bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of social participation on health among middle-aged and elderly adults Evidence from longitudinal survey data in China
Authors: Ma Xinxin , Piao Xiangdan , Oshio Takashi 
Published: February 2020

Abstract

Background: Social participation (SP) is known to have a favourable impact on health. However, studies on this issue have been conducted mainly in advanced countries, and results in China have been mixed. This study examined the impact of SP on health outcomes of middle-aged and elderly adults in China, adjusted for simultaneity and heterogeneity biases.

Methods: In total, 57,417 observations of 28,935 individuals obtained from the population-based, three-wave panel survey, Chinese Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015 were used. The associations between one- or two-wave-lagged SP and health outcomes (mental health, self-rated health [SRH], activities of daily living [ADL], and diagnosed diseases) were examined by linear regression models. Individual-level heterogeneity was addressed by the random-effects estimation method.

Results: SP was found to have a positive impact on mental health and ADL. Specifically, one-wave-lagged SP improved mental health measure (range: 10–70) by 0.820 (standard error [SE]: 0.199, p < 0.001), the basic ADL measure (range: 6–24) by 0.147 (SE: 0.043, p < 0.001), and the instrumental ADL measure (range: 5–20) by 0.159 (SE: 0.035, p < 0.001). In contrast, SP did not significantly affect SRH or diagnosed diseases. The impact of SP differed by SP type; playing Mah-jong (Chinese traditional game), chess, or cards, or going to the community club had the most favourable effect. The impact of SP on health was also greater for women than men and greater for individuals aged 60–69 years than those aged 45–59 years and aged 70 and older.

Conclusions: SP had a positive, albeit selective, impact on health outcomes among middle-aged and elderly adults in China. The results suggest that policy measures to encourage these individuals to engage in SP are needed to enhance their health.
A hybrid cost-sensitive ensemble for heart disease prediction
Authors: Qi Zhenya , Zhang Zuoru 
Published: February 2020

Abstract
Heart disease is the primary cause of morbidity and mortality in the world. It includes numerous problems and symptoms. The diagnosis of heart disease is difficult because there are too many factors to analyze. What's more, the misclassification cost could be very high. In this paper, I firstly propose a cost-sensitive ensemble model to improve the accuracy of diagnosis and reduce the misclassification cost. The proposed model contains five heterogeneous classifiers: random forest, logistic regression, support vector machine, extreme learning machine and k-nearest neighbor. Then, experiments are done on three datasets from UCI machine learning repository. The highest classification accuracy of 91.74%, highest G-mean of 90.55%, highest precision of 96.11%, highest recall of 89.61% and lowest misclassification cost of 30.32% are achieved by the proposed model according to ten-fold cross validation. The results demonstrate that the performance of the proposed model is superior to those of previously reported classification techniques.
Serum Hepcidin, the Hepcidin/Ferritin Ratio and the Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis
Authors: Karamzad Nahid , Eftekhari Aziz , Ashrafi-Asgarabad Ahad , Sullman Mark J.M. , Sahebkar Amirhossein , Safiri Saeid 
Published: February 2020

Objectives:
To perform a meta-analysis on the relationship type 2 diabetes has with serum
hepcidin and the hepcidin/ferritin ratio.

Methods:
The following databases were searched using all relevant keywords: Web of Science, Medline,
Scopus, Embase and Google Scholar. All studies that examined the relationship type 2 diabetes
has with serum hepcidin or the hepcidin/ferritin ratio were included in this meta-analysis and systematic
review provided, were published in English between 2011 and 2018. A random-effects model was
used to pool the standardized mean difference (SMD).

Results:
The SMD of serum hepcidin among patients with type 2 diabetes and healthy controls were
compared across eight studies (n cases=878; n controls=2306). The pooled SMD of serum hepcidin did not
differ significantly between study groups (SMD: 0.04; 95% confidence interval (CI): -0.29 to 0.35). In
contrast, the serum hepcidin/ferritin ratio was examined across five studies (n cases=229; n controls=1426)
and was found to be negatively associated with the risk of type 2 diabetes (SMD: -0.52; 95% confidence
interval (CI): -0.85 to -0.19). There was no publication bias found for the associations serum
hepcidin (Egger´s test: P =0.97) or the hepcidin/ferritin ratio (Egger´s test: P =0.75) had with type 2
diabetes.

Conclusions:
Although hepcidin has been proposed as a risk marker for type 2 diabetes, our metaanalysis
found that the hepcidin/ferritin ratio was superior to hepcidin alone as a risk marker.
Pisosterol Induces G2/M Cell Cycle Arrest and Apoptosis via the ATM/ATR Signaling Pathway in Human Glioma Cells
Authors: Ferreira Wallax A.S. , Burbano Rommel R. , do Ó. Pessoa Claudia , Harada Maria L. , do Nascimento Borges Bárbara , de Oliveira Edivaldo H. Correa 
Published: February 2020

Background:
Pisosterol, a triterpene derived from Pisolithus tinctorius, exhibits potential antitumor
activity in various malignancies. However, the molecular mechanisms that mediate the pisosterol-specific effects
on glioma cells remain unknown.

Objective:
This study aimed to evaluate the antitumoral effects of pisosterol on glioma cell lines.

Methods:
The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) and trypan blue exclusion
assays were used to evaluate the effect of pisosterol on cell proliferation and viability in glioma cells. The effect
of pisosterol on the distribution of the cells in the cell cycle was performed by flow cytometry. The expression
and methylation pattern of the promoter region of MYC, ATM, BCL2, BMI1, CASP3, CDK1, CDKN1A,
CDKN2A, CDKN2B, CHEK1, MDM2, p14ARF and TP53 was analyzed by RT-qPCR, western blotting and bisulfite
sequencing PCR (BSP-PCR).

Results:
Here, it has been reported that pisosterol markedly induced G2/M arrest and apoptosis and decreased
the cell viability and proliferation potential of glioma cells in a dose-dependent manner by increasing the expression
of ATM, CASP3, CDK1, CDKN1A, CDKN2A, CDKN2B, CHEK1, p14ARF and TP53 and decreasing
the expression of MYC, BCL2, BMI1 and MDM2. Pisosterol also triggered both caspase-independent and
caspase-dependent apoptotic pathways by regulating the expression of Bcl-2 and activating caspase-3 and p53.

Conclusions:
It has been, for the first time, confirmed that the ATM/ATR signaling pathway is a critical mechanism
for G2/M arrest in pisosterol-induced glioma cell cycle arrest and suggests that this compound might be a
promising anticancer candidate for further investigation.
Design and Development of Lomustine Loaded Chitosan Nanoparticles for Efficient Brain Targeting
Authors: Anand Anupriya , Iyer Bharadhwaj Ramesh , Ponnusamy Chandrasekar , Pandiyan Rajesh , Sugumaran Abimanyu 
Published: February 2020

Aim:
The present research work discussed the preparation of lomustine loaded with
chitosan nanoparticles (LNCp) by ionic gelation method with homogenization using the design on
experiments by Box-Behnken design.

Methods:
The nanoparticles are evaluated by particle size, zeta potential, surface morphology, drug
content, entrapment efficiency and in-vitro drug release.

Results:
The FT-IR results support that drug have no interaction with excipients, which are used in
the preparation of nanoparticle. The particle size, drug content and encapsulation efficiency of the
developed nanoparticles ranged from 190 to 255 nm, 80.88% to 94.02%, and 77.12 to 88.74%, respectively.
The drug release rate is diffusion-controlled over 8 hours. The F-value for all of the responses
shows that the models are significant. The p-value, less than 0.05 for all the responses reveals
the significance of the models. Graphical optimisation is done by desirability plot and overlay
plot, which contains optimal values of independent variables with the desirability of 1.

Conclusion:
In conclusion, the results suggested that the optimised lomustine loaded chitosan nanoparticles
are useful for brain targeting hence hold the potential for further research and clinical application.
Evaluation of the Antioxidant and Antidiabetic Potential of the Poly Herbal Formulation: Identification of Bioactive Factors
Authors: Uddandrao V.V. Sathibabu , Brahmanaidu Parim , Ganapathy Saravanan 
Published: February 2020

Background & Objectives:The present investigation is intended to prepare a Poly Herbal Formulation (PHF) with Piper nigrum (fruits), Terminalia paniculata (bark) and Bauhinia purpurea (bark) and assess their antioxidant and glucose-lowering effects utilizing in vitro models.Methods:The individual plant methanolic extracts and PHF are exposed to phytochemical examination and to distinguish the bioactive factors by GC-MS. We assessed the antioxidant properties of individual plant extracts and the PHF by using the DPPH scavenging method, H2O2 scavenging assay, TBARS assay and total antioxidant estimation. Likewise, the anti-diabetic activity was assessed by ɑ-amylase and α-glucosidase enzyme inhibition and glucose diffusion inhibitory techniques.Results:We found that PHF contains a high measure of total phenolics, total flavonoids and tannin compared to individual plant extracts. The GC-MS identified the bioactive components. We also found that PHF had significantly higher antioxidant and glucose-lowering effects than the individual plant concentrates.Conclusion:In conclusion, it could be reasoned that due to the nearness of antioxidant components, the PHF has good potential in the administration of hyperglycemia, diabetes and the related state of oxidative stress. This study shows that PHF is superior to individual plant extracts, supporting the conventional PHF concept.
Use of the Healthy Lifestyle Coaching Chatbot App to Promote Stair-Climbing Habits Among Office Workers: Exploratory Randomized Controlled Trial
Authors: Piao Meihua , Ryu Hyeongju , Lee Hyeongsuk , Kim Jeongeun 
Published: February 2020

Background
Lack of time for exercise is common among office workers given their busy lives. Because of occupational restrictions and difficulty in taking time off, it is necessary to suggest effective ways for workers to exercise regularly. Sustaining lifestyle habits that increase nonexercise activity in daily life can solve the issue of lack of exercise time. Healthy Lifestyle Coaching Chatbot is a messenger app based on the habit formation model that can be used as a tool to provide a health behavior intervention that emphasizes the importance of sustainability and involvement.

Objective
This study aimed to assess the efficacy of the Healthy Lifestyle Coaching Chatbot intervention presented via a messenger app aimed at stair-climbing habit formation for office workers.

Methods
From February 1, 2018, to April 30, 2018, a total of 106 people participated in the trial after online recruitment. Participants were randomly assigned to the intervention group (n=57) or the control group (n=49). The intervention group received cues and intrinsic and extrinsic rewards for the entire 12 weeks. However, the control group did not receive intrinsic rewards for the first 4 weeks and only received all rewards as in the intervention group from the fifth to twelfth week. The Self-Report Habit Index (SRHI) of participants was evaluated every week, and the level of physical activity was measured at the beginning and end of the trial. SPSS Statistics version 21 (IBM Corp) was used for statistical analysis.

Results
After 4 weeks of intervention without providing the intrinsic rewards in the control group, the change in SRHI scores was 13.54 (SD 14.99) in the intervention group and 6.42 (SD 9.42) in the control group, indicating a significant difference between the groups (P=.04). When all rewards were given to both groups, from the fifth to twelfth week, the change in SRHI scores of the intervention and control groups was comparable at 12.08 (SD 10.87) and 15.88 (SD 13.29), respectively (P=.21). However, the level of physical activity showed a significant difference between the groups after 12 weeks of intervention (P=.045).

Conclusions
This study provides evidence that intrinsic rewards are important to enhance the sustainability and effectiveness of an intervention. The Healthy Lifestyle Coaching Chatbot program can be a cost-effective method for healthy habit formation.

Trial Registration
Clinical Research Information Service KCT0004009; https://tinyurl.com/w4oo7md
The Use of Internet-Based Health and Care Services by Elderly People in Europe and the Importance of the Country Context: Multilevel Study
Authors: Merkel Sebastian , Hess Moritz 
Published: February 2020

Background
Digital health care is becoming increasingly important, but it has the risk of further increasing the digital divide, as not all individuals have the opportunity, skills, and knowledge to fully benefit from potential advantages. In particular, elderly people have less experience with the internet, and hence, they are in danger of being excluded. Knowledge on the influences of the adoption of internet-based health and care services by elderly people will help to develop and promote strategies for decreasing the digital divide.

Objective
This study examined if and how elderly people are using digital services to access health and social care. Moreover, it examined what personal characteristics are associated with using these services and if there are country differences.

Methods
Data for this study were obtained from the Special Eurobarometer 460 (SB 460), which collected data on Europeans’ handling of and attitudes toward digital technologies, robots, and artificial intelligence, including data on the use of internet-based health and social care services, among 27,901 EU citizens aged 15 years or older. Multilevel logistic regression models were adopted to analyze the association of using the internet for health and social care services with several individual and country-level variables.

Results
At the individual level, young age, high education, high social class, and living in an urban area were positively associated with a high probability of using internet-based health and social services. At the country level, the proportion of elderly people who participated in any training activity within the last month was positively associated with the proportion of elderly people using these services.

Conclusions
The probability of using internet-based health and social services and their accompanying advantages strongly depend on the socioeconomic background. Training and educational programs might be helpful to mitigate these differences.
A Questionnaire for Assessing User Satisfaction With Mobile Health Apps: Development Using Rasch Measurement Theory
Authors: Melin Jeanette , Bonn Stephanie Erika , Pendrill Leslie , Trolle Lagerros Ylva 
Published: February 2020

Background
Mobile health (mHealth) apps offer great opportunities to deliver large-scale, cost-efficient digital solutions for implementing lifestyle changes. Furthermore, many mHealth apps act as medical devices. Yet, there is little research on how to assess user satisfaction with an mHealth solution.

Objective
This study presents the development of the mHealth Satisfaction Questionnaire and evaluates its measurement properties.

Methods
Respondents who took part in the Health Integrator Study and were randomized to use the Health Integrator smartphone app for lifestyle changes (n=112), with and without additional telephone coaching, rated their satisfaction with the app using the new 14-item mHealth Satisfaction Questionnaire. The ratings were given on a 5-point Likert scale and measurement properties were evaluated using Rasch measurement theory (RMT).

Results
Optimal scoring was reached when response options 2, 3, and 4 were collapsed, giving three response categories. After omitting two items that did not fit into the scale, fit residuals were within, or close to, the recommended range of ±2.5. There was no differential item functioning between intervention group, age group, or sex. The Person Separation Index was 0.79, indicating that the scale’s ability to discriminate correctly between person leniency was acceptable for group comparisons but not for individual evaluations. The scale did not meet the criterion of unidimensionality; 16.1% (18/112) of the respondents were outside the desired range of −1.96 to 1.96. In addition, several items showed local dependency and three underlying dimensions emerged: negative experiences, positive experiences, and lifestyle consequences of using the mHealth solution.

Conclusions
In times where mHealth apps and digital solutions are given more attention, the mHealth Satisfaction Questionnaire provides a new possibility to measure user satisfaction to ensure usability and improve development of new apps. Our study is one of only a few cases where RMT has been used to evaluate the usability of such an instrument. There is, though, a need for further development of the mHealth Satisfaction Questionnaire, including the addition of more items and consideration of further response options. The mHealth Satisfaction Questionnaire should also be evaluated in a larger sample and with other mHealth apps and in other contexts.

Trial Registration
ClinicalTrials.gov NCT03579342; http://clinicaltrials.gov/ct2/show/NCT03579342.
The Association Between Poor Glycemic Control and Health Care Costs in People With Diabetes: A Population-Based Study
Authors: Mata-Cases Manel , Rodríguez-Sánchez Beatriz , Mauricio Dídac , Real Jordi , Vlacho Bogdan , Franch-Nadal Josep , Oliva Juan 
Published: February 2020

OBJECTIVE
To analyze the differences in health care costs according to glycemic control in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Data on health care resource utilization from 100,391 people with type 2 diabetes were extracted from the electronic database used at the Catalan Health Institute. Multivariate regression models were carried out to test the impact of glycemic control (HbA1c) on total health care, hospital admission, and medication costs; model 1 adjusted for a variety of covariates, and model 2 also included micro- and macrovascular complications. Glycemic control was classified as good for HbA1c &lt;7%, fair for ≥7% to &lt;8%, poor for ≥8% to &lt;10%, and very poor for ≥10%.

RESULTS
Mean per patient annual direct medical costs were €3,039 ± SD €6,581. Worse glycemic control was associated with higher total health care costs: compared with good glycemic control, health care costs increased by 18% (€509.82) and 23% (€661.35) in patients with very poor and poor glycemic control, respectively, when unadjusted and by €428.3 and €395.1, respectively, in model 2. Medication costs increased by 12% in patients with fair control and by 28% in those with very poor control (model 2). Patients with poor control had a higher probability of hospitalization than those with good control (5% in model 2) and a greater average cost when hospitalization occurred (€811).

CONCLUSIONS
Poor glycemic control was directly related to higher total health care, hospitalization, and medication costs. Preventive strategies and good glycemic control in people with type 2 diabetes could reduce the economic impact associated with this disease.
Predicting 10-Year Risk of End-Organ Complications of Type 2 Diabetes With and Without Metabolic Surgery: A Machine Learning Approach
Authors: Aminian Ali , Zajichek Alexander , Arterburn David E. , Wolski Kathy E. , Brethauer Stacy A. , Schauer Philip R. , Nissen Steven E. , Kattan Michael W. 
Published: February 2020

OBJECTIVE
To construct and internally validate prediction models to estimate the risk of long-term end-organ complications and mortality in patients with type 2 diabetes and obesity that can be used to inform treatment decisions for patients and practitioners who are considering metabolic surgery.

RESEARCH DESIGN AND METHODS
A total of 2,287 patients with type 2 diabetes who underwent metabolic surgery between 1998 and 2017 in the Cleveland Clinic Health System were propensity-matched 1:5 to 11,435 nonsurgical patients with BMI ≥30 kg/m2 and type 2 diabetes who received usual care with follow-up through December 2018. Multivariable time-to-event regression and random forest machine learning models were built and internally validated using fivefold cross-validation to predict the 10-year risk for four outcomes of interest. The prediction models were programmed to construct user-friendly web-based and smartphone applications of Individualized Diabetes Complications (IDC) Risk Scores for clinical use.

RESULTS
The prediction tools demonstrated the following discrimination ability based on the area under the receiver operating characteristic curve (1 = perfect discrimination and 0.5 = chance) at 10 years in the surgical and nonsurgical groups, respectively: all-cause mortality (0.79 and 0.81), coronary artery events (0.66 and 0.67), heart failure (0.73 and 0.75), and nephropathy (0.73 and 0.76). When a patient’s data are entered into the IDC application, it estimates the individualized 10-year morbidity and mortality risks with and without undergoing metabolic surgery.

CONCLUSIONS
The IDC Risk Scores can provide personalized evidence-based risk information for patients with type 2 diabetes and obesity about future cardiovascular outcomes and mortality with and without metabolic surgery based on their current status of obesity, diabetes, and related cardiometabolic conditions.
Knowledge, Perception and Attitude Regarding Generic Medicines among Iraqi Physicians
Authors: Al-Jumaili Ali Azeez , Mahdi Layla Abdullah , Kadhim Dheyaa Jabbar 
Published: February 2020

Objectives: The study aim was to explore the knowledge, perceptions, and attitudes of Iraqi physicians regarding generic and locally manufactured medicines.
Methods: A total of 124 physicians were involved in this cross -sectional study. The convenience sample was collected from five public hospitals in Baghdad. A self-administered questionnaire was distributed and collected in-person. Fisher's Exact Test was used to measure the association between physician years of experience, gender and categorical (perception and knowledge) variables.
Results: Most respondent answers regarding the knowledge of generic medicines were incorrect. Only up to one-third of the participants knew that generic medicines are therapeutically equivalent to brand name medicines (26.6%), as safe as brand name medicines (34.7%) and required to meet similar safety standards as brand name medicines (12.1%). With respect to perception, many physicians had negative perceptions about generic medicines such as viewing generic medicines as lower quality (57.3%) and cause more side effects (41.1%) compared to brand name medicines. Regarding physician attitudes toward generic medicines, about two-thirds (64.5%) of the physicians were willing to prescribe low cost medicines; however, only about half (51.6%) of the physicians reported they offer generic medicines to their patients. Finally, 64.5% of the participants were not comfortable with pharmacist replacing prescribed brand with generic medicines.
Conclusions: In general, Iraqi physicians have negative perceptions and attitudes about generic and locally manufactured medicines. Significant gaps were identified in the knowledge and perceptions among physicians regarding generic medicines especially in relation to efficacy and safety of generic medicines.

Article Type: Original Research