bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of differing frames on early stages of intersectoral collaboration: the case of the First 1000 Days Initiative in the Western Cape Province
Authors: Okeyo Ida , Lehmann Uta , Schneider Helen 
Published: January 2020

Abstract
Background
While intersectoral collaboration is considered valuable and important for achieving health outcomes, there are few examples of successes. The literature on intersectoral collaboration suggests that success relies on a shared understanding of what can be achieved collectively and whether stakeholders can agree on mutual goals or acceptable trade-offs. When health systems are faced with negotiating intersectoral responses to complex issues, achieving consensus across sectors can be a challenging and uncertain process. Stakeholders may present divergent framings of the problem based on their disciplinary background, interests and institutional mandates. This raises an important question about how different frames of problems and solutions affect the potential to work across sectors during the initiating phases of the policy process.

Methods
In this paper, this question was addressed through an analysis of the case of the First 1000 Days (FTD) Initiative, an intersectoral approach targeting early childhood in the Western Cape Province of South Africa. We conducted a documentary analysis of 34 policy and other documents on FTD (spanning global, national and subnational spheres) using Schmidt’s conceptualisation of policy ideas in order to elicit framings of the policy problem and solutions.

Results
We identified three main frames, associated with different sectoral positionings — a biomedical frame, a nurturing care frame and a socioeconomic frame. Anchored in these different frames, ideas of the problem (definition) and appropriate policy solutions engaged with FTD and the task of intersectoral collaboration at different levels, with a variety of (sometimes cross) purposes.

Conclusions
The paper concludes on the importance of principled engagement processes at the beginning of collaborative processes to ensure that different framings are revealed, reflected upon and negotiated in order to arrive at a joint determination of common goals.
Perceptions of artificial intelligence in healthcare: findings from a qualitative survey study among actors in France
Authors: Laï M.-C. , Brian M. , Mamzer M.-F. 
Published: January 2020

AbstractBackgroundArtificial intelligence (AI), with its seemingly limitless power, holds the promise to truly revolutionize patient healthcare. However, the discourse carried out in public does not always correlate with the actual impact. Thus, we aimed to obtain both an overview of how French health professionals perceive the arrival of AI in daily practice and the perception of the other actors involved in AI to have an overall understanding of this issue.MethodsForty French stakeholders with diverse backgrounds were interviewed in Paris between October 2017 and June 2018 and their contributions analyzed using the grounded theory method (GTM).ResultsThe interviews showed that the various actors involved all see AI as a myth to be debunked. However, their views differed. French healthcare professionals, who are strategically placed in the adoption of AI tools, were focused on providing the best and safest care for their patients. Contrary to popular belief, they are not always seeing the use of these tools in their practice. For healthcare industrial partners, AI is a true breakthrough but legal difficulties to access individual health data could hamper its development. Institutional players are aware that they will have to play a significant role concerning the regulation of the use of these tools. From an external point of view, individuals without a conflict of interest have significant concerns about the sustainability of the balance between health, social justice, and freedom. Health researchers specialized in AI have a more pragmatic point of view and hope for a better transition from research to practice.ConclusionAlthough some hyperbole has taken over the discourse on AI in healthcare, diverse opinions and points of view have emerged among French stakeholders. The development of AI tools in healthcare will be satisfactory for everyone only by initiating a collaborative effort between all those involved. It is thus time to also consider the opinion of patients and, together, address the remaining questions, such as that of responsibility.
Selenium-binding protein 1 transcriptionally activates p21 expression via p53-independent mechanism and its frequent reduction associates with poor prognosis in bladder cancer
Authors: Wang Yulei , Zhu Wenzhen , Chen Xiaoqing , Wei Guangnan , Jiang Guosong , Zhang Guochun 
Published: January 2020

Abstract
Background
Recent studies have shown that selenium-binding protein 1 (SELENBP1) is significantly down-regulated in a variety of solid tumors. Nevertheless, the clinical relevance of SELENBP1 in human bladder cancer has not been described in any detail, and the molecular mechanism underlying its inhibitory role in cancer cell growth is largely unknown.

Methods
SELENBP1 expression levels in tumor tissues and adjacent normal tissues were evaluated using immunoblotting assay. The association of SELENBP1 expression, clinicopathological features, and clinical outcome was determined using publicly available dataset from The Cancer Genome Atlas bladder cancer (TCGA-BLCA) cohort. DNA methylation in SELENBP1 gene was assessed using online MEXPRESS tool. We generated stable SELENBP1-overexpression and their corresponding control cell lines to determine its potential effect on cell cycle and transcriptional activity of p21 by using flow cytometry and luciferase reporter assay, respectively. The dominant-negative mutant constructs, TAM67 and STAT1 Y701F, were employed to define the roles of c-Jun and STAT1 in the regulation of p21 protein.

Results
Here, we report that the reduction of SELENBP1 is a frequent event and significantly correlates with tumor progression as well as unfavorable prognosis in human bladder cancer. By utilizing TCGA-BLCA cohort, DNA hypermethylation, especially in gene body, is shown to be likely to account for the reduction of SELENBP1 expression. However, an apparent paradox is observed in its 3′-UTR region, in which DNA methylation is positively related to SELENBP1 expression. More importantly, we verify the growth inhibitory role for SELENBP1 in human bladder cancer, and further report a novel function for SELENBP1 in transcriptionally modulating p21 expression through a p53-independent mechanism. Instead, ectopic expression of SELENBP1 pronouncedly attenuates the phosphorylation of c-Jun and STAT1, both of which are indispensable for SELENBP1-mediated transcriptional induction of p21, thereby resulting in the G0/G1 phase cell cycle arrest in bladder cancer cell.

Conclusions
Taken together, our findings provide clinical and molecular insights into improved understanding of the tumor suppressive role for SELENBP1 in human bladder cancer, suggesting that SELENBP1 could potentially be utilized as a prognostic biomarker as well as a therapeutic target in future cancer therapy.
Serum dickkopf-3 is associated with death and vascular events after ischemic stroke: an observational study from CATIS
Authors: Zhu Zhengbao , Guo Daoxia , Zhong Chongke , Wang Aili , Xu Tan , Peng Yanbo , Peng Hao , Li Qunwei , Ju Zhong , Geng Deqin , Chen Jing , Zhang Yonghong , He Jiang 
Published: January 2020

Abstract
Background
Dickkopf-3 (Dkk-3) is implicated in the progression of atherosclerosis. This study aimed to investigate the association between serum Dkk-3 and the prognosis of ischemic stroke.

Methods
We measured serum Dkk-3 levels in 3344 ischemic stroke patients from CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). The primary outcome was a combination of death and vascular events within 3 months after ischemic stroke.

Results
During 3 months of follow-up, the cumulative incidence rates of primary outcome among ischemic stroke patients in five quintiles of serum Dkk-3 (from low to high) were 4.49%, 3.74%, 2.54%, 5.23%, and 6.73%, respectively (log-rank p = 0.004). Multivariable Cox proportional hazards regression analyses showed that compared with the third quintile of serum Dkk-3, the adjusted hazard ratios (95% confidence intervals) associated with the first and fifth quintile were 3.49 (1.46–8.34) and 4.23 (1.86–9.64) for primary outcome, 3.47 (1.06–11.36) and 5.30 (1.81–15.51) for death, and 2.66 (1.01–7.01) and 3.35 (1.33–8.40) for vascular events, respectively. Multivariable-adjusted Cox proportional hazards regression model with restricted cubic splines showed a U-shaped association between serum Dkk-3 and the risk of primary outcome (p for nonlinearity = 0.030). Moreover, adding serum Dkk-3 to conventional risk factors could improve the predictive power for primary outcome (net reclassification improvement 28.44%, p < 0.001; integrated discrimination improvement 0.48%, p = 0.001).

Conclusions
Both low and high serum Dkk-3 levels are associated with increased risks of death and vascular events within 3 months after ischemic stroke, indicating that serum Dkk-3 may have a special effect on the prognosis of ischemic stroke. We also found that serum Dkk-3 might be a prognostic biomarker for ischemic stroke. Further studies are needed to replicate our findings and to determine the optimal levels of serum Dkk-3.
Unpacking the complexities of de-implementing inappropriate health interventions
Authors: Norton Wynne E. , Chambers David A. 
Published: January 2020

AbstractDe-implementing inappropriate health interventions is essential for minimizing patient harm, maximizing efficient use of resources, and improving population health. Research on de-implementation has expanded in recent years as it cuts across types of interventions, patient populations, health conditions, and delivery settings. This commentary explores unique aspects of de-implementing inappropriate interventions that differentiate it from implementing evidence-based interventions, including multi-level factors, types of action, strategies for de-implementation, outcomes, and unintended negative consequences. We highlight opportunities to continue to advance research on the de-implementation of inappropriate interventions in health care and public health.
Cross-sectional imaging of the torso reveals occult injuries in asymptomatic blunt trauma patients
Authors: Roberts Gregory J. , Jacobson Lewis E. , Amaral Michelle M. , Jensen Courtney D. , Cooke Louis , Schultz Jacqueline F. , Kinstedt Alexander J. , Saxe Jonathan M. 
Published: January 2020

Abstract
Background
High morbidity and mortality rates of trauma injuries make early detection and correct diagnosis crucial for increasing patient’s survival and quality of life after an injury. Improvements in technology have facilitated the rapid detection of injuries, especially with the use of computed tomography (CT). However, the increased use of CT imaging is not universally advocated for. Some advocate for the use of selective CT imaging, especially in cases where the severity of the injury is low. The purpose of this study is to review the CT indications, findings, and complications in patients with low Injury Severity Scores (ISS) to determine the utility of torso CT in this patient cohort.

Methods
A retrospective review of non-intubated, adult blunt trauma patients with an initial GCS of 14 or 15 evaluated in an ACS verified level 1 trauma center from July 2012 to June 2015 was performed. Data was obtained from the hospital’s trauma registry and chart review, with the following data included: age, sex, injury type, ISS, physical exam findings, all injuries recorded, injuries detected by torso CT, missed injuries, and complications. The statistical tests conducted in the analysis of the collected data were chi-squared, Fischer exact test, and ANOVA analysis.

Results
There were 2306 patients included in this study, with a mean ISS of 8. For patients with a normal chest exam that had a chest CT, 15% were found to have an occult chest injury. In patients with a negative chest exam and negative chest X-ray, 35% had occult injuries detected on chest CT. For patients with a negative abdominal exam and CT abdomen and pelvis, 16% were found to have an occult injury on CT. Lastly, 25% of patients with normal chest, abdomen, and pelvis exams with chest, abdomen, and pelvis CT scans demonstrated occult injuries. Asymptomatic patients with a negative CT had a length of stay 1 day less than patients without a corresponding CT. No incidents of contrast-induced complications were recorded.

Conclusions
A negative physical exam combined with a normal chest X-ray does not rule out the presence of occult injuries and the need for torso imaging. In blunt trauma patients with normal sensorium, physical exam and chest X-ray, the practice of obtaining cross-sectional imaging appears beneficial by increasing the accuracy of total injury burden and decreasing the length of stay.
Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?
Authors: Wenning Katharina E. , Hoffmann Martin F. 
Published: January 2020

AbstractBackgroundThe C0 to C2 region is the keystone for range of motion in the upper cervical spine. Posterior procedures usually include a fusion of at least one segment. Atlantoaxial fusion (AAF) only inhibits any motion in the C1/C2 segment whereas occipitocervical fusion (OCF) additionally interferes with the C0/C1 segment.The purpose of our study was to investigate clinical outcome of patients that underwent OCF or AAF for upper cervical spine injuries.MethodsOver a 5-year period (2010–2015), consecutive patients with upper cervical spine disorders were retrospectively identified as having been treated with OCF or AAF. The Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI) were used to evaluate postoperative neck pain and health restrictions. Demographics, follow-up, and clinical outcome parameters were evaluated. Infection, hematoma, screw malpositioning, and deaths were used as complication variables. Follow-up was at least 6 months postoperatively.ResultsNinety-six patients (male = 42, female = 54) underwent stabilization of the upper cervical spine. OCF was performed in 44 patients (45.8%), and 52 patients (54.2%) were treated with AAF. Patients with OCF were diagnosed with more comorbidities (p = 0.01). Follow-up was shorter in the OCF group compared to the AAF group (6.3 months and 14.3 months;p = 0.01). No differences were found related to infection (OCF 4.5%; AAF 7.7%) and revision rate (OCF 13.6%; AAF 17.3%;p > 0.05). Regarding bother and disability, no differences were discovered utilizing the NDI score (AAF 21.4%; OCF 37.4%;p > 0.05). A reduction of disability measured by the NDI was observed with greater follow-up for all patients (p = 0.01).ConclusionTheoretically, AAF provides greater range of motion by preserving the C0/C1 motion segment resulting in less disability. The current study did not show any significant differences regarding clinical outcome measured by the NDI compared to OCF. No differences were found regarding complication and infection rates in both groups. Both techniques provide a stable treatment with comparable clinical outcome.
Establishing views of traditional healers and biomedical practitioners on collaboration in mental health care in Zanzibar: a qualitative pilot study
Authors: Solera-Deuchar Lindsay , Mussa Mahmoud I. , Ali Suleiman A. , Haji Haji J. , McGovern Peter 
Published: January 2020

Abstract
Background
This qualitative pilot study aimed to establish views of traditional and biomedical practitioners towards collaboration between the two sectors on the treatment of people with mental illness in Zanzibar, Tanzania.

Methods
Six traditional healers (known as “waganga” in Swahili) and six nurses working in government secondary mental health services were invited to participate in a series of focus group discussions (FGDs). Two sets of FGDs took place approximately seven weeks apart. In each set, FGDs were conducted with traditional healers only, nurses only, and finally nurses and traditional healers together. FGDs were conducted in Swahili, audio-recorded and then translated to English by an independent translator and coded thematically using NVivo software.

Results
All participants expressed that they were in favour of collaboration between traditional and biomedical practitioners on mental healthcare. Opinions varied regarding what form this collaboration should take. For many nurses and healers, there was acknowledgement of the role of the other group in providing treatment for people with mental illness, with support for the idea of bi-directional referrals between the two sectors. For some nurses, the value of collaboration would be purely in the education of traditional healers in the recognition of mental illness, with subsequent referral to biomedical services. For some traditional healers, the idea of collaboration seemed to appeal in part because of a perceived opportunity to learn additional skills from biomedical practitioners. Both categories of participant expressed a belief that patients possessed by a jinn (a spirit) or those that had been bewitched needed treatment by traditional healers. On the other hand, those with what participants considered to be “mental illness” needed treatment at the hospital clinic. However, some nurses felt that that traditional healers might be able to provide helpful treatment for mental illness, as well as those suspected to be affected by jinn or witchcraft. There was agreement on the need to establish clear referral pathways between the two service providers. The creation of an office for traditional healers at the hospital was an area where there was disagreement among participants.

Conclusions
We conclude that there is a positive view of collaboration among traditional healers and nurses who participated, and a willingness to work towards actual collaboration. The results suggest that views vary as to what form this collaboration should take, with opinions differing between nurses, as well as between traditional healers. Additional work is needed in order to further explore the nature of potential collaboration and extend the research to the wider population of traditional and biomedical practitioners in Zanzibar, to include primary health care workers.
lncTUG1/miR-144-3p affect the radiosensitivity of esophageal squamous cell carcinoma by competitively regulating c-MET
Authors: Wang Pan , Yang Zhuanbo , Ye Ting , Shao Fei , Li Jiagen , Sun Nan , He Jie 
Published: January 2020

Abstract
Background
Long noncoding RNAs (lncRNAs) are involved in the progression of various cancers and affect the response to radiotherapy. This study focused on clarifying the underlying mechanism by which lncTUG1 affects the radiosensitivity of esophageal squamous cell carcinoma (ESCC).

Methods
lncTUG1, miR-144-3p and MET expression levels were detected in ESCC tissues and cells by qRT-PCR. Western blotting was used to examine the protein levels of MET, p-AKT and EGFR. The dual-luciferase reporter system and RNA immunoprecipitation (RIP) assays were used to confirm the interaction between lncTUG1 and miR-144-3p or miR-144-3p and MET. MTT, colony formation and flow cytometry assays were applied to examine the behavioral changes in EC9706 and KYSE30 cells.

Results
lncTUG1 was upregulated in ESCC cells and tissues, and lncTUG1 expression was associated with an advanced pathological stage. The bioinformatics analysis revealed that lncTUG1 could specifically bind to miR-144-3p, which was downregulated in ESCC. There was a negative correlation between lncTUG1 and miR-144-3p. LncTUG1 inhibition retarded proliferation and colony formation and induced apoptosis in ESCC cells. Moreover, lncTUG1 knockdown dramatically improved the effect of radiotherapy on ESCC development both in vivo and in vitro. Furthermore, MET was revealed as a downstream target of miR-144-3p and is downregulated by it. LncTUG1 promoted the progression of ESCC and elevated radiotherapy resistance in ESCC cells, accompanied by a high level of MET expression. Moreover, we found that knockdown of lncTUG1 enhanced the radiosensitivity of ESCC cells via the p-AKT signaling pathway.

Conclusion
Our results indicate that lncTUG1 enhances the radiotherapy resistance of ESCC by lowering the miR-144-3p level and modulating the MET/EGFR/AKT axis.
Blood biomarkers differentiating viral versus bacterial pneumonia aetiology: a literature review
Authors: Thomas Jithin , Pociute Aiste , Kevalas Rimantas , Malinauskas Mantas , Jankauskaite Lina 
Published: January 2020

Abstract
Background and objectives
The goal of this literature review is to compare current studies regarding the accuracy of different serum markers in differentiating viral from bacterial pneumonia in the pediatric population with what is employed in the medical settings at present. Currently there is still a lack of significant research, that would give us evaluation on biomarkers benefits towards getting a definite diagnosis of pneumonia. Finding out the potential of biomarkers to differentiate between viral and bacterial pneumonia is also important because knowing the exact pathogen would prevent irrational use of antibiotics. At present, irrational, broad-spectrum antibiotic use and increasing antibiotic resistance in microorganisms are still one of the greatest challenges in clinical settings. The use of biomarkers in clinical practice would not only facilitate accurate diagnosis, but would also help to reduce the amount of antibiotics overuse.

Materials and methods
Literature search conducted on Medline and Google Scholar using a combination of terms. Articles that were in English and within ten years of the search date were manually sorted according to inclusion and exclusion criteria. Results: Initial search returned n = 13,408. After activating filters, n = 140 were identified of which n = 12 included for literature review.

Conclusions
Rise or drop in the concentration of a single marker is not accurate enough for predicting viral/bacterial community acquired pneumonia. This is because there is overlapping to a varying extent depending on the marker cut-off values, detection methods, analyses, the desired specificity, and sensitivity. Furthermore, the presence of mixed infection makes almost all markers suboptimal to be used universally. New markers such as MxA1 and HMGB1 gave promising results. However, to replicate a similar testing condition in a clinical environment may not be practical. Another approach is to make use of more than one marker and combine with clinical signs and symptoms. This may not be cost-effective in many clinical settings; nevertheless, in many studies, marker combination greatly improved the predictive power.