bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed methods process evaluation of the Sundara Grama intervention promoting latrine use and safe disposal in rural Odisha, India
Authors: Sclar Gloria D , Routray Parimita , Majorin Fiona , Udaipuria Shivika , Portela Gerard , III William J Koehne , Nagel Corey L , Sola Steven , Caruso Bethany A 
Published: May 2021

Abstract
BackgroundProcess evaluations of public health programs are critical to understand if programs were delivered as intended and to identify improvements for future implementations. The aim of this paper is to describe a mixed methods process evaluation of the Sundara Grama intervention, which sought to improve latrine use and safe child feces disposal among latrine-owning households in rural Odisha, India.MethodsThe Sundara Grama intervention was delivered to 36 villages in Puri district by a grassroots NGO and included eight activities: palla performance (folk theater ‘edutainment’), transect walk, community meeting, community wall painting, mother’s meeting on child feces disposal, positive deviant household recognition, household visit, and latrine repairs. The process evaluation quantitatively assessed fidelity, dose delivered, and reach, and qualitatively examined recruitment, context, and satisfaction. Quantitative data collection included an activity observation survey, activity record, and endline trial survey. Qualitative data collection included an activity observation debrief and in-depth interviews with NGO mobilizers. Data collection took place during three time periods: during intervention delivery, immediately after, and several months post-implementation. For the quantitative data, a ‘delivery score’ was calculated for each activity, as well as the proportion of target participants in attendance. Qualitative data was analyzed using thematic analysis.ResultsMean delivery scores, reported as a percentage, were moderate to high. Household visit activities (97% general visit, 96% positive deviant visit) and the mother’s meeting (81%) had the highest delivery scores, followed by the palla (77%), transect walk (77%), and community meeting (60%). Activities were attended, on average, by 30–73% of latrine-owning households. Several factors aided delivery, including pre-intervention rapport building visits and village stakeholder support. Factors that hindered delivery included inclement weather, certain recruitment strategies, and village social dynamics related to caste and gender. With regard to satisfaction, participants and NGO mobilizers praised the palla but reported mixed reactions to other activities.ConclusionsOverall, the Sundara Grama intervention was implemented as intended and achieved good reach. The findings suggest edutainment and multi-level communication approaches are particularly beneficial, and offer lessons for community-wide programs on the importance of examining the implementer experience and broader context.Trial RegistrationThis trial is registered at clinicaltrials.gov: NCT03274245.
A 95-gene Signature Stratifies Recurrence Risk of Invasive Disease in ER-positive, HER2-negative, Node-negative Breast Cancer With Intermediate 21-gene Signature Recurrence Scores
Authors: Fujii Takeo , Masuda Hiroko , Cheng Yee Chung , Yang Fei , Sahin Aysegul A. , Naoi Yasuto , Matsunaga Yuki , Raghavendra Akshara , Sinha Arup Kumar , Fernandez Jose Rodrigo Espinosa , James Anjali , Yamagishi Keisuke , Matsushima Tomoko , Schuetz Robert , Tripathy Debu , Tada Sachiyo , Jackson Rubie S. , Noguchi Shinzaburo , Nakamura Seigo , Acoba Jared D. , Ueno Naoto T 
Published: May 2021

Abstract
Purpose A subset of patients with intermediate 21-gene signature assay recurrence score may benefit from adjuvant chemoendocrine therapy, but a predictive strategy is needed to identify such patients. The 95-gene signature assay was tested to stratify patients with intermediate RS into high (95GC-H) and low (95GC-L) groups that were associated with invasive recurrence risk.Methods Patients with ER-positive, HER2-negative, node-negative breast cancer and RS 11-25 who underwent definitive surgery and adjuvant endocrine therapy without any cytotoxic agents were included. RNA was extracted from archived formalin-fixed, paraffin-embedded samples, and 95-gene signature was calculated. Results Two hundred six patients had RS of 11-25 (95GC-L, N = 163; 95GC-H, N = 43). In Cox proportional hazards model, 95GC-H was significantly associated with shorter time to recurrence than was 95GC-L (HR 5.94; 95%CI 1.81-19.53; P = 0.005). The correlation between 95-gene signature and 21-gene signature assay scores was not strong (correlation coefficient r = 0.27), which might suggest that 95-gene signature reflects biological characteristics differing from what 21-gene signature shows.Conclusions The 95-gene signature stratifies patients with ER-positive, HER2-negative, node-negative invasive breast cancer and intermediate RS of 11-25 into high and low groups that are associated with recurrence risk of invasive disease. Further retrospective analysis in the prospectively-accrued TAILORx population is warranted to confirm that 95-gene signature can identify patients who would benefit from adjuvant chemoendocrine therapy.
Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol
Authors: Tuot Sovannary , Teo Alvin Kuo Jing , Prem Kiesha , Chhoun Pheak , Pall Chamroen , Ung Mengieng , Ly Penh Sun , Jimba Masamine , Yi Siyan 
Published: May 2021

Abstract
BackgroundMulti-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every three to six months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities' burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model's effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia.MethodsWe will conduct this quasi-experimental study in 20 ART clinics across the capital city and 10 provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2,000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and the healthcare providers’ work burden. The secondary endpoints will include the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective.DiscussionThis study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response.Trial registrationClinicalTrials.gov, NCT04766710. Registered 23 February 2021,
Abnormal Variations in the Expressions of LRP5, Runx2, Osterix and RANKL in Bone Tissues Associated With Postmenopausal Osteoporotic Fractures
Authors: Wang Bin , Cao Yanming , Mai Caiyuan , Yadav Ram Ishwar , Gao Jianliang , Pan Lei 
Published: May 2021

Abstract
Objective: To investigate the variations in the expressions of LRP5, Runx2, Osterix, and RANKL factors in bone tissues associated with postmenopausal osteoporotic fractures (PMOPF). Method: Postmenopausal patients with femur fractures were initially divided into control (31 cases) and PMOPF groups (83 cases). All control group patients were operated within 1 day after injury. The patients with PMOPF were operated based on the time after fracture in the respective groups (patients were divided into groups A, B, and C based on the time after fracture). Samples were collected from femurs at fracture sites during the operation. The expression level of each factor in bone tissues was detected using RT-qPCR, and the bone mass samples were decalcified and then histologically analyzed by immunohistochemistry. We subsequently analyzed significant differences in the expressions of factors (LRP5, Runx2, Osterix, and RANKL) between PMOPF and control groups. Results: (1) LRP5, β-catenin, Runx2, and Osterix were under-expressed in patients with PMOPF relative to the controls (P<0.05). In contrast, RANKL was over-expressed in the PMOPF group when compared to the control group (P<0.05); (2) the expressions of LRP5 and Runx2 were lowest in Group A patients (1–3 days after fracture). Osterix expression was lowest in Group C patients (8–14 days after fracture). Conversely, RANKL expression was highest in Group B patients (4–7 days after fracture). Conclusion: The inhibition or reduction in the expressions of osteogenic factors including LRP5, Runx2, and Osterix of the Wnt/β-catenin and BMP-2/Runx2/Osterix signaling pathways are associated with PMOPF incidence. Specifically, upregulation of RANKL in the RANKL/RANK signaling pathway is associated with the incidence of PMOPF. LRP5 and Runx2 expressions decreased considerably within 1-3 days after fracture; Osterix expression decreased considerably within 8-14 days after fracture; RANKL expression was highest within 4-7 days after fracture, which could be associated with bone repair in PMOPF. The expression level of the aforementioned factors affects the development and progression of PMOPF.
Knowledge and attitude of community towards trachoma and trichiasis in Arba Minch Zuria district, Gamo Zone, Southern Ethiopia, 2019
Authors: Churko Chuchu , Asfaw Mekuria Asnakew , Zerdo Zerihun 
Published: May 2021

Abstract
Background

Trachoma is a preventable and treatable disease caused by Chlamydia trachomatis which is the leading cause of blindness in the world affecting mostly the poorest community. Despite so many intervention undertaken on prevention and control for trachoma, Ethiopia is failed to achieve 2020 elimination goal for trachoma. We hypothesized that the knowledge of communities towards trachoma was inadequate in the study area.
Methods

a community based cross sectional study was conducted in Arba Minch zuria district from December 2019 to June 2020. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 811 study participants from the five kebeles. Data were collected using a pretested interviewer administered structured questionnaire and then entered into EPI/INFO version 7 and exported to SPSS V20 for analysis.
Findings:

All of the respondents heard about trachoma. Less than one forth 185 (23.2%) of the study subjects had adequate knowledge towards trachoma. One hundred forty eight (18.6%) strongly agreed that trachoma can be transmitted through gene. On the other hand, 240 (30.1%) of the respondents were unsure that trichiasis patients may loss vision if not operated. Factors like education, occupation, walking distance from home to clean water source and wealth index were significantly associated with knowledge status of the participants.
Conclusion

the proportion of people who had adequate knowledge about trachoma and trichiasis was low. Attention should be given by the district health office, regional government and different stakeholders, who designing and implementing trachoma elimination programs especially improving awareness of community regarding trachoma and trichiasis. Interventions with the F and E components of SAFE strategy are also strongly recommended.
Zebrafish as a model for haloperidol-induced catalepsy-like immobilization
Authors: Hasumi Akihiro , Maeda Hideyuki , Yoshida Ken-ichi 
Published: May 2021

Abstract
This study investigated the validity of screening for antipsychotic-induced catalepsy-like immobilization in zebrafish (Danio rerio), as an alternative to the standard rodent model. To induce the desired symptoms, we used haloperidol, a typical antipsychotic that disturbs dopamine D2-receptors. In addition to observing swimming behaviors generally, we used the light and dark test to assess how drug exposure influences locomotive responses to those stimuli. We selected this test instead of the commonly used bar test for catalepsy in rodents, because fish cannot perform the necessary motions to participate in the latter. Normally, light attenuated activity and decreased locomotion, whereas darkness greatly increased activity levels in zebrafish. We confirmed that haloperidol had a dose-dependent inhibitory effect on activity; the highest dose of 10 mg/L almost stopped fish activity even in darkness. We did not observe any significant differences in heart rate or morphology across the control and treatment groups, whereas abnormal movements like rigid and erratic behaviors occurred in haloperidol-treated groups. Therefore, we found that immobilization and abnormal movements qualify as haloperidol-induced catalepsy. In conclusion, zebrafish appear to be a suitable model for antipsychotic-induced catalepsy-like immobilization.
Title Patient Involvement in the Encounter between General Practice and Patients with Chronic Diseases – A Scoping Review
Authors: Titlestad Signe Beck , Marcussen Michael , Rasmussen Marie Sandstød , Nørgaard Birgitte 
Published: May 2021

Abstract
Background Globally, there is increasing interest in patient involvement in healthcare. Research has shown improved health outcomes when patients are involved in managing their own health conditions and when their individual needs are considered. The aim of this scoping review was to map the existing research regarding chronic disease patients’ involvement in their encounters with general practice, with a specific focus on patients with Type 2 diabetes (TD2) or (Chronic obstructive pulmonary disease (COPD).Methods Studies of any design, date, and language reporting the involvement of adult patients with T2D or COPD were included. A systematic search was conducted using the following databases: MEDLINE, CINAHL, Psycinfo Scopus, and EMBASE. All databases were searched from August 2020 until October 2020. Data were systematically charted by the following study characteristics: Bibliographic aims; study aims; setting; area of interest; results; conclusion.Results 19 studies were included and published between 2001 and 2020 and conducted qualitative methods, survey, or mixed methods. Three and 17 studies contained knowledge on the involvement of patients with COPD and TD2, respectively. The patients reported the importance of being more involved in treatment discussions during consultations as well as a friendly environment. A good relationship and relational continuity make it easier for patients to be more involved in treatment decisions. The general practitioners(GP) mentioned their high work load, long-standing relationships, knowledge about the patients, and prepared patients as factors influencing their ability to involve patients in treatment discussions.Conclusion The existing knowledge within patient involvement in general practice clearly indicates that focus and action must be directed towards research exploring the perspectives of patients with COPD on their involvement in general practice.
Predictor of Recurrence of Allergic Fungal Rhinosinusitis
Authors: Chen yanmin , Zhen Hongtao 
Published: May 2021

Abstract
ObjectivesBy analyzing the clinical manifestations related to allergic fungal sinusitis (AFRS), the aim of this study was to try to make the first step to establish a prognostic evaluation system for predicting the recurrence of AFRS patients after operating.MethodsA descriptive and retrospective study of 19 AFRS out of 272 chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery were enrolled from April 2011 to April 2019. ResultsThe incidence of AFRS was 7.0% (19/272) in this study. The postoperative recurrence rate was 26.3% (5/19). Nasal discharge (73.7%) and nasal obstruction (57.9%) were the most common clinical manifestations. There were significant differences in the age of onset, preoperative duration of symptoms and a total Lund-MacKay CT score between the relapsing group and non-relapsing group.ConclusionsAFRS is less prevalent and high recurrent in Chinese patients. Our preliminary data support that age, duration and Lund-MacKay CT scores as the focus of preoperative clinical evaluation of AFRS: a long duration of symptoms (≥15 months) and a high Lund-MacKay CT score (≥11) are at a high risk of relapse, in further prospective and larger investigations as part of the preoperative work-up for patients with AFRS in order to develop a personalized and effective management approach.
Monitoring of seven industrial anaerobic digesters supplied with biochar
Authors: Heitkamp Kerstin , Latorre-Pérez Adriel , Nefigmann Sven , Gimeno-Valero Helena , Vilanova Cristina , Jahmad Efri , Abendroth Christian 
Published: May 2021

Abstract
Background: Recent research articles indicate that direct interspecies electron transfer (DIET) is an alternative metabolic route for methanogenic archaea that improves microbial methane productivity. It has been shown that multiple conductive materials such as biochar can be supplemented to anaerobic digesters to increase the rate of DIET. However, the industrial applicability, as well as the impact of such supplements on taxonomic profiles, has not been sufficiently assessed to date.

Results: Seven industrial anaerobic digesters were supplemented with biochar for one year. A positive effect was observed for the spectrum of organic acids as the concentration of acetic, propionic, and butyric acid decreased significantly. Quantification of the cofactor F420 using fluorescence microscopy showed a reduction in methanogenic archaea. 16S-rRNA gene amplicon sequencing showed a higher microbial diversity within biochar particles as well as an accumulation of secondary fermenters and halotolerant bacteria. Taxonomic profiles indicate microbial electroactivity, and show the frequent occurrence of Methanoculleus , which has not been described in this context before.

Conclusions: Our results shed light on the interplay between biochar particles and microbial communities in anaerobic digesters. Both the microbial diversity and the absolute frequency of the microorganisms involved were significantly changed between sludge samples and biochar particles. This is particularly important against the background of microbial process monitoring. In addition, it could be shown that biochar is suitable for reducing the content of inhibitory, volatile acids on an industrial scale.
The Roles of Anti-RNP Antibodies in Primary Sjögren’s Syndrome Pathogenesis and Severity May Be Underestimated
Authors: lin wei , Xin Zhifei , Peng Kenan , Ning Xiaoran , Guo Shaoying , Yang Liu , Li Yang , Yang Yupeng , Liu Yixuan , Ren Xiuying , Su Yashuang , Cao Jingjing , Liu Meilu , Sun Lijun , Zhang Fengxiao , Zhang Wen 
Published: May 2021

Abstract
Background Associations between anti-ribonucleoprotein (RNP) antibodies status and distinct clinical primary Sjögren’s syndrome (pSS) subtypes have not yet been firmly established. The aim of our study is to determine whether associations exist between RNP antibody status and the clinical manifestations, laboratory features, or disease activity in pSS. Methods A retrospective cohort of 39 anti-RNP antibody-positive and 294 anti-RNP antibody-negative pSS patients was assembled. Data regarding demographic information, glandular and extraglandular manifestations, laboratory findings, and disease activity (scored according to the European League Against Rheumatism SS disease activity index (ESSDAI)) were extracted from patient records. Univariate methods followed by multivariable logistic regression analysis were used to evaluate potential associations between anti-RNP antibody status and clinicopathologic features. Results Patients with anti-RNP antibody-positive pSS had a higher prevalence of Raynaud’s phenomenon (RP) and hematological, pulmonary, lymphatic system, and mucocutaneous involvement; higher erythrocyte sedimentation rates and serum IgG levels; lower lymphocytes counts; and significantly higher ESSDAI scores (median (interquartile range): 13 (7–18) versus 7 (3–12), p < 0.001). No significant differences were observed between groups for C-reactive protein levels and rheumatoid factor or anti-Ro/SSA or -La/SSB antibody positivity. Multivariate analysis identified RP, interstitial lung disease (ILD), and lymphatic system involvement as independent predictors of anti-RNP antibody positivity in pSS patients. Conclusions In this cohort, anti-RNP antibodies were associated with several clinicopathologic features of severe pSS, such as RP and hematologic, lymphatic, and pulmonary disorders. Therefore, anti-RNP antibodies may play an important role in the pathogenesis and severity of pSS.
Do faecal samples represent the primary site of microbial plant fermentation in hindgut fermenters?
Authors: Eisenhofer Raphael , D’Agnese Erin , Taggart David , Carver Scott , Penrose Beth 
Published: May 2021

Abstract
BackgroundMost herbivorous mammals have symbiotic microbes living in their gastrointestinal tracts that help with harvesting energy from recalcitrant plant fibre. The bulk of research into these microorganisms has focused on samples collected from faeces, representing the distal region of the gastrointestinal (GI) tract. However, the GI tract in herbivorous mammals is typically long and complex, containing different regions with distinct physico-chemical properties that can structure resident microbial communities. Therefore, to determine how representative faeces are to other regions of the GI tract in hindgut-fermenting mammals, we characterised the microbial biogeography of the GI tract of two species of wombats.ResultsUsing 16S rRNA gene sequencing, our results show that GI microbial communities of wombats are structured by GI region. For both the bare-nosed wombat (Vombatus ursinus) and the southern hairy-nosed wombat (Lasiorhinus latifrons), we observed a trend of increasing microbial diversity from stomach to distal colon. The microbial composition in the first proximal colon region was more similar between wombat species than the corresponding distal colon region in the same species. We found several microbial genera that were differentially abundant between the first proximal colon and distal colon regions. Surprisingly, only 99 (10.6%) and 204 (18.7%) amplicon sequence variants (ASVs) were shared between the first proximal colon region and the distal colon region for the bare-nosed and southern hairy-nosed wombat, respectively. ConclusionThese results suggest that microbial communities in the first proximal colon region—the putative site of primary plant fermentation in wombats—are distinct from the distal colon, and that faecal samples have limitations in capturing the diversity of these communities. While faeces are still a valuable and effective means of characterising the distal colon microbiota, future work seeking to better understand how GI microbes impact the energy economy of wombats (and potentially other hindgut-fermenting mammals) may need to take gut biogeography into account.