bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity in paid work time: a qualitative study of employers’ and employees’ perspectives
Authors: Ryde Gemma , Atkinson Patricia , Stead Martine , Gorely Trish , Evans Josie 
Published: September 2019

Abstract
Background Increasing levels of employee stress and poor mental health are a significant concern for workplaces. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous mental health issues as well as improving mental wellbeing. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers’ and employees’ opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time.Methods Focus groups and interviews were conducted with employees and managers at workplaces in central Scotland that had large numbers of desk based employees. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically.Results Three out of five organisations approached took part in this qualitative study. Interviews were held with two strategic managers, and focus groups with16 middle managers and 45 employees. Barriers identified included organisational barriers (cost of lost time), the nature of the job (workload, logistical considerations) and existing workplace norms (colleague’s expectations and a no break, be at your culture). Benefits were anticipated for both employees and the organisation and included improved mental health, productivity and external more favourable employee perceptions of the employer.Conclusion This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
MiR-34c Downregulation Leads to SOX4 Overexpression and Cisplatin Resistance in Nasopharyngeal Carcinoma
Authors: Bissey Pierre-Antoine , Teng Mona , Law Jacqueline H , Shi Wei , Bruce Jeff P , Petit Valentin , Sai Tsao W , Yip Kenneth W , Liu Fei-Fei 
Published: September 2019

Abstract
Background: A major cause of disease-related death in nasopharyngeal carcinoma (NPC) is the development of distant metastasis (DM) despite combination chemo-radiotherapy. We have previously identified and validated a four micro-RNA (miRNA) signature which was prognostic for DM. In this study, characterization of a key component of this signature, miR-34c, revealed its role in chemotherapy resistance.
Methods: 246 NPC patient biopsies samples were subject to comprehensive miRNA profiling and immunohistochemistry (IHC). Two human normal nasopharyngeal cell lines (immortalized; NP69 and NP460), as well as the NPC cell line C666-1, were used to generate pre-miR-34c (gain of function) and anti-miR-34c (loss of function) cells. Signaling pathways were assessed using quantitative real-time PCR (qRT-PCR) and Western blot. Cell viability was measured using the ATP lite assay.
Results: MiR-34c was downregulated in NPC patient samples, and confirmed in vitro to directly target SOX4, a master regulator of epithelial-to-mesenchymal transition (EMT). MiR-34c downregulation triggered EMT-representative changes in NP69 and NP460; Snail, ZEB1, CDH2, and SOX2 were upregulated, while Claudin-1 and CDH1 were downregulated. Phenotypically, inhibition of miR-34c led to cisplatin resistance, whereas miR-34c over-expression sensitized NPC cells to cisplatin. TGFβ1 decreased miR-34c and increased SOX4 expression in vitro. The TGFβ receptor 1 inhibitor SB431542 reduced SOX4 expression and increased cisplatin sensitivity. Finally, immunohistochemistry revealed that in chemotherapy-treated NPC patients, lower SOX4 expression was associated with improved overall survival.
Conclusion: Taken together, miR-34c downregulation correlates with higher incidence of DM; miR-34c also increases SOX4 expression which leads to cisplatin resistance. In association, TGFβ1 represses miR-34c expression, and inhibition of the TGFβ1 pathway is one strategy to restore cisplatin sensitivity in NPC.
Differentiation of suprasellar meningiomas from non-functioning pituitary macroadenomas by 18F-FDG and 13N-Ammonia PET/CT
Authors: Ding Lei , Zhang Fangling , Li Zhoulei , Shi Xinchong , Li Ruocheng , Zhang Xiangsong 
Published: September 2019

Abstract
Objective: Differentiation of suprasellar meningiomas (SSMs) from non-functioning pituitary macroadenomas (NFPMAs) is beneficial for clinical management. We investigated the utility of 13 N-ammonia combined with 18 F-FDG positron emission tomography (PET)/computed tomography (CT) in distinguishing SSMs from NFPMAs in this study. Patients and Methods: Fourteen patients with histopathologic diagnosis of NFPMAs and eleven patients with SSMs were included in this study. Every patient underwent both 18 F-FDG and 13 N-ammonia PET/CT scans. The tumor to gray matter (T/G) ratios were calculated for the evaluation of tumor uptake. Results: The uptake of 18 F-FDG was higher in NFPMAs than SSMs whereas the concentration of 13 N- ammonia was lower in NFPMAs than SSMs. There were significant differences of 18 F-FDG and 13 N-ammonia uptake between the two groups (0.92[0.46] vs 0.59[0.29], P <0.05, 18 F-FDG; 1.58±0.56 vs 2.80±1.45, P <0.05, 13 N-ammonia). Tumor classification demonstrated a high overall accuracy of 96.0% for differential diagnosis. When the two traces were combined, only 1 SSM were misclassified into the NFPMA group. Conclusion: SSMs and NFPMAs have different metabolic characteristics on 18 F-FDG and 13 N-ammonia images. The combination of these two tracers can effectively distinguish SSMs from NFPMAs.
Epidemiology and outcomes of injuries among trauma patients in Ethiopia: A 5 -years retrospective Analysis
Authors: Abate semagn , Abafita Bedru Jemal , Kassim Hailemariam Mulugeta , Basu Bivash 
Published: September 2019

Abstract
Background: Injury becomes life threatening community health problem associated with significant mortality and morbidity worldwide. Road traffic accident is the most commonly encountered trauma and the leading cause of death and disability from injuries in Ethiopia. The aim of this study is to assess the epidemiology and outcomes of injury in Ethiopian University Hospital. Methods: Institutional based retrospective cross-sectional study was conducted from January 2015 to June 2019. Data was collected using questionnaire adapted from WHO injury surveillance guideline. Bivariate and multivariate logistic regressions were performed to determine factors associated with hospital mortality. Results: A total of 376 trauma cases were included in the study. The majority of 196(52.1%) victims were in the age range of 20-40 years. Road traffic accident was the commonest mechanism of injury 178(47.3%) followed by interpersonal violence 113(30.1%). The majority of patients 135(35.9%) had associated with lower extremity injury and there was 23(6%) mortality in this study. Revised trauma score (RTS) < 10 (AOR=2.5; 95% CI, 1.8-25.6), Glasgow coma scale (GCS) (AOR =0.3; 95% CI, 0.13-0.5), Length of hospitalization (LOS) 1-7 days (AOR=0.1; 95% CI, 0.01-0.8), and Time to arrival >24hr were predictors of mortality in a patient with injury. Conclusion: A lower extremity injury was common and mostly associated with RTA. Length of hospitalization > 7 days, RTS<10, decrease GCS and time to arrival >24hr were factors associated with mortality. Pre-hospital emergency medical service system and trauma registry needs to be established to decrease burden of injury. Keywords: Injury, Epidemiology, Outcome, Ethiopia
Understanding health professional role integration in complex adaptive systems A multiple-case study of Physician Assistants in Ontario, Canada
Authors: Burrows Kristen , Abelson Julia , Miller Patricia , Levine Mitch , Vanstone Meredith 
Published: September 2019

Abstract
Background To meet the complex needs of healthcare delivery, the Ministry of Health and Long Term Care (MOHLTC) introduced Physician Assistants (PAs) into the Ontario health care system in 2006 to help increase access to care, decrease wait times, and improve continuity of care. Integration of new health professional roles is often stymied by role resistance and funding barriers. The characterization of healthcare organizations as complex adaptive systems (CAS) may offer insight into the relationships and interactions that optimize and restrict successful PA integration. The aim of this study is to explore the integration of PAs across multiple case settings and to understand the role of PAs within complex adaptive systems.Methods An exploratory, multiple-case study was used to examine PA role integration in four settings: family medicine, emergency, general surgery, and inpatient medicine. Interviews were conducted with 46 healthcare providers and administrators across 13 hospitals and 6 family medicine clinics in Ontario, Canada. Analysis was conducted in three phases: inductive thematic analysis within each of the four cases; a cross-case thematic analysis; and a broader exploration of cross-case patterns pertaining to specific complexity theory principles of interest.Results Support for PA contributions across various health care settings, the importance of role awareness, supervisory relationship attributes, and role vulnerability (in relation to sustainability and funding) are interconnected and dynamic in hospital and community settings. Findings represent the experiences of PAs and other healthcare providers, and demonstrate how the PA’s willingness to work and ability to build relationships within existing health systems allows for the establishment of interprofessional, collaborative, and person-centered care. As a self-organizing agent in complex adaptive systems (i.e. health organizations), PA role exploration revealed patterns of team behavior, non-linear interconnections, open relationships, dynamic systems, and the legacy of role implementation as defined by complexity theory.Conclusions By exploring the role of PAs across multiple sites, the complexity theory lens concurrently fosters an awareness of emerging patterns, relationships and non-linear interactions within the defined context of the Ontario healthcare system. By establishing collaborative, interprofessional care models in community and hospital settings, PAs are making a significant contribution to Ontario healthcare settings.
The Barriers in the implementation of Antimicrobial Stewardship Programs: A systematic Review
Authors: Ahmed Nehad , Khan Irfanullah , Hassali Mohamed Azmi , Haseeb Abdul , Khan Amer Hayat 
Published: September 2019

Abstract
Background The resistance to Antimicrobial is considered as one of the most important risks that affect public health and healthcare. Antimicrobial stewardship programs comprise a series of interventions that help to stop the inappropriate use of antimicrobials.Methods The published literature on the barriers of implementing stewardship programs is limited. We searched for the relevant articles from 2007 till the end of 2017 using the keyword “Antimicrobial Stewardship Programs" in PubMed database.Results There are many barriers in the implementation of antimicrobial stewardship programs. To improve the rational use of antibiotics it is important to overcome these barriers.Conclusion According to the included studies into current review or manuscript, there are 9 major barriers for ASPs. Lack of training and knowledge, inter-professional and inter-specialty conflict, and lack of resources are the most common barriers.
Factors associated with delayed onset of active labor following administration of vaginal Misoprostol among women at Mbarara Regional referral hospital, Uganda: A prospective cohort study
Authors: Kajabwangu Rogers , Bajunirwe Francis , Lukabwe Henry , Atukunda Esther , Munyanderu Baraka , Sanchez Emilio , Nakalinzi Joanita , Mugyenyi Godfrey Rwambuka 
Published: September 2019

Abstract
Background Vaginal misoprostol has been recommended by the World Health Organization as one of the effective methods for induction of labor. Globally 9.6% of all deliveries follow induction of labor. Although the goal of labor induction is to initiate active labor with subsequent vaginal delivery, some mothers undergoing labor induction delay to get into active labor and some fail completely. The factors associated with delayed onset of active labor following labor induction with vaginal misoprostol have not been sufficiently explored in resource limited settings.Methods We conducted a prospective cohort study over a period of 6 months on the antenatal ward and labor suit of Mbarara Regional Referral Hospital, southwestern Uganda. We enrolled mothers of gestational age at least 28 weeks, with indication for labor induction. They received 50 micrograms of vaginal misoprostol every 6 hours with a maximum of 4 doses and were followed up until onset of active labor. Onset of active labor was considered delayed if it occurred at more than 12 hours after administration of the first dose of vaginal misoprostol. Bivariate and multivariate analysis was done to determine the factors associated with delayed onset of active labor.Results Eighty-eight mothers underwent induction of labor, 22.7% had delayed onset of active labor. After adjusting for potential confounders, low/no parity (Relative Risk or RR 2.67, p-value=0.01), low gestational age (RR 3.1, p-value=0.006) and higher BMI (RR 0.36, p-value=0.005), were associated with delayed onset of active labor following vaginal misoprostol administration.Conclusion Nulliparity, gestational age less than 37weeks are associated with delayed onset of active labor following labor induction with vaginal misoprostol while BMI of 26 and above is protective from delayed onset of labor.
Prevalence and associated factors of Khat chewing among people with HIV/AIDS at rural health centers of Ethiopia: a cross-sectional study
Authors: Belayneh Zelalem , Mekuriaw Birhanie 
Published: September 2019

Abstract
Objective: Khat, sometimes called “Qat” or “Chat” is fresh leaves a plant commonly chewed for its psycho-stimulant and euphorigenic effects of the brain. Although the adverse and complicated conspectuses of long term Khat use are evidenced, it is a commonly chewed in Ethiopia. Its burden and associated factors is not well addressed among HIV/AIDS in Ethiopia. This addressed this missed opportunity by assessing the frequency, pattern and associated factors of current Khat use among people with HIV/AIDS in Ethiopia. A systematic random sampling was used to select the study participants. Binary logistic regression was commutated to identify factors associated with Khat use. Results: About 30.1% and 24.7% of people with HIV/AIDS had lifetime and current khat use southern Ethiopia. Male sex {OR=2.46 95% CI(1.28, 4.73)}, rural residency { OR=2.4695%: CI(1.28, 10.14)}alcohol drinking {OR=1.84:95% CI(1.00, 3.37)} and frequency of schedule {OR=5.2595%CI(2.33, 11.85)} had a statistically significant association with current Khat use. This alarms a need for designing appropriate preventive and intervention programs for people living with HIV.
Proposal for name of surgical access-Substernal instead Subxiphoid for pericardial fenestration
Authors: Valchev Daniel Georgiev 
Published: September 2019

Abstract
Objective:
Various surgical accesses for pericardial fenestration are described and used in the literature. Each of
them has its advantages and disadvantages depending on the cause of the need for pericardial
fenestration.
Results:
Operative and perioperative mortality has not been reported. Operative complications such as bleeding, injury to the coronary artery or myocardium have not occurred. Substernal access after resection of the xiphoid process is a safe and effective approach for surgical treatment of pericardial tamponade.
Finite element analysis of occlusal splint therapy in patients with bruxism
Authors: Gholampour Seifollah , Gholampour Hanie , Khanmohammadi Hamed 
Published: September 2019

Abstract
Background: Bruxism is among the habits considered generally as contributory factors for temporomandibular joint (TMJ) disorders and its etiology is still controversial.Methods: Three-dimensional models of maxilla and mandible and teeth of 37 patients and 36 control subjects were created using in-vivo image data. The maximum values of stress and deformation were calculated in 21 patients six months after using a splint and compared with those in the initial conditions. Results: The maximum stresses in the jaw bone and head of mandible were respectively 4.4 and 4.1 times higher in patients than in control subjects. Similar values for deformation were 5.8 and 4.9, respectively. The maximum stress in the jaw bone and head of mandible decreased six months after splint application by up to 71.0% and 72.8%, respectively. Similar values for the maximum deformation were 80.7% and 78.7%, respectively. Following the occlusal splint therapy, the approximation of maximum deformation to the relevant values in control subjects was about 2.6 times the approximation of maximum stress to the relevant values in control subjects. The maximum stress and maximum deformation occurred in all cases in the head of the mandible and the splint had the highest effectiveness in jaw bone adjacent to the molar teeth. Conclusions: Splint acts as a stress relaxer and dissipates the extra stresses generated as well as the TMJ deformation and deviations due to bruxism. The splint also makes the bilateral and simultaneous loading possible and helps with the treatment of this disorder through regulation of bruxism by creating a biomechanical equilibrium between the physiological loading and the generated stress.
Crop Yield and Nitrous Oxide Emissions following Swine Manure Application: A Meta‐Analysis
Authors: Luo Weiquan , O'Brien Peter L. , Hatfield Jerry L. 
Published: September 2019

Core Ideas
Swine manure is a potential nutrient source but may harm environmental quality.
Crops fertilized with swine manure matched those using synthetic fertilizer.
Swine manure did not increase nitrous oxide compared with synthetic fertilizer.
Manure application method and conditions dictate yield and environmental impacts.
Swine manure has potential for reuse as fertilizer on cropland and pastureland. Currently, producers may be hesitant to land apply swine manure because information regarding the impacts to crop production and environmental quality has been inconsistent. The objective of this research was to synthesize the literature investigating impacts of swine manure application on crop yield and soil nitrous oxide emissions as compared to synthetic fertilizer. Overall, the meta‐analysis of 39 studies shows that swine manure does not affect either crop yield or nitrous oxide emissions. However, a moderator analysis indicated that crop yield using manure fertilizer may be adversely affected in fine‐textured soils or when applied to the soil surface. While these results suggest that swine manure may be safely applied as fertilizer, producers should still be cautious with how manure is applied to capture its N value without yield losses or detrimental effects to environmental quality.
Toward a Regional Phosphorus (Re)cycle in the US Midwest
Authors: Margenot Andrew J. , Kitt Dianna , Gramig Benjamin M. , Berkshire Taylor B. , Chatterjee Neha , Hertzberger Allan J. , Aguiar Sammy , Furneaux Aliza , Sharma Navneet , Cusick Roland D. 
Published: September 2019

Redirecting anthropogenic waste phosphorus (P) flows from receiving water bodies to high P demand agricultural fields requires a resource management approach that integrates biogeochemistry, agronomy, engineering, and economics. In the US Midwest, agricultural reuse of P recovered from spatially colocated waste streams stands to reduce point‐source P discharges, meet agricultural P needs, and—depending on the speciation of recovered P—mitigate P losses from agriculture. However, the speciation of P recovered from waste streams via its chemical transformation—referred to here as recovered P (rP) differs markedly based on waste stream composition and recovery method, which can further interact with soil and crop characteristics of agricultural sinks. The solubility of rP presents key tensions between engineered P recovery and agronomic reuse because it defines both the ability to remove organic and inorganic P from aqueous streams and the crop availability of rP. The potential of rP generation and composition differs greatly among animal, municipal, and grain milling waste streams due to the aqueous speciation of P and presence of coprecipitants. Two example rP forms, phytin and struvite, engage in distinct biogeochemical processes on addition to soils that ultimately influence crop uptake and potential losses of rP. These processes also influence the fate of nitrogen (N) embodied in rP. The economics of rP generation and reuse will determine if and which rP are produced. Matching rP species to appropriate agricultural systems is critical to develop sustainable and financially viable regional exchanges of rP from wastewater treatment to agricultural end users.Core Ideas
There is high potential for recovering P (rP) from point sources for agricultural reuse.
rP speciation depends on recovery source and method, interacts with soils and crops.
Engineering, agronomic, and economic considerations of rP are context‐specific.
Modeling the Ecological Impact of Phosphorus in Catchments with Multiple Environmental Stressors
Authors: Glendell Miriam , Palarea‐Albaladejo Javier , Pohle Ina , Marrero Shasta , McCreadie Brian , Cameron Graeme , Stutter Marc 
Published: September 2019

The broken phosphorus (P) cycle has led to widespread eutrophication of freshwaters. Despite reductions in anthropogenic nutrient inputs that have led to improvement in the chemical status of running waters, corresponding improvements in their ecological status are often not observed. We tested a novel combination of complementary statistical modeling approaches, including random‐effect regression trees and compositional and ordinary linear mixed models, to examine the potential reasons for this disparity, using low‐frequency regulatory data available to catchment managers. A benthic Trophic Diatom Index (TDI) was linked to potential stressors, including nutrient concentrations, soluble reactive P (SRP) loads from different sources, land cover, and catchment hydrological characteristics. Modeling suggested that SRP, traditionally considered the bioavailable component, may not be the best indicator of ecological impacts of P, as shown by a stronger and spatially more variable negative relationship between total P (TP) concentrations and TDI. Nitrate‐N (p < 0.001) and TP (p = 0.002) also showed negative relationship with TDI in models where land cover was not included. Land cover had the strongest influence on the ecological response. The positive effect of seminatural land cover (p < 0.001) and negative effect of urban land cover (p = 0.030) may be related to differentiated bioavailability of P fractions in catchments with different characteristics (e.g., P loads from point vs. diffuse sources) as well as resilience factors such as hydro‐morphology and habitat condition, supporting the need for further research into factors affecting this stressor–response relationship in different catchment types. Advanced statistical modeling indicated that to achieve desired ecological status, future catchment‐specific mitigation should target P impacts alongside multiple stressors.Core Ideas
Soluble reactive P (SRP) alone was not the best indicator of diatom response.
Total P (TP) association with diatoms was more spatially variable than SRP.
Nitrate‐N and TP have a combined negative effect on the ecological response.
Seminatural land use had the most important influence on ecological response.
We recommend catchment‐specific mitigation of multiple stressors.