bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a sitting light volleyball intervention: a social-ecological approach
Authors: Leung Ka Man , Chung Pak-Kwong , Chu William 
Published: October 2019

Abstract
Background This study was part of a 15-week sitting light volleyball (SLVB) intervention programme which examined the effectiveness of the intervention on physical and psychological attributes of people with physical disabilities (PWPD) in Hong Kong. Gaining an in-depth understanding of the perceptions and experiences of PWPD in the SLVB intervention is critical to further develop SLVB as a PA intervention and sport. This qualitative study explored and examined the association between the SLVB intervention elements and outcomes. Methods Using a social–ecological model (SEM), the participants’ experiences regarding the intervention were assessed and the suitability and feasibility of the SLVB intervention elements were examined. Twenty participants (mean age = 53.52 years standard deviation (SD = 9.02), 60% female participants; 25% had at least a college degree) attended our semi-structured interviews. Results Using thematic analysis, their experiences at the individual or intrapersonal level (improved health and well-being, enjoyment, novelty, competence autonomy, and self-regulation when playing SLVB); relationship or interpersonal levels (teamwork, social support, socialization, and communication); perceived environment level (comfort, privacy, spaciousness, and accessibility concerns); community or organizational level (safety, dissemination of information, and community facilities); and policy level (resources allocation by the government) were obtained. The participants also commented on the suitability of the SLVB intervention for PWPD, contents and coaching, modified rules, duration of session and scheduling, and number of participants and coaches. Conclusion This qualitative study identified several primary drivers and barriers for engaging PWPD in SLVB, and demonstrated that adopting a multilevel approach to our SLVB intervention has positive outcomes. Our results can facilitate the development of the experiential aspects of SLVB and indicate the suitability and feasibility of organizing SLVB-related activities in a community setting in the future.
The Need for a Telemedicine Strategy for Botswana? A Scoping Review and Situational Assessment
Authors: Ncube Benson , Mars Maurice , Scott Richard E 
Published: October 2019

Abstract
Background: Health, healthcare, and healthcare system problems within the developing world are well recognised. eHealth, the use of Information and Communications Technologies (ICT) for health, is frequently suggested as one means by which to ameliorate such problems. However, to identify and implement the most appropriate ehealth solutions requires development of a thoughtful and broadly evidence-informed strategy. Most published strategies focus on health informatics solutions, neglecting the potential for other aspects of ehealth (telehealth, telemedicine, elearning, and ecommerce). This study examined the setting in Botswana to determine the need for a telemedicine-specific strategy.Methods: A situational assessment of ehealth activities in Botswana was performed through a scoping review of the scientific and grey literature using specified search terms, an interview with the project manager of the major mhealth stakeholder, and benchtop review of policies and other relevant Government documents including the country’s current draft eHealth Strategy. Results: Thirty-nine papers were reviewed. Various ehealth technologies have been applied within Botswana. These include Skype for educational activities, instant messaging (WhatsApp for telepathology; SMS for transmission of laboratory test results, patient appointment reminders, and invoicing and bill payment), and robotics for dermatopathology. In addition health informatics technologies have been used for surveillance, monitoring, and access to information by healthcare workers. The number of distinct health information systems has been reduced from 37 to 12, and 9 discrete EMRs remain active within the public health institutions. Many infrastructural issues were identified. A critical assessment of the current draft ehealth strategy document for Botswana showed limitations. Many telemedicine services have been introduced over the years (addressing cervical cancer screening, teledermatology, teleradiology, oral medicine and eye screening), but only one project was confirmed to be active and being scaled up with the intervention of the Government.Conclusions: Botswana’s draft ‘ehealth’ strategy will not, in and of itself, nurture innovative growth in the application of telemedicine initiatives, which currently are fragmented and stalled. This lack of focus is preventing telemedicine’s recognised potential from being leveraged. A specific Telemedicine Strategy, aligned with and supportive of the pre-existing ehealth strategy, would provide the necessary focus, stimulus, and guidance.
BRAF mutant colorectal cancer: ErbB2 expression levels as predictive factor for the response to combined BRAFi/ErbB1 inhibitors
Authors: Miele Evelina , Abballe Luana , Spinelli Gian Paolo , Mersini Besharat Zein , Catanzaro Giuseppina , Chiacchiarini Martina , Vacca Alessandra , Po Agnese , Capalbo Carlo , Ferretti Elisabetta 
Published: October 2019

Abstract
Background: Colorectal cancer (CRC) is a heterogeneous disease with a complex biology and has a wide number of altered genes such as BRAF, KRAS and PIK3CA. Advances with new-targeted therapies have been achieved and available treating options have prolonged patient’s survival. However, BRAF-mutated CRC patients remain unresponsive to available therapies with RAF inhibitors (RAFi) alone or combined with ErbB inhibitors (ErbBi). These unmet needs require further exploitation of oncogenic signaling in order to set up individualized treatments. Methods: To this end, we tested the efficacy of single agent or combined treatments using the BRAFi, vemurafenib and two different ErbBi: panitumumab and afatinib in CRC cells characterized by different molecular phenotypes. Results: Combination strategies with BRAFi and ErbBi achieved a better response in BRAF V600E mutated cells expressing high levels of ErbB2. Conclusions: In conclusion our findings allow us to indicate that high ErbB2 expression levels is a positive predictor factor since those patients are responsive to BRAFi/ErbBi combination.
Non breathing-related sleep fragmentation and imaging markers in patients with atherosclerotic cerebral small vessel disease (CSVD), a cross-sectional case-control study
Authors: Wang Jihui , Chen Xiaodong , Liao Jinchi , Zhou Li , Han Hongying , Tao Jiong , Lu Zhengqi 
Published: October 2019

Abstract
Objective Evidence of a relationship between non breathing-related sleep fragmentation and imaging markers of the brain in cerebral small vessel disease (CSVD) patients is scarce. The purpose of the present study was to investigate the relationship in CSVD patients living in China, where CSVD is a major pathogenesis underlying stroke. Methods A group of 84 CSVD patients were prospectively recruited along with 24 age and sex matched normal controls. 3.0 T superconducting magnetic resonance imaging and overnight polysomnography were conducted in all the participants. Polysomnography parameters including sleep onset latency, total sleep time; sleep efficiency, wake after sleep onset, percentage of each sleep stage (N1, N2, N3 and REM) and arousal index were compared between the CSVD patients and normal controls, and the relationship between arousal index and CSVD markers was explored in the CSVD group. Results Polysomnography measures showed that CSVD patients had significantly higher arousal index and wake after sleep onset, lower sleep efficiency and N-3 ratio compared to normal controls ( p < 0.05). The results of ordinal logistic regression showed that higher arousal index was positively associated with the severity of periventricular white matter hyperintensity (OR 1.177, 95% CI 0.170 to 2.295) and perivascular space (OR 1.245, 95% CI 0.485 to 2.124) in CSVD patients, after adjusting for all the independent variables. Conclusions These preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is invited to establish the causal relationship between sleep parameters and CSVD pathology.
Genome-wide association analysis of fiber fineness and yield in ramie (Boehmeria nivea) using SLAF-seq
Authors: Huang Kunyong , Shi Yaliang , Zhong Yicheng , Zhu Aiguo , Sun Zhimin , Niu Juan , Chen Jing , Luan M , Chen Jianhua 
Published: October 2019

Abstract
Background: Ramie is a major natural fiber crop cultivated in East Asia. The improvement of its fiber yield and fineness are important breeding goals. Fiber yield is a complex quantitative trait comprising ramet number, stem diameter, plant height, skin thickness, and ﬁber percentage. The fiber fineness is a crucial trait for ramie fiber quality. However, there are few association studies for fiber yield traits and fiber fineness on ramie, and lack high-density SNP maps in natural ramie population.Results: Here, a panel of 112 core ramie germplasms were genotyped by 215,376 consistent single-nucleotide polymorphisms (SNPs) from specific-locus amplified-fragment sequencing (SLAF-seq), and used for genome-wide association study of fiber fineness and yield. Subsequently, the genetic diversity, linkage disequilibrium (LD), and population structure was conducted based on 215,376 SNPs. Population cluster analysis disclosed five subpopulations. Neighbor-joining (NJ) analysis revealed three major clusters. No obvious relationships were identified between them and their geographic origins. The genome-wide linkage disequilibrium (LD) decayed to r2 = 0.1 was ~11.75 kb in physical distance. One, seven, one, seven, and twenty-seven significant SNP marker associations were detected for fiber fineness (third season), stem diameter (third season), stem skin thickness (third season), fiber percentage (second season), and fiber percentage (third season), respectively. Two promising candidate genes, whole_GLEAN_10029622 and whole_GLEAN_10029638 resided in the significant trait-SNP association for fiber fineness (third season), which annotated as a cotton fiber-expressed protein and an Arabidopsis thaliana homeobox protein ATH1, respectively and validated by qPCR. Conclusions: These results provide information for understanding the population structure, LD decay and genetic variation in ramie natural population. The identified loci or genes for fiber fineness and yield may provide the basis for future research on fiber fineness and yield and marker-assisted selection breeding for ramie.
Genomic signatures of divergent selection for production and adaptation in domestic goats (Capra hircus)
Authors: Mwacharo Joram M , Kim Eui-Soo , Elbeltagy Ahmed R , Aboul-Naga Adel M , Rischkowsky Barbara A , Rothschild Max F 
Published: October 2019

Abstract
Background : Goats are distributed worldwide and include many breeds with marked phenotypic variation. Both natural and human driven processes have shaped their genomes. Here, 52K genome-wide SNP genotypes were used to investigate signatures of divergent selection between indigenous goats from an arid hot environment in Egypt and breeds developed under temperate environments in Europe. Three selection signature approaches were used, the di derivative of F ST , iHS and Rsb.
Results: Out of a total of 36 candidate regions that were detected to be under selection by the three approaches, the analysis detected nine regions with the strongest selection signatures spanning 134 genes of which 68 were the most significantly functionally enriched. In addition to well-known genes affecting dairy traits ( LAP3 , ABCG2 , MEPE , IBSP , MED28 ) and body weight and stature ( LCORL , NCAPG , CCSER1 , DCAF16 ) in several mammalian species, we found evidence for selection in regions spanning genes implicated in the regulation of fatty acid synthesis and metabolic pathways ( PI4K2B and PPARGC1A ), inflammatory gene expression and autoimmune response pathways ( CXCL8 , HERC5 , RGS18 , TROVE2 ) and spermatogenesis ( SPATA18 , LAP3 ). Other genes not reported before in goats included SLIT2 , PACRGL , GRP125 , DHX15 , SOD3 and KCNIP4 which have been associated with thermal nociception in mice. We also detected a paralog of TBC1D12 , namely TBC1D14 , in one of the candidate regions. TBC1D12 has been linked to environmental adaptation in sheep. Gene ontology analysis revealed the 68 candidate genes were highly enriched in two biological processes viz regulation of G protein-coupled receptor signaling pathway (GO:0045744) and cellular response to stress (GO:0033554).
Conclusions: Our results provide evidence that goat genomes have evolved, in part, via diverse positive selection directed at breed formation, at past and recent genetic improvement and adaptation to environments. Based on their uniqueness, these breed-group specific signatures of selection can be considered to be footprints of divergence which may be useful in characterizing genome architecture and diversity in domestic animals and for targeted genetic improvement.
Personal Sun Protection and Counseling Patterns among Primary Care Providers
Authors: Nadelman Daniel Alexander , Heidelbaugh Joel J. 
Published: October 2019

Abstract
Background: Personal sun protection and patient counseling patterns among primary care providers is an important topic that has not previously been studied in great detail. Our report evaluates the relationship between sun protection habits among providers, patterns in discussions with patients about sun protection, and prior education on this topic during medical training.
Methods: An online survey was sent to family medicine faculty and house officers. Four survey questions about personal sun protection and patient counseling habits were provided. Participants were then asked whether they had received formal education concerning sun protection during their medical training.
Results: Our results suggest that providers who received formal education on sun protection during their medical training were more likely to personally use adequate protection and counsel their patients on this topic.
Conclusions: This study highlights the importance of sun protection education among primary care providers. Our findings suggest that improving education on this topic among physicians may lead to increased awareness among both patients and providers. Productive discussions about sun protection in the primary care setting has the potential to improve sun protective habits among patients, which can in turn decrease the incidence of skin cancer.
Age is a predictor for the recurrence of syncope in vasovagal syncope patients with a positive head-up tilt test
Authors: Guo Yongjuan , Chen Xiaomin , Zeng Tianze , Wang Lin , Cen Lvwei 
Published: October 2019

Abstract
BACKROUND Valid predictors of the recurrence of syncope in vasovagal syncope (VVS) patients with a positive head-up tilt test (HUTT) are currently lacking. The goal of this study was to identify the predictive performance of age for the recurrence of syncope in VVS patients with a positive HUTT. METHODS in total, 175 VVS patients with a positive HUTT were followed for 6 to 32 months, and ≥1 syncope episodes during follow-up was considered the recurrence of syncope. The study population was divided into 2 groups, namely, a recurrence of syncope group (44 patients) and a no recurrence of syncope group (131 patients). The baseline clinical data, hemodynamic parameters and classification of the vasovagal syncope on the HUTT were analyzed. Binary logistics regression was used to analyze the effect size and confidence interval of age. A receiver operating characteristic(ROC) analysis was used to assess the predictive performance and investigate the predictive value of age by the area under the curve (AUC). RESULTS The age of recurrence of syncope group 60.0 (47.8, 66.0) years was older than that of no recurrence of syncope group 53.0 (43.0, 62.0) years, and there was a significant difference between the two groups (P < 0.05). The trend of syncope recurrence changed with age and the binary logistics regression model adjusted by sex showed that the elder was an increased risk of syncope recurrence in VVS with positive HUTT [OR value: 1.034, 95% confidence interval(CI) 1.008 to 1.061 p < 0.05].Age was a valid predictor for the recurrence of syncope in VVS patients with a positive HUTT (AUC: 0.688; 95%CI 0.598 to 0.777 p < 0.05) . The cut-off value was 53.5 years, and the sensitivity and specificity were 72.7% and 52.7%, respectively. CONCLUSIONS Age was a valid predictor for recurrence of syncope in VVS patients with positive HUTT. The rate of recurrence of syncope increased with increasing age, especially in old female.
Associations between Maternal Autonomy and High-Risk Pregnancy in Bangladesh: the Mediating Influences of Childbearing Practices and Antenatal Care Uptake
Authors: Abedin Sumaiya , Arunachalam Dharma 
Published: October 2019

Abstract
Background A high level of maternal, infant and neonatal mortality occurs in Bangladesh. Certain childbearing practices as well as low use of antenatal care services make Bangladeshi women more vulnerable to experience poor health during pregnancy which contributes adverse birth outcomes. Also, women in Bangladesh remain considerably subordinate to men in almost all aspects of their lives, from education and work opportunities to healthcare utilisation. This lack of opportunities contributes to the low status of women within their family and society, and generally poor health outcomes for both mother and children. This study thus aims to investigate the factors associated with severity of health complications during pregnancy in relation to the low status of women, and the relative role of childbearing practices and antenatal care uptake to influence this relationship. Methods The relevant data from the last Bangladesh Demographic and Health Survey (BDHS) is used in this study. Multinomial logistic regression models (MLRM) of categorical response variables are applied as statistical tools to analyse the relevant data for the outcome variable: high-risk pregnancy. Results In Bangladesh, about 38.7% of women experienced high-risk pregnancies with multiple health complications. Findings of the study firstly found women’s decision-making autonomy and freedom of movement significantly associated with high-risk pregnancies. However, the results further reveal that maternal childbearing practices and antenatal care uptake had strong significant effects on high-risk pregnancies. Maternal age, particularly early childbearing of women had about 52% increased risk, and use of antenatal care had about 0.58 times less risk in having high-risk pregnancies. Conclusion Although the maternal decision-making autonomy and freedom of movement had significant effects on high-risk pregnancies, however, their relationships were strongly mediated by both maternal childbearing practices and uses of antenatal care.
A Case of Bilateral Acute Depigmentation of the Iris in One of Two Identical Twins
Authors: Langevin Spencer , Gershkovich Alexandra , Marr Brian P 
Published: October 2019

Abstract
Background: Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in 2006.1 The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report a patient who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation and never received any pitcher plant injections.
Case Presentation: Patient is a 41-year-old female with history of pitcher plant extract injections to her face for chronic migraine, who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has an identical twin sister who maintained normal iris pigmentation during the entire course.
Discussions and Conclusion: Bilateral Acute depigmentation of the is a recently discovered condition described in the literature in Turkish patients1,2. This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation, without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuchs’ heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis. This is the first reported case in North America and is important for differentiation from the above pathologies. Our patient had a history of pitcher plant extract injections to the face but it is unclear if this is associated with our patient’s development of BADI. As awareness of this condition progresses, a possible etiology may be elucidated.
Early Adolescent Skills for Emotions (EASE) intervention for the treatment of psychological distress in adolescents: Study protocol for randomised controlled trials in Lebanon and Jordan
Authors: Brown Felicity Louise , Steen Frederik , Taha Karine , Aoun May , Bryant Richard A. , Jo Mark J.D. , Malik Aiysha , Ommeren Mark van , Abualhaija Adnan , Aqel Ibrahim Said , Ghatasheh Maha , Habashneh Rand , Sijbrandij Marit , Chammay Rabih El , Watts Sarah , Akhtar Aemal 
Published: October 2019

Abstract
Background There are significant barriers to accessible, quality mental health care for young adolescents affected by adversity. In an attempt to overcome this, the World Health Organization (WHO) has developed the Early Adolescent Skills for Emotions (EASE) psychological intervention for young adolescents with internalizing problems. EASE is group-based (seven sessions for adolescents, three sessions for their caregivers) and can be delivered by non-specialist providers. This paper outlines the study protocols for two trials of EASE in the Middle-East - one in Lebanon and one in Jordan. Methods We will conduct two, single-blind, two-arm, individually randomised group treatment trials in Lebanon and Jordan, with at least 445 young adolescents per trial. Adolescents will be screened eligible for the trial if they demonstrate levels of psychological distress indicative of internalizing problems requiring treatment. Participants will be randomly assigned to receive the EASE intervention, or enhanced usual care (one home-visit psychoeducation session). The primary outcome is reduction in overall child-reported psychological distress over time, with 3 months post-treatment as the primary end-point. Secondary child-reported outcomes include post-traumatic stress symptoms, depression symptoms, daily functioning, and wellbeing. Secondary caregiver-reported outcomes include parenting style, overall child distress, and caregiver psychological distress. Coping strategy use will be explored as a mediator of treatment effects, and relevant moderators of treatment effects will be explored. Discussion These trials will provide the first assessments of the effectiveness of the EASE intervention for use in the middle-east, with important implications for the use of low intensity, non-specialist interventions for this age range.