bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises Nepal: study protocol for a cluster randomised controlled trial (c-RCT)
Authors: Hof E van 't , Sangraula Manaswi , Luitel Nagendra P , Turner Elizabeth L. , Marahatta Kedar , Ommeren Mark van , Shrestha Pragya , Bryant Richard , Kohrt Brandon A. , Jordans Mark J. D. 
Published: June 2019

Abstract
Background
Globally, the lack of availability of psychological services for people exposed to adversities has led to the development of a range of scalable psychological interventions with features that enable better scale-up. Problem Management Plus (PM+) is a brief intervention of 5 sessions that can be delivered by non-specialists. It is designed for people in communities in low- and middle-income countries (LMIC) affected by any kind of adversity. Two recent randomized controlled trials in Pakistan and Kenya demonstrated the effectiveness of individually delivered PM+. A group version of PM+ has been developed to make the intervention more scalable and acceptable. This paper describes the protocol for a cluster randomized controlled trial (c-RCT) on locally adapted Group PM+ in Nepal.
Methods: This c-RCT will compare Group PM+ to enhanced usual care (EUC) in participants with high levels of psychological distress recruited from the community. The study is designed as a two-arm, single-blind c-RCT that will be conducted in a community-based setting in Morang, a flood affected district in Eastern Nepal. Randomization will occur at ward level, the smallest administrative level in Nepal, with 72 enrolled wards allocated to Group PM+ or to EUC (ratio 1:1). Group PM+ consists of five approximately 2.5 hour sessions, in which participants are taught techniques to manage their stressors and problems, and is delivered by trained and supervised community psychosocial workers (CPSWs). EUC consist of a meeting with (a) basic information on adversity and mental health, (b) benefits of getting support, (c) information on seeking services from local health facilities with mhGAP-trained staff. The primary outcome measure is levels of individual psychological distress 20 weeks after baseline, measured by the General Health Questionnaire (GHQ-12). Secondary outcome measures include levels of functioning, depressive symptoms, post-traumatic stress disorder symptoms, levels of social support, somatic symptoms and ways of coping. We hypothesize that skills acquired will mediate any impact of the intervention.
Discussion: This c-RCT will contribute to the growing evidence-base for transdiagnostic psychological interventions delivered by non-specialists for people in communities affected by adversity. If Group PM+ is proven effective the intervention manual will be released for use giving the opportunity to further adaptation and implementation of the intervention in diverse settings with communities that require better access to psychological interventions.
Intra-specific comparison of mitochondrial genomes reveals host gene fragment exchange via intron mobility in Tremella fuciformis Brief Intron variation in mitochondrial genomes of Tremella fuciformis
Authors: Deng Youjin , Zhang Xunxiao , Xie Baogui , Lin Longji , Hsiang Tom , Lin Xiangzhi , Lin Yiying , Zhang Xingtan , Ma Yanhong , Miao Wenjing , Ming Ray 
Published: June 2019

Abstract
Background

Mitochondrial genomic sequences are known to be variable. Comparative analyses of mitochondrial genomes can reveal the nature and extent of their variation.

Results

Draft genomes of 16 Tremella fuciformis isolates (TF01-TF16) were assembled from Illumina and PacBio sequencing data. Mitochondrial DNA contigs were extracted and assembled into complete circular molecules, ranging from 35,104 bp to 49,044 bp in size. All mtDNAs contained the same set of 41 conserved genes with identical gene order. Comparative analyses revealed that introns and intergenic regions were variable, whereas genic regions (including coding sequences, tRNA, and rRNA genes) were conserved. Among 24 introns detected, 11 were in protein-coding genes, 3 in tRNA genes, and the other 10 in rRNA genes. In addition, two mobile fragments were found in intergenic regions. Interestingly, six introns containing N-terminal duplication of the host genes were found in five conserved protein-coding gene sequences. Comparison of genes with and without these introns gave rise to the following proposed model: gene fragment exchange with other species can occur via gain or loss of introns with N-terminal duplication of the host genes.

Conclusions

Our findings suggest a novel mechanism of fungal mitochondrial gene evolution: partial foreign gene replacement though intron mobility.
Post-Stroke Patients with Moderate Function Have the Greatest Risk of Falls: A National Cohort Study
Authors: Wei Wycliffe Enli , De Silva Deidre Anne , Chang Hui Meng , Yao Jiali , Matchar David Bruce , Young Sherry Hsueh Yi , See Siew Ju , Lim Gek Hsiang , Wong Ting Hway , Venketasubramanian Narayanaswamy 
Published: June 2019

Abstract
Background

Stroke patients have increased risks of falls. We examined national registry data to evaluate the association between post-stroke functional level and the risk of low falls among post-stroke patients.

Methods

This retrospective cohort study analyzed data from national registries to examine the risk factors for post-stroke falls. Data for patients who suffered ischemic strokes and survived the index hospital admission was obtained from the Singapore National Stroke Registry and matched to the National Trauma Registry, from 2011 to 2015. The primary outcome measure was a low fall (fall height ≤0.5m). Competing risk analysis was performed to examine the association between functional level (by modified Rankin score [mRS] at discharge) and the risk of subsequent low falls.

Results

In all, 2,255 patients who suffered ischemic strokes had recorded mRS. The mean age was 66.6 years and 58.5% were men. By the end of 2015, 54 (2.39%) had a low fall while 93 (4.12%) died.

After adjusting for potential confounders, mRS was associated with fall risk with an inverted U-shaped relationship. Compared to patients with a score of zero, the sub-distribution hazard ratio (SHR) increased to a maximum of 3.42 (95%CI:1.21-9.65, p=0.020) for patients with a score of 2. The SHR then declined to 2.45 (95%CI:0.85-7.12, p=0.098), 2.86 (95%CI:0.95-8.61, p=0.062) and 1.93 (95%CI:0.44-8.52, p=0.38) for patients with scores of 3, 4 and 5 respectively.

Conclusions

An inverted U-shaped relationship between functional status and fall risk was observed. This is consistent with the complex interplay between decreasing mobility (hence decreased opportunity to fall) and increasing susceptibility to falls. Fall prevention intervention could be targeted accordingly.
Bus workers’ experiences with and perceptions of a health promotion program: a qualitative study using a focus group discussion
Authors: Pyo Jeehee , Lee Mina , Ock Minsu , Park Gwiok , Yang Dongseok , Park Jungsun , Kim Yangho 
Published: June 2019

Abstract
Background

Transportation workers such as bus workers are considered to be vulnerable workers, with a relatively high risk of industrial accidents. A health promotion program, which included stretching training for musculoskeletal disorder prevention, exercise prescription, and counseling, was developed for transportation workers in Ulsan, South Korea. In this study, a focus group discussion was conducted with bus workers to evaluate their experiences and perceptions, as well as the reasons for their participation in the program for vulnerable workers. The study also sought to identify the strengths and weaknesses of the program.

Methods

A total of nine bus workers participated in the focus group discussion. The focus group discussion was conducted based on a semi-structured guide, which was developed from discussions among the researchers and a review of major preliminary studies. The focus group discussion took about two hours. The discussion was recorded and transcribed, after which data were analyzed using content analysis.

Results

A total of 100 codes were derived and categorized into four main categories as follows: “Obstacles to the healthcare of bus workers,” “The first positive impression of the health promotion program,” “Satisfaction and changes after participating in the health promotion program,” and “Improvement of the health promotion program.” For participants who had not been involved in other health management programs, the sole existence of a health promotion program for vulnerable workers in Ulsan was sufficient to attract participants. Participants reported that participation in the program mitigated some of their musculoskeletal symptoms, which are often faced by bus workers.

Conclusions

The findings of this study may contribute to the expansion of the health promotion program targeting workers in vulnerable working environments in Ulsan and other places. In order to increase users’ satisfaction and the sustainability of the program, it is necessary to develop a strategy to increase the accessibility of the program and enhance the self-efficacy of participants.
Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time
Authors: Ojo Samson O , Bailey Daniel P. , Brierley Marsha L. , Hewson David J. , Chater Angel M. 
Published: June 2019

Abstract
Background

The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the BCW to develop a tailored intervention to reduce workplace sitting in desk-based workers.

Methods

The Behaviour Change Wheel (BCW) framework with the COM-B (Capability, Opportunity, Motivation – Behaviour) theoretical model at the hub was used to guide the process of intervention development. Twenty-five office-based workers with high amounts of self-reported workplace sitting were interviewed using questions developed with the TDF.

Results

The majority of participants felt they were physically capable of breaking up their sitting time, while all participants stated the importance of having knowledge regarding both guidelines for sitting time and the consequences of excess sitting. A supportive organisational culture was identified as important, along with the need for environmental context and resources. Both reflective and automatic motivation were identified as potential targets for behaviour change interventions. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace.

Conclusions

The BCW framework provided a systematic process for developing a theory-driven and co-created intervention packages that can be used to break up and decrease prolonged sitting in office workers. Intervention designers should consider these BCW factors and BCTs when developing interventions to break up workplace sitting.
Use of community assets and the role of contextual factors on the participation of people with disability: results of participatory mapping in Envigado, Colombia
Authors: Toro-Hernandez Maria Luisa , Villa-Torres Laura , Mondragón-Barrera Mónica Alejandra , Camelo-Castillo Wendy 
Published: June 2019

Abstract
Background

Disability is an evolving concept that results from the complex interaction between a person with an impairment and the context in which he/she lives. There is limited understanding on the types, access and use of community assets valuable for people with disabilities, and the role of contextual factors. Our goal with this work was to identify access and use of community assets, and the role of contextual factors among people with disabilities, and the perspectives of rehabilitation professionals, residents of a suburban area in Colombia.

Methods

Using participatory mapping, a community based participatory approach, we carried out an assessment of community assets identified by people with disabilities and rehabilitation professionals. In-depth interviews informed the design of two asset mapping activities, one among people with disabilities (n=5) and a second with rehabilitation professionals (n=4).

Results

Main findings indicate a chain of contextual factors that limit access and use of assets stemming from the personal (e.g. financial resources, inaccessible housing), interpersonal level (e.g. lack of a personal assistance or aid), and community levels (e.g. lack of accessible public transportation and inaccessible buildings). In most cases these barriers are heightened by system level barriers (e.g. lack of effective enforcement of the legal framework).

Conclusions

Identifying these contextual factors, and their interactions, call for stronger enforcement of the existing legal framework through articulated work between different stakeholders so persons with disabilities can enjoy community assets.
Strengthening Community-Clinical Linkages to Reduce Cardiovascular Disease Risk in Rural NC: Feasibility Phase of the CHANGE Study
Authors: Samuel-Hodge Carmen D , Gizlice Ziya , Allgood Sallie D , Bunton Audrina J , Erskine Amber , Leeman Jennifer , Cykert Samuel 
Published: June 2019

Abstract
Background

Community Health Workers (CHW) are recommended for delivery of interventions to prevent cardiovascular disease, but there is insufficient evidence from interventions conducted in rural, medically underserved areas.

Methods

Using a hybrid implementation-effectiveness design, we evaluated the implementation and effectiveness of an adapted, evidence-based cardiovascular disease risk reduction intervention among rural high-risk adults. CHWs at a community health center and local health department recruited, enrolled and counseled participants during 4 monthly home visits and 3 brief phone contacts. Participant data collection included pre- and post-intervention measurements of blood pressure, weight, and dietary and physical activity behaviors. We evaluated implementation with measures of intervention reach and delivery fidelity. Statistical analyses included descriptive statistics and paired t-tests.

Results

Study participants (n=105) had a mean age of 62 years and included 88% Non-Hispanic Blacks and 82% females. Recruitment strategies resulted in the enrollment of 38% of interested and eligible participants who received 80% of the planned intervention visits and phone contacts. Mean differences in pre-/post-intervention measures showed significant mean reductions in blood pressure (-5.4 mm Hg systolic, p=.006; -2.3 mm Hg diastolic, p=.04) and body weight (-3.8 lb., p=.02). Self-reported dietary and physical activity behaviors also improved significantly.

Conclusion

This feasibility study demonstrated preliminary implementation and program effectiveness of a CHW-delivered intervention to reduce cardiovascular disease risk factors. Additionally, it identified areas for future refinements to strategies that strengthening community-clinical linkages with an integrated role of CHWs in rural health care delivery. If results from this feasibility study can be enhanced in a larger sample, there would be significant potential to positively impact the excess burden of chronic diseases that adversely impact rural, low-income, and medically underserved populations.
The Bucket Test Differentiates Patients with MRI Confirmed Brainstem/Cerebellar Lesions from Patients Having Migraine and Dizziness Alone
Authors: Chang Tzu-Pu , Winnick Ariel A , Hsu Yung-Chu , Sung Pi-Yu , Schubert Michael C 
Published: June 2019

Abstract
Background: Amongst the most challenging diagnostic dilemmas managing patients with vestibular symptoms (i.e. vertigo, nausea, imbalance) is differentiating dangerous central vestibular disorders from benign causes. Migraine has long been recognized as one of the most common causes of vestibular symptoms, but the clinical hallmarks of vestibular migraine are notoriously inconsistent and thus the diagnosis is difficult to confirm. Here we conducted a prospective study investigating the sensitivity and specificity of combining standard vestibular and neurological examinations to determine how well central vestibular disorders (CVD) were distinguishable from vestibular migraine (VM).
Method: Thirty symptomatic patients diagnosed with CVD and 36 symptomatic patients with VM underwent brain imaging and clinical assessments including; 1) SVV bucket test, 2) ABCD2, 3) headache/vertigo history, 4) presence of focal neurological signs, 5) nystagmus, and 6) clinical head impulse testing.
Results: Mean absolute SVV deviations measured by bucket testing in CVD and VM were 4.8±4.0° and 0.7±1.0°, respectively. The abnormal rate of SVV deviations (>2.3°) in CVD was significantly higher than VM (p<0.001). Using the bucket test alone to differentiate CVD from VM, sensitivity was 73.3%, specificity 91.7%, positive likelihood ratio (LR+) 8.8, and negative likelihood ratio (LR-) 0.3. However, when we combined the SVV results with the clinical exam assessing gaze stability (nystagmus) with an abnormal focal neurological exam, the sensitivity (93.3%) and specificity (88.9%) were optimized (LR+ (8.4), LR- (0.08)).
Conclusion: The SVV bucket test is a useful clinical test to distinguish CVD from VM, particularly when interpreted along with the results of a focal neurological exam and clinical exam for nystagmus.
Análise dos discursos: uma forma de combate ao racismo sob perspectivas filosófica e discursiva
Authors: Zeri de Oliveira Célia , Santana Heinen Isabella Vivianny 
Published: June 2019

Neste artigo fazemos uma reflexão filosófico-discursivaacerca das relações étnico-raciais no contexto social atual em que asociedade brasileira, uma vez constituída por meio da miscigenaçãode povos e suas respectivas culturas, raramente tem atribuído o protagonismoa todos os componentes que são parte da história da nação,pois tem havido dois grupos sociais sistematicamente excluídos eapagados do processo de construção da cultura brasileira: os negrose os indígenas. A linguagem, nesse âmbito, serve para a estruturaçãodas relações sociais e, em simultâneo, também é usada para a manutençãodo status quo como estruturas das hegemonias de poder e dominaçãode uns sobre outros, tal qual um mecanismo naturalizado eaceito pelos integrantes desse sistema, sejam eles os dominadores oudominados. Metodologicamente realizamos a análise discursiva combase em interpretações dos gêneros discursivos/textuais utilizados nos meios de informação e comunicação em nossa sociedade, especificamente,selecionando em meio a textos jornalísticos publicados viainternet e com assinatura de autores que defendem um ou outro pontode vista discursivo em relação às relações étnico-raciais presentesem nossa sociedade. Assim, discutimos os princípios éticos pelo viésfilosófico como base para a construção coletiva de princípios, principalmenteos que se inserem nas relações étnico-raciais.
Evaluation of Stemness Maintenance Properties of the Recombinant Human Laminin α2 LG1-3 Domains in Human Mesenchymal Stem Cells
Authors: Kim Ji-Eun , Seo Hye-Jin , Lee SuJin , Jang Jun-Hyeog 
Published: June 2019

Background:
Laminin, a member of the Extracellular Matrix (ECM), is a glycoprotein
that is used as a factor that affects cell adhesion, proliferation, survival, and differentiation. Of
these, five globular domains (LG domains) of the alpha chain play an important role in influencing
the cell by binding to the integrin.

Objective:
This study aimed to evaluate the ability of globular domains 1-3 of laminin alpha2
(rhLAMA2LG1-3) in maintaining the pluripotency of human Mesenchymal Stem Cells (hMSCs),
which are widely used in regenerative medicine.

Methods:
hMSCs were grown in the medium supplemented with rhLAMA2LG1-3, then the effect of
the protein on hMSCs were confirmed through cell adhesion assay, proliferation assay and RTPCR.

Results:
rhLAMA2LG1-3 expressed in Escherichia coli has a molecular weight of 70 kDa, at 1 µg/ml
concentration of rhLAMA2LG1-3, the attachment and proliferation of hMSCs were approximately
3.18-fold and 1.67-fold, respectively, more efficient than those of untreated controls. In addition,
the undifferentiated state and degree of stemness of hMSCs were measured, on the basis of CD90
and CD105 levels. In the rhLAMA2LG1-3-treated hMSCs, the expression levels of CD90 and CD105
increased by 2.83-fold and 1.62-fold, respectively, compared to those in untreated controls.

Conclusion:
rhLAMA2LG1-3 can be potentially used in stem cell therapy to improve the viability
and maintain the undifferentiated state of hMSCs.
Hot-melt Preparation of a Non-biodegradable Peptide Implant: A Proof of Principle
Authors: D’Hondt Matthias , Verbeke Frederick , Wuytens Pieter , Skirtach Andre , De Spiegeleer Bart , Wynendaele Evelien 
Published: June 2019

Background:Both biodegradable and non-biodegradable peptide-loaded implants are already developed for the long-term treatment of patients, thereby reducing the frequency of drug administration. To further improve peptide formulation, extending the scope of implant-based drug delivery systems towards other polymers and processing techniques is highly interesting.Objective:In this study, as a proof-of-principle, the feasibility of hot-melt processing of a peptide active pharmaceutical ingredient was assessed by developing a non-biodegradable poly(ethylenevinyl acetate) (33% VA) implant loaded with 20% (w/w) buserelin acetate.Methods:Cross-sectional implant characterization was performed by Raman microscopy. The stability of buserelin acetate in the polymeric matrix was evaluated for 3 months under ICH stability conditions and the quantity as well as the degradation products analyzed using LC-UV methods. An in vitro dissolution study was performed as well and buserelin acetate and its degradants analyzed using the same chromatographic methods.Results:No significant quantities of buserelin acetate-related degradation products were formed during the hot-melt preparation as well as during the stability study. Together with the consistent buserelin acetate assay values over time, chemical peptide stability was thus demonstrated. The in vitro buserelin acetate release from the implant was found to be diffusion-controlled after an initial burst release, with stable release profiles in the stability study, demonstrating the functional stability of the peptide implant.Conclusion:These results indicate the feasibility of preparing non-biodegradable peptide-loaded implants using the hot-melt production method and may act as a proof of principle concept for further innovation in peptide medicinal formulations.