bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial
Authors: Adegboye Amanda Rodrigues Amorim , Cocate Paula G , Benaim Camila , Carvalho Maria Claudia da Veiga , Schlüssel Michael M , Castro Maria Beatriz T , Kac Gilberto , Heitmann Berit L 
Published: January 2020

Abstract
Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aim of this study is to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy (PT) and describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study.

Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2x2 factorial feasibility clinical trial were used. 18 women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions and data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies.

Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (>20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, unresponsive to phone calls, and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthy and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation cost) could hinder participation in the study.

Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related socio-demographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.
Global diastolic strain rate for the assessment of left ventricular diastolic dysfunction in young peritoneal dialysis patients: a case control study
Authors: Zhu Jing , Shi Fei , You Tao , Tang Chao , Chen Jianchang 
Published: January 2020

Abstract
Background: Left ventricular (LV) myocardial longitudinal diastolic strain rate measured by two-dimensional speckle tracking imaging (2D-STI) was proved to have a better correlation with the LV diastolic function. We aimed to use this sensitive tool to predict LV myocardial diastolic dysfunction in young peritoneal dialysis (PD) patients with preserved LV ejection fraction (LVEF).

Methods: We enrolled 30 PD patients aged ≤60 with LVEF ≥54% and classified as normal LV diastolic function by conventional echocardiography, and 30 age- and sex-matched healthy people as the control group. The left atrial maximum volume index (LAVI), LV mass index (LVMI), LVEF, LV posterior wall thickness (LVPWT), interventricular septal thickness (IVST), peak velocity of tricuspid regurgitation (TR), peak early diastolic velocity/late diastolic velocity(by Pulsed Doppler) (E/A) and E/peak velocity of the early diastolic wave (by Pulsed-wave tissue Doppler) (E/e’) were recorded by conventional echocardiographic. Next, the average LV global longitudinal systolic strain (GLS avg) and the average LV global longitudinal diastolic strain rate (DSr avg) during early diastole (DSrE avg), late diastole (DSrA avg) and isovolumic relaxation period (DSrIVR avg) were obtained from 2D-STI. Combined them with E, the new noninvasive indexes (E/DSrE avg, E/DSrA avg and E/DSrIVR avg) were derived.

Results: The PD group ’s LVEF, E/e¢, TR and LAVI were in the normal range compared with the controls, and only e¢ (p<0.001) was decreased. The LVMI (p<0.001), LVPWT (p<0.001), IVST (p<0.001) increased while E/A (p<0.001) decreased. The GLS avg (p=0.008) was significantly decreased in PD patients compared with the controls. DSrA avg (p=0.006) and E/DSrE avg (p=0.006) were increased, while DSrE avg (p<0.001), DSrIVR avg (p=0.017) and E/DSrA avg (p<0.001) decreased. After the multivariable regression analysis, the correlation between DSrE and the conventional parameters including LVPWT (p<0.001), E/A (p<0.001) still remained significant.

Conclusions: Young PD patients with preserved LVEF already exhibited myocardial diastolic dysfunction. Global diastolic strain rate indexes were valuable parameters to evaluate diastolic dysfunction. Additionally, LVPWT was highly correlated with DSrE, such parameter should be taken into account for predicting the early LV diastolic dysfunction in clinical practice.
Elevated glycosylated hemoglobin levels and its interactive effects on hypertension risk in non-diabetic population: a cross-sectional survey in China
Authors: song jian , wei nana , zhao yingying , jiang yuhong , wu xuesen , gao huaiquan 
Published: January 2020

Abstract
Background Abnormal glucose metabolism have been suggested to be involved in the development of hypertension. The present study aimed to investigate the associations and potential interactions of hemoglobin A1c (HbA1c) with other factors on the risk of hypertension among Chinese non-diabetic adults. Methods As a cross-sectional survey, the current work provided questionnaire survey, anthropometric tests and biochemical measure for each of the eligible participants. The HbA1c levels were quantified and grouped by quartiles. The correlation between HbA1c and hypertension risk in non-diabetic was investigated by univariate and multivariate analyses. For evaluating the interactive effects, the parameters of Relative Excess Risk due to Interaction (RERI), Attributable Proportion due to Interaction (AP) and Synergy Index (SI) were calculated, respectively. Results In the current study, 1462 non-diabetic subjects were enrolled. Totally, the prevalence of hypertension was 22.4% (n=327) in the individuals without diabetes. When the HbA1c levels were grouped by quartiles, it was revealed that the prevalence of hypertension substantially elevated across groups ( P for trend <0.001). In the multivariable logistic regression analyses, in comparison with the first quartile of HbA1c, the normalized OR for hypertension risk were 1.90 (95% CI:1.28-2.80) for the highest quartile. Also, the risk of ISH also significantly increased with HbA1c levels in the highest quartile as compared with the bottom quartile(OR: 2.23,95% CI:1.47-3.71). Besides, the ROC curve analysis indicated that the best threshold of HbA1c as the predictor for hypertension risk was 4.95 in non-diabetic subjects, with the AUC of 0.60 (0.58-0.63). Eventually, it was demonstrated from the interactive effect analysis that the HbA1c significantly interacted with abdominal obesity (RERI: 1.48, 95% CI: 0.38-2.58; AP: 0.37, 95% CI: 0.14-0.60 and SI: 1.96, 95% CI: 1.06-3.62) and family history of hypertension (AP: 0.37, 95% CI: 0.05-0.70) on the risk of hypertension in non-diabetic participants. Conclusion The risk of hypertension was aggravated by the up-regulated HbA1c in an independent and synergistic manner with abdominal obesity and family history of hypertension in Chinese subjects without diabetes.
EPIDEMIC RIBOTYPES OF CLOSTRIDIUM (NOW CLOSTRIDIOIDES) DIFFICILE ARE LIKELY TO BE MORE VIRULENT THAN NON-EPIDEMIC RIBOTYPES IN ANIMAL MODELS
Authors: Vitucci John C. , Pulse Mark , Tabor-Simecka Leslie , Simecka Jerry W. 
Published: January 2020

Abstract
Background . Clostridioides difficile infections have become more frequently diagnosed and associated with greater disease severity, which has resulted in an increase burden on the healthcare system. These increases are attributed to the increased prevalence of hypervirulent strains encompassing select ribotypes. These epidemic ribotypes were characterized as hypervirulent due to higher in vitro spore and toxin production, as well as increased incidence, severity and mortality within patients. However, it is unclear whether epidemic ribotypes are truly more virulent than non-epidemic ribotypes in vivo. Furthermore, there is conflicting evidence about the ability of a strain’s in vitro phenotype to be predictive of their in vivo virulence. The goals of the current studies were to determine if epidemic ribotypes are more virulent than other ribotypes in animal models, and whether the in vitro virulence phenotype of an isolate or ribotype predict in vivo virulence.
Results. To determine if epidemic strains were truly more virulent than other non-epidemic strains, the in vivo virulence of thirteen C. difficile isolates (7 non-epidemic and 6 epidemic ribotype isolates) were determined in murine (C57BL/6 mice) and hamster (golden Syrian hamster) models of C. difficile infections. The isolates of epidemic ribotype of C. difficile were found to be more virulent in both the murine and hamster models than non-epidemic isolates. In particular, the group of epidemic ribotypes of C. difficile had lower LD 50 values in hamsters. The increased severity of disease was associated with higher levels of Toxin A and Toxin B production found in fecal samples, but not numbers of organisms recovered. The isolates were further characterized for their in vitro virulence phenotypes, e.g. toxin production, growth rates, spore formation and adherence of spores to intestinal epithelial cell lines. Although there were higher levels of toxins produced and greater adherence for the group of epidemic ribotypes, the in vitro profiles of individual isolates were not always predictive of their in vivo virulence.
Conclusions. Overall, the group of epidemic ribotypes of C. difficile were more virulent in vivo despite individual isolates having similar phenotypes to the non-epidemic isolates in vitro .
Integrative analyses of gene expression profile reveal potential crucial roles of mitotic cell cycle and microtubule cytoskeleton in pulmonary artery hypertension
Authors: Luo Jing , Liu Zhenwei , Li Chenlu , Wang Ruochen , Fang Jinxia , Lu Saisai , Guo Jing , Zhu Xiaochun , Wang Xiaobing 
Published: January 2020

Abstract
Background: Pulmonary arterial hypertension (PAH) is a life-threatening condition that gets worse over time. Despite advances in the development of strategies for treating PAH, prognosis of the disease remains unsatisfactory, especially for advanced PAH. The aim of this study was to explore potential crucial genes and pathways associated with PAH based on integrative analyses of gene expression and shed light on the identification of biomarker for PAH.
Results: Gene expression profile of pulmonary tissues from 27 PAH patients and 22 normal controls were downloaded from public database (GSE53408 and GSE113439). A total of 521 differentially expressed genes (DEGs), including 432 up-regulated DEGs and 89 down-regulated DEGs were identified using “limma” package in R. Functional enrichment analysis showed that these DEGs were mainly enriched in mitotic cell cycle process, mitotic cell cycle and microtubule cytoskeleton organization. Moreover, five key genes (CDK1, SMC2, SMC4, KIF23, and CENPE) were identified based on the comprehensive evaluation of protein-protein interaction (PPI) network analysis, modular analysis and cytohubba’s analysis, then further validated in another transcriptomic data set associated with PAH from public database (GSE33463). Furthermore, these hub genes were mainly enriched in promoting mitotic cell cycle process, which may be closely associated with the pathogenesis of PAH. We also found that the predicted micro-RNAs (miRNAs) targeting these hub genes were found to be enriched in TGF-β and Hippo signaling pathway.
Conclusion:These findings are expected to gain a further insight into the development of PAH and provide a promising index for the detection of PAH.
Integrated proteomic and metabolomic analysis to study the effects of spaceflight on Candida albicans
Authors: Wang Jiaping , Liu Yu , Zhao Guangxian , Gao Jianyi , Liu Junlian , Wu Xiaorui , Xu Chong , Li Yongzhi 
Published: January 2020

Abstract
Background: Candida albicans is an opportunistic pathogenic yeast, which could become pathogenic in various stressful environmental factors including the spaceflight environment. In this study, we aim to explore the phenotypic changes and possible mechanisms of C. albicans after exposure to spaceflight conditions.
Results: The effect of C. albicans after carried on the "SJ-10" satellite for 12 days was evaluated by proliferation, morphology, environmental resistance and virulence experiment. The result showed that the proliferation rate, biofilm formation, antioxidant capacity, cytotoxicity and filamentous morphology of C. albicans were increased in the spaceflight group compared to the control group. Proteomics and metabolomics technologies were used to analyze the profiles of proteins and metabolites in C. albicans under spaceflight conditions. Proteomic analysis identified 548 up-regulated proteins involved in the ribosome, DNA replication, base excision repair and sulfur metabolism in the spaceflight group. Moreover, 332 down-regulated proteins related to metabolic processes were observed. The metabolomic analysis found five differentially expressed metabolites. The combined analysis of proteomic and metabolomic revealed the accumulation of cysteine and methionine in C. albicans after spaceflight.
Conclusions: Mechanisms that could explain the results in the phenotypic experiment of C. albicans were found through proteomic and metabolomic analysis. And our data provide an important basis for the assessment of the risk that C. albicans could cause under spaceflight environment.
3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: One disease- many faces
Authors: Grünert Sarah Catharina , Sass Jörn Oliver 
Published: January 2020

Abstract
Background 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency (HMGCLD) is an autosomal recessive disorder of ketogenesis and leucine degradation due to mutations in HMGCL . Method We performed a systematic literature search to identify all published cases. 211 patients of whom relevant clinical data were available were included in this analysis. Clinical course, biochemical findings and mutation data are highlighted and discussed. An overview on all published HMGCL variants is provided. Results More than 95 % of patients presented with acute metabolic decompensation. Most patients manifested within the first year of life, 42.4 % already neonatally. Very few individuals remained asymptomatic. The neurologic long-term outcome was favorable with 62.6 % of patients showing normal development. Conclusion This comprehensive data analysis provides a systematic overview on all published cases with HMGCLD including a list of all known HMGCL mutations.
Development and Evaluation of a Physical Activity Intervention Informed by Participatory Research- A Feasibility Study
Authors: Ramji Rathi , Carlson Elisabeth , Kottorp Anders , Shleev Sergey , Awad Eman , Rämgård Margareta 
Published: January 2020

Abstract
Background: Despite numerous interventions aiming to improve physical activity in socially disadvantaged populations, physical inactivity remains to be a rising challenge to public health globally, as well as, in Sweden. In an effort to address this challenge, a community-based participatory intervention was developed through active community engagement and implemented in a socially disadvantaged neighborhood in Sweden. The current study aims to present the development and initial evaluation of a participatory research driven physical activity intervention.
Methods : Fifteen participants (11 females and 4 males) aged 17-59 years volunteered to participate in the physical activity intervention program. The intervention program was evaluated using a longitudinal mixed methods design measuring health impact changes over time through focus group discussions and quality of life surveys. Further additional biomedical health parameters such as levels of glycosylated hemoglobin, blood pressure, levels of oxygen saturation and body mass index were monitored before and after the intervention. Focus group data were analyzed using content analysis with an inductive approach. The pre-and post-test scores from the survey-based quality of life domains, as well as the health parameters were compared using non-parametric and parametric statistics.
Results : Four themes emerged from the analysis of the focusgroup discussions including sense of fellowship, striving for inclusion and equity, changing the learner perspective and health beyond illness. The scores for the domains Physical Health, Psychological Health, Social Relationships and Health Satisfaction where significantly higher after participation in the physical activity intervention program compared to the pre-test scores ( p <.05)s. There were however, no significant changes in the scores for the environmental domain and overall quality of life after intervention compared to that prior to intervention start. Overall, the biomedical health parameters remained stable within the normal ranges during intervention.
Conclusion : The focusgroup discussions and results from the surveys and biomedical measures reveal important findings to understand and further develop the intervention program to promote health equity among citizens in disadvantaged areas. Evaluating the feasibility of such an intervention using multiple approaches contributes to effective implementation of it for larger communities in need.
The Efficacy and Tolerability of Ubrogepant for Acute Migraine: A Systematic Review and Meta-Analysis
Authors: Diao Yun , Yang Hang , Zhou Yang Chun , Du Biao 
Published: January 2020

Abstract
Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound，the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45，P<0.00001, RR=1.63,95%CI:1.46~1.82，P<0.00001, RR=1.22,95%CI:1.15~1.29，P<0.00001, RR=1.32,95%CI:1.22~1.42，P<0.00001, RR=1.16,95%CI:1.05~1.27，P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.
The role of social network support on treatment outcomes for medication for opioid use disorder: a systematic review protocol
Authors: Kumar Navin , Howell Benjamin A. , Alexander Marcus , O'Connor Patrick G. 
Published: January 2020

Abstract
Background Although medications for opioid use disorder (MOUD) models are the most efficacious evidence-based treatment for opioid use disorder, there remains a high percentage of patients experiencing unfavorable treatment outcomes. Greater understanding of how social network support functions with respect to MOUD treatment outcomes may possibly increase treatment outcomes. Social network support are the kinds of support, such as assistance or help, that people receive from friends, family, peers and neighbors, paid or unpaid, in their social network. We aim to provide quality evidence to understand the role of social network support on MOUD treatment outcomes. Methods A systematic review of experimental and observational studies will be conducted. PubMed, MEDLINE, Embase, PsycINFO and Sociological Abstracts will be searched, updated to capture current literature. Primary outcomes will include adherence to MOUD, defined as continuation in or completion of an MOUD program; and opioid use, defined as the percentage of urine samples negative for opioids and/or self-reported drug use. The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Quality assessments will be conducted using criteria from the Cochrane Handbook. A narrative synthesis will be conducted for all included studies. Discussion This systematic review seeks to provide policymakers, administrators, practitioners and researchers with a systematic and reproducible strategy to query the literature around the role of social network support on MOUD treatment outcomes. Systematic review registration International Prospective Register for Systematic Reviews (PROSPERO), CRD42018095645.
Perpetration of intimate partner violence among HIV positive couples: A Systematic Review
Authors: Apiribu Felix , Kuupiel Desmond , Ncama Busisiwe Purity 
Published: January 2020

Abstract
Background Intimate partner violence (IPV) is a key public health and social concern among couples in countries globally. A systematic review was conducted to find out information that is found in relation to literature on perpetration of IPV among couples infected with human immunodeficiency virus (HIV).Objective The main objective of this study was to search for evidence of IPV among couples infected with HIV. Specifically, we reviewed literature related to the types of violence perpetrated by intimate partners who are infected with HIV and literature on their experiences.Methods The literature review was guided by the frame work of Arksey and O’Maley (2005). The search engines used in the review include PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar and was focused on perpetration of violence among HIV infected concordant or discordant couples.Results Four main categories of violence were identified in the scoping review, namely psychological abuse, physical abuse, sexual victimization or abuse as well as other forms of abuse. We identified 61 literature related to the topic. Fifty-eight (58) articles were left after duplicates were removed, title and abstract screening brought the number to 9 for full article screening. Nine (9) full text studies were assessed out of the 58 and only 4 were included as they contained data on all the three categories of IPV: physical IPV, sexual IPV, and psychological IPV experienced as a result of being HIV positive. Other IPV identified included financial deprivation, prevention of the partner from meeting colleagues, and verbal abuse such as shouting and scornful looks.Conclusions The results of the systematic review showed limited studies on the perpetration of IPV among HIV infected couples. It is recommended that further studies be done on exploring experiences of couples who perpetrate IPV among HIV seroconcordant or serodiscordant infected couples.Systematic review registration PROSPERO CRD42017062190