bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability of Patient-centered Hypertension Education Delivered by Community Health Workers among People Living with HIV/AIDS in Rural Uganda
Authors: Batte Charles , Mukisa John , Rykiel Natalie , Mukunya David , Checkley William , Knauf Felix , Kalyesubula Robert , Siddharthan Trishul 
Published: November 2020

Abstract
Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material ( PocketDoktor Ô ) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor Ô , financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktorÔ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.
The Role of Managerial Leadership in Sickness Absence in Health and Social Care: Antecedent or Moderator in the Association between Psychosocial working Conditions and Register-based Sickness Absence? A Longitudinal Study based on a Swedish Cohort.
Authors: Stengård Johanna , Peristera Paraskevi , Johansson Gun , Nyberg Anna 
Published: November 2020

Abstract
Background: The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership i) is associated with sickness absence directly, ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence.Methods: Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence).Results: A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence.Conclusions: Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.
Analysis of Epidemiological Indices of Coronavirus Disease 2019 (COVID-19) in Countries with High-incidence
Authors: Javan-Noughabi Javad , Mousavi Sayed Ali , Faramarzi Ahmad , Shabanikiya Hamidreza 
Published: November 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) poses an extraordinary threat to global public health. According to a report by WHO, COVID-19 has affected approximately 20 million patients in the world and has caused nearly 728 thousand deaths as of 10 August 2020. The purpose of the current study was to provide an estimate and comparison of epidemiological indices on COVID-19 in 10 countries with high-incidence. Methods: We did a descriptive and comparative study intending to analyze the epidemiological indices of COVID-19 in countries with high-incidence, using the data published by the WHO until August 10, 2020. We estimated the incidence and mortality rate per 100,000 population on a daily and general level. Results: The mean of fatality rate in 10 countries was almost 3.26%. The highest value on the fatality rate was obtained with 10.93% in Mexico, followed by 5.64% in Iran and 4.43 in Peru. The lowest value on the fatality rate is related to the Russian Federation and South Africa at 1.68% and 1.86%, respectively. Chile had the highest incidence rate with 1951 cases per 100,000 population. This rate is followed by 1496, 1428 and 1417 in the United States of America (USA), Peru and Brazil, respectively. Conclusions: Until August 10, 2020, COVID-19 has affected 13.7 million patients and caused 445.2 thousand deaths in 10 countries with high-incidence. This study shows that each country has a specific pattern of COVID-19.
A Community Pharmacist-led Smoking Cessation Intervention Using a Smartphone App (PharmQuit): A Randomized Controlled Trial
Authors: Asayut Narong , Olson Phayom Sookaneknun , Kanjanasilp Juntip , Thanarat Preut , Senkraigul Bhattaraporn , Sittisarn Chuthathip , Suksawat Suratsawatee 
Published: November 2020

Abstract
Background: WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. PharmQuit, a smartphone app, was developed to support smoking cessation efforts by pharmacists taking into consideration the design of the app according to the needs of smokers. This study evaluated the effectiveness of smoking cessation services conducted by community pharmacists using PharmQuit compared with standard care.Methods: An open-label prospective, randomized, controlled trial was conducted. Stratified random sampling by sex, age, and nicotine addiction was used to allocate participants to either the intervention group or control group. Eligible participants were smokers 18 years old or older who smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies situated in three provinces in Thailand. In the intervention group, participants received smoking cessation services by community pharmacists using PharmQuit. The control group received standard care delivered by community pharmacists. Both groups were scheduled follow-ups at day 7, 14, 30, 60, 120, and 180. The primary outcomes were quit rate and number of cigarettes smoked per day. Secondary outcomes were exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. Analysis using the intent-to-treat principle was carried out. Results: A total of 156 smokers were randomly assigned to either the intervention (n=78) or control (n=78) group. Smoking cessation rates and the number of cigarettes smoked per day were significantly better over the follow-up visits in both groups (p<0.05). However, there were no statistically significant differences between the two groups. Adherence rate to the smoking cessation program was higher in the intervention group than the control group (74 days vs 60 days, p>0.05). Relapse rate was found to be lower in the intervention group as compared to the control group (28.6% vs 71.4%). Conclusions: The results showed obvious benefits of the community pharmacist’s contribution in helping smokers quit smoking. PharmQuit was not better than just pharmacist’s counselling but it might help to obtain better adherence to smoking cessation programs, and have less likelihood of relapse. Trial registration: Thai Clinical Trials Registry: TCTR20200925004. Registration date September 25, 2020 – Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841
The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis
Authors: Clarke Jenelle Marie , Waring Justin , Bishop Simon , Hartley Jean , Exworthy Mark , Fulop Naomi , Ramsay Angus , Roe Bridget 
Published: November 2020

Abstract
Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in health care services.Results 62 papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is compromised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through six dimensions of leadership: personal performance, contextual awareness, inter-personal influence, stakeholder engagement, networking and policy influence.Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.
Netrin-1 Ameliorates Postoperative Delirium-like Behavior in Aged Mice by Suppressing Neuroinflammation and Restoring Impaired Blood Brain Barrier Permeability
Authors: Li Ke , Wang Jiayu , Chen Lei , Guo Meimei , Zhou Ying , Li Xiaofeng , Zhang Zongze , Peng Mian 
Published: November 2020

Abstract
Background Postoperative delirium (POD) is a common and serious postoperative complication in elderly patients, of which the underlying mechanism is elusive and without effective therapy at present. In recent years, the neuroinflammatory hypothesis has been developed in the pathogenesis of POD. Netrin-1, an axonal guidance molecule, has been reported to have strong inflammatory regulatory and neuroprotective effects.Methods We applied treatment with Netrin-1(45 µg/kg) in aged mice by using the POD model with a simple laparotomy to assess systemic inflammatory, neuroinflammation by detecting interleukin-6 (IL-6), interleukin-10 (IL-10), high mobility group box chromosomal protein-1(HMGB-1) and assessing the reactive states of microglia, permeability of blood-brain barrier (BBB) by detecting cell junction proteins and leakage of dextran, and behavior of the aged mice.Results We found that a single dose of Netrin-1 prophylaxis decreased the expression of IL-6 and HMGB-1, and upregulated the expression of IL-10 in peripheral blood, hippocampus and prefrontal cortex. Nerin-1 reduced activation of microglia cells in the hippocampus and prefrontal cortex and improved the POD-like behavior. Besides, Netrin-1 also attenuated the anesthesia/surgery-induced increase in BBB permeability by up-regulating the expression of tight junction-associated proteins such as ZO-1, claudin-5, and occludin.Conclusions These findings confirm the anti-inflammatory and BBB protective effects of Netrin-1 in an inflammatory environment in vivo and provide better insights into the pathophysiology and potential treatment of POD.
Discovery of metabolic biomarkers for gestational diabetes mellitus in a Chinese population
Authors: Lu Wenqian , Luo Mingjuan , Fang Xiangnan , Zhang Rong , Tang Mengyang , Yu Xiangtian , Hu Cheng 
Published: November 2020

Abstract
Background Metabolomics has provided new insights into the pathology of GDM and has revealed potential biomarkers related to GDM; however, previous findings lack consistency, and systemic analysis of GDM with metabolites is required for providing more clues for GDM diagnosis and mechanism research. This study aims to reveal metabolic differences between normal pregnant women and GDM patients in the second- and third-trimester stages and to confirm the clinical relevance of these new findings.Methods Using ultra-performance liquid chromatography coupled to tandem mass spectrometry system, metabolites were quantitated with the serum samples of GDM and normal pregnancies in second- and third-trimester stages in a Chinese population. Samples were obtained from 200 healthy pregnant women and 200 GDM women in the second trimester, 199 normal controls, and 199 GDM patients in the third trimester at the University of Hong Kong-Shenzhen Hospital. Both function and pathway analyses were applied to find biological roles involved in the two sets of metabolites. We then identified the trimester stage-specific GDM metabolite biomarkers by combining a few machine learning approaches, and the logistic regression models based on selected biomarkers were constructed to evaluate predictive efficiency. Finally, the weighted gene co-expression network analysis method was used to further capture the associations between metabolite modules with biomarkers and clinical indices.Results The associations of metabolites with GDM were evaluated, with 57 differentially expressed metabolites (DEMs) in the second-trimester group and 72 DEMs in the third-trimester group. The DEMs, functions, and pathways showed remarkable differences between second- and third-trimester groups. Thus, stage specific GDM biomarkers were further identified, and the logistic regression models for these metabolite biomarkers achieved the area under the curve values of 0.807 and 0.81 for the second- and third-trimester groups, respectively. The significant associations between the discovered DEMs/biomarkers and GDM-related indices suggest their clinical relevance with GDM and hyperglycemia in pregnant women.Conclusions The present study shows the metabolomics profile in the second- and third-trimester stages in pregnant women with and without GDM. Pathways, DEMs and their associations with GDM related indices have been found. Indeed, further studies are warranted to confirm our findings.
Microdialysis for Chronic Exertional Compartment Syndrome
Authors: Lohrer Heinz , Klein Jochen , Nauck Tanja , Schönberg Tobias 
Published: November 2020

Abstract
Background: Diagnosing chronic exertional compartment syndrome (CECS) is still a challenge. An increase in intramuscular pressure during and following exercise is accepted as the diagnostic standard. However, neither the methods used nor the interpretation of the obtained results are sufficiently standardized. Methods: In the present study, the metabolic state of CECS patients was investigated using microdialysis. We hypothesized that there was no difference in intramuscular concentrations of glucose, lactate, glutamate, and glycerol before and after exercise (H10) or between patients suffering from CECS and healthy control subjects (H20). This study was designed as an explorative case-control study (level of evidence III). Twelve patients suffering from CECS of the lower leg and six matched asymptomatic control subjects underwent microdialysis in the anterior (n = 7) or deep posterior compartment (n = 11) of the leg. Following ultrasound-guided insertion of the microdialysis catheters, ten-minute fractions of the dialysates were collected first during rest and then following fatigue- or pain-induced discontinuation of exercise. Dialysates were analysed for lactate, glucose, glutamate, and glycerol concentrations 6 × 10 min before and 6 × 10 min after exercise. Results: Exercise-induced increases in lactate, glutamate, and glycerol concentrations were detected in both CECS patients and control subjects (all p < 0.001). No differences between CECS patients and control subjeccts were found by comparing the intramuscular glucose, lactate, glutamate, and glycerol concentrations at rest and following exercise (all p > 0.05). Conclusions: We found exercise-induced increases in the lactate, glutamate, and glycerol levels in skeletal muscle. However, the metabolic changes did not differentiate CECS patients from healthy subjects. Trial registration: The registration trial number is DRKS00021589 on DRKS. 'Retrospectively registered'. Date of registration: April 4, 2020
Mitochondrial protein CMPK2 regulates IFN-alpha-enhanced foam cell formation, potentially contributing to premature atherosclerosis in SLE
Authors: Lai Jenn-Haung , Hung Li-Feng , Huang Chuan-Yueh , Wu De-Wei , Wu Chien-Hsiang , Ho Ling-Jun 
Published: November 2020

Abstract
Background: Premature atherosclerosis occur in patients with systemic lupus erythematosus (SLE); however, the mechanisms remain unclear. Both mitochondrial machinery and proinflammatory cytokine interferon-alpha (IFN-α) potentially contribute to atherogenic processes in SLE. Here, we explore the roles of the mitochondrial protein cytidine/uridine monophosphate kinase 2 (CMPK2) in IFN-α-mediated pro-atherogenic events.Methods: Foam cell measurements were performed by oil red O staining, Dil-oxLDL uptake and the BODIPY approach. The mRNA and protein levels were measured by qPCR and Western blotting, respectively. Isolation of CD4+ T cells and monocytes was performed with monoclonal antibodies conjugated with microbeads. Manipulation of protein expression was conducted by either small interference RNA (siRNA) knockdown or CRISPR/Cas9 knockout. The expression of mitochondrial reactive oxygen species (mtROS) was determined by flow cytometry and confocal microscopy.Results: IFN-α enhanced oxLDL-induced foam cell formation and Dil-oxLDL uptake by macrophages. In addition to IFN-α, several triggers of atherosclerosis, including thrombin and IFN-γ, can induce CMPK2 expression, which was elevated in CD4+ T cells and CD14+ monocytes isolated from SLE patients compared to those isolated from controls. IFN-α-induced CMPK2 expression was inhibited by Janus kinase (JAK)1/2 and tyrosine kinase 2 (Tyk2) inhibitors. Both the knockdown and knockout of CMPK2 attenuated IFN-α-mediated foam cell formation, which involved the reduction of scavenger receptor class A (SR-A) expression. CMPK2 also regulated IFN-α-enhanced mtROS production and inflammasome activation.Conclusions: The study suggests that CMPK2 plays contributing roles in the pro-atherogenic effects of IFN-α and may represent a novel potential therapeutic target for SLE that should be further evaluated.
A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.
Authors: Mohanty Itismita , Niyonsenga Theo , Cochrane Tom , Rickwood Debra 
Published: November 2020

Abstract
Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.