bluuebunny/crossref_metadata_2025_split huggingface dataset:
Users’ Experiences With an Interactive Evidence to Decision (iEtD) Framework: A Qualitative Analysis
Authors: Meneses-Echavez Jose Francisco , Rosenbaum Sarah , Rada Gabriel , Flottorp Signe , Moberg Jenny , Alonso-Coello Pablo 
Published: October 2020

Abstract
Background: Evidence to Decision (EtD) frameworks bring clarity, structure and transparency to health care decision making. The interactive Evidence to Decision (iEtD) tool, developed in the context of the DECIDE project and published by Epistemonikos, is a stand-alone online solution for producing and using EtD frameworks. Since its development, little is known about how organizations have been using the iEtD tool and what characterizes users’ experiences with it.Methods: This study aimed to describe users’ experiences with the iEtD and identify main barriers and facilitators related to use. We contacted all users registered in the iEtD via email and invited people who identified themselves as having used the solution to a semi-structured interview. Audio recordings were transcribed, and one researcher conducted a content analysis of the interviews guided by a user experience framework. Two researchers checked the content independently for accuracy. Results: Out of 860 people contacted, 81 people replied to our introductory email (response rate 9.4%). Twenty of these had used the tool in a real scenario and were invited to an interview. We interviewed all eight users that accepted this invitation (from six countries, four continents). ‘Guideline development’ was the iEtD use scenario they most commonly identified. Most participants reported an overall positive experience, without major difficulties navigating or using the different sections. They reported having used most of the EtD framework criteria. Participants reported tailoring their frameworks, for instance by adding or deleting criteria, translating to another language, or rewording headings. Several people preferred to produce a Word version rather than working online, due to the burden of completing the framework, or lack of experience with the tool. Some reported difficulties working with the exportable formats, as they needed considerable editing.Conclusion: A very limited number of guideline developers have used the iEtD tool published by Epistemonikos since its development. Although users’ general experiences are positive, our work has identified some aspects of the tool that need improvement. Our findings could be also applied to development or improvement of other solutions for producing or using EtD frameworks.
The prognosis prediction significance of Hounsfield unit value for stroke patients treated by intravenous thrombolysis
Authors: Zhu Zhengqi , Zhang Ru , Ren Kaixuan , Cong Ruochen , Zhu Xiangyang , Zhu Li , Wang Tianle 
Published: October 2020

Abstract
Background: Intravenous thrombolysis (IVT) is a rapid and effective treatment in the early stage of ischemic stroke patients and the purpose of this work is to explore the significance of Hounsfield unit(HU) value in Alberta Stroke Program Early CT Score (ASPECTS) for predicting the clinical prognosis of stroke patients with middle cerebral artery occlusion (MCAO) treated by IVT. Methods: The 84 stroke patients with MCAO treated by IVT were divided into good prognosis group (48 cases) and poor prognosis group (36 cases). HU ratio and HU difference calculated from non-contrast computed tomography (NCCT) between groups were analyzed. Results: The HU ratio of good prognosis group was higher than that in poor prognosis group and the HU difference of good prognosis group was lower than that in poor prognosis group (P＜0.05). The HU ratio was negatively correlated with the infarct volume, and the HU difference was positively correlated with the infarct volume (P＜0.05). HU difference was an independent risk factor for prognosis of patients with MCAO treated by IVT. The area under the curve (AUC) of HU ratio and HU difference for prognosis was 0.743 and 0.833 respectively (P＜0.05). Conclusion: The HU value changes are related to the clinical prognosis of stroke patients with MCAO treated by IVT, HU value may be a prognostic indicator for stroke patients with MCAO treated by IVT.
Epidemiologic Trends of Infants With Orofacial Clefts in a Multiethnic Country: A Retrospective Population-based Study
Authors: Yow Mimi , Jin Aizhen , Yeo George SH 
Published: October 2020

Abstract
Objectives: To establish the population-based prevalence and trends of cleft live births, evaluate associated malformations and infant mortality rate (IMR), and delineate the orofacial cleft (OFC) topography, ethnic and gender-specific features of the resident-population in Singapore from 2003 to 2012. Cleft-births surveillance and data of affected individuals, families, ethnic groups, locations and environment are essential in upstream healthcare planning. Well-informed decisions supported by data are all-important in health policies.Methods: Resident population-based data were compiled from the National Birth Defects Registry (NBDR). The Registry’s data was established from multiple sources: cytogenetics and histopathology laboratories, neonatal wards and maternity hospitals, medi-claims, birth defects, death certificates with reported congenital anomalies, stillbirths and abortuses (spontaneous and elective). The significance level of trend testing was set at p<0.05.Results: Prevalence per 10 000 for all cleft live births was 16.72; isolated clefts with no associated malformations, cleft lip, cleft palate, and cleft lip with cleft palate were 8.77, 6.85, 3.16, and 6.71, respectively. Prevalence in cleft live births was sexually dimorphic and ethnic-specific: Male, 17.72; Female, 15.78; Chinese group, 17.17; Malay group, 16.92; Indian group, 10.74; and mixed ethnicity group, 21.73. Infants with isolated clefts, non-isolated clefts with other malformations, and syndromic clefts were 52.5%, 42.1%, and 5.4%, respectively. Upward trend in infants with non-isolated clefts was significant (p=0.0287). The mortality rate in infants with clefts was 4.76%.Conclusions: The population-based prevalence for cleft live births was 16.72 per 10 000 with no significant upward trend. Co-occurrence of malformations and syndromes was found in almost half of all cleft live births. The IMR of infants with OFC was double that of the population norm.
CircRNA ACAP2 is Overexpressed in Myocardial Infarction and Promotes the Maturation of miR-532 to Induce the Apoptosis of Cardiomyocyte
Authors: Zhang Jun , Tang Yanrong , Zhang Jing , Wang Jing , He Jiyun , Zhang Zhenzhen , Liu Fuqiang 
Published: October 2020

Abstract
Background: CircRNA ACAP2 and miR-532 both promotes the apoptosis of cardiomyocytes, which contributes to myocardial infarction (MI). Therefore, ACAP2 and miR-532 may interact with each other to participate in MI. Method: Plasma samples from both MI patients (n=65) and healthy controls (n=65) were subjected to RNA extractions and RT-qPCR to analyze the expression of ACAP2, mature miR-532 and premature miR-532. Correlations among them were analyzed by Pearson’s correlation coefficient. Expression of both mature miR-532 and premature miR-532 in cardiomyocytes with ACAP2 overexpression was analyzed by RT-qPCR to study the effects of ACAP2 overexpression on the maturation of miR-532. The role of ACAP2 and miR-532 in regulating the apoptosis of cardiomyocytes induced by hypoxia was analyzed by cell apoptosis assay.Results: In this study we found that ACAP2 and mature miR-532 were both upregulated in plasma from MI patients. ACAP2 and mature miR-532 were inversely correlated, while ACAP2 and premature miR-532 were not closely correlated. In cardiomyocytes, overexpression of ACAP2 decreased the expression of mature miR-532, but not premature miR-532. Cell apoptosis analysis showed that ACAP2 and miR-532 overexpression promoted the apoptosis of cardiomyocytes induced by hypoxia treatment. In addition, miR-532 inhibitor reduced the effects of ACAP2 overexpression. Conclusion: Therefore, ACAP2 is overexpressed in MI and may promote the maturation of miR-532 to induce the apoptosis of cardiomyocyte.
Mechanism of Action of Limonene in Tumor Cells: A Systematic Review and Meta-Analysis
Authors: de Vasconcelos C. Braz Juliana , de Carvalho Fernanda O. , de Vasconcelos C. Meneses Daniele , Calixto Fernanda A.F. , Santana Hericalizandra S.R. , Almeida Isabella B. , de Aquino Luana A.G. , de Souza Araújo Adriano A. , Serafini Mairim R. 
Published: October 2020

Background:
Cancer is a complex, multifactorial disease, and a major public health problem, as it is
a leading cause of morbidity and mortality worldwide. Although treatments have significantly improved, still
more effective drugs are searched. One source for these drugs is natural products (NPs). One NP that has
shown anticancer activity is Limonene. However, the mechanisms of limonene's antiproliferative, anticancer
and antineoplastic activity are not fully understood.

Objective:
The objective of this study is, therefore, to undertake a systematic review and meta-analysis of the literature on
this subject.

Methods:
A comprehensive literature search was performed using the Scopus, MEDLINE-PubMed, Web of Science,
and Science Direct databases using the keywords: “limonene”, “cancer”, “neoplasm”, and “tumor”. The
inclusion criteria were: in vivo and in vitro studies on the use of limonene in cancer published in English, Portuguese
and Spanish until December 2019. Review articles, meta-analyses, abstracts, conference papers, editorials/
letters and case reports were excluded.

Results:
The search identified 3568 articles, of which, 126 were selected for full reading, with 11 papers meeting
the review criteria. Six more papers were added from the references of the initial 11 texts, giving a total of
17 papers. There was a high level of agreement in inclusion/exclusion (Kappa index > 80%). The risk of bias in
the texts was shown to be high.

Conclusion:
The meta-analysis suggests that limonene acts mainly on tumor regression induced apoptosis and
is a promising natural product for use in the treatment of several types of cancer.
The Identification of A Novel HIV-1 Second-Generation Recombinant form (CRF01_AE/CRF07_BC) Among Men Who Have Sex with Men in Jiangsu, China
Authors: Yueqi Yin , Ying Zhou , Jing Lu , Hongxiong Guo , Jianshuang Chen , Yan Xuan , Hao Cheng , Defu Yuan , Haiyang Hu , Xiaoqin Xu , Bei Wang , Gengfeng Fu 
Published: October 2020

Background:
CRF01_AE and CRF07_BC are the two major HIV-1 virus strains circulating
in China. The proportion of dominant subtypes (CRF01_AE and CRF07_BC) among MSM
in Jiangsu province was over 80%. A large number of URFs have been found in China in recent
years.

Objective:
This study aimed to report on novel HIV-1 recombinants.

Method:
We constructed Phylogenetic trees using the maximum likelihood (ML) method with
1000 bootstrap replicates in IQ-TREE 1.6.8 software and determined recombination breakpoints using
SimPlot 3.5.1.

Results:
We identified a novel, second-generation HIV-1 recombinant (JS020202) between CRF01_
AE and CRF07_BC. The analysis of near full-length genome (NFLG) showed there were at
least 8 breakpoints in the virus, which differed from any previously identified CRF and URF
around the world.

Conclusion:
Novel diverse CRF01_AE/07_BC suggested the complexity trends of HIV-1 genetics.
The emergency situation of diverse recombinant strains should be monitored continuously.
Anticholinergic Burden Among Hospitalised Older Adults with Psychiatric Illnesses- A Retrospective Study
Authors: Mukku Shiva Shanker Reddy , Sinha Preeti , Sivakumar Palanimuthu Thangaraju , Varghese Mathew 
Published: October 2020

Background:
Drugs with anticholinergic properties are known to be associated with
deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older
adults with psychiatric disorders.

Objective:
To examine the anticholinergic cognitive burden and its predictors in hospitalised older
adults having psychiatric disorders.

Methods:
Case records of older adults who sought in-patient care under the Geriatric Psychiatry
Unit from January 2019 to June 2019 were reviewed. The anticholinergic burden was assessed
with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012.

Results:
Sample included 129 older adults with an almost equal number of males (53.48%) and females
(46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included
depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%),
and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older
adults had clinically relevant anticholinergic cognitive burden (ACB score ≥ 3). Use of 3 or more
psychotropic drugs (OR = 4.88), diagnosis of psychosis/mania (OR = 7.62) and dementia/ delirium
(neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3.

Conclusion:
Nearly half of the older adults in the psychiatry in-patient setting had a clinically relevant
anticholinergic burden, which was associated with higher use of psychotropics. Our study
highlights the importance of monitoringanticholinergic effects of psychotropics in older adults.
MU-LapaRobot: A Corporative Surgical Robot for Laparoscopic Surgery
Authors: Direkwatana Chawaphol , Suthakorn Jackrit , Wilasrussamee Chumpon 
Published: October 2020

Objective:Development of surgical instrument robot (MU-LapaRobot) for assisting in conventional laparoscopic surgery.Methods:A robot was designed based on instrument movement for a conventional procedure. The mechanism mimics and constrains manipulation movement through the wire-driven transmission. It is flexible for robot end-effector, which has a lightweight and small size. The usability of the robot is passive and active robot tasks with an interconnected driving system. Three main parts of the robot are robot end-effector, transmission, and a driving system.Results:On a robot platform, a parameter for setup is robot posture. The adjustment of robot position and projection of manipulation area is influenced by the accuracy of movement. To verify movement, command and exact movements are measured. Compensation with the control system is improved in order to improve the accuracy of the system.Conclusion:MU-LapaRobot provides surgical instrument manipulation by using wire-driven transmission with an effective system and requires less interference in the conventional operation.
Fully-autonomous Operation of an AC Micro-grid with Inherent Seamless Switching
Authors: Liu Baoquan , Xu Mengjie , Chen Jingwen 
Published: October 2020

Background::
Conventional micro-grids operate autonomously in islanded mode but they
always rely on the utility grid for BUS voltage support and power balance in the grid-connected
mode. This results in non-seamless mode switching, alternating operation strategy and power exchange
fluctuation problems.

Methods::
An AC/DC/AC converter is utilized as the interface between the micro-grid and the utility
grid. This enables the two entities to have different voltages in the grid-connected mode. The microgrid
exchanges predefined amount of power with the utility grid in the grid-connected mode. The
power amount is estimated based on power forecasting of local generations and loads with the consideration
of the Sate of Charge (SOC) of the battery, and is updated and broadcasted every 15
minutes.

Results::
A 100kVA AC micro-grid with a rotating generator, battery storage and solar arrays is built
on Matlab/Simulink for investigation. Results indicate that the battery can effectively balance the
power flow and mode switching hardly causes distortions.

Conclusions::
The proposed micro-grid can operate autonomously in both grid-connected and islanded
mode without relying on the utility grid. Seamless switching between operation modes can be
achieved naturally. Constant power is exchanged with the power grid, which benefits the powerdispatching
algorithm of the power system.
Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information–Seeking Intentions Among Social Media Users in China: Cross-sectional Survey
Authors: Niu Zhaomeng , Willoughby Jessica , Zhou Rongting 
Published: October 2020

Background
Empirical research has demonstrated that people frequently use social media for gathering and sharing online health information. Health literacy, social media use, and self-efficacy are important factors that may influence people’s health behaviors online.

Objective
We aimed to examine the associations between health literacy, health-related social media use, self-efficacy, and health behavioral intentions online.

Methods
We conducted a cross-sectional survey of adults 18 years and older (n=449) to examine predictors of health-related behavioral intentions online including health literacy, social media use, and self-efficacy in China using 2 moderated mediation models. Mediation and moderation analyses were conducted.

Results
Self-efficacy mediated the effects of health literacy (Bindirect=0.213, 95% CI 0.101 to 0.339) and social media use (Bindirect=0.023, 95% CI 0.008 to 0.045) on health behavioral intentions on social media. Age moderated the effects of health literacy on self-efficacy (P=.03), while previous experience moderated the effects of social media use on self-efficacy (P<.001).

Conclusions
Health literacy and health-related social media use influenced health behavioral intentions on social media via their prior effects on self-efficacy. The association between health literacy and self-efficacy was stronger among younger respondents, whereas the association between health-related social media use and self-efficacy was stronger among those who previously had positive experiences with health information on social media. Health practitioners should target self-efficacy among older populations and increase positive media experience related to health.
Relationship Between Levels of Digital Health Literacy Based on the Taiwan Digital Health Literacy Assessment and Accurate Assessment of Online Health Information: Cross-Sectional Questionnaire Study
Authors: Liu Peggy , Yeh Ling-Ling , Wang Jiun-Yi , Lee Shao-Ti 
Published: October 2020

Background
The increasing amount of health information available on the internet makes it more important than ever to ensure that people can judge the accuracy of this information to prevent them from harm. It may be possible for platforms to set up protective mechanisms depending on the level of digital health literacy and thereby to decrease the possibility of harm by the misuse of health information.

Objective
This study aimed to create an instrument for digital health literacy assessment (DHLA) based on the eHealth Literacy Scale (eHEALS) to categorize participants by level of risk of misinterpreting health information into high-, medium-, and low-risk groups.

Methods
This study developed a DHLA and constructed an online health information bank with correct and incorrect answers. Receiver operating characteristic curve analysis was used to detect the cutoff value of DHLA, using 5 items randomly selected from the online health information bank, to classify users as being at low, medium, or high risk of misjudging health information. This provided information about the relationship between risk group for digital health literacy and accurate judgement of online health information. The study participants were Taiwanese residents aged 20 years and older. Snowball sampling was used, and internet questionnaires were anonymously completed by the participants. The reliability and validity of DHLA were examined. Logistic regression was used to analyze factors associated with risk groups from the DHLA.

Results
This study collected 1588 valid questionnaires. The online health information bank included 310 items of health information, which were classified as easy (147 items), moderate (122 items), or difficult (41 items) based on the difficulty of judging their accuracy. The internal consistency of DHLA was satisfactory (α=.87), and factor analysis of construct validity found three factors, accounting for 76.6% of the variance. The receiver operating characteristic curve analysis found 106 people at high risk, 1368 at medium risk, and 114 at low risk of misinterpreting health information. Of the original grouped cases, 89.6% were correctly classified after discriminate analysis. Logistic regression analysis showed that participants with a high risk of misjudging health information had a lower education level, lower income, and poorer health. They also rarely or never browsed the internet. These differences were statistically significant.

Conclusions
The DHLA score could distinguish those at low, medium, and high risk of misjudging health information on the internet. Health information platforms on the internet could consider incorporating DHLA to set up a mechanism to protect users from misusing health information and avoid harming their health.
Identifying and Ranking Common COVID-19 Symptoms From Tweets in Arabic: Content Analysis
Authors: Alanazi Eisa , Alashaikh Abdulaziz , Alqurashi Sarah , Alanazi Aued 
Published: October 2020

Background
A substantial amount of COVID-19–related data is generated by Twitter users every day. Self-reports of COVID-19 symptoms on Twitter can reveal a great deal about the disease and its prevalence in the community. In particular, self-reports can be used as a valuable resource to learn more about common symptoms and whether their order of appearance differs among different groups in the community. These data may be used to develop a COVID-19 risk assessment system that is tailored toward a specific group of people.

Objective
The aim of this study was to identify the most common symptoms reported by patients with COVID-19, as well as the order of symptom appearance, by examining tweets in Arabic.

Methods
We searched Twitter posts in Arabic for personal reports of COVID-19 symptoms from March 1 to May 27, 2020. We identified 463 Arabic users who had tweeted about testing positive for COVID-19 and extracted the symptoms they associated with the disease. Furthermore, we asked them directly via personal messaging to rank the appearance of the first 3 symptoms they had experienced immediately before (or after) their COVID-19 diagnosis. Finally, we tracked their Twitter timeline to identify additional symptoms that were mentioned within ±5 days from the day of the first tweet on their COVID-19 diagnosis. In total, 270 COVID-19 self-reports were collected, and symptoms were (at least partially) ranked.

Results
The collected self-reports contained 893 symptoms from 201 (74%) male and 69 (26%) female Twitter users. The majority (n=270, 82%) of the tracked users were living in Saudi Arabia (n=125, 46%) and Kuwait (n=98, 36%). Furthermore, 13% (n=36) of the collected reports were from asymptomatic individuals. Of the 234 users with symptoms, 66% (n=180) provided a chronological order of appearance for at least 3 symptoms. Fever (n=139, 59%), headache (n=101, 43%), and anosmia (n=91, 39%) were the top 3 symptoms mentioned in the self-reports. Additionally, 28% (n=65) reported that their COVID-19 experience started with a fever, 15% (n=34) with a headache, and 12% (n=28) with anosmia. Of the 110 symptomatic cases from Saudi Arabia, the most common 3 symptoms were fever (n=65, 59%), anosmia (n=46, 42%), and headache (n=42, 38%).

Conclusions
This study identified the most common symptoms of COVID-19 from tweets in Arabic. These symptoms can be further analyzed in clinical settings and may be incorporated into a real-time COVID-19 risk estimator.