bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA
Authors: Schotthoefer Anna , Stinebaugh Kathryn , Martin Michael , Munoz-Zanzi Claudia 
Published: October 2020

Abstract
Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.
Smoking and Incidence of Insomnia: a systematic review and meta-analysis of cohort studies
Authors: Hu Nan , Wang Chunyi , Liao Yan , Dai Qichen , Cao Shiyi 
Published: October 2020

Abstract
Background: Both smoking and insomnia are worldwide problems and this study aims to investigate the impact of smoking on the incidence of insomnia. Methods: PubMed, EMBASE and OVID were searched through March, 2020. Cohort studies reporting the effect of smoking on the incidence of insomnia were included. We quantitatively analyzed the basic framework and study characteristics, and then pooled estimate effects with 95% confidence intervals (CIs) of outcomes of each included studies using fixed-effects meta-analyses. Results: This systematic review included six cohort studies involving 12445 participants. Quantitatively summarized results suggested smoking could significantly increase the incidence of insomnia (OR: 1.07, 95%CI: 1.02,1.13). Regular smoking was significantly associated with incidence of insomnia (OR=1.07, 95% CI:1.01,1.13). As for occasional smokers and ex-smokers, the pooled analysis didn’t indicate a significant association (occasional smoker: OR=2.09, 95% CI:0.44,9.95; ex-smoker; OR=1.02, 95% CI:0.67,1.54). Subgroup analysis by age, gender ratio and region showed statistically significant relationship between smoking and incidence of insomnia in specific groups. Conclusions: Integrated longitudinal observational evidence identified smoking as a significant risk factor of insomnia. Considering the limited amount of available studies, more high-quality and prospective cohort studies of large sample sizes are needed to explore details of this association.
Empowering Healthcare Volunteer’s through Participatory Action Research in a Comprehensive Healthcare Center
Authors: Vizeshfar Fatemeh , Momennasab Marzieh , Yektatalab Shahrzad , Iman Mohamad Taghi 
Published: October 2020

Abstract
Background: healthcare volunteers act as the link between the society and the healthcare system and are a symbol of people's participation in health maintenance and promotion. Despite the important role of health volunteers in the health system, it seems they experience several problems. The aim of this study was empowering health volunteers by determining and relining their problems through a participatory approach.Methods: This participatory action research was done through two continuous cycles of reflection and acting for change over 20 months, in a comprehensive health center in Fars province, Southern Iran. 25 health volunteers, two instructors, and academic researchers as facilitator participated in this study. In the first cycle, the participants discovered the challenges of health volunteers prioritized them and an action plan was designed. Immersion and implementation of the plans were done. At the end of this cycle evaluation was done with the participants’ cooperation. The second cycle began with reflecting on the results of the first cycle and final evaluation was done. Results: Qualitative content analysis in the first phase led to the emergence of four major categories, including inefficiency of volunteers training, inefficiency of attraction and maintenance of volunteers, and being unknown to people and the major theme was named “unfertilized capacity”. After the implementation of the operational plan, the participants learned through reflection and immersing in action. Finally, quantitative content and data analysis showed improvement of knowledge and performance, satisfaction, effectiveness of programs and improvement in volunteer’s competence.Conclusions: Clarification of the volunteers’ roles, and supporting volunteers to improve their knowledge and skills with coherent planning based on their educational needs, are appropriate management plans to attract and retain volunteers. By presenting their services to the society, they will be empowered and motivated to continue.
Iodine Nutritional Status and Thyroid volume of School-Aged Children in Wuhan, central of China
Authors: Chen Fang , Wu Kai , Yang Yan , Xu Mingxing 
Published: October 2020

Abstract
Background/Aims:

Iodine deficiency is a public health problem over the world. China has achieved the iodine deficiency disorders (IDD) elimination goal through a mandatory universal salt iodization (USI) program. The aim of this study is to assess the current iodine nutritional status and thyroid volume of school-aged children in Wuhan, central of China.
Methods

The cross-sectional study was conducted among 8–10 years old children from 5 districts in Wuhan. A total of 1000 students were investigated. Salt iodine concentrations, urine iodine concentrations were determined using the standardized methods recommended by WHO/ICCIDD. An ultrasonography of thyroid and anthropometric measurements were performed in all subjects.
Results

The median urinary iodine concentration(MUI) of students was 247.50 µg/L with interquartile range of 147.00 to 384.00 µg/L. Two districts were classified as regions with adequate iodine nutrition, two districts as regions above the requirement, and one district as a region excessive according to the MUI. The prevalence of goiter was 3.0% and 7.8% according to Chinese national and WHO reference values, respectively, and the difference was not observed among different iodine nutrition groups(P༞0.05). The median thyroid volume(Tvol) of all students was 2.56 ml and the P97 of thyroid volume of both male and female in our study was generally higher than that reported by WHO/ICCIDD in 2007 as a function of age and BSA. The Tvol was in significant association with age, height, weight and BSA by Spearman’s correlation analysis(P < 0.001),and the result of multivariate linear regression analysis showed that only BSA were found to have a significant effect on thyroid volume after log conversion (t = 13.437, P < 0.001).
Conclusion

The present study indicated that the iodine nutrition among school-aged children in Wuhan was generally adequate with a relatively low goiter rate, while some of them have excess iodine nutrition. Thyroid volume in our study was higher than the reference of WHO and showed a significant correlation with BSA. So further researches were needed to evaluate the thyroid function in children with iodine excessive and the applicability of WHO reference in goiter diagnose. It was also highly recommended to establish the local reference values for thyroid volume that might be applicable to precisely define goiter prevalence in Wuhan.
The BAG2 and BAG6 Genes are Involved in Multiple Abiotic Stress Tolerance in Arabidopsis Thaliana
Authors: Arif Muhammad , Li Zitong , Luo Qiong , Li Luhua , Shen Yuequan , Men Shuzhen 
Published: October 2020

Abstract

Background: The BAG (Bcl-2 associated athanogene) family is a multi-functional group of proteins that perform functions ranges from apoptosis to environmental stress tolerance. The BAG proteins are found in yeast, plants and animals. In plants, especially in Arabidopsis thaliana (Arabidopsis), BAG proteins were found to play roles both in abiotic and biotic stresses tolerance including heat, cold, salt, drought, and pathogens. However, the function of Arabidopsis BAG2 remains largely unknown. Whereas BAG6 was found to play important roles in plants response to biotic stresses, it remains unknown whether BAG6 is involved in plants tolerance to abiotic stresses.Results: In this study, we have characterized functions of the Arabidopsis BAG2 and BAG6 genes. Promoter:GUS analysis results show that both BAG2 and BAG6 genes are expressed in various tissues in Arabidopsis thaliana. Expression of both BAG2 and BAG6 genes is induced by salt, mannitol, and heat stress treatments and by the stress-related hormones including ABA, ethylene, and SA, while BAG6 expression is additionally induced by JA. Germination of the bag2 and bag6 single and bag2 bag6 double mutant seeds are less sensitive to ABA than that of the wild type (WT). Both bag2 and bag6 single mutant and bag2 bag6 double mutant show more survival rate than WT in drought treatment but display less survival rate on 45 ℃ heat stress experiment. Consistently, transcription levels of stress-related genes such as RD29A, RD29B and NCED3 are higher in the mutant than that in the WT. Furthermore, these mutants exhibit lower content of reactive oxygen species (ROS) after drought and ABA treatment but higher ROS accumulation after heat treatment than the WT.Conclusion: These results suggest that BAG2 and BAG6 genes are negatively involved in drought stress but play a positive role in heat stress in Arabidopsis.
Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy
Authors: Perera UKC , Samarasekara JSEA , Shiwanth HWCK , Mohotti WMD , Sriy KA , Marikar Faiz 
Published: October 2020

Abstract
Background: Corticosteroids are potent medications used to treat in many inflammatory conditions in paediatric neurology practice. Although corticosteroids are beneficial, their adverse effects may be numerous and vary. As parents are the primary caregivers of paediatric patients, assessing their awareness is timely important. Methods: To determine the parental awareness on adverse effects of corticosteroid therapy in Paediatric Neurology Patients in the Neurology Unit at the Lady Ridgeway Hospital, Colombo, Sri Lanka. In this descriptive cross-sectional study, 300 parents of paediatric neurology patients on long-term corticosteroid therapy in the paediatric neurology unit were included. Parents were volunteered for the study and signed informed consent. Ethical approval was obtained from the Ethics Review Committee of the same hospital. Data were collected using content validated, pre-tested self-administered questionnaire during January to March 2020. Results: Of the total parents, the majority were mothers (87%, n=262) and more than 70% (n=211) of them completed their secondary education. Findings demonstrated that parents had average awareness about adverse effects of long-term steroid therapy including child’s susceptibility to infections (69.0%, n=207), increase blood glucose levels (69.7%, n=209), moon face (60.3%. n=181), central obesity (60.3%, n=181), increase blood pressure levels (58.0%, n=174) and (irritability 50.3%, n=151) while poor awareness on adverse effects include buffalo humps (26.7%, n=80) increase fracture tendency (24.3%, n=73), tarry colour stools (24.3%, n=73), vision impairment (24.0%, n=72), glaucoma (17.3%, n=52), cataract (16.0%, n=48 ) and delayed wound healing (23.0%, n=69). According to the findings, overall mean (SD) knowledge percentage on parental awareness of adverse effects was found to be low (38.24 ± 20.57). Conclusion: Since parental awareness of the adverse effects of long-term corticosteroid therapy is inconsistent, special attention is needed to plan and implement appropriate awareness sessions.
WITHDRAWN: Consumer Engagement in Health Care Policy, Research and Services: Methods and Effects.
Authors: Wiles Louise Katherine , Kay Debra , Luker Julie , Worley Anthea , Austin Jane , Ball Allan , Bevan Alan , Cousins Michael , Dalton Sarah , Hodges Ellie , Horvat Lidia , Kerrins Ellen , Marker Julie , McKinnon Michele , McMillan Penelope , de Plaza Maria Alejandra Pinero , Smith Judy , Yeung David , Hillier Susan 
Published: October 2020

Abstract
BackgroundTo assess the effects of consumer engagement in health care policy, research and services.MethodsWe updated a review published in 2006 and 2009 and revised the previous search strategies for key databases (The Cochrane Central Register of Controlled Trials; MEDLINE; EMBASE; PsycINFO; CINAHL; Web of Science) up to February 2020. Selection criteria included randomised controlled trials assessing consumer engagement in developing health care policy, research, or health services. The International Association for Public Participation, Spectrum of Public Participation was used to identify, describe, compare and analyse consumer engagement. Outcome measures were effects on people; effects on the policy/research/health care services; or process outcomes.ResultsWe included 23 randomised controlled trials with a moderate or high risk of bias, involving 136,265 participants. Most consumer engagement strategies adopted a consultative approach during the development phase of interventions, targeted to health services. Based on four large cluster-randomised controlled trials, there is evidence that consumer engagement in the development and delivery of health services to enhance the care of pregnant women results in a reduction in neonatal, but not maternal, mortality. From other trials, there is evidence that involving consumers in developing patient information material results in material that is more relevant, readable and understandable for patients, and can improve knowledge. Mixed effects are reported of consumer-engagement on the development and/or implementation of health professional training. There is some evidence that using consumer interviewers instead of staff in satisfaction surveys can have a small influence on the results. There is some evidence that consumers may have a role in identifying broader range of health care priorities that are complementary to those from professionals. There is some evidence that consumer engagement in monitoring and evaluating health services may impact perceptions of patient safety or quality of life.ConclusionsThere is growing evidence from randomised controlled trials of the effects of consumer engagement on the relevance and positive outcomes of health policy, research and services. Health care consumers, providers, researchers and funders should continue to employ evidence-informed consumer engagement in their jurisdictions, with embedded evaluation. Systematic review registrationPROSPERO CRD42018102595.
Out-of-clinic and Self-managed Abortion in Bangladesh: A Qualitative Study of Menstrual Regulation Providers
Authors: Crouthamel Bonnie , Pearson Erin , Tilford Sarah , Hurst Samantha , Paul Dipika , Aqtar Fahima , Silverman Jay , Averbach Sarah 
Published: October 2020

Abstract
Background: In Bangladesh, abortion is illegal except to save a woman’s life, though menstrual regulation (MR) is permitted. MR involves the use of manual uterine aspiration or Misoprostol (with or without Mifepristone) to induce menstruation up to 10-12 weeks from the last menstrual period. Despite the availability of safe and legal MR services, abortions occur outside of the legal system and are associated with high complication rates. Methods: Qualitative semi-structured interviews (SSIs) were conducted with 25 trained MR providers from urban tertiary care facilities in six different cities in Bangladesh. SSIs explored providers’ attitudes about the practice of unsanctioned MR/abortion providers and self-managed MR/abortion, their experiences treating patients who sought abortion services out-of-clinic, barriers/facilitators to safe MR/abortion, and MR/abortion definitions.Results: There were three predominant yet overlapping themes: (i) logistics of obtaining MR/PAC/abortion, (ii) provider attitudes, and (iii) overcoming barriers to safe MR. Lack of consensus among trained providers revealed challenges for defining MR/abortion and gestational age cutoffs. Increasing post-abortion care (PAC) services may be due to patients purchasing Mifepristone/Misoprostol from pharmacists who do not provide adequate instruction, or patients may be directed to untrained providers by brokers, who intercept patients entering the hospitals/clinics and receive a commission from unsanctioned clinics for bringing patients. Perceived barriers to accessing in-clinic MR include distance, family influence, brokers, lack of knowledge, and provider attitudes toward MR.Conclusions: Providers in urban tertiary care facilities in Bangladesh see primarily the complicated MR/PAC cases, and the safety of out-of-clinic/self-managed abortion is unknown. Lack of standardization among providers of MR definition/gestational age cutoffs may affect patient care and MR access. MR safety may be improved by eliminating brokers. A harm reduction approach to improve MR/abortion care provided by pharmacies may improve safety and access. Policy makers should consider increasing training of frontline health workers, such as Family Welfare Visitors (FWVs) to provide evidence-based information about Mifepristone/Misoprostol.
Short- and long-term recurrence of early-stage invasive ductal carcinoma in middle-aged and old women with different treatments: A nationwide population-based cohort study
Authors: Wu Ying-Jhen , Kao Yuan , Hsu Chien-Chin , Lin Hung-Jung , Wang Jhi-Joung , Weng Shih-Feng , Huang Chien-Cheng 
Published: October 2020

Abstract
Background

Most new cases and the highest mortality rates of breast cancer occur among middle-aged and old women. The recurrence rate of early-stage invasive ductal carcinoma (IDC) among women aged ≥ 50 years and receiving different treatments remains unclear.
Methods

Therefore, this study was conducted to determine these rates. We used Surveillance, Epidemiology, and End Results (SEER) data for this nationwide population-based cohort study. All women aged ≥ 50 years and diagnosed with early-stage IDC between 2000 and 2015 were identified and divided into three treatment groups, namely, breast conservation therapy (BCT), mastectomy alone (MAS), and mastectomy with radiation therapy (MAS + RT). The recurrence rates of IDC among these groups were then compared.
Results

The BCT group had a lower short-term recurrence risk than the MAS and MAS + RT groups (hazard ratio [HR]: 1.00 vs. 2.90 [95% CI: 1.36–2.66] vs. 2.07 [95% CI: 0.97–4.44]); however, the BCT group also had a higher long-term recurrence risk than MAS and MAS + RT groups (HR: 1.00 vs. 0.30 [95% CI: 0.26–0.35] vs. 0.43 [95% CI: 0.30–0.63]). The high long-term recurrence rate of the BCT group was especially prominent at the 10- and 15-year follow-ups.
Conclusion

The results provide valuable evidence of the most reliable treatment strategy for this population. Further studies including more variables and validation in other countries are warranted to confirm our findings.
Hepatoprotective Effect of Qushihuayu Formula on Non-Alcoholic Steatohepatitis Induced by MCD Diet in Rat
Authors: Lan Qingping , Ren Zhitao , Chen Yan , Cui Guozhen , Cheong Choi I. , Yu Hon Ho , Lee Simon Ming-Yuen 
Published: October 2020

Abstract
Background:NASH is developed from NAFLD and there is no proven pharmaceutical therapy for patients. Traditional Chinese medicine formula of Qushihuayu(QSHY) shows strong advantage because of their various bioactive compounds in curing NAFLD and NASH.Methods:Male Wistar rats with six weeks old received methionine-choline- supplemented diet (MCS) diet for 8 weeks as the blank control. Another 7 rats received MCD diet for 6 weeks first and MCS&MCD (1:1) mixture diet for the last 2 weeks as the model group. QSHY Pre-treatment, low dosage, medium dosage and high dosage groups were received the same diet as the model group. Except for pre-treatment group (1 week in advanced of other groups), all QSHY treatment groups received QSHY formula by gavage every day since the MCD diet started.Results:QSHY formula decreased the serum ALT and AST levels, lipid droplets, inflammation foci, FAS and α-SMA protein expression than MCD diet group. MAPK pathways phospharylation are markedly depressed by QSHY formula. Moreover, QSHY formula enhanced PPAR-γ and p-p65 translocating into nucleus. The administration of QSHY increased hepatic mRNA levels of Transcription Factor 1 alpha (HNF1A), Hepatocyte Nuclear Factor 4 alpha (HNF4A) and Forkhead box protein A3 (FOXA3) which play a pivotal role in Hepatic stellate cell (HSCs) reprogramming.Conclusion:These findings suggest that QSHY formula exerts a hepatoprotective effect against steatosis and fibrosis presumably via depressed MAPK pathways phosphorylation, reinforcement of PPAR-γ and p-p65 translocating into nucleus and enhanced HSCs reprogramming.