bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to make HIV vertical transmission prevention good value for money in settings with very low HIV prevalence? Using economic evaluation guiding policy in the Philippines
Authors: Uy Geovin Dexter Chua , Bayani Diana Beatriz Samson , Luz Alia Cynthia Gonzales , Teerawattananon Yot 
Published: August 2020

Abstract
Background: Preventing mother-to-child transmission of human immunodeficiency virus is important due to the impact of the disease to the women and their children’s health. Established guidelines have recommended strengthening the ability to detect and treat HIV as early as possible. This study attempts to explore cost-effective PMTCT interventions in a low incidence, low-middle income setting such as the Philippines that can be replicated in other similar country settings.Methods: The study utilized a model-based cost-effectiveness analysis through a decision tree analysis. The decision tree reflected the first ANC visit of a pregnant woman in the Philippines. Vertical transmission program was explored as ten possible PMTCT policy strategies including Do-nothing approach; status quo approach, which had 9% HIV testing, provision of tenofovir-based ART and neonatal prophylaxis, and automatic cesarean section; Eight universal screening policy strategies, which had 100% HIV testing and counselling, provision of tenofovir-based ART and neonatal prophylaxis with inclusion or exclusion of raltegravir for aggressive late antenatal care (ANC) HIV treatment on top of the ART given, breastfeeding or provision of substitute feeding, and normal delivery or cesarean section deliveryResults: Base case analysis revealed that policy strategy of universal HIV screening, with additional provision of raltegravir on those receiving late antiretroviral therapy, neonatal prophylaxis, and substitute feeding on normal delivery (urndnpsf) had the lowest ICER values among all policy strategies compared to status quo (₱291,170.26/QALY) and do nothing (₱291,710.26/QALY). Through universal screening coverage, at least 91% of the HIV cases in newborn may be averted. Cost of HIV test must be reduced by at least 45% to have a cost-effective PMTCT program. Alternatively, by performing group pre-test HIV counselling of at least three persons per session, the program will become cost-effective when compared to the unofficial Philippine threshold of ₱150,000/QALY.Conclusions: Model design on HIV testing among pregnant women allows exploration of costs and outcomes of PMTCT interventions that focused on a low prevalence, low-middle income setting. From the study, HIV testing can be a major cost constraint for PMTCT. Furthermore, by performing group pre-test HIV counselling instead of per individual, a cost-effective PMTCT program may be achieved.
Understory Species Diversity, Regeneration and Recruitment Potential of Sacred Groves in South West Nigeria
Authors: Onyekwelu J. C. , Lawal A. , Mosandl R. , Stimm B. , Agbelade A. D. 
Published: August 2020

Abstract
Background Global species extinction rates due to forest conversions are increasing. Ecologists, conservationists and governments have adopted various conservation methods. Sacred grove is one conservation option that has gained attention in recent time. We assessed understory species diversity, regeneration and recruitment potentials of four sacred groves in southwestern Nigeria. Overstory tree species were inventoried in eight 800m2 temporary sample plots, systematically laid along two transects of 1000m each. Understory tree species were assessed in 100m2 plots for saplings and 25m2 plots for seedlings in all sample plots. Results Shannon-Wiener diversity index (1.8-3.46 (overstory); 2.65-3.55 (understory)), number of species (32-58 (overstory); 39-78 (understory)) and tree density (309-417 individuals/ha (overstory); 775-1445 individuals/ha (understory)) were comparable and/or higher at the understories than the overstories. Dbh distribution curves showed highest stand density at the lowest class (10–20 cm) and decreased with increasing dbh, indicating good regeneration status and healthy ecosystem. Regeneration was considered good and fair, because in most cases, number of seedlings > saplings > overstory trees or number of seedlings > saplings ≤ overstory trees. The good regeneration status was further confirmed by the good species recruitment in the understory. Some tree species were found to be unique to some sacred groves while some species that were absent in protected forests existed in the groves. The presence of these unique tree species indicated the potential of sacred groves in conserving important tree species. The high regeneration could be attributed to strict access restrictions in the groves, and the taboos and myths feared by the people. However, the high influx of people into sacred groves for festivals and rituals, which results in trampling and burning of seedlings, is a threat to the diversity, regeneration and recruitment potentials of the groves.Conclusion High regeneration and recruitment status maintained in all the sacred groves in this study were achieved using taboos, cultural and traditional methods. These methods could be incorporated in managing forest reserves in Southwestern Nigeria.
Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.
Authors: Daini Babajide Oluseyi , Okafor Emeka , Baruwa Sikiru , Adeyanju Oluwafunmito , Anyanti Jennifer 
Published: August 2020

Abstract
Background

In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and Family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of health training on the provision and stocking of FP services and commodities by vendors.
Methods

We conducted a census of all patent and proprietary medicine vendor (PPMV) shops and followed up with a facility assessment among 10% of the mapped shops; utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (C.I) for the test of significance in the study.
Results

8,318 medicine shops were censused (76.2% Urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any trade association. Also, 28.2% of vendors reported formal health training; with 56.3% of these health trained vendors relatively new in the business, opening within the last five years. Vendors utilized open drug markets as the major source of supply for FP products. Health training significantly increased the stocking of FP products and inhibited the utilization of open drug markets.
Conclusion

PPMVs have continued to grow progressively in the last five years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria. Now comprised of a considerable mass of health trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV shop and lack of access to quality health commodities and consumables have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.
New-onset Atrial Fibrillation In Sepsis No Correlation With Inflammatory Cytokines in Real-life Clinical Setting
Authors: Li Zhuanyun , Li Dandan , Chai Yage , Li Jiming , Peng Peng , Yang Jianzhong 
Published: August 2020

Abstract
Background

New-onset atrial fibrillation(new-onset AF) is one of the most common tachyarrhythmia in critically ill patients and is associated with increased morbidity and mortality. Unfortunately, risk factors for new-onset AF in sepsis have not been clearly elucidated. This study aims to determine the association of new-onset AF with circulating inflammatory cytokine concentrations.
Methods

This is a retrospective analysis of the relationship between new-onset AF in sepsis and inflammatory cytokine concentrations. The study included patients with sepsis diagnosed in the Emergency Intensive Care Unit(EICU) of The First Affiliated Hospital of Xinjiang Medical University. This study was conducted on data submitted from June 2016 through May 2019. The patients were classified based on the new-onset AF into Control group(n = 100)、Non New-onset AF in sepsis group(n = 182)、New-onset AF in sepsis group(n = 89). We aimed to investigate whether new-onset AF in sepsis can be explained by increased circulating inflammatory cytokine concentrations.
Results

Unadjusted analysis of the 371 observations from the retrospective cohort study demonstrated that serum cytokine concentrations do not correlate with new-onset AF in sepsis, despite the fact that cytokines predict mortality and correlate with organ dysfunction and sepsis severity (APACHEⅡ and SOFA scores). On multivariable analysis, the present study shows that hypertension, BMI, fibrinogen and hs-Troponin-T strongly correlated with the new-onset AF in sepsis. Besides, none of the cytokine concentrations correlated with any of the hs-Troponin-T or fibrinogen.
Conclusions

Our study shows that risk factors for new-onset AF in sepsis are mainly factors that are associated with the pre-admission comorbidity, coagulation, cardiac biomarkers. none of the measured inflammatory cytokines correlates with new-onset AF in sepsis.
Dynamic plasma extracellular vesicle long RNA profiling changes during the peri-operative period
Authors: hua qing , xu wenhao , shen xuefang , tian xi , Wang Peng , Zhang hailiang , Li yan , xu pingbo 
Published: August 2020

Abstract
Background: Surgery remains the most important treatment strategy for solid tumors, such as colorectal cancer (CRC); However, a number of studies have suggested that surgical stress contributes to tumor recurrence or distant metastases. Extracellular vesicles (EVs), which contain a rich variety of RNAs with specialized functions and clinical applications, have been shown to be an indicator for diagnosis and prognosis of cancers. The effect of surgical stress on the landscape and characteristics of EV long RNA (exLR) in human blood, however, remains largely unknown.Methods: We present an optimized strategy for exLR sequencing (exLR-seq) the plasma from three patients with CRC at 4 time points (before surgery [T0], after extubation [T1], 1 day after surgery [T2], and 3 days after surgery [T4]). The “Limma” R package was used to evaluate the dynamic changes of mRNAs and long non-coding (lnc)RNAs from EVs. We also constructed a protein–protein interaction (PPI) network of hub genes and predicted biological processes, cellular components, and molecular functions of gene ontology (GO) functional analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. Results: We observed a sufficient number of exLRs, including 12,924 mRNAs and 2196 lncRNAs. Both mRNAs and lncRNAs underwent dynamic changes during the peri-operative period. Compared with T0, there were 110 mRNAs differentially expressed after extubation, 60 differentially expressed genes（DEGs）1 day after surgery, and 50 DEGs 3 days after surgery. A total of 11 genes changed at all 3 time points and were related to regulation of the membrane potential, receptor complex, and passive transmembrane transporter activity. In addition, 22 lncRNAs were differentially expressed after extubation (T1). Nineteen lncRNAs were differentially expressed between T0 and T2, and 38 lncRNAs were differentially expressed between T0 and T3. In addition, we found that only 3 lncRNAs changed at 3 time points. Interestingly, blood exLRs reflected the tissue origins and relative fractions of different immune cell types. EVs from CD8+ T，CD4+ memory T, and NK cells decreased after surgery and the absolute quality of EVs from immune cells decreased as well. Conclusion: In summary, this study demonstrated abundant exLRs in human plasma and the dynamic changes of these exLRs and exLRs originating from CD8+ T and CD4+ memory T cells were reduced during the peri-operative period.
Analysis of the Karst Development Law Based on Multiple Exploration Technologies of Cambrian Limestone
Authors: Guo J.W. , Zhang B. , Wang X. Y. 
Published: August 2020

Abstract
Coal mine floor limestone aquifers are a major source of water inrush from the coal seam floor and a serious threat to the safety of coal mining. In order to reduce and avoid the occurrence of water inrush within the coal mine, we use multiple detection techniques, which are geophysical exploration technology , drilling technology, water inrush accidents and tracer test, to develop a multi-faceted exploration of karst development and analyze its development characteristics in the Chaochuan mine No. 1 well of Pingdingshan Coal Co.Ltd, Henan Province, China. The results show that, the Cambrian limestone (CL) karst water is poor; there is a certain hydraulic connection. Near faults F5, F1, and SF28, the area is less water-rich area, the water is weak, and the deep karst water forms a closed area; 61.54 % of shallow water inrush accidents in the Taiyuan limestone and CL karsts were caused by large tectonic and nearby shallow faults. The karst vertical zonation is shallow; the shallow water level decreased more in the West Wing of the No. 1 well than in the East Wing at elevations above 140 m and below -150 m. The F125 level decline is greater than that of the east, and the west fault is more than 170 m due to the hydraulic connection intrusive barrier wings of the karst water. the East Wing below -150 m F125 fault was weak and uneven on both sides of the hydraulic connection.
Overexpression of Agrin promotes tumor proliferation and correlates with poor prognosis in cholangiocarcinoma
Authors: He Meimei , Ji Shasha , Tu Junxue , Lou Dan 
Published: August 2020

Abstract
Background

Agrin exists as a shorter Type II Transmembrane form with an internal signal peptide, and is closely correlated with the activation of multiple intercellular signaling pathways. The aim of the present study was to investigate the role of Agrin in the development of cholangiocarcinoma (CCA).
Methods

RT-qPCR and western blotting were performed to detect the expressional level of target genes, including Agrin, in CCA tissues or cell lines. The correlation between Agrin, and tumor characteristics and prognosis, was analyzed using independent sample t-test, the Kaplan-Meier method and Cox proportional hazard model, respectively. Proliferation, migration, invasion and tumorigenesis in CCA cells was determined by CCK8 assay, cell cycle detection, Transwell assay and nude mouse tumorigenicity assay, respectively.
Results

Agrin was significantly upregulated in CCA tissues, as compared to the adjacent non-tumor tissues, and was correlated with poorer tumor characteristics such as portal vein tumor thrombus, intrahepatic metastasis and poor survival. The Agrin overexpression in CCA cell lines clearly promoted proliferation, colony formation, migration, invasion and cell cycle progression, but Agrin knockdown had the opposite effect. Furthermore, CCA cells with inhibitory Agrin expression presented with less and smaller tumors, as compared with the control group in vivo. Mechanistic analysis indicated that Agrin was able to activate the Hippo signaling pathway and induce yap to enter the cell nucleus.
Conclusions

We found that Agrin promotes the CCA progression via activating the Hippo signaling pathway, which could be a potentially promising target for CCA treatment.
Epidemic Dynamics of COVID-19 Based on SEAIUHR Model Considering Asymptomatic Cases in Henan Province, China
Authors: Li Chunyu , Zhu Yuchen , Qi Chang , Liu Lili , Zhang Dandan , Wang Xu , She Kaili , Jia Yan , Liu Tingxuan , Xiong Momiao , Li Xiujun 
Published: August 2020

Abstract
Background

New coronavirus disease (COVID-19), an infectious disease caused by a type of novel coronavirus, has emerged in various countries since the end of 2019 and caused a global pandemic. Many infected people went undetected because their symptoms were mild or asymptomatic, but the proportion and infectivity of asymptomatic infections remained unknown. Therefore, in this paper, we analyzed the proportion and infectivity of asymptomatic cases, as we as the prevalence of COVID-19 in Henan province.
Methods

We constructed SEAIUHR model based on COVID-19 cases reported from 21 January to 26 February 2020 in Henan province to estimate the proportion and infectivity of asymptomatic cases, as we as the change of effective reproductive number, \({R}_{t}\). At the same time, we simulated the changes of cases in different scenarios by changing the time and intensity of the implementation of prevention and control measures.
Results

The proportion of asymptomatic cases among COVID-19 infected individuals was 42% and infectivity of asymptomatic cases was 10% of that symptomatic ones. The basic reproductive number\({R}_{0}\)=2.73, and \({R}_{t}\) dropped below 1 on 1 February under a series of measures. If measures were taken five days earlier, the number of cases would be reduced by 2/3, and after 5 days the number would more than triple.
Conclusions

In Henan Province, the COVID-19 epidemic spread rapidly in the early stage, and there were a large number of asymptomatic infected individuals with relatively low infectivity. However, the epidemic was quickly brought under control with national measures, and the earlier measures were implemented, the better.
Personalized hypertension management based on serial assessment and telemedicine: a cluster randomize controlled trial protocol in Anhui, China
Authors: Xiao Siyi , Shen Xingrong , Liu Rong , Tong Guixian , Liu Tongzhu , Wang Debin 
Published: August 2020

Abstract
Background: Despite tremendous investment worldwide, hypertension treatment and control rates remain low, suggesting that contemporary population-based hypertension management may have reached its efficacy ceiling. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient’s dynamic complications and contexts.Methods/design: PHMA strives to reduce hypertension harms by eight proven “objective behaviors” (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors.Discussion: PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts so comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making.Trial registration: ISRCTN10999269. July 17, 2020; https://doi.org/10.1186/ISRCTN10999269
Causal Effect Between Total Cholesterol and Hdl Cholesterol as Risk Factors for Chronic Kidney Disease: A Mendelian Randomization Study
Authors: Miao Liu , Min Yan , Zhu Chuan-Meng , Chen Jian-Hong , Qi Bin , Wang Yong , Li Jian-Fei , Li Rong-Shan 
Published: August 2020

Abstract
Background

While observational studies show an association between serum lipid levels and cardiovascular disease (CVD), intervention studies that examine the preventive effects of serum lipid levels on the development of CKD are lacking.
Methods

To estimate the role of serum lipid levels in the etiology of CKD, we conducted a two-sample Mendelian randomization (MR) study on serum lipid levels. Single nucleotide polymorphisms (SNPs), which were significantly associated genome-wide with plasma serum lipid levels from the GLGC and CKDGen consortium genome-wide association study (GWAS), including total cholesterol (TC, n = 187365), triglyceride (TG, n = 177861), HDL cholesterol (HDL-C, n = 187167), LDL cholesterol (LDL-C, n = 173082), apolipoprotein A1 (ApoA1, n = 20687), apolipoprotein B (ApoB, n = 20690) and CKD (n = 117165), were used as instrumental variables. None of the lipid-related SNPs was associated with CKD (all P > 0.05).
Results

MR analysis genetically predicted the causal effect between TC/HDL-C and CKD. The odds ratio (OR) and 95% confidence interval (CI) of TC within CKD was 0.756 (0.579 to 0.933) (P = 0.002), and HDL-C was 0.85 (0.687 to 1.012) (P = 0.049). No causal effects between TG, LDL-C- ApoA1, ApoB and CKD were observed. Sensitivity analyses confirmed that TC and HDL-C were significantly associated with CKD.
Conclusions

The findings from this MR study indicate causal effects between TC, HDL-C and CKD. Decreased TC and elevated HDL-C may reduce the incidence of CKD but need to be further confirmed by using a genetic and environmental approach.