bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of reduced visual acuity among school-aged children and adolescents in 6 districts of Changsha city: a population-based survey
Authors: Liao Menglian , Cai Zehuai , Khan Muhammad Ahmad , Miao Wenjie , Lin Ding , Tang Qiongyan 
Published: August 2020

Abstract
Background: To calculate and evaluate the prevalence of reduced uncorrected distant visual acuity (UCDVA) in primary, middle and high schools in 6 districts of Changsha, Hunan, China.Methods: A population-based retrospective study was conducted in 239 schools in 6 districts of Changsha. After routine eye examination to rule out diseases that can affect refraction, 250,980 eligible students from primary, middle and high schools were enrolled in the survey. Then the uncorrected distant and near visual acuity of each eye were measured. Categories of schools, districts, grades, eye exercises and sports time were also documented and analyzed.Results: The overall prevalence of reduced UCDVA was 51.8% (95% confidence interval [CI]: 51.6%-52.0%) in 6 districts of Changsha. Results of individual districts were as follows: Furong district 59.9%(95% CI: 57.9%-61.8%), Tianxin district 62.3%(95% CI: 60.5%-64.0%), Wangcheng district 47.8%(95% CI: 46.8%-48.8%), Kaifu district 58.5%(95% CI: 58.0%-58.9%), Yuhua district 47.0%(95% CI: 46.7%-47.4%) and Yuelu district 52.6%(95% CI: 52.3%-52.9%). The proportion of normal VA is seen to decrease from primary grade 3. The proportion of mildly reduced UCDVA is higher in primary grade 1 and 2. The proportion of moderately reduced UCDVA remains similar during 12 grades. The proportion of severely reduced UCDVA increases with grades. Multivariate analysis shows that the prevalence of reduced UCDVA is higher in key schools (risk ratio [RR]= 1.47, 95% CI 1.44-1.50) than non-key schools. Conclusions: According to the existing data analysis results, the prevalence of reduced UCDVA among primary, middle and high school students in Changsha is very high. Some effective measures need to be taken to prevent it.
Health System Capacity for Post-Abortion Care in Java, Indonesia: A Signal Functions Analysis
Authors: Philbin Jesse , Soeharno Nugroho , Giorgio Margaret , Kurniawan Rico , Ingerick Meghan , Utomo Budi 
Published: August 2020

Abstract
Background: The quality of obstetric care has been identified as a contributing factor in Indonesia’s persistently high level of maternal mortality, and the country’s restrictive abortion laws merit special attention to the quality of post-abortion care (PAC). Due to unique health policies and guidelines, in Indonesia, uterine evacuation for PAC is typically administered only by Ob/Gyns practicing in hospitals. Methods: Using data from a survey of 657 hospitals and emergency obstetric-registered public health centers in Java, Indonesia’s most populous island, we applied a signal functions analysis to measure the health system’s capacity to offer PAC. We then used this framework to simulate the potential impact of the following hypothetical reforms on PAC capacity: allowing first-trimester uterine evacuation for PAC to take place at the primary care level, and allowing provision by clinicians other than Ob/Gyns. Finally, we calculated the proportion of PAC patients treated using four different uterine evacuation procedures. Results: Forty-six percent of hospitals in Java have the full set of services needed to provide PAC, and PAC capacity is concentrated at the highest-level referral hospitals: 86% of referral hospitals have the full set of services, staffing, and equipment compared to 53% of maternity hospitals and 34% of local hospitals. No health centers are adequately staffed or authorized to offer basic PAC services under Indonesia’s current guidelines. PAC capacity at all levels of the health system increases substantially in hypothetical scenarios under which authorization to perform first-trimester uterine evacuation for PAC is expanded to midwives and general physicians practicing in health centers. In 2018, 88% percent of PAC patients were treated using dilation and curettage (D&C). Conclusions: Offering first-trimester uterine evacuation for PAC in PONEDs and allowing clinicians other than Ob/Gyns to perform this procedure would greatly improve the capacity of Java’s health system to serve PAC patients. Increasing the use of vacuum aspiration and misoprostol for PAC-related uterine evacuation would lower the burden of treatment for patients and facilitate the task-shifting efforts needed to expand access to this life-saving service.
Determinants that Influence the Performance of Women Entrepreneurs’ in Micro and Small Enterprises in Ethiopia
Authors: Alene Endalew Terefe 
Published: August 2020

Abstract
Purpose: The purpose of this study was to explore determinants that influence women entrepreneurs’ performance in micro and small enterprises’ in Gondar city, Northwest Ethiopia and in turn contribute to entrepreneurship related literature mainly in developing countries.Design/methodology/approach: The study employed an explanatory research design with agreement of primary data collection via a cross-sectional survey questionnaire followed by quantitative research approach. The sample of this study was 180 women entrepreneurs and selected using random sampling technique. Findings: The findings of this study revealed that educational level, previous entrepreneurial experience, access to business training, access to finance, access to business information, government support, land ownership and tax are significant in explaining women entrepreneurs’ performance in one hand. On the other side, however, age, marital status, access to market and access to physical infrastructure are found to be insignificant variables in determining women entrepreneurs’ performance.Research limitations/implications: The study was used one time data for determinants like level of education, previous working experience, age and profitability of the enterprise. Thus, due to frequent change in such the variables, the study may not reflect the dynamics of the data, which would have a convinced influence on the conclusion. In addition, the research has only consisted of 180 samples. Moreover, such number may not represent the whole population of the entrepreneurs of Ethiopian MSEs. Future research, it is advisable to expand study factors, use interviews as a research tool and make comparison between women and men entrepreneurial performances.Practical implications: The paper might serve as an input for officials to consider such determinants and encourage an environment that increases women entrepreneurs’ performance. In addition, the study might help women entrepreneurs in addressing the factors affecting performance to take actions towards improving their performance and in turn contribute to job creation, wealth, innovation, and poverty alleviation.Originality/value: This study contributes to the literature on the determinants of women entrepreneurs’ performance in micro and small enterprises. Specifically, it tests the impact of educational level, age, marital status, previous entrepreneurial experience, access to business training, access to finance, access to business information, access to market, access to physical infrastructure, government support, land ownership and tax on the performance of women entrepreneurs’.
Characterization of type-2 diacylglycerol acyltransferases in Haematococcus lacustris reveals their functions and engineering potential in triacylglycerol biosynthesis and possible roles in astaxanthin esterification
Authors: Cui Hongli , Zhao Chunchao , Xu Wenxin , Zhang Hongjiang , Hang Wei , Zhu Xiaoli , Ji Chunli , Xue Jinai , Zhang Chunhui , Li Runzhi 
Published: August 2020

Abstract
Background: Haematococcus lacustris is an ideal source of astaxanthin (AST) which is stored at oil bodies containing esterified AST (EAST) and triacylglycerol (TAG). Diacylglycerol acyltransferases (DGATs) catalyze the last step of the acyl-CoA-dependent TAG biosynthesis and are also considered as the crucial enzymes involving in EAST biosynthesis in H. lacustris. Previous studies have identified four putative DGAT2 encoding genes in H. lacustris and only the HpDGAT2D allowed the recovery of TAG biosynthesis, but the engineering potential of HpDGAT2s in TAG biosynthesis, especially possible roles in AST esterification, remains ambiguous.Results: Five putative DGAT2 genes (HpDGAT2A, 2B, 2C, 2D, and 2E) were identified in H. lacustris. Transcription analysis showed that the expression levels of HpDGAT2A, 2B, and 2E genes markedly increased under high light and nitrogen deficient conditions with distinct patterns, which led to significant TAG and EAST accumulation. Functional complementation demonstrated HpDGAT2A, 2B, 2D, and 2E had the capability to restore TAG synthesis in a TAG-deficient yeast strain (H1246) with the large difference in enzymatic activity. Fatty acids (FAs) profiles assays revealed that HpDGAT2A, 2D, and 2E except for 2B preferred monounsaturated fatty acyl-CoA (MUFA) for TAG synthesis in yeast cells, and also showed polyunsaturated fatty acyl-CoA (PUFA) preference by feeding strategy. The over-expression of HpDGAT2D in Arabidopsis thaliana and Chlamydomonas reinhardtii significantly increased the TAG content and obviously promoted the MUFA and PUFA contents. Interestingly, molecular docking analysis implied that HpDGAT2s structures contained AST binding sites, which provides strong evidence for AST esterification function in H. lacustris.Conclusions: Our study represents a pioneering work on the characterization of HpDGAT2s by systematically integrating expression pattern, AST/TAG accumulation, functional complementation, molecular docking, and over-expression in yeast, plants, and algae. These results (1) update the gene models of HpDGAT2s, (2) prove TAG biosynthesis capacity of HpDGAT2s, (3) show the strong preference for MUFA and PUFA, (4) offer target genes to modulate TAG biosynthesis by genetic engineering method, and (5) provide new evidence for HpDGAT2s roles in AST esterification.
Identification of bipolar disorder using a combination of multimodality magnetic resonance imaging and machine learning techniques
Authors: Li Hao , Cui Liqian , Cao Liping , Zhang Yizhi , Liu Yueheng , Deng Wenhao , Zhou Wenjin 
Published: August 2020

Abstract
Background: Bipolar disorder (BPD) is a common mood disorder that is often goes misdiagnosed or undiagnosed for years. Recently, machine learning techniques have been combined with neuroimaging methods to aid in the diagnosis of BPD. However, most studies have focused on the construction of classifiers based on single-modality MRI. Hence, in this study, we aimed to construct a support vector machine (SVM) model using a combination of structural and functional MRI, which could be used to accurately identify patients with BPD.Methods: In total, 44 patients with BPD and 36 healthy controls were enrolled in the study. Clinical evaluation and MRI scans were performed for each subject. Next, image pre-processing, voxel-based morphometry (VBM), and ReHo analyses were performed. The ReHo values of each subject in the clusters showing significant differences were extracted. Further, LASSO approach was recruited to screen features. Based on selected features, the SVM model was established, and discriminant analysis was performed.Results: After using the two-sample t-test with multiple comparisons, a total of 8 clusters were extracted from the data (VBM = 6; ReHo = 2). Next, we used both VBM and ReHo data to construct the new SVM classifier, which could effectively identify patients with BPD at an accuracy of 87.5%, sensitivity of 86.4%, and specificity of 88.9% in the test data (p=0.0022).Conclusions: A combination of structural and functional MRI can be of added value in the construction of SVM classifiers to aid in the accurate identification of BPD in the clinic.
5-Hydroxytryptamine-3 Receptor Antagonist and Dexamethasone as Prophylaxis for Chemotherapy-Induced Nausea and Vomiting During Moderately Emetic Chemotherapy for Solid Tumors: A Multicenter, Prospective, Observational Study
Authors: Matsui Reiko , Suzuki Kenichi , Takiguchi Tomomi , Nishio Makoto , Koike Takeshi , Hayashi Toshinobu , Seto Takashi , Kogure Yuki , Nogami Naoyuki , Fujiwara Kimiko , Kaneda Hiroyasu , Harada Tomohiko , Shimizu Satoru , Kimura Masashi , Kenmotsu Hirotsugu , Shimokawa Mototsugu , Goto Koichi 
Published: August 2020

Abstract
Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.
Biodegradation of atrazine and ligninolytic enzyme production by basidiomycete strains&nbsp;
Authors: Henn Caroline , Monteiro Diego Alves , Boscolo Mauricio , Silva Roberto da , Gomes Eleni 
Published: August 2020

Abstract
Background Atrazine is one of the most widespread chlorinated herbicides, leaving large bulks in soils and groundwater. The biodegradation of atrazine by bacteria is well described, but many aspects of the fungal metabolism of this compound remain unclear. Thus, we investigated the toxicity and degradation of atrazine by 13 rainforest basidiomycete strains. Results In liquid medium, Pluteus cubensis SXS320, Gloelophyllum striatum MCA7, and Agaricales MCA17 removed 30, 37, and 38%, respectively, of initial 25 mg L-1 of the herbicide within 20 days. Deficiency of nitrogen drove atrazine degradation by Pluteus cubensis SXS320; this strain removed 30% of atrazine within 20 days in a culture medium with 2.5 mM of N, raising three metabolites; in a medium with 25 mM of N, only 21% of initial atrazine were removed after 40 days, and two metabolites appeared in culture extracts. This is the first report of such different outcomes linked to nitrogen availability during the biodegradation of atrazine by basidiomycetes. The herbicide also induced synthesis and secretion of extracellular laccases by Datronia caperata MCA5, Pycnoporus sanguineus MCA16, and Polyporus tenuiculus MCA11. Laccase levels produced by of P. tenuiculus MCA11 were 13.3-fold superior in the contaminated medium than in control; the possible role of this enzyme on atrazine biodegradation was evaluated, considering the strong induction and the removal of 13.9% of the herbicide in vivo. Although 88% of initial laccase activity remained after 6 h, no evidence of in vitro degradation was observed, even though ABTS was present as mediator. Conclusions This study revealed a high potential for atrazine biodegradation among tropical basidiomycete strains. Further investigations, focusing on less explored ligninolytic enzymes and cell-bound mechanisms, could enlighten key aspects of the atrazine fungal metabolism and the role of the nitrogen in the process.
Biomarker Discovery in Attention Deficit Hyperactivity Disorder: RNA sequencing of Whole Blood in Discordant Twin and Case-Controlled Cohorts
Authors: McCaffrey Timothy , III Georges St. Laurent , Shtokalo Dmitry , Antonets Denis , Vyatkin Yuri , Jones Daniel , Battison Eleanor , Nigg Joel 
Published: August 2020

Abstract
Background: A variety of DNA-based methods have been applied to identify genetic markers of attention deficit hyperactivity disorder (ADHD), but the connection to RNA-based gene expression has not been fully exploited. Using well defined cohorts of discordant, monozygotic twins from the Michigan State University Twin Registry, and case-controlled ADHD cases in adolescents, the present studies utilized advanced single molecule RNA sequencing to identify expressed changes in whole blood RNA in ADHD. Multiple analytical strategies were employed to narrow differentially expressed RNA targets to a small set of potential biomarkers of ADHD. Results: RNA markers common to both the discordant twin study and case-controlled subjects further narrowed the putative targets, some of which had been previously associated with ADHD at the DNA level. The potential role of several differentially expressed genes, including ABCB5, RGS2, GAK, GIT1 and 3 members of the galactose metabolism pathway (GALE, GALT, GALK1) are substantiated by prior associations to ADHD and by established mechanistic connections to molecular pathways relevant to ADHD and behavioral control. Conclusions: The convergence of DNA, RNA, and metabolic data suggests these may be promising targets for diagnostics and therapeutics in ADHD.
Does Socioeconomic Position Affect Knowledge of the Risk Factors and Warning Signs of Stroke in the WHO European Region? A Systematic Literature Review
Authors: Stack Katie , Robertson Wendy , Blackburn Clare 
Published: August 2020

Abstract
Background: Strokes are one of the leading causes of death worldwide. People with a lower socioeconomic position (SEP) (i.e. with regards to education, income and occupation) are at a higher risk of having a stroke and have worse clinical outcomes compared to the general population. Good knowledge levels about stroke risk factors and warning signs are key to prolonging life and reducing health issues caused by stroke. This systematic review examined differences in knowledge of stroke risk factors and warning signs with regards to SEP in the WHO European region.

Methods: MEDLINE, Embase, Web of Science, PsycINFO and CINAHL were systematically searched using appropriate Medical Subject Headings (MeSH) terms and free text, combining search terms with Boolean operators. Two independent reviewers selected studies in two stages (title and abstract, and full-text), and screened reference lists of included studies. Only studies in English and based in the WHO European region were included.

Results: Screening identified 2,118 records. In the final review, 20 articles were included, with 67,309 study participants between them. Out of 17 studies that looked at stroke risk factors, 11 found increasing knowledge to be associated with higher SEP, four found no difference by SEP, one showed a mixed pattern and one outlier study found increasing knowledge of risk factors to be associated with a lower SEP. Out of 19 studies that looked at stroke warning signs or symptoms, 15 found there to be better knowledge of warning signs with a higher SEP, three found there to be no difference, and the same outlier study found increasing knowledge of warning signs with a lower SEP. Studies that seemed to have a higher quality rating found increasing knowledge of stroke with a higher SEP. A meta-analysis was not possible due to heterogeneity of studies.

Conclusions: In the WHO European region, better knowledge of stroke risk factors and warning signs is associated with a higher SEP. Public health campaigns and educational interventions aiming to increase stroke knowledge should be targeted at people with a lower SEP.
Outcomes Of Treatment With CHOP And EPOCH In Patients With HIV Associated NHL In A Low Resource Setting
Authors: Okello Clement Dove , Omoding Abrahams , Ddungu Henry , Mulumba Yusuf , Orem Jackson 
Published: August 2020

Abstract
Background: The optimal chemotherapy regimen for treating HIV associated NHL in low resource settings is unknown. We conducted a retrospective study to describe survival rates, treatment response rates and adverse events in patients with HIV associated NHL treated with CHOP and dose adjusted-EPOCH regimens at the Uganda Cancer Institute.Methods: A retrospective study of patients diagnosed with HIV and lymphoma and treated at the Uganda Cancer Institute from 2016 – 2018 was done.Results: One hundred eight patients treated with CHOP and 12 patients treated with DA-EPOCH were analysed. Patients completing 6 or more cycles of chemotherapy were 51 (47%) in the CHOP group and 8 (67%) in the DA-EPOCH group. One year overall survival (OS) rate in patients treated with CHOP was 54.5% (95% CI, 42.8 – 64.8) and 80.2% (95% CI, 40.3 – 94.8) in those treated with DA-EPOCH. Factors associated with favourable survival were BMI 18.5-24.9 kg/m2, (p=0.03) and completion of 6 or more cycles of chemotherapy, (p<0.001). The overall response rate was 40% in the CHOP group and 59% in the DA-EPOCH group. Severe adverse events occurred in 19 (18%) patients in the CHOP group and 3 (25%) in the DA-EPOCH group; these were neutropenia (CHOP=13, 12%; DA-EPOCH=2, 17%), anaemia (CHOP=12, 12%; DA-EPOCH=1, 8%), thrombocytopenia (CHOP=7, 6%; DA-EPOCH=0), sepsis (CHOP=1), treatment related death (DA-EPOCH=1) and hepatic encephalopathy (CHOP=1).Conclusion: Treatment of HIV associated NHL with curative intent using CHOP and infusional DA-EPOCH is feasible in low resource settings and associated with >50% one year survival.