bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions and experiences of frontline health managers and providers on accountability in a South African health district
Authors: Mukinda Fidele Kanyimbu , Van Belle Sara , Schneider Helen 
Published: July 2020

AbstractObjectivePublic primary health care and district health systems play important roles in expanding healthcare access and promoting equity. This study explored and described accountability for this mandate as perceived and experienced by frontline health managers and providers involved in delivering maternal, newborn and child health (MNCH) services in a rural South African health district.MethodsThis was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline public sector health managers and providers in the district office and two sub-districts, examining the meanings of accountability and related lived experiences. A thematic analysis approach grounded in descriptive phenomenology was used to identify the main themes and organise the findings.ResultsAccountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the ‘self’. The practice of accountability was seen as constrained by organisational environments where impunity and unfair punishment existed alongside each other, where political connections limited the ability to sanction and by climates of fear and blame. Accountability was seen as enabled by open management styles, teamwork, good relationships between primary health care, hospital services and communities, investment in knowledge and skills development and responsive support systems. The interplay of these constraints and enablers varied across the facilities and sub-districts studied.ConclusionsProviders and managers have well-established ideas about, and a language of, accountability. The lived reality of accountability by frontline managers and providers varies and is shaped by micro-configurations of enablers and constraints in local accountability ecosystems. A ‘just culture’, teamwork and collaboration between primary health care and hospitals and community participation were seen as promoting accountability, enabling collective responsibility, a culture of learning rather than blame, and ultimately, access to and quality of care.
Homozygote CRIM1 variant is associated with thiopurine-induced neutropenia in leukemic patients with both wildtype NUDT15 and TPMT
Authors: Park Yoomi , Kim Hyery , Seo Heewon , Choi Jung Yoon , Ma Youngeun , Yun Sunmin , Min Byung-Joo , Seo Myung-Eui , Yoo Keon Hee , Kang Hyoung Jin , Im Ho Joon , Kim Ju Han 
Published: July 2020

Abstract
Background
NUDT15 and TPMT variants are strong genetic determinants of thiopurine-induced hematological toxicity that results in therapeutic failure in pediatric acute lymphoblastic leukemia (ALL). However, many patients with both wild-type (WT) NUDT15 and TPMT still suffer from thiopurine toxicity and therapeutic failure.

Methods
Whole-exome sequencing was done for discovery (N = 244) and replication (N = 76) cohorts. Age- and sex-adjusted multiple regression analyses of both WT patients were performed to identify (p < 0.01, N = 188 for discovery) and validate (p < 0.05, N = 52 for replication) candidate variants for the tolerated last-cycle 6-mercaptopurine (6-MP) dose intensity percentage (DIP). Both independent and additive effects of the candidate variants on well-known NUDT15 and TPMT were evaluated by multigene prediction models.

Results
Among the 12 candidate variants from the discovery phase, the rs3821169 variant of the gene encoding Cysteine-Rich Transmembrane BMP Regulator 1 (CRIM1) was successfully replicated (p < 0.05). It showed high interethnic variability with an impressively high allele frequency in East Asians (T = 0.255) compared to Africans (0.001), Americans (0.02), Europeans (0.009), and South Asians (0.05). Homozygote carriers of the CRIM1 rs3821169 variant (N = 12, 5%) showed significantly lower last-cycle 6-MP DIPs in the discovery, replication, and combined cohorts (p = 0.025, 0.013, and 0.001, respectively). The traditional two-gene model (NUDT15 and TPMT) for predicting 6-MP DIP < 25% was outperformed by the three-gene model that included CRIM1, in terms of the area under the receiver operating characteristic curve (0.734 vs. 0.665), prediction accuracy (0.759 vs. 0.756), sensitivity (0.636 vs. 0.523), positive predictive value (0.315 vs. 0.288), and negative predictive value (0.931 vs. 0.913).

Conclusions
The CRIM1 rs3821169 variant is suggested to be an independent and/or additive genetic determinant of thiopurine toxicity beyond NUDT15 and TPMT in pediatric ALL.
Predictors of instantaneous relief from spinal manipulation for non-specific low back pain: a delphi study
Authors: Innes Stanley , Beynon Amber , Hodgetts Christopher , Manassah Rachel , Lim Denyse , Walker Bruce F. 
Published: July 2020

AbstractBackgroundThere is some evidence and anecdotal reports that high-velocity low-amplitude (HVLA) spinal manipulation therapy (SMT) for non-specific low back pain (NSLBP) may immediately reduce pain in some patients. The mechanism for such a change remains unclear and the evidence is conflicting. The aim of this study was to seek consensus among a sample of expert manual therapists as to the possible clinical predictors that could help identify patients who are most likely to receive instant relief from NSLBP with SMT intervention.MethodsThirty-seven expert chiropractors and manipulative physiotherapists from around the world were invited to participate in a three round online Delphi questionnaire during the second half of 2018. Participants were provided with a list of 55 potential signs and symptoms as well as offering them the option of suggesting other factors in the first round. The variables were rated using a 4-point Likert likelihood scale and a threshold of 75% agreement was required for any item to progress to the next round.ResultsOf these 37 experts, 19 agreed to participate. Agreement as to the proportion of patients who receive instantaneous relief was minimal (range 10–80%). A total of 62 items were ranked over the 3 rounds, with 18 of these retained following the third round. The highest rated of the 18 was ‘A history including a good response to previous spinal manipulation’.Discussion/conclusionFive categories; patient factors, practitioner factors, signs and symptoms of NSLBP presentation, an instrument of measurement (FABQ), and the presence of cavitation following SMT best describe the overall characteristics of the factors. The 18 factors identified in this study can potentially be used to create an instrument of measurement for further study to predict those patients with NSLBP who will receive instantaneous relief post-SMT.
Knowledge, attitude, motivation and planning of breastfeeding: a cross-sectional study among Jordanian women
Authors: Khasawneh Wasim , Kheirallah Khalid , Mazin Mai , Abdulnabi Sanaa 
Published: July 2020

AbstractBackgroundIn Jordan, the rate of exclusive breastfeeding is declining. The trend variation in breastfeeding practice is determined by different factors including antenatal women’s attitude and planning which are affected by their awareness and the support they receive. This study aims to assess knowledge, attitude, support, and planning of breastfeeding among Jordanian women.MethodsA face-to-face cross-sectional semi-structured questionnaire survey was conducted among healthy women in the antenatal clinic and postpartum ward at three hospitals in Northern Jordan during the period August 2019 to December 2019. Data were collected about demographic characteristics, women’s knowledge and attitude towards breastfeeding, antenatal and postnatal support and counseling, and feeding planning. Customized scales were utilized to assess knowledge and attitude. Factors associated with planning to breastfeed were reported.Results660 women completed the survey questionnaire. The majority were 20 to 35 years of age, 10% were primiparous, and 30% were employed. 78% were knowledgeable about breastfeeding benefits and aware of WHO recommendations. 72% had a positive attitude towards breastfeeding. More than half received support from their husbands to breastfeed their infants, while less than 20% received any counseling from their obstetric providers. 97% reported their intention to breastfeed, and more than half indicated their willingness to breastfeed exclusively. With multivariable logistic regression modelling, predictors of EBF planning include: primiparity (AOR 1.79; 95% CI 1.1, 3.25), positive attitude (AOR 1.80; 95% CI 1.05, 3.1) and positive husband’s support (AOR 1.92; 95% CI 1.18, 3.15). Barriers include women’s employment (AOR 0.43; 95% CI 0.26, 0.70) and low birthweight (AOR 0.46; 95% CI 0.25, 0.84).ConclusionJordanian women are highly knowledgeable about breastfeeding benefits, and they exhibit a positive attitude towards breastfeeding resulting in a very high percentage intending to breastfeed their infants. Limited counseling about breastfeeding is a major gap in antenatal care. As intentions might not reflect the actual practice after delivery, gaps and barriers affecting the determinants of successful breastfeeding should be identified, and corrective tools should be implemented accordingly. Allocating a specific time for antenatal or postnatal counseling and support is expected to promote breastfeeding practice in our population.
Characterizing evolving frameworks: issues from Esmail et al. (2020) review
Authors: Glasgow Russell E. , Estabrooks Paul A. , Ory Marcia G. 
Published: July 2020

AbstractThere are complex issues in understanding and categorizing implementation science theories, models, and frameworks. Systematic reviews of these models are important undertakings for synthesizing current knowledge. The issues involved are even more challenging when reviewing a large number of frameworks and when some of the frameworks have evolved significantly over time. This paper addresses how the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was described in the recent Esmail (2020) review and identifies four mischaracterizations. This is followed by a more general discussion of how advances or extensions of frameworks after an original source publication or influential review tend to be overlooked. We discuss why inadvertent mischaracterization of what a framework is and is not, and what it can and cannot be used for, can have deleterious consequences. Finally, we suggest initial ideas about what could be done to prevent or alleviate some of these problems by reviewers, framework developers, and scholars at large.
Circular RNA atlas in osteoclast differentiation with and without alendronate treatment
Authors: Lin Jianbiao , Ma Shaofeng , Zhu Cong , Chen Changqing , Lin Weibin , Lin Canbin , Huang Guofeng , Ding Zhenqi 
Published: July 2020

Abstract
Background
Alendronate (AL) is the most widely used bisphosphonate in the treatment of osteoporosis (OP). However, the role of circular RNAs (circRNAs) in the treatment of OP with AL remains unclear.

Methods
In this study, we showed that osteoclast (OC) precursors (OPCSs) could be induced into OCs with macrophage colony-stimulating factor (MCSF) and receptor activator of nuclear factor-κB ligand (RANKL) treatment. Subsequently, the OCs were treated with AL. OC differentiation-related biomarkers including RANK, tartrate-resistant acid phosphatase (TRAP), and cathepsin K (CTSK) were analyzed with TRAP staining, quantitative real-time (qPCR), and western blotting. Differentially expressed circRNAs (DECs) were identified among the OPCS, OC, and OC + AL groups. In addition, the expression levels of 10 DECs related to OC differentiation were verified by qPCR.

Results
TRAP staining showed that MCSF and RANKL treatment effectively induced OPCSs to differentiate into OCs. In addition, qPCR and western blot analysis revealed that the three biomarkers of OC (RANK, TRAP, and CTSK) were expressed significantly more in the OC group than those in the OPCS group. In contrast, the mRNA and protein expression levels of these three biomarkers decreased significantly in OCs treated with AL compared with those non-treated OCs. GO analysis of the DECs in the OPCS group vs. the OC group revealed that their functions were mainly related to cell, cell part, binding, and single-organism terms. KEGG analysis of the top 20 DECs in a comparison between the OPCS and OC groups showed that genes involved in mitogen-activated protein kinase signaling were the most common. Results of functional analyses of DECs in an OC vs. OC + AL comparison were similar to those in the OPCS vs. OC comparison. Finally, qPCR showed that, in the OC + AL vs. OC group comparison, the expression levels of seven and three DECs significantly decreased and increased, respectively.

Conclusions
Having successfully induced OPCSs to differentiate into OCs, we showed that AL suppresses the differentiation of OPCS into OC and that 10 DECs were involved in the regulation of this process. This indicates that these DECs might be important to the treatment of OP.
Does ICSI for in vitro fertilization cause more aneuploid embryos?
Authors: Niu Xiangli , Long Jiamin , Gong Fangqiang , Wang Weihua 
Published: July 2020

Abstract
Background
High proportion of human embryos produced by in vitro fertilization (IVF) is aneuploidy. Many factors are related to the prevalence of embryonic aneuploidies, such as maternal age, sperm quality, and in vitro manipulation of oocytes. Oocytes are usually inseminated by intracytoplasmic sperm injection (ICSI) procedures for preimplantation genetic testing. There is still no available information whether insemination procedures, regular IVF or ICSI, affect embryonic aneuploidies.

Methods
In this case report, a patient at her age of 47 years old received donated oocytes from a young donor for infertility treatment. Half of oocytes were inseminated by regular IVF and other half of oocytes were inseminated by ICSI. Fertilized oocytes were cultured to blastocyst stage and then biopsied for preimplantation genetic testing for aneuploidies (PGT-A). The proportions of aneuploidies were compared between two insemination procedures.

Results
Forty-seven oocytes were retrieved, 23 were inseminated by regular IVF and 24 were removed from enclosed cumulus cells for ICSI. Out of 24 oocytes, 21 oocytes at metaphase II were inseminated by ICSI. After fertilization assessment, it was found that 12 oocytes from regular IVF fertilized normally. Nine blastocysts (75%) were biopsied and 1 (11.1%) was aneuploidy. By contrast, 19 out of 21 oocytes inseminated by ICSI fertilized normally, 14 blastocysts (73.7%) were obtained and 7 (50.0%) were aneuploidy. Transfer of a euploid blastocyst from regular IVF resulted in a healthy baby delivery.

Conclusion
These results indicate that more embryos produced by ICSI are aneuploidy as compared with embryos produced by regular IVF. The results indicate that in vitro manipulation of oocytes for ICSI procedure may have adverse effect on human oocytes, and it may be one of the reasons causing aneuploid embryos in human IVF.
Integrated human-machine intelligence for EV charging prediction in 5G smart grid
Authors: Sun Dedong , Ou Qinghai , Yao Xianjiong , Gao Songji , Wang Zhiqiang , Ma Wenjie , Li Wenjing 
Published: July 2020

AbstractWith the rapid development of the power infrastructures and the increase in the number of electric vehicles (EVs), vehicle-to-grid (V2G) technologies have attracted great interest in both academia and industry as an energy management technology in 5G smart grid. Considering the inherently high mobility and low reliability of EVs, it is a great challenge for the smart grid to provide on-demand services for EVs. Therefore, we propose a novel smart grid architecture based on network slicing and edge computing technologies for the 5G smart grid. Under this architecture, the bidirectional traffic information between smart grids and EVs is collected to improve the EV charging experience and decrease the cost of energy service providers. In addition, the accurate prediction of EV charging behavior is also a challenge for V2G systems to improve the scheduling efficiency of EVs. Thus, we propose an EV charging behavior prediction scheme based on the hybrid artificial intelligence to identify targeted EVs and predict their charging behavior in this paper. Simulation results show that the proposed prediction scheme outperforms several state-of-the-art EV charging behavior prediction methods in terms of prediction accuracy and scheduling efficiency.
SMCP: a Secure Mobile Crowdsensing Protocol for fog-based applications
Authors: Concone Federico , Lo Re Giuseppe , Morana Marco 
Published: July 2020

AbstractThe possibility of performing complex data analysis through sets of cooperating personal smart devices has recently encouraged the definition of new distributed computing paradigms. The general idea behind these approaches is to move early analysis towards theedgeof the network, while relying on other intermediate (fog) or remote (cloud) devices for computations of increasing complexity. Unfortunately, because both of their distributed nature and high degree of modularity, edge-fog-cloud computing systems are particularly prone to cyber security attacks that can be performed against every element of the infrastructure. In order to address this issue, in this paper we present SMCP, a Secure Mobile Crowdsensing Protocol for fog-based applications that exploit lightweight encryption techniques that are particularly suited for low-power mobile edge devices. In order to assess the performance of the proposed security mechanisms, we consider as case study a distributed human activity recognition scenario in which machine learning algorithms are performed by users’ personal smart devices at the edge and fog layers. The functionalities provided by SMCP have been directly compared with two state-of-the-art security protocols. Results show that our approach allows to achieve a higher degree of security while maintaining a low computational cost.
Potential use of corneal confocal microscopy in the diagnosis of Parkinson’s disease associated neuropathy
Authors: Che Ning-Ning , Yang Hong-Qi 
Published: July 2020

AbstractParkinson’s disease (PD) is a chronic, progressive neurodegenerative disease affecting about 2–3% of population above the age of 65. In recent years, Parkinson’s research has mainly focused on motor and non-motor symptoms while there are limited studies on neurodegeneration which is associated with balance problems and increased incidence of falls. Corneal confocal microscopy (CCM) is a real-time, non-invasive, in vivo ophthalmic imaging technique for quantifying nerve damage in peripheral neuropathies and central neurodegenerative disorders. CCM has shown significantly lower corneal nerve fiber density (CNFD) in patients with PD compared to healthy controls. Reduced CNFD is associated with decreased intraepidermal nerve fiber density in PD. This review provides an overview of the ability of CCM to detect nerve damage associated with PD.
Representation of inner, outer and expanding circle varieties and cultures in global ELT textbooks
Authors: Tajeddin Zia , Pakzadian Maryam 
Published: July 2020

AbstractThe rise of world Englishes has challenged the emphasis on native-speaker accents and cultures in English language teaching. This study aimed to investigate the representation of world Englishes and cultures in three global language teaching textbooks, namelyInterchange,English Result,andAmerican English File. The textbooks were subjected to content analysis regarding their reference to Inner, Outer, and Expanding Circles’ varieties and their associated cultural contents. Kachru (The alchemy of English: The spread functions and models of non-native Englishes. Oxford: Pergamon, 1986) notion of Concentric Circles, and the categorization proposed by Pfister and Borzelli (Unterrichtspraxis10:102–108, 1977) functioned as a framework to see which aspects of each culture (social, personal, religion/arts/humanities, political systems and institutions, and environmental concerns) were addressed in these textbooks. Findings revealed that most of the references to the three circles and cultural elements embodied in the textbooks were toward Inner Circle countries inAmerican English File. Furthermore, inInterchangeandEnglish Resultseries, reference to Outer and Expanding Circles’ varieties and cultural elements were comparatively more evident. However, all the three textbook series mostly represented Inner-Circle accents. These findings have implications for materials developers to adopt an EIL-aware approach and to avoid the sole representation of native speakers’ linguistic norms and cultures in ELT textbooks.
Clinical features and outcomes of PComA aneurysms originating from fetal posterior communicating arteries in a single institution
Authors: Chen Xin , Li Hao , Wang Ming-Ze , Li Mao-gui , Cao Yong , Zhang Dong , Zhang Yan , Wang Hao , Wang Shuo 
Published: July 2020

Abstract
Background
The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery (PComA) aneurysms originating from fetal posterior cerebral artery (fPCA) and analyze the risk factors for the postoperative radiological infarction and outcome.

Methods
From 2011 to 2020, we retrospectively reviewed 74 PComA aneurysms originating from fPCA in terms of the clinical and radiological features and obtained the follow-up data from the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University. The relationships between these features and follow-up data were assessed with the univariate and multivariate analysis.

Results
In this series, 74 aneurysms were occurring at the origin of fPCAs. All the patients showed complete obliteration of their aneurysms. Full fPCA type tends to be a predictive factor for radiological infarction (univariate χ2 = 5.873, P = 0.027; multivariate OR = 0.264, P = 0.060). Postoperative radiological infarction (univariate χ2 = 12.611, P = 0.001; multivariate OR = 6.033, P = 0.043), rupture (univariate χ2 = 4.514, P = 0.047; multivariate OR = 57.966, P = 0.044), and hypertension (univariate χ2 = 5.301, P = 0.024; multivariate OR = 24.462, P = 0.029) tend to be the independent predictive factors for poor prognosis at 3 months after discharge.

Conclusions
In conclusion, we report a series of patients harboring aneurysms originating from the fPCA. Surgical clipping is a reliable strategy. Full fPCA type is related to postsurgical infarction. Postoperative radiological infarction, rupture, and hypertension tend to be the independent predictive factor for poor prognosis at 3 months after discharge.