bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathways towards scaling up Problem Management Plus in Turkey: A Theory of Change Workshop
Authors: Fuhr Daniela , Acarturk Ceren , Uygun Ersin , McGrath Michael , Ilkkursun Zeynep , Kaykha Sadaf , Sondorp Egbert , Sijbrandij Marit , Ventevogel Peter , Cuijpers Pim , Roberts Bayard 
Published: January 2020

Abstract
Background A considerable evidence base has been produced in recent years highlighting the effectiveness of brief scalable psychological interventions for people living in communities exposed to adversity. However, practical guidance on how to scale up these interventions to wider populations does not exist. In this paper we report on the use of Theory of Change (ToC) to plan the scale up of the World Health Organization’s flagship low intensity psychological intervention “Problem Management Plus” (PM+) for Syrian refugees in Turkey.Methods We conducted a one-day ToC workshop in Istanbul. ToC is a participatory planning process used in the development, implementation and evaluation of projects. It is similar to driver diagrams or logic models in that it offers a tool to visually present the components needed to reach a desired long-term outcome or impact. The overall aim of ToC is to understand the change process of a complex intervention and to map out causal pathways through which an intervention or strategy has an effect. Results Twenty-four stakeholders (including governmental officials, mental health providers, officials from international/national non-governmental organisations, conflict and health researchers) participated in the ToC workshop. A ToC map was produced identifying three key elements of scaling up (the resource team; the innovation and the health system; and the user organisation) which are represented in three distinct causal pathways. Context-specific barriers related to the health system and the political environment were identified, and possible strategies for overcoming these challenges were suggested. Conclusion ToC is a valuable methodology to develop an integrated framework for scaling up. The results highlight that the scaling up of PM+ for Syrian refugees in Turkey needs careful planning and investment from different stakeholders at the national level. Our paper provides a theoretical foundation of the scaling up of PM+, and exemplifies for the first time the use of ToC in planning the scaling up of an evidence-based psychological intervention in global mental health.
Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a systematic review
Authors: Dhungana Raja Ram , Pandey Achyut Raj , Shrestha Nipun , Pedisic Zeljko , de Courten Maximilian 
Published: January 2020

Abstract
Background Untreated and uncontrolled hypertension are major challenges in the cascade of care of hypertension in Nepal. The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system. Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies, including health system strengthening and population-based interventions. However, no systematic review of the strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study, therefore, aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods Six databases namely Embase, PubMed, Web of Science, CINAHL (through EBSCOHost), ProQuest and WorldCat were systematically searched for studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool (MMAT). Themes on barriers and enablers were generated and framed under “health system excluding provider and patient (HS)”, “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods, eight relating to barriers and enablers and six of hypertension strategies. The identified barriers associated with the health system (HS) were: lack of affordable services and lack of resources. The commonly reported barriers at the provider’s level were: lack of clear instructions from the providers for medication use, follow-up visits and lifestyle modifications, and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion There is a range of barriers for hypertension treatment and control in Nepal pertaining to the health system, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.
WITHDRAWN: Sustaining benefits of nutritional therapy in young adults with Phenylketonuria - A 2 year Prospective Study
Authors: Krämer Johannes 
Published: January 2020

Abstract

Introduction. Phenylketonuria (PKU) is an inborn error of metabolism, which is caused by a deficiency in the enzyme phenylalanine hydroxylase (PAH). Life-long Phe-free diet impairs quality of life, especially in adolescents and young adults which take responsibility over their diet and therapy from their parents, but expect freedom in daily routine. Methods and Results. 105 patients with PKU were screened for eligibility for participating in this study. data of 21 patients with GPV≤5 and age between 14 and 30 years were included in the analysis. Mean age of the study population was 22.6±7.5 years, 8 patients (38%) were female. At baseline, structured counselling by a professional nutrionist was performed. Follow-up visits were performed after 6.5±3.9, 11.2±3.3, 19.8±7.4 and 25.5±5.7 months. Mean Phe-level at baseline was 926±432 µmol/l, after six months Phe-levels were significantly reduced to 709±314 µmol/l (p=0.039), in total 4 additional patients (38% of the population) reached values within the therapeutic goal. After 12, 18 and 24 months, mean Phe-level elevated significantly back to initial level (869±427 µmol/l; p=0.311). Mean daily intake of natural protein at baseline was 32.3±24.3 g per day. There was a significant decrease after 6 months (26.9±18.8 g/day; p=0.049) and 12 months (25.9±16.2 g/day; p=0.30) compared to baseline. Values at 18 months (27.5±9.2 g/day; p=0.26) and 24 months (35.0±22.3 g/day; p=0.87) did not differ. Mean daily supplementation of Phe-free amino acids was 26.2±19.2 g per day. In all follow-up examinations a significant increase compared to baseline values was calculated (42.4±17.6 g/day after 6 moths (p=0.028), 52.1±29.9 g/day after 12 months (p=<0.01), 38.7±20.3 g/day after 18 months (p<0.01) and 39.3±21.9 g/day after 24 months (p=0.014)). At baseline, mean total protein intake (natural protein plus supplements) was 0.97±0.42 g per kg body weight (g/kgBW). After 24 months the protein intake was within recommended levels. (1.23±0.33 g/kgKB; p=0.013). After 24 months, plasma Vitamin B12 increased to 424.8±176.9 pg/ml (baseline 368.6±205.6 pg/ml; p=0.049) and Vitamin D increased to 30.4±9.9 ng/ml (baseline 24.5±10.1 ng/ml; p=0.06). Conclusion. Counselling by a professional nutrionist in young adults with PKU has clear short-term effects on plasma Phe-levels. Easy applicable therapeutic recommendations, as additional intake of amino acid supplement, are well tolerated and result in strict therapy adherence up to 24 months. Apart from that, the effects on Phe-levels seem only to sustain for about 6 months. More frequent nutritional counselling, i.e. at least two times per year, is recommended to preserve positive effects on Phe-levels. Lack of Vitamin B12 and Vitamin D still are common in PKU patients, but not necessarily need to be substituted. They can effectively be equalized by a well-balanced diet within 24 months.
Further identification of a 140bp sequence from amid intron 9 of human FMR1 gene as a new exon
Authors: Lan Fenghua , Yang Wen-jing , Liao Juan , Xu Yong-jun , Guo Xiao-yan , Fu Xian-guo , Li Dan , Yan Ai-zhen , Zhang Duo , Lan Feng-hua 
Published: January 2020

Abstract
The disease gene of fragile X syndrome, FMR1 gene, encodes fragile X mental retardation protein (FMRP). The alternative splicing of FMR1 can affect the structure and function of FMRP. However, the biological functions of alternatively spliced isoforms are remain elusive. In previous study, we identified a new cryptic exon of 140bp from the intron 9 of human FMR1 gene. In this study, we further examined the biological functions of this new exon and its underlying signaling pathways. qRT-PCR results showed that this novel exon was commonly expressed in the peripheral blood of normal individuals. Comparative genomics showed that sequences paralogous to the 140bp sequence are only found in the genomes of primates. To explore the biological functions of the new transcript, recombinant eukaryotic expression vectors and lentiviral overexpression vectors were constructed. Results showed that the spliced transcript encoded a truncated protein which was expressed mainly in the cell nucleus. Additionally, a few genes including BEX1 gene involved in mGluR-LTP or mGluR-LTD signaling pathways was significantly influenced when the truncated FMRP was overexpressed. Our work emphasized the notion that the alternative splicing of FMR1 gene is complex which may in a large part account for the multiple functions of FMRP protein.
The impact of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on the mortality in sepsis: A systematic review and meta-analysis
Authors: Yu Yi , Huang Jing , Zheng Bojun , Zhang Jian , Li Jian 
Published: January 2020

Abstract
Background The effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the mortality of patients with sepsis is not well characterized. The aim of this study was to elucidate the association between prior ACEI or ARB exposure and mortality in sepsis. Methods The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for all studies of premorbid ACEI or ARB use and sepsis mortality until November 30 2019. Two reviewers independently assessed, selected, and abstracted data from studies reporting ACEIs or ARBs, sepsis, and mortality. The primary extracted data consisted of premorbid ACEI or ARB exposure, mortality, and general patient data. Two reviewers independently assessed the risk of bias and quality of evidence. Results A total of six studies comprising 281,238 patients with sepsis, including 49,799 cases with premorbid ACEI or ARB exposure were eligible for analysis. Premorbid ACEIs or ARBs exposure decreased the 30-day mortality in patients with sepsis. Moreover, the use of ACEIs or ARBs was associated with approximately a 6% decreased risk of 30-day mortality. Conclusions The results of this systematic review suggest that ACEI or ARB exposure prior to sepsis may be associated with reduced mortality. Further high-quality cohort studies and molecular mechanism experiments are required to confirm our results.
Early immunosuppression was associated with poor prognosis in elderly patients with sepsis: secondary analysis of the ETASS study
Authors: Pei Fei , Zhang Guanrong , Zhou Lixin , Liu Jiyun , Ma Gang , Kou Qiuye , He Zhijie , Chen Minying , Nie Yao , Wu Jianfeng , Guan Xiangdong 
Published: January 2020

Abstract
Background: Although immunosuppression has been investigated in adult septic patients, early immune status remains unclear. In this study, we aimed to assess early immune status in adult patients with sepsis stratified by age and its relevance to hospital mortality. Methods: From post hoc analysis of a multicenter, randomized controlled trial, 273 patients whose levels of monocyte human leukocyte antigen-DR (mHLA-DR) were obtained within 48 hours after onset of sepsis were enrolled. All patients were divided into elderly (≥60yrs) group and non-elderly (<60yrs) group. Early immune status was evaluated by the percentage of mHLA-DR in total monocytes within 48 hours after onset of sepsis and it was classified as immunosuppression (mHLA-DR≤30%) or non-immunosuppression (>30%). Changes in immune status were assessed by the value change in mHLA-DR on day 3 compared with the first measurement. Three logistic regression models were conducted to test the associations between early immunosuppression and hospital mortality. We also did a sensitivity analysis to find out if the definition of early immune status (24 vs. 48 hours after onset of sepsis) affects the outcomes. Results: Of the 181 elderly and 92 non-elderly septic patients, 71 (39.2%) elderly and 25 (27.2%) non-elderly died in hospital. The percentage of early immunosuppression in the elderly was twice of that of the non-elderly patients (32% vs. 16%, p=0.006). Immunosuppressed elderly had higher hospital mortality than the non-immunosuppressed elderly (53.4% vs. 32.5%, p=0.009), but there was no significant difference in mortality between immunosuppresed non-elderly patients and non-immunosuppressed non-elderly patients (33.5% vs. 26.0%, p=0.541). In all of the three logistic regression models, we found that early immunosuppression was independently associated with increased hospital mortality in elderly, but not in non-elderly patients. Sensitivity analysis further confirmed the definition of early immune status did not affect the outcomes. In addition, immune status improvement on day 3 was associated with reduced hospital mortality in both elderly and non-elderly patients. Conclusion: In adult patients with sepsis, the elderly were more susceptible to early immunosuppression after onset of sepsis. Early immunosuppression was independently associated with poor prognosis in elderly patients. Trial registration: ClinicalTrials.gov NCT00711620 , 9 July 2008, https://clinicaltrials.gov/ct2/show/NCT00711620
Development of a nomogram to predict in-hospital mortality of sepsis-associated encephalopathy: a retrospective cohort study
Authors: Yang Yang , Liang Shengru , Geng Jie , Wang Qiuhe , Wang Pan , Cao Yuan , Li Rong , Gao Guodong , Li Lihong 
Published: January 2020

Abstract
Background: Sepsis-associated encephalopathy (SAE) is related to an increased in-hospital mortality in patients with sepsis. We aim to establish a user-friendly nomogram for individual prediction of in-hospital death probability in patients with SAE.Methods: Data were retrospectively retrieved from the Medical Information Mart for Intensive Care (MIMIC III) open source clinical database. SAE was defined by a Glasgow Coma Score (GCS) <15 at the presence of sepsis. Prediction model with a nomogram was constructed in the training set by Logistic regression analysis and then internally validated. A decision curve analysis (DCA) was performed to evaluate the net benefit of intervention with the nomogram.Results: A total of 669 and 287 patients with SAE were randomly assigned to training set and internal validation set according to an allocation ratio of 7:3, respectively. Parameters eligible for the nomogram included age, Sequential Organ Failure Assessment (SOFA) score, red blood cell distribution width (RDW) and the mean values of heart rate, temperature and respiratory rate at first day of ICU admission. The nomogram exhibited good discrimination with an area under the receiver operating characteristic curve (AUROC) of 0.773 (95%CI: 0.729–0.818) in the training set and 0.741 (95%CI 0.673–0.809) in the validation set, respectively. Calibration of the derived model was also excellent, with Brier score of 0.136 (95%CI: 0.12–0.153) and 0.168 (95%CI: 0.144–0.192) in both sets. The DCA of the nomogram indicated greater net benefit than SOFA. X-tile analysis showed that the nomogram can clearly stratify patients into three subgroups with different risks of hospital death. Conclusions: The nomogram presents excellent performance in predicting in-hospital mortality of SAE patients, which can guide the prevention of SAE progression and may be more beneficial once specific treatments towards SAE are developed.
The general movements assessment in term and late-preterm newborns diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age: a scoping review protocol.
Authors: Seesahai Judy , Luther Maureen , Rhoden Carmen Cindy , Church Paige Terrien , Asztalos Elizabeth , Banihani Rudaina 
Published: January 2020

Abstract
Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included neonates more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Text and opinion papers will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed.Discussion The results of this review will guide future research to improve early identification and timely intervention in neonates with neonatal encephalopathy at risk of neuromotor impairment.Systematic review registration Title registration with Joanna Briggs Institute.
Medication literacy in elderly patients with chronic diseases: a community pharmacy perspective
Authors: Plaza-Zamora Javier , Legaz Isabel , Osuna Eduardo , Pérez-Cárceles M. D. 
Published: January 2020

Abstract
Background: Long-term therapy with chronic maintenance medication is essential for reducing risks of disease progression, comorbidity, and mortality. A correct adherence and use of the medication are prerequisite for reducing these risks. Medication literacy (ML) is the specific ability to safely access and understand the information available concerning medication, and act accordingly.Methods: To investigate the ML in a community pharmacy of older users in order to study the factors that are associated with inadequate literacy. A total of 400 patients were analyzed to assess the level of ML (document and numeracy) through the MedLitRxSE tool.Results: Our study showed that 66% had an inadequate-ML. Women were a high frequency of inadequate-ML respect to men (70.1% and 29.9%). Users over 65 years with chronic diseases showed a high frequency of inadequate-ML (76.5%) in both sexes (P<0.001).Conclusions: Older users, those with primary or any studies as well as patients taking many medicines for chronic diseases showed a significantly lower level of ML. Health professionals and managers should adopt new strategies that allow to prevent and reduce the errors in the handling of the medicines and avoiding the undesirable effects of a misuse in older patients.
An in situ approach for characterizing photosynthetic gas exchange of rice panicle
Authors: Chang Tiangen , Song Qing-Feng , Zhao Honglong , Chang Shuoqi , Xin Changpeng , Zhu Xinguang 
Published: January 2020

Abstract
Background: Photosynthesis of reproductive organs in C 3 cereals is generally regarded as important to crop yield. Whereas, photosynthetic characteristics of reproductive organs are much less understood as compared to leaf photosynthesis, mainly due to methodological limitations. To date, many indirect methods were developed to study photosynthesis of reproductive organs and its contribution to grain yield, such as shading, application of herbicides or photosynthetic measurement of excised organs or tissues, which might be intrusive and cause biases. Thus, a robust and in situ approach needs to be developed. Results: Here we report the development of a custom-built panicle chamber (P-chamber), which can be connected to a standard infrared gas analyzer to study photosynthetic/respiratory rate of a rice panicle. With this P-chamber, we measured photosynthetic characteristics of panicles for seven high-yielding elite japonica , japonica-indica hybrid and indica rice cultivars. Results show that, 1) rice panicle is photosynthetically active during grain filling, and there are substantial inter-cultivar variations in panicle photosynthetic and respiratory rates, both for a whole panicle and on a single spikelet basis; 2) among the seven testing cultivars, light saturated whole-panicle gross photosynthetic rates at early grain filling stage are 17 – 54 nmol s -1 , which are estimated to be 20-38% of the corresponding flag leaves; 3) rice panicle photosynthesis has higher apparent CO 2 compensation point, light compensation point and apparent CO 2 saturation point, as compared to that of a typical leaf; 4) there is a strong and significant positive correlation between gross photosynthetic rate at early grain filling stage on a single spikelet basis and grain setting rate at harvest (Pearson correlation coefficient r = 0.93, p -value < 0.0001). Conclusions: Overall, the P-Chamber can be used as a tool to study in situ photosynthetic characteristics of irregular non-foliar plant organs, which is a relatively less explored area in current cereal breeding community.