bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central Serous Chorioretinopathy And Selective Serotonin Reuptake Inhibitors
Authors: ALTUN Ahmet , Atmaca Fatih , Icagasioglu Ahmet , Cekmeceli Selcuk 
Published: July 2020

Abstract
Aim: To investigate the relationship between central serous chorioretinopathy (CSC) and selective serotonin reuptake inhibitor (SSRI) antidepressant drugs.Methods: The files of patients diagnosed with CSC who applied to our clinics were analyzed retrospectively. Group 1 was formed from patients who had never used any antidepressant drug. Group 2 and Group 3 were composed of patients who did not stop and stopped using SSRI after the third month, respectively. Ophthalmological examinations, optical coherence tomography and fundus fluorescein angiography images of the patients were analyzed and the groups were compared with each other. Results: Group 1, Group 2 and Group 3 had 122, 8, 12 eyes, respectively. The time for complete resolution of subretinal fluid (SRF) in Group 3 was statistically significantly shorter than Group 1 and Group 2 (p ˂ 0.01). In Group 2, the time for complete resolution of SRF was significantly longer than Group 1 (p ˂ 0.05). Conclusion: SSRI group antidepressant drugs might be an important factor in CSC etiology and prognosis. Discontinuation of these drugs may accelerate subretinal fluid resolution.
Effect of Toe Exercises and Toe-grip Strength on the Treatment of Primary Metatarsalgia
Authors: Amaha Kentaro , Arimoto Tatsuya , Kitamura Nobuto 
Published: July 2020

Abstract
Background
The relationship of metatarsalgia and toe function is poorly understood. We investigated the efficacy of toe exercises for the treatment of metatarsalgia.
Methods
Forty-one (56 feet) metatarsalgia patients (age mean ± SD: 63.4 ± 10.6) underwent toe strength measurement. We recorded pre- and post-treatment visual analogue scale (VAS), The American Orthopaedics Foot & Ankle Society (AOFAS) score, marble pickup, and single-leg standing time (SLST) and compared in two subgroups to evaluate impact of disease duration on treatment outcome.
Results
Post treatment, toe plantarflexion strength improved (all p < 0.01); VAS scores decreased (p < 0.01); and AOFAS scores, marble pickup, and SLST improved (all p < 0.01). Patients symptomatic for > 1 year had significantly lower changes in VAS scores (p < 0.01). Multivariate analysis showed patients with longer disease duration and larger body mass index had significantly lower improvement in VAS scores (p = 0.029 and p = 0.036, respectively). Device consistency assessed by Intraclass Correlation Coefficients (ICC) was excellent (0.89–0.97).
Conclusion
Toe function and metatarsalgia is improved by toe exercises, suggesting that they are closely related.
Impact of Health Human Resources on the Output Efficiency of Residents’ Health Status in China
Authors: Cheng Jingjing , Kuang Xianming , Zeng Linghuang 
Published: July 2020

Abstract
Background: Along with the development of the Chinese economy, there has been an increasing demand for resident health care services. Human resources for health (HRH) are a cornerstone in the medical system and have a significant influence on the health status of residents. Methods: This study employed the data envelopment analysis (DEA) to explore the output efficiency of residents’ health status. The input variable was medical services and the output variable was the health status of residents. We examined aspects of the provincial and national dimensions in China and used a Tobit regression analysis to explore the impact of HRH on output efficiency scores. Results: We found that in the provincial dimension, all kinds of HRH (except for technicians) had a significantly positive impact on the output efficiency of residents’ health status. In the national dimension, licensed (assistant) doctors, registered nurses, and village doctors had a significantly positive effect on the efficiency in the “with surgical procedures” model. In the “without surgical procedures” model, the effect factors changed to registered nurses and pharmacists. Most importantly, pharmacists played a critical role in both the provincial and national output efficiency scores. For pharmacists, the influence coefficient was three times higher than licensed (assistant) doctors and 11 times higher than registered nurses.Conclusions: There is asymmetry between the demand for drug therapy and the lack of clinical pharmacists. Optimizing the allocation of HRH should be a top priority for healthcare systems and the government should adopt a long-term perspective.
Midwives’ Challenges and Factors that Motivate them to Remain in Their Workplace in the Democratic Republic of Congo – An Interview Study
Authors: Bogren Malin , Grahn Malin , Kaboru Berthollet Bwira , Berg Marie 
Published: July 2020

Abstract
Background: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of Goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service, are therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods: A qualitative content analysis method was used. Data was collected through ten focus-group discussions with a total of 63 midwives working at ten different healthcare facilities. Results: Loving one’s work made it worthwhile for the midwives to remain in the workplace. To be a midwife was not just a profession; it was a calling and made them proud, despite low professional status. The organisational system at facility level was unsupportive, with insufficient work-related security, no remuneration system, and rigid hierarchical management structures. A lack of resources and insufficient competence gave the midwives inadequate pre-conditions for carrying out their professional work.Conclusion: Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including: i) conducting midwifery education programmes following international standards; ii) prioritising and enforcing policies to include adequate remuneration for midwives; iii) involving midwives’ associations in policy and planning about the midwifery workforce; and iv) ensuring that midwives’ working environments are safe and well equipped.
Childhood Obesity, Weight Loss and Long Term Development in Quality-of-Life: A Longitudinal Follow-Up Study.
Authors: Jørgensen Rasmus Møller , Vestergaard Esben Thyssen , Kremke Britta , Bahnsen Rikke Frederiksen , Nielsen Bent Windelborg , Bruun Jens Meldgaard 
Published: July 2020

Abstract
Background To evaluate long-term effects of a multifactorial lifestyle intervention on measures of quality-of-life (QoL) in children with obesity. Methods One hundred and twenty children age 4-17 years with a BMI standard deviation score (BMI-SDS) >2 participated in a multifactorial lifestyle intervention. QoL and wellbeing were measured by a 6-item Visual Analogue Scale (VAS) throughout the intervention.Results Follow-up time was 26.4 months (13.9 SD). VAS scores decreased on bullying (0.6 vs. 0.0 median) and in motivation (10.0 vs. 9.6). QoL increased in children with a BMI-SDS reduction (0.65 (2.49 SD)) opposite children with no-change or increasing BMI-SDS who reported reduced QoL (-0.36 (1.55 SD) and -0.96 (2.27 SD)). Boys experienced reduced appetite (6.7 (2.3 SD) to 5.7 (2.6 SD)), bullying (median 0.4 vs. 0.0) and motivation (median 10.0 vs. 8.9), while girls experienced reduction in bullying (median 0.6 vs. 0.0) and an enhancement in Joy of Life compared to boys (0.73 (2.10 SD) vs. -0.04 (2.08 SD)).Conclusion Multifactorial lifestyle intervention for children with obesity induces long-term BMI-SDS reduction for the majority, and exerts significant reduction in bullying and improves QoL if weight loss is obtained and maintained.
Living with Chronic Illness Scale: Validation in a Type 2 Diabetes Mellitus Population
Authors: Caro-Bautista Jorge , Rodriguez-Blázquez Carmen , Perez-Manchon David , Timonet Eva , Carvajal Gloria , Fuentes-Ramírez Alejandra , Corchon Silvia , Aranda-Gallardo Marta , Ambrosio Leire 
Published: July 2020

Abstract
Background: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population.Methods: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary health care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument.Results: The instrument has adequate internal consistency and test retest reliability (Cronbach’s alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is accurate (standard error of measurement = 3.34, with values <½SD = 8.52 considered acceptable) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL) (rs = 0.51-0.30) and satisfaction (SLS-6) (rs = 0.50-0.38). The questionnaire discriminates by the level of severity of the illness (Patient Based Global Impression of Severity Scale), associating lower values with greater severity, and also by male gender. The COSMIN checklist is favourable for all the properties analysed, although some weaknesses are detected for content validity.Conclusions: “Living with T2DM” (LW-T2DM) is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.
Impact of CRP on continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation
Authors: Yang Wenbo , Qu Zhan , Du Yiqing , Bai Wenjun , Yu Luping , Zhang Xiaopeng , Wang Qi , Zhang Xiaowei , Li Qing , Xu Tao 
Published: July 2020

Abstract
Background Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need. Methods The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients. Results The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC༞37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05). Conclusions The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.
Identification of Core Genes and Pathways in Major Depressive Disorder Applying Bioinformatics
Authors: Yang Wenshan , Yin Hong , Wang Yichen , Liu Ping , Hu Yuan 
Published: July 2020

Abstract
Background: Although extensive study efforts on major depressive disorder (MDD), the pathogenesis related to the biological factors are not fully understood and present therapeutic regimen are ineffective in some depressive patients. This study aims to identify key genes and pathways associated with the molecular biological mechanisms of major depressive disorder through bioinformatics analysis in the Gene Expression Omnibus (GEO) public database of the National Center for Biotechnology Information (NCBI) website.Materials and methods: The whole-transcriptome brain expression profile dataset (GSE101521) was obtained from the GEO database. Differentially-expressed genes (DEGs) in normal group (non-psychiatric human) and MDD group (depressive patients) were identified applying Networkanalyst online database. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed to function annotation and enrichment analysis. After that, STRING online database was conducted to protein–protein interaction (PPI) network, and Cytoscape.3.7.2 software was performed to module analysis. Results: Out of the 41 DEGs identified from normal tissue samples and MDD, 39 were upregulated and 2 were downregulated. GO enrichment analysis discovered that DEGs were primarily involved in inflammatory response, and KEGG pathway analysis suggested that the most chiefly pathway related to MDD were IL-17 signaling pathway, TNF signaling pathway and NOD-like receptor signaling pathway. Six hub genes (IL6, CXCL8, IL1B, FOS, CCL2 and CXCL2) were identified by PPI network and module analysis. Conclusion: Our current study detected novel markers and targets involved immune system, which are involved in pivotal biological mechanisms related to the pathogenesis of major depression. Looking forward, these findings still need to be validated in future experimental studies.
Evaluation of Curcumin and Copper Acetate Against Salmonella Typhimurium Infection, Intestinal Permeability, and Cecal Microbiota Composition in Broiler Chickens
Authors: Leyva-Diaz Anaisa A. , Hernandez-Patlan Daniel , Solis-Cruz Bruno , Adhikari Bishnu , Kwon Young Min , Latorre Juan D. , Hernandez-Velasco Xochitl , Fuente-Martinez Benjamin , Hargis Billy M. , Lopez-Arellano Raquel , Tellez Guillermo 
Published: July 2020

Abstract
Background: Interest in the use of natural feed additives as an alternative to antimicrobials in the poultry industry has increased in recent years because of the risk of bacterial resistance. One of the most studied groups are polyphenolic compounds, given their advantages over other types of additives and their easy potentiation of effects when complexes are formed with metal ions. Therefore, the objective of the present study was to evaluate the impact of dietary supplementation of Copper Acetate (CA), Curcumin (CR), and their combination (CA-CR) against Salmonella Typhimurium colonization, intestinal permeability, and cecal microbiota composition in broiler chickens.Results: The obtained results showed that in two independent studies, all experimental treatments were able to significantly reduce the S. Typhimurium colonization in cecal tonsils (CT, p < 0.05) compared to the positive control (PC) group. However, CR and CA-CR were the best treatments reducing S. Typhimurium counts. Furthermore, the serum fluorescein isothiocyanate dextran (FITC-d) concentration in chickens treated with CR was significantly lower when compared to PC (p < 0.05). The effect of dietary treatments in reducing S. Typhimurium colonization was further supported by the Linear discriminant analysis effect size (LEfSe) analysis of microbiome data, where Salmonella was significantly enriched in PC group (LDA score > 2.0 and p<0.05). In addition, Coprobacillus, Eubacterium, and Clostridium were significantly higher in the PC group compared to other treatment groups. On the contrary, Fecalibacterium and Enterococcus at CR, unknown genus of Erysipelotrichaceae at CA-CR, and unknown genus of Lachnospiraceae at CA were significantly abundant respectively.Conclusions: CR treatment was the most effective treatment to reduce S. Typhimurium intestinal colonization and intestinal permeability associated with variations in the cecae microbiota structure in broiler chickens.
Etoposide and topoisomerase II inhibition for aggressive prostate cancer: data from a translational study.
Authors: Cattrini Carlo , Capaia Matteo , Boccardo Francesco , Barboro Paola 
Published: July 2020

Abstract
Background. Etoposide phosphate (VP-16) is a topoisomerase 2 (TOP2) inhibitor that demonstrated limited activity in patients with metastatic castration-resistant prostate cancer (mCRPC). In our study, we investigated the sensitivity of prostate cancer (PCa) cells (LNCaP, 22Rv1, PC3, DU145, PDB and MDB) to VP-16 and the possible relationship between VP-16 activity and TOP2 expression. We also compared the activity of VP-16 with that of docetaxel, enzalutamide and olaparib. In the datasets analysis, we explored the prevalence and clinical significance of TOP2 genetic and transcriptomic alterations in mCRPC. Methods. Cell cultures and crystal violet cell proliferation assays were performed. Specific antibodies were used in western blots analyses of cell protein extracts. Large scale datasets were analyzed in cBioportal and STRING was used for the functional enrichment analysis. Results. VP-16 was active in all PCa cell lines analyzed and this drug demonstrated increased activity in the aggressive PC3 and DU145 cells. VP-16 was more cytotoxic compared to the other treatments, except for LNCaP and 22Rv1, which were more sensitive to docetaxel. Of note, the maintainment of antiandrogen treatment in bicalutamide-resistant MDB and PDB increased sensitivity to VP-16, docetaxel and enzalutamide. Compared to LNCaP, TOP2A was found to be overexpressed in 22Rv1, DU145 and PC3, whereas TOP2B was overexpressed in 22Rv1 and PDB. In the mCRPC datasets analysis, TOP2A mRNA overexpression was associated with worse patients’ prognosis, with the molecular features of neuroendocrine prostate cancer (NEPC) and with lower androgen receptor (AR) score. Patients overexpressing TOP2A mRNA were more likely to harbor RB1 loss. Conclusions. Specific subpopulations of patients with aggressive variant prostate cancer (AVPC) could benefit from VP-16 treatment. TOP2A overexpression, rather than TOP2B, might be a good biomarker to predict response to VP-16. Further investigations are warranted to determine the role of TOP2A in mCRPC and to assess the efficacy of VP-16, alone or in combination with other agents, for the treatment of patients with mCRPC.Key points: · Etoposide is a chemotherapeutic agent that shows significant activity in preclinical models of prostate cancer and increased activity is observed in the most aggressive cells.· Overexpression of topoisomerase II alfa and decreased functionality of the androgen receptor signaling seem to be associated with response to etoposide.· Specific patients with castration-resistant prostate cancer could benefit from etoposide treatment, alone or in combination with other agents.
Pacemaker-Generated Stress Fracture of The Second Rib: A Case Report
Authors: Ksela Jus , Racman Mark , Zbacnik Rok , Djordjevic Anze , Jan Matevz 
Published: July 2020

Abstract
Background: Pocket-related complications following the implantation of cardiovascular implantable electronic devices primarily include pocket hematoma, infection, skin erosion or decubitus, device migration, and Twiddler's syndrome, with other pathologies such as nerve impairment or bone lesions being extremely rarely encountered. We report a case of a 20-year old asthenic, non-athlete female patient presenting with a device-generated fracture of the second rib several months after sub-muscular permanent pacemaker implantation due to repeated bilateral pre-pectoral pocket infections.Case presentation: A 20-year old female patient was readmitted to our institution 9 months following sub-pectoral implantation of a permanent pacemaker, complaining of severe pocket-related pain, which arose spontaneously in the absence of direct trauma, intense physical activity or vigorous coughing, and was associated with normal day-to-day activity. To rule out a pacemaker re-infection, a native computed tomography and a positron emission tomography - computed tomography of the thorax were performed. Both modalities excluded an infection but showed a healing fracture and a focus of enhanced metabolic activity in the anterolateral part of the right second rib, indicating a non-traumatic or stress fracture of the bone. Consequently, a complete extraction of the pulse generator and both leads was performed and the smallest available single-chamber pulse generator with a single atrial electrode was implanted in the sub-fascial, pre-muscular pocket in the now recovered and uninfected left subclavicular region, alleviating patient’s severe pain symptoms and significantly enhancing her quality of life.Conclusions: In the absence of direct trauma, intense physical activity or vigorous coughing, we assume that in this asthenic girl a normal day-to-day motion of the right shoulder has persistently forced the sub-muscularly placed pulse generator toward thoracic wall, putting increased repetitive pressure force on the underlying bones, finally causing a fatigue stress fracture of the second rib. In asthenic phenotype patients with small thorax and short subclavicular distance, a sub-muscular pacemaker implantation can potentially cause unique and unexpected pocket-related adverse events necessitating advanced diagnostics and timely treatment.