bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of the Consolidated Framework for Implementation Research to examine nurses’ perception of the task shifting strategy for hypertension control trial in Ghana
Authors: Gyamfi Joyce , Allegrante John P. , Iwelunmor Juliet , Williams Olajide , Plange-Rhule Jacob , Blackstone Sarah , Ntim Michael , Apusiga Kingsley , Peprah Emmanuel , Ogedegbe Gbenga 
Published: January 2020

Abstract
Background
The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses’ perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation.

Methods
Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017. TASSH evaluated the comparative effectiveness of the WHO-PEN program versus provision of health insurance for blood pressure reduction in hypertensive adults. Qualitative data were analyzed using open and axial coding techniques with emerging themes mapped onto the Consolidated Framework for Implementation Research (CFIR).

Results
Three themes emerged following deductive analysis using CFIR, including: (1) Patient health goal setting- relative priority and positive feedback from nurses, which motivated patients to make healthy behavior changes as a result of their health being a priority; (2) Leadership engagement (i.e., medical directors) which influenced the extent to which nurses were able to successfully implement TASSH in their various facilities, with most directors being very supportive; and (3) Availability of resources making it possible to implement the TASSH protocol, with limited space and personnel time to carry out TASSH duties, limited blood pressure (BP) monitoring equipment, and transportation, listed as barriers to effective implementation.

Conclusion
Assessing stakeholders’ perception of the TASSH implementation process guided by CFIR is crucial as it provides a platform for the nurses to thoroughly evaluate the task shifting program, while considering the local context in which the program is implemented. The feedback from the nurses informed barriers and facilitators to implementation of TASSH within the current healthcare system, and suggested system level changes needed prior to scale-up of TASSH to other regions in Ghana with potential for long-term sustainment of the task shifting intervention.

Trial registration
Trial registration for parent TASSH study: NCT01802372. Registered February 27, 2013.
Integrating pathway elucidation with yeast engineering to produce polpunonic acid the precursor of the anti-obesity agent celastrol
Authors: Hansen Nikolaj L. , Miettinen Karel , Zhao Yong , Ignea Codruta , Andreadelli Aggeliki , Raadam Morten H. , Makris Antonios M. , Møller Birger L. , Stærk Dan , Bak Søren , Kampranis Sotirios C. 
Published: January 2020

Abstract
Background
Celastrol is a promising anti-obesity agent that acts as a sensitizer of the protein hormone leptin. Despite its potent activity, a sustainable source of celastrol and celastrol derivatives for further pharmacological studies is lacking.

Results
To elucidate the celastrol biosynthetic pathway and reconstruct it in Saccharomyces cerevisiae, we mined a root-transcriptome of Tripterygium wilfordii and identified four oxidosqualene cyclases and 49 cytochrome P450s as candidates to be involved in the early steps of celastrol biosynthesis. Using functional screening of the candidate genes in Nicotiana benthamiana, TwOSC4 was characterized as a novel oxidosqualene cyclase that produces friedelin, the presumed triterpenoid backbone of celastrol. In addition, three P450s (CYP712K1, CYP712K2, and CYP712K3) that act downstream of TwOSC4 were found to effectively oxidize friedelin and form the likely celastrol biosynthesis intermediates 29-hydroxy-friedelin and polpunonic acid. To facilitate production of friedelin, the yeast strain AM254 was constructed by deleting UBC7, which afforded a fivefold increase in friedelin titer. This platform was further expanded with CYP712K1 to produce polpunonic acid and a method for the facile extraction of products from the yeast culture medium, resulting in polpunonic acid titers of 1.4 mg/L.

Conclusion
Our study elucidates the early steps of celastrol biosynthesis and paves the way for future biotechnological production of this pharmacologically promising compound in engineered yeast strains.
Results of ultrasound-guided release of tarsal tunnel syndrome: a review of 81 cases with a minimum follow-up of 18 months
Authors: Iborra A. , Villanueva M. , Sanz-Ruiz P. 
Published: January 2020

Abstract
Background
This study aims to analyse the clinical results of ultrasound-guided surgery for the decompression of the tibial nerve, including its distal medial and lateral branches, to treat tarsal tunnel syndrome. These structures are the complete flexor retinaculum and the deep fascia of the abductor hallucis muscle, including individualised release of the medial and lateral plantar nerve tunnels.

Method
This is a retrospective review of 81 patients (36 men and 45 women) with an average age of 41 years old (32–62) and an average clinical course of 31 months (8–96) compatible with idiopathic tarsal tunnel syndrome, who underwent ultrasound-guided decompression of the proximal and distal tarsal tunnel between February 2015 and November 2017 (both months included), with a minimum follow-up of 18 months.

Results
Based on the Takakura et al. scale for the 81 patients, 76.54% obtained excellent results, 13.58% good results, and 9.87% poor results.
The patients with the longest course of symptoms displayed the worst results.

Conclusion
Although 9% of patients did not improve, ultrasound-guided tarsal tunnel release might be a viable alternative to conventional open approaches.
Using the knowledge-to-action framework with joint arthroplasty patients to improve the quality of care transition: a quasi-experimental study
Authors: Xu Yaping , Li Shuang , Zhao Peiyu , Zhao Jing 
Published: January 2020

Abstract
Background
Total joint arthroplasty is a mature and effective treatment for end-stage osteoarthritis. Assisting patients in completing the transition of the perioperative period and improving their satisfaction are important aspects of quality of care. This study aimed to investigate an intervention to improve the quality of care transition for joint arthroplasty patients informed by the knowledge-to-action (KTA) framework.

Methods
In this quasi-experimental study, a total of 160 patients who underwent joint arthroplasty at a tertiary hospital from September to November 2018 and January to March 2019 were selected as participants using convenience sampling. The control group received routine medical care, while the observation group received medical care based on the KTA framework. Transitional care quality was assessed by the Care Transition Measure (CTM), with follow-up 1 week after discharge.

Results
The observation group fared significantly better than the control group on general self-care preparation and written plan dimensions, as well as the quality of care transition. There was no significant difference in doctor–patient communication or health monitoring.

Conclusions
The KTA framework provides a logical, valuable tool for clinical work. Using the KTA framework for joint arthroplasty patients helps to improve the quality of care transition, which is worth promoting.
Correlation between GLA variants and alpha-Galactosidase A profile in dried blood spot: an observational study in Brazilian patients
Authors: Varela Patrícia , Mastroianni Kirsztajn Gianna , Motta Fabiana L. , Martin Renan P. , Turaça Lauro T. , Ferrer Henrique L. F. , Gomes Caio P. , Nicolicht Priscila , Mara Marins Maryana , Pessoa Juliana G. , Braga Marion C. , D’Almeida Vânia , Martins Ana Maria , Pesquero João B. 
Published: January 2020

Abstract
Background
Fabry disease is a rare X-linked inherited disorder caused by deficiency of α-Galactosidase A. Hundreds of mutations and non-coding haplotypes in the GLA gene have been described; however, many are variants of unknown significance, prompting doubts about the diagnosis and treatment. The α-Galactosidase A enzymatic activity in dried blood spot (DBS) samples are widely used for screening purposes; however, even when values below the normal are found, new tests are required to confirm the diagnosis. Here we describe an analysis of GLA variants and their correlation with DBS α-Galactosidase A enzymatic activity in a large Brazilian population with Fabry disease symptoms.

Results
We analyzed GLA variants by DNA sequencing of 803 male patients with suspected Fabry disease or belonging to high-risk populations; in 179 individuals, 58 different exonic variants were detected. From these, 50 are variants described as pathogenic and eight described as variants of unknown significance. The other individuals presented complex non-coding haplotypes or had no variants. Interestingly, the enzymatic activity in DBS was different among pathogenic variants and the other genotypes, including variants of unknown significance; the first presented mean of 12% of residual activity, while the others presented levels above 70% of the activity found in healthy controls.

Conclusion
The activity of α-Galactosidase A in DBS was markedly reduced in males with known pathogenic variants when compared with subjects presenting variants of unknown significance, non-coding haplotypes, or without variants, indicating a possible non-pathogenic potential of these latter genotypes. These findings bring a better understanding about the biochemical results of α-Galactosidase A in DBS samples, as well as the possible non-pathogenic potential of non-coding haplotypes and variants of unknown significance in GLA gene. These results certainly will help clinicians to decide about the treatment of patients carrying variants in the gene causing this rare but life-threatening disease.
Molecular basis of Leigh syndrome: a current look
Authors: Schubert Baldo Manuela , Vilarinho Laura 
Published: January 2020

AbstractLeigh Syndrome (OMIM 256000) is a heterogeneous neurologic disorder due to damage in mitochondrial energy production that usually starts in early childhood. The first description given by Leigh pointed out neurological symptoms in children under 2 years and premature death. Following cases brought some hypothesis to explain the cause due to similarity to other neurological diseases and led to further investigation for metabolic diseases. Biochemical evaluation and specific metabolic profile suggested impairment in energy production (OXPHOS) in mitochondria. As direct approach to involved tissues is not always possible or safe, molecular analysis is a great cost-effective option and, besides biochemical results, is required to confirm the underlying cause of this syndrome face to clinical suspicion. The Next Generation Sequencing (NGS) advance represented a breakthrough in molecular biology allowing simultaneous gene analysis giving short-time results and increasing the variants underlying this syndrome, counting over 75 monogenic causes related so far. NGS provided confirmation of emerging cases and brought up diagnosis in atypical presentations as late-onset cases, which turned Leigh into a heterogeneous syndrome with variable outcomes. This review highlights clinical presentation in both classic and atypical phenotypes, the investigation pathway throughout confirmation emphasizing the underlying genetic heterogeneity and increasing number of genes assigned to this syndrome as well as available treatment.
The effects of taurine supplementation on oxidative stress indices and inflammation biomarkers in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial
Authors: Maleki Vahid , Mahdavi Reza , Hajizadeh-Sharafabad Fatemeh , Alizadeh Mohammad 
Published: January 2020

Abstract
Background
Reduced serum level of taurine in type 2 diabetes mellitus (T2DM) was shown to be associated with the metabolic alterations and clinical complications of diabetes. Dietary supplementation with taurine may attenuate oxidative stress and inflammatory responses in T2DM as well as alleviate diabetes-induced complications. Hence, this study evaluated the effect of taurine supplementation on oxidative stress and inflammatory biomarkers in patients with T2DM.

Methods
Fifty patients with T2DM were randomly allocated to two groups to consume either taurine (containing 1000 mg taurine), or placebo (containing crystalline microcellulose) three times per day for 8 weeks. Anthropometric data, dietary intake, serum total antioxidant capacity (TAC), malondialdehyde (MDA), the activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), serum levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were assessed before and after intervention.

Results
There was a significant increase in SOD (5.1%, p = 0.004) and CAT (4.22%, p = 0.001) after 8 weeks of taurine supplementation. In addition, serum levels of MDA (26.33%, p = 0.001), hs-CRP (16.01%, p = 0.001), and TNF‐α (11.65%, p = 0.03) significantly decreased in the taurine group compared with baseline. Following treatment, the taurine group had fewer serum levels of MDA (p = 0.04), hs-CRP (p = 0.002) and TNF-α (p = 0.006) than the placebo group. Also, a significant increase was observed in SOD (p = 0.007), and CAT (p = 0.001) in the taurine group compared with the placebo group. There were no differences in the serum levels of IL-6 or TAC.

Conclusions
The findings of this study showed that taurine supplementation improved some oxidative stress indices and inflammatory biomarkers in patients with T2DM.
Trial registration The protocol of this clinical trial is registered with the Iranian Registry of Clinical Trials (http://www.IRCT.IR, identifier: IRCT20121028011288N16).
Repeat induced abortion and associated factors among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017
Authors: Waktola Mahlet Imana , Mekonen Dawit Gebeyehu , Nigussie Tewodros Seyoum , Cherkose Endeshaw Adimasu , Abate Addisu Taye 
Published: January 2020

Abstract
Objective
The aim of this study was to assess the proportion and determinants of repeat induced abortion among women seeking abortion care services at Debre Markos town health institutions, Amhara regional state, Ethiopia, 2017.

Result
From the total 567-sample size, 547 women were participated in the study making a response rate of 96.5%. In this study 191 women reported that they had at least one previous abortion, making the proportion of repeat induced abortion 34.9%. In multivariable logistic regression analysis; illiteracy (AOR = 8.45, 95% CI 1.85, 36.49), living in an urban area (AOR = 5.14, 95% CI 2.29, 11.53), having multiple sexual partner (AOR = 6.16, 95% CI 3.25, 11.68), consuming alcohol (AOR = 2.77, 95% CI 1.52, 5.05) and having a history of physical violence by a male partner (AOR = 2.68, 95% CI 1.45, 4.94) were significantly associated with repeat induced abortion at p value less than 0.05.
Exact solutions to cable equations in branching neurons with tapering dendrites
Authors: Yihe Lu , Timofeeva Yulia 
Published: January 2020

AbstractNeurons are biological cells with uniquely complex dendritic morphologies that are not present in other cell types. Electrical signals in a neuron with branching dendrites can be studied by cable theory which provides a general mathematical modelling framework of spatio-temporal voltage dynamics. Typically such models need to be solved numerically unless the cell membrane is modelled either by passive or quasi-active dynamics, in which cases analytical solutions can be reduced to calculation of the Green’s function describing the fundamental input-output relationship in a given morphology. Such analytically tractable models often assume individual dendritic segments to be cylinders. However, it is known that dendritic segments in many types of neurons taper, i.e. their radii decline from proximal to distal ends. Here we consider a generalised form of cable theory which takes into account both branching and tapering structures of dendritic trees. We demonstrate that analytical solutions can be found in compact algebraic forms in an arbitrary branching neuron with a class of tapering dendrites studied earlier in the context of single neuronal cables by Poznanski (Bull. Math. Biol. 53(3):457–467, 1991). We apply this extended framework to a number of simplified neuronal models and contrast their output dynamics in the presence of tapering versus cylindrical segments.
Targeting dePARylation for cancer therapy
Authors: Kassab Muzaffer Ahmad , Yu Lily L. , Yu Xiaochun 
Published: January 2020

AbstractPoly(ADP-ribosyl)ation (PARylation) mediated by poly ADP-ribose polymerases (PARPs) plays a key role in DNA damage repair. Suppression of PARylation by PARP inhibitors impairs DNA damage repair and induces apoptosis of tumor cells with repair defects. Thus, PARP inhibitors have been approved by the US FDA for various types of cancer treatment. However, recent studies suggest that dePARylation also plays a key role in DNA damage repair. Instead of antagonizing PARylation, dePARylation acts as a downstream step of PARylation in DNA damage repair. Moreover, several types of dePARylation inhibitors have been developed and examined in the preclinical studies for cancer treatment. In this review, we will discuss the recent progress on the role of dePARylation in DNA damage repair and cancer suppression. We expect that targeting dePARylation could be a promising approach for cancer chemotherapy in the future.
Screening for esophageal adenocarcinoma and precancerous conditions (dysplasia and Barrett’s esophagus) in patients with chronic gastroesophageal reflux disease with or without other risk factors: two systematic reviews and one overview of reviews to inform a guideline of the Canadian Task Force on Preventive Health Care (CTFPHC)
Authors: Hamel Candyce , Ahmadzai Nadera , Beck Andrew , Thuku Micere , Skidmore Becky , Pussegoda Kusala , Bjerre Lise , Chatterjee Avijit , Dennis Kristopher , Ferri Lorenzo , Maziak Donna E. , Shea Beverley J. , Hutton Brian , Little Julian , Moher David , Stevens Adrienne 
Published: January 2020

Abstract
Background
Two reviews and an overview were produced for the Canadian Task Force on Preventive Health Care guideline on screening for esophageal adenocarcinoma in patients with chronic gastroesophageal reflux disease (GERD) without alarm symptoms. The goal was to systematically review three key questions (KQs): (1) The effectiveness of screening for these conditions; (2) How adults with chronic GERD weigh the benefits and harms of screening, and what factors contribute to their preferences and decision to undergo screening; and (3) Treatment options for Barrett’s esophagus (BE), dysplasia or stage 1 EAC (overview of reviews).

Methods
Bibliographic databases (e.g. Ovid MEDLINE®) were searched for each review in October 2018. We also searched for unpublished literature (e.g. relevant websites). The liberal accelerated approach was used for title and abstract screening. Two reviewers independently screened full-text articles. Data extraction and risk of bias assessments were completed by one reviewer and verified by another reviewer (KQ1 and 2). Quality assessments were completed by two reviewers independently in duplicate (KQ3). Disagreements were resolved through discussion. We used various risk of bias tools suitable for study design. The GRADE framework was used for rating the certainty of the evidence.

Results
Ten studies evaluated the effectiveness of screening. One retrospective study reported no difference in long-term survival (approximately 6 to 12 years) between those who had a prior esophagogastroduodenoscopy and those who had not (adjusted HR 0.93, 95% confidence interval (CI) 0.58–1.50). Though there may be higher odds of a stage 1 diagnosis than a more advanced diagnosis (stage 2–4) if an EGD had been performed in the previous 5 years (OR 2.27, 95% CI 1.00–7.67). Seven studies compared different screening modalities, and showed little difference between modalities. Three studies reported on patients’ unwillingness to be screened (e.g. due to anxiety, fear of gagging). Eleven systematic reviews evaluated treatment modalities, providing some evidence of early treatment effect for some outcomes.

Conclusions
Little evidence exists on the effectiveness of screening and values and preferences to screening. Many treatment modalities have been evaluated, but studies are small. Overall, there is uncertainty in understanding the effectiveness of screening and early treatments.

Systematic review registrations
PROSPERO (CRD42017049993 [KQ1], CRD42017050014 [KQ2], CRD42018084825 [KQ3]).
PHYAlert: identity spoofing attack detection and prevention for a wireless edge network
Authors: Jiang Zhiping , Zhao Kun , Li Rui , Zhao Jizhong , Du Junzhao 
Published: January 2020

AbstractDelivering service intelligence to billions of connected devices is the next step in edge computing. Wi-Fi, as the de facto standard for high-throughput wireless connectivity, is highly vulnerable to packet-injection-based identity spoofing attacks (PI-ISAs). An attacker can spoof as the legitimate edge coordinator and perform denial of service (DoS) or even man-in-the-middle (MITM) attacks with merely a laptop. Such vulnerability leads to serious systematic risks, especially for the core edge/cloud backbone network.In this paper, we propose PHYAlert, an identity spoofing attack alert system designed to protect a Wi-Fi-based edge network. PHYAlert profiles the wireless link with the rich dimensional Wi-Fi PHY layer information and enables real-time authentication for Wi-Fi frames. We prototype PHYAlert with commercial off-the-shelf (COTS) devices and perform extensive experiments in different scenarios. The experiments verify the feasibility of spoofing detection based on PHY layer information and show that PHYAlert can achieve an 8x improvement in the false positive rate over the conventional signal-strength-based solution.