bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and evaluation of a patient passport to promote self-management in patients with heart diseases
Authors: Stamm-Balderjahn Sabine , Faliniski Rebecca , Rossek Susanne , Spyra Karla 
Published: October 2019

Abstract

Background
Patients with cardiovascular diseases (CVD) are treated over a long period of time by physicians and therapists from various institutions collaborating within a multidisciplinary team. Usually, medical records detailing the diagnoses and treatment regimens are long and extensive. Brief overviews of relevant diagnostic and treatment data in the form of a patient passport are currently missing in routine care for patients with CVD. This study aimed to develop and evaluate a patient passport (the Kardio-Pass) based on the needs of patients who had undergone cardiac rehabilitation, and of healthcare professionals.

Methods
A mixed method design was adopted consisting of an explorative qualitative phase followed by a quantitative evaluation phase. Interviews with patients and experts were conducted to develop the Kardio-Pass. CVD rehabilitees (N = 150) were asked to evaluate the passport using a semi-standardized written questionnaire.

Results
Patients and experts who were interviewed in the qualitative study phase considered the following passport contents to be particularly important: documentation of findings and diagnoses, cardiac diagnostics and intervention, medication plan, risk factors for heart disease, signs of a heart attack and what to do in an emergency. During the evaluation phase, 93 rehabilitees (response rate: 62%) completed the questionnaire. The Kardio-Pass achieved high overall approval: All respondents considered the information contained in the passport to be trustworthy. The professionalism and the design of the passport were rated very highly by 93 and 92% of participants, respectively. Use of the Kardio-Pass prompted 53% of participants to regularly attend follow-up appointments. The most common reasons for non-use were a lack of support from the attending doctor, failure by the patient to make entries in the passport, and loss of the passport.

Conclusions
By documenting the course of cardiac diseases, the patient passport pools all medical data–from diagnosis to treatment and aftercare–in a concise manner. Rehabilitees who used the cardiac passport rated it as a helpful tool for documenting follow-up data. However, with regard to this explorative study there is a need for further research, particularly on whether the patient passport can improve heart patient care.
Promoting and delivering antenatal care in rural Jimma Zone, Ethiopia: a qualitative analysis of midwives’ perceptions
Authors: Bergen Nicole , Hudani Alzahra , Asfaw Shifera , Mamo Abebe , Kiros Getachew , Kurji Jaameeta , Morankar Sudhakar , Abebe Lakew , Kulkarni Manisha A. , Labonté Ronald 
Published: October 2019

Abstract

Background
Despite improvements in recent years, Ethiopia faces a high burden of maternal morbidity and mortality. Antenatal care (ANC) may reduce maternal morbidity and mortality through the detection of pregnancy-related complications, and increased health facility-based deliveries. Midwives and community-based Health Extension Workers (HEWs) collaborate to promote and deliver ANC to women in these communities, but little research has been conducted on the professional working relationships between these two health providers. This study aims to generate a better understanding of the strength and quality of professional interaction between these two key actors, which is instrumental in improving healthcare performance, and thereby community health outcomes.

Methods
We conducted eleven in-depth interviews with midwives from three rural districts within Jimma Zone, Ethiopia (Gomma, Kersa, and Seka Chekorsa) as a part of the larger Safe Motherhood Project. Interviews explored midwives’ perceptions of strengths and weaknesses in ANC provision, with a focus as well on their engagement with HEWs. Thematic content analysis using Atlas.ti software was used to analyse the data using an inductive approach.

Results
Midwives interacted with HEWs throughout three key aspects of ANC promotion and delivery: health promotion, community outreach, and provision of ANC services to women at the health centre and health posts. While HEWs had a larger role in promoting ANC services in the community, midwives functioned in a supervisory capacity and provided more clinical aspects of care. Midwives’ ability to work with HEWs was hindered by shortages in human, material and financial resources, as well as infrastructure and training deficits. Nevertheless, midwives felt that closer collaboration with HEWs was worthwhile to enhance service provision. Improved communication channels, more professional training opportunities and better-defined roles and responsibilities were identified as ways to strengthen midwives’ working relationships with HEWs.

Conclusion
Enhancing the collaborative interactions between midwives and HEWs is important to increase the reach and impact of ANC services and improve maternal, newborn and child health outcomes more broadly. Steps to recognize and support this working relationship require multipronged approaches to address imminent training, resource and infrastructure deficits, as well as broader health system strengthening.
Ubiquitin-mediated regulation of autophagy
Authors: Chen Ruey-Hwa , Chen Yu-Hsuan , Huang Tzu-Yu 
Published: October 2019

AbstractAutophagy is a major degradation pathway that utilizes lysosome hydrolases to degrade cellular constituents and is often induced under cellular stress conditions to restore cell homeostasis. Another prime degradation pathway in the cells is ubiquitin-proteasome system (UPS), in which proteins tagged by certain types of polyubiquitin chains are selectively recognized and removed by proteasome. Although the two degradation pathways are operated independently with different sets of players, recent studies have revealed reciprocal cross talks between UPS and autophagy at multiple layers. In this review, we summarize the roles of protein ubiquitination and deubiquitination in controlling the initiation, execution, and termination of bulk autophagy as well as the role of ubiquitination in signaling certain types of selective autophagy. We also highlight how dysregulation of ubiquitin-mediated autophagy pathways is associated with a number of human diseases and the potential of targeting these pathways for disease intervention.
Residential relocation trajectories and neighborhood density, mixed land use and access networks as predictors of walking and bicycling in the Northern Finland Birth Cohort 1966
Authors: Kärmeniemi Mikko , Lankila Tiina , Ikäheimo Tiina , Puhakka Soile , Niemelä Maisa , Jämsä Timo , Koivumaa-Honkanen Heli , Korpelainen Raija 
Published: October 2019

AbstractBackgroundGiven the high global prevalence of physical inactivity, there is a need to design cities that support active modes of transportation. High density diverse neighborhoods with good access networks have been associated with enhanced walking and cycling, but there is a lack of large-scale longitudinal studies utilizing a life course perspective to model residential relocation trajectories. The objectives of the present longitudinal study were to model and visualize residential relocation trajectories between 31 and 46 years of age based on neighborhood density, mixed land use and access networks (DMA), and to assess neighborhood DMA as a predictor of self-reported regular walking and cycling and objectively measured physical activity.MethodsBased on data from the Northern Finland Birth Cohort 1966 (N = 5947), we used self-reported regular walking and cycling and objectively measured physical activity as outcome variables and objectively assessed neighborhood DMA as the main explanatory variable. We conducted sequence analysis to model residential relocation trajectories, and generalized linear mixed models and Fisher’s exact test were used to explore longitudinal associations between neighborhood DMA and physical activity.ResultsOver 80% of the participants lived in a neighborhood with the same level of neighborhood DMA during the follow-up. Relocation occurred more often from higher to lower DMA neighborhoods than reverse. Increased neighborhood DMA was associated with increased regular walking (OR 1.03; 95% CI: 1.00, 1.05;p = 0.023) and cycling (OR 1.17; 95% CI: 1.12, 1.23;p <  0.001). Residential relocation trajectory from lower to highest neighborhood DMA increased the odds of starting regular walking (OR 3.15; 95% CI: 1.50, 7.14;p = 0.001) and cycling (OR 2.63; 95% CI: 1.23, 5.79;p = 0.009) as compared to higher to lower neighborhood DMA trajectory.ConclusionsThe results strongly support the hypothesis that increasing urban DMA can enhance regular walking and cycling at population level and so improve public health. The findings have implications for zoning and transportation policies, favoring the creation of dense and diverse neighborhoods with good access networks to support regular walking and cycling.
Treg/Th17 imbalance and its clinical significance in patients with hepatitis B-associated liver cirrhosis
Authors: Lan Yong-Ting , Wang Zhen-li , Tian Peng , Gong Xiao-Na , Fan Yu-Chen , Wang Kai 
Published: October 2019

Abstract

Background
Recent studies have shown that T cell-mediated cellular immune mechanisms play important roles in the progression of hepatitis B to liver cirrhosis, but the underlying mechanisms remain unclear. This present study was aimed to determine the relationship between Treg/Th17 and hepatitis B-associated liver cirrhosis.

Methods
The Treg and Th17 cell frequencies in the peripheral blood of all participants, including 93 patients with hepatitis B-associated liver cirrhosis and 40 healthy subjects, were measured by flow cytometer. Cox regression model and receiver operating characteristic(ROC) curves were applied to investigate the prognostic significance of Treg/Th17 ratio in decompensated liver cirrhosis.

Results
We observed the Treg/Th17 imbalance was present in patients with hepatitis B-associated liver cirrhosis, with reduced Treg cells in their peripheral blood, increased Th17 cells and decreased Treg/Th17 ratio. Treg and Th17 cells were negatively correlated. Treg/Th17 imbalance was closely related to the clinical stage of hepatitis B-associated liver cirrhosis. The Virus load, Treg frequencies and the Treg/Th17 ratio were independent factors predicting decompensated liver cirrhosis from a Cox regression model. The ROC analysis showed that the Treg/Th17 ratio was the best marker for predicting decompensated liver cirrhosis.

Conclusions
Treg/Th17 imbalance is involved in the pathogenesis of hepatitis B-associated liver cirrhosis and the Treg/Th17 ratio can be used as a potential marker for predicting decompensated liver cirrhosis.
The urinary levels of CTX-II, C2C, PYD, and Helix-II increased among adults with KBD: a cross-sectional study
Authors: Song Quan Quan , Sun Li Yan , Li Chun Hui , Liu Yu Jiao , Cui Si Lu , Liu Yun Qi , Cao Yan Hong , Pei Jun Rui , Wang Yue , Lian Wei , Jiao Zhe , Deng Qing , Yu Jun 
Published: October 2019

Abstract

Background
Kashin-Beck disease (KBD) is an endemic osteoarthropathy, and its pathogenesis is still not entirely clear. Pathologically, many KBD changes are similar to those of osteoarthritis (OA). Therefore, this study aimed to identify changes in the levels of potential urinary biomarkers for OA, including C-telopeptide of type II collagen (uCTX-II), type II collagen cleavage neoepitope (uC2C), pyridinoline (uPYD), and uHelix-II, among adults with KBD.

Methods
Urinary samples of 83 external control (EC) subjects, 91 KBD patients, and 86 internal control (IC) subjects were tested by ELISA after the subjects completed a questionnaire and X-ray examination.

Results
The medians of the four markers in the KBD group were higher than those in the EC group and those in the IC group. The medians in the grade II KBD group were higher than those in the grade I group but were not statistically significant (P = 0.301, P = 0.408, P = 0.204, and P = 0.898 for uCTX-II, uC2C, uPYD, and uHelix-II, respectively). The area under the curve (AUC) of uCTX-II (0.775) was higher than that of the others (0.672, 0.639, and 0.628 for uC2C, uPYD, and uHelix-II, respectively).

Conclusion
The levels of uCTX-II, uC2C, uPYD, and uHelix-II were elevated in adults with KBD and showed an increasing trend as the severity of KBD increased. The prediction accuracy of uCTX-II was more useful than that of the others for assisting in the diagnosis of KBD.
The effectiveness of intervention with board games: a systematic review
Authors: Noda Shota , Shirotsuki Kentaro , Nakao Mutsuhiro 
Published: October 2019

Abstract
To examine the effectiveness of board games and programs that use board games, the present study conducted a systematic review using the PsycINFO and PubMed databases with the keywords “board game” AND “trial;” in total, 71 studies were identified. Of these 71 studies, 27 satisfied the inclusion criteria in terms of program content, intervention style, and pre–post comparisons and were subsequently reviewed. These 27 studies were divided into the following three categories regarding the effects of board games and programs that use board games: educational knowledge (11 articles), cognitive functions (11 articles), and other conditions (five articles). The effect sizes between pre- and post-tests or pre-tests and follow-up tests were 0.12–1.81 for educational knowledge, 0.04–2.60 and − 1.14 – − 0.02 for cognitive functions, 0.06–0.65 for physical activity, and − 0.87 – − 0.61 for symptoms of attention-deficit hyperactivity disorder (ADHD). The present findings showed that, as a tool, board games can be expected to improve the understanding of knowledge, enhance interpersonal interactions among participants, and increase the motivation of participants. However, because the number of published studies in this area remains limited, the possibility of using board games as treatment for clinical symptoms requires further discussion.
The governmental health policy-development process for Syrian refugees: an embedded qualitative case studies in Lebanon and Ontario
Authors: Khalid Ahmad Firas , Lavis John N. , El-Jardali Fadi , Vanstone Meredith 
Published: October 2019

Abstract

Background
The unprecedented amount of resources dedicated to humanitarian aid has led many stakeholders to demand the use of reliable evidence in humanitarian aid decisions to ensure that desired impacts are achieved at acceptable costs. However, little is known about the factors that influence the use of research evidence in the policy development in humanitarian crises. We examined how research evidence was used to inform two humanitarian policies made in response to the Syrian refugee crisis.

Methods
We identified two policies as rich potential case studies to examine the use of evidence in humanitarian aid policy decision-making: Lebanon’s 2016 Health Response Strategy and Ontario’s 2016 Phase 2: Health System Action Plan, Syrian Refugees. To study each, we used an embedded qualitative case study methodology and recruited senior decision-makers, policy advisors, and healthcare providers who were involved with the development of each policy. We reviewed publicly available documents and media articles that spoke to the factors that influence the process. We used the analytic technique of explanation building to understand the factors that influence the use of research evidence in the policy-development process in crisis zones.

Results
We interviewed eight informants working in government and six in international agencies in Lebanon, and two informants working in healthcare provider organizations and two in non-governmental organizations in Ontario, for a total of 18 key informants. Based on our interviews and documentary analysis, we identified that there was limited use of research evidence and that four broad categories of factors helped to explain the policy-development process for Syrian refugees – development of health policies without significant chance for derailment from other government bodies (Lebanon) or opposition parties (Ontario) (i.e., facing no veto points), government’s engagement with key societal actors to inform the policy-development process, the values underpinning the process, and external factors significantly influencing the policy-development process.

Conclusions
This study suggests that use of research evidence in the policy-development process for Syrian refugees was subordinate to key political factors, resulting in limited influence of research evidence in the development of both the Lebanese and Ontarian policy.
Ecologies of care: mental health and psychosocial support for war-affected youth in the U.S.
Authors: Bennouna Cyril , Ocampo Maria Gandarilla , Cohen Flora , Basir Mashal , Allaf Carine , Wessells Michael , Stark Lindsay 
Published: October 2019

AbstractBackgroundYouth resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. As they cope with their experiences of armed conflict and forced migration, these girls and boys must also adjust to the language and social norms of their new society, often encountering prejudice and discrimination along the way. Previous studies indicate that schools can play a central role in facilitating this adjustment while also promoting mental health and psychosocial wellbeing. This qualitative study aims to understand the lived experiences of MENA newcomers resettled in Austin, Texas and Harrisonburg, Virginia and to assess how schools, families, and communities support their mental and psychosocial wellbeing.MethodsWe held six focus group discussions across the two cities with a total of 30 youths (13–23 years) from Iraq, Syria, and Sudan. We also conducted semi-structured interviews with 30 caregivers and 27 key informants, including teachers, administrators, service providers, and personnel from community-based organizations.ResultsGuided by Bioecological Theory, our thematic analysis identifies several means by which various actors work together to support resettled adolescents. We highlight promising efforts that seek to enhance these supports, including sheltered instruction, school-parent collaboration, peer support programming, social and emotional learning initiatives, and integrated mental health centers.ConclusionWhile this study underscores the resilience of newcomers and the value of local support systems, it also reflects the importance of investment in schools, mental health systems, and resettlement programs that can enable newcomers to achieve their full potential.
MicroRNA profiling in adults with high-functioning autism spectrum disorder
Authors: Nakata Masatoshi , Kimura Ryo , Funabiki Yasuko , Awaya Tomonari , Murai Toshiya , Hagiwara Masatoshi 
Published: October 2019

Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and repetitive behaviors. Owing to the difficulty of clinical diagnosis, ASD without intellectual disability (i.e., high-functioning ASD) is often overlooked. MicroRNAs (miRNAs) have been recently recognized as potential biomarkers of ASD as they are dysregulated in various tissues of individuals with ASD. However, it remains unclear whether miRNA expression is altered in individuals with high-functioning ASD. Here, we investigated the miRNA expression profile in peripheral blood from adults with high-functioning ASD, and age and gender-matched healthy controls. We identified miR-6126 as being robustly down-regulated in ASD and correlated with the severity of social deficits. Enrichment analysis of predicted target genes revealed potential association with neurons, synapses, and oxytocin signaling pathways. Our findings may provide insights regarding the molecular clues for recognizing high-functioning ASD.
Effect of Endometrioma cystectomy on cytokines of follicular fluid and IVF outcomes
Authors: Liang Yu , Yang Xiaokui , Lan Yonglian , Lei Lingling , Li Ying , Wang Shuyu 
Published: October 2019

Abstract

Background
Endometriosis patients undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment suffer from lower success rates. The success of IVF-ET is related to the receptivity of the uterus and the quality of embryos, and it is well known a patient’s endometriosis does not impair the receptivity. Whether endometrioma should be removed surgically before IVF remains controversial. Studies have shown that endometrioma removal decreases peritoneal inflammation, but little information is available regarding the alteration in the cytokines of follicular fluid. The objective of this study was to examine the impact of endometrioma cystectomy on the outcome of IVF and the levels of intrafollicular inflammatory cytokines and to investigate correlations between cytokine concentrations and IVF outcomes.

Method
A total of 41 women with endometriosis-associated infertility undergoing IVF were recruited; 13 patients (surgery group, S group) had surgery to remove the endometrioma before enrollment, and 28 patients (non-surgery group, NS group) were untreated before IVF. The follicular fluid from a dominant follicle was collected during oocyte retrieval, and the concentrations of sixteen soluble cytokines known to be involved in ovarian function were measured.

Results
Among the soluble molecules examined in this study, chemokines and growth factors and a few are inflammatory cytokines were found in the follicular fluid of patients with endometriosis. In addition, the expression levels of chemokines, growth factors, and most inflammatory cytokines did not differ between the S and NS groups, but interleukin (IL)-18 levels were significantly lower in the NS group. However, the levels of IL-18 in the FF did not correlate with IVF cycle parameters. The implantation and clinical pregnancy rates were similar between the two groups, but the anti-Müllerian hormone (AMH) level was lower in the S group than in the NS group.

Conclusions
These findings suggest that endometrioma surgery may potentially reduce the ovarian reserve and has little impact on the success rate of IVF. Ovarian endometriomas are not associated with cytokine profiles in FF from infertile women, and they are not likely to affect the quality of the oocyte and embryo as a result of an inflammatory mechanism.
Practical tools to identify short children born small-for-gestational-age eligible for rhGH treatment according to Italian regulation
Authors: Tornese Gianluca , Pricci Flavia , Pellegrin Maria Chiara , Villa Marika , Rotondi Daniela , Agazio Elvira , Barbi Egidio 
Published: October 2019

AbstractRecombinant human growth hormone (rhGH) is an approved and effective treatment for short children born small for gestational age (SGA). Prevalence of children eligible for treatment as SGA is reported to be 1:1800. The latest data from the National Registry of Growth Hormone therapy (RNAOC) showed that the number of children treated with SGA indication is still small (prevalence 0.37/100,000) and these children are significantly less reported than those treated for growth hormone deficiency (GHD), although GHD prevalence is 1:4000–1:10,000. This means that many short children born SGA are still not properly identified, and therefore not treated with rhGH, or misdiagnosed as GHD. This article provides some practical tools for the identification of children eligible for rhGH treatment.