bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India
Authors: Mungai Isaac Gikandi , Baghel Sumit Singh , Soni Shuchi , Vagela Shailja , Sharma Megha , Diwan Vishal , Tamhankar Ashok J. , Lundborg Cecilia Stålsby , Pathak Ashish 
Published: October 2020

Abstract
Background
More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge.

Methods
A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice.

Results
Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th).

Conclusions
The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.
The chest CT features of coronavirus disease 2019 (COVID-19) in China: a meta-analysis of 19 retrospective studies
Authors: Yang Haitao , Lan Yuzhu , Yao Xiujuan , Lin Sheng , Xie Baosong 
Published: October 2020

Abstract
Objective
Aimed to summarize the characteristics of chest CT imaging in Chinese hospitalized patients with Coronavirus Disease 2019 (COVID-19) to provide reliable evidence for further guiding clinical routine.

Methods
PubMed, Embase and Web of Science databases were searched to identify relevant articles involving the features of chest CT imaging in Chinese patients with COVID-19. All data were analyzed utilizing R i386 4.0.0 software. Random-effects models were employed to calculate pooled mean differences.

Results
19 retrospective studies (1332 cases) were included. The results demonstrated that the combined proportion of ground-glass opacities (GGO) was 0.79 (95% CI 0.68, 0.89), consolidation was 0.34 (95% CI 0.23, 0.47); mixed GGO and consolidation was 0.46 (95% CI 0.37; 0.56); air bronchogram sign was 0.41 (95% CI 0.26; 0.55); crazy paving pattern was 0.32 (95% CI 0.17, 0.47); interlobular septal thickening was 0.55 (95% CI 0.42, 0.67); reticulation was 0.30 (95% CI 0.12, 0.48); bronchial wall thickening was 0.24 (95% CI 0.11, 0.40); vascular enlargement was 0.74 (95% CI 0.64, 0.86); subpleural linear opacity was 0.28 (95% CI 0.12, 0.48); intrathoracic lymph node enlargement was 0.03 (95% CI 0.00, 0.07); pleural effusions was 0.03 (95% CI 0.02, 0.06). The distribution in lung: the combined proportion of central was 0.05 (95% CI 0.01, 0.11); peripheral was 0.74 (95% CI 0.62, 0.84); peripheral involving central was 0.38 (95% CI 0.19, 0.75); diffuse was 0.19 (95% CI 0.06, 0.32); unifocal involvement was 0.09 (95% CI 0.05, 0.14); multifocal involvement was 0.57 (95% CI 0.48, 0.68); unilateral was 0.16 (95% CI 0.10, 0.23); bilateral was 0.83 (95% CI 0.78, 0.89); The combined proportion of lobes involved (> 2) was 0.70 (95% CI 0.61, 0.78); lobes involved (≦ 2) was 0.35 (95% CI 0.26, 0.44).

Conclusion
GGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19, which distribution features were peripheral, bilateral, involved lobes > 2. Therefore, based on chest CT features of COVID-19 mentioned, it might be a promising means for identifying COVID-19.
Activation of the KDM5A/miRNA-495/YTHDF2/m6A-MOB3B axis facilitates prostate cancer progression
Authors: Du Chen , Lv Caihong , Feng Yue , Yu Siwen 
Published: October 2020

Abstract
Background
Accumulating evidence supports that lysine-specific demethylase 5 (KDM5) family members act as oncogenic drivers. This study was performed to elucidate the potential effects of KDM5A on prostate cancer (PCa) progression via the miR-495/YTHDF2/m6A-MOB3B axis.

Methods
The expression of KDM5A, miR-495, YTHDF2 and MOB3B was validated in human PCa tissues and cell lines. Ectopic expression and knockdown experiments were developed in PCa cells to evaluate their effects on PCa cell proliferation, migration, invasion and apoptosis. Mechanistic insights into the interaction among KDM5A, miR-495, YTHDF2 and MOB3B were obtained after dual luciferase reporter, ChIP, and PAR-CLIP assays. Me-RIP assay was used to determine m6A modification level of MOB3B mRNA in PCa cells. Mouse xenograft models of PCa cells were also established to monitor the tumor growth.

Results
KDM5A was highly expressed in human PCa tissues and cell lines. Upregulated KDM5A stimulated PCa cell proliferation, migration and invasion, but reduced cell apoptosis. Mechanistically, KDM5A, as a H3K4me3 demethylase, bound to the miR-495 promoter, which led to inhibition of its transcription and expression. As a target of miR-495, YTHDF2 could inhibit MOB3B expression by recognizing m6A modification of MOB3B mRNA and inducing mRNA degradation. Furthermore, KDM5A was found to downregulate MOB3B expression, consequently augmenting PCa cell proliferation, migration and invasion in vitro and promoting tumor growth in vivo via the miR-495/YTHDF2 axis.

Conclusion
In summary, our study highlights the potential of histone demethylase KDM5A activity in enhancing PCa progression, and suggests KDM5A as a promising target for PCa treatment.
Probiotics and the envisaged role in treating human infertility
Authors: Younis Nagham , Mahasneh Adel 
Published: October 2020

Abstract

Background
Considerable attention is being directed nowadays towards using probiotics as an alternative therapy in treating several human diseases including gastrointestinal tract diseases especially colorectal cancers, cardiovascular diseases, hyperlipidemia, and blood pressure cases. However, infertility as affected by the microbiome and the probable role of probiotics in alleviating infertility problems did not receive the deserved attention, especially in IVF patients with male or female factors.

Main body
In this review, we tried to draw the attention of researchers in the medical settings to the importance of the forthcoming role of probiotics use in elucidating the role of the microbiome in infertile patients. The hope is to attain the best performance of both male and female reproductive systems and to shed some light on infertility problems.

Conclusion
More in vivo experiments are still needed to address many aspects of probiotics like proper administration, exact functional strains, required dose, application method, duration of treatment, and combination with antibiotics before considering probiotics as an alternative treatment.
Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective
Authors: El-Demerdash Ashraf Ali , Beheiry Essam Abdel Wanees , El-Aini Sherif Maher , Mohamed Asmaa Shams El-Dein , Khattab Ahmed Mohamed Ibrahim 
Published: October 2020

Abstract
Background
The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients.

Methods
Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital.

Results
By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B.

Conclusion
The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.
Effect of Treatment of Periodontitis on Incretin Axis in Obese and Nonobese Individuals: A Cohort Study
Authors: Suvan Jeanie , Masi Stefano , Harrington Zoe , Santini Eleonora , Raggi Francesco , D’Aiuto Francesco , Solini Anna 
Published: October 2020

Abstract

Context
Periodontitis confers an increased risk of developing type 2 diabetes and, in patients with obesity, it might interfere with the incretin axis. The effect of periodontal treatment on glucoregulatory hormones remains unknown.

Objective
To evaluate the effect of periodontal treatment on incretin axis in obese and lean nondiabetic individuals.

Setting
King’s College Dental Hospital and Institute, London, UK.

Participants and Methods
The metabolic profile of obese and normal-body-mass-index individuals affected by periodontitis was studied at baseline, 2, and 6 months after intensive periodontal treatment, by measuring plasma insulin, glucagon, glucagon-like peptide-1(GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) and markers of systemic inflammation and oxidative stress.

Main Outcome Measure(s)
Circulating levels of incretins and inflammatory markers.

Results
At baseline, periodontal parameters were worse for obese than nonobese; this was accompanied by higher levels of circulating high-sensitivity C-reactive protein (hs-CRP), insulin, and GLP-1. The response to periodontal treatment was less favorable in the obese group, without significant variations of hs-CRP or malondialdehyde. Glucoregulatory hormones changed differently after treatment: while insulin and glucagon did not vary at 2 and 6 months, GLP-1 and GIP significantly increased at 6 months in both groups. In particular, GLP-1 increased more rapidly in obese participants, while the increase of GIP followed similar trends across visits in both groups.

Conclusions
Nonsurgical treatment of periodontitis is associated with increased GLP-1 and GIP levels in nonobese and obese patients; changes in GLP-1 were more rapid in obese participants. This might have positive implications for the metabolic risk of these individuals.
What Is EU Public Health and Why? Explaining the Scope and Organization of Public Health in the European Union
Authors: Greer Scott L. , Jarman Holly 
Published: October 2020

AbstractPublic health is notoriously difficult to define, and that is the case for public health in the European Union as much as other political systems. In this article, the authors try to identify the actual scope and meaning of public health as it is institutionalized in the EU political system. Using a mixture of historical policy and legal analysis, the authors show how the evolution of the institutional space called public health in the EU has been shaped by the EU's distinctive constitutional nature, its focus on regulation, and the legacy of its focus on market making as well as the preferences of its political leaders. The European Union does have an increasingly large space named “public health,” in which health ministers, the health directorate-general, and invocation of its public health treaty article 168 can be found, as well as a much broader and older area of activities justified by the need to manage adverse health consequences of market-making policies in other areas such as labor standards and agriculture. The COVID-19 crisis of 2020 not only led to a strengthening of EU public health but also showed that the EU is one of the many political systems in which the legal and bureaucratic domain of public health is far smaller than the actual issues affecting the public's health.
Health “Brexternalities”: The Brexit Effect on Health and Health Care outside the United Kingdom
Authors: Hervey Tamara , Antova Ivanka , Flear Mark L. , McHale Jean V. , Speakman Elizabeth , Wood Matthew 
Published: October 2020

AbstractThe principal effects of Brexit on health and health care will fall within the United Kingdom, and all forms of Brexit have overwhelmingly negative implications for health care and health within the UK. This article focuses on the external effects of Brexit (“Brexternalities”) for health and health care. The EU is a particularly powerful institutional and legal arrangement for managing economic and political externalities in health policy as in any other policy. Equally, when a state leaves the EU, the manner of leaving will result in better or worse management of relevant externalities. Brexternalities thus involve questions about policy legitimacy and accountability. Health Brexternalities do not fall equally in all EU countries. They are felt more distinctly in the context of those elements of health policy that are most closely entwined with the UK's health policy (e.g., on the island of Ireland, certain areas of Spain, and other parts of southern Europe). Some health Brexternalities, such as in medicine safety, will be imposed on the whole population of the EU. And some health Brexternalities, such as communicable disease control, will be felt globally.
Determinants of newborn care utilization in Pakistan: Findings from the Demographic and Health Surveys
Authors: Pongpanich Sathirakorn , Ghaffar Abdul , Ghaffar Najma , Majid Hafiz Abdul 
Published: October 2020

Background: Information on determinants of postnatal care is essential for maternal health services, and this information is scarce in Pakistan. This study aimed to determine the factors of newborn postnatal care utilization from the Pakistan Demographic and Health Surveys (PDHS) conducted from 2006–2018. Methods: We analyzed data from three rounds of cross-sectional, nationally representative PDHS 2006–07, 2012–13, and 2017–18. Multivariable logistic regression models were applied to explore factors associated with utilization of newborn postnatal care within two months. Results: This study included 5724 women from the 2006–07 PDHS, 7461 from the 2012–13 survey, and 8287 from the 2017–18 survey. The proportion of women receiving newborn postnatal care within the first two months of delivery increased from 13% in 2006–07 to 43% in 2012–13 but dropped to 27% in 2017–18. Respondent’s occupation and prenatal care utilization of maternal health services were common factors that significantly influenced newborn postnatal care utilization within two months. The utilization of postnatal care was greater among women having educated husbands and where the first child was a male in PDHS 2007 round. Higher wealth index and educated respondent had higher postnatal care utilization odds in DHS 2012 and DHS 2018. However, the odds of using postnatal care decreased with the number of household members and total number of children ever born in DHS 2012 and 2018 rounds. Conclusions: There was a general increase in the proportion of women who utilized postnatal care for their newborns during 2006–2013 but a decrease in 2018. The decreased utilization in 2018 warrants further investigation. Improving women’s economic status, education, employment, and antenatal care attendance and reducing parity may increase newborn postnatal care utilization.
IMPACT-Restart: the influence of COVID-19 on postoperative mortality and risk factors associated with SARS-CoV-2 infection after orthopaedic and trauma surgery
Authors: Clement Nicholas D. , Hall Andrew James , Makaram Navnit S. , Robinson Patrick G. , Patton Robyn F. L. , Moran Matthew , Macpherson Gavin J. , Duckworth Andrew D. , Jenkins Paul J. 
Published: October 2020

AimsThe primary aim of this study was to assess the independent association of the coronavirus disease 2019 (COVID-19) on postoperative mortality for patients undergoing orthopaedic and trauma surgery. The secondary aim was to identify factors that were associated with developing COVID-19 during the postoperative period.MethodsA multicentre retrospective study was conducted of all patients presenting to nine centres over a 50-day period during the COVID-19 pandemic (1 March 2020 to 19 April 2020) with a minimum of 50 days follow-up. Patient demographics, American Society of Anesthesiologists (ASA) grade, priority (urgent or elective), procedure type, COVID-19 status, and postoperative mortality were recorded.ResultsDuring the study period, 1,659 procedures were performed in 1,569 patients. There were 68 (4.3%) patients who were diagnosed with COVID-19. There were 85 (5.4%) deaths postoperatively. Patients who had COVID-19 had a significantly lower survival rate when compared with those without a proven SARS-CoV-2 infection (67.6% vs 95.8%, p < 0.001). When adjusting for confounding variables (older age (p < 0.001), female sex (p = 0.004), hip fracture (p = 0.003), and increasing ASA grade (p < 0.001)) a diagnosis of COVID-19 was associated with an increased mortality risk (hazard ratio 1.89, 95% confidence interval (CI) 1.14 to 3.12; p = 0.014). A total of 62 patients developed COVID-19 postoperatively, of which two were in the elective and 60 were in the urgent group. Patients aged > 77 years (odds ratio (OR) 3.16; p = 0.001), with increasing ASA grade (OR 2.74; p < 0.001), sustaining a hip (OR 4.56; p = 0.008) or periprosthetic fracture (OR 14.70; p < 0.001) were more likely to develop COVID-19 postoperatively.ConclusionPerioperative COVID-19 nearly doubled the background postoperative mortality risk following surgery. Patients at risk of developing COVID-19 postoperatively (patients > 77 years, increasing morbidity, sustaining a hip or periprosthetic fracture) may benefit from perioperative shielding. Cite this article: Bone Joint J 2020;102-B(12):1774–1781.
The Effect of Working Capital Management on Dividend Policy: An Empirical Analysis of Listed Firms in Ghana
Authors: Yakubu I.N 
Published: October 2020

Relying on more recent data spanning 2007-2016, this paper investigates the impact of working capital management (WCM) on dividend policy of listed non-financial firms in Ghana. Specifically, the study assesses the effect of cash conversion cycle (CCC), days inventory outstanding (DIO), profitability, and firm growth on dividend policy. Employing the ordinary least squares (OLS) analytical technique, the findings reported that working capital management (in terms of cash conversion cycle and days inventory outstanding) and dividend policy are positively related, with DIO having a significant effect on dividend policy. The results also established a positive association between the control variables (profitability and firm growth) and dividend policy albeit insignificantly. Based on the findings, the study concludes that working capital management in terms of days inventory outstanding (DIO) is a critical factor influencing firms’ dividend policy decisions. The study extends the inconclusive empirical evidence on the determinants of dividend policy and fills the lacuna in existing literature by focusing on how working capital management practices influence dividend policy of firms in Ghana. The findings are also useful to the board of directors of non-financial firms in deciding an appropriate dividend policy, and to the shareholders in making investment decisions.
ENHANCING INTEGRITY IN WATER GOVERNANCE IN MOROCCO: OPPORTUNITIES AND CHALLENGES
Authors: Legrouri Ahmed , Sendide Khalid , Kalpakian Jack 
Published: October 2020

This paper examines Morocco’s effort at enhancing integrity in the water sector using stakeholder analysis, exposition concerning the major structures governing water, and structured encounters with stakeholders. Using fieldwork, participant observation and direct interaction with the various stakeholders, the paper finds that the process of improving integrity in the Moroccan water sector is underway and is at the awareness-raising stage. Deeper questions that deal with competencies related to transparency, working with civil society and the media remain challenges that are in the process of being articulated in order to be addressed.
Confirmatory testing of primary aldosteronism with saline infusion test and LC-MS/MS
Authors: Fuss Carmina Teresa , Brohm Katharina , Kurlbaum Max , Hannemann Anke , Kendl Sabine , Fassnacht Martin , Deutschbein Timo , Hahner Stefanie , Kroiss Matthias 
Published: October 2020

Objective
Saline infusion testing (SIT) for confirmation of primary aldosteronism (PA) is based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Liquid chromatography tandem mass spectrometry (LC-MS/MS) is increasingly used in clinical routine. We aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the diagnostic utility of steroid panel analysis.

Design
Retrospective cohort study of 187 paired SIT samples (2009–2018). Diagnosis of PA (n = 103) and EH (n = 84) was established based on clinical routine workup without using LC-MS/MS values.

Setting
Tertiary care center.

Methods
LC-MS/MS using a commercial steroid panel. Receiver operator characteristics analysis was used to determine method-specific cut-offs using a positive predictive value (PPV) of 90% as criterion.

Results
Aldosterone measured by IA was on average 31 ng/L higher than with LC-MS/MS. The cut-offs for PA confirmation were 54 ng/L for IA (sensitivity: 95%, 95% CI: 89.0–98.4; specificity: 87%, 95% CI: 77.8–93.3; area under the curve (AUC): 0.955, 95% CI: 0.924–0.986; PPV: 90%, 95% CI: 83.7–93.9) and 69 ng/L for LC-MS/MS (79%, 95% CI: 69.5–86.1; 89%, 95% CI: 80.6–95.0; 0.902, 95% CI: 0.857–0.947; 90%, 95% CI: 82.8–94.4). Other steroids did not improve SIT.

Conclusions
Aldosterone quantification with LC-MS/MS and IA yields comparable SIT-cut-offs. Lower AUC for LC-MS/MS is likely due to the spectrum of disease in PA and previous decision making based on IA results. Until data of a prospective trial with clinical endpoints are available, the suggested cut-off can be used in clinical routine.