bluuebunny/crossref_metadata_2025_split huggingface dataset:
Governing industry involvement in the non-communicable disease response in Kenya
Authors: Bünder Tobias , Karekezi Catherine , Wirtz Veronika 
Published: October 2021

Abstract
Background
In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development.

Methods
We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents.

Results
The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action.

Conclusion
The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.
Exploring perception and usage of narrative medicine by physician specialty: a qualitative analysis
Authors: Fox Daniel A. , Hauser Joshua M. 
Published: October 2021

AbstractBackgroundNarrative medicine is a well-recognized and respected approach to care. It is now found in medical school curricula and widely implemented in practice. However, there has been no analysis of the perception and usage of narrative medicine across different medical specialties and whether there may be unique recommendations for implementation based upon specialty. The aims of this study were to explore these gaps in research.MethodsFifteen senior physicians who specialize in internal medicine, pediatrics, or surgery (5 physicians from each specialty) were interviewed in a semi-structured format about the utilization, benefits, drawbacks (i.e., negative consequences), and roles pertaining to narrative medicine. Qualitative content analysis of each interview was then performed.ResultsThree themes emerged from our analysis: roles, practice, and outcomes. Through these themes we examined the importance, utilization, barriers, benefits, and drawbacks of narrative medicine. There was consensus that narrative medicine is an important tool in primary care. Primary care physicians (general internists and general pediatricians) also believed that narrative medicine is not as important for non-primary care providers. However, non-primary care providers (surgeons) generally believed narrative medicine is valuable in their practice as well. Within specialties, providers’ choice of language varied when trying to obtain patients’ narratives, but choice in when to practice narrative medicine did not differ greatly. Among specialties, there was more variability regarding when to practice narrative medicine and what barriers were present. Primary care physicians primarily described barriers to eliciting a patient’s narrative to involve trust and emotional readiness, while surgeons primarily described factors involving logistics and patient data as barriers to obtaining patients’ narratives. There was broad agreement among specialties regarding the benefits and drawbacks of narrative medicine.ConclusionsThis study sheds light on the shared and unique beliefs in different specialties about narrative medicine. It prompts important discussion around topics such as the stereotypes physicians may hold about their peers and concerns about time management. These data provide some possible ideas for crafting narrative medicine education specific to specialties as well as future directions of study.
1H-NMR-based metabolic profiling identifies non-invasive diagnostic and predictive urinary fingerprints in 5q spinal muscular atrophy
Authors: Saffari Afshin , Cannet Claire , Blaschek Astrid , Hahn Andreas , Hoffmann Georg F. , Johannsen Jessika , Kirsten Romy , Kockaya Musa , Kölker Stefan , Müller-Felber Wolfgang , Roos Andreas , Schäfer Hartmut , Schara Ulrike , Spraul Manfred , Trefz Friedrich K. , Vill Katharina , Wick Wolfgang , Weiler Markus , Okun Jürgen G. , Ziegler Andreas 
Published: October 2021

Abstract
Background
5q spinal muscular atrophy (SMA) is a disabling and life-limiting neuromuscular disease. In recent years, novel therapies have shown to improve clinical outcomes. Yet, the absence of reliable biomarkers renders clinical assessment and prognosis of possibly already affected newborns with a positive newborn screening result for SMA imprecise and difficult. Therapeutic decisions and stratification of individualized therapies remain challenging, especially in symptomatic children. The aim of this proof-of-concept and feasibility study was to explore the value of 1H-nuclear magnetic resonance (NMR)-based metabolic profiling in identifying non-invasive diagnostic and prognostic urinary fingerprints in children and adolescents with SMA.

Results
Urine samples were collected from 29 treatment-naïve SMA patients (5 pre-symptomatic, 9 SMA 1, 8 SMA 2, 7 SMA 3), 18 patients with Duchenne muscular dystrophy (DMD) and 444 healthy controls. Using machine-learning algorithms, we propose a set of prediction models built on urinary fingerprints that showed potential diagnostic value in discriminating SMA patients from controls and DMD, as well as predictive properties in separating between SMA types, allowing predictions about phenotypic severity. Interestingly, preliminary results of the prediction models suggest additional value in determining biochemical onset of disease in pre-symptomatic infants with SMA identified by genetic newborn screening and furthermore as potential therapeutic monitoring tool.

Conclusions
This study provides preliminary evidence for the use of 1H-NMR-based urinary metabolic profiling as diagnostic and prognostic biomarker in spinal muscular atrophy.
The association of sleep duration and metabolic syndrome in the Bandare-Kong cohort study, a cross-sectional survey (finding from PERSIAN cohort study)
Authors: Rafati Shideh , Isheh Maryam , Azarbad Abnoos , Ghadiri Soufi Farhad , Rahimi Arash , Kheirandish Masoumeh 
Published: October 2021

Abstract
Background
A variety of health problems, such as metabolic syndrome (MetS), have been linked to sleep disorders. While numerous epidemiological studies have shown a U-shaped relationship between sleep duration and poor health outcomes, the results were limited and inconsistent. This study was designed to evaluate the relationship between sleep duration and MetS.

Methods
This population-based study was conducted on the participants aged 35–70 of Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in IrAN (PERSIAN). MetS was diagnosed according to the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). Sleep information was extracted through a standard questionnaire based on self-reported information. Data were analyzed by R software using generalized additive models (GAMs). A statistically significant level was considered as P < 0.05.

Results
A total of 3695 participants were included in the analyses. The mean age was 48.05 years (SD 9.36), and 2067 (55.9%) were female. The estimated Prevalence of MetS was 35.9%, and women appeared to be more likely to have MetS than men (P < 0.001). There was a non-linear and linear association between sleep duration and the risk of MetS in women and men, respectively. The lowest risk was observed among those with 7–7.5 h of sleep duration per night.

Conclusion
Long sleep duration was associated with increased risk of MetS and higher MetS severity score in both genders, while the short sleep duration increased the risk of Mets as well as MetS severity score just in women. The longitudinal studies would be suggested to assess the relationship between sleep quality and quantity components and MetS.
Perceived social and built environment associations of leisure-time physical activity among adults in Sri Lanka
Authors: De Silva Weliange Shreenika , Perera Madhawa , Gunatilake Jagath 
Published: October 2021

Abstract
Objective
Although perceived neighbourhood environment is considered a predictor of leisure-time physical activity (LTPA), evidence for this is limited in South Asia. Thus, the aim was to determine the association between neighbourhood social and built environment features in carrying out LTPA among adults in Colombo District, Sri Lanka. A cross-sectional study among 1320 adults was carried out using validated questionnaires for physical activity (PA) and built environment data collection. Multiple logistic regression analysis was conducted to assess the associations between environment characteristics and LTPA after adjusting for gender, age, employment status, income level and sector of residence.

Results
A total of 21.7% of adults participated in some LTPA. The commonest type of LTPA was walking; carried out by 14.5%. Moderate and vigorous activity at leisure was carried out by 10.3% and 3.9% respectively. Perceived social acceptance for PA was positively associated with LTPA. Out of the built environment characteristics perceived infrastructure for walking, and recreational facilities for PA were negatively associated with LTPA. Self-efficacy emerged as an important positive correlate of LTPA. The participants were positively influenced by the self-efficacy and perceived social environment which should be addressed when promoting LTPA.
Gut–microbiota–microglia–brain interactions in Alzheimer’s disease: knowledge-based, multi-dimensional characterization
Authors: Wang QuanQiu , Davis Pamela B. , Qi Xin , Chen Shu G. , Gurney Mark E. , Perry George , Doraiswamy P. Murali , Xu Rong 
Published: October 2021

Abstract
Background
Interactions between the gut microbiota, microglia, and aging may modulate Alzheimer’s disease (AD) pathogenesis but the precise nature of such interactions is not known.

Methods
We developed an integrated multi-dimensional, knowledge-driven, systems approach to identify interactions among microbial metabolites, microglia, and AD. Publicly available datasets were repurposed to create a multi-dimensional knowledge-driven pipeline consisting of an integrated network of microbial metabolite–gene–pathway–phenotype (MGPPN) consisting of 34,509 nodes (216 microbial metabolites, 22,982 genes, 1329 pathways, 9982 mouse phenotypes) and 1,032,942 edges.

Results
We evaluated the network-based ranking algorithm by showing that abnormal microglia function and physiology are significantly associated with AD pathology at both genetic and phenotypic levels: AD risk genes were ranked at the top 6.4% among 22,982 genes, P < 0.001. AD phenotypes were ranked at the top 11.5% among 9982 phenotypes, P < 0.001. A total of 8094 microglia–microbial metabolite–gene–pathway–phenotype–AD interactions were identified for top-ranked AD-associated microbial metabolites. Short-chain fatty acids (SCFAs) were ranked at the top among prioritized AD-associated microbial metabolites. Through data-driven analyses, we provided evidence that SCFAs are involved in microglia-mediated gut–microbiota–brain interactions in AD at both genetic, functional, and phenotypic levels.

Conclusion
Our analysis produces a novel framework to offer insights into the mechanistic links between gut microbial metabolites, microglia, and AD, with the overall goal to facilitate disease mechanism understanding, therapeutic target identification, and designing confirmatory experimental studies.
Vertebral artery dissection in term pregnancy after cervical spine manipulation: a case report and review the literature
Authors: Monari Francesca , Busani Stefano , Imbrogno Maria Giovanna , Neri Isabella , Girardis Massimo , Ghirardini Annamaria , Cavalleri Francesca , Facchinetti Fabio 
Published: October 2021

Abstract
Background
Vertebral artery dissection is an uncommon, but potentially fatal, vascular event. This case aimed to describe the pathogenesis and clinical presentation of vertebral artery dissection in a term pregnant patient. Moreover, we focused on the differential diagnosis, reviewing the available evidence.

Case presentation
A 39-year-old Caucasian woman presented at 38 + 4 weeks of gestation with a short-term history of vertigo, nausea, and vomiting. Symptoms appeared a few days after cervical spine manipulation by an osteopathic specialist. Urgent magnetic resonance imaging of the head was obtained and revealed an ischemic lesion of the right posterolateral portion of the brain bulb. A subsequent computed tomography angiographic scan of the head and neck showed a right vertebral artery dissection. Based on the correlation of the neurological manifestations and imaging findings, a diagnosis of vertebral artery dissection was established. The patient started low-dose acetylsalicylic acid and prophylactic enoxaparin following an urgent cesarean section.

Conclusion
Vertebral artery dissection is a rare but potential cause of neurologic impairments in pregnancy and during the postpartum period. It should be considered in the differential diagnosis for women who present with headache and/or vertigo. Women with a history of migraines, hypertension, or autoimmune disorders in pregnancy are at higher risk, as well as following cervical spine manipulations. Prompt diagnosis and management of vertebral artery dissection are essential to ensure favorable outcomes.
Transcriptional differentiation driving Cucumis sativus–Botrytis cinerea interactions based on the Skellam model and Bayesian networks
Authors: Zhang Qi , Li Kaihang , Yang Yan , Li Beibei , Jiang Libo , He Xiaoqing , Jin Yi , Zhao Guozhu 
Published: October 2021

AbstractRobust statistical tools such as the Skellam model and Bayesian networks can capture the count properties of transcriptome sequencing data and clusters of genes among treatments, thereby improving our knowledge of gene functions and networks. In this study, we successfully implemented a model to analyze a transcriptome dataset ofCucumis sativusandBotrytis cinereabefore and after their interaction. First, 4200 differentially expressed genes (DEGs) fromC. sativuswere clustered into 17 distinct groups, and 670 DEGs fromB. cinereawere clustered into 12 groups. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were applied on these DEGs to assess the interactions betweenC. sativusandB. cinerea. InC. sativus, more DEGs were divided into terms in the molecular function and biological process domains than into cellular components, and 277 DEGs were allocated to 19 KEGG pathways. InB. cinerea, more DEGs were divided into terms in the biological process and cellular component domains than into molecular functions, and 150 DEGs were allocated to 26 KEGG pathways. In this study, we constructed networks of genes that interact with each other to screen hub genes based on a directed graphical model known as Bayesian networks. Through a detailed GO analysis, we excavated hub genes which were biologically meaningful. These results verify that availability of Skellam model and Bayesian networks in clustering gene expression data and sorting out hub genes. These models are instrumental in increasing our knowledge of gene functions and networks in plant–pathogen interaction.
Effect of organic acids on growth performance, intestinal morphology, and immunity of broiler chickens with and without coccidial challenge
Authors: Mustafa Ahsan , Bai Shiping , Zeng Qiufeng , Ding Xuemei , Wang Jianping , Xuan Yue , Su Zhuowei , Zhang Keying 
Published: October 2021

AbstractA total of 360-day-old broiler chicks were allocated into six groups in 2 (Coccidial challenge or not) × 3 (dietary treatments) factorial design. Three dietary treatments including: basic diet, basic diet plus organic acids (OAs) in drinking water, and basic diet plus OAs in the feed with and without coccidial challenge. The OAs in water or feed improved (P < 0.01) average body weight (ABW), average body weight gain (ABWG), and feed conversion ratio (FCR) as compared with the control diet during starter, grower, and whole experimental period. Coccidial challenge decreased BW, ABWG, and average feed intake (AFI), as well as resulted in poor FCR during the starter and whole experimental period (P < 0.05). Though there was no interaction between OAs supplementation and coccidial challenge, the OAs supplementation improved the overall performance with and without coccidial challenge birds on 21 d and 35 d. IgG was found higher (P = 0.03) in broilers fed OAs in feed without the coccidial challenge group. On 18 d, OAs supplementation in feed increased TNF-γ (P = 0.006), whereas the coccidial challenge decreases TNF-γ (P = 0.01) and IL-10 (P =  < .0001), and increases IgM (P = 0.03), IgG (P = 0.04) and IgA (P = 0.02). On 29 d, the coccidial challenge increases IgM and IgA. On 18 d, jejunal lesion score was found significantly higher in the coccidial challenged group as compared to OAs supplementation with coccidial challenged groups on 18 d (P < 0.0001) and 29 d (P = 0.03). Crypt depth was higher, and Villus-height to Crypt depth ratio was lower in the coccidial challenge group on 18 and 29 d. The Goblet cells were found higher in the non-coccidial challenge on 18 d. After 18 d, 16S rDNA gene sequence analysis of ileal chyme has shown that coccidial challenge decreases Lactobacillus_reuteri species as compared to the non-challenged group (P = 0.02). After 29, Cyanobacteria abundance reduced (P = 0.014) in the challenged group than the non-challenged group at the phylum level. At the genus level, Lactobacillus (P = 0.036) and unidentified Cyanobacteria (P = 0.01) were found higher in the non-challenged group than the coccidial challenge group. The results indicate that the OAs supplementation showed improved responses in a pattern similar to the non-challenged control group by neutralizing the negative effects of the coccidial challenge.
Interventions for improving outcomes in patients with multimorbidity in primary care and community setting: a systematic review
Authors: Smith Susan M. , Wallace Emma , Clyne Barbara , Boland Fiona , Fortin Martin 
Published: October 2021

AbstractBackgroundMultimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review updated and narrowed the focus of a previous Cochrane review and aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.MethodsWe searched eight databases and two trials registers up to 9 September 2019. Two review authors independently screened potentially eligible titles and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health-related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.ResultsWe included 16 RCTs with 4753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI −0.01 to 0.07,I2= 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall, the certainty of the evidence was graded as low due to significant variation in study participants and interventions.ConclusionsThere are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.
Using the QI Maturity Tool – Modified Ontario Version to assess the state of QI maturity in Ontario’s public health units
Authors: Law Madelyn P. , Berry Alex , Clarke Nicole , Hay Graham , Muhl Caitlin , Pilato Kelly , Hunter Danielle , Larson Anna 
Published: October 2021

Abstract
Background
Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of QI maturity in Ontario’s PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario’s PHUs.

Methods
The QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU’s score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures.

Results
Across the 34 PHUs, 3503 staff participated in the survey. A review of individual PHU scores indicates that Ontario’s PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the “Emerging” stage of QI maturity. By QI dimensions, the participating PHUs scored in the “Emerging” stage for QI Organizational Culture (5.09), the “Beginning” stage for QI Competency and Capacity (4.58), and the “Achieving” stage for QI Perceived Value (6.00).

Conclusion
There is an urgent need for Ontario’s PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less “mature” stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.