bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adapting Breastfeeding Support in Areas of Socio-Economic Deprivation: A Case Study Approach.
Authors: Hunt Louise , Thomson Gill , Whittaker Karen , Dykes Fiona 
Published: November 2020

Abstract
Background: There are inequalities in breastfeeding initiation and continuation rates, whereby socio-economically disadvantaged mothers are least likely to breastfeed. Breastfeeding peer support (BPS) interventions are recommended as a solution, and in the UK non-profit organisations are commissioned to deliver BPS services in areas of socio-economic deprivation. BPS interventions have a mixed evidence base, offering limited knowledge about the interaction between context and intervention and how this affects women’s experiences. Methods: This interpretive study used a case study methodology to explore how and why two BPS services developed their services in socio-economically deprived contexts. Methods aimed to generate holistic understanding of BPS service development. Data collected across both cases comprised; observation (n=1), and semi-structured interviews with: mothers who had (n=10) and had not (n=9) engaged with the BPS services, peer supporters (PSs) (n=9), community health professionals (n=5), infant feeding co-ordinators (n=2), non-profit organisation managers (n=3), and public health commissioners (n=2). Inductive grounded theory analytic techniques of open coding and constant comparisons, followed by cross case comparisons, were used to analyse the data. Results: The over-arching theme - ‘the transcending influence of society’ – offers insights into the underlying context and drivers impacting service development. It reflects how funding and data sharing arrangements determined service operation and the peer’s access to women. Four underpinning themes explain how: peer supporters were resourceful in adapting their services (‘adapting and modifying the support’); BPS organisations worked to enable women’s access to supportive breastfeeding environments, but did not necessarily focus service development on the needs of women living in areas of deprivation (‘supporting women’s journeys to access’); the BPS-professional connections for supporting access and how BPS could result in more supportive community environments (‘building relationships’); and how management practices precluded meaningful use of data to provide context led service development (‘ways of using knowledge’). Conclusions: Findings suggest that while PSs are commissioned to focus on those most in need, there is limited discussion, collection, or use of knowledge about women’s lives to develop needs-led service delivery. The key recommendation is the development of a social ecological tool to facilitate the use and application of contextual knowledge.
Inequalities in Access to Medicines for Chronic Diseases in Different Regions of Brazil: A Population-Based Study.
Authors: Miranda Vanessa , Schäfer Antônio Augusto , Tomasi Cristiane Damiani , Soratto Jacks , Meller Fernanda de Oliveira , Silveira Marysabel Pinto Telis 
Published: November 2020

Abstract
ObjectiveTo analyze the economic and regional inequalities in access to medicines for diabetes and hypertension among the adult population in Brazil.MethodsThis was a cross-sectional study with adults aged 18 and over from the VIGITEL study conducted in 2019 in all Brazilian regions. Non-access to antidiabetic and antihypertensive drugs was assessed according to education and housing macro-region. The slope index of inequality (SII) was used to analyze the absolute inequalities.ResultsThe total number of individuals interviewed was 52,443. Approximately 10.0% of people with diabetes and/or hypertension reported not having access to drug treatment. For antihypertensive drugs, the main means of obtaining it in all regions was the private pharmacy, and for antidiabetics, the North had greater access through private pharmacies, while the Northeast, Southeast and South had greater access through public setor. Inequalities were found in the lack of access to medicines according to the region of residence, mainly for the North region.ConclusionThe lack of access to medicines showed regional disparities, mainly in the most economically vulnerable regions.
Inequalities in Cognitive Impairment Among Older Adults in China and the Associated Social Determinants: A Decomposition Approach
Authors: Deng Qingwen , Liu Wenbin 
Published: November 2020

Abstract
BackgroundDespite there is growing evidence focusing on health inequalities in China, socioeconomic inequalities in cognitive impairment among older adults have received little attention. This study aims to measure socioeconomic inequalities in cognitive impairment among Chinese older adults, and determine the contributing social factors to the inequalities.MethodsA cross-sectional analysis was performed using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a total of 10556 older adults aged 65 and over were included in the study. The prevalence of cognitive impairment was measured by using the Chinese version of the Mini-Mental State Examination. The socioeconomic inequalities in cognitive impairment were illustrated and quantified by the concentration curve and normalized concentration index. Multivariate logistic regression was conducted to identify the associated factors of cognitive impairment. And decomposition analysis was further applied to decompose the contribution of each determinant to the observed inequalities in cognitive impairment.ResultsThe study indicated that the prevalence of cognitive impairment among Chinese older adults was 18.95%. The overall concentration index for cognitive impairment was − 0.046, which suggested a higher concentration of cognitive impairment among socioeconomically disadvantaged older adults. The results showed the prevalence of cognitive impairment was associated with sex, age, marital status, education level, occupation, economic status, emotional support, financial support, living arrangement, and participation in informal activities. Decomposition results further revealed the contributions of the determinants to the inequalities in cognitive impairment. Specifically, age (131.61%), marital status (85.68%), emotional support (84.85%), education level (39.73%), occupation (21.24%), sex (17.25%), financial support (− 4.19%), economic status (1.02%), living arrangement (0.88%), and informal activities (0.30%) have varying degrees of contributions to the inequality in cognitive impairment.ConclusionThis study sheds light on the pro-rich inequality in cognitive impairment among older adults in China. It suggests that policymakers should pay more attention to older adults who are female, old-old, widowed, illiterate, economically disadvantaged, have no social support, and are less socially involved. Also, more targeted interventions should be undertaken to improve the socioeconomic conditions of these vulnerable individuals and their ability to cope with the risk of cognitive impairment.
4-Hexylresorcinol Inhibits Osteoclastogenesis by Suppressing NF‐κB Signaling Pathway and Reverses Bone Loss in Ovariectomized Mice
Authors: Yi Wenkai , Liu Tao , Gao Xinfeng , Xie Yonghua , Liu Ming 
Published: November 2020

Abstract
Background: 4-Hexylresorcinol is a small organic compound that is widely used as additive antiseptic and antioxidant. In the present study, we investigated its role in osteoclastogenesis. Methods: Bone marrow-derived macrophages were used to test the role of 4-Hexylresorcinol on osteogenesis. Ovariectomy model was created to examine the effect of 4-Hexylresorcinol in vivo. Results: In this study 4-Hexylresorcinol effectively suppressed RANKL‐induced osteoclastogenesis in a dose‐dependent manner. It also significantly suppressed the expression of osteoclast‐specific markers including tartrate‐resistant acid phosphatase, cathepsin K, nuclear factor of activated T‐cells cytoplasmic 1 and c‐Fos. Furthermore, it inhibited osteoclastogenesis by inhibiting activation of NF‐κB signaling pathway. Consistent with in vitro results, 4-Hexylresorcinol effectively ameliorated ovariectomy surgery induced bone loss and profoundly reduced osteoclast number in vivo. Conclusions: Overall, our results suggested that 4-Hexylresorcinol may be a novel therapeutic approach for osteoporosis treatment.
Artificial Neural Networks (ANNs) and Response Surface Methodology (RSM) Approach for Modeling and Optimization of Pectin Extraction from Banana Peel
Authors: AKLILU ERMIAS GIRMA 
Published: November 2020

Abstract
The present study, the influence of three independent variables for extraction of pectin were investigated and optimized using artificial neural network and response surface methodology on the yield and degree of esterification of banana peel pectin obtained using acid extraction method. The results revealed that properly trained artificial neural network model is found to be more accurate in prediction as compared to response surface method model. The optimum conditions were found to be temperature of 82oC, pH of 2 and extraction time of 102 min in the desirable range of the order of 0.977. The yield of pectin and degree of esterification under these optimum conditions was 15.64% and 65.94, respectively. Temperature, extraction time and pH revealed a significant (p < 0.05) effect on the pectin yield and degree of esterification. The extracted banana peel pectin was categorized as high methoxyl pectin, based on the high methoxyl content and degree of esterification. In general, the findings of the study show that banana peel can be explored as a promising alternative for the commercial production of pectin.
Energy Devices Safety and Impact on Video-assisted Thoracoscopic Lung Lobectomy Postoperative Course: Monopolar Electrocautery Versus Ultrasonic Dissector
Authors: Cattoni Maria , Rotolo Nicola , Nardecchia Elisa , De Maio Silvia , Dominioni Lorenzo , Imperatori Andrea 
Published: November 2020

Abstract
Background This study aims to compare safety and impact of monopolar electrocautery and ultrasonic dissector (Harmonic ACE Plus®) on postoperative short-term outcomes after video-assisted thoracoscopic (VATS) lobectomy and lymphadenectomy for lung cancer.Methods We retrospectively analyzed prospectively collected data of 140 consecutive patients [59% male; median age: 71(IQR:62-76) years] undergoing VATS lobectomy and lymphadenectomy in our institution between October 2016 and November 2019. Patients were divided in two groups based on device used: monopolar electric hook in 79 cases (Group A); ultrasonic dissector in 61(Group B). Energy instrument-related intraoperative accidents, hemothorax/chylothorax incidence, total pleural effusion volume at 48 postoperative hours and chest tube duration were compared between groups. Multivariable analysis was performed to test energy device as possible independent risk factor for increased pleural effusion volume or for prolonged chest tube duration.Results No intraoperative accidents due to energy device occurred. No hemothorax was recorded. Chylothorax incidence was slightly higher in Group A (2.5% vs 0%; p-value=0.21). Total pleural effusion volume at 48 hours was significantly higher in Group B: 400 (285-500) vs 255 (150-459) ml (p-value=0.005). Chest tube duration was similar in the two groups: 5 (3-9) vs 5 (3-8) days (p-value=0.77). At multivariable analysis the energy device used was not associated with increased pleural effusion volume (p-value=0.43) nor with prolonged chest tube duration (p-value=0.20).Conclusions Monopolar electrocautery and Harmonic ACE Plus® were safe and had a similar impact on short-term outcomes after VATS lobectomy and lymphadenectomy, suggesting that energy devices choice could be left to surgeon’s preference.
The Effect of Multi-Component Interventions on the Incidence Rate, Severity, and Duration of Post Open Heart Surgery Delirium among Hospitalized Patients
Authors: Tehranineshat Banafsheh , Hosseinpour Nima , Mani Arash , Rakhshan Mahnaz 
Published: November 2020

Abstract
Background: Delirium is one of the prevalent complications of post open heart surgery. The present research aimed to assess the effect of multi-component interventions on the incidence rate, severity, and duration of post open heart surgery delirium among hospitalized patients.Methods: In this quasi-experimental study, 96 patients under open heart surgery were selected using convenience sampling and were divided into a control and an intervention group. The interventions included patients’ preoperative education, nurses’ education, and intra-ward environmental interventions. The demographic information and Mini-Mental State Examination (MMSE) questionnaires were completed a day before surgery. The patients in both groups were also surveyed after extubation until the fourth day post operation using Delirium Observation Screening (DOS) scale considering the incidence, severity, and duration of delirium. The data were analyzed using the SPSS statistical software, version 20.Results: The incidence rate of delirium was 14.6% and 6.2% in the control and intervention groups, respectively (p>0.05). Besides, the mean severity of delirium was 0.53 in the control group and 0.40 in the intervention group (p>0.05). Finally, the mean duration of delirium was 4.5 and 3.25 hours in the two groups, respectively (p>0.05).Conclusions: Since prevention of delirium can play a considerable role in patients’ recovery after heart surgery, it is necessary to carry out some measures to prevent such complications. Even though the interventions performed in this study did not cause significant changes in this regard, the results suggested that prevention interventions should be performed with stronger and more integrated planning for achieving better outcomes.
The role of nickel-titanium shape memory alloy embracing fixator in determination of the implantation angle of hip tumor prosthesis stem following tumor resection and the analysis of its efficacy ： a retrospective study
Authors: Wang Yang , Zhou Panyu , Xia Demeng , Wang Yunyun , Wang Sheng , Zhang Hongyue , Xu Shuogui 
Published: November 2020

Abstract
Background: To explore the role of nickel-titanium(NiTi) shape memory alloy embracing fixator in determination of implantation angle of hip tumor prosthesis stem and analyze its efficacy. Methods: 36 patients with proximal femur tumor were treated with extended tumor resection and prosthetic replacement. 14 patients received prosthetic replacements with the embracing fixators fixing between the junction of the prosthesis stem and the femur temporarily, while the other 22 patients received the same replacements but without the fixators. Following aspects were compared: occurrence of complications, limb function and active hip ROM.Results: There are fewer cases of hip dislocation in the group received prosthetic replacements with the use of embracing fixators. Occurrence of deep infection presented no difference between the two groups. Better limb function and higher active range of motion (ROM) on abduction or flexion were also found in the group using embracing fixators. Conclusion: Ni-Ti shape memory alloy embracing fixator plays a key part in assisting the accurate implantation angle of the prosthesis stem in the prosthetic replacement. The prosthesis stem can be adjusted to the optimal angle with the help of the embracing fixator. Patients have lower chance of dislocation, better limb function, and higher active hip ROM. Trial registration: retrospectively registered.
Overexpressed Pseudogene MT1L Associated with Tumor Immune Infiltrates and Indicates a Worse Prognosis in BLCA
Authors: Ding Yanpeng , Liu Nuomin , Chen Mengge , Xu Yulian , Fang Sha , Xiang Wenbin , Hua Xinying , Chen Gaili , Zhong Yahua , Yu Haijun 
Published: November 2020

Abstract
Background BLCA is common cancer worldwide, aggressive, and fatal. Immunotherapy (ICT) has achieved an excellent curative effect in BLCA; however, only part of these patients can benefit from ICT treatment. MT1L belongs to pseudogene, and a previous study has suggested that MT1L can be used as an indicator of prognosis in colorectal cancer. However, the role of MT1L in BLCA has not yet been illuminated. Methods Data was collected from TCGA, and logistic regression, Kaplan-Meier Plotter, and multivariate Cox analysis have been performed to demonstrate the correlation between pseudogene MT1L and prognosis in BLCA. To identify the association of MT1L with tumor-infiltrating immune cells, TIMER and TISIDB were utilized. And GSEA was performed to illuminate the potential biologic function. Results The expression of MT1L was decreased in BLCA. And it is positively connected with immune cells, like Tregs(ρ=0.708) and MDSCs(ρ=0.664). We also confirmed that MT1L is related to typical markers of immune cells，like PD-1, CTLA-4. Besides, the high MT1L expression level is related to the high stage of T, N, and the high grade in BLCA and the increased expression of MT1L was significantly associated with the shorter OS of BLCA patients (P<0.05). Multivariate Cox analysis revealed that MT1L expression could be an independent prognostic factor of BLCA. Conclusion Collectively, our findings demonstrated that pseudogene MT1L regulates the immune microenvironment, correlates with poor survival, and serves as an independent prognostic biomarker in BLCA.
MiR-10a-5p regulates proliferation, apoptosis and cell cycle of NPM1-mutated acute myeloid leukemia cells by targeting SHANK3
Authors: Chen Sangsang , Cheng Ling 
Published: November 2020

Abstract
Objective: Although NMP1 mutation plays a crucial role in regulating the occurrence and development of acute myeloid leukemia (AML), there is still a lack of effective means to improve the prognosis of AML. Studies showed that miR-10a-5p is significantly highly expressed in leukemia and other cancers. However, the function and mechanism of miR-10a-5p in NPM1-mutated AML remain unclear. Methods: The differential expression of miRNAs and mRNAs related to AML from GEO database were analyzed by bioinformatics. NPM1-mutated AML cell lines were constructed, while miR-10a-5p and SHANK3 were overexpressed to analyze cell proliferation, apoptosis and cell cycle. The targeting relationship between SHANK3 and miR-10a-5p was predicted by bioinformatics and further validated by dual luciferase assay. Results: Bioinformatics analysis on NPM1-mutated AML samples revealed that miR-10a-5p was highly expressed while SHANK3 was poorly expressed, and miR-10a-5p might target to regulate SHANK3 expression. Overexpression of miR-10a-5p promoted the proliferation, inhibited the apoptosis and regulated the cell cycle of NPM1-mutated AML cells, while opposite results were observed when SHANK3 was overexpressed. Collectively, miR-10a-5p regulated the proliferation, apoptosis and cell cycle of NPM1-mutated AML cells partially by inhibiting SHANK3 expression. Conclusion: These results demonstrate the role of miR-10a-5p/SHANK3 in NPM1-mutated AML, which provides a potential method for prognosis prediction of AML patients.
Instrument Development and Validation of the Comprehensive Ability of Older People Assessment scale
Authors: Li Weitong , Zhu Yuan , Chen Yujing , Pu Yalou , Xu Guihua 
Published: November 2020

Abstract
Background: At present, many aging assessment instruments have been developed at home and abroad, but the quality of care service in China's pension institutions is uneven, and there is still a lack of a unified tool for assessing the ability of the elderly uesd by evaluators of long-term care institutions.Method: The Comprehensive Ability of Older People Assessment scale was completed by a sample of 971 older people from 4 long-term care facilities in China and the data were collected between April 2018-December 2019. One-way analysis of variance and multiple regression analysis were used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach’s alpha and homogeneity evaluation using corrected item-total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, with correlation analysis used to perform reverse verification.Results: Factor analysis yielded 40 items with six dimensions, including ‘Mentation and cognitive,’ ‘Perception and communication,’ ‘Emotional problems,’ ‘Mental and behavioral problems,’ ‘Daily life and social participation,’ and ‘Skin and oral status’. The Cronbach’s α was 0.951 while the dimensions show a Cronbach’s α 0.760–0.946. The rationality and scientificity of the scale was proved by the correlation analysis of reverse validation.Conclusion: The 4-grade Comprehensive Ability of Older People Assessment Scale had good validity and reliability and should be considered for institutional assessors.
Substitution of Citrate with Tissue Plasminogen Activator (rt-PA) for Catheter Lock Does Not Improve Patency of Tunneled Hemodialysis Catheters in a Randomized Trial
Authors: Richtrova Pavlina , Mares Jan , Kielberger Lukas , Klaboch Jan , Eiselt Jaromir , Reischig Tomas 
Published: November 2020

Abstract
Background: The study aim was to establish if substitution of citrate with rt-PA for catheter lock once weekly can reduce the incidence of catheter-related blood stream infections (CR-BSI) or improve patency of tunneled hemodialysis catheters.Methods: All incident patients undergoing insertion of a tunneled hemodialysis catheter were screened and included except those suffering infection or using oral anticoagulation. Study participants were randomized into two arms according to the solution applied as catheter lock: receiving either trisodium citrate (Citra-LockTM 4%) only or rt-PA (Actilyse® 1mg/ml) on the middle session each week with citrate used on the first and third sessions. The incidence of CR-BSI (confirmed by positive blood culture), catheter non-function (complete obstruction), and malfunction (blood flow <250ml/min) was recorded. Statistical significance was tested with ANOVA, post hoc analysis was performed by means of multiple linear regression.Results: Totally, 18 patients were included and followed during 655 hemodialysis sessions. No episode of CR-BSI was detected while 6 catheter non-functions (0.9% sessions) and 101 malfunctions (15.4% sessions) were recorded. The incidence of both events was equal between the study arms: 4 non-functions and 55 malfunctions in the rt-PA arm and 2 non-functions and 46 malfunctions in the citrate arm (p=0.47 and p=0.24, respectively). Additionally, the mean blood flow achieved did not differ significantly between the arms: 326±1,8 and 326±1,9 ml/min (p=0.95) in rt-PA and citrate arms, respectively. Post hoc analysis identified time elapsed since previous session (β=0.12, p=0.005) and malfunction on previous session (β=0.25, p<0.001) as significant factors affecting the occurrence of malfunction. By contrast, the study arm, rt-PA application on previous session, and catheter vintage did not enter the model.Conclusion: Substitution of citrate with rt-PA for catheter lock does not reduce the incidence of catheter malfunction neither does it affect the blood flow achieved during hemodialysis. Catheter patency is related rather to the time interval between sessions and to previous malfunction (thus probably reflecting undefined individual factors). The incidence of CR-BSI within pre-selected hemodialysis population is sporadic (less than 1 per 4.3 patient years in our sample).Trial registration: The study was registered on the ACTRN 12612000152820