bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamics of nuclear matrix attachment regions during 5th instar posterior silk gland development in Bombyx mori
Authors: Chunduri Alekhya Rani , Rajan Resma , Lima Anugata , Ramamoorthy Senthilkumar , Mamillapalli Anitha 
Published: March 2022

Abstract
Background
Chromatin architecture is critical for gene expression during development. Matrix attachment regions (MARs) control and regulate chromatin dynamics. The position of MARs in the genome determines the expression of genes in the organism. In this study, we set out to elucidate how MARs temporally regulate the expression of the fibroin heavy chain (FIBH) gene during development. We addressed this by identifying MARs and studying their distribution and differentiation, in the posterior silk glands of Bombyx mori during 5th instar development.

Results
Of the MARs identified on three different days, 7.15% MARs were common to all 3 days, whereas, 1.41, 19.27 and 52.47% MARs were unique to day 1, day 5, and day 7, respectively highlighting the dynamic nature of the matrix associated DNA. The average chromatin loop length based on the chromosome wise distribution of MARs and the distances between these MAR regions decreased from day 1 (253.91 kb) to day 5 (73.54 kb) to day 7 (39.19 kb). Further significant changes in the MARs in the vicinity of the FIBH gene were found during different days of 5th instar development which implied their role in the regulation and expression of the FIBH gene.

Conclusions
The presence of MARs in the flanking regions of genes found to exhibit differential expression during 5th instar development indicates their possible role in the regulation of their expression. This reiterates the importance of MARs in the genomic functioning as regulators of the molecular mechanisms in the nucleus. This is the first study that takes into account the tissue specific genome-wide MAR association and the potential role of these MARs in developmentally regulated gene expression. The current study lays a foundation to understand the genome wide regulation of chromatin during development.
Self-management support in flemish primary care practice: the development of a preliminary conceptual model using a qualitative approach
Authors: Timmermans Lotte , Boeykens Dagje , Sirimsi Mustafa Muhammed , Decat Peter , Foulon Veerle , Van Hecke Ann , Vermandere Mieke , Schoenmakers Birgitte ,   on behalf of the Primary Care Academy, Remmen Roy , Verté Emily , Sirimsi Muhammed Mustafa , Van Bogaert Peter , De Loof Hans , Van den Broeck Kris , Anthierens Sibyl , Huybrechts Ine , Raeymaeckers Peter , Buffel Veerle , Devroey Dirk , Aertgeerts Bert , Schoenmakers Birgitte , Timmermans Lotte , Foulon Veerle , Declerq Anja , Van de Velde Dominique , Boeckxstaens Pauline , De Sutter An , De Vriendt Patricia , Lahousse Lies , Pype Peter , Boeykens Dagje , Van Hecke Ann , Decat Peter , Roose Rudi , Martin Sandra , Rutten Erica , Pless Sam , Tuinstra Anouk , Gauwe Vanessa , Reynaert Didier , Van Landschoot Leen , Hartmann Maja Lopez , Claeys Tony , Vandenhoudt Hilde , De Vliegher Kristel , Op de Beeck Susanne 
Published: March 2022

Abstract
Background
Coping with a chronic disease can be really challenging. Self-management represents a promising strategy to improve daily life experiences. The role of primary healthcare professionals cannot be underestimated in supporting self-management. Due to a shortage of theory, implementation of self-management support is hindered in primary care practice. The aim of this study is to create a conceptual model for self-management support by analysing patients’ care experiences towards self-management support.

Methods
An explorative-descriptive qualitative study was conducted in Flanders, Belgium. Semi-structured interviews were performed with 16 patients and their informal caregiver (dyads) using a purposive sampling strategy and processed by an inductive content analysis, according to Graneheim and Lundman.

Results
Interviews revealed in-depth insights into patients’ care experiences. A conceptual model was developed for primary care practice, including five fundamental tasks for healthcare professionals - Supporting, Involving, Listening, Coordinating and Questioning (SILCQ) – contributing to the support of self-management of chronic patients.

Conclusions
This qualitative paper emphasises the use of the SILCQ-model to develop optimal roadmaps and hands-on toolkits for healthcare professionals to support self-management. The model needs to be further explored by all stakeholders to support the development of self-management interventions in primary care practice.
Implementing an intervention to reduce use of antibiotics for suspected urinary tract infection in nursing homes – a qualitative study of barriers and enablers based on Normalization Process Theory
Authors: Kousgaard Marius Brostrøm , Olesen Julie Aamand , Arnold Sif Helene 
Published: March 2022

Abstract
Background
Overuse of antibiotics in the elderly population is contributing to the global health problem of antibiotic resistance. Hence, it is important to improve prescribing practices in care facilities for elderly residents. In nursing homes, urinary tract infection (UTI) is the most common reason for antibiotic prescription but inappropriate prescriptions are frequent. In order to reduce the use of antibiotics for suspected urinary tract infection in this context, a complex intervention based on education as well as tools for reflection and communication had been developed and trialed in a group of nursing homes. The presents study explored the barriers and enablers in implementing this complex intervention.

Methods
After the intervention trial period, a qualitative interview study was performed in six of the nursing homes that had received the intervention. The study included 12 informants: One senior manager, four nurses, six healthcare assistants, and one healthcare helper. Normalization Process Theory was used to structure the interviews as well as the analysis.

Results
The intervention was well received among the informants in terms of its purpose and content. The initial educational session had altered the informants’ perceptions of UTI and of the need for adopting a different approach to suspected UTIs. Also, the study participants generally experienced that the intervention had positively impacted their practice. The most important barrier was that some of the interventions’ clinical content was difficult to understand for the staff. This contributed to some problems with engaging all relevant staff in the intervention and with using the observation tool correctly in practice. Here, nurses played a key role in the implementation process by regularly explaining and discussing the intervention with other staff.

Conclusion
The results suggest that it is possible to implement more evidence-based practices concerning antibiotics use in nursing homes by employing a combination of educational activities and supportive tools directed at nursing home staff.
Essential elements of and challenges to rapid ART implementation: a qualitative study of three programs in the United States
Authors: Koester Kimberly A. , Moran Lissa , LeTourneau Noelle , VanderZanden Lyndon , Coffey Susa , Crouch Pierre-Cedric , Broussard Janessa , Schneider John , Christopoulos Katerina A. 
Published: March 2022

Abstract
Background
Antiretroviral therapy (ART) initiation on the day of an HIV diagnosis or as soon as possible after diagnosis, known as rapid ART (henceforth “RAPID”), is considered to be a safe and effective intervention to quickly reduce viral load and potentially improve engagement in care over time. However, implementation of RAPID programming is not yet widespread. To facilitate broader dissemination of RAPID, we sought to understand health care worker experiences with RAPID implementation and to identify essential programmatic elements.

Methods
We conducted 27 key informant interviews with medical providers and staff involved in RAPID service delivery in three distinct clinical settings: an HIV clinic, a Federally Qualified Health Center and a sexual health and wellness clinic. Interviews were structured around domains associated with the Consolidated Framework for Implementation Research and were audio-recorded, transcribed, and thematically analyzed.

Findings
We identified seven (7) essential elements across settings associated with successful RAPID program implementation. These high-impact elements represent essential components without which a RAPID program could not function. There was no one requisite formation. Instead, we observed a constellation of essential elements that could be operationalized in various formations and by various people in various roles. The essential elements included: (1) presence of an implementation champion; (2) comfort and competence prescribing RAPID ART; (3) expedited access to ART medications; (4) expertise in benefits, linkage, and care navigation; (5) RAPID team member flexibility and organizations’ adaptive capacity; (6) patient-centered approach; and (7) strong communication methods and culture.

Conclusions
The RAPID model can be applied to a diverse range of clinical contexts. The operational structure of RAPID programs is shaped by the clinical setting in which they function, and therefore the essential elements identified may not apply equally to all programs. Based on the seven essential elements described above we recommend future implementers identify where these elements currently exist within a practice; leverage them when possible; strengthen them when necessary or develop them if they do not yet exist; and look to these elements when challenges arise for potential solutions.
High heterogeneity of fecal carriage extended-spectrum beta-lactamase-producing E. coli isolated from iranian community and clinical settings
Authors: Aghamohammad Shadi , Nikbin Vajihe Sadat , Badmasti Farzad , Shahcheraghi Fereshteh 
Published: March 2022

Abstract
Background
Extended-spectrum beta-lactamase-producing enterobacteria (ESBL-PE) in carriers have become a global health problem. Using molecular typing techniques, including PFGE, could be useful to determine the source of bacterial dissemination. The current study aimed to investigate the intestinal carriage of ESBL-producing E. coli (ESBL-EC) and clonal relatedness among ESBL-EC isolated from hospitalized and outpatient fecal carriers in Iran.

Methods
A total of 120 rectal swabs were collected; 50.8% (61/120) from intensive care unit (ICU) inpatients and 49.2% (59/120) from outpatients. MacConkey agar enriched with cefotaxime was used to screen the ESBL-EC. PCR assays were performed to detect ESBL and carbapenemase genes. Pulse-fields gel electrophoresis (PFGE) was performed to assess clonal relatedness.

Results
Totally, 60.0% (72/120) were carrier for ESBL-EC. The rates of resistance against ceftazidime and cefepime were 90.2% (65/72) and 93.0% (67/72), respectively. The rates of blaCTX-M-15, blaTEM, blaSHV, blaNDM-1, blaOXA-48 and blaIMP was 90.2% (65/72), 50.0% (36/72), 5.5% (4/72), 4.1% (3/72), 4.1% (3/72) and 1.3% (1/72), respectively. Based on a cut-off 80%, 69 ESBL-EC isolates could be categorized in 10 mini-cluster and 47 isolates were considered as singletons.

Discussion
High heterogeneity among isolates from ESBL-EC suggests that this bacterium probably has a different source of dissemination. Screening of carriers in hospitals and communities could help the infection control program in public health.
Early pregnancy anxiety during the COVID-19 pandemic: preliminary findings from the UCSF ASPIRE study
Authors: Morris Jerrine R. , Jaswa Eleni , Kaing Amy , Hariton Eduardo , Andrusier Miriam , Aliaga Katie , Davis Maya , Cedars Marcelle I. , Huddleston Heather G. 
Published: March 2022

Abstract
Background
Antenatal anxiety has been linked to adverse obstetric outcomes, including miscarriage and preterm birth. However, most studies investigating anxiety during pregnancy, particularly during the COVID-19 pandemic, have focused on symptoms during the second and third trimester. This study aims to describe the prevalence of anxiety symptoms early in pregnancy and identify predictors of early pregnancy anxiety during the COVID-19 pandemic.

Methods
We assessed baseline moderate-to-severe anxiety symptoms after enrollment in the UCSF ASPIRE (Assessing the Safety of Pregnancy in the Coronavirus Pandemic) Prospective Cohort from May 2020 through February 2021. Pregnant persons < 10 weeks’ gestation completed questions regarding sociodemographic characteristics, obstetric/medical history, and pandemic-related experiences. Univariate and multivariate hierarchical logistic regression analyses determined predictors of moderate or severe anxiety symptoms (Generalized Anxiety Disorder-7 questionnaire score ≥ 10). All analyses performed with Statistical Analysis Software (SAS®) version 9.4.

Results
A total of 4,303 persons completed the questionnaire. The mean age of this nationwide sample was 33 years of age and 25.7% of participants received care through a fertility clinic. Over twelve percent of pregnant persons reported moderate-to-severe anxiety symptoms. In univariate analysis, less than a college education (p < 0.0001), a pre-existing history of anxiety (p < 0.0001), and a history of prior miscarriage (p = 0.0143) were strong predictors of moderate-to-severe anxiety symptoms. Conversely, having received care at a fertility center was protective (26.6% vs. 25.7%, p = 0.0009). COVID-19 related stressors including job loss, reduced work hours during the pandemic, inability to pay rent, very or extreme worry about COVID-19, and perceived stress were strongly predictive of anxiety in pregnancy (p < 0.0001). In the hierarchical logistic regression model, pre-existing history of anxiety remained associated with anxiety during pregnancy, while the significance of the effect of education was attenuated.

Conclusion(s)
Pre-existing history of anxiety and socioeconomic factors likely exacerbated the impact of pandemic-related stressors on early pregnancy anxiety symptoms during the COVID-19 pandemic. Despite on-going limitations for in-person prenatal care administration, continued emotional health support should remain an important focus for providers, particularly when caring for less privileged pregnant persons or those with a pre-existing history of anxiety.
COVID-19 and substance use disorders: a review of international guidelines for frontline healthcare workers of addiction services
Authors: Ostinelli Edoardo G. , Smith Katharine , Zangani Caroline , Ostacher Michael J. , Lingford-Hughes Anne R. , Hong James S. W. , Macdonald Orla , Cipriani Andrea 
Published: March 2022

Abstract
Background
People with substance use disorders may be at a greater risk of contracting COVID-19 infection and developing medical complications. Several institutional and governmental health agencies across the world developed ad hoc guidance for substance use disorder services and care of individuals misusing substances. We aimed to synthesise the best available recommendations on management and care of people with or at risk of substance use disorders during the COVID-19 pandemic from existing guidelines published in UK, USA, Australia, Canada, New Zealand, and Singapore.

Methods
We systematically searched existing guidelines and websites from 28 international institutions and governmental bodies in the context of the COVID-19 pandemic (May 4th 2021). We summarized the extracted data as answers to specific clinical questions.

Results
We organised the available recommendations from 19 sources in three sections. First, we focused on general advice and recommendations for people who misuse alcohol or drugs during the COVID-19 pandemic, the design of contingency plans, safeguarding issues for children and families of service users and advice to the public, patients, and carers. Then, we summarised specific guidelines for people who use illicit drugs and related services, such as opioid substitution treatment and needle and syringe programmes. Finally, we provided a synthesis on specific recommendations for services supporting people who misuse alcohol and key topics in the field, such as management of alcohol detoxification and safe transition between supervised and unsupervised consumption.

Conclusions
Available guidance reflected different approaches, ranging from being extremely cautious in providing recommendations other than generic statements to proposing adaptation of previously available guidelines to confront the challenges of the COVID-19 pandemic. After the early phase, guidance focused on reduction of infection transmission and service delivery. Guidance did not provide advice on infection prevention via vaccination programmes and service access strategies tailored to individuals with substance use disorders.
The Bergen Facebook Addiction Scale: its psychometric properties and invariance among women with eating disorders
Authors: Ali Amira Mohammed , Hendawy Amin Omar , Abd Elhay Eman Sameh , Ali Esraa Mohammed , Alkhamees Abdulmajeed A. , Kunugi Hiroshi , Hassan Nagia I. 
Published: March 2022

Abstract
Objective
Facebook addiction is increasing, giving rise to limited real-life social networks, loneliness, poor work and academic performance, psychopathology, and low well-being. Facebook entails numerous factors that increase the risk for disordered eating attitudes and behaviors (e.g., use time and Facebook activities such as social grooming and photo sharing). This study aimed to evaluate the psychometric properties of the Bergen Facebook Addiction Scale (BFAS) among patients with eating disorders (EDs) given lack of validation of Facebook addiction measures in this population.

Methods
A cross-sectional study involving 123 inpatient and outpatient women with EDs (Mean age = 27.3, SD = 10.6, range = 14–59 years) used confirmatory factor analysis (CFA), multigroup CFA, structural equation modeling (SEM), Spearman’s rho Spearman’s analysis, McDonald's Omega (ω), Cronbach’s alpha (α), and item-total correlations to examine the structure, invariance, criterion validity, reliability, and discriminant validity of the BFAS.

Results
Correlating the residuals of items 2, 3, and 5 resulted in an excellent fit of a one-factor structure of the BFAS (χ2(7) = 8.515, p = .289, CFI = .998, TLI = .996, RMSEA = .042, SRMR = .0099). The BFAS was invariant at the configural, metric, and scalar levels across groups of EDs, age, education, and marital status. High values of ω and α (.96) as well as item-total correlations (.851–.929) indicated excellent reliability and high discrimination index of the BFAS. Criterion validity is noted by strong positive correlation with the Six-item Internet Addiction Test (S-IAT, r = .88) and SEM using the S-IAT to predict the BFAS (χ2(49) = 103.701, p = .001, CFI = .975, TLI = .966, RMSEA = .096, SRMR = .0317)..

Conclusion
The BFAS is a reliable unidimensional measure. Its high discrimination index and invariance across different groups make it useful for detecting Facebook addiction among patients with ED.
Paravertebral abscess and bloodstream infection caused by Burkholderia pseudomallei after acupuncture: a case report
Authors: Xiao Lingyan , Zhou Tong , Chen Jun , Hu Yanqing , Zheng Yishan 
Published: March 2022

Abstract
Background
Various pathogenic bacterial infections caused by acupuncture have raised widespread concern, but paravertebral abscesses and bloodstream infections of Burkholderia pseudomallei (B.pseudomallei) after acupuncture have not been reported.

Case presentation
A 49-year-old man was admitted to hospital with recurrent back pain and fever for 1 month, along with the finding of undiagnosed diabetes. He was considered to have tuberculosis because of unrelieved high fever and pulmonary nodules. Bilateral blood culture suggested B.pseudomallei infection, MRI of the lumbar spine suggested paravertebral abscess, and the final diagnosis was paravertebral abscess and bloodstream infection after acupuncture combined with migrating lung infection. He was discharged after abscess debridement and intensive anti-infective therapy, but no further oral antibiotics were administered because of his poor adherence. More than 5 months later, he was readmitted with the urine culture findings of B.pseudomallei. No other abscess formation was observed and he received oral antibiotics for more than 3 months without recurrence.

Conclusions
Acupuncture may lead to B.pseudomallei infection in high-risk groups, and inadequate treatment can lead to recurrent infections.
The changing clinical landscape in acupuncture for women’s health: a cross-sectional online survey in New Zealand and Australia
Authors: Graca Sandro , Betts Debra , Roberts Kate , Smith Caroline A. , Armour Mike 
Published: March 2022

Abstract
Background
Acupuncture is a popular treatment for women’s health. Several trials and meta-analysis have been published in recent years on key women’s health conditions but it is unclear if this has led to any changes in clinical practice or referrals from other health professionals. The aim of this survey was to explore if, how, and why, aspects of acupuncture practice have changed since our survey in 2013.

Method
An online cross-sectional survey of registered acupuncturists and Chinese Medicine practitioners in Australia and New Zealand. Questions covered the practitioner demographics and training, women’s health conditions commonly treated, modalities used, sources of information and continuing education (CE) (e.g. webinars), changes in clinical practice, and referral networks.

Results
One hundred and seventy registered practitioners responded to this survey, with 93% reporting treating women’s health in the last 12 months. The majority of respondents were from Australia (60%), held a bachelors level qualification (60%), and used a traditional Chinese medicine framework (86%). Most practitioners incorporated other modalities in addition to acupuncture. Most practitioners’ referral networks were predominantly based on word of mouth for menstrual, fertility and pregnancy related conditions, with referrals from medical practitioners being much less common. More than half (57%) reported having changed their women’s health practice in the past 12 months; just over a quarter of those who changed treatment (27%) reported it was due to research findings. The most commonly used sources of information/CE used to inform treatment were webinars and conferences, while peer-reviewed journal articles were the least commonly used source.

Conclusion
Acupuncture practitioners in Australia and New Zealand commonly treat women’s health conditions, but this is usually the result of women seeking them out, rather than being referred from a medical practitioner. The majority of practitioners did report changing their women’s health practice, but peer reviewed academic articles alone are not an ideal medium to convey this information since practitioners favour knowledge obtained from webinars and conferences. Academics and other clinician researchers should consider alternative means of disseminating knowledge beyond traditional academic publications and conferences, special interest groups may assist in this and also help improve research literacy.