bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-spatial contamination of environmental aquatic matrices with Cryptosporidium: a climate, health, and regulatory framework for the Philippines
Authors: Masangkay Frederick R. , Milanez Giovanni D. , Somsak Voravuth , Kotepui Manas , Tangpong Jitbanjong , Karanis Panagiotis 
Published: September 2020

Abstract
Background
Cryptosporidium is a waterborne global pathogen causing diarrhea primarily in infants and immunocompromised individuals. The Philippines is a tropical country susceptible to the influences of climate change and water crises. To date, the country has no existing epidemiologic data, regulation, or strategy for monitoring Cryptosporidium in freshwater systems. We, therefore, endeavored to provide evidence on the multi-spatial contamination of Cryptosporidium in environmental aquatic matrices using low-cost, user-friendly, and sustainable strategies and submit implications on the presence of Cryptosporidium in freshwater systems in a climate, health, and regulatory framework.

Results
Here, we present the microscopic detection of Cryptosporidium oocysts in low-volume (50 mL) environmental samples of surface water (SW), sediments (BW), and substrate-associated biofilm (SAB) and in 1 L bulk SW investigated by PCR. The multi-spatial distribution of Cryptosporidium oocysts in the low-volume (50 ml) aquatic matrices based on microscopy was highest at 69% (20/29) in SW and lowest at 50% (13/26) in BW. Immunofluorescence technique provided the highest microscopic positivity rate with 59% (17/29), 38% (10/26), and 50% (10/20) detection in SW, BW, and SAB, respectively. The detection and identification of Cryptosporidium in 1 L bulk SW by PCR and sequence analysis was recorded in total at 21% (6/29) in sampling sites where the differential identification of C. parvum, C. hominis, and Cryptosporidium spp. was 7% (2/29), 10% (3/29), and 3% (1/29), respectively.

Conclusions
We report the microscopical and first molecular epidemiologic data of Cryptosporidium from the most significant environmental freshwater systems in the Philippines. The presence of the two main human and animal pathogenic species C. parvum and C. hominis from the largest lakes and major water reservoirs in the country calls for sustainable solutions in safeguarding the quality of freshwater resources in a climate, health, and regulatory approach.
Iranian’s healthcare system challenges during natural disasters: the qualitative case study of Kermanshah earthquake
Authors: Mohammadpour Mohammadtaghi , Sadeghkhani Omid , Bastani Peivand , Ravangard Ramin , Rezaee Rita 
Published: September 2020

Abstract
Background
In order to the significance of lessons learned from the natural disasters for health care systems particularly in developing and under-developed countries, the main purpose of this study was to identify challenges and limitations in light of the earthquake experience in Kermanshah Province.

Methods
The present study was conducted in 2019 as a qualitative research using content analysis method. In this regard, 19 key informants were selected using snowball sampling. To enhance the accuracy of the study, the four validation criteria for qualitative studies in data coding developed by Guba and Lincoln including credibility, transferability, dependability and confirmability were used. Data was analyzed applying Graneheim and Lundman (2004) approach for analyzing the qualitative content of an interview text.

Results
Analysis of the data led to the identification of 2 main themes, 5 sub- themes and 17 main categories. The first main theme was health system oriented challenges containing challenges of medication supply and preparation, structural challenges, challenges in crisis-scene management and challenges of service delivery and the second main theme was non-health system oriented challenges including social and psychosocial challenges.

Conclusion
According to the results, along with health system oriented challenges with the inter-sectoral or intra-sectoral nature, the non-health system oriented challenges the same as social, cultural and psychological factors can be considered as the major challenges of Iran’s healthcare system in the face of crises. This complicated context can shed the light to policy makers that not only attention to the medicine and medical equipment supply chain, manpower preparation and service delivery system can be considered as an emergency, but also careful attention to the structural challenges and crisis-scene management should be planned and considered as a priority. Besides, the policy makers and the local managers should try to plan and act in a contingent situation according to the social and cultural characteristics of the region and the psychological condition and the mental needs of the people.
The association between HPV gene expression, inflammatory agents and cellular genes involved in EMT in lung cancer tissue
Authors: Rezaei Marzieh , Mostafaei Shayan , Aghaei Amir , Hosseini Nayyerehalsadat , Darabi Hassan , Nouri Majid , Etemadi Ashkan , Neill Andrew O’. , Nahand Javid Sadri , Mirzaei Hamed , Donnelly Seamas C. , Doroudian Mohammad , Moghoofei Mohsen 
Published: September 2020

Abstract
Background
Lung cancer is a leading cause of cancer morbidity and mortality worldwide. Several studies have suggested that Human papillomavirus (HPV) infection is an important risk factor in the development of lung cancer. In this study, we aim to address the role of HPV in the development of lung cancer mechanistically by examining the induction of inflammation and epithelial-mesenchymal transition (EMT) by this virus.

Methods
In this case-control study, tissue samples were collected from 102 cases with lung cancer and 48 controls. We examined the presence of HPV DNA and also the viral genotype in positive samples. We also examined the expression of viral genes (E2, E6 and E7), anti-carcinogenic genes (p53, retinoblastoma (RB)), and inflammatory cytokines in HPV positive cases.

Results
HPV DNA was detected in 52.9% (54/102) of the case samples and in 25% (12/48) of controls. A significant association was observed between a HPV positive status and lung cancer (OR = 3.37, 95% C.I = 1.58–7.22, P = 0.001). The most prevalent virus genotype in the patients was type 16 (38.8%). The expression of p53 and RB were decreased while and inflammatory cytokines were increased in HPV-positive lung cancer and HPV-positive control tissues compared to HPV-negative lung cancer and HPV-negative control tissues. Also, the expression level of E-cad and PTPN-13 genes were decreased in HPV- positive samples while the expression level of SLUG, TWIST and N-cad was increased in HPV-positive samples compared to negative samples.

Conclusion
Our study suggests that HPV infection drives the induction of inflammation and EMT which may promote in the development of lung cancer.
Supporting patient access to medicines in community palliative care: on-line survey of health professionals’ practice, perceived effectiveness and influencing factors
Authors: Latter Sue , Campling Natasha , Birtwistle Jacqueline , Richardson Alison , Bennett Michael I. , Ewings Sean , Meads David , Santer Miriam 
Published: September 2020

Abstract
Background
Patient access to medicines at home during the last year of life is critical for symptom control, but is thought to be problematic. Little is known about healthcare professionals’ practices in supporting timely medicines access and what influences their effectiveness. The purpose of the study was to evaluate health professionals’ medicines access practices, perceived effectiveness and influencing factors.

Methods
On-line questionnaire survey of health care professionals (General Practitioners, Community Pharmacists, community-based Clinical Nurse Specialists and Community Nurses) delivering end-of-life care in primary and community care settings in England. Quantitative data were analysed using descriptive statistics.

Results
One thousand three hundred twenty-seven responses were received. All health professional groups are engaged in supporting access to prescriptions, using a number of different methods. GPs remain a predominant route for patients to access new prescriptions in working hours. However, nurses and, increasingly, primary care-based pharmacists are also actively contributing. However, only 42% (160) of Clinical Nurse Specialists and 27% (27) of Community Nurses were trained as prescribers. The majority (58% 142) of prescribing nurses and pharmacists did not have access to an electronic prescribing system. Satisfaction with access to shared patient records to facilitate medicines access was low: 39% (507) were either Not At All or only Slightly satisfied. Out-of-hours specialist cover was reported by less than half (49%; 656) and many General Practitioners and pharmacists lacked confidence advising about out-of-hours services. Respondents perceived there would be a significant improvement in pain control if access to medicines was greater. Those with shared records access reported significantly lower pain estimates for their caseload patients.

Conclusions
Action is required to support a greater number of nurses and pharmacists to prescribe end-of-life medicines. Solutions are also required to enable shared access to patient records across health professional groups. Coverage and awareness of out-of-hours services to access medicines needs to be improved.
Comparison of different feedback modalities for the training of procedural skills in Oral and maxillofacial surgery: a blinded, randomized and controlled study
Authors: Seifert Lukas B. , Herrera-Vizcaino Carlos , Herguth Philipp , Sterz Jasmina , Sader Robert 
Published: September 2020

Abstract
Background
The feedback given to students plays an important role in their efficiency related to learning practical skills. In the present study, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in an oral and maxillofacial surgery setting with conventional direct expert feedback (control group).

Methods
This prospective, randomized, controlled, and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20 per group) using simple randomization. All participants watched an instruction video for an interdental (‘Ernst’) ligature and periphery venous catheterization. Next, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned feedback modalities. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) to evaluate their long-term knowledge retention. All examiners were blinded regarding the students’ instructional approach and their affiliation in terms of the learning group.

Results
For the interdental ligature, we found significant improvements in performance in each feedback modality group between the pre-test and post-test (p < 0.001). UVF had the strongest effect on performance time. The comparison between each group in the post-test showed no significant differences between the three groups.

Conclusion
This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery. However, DEF showed to be the most effective method of feedback and therefore preferable in teaching.
Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study
Authors: van der Toorn Janine E. , Rueda-Ochoa Oscar L. , van der Schaft Niels , Vernooij Meike W. , Ikram M. Arfan , Bos Daniel , Kavousi Maryam 
Published: September 2020

Abstract
Background
Evidence has pointed towards differences in the burden of arteriosclerosis according to its location and sex. Yet there is a scarcity of population-based data on aggregated sex-specific cardiovascular risk profiles, instead of single risk factors, and mortality risk according to the location of arteriosclerosis. We assessed sex-specific cardiovascular risk profiles and mortality risk associated with arteriosclerosis.

Methods
From the population-based Rotterdam Study, 2357 participants (mean age 69 years, 53% women) underwent non-contrast computed tomography to quantify calcification, as a proxy for arteriosclerosis, in the coronary arteries (CAC), aortic arch (AAC), extracranial (ECAC) and intracranial carotid arteries (ICAC), vertebrobasilar arteries (VBAC), and aortic valve (AVC). Principal component analysis (PCA) of eight distinct cardiovascular risk factors was performed, separately for women and men, to derive risk profiles based on the shared variance between factors. We used sex-stratified multivariable logistic regression to examine the associations between PCA-derived risk profiles and severe calcification at different locations. We investigated the associations of severe calcification with mortality risk using sex-stratified multivariable Cox regression.

Results
PCA identified three cardiovascular risk profiles in both sexes: (1) anthropometry, glucose, and HDL cholesterol; (2) blood pressure; and (3) smoking and total cholesterol. In women, the strongest associations were found for profile 2 with severe ECAC and ICAC (adjusted OR [95% CI] 1.32 [1.14–1.53]) and for profile 3 with severe at all locations, except AVC. In men, the strongest associations were found for profile 2 with VBAC (1.31 [1.12–1.52]) and profile 3 with severe AAC (1.28 [1.09–1.51]). ECAC and AVC in women and CAC in men showed the strongest, independent associations with cardiovascular mortality (HR [95% CI] 2.11 [1.22–3.66], 2.05 [1.21–3.49], 2.24 [1.21–3.78], respectively).

Conclusions
Our findings further underline the existence of sex- and location-specific differences in the etiology and consequences of arteriosclerosis. Future research should unravel which distinct pathological processes underlie differences in risk profiles for arteriosclerosis.
Collagen extract obtained from Nile tilapia (Oreochromis niloticus L.) skin accelerates wound healing in rat model via up regulating VEGF, bFGF, and α-SMA genes expression
Authors: Elbialy Zizy I. , Atiba Ayman , Abdelnaby Aml , Al-Hawary Ibrahim I. , Elsheshtawy Ahmed , El-Serehy Hamed A. , Abdel-Daim Mohamed M. , Fadl Sabreen E. , Assar Doaa H. 
Published: September 2020

Abstract
Background
Collagen is the most abundant structural protein in the mammalian connective tissue and represents approximately 30% of animal protein. The current study evaluated the potential capacity of collagen extract derived from Nile tilapia skin in improving the cutaneous wound healing in rats and investigated the underlying possible mechanisms. A rat model was used, and the experimental design included a control group (CG) and the tilapia collagen treated group (TCG). Full-thickness wounds were conducted on the back of all the rats under general anesthesia, then the tilapia collagen extract was applied topically on the wound area of TCG. Wound areas of the two experimental groups were measured on days 0, 3, 6, 9, 12, and 15 post-wounding. The stages of the wound granulation tissues were detected by histopathologic examination and the expression of vascular endothelial growth factor (VEGF), and transforming growth factor (TGF-ß1) were investigated using immunohistochemistry. Moreover, relative gene expression analysis of transforming growth factor-beta (TGF-ß1), basic fibroblast growth factor (bFGF), and alpha-smooth muscle actin (α-SMA) were quantified by real-time qPCR.

Results
The histopathological assessment showed noticeable signs of skin healing in TCG compared to CG. Immunohistochemistry results revealed remarkable enhancement in the expression levels of VEGF and TGF-β1 in TCG. Furthermore, TCG exhibited marked upregulation in the VEGF, bFGF, and α-SMA genes expression. These findings suggested that the topical application of Nile tilapia collagen extract can promote the cutaneous wound healing process in rats, which could be attributed to its stimulating effect on recruiting and activating macrophages to produce chemotactic growth factors, fibroblast proliferation, and angiogenesis.

Conclusions
The collagen extract could, therefore, be a potential biomaterial for cutaneous wound healing therapeutics.
Dual-responsive doxorubicin-loaded nanomicelles for enhanced cancer therapy
Authors: Zhang Xinyi , Zhu Tiantian , Miao Yaxin , Zhou Lu , Zhang Weifang 
Published: September 2020

AbstractBackgroundThe enhancement of tumor retention and cellular uptake of drugs are important factors in maximizing anticancer therapy and minimizing side effects of encapsulated drugs. Herein, a delivery nanoplatform, armed with a pH-triggered charge-reversal capability and self-amplifiable reactive oxygen species (ROS)-induced drug release, is constructed by encapsulating doxorubicin (DOX) in pH/ROS-responsive polymeric micelle.ResultsThe surface charge of this system was converted from negative to positive from pH 7.4 to pH 6.8, which facilitated the cellular uptake. In addition, methionine-based system was dissociated in a ROS-rich and acidic intracellular environment, resulting in the release of DOX and α-tocopheryl succinate (TOS). Then, the exposed TOS segments further induced the generation of ROS, leading to self-amplifiable disassembly of the micelles and drug release.ConclusionsWe confirms efficient DOX delivery into cancer cells, upregulation of tumoral ROS level and induction of the apoptotic capability in vitro. The system exhibits outstanding tumor inhibition capability in vivo, indicating that dual stimuli nano-system has great potential to function as an anticancer drug delivery platform.
Plasmodium infection inhibits tumor angiogenesis through effects on tumor-associated macrophages in a murine implanted hepatoma model
Authors: Wang Benfan , Li Qinyan , Wang Jinyan , Zhao Siting , Nashun Bayaer , Qin Li , Chen Xiaoping 
Published: September 2020

Abstract
Background
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death in China. The lack of an effective treatment for this disease results in a high recurrence rate in patients who undergo radical tumor resection, and the 5-year survival rate of these patients remains low. Our previous studies demonstrated that Plasmodium infection provides a potent antitumor effect by inducing innate and adaptive immunity in a murine Lewis lung carcinoma (LLC) model.

Methods
This study aimed to investigate the inhibitory effect of Plasmodium infection on hepatocellular carcinoma in mice, and various techniques for gene expression analysis were used to identify possible signal regulation mechanisms.

Results
We found that Plasmodium infection efficiently inhibited tumor progression and prolonged survival in tumor-bearing mice, which served as a murine implanted hepatoma model. The inhibition of tumor progression by Plasmodium infection was related to suppression of tumor angiogenesis within the tumor tissue and decreased infiltration of tumor-associated macrophages (TAMs). Further study demonstrated that matrix metalloprotease 9 (MMP-9) produced by TAMs contributed to tumor angiogenesis in the tumor tissue and that the parasite-induced reduction in MMP-9 expression in TAMs resulted in the suppression of tumor angiogenesis. A mechanistic study revealed that the Plasmodium-derived hemozoin (HZ) that accumulated in TAMs inhibited IGF-1 signaling through the PI3-K and MAPK signaling pathways and thereby decreased the expression of MMP-9 in TAMs.

Conclusions
Our study suggests that this novel approach of inhibiting tumor angiogenesis by Plasmodium infection is of high importance for the development of new therapies for cancer patients.
Beyond the healthy immigrant paradox: decomposing differences in birthweight among immigrants in Spain
Authors: Stanek Mikolaj , Requena Miguel , del Rey Alberto , García-Gómez Jesús 
Published: September 2020

Abstract
Background
The healthy immigrant paradox refers to the unexpected health advantages of immigrant groups settled in host countries. In this population-based study we analyze immigrant advantages in birthweight decomposing differences between infants born to immigrant mothers from specific origins.

Method
Using publicly available data from Spanish Vital Statistics for the period 2007–2017, differential birthweights among several groups of immigrants were estimated with an ordinary least squares regression. The Oaxaca–Blinder regression-based decomposition method was then applied to identify the extent to which differences in birthweight between groups corresponded to compositional disparities or to other factors.

Results
Our analysis of singleton live births to migrant mothers in Spain between 2007 and 2017 (N = 542,137) confirmed the healthy immigrant paradox for certain immigrant populations settled in Spain. Compared with infants born to mothers from high-income countries, the adjusted birthweight was higher for infants born to mothers from non-high- income European countries (33.2 g, 95% CI: 28.3–38.1, P < 0.01), mothers from African countries (52.2 g, 95% CI: 46.9–57.5, P < 0.01), and mothers from Latin American countries (57.4 g, 95% CI: 52.9–61.3, P < 0.01), but lower for infants born to mothers from Asian non-high-income countries (− 31.4 g, 95% CI: − 38.4 to − 24.3, P < 0.01). Decomposition analysis showed that when compared with infants born to mothers from high-income countries, compositional heterogeneity accounts for a substantial proportion of the difference in birthweights. For example, it accounts for 53.5% (95% CI: 24.0–29.7, P < 0.01) of the difference in birthweights for infants born to mothers from non-high-income European countries, 70.9% (95% CI: 60–66.7, P < 0.01) for those born to mothers from African countries, and 38.5% (95% CI: 26.1–29.3, P < 0.01) for those born to mothers from Latin American countries.

Conclusions
Our results provide strong population-based evidence for the healthy immigrant paradox in birthweight among certain migrant groups in Spain. However, birth outcomes vary significantly depending on the origins of migrant subpopulations, meaning that not all immigrant groups are unexpectedly healthier. A significant portion of the perinatal health advantage of certain immigrant groups is only a by-product of their group composition (by age, parity, marital status, socioeconomic status, and citizenship of mother, age and migratory status of father and type of delivery) and does not necessarily correspond to other medical, environmental, or behavioral factors.