bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced differentiation of human pluripotent stem cells into pancreatic endocrine cells in 3D culture by inhibition of focal adhesion kinase
Authors: Liu Xiaofang , Qin Jinhua , Chang Mingyang , Wang Shuyong , Li Yali , Pei Xuetao , Wang Yunfang 
Published: October 2020

Abstract
Background: Generation of insulin-producing cells from human pluripotent stem cells (hPSCs) in vitro would be useful for drug discovery and cell therapy in diabetes. Three-dimensional (3D) culture is important for the acquisition of mature insulin-producing cells from hPSCs, but the mechanism by which it promotes β cell maturation is poorly understood.Methods: We established a stepwise method to induce high-efficiency differentiation of human embryonic stem cells (hESCs) into mature monohormonal pancreatic endocrine cells (PECs), with the last maturation stage in 3D culture. To comprehensively compare two-dimensional (2D) and 3D culture, we examined gene expression, pancreas-specific markers and functional characteristics in 2D culture-induced PECs and 3D culture-induced PECs. The mechanisms were considered from the perspectives of cell-cell and cell-extracellular matrix interactions which are fundamentally different between 2D and 3D culture.Results: The expression of the pancreatic endocrine-specific transcription factors PDX1, NKX6.1, NGN3, ISL1, and PAX6 and the hormones INS, GCG, and SST was significantly increased in 3D culture-induced PECs. 3D culture yielded monohormonal endocrine cells, while 2D culture-induced PECs co-expressed INS and GCG or INS and SST or even expressed all three hormones. We found that focal adhesion kinase (FAK) phosphorylation was significantly downregulated in 3D culture-induced PECs, and treatment with the selective FAK inhibitor PF-228 improved the expression of β cell-specific transcription factors in 2D culture-induced PECs. We further demonstrated that 3D culture may promote endocrine commitment by limiting FAK-dependent activation of the SMAD2/3 pathway. Moreover, the expression of the gap junction protein Connexin 36 was much higher in 3D culture-induced PECs than in 2D culture-induced PECs, and inhibition of the FAK pathway in 2D culture increased Connexin 36 expression.Conclusion: We developed a strategy to induce differentiation of monohormonal mature PECs from hPSCs and found limited FAK-dependent activation of the SMAD2/3 pathway and unregulated expression of Connexin 36 in 3D culture-induced PECs. This study has important implications for the generation of mature, functional β cells for drug discovery and cell transplantation therapy for diabetes, and sheds new light on the signalling events that regulate endocrine specification.
Climatic and topographic changes since the Miocene influenced the diversification and biogeography of the tent tortoise (Psammobates tentorius) species complex in Southern Africa
Authors: Zhao Zhongning , Heideman Neil , Bester Phillip , Jordaan Adriaan , Hofmeyr Margaretha D. 
Published: October 2020

Abstract
Background Climatic and topographic changes function as key drivers in shaping genetic structure and cladogenic radiation in many organisms. Southern Africa has an exceptionally diverse tortoise fauna, harbouring one-third of the world’s tortoise genera. The distribution of Psammobates tentorius (Kuhl, 1820) covers two of the 25 biodiversity hotspots of in the world, the Succulent Karoo and Cape Floristic Region. The highly diverged P. tentorius represents an excellent model species for exploring biogeographic and radiation patterns of reptiles in Southern Africa.Results We investigated genetic structure and radiation patterns against temporal and spatial dimensions since the Miocene in the Psammobates tentorius species complex, using multiple types of DNA markers and niche modelling analyses. Cladogenesis in P. tentorius started in the late Miocene (11.63–5.33 Ma) when populations dispersed from north to south to form two geographically isolated groups. The northern group diverged into a clade north of the Orange River (OR), followed by the splitting of the group south of the OR into a western and an interior clade. The latter divergence corresponded to the intensification of the cold Benguela current, which caused western aridification and rainfall seasonality. In the south, tectonic uplift and subsequent exhumation, together with climatic fluctuations seemed responsible for radiations among the four southern clades since the late Miocene. We found that each clade occurred in a habitat shaped by different climatic parameters, and that the niches differed substantially among the clades of the northern group but were similar among clades of the southern group. Conclusion Climatic shifts, and biome and geographic changes were possibly the three major driving forces shaping cladogenesis and genetic structure in Southern African tortoise species. Our results revealed that the cladogenesis of the P. tentorius species complex was probably shaped by environmental cooling, biome shifts and topographic uplift in Southern Africa since the late Miocene. The Last Glacial Maximum (LGM) may have impacted the distribution of P. tentorius substantially. We found the taxonomic diversify of the P. tentorius species complex to be highest in the Greater Cape Floristic Region. All seven clades discovered warrant conservation attention, particularly Ptt-B–Ptr, Ptt-A and Pv-A.
Determinants of successful guideline implementation: A national cross-sectional survey
Authors: Jin Yinghui , Tan Li-Ming , Khan Khalid S. , Deng Tong , Huang Chao , Han Fei , Zhang Jing , Huang Qiao , Huang Di , Wang Dan-qi , Wang Yu , Zeng Xiantao , Wang Qiang , Wang Xing-huan 
Published: October 2020

Abstract
Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. At last, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95%CI).Results: The questionnaire consisted of four sections: knowledge on methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P＜0.001; the west P=0.02; the middle P＜0.001 compared with the east), hospital grades(P=0.028), length of practitioners’ practice (P =0.006), education background (PhD, P=0.027; Master, P=0.002), evidence-based medicine skills acquired in work unit (P=0.012), and medical specialty of practitioner (General Practice, P=0.006; Surgery, P=0.043). Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study.
Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: A multicenter study in a metropolitan area
Authors: Takubo Youji , Nemoto Takahiro , Iwai Momoko , Kashima Minako , Yamaguchi Eriko , Maruyama Akiko , Miura Sachio , Saito Hisaaki , Tsujino Naohisa , Mizuno Masafumi 
Published: October 2020

Abstract
Background: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognized as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system.Methods: A multicenter retrospective chart review research was conducted. The subjects were foreign residents who presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of three years. We investigated the patients’ demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals, and outcome.Results: The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign residents in Japan Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea, and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it.Conclusions: The results suggest that foreign residents in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign residents. The development of a community-based integrated care system accessible to foreign residents seems to be indispensable.
Patients' experiences of eHealth in palliative care: An integrative review
Authors: Widberg Cecilia , Wiklund Birgitta , Klarare Anna 
Published: October 2020

Abstract
Background: With a growing world population, a longer life expectancy, and more deaths due to chronic diseases, the need for palliative care is increasing. Palliative care aims to alleviate suffering and to promot e well-being for patients with progressive, incurable disease or injury. E - Health entails us ing of information and communication technology for healthcare provision . I t is unclear to how patients experience use of eHealth technology within palliative care Methods: The aim of this study was to describe patients’ experiences of eHealth in palliative care. A systematic integrative review w as performed using six databases: Cinahl Complete; MEDLINE; PubMed; Psychology and Behavioral Sciences Collection; Nursing and Allied Health; and PsycINFO . Twelve studies met the inclusion criteria of adult patients in palliative care, English language , published 2014-2019: comprising 397 patients . S ix studies were from European countries, four from North America, one from South America and one from Oceania . Seven were feasibility or pilot studies. Results: The findings are synthesized in the main theme: E-health applications – promoting communication on patients’ and families’ terms , and three sub- themes: usability and feasibility of eHealth applications; symptom control and individualized care; and use of eHealth applications increased sense of security and patient safety. Patients ’ experiences were that eHealth promoted individualized care, sense of security, better symptom management and participation in care . Communication was facilitated by the inherent flexibility provided by technology . Conclusions: E-Health applications seem promising in promoting equal, individualized care, and may be a tool to endorse accessibility and patient participation in palliative care settings. I ndications are that eHealth communication resulted in patients and families receiving more information, which contributed to experiences of patient safety and feelings of security. At organizational and societal levels, eHealth may contribute to sustainable development and more efficient use of resources.
Driving stress and seismotectonic implications of the 2013 Mw5.8 Awaji Island earthquake, southwestern Japan, based on earthquake focal mechanisms before and after the mainshock
Authors: Imanishi Kazutoshi , Ohtani Makiko , Uchide Takahiko 
Published: October 2020

Abstract
A driving stress of the M w 5.8 reverse-faulting Awaji Island earthquake (2013), southwest Japan, was investigated using focal mechanism solutions of earthquakes before and after the mainshock. The seismic records from regional high-sensitivity seismic stations were used. Further, the stress tensor inversion method was applied to infer the stress fields in the source region. The results of the stress tensor inversion and the slip tendency analysis revealed that the stress field within the source region deviates from the surrounding area, in which the stress field locally contains a reverse-faulting component with ENE-WSW compression. This local fluctuation in the stress field is key to producing reverse-faulting earthquakes. The existing knowledge on regional-scale stress (tens to hundreds of km) cannot predict the occurrence of the Awaji Island earthquake, emphasizing the importance of estimating local-scale (< tens of km) stress information. It is possible that the local-scale stress heterogeneity has been formed by local tectonic movement, i.e., the formation of flexures in combination with recurring deep aseismic slips. The coseismic Coulomb stress change, induced by the disastrous 1995 M w 6.9 Kobe earthquake, increased along the fault plane of the Awaji Island earthquake; however, the postseismic stress change was negative. We concluded that the gradual stress build-up, due to the interseismic plate locking along the Nankai trough, overcame the postseismic stress reduction in a few years, pushing the Awaji Island earthquake fault over its failure threshold in 2013. The observation that the earthquake occurred in response to the interseismic plate locking has an important implication in terms of seismotectonics in southwest Japan, facilitating further research on the causal relationship between the inland earthquake activity and the Nankai trough earthquake. Furthermore, this study highlighted that the dataset before the mainshock may not have sufficient information to reflect the stress field in the source region due to the lack of earthquakes in that region. This is because the earthquake fault is generally locked prior to the mainshock. Further research is needed for estimating the stress field in the vicinity of an earthquake fault via seismicity before the mainshock alone.
The Awareness of Women on Prostate Cancer: A Mixed-Methods Systematic Review Protocol
Authors: Wiafe Ebenezer , Mensah Kofi Boamah , Mensah Adwoa Bemah Boamah , Bangalee Varsha , Oosthuizen Frasia 
Published: October 2020

Abstract
Background: Prostate cancer accounts for about 10% of cancers affecting and claiming the lives of men. Studies have reported that women are better than men in recognition of the early manifestations of various cancers. Besides, women have been recognized to show a profound interest in their partners' health and hence, make observations that men don't know. Several studies have reported on the knowledge gaps of prostate cancer among patients and the general population. It is vital to comprehensively review the available evidence and identify research gaps in our current understanding of knowledge of women on prostate cancer.Methods: A search of bibliographic databases, MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Web of Science, and EMBASE (Ovid) will be undertaken from January 1999 to December 2019. The search will be limited to studies published in the English language. Duplication of studies will be removed using the EndNote citation manager. After deduplication, citations will be screened independently by two authors according to prespecified criteria. Data extraction and quality assessment of the selected studies will be done independently by two authors. Meta-analytic methods will be used where appropriate. The convergent segregated method of synthesis will be adopted in this review. Ethics and dissemination: Primary data collection will not be involved in this study, hence formal ethical clearance will not be needed. The results of the study will be presented through a peer-reviewed journal and conference presentation.Patient and public involvement: Patients or the public will not be engaged in the conduct of this study.Trial registration number: Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/OSF.IO/EYHF2
IPSE, an Abundant Egg-Secreted Protein of the Carcinogenic Helminth Schistosoma haematobium, Promotes Proliferation of Bladder Cancer Cells and Angiogenesis
Authors: Mbanefo Evaristus C. , Agbo Chinwike Terry , Zhao Yuanlong , Lamanna Olivia K. , Thai Kimberly H. , Karinshak Shannon , Khan Mohammad , Fu Chi-Ling , Odegaard Justin , Saltikova Irina , Smout Michael , Pennington Luke , Nicolls Mark , Jardetzky Theodore , Loukas Alex , Brindley Paul , Falcone Franco , Hsieh Michael 
Published: October 2020

Abstract
Background: Schistosoma haematobium, the helminth causing urogenital schistosomiasis, is a known bladder carcinogen. Despite the causal link between S. haematobium and bladder cancer, the underlying mechanisms are poorly understood. S. haematobium oviposition in the bladder is associated with angiogenesis and urothelial hyperplasia. These changes may be pre-carcinogenic events in the bladder. We hypothesized that the Interleukin-4-inducing principle of Schistosoma mansoni eggs (IPSE), an S. haematobium egg-secreted “infiltrin” protein that enters host cell nuclei to alter cellular activity, is sufficient to induce angiogenesis and urothelial hyperplasia. Methods: Mouse bladders injected with S. haematobium eggs were analyzed via microscopy for angiogenesis and urothelial hyperplasia. Endothelial and urothelial cell lines were incubated with recombinant IPSE protein or an IPSE mutant protein that lacks the native nuclear localization sequence (NLS-) and proliferation measured using CFSE staining and real-time monitoring of cell growth. IPSE’s effects on urothelial cell cycle status was assayed through propidium iodide staining. Endothelial and urothelial cell uptake of fluorophore-labeled IPSE was measured. Findings: Injection of S. haematobium eggs into the bladder triggers angiogenesis, enhances leakiness of bladder blood vessels, and drives urothelial hyperplasia. Wild type IPSE, but not NLS-, increases proliferation of endothelial and urothelial cells and skews urothelial cells towards S phase. Finally, IPSE is internalized by both endothelial and urothelial cells. Interpretation: IPSE drives endothelial and urothelial proliferation, which may depend on internalization of the molecule. The urothelial effects of IPSE depend upon its NLS. Thus, IPSE is a candidate pro-carcinogenic molecule of S. haematobium.
Implementation and factors affecting the nursing process among nurses working in selected government Hospitals in Southwest Ethiopia
Authors: Adasho Zerihun Adraro , Bekele Daniel Mengistu 
Published: October 2020

Abstract
Background: The nursing process was initially adopted from the general system theory, and was developed and implemented in the field of education in the early years.Objective: The purpose of this study was to assess implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia.Methods: An institution-based cross-sectional descriptive study was conducted from March 10 to April 1, 2015 in three hospitals in southwest Ethiopia using self-administered questionnaires. This study included a total of 138 nurses using simple random sampling. Data were classified, coded and entered into epidemiological information version 3.5.3, and exported to the statistical package for social science version 20 for analysis, descriptive statistics were used to describe the variables, bivariable and multivariable logistic regression were used to see the effect of each variable on the dependent variable.Result: The nursing process was found to be 73.9 per cent implemented. Compared to a Bachelor of Science, the likelihood of implementing the nursing process was less likely among diploma nurses. Nurses working in administratively supported hospitals implemented the nursing process more compared to those without administrative support. The nursing process had been implemented higher by trained nurses compared to untrained nurses.Conclusion: The implementation of nursing process was good where; nearly seven in every ten nurses implemented the nursing process. Low educational qualification, lack of training, and non-supportive hospital administration were predictors of the nursing process implementation.
Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania Region, Italy
Authors: Nunziata Francesco , Bruzzese Eugenia , Poeta Marco , Pierri Luca , Catzola Andrea , Ciccarelli Gian Paolo , Vassallo Edoardo , Montella Emma , Vecchio Andrea Lo , Guarino Alfredo 
Published: October 2020

Abstract
Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted.Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information.Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2-9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5-19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time.Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteriaThe management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes.