bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Supply-side and Demand-side Interventions on Use of Antenatal and Maternal Services in Western Kenya: A Qualitative Study
Authors: Hirai Mitsuaki , Morris Jamae , Ouda Rosebel , Atieno Nancy , Quick Robert 
Published: November 2019

Abstract
Background : Antenatal care (ANC) and delivery by skilled providers have been well recognized as effective strategies to prevent maternal and neonatal mortality. ANC and delivery services at health facilities, however, have been underutilized in Kenya. One potential strategy to increase the demand for ANC services is to provide health interventions as incentives for pregnant women. In 2013, an integrated ANC program was implemented in western Kenya to promote ANC visits by addressing both supply- and demand-side factors. Supply-side interventions included nurse training and supplies for obstetric emergencies and neonatal resuscitation. Demand-side interventions included SMS text messages with appointment reminders and educational contents, group education sessions, and vouchers to purchase health products.

Methods : To explore pregnant mothers’ experiences with the intervention, ANC visits, and delivery, we conducted focus group discussions (FGDs) at pre- and post-intervention. A total of 19 FGDs were held with pregnant mothers, nurses, and community health workers (CHWs) during the two assessment periods. We performed thematic analyses to highlight study participants’ perceptions and experiences.

Results : FGD data revealed that pregnant women perceived the risks of home-based delivery, recognized the benefits of facility-based delivery, and were motivated by the incentives to seek care despite barriers to care that included poverty, lack of transport, and poor treatment by nurses. Nurses also perceived the value of incentives to attract women to care but described obstacles to providing health care such as overwork, low pay, inadequate supplies and equipment, and insufficient staff. CHWs identified the utility and limitations of text messages for health education.

Conclusions : Future interventions should ensure that adequate workforce, training, and supplies are in place to respond to increased demand for maternal and child health services stimulated by incentive programs.
Reference values and correlations for multiple physical performance measures: a prospective cross-sectional study among independently mobile older men in Japan
Authors: Ishii Yoshinori , Noguchi Hideo , Sato Junko , Ishii Hana , Ishii Ryo , Kobayashi Seiya , Iwamura Takashi , Toyabe Shin-ichi 
Published: November 2019

Abstract

Background: As the most rapidly aging country in the world, Japan is one of few countries with a male life expectancy over 80 years. The gap between the healthy life span and the total life expectancy is large, highlighting the importance of maintaining physical performance (e.g., walking speed, grip strength, and standing balance) in later life, which is also negatively associated with mortality among older adults. The present study aimed to establish reference values for multiple physical performance measures among high-functioning oldest-old Japanese men and to investigate the correlations among these measurements to understand how these variables are related in a more detailed and objective way, compared with previous studies. Methods: This single-center prospective cross-sectional study was conducted from September 2018 to August 2019 with 120 male orthopedic patients in Japan who were able to walk independently. Seven measures of physical performance were assessed: handgrip strength, quadriceps strength, static balance ability (one-legged stance), dynamic balance ability (Functional Reach Test; FRT), walking ability (5-m walking time test), combined movement ability (Timed Up & Go test), and bone quality. Cognitive function was also measured (Mini-Mental State Examination; MMSE). Spearman’s rank correlation was used to evaluate correlations between the variables. Results: Specific reference values are reported for each physical performance measurement explored in this study. Only six participants were classified as cognitively impaired, and 16 had mild cognitive impairment. There were significant correlations of varying levels among all of the measures of physical performance. Age was significantly correlated with all performance measures except FRT, and there was no correlation between age and MMSE. MMSE was weakly correlated with FRT and unrelated to the other performance measures. Conclusions: The reference ranges from this study among a high-functioning cohort of men aged 80 years or older can be used by older men who have not yet reached this age and their health care providers as physical performance targets to facilitate the maintenance of independent mobility in later life. There is an urgent need for the establishment of exercise interventions that will allow these men to achieve the desired targets, potentially lengthening their healthy life span.
Oropharyngeal dysphagia and quality of life in elderly patients after stroke.
Authors: Oliveira Leticia Sampaio de , Cardenas Jonan Emi Valencia , Mituuti Claudia Tiemi , Rosa Raquel Rodrigues , Andrade Eduardo Carvalho de , Berretin-Felix Giédre 
Published: November 2019

Abstract
Objective To verify the association between oropharyngeal dysphagia and quality of life in elderly individuals, at the late stage of stroke.Methods Retrospective cross-sectional study, whose results were obtained by analysis of the databank of a project that analyzed 30 elderly individuals affected by stroke in the late stage. All were submitted to clinical and instrumental evaluation (fiberoptic endoscopic) of swallowing, testing foods of solid, liquid and pudding textures. The degree of dysphagia was classified according to data from clinical examination and images of videoendoscopy examinations using the DOSS scale (Dysphagia Outcome and Severity Scale). The quality of life related to swallowing was analyzed by the SWAL-QOL protocol (Quality of Life in Swallowing Disorders), previously applied to the elderly individuals. Data were submitted to descriptive statistical an analysis and the Spearman correlation test.Results The clinical evaluation evidenced that most individuals presented mild oropharyngeal dysphagia, while the DOSS scale demonstrated swallowing with functional limitations. Mild impact or lack of impact was observed on the quality of life related to swallowing. There was positive correlation between burden, wish to feed, duration of feeding and mental state with the severity of oropharyngeal dysphagia, both by clinical and instrumental evaluations; and between the frequency of symptoms and severity of dysphagia by clinical evaluation (p<0.01).Conclusion There was association between the severity of oropharyngeal dysphagia and quality of life of elderly individuals in the late stage of stroke, demonstrating the importance of longitudinal follow-up of these individuals concerning the feeding aspects.
Physical activity and risk of dementia in community-dwelling older people: the Three-City cohort.
Authors: Dupré Caroline , Bongue Bienvenue , Helmer Catherine , Dartigues Jean François , Hupin David , Roche Frédéric , Berr Claudine , Carriere Isabelle 
Published: November 2019

Abstract
Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people.Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype.Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant protective effect was found for leisure/sport activities.Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.
The Effect of Otago Exercise Program Training on Balance and Fear of Falling in Elderly Individuals
Authors: Arzhane Saeide Solati Dasht , Hazrati Maryam , Ashraf Alireza 
Published: November 2019

Abstract
Background Balance is an index to determine the independence level of elderly individuals in their daily activities. This study aimed to examine the effects of Otago Exercise Program (OEP) on balance and fear of falling among elderlies.Methods This clinical trial with pre/posttest design was conducted on 88 individuals aged 60 years and over who had referred to Imam Reza geriatric clinic and Kholdebarin retirement center in Shiraz. The participants were selected through simple random sampling. In the pretest, the two groups were assessed via 30-second chair stand, timed up and go, and four-stage balance tests to determine their balance status. Their fear of falling was also evaluated using the Fall Efficacy Scale-International (FES-I). The OEP was administered to the intervention group over one month in form of two 1.5-hour sessions per week. However, the control group received no trainings. The exercises were performed by the participants in their houses 5-6 times a week each lasting for 40-60 minutes over eight weeks. The participants were also followed up via telephone contacts weekly to ensure the performance of the exercises. The data were analyzed using the SPSS 21.Results The results showed that the implementation of OEP had a significant effect on improvement of balance among the elderly participants. Furthermore, the results revealed the effectiveness of OEP in reducing the fear of falling among the participants. The mean score of fear of falling was 18.88 in the intervention group and 30.30 in the control group. However, no significant differences were found between the pretest and posttest scores in the control group.Conclusion The study results indicated that OEP could be effective in improving postural stability as well as dynamic and static balance and declining the fear of falling. Trial Registration: Registration number of this study is IRCT20131117015426N7 and the date of registration is 2019.06.17.
Drought and flood occurrences in the Lancang River Basin during the last 60 years: their variations and teleconnections with monsoons
Authors: Tang Jian , Cao Huiqun 
Published: November 2019

Abstract
Understanding the inconsistency in the effects of monsoon changes on drought and flood occurrences would allow scientists to identify useful indicators in the prediction and early warning of regional drought and flood. Based on the calculation of the Standardized Precipitation Index, monsoon indices, and water vapor fluxes from 1956 to 2015, the relationships between drought–flood occurrences and monsoons in different regions of the Lancang River Basin were investigated. Drought and flood occurrences had spatial differences. Areas located in the lower basin had high drought and flood occurrences. The frequencies of drought and flood occurrences have no obvious regional differences and mainly varied periodically at 3–5, 8–15, and 20–25 years. Because the impact and strength of the Tibetan Plateau Monsoon (TPM) and South Asian monsoon (SAM) are limited, the TPM and SAM are the key factors that affect the occurrences of drought and flood in the upstream and downstream regions of the Lancang River Basin, respectively. The TPM and SAM are potentially useful indicators in the prediction of drought and flood occurrences. These results are of great scientific merit in developing an effective mitigation strategy to reduce the impacts of drought–flood disasters in the Lancang River Basin.
Biosorption of Cd2+ from aqueous solution by Ca2+/Mg2+ type Citrus paradisi Macf. peel biosorbents
Authors: Sun Hongyan , Wang Xiaoyun , Wang Rui , Zhang Yuezhong , Wang Xiaoxiao 
Published: November 2019

Abstract
Grape fruit (Citrus paradisi Macf.) peel (GP) was used as raw material to prepare two novel biosorbents: CaGP (Ca2+ type) and MgGP (Mg2+ type). Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and N2 adsorption–desorption isotherms were used to characterize prepared adsorbents. Cd2+ biosorption by CaGP, MgGP and GP was investigated systematically by studying the effects of pH, biosorption time and initial concentration on the biosorption of Cd2+. The results showed that biosorption efficiencies of Cd2+ on CaGP and MgGP increased with increase in pH, and the highest removal of Cd2+ was occurred at pH 6.0. Meanwhile, Cd uptake capacity increased with contact time, and could reach equilibrium within 20 min. The rates of biosorption of Cd2+ on three prepared biosorbents were found to best-fit pseudo-second-order equation. Experimental isotherms were well fitted by Langmuir and Freundlich isotherms models. Moreover, according to the Langmuir equation, the maximum biosorption capacities (qm) of Cd2+ on CaGP and MgGP were found to be increased by 46.3% and 27.0%, respectively, compared with GP. The present study demonstrated that the waste grape fruit peel after simple Ca2+ or Mg2+ treatment could be used as a potential biosorbent for Cd2+, which indicated modified novel inactive/dead biological materials could remove Cd2+ from water.
Photocatalytic degradation of chlortetracycline hydrochloride in marine aquaculture wastewater under visible light irradiation with CuO/ZnO
Authors: Liu Jinghua , Yu Xiaocai , Wang Liping , Guo Meicen , Zhu Wanting , Tian Siyao 
Published: November 2019

Abstract
A CuO/ZnO photocatalyst nanocomposite was successfully prepared by co-precipitation and characterized by investigating its chemical and physical properties by X-ray diffraction, scanning electron microscopy, energy dispersive spectroscopy, UV-vis diffuse reflectance spectroscopy and photoluminescence spectroscopy. The average particle size of CuO/ZnO composite was found to be around 80 nm. The degradation of chlortetracycline hydrochloride pollutants in marine aquaculture wastewater using ZnO and CuO/ZnO was compared and it was found that CuO/ZnO nanocomposite is more efficient than ZnO. The effects of external factors on the photocatalytic effectiveness of nanocomposite were investigated under visible light. Also, the photocatalytic conditions for the degradation of chlortetracycline hydrochloride by the nanocomposite were optimized. Based on both ability and efficiency of degradation, and on the cost and availability, 10:2 molar ratio of Zn2+/Cu2+ and 0.7 g/L nanocomposite, was found to be optimal, in which case the average photocatalytic degradation rate of chlortetracycline hydrochloride reached 91.10%.
MicroRNA-542-3p Regulates P-glycoprotein Expression in Rat Epilepsy via the Toll-like Receptor 4/Nuclear Factor-kappaB Signaling Pathway
Authors: Yan YuKui , Xia Hongping , Hu Jianqin , Zhang Bing 
Published: November 2019

Background:
The function of microRNA-542-3p (miR-542-3p) in rat epilepsy is still
unclear.

Methods:
The levels of miR-542-3p and toll-like receptor 4 (TLR4) were determined through
quantitative real-time PCR. The protein levels were examined via the western blot analysis. The
relationship between miR-542-3p and TLR4 was confirmed through luciferase assay. Pathological
changes were analyzed via Hematoxylin-eosin (HE) and Nissl staining.

Results:
The rats and hippocampal cells were treated with kainic acid (KA) in vivo and in vitro.
miR-542-3p was low in KA-treated rats, hippocampal cells and cerebrospinal fluid of patients with
epilepsy. Further functional analysis showed that miR-542-3p overexpression inhibited KAinduced
average seizure frequency, damage of hippocampal neuron and cell apoptosis, leading to
the alleviation of the brain injury in epilepsy rats. miR-542-3p was determined to downregulate
TLR4 expression. The relationship between miR-542-3p and TLR4 was confirmed. TLR4 knockdown
reduced KA-induced nuclear factor-kappa B p65 (NF-κB p65), multidrug resistance 1
(MDR1), P-glycoprotein (P-gp) and apoptosis-associated protein levels. Further, for NF-κB p65,
MDR1, P-gp and apoptosis-associated protein levels detection, miR-542-3p mimic showed a suppressive
effect on these KA-induced protein levels, whereas TLR4 overexpression ameliorated the
miR-542-3p-induced these protein levels in KA-treated epilepsy rats.

Conclusion:
We identified that miR-542-3p attenuated seizure-induced brain injury and the expression
of P-gp in epilepsy rats through inhibiting TLR4/NF-κB signaling pathway, which might
contribute to improved epilepsy therapy.
African Plants with Antidiabetic Potentials: Beyond Glycaemic Control to Central Nervous System Benefits
Authors: Onaolapo Adejoke Y. , Onaolapo Olakunle J. 
Published: November 2019

Background:
For centuries, humans have used medicinal plants in the management of both
acute and chronic diseases. Currently, the practice of using medicinal plants to manage diseases is becoming
increasingly-common; especially in medium to low-income economies where the cost of, or
ease of access to orthodox medications are limitations to their effective and sustained use. Diabetes
mellitus is a chronic disease whose prevalence continues to increase worldwide. An aspect of diabetes
mellitus that causes significant morbidity is its neurological complications, which are known to be associated
with an enormous economic burden and reduction in quality of life.

Objectives:
While research continues to demonstrate that a wide range of plants that are indigenous to
Africa have significant antihyperglycaemic properties, scientific information on the neurobehavioural
and/or neuromorphological effects of these plants appear to be lacking. Also, their possible benefits in
the prevention or amelioration of the neurological complications of diabetes mellitus remain generally
unexamined.

Methodology:
In this narrative review, we the examine available scientific literature dealing with the
neurobehavioural and/or neuromorphological profiles of selected African plants with substantiated antihyperglycaemic
properties; aiming to highlight their potential applications in the prevention and management
of the neurological complications of diabetes mellitus.

Results:
This review demonstrates that a number of the African plants with antidiabetic properties also
exhibit central nervous system effects.

Conclusion:
While the neurobehavioural and neuromorphological effects of some of these plants had
been investigated in animal models of DM; their possible roles in the prevention or amelioration of the
neurological complications of DM are yet to be established.
Secondary Metabolite Produced by Diaporthe terebinthifolli LGMF658 – Bioactivity and Chemical Structure Relationship
Authors: Tonial Fabiana , Bertol Charise D. , Sales Maia Beatriz H.L.N. , Figueiredo Josiane A.G. , Guerra Kielli C.F. , Glienke Chirlei 
Published: November 2019

Background:
Motivated by the need for bioprospecting new drug studies have revealed a
variety of secondary metabolites with biological activity. In particular, antimicrobial research confronts
the growing reality of resistance of microorganisms to currently available drugs. Modifications in the
chemical structure of secondary metabolites may be important in the development of a product to improve
the efficacy of these compounds. Being cognizant of the fact that modifications in the chemical
structure could enhance the biological activity and improve the compound characteristics for the development
of a product, the present study aimed to verify, if there is the possibility of a significant difference
in the bioactivity of verbanol in relation to verbenol.

Methods:
The biological activity was evaluated by agar diffusion assay and microdilution.

Results:
Verbanol is a bioactive secondary metabolite produced by the endophytic fungus Diaporthe
terebinthifolli LGMF658. This compound has bactericidal activity against Staphylococcus aureus and
fungicide against Candida albicans according to the microdilution assay.

Discussion:
In contrast, verbenol, a byproduct of verbanol, did not control the development of the bacterium
and showed fungistatic activity against yeast.

Conclusion:
The results demonstrated that the presence of the double bond, which increased the polarity
of the compound, reduced its bioactivity, corroborating with other studies that report the importance
of lipophilicity for antimicrobial action.
Comparison of Different Uses of Cyclophosphamide in Lupus Nephritis: A Meta-Analysis of Randomized Controlled Trials
Authors: Li Yebei , Xu Shizhang , Xu Gaosi 
Published: November 2019

Background:The present study aims to compare the relative efficacy and safety of different uses of cyclophosphamide (CYC) in lupus nephritis (LN).Methods:We searched the Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed for articles from the database till June 2018.Results:12 randomized controlled trials with 994 participants were included. The meta-analysis indicated that the short-interval lower-dose intravenous CYC regime remarkably reduced 24-hour proteinuria [mean difference (MD) -0.45; 95% confidence interval (CI) -0.62 to -0.27; I2 0%], incidence of major infections [odds ratio (OR) 0.62, 95% CI 0.40 to 0.95; I2 42%], gonadal toxicity (OR 0.41, 95% CI 0.27 to 0.62; I2 0%), and leukopenia (OR 0.55, 95% CI 0.33 to 0.94, I2 0%), while high-dose regime had an obvious lower probability of doubling of serum creatinine (Scr) level (OR 2.43; 95% CI 1.19 to 4.95; I2 0%). However, the difference in the complete and total remission rates between the two regimens was not observed.Conclusion:The result suggested that the short-interval lower-dose CYC regime remarkably reduced 24-hour proteinuria and the incidence of adverse events, while the long-course high-dose regime played a significant role in reducing the rate of doubling Scr level.