bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.
Authors: Catarino Diana , Silva Diana , Guiomar Joana , Ribeiro Cristina , Ruas Luísa , Cardoso Luís , Paiva Isabel 
Published: June 2020

Abstract
Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.
MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework
Authors: Ansbro Éimhín , Homan Tobias , Quasim Jamil , Bil Karla , Tarawneh Mohammed Rasoul , Roberts Bayard , Perel Pablo , Jobanputra Kiran 
Published: June 2020

Abstract
Background: In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated a multidisciplinary, primary-level model of NCD care for Syrian refugees and vulnerable Jordanians in Irbid, Jordan. We examined the programme’s Reach, Effectiveness, Adoption and acceptance; Implementation and Maintenance over time.Methods: This mixed methods, retrospective evaluation, undertaken in 2017, comprised secondary analysis of pre-existing cross-sectional household survey data; analysis of routine cohort data from December 2014 - December 2017; descriptive costing analysis of total annual, per-patient and per-consultation costs for 2015-2017 from the provider-perspective; clinical audit; medication adherence survey of 300 patients; and qualitative research involving thematic analysis of individual interviews and focus group discussions. Results: The programme enrolled 23% of Syrian adult refugees with NCDs in Irbid governorate. The cohort mean age was 54.7 years; 71% had multi-morbidity and 9.9% self-reported a disability. The programme was acceptable to patients, staff and stakeholders. Blood pressure and glycaemic control improved as the programme matured and by 7 mmHg and 26 mg/dL respectively within six months of patient enrolment. Total costs increased in parallel with increased service complexity from INT$ 4,206,481 in 2015 to 6,739,438 in 2017. Staff reported that clinical guidelines were usable and patients’ self-reported medication adherence was high. Individual and organisational challenges to programme implementation and maintenance included the impact of war and the refugee experience on Syrian refugees’ ability to engage; inadequate low-cost referral options; and challenges of operating in a regulated, middle-income country. Essential programme adaptations included refinement of health education, development of mental health and psychosocial services and addition of essential referral pathways, home visit, physiotherapy and social worker services.Conclusion: RE-AIM proved a valuable tool in evaluating a complex intervention in a protracted humanitarian crisis setting. This multidisciplinary programme was highly acceptable. It achieved good clinical outcomes but for a limited number of patients and at relatively high cost. We propose that model simplification, adapted procurement practices and use of technology could improve cost effectiveness without reducing acceptability, and may facilitate replication.
Descriptive epidemiology of objectively-measured, free-living sleep parameters in a rural African setting.
Authors: Cook Ian , Mohlabe Matlawa , Alberts Marianne 
Published: June 2020

Abstract
Objectives: To investigate the descriptive nature of objectively-measured, free-living sleep quantity and quality, and the relationship to adiposity, in a rural African setting in 145 adults (≥40 years, female: n=104, male: n=41). Wrist-mounted, triaxial accelerometry data was collected over nine days. Measures of sleep quantity and quality, and physical activity were extracted from valid minute-by-minute data. Adiposity indices were body-mass-index, waist circumference and conicity index. Self-reported data included behavioural, health and socio-demographic variables. Community consultation followed the quantitative data analyses, for validation and interpretation of findings. Results: Females had more nocturnal sleep than males (7.2 vs. 6.8 hours/night, p=0.0464) while males recorded more diurnal sleep time (p=0.0290). Wake after sleep onset and number of awakenings were higher in females, and sleep efficiency was higher in males (p≤0.0225). Sleep indices were generally similar between weekdays and weekends, except for sleep fragmentation index (p=0.0458). Sleep quantity, but not sleep quality was independently and inversely associated with adiposity (p=0.0453). Physical activity and morbidity measures were significantly and consistently associated with sleep and adiposity measures (p<0.0458). The preliminary qualitative data suggests that future studies should include more detailed data around contextual issues of sleep (social, cultural, economic, environment).
Prognostic factors for overall survival in patients with spinal metastasis secondary to prostate cancer: a systematic review and meta-analysis
Authors: Gao Zhong-yu , Zhang Tao , Zhang Hui , Pang Cheng-gang , Jiang Wen-xue 
Published: June 2020

Abstract
Background: To guide the selection of treatments for spinal metastases, the expected survival time is one of the most important determinants. Few scoring systems are fully applicable for spinal metastasis secondary to prostate cancer (PCa). This study aimed to identify the independent factors to predict the overall survival (OS) of patients with spinal metastases from PCa.Methods: The PubMed, Embase and CENTRAL were retrieved by two reviewers independently, to identify studies analyzed the prognostic effect of different factors in spinal metastasis from PCa. A systematic review and quantitative meta-analysis was conducted with hazard ratio (HR) and 95% confidence interval (95%CI) as the effect size.Results: A total of 12 retrospective cohort studies (1566 patients) were eligible for qualitative synthesis and 10 for quantitative meta-analyses. The OS was significantly influenced by performance status, visceral metastasis, ambulatory status and time from PCa diagnosis in more than half of the available studies. The meta-analyses demonstrated that OS was significantly influenced by visceral metastasis (HR=2.24, 95%CI:1.53-3.27, p<0.001), pre-treatment ambulatory status (HR=2.64, 95%CI:1.82-3.83, p<0.001), KPS (HR=4.45, 95%CI:2.01-9.85, p<0.001), ECOG (HR=2.96, 95%CI:2.02-4.35, p<0.001), extraspinal bone metastasis (HR=2.04, 95%CI:1.13-3.68, p=0.018), time developing motor deficit (HR=1.57, 95%CI:1.30-1.88, p<0.001) and time from PCa diagnosis (HR=1.37, 95%CI:1.17-1.59, p<0.001).Conclusions: Visceral metastasis, ambulatory status, extraspinal bone metastasis, performance status, time developing motor deficit and time interval from primary tumor diagnosis were significantly associated with the OS for spinal metastasis from PCa. When selecting the treatment modality, clinicians should fully consider the patients’ systematic status based on all potential prognostic factors.Level of Evidence: Ⅰ Meta-analysis
Effectiveness of a Psychoeducation Intervention by Midwiveson childbirth fear and childbirth self-efficacy in fearful first time pregnant women: a randomized controlled trial
Authors: Firouzan Laya , Kharaghani Roghieh , Zenoozian Saeedeh , Moloodi Reza , Jafari Elham 
Published: June 2020

Abstract
Background: Studies showed that childbirth fear is a prevalent problem among Iranian women and most women prefer caesarean section. However, there is no published study that explore effectiveness of psychoeducational intervention on childbirth fear among Iranian women. Thus, present study investigated the effectiveness of a psychoeducation intervention by midwives (Birth Emotions- Looking to Improve Expectant Fear (BELIEF)) in decreasing childbirth fear and increasing childbirth self-efficacy among fearful first pregnant women.Methods: One-hundred-seventy-one pregnant women who referred to six governmental antenatal clinics of healthcare centers of Zanjan city screened to participate in the study. Among them, 80 women who got score ≥ 66 on the Wijma Delivery Expectancy/Experience Questionnaire were recruited. They were randomly assigned into two groups: intervention (n = 40) and control group (n = 40). The intervention group received two face-to-face counseling sessions in the 24th week and 34th week of pregnancy. Between this two counseling sessions, intervention group women had 8 weekly telephone counseling sessions. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results: At the post-test, the intervention group showed significantly higher reduction in childbirth fear and higher increase in childbirth self-efficacy compared to the control group. Also, at post-test more women in the intervention group reported that they preferred normal vaginal birth than women in the control group.Conclusions: The BELIEF protocol could be effective approach to improve childbirth fear and childbirth self-efficacy in fearful first pregnant women. Trial registration number: IRCT20101219005417N3, Date of Registration: 2018-12-19.
Estimation of Bulk Permittivity of the Moon’s Surface Using Lunar Radar Sounder On-board Selenological and Engineering Explorer
Authors: Hongo Keigo , Toh Hiroaki , Kumamoto Atsushi 
Published: June 2020

Abstract
Site-dependent bulk permittivities of the lunar uppermost media with thicknesses of tens to hundreds meters were estimated based on the data from Lunar Radar Sounder onboard the Selenological and Engineering Explorer (SELENE). It succeeded in sounding almost all over the Moon’s surface in a frequency range around 5 MHz to detect subsurface reflectors beneath several lunar maria. However, it is necessary to estimate the permittivity of the surface regolith of the Moon in order to determine the actual depths to those reflectors instead of apparent depths assuming a speed of light in the vacuum. In this study, we determined site-dependent bulk permittivities by two-layer models consisting of a surface regolith layer over a half-space with uniform but different physical properties from the layer above. Those models consider the electrical conductivity as well as the permittivity, whose trade-off was resolved by utilizing the correlation between iron-titanium content and measured physical properties of lunar rock samples. Distribution of the iron-titanium content on the Moon’s surface had already been derived by spectroscopic observation from SELENE as well.

Four lunar maria, Mare Serenitatis, Oceanus Procellarum, Mare Imbrium, and Mare Crisium, were selected as regions of evident reflectors, where we estimated the following four physical properties of each layer, i.e., bulk permittivity, porosity, loss tangent and electrical conductivity to conclude the actual depths of the reflectors are approximately 200m on average. The bulk permittivity ranges from 2.96 at Mare Imbrium to 6.37 at Oceanus Procellarum, whereas the porosity takes the values between 1.8% to 41.1% in the respective maria. It was found that although the bulk permittivity of the four lunar maria differs from a mare to a mare, it shows a good correlation with their composition, viz., their iron-titanium content.
Sequence analysis and protein interactions of Arabidopsis CIA2 and CIL proteins
Authors: Yang Chun-Yen , Sun Chih-Wen 
Published: June 2020

Abstract
Background: A previous screening of Arabidopsis thaliana for mutants exhibiting dysfunctional chloroplast protein transport identified the chloroplast import apparatus ( cia ) gene. The cia2 mutant has a pale green phenotype and reduced rate of protein import into chloroplasts, but leaf shape and size are similar to wild-type plants of the same developmental stage. Microarray analysis showed that nuclear CIA2 protein enhances expression of the Toc75 , Toc33 , CPN10 and cpRPs genes, thereby up-regulating protein import and synthesis efficiency in chloroplasts. CIA2-like (CIL) shares 65% sequence identity to CIA2, suggesting that CIL and CIA2 are homologous proteins in Arabidopsis. Here, we further assess the protein interactions and sequence features of CIA2 and CIL. Results: Subcellular localizations of truncated CIA2 protein fragments in our onion transient assay demonstrate that CIA2 contains two nuclear localization signals (NLS) located at amino acids (aa) 62-65 and 291-308, whereas CIL has only one NLS at aa 47-50. We screened a yeast two-hybrid (Y2H) Arabidopsis cDNA library to search for putative CIA2-interacting proteins and identified 12 nuclear proteins, including itself, CIL, and flowering-control proteins (such as CO, NF-YB1, NF-YC1, NF-YC9 and ABI3). Additional Y2H experiments demonstrate that CIA2 and CIL mainly interact with flowering-control proteins via their N-termini, but preferentially form homo- or hetero-dimers through their C-termini. Moreover, sequence alignment showed that the N-terminal sequences of CIA2, CIL and NF-YA are highly conserved. Therefore, NF-YA in the NF-Y complex could be substituted by CIA2 or CIL. Conclusions: We show that Arabidopsis CIA2 and CIL can interact with CO and NF-Y complex, so not only may they contribute to regulate chloroplast function but also to modulate flower development.
Evaluation of Small Bowel Motion and Feasibility of using the Peritoneal Space to Replace Bowel Loops for Dose Constraints during Intensity-Modulated Radiotherapy for Rectal Cancer
Authors: Li Siyuan , Gong Yanping , Yang Yongqiang , Guo Qi , Qian Jianjun , Tian Ye 
Published: June 2020

Abstract
Background: The goal of this study was to assess small bowel motion and explore the feasibility of using peritoneal space (PS) to replace bowel loops (BL) via the dose constraint method to spare the small bowel during intensity-modulated radiotherapy (IMRT) for rectal cancer. Methods: A total of 24 patients with rectal cancer who underwent adjuvant or neoadjuvant radiotherapy were selected. Weekly repeat CT scans from pre-treatment to the fourth week of treatment were acquired and defined as Plan, 1W, 2W, 3W, and 4W. The 4 weekly CT scans were co-registered to the Plan CT, BL and PS contours were delineated in all of the scans, an IMRT plan was designed on Plan CT using PS constraint method, and then copied to the 4 weekly CT scans. The dose-volume, normal tissue complication probability (NTCP) of the small bowel and their variations during treatment were evaluated. Results: Overall, 109 sets of CT scans from 24 patients were acquired, and 109 plans were designed and copied. The BL and PS volumes were 250.3 cc and 1339.3 cc. The V15 of BL and PS based plan of pre-treatment were 182.6 cc and 919.0 cc, the shift% of them were 28.9% and 11.3% during treatment (p=0.000), which was less in the prone position than in the supine position (25.2% vs 32.1%, p =0.000; 9.9% vs 14.9%, p=0.000). The NTCPC and NTCPA based plan of pre-treatment were 2.0% and 59.2%, the shift% during treatment were 46.1% and 14.0% respectively. Majority of BL’s Dmax and V15 were meet the safety standard during treatment using PS dose limit method except 3 times (3/109) of V15 and 5 times of Dmax (5/109).Conclusions: This study indicated that small bowel motion may lead to uncertainties in its dose volume and NTCP evaluation during IMRT for rectal cancer. The BL movements were significantly greater than PS, and the prone position was significantly less than the supine position. It is feasibility of using PS to replace BL to spare the small bowel, V15<830 cc is the dose constraint standard.
The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence
Authors: Monaghesh Elham , Hajizadeh Alireza 
Published: June 2020

Abstract
Purpose: The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak.Methods: This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results: Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions: The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.
Changes of wavefront aberrations and corneal surface regularity in dry eye patients measured with OPD Scan III
Authors: Liu Rongjun , Ma Baikai , Gao Yufei , Liu Yiyun , QI HONG 
Published: June 2020

Abstract
Background

To evaluate changes of wavefront aberrations and corneal surface regularity in dry eye (DE) patients with OPD Scan-III (NIDEK, JPN).
Methods

Twenty-seven right eyes of 27 DE patients and 23 right eyes of normal subjects were included. The examinations for ocular surface including the Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT) and corneal fluorescein staining (CFS). OPD Scan-III was used to measure anterior corneal aberrations including total corneal aberrations, high order aberration (HOA), spherical aberration (SA), coma and trefoil aberration, standard deviation of corneal power (SDP), surface regularity index (SRI) and surface asymmetry index (SAI). Statistical analysis were assessed with one sample t-test. Correlations between those parameters were also analyzed.
Results

Wavefront aberrations parameters including total corneal aberrations, HOA, SA, coma and trefoil in DE group were significantly higher than in normal group (P < 0.05). Corneal surface regularity parameters including SRI and SAI in DE group were significantly higher than in normal group (P < 0.05). TBUT had negative correlations with total corneal aberrations and coma (P < 0.05). Both CFS scores and central CFS scores had no correlations with wavefront aberrations parameters and had positive correlations with SDP and SRI (P༜0.05). Central CFS scores also positively correlated with SAI ( P < 0.05).
Conclusions

Wavefront aberrations and corneal surface irregularity are increased in DE patients. OPD Scan III was have potential to be a new instrument to evaluate the severity of DE and monitor the treatment of DE.