bluuebunny/crossref_metadata_2025_split huggingface dataset:
Readability of web-based sources about induced abortion: a cross-sectional study
Authors: Georgsson Susanne , Carlsson Tommy 
Published: June 2020

Abstract
Background
High-quality information is essential if clients who request an abortion are to reach informed decisions and feel prepared for the procedure, but little is known concerning the readability of web-based sources containing such material. The aim was to investigate the readability of web-based information about induced abortion.

Methods
The search engine Google was used to identify web pages about induced abortion, written in the English language. A total of 240 hits were screened and 236 web pages fulfilled the inclusion criteria. After correcting for duplicate hits, 185 web pages were included. The readability of the text-based content of each web page was determined with Flesch Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook, and Flesch Reading Ease. Data were analyzed with descriptive statistics, Pearson’s correlation coefficient and Kruskal-Wallis with Dunn’s test as post hoc analysis.

Results
Across all grade level measures, a small minority of the web pages had a readability corresponding to elementary school (n < 3, 1%), while the majority had readability corresponding to senior high school or above (n > 153, 65%). The means of the grade level measures ranged between 10.5 and 13.1, and the mean Flesch Reading Ease score was 45.3 (SD 13.6). Only weak correlations (rho < 0.2) were found between the readability measures and search rank in the hit lists. Consistently, web pages affiliated with health care had the least difficult readability and those affiliated with scientific sources had the most difficult readability.

Conclusions
Overall, web-based information about induced abortions has difficult readability. Incentives are needed to improve the readability of these texts and ensure that clients encounter understandable information so that they may reach informed decisions and feel adequately prepared when requesting an abortion.
Post-hospital medical respite care for homeless people in Denmark: a randomized controlled trial and cost-utility analysis
Authors: Bring Camilla , Kruse Marie , Ankarfeldt Mikkel Z. , Brünés Nina , Pedersen Maja , Petersen Janne , Andersen Ove 
Published: June 2020

AbstractBackgroundBeing homeless entails higher mortality, morbidity, and prevalence of psychiatric diseases. This leads to more frequent and expensive use of health care services. Medical respite care enables an opportunity to recuperate after a hospitalization and has shown a positive effect on readmissions, but little is known about the cost-effectiveness of medical respite care for homeless people discharged from acute hospitalization. Therefore, the aim of the present study was to investigate the cost-effectiveness of a 2-week stay in post-hospital medical respite care.MethodsA randomized controlled trial and cost-utility analysis, from a societal perspective, was conducted between April 2014 and March 2016. Homeless people aged > 18 years with an acute admission were included from 10 different hospitals in the Capital Region of Denmark. The intervention group (n = 53) was offered a 2-week medical respite care stay at a Red Cross facility and the control group (n = 43) was discharged without any extra help (usual care), but with the opportunity to seek help in shelters and from street nurses and doctors in the municipalities. The primary outcome was the difference in health care costs 3 months following inclusion in the study. Secondary outcomes were change in health-related quality of life and health care costs 6 months following inclusion in the study. Data were collected through Danish registries, financial management systems in the municipalities and at the Red Cross, and by using the EQ-5D questionnaire.ResultsAfter 3 and 6 months, the intervention group had €4761 (p = 0.10) and €8515 (p = 0.04) lower costs than the control group, respectively. Crude costs at 3 months were €8448 and €13,553 for the intervention and control group respectively. The higher costs in the control group were mainly related to acute admissions. Both groups had minor quality-adjusted life year gains.ConclusionsThis is the first randomized controlled trial to investigate the cost-effectiveness of a 2-week medical respite care stay for homeless people after hospitalization. The study showed that the intervention is cost-effective. Furthermore, this study illustrates that it is possible to perform research with satisfying follow-up with a target group that is hard to reach.Trial registrationClinicalTrials.gov Identifier:NCT02649595.
How well does Malaysia achieve value for money in public sector purchasing of medicines? Evidence from medicines procurement prices from 2010 to 2014
Authors: Hamzah NM , Perera P. N. , Rannan-Eliya R. P. 
Published: June 2020

AbstractBackgroundMalaysia’s public healthcare sector provides a greater volume of medicines at lower overall cost compared to the private sector, indicating its importance in providing access to medicines for Malaysians. However, the Ministry of Health (MOH) has concerns about the continuous increase in the public sector medicines budget, and achieving efficiencies in medicines procurement is an important goal. The objectives of this study were to assess the overall trend in public sector pharmaceutical procurement efficiency from 2010 to 2014, and determine if the three different ways in which MOH procures medicines influence efficiency.MethodsWe matched medicines from the public sector procurement report by medicine formulation to medicines with a Management Sciences for Health (MSH) International Reference Price (IRP) for each year. Price ratios were calculated, and utilizing the information on quantity and expenditure for each product, summary measures of procurement efficiency were reported as quantity- and expenditure-weighted average price ratios (WAPRs) for each year. Utilizing MOH procurement data to obtain information on procurement type, a multiple regression analysis, controlling for factors that can influence prices, assessed whether procured efficiency (relative to IRPs) differed by MOH procurement type.ResultsMalaysia’s public sector purchased medicines at two to three times the IRP throughout the study period. However, procurement prices were relatively stable in terms of WAPRs each year (2.2 and 3.2 in 2010 to 1.9 and 2.9 in 2014 for quantity and expenditure WAPRs, respectively). Procurement efficiency did not vary between the three different methods of MOH procurement. Procurement efficiency of both imported originators and imported generics were significantly lower (P < 0.001 andP < 0.01) than local generic products, and medicine source and category influenced the procurement efficiency of each MOH procurement mechanism.ConclusionThe design of different medicines procurement mechanisms, along with the balance between ensuring competitive procurement prices and adhering to national industry and procurement policies, have not been able to achieve lower public sector medicines procurement prices (relative to IRP). Introducing pooled procurement options along with continuous monitoring of procurement efficiency and exploring ways to improve price competition among local and foreign suppliers is recommended.
Predictive factors over time of health-related quality of life in COPD patients
Authors: Esteban Cristóbal , Arostegui Inmaculada , Aramburu Amaia , Moraza Javier , Najera-Zuloaga Josu , Aburto Myriam , Aizpiri Susana , Chasco Leyre , Quintana José M. 
Published: June 2020

Abstract
Background
Health-related quality of life (HRQoL) should be seen as a tool that provides an overall view of the general clinical condition of a COPD patient. The aims of this study were to identify variables associated with HRQoL and whether they continue to have an influence in the medium term, during follow-up.

Methods
Overall, 543 patients with COPD were included in this prospective observational longitudinal study. At all four visits during a 5-year follow-up, the patients completed the Saint George’s Respiratory Questionnaire (SGRQ), pulmonary function tests, the 6-min walk test (6MWT), and a physical activity (PA) questionnaire, among others measurements. Data on hospitalization for COPD exacerbations and comorbidities were retrieved from the personal electronic clinical record of each patient at every visit.

Results
The best fit to the data of the cohort was obtained with a beta-binomial distribution. The following variables were related over time to SGRQ components: age, inhaled medication, smoking habit, forced expiratory volume in one second, handgrip strength, 6MWT distance, body mass index, residual volume, diffusing capacity of the lung for carbon monoxide, PA (depending on level, 13 to 35% better HRQoL, in activity and impacts components), and hospitalizations (5 to 45% poorer HRQoL, depending on the component).

Conclusions
Among COPD patients, HRQoL was associated with the same variables throughout the study period (5-year follow-up), and the variables with the strongest influence were PA and hospitalizations.
Suboptimal response to GnRH-agonist trigger during oocyte cryopreservation: a case series
Authors: Russo Miguel , Liu Kimberly , Chan Crystal 
Published: June 2020

Abstract
Background
Random-start, controlled ovarian stimulation (COS) has advanced the field of fertility preservation, allowing patients to expedite fertility treatment and avoid further delays to their cancer therapy. This novel approach allows patients to initiate ovarian stimulation at any point, regardless of where they are in their menstrual cycle. Luteal-phase start (LPS) protocols describe treatment cycles where COS is initiated during the luteal-phase of the menstrual cycle. LPS protocols have not been studied or optimized to the same degree as conventional, early-follicular COS. Particularly, there is a paucity of evidence evaluating treatment outcomes using different trigger medications in LPS protocols. The present study aims to evaluate the efficacy of using a GnRH agonist (GnRH-a) trigger in patients undergoing oocyte cryopreservation in LPS protocols.

Methods
This descriptive case series describes two patients, recently diagnosed with cancer, who underwent oocyte cryopreservation using an LPS protocol and a GnRH-a trigger at a university-affiliated, academic center.

Results
The patients described in our case series both failed to adequately respond to a GnRH-a trigger, based on their serum levels of luteinizing hormone (LH) and progesterone 12 h after their GnRH-a trigger. They both required a single rescue dose of human chorionic gonadotropin (hCG).

Conclusions
These findings highlight the potential risk of a suboptimal response to a GnRH-a trigger in patients undergoing LPS, controlled ovarian stimulation for oocyte cryopreservation. This risk might be attributed to the downregulation of GnRH receptors by elevated serum progesterone levels during the luteal phase. Currently, there is insufficient evidence to recommend for or against the use of a GnRH-a trigger during LPS controlled ovarian stimulation. This case series offers a number of management strategies to mitigate this risk and emphasizes the need for further research in this area.
Estrogen-ERα signaling and DNA hypomethylation co-regulate expression of stem cell protein PIWIL1 in ERα-positive endometrial cancer cells
Authors: Chen Zheng , Yang Hua-Jing , Lin Qin , Zhu Min-Jiao , Yu Ying-Ying , He Xiao-Ying , Wan Xiao-Ping 
Published: June 2020

Abstract
Background
We previously identified PIWIL1 as an oncogene involved in endometrial carcinogenesis. However, the mechanism of Piwil1 mediated regulation of tumorigenesis remains poorly understood.

Methods
The expression levels of target genes in endometrial cancer cells were detected by quantitative reverse transcription-PCR (RT-qPCR) and western blotting. Up- or down-regulation of ERα or PIWIL1 was achieved by transient transfection with expressing plasmids or short hairpin RNA (shRNA). Dual-luciferase reporter assays and chromatin immunoprecipitation (ChIP) were used to demonstrate the ERα bound to the half estrogen response element (half-ERE) located in PIWIL1 promoter. The expression of PIWIL1 and ERα in endometrial carcinoma tissues were investigated using immunohistochemistry and RT-qPCR. The proliferation ability of cancer cells were evaluated by MTT. Methylation status of the PIWIL1 promoter was detected by bisulfite sequencing PCR (BSP).

Results
In the present study, we found that PIWIL1 mediated E2-stimulated cancer cell proliferation. In ERα-positive endometrial cancer cells, we demonstrated that estrogen-ERα signaling significantly up-regulated the expression of PIWIL1, which was mediated by binding of the ERα onto the PIWIL1 promoter. Furthermore, we found that a half-ERE in the PIWIL1 promoter was essential for ERα binding. The PIWIL1 promoter was hypomethylated in ERα-positive endometrial cancer cells. Treatment with 5-aza-deoxycytidine (5-aza-dC) could up-regulate PIWIL1 expression.

Conclusions
These findings uncover a novel molecular mechanism by which estrogen-ERα signaling and DNA hypomethylation co-regulate PIWIL1 expression. These findings provide novel insights into the hormonal regulation of PIWIL1 in endometrial cancer and the PIWIL1’s role in estrogen-stimulated endometrial carcinogenesis.
Does a ketogenic diet as an adjuvant therapy for drug treatment enhance chemotherapy sensitivity and reduce target lesions in patients with locally recurrent or metastatic Her-2-negative breast cancer? Study protocol for a randomized controlled trial
Authors: Wang Yan , Jing Ming-Xi , Jiang Lei , Jia Yu-Feng , Ying E. , Cao Hui , Guo Xiang-Yu , Sun Tao 
Published: June 2020

Abstract
Background
Recent studies have indicated that a ketogenic diet can be used as an adjuvant therapy to enhance sensitivity to chemotherapy and radiotherapy in cancer patients. However, there are no sufficient data and no consistent international treatment guidelines supporting a ketogenic diet as an adjuvant therapy for metastatic breast cancer. Therefore, this trial was designed to observe whether irinotecan with a ketogenic diet can promote sensitivity to chemotherapy and remit target lesions in locally recurrent or metastatic Her-2-negative breast cancer patients.

Methods/design
This trial aims to recruit 518 women with locally recurrent or metastatic breast cancer admitted to the Liaoning Cancer Hospital and Institute (Shenyang, China) in northeast China. All patients will be randomly assigned into the combined intervention group (n = 259) or the control group (n = 259), followed by treatment with irinotecan + ketogenic diet or irinotecan + normal diet, respectively. The primary endpoints are sensitivity to irinotecan and the objective response rate of target lesions; the secondary endpoints include quality of life scores (EORTC QLQ-C30), progression-free survival, overall survival time, incidence of adverse events, and cost-effectiveness. The endpoints will be evaluated at baseline (before drug administration), during treatment, 4 weeks after treatment completion, and every 3months (beginning 2 months after treatment completion).

Discussion
This trial attempts to investigate whether irinotecan treatment with a ketogenic diet for locally recurrent or metastatic breast cancer among women in northeast China can enhance the disease’s sensitivity to chemotherapy and reduce target lesions.

Trial registration
Chinese Clinical Trial Registry, ID: ChiCTR1900024597. Registered on 18 July 2019. Protocol Version: 1.1, 24 February 2017.
A study on parameter estimation and suppression for smeared spectrum jamming based on short-time Fourier transform
Authors: Wu Chuanzhang , Chen Baixiao , Yang Minglei , Dong Mei 
Published: June 2020

AbstractWe address the suppressing problem of smeared spectrum (SMSP) jamming from the mixed signal received by the radar. To this end, we resort to the time-frequency analysis algorithm and give the concrete expression formula of the short-time Fourier transform (STFT) of SMSP jamming. The proposed method is to estimate the parameters of the jamming signal based on the STFT result, and then the jamming signal is reconstructed and suppressed form the mixed signal. In order to perform effective interference even after the pulse compression process, the jamming-to-target ratio (JSR) is always positive. Based on this assumption, the estimation steps for different parameters of SMSP jamming are given, including the number of sub-waveforms, the amplitude, and the time delay. The influence of choosing different window is also considered in this paper. The estimated performance of this method is verified by Monte Carlo simulation, and the results show the effectiveness of the proposed method.
Research on correction algorithm of propagation error in wireless sensor network coding
Authors: Zhang Dongqiu , Pang Mingyong , Zhang Guangzhi , Huang Dandan 
Published: June 2020

AbstractIt is very difficult to deal with the problem of error correction in random network coding, especially when the number of errors is more than the min-cut of the network. We combine a small field with rank-metric codes to solve this problem in this paper. With a small finite field, original errors are compressed to propagated errors, and their number is smaller than the min-cut. Rank-metric codes are introduced to correct the propagated errors, while the minimum rank distance of the rank-metric code is hardly influenced by the small field. It is the first time to correct errors more than the min-cut in network coding with our method using a small field. This new error-correcting algorithm is very useful for the environment such as a wireless sensor network where network coding can be applied.
Lasota–Opial type conditions for periodic problem for systems of higher-order functional differential equations
Authors: Mukhigulashvili Sulkhan , Půža Bedřich 
Published: June 2020

AbstractIn the paper we study the question of solvability and unique solvability of systems of the higher-order functional differential equations $$ u_{i}^{(m_{i})}(t)=\ell _{i}(u_{i+1}) (t)+ q_{i}(t) \quad (i= \overline{1, n}) \text{ for } t\in I:=[a, b] $$ui(mi)(t)=ℓi(ui+1)(t)+qi(t)(i=1,n‾) for t∈I:=[a,b] and $$ u_{i}^{(m_{i})} (t)=F_{i}(u) (t)+q_{0i}(t) \quad (i = \overline{1, n}) \text{ for } t\in I $$ui(mi)(t)=Fi(u)(t)+q0i(t)(i=1,n‾) for t∈I under the periodic boundary conditions $$ u_{i}^{(j)}(b)-u_{i}^{(j)}(a)=c_{ij} \quad (i=\overline{1, n},j= \overline{0, m_{i}-1}), $$ui(j)(b)−ui(j)(a)=cij(i=1,n‾,j=0,mi−1‾), where $u_{n+1}=u_{1} $un+1=u1, $m_{i}\geq 1$mi≥1, $n\geq 2 $n≥2, $c_{ij}\in R$cij∈R, $q_{i},q_{0i}\in L(I; R)$qi,q0i∈L(I;R), $\ell _{i}:C^{0}_{1}(I; R)\to L(I; R)$ℓi:C10(I;R)→L(I;R) are monotone operators and $F_{i}$Fi are the local Caratheodory’s class operators. In the paper in some sense optimal conditions that guarantee the unique solvability of the linear problem are obtained, and on the basis of these results the optimal conditions of the solvability and unique solvability for the nonlinear problem are proved.
Medicinal plants species used by herbalists in the treatment of snakebite envenomation in Uganda
Authors: Okot David Fred , Anywar Godwin , Namukobe Jane , Byamukama Robert 
Published: June 2020

Abstract
Background
There are high mortality and morbidity rates due to poisonous snakebites globally with sub-Saharan Africa having some of the highest cases. However, traditional medicine practitioners (TMP) have been treating snakebites in Uganda for long despite the fact that few studies have been conducted to document such vital and rich indigenous traditional knowledge before it is lost. This study aimed to document the medicinal plant species used by experienced TMP in treating snakebite envenomation in selected post-conflict parts of Uganda. An ethnopharmacological survey was conducted in Kitgum, Serere, Kaberamaido and Kaabong districts in Uganda. Twenty-seven TMP with expertise in treating snakebites were purposively identified using the snowball technique and interviewed using semi-structured questionnaires. Data were analysed using simple descriptive statistics.

Results
Sixty plant species from 28 families were documented with high consensus among the isolated indigenous Ik tribe of Kaabong district. Most of the plant species used were from the Asteraceae and Fabaceae families with eight species each. The genus Echinops was the most well-represented with three species. The most commonly used plant species were of citation were Steganotaenia araliaceae (16), Microglossa pyrifolia (Lam.), Gladiolus dalenii Van Geel (13), Aframomum mildbraedii Loes. (11), Jasminum schimperi Vatke and Cyathula uncinulata (Schrad) Schinz (10) and Crinum macowanii Baker and Cyphostemma cyphopetalum (Fresen.) Desc. ex Wild & R.B. Drumm (10). S. araliaceae which was mentioned by all the TMP in the Ik community was used for first aid. Most of the plant species were harvested from the wild (68.75%) and were herbs (65.0%) followed by trees (23.3%). The most commonly used plant parts were roots (42.6%) and leaves (25.0%). Thirteen different methods of preparation and administration were used. Most of the medicines were administered orally (61.2%) and topically (37.6%). The commonest methods of oral application were cold water infusions (32.5%) and decoctions (21.7%).

Conclusions
TMP widely use several medicinal plant species for treating snakebite envenomation in the selected post-conflict regions of Uganda
Sex Differences in 11-Oxygenated Androgen Patterns Across Adulthood
Authors: Davio Angela , Woolcock Helen , Nanba Aya T , Rege Juilee , O’Day Patrick , Ren Jianwei , Zhao Lili , Ebina Hiroki , Auchus Richard , Rainey William E , Turcu Adina F 
Published: June 2020

Abstract

Context
The gonads are the major source of sex steroids during reproductive ages. The gonadal function declines abruptly in women and gradually in men. The adrenals produce 11-oxygenated androgens (11-oxyandrogens), which start rising during adrenarche. Following menopause, 11-oxyandrogens levels remain similar to reproductive ages.

Objective
To compare the circulating 11-oxyandrogen concentrations in men and women across adult ages.

Methods
We used mass spectrometry to measure testosterone (T), androstenedione (A4), 11β-hydroxytestosterone (11OHT), 11-ketotestosterone (11KT), 11β-hydroxyandrostenedione (11OHA4), 11-ketoandrostenedione (11KA4), cortisol, and cortisone in morning sera obtained from adults in outpatient setting. We performed double immunofluorescence of 3β-hydroxysteroid dehydrogenase type 2 and cytochrome b5 in adrenal tissue from 19 men, age 23–78 years.

Results
We included 590 patients (319 men), aged 18 to 97 years, and 84% white. 11KT and 11KA4 were stable across ages in women, but they declined in men (0.21 and 0.06 ng/dL/year, respectively; P &lt; 0.05). 11OHA4 and 11OHT increased modestly with age in women (0.6 and 0.09 ng/dL/year, respectively; P &lt; 0.01), and both remained stable across ages in men. As body mass index (BMI) increased, 11KA4 decreased in women, and 11KT increased in men, both suggesting higher 17β-hydroxysteroid dehydrogenase activity in obese individuals. A4 and T declined with age and A4 with BMI in both sexes; T declined with BMI in men. Adrenal androgenic enzyme expressions in aging men were similar to those observed in women.

Conclusions
In contrast with traditional androgens, the production of 11OHA4 and 11OHT is sustained with aging in both sexes. The bioactive androgen 11KT declines in aging men but not in women.