bluuebunny/crossref_metadata_2025_split huggingface dataset:
A critical discourse analysis of adolescent fertility In Zambia-a postcolonial perspective
Authors: Munakampe Margarate Nzala , Michelo Charles , Zulu Joseph Mumba 
Published: December 2020

Abstract
Background: Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods: A qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic analysis was used to analyze the data critically. Results: Adolescents’ age significantly reduced their access to Sexual and Reproductive Health, SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community. Conclusion: The pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.
The political economy of sugar-sweetened beverages taxation in Latin America: Lessons from Mexico, Chile and Colombia
Authors: Carriedo Angela , Koon Adam , Encarnación Luis Manuel , Lee Kelley , Smith Richard , Walls Helen 
Published: December 2020

Abstract
Background: In Latin America, total sales of sugar-sweetened beverages continue to rise at an alarming rate. Consumption of added sugar is a leading cause of diet-related non-communicable diseases. Coalitions of stakeholders have formed in several countries in the region to address this public health challenge including participation of civil society organizations and transnational corporations. Little is currently known about these coalitions – what interests they represent, what goals they pursue and how they operate. Ensuring the primacy of public health goals is a particular governance challenge. This paper comparatively analyses governance challenges involved in the adoption of taxation of sugar-sweetened beverages in Chile, Mexico and Colombia. The three countries have similar political and economic systems, institutional arrangements and regulatory instruments but differing policy outcomes..Methods: We analyse the political economy of SSB taxation based on a qualitative synthesis of existing empirical evidence. We identify the key stakeholders involved in the policy process, identify their interests, and assess how they influenced adoption and implementation of the tax.Results: Coalitions for and against the SSB taxation formed the basis of policy debates in all three countries. Intergovernmental support was critical to framing the SBB tax aims, benefits and instrumentation; and for countries to adopt it. A major constraint to implementation was the strong influence of transnational corporations (TNCs) in the policy process. A lack of transparency during agenda setting was notably enhanced by the powerful presence of TNCs.Conclusion: NCD prevention policies need to be supported across government, alongside grassroots organizations, policy champions and civil society groups to enhance their success. However, governance arrangements involving coalitions between public and private sector actors need to recognize power asymmetries among different actors and mitigate their potentially negative consequences. Such arrangements should include clear mechanisms to ensure transparency and accountability of all partners, and prevent undue influence by industry interests associated with unhealthy products.
Group or individual Lifestyle-integrated Functional Exercise (LiFE)? A qualitative analysis of acceptability
Authors: Reicherzer Leah , Kramer-Gmeiner Franziska , Labudek Sarah , Jansen Carl-Philipp , Nerz Corinna , Nystrand Malin J. , Becker Clemens , Clemson Lindy , Schwenk Michael 
Published: December 2020

Abstract
Background: The Lifestyle-integrated Functional Exercise (LiFE) program is an effective but resource-intensive fall prevention program delivered one-to-one in participants’ homes. A recently developed group-based LiFE (gLiFE) could enhance large-scale implementability and decrease resource intensity. The aim of this qualitative focus group study is to compare participants’ experiences regarding acceptability of gLiFE vs LiFE.Methods: Programs were delivered in seven group sessions (gLiFE) or seven individual home visits (LiFE) within a multi-center, randomized non-inferiority trial. Four structured focus group discussions (90 – 100 minutes duration; one per format and study site) on content, structure, and subjective effects of gLiFE and LiFE were conducted. Qualitative content analysis using the method of inductive category formation by Mayring was applied for data analysis. Coding was managed using NVivo.Results: In both formats, participants (N=30, 22 women, ngLiFE=15, nLiFE=15, mean age 78.5±6.6 years) were positive about content, structure, and support received by trainers. Participants reflected on advantages of both formats: the social aspects of learning the program in a peer group (gLiFE), and benefits of learning the program at home (LiFE). In gLiFE, some difficulties with the implementation of activities were reported. In both formats, the majority of participants reported positive outcomes and successful implementation of new movement habits.Conclusion: This is the first study to examine participants’ views on and experiences with gLiFE and LiFE, revealing strengths and limitations of both formats that can be used for program refinement. Both formats were highly acceptable to participants, suggesting that gLiFE may have similar potential to be adopted by adults aged 70 years and older compared to LiFE.Trial registration: ClinicalTrials.gov, NCT03462654. Registered on March 12, 2018. https://clinicaltrials.gov/ct2/show/NCT03462654.
Exploring Factors Influencing Retention of Nurses in a Religious Hospital in Taiwan: A Cross-Sectional Quantitative Study
Authors: Chiao Li-Hua , Wu Chiu-Feng , Tzeng I-Shiang , Teng An-Na , Liao Ru-Wen , Yu Li Ying , Huang Chin Min , Pan Wei-Han , Chen Chu-Yueh , Su Tsai-Tsu 
Published: December 2020

Abstract
Background: Long-term shortages in the nursing workforce and high turnover rates are common in Taiwan medical industry. Little research has investigated the psychological factors associated with retention of nursing staff. However, in practice, religious hospitals often provide education in medicine or the medical humanities to enhance psychological satisfaction. The objective of this study was to explore factors influencing nursing staff’s retention with their work across different levels of demand. A further objective was to investigate whether medical humanities educations were associated with the retention of nursing staff. Methods: This study used self-administrated questionnaires to survey nurses working in northern areas of Taiwan. The questionnaire design was based on the six levels of Maslow's hierarchy of needs. Participation was voluntary and participants signed informed consent documents. Self-administrated questionnaires were administered by contacting a total of 759 participants; 729 questionnaires were returned (response rate 96.04%). A logistic regression analysis was used to estimate the impact of seniority of nursing work on nurses reported intention to stay after adjusting for nurse characteristics (gender and age).Results: In the Pearson correlation analysis, nurses’ willingness to stay was moderately correlated with “physical needs”, “safety needs”, “love and belonging needs”, and “esteem needs” (r=0.559, P<0.001; r=0.533, P<0.001; r=0.393, P<0.001; r=0.476, P<0.001, respectively). Furthermore, nurses’ willingness to stay was highly correlated with “self-actualization needs”, “behind self-actualization needs” and “medical humanities education relevant” (r=0.707, P<0.001; r=0.728, P<0.001; r=0.678, P<0.001, respectively). We found that the odds ratio (OR) of retention of nursing staff who worked within 1 year (OR=4.511, P=0.002) and 1-3 years (OR=3.248, P=0.003) was significantly higher referred to those who worked 5-10 years.Conclusions: With regard to medical humanities education, we recommend adjusting the training as the compulsory activities under the official programs are inadequate and adjusting the required hours of medical humanities education. Tailoring different educational programs for different groups (especially for the groups of nurses who have worked 3-5 years and 5-10 years in the case study hospital) might improve acceptance by nursing staff.
Comprehensive transcriptional analysis reveals salt stress-regulated key pathways, hub genes and time-specific response categories in common bermudagrass (Cynodon dactylon (L.) Pers.) roots
Authors: Shao An , Wang Wei , Fan Shugao , Xu Xiao , Yin Yanling , Amombo Erick , Li Xiaoning , Wang Guangyang , Wang Hongli , Fu Jinmin 
Published: December 2020

Abstract
Background: Despite its good salt-tolerance level, key genes and pathways that are involved with temporal salt response of common bermudagrass (Cynodon dactylon (L.) Pers.) have not been explored. Therefore, in this study, to understand the underlying regulatory mechanism following the different period of salt exposure, a comprehensive transcriptome analysis of the bermudagrass roots was conducted.Results: The transcripts regulated after 1 h, 6 h, or 24 h of hydroponic exposure to 200 mM NaCl in the roots of bermudagrass were investigated. Dataset series analysis revealed 16 distinct salt-responsive temporal transcripts. Enrichment analysis identified common and distinct stress response themes such as hormonal metabolism, secondary metabolism, misc, cell wall, transcription factors and genes encoded a series of transporters. Weighted gene co-expression network analysis (WGCNA) revealed that lavenderblush2 and brown4 modules were significantly positively correlated with the proline content and peroxidase activity and hub genes within these two modules were further determined. Besides, after 1 h of salt treatment, categories such as signalling receptor kinase, transcription factors, tetrapyrrole synthesis and lipid metabolism were immediately and exclusively up-enriched compared to the subsequent time points, which indicated fast-acting and immediate physiological responses. Other specific categories involved in secondary metabolite biosynthesis such as simple phenols, glucosinolates, isoflavones and tocopherol biosynthesis were exclusively up-regulated after 24 h of salt treatment, suggesting a slightly slower reaction of metabolic adjustment.Conclusion: Here, we revealed salt response themes that were commonly or differentially expressed in short-term salt stress, suggesting possible adaptive salt response mechanisms in the roots. Also, the distinctive salt-response pathways and potential salt-tolerant hub genes investigated can provide useful future references to explore the molecular mechanisms of bermudagrass.
Predicting Future Harm from Gambling over a Five-Year period in a General Population Sample: A Survival Analysis
Authors: Currie Shawn , Hodgins David , Williams Robert , Fiest Kirsten 
Published: December 2020

Abstract
Background. There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods. Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥ 75CAD per month; percent of household income spent on gambling ≥ 1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results. In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥ 2 consequences on the Problem Gambling Severity Index [PGSI]) within five years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling.Conclusions. Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.
Trend and treatment outcomes of latent tuberculosis infection among migrant persons in Japan: retrospective analysis of Japan Tuberculosis Surveillance data
Authors: Kawatsu Lisa , Uchimura Kazuhiro , Ohkado Akihiro 
Published: December 2020

Abstract
Background: Screening for latent tuberculosis infection (LTBI) among migrant population has become a critical issue for many low tuberculosis (TB) burden countries. Evidence regarding effectiveness of LTBI programs are limited, however, partly because of paucity of national data on treatment outcomes for LTBI. In Japan, notification of LTBI is mandatory, and its treatment outcome is reported as part of Japan’s national TB surveillance system. We thus conducted a detailed analysis of LTBI among foreign-born persons, to update the epidemiological trend of newly notified LTBI between 2007 and 2018, and to examine the treatment regimen and outcome of those notified in 2016 and 2017, focusing specifically on the potential risk factors for lost to follow-up. Methods: We extracted and analyzed the data of newly notified LTBI patients from the Japan Tuberculosis Surveillance System to examine the overall trend of notification and by age groups and modes of detection between 2007 and 2018, and the cohort data for treatment regimen and outcomes of foreign-born persons notified with LTBI in 2016 and 2017. Trends and proportions were summarized descriptively, and logistic regression analysis was conducted to identify potential risk factors for lost to follow-up. Comparisons were made with the Japan-born patients where appropriate, using chi-squared tests. Results: Both the number and proportion of LTBI among foreign-born persons have been constantly increasing, reaching 963 cases in 2018. Cohort analysis of the surveillance data indicated that the proportion of those on shorter regimen was higher among the foreign- than Japan-born patients (5.5% vs. 1.8%, p<0.001). The proportion of those who have been lost to follow-up and transferred outside of Japan combined was higher among the foreign- than Japan-born patients (12.0% vs, 8.2%, p<0.001). Risk factors for lost to follow-up were being employed on a temporal basis, and job status unknown (adjusted odds ratios 3.11 and 4.09, 95% confidence intervals 1.34-7.26 and 1.60-10.48, respectively). Conclusions: Migrant population face greater risk of interrupting LTBI treatment, and interventions to improve adherence are a critical component of programmatic management of LTBI. Further studies are needed to explore the cultural and socioeconomic situation in which foreign-born persons undergo LTBI treatment in Japan.
Estimation of Energy Expenditure of Nordic Walking: A Crossover Trial
Authors: Baek Sora , Ha Yuncheol 
Published: December 2020

Abstract
Background: Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg-1·min-1) of NW.Methods: This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h-1) and grade (0%–7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW.Results: Oxygen uptake (+15.8%), minute ventilation (+17.0%), heart rate (+8.4%), and systolic blood pressure (+7.7%) were higher in NW than in W (P<.05). NW resulted in increased muscle activity in all of the upper limb muscles (P<.05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P<.05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade.Conclusion: NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg-1·min-1. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
Hypoxia-induced Tie1 drives stemness and cisplatin resistance in non-small cell lung carcinoma cells
Authors: Li Chaojie , Yang Nannan , Chen Zhijin , Xia Ning , Shan Qungang , Wang Ziyin , Lu Jian , Shang Mingyi , Wang Zhongmin 
Published: December 2020

Abstract
Background: Drug resistance and metastasis involving hypoxic tumor environments and persistent stem cell populations are detrimental to the survival of patients with non-small cell lung carcinoma (NSCLC). Tie1 is upregulated in hypoxia and is believed to counteract the effectiveness of platinum agents by promoting the stemness properties in cells. We have investigated the association of Tie1 with HIF-1α and cisplatin resistance in NSCLC cell lines.Methods: The expression of Tie1 in a pulmonary microvascular endothelial cell line (HPMEC) and NSCLC cell lines was detected using qRT-PCR and western blotting. The effect of Tie1 on cell stemness and migration was examined by sphere-forming and transwell assays in NSCLC cells with Tie1 silenced. The regulation of Tie1 by HIF-1α was evaluated by a dual-luciferase reporter assay and chromatin immunoprecipitation.Results: We found that hypoxia could induce stemness and cisplatin resistance in vitro. Tie1 was expressed at low levels in NSCLC cells when compared with human pulmonary microvascular endothelial cells, however, its expression was increased by hypoxia. Additionally, Tie1 knockdown could reduce stemness properties and increase sensitivity to cisplatin in vitro and in a xenograft mouse model. The promoter of Tie1 contains two predicted hypoxia-response elements (HREs). We mutated both HRE sites and conducted chromatin immune-precipitation and promoter luciferase reporter assays and were able to conclude that the induction of Tie1 by hypoxia was HIF-1α-dependent.Conclusions: Our findings indicated that Tie1 is upregulated in a hypoxic environment by HIF-1α and contributes to tumorigenesis and cisplatin resistance through the promotion of stemness in NSCLC cells.
Responses to drought stress modulate the susceptibility to Plasmopara viticola in grapevine
Authors: Heyman Lisa , Chrysargyris Antonios , Demeestere Kristof , Tzortzakis Nikolaos , Höfte Monica 
Published: December 2020

Abstract
BackgroundClimate change will increase the occurrence of plants being simultaneously subjected to drought and pathogen stress. Although it is well known that drought can alter the way in which plants respond to pathogens, knowledge about the effect of concurrent drought and biotic stress on grapevine is scarce. This is especially true for Plasmopara viticola, the causal agent of grapevine downy mildew. This research addresses how vines with different drought tolerances respond to challenge with P. viticola, drought stress or their combination and how one stress affects the other.ResultsArtificial inoculation was performed on two cultivars exposed to full or deficit irrigation in the Mediterranean climate of Cyprus. In parallel, leaf discs from these plants were inoculated under controlled conditions. Leaves were sampled at an early infection stage to determine the influence of the single and combined stresses on oxidative parameters, chlorophyll, and phytohormones. Under irrigation, the local Cypriot cultivar Xynisteri was more susceptible to P. viticola than the drought-sensitive cultivar Chardonnay. Successful infection by P. viticola at 1.5 days post inoculation was associated with high levels of indole-3-acetic acid (IAA), salicylic acid (SA), jasmonic acid (JA), and proline and strong decreases in antioxidant enzyme activity. Drought, on the other hand, triggered the accumulation of IAA and abscisic acid (ABA), which antagonized JA and SA. Exposure to drought stress increased the susceptibility to P. viticola of the leaves inoculated under controlled conditions. Conversely, both cultivars showed resistance against P. viticola when inoculated in planta under continued deficit irrigation. Despite their resistance, the pathogen-associated responses of IAA, antioxidant enzyme activity, and proline still occurred in these drought-stressed plants. Surprisingly, ABA, rather than the generally implicated JA and SA, seemed to play a prominent role in this resistance.ConclusionsDrought exposure increased the susceptibility of leaves inoculated in vitro. Conversely, deficit irrigation induced resistance to P. viticola in both Chardonnay and Xynisteri plants inoculated in planta. ABA, rather than JA and SA, was implicated in this resistance. The irrigation-dependent susceptibility indicates that the changing climate and the practices used to mitigate its effects may have a profound impact on plant pathogens.