bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early essential newborn care is associated with increased breastfeeding: a quasi-experimental study from Sichuan Province of Western China
Authors: Wang Chenran , Li Xiayun , Zhang Lin , Wu Linman , Tan Ling , Yuan Fei , Guo Yao , Williams Sarah , Xu Tao 
Published: November 2020

Abstract
Background: Breastfeeding is critical to promote maternal and child health in a short and long term. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full-term vaginally delivered neonates in the first six months of life.Methods: We conducted a quasi-experimental study in eight maternal and children’s hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to six months of age. Data in both groups were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. Written consent was obtained from eligible mothers enrolled in this study. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects.Results: Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25min vs. 33min, P<0.01), an increased chance of successful first-time breastfeeding (OR=5.53; 95% CI: 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI: 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI: 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P<0.001), 3 months (OR=3.20; 95% CI: 1.01, 10.15), and 6 months (OR=4.91; 95% CI: 1.71, 14.13) of age.Conclusions: EENC enhances early and successful breastfeeding initiation, prolongs duration of the first breastfeed, and increases the rate of exclusive breastfeeding at six months of age. Our evidence suggests that nation wide scale up of EENC would increase the exclusive breastfeeding rate in the first six months of life.
Impact of three methods of ischemic preconditioning on ischemia-reperfusion injury in a pig model of liver transplantation
Authors: Belon Alessandro Rodrigo , Tannuri Ana Cristina Aoun , Moreira Daniel Albuquerque , Figueiredo Jose Luiz , Silva Alessandra Matheus , Serafini Suellen , Guimarães Raimundo Renato , Faria Caroline Silverio , Alexandre Alcione Sanches , Gonçalves Josiane de Oliveira , Paes Vitor Ribeiro , Tannuri Uenis 
Published: November 2020

Abstract
Background. Ischemic preconditioning (IPC), either direct (DIPC) or remote (RIPC), is a procedure aimed at reducing the harmful effects of ischemia-reperfusion injury. Aims. To assess the local and systemic effects of DIPC, RIPC, and both combined, in the pig liver transplant model. Methods. Twenty-four pigs underwent orthotopic liver transplantation and were divided into 4 groups according to the procedures applied: direct donor preconditioning; indirect preconditioning at the recipient and a group with direct donor and indirect recipient preconditioning. The following parameters were recorded: donor and recipient weight, graft-to-recipient weight ratio (GRWR), surgery time, hot and cold ischemia time, and intraoperative hemodynamic values. Blood samples were collected before native liver removal (BL) and at 0h, 1h, 3h, 6h, 12h, 18h, and 24h post-reperfusion and the following biochemical tests were performed: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), creatinine, BUN (blood urea nitrogen), lactate, total and direct bilirubin. Histopathological examination of liver, gut, kidney, and lung fragments were performed, as well as molecular analyses for expression of the apoptosis-related BAX (pro-apoptotic) and Bcl-XL (anti-apoptotic) genes, eNOS (endothelial nitric oxide synthase) gene, and IL-6 gene related to inflammatory ischemia-reperfusion injury, using real-time polymerase chain reaction (RT-PCR). Results. There were no differences between the groups regarding biochemical and histopathological parameters. We found a reduced ratio between the expression of the pro-apoptotic BAX gene and the expression of the anti-apoptotic Bcl gene in the livers of animals with IPC versus the control group. Conclusions. DIPC, RIPC or a combination of both produce local beneficial effects only at the molecular level but do not translate into biochemical or histological changes.
Averting Expenditure on Malaria: Effects on Labour Productivity of Maize Farmers in Bunkpurugu-Nakpanduri District of Ghana
Authors: Mabe Franklin Nantui , Dafurika Thomas 
Published: November 2020

Abstract
Background Malaria has been one of the commonest diseases during farming season which affects farmers’ health resulting in a reduction in the number of days spent on the farm. As a result, farmers are regularly trying to avert malaria infection through preventive measures. Motivated by this argument, this study sought to determine the effects of malaria averting expenditure on labour productivity of maize farmers in Bunkpurugu-Nakpanduri District in the Northern Region of Ghana. Methods A cross-sectional primary data was collected from 194 maize farmers. Both descriptive and quantitative data analysis approaches were employed. Conditional Mixed Process was used to estimate the effects of malaria prevention expenditure on maize farmers’ labour productivity. Results The study revealed that maize farmers incurred an average expenditure of GHc284.6 to prevent malaria annually. The result shows that factors that affect maize farmers’ malaria prevention expenditure include off-farm income, household size, presence of bushes around houses, presence of pregnant women and number of household members in school. Meanwhile, quantity of fertilizer, seed, weedicides, farming experience, age, ownership of motor bike and averting expenditure are significant determinants of maize labour productivity. The study revealed that farmers who spend more amount of money to avert malaria attack are more labour productive. Conclusions Therefore, this study recommends that Ministry of Health and Ministry of Food and Agriculture should collaborate and integrate health extension service on malaria in agricultural extension to educate farmers on the need to avert malaria. Farmers should be educated on malaria preventive strategies such as clearing of bushes around houses, draining of stagnant water, sleeping in treated mosquito nets among others. Lastly, aside distribution of free mosquito nets to pregnant women, they should be subsidized and made available for all farmers to procure for malaria prevention.
Developing an Assessment Scale for Long-term Care Reablement Literacy in Home Care Workers in Taiwan Using a Modified Delphi Method
Authors: Yu Hsiao-Wei , Chiu Tzu-Ying , Chen Pin-Yuan , Liao Tai-Hsiang , Chang Wen-Hui , Wang Mei-Wen , Lin Pay-Shin 
Published: November 2020

Abstract
Background: Reablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in LTC research. This study aimed to develop a scale for the assessment of long-term care reablement literacy (LTCRL) and employ this scale to assess the performance of home care workers in Taiwan.Methods: To develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from northern, central, and southern Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire that included items related to basic demographic characteristics and questions to assess LTCRL.Results: Based on the experts’ consensus on the procedure of the modified Delphi technique, the LTCRL assessment sale consists of 29 questions on four aspects of knowledge acquisition: the abilities to access/obtain, understand, process/appraise, and apply/use. The results revealed that higher education levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers.Conclusions: The LTCRL assessment scale based on a modified Delphi technique is useful and feasible for evaluating LTCRL in home care workers who provide reablement services in Taiwan.
TaClpS1, Negatively Regulates Wheat Resistance Against Puccinia striiformis f. sp. tritici
Authors: Yang Qian , Islam Md Ashraful , Cai Kunyan , Tian Shuxin , Liu Yan , Kang Zhensheng , Guo Jun 
Published: November 2020

Abstract
Background: The degradation of intracellular proteins plays an essential role in plant responses to stressful environments. ClpS1 and E3 ubiquitin ligase function as adaptors for selecting target substrates in caseinolytic peptidase (Clp) proteases pathways and the 26S proteasome system, respectively. Currently, the role of E3 ubiquitin ligase in the plant immune response to pathogens is well defined. However, the role of ClpS1 in the plant immune response to pathogens remains unknown. Results: Here, wheat (Triticum aestivum) ClpS1 (TaClpS1) was studied and resulted to encode 161 amino acids, containing a conserved ClpS domain and a chloroplast transit peptide (1-32 aa). TaClpS1 was found to be specifically localized in the chloroplast when expressed transiently in wheat protoplasts. The transcript level of TaClpS1 in wheat was significantly induced during infection by Puccinia striiformis f. sp. tritici (Pst). Knockdown of TaClpS1 via virus-induced gene silencing (VIGS) resulted in an increase in wheat resistance against Pst, accompanied by an increase in the hypersensitive response (HR), accumulation of reactive oxygen species (ROS) and expression of TaPR1 and TaPR2, and a reduction in the number of haustoria, length of infection hypha and infection area of Pst. Furthermore, heterologous expression of TaClpS1 in Nicotiana benthamiana enhanced the infection by Phytophthora parasitica. Conclusions: These results suggest that TaClpS1 negatively regulates the resistance of wheat to Pst.
Modulation of steroidogenesis by Actaea racemosa and vitamin C combination, in letrozole induced polycystic ovarian syndrome rat model: Promising activity without the risk of hepatic adverse effect
Authors: Azouz Asmaa A. , Ali Sara E. , Abd-Elsalam Reham M. , Emam Shimaa R. , Galal Mona K. , Elmosalamy Sherif H. , Alsherbiny Muhammad , Hassan Bardes B. , Li Chun Guang , Badawy Shymaa A. El 
Published: November 2020

Abstract
Background: Complementary remedies such as the Chinese herb ‘Sheng Ma’ (Black cohosh; Actaea racemosa ‘AR’) are being sought to overcome the shortcomings of conventional hormonal and surgical therapies developed for treatment of polycystic ovary syndrome (PCOS). However, the AR hepatotoxicity urges a cautionary warning to be labeled on its products as recommended by the United States Pharmacopeia, where four out of seven hepatotoxic cases in Sweden were possibly associated with black cohosh products.Methods: We investigated the effects, safety, and molecular targets of black cohosh ethanolic extract and/or vitamin C on ovarian functionality and oxidative response in hyperandrogenism-induced PCOS rats. A well-established rat model using oral letrozole, daily, for 21 days was employed then rats received the AR extract with and without vitamin C for 28 days. The hormonal evaluation, antioxidant status, histopathological examination, immunohistochemical analysis, cell proliferation, and the expression ratio of the aromatase (Cyp19α1) gene were evaluated. Additionally, a holistic profiling of AR arsenal of secondary metabolites was performed using ultra high-performance liquid chromatography (UHPLC) coupled with quadrupole high resolution time of flight mass spectrometry (QTOF-MS).Results: Beneficial effects were exerted by AR in PCOS rats via the improved antioxidant status, hormonal profile, lipid profile, glucose level, liver functions, and the induced Ki-67 expression in the granulosa, theca cell layers and interstitial stromal cells. Notably, the combination of AR with vitamin C was not only more effective in reversing the dysregulated levels of testosterone, luteinizing hormone, and mRNA level of Cyp19α1 gene in the PCOS rat, but also safer. The combination regulated both ovarian and hepatic MDA and GSH levels with histological improvement observed in the liver and ovaries. In addition, the untargeted metabolomic profiling enabled the identification of 61 metabolites allocated in five major chemical classes.Conclusion: This study demonstrated the benefit of the combination between AR and vitamin C in mitigating the reproductive and metabolic disorders of PCOS with the elimination of AR hepatotoxic risk.
Disability, Frailty and Depression in the Community-dwelling Elderly with Osteosarcopenia
Authors: Park Ki-Soo , Lee Gyeong-Ye , Seo Sung-Hyo , Seo Young-Mi , Yoo Jun-Il 
Published: November 2020

Abstract
Background: The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression.Methods: This study was performed using the baseline data of Namgaram-2, which was developed to study the relationship between the prevalence of musculoskeletal disorders and activity limitations in the elderly in rural areas. Among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist was completed for diagnosis of frailty and the degree of disability in everyday life was evaluated by World Health Organization Disability Assessment Schedule (WHODAS). To understand the symptoms of depression in the elderly, the Geriatric Depression Scale-Short Form-Korean (GDSSF-K) was used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Sarcopenia was defined as SMI less than 7.0 kg/m2 in men and less than 5.4 kg/m2 in women. The maximum grip strength was used as a reference level, for men below 28 kg and for women below 18 kg. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than -1.0.The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia.Results: Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS, Kaigo-Yobo, and GDSSF scores were statistically significantly higher in the osteosarcopenia group compared the other groups.Conclusions: Osteosarcopenia is a relatively common disease group in the elderly community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the elderly, management of those in both disease groups should occur together.
Is There a Health Inequality in Gambling Related Harms? A Systematic Review
Authors: Raybould Jodie , Larkin Michael , Tunney Richard 
Published: November 2020

Abstract
Background: Here we present a systematic review of the existing research into gambling harms, in order to determine whether there are differences in the presentation of these across demographic groups such as age, gender, culture, and socioeconomic status, or gambling behaviour categories such as risk severity and play frequency. Primary and Secondary Outcome Measures: Inclusion criteria were: 1) focus on gambling harms; 2) focus on harms to the gambler rather than affected others; 3) discussion of specific listed harms and not just harms in general terms. Exclusion criteria were: 1) research of non-human subjects; 2) not written in English; 3) not an empirical study; 3) not available as a full article.Methods: We conducted a systematic search using the Web of Science and Scopus databases in August 2020. Assessment of quality took place using Standard Quality Assessment Criteria.Results: A total of 59 studies published between 1994 and 2020 met the inclusion criteria. These were categorised into thematic groups for comparison and discussion. There were replicated differences found in groups defined by age, socioeconomic status, education level, ethnicity and culture, risk severity, and gambling behaviours. Conclusion: Harms appear to be dependent on specific social, demographic and environmental conditions that suggests there is a health inequality in gambling related harms. Further investigation is required to develop standardised measurement tools and to understand confounding variables and co-morbidities. With a robust understanding of harms distribution in the population, Primary Care Workers will be better equipped to identify those who are at risk, or who are showing signs of Gambling Disorder, and to target prevention and intervention programmes appropriately.
Comparing two treatment approaches for patients with type 1 diabetes during aerobic exercise: a randomised, crossover study
Authors: Vartak Varun , Chepulis Lynne , Driller Matt , Paul Ryan 
Published: November 2020

Abstract
In a randomised, counterbalanced, crossover design, eight men with type 1 diabetes (T1D; mean ± SD age: 27.6 ± 11.4 years) reduced insulin (INS) by 50% of their normal dose or consumed carbohydrates equivalent to 1 g of carbohydrate/kg of their body weight without the usual insulin bolus (CARBS) over two sessions, held a week apart. Each session included standardised meals, a 45-minute treadmill-walk at 7.24 km.h-1 and a six-minute walk test (6MWT). Rate of perceived exertion (RPE), blood glucose, blood ketone and blood lactate measures were taken before, during and immediately after the aerobic exercise. The distance covered in metres and the predicted VO2 max (mL⋅kg−1⋅min−1) were also calculated for the 6MWT. Participants completing the INS intervention spent more time in normoglycaemia (242 ± 135 min vs 88 ± 132 min; P < 0.01) and less time in hyperglycaemia (41 ± 95 min vs 154 ± 125 min; P = 0.01) as compared to the CARBS intervention. Mild hypoglycaemia occurred in two participants during INS and no participants during CARBS. Furthermore, there was no significant difference for blood lactate, ketone, RPE, distance covered and predicted VO2 max between interventions. Based on this pilot study, INS intervention appears to be the best approach for maintaining blood glucose levels in those with T1D during aerobic exercise, though this does need evaluating in other groups, including women, children and those with sub-optimal glycaemic control. Trial registration: ACTRN12619001397101p. Registered 09 September 2019, http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378264
Radiological evaluation of malignant pleural mesothelioma&nbsp;- defining distant metastatic disease
Authors: Collins Dearbhaile Catherine , Sundar Raghav , Constantidinou Anastasia , Dolling David , Yap Timothy Anthony , Popat Sanjay , O’Brien Mary E , Banerji Udai , de Bono Johann Sebastian , Lopez Juanita Suzanne , Tunariu Nina , Minchom Anna 
Published: November 2020

Abstract
BackgroundMalignant pleural mesothelioma (MPM) is traditionally characterized by local destructive spread of the pleura and surrounding tissues. Patient outcomes in MPM with distant metastatic dissemination are lacking.MethodsIn this retrospective study, we reviewed a cohort of 164 MPM patients referred to a Phase I trials unit, aiming to describe identified metastatic sites, and correlate with clinical outcomes. Results67% of patients were diagnosed with distant metastatic disease with a high incidence of bone (19%), visceral (14%), contralateral lung (35%) and peritoneal metastases (22%). Peritoneal metastases were more likely in epithelioid versus biphasic/ sarcomatoid MPM (p=0.015). Overall survival was 23.8 months with no statistical difference in survival between those with distant metastases and those without.ConclusionsThis report highlights the frequency of distant metastases and encourages further radiological investigations in the presence of symptoms. In particular, given the relatively high incidence of bone metastases, bone imaging should be considered in advanced MPM clinical workflow and trial protocols. The presence of distant metastases does not appear to have prognostic implications under existing treatment paradigms. This cohort of MPM patients gives an indication of patterns of metastatic spread that are likely to become prevalent as prognosis improves with emerging treatment paradigms.
Effectiveness of blended learning versus lectures alone&nbsp;on ECG analysis and interpretation by medical students
Authors: Viljoen Charle Andre , Millar Rob Scott , Manning Kathryn , Burch Vanessa Celeste 
Published: November 2020

Abstract
BackgroundMost medical students lack confidence and are unable to accurately interpret ECGs. Thus, better methods of ECG instruction are being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, compared to conventional teaching (lectures alone).MethodsTwo cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of systematic ECG analysis and interpretation, with immediate feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediate post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test.ResultsThe pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d=1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d=1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation.ConclusionBlended learning achieved significantly better levels of ECG competence and confidence amongst medical students than conventional ECG teaching did. Although medical students undergo a significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications encouraging a stepwise approach to ECG analysis and enabling deliberate practice with feedback may, therefore, be a useful adjunct to lectures for teaching Electrocardiography.