bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of A Feedback Intervention on Antibiotic Prescription Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Chang Yue , Cui Zhezhe , Yang Guanghong , Zhang Xin , Tang Lei 
Published: September 2020

Abstract
Background The global health system is improperly using antibiotics. We aimed to examine the effectiveness of implementing a feedback intervention for the unreasonable control of antibiotic prescriptions. Methods Relevant literature published in the databases of Pubmed, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Journal Full-text (CNKI), Science Direct, Proquest and Wanfang was searched. Data were independently filtered and extracted based on the pre-designed inclusion and exclusion criteria by two reviewers. The Cochrane collaborative bias risk tool was used to evaluate the quality of the included study. RevMan 5.3 software was used for meta-analysis. Results Nine relevant randomized controlled trials were included in this study, of which 1 was written in Chinese and 8 in English. Tabulation resulted in a total of 238,196 prescriptions (103,370 in the intervention group and 134,826 in the control group) from seven countries: China, the United States, England, Spain, Norway, Germany, and France. The meta-analysis showed that the antibiotic prescription rate in the intervention group was significantly lower than that in the control group after the feedback intervention, and the difference was statistically significant (risk difference = -0.12, 95% CI = -0.16, -0.07, P <0.01). Due to the large heterogeneity of the results, subgroup analysis was performed according to the study area, whether prescription recommendations were given to doctors by peer experts, and the intervention mode. Conclusion Implementing feedback interventions in hospitals can effectively reduce antibiotic prescription rates. Adding multiple feedback interventions to educational interventions may be a more reasonable control method.Registrations: This systematic review was registered in PROSPERO, registration number: CRD42020192560.
Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose
Authors: Li Hui , Yu Xiaobing , Zheng Bodi , Ding Shan , Mu Zhongqing , Guo Lixin 
Published: September 2020

Abstract
Aim: To investigate the changes of retinal optic disc nerve fiber layer thickness and macular blood flow density in preclinical stage of diabetic retinopathy and their relationship with blood glucose. Methods: In this cross-sectional study,97 diabetic patients(total 188 eyes,144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group ) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different group by HbA1c , and underwent ocular examination by optical coherence tomography angiography. We compare optical coherence tomography angiography parameter and retinal nerve fiber layer thickness among different glucose group.Results: The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (P < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index as compared with the normal group. From the normal group to no diabetic retinopathy group and then to mild non-proliferative retinopathy group, vessel density decreased and acircularity index increased (P < 0.001). Foveal vascular density and parafoveal vessel density decreased with the increase of HbA1c. There was a negative correlation between parafoveal vessel density of the deep retinal vascular layer and FBG (P<0.01). The temporal retinal nerve fiber layer thickness decreased among different HbA1c levels groups and was positively correlated with the parafoveal vessel density in superficial retinal vascular layer(P<0.05).Conclusions: This study shows retinal microvasculopathy and neuropathy has been present during no retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal RNFL thickness was positively correlated with the vessel density of superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists to detect early diabetic retinal pathological lesions.
Analysis of Spatial-Temporal Distribution of Respiratory Infectious Diseases in Shandong Province, China During 2005-2014
Authors: Li Xiaomei , Chen Dongzhen , Zhang Yan , Xue Xiaojia , Li Xuewen , Zhang Shengyang , Chen Meng , Liu Xuena , Ding Guoyong 
Published: September 2020

Abstract
Background: Little comprehensive information on overall epidemic trend of respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of respiratory infectious diseases.Methods: Time series was firstly performed to describe the temporal distribution feature of respiratory infectious diseases during 2005-2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of respiratory infectious diseases. Global and local Moran’s I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations. Results: A total of 537,506 cases of respiratory infectious diseases were reported in Shandong province during 2005-2014. The morbidity of respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran’s I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively.Conclusions: There were obvious spatiotemporal clusters of respiratory infectious diseases in Shandong during 2005–2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of respiratory infectious diseases to establish new strategies for its control.
Controlling the Phase Content of Li2O-Al2O3-SiO2-B2O3-BaO Glass-Ceramic Bonds with CTE Close to cBN
Authors: Guo Zichen , He Feng , Li Zuhao , Yan Dongyang , Xie Junlin 
Published: September 2020

Abstract
Li2O-Al2O3-SiO2-B2O3-BaO glass-ceramic bonds with CTE close to cBN for vitrified cBN composites was prepared via a two-step heat treatment method. The crystalline phases were identified by XRD and the phase content was analyzed by WPF refinement. The increasing crystallization temperature would promote the precipitation of more LiAlSi3O8 phase in the glass-ceramic, which was conducive to the preparation of low CTE glass-ceramics. Besides, a crystallization temperature below 625 °C was necessary for the preparation of Li2O-Al2O3-SiO2-B2O3-BaO glass-ceramic with CTE close to cBN (3.50 × 10− 6 °C− 1), proving that the two-step heat treatment was an effective sintering process to the preparation of low CTE glass-ceramic bonds for vitrified cBN composites.
Association of Initial Symptoms or Comorbidities With Pneumonia Lesions in COVID-19 Patients: Based on Artificial Intelligence-Enabled CT Quantitation
Authors: Yuan Fangzhengyuan , Liu Chuan , Yang Jie , Tan Hu , Bian Shizhu , Gao Xubin , Zhang Jihang , Hu Mingdong , Chen Renzheng , Shen Yang , Ke Jingbin , Yang Yuanqi , He Chunyan , Cheng Ran , Huang Lan 
Published: September 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) patients with a larger ratio of pneumonia lesions are more likely to progress to acute respiratory distress syndrome and death. This study aimed to investigate the relationship of baseline parameters with pneumonia lesions on admission, as quantified by an artificial intelligence (AI) algorithm using computed tomography (CT) images. Methods: This retrospective study quantitatively assessed lung lesions on CT using an AI algorithm in 1630 consecutive patients confirmed with COVID-19 on admission and classified the patients into none (0%), mild (>0–25%), intermediate (>25–50%), and severe (>50%) groups, according to the lesion ratio of the whole lung. A multivariate linear regression model was established to explore the relationship between the lesion ratio and laboratory parameters. The baseline parameters associated with lung lesions, including demographics, initial symptoms, and comorbidities, were determined using a multivariate ordinal regression model. Results: The 1630 patients confirmed with COVID-19 had a median whole lung lesion ratio of 4.1%, and the right lower lung lobe had the most lesions among the five lung lobes based on the evaluation of CT using AI algorithm. The whole lung lesion ratio was associated with the levels of plasma fibrinogen (r=0.280, p<0.001), plasma D-dimer (r=0.248, p<0.001), serum α-hydroxybutyrate dehydrogenase (r=0.363, p<0.001), serum albumin (r=-0.300, p<0.001), and peripheral blood leukocyte count (r=0.194, p<0.001). Among the four patients groups categorised by whole lung lesion ratio, the highest frequency of cough (p<0.001) and shortness of breath (p<0.001) were found in the severe group, and the highest frequency of hypertension (p<0.001), diabetes (p<0.001) and anemia (p=0.039) were observed in the intermediate group. Based on baseline ordinal regression analysis, cough (p=0.009), shortness of breath (p<0.001), hypertension (p=0.002), diabetes (p=0.005), and anemia (p=0.006) were independent risk factors for more severe lung lesions. Conclusions: Based on AI-enabled CT quantitation, patients with initial symptoms of cough/shortness of breath, or with comorbidities of hypertension, diabetes, or anemia, had a higher risk for more severe lung lesions on admission in COVID-19 patients.
Text Encryption Based on Huffman Coding and ElGamal Cryptosystem
Authors: Singh Khoirom Motilal , Singh Laiphrakpam Dolendro , Tuithung Themrichon 
Published: September 2020

Background:
Data that are in the form of text, audio, image, and video are used everywhere
in our modern scientific world. These data are stored in physical storage, cloud storage and
other storage devices. Some of these data are very sensitive and require efficient security while
storing as well as in transmitting from the sender to the receiver.

Objective:
With the increase in data transfer operation, enough space is also required to store these
data. Many researchers have been working to develop different encryption schemes, yet there exist
many limitations in their works. There is always a need for encryption schemes with smaller cipher
data, faster execution time and low computation cost.

Methods:
A text encryption based on Huffman coding and ElGamal cryptosystem is proposed. Initially,
the text data is converted into its corresponding binary bits using Huffman coding. Next, the
binary bits are grouped and again converted into large integer values which will be used as the input
for the ElGamal cryptosystem.

Results:
Encryption and Decryption are successfully performed where the data size is reduced using
Huffman coding and advance security with the smaller key size is provided by the ElGamal
cryptosystem.

Conclusion:
Simulation results and performance analysis specify that our encryption algorithm is
better than the existing algorithms under consideration.
HIV-Related Knowledge, Attitudes, and Behaviors among Grade 10 Girls and Boys in Mpumalanga and KwaZulu-Natal: Cross-Sectional Results
Authors: Speizer Ilene S. , Xiong Khou , Mandal Mahua , Makina-Zimalirana Ndinda , Hattori Aiko , Durno Darryn 
Published: September 2020

Background:
Young people in KwaZulu-Natal and Mpumalanga South Africa are at high risk of HIV and other sexually transmitted infections. Therefore, awareness programs are needed to reach these young people and change their knowledge, attitudes, and behaviors.

Objective:
The objective of this study is to use cross-sectional data from grade 10 female and male learners in randomly assigned intervention and control schools to examine their knowledge, attitudes, and sexual behaviors.

Methods: Participants, who were in grade 10 in the 2018 school year and attending schools, were randomly assigned to the intervention and control arms for implementation of the Department of Basic Education’s adapted life orientation curriculum that included scripted lesson plans. The study took place in two high HIV prevalence provinces in South Africa. Participants completed self-administered tablet-based surveys and female participants provided a dried blood spot for HIV testing.

Results:
Results demonstrate that two-fifths to one-half of male learners reported being sexually experienced and a quarter (KwaZulu-Natal) to a third (Mpumalanga) of the female learners reported the same. A greater percentage of learners in Mpumalanga reported consistent condom use than learners in KwaZulu-Natal. HIV prevalence among female grade 10 learners in both provinces was about 6-7%. No notable differences were observed between intervention and control school learners on the knowledge, attitudes, and behavior outcomes.

Conclusion:
The findings demonstrate the importance of developing HIV prevention programs for young people in high HIV prevalence provinces since these young people remain at high risk for HIV and other negative outcomes.

Trial Registration:
This study has been registered at ClinicalTrials.gov. The trial registration number is: NCT04205721. The trial was retrospectively registered on December 18, 2019.
HEPATOPROTECTIVE, ANTIDIABETIC, AND ANTIPYRETIC ACTIVITY STUDIES OF SIDDHA FORMULATION – NILAVEMBU KUDINEER
Authors: N KASIRAJAN , B MAHESHWARI , G SUBASHCHANDRAN , KS MAANICKHA CHELVI 
Published: September 2020

Objective: Traditional medicines like Siddha System of Medicine are one of the most primitive medical system. It plays a major role in treating ailments of humankind. Nowadays, this system flourished throughout India using Nilavembu kudineer (NVK) as a drug to treat in various outbreaks such as dengue, Chikungunya, and other related virus infections. As per literature, NVK indicated many types of fever and various diseases. This study emphasizes on antipyretic, antidiabetic, and hepato protective activities of NVK by In vitro study methods.
Methods: Hepatoprotective effect of NVK on Carbon tetrachloride-induced hepatotoxicity in the rat in five groups, antipyretic activity tested by subcutaneous injection of 10 ml/kg of 15% w/v yeast suspended in 0.5% w/v carboxymethyl cellulose solution for elevation of body temperature of rats in 6 groups. Antidiabetic activity done by administration of streptozotocin dissolved in citrate buffer (pH 4.5) and nicotinamide, intraperitoneal injection of 60 mg/kg streptozotocin, 15 min after the i.p administration of 120 mg/kg of nicotinamide in non-insulin-dependent diabetes, in six groups.
Results: The hepatoprotective effect having the significance of one way ANOVA followed by Dunnett’s (n=6); nsp>0.05, *p<0.05, **p<0.01, and ***p<0.001, calculated by comparing treated groups tumor with the control group. Antidiabetic activity having the significance of Dunnett’s ***p<0.001, **p<0.01, and *p<0.05 calculated by comparing the treated group with the control group and antipyretic activity results in Dunnett’s *p<0.05 calculated by comparing the treated group with the control group were considered to be significant.
Conclusion: The study shows that NVK having the potency of hepatoprotective and capability of diabetes in vitro studies. This study also revealed the potency of antipyretic activity against yeast.
ABHRAK BHASMA AND SiO2 INFLUENCED FREE RADICAL STATUS IN LIVER AND KIDNEY OF CCl4-INDUCED ACUTELY INTOXICATED MALE ALBINO RAT
Authors: B TELI PARASHURAM , A KANASE ARUNA 
Published: September 2020

Objective: The objective of the study was to study the mechanism of action of abhrak bhasma-mediated liver and kidney protection in CCl4-induced acute hepatotoxicity-induced male albino rats. Action of abhrak bhasma is compared with the action of SiO2 in similar experimental conditions to differentiate the role of silicon.
Methods: Male albino rats (Rattus norvegicus) were used for experiments. The acute hepatotoxicity was induced by daily dose of CCl4 (3.0 ml/kg body wt for 7 days consecutive). Concurrent treatment of abhrak bhasma in graded doses (10, 20, 30, and 40 mg) was given for 7 days (PO). SiO2 (10, 20, 30, and 40 mg) in graded doses was also given in independent groups of rats as silica control. Lipid peroxidation (LPO) in liver and kidney was studied by malondialdehyde (MDA) estimations as parameter of toxicity and also to study protection.
Results: CCl4-induced hepatotoxicity (MDA levels) is partially managed by low doses of SiO2 but not by high doses. Abhrak bhasma hepatoprotective activities were dose dependent. A 40 mg dose maintained normal levels of LPO. Abhrak bhasma also protected associated renal toxicity.
Conclusion: Abhrak bhasma protected CCl4-induced hepatotoxicity and also associated renal toxicity. Silicon from both SiO2 and abhrak bhasma is hepatoprotective in 10 ml doses (10 and 20 mg) but silicon processed in abhrak bhasma by traditional Ayurvedic processes increased its potency and hepatoprotection and added the potency of renal protection.
CLINICAL TRIALS: PERSPECTIVES OF MEDICAL COMMUNITY
Authors: SANKAR KN HARI , PALAPPALLIL DHANYA SASIDHARAN , PANATTIL PRABITHA 
Published: September 2020

Objective: The objective of the study was to determine the knowledge, attitude, and perception about clinical trials (CTs) among medical community of a tertiary care institution.
Methodology: This was a questionnaire-based cross-sectional study conducted in the Department of Pharmacology, Government Medical College in Central Kerala for a period of 1 year. In a sample population of 690 comprising medical undergraduates (3rd phase), residents, and doctors in Medical Education Service (MES), 309 questionnaires were distributed randomly assuming 80% response to achieve the sample size of 247. Knowledge, attitude, and perceptions were quantified with a cumulative score with a scoring scheme of +1 for a correct response/positive attitude/positive perception and 0 for an incorrect response/no response/negative attitude/negative perception. The data were analyzed using SPSS 16, the knowledge, attitude, and perception were expressed as mean score as well as proportion.
Results: The response rate was 95.79%. Of the 296 completed responses, 158 (53.4%) were from medical undergraduates, 62 (20.9%) from residents, and 76 (25.7%) from doctors in MES. The mean knowledge was 14.8±3.79 (maximum score 25). The mean attitudinal score was 7.07±1.82 (maximum score 10). The mean score of the participants on perception (maximum score=10) about CTs conducted in India was 4.11±2.02 which denoted a negative perception.
Conclusion: The participants had good knowledge and positive attitude about CTs, however, all the three groups of participants had negative perception about CTs currently conducted in India.
ASSESSMENT OF KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING HYPOTHYROIDISM AMONG INFERTILE WOMEN WITH HYPOTHYROIDISM
Authors: PRASANNA G VIMALA DEVA , SM SHARUMATHI , SUNDARAM R SHANMUGA 
Published: September 2020

Objective: The study was designed to assess the knowledge, attitude, and practice (KAP) of hypothyroidism among infertile women with hypothyroidism.
Methods: A cross-sectional analysis was performed in an outpatient environment of infertility centers. We used a validated questionnaire to assess hypothyroidism KAP. Using frequency counts (n) and percentages (%), discrete data were summarized. The Chi-square/Fisher test was used between groups to compare.
Results: The mean age of participants was found to be 32±5.77 years. It was found that 72% of the subjects had poor knowledge, 44% were extremely concerned, and 81% were practicing with a moderate level of precaution. Among the consequences of hypothyroidism, 68% of the study subjects most properly-recognized menstrual disturbance, followed by 66%, 51%, and 48% of study subject properly-recognized weight gain, fatigue, and muscle aches/pain as a clinical manifestation of hypothyroidism. Most patients (98%) adhered to their medications. Nearly half of the study patients (45%) did not avoid cabbage, cauliflower, or soya.
Conclusion: Our study highlighted the significance of investing appropriate time to provide patients with a comprehensive education to bridge the gaps in patient care. The findings also indicated that it be better for the understanding of the patients if health-care providers could provide patients with data sheets explaining the disease or having some pictorial/pamphlets about the disease’s reality and myths.
MODULATORY EFFECT OF POLYMER TYPE AND CONCENTRATION ON DRUG RELEASE FROM SUSTAINED RELEASE MATRIX TABLETS OF RANOLAZINE: A COMPARATIVE RELEASE KINETIC STUDY
Authors: M AGIBA AHMED , HAKEEM WAGEEH ABDEL , G ZAYED ASHRAF 
Published: September 2020

Objective: Ranolazine (RZ), antianginal drug indicated for the treatment of chronic stable angina pectoris, was formulated into sustained-release matrix tablets and optimized to improve patient compliance and achieve controlled release over a certain period.
Methods: Different formulations were prepared by wet- and melt-granulation techniques. Excipients at different ratios as Eudragit® L100-55, Methocel™ E5, Avicel® PH-101, and carnauba wax powder were used to develop a ternary polymeric matrix system for the controlled delivery of RZ. The prepared formulations were subjected to granulometric and characteristic studies. Comparative dissolution and release kinetic studies of the selected formulation and the reference product, Ranexa® extended-release film-coated tablets, Gilead Sciences, Inc., USA, were further carried out to ensure product similarity.
Results: The optimum pH-dependent to pH-independent polymers ratio was 1:1.3 (w/w). Extragranular carnauba wax in a concentration of 32.50 mg/tablet (2.50 gm% w/w) was the key excipient in controlling drug release kinetics by forming waxy matrix granules which prevent rapid dissolution. Modulation of the microenvironmental pH using a potent alkalinizing agent was very effective for controlling drug release patterns in different dissolution media from pH 1.2–6.8.
Conclusion: The release of RZ from the matrix tablets was controlled for a period of 24 h, and thereby expected to provide patient compliance with minimal side effects.
CORRELATION OF IRON AND MYELOPEROXIDASE LEVELS IN ISCHEMIC HEART DISEASE
Authors: MUPPALA THEJASWINI , RAJESH DASARAJU , PATIL PRIYA , V RAO ASHALATHA 
Published: September 2020

Objective: The objective of the study was to estimate, compare, and correlate serum iron and myeloperoxidase (MPO) levels in acute ischemic heart disease (IHD) cases.
Methods: Subjects for the study were divided into two groups of 35 acute IHD cases and 35 age and sex matched controls. Serum iron and MPO levels were assayed, and results compared.
Statistical analysis: The comparison between two groups was done using the Student’s t-test. Correlation between iron and MPO was established using Pearson’s correlation test.
Results: High serum MPO levels and low iron levels were observed in acute IHD cases in comparison to controls. There was no significant correlation between serum iron and MPO in acute IHD cases.
Conclusion: High iron levels have a beneficial role, whereas high MPO levels have an inflammatory role in the development of IHD. Determination of serum iron and MPO levels in high-risk subjects may help in taking proper measures to prevent acute IHD.