bluuebunny/crossref_metadata_2025_split huggingface dataset:
Missed opportunities for diagnosis and treatment in patients with tuberculosis symptoms: a systematic review
Authors: Divala Titus Henry , Lewis Joe , Bulterys Michelle , Lutje Vittoria , Corbett Elizabeth , Schumacher Samuel , MacPherson Peter 
Published: October 2020

Abstract
Background Identification of symptomatic patients followed by prompt on-site investigation form the foundation of facility-based tuberculosis (TB) screening and diagnosis. However, underdiagnosis is common, contributing to ongoing transmission and adverse health outcomes. We conducted this systematic review with the hypothesis that underdiagnosis is largely secondary to to failure of the symptom-screen-based approach to efficiently identify patients at risk of TB. Methods We searched (to 22 January 2019) MEDLINE, Embase, and Cinahl for studies investigating the pathway of care for patients (and standardised patients) presenting to health facilities or pharmacies with TB symptoms. We used QUADAS-2 to assess risk of bias. We reported the proportions of symptomatic patients at each stage of the diagnostic and care pathway from symptom screening to treatment initiation. We adhered to the PRISMA statement throughout this work. Results After screening 3,184 titles and abstracts, we identified 14 eligible studies. None provided data addressing the full cascade of care from clinical presentation to treatment initiation in the same patient population. Symptom-screening, the critical entry point for diagnosis of TB, was not done for 40%, 50%, and 96% of symptomatic participants in the three studies that reported this outcome. The proportion of symptomatic attendees offered a diagnostic investigation (data available for 13 studies), was very low with a study level median of 38% (IQR: 22% to 45%, range 5% to 84%).Conclusions Inefficiencies of the TB symptom screen-based patient pathway are a major contributor to underdiagnosis of TB in health facilities, and reflect inconsistent implementation of longstanding guidelines to ask all patients attending health facilities about respiratory symptoms and to offer diagnostic tests to all patients promptly once TB symptoms are identified. Screening tools and interventions with better diagnostic performance than symptoms, are urgently needed to improve the efficiency of TB care pathways in health facilities.
Methodologies and Procedures Employed in the Identification and Quantitation of Lipid Mediators via LC-MS/MS
Authors: Colas Roman A. , Gomez Esteban A , Dalli Jesmond 
Published: October 2020

Abstract
Liquid chromatography tandem mass spectrometry (LC-MS/MS) is a sensitive and robust approach for the identification and quantitation of lipid mediators including the specialized pro-resolving mediators (resolvins, maresins, protectins and lipoxins), and the classic eicosanoids. Due to the relatively low concentration of these molecules in biological samples, this methodology is classically coupled with solid phase extraction (SPE) techniques that enhance the sensitivity of the assay. Herein, we provide a step-by-step description of instrumentation employed in the both SPE and LC-MS/MS and detailed methodologies employed in the extraction of these lipid mediators and their identification and quantitation using LC-MS/MS.
Satisfaction with malaria care among pregnant women and mothers of under-five years children in Ibadan, Southwest Nigeria
Authors: Oladimeji Kelechi Elizabeth , Tsoka-Gwegweni Joyce Mahlako , Yaya Sanni , Nutor Jerry John , Adeola Abiodun M , Cumber Samuel Nambile , Hyera Francis Leonard Mpotte , Goon Ter Daniel 
Published: October 2020

Abstract
BackgroundPatient satisfaction is as an important measure of program assessment and health system performance. In our study, we assessed patient’s satisfaction with malaria care among pregnant women (PW) and mothers of children less than five years of age (MU5) in Ibadan, Nigeria. MethodsA cross-sectional design, patient satisfaction with malaria care was assessed among 1,373 participants (818 PW and 555 MU5) with the anti-malarial care they received in a comprehensive hospital in Ibadan, Nigeria. Data on patient satisfaction was obtained using a validated eighteen-item questionnaire (PSQ-18) and analysed using the standard satisfaction scales and quantitative scores. ResultsMajority of the study respondents were married and within the age group 25-34years. Overall, indecisive satisfaction (mean range of 3.0-3.99) was observed for items 4, 7, 9, 10, 12, 13, and 16 in the PSQ-18 tool. From the satisfaction sub-scales derived, lowest mean score reflecting poor satisfaction (mean 2.96) was observed for the domain ‘time spent with doctor’ among the pregnant women, while in mothers of children aged under five years, poor satisfaction (mean 2.95) was observed for the general satisfaction sub-scale. Results of the multivariate analysis showed that pregnant women in the upper socioeconomic class had statistically significant lower odds of satisfaction (OR: 0.29, 95% CI: 0.10 – 0.84) with the interpersonal way malaria care was provided. Among mothers of children less than five years old, education and socioeconomic status were significant predictors of higher odds of satisfaction with financial aspects of malaria care.ConclusionSocio economic status and one of its indicators, education plays significant roles in mothers’ satisfaction with health care access, level of care received and most importantly their prospective health seeking behaviour. Important aspect, such as patient’s perception of being well treated by the health care provider should be a key consideration for formulate a patients’ centred strategy to improve health care for malaria in malaria endemic settings.
The Physical Activity Wearables in the Police Force (PAW-Force) study: Acceptability and impact&nbsp;
Authors: Buckingham Sarah Ann , Morrissey Karyn , Williams Andrew James , Price Lisa , Harrison John 
Published: October 2020

Abstract
Background: Policing is a highly stressful and increasingly sedentary occupation. The study aim was to assess the acceptability and impact of a mobile health (mHealth) technology intervention (Fitbit® activity monitor and ‘Bupa Boost’ smartphone app) to promote physical activity (PA) and reduce sedentary time in the police force.Methods: Single-group, pre-post, mixed methods pilot study. Police officers and staff (n=180) were recruited from two police forces in South West England. Participants used the technology for 12 weeks (an ‘individual’ then ‘social’ phase) followed by five months of optional use. Data sources included Fitbit®-recorded objective step count, questionnaire surveys and semi-structured interviews (n=32). Outcome assessment points were baseline (week 0), mid-intervention (week 6), post-intervention (week 12) and follow-up (month 8). Paired t-tests were used to investigate changes in quantitative outcomes. Qualitative analysis involved framework and thematic analysis.Results: Changes in mean daily step count were non-significant (p>0.05), but self-reported PA increased in the short term (e.g. +465.4 MET-minutes/week total PA baseline to week 12, p=0.011) and longer term (e.g. +420.5 MET-minutes/week moderate-to-vigorous PA baseline to month 8, p=0.024). The greatest impact on behaviour was perceived by less active officers and staff. There were no significant changes in sedentary time; the qualitative findings highlighted the importance of context and external influences on behaviour. There were no statistically significant changes (all p-values >0.05) in any secondary outcomes (physical and mental health-related quality of life, perceived stress and perceived productivity), with the exception of an improvement in mental health-related quality of life (SF-12 mental component score +1.75 points, p=0.020) from baseline to month 8. Engagement with and perceived acceptability of the intervention was high overall, but a small number of participants reported negative physical (skin irritation) and psychological (feelings of guilt and anxiety) consequences of technology use. Individual app features (such as goal-setting and self-monitoring) were generally preferred to social components (social comparison, competitions and support). Conclusions: mHealth technology is an acceptable and potentially impactful intervention for increasing PA in the police force. The intervention was less useful for reducing sedentary time and the impact on secondary outcomes is unclear.
Effects of Propofol on Intracranial Pressure and Prognosis in Patients with Severe Brain Diseases Undergoing Endotracheal Suctioning
Authors: Wu Menghang , Yin Xiaorong , Chen Maojun , Liu Yan , Zhang Xia , Li Tingting , Long Yujuan , Wu Xiaomei , Pu Lihui , Zhang Maojie , Hu Zhi , ye ling 
Published: October 2020

Abstract
BackgroundTo investigate whether the administration of intravenous propofol before endotracheal suctioning (ES) in patients with severe brain disease can reduce the sputum suction response, improve prognosis, and accelerate recovery.MethodsA total of 208 severe brain disease patients after craniocerebral surgery were enrolled in the study. The subjects were randomly assigned to the experimental group (n=104) and the control group (n=104). The experimental group was given intravenous propofol (10ml propofol with 1ml 2% lidocaine), 0.5-1 mg/kg, before ES, while the control group was subjected to ES only. Changes in vital signs, sputum suction effect, the fluctuation range of intracranial pressure (ICP) before and after ES, choking cough response, short-term complications, length of stay, and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at six months after the operation.ResultsAt the baseline, the characteristics of the two groups were comparable (P>0.05). The increase of systolic blood pressure after ES was higher in the control group than in the experimental group (P < 0.05). The average peak value of ICP in the experimental group during the suctioning (15.57 ± 12.31 mmHg) was lower than in the control group (18.24 ± 8.99 mmHg; P < 0.05). The percentage of patients experiencing cough reaction- during suctioning in the experimental group was lower than in the control group (P < 0.05), and the fluctuation range of ICP was increased (P < 0.0001). The effect of ES was achieved in both groups. The incidence of short-term complications in the two groups was comparable (P > 0.05). At 6 months after the surgery, the GOS scores were significantly higher in the experimental than in the control group (4-5 points, 51.54% vs. 32.64%; 1-3 points, 48.46% vs. 67.36%; P<0.05). There was no significant difference in the length of stay and hospitalization cost between the two groups.ConclusionsPropofol sedation before ES could reduce choking cough response and intracranial hypertension response. The use of propofol was safe and improved the long-term prognosis.The study was registered in the Chinese Clinical Trial Registry on May 16, 2015 (ChiCTR-IOR-15006441).
Reversibility of hAT-MSCs phenotypic and metabolic changes after exposure to and withdrawal form HCC-conditioned medium through regulation of the ROS/MAPK/HIF-1α signalling pathway
Authors: Wang Chenyang , Hu Jie , Chen Zheng , Wang Yifan , Lu Sinan , Zhang Yuan , Li Yufeng , Xiang Yucheng , Ji Yutian , Zeng Cheng , Ding Yuan , Wang Weilin 
Published: October 2020

Abstract
Background: Mesenchymal stem cells (MSCs) play an important role in tumor progression; concomitantly, MSCs also undergo profound changes in the tumor microenvironment (TME). These changes can directly impact the application and efficacy of MSC-based anti-tumor therapy. However, few studies have focused on the regulation of MSC fate in TME, which will limit the progress of MSC-based anti-tumor therapy. Herein, we investigated the effects of conditioned medium from human hepatocellular carcinoma cells (HCC-CM) on the phenotype and glucose metabolism of human adipose tissue-derived MSCs (hAT-MSCs). Methods: The passage 2 (P2) to passage 3 (P3) hAT-MSCs were exposed to conditioned medium from Hep3B, Huh7 and HCCLM3 cells for 4-8 weeks in vitro. Then, immunofluorescent, CCK-8 assay, EdU assay, Transwell assay, and flow cytometry were used to assess the alterations in cell phenotype in terms of cell morphology, secretory profiles, proliferation, migration, invasion, cell cycle, and apoptosis. In addition, glucose metabolism was evaluated by related kits. Next, the treated hAT-MSCs were subjected to withdrawal from HCC-CM for 2-4 weeks, and alterations in phenotype and glucose metabolism were reevaluated. Finally, the molecular mechanism was clarified by Western blotting. Results: The results revealed that after exposure to HCC-CM, hAT-MSCs developed a stellate-shaped morphology. In association with cytoskeleton remodelling, hAT-MSCs showed enhanced capacities for migration and invasion, while cell proliferation was inhibited by regulating the cell cycle by downregulating cyclins and cyclin-dependent kinases and activating the mitochondrial apoptosis pathway. In terms of glucose metabolism, our results showed mitochondrial dysfunction and elevated glycolysis of hAT-MSCs. However, interestingly, when the treated hAT-MSCs were subjected to withdrawal from HCC-CM, the alterations in phenotype and glucose metabolism could be reversed, but secretory phenotype and tumor-promoting properties appear to be permanent. Further studies showed that these changes in hAT-MSCs may be regulated by the ROS/MAPK/HIF-1α signalling pathway. Conclusion: Taken together, the effects of long-term HCC-CM treatment on phenotype and glucose metabolism in hAT-MSCs are modest and largely reversible after withdrawal, but HCC-CM endow hAT-MSCs with permanent secretory phenotype and tumor-promoting properties. This is the first report on the reversal of phenotype and glucose metabolism in tumor-associated MSCs (TA-MSCs), it is anticipated that new insights into TA-MSCs will lead to the development of novel strategies for MSC-based anti-tumor therapy.
Cerebrospinal fluid α-synuclein predicts neurodegeneration and clinical progression in non-demented elders
Authors: Li Jie-Qiong , Bi Yan-Lin , Shen Xue-Ning , Wang Hui-Fu , Xu Wei , Tan Chen-Chen , Dong Qiang , Wang Yan-Jiang , Tan Lan , Yu Jin-Tai 
Published: October 2020

Abstract
Background Accumulating reports have suggested that α-synuclein is involved in the pathogenesis of Alzheimer’s disease (AD). As the cerebrospinal fluid (CSF) α-synuclein has been suggested as a potential biomarker of AD, this study was set out to test whether CSF α-synuclein is associated with other AD biomarkers and could predict neurodegeneration and clinical progression in non-demented elders. Methods The associations between CSF α-synuclein and other AD biomarkers were investigated at baseline in non-demented Chinese elders. The predictive values of CSF α-synuclein for longitudinal neuroimaging change and the conversion risk of non-demented elders were assessed using linear mixed effects models and multivariate Cox proportional hazard models, respectively, in the Alzheimer's disease Neuroimaging Initiative (ADNI) database.Results The CSF α-synuclein levels correlated with AD-specific biomarkers, CSF total tau and phosphorylated tau levels, in 651 Chinese Han participants (training set). These positive correlations were replicated in the ADNI database (validation set). Using a longitudinal cohort from ADNI, the CSF α-synuclein concentrations were found to increase with disease severity. The CSF α-synuclein had high diagnostic accuracy for AD based on the “ATN” (amyloid, tau, neurodegeneration) system (A+T+ versus A−T−control) (area under the receiver operating characteristic curve, 0.84). Moreover, CSF α-synuclein predicted longitudinal hippocampus atrophy and conversion from MCI to AD dementia.Conclusions CSF α-synuclein is associated with CSF tau levels and could predict neurodegeneration and clinical progression in non-demented elders. This finding indicates that CSF α-synuclein is a potentially useful early biomarker for AD.
Medical students’ self-reported gender discrimination and sexual harassment over time
Authors: Kisiel Marta Alina , Kühner Sofia , Stolare Karin , Lampa Erik , Wohlin Martin , Johnston Nina , Rask-Andersen Anna 
Published: October 2020

Abstract
Background Gender discrimination (GD) and sexual harassment (SH) occur at all academic institutions worldwide. Medical students seem particularly affected, which may negatively affect their education and health. There are indications that policies and reforms on reducing GD/SH are insufficient. Swedish medical students’ experiences of GD/SH are monitored by course-evaluations and bi-annual student union evaluations; however, the response rate is usually low. The aim of this study was to compare the exposure to and context of self-reported GD/SH over an 11-year period amongst medical students at a Swedish university. Methods In 2002, a questionnaire (n=622) was mailed to medical students’ home addresses. It was repeated in 2013 and then distributed during mandatory lectures (n=856). The questions used a behavioristic approach and asked about specific GH/SH experiences. Participation was voluntary and anonymous. The changes in prevalence over time were calculated by sampling weights in order to obtain comparable estimates, representative of both cohorts. Results The response frequency was 55% (62% women) in 2002 and 81% (59% women) in 2013. The prevalence of GD tended to decrease for male and clinical students in comparison to female and pre-clinical peers. However, the prevalence of SH increased for female compared to male students. The ratio of SH for female pre-clinical students doubled in many instances; most often, the mistreatment occurred in the clinic. Medical doctors were indicated as perpetrators up to five times more often by all students in 2013. Conclusion Our results show a disproportional change in exposure to GD/SH between female and male medical students, resulting in a widening of the gender gap regarding prevalence of GD and SH between 2002 and 2013. In particular, personal experiences of SH increased for both sexes. It is proof that institutional efforts to fight mistreatment might be ineffective.
Evaluation of a training program for soft skill education and financial literacy to community health workers in India: a quasi-experimental study
Authors: Sharma Shantanu , Arora Kanishtha , Shekhar Chandra , Sinha Rajesh Kumar , Akhtar Faiyaz , Mehra Sunil 
Published: October 2020

Abstract
Background: Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on life skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about life skills and financial literacy.Methods: We conducted a quasi-experimental, non-randomized, controlled study with pre- and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to life skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, perceptions regarding changes in practices related to gender issues, life skills, and savings at the personal, community, and workplace levels were obtained from the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four domains of life skills, financial literacy, and domains of perceptions of change in practices were correlated to each other. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables.Results: The data of 171 ASHA were analyzed (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the life skills and financial literacy in the intervention group (p<0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for perceptions related to change in practices) was positively associated with ASHAs aged 38 and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience.Conclusions: The P.A.C.E training program was found effective in improving the life skills and financial literacy of ASHAs in India.
Perturbation of PI3K/Akt Signaling affected Autophagy Modulation in Dystrophin-Deficient Myoblasts
Authors: Yazid Muhammad Dain , Chen Hung-Chih 
Published: October 2020

Abstract
The absence of dystrophin has gave a massive impact on myotube development in Muscular Dystrophy pathogenesis. One of the conserved signaling pathways involved in skeletal muscle differentiation is the PI3K/Akt/mTOR pathway that plays a vital role in autophagy regulation. To further understand and establish targeted therapy in dystrophin-deficient myoblasts, protein expression profiling has been determined which provides information on perturbed autophagy modulation and activation. In this study, a dystrophin-deficient myoblast cell line established from the skeletal muscle of a dystrophic (mdx) mouse was used as a model. The dfd13 (dystrophin-deficient) and C2C12 (non-dystrophic) myoblasts were cultured in low mitogen conditions for 10 days to induce differentiation. The cells were subjected to total protein extraction prior to Western blotting assay technique. Protein sub-fractionation has been conducted to determine protein localization. The live-cell analysis of autophagy assay was done using a flow cytometer. As result, in our culture system, the dfd13 myoblasts did not achieve terminal differentiation. PTEN expression was profoundly increased in dfd13 myoblasts throughout the differentiation day subsequently indicates perturbation of PI3K/Akt/mTOR regulation. In addition, rictor-mTORC2 was also found inactivated in this event. This occurrence has caused FoxO3 misregulation leads to higher activation of autophagy-related genes in dfd13 myoblasts. Autophagosome formation was increased as LC3B-I/II showed accumulation upon differentiation. However, the ratio of LC3B lipidation and autophagic flux were shown decreased which exhibited dystrophic features. As a conclusion, perturbation of the PTEN-PI3K/Akt pathway triggers excessive autophagosome formation and subsequently reduced autophagic flux within dystrophin-deficient myoblasts where these findings are of importance to understand Duchenne Muscular Dystrophy (DMD) patients. We believe that some manipulation within its regulatory signaling reported in this study could help restore muscle homeostasis and attenuate disease progression.