bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explaining juvenile idiopathic arthritis to paediatric patients using illustrations and easy-to-read texts: improvement of disease knowledge and adherence to treatment
Authors: Reiser Christiane , Zeltner Nina A. , Rettenbacher Beatrix , Baumgaertner Petra , Huemer Martina , Huemer Christian 
Published: November 2021

Abstract
Introduction
Juvenile idiopathic arthritis (JIA) is the leading chronic rheumatic disease in childhood. To achieve adherence to therapy, in-depth understanding of disease and treatment options are important.

Objective
Development of specifically designed illustrations and standardised, easy-to-read texts for children and adolescents with JIA. Education materials were tested for comprehensibility and content validity. We hypothesised that children would be able to increase their knowledge about JIA after presentation of materials.

Methods
The illustrations were designed by a graphic artist and the informative texts consecutively transformed to easy-to-read language. The materials appear as a modular system to allow individualized information for each patient.
The illustrations and texts were tested for knowledge gain and improvement of self-efficacy in children affected by JIA/ rheumatic diseases and controls. Health-related quality of life (HRQoL) was tested as an overall assessment of patients’ well-being.

Results
46 controls (71% female) and 38 patients (48% female) with a median age of 11 years were tested in a standardised setting. In both groups knowledge gain was significant (controls: t (44) = 11.08, p < 0.001, d = 1.65; patients: t (37) = 7.48, p < 0.001, d = 1.21). The control group had a significantly higher enhancement of disease knowledge compared to patients’ group (p = .046) The follow-up testing was only performed in one school class (20 controls) due to Covid-19 pandemic with significant improvement compared to the pre-test results (p = .002).
The enhancement of self-efficacy through the teaching session was significantly higher in the patients’ group. No impairment of HRQoL was seen.

Conclusion
Explaining juvenile rheumatic diseases and therapeutic strategies is an important task in paediatric rheumatology. To avoid incomprehensible explanations in medical jargon, illustrations and easy-to-read texts were developed. Standardised presentation of the newly created materials resulted in a significant improvement of disease knowledge in patients and controls in addition to an enhancement of self-efficacy in patients.
Changes in T and B cell subsets in end stage renal disease patients before and after kidney transplantation
Authors: Wang Lei , Rondaan Christien , de Joode Anoek A. E. , Raveling-Eelsing Elisabeth , Bos Nicolaas A. , Westra Johanna 
Published: November 2021

Abstract
Background
The incidence of kidney transplantation performed in elderly patients has increased steadily recently. Higher risk of infection and mortality, but lower rate of rejection, are reported in older kidney transplant patients. This study aims to analyze the effect of transplantation on aging of T and B cells in kidney transplant patients, with the emphasis on age and Cytomegalovirus (CMV) latency.

Results
We included 36 patients before and after (median 2.7 years) kidney transplantation and 27 age- and sex-matched healthy controls (HC). T and B cell subsets were measured by flow cytometry, with a focus on aged T cells (CD28-), and age associated B cells (ABCs, CD19 + CD21-CD11c+). Three years after transplantation a significant increase of total T cells among the lymphocytes was found compared to pre-transplantation and HC. Among the T cells CD4+ cells were decreased, especially naïve CD4+ cells and regulatory T cells. Total CD8+ cell proportions were increased, and proportions of naïve CD8+ cells were significantly decreased after transplantation, while CD8+ effector memory T cells re-expressing CD45RA were increased. CD28− T cells were significantly higher compared to HC after transplantation, especially in CMV seropositive patients. B cells were significantly decreased, while among B cells memory B cells and especially ABCs were increased after transplantation.

Conclusions
After transplantation T and B cell subsets change towards more terminally differentiated memory cells compared to age-matched HC. Proportions of aged T cells and ABCs were associated with CMV serostatus.
Shifting perceptions, preferences and practices in the African fruit trade: the case of African plum (Dacryodes edulis) in different cultural and urbanization contexts in Cameroon
Authors: Rimlinger Aurore , Duminil Jérôme , Lemoine Taïna , Avana Marie-Louise , Chakocha Armel , Gakwavu Alexis , Mboujda Franca , Tsogo Mélanie , Elias Marlène , Carrière Stéphanie M. 
Published: November 2021

Abstract
Background
Understanding the perceptions, preferences and management practices associated with intraspecific variability of emblematic African tree crops is critical for their sustainable management. In this paper, we examine how the agrobiodiversity of a fruit tree species native to Central Africa, the African plum tree (Dacryodes edulis), is perceived and managed by Cameroonian cultivators.

Methods
Semi-structured interviews and tree surveys were conducted over four months with 441 African plum tree owners from three different ethnic groups (Bamileke, Bassa, Beti) in urban, peri-urban and rural areas. Questions focused on trees owners’ perceptions—including the local nomenclature—preferences and management practices related to African plum trees and their intraspecific agrobiodiversity.

Results
Across the three ethnic groups in the study area, more than 300 different local varietal names were recorded. These were mainly based on morphological and organoleptic traits, with two-thirds of the names referring to fruit size, skin color and fruit taste. The same traits were used by tree owners to describe their fruit preferences, but their relative importance in shaping fruit preferences varied among groups. The preferences of urban dwellers from different ethnic groups when purchasing African plum fruit focused on the fruit’s taste characteristics, while those of rural dwellers differed among ethnic groups. In rural areas, where African plums are sold and consumed by their growers, the preferences of Bassa consumers reflect quantity (fruit size) over quality (fruit taste or skin color) considerations. These preferences are reflected in the choice of seeds used for planting. Bassa owners sought seeds from trees with large fruits (with 34.8% of Bassa owners giving top priority to this trait as a selection criterion) to a significantly greater extent than Bamileke and Beti owners who prioritized taste and skin color instead. Among tree growers who selectively retained African plum trees in their fields, 44% considered tree productivity as a primary selection criterion.

Conclusions
Findings linking perceptions of and preferences for fruit traits to intraspecific tree diversity, with attention to inter-ethnic and rural–urban differences, will help design locally specific measures to conserve the agrobiodiversity of African plum in the context of its ongoing domestication.
Making it “work”: mothers’ perceptions of workplace breastfeeding and pumping at Dutch universities
Authors: Hentges Maike , Pilot Eva 
Published: November 2021

AbstractBackgroundDutch breastfeeding rates are below World Health Organization’s recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping.MethodsThe study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis.ResultsFour main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people’s lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short.ConclusionsUniversities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.
Alcohol use during pregnancy in post-conflict northern Uganda: pregnant women’s experiences and provider perceptions
Authors: Agiresaasi Apophia , Tumwesigye Nazarius Mbona , Nabiwemba Elizabeth , Kiguli Juliet , Maina Gakenia Wamuyu , Nassanga Goretti 
Published: November 2021

AbstractBackgroundAlcohol use during pregnancy has been associated with several birth defects and developmental disabilities generally known as Fetal Alcohol Spectrum Disorders (FASD). Contextual in-depth understanding on why women drink while pregnant is scarce. For this reason, we explored pregnant women’s experiences, knowledge, attitudes as well as provider perceptions regarding prenatal alcohol consumption to inform interventions meant to address alcohol-exposed pregnancies in post-conflict settings.MethodsIn the months of May and June 2019, 30 in-depth interviews were conducted with pregnant mothers who reported maternal alcohol use during pregnancy. In addition 30 Key informant interviews were carried out with health workers providing Antenatal Care services (ANC) in health facilities in Gulu, Kitgum and Pader districts in Northern Uganda. Data was recorded, transcribed and subjected to thematic content analysis.ResultsWomen reported diverse views regarding maternal alcohol use during pregnancy. Whereas some felt it was favourable, others had misgivings about it. There was marked variability in knowledge on dangers of drinking during pregnancy. In this study, women reported that they found themselves in alluring situations that predisposed them to drinking alcohol. These included brewing alcohol as a source of livelihood, pregnancy-induced craving for alcohol, and participation in cultural festivities that are characterised by eating and drinking alcohol. Nonetheless, women who consume alcohol during pregnancy were not held in high esteem in the Acholi communities. Various prevention interventions reportedly existed in communities to address alcohol use during pregnancy including ANC health education, public debates, radio talk shows, community health worker group and individual counselling, and local council by laws.Conclusions and recommendationsPregnant mothers in post-conflict northern Uganda regard alcohol as a remedy to some of the social, economic and health challenges they face. Hence they continue drinking even during pregnancy because of the existing socio-cultural norms that promote it. The findings of this study demonstrate a need for sensitising communities in which pregnant women live so they can provide a supportive environment for mothers to abstain from alcohol consumption during pregnancy. Health care providers should ensure pregnant women consistently receive accurate and honest messages on the dangers of drinking during pregnancy so they can make informed decisions.
An explainable artificial intelligence approach for decoding the enhancer histone modifications code and identification of novel enhancers in Drosophila
Authors: Wolfe Jareth C. , Mikheeva Liudmila A. , Hagras Hani , Zabet Nicolae Radu 
Published: November 2021

Abstract
Background
Enhancers are non-coding regions of the genome that control the activity of target genes. Recent efforts to identify active enhancers experimentally and in silico have proven effective. While these tools can predict the locations of enhancers with a high degree of accuracy, the mechanisms underpinning the activity of enhancers are often unclear.

Results
Using machine learning (ML) and a rule-based explainable artificial intelligence (XAI) model, we demonstrate that we can predict the location of known enhancers in Drosophila with a high degree of accuracy. Most importantly, we use the rules of the XAI model to provide insight into the underlying combinatorial histone modifications code of enhancers. In addition, we identified a large set of putative enhancers that display the same epigenetic signature as enhancers identified experimentally. These putative enhancers are enriched in nascent transcription, divergent transcription and have 3D contacts with promoters of transcribed genes. However, they display only intermediary enrichment of mediator and cohesin complexes compared to previously characterised active enhancers. We also found that 10–15% of the predicted enhancers display similar characteristics to super enhancers observed in other species.

Conclusions
Here, we applied an explainable AI model to predict enhancers with high accuracy. Most importantly, we identified that different combinations of epigenetic marks characterise different groups of enhancers. Finally, we discovered a large set of putative enhancers which display similar characteristics with previously characterised active enhancers.
HOME DM-BAT: home-based diabetes-modified behavioral activation treatment for low-income seniors with type 2 diabetes—study protocol for a randomized controlled trial
Authors: Egede Leonard E. , Davidson Tatiana M. , Knapp Rebecca G. , Walker Rebekah J. , Williams Joni S. , Dismuke Clara E. , Dawson Aprill Z. 
Published: November 2021

Abstract
Background
About 13% of African Americans and 13% of Hispanics have diabetes, compared to 8% of non-Hispanic Whites (NHWs). This is more pronounced in the elderly where about 25–30% of those aged 65 and older have diabetes. Studies have found associations between social determinants of health (SDoH) and increased incidence, prevalence, and burden of diabetes; however, few interventions have accounted for the context in which the elderly live by addressing SDoH. Specifically, psychosocial factors (such as cognitive dysfunction, functional impairment, and social isolation) impacting this population may be under-addressed due to numerous medical concerns addressed during the clinical visit. The long-term goal of the project is to identify strategies to improve glycemic control and reduce diabetes complications and mortality in African Americans and Hispanics/Latinos with type 2 diabetes.

Methods
This is a 5-year prospective, randomized clinical trial, which will test the effectiveness of a home-based diabetes-modified behavioral activation treatment for low-income, minority seniors with type 2 diabetes mellitus (T2DM) (HOME DM-BAT). Two hundred, aged 65 and older and with an HbA1c ≥8%, will be randomized into one of two groups: (1) an intervention using in-home, nurse telephone-delivered diabetes education, and behavioral activation or (2) a usual care group using in-home, nurse telephone-delivered, health education/supportive therapy. Participants will be followed for 12 months to ascertain the effect of the intervention on glycemic control, blood pressure, and low-density lipoprotein (LDL) cholesterol. The primary hypothesis is low-income, minority seniors with poorly controlled type 2 diabetes randomized to HOME DM-BAT will have significantly greater improvements in clinical outcomes at 12 months of follow-up compared to usual care.

Discussion
Results from this study will provide important insight into the effectiveness of a home-based diabetes-modified behavioral activation treatment for low-income, minority seniors with uncontrolled type 2 diabetes mellitus and inform strategies to improve glycemic control and reduce diabetes complications in minority elderly with T2DM.

Trial registration
ClinicalTrials.govNCT04203147). Registered on December 18, 2019, with the National Institutes of Health Clinical Trials Registry.
Implementing a personalized pharmaceutical plan in kidney or liver transplant patients: study protocol for a stepped-wedge cluster randomized trial (GRePH)
Authors: Pourrat Xavier , Berthy Elise , Dupuis Antoine , Barbier Louise , Buchler Matthias , Guillon Leslie Grammatico , Monmousseau Fanny , Ruspini Eric , Salamé Ephrem , Houdard Solène Brunet , Giraudeau Bruno 
Published: November 2021

Abstract
Background
Nowadays, the main challenge of transplantation is the improvement of long-term care, aiming at reducing treatment-related complications and at decreasing rejection rates. Patients’ adherence to both treatment and hygienic-dietary measures is mandatory to achieve these objectives. Adherence to immunosuppressive drugs is estimated to be only 70%. We hypothesized that the implementation of a personalized pharmaceutical plan (PPP) would increase adherence and therefore graft survival.

Methods/design
This study is a stepped-wedge cluster randomized trial with transplantation units defining clusters. Twelve clusters from 10 university hospitals were recruited. All centres started on the same day in the control phase. Every 7 weeks, one centre will switch to the intervention phase and remain there until the end of inclusions. We plan to recruit 1716 kidney and/or liver transplant patients. The intervention phase consists in setting up the PPP: development of the patient’s hospital and community pharmaceutical follow-up. In the hospital, the pharmacist will carry out drug reconciliation upon admission, daily pharmaceutical follow-up of prescriptions and pharmaceutical interviews with the patient in order to explain the modalities of taking immunosuppressive drugs and hygienic-dietary measures. After hospitalization, during the post-transplantation year, pharmaceutical meetings will take place, prior to medical consultations in order to check the patient’s understanding of the prescription, his adherence, to remind them of hygienic-dietary measures and to look for adverse effects. The hospital pharmacist will also be in charge of establishing a close link with the community pharmacist (CP) and general practitioner, especially providing discharge medication reconciliation, an e-learning and a checklist. Moreover, prior to each pharmaceutical consultation, the hospital pharmacist will contact the CP to discuss patient adherence.
The primary outcome is adherence to immunosuppressive treatments 1 year post-transplantation assessed by using the BAASIS questionnaire and the health insurance data from the national health data system. A medico-economic study will measure the efficiency of this plan.

Discussion
GRePH aims to increase adherence of liver and/or kidney transplant patients to their immunosuppressive therapies in order to reduce transplant rejections. To this end, a new clinical pharmacy model, the PPP, will be set up in 10 university hospitals.

Trial registration
ClinicalTrials.gov NCT04295928. Registered on 5 March 2020
A new cluster of rhabdovirus detected in field-caught sand flies (Diptera: Psychodidae: Phlebotominae) collected from southern Thailand
Authors: Phumee Atchara , Wacharapluesadee Supaporn , Petcharat Sininat , Siriyasatien Padet 
Published: November 2021

Abstract
Background
The distribution of phlebotomine sand flies is changing rapidly due to climate change. This issue has implications for the epidemiology of sand fly-borne diseases, especially sand fly-associated viruses. Few studies concerning sand fly-associated viruses have been conducted in Thailand. Therefore, this study aimed to perform a molecular survey of groups of pathogenic RNA viruses belonging to the Orbivirus, Phlebovirus, and Flavivirus genera and family Rhabdoviridae in sand fly samples collected from southern Thailand.

Methods
Sand flies were collected at two locations in Trang and Songkhla provinces of southern Thailand, and individual sand fly samples were processed for species identification and virus detection. The Orbivirus, Phlebovirus, and Flavivirus genera and family Rhabdoviridae molecular determination was performed by RT-PCR, and positive samples were identified by cloning and sequencing, cell culture inoculation, and phylogenetic analysis.

Results
The results presented in this study were based on the analysis of a total of 331 female sand flies. This molecular study revealed evidence of Rhabdoviridae family virus presence in Phlebotomus papatasi (3/331, 0.9%). The findings demonstrated a new cluster of rhabdovirus that was closely related to Bactrocera dorsalis sigmavirus strain BDSV.abc5 and the lineages of insect-specific Rhabdoviridae. In addition, the Bayesian tree suggested that the common ancestor of this group was the dimarhabdovirus clade. It was assumed that the virus may have switched hosts during its evolution. However, the detection of Orbivirus, Phlebovirus, and Flavivirus genera using specific primers for RT-PCR was negative in the collected sand flies.

Conclusions
There is limited knowledge on the genetic diversity and ecology of Rhabdoviridae in Thailand. This is the first data regarding the circulation of Rhabdoviridae in Ph. papatasi from Thailand. We found a new cluster of rhabdoviruses that was close to the new B. dorsalis sigmavirus. It is possible that there is a great deal of diversity in this family yet to be discovered, and a more extensive survey for new rhabdoviruses may uncover viruses from a wide diversity of host taxa and broaden our understanding of the relationships among the Rhabdoviridae.

Graphical abstract
First-year follow-up of children with chronic nonbacterial osteomyelitis—an analysis of the German National Pediatric Rheumatologic Database from 2009 to 2018
Authors: Reiser Christiane , Klotsche Jens , Hospach Anton , Berendes Rainer , Schnabel Anja , Jansson Annette F. , Hufnagel Markus , Grösch Nadine , Niewerth Martina , Minden Kirsten , Girschick Hermann 
Published: November 2021

Abstract
Objective
To assess the first-year features of patients with chronic nonbacterial osteomyelitis (CNO).

Methods
Patients with a diagnosis of CNO, disease duration of under 13 months, and first registration in the German National Pediatric Rheumatologic Database (NPRD) between 2009 and 2018 were included in this cross-sectional analysis.

Results
Of 774 documented patients, 62.8% were female, and all patients had a median age of 11 years. The most affected clinical sites were the tibia (29.7%), pelvis (28.0%), and femur (27.8%). HLA-B27 was positive in 48 of 314 analyzed patients (15.3%). In 406 patients, an X-ray was performed at the first visit; X-ray results showed osteosclerosis/−lysis in 34.0% and hyperostosis in 14.5% of the patients. MRI scans (focal and whole-body scans) were performed in 648 patients, and 81.5% showed a positive TIRM/STIR signal. A total of 84.7% of the patients were administered nonsteroidal anti-inflammatory drugs, 9.6% were administered oral glucocorticoids, 10.8% were administered disease-modifying anti-rheumatic drugs (DMARDs), and 6.1% were administered bisphosphonates. An evaluation of the patient’s questionnaire showed an overall well-being (NRS 0–10) of 2.0. The PedCNO disease “activity” score revealed a 70% improvement in variables in 43% of patients in the initial 1-year follow-up. Copresentation with diagnostic criteria of pediatric enthesitis-related arthritis was rare.

Conclusion
To our knowledge, the NPRD cohort seemed to be the largest cohort of children and adolescents suffering from CNO worldwide. Most patients were treated effectively with NSAIDs, and only a small group of patients was administered additional medication. The patient-defined measures of disease activity had a moderate impact on patients’ daily lives.

Trial registration
Not applicable.