bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived stress in the time of COVID-19: the association with brooding and COVID-related rumination in adults with and without migraine
Authors: Kovács Lilla Nóra , Baksa Dániel , Dobos Dóra , Eszlári Nóra , Gecse Kinga , Kocsel Natália , Juhász Gabriella , Kökönyei Gyöngyi 
Published: April 2021

AbstractBackgroundThe main goal of this research was to explore whether migraineurs had a higher level of perceived stress than healthy controls during the times of the coronavirus and related restrictive measures, and to examine the relationship between different subtypes of rumination and perceived stress in these groups. We measured two facets of depressive rumination, brooding and reflection, along with rumination about the current COVID-19 situation to see whether these different subtypes of rumination explained perceived stress among migraineurs and healthy controls.MethodsHealthy adults (n = 64) and migraine patients (n = 73) filled out self-report questionnaires online. A multiple linear regression model was used to test whether depressive rumination (i.e. brooding and reflection) and COVID-related rumination explained perceived stress among adults with and without migraine during the times of COVID-19, after controlling for gender, age, migraine/control group status and migraine disability.ResultsAlthough we did not find any difference in the level of perceived stress among migraineurs and the control group, perceived stress was more strongly associated with brooding as well as COVID-related rumination among migraineurs than healthy controls. COVID-related rumination and brooding (but not reflection) explained the level of perceived stress after controlling for gender, age, migraine/control group status and migraine disability.ConclusionsThe similar degree of perceived stress among migraineurs and the control group may imply that there is great variation in the personal experience of people regarding the pandemic, that may be determined by numerous other factors. Our results demonstrate that ruminating about the pandemic and related difficulties, as well as brooding (but not reflection) appear to be associated with higher level of perceived stress during the times of the coronavirus. This association was slightly stronger among migraineurs, hinting at the increased vulnerability of this patient group in stressful situations like the COVID-19 pandemic. Our results also suggest that ruminating about the pandemic and its consequences is weakly associated with trait-level depressive rumination, thus may be more contingent on specific factors.
Veganism and eating disorders: assessment and management considerations
Authors: Fuller Sarah J. , Brown Andrea , Rowley Jeanette , Elliott-Archer Jade 
Published: April 2021

SummaryThe number of people following a vegan diet in the UK is increasing. Eating disorder clinicians are anecdotally reporting that more of their patients with anorexia nervosa are wanting to follow a vegan diet. The relationship between veganism and eating disorders is unclear. A fictitious scenario is used to explore these issues. An approach is described that clinicians may follow to help patients to understand the potential relationship between their eating disorder and veganism. The human rights issues this involves are also explored. It is hoped that this article will make readers more aware of this complex issue and the impact it can have on engagement with services and on treatment options.
Patients in mental healthcare should be referred to as patients and not service users
Authors: Priebe Stefan 
Published: April 2021

SummaryOver the past few years the term ‘service users’ has been increasingly used to describe patients in mental healthcare. This paper argues that the term ‘service user’ in this context should be avoided and outlines four reasons: the term is discriminating, cynical, patronising and detrimental. Of course, none of these effects is intentional, but that does not change them. The term ‘patient’, however, describes appropriately a temporary role in healthcare, provides parity of esteem with patients in physical healthcare and reflects the reasons why large parts of society are willing to fund healthcare, in solidarity with those who are sick.
Two distinct motifs for Zic-r.a drive specific gene expression in two cell lineages
Authors: Oda-Ishii Izumi , Yu Deli , Satou Yutaka 
Published: April 2021

ABSTRACT
Zic-r.a, a maternal transcription factor, specifies posterior fate in ascidian embryos. However, its direct target, Tbx6-r.b, does not contain typical Zic-r.a-binding sites in its regulatory region. Using an in vitro selection assay, we found that Zic-r.a binds to sites dissimilar to the canonical motif, by which it activates Tbx6-r.b in a sub-lineage of muscle cells. These sites with non-canonical motifs have weak affinity for Zic-r.a; therefore, it activates Tbx6-r.b only in cells expressing Zic-r.a abundantly. Meanwhile, we found that Zic-r.a expressed zygotically in late embryos activates neural genes through canonical sites. Because different zinc-finger domains of Zic-r.a are important for driving reporters with canonical and non-canonical sites, it is likely that the non-canonical motif is not a divergent version of the canonical motif. In other words, our data indicate that the non-canonical motif represents a motif distinct from the canonical motif. Thus, Zic-r.a recognizes two distinct motifs to activate two sets of genes at two timepoints in development.
This article has an associated ‘The people behind the papers’ interview.
Patrones de actividad de murciélagos filostómidos en un bosque seco en Honduras
Authors: Turcios-Casco Manfredo A. , Ávila-Palma Hefer D. , Soler Orellana José A. , Ordoñez Trejo Eduardo J. , Ordoñez Mazier Diego I. 
Published: April 2021

En Honduras, los estudios sobre murciélagos son escasos y se desconoce cómo la actividad de los murciélagos filostómidos es influenciada por factores ambientales. Describimos patrones de actividad de especies de murciélagos filostómidos en Ciudad Universitaria, Francisco Morazán (centro de Honduras). Realizamos 21 jornadas y capturamos murciélagos con 2 redes de niebla del 26 de febrero de 2015 al 29 de abril de 2016. En total, se registraron 114 individuos en 1,428.24 horas/red/metro. Con base en el análisis ANOVA, los murciélagos filostómidos se encontraron entre 58 % y 93.5 % de humedad relativa del aire, y entre 17.4 ºC y 22.8 ºC de temperatura del aire. Nuestros resultados indican diferencias interespecíficas en la actividad de los murciélagos filostómidos en el área de estudio. Este es el primer intento en describir sus patrones de actividad en un bosque seco en Honduras.
Korelasi Kadar Asam Urat dan High-Mobility Group Box 1 Serum dengan Keparahan Stenosis Arteri Koroner Pasien Sindrom Koroner Akut: Tinjauan Sistematis
Authors: Prasetyo Diding Heri , Nasution Sally Aman , Alwi Idrus , Abdullah Murdani 
Published: April 2021

<p><strong>Pendahuluan</strong><strong>:</strong> Sindrom koroner akut (SKA) adalah gangguan yang mengancam jiwa yang tetap menjadi sumber morbiditas dan mortalitas yang tinggi meskipun ada kemajuan dalam pengobatan. Asam urat dan <em>high-mobility group box 1</em> (HMGB1) keduanya berperan penting dalam patofisiologi SKA, tetapi interaksi kooperatif antara keduanya dalam kejadian keparahan stenosis arteri koroner pada SKA, belum sepenuhnya jelas. Penelitian ini bertujuan untuk melakukan tinjauan sistematis maupun meta analisis untuk mensintesis hasil-hasil penelitian yang berbeda tersebut agar diperoleh data baru yang bersifat kuantitatif dan lebih akurat. </p><p><strong>Metode</strong><strong>:</strong> Protokol penelitian didaftarkan dengan PROSPERO (CRD42020210948) dan tinjauan sistematis mengikuti pedoman <em>preferred reporting items for systematic reviews and meta-analyses</em> (PRISMA), dengan menelusuri studi yang dipublikasikan dalam rentan waktu dari Januari 2010 hingga Mei 2020. <em>Cochrane Library</em>, <em>Ebsco</em>, <em>Medline/PubMed</em>, <em>ProQuest</em> dan <em>Sience Direct</em> adalah sumber dari studi yang dipublikasikan. Meta-analisis dilakukan untuk mensintesis korelasi antara kadar asam urat dan HMGB1 serum dan keparahan stenosis arteri koroner. Heterogenitas dinilai menggunakan I<sup>2</sup>, dan meta analisis menggunakan perangkat lunak <em>Comprehensive Meta Analysis Version 3</em> (CMA3).</p><p><strong>Hasil</strong><strong>:</strong> Lima studi (n = 601 pasien) diidentifikasi didapatkan korelasi antara kadar asam urat serum dan skor Gensini (r = 0,548; p &lt;0,001) pada pasien SKA. Sedangkan, korelasi antara kadar HMGB1 serum dan skor Gensini pada pasien SKA didapatkan satu studi (n = 60 pasien) dengan nilai r = 0,588; p &lt;0,001. Bias heterogenitas ditemukan dalam analisis, sedangkan bias publikasi tidak ditemukan.</p><p><strong>Kesimpulan</strong><strong>:</strong> Keparahan stenosis arteri koroner pada pasien dengan SKA berkorelasi positip dengan kadar asam urat dan HMGB1 serum.</p>
Maximizing and evaluating the impact of test-trace-isolate programs: A modeling study
Authors: Grantz Kyra H. , Lee Elizabeth C. , D’Agostino McGowan Lucy , Lee Kyu Han , Metcalf C. Jessica E. , Gurley Emily S. , Lessler Justin 
Published: April 2021

Background
Test-trace-isolate programs are an essential part of coronavirus disease 2019 (COVID-19) control that offer a more targeted approach than many other nonpharmaceutical interventions. Effective use of such programs requires methods to estimate their current and anticipated impact.

Methods and findings
We present a mathematical modeling framework to evaluate the expected reductions in the reproductive number, R, from test-trace-isolate programs. This framework is implemented in a publicly available R package and an online application. We evaluated the effects of completeness in case detection and contact tracing and speed of isolation and quarantine using parameters consistent with COVID-19 transmission (R0: 2.5, generation time: 6.5 days). We show that R is most sensitive to changes in the proportion of cases detected in almost all scenarios, and other metrics have a reduced impact when case detection levels are low (<30%). Although test-trace-isolate programs can contribute substantially to reducing R, exceptional performance across all metrics is needed to bring R below one through test-trace-isolate alone, highlighting the need for comprehensive control strategies. Results from this model also indicate that metrics used to evaluate performance of test-trace-isolate, such as the proportion of identified infections among traced contacts, may be misleading. While estimates of the impact of test-trace-isolate are sensitive to assumptions about COVID-19 natural history and adherence to isolation and quarantine, our qualitative findings are robust across numerous sensitivity analyses.

Conclusions
Effective test-trace-isolate programs first need to be strong in the “test” component, as case detection underlies all other program activities. Even moderately effective test-trace-isolate programs are an important tool for controlling the COVID-19 pandemic and can alleviate the need for more restrictive social distancing measures.
Barriers to utilize nutrition interventions among lactating women in rural communities of Tigray, northern Ethiopia: An exploratory study
Authors: Beyene Selemawit Asfaw , Weldegerima Lemlem , Tela Freweini Gebrearegay , Seid Omer , Brown Amal Tucker , Bezabih Afework Mulugeta 
Published: April 2021

Background
While lactation is a physiological process requiring high energy demand to fulfill the nutrient requirements of the mother and the breastfeeding child, many factors affecting maternal nutrient intake can lead to nutritional deficits. Previous studies in Ethiopia have reported the prevalence of maternal and child undernutrition and related complications. However, qualitative studies exploring potential barriers to utilizing available nutrition interventions are limited. This study, therefore, sought to qualitatively explore barriers hindering the uptake of nutrition services among lactating mothers from rural communities in Tigray, northern Ethiopia.

Methods
We conducted 6 in-depth interviews, 70 key informant interviews, and 13 focus group discussions among purposively selected community groups, experts, and lactating mothers between November- 2017 and January- 2018. Audio records of all interviews and focus group discussions were transcribed verbatim (word-to-word) and translated into English. Then, translated data were analyzed thematically using qualitative data analysis software Atlas ti-version 7.4.

Results
The participants in this study perceived that lactating mothers in their study area are not properly utilizing available and recommended nutrition interventions, and as a result, their nutrient intake was reported as inadequate. Participants identified inadequate accessibility and availability of foods, feeding practices, cultural and religious influences, focus on agricultural production and productivity, barriers related to health services and poor access to water, sanitation and hygiene as major barriers hindering the uptake of nutrition interventions by lactating women in Tigray, northern Ethiopia.

Conclusion
The uptake of nutrition intervention services was low among lactating mothers and was hindered by multiple socio-cultural and health service related factors requiring problem-specific interventions at community, health facility, and administrative levels to improve the nutritional status of lactating mothers in the study area.
Effects of Central Obesity on Esophageal Epithelial Barrier Function
Authors: Gibbens Ying Y. , Lansing Ramona , Johnson Michele L. , Blevins Christopher H. , Katzka David A. , Iyer Prasad G. 
Published: April 2021

INTRODUCTION:
We assessed if obesity perturbs the esophageal epithelial barrier function independent of promotion of gastroesophageal reflux (GER).

METHODS:
Thirty-eight participants were divided into 4 groups: Obesity−/GER–, Obesity+/GER−, Obesity−/GER+, and Obesity+/GER+. Esophageal intercellular space and desmosome density (structural integrity) and fluorescein leak (functional integrity) were measured.

RESULTS:
The Obesity+/GER− group demonstrated increased intercellular space, reduced desmosome density, and increased fluorescein leak compared with control subjects. These changes were similar but not additive to findings seen in Obesity−/GER + and Obesity+/GER+ patients.

DISCUSSION:
Central obesity impairs structural and functional integrity of the esophageal barrier independent of GER, likely predisposing to esophageal injury.
Initial Evaluation, Long-Term Monitoring, and Hepatocellular Carcinoma Surveillance of Chronic Hepatitis B in Routine Practice: A Nationwide US Study
Authors: Tran Sally , Jeong Donghak , Henry Linda , Cheung Ramsey C. , Nguyen Mindie H. 
Published: April 2021

INTRODUCTION:
Previous studies, mostly small and single center, have shown gaps in the evaluation and monitoring of patients with chronic hepatitis B (CHB) virus infection. We aimed to examine the rates and predictors of adherence to guidelines for CHB care in a large nationwide cohort.

METHODS:
We identified adult patients with CHB infection from the Truven MarketScan databases of commercially insured and Medicare patients with private insurance supplement (2007–2014) using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The initial evaluation cohort had at least 6 months follow-up, whereas at least 12 months was required for the long-term monitoring cohort.

RESULTS:
We analyzed 55,317 eligible patients with CHB infection: mean age 46 ± 12 years, 58% men, and 14.8% with cirrhosis. Over a mean follow-up of 3.2 ± 2.3 years, 55.8% had specialist (gastroenterology or infectious diseases) visits. For initial evaluation, 59% of patients received both alanine aminotransferase (ALT) and hepatitis B virus (HBV) DNA tests, whereas only 33% had ALT, HBV DNA, and hepatitis B e antigen tests, with higher frequencies among patients with specialist visits. For long-term monitoring, only 25% had both ALT and HBV DNA tests performed annually. Among patients at higher risk of developing hepatocellular carcinoma (patients with cirrhosis, male patients without cirrhosis older than 40 years, and female patients without cirrhosis older than 50), less than 40% underwent annual hepatocellular carcinoma surveillance, with 25% never receiving surveillance during the study period. Predictors of optimal initial evaluation and long-term monitoring were compensated cirrhosis (odds ratio: 1.60 and 1.47, respectively) and specialist visits (odds ratio: 1.86 and 1.31, respectively) (both P < 0.001).

DISCUSSION:
In this large cohort of patients with CHB infection with private insurance or Medicare with private insurance supplement, we observed poor adherence to the recommended initial evaluation and long-term monitoring. Among the predictors of adherence were specialist visits. Further efforts are needed to identify barriers and improve access to care.
Effect of Vitamin D Supplementation on Vitamin D Level and Bone Mineral Density in Patients With Cirrhosis: A Randomized Clinical Trial
Authors: Grover Indu , Gunjan Deepak , Singh Namrata , Benjamin Jaya , Ramakrishnan Lakshmy , Pandey Ravindra M. , Sati Hem C. , Saraya Anoop 
Published: April 2021

Introduction:
In patients with cirrhosis, highly prevalent vitamin D deficiency and low bone mineral density (BMD) increase the burden of disease, and role of vitamin D supplementation is not clear. So, our aim was to determine the effect of vitamin D supplementation on vitamin D level and BMD in patients with cirrhosis.

Methods:
Patients with cirrhosis (18–60 years) of any etiology were enrolled. We measured serum 25(OH)D, parathyroid hormone, thyroid-stimulating hormone, free T4, bone-specific alkaline phosphatase, insulin-like growth factor (IGF)-1, and health-related quality of life at entry and at 1 year; however, serum calcium was measured at 3-month interval. BMD was measured by dual-energy x-ray absorptiometry at lumbar spine and left hip neck at entry and after 1 year. Statistical analysis was performed according to intention-to-treat analysis.

Results:
Of 390 screened patients with cirrhosis, 164 participants (82 in each group) were randomized. There was significant increase in 25(OH)D levels in intervention group after 1 year (33.7 [24.3–45.7] ng/mL vs 23.1 [17–28.2] ng/mL; P < 0.001) when compared with placebo. The mean difference in BMD at lumbar spine and left hip neck was not significantly changed after 1 year of intervention with vitamin D between both groups. There was no significant change in both the groups in levels of calcium, thyroid-stimulating hormone, parathyroid hormone, free T4, IGF-1, and bone-specific alkaline phosphatase and quality of life.

Discussion:
Supplementation with vitamin D for 1 year improves vitamin D levels but did not result in improvement in BMD at lumbar spine and left hip neck in patients with cirrhosis.
Analisis Kepuasan Pasien Dilihat dari Minat untuk Dirawat Kembali Terhadap Pelayanan Dokter dan Perawat
Authors: Masruron Lailil , Kuntjoro Tjahjono , Kartasurya Martha Irene 
Published: April 2021

Title :Patient Satisfaction To Doctor’s And Nurse’s Care Associated To The Interest To Be Rehospitalized (A study at RSUD Dolopo, Madiun Regency). AbstractBed Occupancy Rate (BOR) at Dolopo Public Hospital had decreased from 56.16% in 2013 to 35.86% in 2104 and 35.2% in 2015, and the average ALOS (Average Length of Stay) and Turn over Interval (TOI) increased. The preliminary study on patients of Social Security Agency (BPJS Non PBI) showed a dissatisfaction to nurse’s and doctor’s services. The aim of this study was to analyze the associations between patient satisfaction toward doctor’s & nurse’s services to the interest to be rehospitalized.This study was conducted in a cross sectional design. The subjects were 95 patients of BPJS with Non PBI in inpatient room for class I, II, III, which was choosen by using accidental sampling. Data were gathered through interviews using structured questionnaires. Data analysis was conducted by Chi-square tests and logistic regression.Results showed that the patient satisfaction based on aspects of tangibles, reliability, responsiveness, assurance, and empathy were lower than the expectations. Most of the subjects have positive attitudes, negative subjective norms and perceptions of behavior control and had a poor accesibility to the hospital. However 75.8% of the respondents were interested to be rehospitalized at Dolopo Hospital. There were correlations between patient satisfaction (p=0.009), attitude (p=0.000), subjective norm (p=0.002) with the interest to be rehospitalized. There was no correlation between control perception behavior (p=0.103), and access (p = 0.454) with the interest to be rehospitalized. After controlled for the attitude toward doctors’ and nurses’ services, the patients who were satisfied to the doctor’ and nurses’ services had 3.84 times to be interested to be rehospitalized than the patients who were not satifsfied (OR = 3.84 ; CI 95% : 0.98-15.12, p=0.054).Keywords : Patient Satisfaction, Rehospitalized, BPJS.
Job Satisfaction is Dominant Factor Influencing of Nurse Performance in X Hospital Pekanbaru
Authors: Ismainar Hetty , Djuhaeni Henny , Magretta Jeanny Susana 
Published: April 2021

Introduction: The provision of optimal health services is determined by the quality of health workers. The research objective was to explore the factors that influence the performance of nurses in health service.Method: It was a quantitative analytic study with a cross-sectional design. A total of 58 nurses participated with a purposive random sampling technique. The data was collected by questionnaire and worksheets observation. The statistical analysis was done by Smart PLS (Partial Least Square).Result: This study showed that individual characteristics are correlated to job satisfaction (p-value 0.001) but not correlated with the performance of nurses (p-value 0.468). Organizational factors were correlated to job satisfaction (p-value 0.000) but not correlated to work performance (p-value 0.865). Job satisfaction was correlated to work performance (p-value 0.001). There was a negative correlation between individual characteristics and nurse performance (-0.466). Meanwhile, the organizational factor only has a direct effect of 0.025 on nurse performance. Only job satisfaction has a direct effect on nurse performance with an increase of 0.5 (50%) for every increase of one value of job satisfaction.Conclusion: Job satisfaction is a dominant factor that has a direct effect on nurse performance. Hospital management needs to consider health workforce planning, mapping, and development competency to optimize nurse performance.
Phosphine oxide for reducing flammability of ethylene-vinyl-acetate copolymer
Authors: Jiang Jiawei , Guo Ruifeng , Shen Haifeng , Ran Shiya 
Published: April 2021

Abstract
In this work, a phosphorous-containing flame retardant, phenylphosphonate-based compound (EHPP), is synthesized by alcoholysis and hydrazinolysis of phenylphosphonic dichloride, which is subsequently introduced to ethylene-vinyl-acetate (EVA) copolymer to improve its flame retardant performance. The resultant compound was characterized by Fourier transform infrared (FTIR), 1H NMR, 13C NMR, and 31P NMR. The influence of the EHPP on the combustion behaviors of EVA is studied by limiting oxygen index (LOI), UL-94, and cone calorimeter test. The results show that 1 wt% EHPP can reduce peak heat release rate (PHRR) by 40%. Moreover, 2 wt% EHPP can increase LOI from 20.5% to 25.5%. Thermogravimetric analysis/infrared spectrometry (TGA-FTIR) was used to detect the gaseous products of EVA/EHPP to study the gaseous-phase flame retardant mechanism. The EHPP released phosphorus-containing radicals to capture highly active free radicals to improve the flame retardancy of EVA.