bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to and facilitators of the implementation of multi-disciplinary care pathways in primary care: a systematic review
Authors: Seckler Eva , Regauer Verena , Rotter Thomas , Bauer Petra , Müller Martin 
Published: May 2020

Abstract
Background : Care pathways (CPWs) are complex interventions that have the potential to reduce treatment errors and optimize patient outcomes by translating evidence into local practice. To design an optimal implementation strategy, potential barriers to and facilitators of implementation must be considered. The objective of this systematic review is to identify barriers to and facilitators of the implementation of CPWs in primary care (PC). Methods : A systematic search via Cochrane Library, CINAHL, and MEDLINE via PubMed supplemented by hand searches and citation tracing was carried out. We considered articles reporting on CPWs targeting patients at least 65 years of age in outpatient settings that were written in the English or German language and were published between 2007 and 2019. We considered (non-)randomized controlled trials, controlled before-after studies, interrupted time series studies ( main project reports ) as well as associated process evaluation reports of either methodology. Two independent researchers performed the study selection; the data extraction and critical appraisal were duplicated until the point of perfect agreement between the two reviewers. Due to the heterogeneity of the included studies, a narrative synthesis was performed. Results : 14 studies (seven main project reports and seven process evaluation reports) of the identified 8,154 records in the search update were included in the synthesis. The structure and content of the interventions as well as the quality of evidence of the studies varied. The identified barriers and facilitators were classified using the Context and Implementation of Complex Interventions framework . The identified barriers were inadequate staffing, insufficient education, lack of financial compensation, low motivation and lack of time. Adequate skills and knowledge through training activities for health professionals, good multi-disciplinary communication and individual tailored interventions were identified as facilitators. Conclusions : In the implementation of CPWs in PC, a multitude of barriers and facilitators must be considered, and most of them can be modified through the careful design of intervention and implementation strategies. Furthermore, process evaluations must become a standard component of implementing CPWs to enable other projects to build upon previous experience. Trial registration : PROSPERO 2018 CRD42018087689
Refractive Outcomes following Vitrectomy and Phacovitrectomy in Rhegmatogenous Retinal Detachment
Authors: Liu Nan , Li Fuqiang , Che Songtian , Shu Zhimin , Shan Chenli , Zhao Jinsong 
Published: May 2020

Abstract
Background

Cataracts are commonly seen during the diagnosis of rhegmatogenous retinal detachment (RRD) or occur following its surgical management. Refractive changes following combined phacoemulsification and vitrectomy (phacovitrectomy) can affect the quality of vision. This study aimed to evaluate the refractive changes following vitrectomy versus phacovitrectomy in patients with RRD.
Methods

A total of 96 patients who underwent retinal surgery for RRD in one eye, between August 2016 and January 2018, were enrolled and divided into three groups. In 18 eyes, 23-gauge transconjunctival sutureless vitrectomy (23G TSV) was performed (group A); 25G TSV was performed in 49 eyes (group B), and phacovitrectomy with 25G TSV was performed in 29 eyes (group C). Silicone oil was injected after the surgery in all three groups. Anterior and posterior corneal astigmatism, axial length (AL), and anterior chamber depth (ACD) were measured at baseline and postoperatively at 1 week, 1 month, and 3 months.
Results

Anterior and posterior corneal astigmatism did not change, and AL continued to increase for 3 months after surgery, whereas ACD decreased postoperatively but quickly returned to baseline in groups A and B. In group C, anterior and posterior corneal astigmatism, AL, and ACD increased postoperatively, and corneal astigmatism returned to baseline by 3 months, but AL and ACD continued to increase for 3 months.
Conclusion

Vitrectomy alone does not affect anterior or posterior corneal astigmatism. Following vitrectomy, the AL increases, while the ACD decreases transiently. When vitrectomy is combined with phacoemulsification for cataract removal, the anterior and posterior corneal astigmatism increases transiently, while AL and ACD are enlarged for several months following surgery.
The mitochondrial calcium uniporter induces apoptosis in cardiomyocytes cultured with high-glucose medium by affecting mitochondrial function
Authors: Chen Xia , Guo Wenyun , Jing Zhe , Zhang Tao , Wu Zhaoqi , Cui Hengqiang , Zheng Wenxue , Chen Yongqing , Chen Hui 
Published: May 2020

Abstract
Background

As the number of diabetics worldwide continues to increase, diabetic cardiomyopathy has become one of the main causes of cardiovascular disease risk in diabetic patients. Currently, the pathophysiological mechanism of DCM has not been fully elucidated. In the present study, relevant pathological changes of cardiomyocytes in the high glucose environment were simulated by in vitro culture of rat H9C2 cardiomyocytes, to explore the mechanism by which MCU induces apoptosis in cardiomyocytes.
Method:

Cultured rat myocardium H9C2 cells in vitro and divided into high glucose group (glucose concentration 33 mmol/L), normal group (glucose concentration 5.5 mmol/L), experimental group (5.5 mmol/L glucose and transfected with MCU siRNA) and control group (5.5 mmol/L glucose and transfected negative control siRNA). Comparative analysis of MCU expression, Ca2+ uptake, mitochondrial function, oxidative stress and apoptosis of two groups of cells.
Results

(1) Compared with normal group, in the high glucose group the MCU expression of myocardial cells in H9C2 rats decreased, The Ca2+ levels, membrane potential and mitochondrial ATP levels decreased, mitochondrial ROS levels increased, NADH+/NADPH ratio in cardiomyocytes increased, GSH/GSSG ratio decreased, the expression levels of cleaved caspase-3 and cleaved caspase-9 increased, bcl-2 expression decreased, the number of cardiomyocytes apoptotic cells increases. (2) Compared with the normal group and the control group, the experimental group MCU expression of myocardial cells in H9C2 rats decreased, The Ca2+ levels, membrane potential and mitochondrial ATP levels decreased, mitochondrial ROS levels increased, NADH+/NADPH ratio in cardiomyocytes increased, GSH/GSSG ratio decreased, the expression levels of cleaved caspase-3 and cleaved caspase-9 increased, bcl-2 expression decreased, the number of cardiomyocytes apoptotic cells increases.
Discussion

This study suggested that MCU expression in rat H9C2 cardiomyocytes was decreased in the high glucose environment, causing abnormal mitochondrial calcium uptake and imbalanced calcium homeostasis, which may further contribute to mitochondrial dysfunction and enhanced oxidative stress in cardiomyocytes. Mitochondrial dysfunction and enhanced oxidative stress ultimately led to apoptosis in cardiomyocytes.
Clinical features of middle-aged patients died of 2019 Novel Coronavirus–Infected Pneumonia
Authors: Huang Yangyang , Zeng Guangwang , Chen Guoxi , Cai Yuyang , Huang Hai , Wang Yaling , Hou Min , Li Xiaopan , Ji Chen , Zhang Di , Lan Xing , Yang Ling 
Published: May 2020

Abstract
Background

Since December, 2019, the emerge of a Novel Coronavirus Disease 2019 (COVID-19) have caused global concern, the majority viewpoints are that the deaths are related to advanced ages, however, the emergence of younger deaths needs immediate attention.
Methods

Clinical characteristics, laboratory results, chest CT scans and treatment measures were retrospectively reviewed for six deceased patients under 60 years old with confirmed COVID-19 who were admitted to Wuhan Pulmonary Hospital in Wuhan, Hubei Province, China, from 6th January to 4th March, 2020.
Results

The age range of the patients was 50.17 ± 3.25 years (45–55 years), none of them had underlying diseases. All of patients presented with the symptoms of fever, respiratory system and digestive system. The level of albumin and lymphocyte counts decreased early in the stages of the disease, and then gradually increased. The neutrophil to lymphocyte ratio (NLR) increased (higher than normal range) in early stage and gradually decreased when the disease progressed. All the six patients showed ground-glass opacity (GGO) and bilateral patchy shadowing in early stage under the computed tomography (CT). All the patients died of severe pneumonia and multiple organ failure.
Conclusions

The decreased level of serum albumin occurred in the early stages of the disease, and delays in the first admission to hospital probably aggravate the disease development. The increase of the NLR in early stage of disease may be a risk of death for COVID-19. These findings may provide useful information for optimizing supportive care for COVID-19 pneumonia.
Comparative Analysis of the Mitochondrial Genome Sequences of two Medicinal Plants: Arctium Lappa and A. Tomentosum
Authors: Zhang Dachuan , Xing Yanping , Xu Liang , Zhao Rong , Yang Yanyun , Zhang Tingting , Li Shengnan , Bao Guihua , Ao Wuliji , Liu Tao , Kang Tingguo 
Published: May 2020

Abstract
Backguound: Mitochondrial genome sequence analysis is of great significance for understanding the evolution and genome structure of different plant species. Arctium lappa and A. tomentosum are distributed in China and frequently used as medicinal plants. People usually think A. tomentosum is an adulterant or substitute of A. lappa as a traditional Chinese Medicine (TCM). It is therefore critically important to identify the different species that are utilized in medicinal applications. This study aims to determine and compare their mitochondrial genomes, gene structure, and phylogenetic relationship. These results may provide additional insights into development of genetic research. Results: We determined the complete sequences of the mitochondrial genomes of A. lappa and A. tomentosum for the first time. The mitochondrial genomes of A. lappa and A. tomentosum were assembled into 2 single circular molecules of 312598 bp and 312609 bp, respectively. A total of 131 and 130 genes were annotated in two plants. 50 pairs of large repeat sequences were detected in A. lappa and A. tomentosum. The number of simple sequence repeats (SSRs) in both species was 192 while the total length of SSR was 2491 bp for A. lappa and 2489 bp for A. tomentosum. Only 51 single nucleotide polymorphisms (SNPs) and 3 insertion-deletions (InDels) were detected between the two plants. The two mitochondrial genome structures were highly similar and highly collinear. Both of the chloroplast genomes and mitochondrial genomes of the two plants had the phenomenon of gene exchange and transfer. Core genes and specific genes were analyzed for A. lappa and A. tomentosum and three closely related Asteraceae species, the specific gene of A. lappa was orf115a. In addition, a phylogenetic tree of the mitochondrial genomes were constructed, which laced the two Arctium species into one branch within Asteraceae. Conclusions: We identified and analyzed the mitochondrial genome features of two species of Arctium in China with implications for species identification and phylogenetic analysis. The mitochondrial genomes of A. lappa and A. tomentosum were very similar in size and structure. The ORF genes of the two were different, which could provide a theoretical basis for the development of molecular markers.
Analysis of metabolic syndrome factors to determine contributions to pathogenesis of mammary gland disease in Japanese women– Case-control study based on health screening results
Authors: Iida Tadayuki , Sumida Sakika , Masao Yoshikawa , Kaoru Nagaoka 
Published: May 2020

Abstract
Background: Recently, the relationship between obesity and breast cancer has been clarified, and findings obtained in a study that used body mass index (BMI) suggested that its presence might increase the risk for development of that disease. However, the association between metabolic syndrome caused by obesity and development of mammary gland disease has not been elucidated in a longitudinal manner. In the present case-control study, that association was examined.Methods: Two hundred sixty-five women who underwent breast cancer screening with mammography and measurements of metabolic syndrome factors, including waist circumference, blood glucose, and triglycerides, HDL-cholesterol levels, and systolic and diastolic blood pressure, twice within a 2-year period at the Disease Prevention Promotion and Research Center of the Dai-ikai Medical Corporation were enrolled. To determine the presence of mammary gland disease, 2 expert physicians interpreted radiogram findings, with category 3 or higher shown by mammography considered to indicate an abnormality.Results and Discussion: Waist circumference at the initial measurement was shown to be significantly associated (odds ratio=1.036, p=0.045) as a risk factor for onset of mammary gland disease. During the 2-year examination period, changes in systolic blood pressure (odds ratio=1.020, p=0.085) and diastolic pressure (odds ratio=1.040, p=0.065) showed a marginally significant association. As for protective factors, HDL-cholesterol level (odds ratio=0.982, p=0.064) at the initial examination was confirmed to have a marginally significant relationship. We concluded that waist circumference and 2-year changes in systolic and diastolic blood pressure are risk factors for mammary gland disease, while HDL-cholesterol level is a protective factor.
WITHDRAWN: Comparison of Standard Versus Accelerated Epithelium-Off and Transepithelial Corneal Cross-Linking in Pediatric Keratoconus: An Up-to-date Meta-Analysis
Authors: Li Yuanjun , Yin Yewei , Hu Tu , Du Kaixuan , Lu Ying , Fu Yanyan , Xiang Aiqun , Wu Xiaoying , Xia Xiaobo , Wen Dan 
Published: May 2020

Abstract
Purpose: To compare the efficacy of four corneal cross-linking (CXL) protocols: standard epithelium-off (SCXL), accelerated epithelium-off (ACXL), transepithelial (TCXL), and accelerated transepithelial (A-TCXL) for pediatric keratoconus.Methods:A comprehensive literature search on the efficacy of SCXL, ACXL, TCXL and A-TCXL in treating keratoconus patients age 18-year or under was conducted using PubMed and EMBASE up to March 2020. Primary outcomes included uncorrected visual acuity (UCVA) and maximum keratometry (Kmax). Secondary outcomes included best-corrected visual acuity (BCVA), central corneal thickness (CCT), and mean refractive spherical equivalent (MRSE). Estimations were analyzed by weighted mean difference (WMD) and 95% confidence interval (95% CI) for the outcomes during observation periods from 6 to 36 months.Results:Eight papers involving total 704 eyes were enrolled. In pediatrics, ACXL resulted in significantly better postoperative UCVA than SCXL at 12-month observation (WMD = 0.08, 95% CI: 0.02 to 0.14, P = 0.007), while SCXL provided statistically better BCVA (WMD = -0.07, 95% CI: -0.12 to -0.01, P = 0.01) and MRSE (WMD = 0.31, 95% CI: 0.06 to 0.56, P = 0.01) than ACXL at 24 months. Furthermore, SCXL provided significantly improved BCVA compared with TCXL at 12- to 24-month observation. (WMD = -0.13, 95% CI: -0.21 to -0.05, P = 0.001). Conclusions:In pediatric keratoconus, although UCVA in short-term follow-up after ACXL was better than that after SCXL, the long-run results showed that SCXL may provide superior visual acuity than either ACXL or TCXL. Further investigation is required to compare the efficacy of different CXL protocols for the management of pediatric keratoconus.
Interactive Effects of Spectral Lights and Salt Stress on Production of Secondary Metabolites and Growth Behavior in Economically Important Brassica Rapa
Authors: Khan Iftikhar Muhammad , Iqbal Javeed , Ahmad Nisar , Ali Waqar , Rehman Hina , Ali Syed Shujait , Fazal Hina , Khan Abbas , Wei Dong Qing 
Published: May 2020

Abstract
BackgroundEnvironmental factors like, temperature, humidity, light intensity, the supply of water, minerals, and CO2 influence the growth of a plant and biomass accumulation and production of secondary metabolites. Plant cell culture technologies have been effective tools for both studying and producing plant secondary metabolites under in vitro conditions and for plant improvement. The main objective of the current study was to investigate the biomass production and accumulation of secondary metabolites in Brassica rapa in response to synergism of abiotic factors including salt and colored lights.MethodsBrassica rapa sterilized seed were germinated and exposed to different colored lights (white as a control, yellow, blue, green and red) in combination with different concentrations of salt. The length of shoot, root and biomass (fresh and dry) were monitored during the developmental stages. Total phenolics and flavonoids content of the samples were also investigated. Data was analyzed using ANOVA-single factorial.ResultsResults revealed that plants exposed to the synergism of salt stress and spectral lights have shown negative effects on the seed germination. Shoot length (75 mm) increased, while root length (55 mm) was inhibited in plants exposed to synergism of spectral lights and different concentrations of salt when compared with controlled conditions (48 mm for shoot and 100 mm for root). However, the fresh weight of the plants was increased at lower concentration of salt than controlled. Lowest concentration of salt in synergism with green light showed the maximum response. Total phenolic content increased, while total flavonoid decreases with increasing salt concentration. Maximum total phenolic and flavonoids content were recorded in dark incubation with a high and medium concentration of salt respectively.ConclusionBased on these results, it was concluded that synergism of low salt concentration and colored lights are effective but high concentrations of salt in combination with colored lights inhibited the growth of Brassica rapa.
Interaction of light and gravity signals as a mechanism of counteracting alterations caused by simulated microgravity in proliferating plant cells
Authors: Manzano Aránzazu , Pereda-Loth Veronica , Bures Anne de , Sáez-Vásquez Julio , Herranz Raúl , Medina F. Javier 
Published: May 2020

Abstract
Background

Light and gravity are fundamental cues for plant development on Earth. In space, understanding the effects of changing conditions affecting to these two stimuli is key for optimizing the life support systems to come with space exploration. Simulated microgravity is useful as a complement to real spaceflight experiments into refining our knowledge of early plant development adaptation to extraterrestrial environments.
Results

In wild type Arabidopsis and in mutants of the two genes of the essential nucleolar protein nucleolin (nuc1 and nuc2), the use of an extended toolbox of cell proliferation, cell growth and ribosome biogenesis markers, has allowed us to show that the incorporation of an illumination regime, in this case photoperiod, has been sufficient to attenuate or suppress the effects caused by gravitational stress at the cellular level in the root meristem. These results are consistent with other experiments carried out at real and simulated microgravity in which early plant development is nominal when the environmental conditions are optimal (nutrients, light, temperature, humidity).
Conclusions

Light signals may total or partially replace gravity signals significantly improving plant growth and development in microgravity. Despite that, molecular alterations are still compatible with the expected adaptation mechanisms that should be better understood. The differential sensitivity of nuc1 and nuc2 mutants to gravitational stress points to new strategies to produce more resilient plants to travel with humans in new extraterrestrial endeavors.
Manual CPR Vs Mechanical CPR: Which One Is More Effective During Ambulance Transport?
Authors: Şan İshak , Bekgöz Burak , Ergin Mehmet , Usul Eren 
Published: May 2020

Abstract
Objectives We aimed to evaluate and compare the qualities of chest compressions performed manually by healthcare professionals and by a mechanical chest compression device on a training model during an ambulance transfer. DesignThis is an experimental trial. Setting This study was performed by the EMS of Ankara City (Capital of Turkey). 20 (10 male and 10 female) paramedic participated the study. We used LUCAS 2 as mechanical chest compression device in the study. A total of 40 rounds were driven on the track; in that moving ambulance, the model was applied chest compression in 20 rounds by paramedics, while in 20 rounds were applied by mechanical chest compression device. The depth, rate and hands-off time of chest compression were measured by means of the model's recording system. Results The median chest compression rate was 120.1 compressions per minute (IQR 25–75%=117.9–133.5) for the paramedics, whereas it was 102.3 compressions per minute for the mechanical chest compression device (IQR 25–75%=102.1–102.7) (p<0.001). The median chest compression depth was 38.9 millimeters (IQR 25–75%=32.9–45.5) for the paramedics, whereas it was 52.7 millimeters for the mechanical chest compression device (IQR 25–75%=51.8–55.0) (p<0.001). The median hands-off time during cardiopulmonary resuscitation was 6.9% (IQR 25–75=5.0–10.1%) for the paramedics and 9% (IQR 25–75%=8.2–12.5%) (p=0.09). Conclusion Chest compressions performed by the mechanical chest compression device were found to be within the range recommended by the guidelines in terms of both speed and duration.
Hygienic Food Practice among Food Workers in Jordanian Food Factories during pandemic crisis: COVID-19:comparative study
Authors: omar sharaf 
Published: May 2020

Abstract
Food borne disease is transmitted easily among food handlers working in food factories. This study aimed to evaluate hygienic food practice among food handlers working in food factories in Jordan during pandemic crisis: COVID-19 . A total of 500 food handlers in 25 food factories were participated in this question survey study. The knowledge of food handlers during COVID-19 pandemic was higher than their knowledge before COVID-19 pandemic with a mean percentage score of 83.4 ± 8.3%, 73.3 ± 10.8% respectively. In general, the food handlers attitude toward safe food handling during COVID-19 was higher than their attitude before COVID-19 with mean percentage score of 91.3% ± 12.7 and 88.36% ± 10.7% respectively. The awareness of food handlers in Jordanian factories for COVID-19 requirements was with a mean percentage score of 70.4% ± 14.9%. Our study showed that fair knowledge for food handlers in food safety doesn't necessary reflect their positive attitude. The overall scores for this study were 79.13% . Enforcement the governmental regulations, increasing the number of education and training courses and encourage the positive behavior food handlers would improve the status of food hygiene during COVID-19.