bluuebunny/crossref_metadata_2025_split huggingface dataset:
MicroRNA-183-5p acts as a potential diagnostic biomarker for atherosclerosis and regulates the growth of vascular smooth muscle cell
Authors: Sun Bin , Shan Zhengkun , Sun Guoyu , Wang Xiaolong 
Published: January 2020

Abstract
Background Atherosclerosis (AS) is a multifactorial chronic disease, and vascular smooth muscle cells (VSMCs) plays an important role in the pathology of AS. MicroRNAs regulate multiple cellular biological processes. This study aimed to investigate the clinical value of miR-183-5p in AS patients, and further explored the effects of miR-183-5p on the proliferation and migration of VSMCs. Methods qRT-PCR was used to test the level of miR-183-5p. The diagnostic value of miR-183-5p for AS patients was assessed by a receiver operating characteristic (ROC) analysis. Cell proliferation and migration were determined via CCK-8 and Transwell assay. Results MiR-183-5p was highly expressed in AS patients compared with the healthy group. Serum miR-183-5p expression was positively associated with CIMT and CRP in AS patients. The ROC analysis suggested that miR-183-5p had quality to be used as a biomarker with high specificity and sensitivity for AS detection. Overexpression of miR-183-5p promoted the proliferation and migration of VSMCs. Downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. Conclusion MiR-183-5p is highly expressed in AS patients, and downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. MiR-183-5p may be a key molecular for the diagnosis and treatment of AS in the future.
Implementation of a National Electronic Health Information System in Gabon: A Survey of Healthcare Providers’ Perceptions
Authors: Bagayoko C.O. , Tcheente Jack , Traoré Diakaridia , Moukoumbi Gaetan , Ondzigue Raymond , Koumamba Aimé Patrice , Ondjani Myriam Corille , Ndjeli Olive Lea , Gagnon Marie-Pierre 
Published: January 2020

Abstract
Background: Health information System(HIS) is a set of computerized toolsfor the collection, storage, management and transmission of health data.Their role in supporting the modernization of health systems, improving access to quality healthcare and reducing costs in developing countries is unquestionable; but their implementation faces several challenges. In Gabon, a unique national electronic HIShas been launched.It will connect healthcare institutions and providers at all levels in the whole country.Objective: This study aims to explore and identify the factors influencing healthcare providers’ perceptions of the national electronic HIS. Methods: We adapted a questionnairebased on the Information System Success Model (ISSM).Twenty six hundreds(2600) healthcare providers,recruited across the country, took part in the research. We checked the reliability and validity of the application and performed a logistic regression to identify the factors influencing healthcare providers’ perceptions towards the system.Results: A total of 2327 questionnaires were completed (i.e. 89.5% response rate). The logistic regression identified five elements that significantly influenced perceived system impact: System Quality (Odds Ratio–OR=1.70), Information Quality (OR=1.69), Actual Use (OR=1.41), Support Quality (OR=1.37), and Useful Functions (OR=1.14). The model explained 30% of the variance in providers’ perceptionshow that the HIS leads to positive impacts. Discussion: The results show that healthcare providers’ perceptions regarding the positive impact are influenced by their use of a previous HIS, the scope of their usage and the quality of the system, information and support provided to users. These results could inform the development of strategies to ensure adequate change of management and user experience for the implementation of the national electronic HIS in Gabon, and eventually in other low resources environment.
Novel mutations of the SRF gene in Chinese sporadic conotruncal heart defect patients
Authors: Mengmeng Xu , Yuejuan Xu , Sun Chen , Yanan Lu , Fen Li , Kun Sun 
Published: January 2020

Abstract
Background: Conotruncal heart defects (CTDs) are a group of congenital heart malformations that cause anomalies of cardiac outflow tracts. In the past few decades, many genes related to CTDs have been reported. Serum response factor (SRF) is a ubiquitous nuclear protein that acts as transcription factor, and SRF was found to be a critical factor in heart development and to be strongly expressed in the myocardium of the developing mouse and chicken hearts. The targeted inactivation of SRF during heart development leads to embryonic lethality and myocardial defects in mice. Results: To illustrate the relationship between SRF and human heart defects, we screened SRF mutations in 527 CTD patients, a cross sectional study. Two novel mutations (Mut1: c.821A>G p.G274D, the adenine(A) was mutated to guanine(G) at position 821 of the SRF gene coding sequences (CDS), lead to the Glycine(G) mutated to Asparticacid(D) at position 274 of the SRF protein amino acid sequences; Mut2: c.880G>T p.G294C, the guanine(G) was mutated to thymine (T) at position 880 of the SRF CDS, lead to the Glycine(G) mutated to Cysteine (C) at position 294 of the SRF protein amino acid sequences.) of SRF (NM_003131.2) were identified. Western blotting and real-time PCR showed that there were no obvious differences between the protein expression and mRNA transcription of mutants and wild-type SRF. A dual luciferase reporter assay showed that both SRF mutants (G274D and G294C) impaired SRF transcriptional activity at the SRF promoter and atrial natriuretic factor (ANF) promoter (p<0.05), additionally, the mutants displayed reduced synergism with GATA4. Conclusion: These results suggest that SRF-p.G274D and SRF-p.G294C may have potential pathogenic effects.
Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study
Authors: Foo Kah Mun , Sundram Meena , Legido-Quigley Helena 
Published: January 2020

Abstract
Background
About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore.

Methods
This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare.

Results
Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time.
Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients.
Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment.

Conclusions
There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.
Blood signatures for second stage Human African Trypanosomiasis: A transcriptomic approach.
Authors: Mulindwa Julius , Matovu Enock , Enyaru John , Clayton Christine 
Published: January 2020

Abstract
Background: Rhodesiense sleeping sickness is caused by infection with T. b rhodesiense parasites resulting in an acute disease that is fatal if not treated in time. The global impact of active T. b rhodesiense infection on the patient’s immune response in the early and late stages of the disease is not known. Methods: RNASeq was carried out on blood and cerebral spinal fluid (CSF) samples obtained from T. b. rhodesiense infected patients. The control samples used were from healthy individuals in the same foci. The Illumina sequenced reads were analysed using the Tuxedo suite pipeline (Tophat, Cufflinks, Cuffmerge, Cuffdiff) and differential expression analysis carried out using the R package DESeq2. The gene enrichment and function annotation analysis were done using the ToppCluster, DAVID and InnateDB algorithms. Results: We previously described the transcriptomes of T. b rhodesiense from infected early stage blood (n=3) and late stage CSF (n=3) samples from Eastern Uganda. We here identify human transcripts that were differentially expressed (padj < 0.05) in the early stage blood versus healthy controls (n=3) and early stage blood versus late stage CSF. Differential expression in infected blood showed an enrichment of innate immune response genes whereas that of the CSF showed enrichment for anti-inflammatory and neuro-degeneration signalling pathways. We also identified genes (C1QC, MARCO, IGHD3-10) that were up-regulated (log 2 FC > 2.5) in both the blood and CSF. Conclusion: The data yields insights into the host’s response to T. b rhodesiense parasites in the blood and central nervous system. We identified key pathways and signalling molecules for the predominant innate immune response in the early stage infection; and anti-inflammatory and neuro-degeneration pathways associated with sleep disorders in second stage infection. We further identified potential blood biomarkers that can be used for diagnosis of late stage disease without the need for lumbar puncture.
Contextual and individual determinants of tooth loss in adults: a population-based multilevel study
Authors: Roberto Luana Leal , Silveira Marise Fagundes , De Paula Alfredo Mauricio Batista , Ferreira Efigênia Ferreira , Martins Andréa Maria Eleutério De Barros Lima , Haikal Desirée Sant'Ana 
Published: January 2020

Abstract
Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.
Gender Disparities in the Education Gradient in Self-Reported Health across Birth Cohorts in China
Authors: Zhu Bowen , Ye Yiwan 
Published: January 2020

Abstract
Background: Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is research on gender disparity and cohort variations in educational effect on health using samples from the U.S. and Europe, research about China’s is limited. Given the specific social changes in China, our study is designed to analyze the gender and cohort patterns in the education-health gradient.
Method: The latent growth-curve modeling was used to analyze the gender and cohort variations in the education gradient in self-rated health among Chinese respondents. The study employed longitudinal and nationally representative data from the Chinese Family Panel Studies from the years 2010 to 2016. Each cohort is specified according to their distinct periods of social change in China. Following the analysis, we used latent growth-curve model to illustrate gender and cohort differences in the age-graded education and health trajectories.
Results: Although Chinese men have reported to have better health than women in general, women reported 1.6 percentage points higher in self-reported health for each additional year of schooling compared to that of men (P < 0.001). The latent growth curve model showed women’s extra education benefits were persistent overtime. Compared to the people born during the “Old China” (1908-1938), the education gradient in self-rated health did not change for cohorts born before 1955 and after 1977, but the education-health gap changed significantly in the 1956-1960 (O.R.=1.038, P<0.05), 1967-1976 (O.R.=1.058, P<0.001), and 1977-1983 (O.R.=1.063, P<0.001) cohorts. There was a gender difference for the cohort variations in the education-health gradient. For women, the education effect in the 1956-1960 (O.R.=1.063, P<0.05) , 1967-1976 (O.R.=1.088, P<0.001) and 1977-1983 (O.R.=1.102, P<0.001) cohorts was significantly higher than that of the 1908-1938 cohort. On the contrary, the education-health gradient remained the same across all cohorts for men.
Conclusion: Our study suggests that the education-health gradient varies across cohorts for women, but the size of education effect remains consistent for men across cohorts. The findings support the resource-substitution hypothesis and not the rising-importance hypothesis in China. We discussed the potential influences of the unique, social transformation and educational expansion in China.
Tumour Content Ratio Matters for Detecting Epidermal Growth Factor Receptor Mutation by Cobas Test in Small Biopsies; a Retrospective Study
Authors: Kogo Mariko , Fujimoto Daichi , Hosoya Kazutaka , Nagata Kazuma , Nakagawa Atsushi , Tachikawa Ryo , Yamashita Daisuke , Kitamura Yuka , Imai Yukihiro , Tomii Keisuke 
Published: January 2020

Abstract
Background Recent studies indicate the benefit of treatment with osimertinib over that with conventional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for untreated EGFR -mutated non-small cell lung cancer (NSCLC). Cobas ver2 is the only companion diagnostic method for detecting EGFR mutations with osimertinib treatment. We clinically experience false negative cases with this test, but its actual sensitivity is unknown. Moreover, no study has suggested the importance of tumour dissection, and most facilities do not routinely perform them on small biopsies. The purpose of this study was to evaluate the sensitivity of cobas in clinical practice and clarify the role of dissection as a component of the cobas testing. Methods We examined 132 patients with EGFR -mutated NSCLC diagnosed by bronchoscopy and confirmed with PCR clamp. Patients were tested with cobas and the EGFR -positive rate was calculated. Samples with undetected EGFR mutations were retested after tumour dissection and the rate of samples whose EGFR mutation was corrected to positive was assessed. To evaluate tumour cellularity, the tumour content ratio was assessed by calculating tumour cell count over the total cell count on the slide. Results The positive rate of EGFR mutation identification was 76% with cobas, although EGFR mutation-negative patients retained responses to TKI therapy equivalent to positive patients did; however, the tumour content ratio of negative samples was significantly lower than that of positive samples. Twenty-nine negative samples underwent dissection and 24% were corrected to positive. Moreover, 53% of the samples with a tumour content ratio below 10% was negative for cobas, but 33% of these turned positive after dissection. Conclusions Cobas had a high false negative rate in clinical practice, and tumour content ratio might be associated with this rate. Dissection could improve the sensitivity of cobas, especially in samples with low tumour cellularity.
An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programme in Nigeria
Authors: Onyeso Ogochukwu Kelechi , Umunnah Joseph O , Ezema Charles Ikechukwu , Balogun Joseph A , Uchenwoke Chigozie , Nwankwo Maduabuchukwu Joseph , Oke Kayode Israel , Bello Bashir , Nwosu Ifeoma Blessing , Adje Mishael E. 
Published: January 2020

Abstract
Background: Previous studies have shown that deficiency in training may lead to inappropriate utilisation of diagnostic imaging among healthcare professionals, thus, raising concerns about patient safety and economic cost. This study aimed to evaluate the nature and level of musculoskeletal imaging (MI) training received by physiotherapists who graduated from Nigerian universities and completed the one-year mandatory internship. Methods: An online version of the Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), which was previously validated, was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board’s (MRTBN). Data were obtained on demographics, nature, and level of training on various MI modalities using the PMIPQ. Descriptive statistics, Friedman’s ANOVA, and Kruskal-Wallis tests were used for the data analysis at P ≤ 0.05. Results: The results showed that only 10.0% of the respondents had a standalone undergraduate course in MI, 92.8% did not have any MI clinical posting exposure during the internship, and 67.3% had never attended any MI workshop. There was a significant difference in the level of training received across various MI modalities [χ2 (15) = 1285.899; P = 0.001]. However, there was no significant difference in the level of MI training across the institutions (P = 0.36). The study participants with Doctor of Physiotherapy (DPT) education were better trained in MI than their counterparts with a bachelor’s degree (P = 0.047). Conclusions: The self-reported level of MI training among the respondents was deficient, but the knowledge of X-ray was significantly higher than other MI modalities. Based on the overall findings in this study, we recommend that diagnostic imaging contents be introduced early in the current and future physiotherapy training programmes.
Identifying and selecting implementation theories, models and frameworks: a qualitative study to inform the development of a decision support tool
Authors: Strifler Lisa , Barnsley Jan M. , Hillmer Michael , Straus Sharon E. 
Published: January 2020

Abstract
Background: Implementation theories, models and frameworks offer guidance when implementing and sustaining healthcare evidence-based interventions. However, selection can be challenging given the myriad of potential options. We propose to develop a decision support tool to facilitate the appropriate selection of an implementation theory, model or framework in practice. To inform tool development, this study aimed to explore barriers and facilitators to identifying and selecting implementation theories, models and frameworks in research and practice, as well as end-user preferences for features and functions of the proposed tool.Methods: We used an interpretive descriptive approach to conduct semi-structured interviews with implementation researchers and practitioners in Canada, the United States and Australia. Audio recordings were transcribed verbatim. Data were inductively coded by a single investigator with a subset of 20% coded independently by a second investigator and analyzed using thematic analysis.Results: Twenty-four individuals participated in the study. Categories of barriers/facilitators, to inform tool development, included characteristics of the individual or team conducting implementation and characteristics of the implementation theory, model or framework. Major barriers to selection included inconsistent terminology, poor fit with the implementation context and limited knowledge about and training in existing theories, models and frameworks. Major facilitators to selection included the importance of clear and concise language and evidence that the theory, model or framework was applied in a relevant health setting or context. Participants were enthusiastic about the development of a decision support tool that is user-friendly, accessible and practical. Preferences for tool features included key questions about the implementation intervention or project (e.g., purpose, stage of implementation, intended target for change) and a comprehensive list of relevant theories, models and frameworks to choose from along with a glossary of terms and the contexts in which they were applied.Conclusions: An easy to use decision support tool that addresses key barriers to selecting an implementation theory, model or framework in practice may be beneficial to individuals who facilitate implementation practice activities. Findings on end-user preferences for tool features and functions will inform tool development and design through a user-centered approach.