bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)
Authors: Muddu Martin , Tusubira Andrew K. , Nakirya Brenda , Nalwoga Rita , Semitala Fred C. , Akiteng Ann R. , Schwartz Jeremy I , Ssinabulya Isaac 
Published: January 2020

Abstract
BackgroundPersons Living with HIV (PLHIV) receiving antiretroviral therapy have increased risk of cardiovascular disease (CVD). Integration of services for hypertension (HTN), the primary CVD risk factor, into HIV clinics is recommended in Uganda. Our prior work demonstrated multiple gaps in implementation of integrated HTN care along the HIV treatment cascade. In this study, we sought to explore barriers to, and facilitators of, integrating HTN screening and treatment into HIV clinics in Eastern Uganda.MethodsWe conducted a qualitative study at three HIV clinics with low, intermediate, and high HTN care cascade performance, which we classified based on our prior work. Guided by the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured interviews with health services managers, health care providers and hypertensive PLHIV (n=83). Interviews were transcribed verbatim. Three qualitative researchers used both deductive (CFIR model-driven) and inductive (open coding) methods to develop relevant codes and themes. Ratings were performed to determine valence and strengths of each CFIR construct regarding influencing HTN/HIV integration. ResultsOf the 39 CFIR constructs assessed, 17 were relevant to either barriers or facilitators to HTN/HIV integration. Six constructs strongly distinguished performance and were barriers, three of which were in the Inner setting (Organizational Incentives & Rewards, Available Resources, Access to Knowledge & Information); two in Characteristics of individuals (Knowledge & Beliefs about the Intervention and Self-efficacy) and one in Intervention characteristics (Design Quality & Packaging). Four additional constructs were weakly distinguishing and negatively influenced HTN/HIV integration. There were four facilitators for HTN/HIV integration related to the intervention (Relative advantage, Adaptability, Complexity and Compatibility). The remaining three constructs negatively influenced HTN/HIV integration but were non-distinguishing. ConclusionUsing the CFIR, we have shown that while there are modifiable barriers to HTN/HIV integration in the Inner setting, Outer setting, Characteristics of individuals and implementation Process, HTN/HIV integration is of interest to patients, health care providers and managers. Improving access to HTN care among PLHIV will require overcoming barriers and capitalizing on the facilitators using a health system strengthening approach. These findings are a springboard for designing contextually appropriate interventions for HTN/HIV integration in low- and middle-income countries.
Efficacy of transversus abdominis plane block on the chronic pain after colorectal surgery: a retrospective cohort study
Authors: Pan Zi-Ye , Hu Zhong-Hua , Zhang Fan , Xie Wen-Xiu , Tang Yong-Zhong , Liao Qin 
Published: January 2020

Abstract
Background: Chronic postsurgical pain (CPSP) is common and would reduce the quality of life of patients. Transversus abdominal plane (TAP) block has been widely used in lower abdominal surgery and many researchers demonstrated that it could improve acute postsurgical pain. We aim to determine whether TAP block could improve chronic postoperative pain at 3 months and 6 months after colorectal surgery.Methods: A total of 307 patients received selective colorectal surgery under general anesthesia between January, 2015 and January, 2019 in a single university hospital were included: 128 patients received TAP block combined with patient-controlled intravenous analgesia (PCIA) for postsurgical analgesia (group TP) and 179 only administrated with PCIA (group P). Main outcome was the incidence of pain at 3 months and 6 months after colorectal surgery, and NRS score of pain at 24 hours, 48 hours, 3 months and 6 months after colorectal surgery. The data was analyzed by two-way repeated measures anova and the chi-square test.Results: The NRS score decreased significantly at 24 hours after surgery (rest NRS 1.07±1.34 vs 1.65±1.67, P=0.003; and movement NRS 3.00±1.45 vs 3.65±1.89; p=0.003) and at 3 months after surgery (movement NRS 0.59±1.23 vs 0.92±1.65, p=0.045 )in group TP than that in group P. There were no significant difference of NRS score at 48 hours and 6 months after surgery (all p>0.05). Among 307 patients, 62/307(20.2%) developed chronic post-surgical pain (CPSP) at 3 months after surgery, and 42/307(13.7%) experienced CPSP at 6 months after surgery. The prevalence of CPSP in group TP showed no significant difference compared with group P at 3 months (19.5% vs 20.7%, p=0.806) and 6 months (13.2% vs 13.9%, p=0.863) after surgery.Conclusions: TAP block could decrease the movement pain score at 3 months after surgery, but could not reduce the incidence of CPSP at 3 months and 6 months after selective colorectal surgery. TAP block may have positive effect on chronic postsurgical pain.
Outcome impact of individualized fluid management during spine surgery A before-after prospective comparison study
Authors: Che Lu , Zhang Xiu H , Li Xu , Zhang Yue L , Huang Yu G , Xu Li 
Published: January 2020

Abstract
Background: Individualized fluid management (IFM) has been shown to be useful to improve the postoperative outcome of patients undergoing major abdominal surgery. A limited number of clinical studies have been done in orthopaedic patients and have yielded conflicting results. We designed the present study to investigate the clinical impact of IFM in patients undergoing major spine surgery. Methods: This is a before-after study done in 300 patients undergoing posterior spine arthrodesis. Postoperative outcomes were compared between control group implementing standard fluid management (n = 150) and IFM group (n = 150) guided by fluid protocol based on continuous stroke volume monitoring and optimization. The primary outcome measure was the proportion of patients who developed one or more complications within 30 days following surgery.Results: During surgery, patients received on average the same volume of crystalloids (7.4 vs 7.2 ml/kg/h) and colloids (1.6 vs 1.6 ml/kg/h) before and after the implementation of IFM. During 30 days following surgery, the proportion of patients who developed one or more complications was lower in the IFM group (32 vs 48%, p<0.01). This difference was mainly explained by a significant decrease in post-operative nausea and vomiting (from 38 to 19%, p<0.01), urinary tract infections (from 9 to 1%, p<0.01) and surgical site infections (from 5 to 1%, p<0.05). Median hospital length of stay was not affected by the implementation of IFM. Conclusions: In patients undergoing major spine surgery, the implementation of IFM was associated with a significant decrease in postoperative morbidity.
Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis
Authors: Li Weiqin , Xie Xiaochun , Dong Jie , Lu Guotao , Gao Kun , Li Xiaoyao , Mao Wenjian , Chen Faxi , Tong Zhihui , Li Baiqiang 
Published: January 2020

Abstract
Background: Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP).Methods: We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the highest TBA value (TBAmax) within 7 days after admission was ≥10μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between circulating TBA and organ failure in AP patients.Results: 293 patients were included in this study, of whom 18.43% (54/293) were in the HTBA group. The incidence of OF in the HTBA group was significantly higher than that in the NTBA group (59.3% vs 17.2%; P < 0.001), and the AP severity classification in the HTBA group was more serious than that in the NTBA group. The pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate, open surgery rate and mortality rate in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF. Conclusions: The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.
Transcriptome and metabolite analyses provide insights into zigzag-stem formation in tea plants (Camellia sinensis)
Authors: Cao Hongli , Wang Feiquan , Lin Hongzheng , Ye Yijun , Zheng Yucheng , Li Jiamin , Hao Zhilong , Ye Naixing , Yue Chuan 
Published: January 2020

Abstract
BackgroundShoot orientation is important for plant architecture formation, and the zigzag shoot is a special trait of many plants. The zigzag-shaped shoot has been selected and well studied in Arabidopsis, however, the regulatory mechanism of zigzag-shaped shoot development in other plants especially woody plants is largely unknown.ResultsIn this study, tea plants with zigzag shoots, namely, Qiqu (QQ) and Lianyuanqiqu (LYQQ), were investigated and compared with the erect-shoot tea plant Meizhan (MZ) in an attempt to reveal the regulation of zigzag-shoot formation. Tissue section observation showed that the cell arrangement and shape of zigzag stems were aberrant compared with those of normal shoots. Moreover, a total of 2175 DEGs were identified from the zigzag shoots of the tea plants QQ and LYQQ compared to the shoots of MZ using transcriptome sequencing, and the DEGs involved in the “Plant-pathogen interaction”, “Phenylpropanoid biosynthesis”, “Flavonoid biosynthesis” and “Linoleic acid metabolism” pathways were significantly enriched. Additionally, the DEGs associated with cell expansion, vesicular trafficking, phytohormones, and transcription factors were identified and analysed. Metabolomic analysis showed that 13 metabolites overlapped and were significantly changed in the shoots of QQ and LYQQ compared to MZ.ConclusionsOur results suggest that zigzag-shaped shoot formation might be associated with the gravitropism response and polar auxin transport in tea plants and provides a valuable foundation for further understanding the regulation of plant architecture formation and for the cultivation and application of horticultural plants in the future.
Genome-wide association studies on heat stress tolerance during grain development in wheat (Triticum aestivum L.)
Authors: Guo Jie , Shi Weiping , Guo Jiahui , Yue Linqi , Zhuang Lei , Zhang Wenying , Tian Xiaohai , Xu Yanhao , Zhou Meixue 
Published: January 2020

Abstract
BackgroundHeat stress at the late reproductive stages is a common problem encountered in autumn-sown wheat production regions in China with the affected area covering as much as two-thirds of the crop. In order to develop wheat cultivars with heat-tolerance, it is crucial to explore favorable alleles for use in breeding programs.ResultsIn this study, we performed a 90K iSelect SNP genotyping assay on a collection of 207 wheat cultivars subjected to heat stress during grain-fill growth stage in three years (2015-2017). Genotypic analyses of 19 phenotypic traits revealed that heat stress had major impacts on grain weight, size, and quality. Correlation analyses indicated that thousand kernel weight (TKW) was significantly correlated with grain width (GW) and grain perimeter (GP), whereas grain protein content (GPC) was negatively correlated with total starch content (TSC) (P <0.01). We applied heat susceptibility indices (HSI) for different traits to assess heat tolerance. Genome-wide association studies (GWAS) revealed a total of 125 marker-trait associations (MTAs) at 63 SNP loci on 16 chromosomes each accounting for phenotypic variation (R2) of 3.0-21.4%. 17 loci showed significant associations in three environments. The analysis of selective sweeps indicated that RAC875_c19042_2102 (2B), wsnp_Ex_c257_491667 (3B), wsnp_Ex_rep_c101323_86702413 (5A) and BS00061911_51 (7A) were selected between two subpopulations (top 5%).ConclusionsThese four key MTAs detected in the present study are candidates for further genetic dissection and development of molecular markers.
Mouse skeletal muscles infected with Plasmodium berghei and Plasmodium chabaudi reveal a crosstalk between lipid mediators and gene expression
Authors: Marrelli Mauro Toledo , Wang Zhiying , Huang Jian , Brotto Marco 
Published: January 2020

Abstract
Background Malaria is one of the most prevalent infectious disease in the world with 3.2 billion humans at risk. Malaria causes splenomegaly and damage in other organs including skeletal muscles. Skeletal muscles comprise nearly 50% of the human body and are largely responsible for the regulation and modulation of overall metabolism. it is essential to understand how malaria damages muscles in order to develop effective preventive measures and/or treatments. Using a pre-clinical animal model, we investigated the potential molecular mechanisms of plasmodia infection affecting skeletal muscles of mice.Methods We employed the Mouse Signal Transduction Pathway Finder PCR Array to monitor gene expression changes of 10 essential signaling pathways in skeletal muscles from mice infected with Plasmodium berghei and P. chabaudi . We then applied our new targeted-lipidomic approach using liquid chromatography with tandem mass spectrometry to profile 158 lipid signaling mediators (LMs), mostly arachidonoids, eicosanoids and docosanoids. We further quantified 16 key LMs directly associated with inflammation, oxidative stress, and tissue healing in skeletal muscles. Results Our results showed that the expression of key genes altered by malaria infection associate with inflammation, oxidative stress, and atrophy. In support to our gene profiling, lipidomics revealed higher concentrations of LMs in skeletal muscles directly related to inflammatory responses, while on the levels of LMs crucial in resolving inflammation and tissue repair reduced significantly.Conclusion Our results provide new insights into the molecular mechanisms of malaria-induced muscle damage and revealed a potential mechanism modulating inflammation in malarial muscles. These pre-clinical studies should help with future clinical studies in humans aimed at monitoring of disease progression and development of specific interventions for the prevention and mitigation of long-term chronic effects on skeletal muscle function.
The effect of microinjection of CART 55-102 into the nucleus accumbens shell on morphine-induced conditioned place preference in rats: Involvement of the NMDA receptor
Authors: Bakhtazad Atefeh , Vousooghi Nasim , Nasehi Mohammad , Sanadgol Nima , Garmabi Behzad , Zarrindast Mohammad Reza 
Published: January 2020

Abstract
Background The addictive properties of opioids may be mediated to some extent by cocaine- and amphetamine-regulated transcript (CART) in the reward pathway. There are also some claims regarding the interaction of CART and glutamate system. Drug-paired learning and memory may induce conditioned place preference (CPP) or conditioned place aversion (CPA). Here, we have evaluated whether intra-nucleus accumbens (NAc) shell infusions of CART induces CPP or CPA and affect morphine reward. In addition, we have measured the expression of the NR1 subunit of the N-methyl-D-aspartate (NMDA) glutamate receptor in various parts of the reward pathway (NAc, prefrontal cortex (PFC), and hippocampus) after conditioning tests. Bilateral cannulas were implanted in the rats NAc shell and then the animals were exposed to place conditioning. Animals were place-conditioned with several doses of subcutaneous (s.c.) morphine prior to the intra-NAc shell infusion of artificial cerebral spinal fluid (aCSF). Immunohistochemistry (IHC) data showed a dose-dependent increase in the expression of the NR1 subunit in all examined parts. Then, rats were conditioned with intra-NAc shell infusion of different doses of CART. CPP and CPA were induced with 2.5 and 5 μg/side, respectively.Results IHC showed an elevated level of NR1 with 2.5 μg/side and a decrease with 5 μg/side in all areas. Administration of a sub-rewarding dose of CART (1.25 μg/side) prior to the injection of a sub-rewarding dose of morphine (2.5 mg/kg) induced CPP and IHC analysis showed an increased amount of NR1 in all examined tissues. However, infusion of an aversive dose of CART (5 μg/side) prior to the injection of a rewarding dose of morphine (5 mg/kg) produced neither CPP nor CPA and IHC data showed a significant decrease in the amount of NR1 subunit in the NAc and hippocampus.Conclusions It seems that the rewarding or aversive effects of intra-NAc shell CART and its facilitating or inhibiting effects on morphine reward are dose-dependent. Furthermore, the NMDA receptor may be closely involved in the affective properties of opioids and CART in the reward pathway.
Transcriptomics analysis reveals the high biodegradation efficiency of white-rot fungus Phanerochaete sordida YK-624 on native lignin
Authors: Wang Jianqiao , Suzuki Tomohiro , Dohra Hideo , Mori Toshio , Kawagishi Hirokazu , Hirai Hirofumi 
Published: January 2020

Abstract
Background Lignocellulosic biomass is an organic matrix composed of cellulose, hemicellulose, and lignin. In nature, lignin degradation by basidiomycetes is the key step in lignocellulose decay. The white-rot fungus Phanerochaete sordida YK-624 (YK-624) has been extensively studied due to its high lignin degradation ability. In our previous study, it was demonstrated that YK-624 can secrete lignin peroxidase and manganese peroxidase for lignin degradation. However, the underlying mechanism for lignin degradation by YK-624 remains unknown.Results Here, we analyzed YK-624 gene expression following growth under ligninolytic and nonligninolytic conditions and compared the differentially expressed genes in YK-624 to those in the model white-rot fungus P. chrysosporium by next-generation sequencing. More ligninolytic enzymes and lignin-degrading auxiliary enzymes were upregulated in YK-624. This might explain the high degradation efficiency of YK-624. In addition, the genes involved in energy metabolism pathways, such as the TCA cycle, oxidative phosphorylation, lipid metabolism, carbon metabolism and glycolysis, were upregulated under ligninolytic conditions in YK-624.Conclusions In the present study, the first differential gene expression analysis of YK-624 under ligninolytic and nonligninolytic conditions was reported. The results obtained in this study indicated that YK-624 produces more energy- and lignin-degrading enzymes for more efficient lignin biodegradation.
Psychometric properties of a Chinese version of the Fraboni Scale of Ageism: evidence from medical students sample
Authors: Fan Jun-Yao , Zhao Hui-Min , Liu Yue-Ting , Kong Ling-Lin , Mao Jing , Li Jie 
Published: January 2020

Abstract
Background The increasing of older adults has led to enormous demand for medical care. However, as a group with unique needs and characteristics, older adults are often discriminated against in the medical field. In this paper, we aimed to translate the Fraboni Scale of Ageism (FSA) into Chinese and examine its construct validity, content validity, and reliability in Chinese mainland medical students. In order to evaluate the prevalence of ageism in Chinese medical students and prompt medical college to adopt necessary teaching methods to mitigate ageism in medical students.Methods By Brislin's translation guidelines, FSA was translated to Chinese. The convenient sampling method was used to select samples for this survey, including 1,974 students from two medical schools in central and north China. Construct validity was verified by the exploratory and confirmatory factor analysis. The content validity index (CVI) was used to assess content validity. The Cronbach's alpha coefficients and intraclass correlation coefficient (ICC) were used to estimate reliability.Results The alpha coefficients for FSA (Chinese version) was 0.81 and ICC was 0.87. The CVI was 0.93. Three factors were identified by exploratory factor analysis explaining 34.84% of the total variance and a three-factor model was confirmed to fit by confirmatory factor analysis.Conclusions FSA (Chinese version) is a reliable and valid scale for measuring discrimination degree against the older adults in Chinese medical students.
Impact Evaluation of the Kenya Frontline Field Epidemiology Training Program
Authors: Roka Zeinab Gura , Githuku Jane , Obonyo Mark , Kanyina Evalyne , Oyugi Elvis Omondi , Boru Waqo Gufu , RANSOM JAMES Anthony 
Published: January 2020

Abstract
Background In 2014, Kenya’s field epidemiology and laboratory training program (FELTP) initiated a 3-month-long field-based frontline training (FETP-F) for local public health workers.Methods Between February and April 2017, FELTP conducted a mixed-methods evaluation to examine outcomes achieved among 2014 and 2015 graduates of the trainings. Data quality assessment (DQA) and data consistency assessment (DCA) scores, on-time-reporting (OTR) percentages, and ratings of the training experience were the quantitative measures tracked from baseline and then at 6-month intervals up to 18 months post-completion of the training. The qualitative component consisted of semi-structured face-to-face interviews and observations. Quantitative data were analyzed using one-way analysis of variance (ANOVA). Qualitative data were transcribed and analyzed to identify key themes and dimensions.Results One hundred and three graduates were included. For the qualitative component, we reached saturation after 19 onsite interviews and observation exercises. ANOVA showed that the trainings had small but significant impacts on mean DQA and OTR scores. Results showed an insignificant increase in mean DCA scores. Qualitative analyses showed that 68% of respondents acquired new skills, 83% applied those skills to their day-to-day work, and 91% improved work methods.Conclusion The findings show that FETP-F is effective in improving work methods, facilitating behavior change, and improving key public health competencies.