bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between private education costs and parental depression in South Korea
Authors: Oh Byeong Cheol , Yeon Ji-Yoon , Lee Hyo-Sang , Lee Doo Woong , Park Eun-Cheol 
Published: June 2020

Abstract
Background
In Korea, higher education has rapidly grown influenced by sociocultural tradition. Parents invest a significant portion of their household income in their children’s education. Private education has been considered to greatly affect students’ psychology and behavior. However, past research has largely neglected to study parents who pay these costs. Since household income and education level are important determinants of socioeconomic status (SES), education expenditures are likely to cause depressive symptoms. Therefore, the study aimed to investigate the correlation between private education costs and parental depression in South Korea.

Methods
Data were collected from the Korean Welfare Panel Study (KoWePS, 2015, 2018). The sample analyzed consisted of 397 and 337 fathers and 403 and 370 mothers in 2015 and 2018, respectively. The independent variable in this study was the proportion of private education cost. This proportion was calculated by dividing each household’s private education costs by its equivalized household disposable income (EHDI) and multiplying this number by 100. The main dependent variable was parental responses to the Center for Epidemiologic Studies Depression Scale-11 (CESD-11). Using a generalized linear model, we investigated the effects of the proportion of private education cost on parental depression.

Results
The results showed that fathers with higher proportions of private education cost exhibited higher CESD-11 scores compared to fathers with lower proportions cost (moderate: β = 0.419, S. E = 0.164, p = 0.0105; high: β = 0.476, S. E = 0.178, p = 0.0076), indicating that a higher ratio of private education cost may negatively affect depression in fathers. However, there was no discernable correlation between mothers’ CESD-11 scores and the proportion of private education cost (moderate: β = − 0.078, S. E = 0.250, p = 0.7555; high: β = 0.003, S. E = 0.215, p = 0.9882).

Conclusions
These results may be explained by the tendency for fathers to experience greater economic burdens than mothers in patriarchal Korean society.
Choosing and Doing wisely: triage level I resuscitation a possible new field for starting palliative care and avoiding low-value care – a nationwide matched-pair retrospective cohort study in Taiwan
Authors: Lin Chih-Yuan , Lee Yue-Chune 
Published: June 2020

Abstract
Background
The association between palliative care and life-sustaining treatment following emergency department (ED) resuscitation is unclear. This study aims to analyze the usage of palliative care and life-sustaining treatments among ED triage level I resuscitation patients based on a nationally representative sample of patients in Taiwan.

Methods
A matched-pair retrospective cohort study was conducted to examine the association between palliative care and outcome variables using multivariate logistic regression and Kaplan–Meier survival analyses. Between 2009 and 2013, 336 ED triage level I resuscitation patients received palliative care services (palliative care group) under a universal health insurance scheme. Retrospective cohort matching was performed with those who received standard care at a ratio of 1:4 (usual care group). Outcome variables included the number of visits to emergency and outpatient departments, hospitalization duration, total medical expenses, utilization of life-sustaining treatments, and duration of survival following ED triage level I resuscitation.

Results
The mean survival duration following level I resuscitation was less than 1 year. Palliative care was administered to 15% of the resuscitation cohort. The palliative care group received significantly less life-sustaining treatment than did the usual care group.

Conclusion
Among patients who underwent level I resuscitation, palliative care was inversely correlated with the scope of life-sustaining treatments. Furthermore, triage level I resuscitation status may present a possible new field for starting palliative care intervention and reducing low-value care.
Pioglitazone for primary stroke prevention in Asian patients with type 2 diabetes and cardiovascular risk factors: a retrospective study
Authors: Hung Yi-Chih , Chiu Lu-Ting , Huang Hung-Yu , Bau Da-Tian 
Published: June 2020

Abstract
Background
Studies assessing the efficacy of pioglitazone solely for primary stroke prevention in Asian patients with type 2 diabetes mellitus (DM) and present multiple cardiovascular (CV) risk factors are rare. Thus, we aimed to assess the effect of pioglitazone on primary stroke prevention in Asian patients with type 2 DM without established CV diseases but with risk factors for CV diseases.

Methods
Between 2000 and 2012, we enrolled patients aged ≥ 18 years, who were newly diagnosed with type 2 diabetes and had at least one of the following CV risk factors: hypertension and hyperlipidemia. Patients with a history of stroke and those using insulin or glucagon-like peptide-1 agonist for more than 3 months were excluded. Patients were divided into the pioglitazone and non-pioglitazone groups based on their receipt of pioglitazone during the follow-up period. Propensity-score matching (1:1) was used to balance the distribution of the baseline characteristics and medications. Follow-up was terminated upon ischemic stroke development, withdrawal from the insurance system, or on December 31, 2013, whichever occurred first. The overall incidence of new-onset ischemic stroke in the two groups was subsequently compared. The subgroup analyses of ischemic stroke were conducted using different baseline features. Additionally, the effect of pioglitazone exposure dose on the occurrence of ischemic stroke was evaluated. Chi square test, Student’s t-test, competing risk regression models, Kaplan–Meier method, and log-rank test were some of the statistical tests conducted.

Results
A total of 13 078 patients were included in the pioglitazone and non-pioglitazone groups. Compared with patients who did not receive pioglitazone, those administered pioglitazone had a lower risk of developing ischemic stroke (adjusted hazard ratio: 0.78; 95% confidence interval: 0.62–0.95). The subgroup analyses defined by different baseline features did not reveal significant alterations in the observed effect of pioglitazone. Moreover, a significant decreasing trend in ischemic stroke risk with an increase in pioglitazone dose (p-value for trend = 0.04) was observed.

Conclusion
Pioglitazone use decreased the risk of new-onset ischemic stroke in Asian patients with type 2 DM and CV risk factors.
Trial registration number CMUH104-REC2-115-CR4
Sociodemographic factors associated with low intake of bioavailable iron in preschoolers: National Health and Nutrition Survey 2012, Mexico
Authors: Venegas-Aviles Yazmín , Rodríguez-Ramírez Sonia , Monterrubio-Flores Eric , García-Guerra Armando 
Published: June 2020

Abstract
Background
Children < 5 years of age are at risk of developing an iron deficiency due to a low intake of bioavailable iron (FeBio). Few studies have estimated dietary FeBio in children at a national level in relation to sociodemographic characteristics. This study aimed to estimate FeBio intake and its association with sociodemographic factors among Mexican children aged 12–59 months.

Methods
A cross-sectional study was carried out. Information on serum ferritin and diet was obtained from a national survey and representative sample of 1012 Mexican children aged 12–59 months. We used a 24-h recall to estimate total iron, heme and non-heme iron, vitamin C, phytates, calcium, and meat intake. We calculated FeBio intake using an algorithm. Differences in FeBio intake were analyzed by area of residence (rural/urban), country region (north, center, south), and socioeconomic status (SES), using linear regression models by age subgroups (12–23 and 24–59 months) and total population, while adjusting for study design.

Results
Total iron intake was 9.2 ± 6.7 mg/d. The estimated average of total FeBio fluctuated between 0.74–0.81 mg/d, with a bioavailability of 9.15–12.03% of total iron. Children aged 12–23 months residing in rural areas consumed less FeBio than those in urban areas (β = − 0.276) (p < 0.05). Children aged 24–59 months with high SES consumed more FeBio (β = 0.158 mg/d) than those of a low SES (p < 0.05).

Conclusions
FeBio is low in Mexican preschoolers. Being from a rural area and having low SES were negatively associated with FeBio intake. These results can benefit interventions seeking to improve iron status.
Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: findings from the NuAge study
Authors: D’Amico Danielle , Parrott Matthew D. , Greenwood Carol E. , Ferland Guylaine , Gaudreau Pierrette , Belleville Sylvie , Laurin Danielle , Anderson Nicole D. , Kergoat Marie-Jeanne , Morais Jose A. , Presse Nancy , Fiocco Alexandra J. 
Published: June 2020

Abstract
Background
Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life.

Methods
The current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS).

Results
Adjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = − 0.652, p = 0.02, 95% CI [− 1.22, − 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women.

Conclusions
These findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.
PARP inhibitor resistance: the underlying mechanisms and clinical implications
Authors: Li He , Liu Zhao-Yi , Wu Nayiyuan , Chen Yong-Chang , Cheng Quan , Wang Jing 
Published: June 2020

AbstractDue to the DNA repair defect, BRCA1/2 deficient tumor cells are more sensitive to PARP inhibitors (PARPi) through the mechanism of synthetic lethality. At present, several PAPRi targeting poly (ADP-ribose) polymerase (PARP) have been approved for ovarian cancer and breast cancer indications. However, PARPi resistance is ubiquitous in clinic. More than 40% BRCA1/2-deficient patients fail to respond to PARPi. In addition, lots of patients acquire PARPi resistance with prolonged oral administration of PARPi. Homologous recombination repair deficient (HRD), as an essential prerequisite of synthetic lethality, plays a vital role in killing tumor cells. Therefore, Homologous recombination repair restoration (HRR) becomes the predominant reason of PARPi resistance. Recently, it was reported that DNA replication fork protection also contributed to PARPi resistance in BRCA1/2-deficient cells and patients. Moreover, various factors, such as reversion mutations, epigenetic modification, restoration of ADP-ribosylation (PARylation) and pharmacological alteration lead to PARPi resistance as well. In this review, we reviewed the underlying mechanisms of PARP inhibitor resistance in detail and summarized the potential strategies to overcome PARPi resistance and increase PARPi sensitivity.
The adaptation and validation of the satisfaction with stroke care questionnaire (Homesat) (SASC10-My™) for use in public primary healthcare facilities caring for long- term stroke survivors residing at home in the community
Authors: Abdul Aziz Aznida Firzah , Tan Chai-Eng , Ali Mohd Fairuz , Aljunid Syed Mohamed 
Published: June 2020

Abstract
Background
Satisfaction with post stroke services would assist stakeholders in addressing gaps in service delivery. Tools used to evaluate satisfaction with stroke care services need to be validated to match healthcare services provided in each country. Studies on satisfaction with post discharge stroke care delivery in low- and middle-income countries (LMIC) are scarce, despite knowledge that post stroke care delivery is fragmented and poorly coordinated. This study aims to modify and validate the HomeSat subscale of the Dutch Satisfaction with Stroke Care-19 (SASC-19) questionnaire for use in Malaysia and in countries with similar public healthcare services in the region.

Methods
The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study.

Results
One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge.

Conclusions
The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes.

Trial registration
No.: ACTRN12616001322426 (Registration Date: 21st September 2016.
Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia
Authors: Hall Katherine S. , Hyde Eric T. , Bassett David R. , Carlson Susan A. , Carnethon Mercedes R. , Ekelund Ulf , Evenson Kelly R. , Galuska Deborah A. , Kraus William E. , Lee I-Min , Matthews Charles E. , Omura John D. , Paluch Amanda E. , Thomas William I. , Fulton Janet E. 
Published: June 2020

Abstract
Background
Daily step counts is an intuitive metric that has demonstrated success in motivating physical activity in adults and may hold potential for future public health physical activity recommendations. This review seeks to clarify the pattern of the associations between daily steps and subsequent all-cause mortality, cardiovascular disease (CVD) morbidity and mortality, and dysglycemia, as well as the number of daily steps needed for health outcomes.

Methods
A systematic review was conducted to identify prospective studies assessing daily step count measured by pedometer or accelerometer and their associations with all-cause mortality, CVD morbidity or mortality, and dysglycemia (dysglycemia or diabetes incidence, insulin sensitivity, fasting glucose, HbA1c). The search was performed across the Medline, Embase, CINAHL, and the Cochrane Library databases from inception to August 1, 2019. Eligibility criteria included longitudinal design with health outcomes assessed at baseline and subsequent timepoints; defining steps per day as the exposure; reporting all-cause mortality, CVD morbidity or mortality, and/or dysglycemia outcomes; adults ≥18 years old; and non-patient populations.

Results
Seventeen prospective studies involving over 30,000 adults were identified. Five studies reported on all-cause mortality (follow-up time 4–10 years), four on cardiovascular risk or events (6 months to 6 years), and eight on dysglycemia outcomes (3 months to 5 years). For each 1000 daily step count increase at baseline, risk reductions in all-cause mortality (6–36%) and CVD (5–21%) at follow-up were estimated across a subsample of included studies. There was no evidence of significant interaction by age, sex, health conditions or behaviors (e.g., alcohol use, smoking status, diet) among studies that tested for interactions. Studies examining dysglycemia outcomes report inconsistent findings, partially due to heterogeneity across studies of glycemia-related biomarker outcomes, analytic approaches, and sample characteristics.

Conclusions
Evidence from longitudinal data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. However, the shape of the dose-response relation is not yet clear. Data are currently lacking to identify a specific minimum threshold of daily step counts needed to obtain overall health benefit.
Poor sleep quality and associated factors among prisoners of the Diredawa correctional facility in eastern Ethiopia
Authors: Getachew Yibeltal , Azale Telake , Necho Mogesie 
Published: June 2020

Abstract
Background
Impaired sleep quality affects judgment, psychomotor skills, memory, decision-making, concentration, and attention. It might also contribute to the development of new physical health problems, as well as exacerbating already existing physical problems. Despite this, there is a scarcity of research done in Africa including Ethiopia that addressed this issue. So this study assessed the quality of sleep and related factors among prisoners of the Diredawa correctional facility, Diredawa, eastern Ethiopia.

Methods
A cross-sectional study was done using a simple random sampling technique to recruit 421 participants from May 21 to June 21; 2017. A semi-structured questionnaire, Pittsburgh Sleeps Quality Index (PSFIG), Patient Health Questionnaire-9 (PQ-9), and Sleep Hygiene Index (SHI) were used to assess participants’ socio-demographic data, sleep quality, depression, and sleep hygiene, respectively. The collected data were entered into EPA-data 3.1 and analyzed by using SPAS-20. Descriptive and analytical statistics were used. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed. The statistical significance was declared at p value < 0.05.

Results
A total of 421 out of 423 prisoners were interviewed, resulting in a response rate of 99.5%. The prevalence of poor sleep quality was 227 (53.9%) with 95% CI (49.2, 58.7). Having co-morbidity of depression (adjusted odds ratio; OAR = 3.47, 95% CI 1.38,8.76), lifetime use of cigarette (OAR = 2.16, 95% CI 1.21,5.58), marijuana and hashish (OAR = 5.02, 95% CI 1.63,15.46), current use of coffee (OAR = 2.75, CI 1.37, 7.05), poor sleep hygiene (OAR = 3.19, CI 1.32,7.69), committing assault crime (OAR = 4.12, CI 1.29,10.63) and crime of rape (OAR = 5.57, CI (1.45, 13.89) were the associated factors for poor sleep quality in this study.

Conclusion
More than half of the participants (53.9%) have poor sleep quality. Depression, lifetime use of cigarettes, using cannabis and hashish, current use of coffee, poor sleep hygiene, and crime types were the associated factors that should be taken into consideration and evaluated early to minimize poor sleep quality.
Radiotherapy combined with gefitinib for patients with locally advanced non-small cell lung cancer who are unfit for surgery or concurrent chemoradiotherapy: a phase II clinical trial
Authors: Fu Zhixue , Yang Xu , Wang Wenqing , Deng Lei , Zhang Tao , Bi Nan , Wang Xiaozhen , Chen Dongfu , Zhou Zongmei , Wang Luhua , Liang Jun 
Published: June 2020

Abstract
Background
The objectives of this study were to determine the objective effective response rate, survival, and safety of radiotherapy combined with gefitinib in patients with locally advanced non-small cell lung cancer (NSCLC) who were unfit for surgery or concurrent chemoradiotherapy.

Methods
The patients with the locally advanced NSCLC who were unfit to receive surgery or concurrent chemoradiotherapy, received thoracic intensity-modulated radiotherapy (IMRT) combined with gefitinib 250 mg daily.

Results
29 patients were enrolled between July 2014 and March 2017. 28 patients was in the analysis. Of the 28 patients, 21 (75.0%) experienced a partial response, 5 (17.9%) had stable disease, and 2 (7.1%) experienced progression of disease. The objective response rate was 75.0%, and the disease control rate was 92.9%. The median follow-up time was 51 months. The disease progression showed in 25 (89.3%) patients, including local progression in 19 (67.9%) and distant metastasis in 16 (57.1%). The median overall survival and progression-free survival time (PFS) were 26 and 11 months, respectively. The 3-, 4-, 5-year survival rates were 39.0, 30.1 and 30.1%, respectively. The 3-, 4-, 5-year PFS rates were 14.3, 9.5 and 9.5%. Two patients developed grade 3 acute adverse events. Seven patients developed grade 2 acute irradiation pneumonitis, and there was no grade 3 acute irradiation pneumonitis.

Conclusions
For patients with locally advanced NSCLC who are not eligible for surgery or concurrent chemoradiotherapy, IMRT combined with gefitinib can improve the objective effective rate and is generally well-tolerated.