bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening Referral Networks for Management of Hypertension Across the Health System (STRENGTHS) in western Kenya: a study protocol of a cluster randomized trial
Authors: Mercer Tim , Njuguna Benson , Bloomfield Gerald S. , Dick Jonathan , Finkelstein Eric , Kamano Jemima , Mwangi Ann , Naanyu Violet , Pastakia Sonak D. , Valente Thomas W. , Vedanthan Rajesh , Akwanalo Constantine 
Published: September 2019

Abstract

Background
Hypertension is a major risk factor for cardiovascular disease (CVD), yet treatment and control rates for hypertension are very low in low- and middle-income countries (LMICs). Lack of effective referral networks between different levels of the health system is one factor that threatens the ability to achieve adequate blood pressure control and prevent CVD-related morbidity. Health information technology and peer support are two strategies that have improved care coordination and clinical outcomes for other disease entities in other settings; however, their effectiveness and cost-effectiveness in strengthening referral networks to improve blood pressure control and reduce CVD risk in low-resource settings are unknown.

Methods/design
We will use the PRECEDE-PROCEED framework to conduct transdisciplinary implementation research, focused on strengthening referral networks for hypertension in western Kenya. We will conduct a baseline needs and contextual assessment using a mixed-methods approach, in order to inform a participatory, community-based design process to fully develop a contextually and culturally appropriate intervention model that combines health information technology and peer support. Subsequently, we will conduct a two-arm cluster randomized trial comparing 1) usual care for referrals vs 2) referral networks strengthened with our intervention. The primary outcome will be one-year change in systolic blood pressure. The key secondary clinical outcome will be CVD risk reduction, and the key secondary implementation outcomes will include referral process metrics such as referral appropriateness and completion rates. We will conduct a mediation analysis to evaluate the influence of changes in referral network characteristics on intervention outcomes, a moderation analysis to evaluate the influence of baseline referral network characteristics on the effectiveness of the intervention, as well as a process evaluation using the Saunders framework. Finally, we will analyze the incremental cost-effectiveness of the intervention relative to usual care, in terms of costs per unit decrease in systolic blood pressure, per percentage change in CVD risk score, and per disability-adjusted life year saved.

Discussion
This study will provide evidence for the implementation of innovative strategies for strengthening referral networks to improve hypertension control in LMICs. If effective, it has the potential to be a scalable model for health systems strengthening in other low-resource settings worldwide.

Trial registration
Clinicaltrials.gov, NCT03543787. Registered on 29 June 2018.
Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: a cross-sectional study
Authors: Bahrey Degena , Gebremedhn Gebreamlak , Mariye Teklewoini , Girmay Alem , Aberhe Woldu , Hika Assefa , Teklay Girmay , Tasew Hagos , Zeru Teklay , Gerensea Hadgu , Demoz Gebre Teklemariam 
Published: September 2019

Abstract

Objective
The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected 578 hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0.

Result
Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 (22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7%, 27.3% and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI 1.43 (1.07–1.81)], uncontrolled hypertension 4.434 [AOR (95% CI 9.45 (1.34, 14.73)], overweight/obese [AOR (95% CI 7.422 (2.72, 20.28)], dyslipidemia [AOR (95% CI) 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.
Sketching for sequential change-point detection
Authors: Cao Yang , Thompson Andrew , Wang Meng , Xie Yao 
Published: September 2019

Abstract
We present sequential change-point detection procedures based on linear sketches of high-dimensional signal vectors using generalized likelihood ratio (GLR) statistics. The GLR statistics allow for an unknown post-change mean that represents an anomaly or novelty. We consider both fixed and time-varying projections, derive theoretical approximations to two fundamental performance metrics: the average run length (ARL) and the expected detection delay (EDD); these approximations are shown to be highly accurate by numerical simulations. We further characterize the relative performance measure of the sketching procedure compared to that without sketching and show that there can be little performance loss when the signal strength is sufficiently large, and enough number of sketches are used. Finally, we demonstrate the good performance of sketching procedures using simulation and real-data examples on solar flare detection and failure detection in power networks.
Putrescine mitigates intestinal atrophy through suppressing inflammatory response in weanling piglets
Authors: Liu Bangmin , Jiang Xianren , Cai Long , Zhao Xuemei , Dai Zhaolai , Wu Guoyao , Li Xilong 
Published: September 2019

Abstract

Background
Polyamines are essential for cell growth and beneficial for intestinal maturation. To evaluate the effects of putrescine on alleviating intestinal atrophy and underlying molecular mechanisms, both in vivo feeding trial and in vitro cell culture were conducted. Weanling pigs were fed a diet supplemented with 0, 0.1%, 0.2% or 0.3% putrescine dihydrochloride, whereas porcine intestinal epithelial cells (IPEC-J2) were challenged with lipopolysaccharide (LPS) in the presence of 200 μmol/L putrescine.

Results
Dietary supplementation with 0.2% putrescine dihydrochloride decreased the incidence of diarrhea with an improvement in intestinal integrity. Inhibition of ornithine decarboxylase activity decreased the proliferation and migration of IPEC-J2 cells, and this effect was alleviated by the supplementation with putrescine. The phosphorylation of extracellular signal regulated kinase and focal adhesion kinase was enhanced by putrescine. LPS increased the expression of inflammatory cytokines [tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and IL-8], and inhibited cell proliferation and migration in IPEC-J2 cells. Adding exogenous putrescine suppressed the expression of TNF-α, IL-6 and IL-8, and recovered cell migration and proliferation in LPS-treated IPEC-J2 cells. Dietary putrescine supplementation also reduced the mRNA levels of TNF-α, IL-6 and IL-8 and their upstream regulator nuclear receptor kappa B p65 subunit in the jejunal mucosa of piglets.

Conclusions
Dietary supplementation with putrescine mitigated mucosal atrophy in weanling piglets through improving anti-inflammatory function and suppressing inflammatory response. Our results have important implications for nutritional management of intestinal integrity and health in weanling piglets and other neonates.
OpenStreetMap history for intrinsic quality assessment: Is OSM up-to-date?
Authors: Minghini Marco , Frassinelli Francesco 
Published: September 2019

Abstract
OpenStreetMap (OSM) is a well-known crowdsourcing project which aims to create a geospatial database of the whole world. Intrinsic approaches based on the analysis of the history of data, i.e. its evolution over time, have become an established way to assess OSM quality. After a comprehensive review of scientific as well as software applications focused on the visualization, analysis and processing of OSM history, the paper presents “Is OSM up-to-date?”, an open source web application addressing the need of OSM contributors, community leaders and researchers to quickly assess OSM intrinsic quality based on the object history for any specific region. The software, mainly written in Python, can be also run in the command line or inside a Docker container. The technical architecture, sample applications and future developments of the software are also presented in the paper.
Comparison between central and ambulatory blood pressure measurements in early detection of end organ damage: a single-center prospective non-randomized controlled trial
Authors: Fouad Doaa A. , Al Araby Hosam Hassan , Ashraf Mohammad , El-Kousy Ahmed El-Sherif 
Published: September 2019

Abstract

Background
Both ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD). However, the comparison between these two methods needs more clarification. Our cross-sectional study included 100 hypertensive patients with a mean age of 47.52 ± 8.35 years on regular antihypertensive treatment for ≥ 1 year (50 controlled, 50 uncontrolled). We compared associations, sensitivity, and specificity of EOD parameters with office, AMBP, and NCBP measurements. We measured left ventricular mass index (LVMI), carotid intimal medial thickness (CIMT), ankle-brachial index (ABI), serum creatinine, glomerular filtration rate (GFR), and pulse wave velocity (PWV).

Results
We found a significant relation between SBP of NCBP, AMBP and LVMI, and CIMT, PWV, and GFR respectively (P < 0.05) while office SBP showed no significant relation. Systolic AMBP showed a high sensitivity to ABI (98%) and CIMT (92%) while systolic NCBP had 92% specificity and DBP showed 90% sensitivity for ABI.

Conclusion
AMBP and NCBP show a significant relation to LVMI, CIMT, PWV, and GFR with little superiority of central BP while office BP does not. Systolic ABPM has high sensitivity to ABI and CIMT and systolic NCBP has a high sensitivity and specificity to ABI.
Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment
Authors: Hoffmann Ditte , Rask Charlotte Ulrikka , Hedman-Lagerlöf Erik , Eilenberg Trine , Frostholm Lisbeth 
Published: September 2019

Background
Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay.

Aims
This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment.

Method
Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics.

Results
In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile.

Conclusions
Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics.

Declaration of interest
None.
Factors that contribute to psychological resilience to suicidal thoughts and behaviours in people with schizophrenia diagnoses: qualitative study
Authors: Harris Kamelia , Gooding Patricia , Haddock Gillian , Peters Sarah 
Published: September 2019

BackgroundSuicide is a leading cause of premature death in people with a diagnosis of schizophrenia. Although exposure to stressors can play a part in the pathways to death by suicide, there is evidence that some people with a diagnosis of schizophrenia can be resilient to the impact of suicide triggers.AimsTo investigate factors that contribute to psychological resilience to suicidal thoughts and behaviours from the perspectives of people with a diagnosis of schizophrenia.MethodA qualitative design was used, involving semi-structured, face-to-face interviews. Twenty individuals with non-affective psychosis or schizophrenia diagnoses who had experience of suicide thoughts and behaviours participated in the study. The interviews were audio-recorded, transcribed verbatim and examined using inductive thematic analysis.ResultsParticipants reported that psychological resilience to suicidal thoughts and behaviours involved ongoing effort. This ongoing effort encompassed: (a) understanding experiences (including reconciliation to mental health experiences and seeking reasons to live), (b) active behaviours (including talking to people and keeping occupied), and (c) relationship dynamics (including feeling supported by significant others and mental health professionals).ConclusionsPsychological resilience was described as a dynamic process that developed over time through the experiences of psychosis and the concomitant suicidal experiences. Psychological resilience can be understood using a multicomponential, dynamic approach that integrates buffering, recovery and maintenance resilience models. In order to nurture psychological resilience, interventions should focus on supporting the understanding and management of psychosis symptoms and concomitant suicidal experiences.Declaration of interestNone.
Positron Emission Tomography–Guided Treatment in Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Randomized Phase III HD16 Trial by the German Hodgkin Study Group
Authors: Fuchs Michael , Goergen Helen , Kobe Carsten , Kuhnert Georg , Lohri Andreas , Greil Richard , Sasse Stephanie , Topp Max S. , Schäfer Erhardt , Hertenstein Bernd , Soekler Martin , Vogelhuber Martin , Zijlstra Josée M. , Keller Ulrich Bernd , Krause Stefan W. , Wilhelm Martin , Maschmeyer Georg , Thiemer Julia , Dührsen Ulrich , Meissner Julia , Viardot Andreas , Eich Hans , Baues Christian , Diehl Volker , Rosenwald Andreas , von Tresckow Bastian , Dietlein Markus , Borchmann Peter , Engert Andreas 
Published: September 2019

PURPOSE Combined-modality treatment (CMT) with 2× ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and small-field radiotherapy is standard of care for patients with early-stage favorable Hodgkin lymphoma (HL). However, the role of radiotherapy has been challenged. Positron emission tomography (PET) after 2× ABVD (PET-2) might help to predict individual outcomes and guide treatment. METHODS Between November 2009 and December 2015, we recruited patients age 18 to 75 years with newly diagnosed, early-stage favorable HL for this international randomized phase III trial. Patients were assigned to standard CMT of 2× ABVD and 20-Gy involved-field radiotherapy or PET-guided treatment, omitting involved-field radiotherapy after negative PET-2 (Deauville score < 3). Primary objectives were to exclude inferiority of 10% or more in 5-year progression-free survival (PFS) of ABVD alone compared with CMT in a per-protocol analysis among PET-2–negative patients (noninferiority margin for hazard ratio, 3.01) and to confirm PET-2 positivity (Deauville score ≥ 3) as a risk factor for PFS among CMT-treated patients. RESULTS We enrolled 1,150 patients. Median follow-up was 45 months. Among 628 PET-2–negative, per-protocol–treated patients, 5-year PFS was 93.4% (95% CI, 90.4% to 96.5%) with CMT and 86.1% (95% CI, 81.4% to 90.9%) with ABVD (difference 7.3% [95% CI, 1.6% to 13.0%]; hazard ratio, 1.78 [95% CI, 1.02 to 3.12]). Five-year overall survival was 98.1% (95% CI, 96.5% to 99.8%) with CMT and 98.4% (95% CI, 96.5% to 100.0%) with ABVD. Among 693 patients who were assigned to CMT, 5-year PFS was 93.2% (95% CI, 90.2% to 96.2%) among PET-2–negative patients and 88.4% (95% CI, 84.2% to 92.6%) in PET-2–positive patients ( P = .047). When using the more common liver cutoff (Deauville score, 4) for PET-2 positivity, the difference was more pronounced (5-year PFS, 93.1% [95% CI, 90.7% to 95.5%] v 80.9% [95% CI, 72.2% to 89.7%]; P = .0011). CONCLUSION In early-stage favorable HL, a positive PET after two cycles ABVD indicates a high risk for treatment failure, particularly when a Deauville score of 4 is used as a cutoff for positivity. In PET-2–negative patients, radiotherapy cannot be omitted from CMT without clinically relevant loss of tumor control.
“Εφαρμογή του μαθησιακού μοντέλου 4ΜΑΤ με την αξιοποίηση authoring tools (CourseLab) στη διδασκαλία των αρχαίων ελληνικών”
Authors: Ριζοπούλου Ελένη Ευριπίδη , Σοφός Αλιβίζος (Λοΐζος) 
Published: September 2019

Η εργασία σχεδιάστηκε για να διερευνήσει αν υπάρχουν διαφορές στα μαθησιακά αποτελέσματα που προκύπτουν από την εφαρμογή τριών παιδαγωγικών μεθόδων, την παραδοσιακή, την βασισμένη στο μοντέλο 4ΜΑΤ και έναν συνδυασμό 4ΜΑΤ και ηλεκτρονικής μάθησης στην οποία χρησιμοποιήθηκε το authoring tool CourseLab. Ελέγχθηκαν τα μαθησιακά αποτελέσματα που προέκυψαν από την εφαρμογή των μεθόδων αυτών σε 67 μαθητές της Α΄Λυκείου του δημόσιου ΓΕΛ Ν.Μάκρης, στο μάθημα των αρχαίων ελληνικών. Η αξιολόγηση των μεθόδων βασίστηκε σε κριτήρια αξιολόγησης και στα βαθμολογικά δεδομένα που προέκυψαν από αυτά, εφαρμόστηκαν τα κριτήρια One-way ANOVA και Kruskall-Wallis. Τα ευρήματα της έρευνας έδειξαν ότι καμία από τις μεθόδους δε φαίνεται να υπερτερεί έναντι των άλλων. Διανεμήθηκαν ερωτηματολόγια που συμπληρώθηκαν από τους μαθητές/τριες για να αξιολογηθεί το ηλεκτρονικό μάθημα και να αποτιμηθεί η στάση των παιδιών απέναντι σε αυτή τη μορφή διδασκαλίας. Οι μαθητές/τριες φαίνεται ότι απέναντι στο ψηφιακό μάθημα που ήταν δομημένο με τις αρχές του μοντέλου 4ΜΑΤ είχαν θετικότερη στάση σε σχέση με την παραδοσιακή διδασκαλία.
Οι Λεξικές Βάσεις Δεδομένων ως Εκπαιδευτικό Εργαλείο Εκμάθησης Ορολογίας στην Υπολογιστική Γλωσσολογία
Authors: Καρβουνιάρη Δήμητρα , Παπακίτσος Ευάγγελος Χρήστος 
Published: September 2019

Oι λεξικές βάσεις δεδομένων αποτελούν ένα ισχυρό και εύκολα επεκτάσιμο εκπαιδευτικό εργαλείο στον τομέα της εκμάθησης ορολογίας. Η χρήση τους μπορεί να προσφέρει στους σπουδαστές εμπειρίες εκμάθησης με φιλικό τρόπο, παρέχοντας πρόσβαση σε ποικιλία πηγών και πληροφοριών σε αυθεντικά γλωσσικά περιβάλλοντα. Στην παρούσα εργασία περιγράφεται η σχεδίαση και υλοποίηση μιας λεξικής βάσης δεδομένων, ως εφαρμογής λογισμικού του τεχνολογικού πεδίου της Ηλεκτρονικής Λεξικογραφίας. Ο αρχικός σκοπός της δημιουργίας ενός τέτοιου εργαλείου ήταν η διευκόλυνση της εκμάθησης της τεχνικής ορολογίας του επιστημονικού πεδίου της Υπολογιστικής Γλωσσολογίας, στην οποία εμφανίζεται συχνά το φαινόμενο της πολυσημίας, δηλαδή ο ίδιος όρος να έχει δύο τουλάχιστον διαφορετικές σημασίες. Το φαινόμενο αυτό οφείλεται τόσο στη μετάφραση αγγλικών όρων στην ελληνική γλώσσα όσο και στο συνδυασμό διαφορετικών επιστημών (Πληροφορικής, Μαθηματικών και Γλωσσολογίας) στο ίδιο πεδίο εφαρμογών.
Πρόγραμμα εξ αποστάσεως επιμόρφωσης Εκπαιδευτικών Πρωτοβάθμιας Εκπ/σης «Ψηφιακός Γραμματισμός στα Οπτικοακουστικά Μέσα σε Διαδικτυακά Περιβάλλοντα Μάθησης»: Αποτελέσματα και Προτάσεις από την Πιλοτική Εφαρμογή
Authors: Papadimitriou Sofia Theodor , Sofos Alivisos 
Published: September 2019

Οι προκλήσεις αλλά και οι δυνατότητες που παρέχει το σύγχρονο ψηφιακό περιβάλλον απαιτούν τη μεθοδική προσέγγιση του ψηφιακού γραμματισμού από την πρώτη εκπαιδευτική βαθμίδα. Περιβάλλοντα Μάθησης στο Διαδίκτυο εξοικειώνουν τους νέους με τα ψηφιακά Μέσα και συμβάλλουν στην ανάπτυξη ψηφιακών γραμματισμών. Ειδικότερα, τα Οπτικοακουστικά Μέσα, επιφέρουν αλλαγές στη διδασκαλία εμπλέκοντας τους μαθητές σε πλούσιες αλληλεπιδραστικές μαθησιακές εμπειρίες, μετατρέποντάς τους από παθητικούς δέκτες σε ενεργούς συμμετέχοντες. Προϋπόθεση είναι οι εκπαιδευτικοί να γνωρίζουν τρόπους να αξιοποιούν τα οπτικοακουστικά μέσα ως ένα περιβάλλον ενεργής μάθησης. Το πρόγραμμα επιμόρφωσης «Ψηφιακός Γραμματισμός σε Οπτικοακουστικά Μέσα σε Διαδικτυακά Περιβάλλοντα Μάθησης» του Πανεπιστημίου Αιγαίου υλοποιήθηκε το φθινόπωρο του 2018 με τη μέθοδο της εξ αποστάσεως εκπαίδευσης και είχε στόχο την υποστήριξη του ψηφιακού γραμματισμού στα Οπτικοακουστικά Μέσα των εκπαιδευτικών πρωτοβάθμιας εκπαίδευσης. Στο άρθρο παρουσιάζονται ο σχεδιασμός, η ανάπτυξη και υλοποίηση καθώς και τα αποτελέσματα της πιλοτικής εφαρμογής του προγράμματος επιμόρφωσης. Επιπλέον, αναδεικνύονται οι προβληματισμοί, οι προτάσεις των εκπαιδευτικών και τα συμπεράσματα με στόχο τη δημιουργία αυθεντικών περιβαλλόντων μάθησης με επίκεντρο τα Οπτικοακουστικά Μέσα στο σύγχρονο σχολείο.