bluuebunny/crossref_metadata_2025_split huggingface dataset:
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: May 2020

Abstract
Background South Africa faces a chronic shortage of professional health workers. Accordingly, community health workers (CHWs) are being employed to mitigate the ongoing health workforce 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 explored CHWs’ motivation to deliver systematic household contact TB investigation (SHCI). Methods In 2017, a cross-sectional survey was conducted among CHWs enrolled in the ward-based PHC outreach teams in the Mangaung Metropolitan District in the Free State Province. Exploratory factor analysis (EFA) was performed on a 30-item scale to determine the dimensions underlying CHW motivation. Items with factor loadings of 0.4 and above were retained. Descriptive and inferential analyses were used to determine CHW motivation levels. Multiple linear regression analysis was used investigate the determinants of CHW motivation. Statistical significance was determined at p ≤ 0.05. Results Out of 235 participants, the majority were female (89.2%). Participants’ median age was 39 (inter-quartile range: 33-45) years. CHW motivation was defined by 16 items across three dimensions — intrinsic job satisfaction, burnout and team commitment, together explaining 56.04% of the total variance. The derived 16-item scale showed satisfactory internal consistency (Cronbach’s α: 0.81), with a mean motivation score of 51.29 (sd: 5.14) out of 64. Formal CHWs — with at least phase 1 of standardised training scored statistically significantly higher than informal CHWs – with non-standardised training on the team commitment sub-scale (mean: 17.82; sd: 2.48) vs. 17.07; sd: 2.82; t(233) = 2.157; p = 0.013). CHW age (β = 0.117, p = 0.030), location (β = 1.759, p = 0.038), length of service (β = -0.505, p <0.001), attendance of TB SHCI training (B = 1.833, p = 0.33), and TB SHCI competence (β = 0.713, p <0.001), contributed statistically significantly to CHW motivation. Conclusion CHW motivation to perform TB SHCI was both intrinsic and extrinsic. The high overall mean score implies that the CHWs were well-motivated to perform TB SHCI. To ensure sustained improved access to quality TB SHCI service provision, the tool derived from this study could potentially be used by TB programme managers in the Free State and similar settings to monitor and inform CHW motivation interventions. Interventions should especially pay close attention to the CHWs’ formalisation, competence and training.
The Governance of Traditional Medicine and Herbal Remedies in the Selected Local Markets of Western Kenya.
Authors: Chebii Willy Kibet , Muthee John Kaunga , Kiemo Karatu 
Published: May 2020

Abstract
Background A lot of emphasis is often placed on modern governance systems and little or no attention is given to traditional governance practices which remain largely undocumented. The study aimed at finding out important traditional and modern governance practices that regulate traditional medicine sector in the Western Kenya. Materials and Methods The study was carried out in selected market centres of Western Kenya where the identified Traditional Medicine Practitioners (TMPs) sell their traditional medicine. All consenting TMPs and Professional Experts were interviewed with the aid of a semi-structured questionnaire. Purposive sampling design with elements of snow ball techniques was employed in tracing competent traditional medicine (TM) experts and relevant professional experts. The data collected was processed in Microsoft Excel and descriptive statistics performed. The Pearson’s Chi square statistics was carried out to determine the significance of the traditional and modern governance data sets using the STATA software. Results Modern governance practices were not significantly different in all the market centres surveyed (p=0.080). Equally, the traditional governance practices were also not significantly different in all the selected market centres (p=1.000). Conclusions Traditional governance practices play an important role in the governance of traditional medicine, and are shaped by the socio-cultural beliefs of the local communities. Modern governance practices, on the other hand, are widely perceived as top down regulation of the traditional medicine growing industry.
Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review
Authors: Niazkhani Zahra , Toni Esmaeel , Cheshmekaboodi Mojgan , Georgiou Andrew , Pirnejad Habibollah 
Published: May 2020

Abstract
Background Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) dtabase was performed to find original studies assessing barriers to ePHR adoption/use in chronic care till the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The MMAT was used to assess the quality of evidence. Results Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings and providers involved in chronic care). Conclusions ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. Deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.
Association between physical activity and conversion from mild cognitive impairment to dementia
Authors: Kim Yeo Jin , Han Kyung-Do , Baek Min Seok , Cho Hanna , Lee Eun Joo , Lyoo Chul Hyoung 
Published: May 2020

Abstract
Background: Physical activity has been suggested to prevent the conversion of mild cognitive impairment (MCI) to dementia in patients. We investigated the association between the continuance and regularity of physical activity and the risk of developing dementia in patients with MCI.Methods: We analyzed 6-year followed up data for 247,149 individuals in the National Health Insurance Service (NHIS) cohort of Korea who were enrolled between January 1, 2009 and December 31, 2015. The patients were divided into four groups: those who did not engage in physical activity consistently (Never-PA group), those who initiated physical activity (Initiation-PA group), those who ceased physical activity (Withdrawal-PA group), and those who performed physical activity consistently (Maintenance-PA group). We also divided the patients into two groups: those who engaged in physical activity irregularly (Irregular-PA) and those who undertook physical activity regularly (Regular-PA).Results: When the risk for the Never-PA group was set as the benchmark (ref=1), the Maintenance-PA group had the lowest incidence of dementia of the Alzheimer type (DAT) compared to the other groups (HR= 0.82, 95% CI 0.79-0.86). The DAT risk of Initiation-PA group (HR = 0.89, 95% CI 0.85-0.93) was lower than the Never-PA group. In addition, compared to the Irregular-PA group, the Regular-PA group had a 15% reduced risk for developing DAT.Conclusions: Continued regular physical activity in patients with MCI is associated with a protective effect against developing DAT. Moreover, ceasing physical activity could halt this protective effect.
Three kinds of treatment with Homoharringtonine, Hydroxychloroquine or shRNA and their combination against coronavirus PEDV in intro
Authors: Li Cui-Cui , Wang Xiao-Jia 
Published: May 2020

Abstract
Background: Porcine epidemic diarrhea virus (PEDV) of the family Coronaviridae has caused substantial economic losses in the swine husbandry industry. There’s currently no specific drug available for treatment of coronaviruses or PEDV. Method: In the current study, we use coronavirus PEDV as a model to study antiviral agents. Briefly, a fusion inhibitor tHR2, recombinant lentivirus-delivered shRNAs targeted to conserved M and N sequences, homoharringtonine (HHT), and hydroxychloroquine (HCQ) were surveyed for their antiviral effects. Results: Treatment with HCQ at 50 mM and HHT at 150 nM reduced virus titer in TCID50 by 30 and 3.5 fold respectively, and the combination reduced virus titer in TCID50 by 200 fold. Conclusion: Our report demonstrates that the combination of HHT and HCQ exhibited higher antiviral activity than either HHT or HCQ exhibited. The information may contribute to the development of antiviral strategies effective in controlling PEDV infection.
Progress towards the 2020 Fast Track HIV/AIDS reduction targets in Ethiopia comparing with neighboring countries and across ages; using Global Burden of Diseases 2017 data
Authors: Mirkuzie Alemnesh H. , Ali Solomon , Abate Ebba , Worku Asnake , Misganaw Awoke 
Published: May 2020

Abstract
Background Sustainable Development Goal (SDG) 3.3, targets to eliminate HIV from being a public health threat by 2030. For better tracking of this target interim Fast Track milestones for 2020 and composite complementary measures have been indicated. This study measured the Fast Track progress in the epidemiology of HIV/AIDS in Ethiopia comparing with neighboring countries and across ages. Methods The National Data Management Center for health’s research team at the Ethiopian Public Health Institute has analyzed the Global Burden of Disease (GBD) 2017 data for the year 2010 to 2017 for Ethiopia and its neighbors. GBD 2017 data sources were census, demographic and a health survey, prevention of mother-to-child HIV transmission, antiretroviral treatment programs, sentinel surveillance, and UNAIDS reports. Age-standardized and age-specific HIV/AIDS incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), incidence:mortality ratio and incidence:prevalence ratio were calculated with corresponding 95% confidence intervals. Results Ethiopia and neighboring countries recorded slow progress in reducing new HIV infection in since 2010. Only Uganda would achieve the 75% target by 2020. Ethiopia, Tanzania, and Uganda already achieved the 75% mortality reduction target set for 2020. The incidence: prevalence ratio for Ethiopia, Rwanda, and Uganda were < 0.03, indicating the countries were on track to end HIV by 2030. Ethiopia had an incidence: mortality ratio <1 due to high mortality; while Kenya, Rwanda, Tanzania and Uganda had a ratio of >1 due to high incidence. The HIV incidence rate in Ethiopia was dropped by 76% among under 5 children in 2017 compared to 2010; the country would likely to attain the 2020 national target but far behind achieving the target among the 15-49 age groups. Conclusions Ethiopia and neighboring countries have made remarkable progress towards achieving the 75% HIV/AIDS mortality reduction target by 2020, although they progress poorly in reducing HIV incidence. By having an incidence:prevalence ratio benchmark less than 0.03, Ethiopia, Rwanda, and Uganda are well heading towards epidemic control. Nonetheless, the high HIV/AIDS mortality rate in Ethiopia for its incidence requires innovative strategies to reach out undiagnosed cases and to build institutional capacity for generating strong evidence to ensure sustainable epidemic control.
Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy
Authors: Kim Jin Woo , Lee You Jin , Ha Yun-Sok , Lee Jun Nyung , Kim Hyun Tae , Chun So Young , Kim Bum Soo 
Published: May 2020

Abstract
Background: Febrile urinary tract infection (UTI) is one of the most common complications after ureteroscopic lithotripsy (URS). We evaluated the effect of secondary signs on preoperative computed tomography (CT) for febrile UTI after URS.Methods: In total, 182 patients who underwent URS for ureteral stones from January 2013 to December 2015 were retrospectively included in this study. These patients were divided into two groups according to the presence of postoperative febrile UTI after URS. We compared the clinical factors, stone factors, and secondary signs between the groups. Predictive factors for febrile UTI after URS were analyzed using a multivariate logistic regression model. Results: Febrile UTI occurred in 26 of the 182 patients. In univariate analysis, presence of comorbid chronic kidney disease (CKD) and stone size were significantly different between UTI and non-UTI groups. Among secondary signs, presence of hydroureter, perinephric fat stranding, periureteral fat stranding, and tissue rim sign were significantly different between the groups. In multivariate logistic regression analysis, comorbid CKD, stone size, perinephric fat stranding, and tissue rim sign were independent predictive factors for febrile UTI after URS. Conclusion: This study demonstrated that secondary signs including perinephric fat stranding and tissue rim sign on preoperative CT, CKD, and stone size are independent predictive factors for febrile UTI after URS.
Article Functional MYB transcription factor gene HtMYB2 is associated with anthocyanin biosynthesis in Helianthus tuberosus L.
Authors: Gao Jieming , Sun Xuemei , Zong Yuan , Yang Shipeng , Wang Lihui , Liu Baolong 
Published: May 2020

Abstract
Background: Tuber color is an important trait for Helianthus tuberosus L. (Jerusalem artichoke). Usually, purple tubers with high anthocyanin content are more nutritious than white tuber. But, the molecular mechanism underlying it is unknown.
Results: In the current study, high-throughput RNA-sequencing was used to compare the transcriptomes between plants with tubers with red or white epidermis. Anthocyanin biosynthesis structural genes had greater expression in the red-skinned tubers of cultivar QY1, indicating that the anthocyanin biosynthesis pathway was activated in ‘QY1’; quantitative PCR confirmed this difference in expression. HtMYB2 (Unigene44371_All) was the only MYB transcription factor, homologous to the MYB transcription factor regulating anthocyanin biosynthesis, expressed in the red tuber epidermis of ‘QY1’. The anthocyanin concentration in the root, stem, leaf, flower, and tuber epidermis of ‘QY1’ was higher than in ‘QY3’, especially tuber epidermis. Correspondingly, HtMYB2 had greater expression in these tissues of ‘QY1’ than in ‘QY3’. The expression of HtMYB2 was associated with anthocyanin accumulation in the different tissues. Overexpression of HtMYB2 activated the anthocyanin biosynthesis pathway, accumulating the pigment in leaves of transgenic tobacco, supporting the model that HtMYB2 regulated anthocyanin biosynthesis. Further experiments found that HtMYB2 had the same coding sequence and genomic sequence in ‘QY1’ and ‘QY3’, but that there were several single nucleotide polymorphisms and one insertion–deletion (indel) mutation of 21 nucleotides in the promoter region between the two alleles. The deletion of three nucleotides “AAA” made the promoter of ‘QY1’ predicted to contain one more possible promoter region. A specific primer, based on the indel, could differentiate between cultivars with red or white tuber epidermis. The genetic variation in HtMYB2 was associated with the tuber skin color in a natural population.
Conclusions: RNA-seq can successfully isolate the candidate gene ( HTMYB2 ) controlling anthocyanin biosynthesis in purple epidermis of Jerusalem artichoke tuber. HTMYB2 can regulate anthocyanin biosynthesis in plants and is closely related to the formation of purple phenotype in tubers. This study should be useful in understanding the genetic mechanism underlying different tuber skin colors and in breeding new H. tuberosus cultivars with different tuber skin colors.
Biovalorisation of crude glycerol and xylose into xylitol by oleaginous yeast Yarrowia lipolytica
Authors: Prabhu Ashish , Thomas Dominic J , Amaro Rodrigo Ledesma- , Leeke Gary A , Vaya Angel Medina , Verheecke-Vaessen Carol , Coulon Frederic , Agrawal Deepti , Kumar Vinod 
Published: May 2020

Abstract
Background: Xylitol is a commercially important chemical with multiple applications in the food and pharmaceutical industries. According to the US Department of Energy, xylitol is one of the top twelve platform chemicals that can be produced from biomass. The chemical method for xylitol synthesis is however expensive and energy intensive. In contrast, the biological route using microbial cell factories offers a potential cost-effective alternative process. The bioprocess occurs under ambient conditions and makes use of biocatalysts and biomass which can be sourced from renewable carbon originating from a variety of cheap waste feedstocks. Result: In this study, biotransformation of xylose to xylitol was investigated using Yarrowia lipolytica an oleaginous yeast which was firstly grown on a glycerol/glucose for screening of co-substrate, followed by media optimisation in shake flask, scale up in bioreactor and downstream processing of xylitol. A two-step medium optimization was employed using central composite design and artificial neural network coupled with genetic algorithm. The yeast amassed a concentration of 53.2 g/L xylitol using pure glycerol (PG) and xylose with a bioconversion yield of 0.97 g/g. Similar results were obtained when PG was substituted with crude glycerol (CG) from the biodiesel industry (titer: 50.5 g/L; yield: 0.92 g/g). Even when xylose from sugarcane bagasse hydrolysate was used as opposed to pure xylose, a xylitol yield of 0.54 g/g was achieved. Xylitol was successfully crystallized from PG/xylose and CG /xylose fermentation broths with a recovery of 39.5 and 35.3%, respectively. Conclusion: To the best of the author’s knowledge, this study demonstrates for the first time the potential of using Y. lipolytica as a microbial cell factory for xylitol synthesis from inexpensive feedstocks. The results obtained are competitive with other xylitol producing organisms.
Improved health-related quality of life in patients treated with topical sirolimus for facial angiofibroma associated with tuberous sclerosis complex.
Authors: Hatano Takashi , ohno Yuki , Imai YU , Moritake Jun , Endo Katsuhisa , Tamari Mayumi , Egawa Shin 
Published: May 2020

Abstract
Background: Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder forming hamartomas throughout the body. Facial angiofibromas (FAs) occur in 75% of TSC patients, which are often enlarged, impairing the appearance of the face, and reducing the patient's quality of life (QOL). The aim of this study was to characterize the impact of topical sirolimus treatment on the health-related QOL in patients with FA associated with TSC.Methods: We investigated a total of 33 patients who received sirolimus gel treatment for FA associated with TSC and assessed the changes in the health-related QOL using the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey. SF-36 surveys were performed before and after three months of treatment. The conditions of the patients after using the sirolimus gel were categorized into the following three categories: "improved," "unchanged," and "aggravated." Adverse events were investigated using the CTCAE v5.0-JCOG.Results: The median age of the patients was 25 (range 14-55) years. After 3 months of sirolimus gel treatment, three scale scores of the SF-36, vitality (VT), social function (SF), and mental health (MH), were significantly improved compared to before the treatment. The VT and SF in patients who had improved FA were significantly better than those in the other patients. There were no significant differences in any scale scores between patients with and without adverse events at three months after the initiation of sirolimus gel treatment.Conclusions: This is the first report regarding improved health-related quality of life in patients treated with sirolimus gel for FA associated with TSC by using the SF-36. The three scale scores associated with mental health were significantly improved compared to before the treatment. The health-related QOL in patients receiving sirolimus gel treatment is more strongly affected by the treatment efficacy than adverse events. Mini-abstractSirolimus gel treatment improves the health-related QOL in patients with FA associated with TSC.
Phenotyping Individuals With Newly-Diagnosed Type 2 Diabetes at Risk for All-Cause Mortality: A Single Centre Observational, Prospective Study
Authors: Biancalana Edoardo , Parolini Federico , Mengozzi Alessandro , Solini Anna 
Published: May 2020

Abstract
Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty.Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered.Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.