bluuebunny/crossref_metadata_2025_split huggingface dataset:
How prepared are healthcare professionals for delivering physical activity guidance to those with diabetes? A formative evaluation
Authors: Kime N. , Pringle A. , Zwolinsky S. , Vishnubala D. 
Published: January 2020

Abstract
Background
Physical activity is recognised as important for diabetes management and improved overall health of individuals with diabetes, yet many adults with diabetes are inactive. Healthcare professionals have been identified as key to promoting physical activity, including individuals with diabetes, but are ill-prepared to deliver this. Our paper evaluates the barriers/facilitators of healthcare professionals’ delivery of physical activity guidance to adults with diabetes and aims to inform efforts to investigate and enhance their preparedness to promote physical activity.

Methods
A sequential mixed method, two-phase design was adopted involving a purposeful sample of healthcare professionals. Phase one was an online pilot survey designed to test assumptions around healthcare professionals’ knowledge, training and preparedness to deliver physical activity guidance. Phase two comprised eighteen semi-structured interviews, thematically analysed to provide an in-depth exploration of healthcare professionals’ experiences of delivering physical activity guidance to adults with diabetes.

Results
Healthcare professionals are committed to promoting physical activity to adults with diabetes and are reasonably confident in giving basic, generic guidance. Yet, significant challenges prevent them from achieving this in their practice, including: lack of education and training around physical activity, diabetes and health; ignorance of recommended physical activity and diabetes guidelines; lack of awareness of referral options; limited time and accessibility to appropriate resources. Nevertheless, healthcare professionals believed discussions around physical activity needed to be an integral part of consultations, incorporating improved communication strategies for conveying key physical activity messages.

Conclusions
HCPs have a key role in the promotion of physical activity to people with long-term conditions such as diabetes and they are identified within both the strategic policy context and national interventions for physical activity. Yet, this study indicated that HCPs face multiple and at times complex barriers to physical activity promotion generally and with diabetes patients. Conversely HCPs also reported what works, why and how, when promoting physical activity. Rich information derived from the day-to-day, working healthcare professional is integral to shaping future practices going forward. The bottom up, iterative design adopted in this study provides an approach to tap into this information.
The transfer of knowledge on integrated care among five European regions: a qualitative multi-method study
Authors: Grooten Liset , Vrijhoef Hubertus Johannes Maria , Alhambra-Borrás Tamara , Whitehouse Diane , Devroey Dirk 
Published: January 2020

Abstract
Background
To examine how the knowledge transfer processes unfolded within SCIROCCO, a EU funded project (3rd Health Programme (2014–2020)) that aimed to facilitate the process of knowledge sharing across five European regions, to speed up adoption and scaling-up of integrated care initiatives.

Methods
A qualitative multi-method design was used. Data collection methods included focus groups, project documents and action plans of the regions. The data was analysed using a qualitative content-analysis procedure, which was guided by the frameworks of knowledge exchange and the why, whose, what, how framework for knowledge mobilisers.

Results
All five components (including the themes) of knowledge exchange could be identified in the approach developed on the knowledge transfer processes. The four questions and accompanying categories of the framework of knowledge mobilisation were also identified to a large degree.

Conclusions
The observed incorporation of distinct forms of knowledge from multiple sources and the observed dynamic and fluid knowledge transfer processes both suggest that SCIROCCO developed a comprehensive knowledge transfer approach aiming to enable the adoption and scaling-up of integrated care. Overall, the multi-method qualitative nature of this research has allowed some new and practical insights in the knowledge transfer activities on integrated care between several European regions. To obtain a clear understanding of the content of the knowledge transfer approaches, which could assist the operationalising of models to support the evaluation of knowledge transfer activities, it is strongly recommended that further research of this type should be conducted in other research settings.
Paediatric nurses’ general self-efficacy, perceived organizational support and perceived professional benefits from Class A tertiary hospitals in Jilin province of China: the mediating effect of nursing practice environment
Authors: Cheng Linan , Cui Yajuan , Chen Qian , Ye Yansheng , Liu Yingchun , Zhang Fengying , Zeng Weiyan , Hu Xiuying 
Published: January 2020

AbstractBackgroundGeneral self-efficacy is considered one of the most influential parameters affecting the quality of clinical practice and nurses’ perceived professional benefits (NPPB). Perceived organizational support (POS) is regarded as being central in understanding job-related attitudes, and it is important to enhance POS for nurses to maintain their current employment. NPPB can further reduce nurses’ job burnout and turn-over intention. Many studies have explored the relationships among general self-efficacy, POS, nursing practice environment (NPE) and NPPB. However, a moderating effect of NPE has not been fully explored in nurses, especially among paediatric nurses.MethodsA descriptive cross-sectional study was conducted from July to October 2018 with 300 paediatric nurses from 3 Class A tertiary hospitals in Jilin Province. The respondents completed the General Self-Efficacy Scale, Perceived Organizational Support Scale, Practice Environment Scale and Nurses’ Perceived Professional Benefits Scale. The data were analyzed using path analysis and SPSS (version 23.0, IBM).ResultsGeneral self-efficacy and POS were significantly positively associated with NPPB, which showed that the model had a good fit to the data. NPE was found to play a partial mediating role between POS and NPPB and also had a complete mediating role between general self-efficacy and NPPB.ConclusionsThe results suggest that general self-efficacy indirectly influences NPPB, and POS directly and indirectly influences NPPB by NPE. Effective measures should be taken to improve nurses’ practice environment in hospitals to raise nurses’ enthusiasm and confidence in their work.
Patients’ satisfaction with clinical Laboratory Services in Public Hospitals in Ethiopia
Authors: Hailu Hiwot Amare , Desale Adinew , Yalew Anteneh , Asrat Habtamu , Kebede Sisay , Dejene Daniel , Abebe Hiwot , Gashu Andargachew , Yenealem Dereje , Moges Birhan , Yemanebrhane Nebiyou , Melese Daniel , Gurmessa Ashebir , Mohammed Awad , Getu Zekaryas , Ayana Gonfa , Kebede Adisu , Abate Ebba 
Published: January 2020

AbstractBackgroundKnowing customers’ level of satisfaction is relevant to improve and provide quality health care services. In the clinical laboratory, monitoring customers’ satisfaction is an important indicator of the quality management system and required by international laboratory standards. However, in Ethiopia, there has not been baseline data about the satisfaction level of patients’ with laboratory services at the national level. The aim of this national level survey was to assess patients’ satisfaction level with laboratory services at public hospitals in Ethiopia.MethodsA national survey was conducted using an institutional based cross-sectional study design was employed from 01 to 30 November 2017. A total of 2399 patients were selected randomly from 60 public hospitals. Data was collected using structured questionnaire, entered in Epi Info and analyzed with SPSS software. Multiple logistic regression model was fitted to identify predictors of patients’ satisfaction with laboratory services. Ap-value of less than 0.05 was taken as statistically significant.ResultOverall, 78.6% of the patients were satisfied with the clinical laboratory services. Patients were dissatisfied with cleanness of latrine (47%), long waiting time (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%) and latrine location (20%), availability of requested service (18%), unfair payment of service (17%) and missing of result (12%). The educational status (P = 0.032), and distance (P = 0.000) were significantly associated with client overall satisfaction level.ConclusionMost laboratory patients’ were satisfied with the service provided by public hospital laboratories in public hospitals in Ethiopia. However, patients’ were dissatisfied with the accessibility of sites, adequacy of waiting area, cleanness of latrine, long TAT, communication, missing of results, availability of requested service and cost of service. Therefore, responsible bodies in each level should act on the identified gaps and improve the need of patients in each hospital laboratory. In addition, all hospital laboratories should conduct a satisfaction survey and meet the needs of laboratory patients.
Favorable outcome of pheochromocytoma in a dog with atypical Cushing’s syndrome and diabetes mellitus following medical treatment: a case report
Authors: Lee Ga-Won , Yoo Cho-Rong , Lee Dan , Park Hee-Myung 
Published: January 2020

Abstract
Background
Pheochromocytoma (PCC) has poor prognosis and adrenalectomy is hard to be performed, in case of caudal vena cava invasion. The long-term administration of phenoxybenzamine in PCC has not been reported in dogs.

Case presentation
A 14-year-old castrated male Poodle dog presented with an abdominal mass. On physical examination, hypertension, increased lens opacity, calcinosis cutis, generalized alopecia, and systolic murmur were observed. Serum chemistry and urinalysis profiles revealed hyperglycemia, hypercholesterolemia, elevated liver enzymes, and glucosuria. Abdominal ultrasonography showed a right adrenal mass with invasion of the caudal vena cava, which was cytologically diagnosed as suspected PCC. An adrenal mass (width × height × length, 28 × 26 × 48 mm3) was found on computed tomography and diagnosed as PCC with increased plasma metanephrines and normetanephrines. An adrenocorticotropin hormone stimulation test showed elevated adrenal hormones (androstenedione, estradiol, progesterone, and 17-OH progesterone) with normal cortisol, compatible with atypical Cushing’s syndrome. The dog was managed with trilostane, phenoxybenzamine, and insulin therapy. Glycosylated hemoglobin and fructosamine levels gradually decreased, and hypertension resolved. In the 10-month follow-up period, the liver enzymes levels gradually decreased, and the clinical signs of the dog were well-controlled without deterioration.

Conclusions
This case report describes long-term medical management without adrenalectomy of PCC complicated with atypical Cushing’s syndrome and DM.
RETRACTED ARTICLE: Circular RNA circ_0003204 inhibits proliferation, migration and tube formation of endothelial cell in atherosclerosis via miR-370-3p/TGFβR2/phosph-SMAD3 axis
Authors: Zhang Shanchao , Song Guixiang , Yuan Jing , Qiao Shan , Xu Shan , Si Zhihua , Yang Yang , Xu Xuxu , Wang Aihua 
Published: January 2020

Abstract
Background
Circular RNAs (circRNAs) represent a class of non-coding RNAs (ncRNAs) which are widely expressed in mammals and tissue-specific, of which some could act as critical regulators in the atherogenesis of cerebrovascular disease. However, the underlying mechanisms by which circRNA regulates the ectopic phenotype of endothelial cells (ECs) in atherosclerosis remain largely elusive.

Methods
CCK-8, transwell, wound healing and Matrigel assays were used to assess cell viability, migration and tube formation. QRT-qPCR and Immunoblotting were used to examine targeted gene expression in different groups. The binding sites of miR-370-3p (miR-370) with TGFβR2 or hsa_circ_0003204 (circ_0003204) were predicted using a series of bioinformatic tools, and validated using dual luciferase assay and RNA immunoprecipitation (RIP) assay. The localization of circ_0003204 and miR-370 in ECs were investigated by fluorescence in situ hybridization (FISH). Gene function and pathways were enriched through Metascape and gene set enrichment analysis (GSEA). The association of circ_0003204 and miR-370 in extracellular vesicles (EVs) with clinical characteristics of patients were investigated using multiple statistical analysis.

Results
Circ_0003204, mainly located in the cytoplasm of human aorta endothelial cells (HAECs), was upregulated in the ox-LDL-induced HAECs. Functionally, the ectopic expression of circ_0003204 inhibited proliferation, migration and tube formation of HAECs exposed to ox-LDL. Mechanically, circ_0003204 could promote protein expression of TGFβR2 and its downstream phosph-SMAD3 through sponging miR-370, and miR-370 targeted the 3′ untranslated region (UTR) of TGFβR2. Furthermore, the expression of circ_0003204 in plasma EVs was upregulated in the patients with cerebral atherosclerosis, and represented a potential biomarker for diangnosis and prognosis of cerebrovascular atherogenesis.

Conclusions
Circ_0003204 could act as a novel stimulator for ectopic endothelial inactivation in atherosclerosis and a potential biomarker for cerebral atherosclerosis.
Bile and urine peptide marker profiles: access keys to molecular pathways and biological processes in cholangiocarcinoma
Authors: Voigtländer Torsten , Metzger Jochen , Husi Holger , Kirstein Martha M. , Pejchinovski Martin , Latosinska Agnieszka , Frantzi Maria , Mullen William , Book Thorsten , Mischak Harald , Manns Michael P. 
Published: January 2020

AbstractBackgroundDetection of cholangiocarcinoma (CCA) remains a diagnostic challenge. We established diagnostic peptide biomarkers in bile and urine based on capillary electrophoresis coupled to mass spectrometry (CE-MS) to detect both local and systemic changes during CCA progression. In a prospective cohort study we recently demonstrated that combined bile and urine proteome analysis could further improve diagnostic accuracy of CCA diagnosis in patients with unknown biliary strictures. As a continuation of these investigations, the aim of the present study was to investigate the pathophysiological mechanisms behind the molecular determinants reflected by bile and urine peptide biomarkers.MethodsProtease mapping and gene ontology cluster analysis were performed for the previously defined CE-MS based biomarkers in bile and urine. For that purpose, bile and urine peptide profiles (from samples both collected at the date of endoscopy) were investigated from a representative cohort of patients with benign (n = 76) or CCA-associated (n = 52) biliary strictures (verified during clinical follow-up). This was supplemented with a literature search for the association of the individual biomarkers included in the proteomic patterns with CCA or cancer progression.ResultsFor most of the peptide markers, association to CCA has been described in literature. Protease mapping revealed ADAMTS4 activity in cleavage of both bile and urine CCA peptide biomarkers. Furthermore, increased chymase activity in bile points to mast cell activation at the tumor site. Gene ontology cluster analysis indicates cellular response to chemical stimuli and stress response as local and extracellular matrix reorganization by tissue destruction and repair as systemic events. The analysis further supports that the mapped proteases are drivers of local and systemic events.ConclusionsThe study supports connection of the CCA-associated peptide biomarkers to the molecular pathophysiology and indicates an involvement in epithelial-to-mesenchymal transition, generation of cancer-associated fibroblasts and activation of residual immune cells. Proteases, extracellular matrix components, inflammatory cytokines, proangiogenic, growth and vasoactive factors released from the tumor microenvironment are drivers of systemic early events during CCA progression.
Blood eosinophil count, a marker of inhaled corticosteroid effectiveness in preventing COPD exacerbations in post-hoc RCT and observational studies: systematic review and meta-analysis
Authors: Harries Timothy H. , Rowland Victoria , Corrigan Christopher J. , Marshall Iain J. , McDonnell Lucy , Prasad Vibhore , Schofield Peter , Armstrong David , White Patrick 
Published: January 2020

Abstract
Background
Blood eosinophil count has been proposed as a predictor of response to inhaled corticosteroid (ICS) in the prevention of acute exacerbations of COPD. An optimal threshold of blood eosinophil count for prescribing ICS has not been agreed. Doubt has been cast on the role by observational studies. The role of inhaled corticosteroids in this relationship, independent of long-acting bronchodilators, has not been examined.

Methods
We conducted a systematic review of post-hoc analyses of randomised controlled trials (RCTs) and observational studies examining three blood eosinophil thresholds and the independent role of ICS. Included studies were categorised by the form (relative or absolute count) and cut point of eosinophil threshold used. Thresholds assessed were relative eosinophil count of 2%, and absolute counts of 150 cells/μL and 300 cells/μL. Three meta-analyses of the effect of ICS use in post-hoc analyses of RCTs based on these counts were carried out. Initial analysis included all studies of ICS vs. any non-ICS regimen. Further analysis examined the effect of ICS, independent of the effect of long-acting bronchodilators.

Results
Sixteen studies examined the association between blood eosinophil count and response of exacerbation risk to ICS, in COPD patients. Eleven studies (25,881 patients) were post-hoc analyses of RCTs. Five studies (109,704 patients) were retrospective observational studies. The independent effect of ICS on the reduction of exacerbation risk was 20% at ≥2% blood eosinophil threshold (RR, 0.80; 95% CI, 0.74–0.85), 35% at ≥150 cells/μL blood eosinophil threshold (RR, 0.65; 0.52–0.79), and 39% at ≥300 cells/μL blood eosinophil threshold (RR, 0.61; 0.44–0.78). No association was found in four out of five observational studies.

Conclusion
This is the first systematic review to assess, in post-hoc analyses of RCTs, the independent effect of ICS in reducing the risk of COPD exacerbation across a range of blood eosinophil thresholds. Association between ICS prescription and reduced exacerbation risk at these thresholds was confirmed. The lack of association found in the observational studies questions the relevance of these observations to a “real world” COPD population. To clarify the clinical utility of this biomarker, the association should be tested in prospective effectiveness studies.
Patient-derived xenografts of different grade gliomas retain the heterogeneous histological and genetic features of human gliomas
Authors: Zeng Wenxin , Tang Zhaohua , Li Yongguo , Yin Guangnian , Liu Zili , Gao Jie , Chen Yan , Chen Feilan 
Published: January 2020

Abstract
Background
Gliomas account for the major part of primary brain tumors. Based on their histology and molecular alternations, adult gliomas have been classified into four grades, each with distinct biology and outcome. Previous studies have focused on cell-line-based models and patient-derived xenografts (PDXs) from patient-derived glioma cultures for grade IV glioblastoma. However, the PDX of lower grade diffuse gliomas, particularly those harboring the endogenous IDH mutation, are scarce due to the difficulty growing glioma cells in vitro and in vivo. The purpose of this study was to develop a panel of patient-derived subcutaneous xenografts of different grade gliomas that represented the heterogeneous histopathologic and genetic features of human gliomas.

Methods
Tumor pieces from surgical specimens were subcutaneously implanted into flanks of NOD-Prkdcscid ll2rgnull mice. Then, we analyzed the association between the success rate of implantation with clinical parameters using the Chi square test and resemblance to the patient’s original tumor using immunohistochemistry, immunofluorescence, short tandem repeat analysis, quantitative real-time polymerase chain reaction, and whole-exome sequencing.

Results
A total of 11 subcutaneous xenografts were successfully established from 16 surgical specimens. An increased success rate of implantation in gliomas with wild type isocitrate dehydrogenase (IDH) and high Ki67 expression was observed compared to gliomas with mutant IDH and low Ki67 expression. Recurrent and distant aggressive xenografts were present near the primary implanted tumor fragments from WHO grades II to IV. The xenografts histologically represented the corresponding patient tumor and reconstituted the heterogeneity of different grade gliomas. However, increased Ki67 expression was found in propagated xenografts. Endothelial cells from mice in patient-derived xenografts over several generations replaced the corresponding human tumor blood vessels. Short tandem repeat and whole-exome sequencing analyses indicated that the glioma PDX tumors maintained their genomic features during engraftments over several generations.

Conclusions
The panel of patient-derived glioma xenografts in this study reproduced the diverse heterogeneity of different grade gliomas, thereby allowing the study of the growth characteristics of various glioma types and the identification of tumor-specific molecular markers, which has applications in drug discovery and patient-tailored therapy.
TSPAN9 suppresses the chemosensitivity of gastric cancer to 5-fluorouracil by promoting autophagy
Authors: Qi Yaoyue , Qi Weiwei , Liu Shihai , Sun Libin , Ding Aiping , Yu Guohong , Li Hui , Wang Yixuan , Qiu Wensheng , Lv Jing 
Published: January 2020

Abstract
Background
The issue of drug resistance in gastric cancer has attracted global attention. TSPAN9, a 4-transmembrane protein that plays an important role in tumor progression and signal transduction, has been found to be closely related to tumor invasion, metastasis, and autophagy.

Methods
Immunoblotting was used to evaluate TSPAN9 expression in parental and drug-resistant gastric cancer cells. Functional assays, such as the CCK-8 assay, were used to detect the proliferation of gastric cancer cells and the response of TSPAN9 to 5-fluorouracil (5-FU). Western blotting was used to analyze the expression of constituents of the PI3K/AKT/mTOR-mediated autophagy pathway induced by TSPAN9. Coimmunoprecipitation was performed to assess the specific mechanism by which TSPAN9 affects the PI3K pathway.

Results
We demonstrated that TSPAN9 is overexpressed in 5-FU-resistant cells compared to parental cells. 5-FU-mediated inhibition of cell proliferation can be significantly restored by increasing TSPAN9 expression, and inhibiting this expression in drug-resistant cells can restore the sensitivity of the cells to 5-FU. In addition, TSPAN9 also significantly promoted autophagy in gastric cancer cells in vitro. Further studies indicated that TSPAN9 downregulates the expression of PI3K and proteins associated with PI3K-mediated autophagy. In addition, TSPAN9 interacts with PI3K and inhibits its catalytic activity.

Conclusion
The current study reveals the important role of TSPAN9 in drug resistance to 5-FU in gastric cancer. It also provides a new target to clinically address drug-resistant gastric cancer and will contribute to the treatment strategy of this disease.