bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Tripartite Analysis of Online Healthcare Platforms: Evidence from Spring Rain Doctor in China
Authors: Cao Xia , Zhang Lanting , Lv Dan , Li Weijia , Xing Zeyu 
Published: July 2020

Abstract
Background

Online healthcare platform (OHP) is a new form of medical treatment, which solves the problems of unbalanced distribution of medical resources and expensive medical treatment in China. Especially under the epidemic of COVID-19, OHP has greatly reduced the medical pressure of the hospital and the risk of cross infection.
Methods

This paper uses evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the promotion of OHP, and then numerical simulations are carried out with the help of program compilation.
Results

The results demonstrate that: (1) both the stricter qualification inspection of doctors and the more investment in information protection promote the participation of doctors and the use of patients; (2) with a higher initial probability of doctors joining, the possibility for patients in using OHP and platforms to provide standardized online healthcare services becomes higher; (3) if the initial probability of patients using is higher, the possibility for doctors to participate OHP and platforms to provide standardized online healthcare services raises; (4) the trend of doctors joining the platform is affected by factors, such as registration cost, time cost, reputation loss and so on; (5) the tendency of patients in using online healthcare is mainly decided by the cost.
Conclusions

Based on theoretical analysis, this article takes the Spring Rain Doctor OHP as an example to verify the game results. Therefore, OHP should attach importance to the inspection of doctors and the protection of privacy information, and strengthen the publicity in remote places. At the same time OHP can promote the active participation of grassroots doctors, and set a reasonable evaluation mechanism, so as to popularize online medical treatment among patients further.
Epigenetic Immunomodulatory Effect of Eugenol and Astaxanthin on Doxorubicin Cytotoxicity in Hormonal Positive Breast Cancer Cells
Authors: Fouad Mariam A. , Sayed-Ahmed Mohamed M. , Huwait Etimad A. , Hafez Hafez F. , Osman Abdel-Mneim M. 
Published: July 2020

Abstract
Background: Hormonal receptor positive (HR+) breast cancer is the most commonly diagnosed molecular subtype of breast cancer; which showed good response to doxorubicin (DOX)-based chemotherapy. Eugenol (EUG) and astaxanthin (AST) are natural compounds with proved epigenetic and immunomodulatory effects in several cancer cell lines. This study has been initiated to improve the cytotoxic activity and reduce resistance of DOX through combination with EUG and AST in MCF7 cells.Methods: Cytotoxic activity of DOX alone and combined with either 1mM EUG or 40µM AST was performed using sulphorhodamine-B assay in MCF7 cells. Global histones acetylation and some immunological markers were investigated using ELISA, western blotting and quantitative RT-PCR techniques. Functional assay of multidrug resistance was performed using rhodamine 123 and Hoechst 3342 dyes. Flow cytometry with annexin V and propidium iodide were used to assess the change in cell cycle and apoptosis along with the expression of some differentiation, apoptosis and autophagy proteins. Results: DOX alone resulted in concentration-dependent cytotoxicity with IC50 of 0.5 μM. Both EUG and AST significantly increased DOX cytotoxicity which is manifested as a significant decrease in DOX IC50 from 0.5 μM to 0.088 μM with EUG and to 0.06 μM with AST. Combinations of DOX with 1mM EUG or 40 µM AST significantly increased the level of histones acetylation and histone acetyl transferase expression, while reduced the expression of aromatase and epidermal growth factor receptor (EGFR) when compared with 0.25 µM DOX alone. Also both combinations showed higher uptake of rhodamine but lower of Hoechst stains, along with increased the percentage of caspase 3, and decreased the expression of CK7 and LC3BI/II ratio. EUG combination induced IFγ but reduced TNFα causing shifting of cells from G2/M to S and G0/ G1 phases. Combination of DOX with EUG induced apoptosis through the higher BAX/ BCl2 ratio, while with AST was through the increase in caspase 8 expressions. Conclusion: EUG and AST potentiated the anticancer activity of DOX through epigenetic histones acetylation along with the immunonomodulation of different apoptotic approaches in MCF7 cells.
Expression of transduced Nucleolin promotes the clearance of accumulated alpha-synuclein
Authors: HO DONG HWAN , Nam Daleum , Jeong Soyeon , Seo Mi Kyoung , Park Sung Woo , Seol Wongi , Son Ilhong 
Published: July 2020

Abstract
Background

Alpha-synuclein (αSyn) is a major component of Lewy bodies, which are known to be a pathogenic marker of Parkinson’s disease (PD). The accumulation of αSyn is caused by dysfunctions in protein degradation machinery. The reinforcement of αSyn degradation is a potential therapeutic target of PD since accumulated αSyn is responsible for the pathogenesis of PD. Nucleolin (NCL) is essential for forming nucleolar structure. The function of NCL is correlated with oxidative stress-mediated cell death. A previous study demonstrated that NCL was reduced in PD brains, and overexpression of NCL alleviated rotenone-induced neural toxic effects. Knockdown of NCL had the opposite effect. These results suggest that the malfunctioning of NCL would exacerbate PD pathology. Thus, we hypothesized that the introduction of ectopic NCL could rescue the α-synucleinopathy in PD.
Methods

We tested whether ectopic expression of NCL facilitates the clearance of αSyn. The Ectopic expression of NCL was accomplished by the transfection of GFP or GFP-NCL in mouse embryonic fibroblasts (MEF) or transduction of green fluorescent protein (GFP) or GFP-NCL using lentivirus in rat primary cortical neuron. We also investigated whether the expression of GFP or GFP-NCL in mouse substantia nigra alleviates the PD pathology derived by αSyn aggregates.
Results

The expression of NCL enhanced the clearance of αSyn accumulation or aggregates in MEF and rat primary cortical neurons. The activity of autophagy-lysosome pathway was enhanced by NCL expression. The transduction of NCL in the substantia nigra, which was co-injected with αSyn fibrils, rescued PD manifestations.
Conclusions

The elevation of NCL levels may reflect a therapeutic strategy for α-synucleinopathy in PD.
A novel nomogram provides improved accuracy for predicting biochemical recurrence after radical prostatectomy
Authors: Xia Haizhui , Bi Hai , Yan Ye , Yang Bin , Ma Ruozhuo , He Wei , Zhu Xuehua , Zhang Zhiying , Zhang Yuting , Ma Lulin , Hou Xiaofei , Lu Jian 
Published: July 2020

Abstract
Background: Various prediction tools have been developed to predict biochemical recurrence (BCR) after radical prostatectomy (RP), however, few of the previous prediction tools used serum prostate specific antigen (PSA) nadir after RP and maximum tumor diameter (MTD) at the same time. In this study, a nomogram incorporating MTD and PSA nadir was developed to predict BCR-free survival. Methods: 337 patients who underwent RP were retrospectively enrolled in this study. The maximum diameter of the index lesion was measured on magnetic resonance imaging (MRI). Cox regression analysis was performed to evaluate independent predictors of BCR. A nomogram was subsequently developed for the prediction of BCR-free survival at 3 and 5 years after RP. Time-dependent receiver operating characteristic (ROC) curve and decision curve analysis were performed to identify the advantage of the new nomogram in comparison with the CAPRA-S score. Results: A novel nomogram was developed to predict BCR by including PSA nadir, MTD, Gleason score, surgical margin (SM), and seminal vesicle invasion (SVI), since these variables were significantly associated with BCR in both univariate and multivariate analysis (p <0.05). In addition, a basic model including Gleason score, SM, and SVI was developed and used as a control to assess the incremental predictive power of the new model. The concordance index of our model was slightly higher than CAPRA-S model (0.76 vs. 0.70, p =0.02) and it was significantly higher than that of the basic model (0.76 vs. 0.66, p =0.001). Time-dependent ROC curves and decision curve analyses also demonstrated the advantages of the new nomogram.Conclusions: PSA nadir after RP and MTD based on MRI before surgery are independent predictors of BCR. By incorporating PSA nadir and MTD into the conventional predictive model, our newly developed nomogram significantly improved the accuracy in predicting BCR-free survival after RP.
Mental health, attitudes, and behavior of healthcare workers amid Covid-19 pandemic
Authors: Kurt Ercan , Ovalı İbrahim Ethem , Tibilli Hakan , Gulacti Umut , Kaya Hakan , Koparal Mehtap , Lok Ugur , Canpolat Semih , Canpolat Esra Kurt , Doğan Fatih , Afsin Abdulmecit , Kafadar Safiye , Yucetas Şeyho Cem , Kafadar Hüseyin 
Published: July 2020

Abstract
Objective: To evaluate the mental Health and Psychosocial status, thoughts about the measures taken by the government, attitudes, and behaviors of HCWs facing the Covid-19 pandemic.Methods: A 56-question multiple-choice survey was performed by a one-to-one interview with the HCWs in 3 registered hospitals fighting the Covid-19 pandemic from 20 May to 10 June 2020. Mental health variables were assessed via the Patient Health Questionnaire-4 (PHQ-4) and the Turkish Beck Depression Scale to specify psychological manifestations. A scoring system was applied using a four-point Likert scale, from no points (“strongly disagree”) to three points (“strongly agree”) to determine the levels of anxiety and depression.Results: A total of 300 HCWs (45 physicians, 255 non-physician health care workers) enrolled in the survey. Only 0.8% of HCWs took psychological support from a therapist or psychiatrist. The most common concern about Covid-19 pandemic was that “the elderly and other risky population was being infected” (37.9%). 89.2% HCWs who felt the concern was that they had changed their thoughts with the information they got from television (P= 0.005, χ2= 20.271). Compared with non-physician HCWs, the physicians about the spreading of the Covid- 19 felt more the concern (%80 vs %47.1, p= 0.006 χ2=12.591) and physicians higher rate agreed that the number of tests being performed was sufficient enough. (53.3% vs. 41.2%, p=0.030, OR:0.29-0.35, χ2: 7.047), For all HCWs, the "feeling of being infected with Covid-19” item had the highest mean total score (2.60 ± 0.97). The mean score of “feeling nervous/anxious/on edge” item was 2.53±0.52 for physicians, and 2.26±0.86 for non-physician HCWs. Non-physicians HCWs had a higher mean score for “Feeling of increased body pain and agony” item than physicians (0.27±0.80 vs 0.76±1.23; mean dif= -0.50, 95% confidence interval=-1.002 to 0.006, p<0.05).Conclusions:The results of this survey study showed that the highest anxiety score for all healthcare professionals was the “feeling of being infected with covid-19”. Both physicians and non-physicians HCWs were feeling nervous/anxious/on edge largely according to anxiety scores.
Severe COVID-19 in cardiopath young pregnant without vertical transmission: a case report
Authors: França Ana Paula Figueiredo de Montalvão , Pereira Danielly do Vale , Rodrigues Elaine Valéria , Vieira Flávia Nunes , Machado Karine Santos , Nogueira Pedro Aleixo , Fonseca Ricardo Roberto de Souza , Machado Luiz Fernando Almeida 
Published: July 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
Adaptive SIR model for propagation of SARS-CoV-2 in Brazil
Authors: Santos I. F. F. dos , Almeida G. M. A. , de Moura F. A. B. F. 
Published: July 2020

Abstract
We study the spreading of SARS-CoV-2 in Brazil based on official data available since March 22, 2020. The calculations are based on an adaptive susceptible-infected-removed (SIR) model featuring dynamical recuperation and propagation rates and can reproduce the number of confirmed cases over time with less than $5\%$ error. Furthermore, it is possible to predict the epidemic progression in the near future and we go on to estimate the time required to stabilize the virus propagation. The model is also proved to be accurate for analyzing the epidemic dynamics in other countries.
Are Danish vocational schools ready to implement ‘smoke-free school hours’? A qualitative study informed by the theory of organizational readiness for change
Authors: Hjort Anneke Vang , Schreuders Michael , Rasmussen Kathrine Højlund , Klinker Charlotte Demant 
Published: July 2020

Abstract
Background
Vocational education and training is a lower level of education and the smoking prevalence among Danish vocational students is high. The school tobacco policy regarding smoke-free school hours stipulates that students and staff are not allowed to smoke during school hours—inside or outside school premises—and it might be an effective intervention for reducing smoking in vocational schools. For school tobacco policies to be effective, they must be appropriately implemented. A primary predictor for successful implementation is organizational readiness for change. This study seeks to identify and understand the barriers to and facilitators for developing organizational readiness to implement smoke-free school hours in Danish vocational schools.
Methods
Semi-structured interviews and focus groups were carried out with managers and teachers (n = 22 participants) from six vocational schools. The interview guides were informed by ‘A theory of organizational readiness for change’ developed by Weiner, which was also used as a framework to analyze the data.
Results
We identified 13 facilitators and barriers. Nine factors acted as facilitators, including the following: believing that health promotion is a school role and duty; believing that society and workplaces are becoming more smoke-free, and believing that smoke-free school hours is a beneficial strategy to achieve fewer educational interruptions. Additional facilitators include establishing clear rules for sanctioning and enforcement; developing a joint understanding about smoke-free school hours; developing skills to deal with student responses to smoke-free school hours; establishing social alternatives to smoking; offering smoking cessation help and mandating smoke-free school hours by law. Four organizational norms, practices or discourses acted as barriers: Believing that smoke-free school hours violate personal freedom; believing that students have more important problems than smoking; believing that it is difficult to administer the level of enforcement; and believing that the enforcement of smoke-free school hours negatively influences student-teacher relations.
Discussion
Our results suggest that developing organizational readiness before adopting a comprehensive tobacco policy such as smoke-free school hours is important for successful implementation. Further research should investigate how to strengthen the facilitators for and counter the barriers to developing readiness for implementing smoke-free school hours.
Planning of Births and Childhood Undernutrition in Nepal: Evidence from a 2016 National Survey
Authors: Tiwari Ishwar , Acharya Kiran , Paudel Yuba Raj , Sapkota Bhim Prasad , Kafle Ramesh Babu 
Published: July 2020

Abstract
Background
Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aim to investigate the relationship between PoB and childhood undernutrition in the current study.
Methods
We used the Nepal Demographic Health Survey 2016 data, which is a nationally representative cross-sectional household survey. We used two common anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor of interest. Binary logistic regression with sampling weights was used to estimate adjusted odds ratios (OR) and 95% confidence intervals to examine the association between the PoB and childhood undernutrition.
Results
The overall prevalence of stunting was 35.8%, and underweight was 27.1% in under-five children in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of interval between birth and subsequent birth (IBBSB). The association between the birth order of children and the prevalence of undernutrition had strong statistical significance (p < 0.001). Mother’s age at marriage (p = 0.001), underweight mother (p < 0.001), mother’s education (p < 0.001), father’s education (p < 0.001), wealth quintile (p < 0.001), no exposure to mass media (p < 0.001), children’s age (p < 0.001), area of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting as compared to those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9).
Conclusion
The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced odds of childhood stunting. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.
Food from the Campus: Understanding Africa’s Transition to Sustainable Urban FoodSecurity during the Covid-19 Pandemic
Authors: Barau Aliyu , Jibrin Jibrin Mohammed , Badamasi Murtala Muhammad , Mustapha Amina 
Published: July 2020

Abstract
This paper takes a critical look at the 20-hectares research/demonstration farm at Bayero University Kano’s Centre for Dryland Agriculture (CDA) in Kano, Nigeria. The paper examines how knowledge-based mode farm driven by scientific, ethical, and technological innovations contributes to ensuring some level of food security during the COVID-19 pandemic. The main research question driving the current study is: in what ways can universities demonstration farms support urban food security during pandemics? The study circumvented lockdown restriction challenges by deploying elevator pitch approach, walk-in interviews, document analysis, and covert observation to elicit the needed data for the study. The CDA farm produced several tons of variety of vegetables using its clean energy and locally recyclable water sources to secure food needs of some urban households during the lockdown. The ability of the farm to effectively embrace sustainable farming system suggests that transitioning to bioeconomy based food security is achievable and affordable in developing countries. Essentially, the paper recommends the need for universities to take a leading role and responsibility in promoting the principles of bioeconomy in agriculture through engagement and collaborations with municipalities and planned and unplanned urban communities in Africa’s fast urbanising cities.
Prediction of Therapeutic Efficacy of Gabapentin by Hull Airway Reflux Questionnaire in Chronic Refractory Cough
Authors: Zhang Mengru , CHEN Qiang , DONG Ran , YU Li , AI Zisheng , XU Xianghuai , QIU Zhongmin 
Published: July 2020

Abstract
BackgroundGabapentin is recommended for the treatment of chronic refractory cough. This study aims to identify its therapeutic predictors in a prospective clinical study.Methods179 patients with chronic refractory cough were treated with gabapentin. Prior to the therapy, all patients were assessed by Hull Airway Reflux Questionnaire (HARQ) and inhaled capsaicin test. When the treatment ended and cough resolution was confirmed, a stepwise logistic regression analysis was performed to identify the therapeutic predictors for gabapentin and to establish the prediction equation. ResultsGabapentin treatment achieved a therapeutic success rate of 66.5%. HARQ scores were significantly higher in responders than non-responders to gabapentin (29.79 ± 9.58 vs 21.95 ± 7.83, t = -3.685, P = 0.000), which were positively related to the therapeutic efficacy of gabapentin (r = 0.433, P < 0.01). The optimal cutoff point of 21.5 in HARQ presented with a moderate ability to predict gabapentin efficacy, with a sensitivity of 84.6% and specificity of 63.6%. Multiple logistic regression identified items of “A tickle in your throat, or a lump in your throat” (OR= 7.927, P=0.005), “Cough when you get out of bed in the morning” (OR=7.016, P=0.045) and “Cough with eating” (OR=6.689, P=0.011) as independent predictors. The established logistic regression equation predicted ³ 80% of the treatment success rate of gabapentin, which was verified by consequent preliminary revalidating study in 59 patients.ConclusionsHARQ may be useful to screen patients with chronic refractory cough most likely responsive to gabapentin, and help improve the therapeutic success. Trial registrationhttp://www.chictr.org/; No.: ChiCTR-ONC-13003123
Dose Response of a Novel Exogenous Ketone Supplement on Physiological, Perceptual, and Performance Parameters
Authors: Prins Philip , D’Agostino Dominic P. , Rogers Christopher Q. , Ault Dana L. , Welton Gary L. , Jones Dalton W. , Henson Samuel R. , Rothfuss Tyler J. , Aiken Kylie G. , Hose Jantzen L. , England Emilia L. , Atwell Adam D. , Buxton Jeffrey D. , Koutnik Andrew P. 
Published: July 2020

Abstract
Background: Interest into the health, disease, and performance impact of exogenous ketone bodies has rapidly expanded due to their multifaceted physiological and signaling properties but limiting our understanding is the isolated analyses of individual types and dose/dosing protocols.Methods: Thirteen recreational male distance runners (24.8±9.6y, 72.5±8.3kg, VO2max 60.1±5.4ml/kg/min) participated in this randomized, double-blind, crossover design study. The first two sessions consisted of a 5-km running time trial (TT) familiarization and a VO2max test. During subsequent trials, subjects were randomly assigned to one (KS1:22.1g) or two (KS2:44.2g) doses of beta-hydroxybutyrate (βHB) and medium chain triglycerides (MCTs) or flavor matched placebo (PLA). Blood R-βHB, glucose, and lactate concentrations were measured at baseline (0-min), post-supplement (30 & 60mins), post-exercise (+0min, +15mins). Time, HR, RPE, affect, RER, VO2, VCO2, and VE were measured during exercise. Cognitive performance was evaluated prior to and post-exercise.Results: KS significantly increased R-βHB, with more potent and prolonged elevations in KS2, illustrating an administrative and dosing effect. R-βHB was significantly decreased in KS1 compared to KS2 illustrating a dosing and exercise interaction effect. Blood glucose elevated post-exercise but was unchanged across groups. Blood lactate significantly increased post-exercise but was augmented by KS administration. Gaseous exchange, respiration, heart rate, affect, RPE, and exercise performance was unaltered with KS administration. However, clear responders and none-responders were indicated. KS2 significantly augmented cognitive function in pre-exercise conditions, while exercise increased cognitive performance for KS1 and PLA to pre-exercise KS2 levels. Conclusion: Novel βHB+MCT formulation had a dosing effect on R-βHB and cognitive performance, an administrative response on blood lactate, while not influencing gaseous exchange, respiration, heart rate, affect, RPE, and exercise performance.