bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and study protocol for a cluster randomized trial of a multi-faceted implementation strategy to increase the uptake of the USPSTF hypertension screening recommendations: the EMBRACE study
Authors: Moise Nathalie , Phillips Erica , Carter Eileen , Alcantara Carmela , Julian Jacob , Thanataveerat Anusorn , Schwartz Joseph E. , Ye Siqin , Duran Andrea , Shimbo Daichi , Kronish Ian M. 
Published: August 2020

Abstract
Background
The US Preventive Services Task Force (USPSTF) recommends out-of-office blood pressure (BP) testing to exclude white coat hypertension prior to hypertension diagnosis. Despite improved availability and coverage of home and 24-h ambulatory BP monitoring (HBPM, ABPM), both are infrequently used to confirm diagnoses. We used the Behavior Change Wheel (BCW) framework, a multi-step process for mapping barriers to theory-informed behavior change techniques, to develop a multi-component implementation strategy for increasing out-of-office BP testing for hypertension diagnosis. Informed by geographically diverse provider focus groups (n = 63) exploring barriers to out-of-office testing and key informant interviews (n = 12), a multi-disciplinary team (medicine, psychology, nursing) used rigorous mixed methods to develop, refine, locally adapt, and finalize intervention components.
The purpose of this report is to describe the protocol of the Effects of a Multi-faceted intervention on Blood pRessure Actions in the primary Care Environment (EMBRACE) trial, a cluster randomized control trial evaluating whether a theory-informed multi-component strategy increased out-of-office testing for hypertension diagnosis.

Methods/design
The EMBRACE Trial patient sample will include all adults ≥ 18 years of age with a newly elevated office BP (≥ 140/90 mmHg) at a scheduled visit with a primary care provider from a study clinic. All providers with scheduled visits with adult primary care patients at enrolled ACN primary care clinics were included. We determined that the most feasible, effective implementation strategy would include delivering education about out-of-office testing, demonstration/instruction on how to perform out-of-office HBPM and ABPM testing, feedback on completion rates of out-of-office testing, environmental prompts/cues via computerized clinical decision support (CDS) tool, and a culturally tailored, locally accessible ABPM testing service. We are currently comparing the effect of this locally adapted multi-component strategy with usual care on the change in the proportion of eligible patients who complete out-of-office BP testing in a 1:1 cluster randomized trial across 8 socioeconomically diverse clinics.

Conclusions
The EMBRACE trial is the first trial to test an implementation strategy for improving out-of-office testing for hypertension diagnosis. It will elucidate the degree to which targeting provider behavior via education, reminders, and decision support in addition to providing an ABPM testing service will improve referral to and completion of ABPM and HBPMs.

Trial registration
Clinicaltrials.gov, NCT03480217, Registered on 29 March 2018
Apolipoprotein D alleviates glucocorticoid-induced osteogenesis suppression in bone marrow mesenchymal stem cells via the PI3K/Akt pathway
Authors: Yu Rong-Hua , Zhang Xiang-yang , Xu Wei , Li Zhi-kun , Zhu Xiao-dong 
Published: August 2020

Abstract
Background
To clarify the role of apolipoprotein D (Apod) in alleviating glucocorticoid-induced osteogenesis suppression in bone marrow mesenchymal stem cells (MSCs) via the PI3K/Akt pathway, thus influencing the progression of osteoporosis (OP).

Methods
Osteogenesis in MSCs was induced by dexamethasone (DEX) stimulation. Dynamic expressions of Apod in MSCs undergoing osteogenesis for different time points were determined by qRT-PCR. Relative levels of osteogenesis-associated genes, including ALP, RUNX2, and Osterix, in DEX-induced MSCs overexpressing Apod or not were examined. Moreover, the protein level of RUNX2, ALP, and Osterix; ALP activity; and mineralization ability influenced by Apod in osteogenic MSCs were assessed. At last, the potential influences of Apod on the PI3K/Akt pathway were identified through detecting the expression levels of PI3K and Akt in MSCs by Western blot.

Results
Apod was time-dependently upregulated in MSCs undergoing osteogenesis. DEX induction downregulated ALP, RUNX2, and Osterix and attenuated ALP activity and mineralization ability in MSCs undergoing osteogenesis, which were partially reversed by overexpression of Apod. In addition, Apod overexpression upregulated the reduced levels of PI3K and Akt in DEX-induced MSCs.

Conclusion
Apod alleviates glucocorticoid-induced osteogenesis suppression in MSCs via the PI3K/Akt pathway, thus protecting the progression of OP.
Exploring staff conceptions of prevention and management practices in encounters with staff-directed aggression in supported housing following education and training
Authors: Maagerø-Bangstad Erlend R. , Sælør Knut Tore , Lillevik Ole Greger , Ness Ottar 
Published: August 2020

AbstractBackgroundStaff-directed aggression is a concern for service providers in mental healthcare, frequently affecting both the quality of services and staff wellbeing. This also applies to supported housing services for people with mental health problems. Staff themselves consider training to be an important route to improve the prevention and management of staff-directed aggression. The aims of this study are to explore how staff in community mental health supported housing services conceptualize practice in prevention and management of aggression and how these conceptions develop following a local education and training endeavor in disempowerment-sensitive, de-escalating and knowledge-based risk assessment and management.MethodPhenomenography, a qualitative research approach, was adopted to pursue the study aims. The data consisted of 26 semi-structured interviews with 13 participants from five different municipal housing facilities in Oslo, Norway. Participants were interviewed on two occasions, once prior to participation and once subsequent to the finalization of the education and training sessions.ResultsThe analysis led to the development of six qualitatively different, yet logically interrelated, categories of description regarding practice in encounters with staff-directed aggression: (1)Observation, alertness and awareness, (2)Established understanding and knowledge of service users, (3)Team-based risk management and deliberation, (4)Adaption of own dispositions and behaviors, (5)Reflexivity, sensitivity and careand (6)Involvement and dialogue. These conceptions were found to vary in meaning and focus; they ranged from implementing safeguarding and protective measures, to drawing on what was portrayed in terms of staff’s expert knowledge, to increasingly allowing for, and committing to, tenant perspectives in designing practice. The results indicate a moderate, yet beneficial, effect of the course on conceptual change in the participants.ConclusionThis study shows that practice in encounters with staff-directed aggression is conceptualized as complex and multifaceted by staff in mental health supported housing services and that the various conceptions have different implications for the way staff-directed aggression is mitigated individually and collectively. Our findings also suggest that it is beneficial to take conceptual variation regarding practice into consideration when devising education and training aimed at enhancing staff knowledge, skills and practices.
Molecular characterization and zoonotic potential of Enterocytozoon bieneusi, Giardia duodenalis and Cryptosporidium sp. in farmed masked palm civets (Paguma larvata) in southern China
Authors: Yu Zhengjie , Wen Xi , Huang Xitong , Yang Ruohong , Guo Yaqiong , Feng Yaoyu , Xiao Lihua , Li Na 
Published: August 2020

Abstract
Background
Masked palm civets are known to play an important role in the transmission of some zoonotic pathogens. However, the distribution and zoonotic potential of Enterocytozoon bieneusi, Giardia duodenalis and Cryptosporidium spp. in these animals remain unclear.

Methods
A total of 889 fecal specimens were collected in this study from farmed masked palm civets in Hainan, Guangdong, Jiangxi and Chongqing, southern China, and analyzed for these pathogens by nested PCR and DNA sequencing.

Results
Altogether, 474 (53.3%), 34 (3.8%) and 1 (0.1%) specimens were positive for E. bieneusi, G. duodenalis and Cryptosporidium sp., respectively. Sequence analysis revealed the presence of 11 novel E. bieneusi genotypes named as PL1–PL11 and two known genotypes Peru8 and J, with PL1 and PL2 accounting for 90% of E. bieneusi infections. Phylogenetically, PL4, PL5, PL9, PL10 and PL11 were clustered into Group 1, while PL1, PL2, PL3, PL6, PL7 and PL8 were clustered into Group 2. Assemblage B (n = 33) and concurrence of B and D (n = 1) were identified among G. duodenalis-positive animals. Further multilocus genotyping of assemblage B has revealed that all 13 multilocus genotypes in civets formed a cluster related to those from humans. The Cryptosporidium isolate from one civet was identified to be genetically related to the Cryptosporidium bamboo rat genotype II.

Conclusions
To the best of our knowledge, this first report of enteric protists in farmed masked palm civets suggests that these animals might be potential reservoirs of zoonotic E. bieneusi and G. duodenalis genotypes.
The implementation of a physical activity intervention in adults with Obstructive Sleep Apnoea over the age of 50 years: a feasibility uncontrolled clinical trial
Authors: Black Julie K. , Whittaker Anna C. , Tahrani Abd A. , Balanos George M. 
Published: August 2020

Abstract
Background
Obstructive Sleep Apnoea (OSA) is a risk factor for cardiovascular disease (CVD) and Type 2 diabetes (T2D). Observational studies suggested that OSA treatment might reduce CVD and T2D but RCTs failed to support these observations in part due to poor adherence to continuous positive airway pressure (CPAP). Physical activity (PA) has been shown to have favourable impact on CVD and the risk of T2D independent of its impact on weight and therefore might provide additional health gains to patients with OSA, whether or not adherent to CPAP.

Methods
The main aim of this study was to explore the feasibility of providing a 12-week PA intervention to adults aged over 50 with OSA. The secondary aim was to assess the impact of the PA intervention on OSA severity. Patients with moderate-severe OSA (apnoea hypopnea index (AHI) ≥ 15 events/hour (based on overnight ApneaLink™) were recruited in response to posters displayed in workplaces. A 12-week daily PA intervention was delivered in participant’s home setting and PA was monitored via text and validated by objective PA measures (GT3X accelerometers).

Results
The intervention was feasible as all 10 patients (8 males, mean (SD) age 57.3 (6.01)) completed the intervention and PA increased across the 12-weeks. The duration of PA increased from baseline (113.1 min (64.69) per week to study-end following the intervention (248.4 min (148.31) (p = 0.02). Perceived Exertion (RPE) (physical effort) increased significantly between baseline (M = 10.7 (1.94)) to end of intervention (M = 13.8, (1.56) (p < 0.001). The intervention had no significant impact on weight or composition. Following the intervention, there was a statistically non-significant a reduction in AHI from baseline to study end (22.3 (7.35) vs. 15.8 (7.48); p = 0.09).

Conclusion
It is feasible to deliver a PA intervention to adults aged over 50 with OSA. The intervention resulted in improved PA and AHI levels somewhat and seemingly independent of weight changes. Future trials need to examine whether PA can reduce the burden of OSA associated comorbidities.

Trial registration
CTN: ISRCTN11016312 Retrospectively Registered 21/07/20.
C. perfringens challenge reduces matrix metalloproteinase activity in the jejunal mucosa of Eimeria-infected broiler chickens
Authors: Van Damme Lore , Cox Natasja , Callens Chana , Haesebrouck Freddy , Dargatz Michelle , Ducatelle Richard , Van Immerseel Filip , Goossens Evy 
Published: August 2020

AbstractMatrix metalloproteinases (MMPs) play an important role in intestinal extracellular matrix homeostasis. An overexpression of MMPs results in tissue destruction and local inflammation and has been associated with multiple inflammatory diseases. These host proteases might also be important in tissue damage caused by infectious agents, such as in intestinal damage in Clostridium perfringens-induced avian necrotic enteritis (NE). The aim of the present study was to elucidate the effect of a C. perfringens infection on the MMP activity in the small intestine of birds with a pre-disposing coccidial infection to obtain a more thorough understanding of the pathogenesis of NE. For this purpose, the gelatinolytic activity present in jejunal tissue of Eimeria infected birds which were challenged with either a pathogenic C. perfringens type G strain or a commensal C. perfringens type A strain was analyzed using substrate zymography. The results show that infection of broilers with Eimeria and different C. perfringens strains, independent of their pathogenicity, decreases the expression of a 40–45 kDa host collagenase in the jejunum, as compared to the expression in Eimeria-infected control birds. It was also shown that the expression of 2 MMPs with molecular weights of approximately 50–60 and 60–70 kDa was significantly lower in necrotic tissue as compared to the activity in macroscopically healthy tissue adjacent to the lesion. These results indicate that host collagenases are not elicited by the C. perfringens infection for permeabilizing the host mucosa to allow penetration of the NetB toxin in Eimeria infected broilers.
Estimation of acoustic echoes using expectation-maximization methods
Authors: Saqib Usama , Gannot Sharon , Jensen Jesper Rindom 
Published: August 2020

AbstractEstimation problems like room geometry estimation and localization of acoustic reflectors are of great interest and importance in robot and drone audition. Several methods for tackling these problems exist, but most of them rely on information about times-of-arrival (TOAs) of the acoustic echoes. These need to be estimated in practice, which is a difficult problem in itself, especially in robot applications which are characterized by high ego-noise. Moreover, even if TOAs are successfully extracted, the difficult problem of echolabeling needs to be solved. In this paper, we propose multiple expectation-maximization (EM) methods, for jointly estimating the TOAs and directions-of-arrival (DOA) of the echoes, with a uniform circular array (UCA) and a loudspeaker in its center for probing the environment. The different methods are derived to be optimal under different noise conditions. The experimental results show that the proposed methods outperform existing methods in terms of estimation accuracy in noisy conditions. For example, it can provide accurate estimates at SNR of 10 dB lower compared to TOA extraction from room impulse responses, which is often used. Furthermore, the results confirm that the proposed methods can account for scenarios with colored noise or faulty microphones. Finally, we show the applicability of the proposed methods in mapping of an indoor environment.
q-Analogues and properties of the Laplace-type integral operator in the quantum calculus theory
Authors: Al-Omari Shrideh Khalaf 
Published: August 2020

AbstractIn this paper, we discuss the q-Laplace-type integral operator on certain class of special functions. We propose q-analogues and obtain results involving polynomials of even orders and functions of q-trigonometric types. Moreover, we establish results related to q-hyperbolic functions and certain q-differential operators. Relying on the given q-differentiation formulas, we finally derive the nth derivative of the q-Laplace-type integral and attain formulas including q-convolution products.
Generalized metric spaces endowed with vector-valued metrics and matrix equations by tripled fixed point theorems
Authors: Hadi Bonab Samira , Abazari Rasoul , Bagheri Vakilabad Ali , Hosseinzadeh Hasan 
Published: August 2020

AbstractThis research focuses on proving the results of tripled fixed point and coincidence point in generalized metric spaces endowed with vector-valued metrics and matrix equations. The results from this study are illustrated by two applications.
Absolutely stable difference scheme for a general class of singular perturbation problems
Authors: El-Zahar Essam R. , Alotaibi A. M. , Ebaid Abdelhalim , Baleanu Dumitru , Tenreiro Machado José , Hamed Y. S. 
Published: August 2020

AbstractThis paper presents an absolutely stable noniterative difference scheme for solving a general class of singular perturbation problems having left, right, internal, or twin boundary layers. The original two-point second-order singular perturbation problem is approximated by a first-order delay differential equation with a variable deviating argument. This delay differential equation is transformed into a three-term difference equation that can be solved using the Thomas algorithm. The uniqueness and stability analysis are discussed, showing that the method is absolutely stable. An optimal estimate for the deviating argument is obtained to take advantage of the second-order accuracy of the central finite difference method in addition to the absolute stability property. Several problems having left, right, interior, or twin boundary layers are considered to validate and illustrate the method. The numerical results confirm that the deviating argument can stabilize the unstable discretized differential equation and that the new approach is effective in solving the considered class of singular perturbation problems.
Dynamic behaviour and stabilisation to boost the immune system by complex interaction between tumour cells and vitamins intervention
Authors: Alharbi Sana Abdulkream , Rambely Azmin Sham 
Published: August 2020

AbstractIn this paper, we establish and examine a mathematical model that combines the effects of vitamins intervention on strengthening the immune system and its role in suppressing and delaying the growth and division of tumour cells. In order to accomplish this, we propose a tumour–immune–vitamins model (TIVM) governed by ordinary differential equations and comprised of two populations, namely tumour and immune cells. It is presumed that the source of vitamins in TIVM originates from organic foods and beverages, based on the food pyramid. The simulation of TIVM employs the fourth order Runge–Kutta method. It is found from the analysis and simulation results that one of the side effects of weakening the immune system is the possibility of transforming immune cells into immune cancer cells to prevent or delay the growth and division of tumour cells. Evidently, for regular intakes of vitamins, which is projected at 55% of vitamins per day, the immune system is strengthened, preventing the production of tumour cells.
Approximate multi-degree reduction of Q-Bézier curves via generalized Bernstein polynomial functions
Authors: Hu Xianzhi , Hu Gang , Abbas Muhammad , Misro Md Yushalify 
Published: August 2020

AbstractQuasi Bézier curves (or QB-curves, for short) possess the excellent geometric features of classical Bézier curves and also have good shape adjustability. In this paper, an algorithm for a multi-degree reduction of QB-curves based on $L_{2}$

L
2

norm and by the analysis of geometric characteristics of QB-curves is constructed. The approximating approach for QB-curves of degree $n+1$
n
+
1
by degree m ($m\leq n$
m
≤
n
) is also given. Secondly, by solving the linear equations under the constraints of $C^{0}$

C
0

and $C^{1}$

C
1

and without constraints, the explicit expression of the points of the approximating curve is obtained, which minimizes the error between the original curve and the approximating curve using the least square method. Some numerical examples of degree reduction under different constraints are given, and the corresponding errors are calculated as well. The results show that this method can be easily implemented, is highly precise and very effective.
Oscillatory and asymptotic behavior of advanced differential equations
Authors: Bazighifan Omar , Chatzarakis George E. 
Published: August 2020

AbstractIn this paper, a class of fourth-order differential equations with advanced type is studied. Applying the generalized Riccati transformation, integral averaging technique and the theory of comparison, a set of new criteria for oscillation or certain asymptotic behavior of solutions of this equations is given. Our results essentially improve and complement some earlier publications. Some examples are presented to demonstrate the main results.
Surviving in steep terrain: a lab-to-field assessment of locomotor costs for wild mountain lions (Puma concolor)
Authors: Dunford Carolyn E. , Marks Nikki J. , Wilmers Christopher C. , Bryce Caleb M. , Nickel Barry , Wolfe Lisa L. , Scantlebury D. Michael , Williams Terrie M. 
Published: August 2020

AbstractBackgroundUnder current scenarios of climate change and habitat loss, many wild animals, especially large predators, are moving into novel energetically challenging environments. Consequently, changes in terrain associated with such moves may heighten energetic costs and effect the decline of populations in new localities.MethodsTo examine locomotor costs of a large carnivorous mammal moving in mountainous habitats, the oxygen consumption of captive pumas (Puma concolor) was measured during treadmill locomotion on level and incline (6.8°) surfaces. These data were used to predict energetic costs of locomotor behaviours of free-ranging pumas equipped with GPS/accelerometer collars in California’s Santa Cruz Mountains.ResultsIncline walking resulted in a 42.0% ± 7.2 SEM increase in the costs of transport compared to level performance. Pumas negotiated steep terrain by traversing across hillsides (mean hill incline 17.2° ± 0.3 SEM; mean path incline 7.3° ± 0.1 SEM). Pumas also walked more slowly up steeper paths, thereby minimizing the energetic impact of vertical terrains. Estimated daily energy expenditure (DEE) based on GPS-derived speeds of free-ranging pumas was 18.3 MJ day− 1 ± 0.2 SEM. Calculations show that a 20 degree increase in mean steepness of the terrain would increase puma DEE by less than 1% as they only spend a small proportion (10%) of their day travelling. They also avoided elevated costs by utilizing slower speeds and shallower path angles.ConclusionsWhile many factors influence survival in novel habitats, we illustrate the importance of behaviours which reduce locomotor costs when traversing new, energetically challenging environments, and demonstrate that these behaviours are utilised by pumas in the wild.