bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severity of nausea and vomiting in pregnancy and early childhood neurobehavioural outcomes: The Growing Up in Singapore Towards Healthy Outcomes study
Authors: Syn Nicholas L. , Chan Shiao‐Yng , Chia Elisha Wan Ying , Ong Wei Xin , Phua Desiree , Cai Shirong , Shek Lynette P. C. , Chong Yap‐Seng , Daniel Lourdes Mary , Broekman Birit F. P. , Godfrey Keith M. , Meaney Michael J. , Law Evelyn C. 
Published: June 2020

AbstractBackgroundNausea and vomiting of pregnancy (NVP) affects 50 to 80 per cent of women. The existing literature has examined NVP from the perspective of the mother, and relatively less is known about offspring outcomes.ObjectivesTo study the relationships of NVP with social‐emotional, behavioural, and cognitive outcomes of the offspring in a multi‐ethnic Asian cohort.MethodsIn the Growing Up in Singapore Towards Healthy Outcomes prospective mother‐offspring cohort study, mothers responded to a structured NVP questionnaire at 26‐28 weeks’ gestation (n = 1172) and participants with severe NVP were confirmed using medical records. Children underwent multiple neurodevelopmental assessments throughout childhood. We conducted multivariable regressions with post‐estimation predictive margins to understand the associations of NVP with offspring neurobehavioural outcomes, which included 1‐year Infant‐Toddler Social and Emotional Assessment, 1.5‐year Quantitative Checklist for Autism in Toddlers, 2‐year Bayley Scales of Infant and Toddler Development, 2‐ and 4‐year Child Behavior Checklist, and 4.5‐year Kaufman Brief Intelligence Test. Analyses were adjusted for household income, birth variables, maternal mental health, and other relevant medical variables. Cohen's d effect sizes were calculated using standardised mean differences (μd).ResultsMothers were categorised into no (n = 296, 25.3%), mild‐moderate (n = 686, 58.5%), and severe NVP (n = 190, 16.2%), of whom 67 (5.7%) required admission. Compared to children of mothers who had no or mild‐moderate NVP, children with exposure to severe NVP exhibited more externalising behaviours (μd 2.0, 95% CI 0.3, 3.6; Cohen's d = 0.33) and social communication difficulties before 2 years (μd 4.1, 95% Cl 0.1, 8.0; Cohen's d = 0.38), both externalising (μd 1.5, 95% CI 0.4, 2.6; Cohen's d = 0.43) and internalising behaviours at 2 years (μd 1.2, 95% CI 0.1, 2.2; Cohen's d = 0.35), and only internalising behaviours after 2 years (μd 1.1, 95% CI 0.4, 2.0; Cohen's d = 0.37).ConclusionsSevere NVP is highly prevalent in this Asian cohort and may be adversely associated with multiple offspring neurobehavioural outcomes.
Spaced education and student learning: Results from a medical school
Authors: Chugh Preeta K , Tripathi CD 
Published: June 2020

SUMMARYBackgroundIt is critical for medical students to retain and apply their knowledge of basic sciences to become competent prescribing physicians. Poor long‐term retention is a pervasive concern. We investigated the impact of ‘spaced education’ teaching modules to improve knowledge retention in medical students on a topic of public health: vitamin D and its role in health and disease.It is critical for medical students to retain and apply their knowledge of basic sciences to become competent prescribing physiciansMethodsIn a self‐matched design, 148 medical students were randomised and evaluated on vitamin D‐related topics to assess reinforced and non‐reinforced knowledge in a multiple‐choice question format. Initial learning and long‐term retention were assessed with an estimation of Cohen's effect size at 24 and 72 weeks, respectively.ResultsThe administration of spaced educational material significantly improved composite formative test scores at 24 weeks (p < 0.001, effect size = 1.33). Although the scores dipped, there was a retention of knowledge at 72 weeks (effect size = 0.48).DiscussionSpaced reinforcement and testing statistically improved knowledge retention among our medical students. Gaps in the present teaching could be bridged by motivating the students to extend their learning time by appropriate spacing intervals and to understand the relevance of course content in different scenarios as a physician. Further research could be instrumental in optimising interventions to enhance learning opportunities for medical students.
How Can We Quarantine Without a Home? Responses of Activism and Urban Social Movements in Times of COVID‐19 Pandemic Crisis in Lisbon
Authors: Mendes Luís 
Published: June 2020

AbstractIn Lisbon, during the COVID‐19 pandemic period, new spaces for contestation and the action of urban social movements intensified, capitalising on the visibility for the right to housing, as a basic human right and an unconditional public health imperative, to fulfil the duties of lockdown and social isolation, imposed by the State of Exception. Its narrative and strategies reinforces the counter‐hegemonic movement that denounces the logics of commodification and financialisation in the housing sector, placing hope in a post‐capitalist transition in the post‐COVID horizon. We conclude that the actors in this urban struggle have limited power over the changes they initiate, or make an effort to inflict, if they are not involved in a concerted and politically integrated action, not least because the achievements they obtain are temporary and exceptional, like the state of emergency imposed by COVID‐19.
Expansion of MIR482/2118 by a class‐II transposable element in cotton
Authors: Shen Enhui , Chen Tianzi , Zhu Xintian , Fan Longjiang , Sun Jie , Llewellyn Danny J. , Wilson Iain , Zhu Qian‐Hao 
Published: June 2020

SUMMARYSome plant microRNA (miRNA) families contain multiple members generating identical or highly similar mature miRNA variants. Mechanisms underlying the expansion of miRNA families remain elusive, although tandem and/or segmental duplications have been proposed. In this study of two tetraploid cottons, Gossypium hirsutum and Gossypium barbadense, and their extant diploid progenitors, Gossypium arboreum and Gossypium raimondii, we investigated the gain and loss of members of the miR482/2118 superfamily, which modulates the expression of nucleotide‐binding site leucine‐rich repeat (NBS‐LRR) disease resistance genes. We found significant expansion of MIR482/2118d in G. barbadense, G. hirsutum and G. raimondii, but not in G. arboreum. Several newly expanded MIR482/2118d loci have mutated to produce different miR482/2118 variants with altered target‐gene specificity. Based on detailed analysis of sequences flanking these MIR482/2118 loci, we found that this expansion of MIR482/2118d and its derivatives resulted from an initial capture of an MIR482/2118d by a class‐II DNA transposable element (TE) in G. raimondii prior to the tetraploidization event, followed by transposition to new genomic locations in G. barbadense, G. hirsutum and G. raimondii. The ‘GosTE’ involved in the capture and proliferation of MIR482/2118d and its derivatives belongs to the PIF/Harbinger superfamily, generating a 3‐bp target site duplication upon insertion at new locations. All orthologous MIR482/2118 loci in the two diploids were retained in the two tetraploids, but mutation(s) in miR482/2118 were observed across all four species as well as in different cultivars of both G. barbadense and G. hirsutum, suggesting a dynamic co‐evolution of miR482/2118 and its NBS‐LRR targets. Our results provide fresh insights into the mechanisms contributing to MIRNA proliferation and enrich our knowledge on TEs.
Fez: entre la cultura de la ciudad y el festival de música sagrada del mundo
Authors: Selkani Ikrame 
Published: June 2020

Desde su creación en 1994, el éxito del Festival de la Música Sagrada del Mundo, promovido por la Fundación Espíritu de Fez, ha traspasado las fronteras de Marruecos. Este acontecimiento ofrece un amplio abanico de cantos y música espirituales, y pretende transmitir el espíritu de Fez, capital cultural que valoriza el intercambio entre las civilizaciones.
Este festival se ha consolidado como uno de los más importantes de las músicas del mundo, y fue reconocido en 2001 por la ONU por el importante papel que desempeña en la promoción del diálogo de las culturas y de las religiones.
Los encuentros de Fez reúnen a intelectuales, científicos y humanistas en torno a un tema determinado. Abiertos a un amplio público, son objeto de intercambios, diálogos y debates a la sombra de un majestuoso roble del museo Batha.
Numerical Modeling of Subcooled Flow Boiling and Heat Transfer Enhancement: Validation and Applicability to Fusion Reactor Target Design
Authors: Young Graeme , Karimi Nader , Mackenzie Ross 
Published: June 2020

AbstractBoiling flows are an extremely efficient mechanism for the transfer of ultrahigh heat fluxes and used in numerous industrial applications. In this paper, the accuracy of computational fluid dynamics in predicting the temperature distributions and heat transfer performance is examined within a nuclear fusion reactor divertor. The aim is to establish the role of computational fluid dynamics (CFD) within the design of complicated high heat flux components using a semi-mechanistic approach to flow boiling that is independent of geometry and flow conditions. An Eulerian–Eulerian two-fluid method is developed and a conjugate heat transfer model is validated against the existing experimental data where available. Overall, a satisfactory accuracy is achieved in the prediction of several important quantities. Temperature distribution throughout the divertor is found to be highly accurate and aligns with the physical testing across two expected operating regimes. Additionally, the system heat transfer coefficients and coolant temperatures are close to the assumptions already established within the literature. Heat transfer enhancement is a critical component of the divertor design, and a twisted-tape insert appears to be necessary for the system to withstand ultrahigh heat fluxes encountered within the fusion reactor. The results show that the inclusion of a twisted tape improved the heat transfer coefficient of the system by almost 45% allowing the divertor to withstand the required heat fluxes of 10 MW/m2 and 20 MW/m2.
A Six-Year Review of the Biomedical Engineering in Simulations, Imaging, and Modeling Undergraduate Research Experience
Authors: George Stephanie M. , Domire Zachary J. 
Published: June 2020

Abstract
Undergraduate research continues to serve as an effective strategy for mitigating the effects of a leaky pipeline. Significant funding from institutions and government agencies has increased the number of students participating in undergraduate research. In this paper, we report on the six-year experience of a National Science Foundation funded Research Experiences for Undergraduates (REU) Site: Biomedical Engineering in Simulations, Imaging, and Modeling (BME-SIM). The operation and evaluation of the program are both described. We report on the results from 55 students over six summers from 2014 to 2019. Our program was successful in attracting a diverse group of participants including 46% under-represented minority students and 53% women. Based on evaluation results, students reported significant gains in technical skills, communication skills, and knowledge of graduate school. Our findings indicate baseline gender differences for several learning outcomes, where women and nonbinary students report lower levels of mastery. These gaps are closed by the end of the program except for confidence in skills, which is still significantly lower than those reported by male counterparts. The impact of the experience on ultimate career path is difficult to determine due to underlying biases and other motivating factors; however, 67.6% of graduates have entered graduate programs. Finally, we have provided lessons learned for those who are interested in building a summer research program. In conclusion, we have described the successful implementation of an REU site and the positive learning outcomes of the student participants.
Effect of treatment with exenatide and pioglitazone or basal-bolus insulin on diabetic neuropathy: a substudy of the Qatar Study
Authors: Ponirakis Georgios , Abdul-Ghani Muhammad A , Jayyousi Amin , Almuhannadi Hamad , Petropoulos Ioannis N , Khan Adnan , Gad Hoda , Migahid Osama , Megahed Ayman , DeFronzo Ralph , Mahfoud Ziyad , Hassan Mona , Al Hamad Hanadi , Ramadan Marwan , Alam Uazman , Malik Rayaz A 
Published: June 2020

IntroductionTo assess the effect of exenatide and pioglitazone or basal-bolus insulin on diabetic peripheral neuropathy (DPN) in patients with poorly controlled type 2 diabetes (T2D).Research design and methodsThis is a substudy of the Qatar Study, an open-label, randomized controlled trial. 38 subjects with poorly controlled T2D were studied at baseline and 1-year follow-up and 18 control subjects were assessed at baseline only. A combination of exenatide (2 mg/week) and pioglitazone (30 mg/day) or glargine with aspart insulin were randomly assigned to patients to achieve an HbA1c <53 mmol/mol (<7%). DPN was assessed with corneal confocal microscopy (CCM), DN4, vibration perception and sudomotor function.ResultsSubjects with T2D had reduced corneal nerves, but other DPN measures were comparable with the control group. In the combination treatment arm (n=21), HbA1c decreased by 35.2 mmol/mol (3.8 %) (p<0.0001), body weight increased by 5.6 kg (p<0.0001), corneal nerve branch density increased (p<0.05), vibration perception worsened (p<0.05), and DN4 and sudomotor function showed no change. In the insulin treatment arm, HbA1c decreased by 28.7 mmol/mol (2.7 %) (p<0.0001), body weight increased by 4.6 kg (p<0.01), corneal nerve branch density and fiber length increased (p≤0.01), vibration perception improved (p<0.01), and DN4 and sudomotor function showed no change. There was no association between the change in CCM measures with change in HbA1c, weight or lipids.ConclusionsTreatment with exenatide and pioglitazone or basal-bolus insulin results in corneal nerve regeneration, but no change in neuropathic symptoms or sudomotor function over 1 year.
Effectiveness of a comprehensive care protocol in patients with new diagnoses of type 2 diabetes mellitus and associated comorbidities in primary care: study protocol of a quasi-experimental trial
Authors: Lapena Carolina , Borràs Enriqueta , Digon Clarisa , Aznar Rosa , del Val Garcia Jose Luis , Castelblanco Esmeralda , Garaikoetxea Ana , Laguna Vicencia 
Published: June 2020

IntroductionType 2 diabetes mellitus (T2DM) is a highly prevalent chronic disease in the Spanish population. Typically, T2DM is associated with other chronic conditions. Intensive medication at the time of diagnosis has proven effective in reducing cardiovascular risk, improving glycaemic control and preventing T2DM complications. However, it has not yet been demonstrated that a comprehensive and intensive health education protocol at the time of diagnosis has the benefits described previously. Currently, there is great variability in the practices of primary care nurses regarding health education at the time of disease diagnosis.We aimed to evaluate the effectiveness of a systematic protocol with a comprehensive care programme in people with newly diagnosed T2DM with associated comorbidities.Methods and analysisA multicentre quasi-experimental design comparing a group of individuals taking part in the intervention (intervention group (IG)) with a similar group receiving standard diabetes care (comparison group (CG)) is planned. The intervention will take place during the 3 months after study enrolment. Data will be collected at baseline and at 3, 6 and 12 months. Ten primary care centres in Barcelona city will be selected for participation: 5 for the IG and 5 for the CG. The IG will include five structured individual visits postdiagnosis with the primary care nurse, during which aspects of diabetes education will be discussed with the patient and his/her family. The results will be measured in terms of health-related quality of life and the change in main outcomes (glycated haemoglobin and weight).Ethics and disseminationThe study fully met the requirements of the Ethical Committee of Clinical Investigation of the IDIAP Jordi Gol (approval code: P13/118). Patients will be informed that their data are confidential, and they have the right to withdraw at any time without penalty. Dissemination will include publishing the findings in peer-reviewed journals and sharing our findings at scientific conferences.Trial registration numberNCT03990857; Pre-results.
Development of an implementation and evaluation strategy for the Australian ‘Zero Childhood Cancer’ (Zero) Program: a study protocol
Authors: Rapport Frances , Smith James , O’Brien Tracey A , Tyrrell Vanessa J , Mould Emily VA , Long Janet C , Gul Hossai , Braithwaite Jeffrey 
Published: June 2020

IntroductionEffective implementation of a research Program requires an actionable plan to guide execution. To assess the actionability and success of that plan, both scientific and implementation elements must be taken into account. The aim of this study is to assess the ‘Zero Childhood Cancer Personalised Medicine Program’ (the Zero Program), an Australian first-ever and most comprehensive personalised medicine programme for children with high-risk or relapsed cancer, in terms of its structure, process and implementational effect.Methods and analysisWe will assess Program delivery mechanisms. The development of the implementation and evaluation strategy will concentrate on the work of the Zero Program as a complex whole. This includes the structure of collaborative links across stakeholder groups involved in Program development and delivery, changes to collaborative relationships over time and the impact of group working on Program outcomes. We are applying a mixed-methods design including: a rapid ethnography (observations of stakeholder interactions and informal conversations), Program professionals’ completion of a rapid health implementation proforma and a social network analysis. Formative evaluations of the implementation science effects, applying feedback techniques, for example, Formative Evaluation Feedback Loops and the Zero Program professionals’ feedback, will determine where Program tailoring may be needed. A repeat of the social network analysis downstream will examine network changes over time, followed by an expert panel using the expert recommendations for implementing change to assess the integration of implementation strategies into the Program structure. A summative evaluation of the Program will bring the research elements together, leading to comprehensive data triangulation and determining the sustainability and implementational effects of Program delivery.Ethics and disseminationEthical approval for this study has been granted by Hunter New England Research Ethics Committee, New South Wales, Australia (approval ref: 2019/ETH12025). Knowledge translation will be achieved through publications, reports and conference presentations to healthcare professionals, patients, families and researchers.Trial RegistrationNCT03336931; Pre-results.
Lessons from the failure of implementing the ‘Better Care Better Value’ prescribing indicator for renin–angiotensin system drugs in England: a qualitative study of general practitioners’ perceptions using behavioural change framework
Authors: Kurdi Amanj , Elliott Rachel Ann , Chen Li-Chia 
Published: June 2020

ObjectivesTo explore reasons for the lack of uptake of ‘Better Care Better Value (BCBV)’ prescribing indicators for renin–angiotensin–aldosterone system (RAAS) inhibitors and identify learning lessons to inform the implementation of future prescribing policies.DesignIn-depth, semistructured interviews to explore: general practitioners’ (GPs) experiences in prescribing RAAS, perceptions of the BCBV policy and potential barriers to policy implementation and suggestions for improving future policy implementation. Interviews were audio recorded, transcribed verbatim and analysed thematically, then mapped onto behavioural change frameworks (the Capability, Opportunity, Motivation and Behaviour) model and Behaviour Change Wheel (BCW)).SettingPrimary care setting in EnglandParticipantsInterviews were conducted with 16 GPs recruited from a purposive sample of 91 GP practices in three English counties.ResultsFour factors/barriers, related mainly to GPs’ psychological capability and reflective motivation, emerged as the possible barriers for the BCBV’s lack of uptake, including: lack of the policy awareness, negative attitude to the policy, lack of incentives and GPs’ reluctance to switch patients from angiotensin receptor blockers (ARBs) to ACE inhibitors (ACEIs). The participating GPs proposed interventions to improve future BCBV implementation and they were related to six intervention/policy functions of the BCW, addressing the four identified barriers: education/communication (increase GPs’ awareness) and environmental restructuring/regulations (provide GPs with reminding alerts); incentivisation/fiscal (provide GPs with financial incentives); enablement/guidelines-regulations (provide GPs with benchmarking against peers) and enablement/regulations and education/guidelines (facilitate switching from ARBs to ACEIs).ConclusionsThe main reason underpinning the low uptake of the BCBV indicator appears to be lack of a proactive implementation strategy. This case study demonstrated that passively disseminating policy without an effective implementation strategy results in low uptake. Furthermore, multifaceted implementation strategies are necessary to influence complex clinical decision making in a time-limited environment, such as prescribing behaviours. These findings suggest that effective policy implementation requires the application of a systematic comprehensive behaviours change framework.
Patient-level and system-level barriers associated with treatment delays for ST elevation myocardial infarction in China
Authors: Yin Xuejun , He Yibo , Zhang Jing , Song Feier , Liu Jin , Sun Guoli , Liang Yan , Ye Jianfeng , Hu Yunzhao , Song Mingcai , Chen Cong , Xu Qingbo , Tan Ning , Chen Jiyan , Liu Yong , Liu Hueiming , Tian Maoyi 
Published: June 2020

ObjectiveThis study aims to understand the current ST elevated myocardial infarction (STEMI) treatment process in Guangdong Province and explore patient-level and system-level barriers associated with delay in STEMI treatment, so as to provide recommendations for improvement.MethodsThis is a qualitative study. Data were collected using semistructured, face-to-face individual interviews from April 2018 to January 2019. Participants included patients with STEMI, cardiologists and nurses from hospitals, emergency department doctors, primary healthcare providers, local health governors, and coordinators at the emergency medical system (EMS). An inductive thematic analysis was adopted to generate overarching themes and subthemes for potential causes of STEMI treatment delay. The WHO framework for people-centred integrated health services was used to frame recommendations for improving the health system.ResultsThirty-two participants were interviewed. Patient-level barriers included poor knowledge in recognising STEMI symptoms and not calling EMS when symptoms occurred. Limited capacity of health professionals in hospitals below the tertiary level and lack of coordination between hospitals of different levels were identified as the main system-level barriers. Five recommendations were provided: (1) enhance public health education; (2) strengthen primary healthcare workforce; (3) increase EMS capacity; (4) establish an integrated care model; and (5) harness government’s responsibilities.ConclusionsBarriers associated with delay in STEMI treatment were identified at both patient and system levels. The results of this study provide a useful evidence base for future intervention development to improve the quality of STEMI treatment and patient outcomes in China and other countries in a similar situation.