bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to Receiving the Recommended Standard Care During Pregnancy by Illiterate Women in Rural, Northern Tanzania
Authors: Matovelo Dismas , Ndaki Pendo , Yohani Victoria , Laisser Rose , Bakalemwa Respicious , Ndaboine Edgar , Masatu Zabron , Mwaikambo Magdalena , Brenner Jennifer L. , Wilson Warren M. 
Published: September 2020

Abstract
Background: In 2017, an estimated 540 women in Sub-Saharan Africa died every day from preventable causes related to pregnancy and childbirth. To stem this public-health crisis, the WHO recommends a maternal and neonatal health continuity of patient care, yet most women do not meet this recommendation. Surveys suggest that illiteracy limits uptake of the proposed maternal-newborn package, yet little is known about the association between illiteracy and healthcare seeking, particularly in rural regions of low-income countries. This knowledge gap compromises the ability of public health experts and healthcare providers to provide culturally relevant policy and practice. To begin to address this gap this study explores the experiences related to care-seeking by illiterate, pregnant women in rural Tanzania.Methods: A qualitative study was conducted in four communities encompassing eight focus group discussions with 81 illiterate women, 13 interviews with illiterate women of reproductive age and seven interviews with members of these communities perceived to have some influence on women’s decisions concerning perinatal care services. Themes were coded and their relative importance determined using frequency reports and cross-tabulations. Findings: Three key themes emerged, illiterate women (1) could not read their healthcare cards or public health messaging; (2) spoke the local language, not Swahili, the language used by healthcare providers, and (3) have endeavored to develop coping strategies to overcome these obstacles. In addition, health service providers are often unaware of who is illiterate.Recommendations: More health needs of this group could be met, in the short term, by developing a protocol for health service providers to determine who is illiterate, providing translation services for those unable to speak Swahili, and graphic public health messaging that does not require literacy. In the long term, this barrier may be addressed by ensuring that all Tanzanians receive a high-quality, formal education, supporting community health workers, and recruiting healthcare providers from rural areas. A failure of to address the needs of this at-risk group will likely mean that they will continue to experience barriers to achieving the recommended continuity of patient care with detrimental health outcomes for both mothers and newborns.
miR-186 Regulates the Initiation and Development of Breast Cancer via SHP-1 Methylation
Authors: Wang Kun , Zhou Chunxia , Wang Di , Zhang Bin , Zheng Yongjian , Tong Lifei , Zhang Xia , Zhang Weiguo 
Published: September 2020

Abstract
Background Change in the methylation status of genomic DNA, especially in CpG islands in the promoter region, is considered to be an early event in tumor initiation, leading to silencing of gene expression, subsequent abnormalities in gene structure and function, and malignant transformation of the cell. Due to the abnormal expression of miR-186 and SHP-1 in breast cancer tissues and cells, we propose that miR-186 is closely related to the methylation of SHP-1Method Using 5-azacytidine as a de-methylation agent and Validating with Setylation-specific polymerase chain reaction (MSP) after treatment. Measurement of the viability of breast cancer cells using the CCK-8 method Measurement of the apoptotic rate of breast cancer cells using annexin V-FITC/PI double labeling. Cell metastasis were measured by wound healing assay. Luciferase reporter assays was used to confirm the target of MiR-186. SHP-1 and miR-186 expression was measured by RT-PCR and western blot.Results In the present study, we found that SHP-1 expression was reduced to various degrees in all 5 cell lines (UACC-812, MDA-MB-213, MDA-MB-468, SK-RB-3 and MCF-7). 5-azacytidine can remove the methylation from the SHP-1 promoter region. Apoptosis was observed in MCF-7 cells after demethylation of the SHP-1 gene promoter region by 5-azacytidine, and the effect was time- and concentration-dependent. Luciferase reporter assays showed that miR-186 promotes methylation through binding with the 3’ UTR of the SHP-1 promoter region.Western blot showed miR-186 regulates the initiation and development of tumor cells through the SHP-1-JAK-STAT axis. In animal models, low expression of miR-186 can cause significantly limited tumor growth.Conclusion The low SHP-1 expression may be an important factor in the initiation of breast cancer, and that miR-186 could serve as an excellent molecular diagnostic marker and a possible therapeutic target.
Evaluation of Peripheral Immune Activation in Amyotrophic Lateral Sclerosis
Authors: Wang Mengli , Liu Zhen , Du Juan , Yuan Yanchun , Jiao Bin , Zhang Xuewei , Hou Xuan , Shen Lu , Guo Jifeng , Jiang Hong , Xia Kun , Tang Beisha , Wang Junling 
Published: September 2020

Abstract
Background: Accumulating evidence has revealed that immunity plays an important role in amyotrophic lateral sclerosis (ALS) progression. However, the results regarding the serum levels of immunoglobulin and complement are inconsistent in patients with ALS. Although immune dysfunctions have also been reported in patients with other neurodegenerative diseases, few studies have explored whether immune dysfunction in ALS is similar to that in other neurodegenerative diseases.Methods: Serum levels of immunoglobulin and complement were measured in 245 patients with ALS, 65 patients with multiple system atrophy (MSA), 60 patients with Parkinson’s disease (PD), and 82 healthy controls (HCs). The serum levels of immunoglobulin and complement were compared among different groups, and the differences in the levels of immunoglobulin and complement between ALS patients and HCs were evaluated using meta-analysis including data from this study. In addition, the association between vitamins and clinical ALS characteristics were evaluated.Results: Patients with ALS had higher C4 levels than did HCs. No significant differences existed between patients with ALS and other neurodegenerative diseases in IgG, IgA, IgM, C3, or C4 levels. The IgA levels were lower in early-onset ALS patients than in late-onset ALS patients. The correlations between age at onset of ALS and IgG or IgA levels were significantly positive.Conclusions: Peripheral immunity abnormalities existed in patients with ALS, and lower IgA levels were associated with early-onset ALS.
Dietary Assessment and Patients Perspective Reasons for Diet and Exercise Adherence Post Bariatric Surgery
Authors: Assakran Bandar Saad , Widyan Adel Mefleh , Alhumaidan Najla Abdulaziz , Alharbi Fadiyah Abdullah , Alhnaya Mohammed Abdullah , Aljabali Abdullatif Abdullah , Aleid Mohammed Abdulrahman 
Published: September 2020

Abstract
Objective: Obesity prevalence is increasing and as an outcome; bariatric procedures are on the rise. Previous articles about bariatric surgery disclosed tremendous results. This study aims to estimate the rate and identify the reasons behind poor adherence to diet and exercise in post-bariatric patients.Results: Majority (85.5%) of our patients scored “good”, 12% scored “fair”, and only 2% scored “excellent”. None scored “needs improvement”. Fruits had a mean of 1.51 ± 0.79 and vegetables 1.78 ± 0.76. The main reasons for patient non-adherence to healthy eating were: low self-discipline (48%), lack of motivation (28%), availability of healthy food, and being too busy to prepare healthy meals; both (25%). (55.9%) of the study subjects engaged in physical activity. Lack of time (47%), low self-discipline (38%), and weather (32%) were the primary reasons for not exercising regularly.
A Primer in Resilience Status for German Medical Graduates - A Necessary Step in Building an Emotionally Equipped Healthcare Workforce
Authors: Kiesewetter Jan , HUber Johanna 
Published: September 2020

Abstract
BackgroundResilience is a widely-used catchword in the last couple of years to describe the resistance to psychological strains of life, especially for the healthcare work force. The promises of resilience to burnout sound great and what we all would want: less health impairment despite stress, higher work satisfaction and last but not least higher work performance. However, little is known scientifically regarding the resilience status of the upcoming work-force. With our study we would like to investigate the resilience status of medical graduates from five medical schools within their first year after graduation. MethodsFor the identification of the resilience status we included the 5-point Likert 10-Item Connor-Davidson Resilience Scale, German Version in a graduate survey posted to 5 medical schools and over 1610 eligible participants of whom 610 (60% female) filled out at least parts of the survey. ResultsThe resilience status showed a mean resilience score of M = 37.1 (SD = 6.30). The score ranges from 3.22 (I am not easily discouraged by failure) to 4.26 (I am able to adapt to change). The item “I am able to handle unpleasant feeling” is interesting as one third of the participants did choose not to answer. Relationships to other constructs are presented in the article. ConclusionsThe study shows that the overall resilience status of medical graduates one year after their graduation is rather high, but subjectively they do not feel equivalently resilient for the different aspects they face in their job. Further research needs to see how trainings can provide medical students and professionals with the emotional coping skills that they lack in the moment.
The relationship between empathy and altruistic motivations in nursing studies: A cross-sectional study
Authors: Messineo Linda , Seta Luciano , Allegra Mario 
Published: September 2020

Abstract
Background. According to the biopsychosocial approach and patient-centred models, efficient management of relational competences by healthcare professionals is crucial to affect a patient’s treatment and care process positively. Empathy is one of the major components of the relational skills expected of health professionals. The knowledge of the empathic ability of undergraduate healthcare students represents important information for educators in defining specific and efficient educational programs aimed at supporting or enhancing empathic competences. In this study, we measured the attitude towards the value of health professional empathy in clinical encounters of the first-year undergraduate nursing students. Motivations for a nursing education choice were also evaluated. We expected a significant association between students’ positive attitude towards the value of health professional empathy and the prosocial and altruistic motivations in choosing nursing studies. Methods. A cross-sectional study was performed on 77 first-year nursing students. The Jefferson Scale of Empathy – Health Professions Student Version was administered. The motivations for choosing nursing studies were detected through an open question.Results. Seven distinct themes, distinguishing between internal and external motivational factors, were identified through the thematic analysis of students’ answers regarding their choice for entering the nursing degree course. On the empathy scale, females gained higher scores than males. When the age was considered, this difference was shown only for younger students, with young females’ total scores being higher than that of young males. High scores of empathy were positively associated with altruistic motivational factors. A negative correlation was found between external motivational factors and the scores of the Compassionate Care subscale of the Jefferson Scale of Empathy. Conclusions. Knowing the level of nursing students’ empathy and their motivational factors for entering nursing studies is important for educators to implement training paths that enhance students’ relational attitudes and skills and promote positive motivational aspects central for this profession.
Characterization of BRS1 Functions in Plant Stress Responses
Authors: Zhang Dongzhi , Zhao Peng , Xu Shengbao 
Published: September 2020

Abstract
Background: Brassinosteroid-insensitive 1 suppressor 1 (BRS1), is a serine carboxypeptidase that mediates brassinosteroid signaling and participates in multiple developmental processes in Arabidopsis. However, little is known about the precise role of BRS1 in this context. Results: In this study, we analyzed transcriptional and proteomic profiles of Arabidopsis seedlings overexpressing BRS1 and found that this gene is involved in both biotic and abiotic stress responses and redox regulation. Further proteomic evidence shows that BRS1 regulates cell redox by indirectly interacting with cytosolic NADP+-dependent isocitrate dehydrogenase (cICDH). We identified two novel splice products of BRS1, which might play important roles in development and stress responses in plants. Conclusions: This study highlights the role of BRS1 in plant redox regulation and stress responses, which extends our understanding of extracellular serine carboxypeptidases.
Pneumocystis pneumonia in patients with primary nephrotic syndrome: analysis of 18 cases
Authors: You Xiaohan , Zhang Ji , Zhou Qiongxiu , Zhang Jianna 
Published: September 2020

Abstract
Background

The aim of this study was to analysis the clinical features, risk factors and outcomes of patients with primary nephrotic syndrome (PNS) who developed pneumocystis pneumonia (PCP).

Methods

We systematically reviewed medical records from 18 PNS patients with PCP admitted to our hospital from April 2007 to April 2019. A total of 180 cases were randomly selected as controls from PNS inpatients without infection.

Results

In PCP patients, the mean age at presentation was 48.5 years, mean duration of prednisone treatment was 3.7 months and mean prednisone dose on admission was 31.3 mg/d, the most common clinical manifestation was fever (100%) and average PaO 2 on admission was 59.5 mmHg. Eight patients (44.4%) had coexisting infections, most often was cytomegalovirus (4 patients), 11 patients (61.1%) had ICU admission and 9 patients (50%) had mechanical ventilation. PCP patients had more prednisone, more immunosuppressive therapy, lower CD4+ cell counts and hemoglobin, and higher serum creatinine than those without infections (p<0.05). Logistic regression analysis showed that patients with prednisone usage and lower CD4+ cell counts were more likely to have PCP compared to controls (p<0.05). All patients survived after treatment.

Conclusion

PCP was not unusual in PNS patients, and the most important risk factor was a lower CD4+ cell count, but however, these patients had a good outcome after enough treatments.
Training tomorrow’s doctors: the impact of a Student Selected Component in Global Health during medical school
Authors: Matthews Natasha Roya , Walker Richard 
Published: September 2020

Abstract
Background
Several reports highlight the importance of global health education (GHE) for training tomorrow’s doctors. In 2006, Newcastle University Medical School developed a Student Selected Component (SSC) in Global Health, which has since become increasingly popular. We followed up students who have undertaken the SSC in Global Health to assess the impact on their experience as practising clinicians and postgraduate career development.
Methods
We developed an electronic survey including questions about speciality choice, postgraduate qualifications, extracurricular activity and international work. Surveys were sent to 72 SSC participants identified between 2006–2017 through the Newcastle University Alumni and Supporters network and social media.
Results
Surveys were returned by 37 (51%) SSC participants; 25 (71%) and 16 (46%) believed the SSC had influenced their clinical practice and career choice respectively. Twenty-two (60%) obtained an intercalated degree programme, of whom nine (24.3%) did a Masters programme specifically in Global Health and four (10.8%) and two (5.4%) completed a Masters degree in Epidemiology and Control of Infectious Diseases respectively, both key themes within GHE. Four (11%) undertook and ten (29%) were considering postgraduate study related to global health, of whom three (8.6%) specified undertaking a Diploma in Tropical Medicine and Hygiene (DTM&H) and one (2.9%) studying a Masters degree in Public Health. Five (14%) had and 19 (54%) were planning to work abroad, with most referring to work in humanitarian or low resource settings and GHE programmes.
Conclusions
Participation in an SSC in Global Health may affect significant positive change in student’s clinical practice and help inform academic and clinical career choice. Whilst a causative relationship cannot be inferred, the experience may support or increase the pursuit of further global health opportunities including additional qualifications, research and international health work. Medical schools that endeavour to produce graduates motivated to tackle the global health challenges of our society should champion comprehensive global health modules for students.
In Vitro and in Vivo Evaluation of Paclitaxel-induced Release of Apoptotic Biomarker ccCK18 to Guide Treatment Optimization in Ovarian Cancer
Authors: Thaye Elien De , Vijver Koen Van de , Dorpe Jo Van , Vermeulen An , Bocxlaer Jan Van , Colin Pieter 
Published: September 2020

Abstract
Background: Cytokeratins hold potential as biomarkers due to their epithelial specificity, abundance and cleavage by caspases during apoptosis. We evaluated paclitaxel-induced circulating caspase-cleaved (cc) cytokeratin 18 (CK18) as potential apoptotic cell-death marker to guide treatment optimization in ovarian cancer.Methods: Six ovarian cancer cell lines (SK-OV-3, SK-OV-3lucIP1, Caov-3, NIH:OVCAR-3, PA-1 and PM-LGSOC-01) were exposed in vitro to paclitaxel (PTX, 0 to 1000 nM) for 24h. Extracellular levels of ccCK18 were measured until 5 days after drug exposure. Cell count and ccCK18 release data were analyzed using a phase-nonspecific pharmacodynamic model implemented in NONMEM®. PA-1 and SK-OV-3lucIP1 xenografted female SCID/Beige mice received a placebo or single dose of 50 mg/kg PTX intraperitoneally. Response to PTX was evaluated in vivo using tumor volume and released ccCK18 levels. Results: In vitro, the correlation between cell count and released ccCK18 levels was present in all cell lines (Spearman’s rank correlation coefficient > 0.64). Tumor volume and ccCK18 longitudinal dynamics were markedly different for controls and PTX-treated PA-1 xenografts with changes in ccCK18 release preceding changes in tumor volume. For SK-OV-3lucIP1 xenografts, no differences were found between controls and PTX-treated mice. Conclusions: An association between PTX-induced ccCK18 release and cell count was demonstrated in vitro. The in vivo study supported the presence of an early-apoptotic peak in ccCK18 levels compared to a later observed effect on tumor volume in PTX-sensitive xenografts. Given the heterogeneous character of ovarian cancer, application and implementation of ccCK18 in a clinical setting to optimize or personalize cancer treatment needs further refinement.
Sepsis score performance in women at high and low risk of intraamniotic infection: a retrospective case-control study
Authors: Sela Hen Y , Seri Vered , Zimmerman Frederic S. , Levin Philip D. , Smueloff Arnon , Einav Sharon 
Published: September 2020

Abstract
Background: Early infection identification may improve outcomes in obstetric patients. However, obstetric vital signs and laboratory values differ from the non-pregnant, possibly limiting current sepsis score use. Thus, we evaluated sepsis score use in peripartum infection. Methods: This case-control study evaluates sepsis criteria fulfilment in preterm premature rupture of membranes (PPROM) – at high infection risk– versus in elective caesarean delivery (CD) – at low risk. The study was perfoemd at the departement of obstetrics & gynecologt at Shaare Zedek Medical Center, a 1000-bed university-affiliated acute care hospital. We inlcuded women with PPROM undergoing CD (n=453) at gestational weeks 24-36 versus those undergoing elective term CD (n=2004). The primary and secondary outcome measures were SIRS and qSOFA criteria fullfilment and availability of the score components and clinical intraamniotic infection and positive cultures rates. Results: At admission 14.8% of the study group and 4.6% of control met SIRS criteria (p=0.001), as did 12.5% and 5.5% on post-operation day (POD) 1 (p=0.001), with no significant differences on POD 0 or 2. In the study group more cultures (29.8% versus 1.9% – cervix; 27.4% versus 1.1% – placenta; 7.5% versus 1.7% – blood; p=0.001 – all differences) and more positive cultures (5.5% versus 3.0% – urine – p=0.008; 4.2% versus 0.2% – cervix – p=0.001; 7.3% versus 0.0% – placenta – p=0.001; 0.9% versus 0.1% – blood – p=0.008) were obtained. 10.6% of the study group and 0.4% of control met criteria for intraamniotic infection (p=0.001). Conclusions: Though significant difference was noted in SIRS criteria fulfilment in the study group versus control, there was considerable between-group overlap, questioning utility of SIRS in intraamniotic infection diagnosis.
Integrating Motivational Interviewing into Clinical Care to Increase Physical Activity Levels in Women with Gestational Diabetes
Authors: Smith Ralph , Ridout Ashley , Livingstone Angus , Wango N. , Kenworthy Yvonne , Barlett Katy , Coburn Hazel , Reid Hamish , Jones Natasha , Mackillop Lucy 
Published: September 2020

Abstract
Background: Regular physical activity (PA) improves glycaemic control in women diagnosed with Gestational Diabetes (GDM). However, PA advice competes with other components of care, with many women forgoing the benefits of regular PA. Motivational interviewing (MI) is an effective technique for increasing individual PA levels. A clinical pathway was developed integrating MI on PA into the routine care. This report evaluates the impact of MIs on self-reported PA levels.Methods: Women attending a single centre NHS GDM clinic were invited to engage in an individual PA-focused MI session, delivered by a trained midwife. This included goal setting and activity planning. All women had a confirmed diagnosis of GDM based on a 75g oral glucose tolerance test using the International association of diabetes and pregnancy study group diagnostic thresholds. A modified version of the exercise vital sign was used to evaluate self-reported aerobic PA levels at baseline and two-week telephone follow-up. PA levels were coded into three categories: i) red (<30mins moderate intensity PA (MIPA)/week), ii) amber (30-150mins MIPA/week) and iii) green (150mins MIPA/week). Women with contraindications to PA were excluded. The main outcome was the difference PA levels from baseline to two weeks. The Pearson’s Chi-squared test was used to evaluate statistical difference in self-reported PA levels from baseline to follow-up.Results: Complete follow-up data was obtained from 62 women. Mean gestation was 27+5/40 weeks (9-36+4/40), mean age 31.7y (21-43y) and mean BMI 29.9kg/m2 (18.3-48.2 kg/m2). At baseline, 19 (30.6%) were coded red (<30mins MIPA/week); 26 (41.9%) amber (30-150mins MIPA/week); and 17 (27.4%) green (150mins MIPA/week). Self-reported physical activity levels of these women at two-week follow-up revealed only 3 (4.8%) women coded red, 24 (38.7%) amber and 35 (56.5%) green. This demonstrates a significant association for increased PA levels after MI at two-week follow-up (p=0.0001).Conclusion: This new clinical pathway provides encouraging results, showing that self-reported PA increased significantly at two-week follow-up. Further work is now required to examine the impact on glycaemic control, maternal and fetal outcomes, and maintenance of PA levels. This model of care should be integrated into other high-risk patient groups.