bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania
Authors: Smith Fawzi Mary C. , Siril Hellen , Larson Elysia , Aloyce Zenaice , Araya Ricardo , Kaale Anna , Kamala Janeth , Kasmani Muhummed Nadeem , Komba Amina , Minja Anna , Mwimba Angelina , Ngakongwa Fileuka , Somba Magreat , Sudfeld Christopher R. , Kaaya Sylvia F. 
Published: January 2020

Abstract
Background
Perinatal women accessing prevention of mother-to-child transmission of HIV (PMTCT) services are at an increased risk of depression; however, in Tanzania there is limited access to services provided by mental health professionals. This paper presents a protocol and baseline characteristics for a study evaluating a psychosocial support group intervention facilitated by lay community-based health workers (CBHWs) for perinatal women living with HIV and depression in Dar es Salaam.

Methods
A cluster randomized controlled trial (RCT) is conducted comparing: 1) a psychosocial support group intervention; and 2) improved standard of mental health care. The study is implemented in reproductive and child health (RCH) centers providing PMTCT services. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under clinicaltrials.gov (NCT02039973).

Results
Among 742 women enrolled, baseline characteristics were comparable for intervention and control groups, although more women in the control group had completed secondary school (25.2% versus 18.2%). Overall, findings suggest that the population is highly vulnerable with over 45% demonstrating food insecurity and 17% reporting intimate partner violence in the past 6 months.

Conclusions
Baseline characteristics for the cluster RCT were comparable for intervention and control groups. The trial will examine the effectiveness of a psychosocial support group intervention for the treatment of depression among women living with HIV accessing PMTCT services. A reduction in the burden of depression in this vulnerable population has implications in the short-term for improved HIV-related outcomes and for potential long-term effects on child growth and development.

Trial registration
The trial is registered under clinicaltrials.gov (NCT02039973). Retrospectively registered on January 20, 2014.
Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia
Authors: Mohammed Osman Yimer , Tesfahun Esubalew , Mohammed Abdurahman 
Published: January 2020

Abstract
Background
Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior.

Methods
School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis.

Result
A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18–18.78), maternal education (AOR: 5.12, 95%CI = 1.09–23.83), access to TV (AOR: 4.87, 95%CI = 1.99–11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14–4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43–6.17) were positively associated with adolescent sedentary behavior.

Conclusion
The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.
Social values for health technology assessment in Canada: a scoping review of hepatitis C screening, diagnosis and treatment
Authors: O’Keefe-Markman Caroline , Lea Kristina Dawn , McCabe Christopher , Hyshka Elaine , Bubela Tania 
Published: January 2020

Abstract
Background
Health care system decision makers face challenges in allocating resources for screening, diagnosis and treatment of hepatitis C. Approximately 240,000 individuals are infected with the hepatitis C virus (HCV) in Canada. Populations most affected by HCV include Indigenous people, people who inject drugs, immigrants and homeless or incarcerated populations as well as those born between 1946 and 1965. Curative but expensive drug regimens of novel direct acting antivirals (DAAs) are available. We aim to identify social values from academic literature for inclusion in health technology assessments.

Methods
We conducted a scoping review of academic literature to identify and analyze the social values and evidence-based recommendations for screening, diagnosis and treatment of HCV in Canada. After applying inclusion/exclusion criteria, we abstracted: type of intervention(s), population(s) affected, study location, screening methods, diagnostics and treatments. We then abstracted and applied qualitative codes for social values. We extracted social value statements and clustered them into one of 4 categories: (1) equity and justice, (2) duty to provide care, (3) maximization of population benefit, and (4) individual versus community interests.

Results
One hundred and eighteen articles met our inclusion criteria on screening, diagnosis and treatment of HCV in Canada. Of these, 54 (45.8%) discussed screening, 4 (3.4%) discussed diagnosis and 60 (50.8%) discussed treatment options. Most articles discussed the general population and other non-vulnerable populations. Articles that discussed vulnerable populations focused on people who inject drugs. We coded 1243 statements, most of which fell into the social value categories of equity and justice, duty to provide care and maximization of population benefit.

Conclusion
The academic literature identified an expanded set of social values to be taken into account by resource allocation decision makers in financially constrained environments. In the context of hepatitis C, authors called for greater consideration of equity and justice and the duty to provide care in making evidence-based recommendations for screening, diagnosis and treatment for different populations and in different settings that also account for individual and community interests.
The association between believing staying active is beneficial and achieving a clinically relevant functional improvement after 52 weeks: a prospective cohort study of patients with chronic low back pain in secondary care
Authors: Riis Allan , Karran Emma Louise , Thomsen Janus Laust , Jørgensen Anette , Holst Søren , Rolving Nanna 
Published: January 2020

Abstract
Background
According to clinical guidelines, advice to stay active despite experiencing pain is recommended to patients with non-specific low back pain (LBP). However, not all patients receive guideline-concordant information and advice, and some patients still believe that activity avoidance will help them recover. The purpose was to study whether guideline-concordant beliefs among patients and other explanatory variables were associated with recovery. The main aim was to investigate whether believing staying active despite having pain is associated with a better functional outcome.

Methods
This was a prospective cohort study involving adults with non-specific LBP referred from general practices to the Spine Centre at Silkeborg Regional Hospital, Denmark. Patients reported on their beliefs about the importance of finding the cause, the importance of diagnostic imaging, perceiving to have received advice to stay active, pain duration, pain intensity, and STarT Back Tool. Agreeing to: ‘An increase in pain is an indication that I should stop what I’m doing until the pain decreases’ adjusted for age, gender, and education level was the primary explanatory analysis. A 30% improvement in the Roland Morris Disability Questionnaire (RMDQ) score after 52 weeks was the outcome.

Results
816 patients were included and 596 (73.0%) agreed that pain is a warning signal to stop being active. Among patients not considering pain as a warning signal, 80 (43.2%) had a favourable functional improvement of ≥30% on the RMDQ compared to 201 (41.2%) among patients considering pain a warning signal. No difference was found between the two groups (adjusted P = 0.542 and unadjusted P = 0.629). However, STarT Back Tool high-risk patients had a less favourable functional outcome (adjusted P = 0.003 and unadjusted P = 0.002). Chronic pain was associated with less favourable functional outcome (adjusted P < 0.001 and unadjusted P < 0.001), whereas beliefs about finding the cause, diagnostic imaging, perceiving to have received advice to stay active, or pain intensity were not significantly associated with outcome.

Conclusions
Holding the single belief that pain is a warning signal to stop being active was not associated with functional outcome. However, patients characterised by having multiple psychological barriers (high-risk according to the STarT Back Tool) had a less favourable functional outcome.

Trial registration
Registered at ClinicalTrials.gov (registration number: NCT03058315), 20 February 2017.
Finally, a step forward in nomenclature of subchondral nonneoplastic bone lesions
Authors: Postma William Fulton , Micheaelson Evan , Keeling Laura 
Published: January 2020

AbstractThis paper is a commentary on the article entitled “Nomenclature of Subchondral Nonneoplastic Bone.Lesions1” by Gorbachova, Amber, Beckmann, Bennett, Chang, Davis, Gonzalez, Hansford, Howe, Lenchik, Winalski, and Bredella. The purpose of this commentary is to provide an orthopaedic perspective on the aforementioned article and critique their analysis and proposal regarding nomenclature of subchondral bone lesions. It provides an overview and a section by section evaluation of a well-designed and executed article.
Production, purification and characterization of recombinant human R-spondin1 (RSPO1) protein stably expressed in human HEK293 cells
Authors: Levin Gabriel , Koga Bruna Andrade Aguiar , Belchior Gustavo Gross , Carreira Ana Claudia Oliveira , Sogayar Mari Cleide 
Published: January 2020

AbstractBackgroundThe R-Spondin proteins comprise a family of secreted proteins, known for their important roles in cell proliferation, differentiation and death, by inducing the Wnt pathway. Several studies have demonstrated the importance of RSPOs in regulation of a number of tissue-specific processes, namely: bone formation, skeletal muscle tissue development, proliferation of pancreatic β-cells and intestinal stem cells and even cancer. RSPO1 stands out among RSPOs molecules with respect to its potential therapeutic use, especially in the Regenerative Medicine field, due to its mitogenic activity in stem cells. Here, we generated a recombinant human RSPO1 (rhRSPO1) using the HEK293 cell line, obtaining a purified, characterized and biologically active protein product to be used in Cell Therapy. The hRSPO1 coding sequence was synthesized and subcloned into a mammalian cell expression vector. HEK293 cells were stably co-transfected with the recombinant expression vector containing the hRSPO1 coding sequence and a hygromycin resistance plasmid, selected for hygrorand subjected to cell clones isolation.ResultsrhRSPO1 was obtained, in the absence of serum, from culture supernatants of transfected HEK293 cells and purified using a novel purification strategy, involving two sequential chromatographic steps, namely: heparin affinity chromatography, followed by a molecular exclusion chromatography, designed to yield a high purity product. The purified protein was characterized by Western blotting, mass spectrometry and in vitro (C2C12 cells) and in vivo (BALB/c mice) biological activity assays, confirming the structural integrity and biological efficacy of this human cell expression system. Furthermore, rhRSPO1 glycosylation analysis allowed us to describe, for the first time, the glycan composition of this oligosaccharide chain, confirming the presence of an N-glycosylation in residue Asn137 of the polypeptide chain, as previously described. In addition, this analysis revealing the presence of glycan structures such as terminal sialic acid, N-acetylglucosamine and/or galactose.ConclusionTherefore, a stable platform for the production and purification of recombinant hRSPO1 from HEK293 cells was generated, leading to the production of a purified, fully characterized and biologically active protein product to be applied in Tissue Engineering.
Auxotrophic mutations of Trichophyton rubrum created by in vitro synthesized Cas9 ribonucleoprotein
Authors: Blechert Oliver , Mei Huan , Zang Xiaohui , Zheng Hailin , Liang Guanzhao , Liu Weida 
Published: January 2020

Abstract
Background
Trichophyton rubrum is an obligate human parasitic fungus and responsible for approximately 80–90% of dermatomycosis in human. Molecular genetic manipulations of this pathogen are challenging and available tools and protocols are only rudimentary. We adapt molecular genetics methods of well established fungal model organism, to knock out genes in T. rubrum. For the adaptation, crucial modifications are necessary. With the implementation of in vitro synthesized Cas9-sgRNA ribonucleoprotein complex, it is possible to adapt molecular genetic methods, to knock out genes in T. rubrum.

Results
The gene knock-out method is based on integration of a selection marker into the target site, to interrupt the gene translation. The target gene gets preassigned by the homologous sequence of the in vitro synthesized Cas9-sgRNA ribonucleoprotein complex. To develop the method, we first isolated and characterized a T. rubrum strain with a high amount of microconidia. Next, we developed a transformation protocol, whereby the Cas9-sgRNA ribonucleoprotein gets delivered into the fungal protoplast by the PEG method.
We knocked out the URA3 gene and resulted, as predicted, uracil auxotrophic strains. These strains can be used for specific gene knock-outs by reintegrating the URA3 fragment and selection on uracil lacking cultivation media. Exemplary, we knocked out the TRP3 gene and got the predicted phenotype, tryptophan auxotrophic strains. The mutation had been verified by sequencing.

Conclusions
We developed a method, based on in vitro synthesized Cas9-sgRNA ribonucleoprotein complex, for target specific gene knock-outs in T. rubrum. We knocked out the Ura3 gene and resulted uracil auxotrophic strains. These strains were used for target specific gene knock-outs by reintegrating the Ura3 fragment into the target gene site to interrupt the gene transcription. The developed method allows to adapt sophisticate gene manipulation methods of model fungal species to non-model species.
Remuneration systems of community health workers in India and promoted maternal health outcomes: a cross-sectional study
Authors: Koehn Hannah J. , Zheng Shenglin , Houser Robert F. , O’Hara Corey , Rogers Beatrice Lorge 
Published: January 2020

Abstract
Background
This study assessed the association of remuneration systems of paid-for-performance Accredited Social Health Activists (ASHAs) and salaried Anganwadi workers (AWWs) on seven maternal health outcomes in four states in India: Andhra Pradesh (AP), Chhattisgarh, Odisha (Orissa), and Uttar Pradesh (UP).

Methods
The cross-sectional study surveyed mothers of children aged 6–23 months. A total of 3455 mothers were selected via multistage cluster sampling. The seven health outcomes related to the community health worker (CHW) visits were: institutional delivery, complete immunization, exclusive breastfeeding for six months, timely introduction of complementary feeding, continued breastfeeding during child’s illness, handwashing, and awareness of Nutrition and Health Days (NHDs).

Results
The results varied by state. Mothers who received ASHA visits were significantly less likely to have an institutional delivery, timely introduction of complementary feeding, awareness of Nutrition and Health Days (NHDs), proper handwashing, and exclusive breastfeeding for the first six months in at least one of the four states. Conversely, AWW’s home visits were positively predictive of the following health outcomes in certain states: complete immunization for index child, continued breastfeeding during the child’s illness, handwashing, and awareness of NHDs.

Conclusions
ASHAs’ home visits were not more strongly associated with health outcomes for which they were paid than outcomes for which they were unpaid. AWWs’ home visits were positively associated with awareness of NHDs, and associations varied for other recommended health behaviors. Further research could elucidate the causes for successes and failures of CHW programs in different states of India.
“Can do, don’t do” are not the lazy ones: a longitudinal study on physical functioning in patients with COPD
Authors: Sievi Noriane A. , Brack Thomas , Brutsche Martin H. , Frey Martin , Irani Sarosh , Leuppi Jörg D. , Thurnheer Robert , Kohler Malcolm , Clarenbach Christian F. 
Published: January 2020

Abstract
Background and objective
Reduced physical capacity (PC) and physical activity (PA) are common in COPD patients and associated with poor outcome. However, they represent different aspects of physical functioning and interventions do not affect them in the same manner. To address this, a new PC-PA quadrant concept was recently generated to identify clinical characteristics of sub-groups of physical functioning. The objective of this study was to I) proof the new concept and to verify their differentiating clinical characteristics, II) evaluate the consistency of the concept over time, III) assess whether patients changed their quadrant affiliation over time, IV) and to test if changes in quadrant affiliations are associated with changes in clinical characteristics.

Methods
In a longitudinal, prospective, non-interventional cohort with mild to very severe COPD patients, PC and PA as well as respiratory variables, COPD-specific health status, comorbidities, survival, and exacerbations were yearly assessed.

Results
Data from 283 patients were analysed at baseline. Mean (min/max) follow-up time was 2.4 (0.5/6.8) years. The PC-PA quadrants could be characterized as follows: I) “can’t do, don’t do”: most severe and symptomatic, several comorbidities II) “can do, don’t do”: severe but less symptomatic, several comorbidities III) “can’t do, do do”: few patients, severe and symptomatic, less comorbidities IV) “can do, do do”: mildest and less symptomatic, less comorbidities, lowest exacerbation frequency. Of the 172 patients with at least one follow-up, 58% patients never changed their quadrant affiliation, while 17% declined either PC, PA or both, 11% improved their PC, PA or both, and 14% showed improvement and decline in PC, PA or both during study period. None of the clinical characteristics or their annual changes showed consistent significant and relevant differences between all individual sub-groups.

Conclusion
Our findings suggest that there are no clinical characteristics allowing to distinguish between the PC-PA quadrants and the concept seems not able to illustrate disease process. However, the already low PA but preserved PC in the “can do, don’t do” quadrant raises the question if regularly assessment of PA in clinical practice would be more sensitive to detect progressive deterioration of COPD compared to the commonly used PC.

Clinical trial registration
www.ClinicalTrials.gov, NCT01527773.
Immune cell phenotyping in low blood volumes for assessment of cardiovascular disease risk, development, and progression: a pilot study
Authors: Baumer Yvonne , Gutierrez-Huerta Cristhian A. , Saxena Ankit , Dagur Pradeep K. , Langerman Steven D. , Tamura Kosuke , Ceasar Joniqua N. , Andrews Marcus R. , Mitchell Valerie , Collins Billy S. , Yu Quan , Teague Heather L. , Playford Martin P. , Bleck Christopher K. E. , Mehta Nehal N. , McCoy J. Philip , Powell-Wiley Tiffany M. 
Published: January 2020

Abstract
Background
Cardiovascular disease (CVD) is the leading cause of death in the world. Given the role of immune cells in atherosclerosis development and progression, effective methods for characterizing immune cell populations are needed, particularly among populations disproportionately at risk for CVD.

Results
By using a variety of antibodies combined in one staining protocol, we were able to identify granulocyte, lymphocyte, and monocyte sub-populations by CD-antigen expression from 500 µl of whole blood, enabling a more extensive comparison than what is possible with a complete blood count and differential (CBC). The flow cytometry panel was established and tested in a total of 29 healthy men and women. As a proof of principle, these 29 samples were split by their race/ethnicity: African-Americans (AA) (N = 14) and Caucasians (N = 15). We found in accordance with the literature that AA had fewer granulocytes and more lymphocytes when compared to Caucasians, though the proportion of total monocytes was similar in both groups. Several new differences between AA and Caucasians were noted that had not been previously described. For example, AA had a greater proportion of platelet adhesion on non-classical monocytes when compared to Caucasians, a cell-to-cell interaction described as crucially important in CVD. We also examined our flow panel in a clinical population of AA women with known CVD risk factors (N = 20). Several of the flow cytometry parameters that cannot be measured with the CBC displayed correlations with clinical CVD risk markers. For instance, Framingham Risk Score (FRS) calculated for each participant correlated with immune cell platelet aggregates (PA) (e.g. T cell PA β = 0.59, p = 0.03 or non-classical monocyte PA β = 0.54, p = 0.02) after adjustment for body mass index (BMI).

Conclusion
A flow cytometry panel identified differences in granulocytes, monocytes, and lymphocytes between AA and Caucasians which may contribute to increased CVD risk in AA. Moreover, this flow panel identifies immune cell sub-populations and platelet aggregates associated with CVD risk. This flow cytometry panel may serve as an effective method for phenotyping immune cell populations involved in the development and progression of CVD.