bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dimensionality of the system usability scale among professionals using internet-based interventions for depression: a confirmatory factor analysis
Authors: Mol Mayke , van Schaik Anneke , Dozeman Els , Ruwaard Jeroen , Vis Christiaan , Ebert David D. , Etzelmueller Anne , Mathiasen Kim , Moles Bárbara , Mora Teresa , Pedersen Claus D. , Skjøth Mette Maria , Pensado Luisa Peleteiro , Piera-Jimenez Jordi , Gokcay Didem , Ince Burçin Ünlü , Russi Alessio , Sacco Ylenia , Zanalda Enrico , Zabala Ane Fullaondo , Riper Heleen , Smit Jan H. 
Published: May 2020

Abstract
Background
The System Usability Scale (SUS) is used to measure usability of internet-based Cognitive Behavioural Therapy (iCBT). However, whether the SUS is a valid instrument to measure usability in this context is unclear. The aim of this study is to assess the factor structure of the SUS, measuring usability of iCBT for depression in a sample of professionals. In addition, the psychometric properties (reliability, convergent validity) of the SUS were tested.

Methods
A sample of 242 professionals using iCBT for depression from 6 European countries completed the SUS. Confirmatory Factor Analysis (CFA) was conducted to test whether a one-factor, two-factor, tone-model or bi-direct model would fit the data best. Reliability was assessed using complementary statistical indices (e.g. omega). To assess convergent validity, the SUS total score was correlated with an adapted Client Satisfaction Questionnaire (CSQ-3).

Results
CFA supported the one-factor, two-factor and tone-model, but the bi-factor model fitted the data best (Comparative Fit Index = 0.992, Tucker Lewis Index = 0.985, Root Mean Square Error of Approximation = 0.055, Standardized Root Mean Square Residual = 0.042 (respectively χ2diff (9) = 69.82, p < 0.001; χ2diff (8) = 33.04, p < 0.001). Reliability of the SUS was good (ω = 0.91). The total SUS score correlated moderately with the CSQ-3 (CSQ1 rs = .49, p < 0.001; CSQ2 rs = .46, p < 0.001; CSQ3 rs = .38, p < 0.001), indicating convergent validity.

Conclusions
Although the SUS seems to have a multidimensional structure, the best model showed that the total sumscore of the SUS appears to be a valid and interpretable measure to assess the usability of internet-based interventions when used by professionals in mental healthcare.
Reduced serum VGF levels are linked with suicide risk in Chinese Han patients with major depressive disorder
Authors: Li Xingxing , Ge Huifei , Zhou Dongsheng , Wu Xiangping , Qi Gangqiao , Chen Zan , Yu Chang , Zhang Yuanyuan , Yu Haihang , Wang Chuang 
Published: May 2020

Abstract
Background
VGF (nonacronymic) is a neuropeptide that plays an important role in the pathogenesis of major depressive disorder (MDD). However, no studies have yet investigated VGF levels in patients with MDD who are at risk of suicide. The purpose of the present study was to determine whether serum VGF levels are related to suicide risk in patients with MMD.

Methods
A total of 107 patients with MDD and 40 normal control participated in the present study. The risk of suicide was assessed using the Nurses Global Assessment of Suicide Risk (NGASR). On this basis, 60 patients were assigned to a high-risk group (NGASR≥9) and 47 were assigned to a low-risk group (NGASR< 9). The severity of depression was measured using the 17-item Hamilton Depression Rating Scale (HDRS). Levels of serum VGF were determined using a double antibody sandwich enzyme-linked immunosorbent assay.

Results
Serum VGF levels in the high-risk group (883.34 ± 139.67 pg/mL) were significantly lower than in the low-risk group (1020.56 ± 131.76 pg/mL) and in the control group (1107.00 ± 155.38 pg/mL) (F = 31.90, p < 0.001). In patients with MDD, suicide risk was significantly negatively correlated with VGF levels (r = − 0.55, p = 0.001).

Conclusions
Reduced serum VGF levels are related to risk of suicide in patients with MDD, so VGF may be a biomarker of suicide risk in MDD.
Validation of the French version of the McLean screening instrument for borderline personality disorder (MSI-BPD) in an adolescent sample
Authors: Mirkovic Bojan , Speranza Mario , Cailhol Lionel , Guelfi Julien-Daniel , Perez-Diaz Fernando , Corcos Maurice , Robin Marion , Pham-Scottez Alexandra 
Published: May 2020

Abstract
Background
The study examines the psychometric properties of the French version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) created by M. Zanarini to screen borderline personality disorder in clinical and non-clinical populations.

Method
In this multicentric longitudinal study from the European Network on Borderline Personality Disorder, a sample of 84 adolescent patients from five psychiatric centres and 85 matched controls without psychiatric comorbidity completed the MSI-BPD, French version, and were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV), in order to assess the presence or absence of borderline personality disorder.

Results
The MSI-BPD showed excellent internal consistency (α = 0.87 [0.84;0.90]). Compared to the semi-structured reference interview (SIDP-IV), the MSI-BPD showed substantial congruent validity (AUC = 0.93, CI 95%: 0.90–0.97). The optimal cut-off point in the present study was 5 or more, as it had relatively high sensitivity (0.87) and specificity (0.85). In our sample, the cut-off point (7 or more) proposed by the original developers of the MSI-BPD showed high specificity (0.95) but low sensitivity (0.63).

Conclusions
The French version of the MSI-BPD is now available, and its psychometric properties are satisfactory. The French version of the MSI-PBD can be used as a screening tool for borderline personality disorder, for clinical purposes or in research studies.
Development and validation of a short and easy-to-use instrument for measuring health literacy: the Health Literacy Instrument for Adults (HELIA)
Authors: Tavousi Mahmoud , Haeri-Mehrizi Aliasghar , Rakhshani Fatemeh , Rafiefar Shahram , Soleymanian Atoosa , Sarbandi Fatemeh , Ardestani Mona , Ghanbari Shahla , Montazeri Ali 
Published: May 2020

Abstract
Background
Health literacy is the ability to access to, understand, evaluate and use of essential health information to make basic health decisions. This study aimed to develop and psychometrically evaluate an instrument for measuring health literacy among adults (the Health Literacy Instrument for Adults - HELIA).

Methods
In addition to a literature review, a panel of specialists from different disciplines was formed to generate an item pool. Then, a framework was defined to develop the initial questionnaire based on a definition of health literacy and the most important global public health issues. The initial questionnaire contained 66 items. Next, 15 experts in public health were approached to assess content validity. Consequently, 19 items were removed and a provisional version of the questionnaire with 47 items was provided. Finally, a random sample of adults completed the questionnaire and psychometric properties of the instrument were assessed.

Results
Overall, 323 adults aged 18 to 65 years old completed the questionnaire. When the exploratory factor analysis was performed, 33 items were loaded, which indicated a 5-factor solution for the questionnaire that jointly explained 52.9% of the variance observed. The factors were as follows: access to information (6 items), reading (4 items), understanding (7 items), appraisal (4 items), and decision making/behavioral intention (12 items). Confirmatory factory analysis also indicated a good fit to the data for the five-latent structure (χ2/df = 1.60, SRMR = 0.049; RMSEA = 0.043; CFI = 0.98; NFI = 0.95; NNFI = 0.98 and GFI = 0.87). Additional analysis for internal consistency showed satisfactory results with Cronbach’s alpha coefficients ranging from 0.72 to 0.89. Intraclass correlation coefficient (test-retest analysis) also showed acceptable stability for the questionnaire (ICC = 0.84). The mean score for health literacy as measured by the HELIA was 76.3 (SD = 15.1) out of 100 for the study sample.

Conclusion
The findings suggest that the Health Literacy Instrument for Adults (HELIA) is a valid and reliable instrument for measuring health literacy. It is a short and easy-to-use instrument that could be applied in different settings.
Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews
Authors: Lorenc Theo , Lester Sarah , Sutcliffe Katy , Stansfield Claire , Thomas James 
Published: May 2020

Abstract
Background
Adverse Childhood Experiences (ACEs) such as abuse, neglect or household adversity may have a range of serious negative impacts. There is a need to understand what interventions are effective to improve outcomes for people who have experienced ACEs.

Methods
Systematic review of systematic reviews. We searched 18 database sources from 2007 to 2018 for systematic reviews of effectiveness data on people who experienced ACEs aged 3–18, on any intervention and any outcome except incidence of ACEs. We included reviews with a summary quality score (AMSTAR) of 5.5 or above.

Results
Twenty-five reviews were included. Most reviews focus on psychological interventions and mental health outcomes. The strongest evidence is for cognitive-behavioural therapy for people exposed to abuse. For other interventions – including psychological therapies, parent training, and broader support interventions – the findings overall are inconclusive, although there are some positive results.

Conclusions
There are significant gaps in the evidence on interventions for ACEs. Most approaches focus on mitigating individual psychological harms, and do not address the social pathways which may mediate the negative impacts of ACEs. Many negative impacts of ACEs (e.g. on health behaviours, social relationships and life circumstances) have also not been widely addressed by intervention studies.
3+ parity in Egypt: a multilevel decomposition of wealth-based inequality
Authors: Khadr Zeinab 
Published: May 2020

Abstract
Background
Wealth disparities in levels of fertility are well documented in Egypt. Data from the Egypt Demographic and Health Survey (2014) showed that 61% of births to mothers from the poorest wealth quintile were of the third order or higher compared to 33% among mothers from the richest wealth quintile. The current paper investigates the main individual and socio-contextual level determinants of having more than two living children among women aged 30 and older, and decomposes its wealth-based inequality.

Methods
The secondary analysis was based on the 2014 Egypt Demographic and Health Survey. Multilevel linear regression was used to model the number of additional living children a woman has after her first two living children. A decomposition analysis of the wealth-based concentration index was applied using a multilevel model.

Results
Individual level and area level attributes explained 83 and 17% of the variation in 3+ parity, respectively. Only areas not well served by the health system were significantly related to 3+ parity.
Decomposition of the wealth-based concentration index revealed that 55.7 and 44.3% of the 3+ parity inequality were attributed to individual level attributes and area level attributes, respectively. At the individual level, early marriage accounted for 26% of the inequality in 3+ parity inequality. At the area level, living in areas not well served by the health system accounted for 22.3% of the 3+ parity wealth- based inequality, while highly gendered areas contributed 5.8% to this inequality. Areas’ random effects contributed 7.1% to the 3+ parity inequality, assist in identifying specific areas that require targeted policies.

Conclusion
Multilevel decomposition allowed the contributions of both the individual and area level attributes to be quantified. The decomposition highlighted the need for more tailored policies that target different social groups and different areas. Decomposition analysis also pinpointed specific areas that require additional targeted policies. This targeted approach can be used to support the efficient use of limited resources within any society.
Modifiable risk factors associated with non-communicable diseases among adult outpatients in Manzini, Swaziland: a cross-sectional study
Authors: Gbadamosi Mojeed Akorede , Tlou Boikhutso 
Published: May 2020

Abstract
Background
Four major non-communicable diseases (NCD), including T2DM, contributed to nearly three-quarters of all deaths worldwide in 2017. Dietary and lifestyle actors associated with NCDs are potentially modifiable. Therefore, this study was conducted to determine the dietary and lifestyle factors associated with T2DM, pre-diabetes, and hypertension among adult outpatients in Manzini, Swaziland.

Methods
A random sample of 385 subjects aged 18 years and above was selected. The data regarding demographics, socio-economic status, lifestyle behaviour, diet, and physical activities were collected. Additionally, participants’ anthropometric measurements and vital signs were taken. A biochemical examination was done for fasting plasma glucose, and a 2-h oral glucose tolerance test, where necessary. The Statistical Package for Social Sciences (SPSS) version 26 was used for this data analysis, and the level of statistical significance was set at p < 0.05.

Results
A total of 385 (197 men and 188 women) subjects aged 18 years and older participated in the study. The overall prevalence of hypertension was 48.3%, while the prevalence of hypertension stage 1 and 2 were 29.4 and 19%, respectively. Smoking, SES and consumption of sweet drinks, salty processed foods, fruits, and vegetables were significantly associated with T2DM. However, in the multivariate analysis, only consumption of vegetables (p < 0.0001), fruits (p =0.014), sweet drinks (p = 0.042), and salty processed foods (p = 0.005) remained significantly associated with T2DM. Smoking (p = 0.002) and consumption of fruits (p < 0.0001), vegetables (p < 0.0001), and sweet drinks (p = 0.043) were independently associated with pre-diabetes, while the consumption of vegetables (p = 0.002) and salty processed foods (p = 0.003) were the factors independently associated with hypertension.

Conclusions
The factors associated with T2DM, pre-diabetes, and hypertension are potentially modifiable. Therefore, interventions which target lifestyle changes at primary health care and population levels are warranted to address the growing burden of these chronic conditions in Swaziland.
Awareness, treatment, and control of hypertension and related factors in adult Iranian population
Authors: Mirzaei Mohsen , Mirzaei Masoud , Bagheri Behnam , Dehghani Ali 
Published: May 2020

Abstract
Background
Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment of hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension. This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population.

Methods
This cross-sectional study was conducted on 10,000 adults aged 20–69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015–2016. Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control.

Results
The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension.

Conclusion
Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under the supervision of physicians. Implement a family physician program is recommended in the health system.
Two-stage pancreatic head resection after previous damage control surgery in trauma: two rare case reports
Authors: Paulino Jorge , Vigia Emanuel , Cunha Miguel , Amorim Edgar 
Published: May 2020

Abstract
Background
This study describes the successful treatment of two clinical settings of grade V pancreaticoduodenal blunt trauma only possible due to the prompt collaboration of a peripheral trauma hospital and a central hepatobiliary and pancreatic unit.

Case presentation
We reviewed the clinical records of two male patients aged 17 and 47 years old who underwent a two-stage pancreaticoduodenectomy after a previous Damage-Control Surgery (DCS). Both patients were transferred to our Hepatobiliopancreatic Unit 2 days after immediate DCS with haemostasis, debridement, duodenostomy, gastroenterostomy, external drainage and laparostomy. One day after, they both underwent a two-stage Whipple’s procedure with external cannulation of the main bile duct and the main pancreatic duct with seized calibre silicone drains through the skin. The reconstructive phase was performed two weeks later. The first patient had an uneventful post-operative course and was discharged on post-operative day 8. The second patient developed a high debt biliary fistula on post-operative day 5 being submitted to a relaparotomy with extensive peritoneal lavage. After conservative measures the fistula underwent a progressive closure in 15 days, and the patient was discharged at post-operative day 50 without any limitations.

Conclusions
Pancreaticoduodenectomy is a life-saving operation in selected grade V pancreaticoduodenal trauma lesions. DCS is a salvage approach, often performed in peripheral hospitals, making an early referral to an hepatobiliopancreatic centre mandatory to achieve survival in these severely injured patients. A two-staged Whipple’s operation for severe duodenal / pancreatic trauma can be performed safely and may represent a life-saving option under these very unusual circumstances.
GoldenBac: a simple, highly efficient, and widely applicable system for construction of multi-gene expression vectors for use with the baculovirus expression vector system
Authors: Neuhold Jana , Radakovics Katharina , Lehner Anita , Weissmann Florian , Garcia Maria Queralt , Romero Mari Carmen , Berrow Nicholas S. , Stolt-Bergner Peggy 
Published: May 2020

Abstract
Background
Recombinant protein production and purification of large protein complexes in eukaryotes requires efficient methods to generate multi-gene expression constructs, where each individual gene is under the control of its own promoter and terminator. Current methods are based either on serial rounds of combination of several vectors containing loxP sites via the Cre-lox technology, or on multiple rounds of gene combination via PCR or other methods. These methods are multi-step, have lower efficiencies than single gene cloning, and may require laborious processes to verify that all genes of interest are present in the final product. Here, we describe a rapid and simple Golden Gate-based system for the generation of multi-gene expression constructs compatible with baculovirus expression vector systems (BEVS) using either Tn7 transposition or KO1629-based homologous recombination, which we refer to as “GoldenBac”.

Results
This method is based on the construction of a series of vectors containing a promoter-gene of interest-terminator cassette flanked by cleavage sites of the BsaI type IIS restriction enzyme. This series of vectors can be cut by BsaI to excise cassettes with unique overhangs. In the same reaction, the cassettes are then ligated in the correct sequence in a final destination vector to generate multi-gene expression constructs containing 2–15 genes. Individual expression constructs can therefore be combined into a single vector in a single reaction, with over 90% efficiency when combining up to 14 expression cassettes. We demonstrate successful construction and expression of three different co-expression systems, the proteosomal lid complex, the anaphase promoting complex/cyclosome (APC/C), and a series of constructs used to test the effect of chaperone co-expression on the solubility of the HOIP protein.

Conclusions
This robust, single-step cloning system provides an easy-to-use method for generation of multi-gene expression constructs for both transposition and homologous recombination-based baculovirus systems, making this technology available across all laboratories using baculovirus expression systems. This highly efficient and simple method allows for rapid incorporation of multi-gene expression cloning into the standardized service portfolio of protein production facilities and can also easily be adopted by any laboratory for routine generation of multi-gene baculovirus constructs.
Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study
Authors: Zhang Meng , Zhang Xinyue , Zhang Yuan , Li Yanan , Shao Chunchun , Xiong Shijiang , Lan Jing , Wang Zhifeng 
Published: May 2020

Abstract
Background
The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE.

Methods
Children aged 3–5 years old (N = 1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and caregivers’ oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses.

Results
The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits (P < 0.05, chi-square tests). Complete breastfeeding within 6 months of birth primarily contributed to the high ECC risk of the 3-year-old group (OR: 3.39, 95% CI: 1.41–8.17), while high frequency bedtime sweet consumption mainly contributed to that of the 5-year-old group (OR: 3.22, 95% CI: 1.03–10.06; logistic regression analysis). Tooth brushing was not associated with ECC in this study, and some positive knowledge and attitude variables were positively correlated with a high risk of ECC.

Conclusion
These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. We should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage preventive dental visit and supplemental training for oral health practices.