF) of peak load in long-term horizons considering the most important drivers of seasonal similarity, population, gross domestic product (GDP), and electricity price. The proposed methodology is applied to forecast the PDF of annual and seasonal peak load in Queensland Australia.
Aberrant activation of the Hedgehog signaling pathway in granulosa cells from patients with polycystic ovary syndrome
Authors: Li You , Xiong Guohui , Tan Jun , Wang Shudi , Wu Qiongfang , Wan Lei , Zhang ZiYu , Huang Ouping 
Published: December 2020

Abstract
Objective The molecular mechanism that triggers polycystic ovary syndrome (PCOS) is mysterious. Abnormal development of ovarian granulosa cells(GCs) is one of the causes of PCOSMethods The study was carried out by using RNA-seq to detect the different gene expression levels in ovarian GCs between 3 patients with PCOS and 4 normal controls. To further verify the above results, GCs from 22 patients with PCOS and 21 controls with normal ovulation were collected to perform the RT-PCR analysisResults The results found Hedgehog signaling pathway(Hh) members, Ihh and Ptch2 were abnormally highly expressed in the PT. The qPCR results also indicated that the expression levels of other Hh signaling pathway downstream members, Ptch1, Gli1, and Gli2 in the PCOS group (PT) were significantly higher than those in the control group (NT). Besides, the expression of TNF-α mRNA in PCOS patients was higher than that in the control group. Finally, the Hh signaling pathway inhibitor, cyclopamine, can decrease the apoptosis of PCOS ovarian granulosa cellsConclusions These results suggest that abnormally activated Hh signaling pathway, especially Ihh signal, may have a profound influence on PCOS.
Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis
Authors: Bullock Heather L , Lavis John N , Wilson Michael G , Mulvale Gillian , Miatello Ashleigh 
Published: December 2020

Abstract
Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policymakers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.
The Longitudinal Relationship between Immune Cell Profiles and Frailty in Patients with Breast Cancer receiving Chemotherapy
Authors: Gilmore Nikesha , Mohile Supriya , Lei Lianlian , Culakova Eva , Mohamed Mostafa , Magnuson Allison , Loh Kah Poh , Maggiore Ronald , Belcher Elizabeth , Conlin Alison , Weiselberg Lora , Ontko Mary , Janelsins Michelle 
Published: December 2020

Abstract
Background: Frailty is associated with an increased risk of chemotherapy toxicity. Cellular markers of inflammation can help identify patients with frailty characteristics. However, the role of cellular markers of inflammation in identifying patients at risk of developing chemotherapy-induced frailty and their clinical utility are not fully understood.Methods: This study was a secondary analysis of a large nationwide cohort study of women with stage I-IIIC breast cancer (n=581, mean age 53.4; range 22-81). Measures were completed pre-chemotherapy (T1), post-chemotherapy (T2), and 6 months post-chemotherapy (T3). Frailty was assessed at all three time-points using a modified Fried score consisting of four self-reported measures (weakness, exhaustion, physical activity, and walking speed; 0-4, 1 point for each). Immune cell counts as well as neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR) were obtained at T1 and T2 time-points. Separate linear regressions were used to evaluate the associations of: 1) cell counts at T1 with frailty at T1, T2, and T3 and 2) change in cell counts (T2-T1) with frailty at T2 and T3. We controlled for relevant covariates and frailty at the T1 time-point.Results: From T1 to T2, the mean frailty score increased (1.3 vs 2.0; p<0.01) and returned to T1 levels by the T3 time-point (1.3 vs 1.3; p=0.85). At the T1 time-point, there was a positive association between cellular markers of inflammation and frailty: WBC (β=0.04; p<0.05), neutrophils (β=0.04; p<0.05), and NLR (β=0.04; p<0.01). From T1 to T2, a greater increase in cellular markers of inflammation was associated with frailty at T2 (WBC: β=0.02; p<0.05 and neutrophils: β=0.03; p<0.05, NLR: β=0.03; p<0.01). These associations remained significant after controlling for the receipt of growth factors with chemotherapy and the time between when laboratory data was provided and the start or end of chemotherapy.Conclusions: In patients with breast cancer undergoing chemotherapy, cellular markers of inflammation are associated with frailty. Immune cell counts may help clinicians identify patients at risk of frailty during chemotherapy.Trial Registration: ClinicalTrials.gov Identifier: NCT01382082