bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice
Authors: McCombe Geoff , Murtagh Sara , Lazarus Jeffrey V. , Van Hout Marie Claire , Bachmann Max , Jaffar Shabbar , Garrib Anupam , Ramaiya Kaushik , Sewankambo Nelson K. , Mfinanga Sayoki , Cullen Walter 
Published: November 2021

AbstractBackgroundAlthough HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes.MethodsAn international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2.ResultsBased on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity.ConclusionsThis study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.
Eight-year post-trial follow-up of morbidity and mortality of telephone health coaching
Authors: Mustonen Erja , Hörhammer Iiris , Patja Kristiina , Absetz Pilvikki , Lammintakanen Johanna , Talja Martti , Kuronen Risto , Linna Miika 
Published: November 2021

Abstract
Background
Health coaching is a patient-centred approach to supporting self-management for the chronic conditions. However, long-term evidence of effectiveness of health coaching remains scarce. The object of this study was to evaluate the long-term effect of telephone health coaching (THC) on mortality and morbidity among people with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)..

Methods
1535 T2D, CAD and CHF patients with unmet treatment targets were randomly allocated into an intervention group (n = 1034) and control group (n = 501). Intervention group received monthly individual strength-based, autonomy supportive THC sessions (average 30 min) for behavior change with a specially trained nurse for 12 months additional to usual health care. Control group received usual health care services. The primary outcome was a composite of death from cardiovascular causes or non-fatal stroke or non-fatal myocardial infarction (AMI) or unstable angina pectoris (UAP) during a follow-up of 8 years Three other composite endpoints with distinct combinations of fatal and non-fatal cardiovascular events and death from any cause were used as secondary outcomes. Other outcomes followed were the most relevant components of the composite endpoints. Randomized controlled trial (RCT) data was linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year evaluation was conducted using intention-to-treat (ITT) and per-protocol (PP) analysis.

Results
The composite primary outcome event rate per 100 person years was lower in the intervention group (3.45) than in control group (3.88) in ITT -analysis, but the difference was not statistically significant (hazard ratio in the intervention group 0.87; 95% CI, 0.71 to 1.07; P = 0.19). In the subgroup (T2D, CAD/CHF) analysis, there were no statistically significant effects. The secondary PP-analysis showed statistically significant benefits for those who participated in the study.

Conclusions
No statistically significant effect of health coaching on mortality and morbidity was found in intention to treat analysis. The per protocol results suggest, however, that the intervention may be effective among patients who are willing and able to participate in health coaching. More research is needed to identify patients most likely to benefit from low-intensity health coaching.

Trial registration
NCT00552903 (registration date: the 1st of November 2007, updated the 3rd of February 2009).
Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium
Authors: Sinning Christoph , Makarova Nataliya , Völzke Henry , Schnabel Renate B. , Ojeda Francisco , Dörr Marcus , Felix Stephan B. , Koenig Wolfgang , Peters Annette , Rathmann Wolfgang , Schöttker Ben , Brenner Hermann , Veronesi Giovanni , Cesana Giancarlo , Brambilla Paolo , Palosaari Tarja , Kuulasmaa Kari , Njølstad Inger , Mathiesen Ellisiv Bøgeberg , Wilsgaard Tom , Blankenberg Stefan , Söderberg Stefan , Ferrario Marco M. , Thorand Barbara 
Published: November 2021

Abstract
Background
Biomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A1c (HbA1c) is used to monitor the quality of diabetes treatment. Its strength of association with cardiovascular outcomes in the general population remains uncertain. This study aims to assess the association of HbA1c with cardiovascular outcomes in the general population.

Methods
Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA1c was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular disease (CVD) incidence, and overall mortality in subjects without diabetes (N = 32,496) and with diabetes (N = 3684).

Results
Kaplan–Meier curves showed higher event rates with increasing HbA1c levels (log-rank-test: p < 0.001). Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confidence interval (CI) 1.02–1.31, p = 0.02) for cardiovascular mortality, 1.13 (95% CI 1.03–1.24, p = 0.01) for CVD incidence, and 1.09 (95% CI 1.02–1.17, p = 0.01) for overall mortality was observed per 10 mmol/mol increase in HbA1c. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA1c levels (HR 1.12; 95% CI 1.01–1.25, p = 0.04) and HR 1.10; 95% CI 1.01–1.20, p = 0.02) respectively. HbA1c cut-off values of 39.9 mmol/mol (5.8%), 36.6 mmol/mol (5.5%), and 38.8 mmol/mol (5.7%) for cardiovascular mortality, CVD incidence, and overall mortality, showed also an increased risk.

Conclusions
HbA1c is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA1c levels and outcomes. Elevated HbA1c levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA1c levels in the overall population.
Association of MIR17HG and MIR155HG gene variants with steroid-induced osteonecrosis of the femoral head in the population of northern China
Authors: Liu Tingting , Cao Yuju , Han Changxu , An Feimeng , Wang Tiantian , Sun Menghu , Ma Chao , Dong Qiumei , Wang Jianzhong 
Published: November 2021

Abstract
Introduction
Steroid-induced osteonecrosis of the femoral head (ONFH) is a disease of the bone. Metabolism and genetic factors are generally considered to play an important role. The purpose of this study was to investigate the relationship between single-nucleotide polymorphisms (SNPs) in MIR17HG and MIR155HG and the risk of steroid-induced ONFH in the population of northern China.

Methods
A total of 199 steroid-induced ONFH patients and 506 healthy controls were recruited for the study. Four SNPs of MIR17HG and seven SNPs of MIR155HG were genotyped by Sequenom MassARRAY. ORs and 95% CIs were used to evaluate the relationship between these SNPs and steroid-induced ONFH.

Results
In the codominant model, patients with the MIR17HG SNPs (rs7318578) AA genotype had an increased risk of steroid-induced ONFH (OR = 1.79, p = 0.039); in the recessive model, patients with the MIR17HG SNP (rs7318578) AA genotype had an increased risk of steroid-induced ONFH (OR = 1.78, p = 0.032). Stratified analysis showed that a MIR17HG SNP (rs7318578) and the MIR155HG SNPs (rs77218221, rs11911469, rs34904192 and rs4143370) were closely related to different unornamented phenotypes of steroid-induced ONFH. Analysis of the clinical indicators revealed significant differences in high-density lipoprotein (HDL-C) levels between the ONFH group and the control group (p = 0.005). In the MIR17HG SNP (rs75267932), patients with different genotypes had different levels of triglyceride (TG). The MIR155HG SNPs (rs77699734, rs1893650, and rs34904192) showed differences in triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels in patients with different genotypes.

Conclusion
Our results confirm that MIR17HG and MIR155HG gene mutations are associated with steroid-induced ONFH susceptibility in the population of northern China, providing new evidence for the early detection and prevention of ONFH.
Association between type of anesthesia and length of hospital stay in primary unilateral total knee arthroplasty patients: a single-center retrospective study
Authors: Wang Xiaoqing , Li He , Yuan Conghu , Zhao Hang 
Published: November 2021

Abstract
Objective
This study explored the risk factors influencing the length of hospital stay (LOS) and establish whether the type of anesthesia is independently associated with the LOS in patients after primary unilateral total knee arthroplasty (TKA).

Methods
In this retrospective cohort study, 2309 patients undergoing unilateral TKA were recruited between January 2013 and June 2014 in a tertiary academic medical center in Singapore. Univariate and multivariate linear regression analyses were used to identify the independent risk factors associated with LOS. Besides, subgroup and interaction analyses were performed to evaluate the relationship between the type of anesthesia and LOS.

Result
In total, 2309 patients were identified. Out of these, 791 patients underwent general anesthesia, whereas 1518 patients underwent regional anesthesia. Multivariate regression analyses revealed that prolonged LOS was significantly associated with age ≥ 65 years (β = 0.48; 95% CI, 0.09–0.87; P = 0.015), diabetes mellitus (DM) (β = 0.8; 95% CI, 0.33–1.27; P = 0.001), congestive cardiac failure (CCF) (β = 4.1; 95% CI, 2.02–6.17; P < 0.001), perioperative blood transfusion (β = 5.71; 95% CI, 4.86–6.56; P < 0.001), creatinine > 2 mg/dL (β = 4.54; 95% CI, 2.46–6.62; P < 0.001), ASA status (III) (β = 1.72; 95% CI, 0.72–2.71; P = 0.001), general anesthesia (β = 0.78; 95% CI, 0.41–1.66; P < 0.001). The LOS further decreased among participants receiving regional anesthesia at advanced age (age ≥ 65 years) (β = − 1.12; 95% CI, − 1.66 to − 0.58; P < 0.001), patients with BMI ≤ 25 kg/m2 (β = − 1.92; 95% CI, − 2.73 to − 1.11; P < 0.001) or ≥ 30 kg/m2 (β = − 0.58; 95% CI, − 1.1 to − 0.06; P = 0.029).

Conclusion
Our findings demonstrated that age ≥ 65 years, DM, CCF, perioperative blood transfusion, creatinine > 2 mg/dL, ASA status (III), general anesthesia are associated with a prolonged LOS after primary TKA. Elderly patients (age ≥ 65 years) and patients with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2 receiving regional anesthesia have a further reduced LOS. Therefore, when TKA is performed, priority for regional anesthesia is given to the elderly patients (age ≥ 65 years old) and those with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2.
Germline 3p22.1 microdeletion encompassing RPSA gene is an ultra-rare cause of isolated asplenia
Authors: Oszer Aleksandra , Bąbol-Pokora Katarzyna , Kołtan Sylwia , Pastorczak Agata , Młynarski Wojciech 
Published: November 2021

Abstract
Background
Isolated Congenital Asplenia (ICA, OMIM #271400) is a rare, life-threatening abnormality causing immunodeficiency, which is characterized by the absence of a spleen. Diagnosis should be completed in early childhood and antibiotic prophylaxis applied with additional vaccinations.

Case presentation
We report the case of a six-month old girl with hematologic abnormalities and asplenia documented in imaging, with Howell-Jolly bodies in peripheral blood smear. Targeted Next Generation Sequencing screening did not reveal any pathogenic variant in genes associated with congenital asplenia. Since absence of the spleen was found by imaging, high-resolution copy number variations detection was also performed using genomic Single Nucleotide Polymorphism microarray: a heterozygous 337.2 kb deletion encompassing the RPSA gene was observed, together with SLC25A38, SNORA6, SNORA62 and MOBP genes. Despite haploinsufficiency of SLC25A38, SNORA6, SNORA62 and MOBP, no change in the clinical picture was observed. A search of available CNV databases found that a deletion of the RPSA locus seems to be unique and only duplications were found in this region with the frequency of less than 0.02%.

Conclusions
Copy number variations in RPSA gene locus are ultrarare cause of isolated asplenia. Furthermore, since the patient does not present any concomitant clinical features, it would appear that haploinsufficiency of SLC25A38, SNORA6, SNORA62 and MOBP genes does not affect the phenotype of patients. However, to confirm this thesis a longer follow-up of the patient’s development is needed.
CircRNA-DOPEY2 enhances the chemosensitivity of esophageal cancer cells by inhibiting CPEB4-mediated Mcl-1 translation
Authors: Liu Zhenchuan , Gu Shaorui , Wu Kaiqin , Li Lei , Dong Chenglai , Wang Wenli , Zhou Yongxin 
Published: November 2021

Abstract
Background
Cisplatin-based chemotherapy is a mainstay systematic therapy for advanced esophageal squamous cell carcinoma (ESCC), and cisplatin resistance, which is not uncommon, is the major barrier to improving patient outcomes. Circular RNAs (circRNAs) are novel noncoding RNAs that are implicated in cancer progression, but their involvement in modulating cisplatin responsiveness in ESCC remains unknown.

Methods
Bioinformatics analysis was used to profile and identify the circRNAs involved in cisplatin responsiveness in ESCC. The chemosensitive role of cDOPEY2 was confirmed both in vitro and in vivo. The molecular mechanism of cDOPEY2 was investigated by mass spectrometry, immunoprecipitation, and ubiquitination analyses.

Results
We report that a novel circRNA (cDOPYE2, hsa_circ_0008078) was markedly downregulated in cisplatin-resistant ESCC cells (ESCC-CR) compared with parental chemosensitive cells. Re-expression of cDOPEY2 substantially enhanced the cell-killing ability of cisplatin by augmenting the apoptotic process in ESCC-CR cells, which was achieved by decreasing the abundance of the antiapoptotic protein Mcl-1. Mechanistically, we showed that cDOPEY2 acted as a protein scaffold to enhance the interaction between the cytoplasmic polyadenylation element binding protein (CPEB4) and the E3 ligase TRIM25, which in turn facilitated the ubiquitination and degradation of CPEB4. The increased Mcl-1 expression in ESCC-CR cells was dependent on the binding of CPEB4 to its untranslated mRNA, and depletion of CPEB4 mediated by cDOPEY2 reversed this effect. Rescue experiments confirmed that the critical role of cDOPEY2 in maintaining cisplatin sensitivity was dependent on the depletion of CEPB4 and its downstream target Mcl-1. Clinical and in vivo data further corroborated the significant relevance of cDOPEY2 to cisplatin responsiveness in ESCC.

Conclusions
We provide evidence that cDOPEY2 inhibits CPEB4-mediated Mcl-1 translation by promoting the ubiquitination and degradation of CPEB4 to alleviate cisplatin resistance, indicating that cDOPEY2 may serve as a valuable biomarker and potential therapeutic target in ESCC.
Biosynthesis and regulation of terpenoids from basidiomycetes: exploration of new research
Authors: Wang Qi , Cao Rui , Zhang Yuna , Qi Pengyan , Wang Lizhi , Fang Shiming 
Published: November 2021

AbstractBasidiomycetes, also known as club fungi, consist of a specific group of fungi. Basidiomycetes produce a large number of secondary metabolites, of which sesquiterpenoids, diterpenoids and triterpenoids are the primary components. However, these terpenoids tend to be present in low amounts, which makes it difficult to meet application requirements. Terpenoid biosynthesis improves the quantity of these secondary metabolites. However, current understanding of the biosynthetic mechanism of terpenoids in basidiomycetes is insufficient. Therefore, this article reviews the latest research on the biosynthesis of terpenoids in basidiomycetes and summarizes the CYP450 involved in the biosynthesis of terpenoids in basidiomycetes. We also propose opportunities and challenges for chassis microbial heterologous production of terpenoids in basidiomycetes and provide a reference basis for the better development of basidiomycete engineering.
Effect of home-based pulmonary rehabilitation on functional capacity in people with idiopathic pulmonary fibrosis—a systematic review protocol
Authors: Amin Revati , Vaishali K. , Maiya G. Arun , Mohapatra Aswini Kumar , Yadav Uday Narayan , Parsekar Shradha S. 
Published: November 2021

Abstract
Background
Idiopathic pulmonary fibrosis (IPF) is one of the common types of interstitial lung disease having high prevalence and mortality worldwide. As a result of patient-centred hindering factors of adherence to centre-based pulmonary rehabilitation (PR), home-based PR is an alternate mode of rehabilitating individuals with IPF. This systematic review will evaluate the effectiveness of unsupervised home-based PR on functional capacity and health-related quality of life (HRQoL) in individuals with IPF.

Methods
Clinically stable, high resolution computed tomography and physician diagnosed IPF participants having modified Medical Research Council score below 5 will be considered for the systematic review. Studies involving home-based PR as an intervention to treat individuals with IPF will be considered. Randomised controlled trials and quasi-randomised studies (with two groups followed up) are eligible to be included. Outcomes of our interest are functional capacity (6-min walk distance, shuttle walk test and incremental shuttle walk test) and secondary outcome measure would include assessment of quality of life and adverse effects of intervention. Electronic databases such as SCOPUS, Medline (PubMed and Web of Science), PEDRo and CINAHL will be searched using database specific terms. Additionally, forward and backward citations of included studies will be searched to identify potential records. Two review authors, independently, will conduct the screening, data extraction using a customised standard tool, and critical appraisal using Cochrane Risk of Bias 2 tool of included studies. If data permits, meta-analysis will be conducted. In case of substantial heterogeneity, we will do a narrative synthesis. Subgroup analysis will be undertaken based on various contextual and interventional factors.

Discussion
This review will provide comprehensive evidence on the effectiveness of unsupervised home-based PR to physiotherapists, policy makers and researchers who are interested in IPF management. Findings from this review may guide the development and evaluation of more robust evidence based home-based PR that aimed to improve functional capacity among people with IPF.

Systematic review registration
PROSPERO CRD42020213883.
Innovation research on foreign language teaching theory with Chinese characteristics based on Whitehead’s process philosophy
Authors: Su Hui 
Published: November 2021

AbstractSince China’s reform and opening up, foreign language teaching (FLT) in China has achieved rapid development under the guidance of foreign language teaching theories both at home and abroad. However, problems such as ‘time-consuming and inefficient foreign language learning’ and the presence of ‘dumb foreign languages’ in FLT in China have not been fundamentally solved. Based on Whitehead’s process philosophy, this research aims to put forward feasible solutions to the existing problems in FLT in China so that the level of FLT in China can be promoted by discussing the purpose, contents, processes and stages of FLT and the relationship between teachers and students in both FLT and FLT evaluation systems.
Utility of shear wave ultrasound elastography in evaluation of testicular stiffness in patients with varicocele
Authors: Ahmed Ahmed Tohamy 
Published: November 2021

Abstract
Background
Testicular varicocele is the most frequent cause of male infertility. The study aimed at evaluation of testicular stiffness in patients with varicocele measured by shear wave ultrasound elastography (SWE) in correlation to patient semen analysis (total sperm count) and varicocele grade. This case–control study involved 50 patients (40 patients with bilateral testicular varicocele and 10 patients with unilateral Lt. testicular varicocele of different grades) and 25 healthy controls. All participants underwent physical examination, semen analysis (patient group subdivided in two groups: group A; normospermic and group B; oligospermic), scrotal grey scale and Doppler ultrasound, and shear wave ultrasound elastography with measurement of mean testicular stiffness. Evaluation of testicular stiffness and correlation to varicocele grade and semen analysis (total sperm count) were done.

Results
The mean testicular stiffness value measured by SWE in patients with testicular varicocele was greater than that of healthy controls (7.46 ± 1.64 kPa vs. 3.84 ± 0.62 kPa, P < 0.001). The mean testicular stiffness value in group B exceeded that of group A (8.57 ± 1.53 kPa vs. 6.34 ± 1.76 kPa, P = 0.001). A moderate positive correlation was found between mean testicular stiffness value and the varicocele grade (P = 0.01) which was more evident in group B than in group A (P = 0.01).

Conclusions
Testicular ultrasound SWE is a quantitative noninvasive imaging method which helps in the assessment of testicular parenchymal changes due to varicocele. Higher testicular stiffness values were found in testes of patients with varicocele, more in oligospermic patients than the testes of healthy controls. Testicular stiffness is moderately correlated to varicocele grade.