bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of theory-based education on promoting a healthy lifestyle in pre-diabetic women: RCT
Authors: MohammadniaMotlagh Kolsoum , Shamsi Mohsen , Roozbahani Nasrin , Karimi Mahmood , Moradzadeh Rahmatollah 
Published: February 2022

AbstractBackgroundDue to the fact that pre-diabetic people are at higher risk of developing diabetes, it is possible to reduce the risk by taking preventive measures. Therefore, the present study aimed to determine the effect of theory-based education on promoting a healthy lifestyle and fasting blood sugar (FBS) in pre-diabetic women.MethodsThis is a cluster‐randomized controlled trial that was performed on 71 pre-diabetic women referred to Arak Comprehensive Health Service Center. Thus, using cluster sampling method, one center was randomly assigned to the intervention group and one center to the control group. The data collection tool was a questionnaire based on the theory of planned behavior (TPB) and healthy lifestyle behavior that was completed before and at least 3 months after training and FBS test was performed. The experimental group received 3 training sessions of 60 to 90 min and finally the data were analyzed using statistical software.ResultsAfter the intervention, the mean scores of knowledge (P < 0.001), attitude (P = 0.047) and perceived behavioral control related to physical activity (P = 0.046) and dietary function (P = 0.01) increased significantly in the intervention group. In addition, fasting blood sugar in the intervention group (99.70 ± 11.06) improved significantly compared to the control group (110.94 ± 17.09) (P = 0.003).ConclusionEducation based on the theory of planned behavior, by holding face-to-face meetings along with following up the samples after the educational intervention, can promote healthy lifestyle of pre-diabetic women. Therefore, designing and implementing similar interventions on all pre-diabetic individuals seem necessary.Trial registration: The master's thesis in health education is approved by Arak University of Medical Sciences, Iran and is registered in the Iranian Registry of Clinical Trial (IRCT20190304042921N1). Prospectively registered 22/07/2019,https://en.irct.ir/trial/40596.
An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study
Authors: Lewis-Thames Marquita W. , Tom Laura S. , Leung Ivy S. , Yang Anna , Simon Melissa A. 
Published: February 2022

Abstract
Background
Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment.

Methods
Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process.

Results
We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program’s implementation there was limited awareness of the CPNP navigators’ roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials.

Conclusions
These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.
Understanding the context of healthcare utilisation for children under-five with diarrhoea in the DRC: based on Andersen behavioural model
Authors: Zou Siyu , Qi Xinran , Marshall Keiko , Bhura Maria , Takesue Rie , Tang Kun 
Published: February 2022

AbstractBackgroundDiarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC.MethodsData collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey conducted by the National Institute of Statistics in 2017–2018, in collaboration with the United Nations Children’s Fund were used in this study. Both direct and indirect relationships among four latent variables: predisposing traits, enabling resources access, health needs, and health services use were measured using the structural equation modelling to test the Andersen behavioural model. The confirmatory Factor Analysis model was also modified based on the DRC context to explore this further.ResultsThe modified model had the goodness of fit index (GFI) of 0.972, comparative fit index (CFI) of 0.953 and RMSEA of 0.043 (95% CI: 0. 040, 0.047). Health needs (especially diarrhoea) had the largest positive direct effect on healthcare utilisation (standardized regression coefficient [β] = 0.135,P < 0.001), followed by “enabling resources” (β = 0.051,P = 0.015). Health needs also emerged as a mediator for the positive effect of predisposing on utilisation (indirect effect, β = 0.014;P = 0.009).ConclusionAccess to improved water and improved sanitation, as well as socioeconomic factors like household wealth, were significantly associated with health-seeking behaviours for diarrhoea treatment in the DRC. Besides, caregivers who own higher levels of educational attainments were more inclined to have positive health services uses during the treatments. Efforts are needed to enhance the oral rehydration therapy coupled with educating caregivers on its appropriate use.
Effect of an osteoporotic fracture prevention program on fracture incidence in routine care: a cluster-randomized trial
Authors: Rapp Kilian , Lamb Sarah E. , Roigk Patrick , Becker Clemens , Konnopka Claudia , König Hans-Helmut , Peter Raphael S. , Rothenbacher Dietrich , Büchele Gisela 
Published: February 2022

Abstract
Background
Fractures are a major health problem in aging societies. Preventive approaches combining bone health and fall prevention are rare. The osteoporotic fracture prevention program in rural areas (OFRA) is a health care fund-driven program for older people in randomly selected districts in Germany. The components of the program were falls prevention exercise classes, examination of bone health by a dual-energy X-ray absorptiometry (DXA) scan, and a consultation about “safety in the living environment.” The aim of this study was to evaluate this complex preventive intervention in a routine health care setting.

Methods
This cluster-randomized trial was performed from October 2015 to October 2018 and took place in 186 administrative districts in five federal states, 47 districts served as intervention districts, and 139, as controls. Within these districts, we included (a) all community-living women and men aged 70–85 years with prior fragility fractures and (b) all community-living women aged 75–80 years. The analysis used routine data collected by a health insurance company. The primary endpoint was all fragility fractures combined. Fracture types, mortality, and nursing home admission were explorative endpoints. Cox frailty models were used for comparative analyses with a median follow-up time of 365 days (interquartile range: 0 days).

Results
Nine thousand four hundred eight individuals were approached to participate in one of the program components, 27,318 individuals served as controls. The mean age was 78.7 years. Of those approached to participate, nearly 30% joined the exercise classes. DXA measurement was reimbursed for 13.6%, and 51.8% received advice about measures to increase “safety in the living environment.” The incidence of fragility fractures did not differ between the intervention and the control group (HR 0.94; 95% CI 0.80–1.11). However, femoral fractures, the most frequent fracture type, were reduced in the intervention group (HR 0.76; 95% CI 0.59–0.99). Mortality and nursing home admission did not differ between the intervention and the control group.

Conclusions
A comprehensive fracture prevention program for older people living in rural areas was implemented. The program did not affect the primary endpoint of all fragility fractures combined. It has to be considered that we used a modified intention to treat approach based on geographic randomization and information about endpoints relied exclusively on routine data of the health care insurance.

Trial registration
German Clinical Trials Register DRKS-ID: 00009000
Engineering 2D Cu-composed metal–organic framework nanosheets for augmented nanocatalytic tumor therapy
Authors: Zhuang Shangwen , Xiang Huijing , Chen Yixin , Wang Lulu , Chen Yu , Zhang Jun 
Published: February 2022

AbstractThe engineered nanoformulation that can be activated by intracellular tumor microenvironment, including acidic pH, overexpressed H2O2, and high concentration of glutathione (GSH), features high efficacy to eradicate tumor cells with the intrinsic specificity and therapeutic biosafety. However, the relatively slow reaction rate of traditional Fe2+-mediated Fenton reaction induces the low production amount of reactive oxygen species (ROS) and subsequently the limited therapeutic outcome against tumors. Here, we established Cu (II)-based two-dimensional (2D) metal–organic framework (MOF) nanosheets as a distinct chemoreactive nanocatalyst for GSH-triggered and H2O2-augmented chemodynamic therapy (CDT), depending on the “AND” logic gate, for significant tumor suppression. After internalization by tumor cells, the MOF catalytic nanosheets reacted with local GSH for inducing GSH consumption and reducing the Cu2+ into Cu+. Subsequently, abundant hydroxyl radicals (·OH) generation was achieved via Cu+-mediated Fenton-like catalytic reaction. The dual effects of ·OH production and GSH depletion thus enhanced ROS production and accumulation in tumor cells, leading to significant cellular apoptosis and tumor inhibition, which was systematically demonstrated in both 4T1 and MDA-MB-231 tumor models. Therefore, GSH and H2O2, serve as an “AND” logic gate to trigger the Cu+-mediated Fenton-like reaction and reduce GSH level for augmented CDT with high therapeutic specificity and efficacy, thus inducing cellular apoptosis primarily through ferroptosis at the RNA sequence level.
Graphical Abstract
Unconjugated PLGA nanoparticles attenuate temperature-dependent β-amyloid aggregation and protect neurons against toxicity: implications for Alzheimer’s disease pathology
Authors: Paul Pallabi Sil , Cho Jae-Young , Wu Qi , Karthivashan Govindarajan , Grabovac Emily , Wille Holger , Kulka Marianna , Kar Satyabrata 
Published: February 2022

AbstractConversion of β-amyloid (Aβ) peptides from soluble random-coil to aggregated protein enriched with β-sheet-rich intermediates has been suggested to play a role in the degeneration of neurons and development of Alzheimer’s disease (AD) pathology. Aggregation of Aβ peptide can be prompted by a variety of environmental factors including temperature which can influence disease pathogenesis. Recently, we reported that FDA-approved unconjugated poly (d,l-lactide-co-glycolide) (PLGA) nanoparticles can have beneficial effects in cellular and animal models of AD by targeting different facets of the Aβ axis. In this study, using biochemical, structural and spectroscopic analyses, we evaluated the effects of native PLGA on temperature-dependent Aβ aggregation and its ability to protect cultured neurons from degeneration. Our results show that the rate of spontaneous Aβ1–42 aggregation increases with a rise in temperature from 27 to 40 °C and PLGA with 50:50 resomer potently inhibits Aβ aggregation at all temperatures, but the effect is more profound at 27 °C than at 40 °C. It appears that native PLGA, by interacting with the hydrophobic domain of Aβ1–42, prevents a conformational shift towards β-sheet structure, thus precluding the formation of Aβ aggregates. Additionally, PLGA triggers disassembly of matured Aβ1–42 fibers at a faster rate at 40 °C than at 27 °C. PLGA-treated Aβ samples can significantly enhance viability of cortical cultured neurons compared to neurons treated with Aβ alone by attenuating phosphorylation of tau protein. Injection of native PLGA is found to influence the breakdown/clearance of Aβ peptide in the brain. Collectively, these results suggest that PLGA nanoparticles can inhibit Aβ aggregation and trigger disassembly of Aβ aggregates at temperatures outside the physiological range and can protect neurons against Aβ-mediated toxicity thus validating its unique therapeutic potential in the treatment of AD pathology.
Graphical Abstract
The Bronze Age of drug checking: barriers and facilitators to implementing advanced drug checking amidst police violence and COVID-19
Authors: Carroll Jennifer J. , Mackin Sarah , Schmidt Clare , McKenzie Michelle , Green Traci C. 
Published: February 2022

Abstract
Objectives
Unpredictable fluctuations in the illicit drug market increase overdose risk. Drug checking, or the use of technology to provide insight into the contents of illicit drug products, is an overdose prevention strategy with an emerging evidence base. The use of portable spectrometry devices to provide point-of-service analysis of the contents of illicit drugs been adopted by harm reduction organizations internationally but is only emerging in the United States. This study aimed to identify barriers and facilitators of implementing drug checking services with spectrometry devices in an urban harm reduction organization and syringe service program serving economically marginalized people who use drugs in Boston, Massachusetts (USA).

Methods
In-vivo observations and semi-structured interviews with harm reduction staff and participants were conducted between March 2019 and December 2020. We used the consolidated framework for implementation research to identify implementation barriers and facilitators.

Results
This implementation effort was facilitated by the organization’s shared culture of harm reduction—which fostered shared implementation goals and beliefs about the intervention among staff persons—its horizontal organizational structure, strong identification with the organization among staff, and strong relationships with external funders. Barriers to implementation included the technological complexity of the advanced spectroscopy devices utilized for drug checking. Program staff indicated that commercially available spectroscopy devices are powerful but not always well-suited for drug checking efforts, describing their technological capacities as “the Bronze Age of Drug Checking.” Other significant barriers include the legal ambiguity of drug checking services, disruptive and oppositional police activity, and the responses and programmatic changes demanded by the COVID-19 pandemic.

Conclusions
For harm reduction organizations to be successful in efforts to implement and scale drug checking services, these critical barriers—especially regressive policing policies and prohibitive costs—need to be addressed. Future research on the impact of policy changes to reduce the criminalization of substance use or to provide explicit legal frameworks for the provision of this and other harm reduction services may be merited.
The impact of the COVID-19 pandemic on lifestyle behaviors in children and adolescents: an international overview
Authors: Scapaticci S. , Neri C. R. , Marseglia G. L. , Staiano A. , Chiarelli F. , Verduci E. 
Published: February 2022

AbstractThe adverse effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are not limited to the related infectious disease. In children and adolescents, serious risks due to the coronavirus disease 2019 (COVID-19) pandemic are also related to its indirect effects. These include an unbalanced diet with an increased risk of weight excess or nutritional deficiencies, increased sedentary lifestyle, lack of schooling, social isolation, and impaired mental health.Pediatricians should be aware of the side effects of the COVID-19 pandemic on children’s diet, physical mental health and advise the families according to their nutritional needs and financial resources. Moreover, the lack of a targeted therapy able to offer protection against the deleterious effects of SARS-CoV-2 infection should require a greater effort by scientific societies to find a more effective prevention strategy. In this context, much interest should be given to nutritional support, able to contrast malnutrition and to stimulate the immune system.
Effect of minocycline on the left ventricular function following ST-elevation myocardial infarction treated by primary percutaneous coronary intervention
Authors: Nasiri Alireza , Shafiee Akbar , Hosseinsabet Ali , Talasaz Azita Hajhosein , Jalali Arash , Salarifar Mojtaba 
Published: February 2022

Abstract
Background
Cardiac remodeling following myocardial infarction is a pathological process. We aimed to examine the effect of early short-term minocycline on the left ventricular function following ST-elevation myocardial infarction treated by the primary percutaneous coronary intervention.

Methods
In this double-blind, randomized controlled trial, data of 73 patients STEMI patients who were candidates for primary PCI were enrolled. Patients were then randomized to receive minocycline 50 mg orally, followed by 50 mg once a day for 5 days or a placebo with the same schedule. Measurement of serum matrix metalloproteinase-9 (MMP-9) and 2-dimensional speckle tracking echocardiography was performed at baseline and between 4 and 6 months after discharge. Then the demographic, clinical, echocardiographic, and angiographic data, as well as the levels of MMP-9, were compared between the study groups.

Results
There was no statistically significant difference between the study groups regarding the baseline characteristics. Serum levels of MMP-9 did not change following the intervention within each group and were not significantly different between the groups after follow-up. In the follow-up echocardiography, we also did not observe any difference between the two groups

Conclusion
In this study, we did not observe any effect of minocycline on cardiac remodeling based on 2-dimensional speckle tracking echocardiography and MMP-9 levels.

Trial registration
Iranian Registry of Clinical Trials IRCT201411188698N15. Registered on 22 June 2015, prospectively.
Statistical analysis of publicly funded cluster randomised controlled trials: a review of the National Institute for Health Research Journals Library
Authors: Offorha Bright C. , Walters Stephen J. , Jacques Richard M. 
Published: February 2022

Abstract
Background
In cluster randomised controlled trials (cRCTs), groups of individuals (rather than individuals) are randomised to minimise the risk of contamination and/or efficiently use limited resources or solve logistic and administrative problems. A major concern in the primary analysis of cRCT is the use of appropriate statistical methods to account for correlation among outcomes from a particular group/cluster. This review aimed to investigate the statistical methods used in practice for analysing the primary outcomes in publicly funded cluster randomised controlled trials, adherence to the CONSORT (Consolidated Standards of Reporting Trials) reporting guidelines for cRCTs and the recruitment abilities of the cluster trials design.

Methods
We manually searched the United Kingdom’s National Institute for Health Research (NIHR) online Journals Library, from 1 January 1997 to 15 July 2021 chronologically for reports of cRCTs. Information on the statistical methods used in the primary analyses was extracted. One reviewer conducted the search and extraction while the two other independent reviewers supervised and validated 25% of the total trials reviewed.

Results
A total of 1942 reports, published online in the NIHR Journals Library were screened for eligibility, 118 reports of cRCTs met the initial inclusion criteria, of these 79 reports containing the results of 86 trials with 100 primary outcomes analysed were finally included. Two primary outcomes were analysed at the cluster-level using a generalized linear model. At the individual-level, the generalized linear mixed model was the most used statistical method (80%, 80/100), followed by regression with robust standard errors (7%) then generalized estimating equations (6%). Ninety-five percent (95/100) of the primary outcomes in the trials were analysed with appropriate statistical methods that accounted for clustering while 5% were not. The mean observed intracluster correlation coefficient (ICC) was 0.06 (SD, 0.12; range, − 0.02 to 0.63), and the median value was 0.02 (IQR, 0.001–0.060), although 42% of the observed ICCs for the analysed primary outcomes were not reported.

Conclusions
In practice, most of the publicly funded cluster trials adjusted for clustering using appropriate statistical method(s), with most of the primary analyses done at the individual level using generalized linear mixed models. However, the inadequate analysis and poor reporting of cluster trials published in the UK is still happening in recent times, despite the availability of the CONSORT reporting guidelines for cluster trials published over a decade ago.