bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart Rate Variability Enhances the Accuracy of Non-invasive Continuous Blood Pressure Estimation Under Blood Loss
Authors: Zhang Guang , Wang Zongge , Hou Feixiang , Wang Huiquan , Chen Feng , Yu Ming , Wang Jinhai 
Published: October 2020

Abstract
Background: To propose a new method for real-time monitoring of human blood pressure under blood loss (BPBL), this article combines pulse transit time (PTT) and heart rate variability (HRV) as input parameters in order to establish a model for the estimation of BPBL.Methods: Effective parameters such as PTT, R-R internal (RRI), and HRV were extracted and used to establish the blood pressure (BP) estimation. Three BP estimation models were established: the PTT model, the RRI model, and the HRV model, and they were divided into experimental group and control group. Finally, the effects of different estimation models on the accuracy of BPBL estimation were evaluated based on the experimental results.Results: The Pearson correlation coefficients R were 0.7731, 0.8943 and 0.9169 for the PTT model, the RRI model, and the HRV model, respectively. The root means square error of the estimation set (RMSEP) were 16.83 mmHg, 11.87 mmHg and 10.59 mmHg, respectively.Conclusion: The results suggest that the accuracy of the BPBL estimated by the RRI and HRV models is better than that of the PTT model, which means that both RRI and HRV can enhance the accuracy of BPBL estimation, and HRV seems to be more effective in improving the accuracy of BP prediction compared to RRI. These results provide a new idea for other scholars in the field of BPBL estimation research.
Prevalence and Incidence of Venous Leg Ulcers – A Protocol for a Systematic Review
Authors: Probst Sebastian , Weller Carolina D , Bobbink Paul , Saini Camille , Pugliese Maite , Skinner Monika Buehrer , Gethin Georgina 
Published: October 2020

Abstract
Background: Venous leg ulcers (VLUs) are chronic wounds characterised by slow healing and high recurrence. Information on prevalence and incidence is essential for ascertaining the burden of VLU on the health care system and to inform epidemiological research, priority setting and health-care planning. The objective of this protocol is to present a transparent process for how we plan to review the existing international literature on the prevalence and incidence of VLU as well as the characteristics of the population reported within these studies.Methods: An exploratory search was performed using MEDLINE via PubMed and CINHAL via Ebsco to identify concepts, keywords, MeSH terms and headings to identify study types looking at data of VLU prevalence and/or incidence and related patient characteristics. The findings of this exploratory search will determine the final search strategy. The titles and abstracts of the identified articles will be screened independently be two authors for relevance. Study which pass the quality assessment will be included. Data extraction will be performed independently by two authors and in accordance with a pre-designed data extraction form. If the data allows, a meta-analysis will be performed otherwise a descriptive summary of the findings will be conducted. Discussion: The results of this review will contribute to the evidence base on VLU occurrence and may inform the decision making of healthcare professionals, policy-makers, and consumers. It will also inform future research in this area of VLU care.Systematic review registration: CRD42020205855
The Effect of Simulation-Based Neonatal Emergency Team Training on Clinical Performance and Patient Outcome: A Systematic Review
Authors: Lindhard Morten S. , Thim Signe , Laursen Henrik Sehested , Schram Anders Wester , Paltved Charlotte , Henriksen Tine Brink 
Published: October 2020

Abstract
BackgroundA number of neonatal simulation-training programmes have been deployed during the last decade, and a growing number of studies have investigated effects of simulation-based team training. However, the body of evidence remains to be compiled. Therefore, we performed a systematic review on the effects of simulation-based team training on clinical performance and patient outcome.MethodsThe review was conducted according to the preferred reporting items for systematic review and meta-analysis (PRISMA). We included studies on team training in emergency neonatal settings with reported outcome on clinical performance and patient outcome. Two reviewers independently selected articles and assessed risk-of-bias using the Cochrane risk-of-bias tool 2.0 and the Newcastle-Ottawa quality assessment scale. Kirkpatricks’ model for evaluation of training programs provided the framework for a narrative synthesis.ResultsWe screened 1,434 titles and abstracts, evaluated 173 full-texts for eligibility, and included 24 studies. We identified only two studies with neonatal mortality outcome, and they had significant methodological limitations, and no conclusion could be reached regarding effects of simulation training in developed countries. Considering clinical performance, randomized studies showed improved team performance in simulated re-evaluations 3 and 6 months after the intervention.ConclusionsSimulation-based team training in neonatal resuscitation improves team performance and technical performance in simulation-based evaluations 3 to 6 months later. The current evidence was insufficient to conclude on neonatal mortality after simulation-based team training, since no studies were available from developed countries. Future research should include patient outcomes or clinical proxies of treatment quality whenever possible.
Secretomes of human pluripotent stem cell-derived smooth muscle cell progenitors upregulate extracellular matrix metabolism in the lower urinary tract and vagina
Authors: Zhuang Guobing , Wen Yan , Briggs Mason , Shao Qingchun , Tran Darlene , Wang Hongbo , Chen Bertha 
Published: October 2020

Abstract
Background: Adult mesenchymal stem cells (MSCs) have been studied extensively for regenerative medicine, however, they have limited proliferation in vitro, and the long culture time induces cell senescence. MSCs also contribute to tissue repair through their paracrine function. In this study, we sought to examine the paracrine effects of smooth muscle cell progenitors (pSMC) on the urethra and adjacent vagina of stress urinary incontinence rodents. We use human pluripotent stem cell (PSC) lines to derive pSMCs to overcome the issue of decreased proliferation and to obtain a homogenous cell population. This novel approach for treatment of urinary incontinence can also be expanded into treatments for other pelvic floor disorders. Method: Three human PSC lines were differentiated into pSMCs. The conditioned medium (CM) from pSMC culture, which contain pSMC secretomes, was harvested. To examine the effect of the CM on the extracellular matrix of the lower urinary tract, human bladder smooth muscle cells (bSMCs) and vaginal fibroblasts were treated with pSMC-CM in vitro. Stress urinary incontinence (SUI) was induced in rats by surgical injury of the urethra and adjacent vagina. SUI rats were treated with pSMC-CM and monitored for 5 weeks. Urethral pressure testing was performed prior to euthanasia, and tissues were harvested for PCR, Western Blot and histological staining. Kruskal-Wallis one-way ANOVA test and Student t-test were used for statistical comparisons. Results: pSMC-CM upregulated MMP-2, TIMP-2, collagen, and elastin gene expression, and MMP-9 activity in human bladder and vaginal cells consistent with elastin metabolism modulation. pSMC-CM treatment restored in vivo urethral function (increase in leak point pressure compared to intact controls, p<0.05) and increased collagen and elastin expression in the urethra and the adjacent vagina. pSMC-CM also restored the smooth muscle cell layer in the adjacent vagina. Conclusion: Conditioned media from smooth muscle cell progenitors derived from pluripotent stem cells restored urethral function and vaginal smooth muscle cell and elastin content. These findings support a novel therapeutic potential for PSC-based treatments for SUI and pelvic floor disorders where tissues are affected by elastin and smooth muscle loss.
Youth Friendly Reproductive Health Services Among Students of Mizan-Tepi University, South-western Ethiopia
Authors: Zewudie Samuel Getachew , Adulo Lema Abate , Sirna Abel Mandefro , Asres Abiyot 
Published: October 2020

Abstract
Background: Youth friendly reproductive health services are designed to entertain the unique needs of youth. Nevertheless, in developing countries like Ethiopia, knowledge, attitude and utilization of these services is very limited. This study was designed to assess the knowledge, attitude and the extent of utilization of youth friendly reproductive health services (YFRHS) and associated factors among students of Mizan-Tepi University, Southwestern, Ethiopia. Method: A public University-based cross-sectional study was conducted between October and January 2019. Simple random sampling technique was used to select participants from target population. Descriptive analysis, Chi-square test and logistic regression model were employed to identify the factors associated with YFRHS. Result: The results of descriptive analysis showed that about 55.4% of participants had no knowledge, 40.2% had negative attitudes and 61.2% had not practiced YFRHS. Majority 258(60.30%) of the respondents were females and 209(48.80%) were in the age group of 21-22 years. Most of the respondents lack basic information and knowledge, and have no any YFRHS in their surroundings 220(51.4%). Out of the 428 respondents, 57.9%, 59.3%, and 36.4% had never been practiced services related to VCT, family planning and contraception and treatment of sexually transmitted infections (STIs), respectively. The multivariable binary logistic regression result revealed that sex, age, religion, mother’s and father’s educational background, availability of YFRHS in the area and source of information had statistical significant effect on the knowledge, attitude and practices of students toward YFRHS. Male students were more likely to have knowledge and practicing experiences (OR = 1.847, p-value =0.015) and (OR=1.821, p-value = 0.017) respectively, however they had less likely positive attitudes (OR=0.519, p-value = 0.010) compared to their counterpart females. Students from primary and above educated mothers and fathers were more likely to have knowledge, attitude and practicing experience compared to students from uneducated mothers and fathers. Conclusion: The overall utilization, attitude and knowledge of YFRHS among study respondents’ are lower and therefore, further efforts like availability of YFRHS providers and improvement of facility, and education related to the service to all young groups and allocation of appropriate time of services is essential.
A feasibility study using time-driven activity-based costing as a management tool for provider cost estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
Authors: Chirenda Joconiah , Simwaka Bertha Nhlema , Sandy Charles , Bodnar Katharine Donovan , Corbin Shevone , Desai Prathna , Mapako Tonderai , Shamu Shepherd , Timire Collins , Antonio Esther , Makone Albert , Birikorang Alexander , Mapuranga Tawanda , Masunda Tsitsi , Dube M , Wandwalo Eliud , Ngwenya Mkhokheli , Morrison Linden , Kaplan Robert Samuel 
Published: October 2020

Abstract
Background Insufficient cost data and limited capacity constrains understanding of true required resources for TB control. This study using time-drive activity-based costing documented service delivery processes, mapped resources that are required to sustain and identified areas to optimise efficiency in delivery of TB services was conducted in Zimbabwe. Methods A multi-disciplinary team applied time-driven activity-based costing (TDABC) to develop process maps and measure the cost of clinical pathways used for Drug Susceptible TB (DS-TB) at urban polyclinics, rural district and provincial hospitals, and community based targeted screening for TB (Tas4TB). The team performed interviews and observations to collect data on the time taken by health care worker-patient pairs at every stage of the treatment pathway. The personnel’s practical capacity and capacity cost rates were calculated on 5 cost domains. An MS Excel model was used to calculate diagnostic and treatment costs.Findings Twenty-five stages were identified in the TB care pathway across all health facilities except for community targeted screening for TB. Variations existed in health care professionals providing services between facilities for client registration, vital signs, treatment follow-up, medicines dispensing and sample processing.The average cost per patient for the entire DS-TB care was USD324 with diagnosis costing USD69 and treatment costing USD255. The average cost for diagnosis and treatment was higher in clinics than in hospitals (USD392 versus USD256). Nurses in clinics were 1.6 time more expensive than in hospitals. The main cost drivers were human resources (USD130) and laboratory (USD119). Diagnostic cost in Tas4TB was twice that of health facility setting (USD153 vs USD69), with major cost drivers being demand creation (USD89) and sputum specimen transportation (USD5 vs USD3). Conclusion We concluded that TDABC can be used as a costing and management tool in a low resource setting. Results from this study were used to identify areas of innovative improvements in the NTP under public health programme settings. Re-engineering laboratory testing processes and synchronising TB treatment follow-up with antiretroviral treatments could achieve significant cost savings in Zimbabwe.
Effect of oral rehydration solution versus spring water intake during exercise in the heat on muscle cramp susceptibility of young men
Authors: Lau Wing Yin , Kato Haruyasu , Nosaka Kazunori 
Published: October 2020

Abstract
Background: Muscle cramp is a painful, involuntary muscle contraction, and occurs during or following exercise, which is referred to as exercise-associated muscle cramp (EAMC). The causes of EAMC are likely to be multifactorial, but dehydration and electrolytes deficits have been considered to be factors. This study tested the hypothesis that post-exercise muscle cramp susceptibility would be increased with spring water ingestion, but reduced with oral rehydration solution (ORS) ingestion during exercise. Methods: Ten men performed downhill running (DHR) in the heat (35–36°C) for 40–60 min to reduce 1.5–2% of their body mass in two conditions (spring water vs ORS) in a cross-over design. The body mass was measured at 20 min and every 10 min thereafter during DHR, and 30 min post-DHR. The participants ingested either spring water or ORS for the body mass loss in each period. The two conditions were counter-balanced among the participants and separated by a week. Calf muscle cramp susceptibility was assessed by a threshold frequency (TF) of an electrical train stimulation to induce cramp before, immediately after, 30 and 65 min post-DHR. Blood samples were taken before, immediately and 65 min after DHR to measure serum sodium, potassium, magnesium and chroride concentrations, hematocrit (Hct), hemoglobin (Hb), and serum osmolarity. Changes in these varaibles over time were compared between conditions by two-way repeated measures of analysis of variance. Results: The average (±SD) baseline TF (25.6 ± 0.7 Hz) was the same between conditions. TF decreased by 3.8 ± 2.7 to 4.5 ± 1.7 Hz from immediately to 65 min post-DHR for the spring water condition, but increased by 6.5 ± 4.9 to 13.6 ± 6.0 Hz in the same time period for the ORS condition (P<0.05). Hct and Hb did not change significantly (P>0.05) for both conditions, but osmolarity decreased (P<0.05) only for the spring water condition. Serum sodium and chloride concentrations decreased (<2%) at immediately post-DHR for the spring water condition only (P<0.05). Conclusions: These results suggest that ORS intake during exercise decreased muscle cramp susceptibility. It was concluded that ingesting ORS appeared to be effective for preventing EAMC.
Objectively Measured Preoperative Physical Activity is Associated With Time to Functional Recovery after Hepato-Pancreato-Biliary Cancer Surgery: a Pilot Study
Authors: Mylius Caspar , Krijnen Wim , Takken Tim , Lips Daan , Eker Hasan , Schans Cees van der , Klaase Joost 
Published: October 2020

Abstract
Background: Surgical resection is currently the cornerstone of hepato-pancreato-biliary (HPB) cancer treatment. A low preoperative aerobic fitness level has been identified as a modifiable risk factor associated with complications after major abdominal surgery. A person’s aerobic fitness is influenced by performing moderate to vigorous physical activity (MVPA). This study aims to determine the activity monitor measured levels of MVPA performed among patients on the waiting list for HPB cancer surgery and their association with postoperative outcomes. Methods: A prospective, observational multi-center cohort pilot study was conducted. Patients enlisted for resection surgery on suspicion of HPB (pre)malignancy were enrolled. Performed MVPA was measured by an Actigraph wGT3X-BT. Additionally, aerobic fitness was measured via the Incremental Shuttle Walk Test, and (post)operative variables were collected from the electronic patient files. The association between MVPA and the pre and postoperative variables was determined by univariate and multivariate (logistic) robust regression. Results: A total of 38 participants, median age 66.0 (IQR 58.25 – 74.75) years, were enrolled. The meadian daily MVPA was 10.7 (IQR 6.9 – 18.0) minutes, only 8 participants met Dutch MVPA guidelines. Participants age, and incremental shuttle walk test score were associated with MVPA by multivariate statistical analysis. Time to functional recovery was 8 (IQR 5 - 12) days and was associated with MVPA and type of surgery (major/minor) in multivariate analysis. Conclusion: 76% of patients enlisted for resection of HPB (pre)malignancy performed insufficient MVPA. A higher level of MVPA was associated with a shorter time to functional recovery.
ANÁLISE ESPACIAL DAS CAUSAS DE MORTALIDADE INFANTIL NO BRASIL DE 2000 A 2015
Authors: Justino Dayane Caroliny Pereira , Andrade Fábia Barbosa de 
Published: October 2020

Introdução: A análise dos indicadores de saúde da criança é essencial para identificação das necessidades de melhorias assistenciais à saúde. Objetivo: avaliar a distribuição espacial das causas de mortalidade infantil no Brasil de 2000 a 2015 com cobertura da Atenção Básica e consultas de puericultura. Metodologia: Estudo ecológico de tendência temporal com análise espacial realizado no Brasil utilizando dados disponíveis no Departamento de Informática do Sistema Único de Saúde, nos anos de 2000 a 2015, os quais foram coletados em maio de 2017. Resultados: As principais causas de óbitos infantis são causas consideradas evitáveis pela Atenção Básica e observou-se um comportamento parecido em quatro destas que se mostraram com alta autocorrelação nas regiões norte, nordeste e sudeste, os capítulos 01, 10 16 e 18. É importante destacar que apenas uma mostrou-se alta na região sudeste que foram os óbitos por malformações congênitas, deformidades e anomalias cromossômicas. Ao correlacionar com as consultas de puericultura e cobertura da Atenção Básica observou-se que no período de 2000 a 2004 houve uma baixa atuação na atenção à saúde populacional. Conclusões: Os resultados do presente estudo mostram que embora a atenção à saúde da população venha melhorando ao longo dos anos, ainda se faz necessário dar uma atenção maior à saúde infantil do país para que haja a redução dos óbitos infantis por causas evitáveis.
In silico Approach for Exploring the Role of AT1R Polymorphism on its
Function, Structure and Drug Interactions
Authors: Sharma Bhanu , Jaiswal Varun , Khan Mohammed Azhar 
Published: October 2020

Background:
AT1R (Angiotensin II type 1 receptor) is the main component of RAS (renin-angiotensin system)
system which activates when ANG II (angiotensin II) binds to it. AT1R helps in maintaining osmotic homeostasis and
blood pressure regulation. A huge number of polymorphism is associated with AT1R and few of them were studied and
found to be associated with the diseases and drug efficacy. Although it is very important receptor but most of the
polymorphisms (SNPs) were not studied for their implications in diseases. Huge number of polymorphisms is reported in
the databases for AT1R which provide an avenue to explore these polymorphisms for their implications in protein
structure, function and drug efficacy.

Methods:
In the current study all the SNPs (10234) reported in NCBI were analyzed and SNPs which were important in
protein structure and drug interactions were identified. Structures of these polymorphic forms were modeled and in silico
drug interaction studies were carried out.

Results:
Result of the interaction studies with polymorphism was in correlation with the reported case. Two SNP mutated
structures of AT1R i.e. rs780860717 (G288T), rs868647200 (A182C) shows considerably less binding affinities in case of
all angiotensin receptor blockers (ARBs). As a result these polymorphisms may show less efficacy toward these ARBs.
The other mutated structures rs12721226 (A163G), rs749234826 (A292G), rs775810028 (A87G) shows increased binding
affinities in case of Eprosartan and most of the mutated structures shows increased binding affinity toward Telmisartan
than the wild type AT1R. Similarly, these polymorphisms may show increased efficacy in case of these two ARBs.

Conclusion:
The outcome of the study will help in designing better drugs in near future with broader spectrum.
Furthermore in vitro and in vivo studies can be designed according to current results.
The Correlation between Perceived Peer Norms in Attitude and Self-Efficacy Premarital Sexual Behavior
Authors: Vakilian Katayon , Keramat Afsaneh 
Published: October 2020

Background and Aims:
Adolescence is a period of life in which high-risk behaviors, including sexual behaviors, put the adolescents at risk for sexually transmitted diseases, including AIDS. This research aimed at studying the relationship between peers' perception of sexual behavior and adolescents' attitudes and self-efficacy.

Materials and Methods:
This cross-sectional study used a multi-stage method to examine 1500 subjects in the universities of Shahroud, Iran. The questionnaires were consisted of sexual abstinence attitude, abstinence self-efficacy and peer subjective norms. To ensure the confidentiality of information, the questionnaire was distributed among 1500 students in six universities anonymously, and students҆ field of study was not mentioned. The collected data was analyzed with descriptive (Mean, Percent) and inferential tests (independent t-test, chi2, and Spearman test) using SPSS 18 software.

Results:
The mean age of the females was 20.26±1.49, and that of males was 20.32±1.575. 59.3% of male students and 86.8% of female students had poor sexual abstinence to sex before marriage. Moreover, the sexual abstinence self-efficacy of 29% of male students and 13.1% of female students, regarding the sexual abstinence before marriage, was strong. Findings showed that the more one believes in his/her abilities in sexual abstinence, the more they believe that their friends will not be involved in sex

Conclusion:
It is required to provide the opportunities to learn and correct the socio-emotional skills required for physical and sexual health in relationships through social interactions with peers. In this context, the reproductive health programs need to be prioritized in the youth health programs and schools