bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuregulin 4 (NRG4) – the batokine with clinical relevance in Gestational Diabetes Mellitus
Authors: Attique Hira , Baig Saeeda , Ishtiaque Shahina , Rehman Rehana , Ahmed Tousif , Shahid Moazzam Ali 
Published: August 2020

Abstract
Background: Neuregulin4 (NGR4) is a brown fat adipokine that modulates carbohydrate and lipid metabolism, regulate insulin sensitivity. The relationship between NGR4 and gestational diabetes mellitus (GDM) remains unclear due to discrepancy in studies. The objective of this study was to find out association between NRG4 and insulin level in women with GDM and their relationship with other metabolic parameters. Methods: In this comparative cross sectional study, pregnant women (n=80), coming for regular antenatal check-ups between 24 and 28 weeks of gestation were recruited. After informed signed consent, interview based proforma was filled with demographic data and antenatal history. Anthropometric measurements were taken; weight recorded on first visit was considered pre-pregnancy weight. Blood (5ml) was drawn after 12 hours fast for estimation of fasting blood sugar (FBS), insulin, NRG4 and lipid profile and secondly after one hour post-consuming 50gm glucose, for glucose challenge test. Statistical analysis was done using SPSS version20, Mann Whitney and Spearman correlation for finding association between variables, whereas, Kruscal Wallis Test for differences between groups. Results: Median NRG4 level (0.98) in healthy group was significantly high (p<0.038) compared to GDM (0.94). The NRG4 had inverse weak association with GDM. The mean insulin and homeostasis assessment model of insulin resistance (HOMA IR) values had weak direct association with NRG4. Cholesterol, LDL had inverse relationship with NRG4. All parameters of lipid profile were high in GDM compared to non GDM, but only cholesterol was statistically significant (p<0.03). The FBS in healthy group was significantly low (p<0.02) compared to GDM. The association between insulin and HOMA IR was statistically significant (p<0.05). The difference between BMI was statistically significant with age (p<0.015), parity (p<0.035). The difference between FBS and education was found significant (p<0.049). Conclusion: Serum NRG4 level were found low in GDM compared to non-GDM (p<0.03), with a week and direct association with insulin. Future studies are required with bigger sample size to establish NRG4 as a potential biomarker for GDM.
Prohibitin 1 is essential to preserve mitochondria and myelin integrity in Schwann cells.
Authors: Nunes Gustavo Della-Flora , Wilson Emma , Marziali Leandro , Hurley Edward , Silvestri Nicholas , He Bin , O'Malley Bert , Beirowski Bogdan , Poitelon Yannick , Wrabetz Lawrence , Feltri M. Laura 
Published: August 2020

Abstract
Myelin is required for nervous system function. In the peripheral nervous system, Schwann cells (SCs) form myelin and trophically support the axons they ensheath. We previously showed that the mitochondrial protein prohibitin 2 (PHB2) can localize to the axon-SC interface and is required for developmental myelination. Whether the homologous protein PHB1 has a similar role, and whether prohibitins also play important roles in SC mitochondria is unknown. Here we show that deletion of Phb1 in SCs only minimally perturbs development, but later triggers a severe demyelinating peripheral neuropathy. Moreover, mitochondria are heavily affected by ablation of Phb1 and demyelination occurs preferentially in cells with apparent mitochondrial loss. Furthermore, in response to mitochondrial damage, SCs trigger the integrated stress response (ISR), but, contrary to what was previously suggested, the ISR is not detrimental and may be beneficial in this context. These results identify a new role for PHB1 in myelin integrity and advance our understanding of how SCs respond to mitochondrial damage.
The Relationships Between Fall Risk, Depression, Executive Dysfunctions and Daily Life of Older Adults
Authors: Yeger Batya Engel , Zilbershlag Yael 
Published: August 2020

Abstract
Background: Falling is a major problem in older adults that may significantly reduce health and quality of life (QOL). Body dysfunctions that include depression, cognitive decline and executive dysfunctions may elevate fall risk and impair daily activities and QOL. Yet, most studies evaluate these body dysfunctions using laboratory measures in clinical settings. The present study aimed to: (1) compare these body dysfunctions between high/low risk fallers (2) examine the relationship between these body dysfunctions among the high risk fallers (3) explore the specific contribution of fall risk as a mediator between depression, executive dysfunctions and daily life. Methods: Participants were 123 older adults who live in the community. Depression and cognitive status were measured by the GDS-15 and the MoCA. Fall risk was determined by a questionnaire supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the BRIEF-A and the aEFPT medication management assessment. Daily activity performance was measured by the Barthel Index of ADL and the Instrumental ADL Scale. QOL was measured by the World Health Organization Quality of Life Brief Questionnaire. Results: High fall risk was prevalent among 32% of the sample. High risk fallers had significantly lower cognitive level, higher depression, lower EF, lower daily activity performance and lower QOL. Among the high risk group, lower EF as measured in BRIEF-A scales correlated with lower performance of daily activities and lower QOL. SEM model revealed that fall risk mediated between depression, executive dysfunctions and daily life. Conclusions: Depression and executive dysfunctions are more prevalent in older adults with high fall risk and are significantly related to their daily activity performance and to their QOL. Community fall-prevention and rehabilitation programs should screen for fall risk and related body dysfunctions as expressed during daily activity performance and understand their impacts on people’s QOL.
Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes
Authors: Rossen Jenny , Hagströmer Maria , Yngve Agneta , Brismar Kerstin , Ainsworth Barbara , Johansson Unn-Britt 
Published: August 2020

Abstract
Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788
Activation of the plant mevalonate pathway by extracellular ATP
Authors: Cho Sung-Hwan , Tóth Katalin , Kim Daewon , Vo Phuc , Lin Chung-Ho , Handakumbura Pubudu , Rivas-Ubach Albert , Evans Sterling , Pasa-Tolic Ljiljana , Stacey Gary 
Published: August 2020

Abstract
The mevalonate (MVA) pathway plays a critical role in multiple cellular processes in both animals and plants. In plants, the products of this pathway impact growth and development, as well as the response to environmental stress. A forward genetic screen of Arabidopsis thaliana using Ca2+ imaging identified mevalonate kinase (MVK) as a critical component of plant purinergic signaling. MVK interacts directly with the plant extracellular ATP (eATP) receptor P2K1 and is phosphorylated by P2K1 in response to eATP. Mutation of P2K1-mediated phosphorylation sites in MVK eliminates the ATP-induced cytoplasmic calcium response, MVK enzymatic activity, and suppresses pathogen defense. The data demonstrate that the plasma membrane associated P2K1 directly impacts plant cellular metabolism by phosphorylation of MVK, a key enzyme in the mevalonate pathway. The results underline the importance of purinergic signaling in plants and the ability of eATP to influence the activity of a key metabolite pathway with global effects on plant metabolism.
The Effect of Phased Written Health Education Combined With Healthy Diet on the Quality of Life of Patients After Heart Valve Replacement
Authors: Li Dan , Liu Pujuan , Zhang Huijun , Wang Li 
Published: August 2020

Abstract
Background: To observe the effect of phased written health education combined with healthy diet on the quality of life of patients after heart valve replacement. Methods: 130 patients who underwent heart valve replacement surgery in our hospital from January 2019 to January 2020 were enrolled as the research subjects. They were randomly divided into study group (65 patients, phased written health education combined with health Diet) and control group (65 cases, routine health education). The drug compliance and the degree of anticoagulant drugs knowledge were compared between the two groups in the first and second stage rehabilitation and the recovery stage. The health behavior ability and quality of life at different phases were also observed. Results: During the first and the second stage rehabilitation, and the recovery stage, the drug compliance of the study group was superior to that of the control group, with statistical significance (P<0.05). Meanwhile, the knowledge of anticoagulant drugs in the study group was better than that in the control group, with statistical significance (P<0.05). Before intervention, there was no significant difference in health behavior ability and quality of life between the two groups (P>0.05). The healthy behavior ability of study group for each stage was superior to the control group, the difference was significant (P<0.05). The healthy behavior ability and quality of life showed the same results with statistical significance (P<0.05). Conclusions: The use of phased written health education combined with healthy diet in patients after heart valve replacement can effectively improve patients' medication compliance, anticoagulant drugs knowledge, healthy behavior ability and quality of life at different stages, and is worthy of clinical application.
Increases in Social Support Co-Occur with Decreases in Depression and Substance Use Problems Among Adults in Permanent Supportive Housing: An 18-Month Longitudinal Study
Authors: Tan Zhengqi , Mun Eun-Young , Nguyen Uyen-Sa D. T. , Walters Scott T. 
Published: August 2020

Abstract
Background: Social support is a well-known protective factor against depression and substance use problems, but very few studies have examined its protective effects among Permanent Supportive Housing (PSH) residents. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depression, and substance use problems, and to examine their longitudinal associations in a large sample of adults residing in PSH.Methods: Participants were 653 adult PSH residents in North Texas (56% female; 57% Black, 35% White, 8% other; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. Their health behaviors were assessed at baseline and tracked every six months at three follow-up visits.Results: Unconditional LGCMs indicated that over time, social support increased, whereas depressive symptoms and substance use problems decreased. However, their rates of change slowed over time. Further, in parallel process growth models, we found that at baseline, individuals with greater social support tended to have less severe depression and substance use problems (coefficients: –0.67, p<0.01; –0.52, p<0.01, respectively). Individuals with a faster increase in social support tended to have steeper rates of reduction in both depression (coefficient: –0.99, p<0.01) and substance use problems (coefficient: –0.98, p<0.01), respectively.Conclusions: This study suggests that increases in social support, though slowing over time, still positively impact depression and substance use problems among PSH residents. Future PSH programs could emphasize social support as an early component as it may contribute to clients’ overall health.
Impact of the COVID-19 pandemic on emergency eye care provision: A perspective from the Manchester Royal Eye Hospital
Authors: Chaturvedi Ritu , Ku Jae Yee , Zhu Wenyue , Dhawahir-Scala Felipe Eduardo 
Published: August 2020

Abstract
Background: The COVID-19 pandemic has posed global health care challenges. This paper examines the effect of the pandemic on patient numbers, demographics, type and severity of presentations to the emergency eye department (EED) at one of the largest tertiary referral eye hospitals in the United Kingdom (UK) and discusses the management strategies developed.Methods: Retrospective data was collected to compare a four week time frame during the pre-COVID-19 period (PCP; 6/1/20 to 2/2/20) with the COVID-19 period (CP; 23/3/20 to 19/4/20). Results: 2,664 patients were seen during the PCP and this decreased to 759 patients during the CP. This represented a significant decline in mean±SD daily patient presentations from 74±16 during the PCP to 27±7 during the CP (U=18.7, p<0.001). This is equivalent to a decrease by a factor of 2.71 (95% CI: 2.49-2.96). There were proportionally fewer patients at both ends of the age spectrum (≤19 years and 70-89 years) during the CP compared to the PCP but these differences in age distribution were not significantly different (χ2=1.37, p=0.50). There were 73 presentations with sight-threatening conditions during the PCP and 51 during the CP. The mean±SD number of patients who presented with sight-threatening conditions during the PCP (2.6±1.8) was not significantly different from the CP (1.8±1.4) (U=289.5, p=0.09).Conclusion: These findings reassure that current measures at the Manchester Royal Eye Hospital (MREH) are sufficiently robust for patients to access eye care services and ensure patient safety during the CP. Moreover, telemedicine has emerged as an effective tool to meet increasing demand in times of limited resources and may serve an important role in future patient care.
Analysis of accreditation standards for undergraduate medical studies in Serbia through the lens of the National Health Workforce Accounts
Authors: Buljugic Biljana , Milicevic Milena Santric 
Published: August 2020

Abstract
Background Understanding the importance of educational accreditation standards for health and health workforce policymaking is needed more than ever given the growing circulation of physicians, cross-border care and pandemics. The World Health Organization National Health Workforce Accounts (NHWA) for education and training could support the achievement of health care quality through health workforce strategies.Objective To perform a qualitative and quantitative analysis of the effect of accreditation standards on undergraduate medical studies through the lens of NHWA indicators on education and training, and to assess their potential to support quality improvement in health workforce education and health policy planning.Methods Accreditation standards for medical undergraduate studies at the Faculty of Medicine University of Belgrade, Serbia (FMUB) were analyzed using the NHWA indicators on education and training, in addition to the results of surveys of students and employers on the quality of accredited study programs in 2013 and 2016.Results Compulsory accreditation mechanism entails standards for the quality of education at FMUB including continuing professional development and in-service training but not for interprofessional education. Standards partly cover social determinants and social accountability. Students optionally participate in regulatory making. Alike healthcare managers who also serve as providers for training placement for students during the studies, students take part in FMUB accreditation surveys. Based on the results of the survey, the quality of undergraduate medical studies at FMUB has slightly improved from 2013 to 2016. A ten-year quantitative analysis showed a declining trend in freshman enrollment. The average duration of a six-year undergraduate study of medicine is extended to 7.2 ± 0.4 years.Conclusion For improving medical students' practical, organizational skills and independent work, as well as social accountability, and social determinants must be taken as priority standards in the future revisions of accreditation mechanism in Serbia. Health workforce organizations, civil society and the community should participate in accreditation regulatory bodies for establishing a foundation for socially accountable and interprofessional education. If implemented at institutional, local and national level, system of NHWA indicators can support the alignment of higher education standards and plans with the national health and health workforce standards and strategy/plan.
Xenacoelomorpha flatworms are basal Deuterostome
Authors: Wang Yi 
Published: August 2020

Abstract
Background: Whether position Xenacoelomorpha as an early branch of Bilateria (Protostomes + Deuterostomes) has been intensely debated during last several decades. Considering Darwin’s “tree of life”, with the “Phylogenetic Species Concept”, we choose mitochondrial genome as the subject to predict phylogenetic position of Xenacoelomorpha, by genes genealogy. Results: Herein, we sequence Heterochaerus australis’s mitochondrial genome and infer intrinsic relationships of Metazoan with Xenacoelomorpha. The optimal tree under the popular maximum likelihood (ML) and Bayesian phylogenetic reconstructions are consensus with each other being strongly supported. The relationship between Chordates, Ambulacrarians and Xenoturbella/Acoelomorph is resolved. To avoid previous query about alignment process, the datasets are alignmented and trimmed automatically. Reducing taxon or cutting outgroups can not affect the relationship between Xenacoelomorpha and other Metazoan. Meanwhile, analysis using CAT model and Dayhoff groups also supporting the prediction made by mtZOA, relaxing the restriction of alignment criteria ( MAFFT, strategy G–ins–1, BLOSUM 62, 45, 30 ) introducing potential misleading signals can not challenge the tree topology indicating our auto-alignmented mitochondrial dataset is not artificially restricted one. Conclusions: Finally, a repeatable prediction of the genes genealogy with reliable statistical support places Xenacoelomorpha as a basal Deuterostome. Let's enjoy the elegent metapher about Tree of LIfe—— "As buds give rise by growth to fresh buds, and these, if vigorous, branch out and overtop on all sides many a feebler branch, so by generation we believe it has been with the great Tree of Life, which fills with its dead and broken branches the crust of the earth, and covers the surface with its ever branching and beautiful ramifications". (Darwin 1964 [1859], p. 130).
Health-related Quality of Life Among Patients With Chronic Kidney Disease of Unknown Etiology (CKDu) of an Agricultural Community in Kebithigollawa, Sri Lanka&nbsp;&nbsp;
Authors: Suriyakumara Vindika , Samarathunga Thilina Anuradha , Gunaratne Dhanuja , Karunarathne Chaminda , Gajanayaka Raveena , Kumarasinghe Nishantha 
Published: August 2020

Abstract
BACKGROUND – The significant increase in the burden of chronic kidney disease of unknown etiology (CKDu) of Sri Lanka has led to evaluate the factors related to physical, social and mental aspects of health related quality of life (HRQOL) in CKDu patients. METHOD – The quality of life of 84 CKDu patients (stages 1-5) were assessed by means of the Kidney Disease Quality of Life Short-Form survey (KDQOL™-36) Version 1.3 along with biomarkers and patient demographics. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Patients were divided into four groups according to their eGFR; group A with eGFR range 90-60 ml/min/1.73 m2, group B with eGFR range 30–59 ml/min/1.73m2, group C with eGFR range 15–29 ml/min/1.73m2 and group D with eGFR<15 ml/min/1.73m2. RESULTS – The KDQOL™-36 scores impaired substantially across all stages of CKDu and comparatively lower scores were present in latter stages of the disease than the initial stages. The mental composite summary (MCS) scores were more impaired when compared to physical composite summary (PCS) scores during the early stage of disease. Poor KDQOL™-36 scores were present in males than in females. A significant variance in scores was not observed between the gender and younger (<65 years) and elderly (≥65 years) populations. Biochemical parameters showed a statistically significant correlation with majority of KDQOL™-36 dimensions while interestingly urine albumin to creatinine ratio did not. CONCLUSION - Our findings reveals that CKDu patients in any stage of the disease despite their age and gender have a significant physical and mental health burden, and this burden is alarmingly increased among patients as the disease worsens. Thereby, early assessment of health related quality of life will help to identify high risk patients and modifying these factors may provide better active and a healthy lifestyle.