bluuebunny/crossref_metadata_2025_split huggingface dataset:
Describing The Behaviours, Perception and Awareness of Bariatric Surgery Among Primary Care Physicians in Kuwait.
Authors: Alasfour Shaimaa , Almughamis Nouf , Ahmed Ahmed 
Published: December 2020

Abstract
BackgroundObesity is a growing issue globally and bariatric surgery is increasingly being utilized to treat it. The prevalence of obesity in Kuwait is already high compared with global comparisons and increasing. The current study sought to assess the knowledge and attitudes of physicians in Kuwait towards obesity within their patient populations and the use of bariatric surgery.MethodsQuestionnaires were distributed to physicians across Kuwait. Responses were recorded online via Survey Monkey. The self-administered questionnaire collected data about demographic factors, knowledge of bariatric surgery, practices related to the collection of measurements related to weight and height, and attitudes towards bariatric surgery and obesity among patients.ResultsA total of 118 surveys were returned. A minority of respondents (34%) supported the use of bariatric surgery, despite 51% having referred a patient for such a procedure. In terms of behaviours related to overweight and obesity, the majority of respondents regularly took patients weight and height, calculated BMI, and initiated conversations about obesity when they felt they were required. Knowledge related to the morbidity and mortality experienced by those undergoing bariatric surgery was low. Among those who responded to questions related to their knowledge of mortality related to bariatric surgery, over half did not know the 30-day mortality associated with any of the procedures included within the questions. ConclusionAmong our sample of physicians, we report a low level of support for bariatric surgery, as well as low levels of knowledge of the risks and consequences of the procedures. At the same time, while we found low levels of support for this type of surgery, over half had referred a patient for it. As obesity continues to be a key issue of public health concern, globally and within Kuwait, physician and patient education and awareness of the appropriate treatment options available becomes increasingly important.
Recovery Trajectories Over Six Weeks in Patients Selected for A High-Intensity Physiotherapy Program After Total Knee Arthroplasty: A Latent Class Analysis
Authors: Harmelink K.E.M. , Dandis R. , Wees P.J. , Zeegers A.V.C.M. , Sanden M.W. Nijhuis-van der , Staal J.B. 
Published: December 2020

Abstract
Background: Recovery trajectories differ between individual patients and it is hypothesizes that they can be used to predict if an individual patient is likely to recover earlier or later. Primary aim of this study was to determine if it is possible to identify recovery trajectories for physical functioning and pain during the first six weeks in patients after TKA. Secondary aim was to explore the association of these trajectories with one-year outcomes. Methods: Prospective cohort study of 218 patients with the following measurement time points: preoperative, and at three days, two weeks, six weeks, and one year post-surgery. Outcome measures were performance-based physical functioning (Timed Up and Go [TUG]), self-reported physical functioning (Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living [KOOS-ADL]), and pain (Visual Analogue Scale [VAS]). Latent Class Analysis was used to distinguish classes based on recovery trajectories over the first six weeks postoperatively. Multivariable regression analyses were used to identify associations between classes and one year outcomes.Results: TUG showed three classes: “gain group” (n=203), “moderate gain group” (n=8) and “slow gain group” (n=7), KOOS showed two classes: “gain group” (n=86) and “moderate gain group” (n=132), and VAS-pain three classes: “no/very little pain” (n=151), “normal decrease of pain” (n=48) and “sustained pain” (n=19). The ”low gain group” scored 3.31 [95% CI 1.52, 5.09] seconds less on the TUG than the “moderate gain group” group, and the KOOS “gain group” scored 11.97 [95% CI 8.62, 15.33] points better than the “moderate gain group” after one year.Patients who had an early trajectory of “sustained pain” had less chance to become free of pain at one year than those who reported “no or little pain” (odds ratio 0.11 [95% CI 0.03,0.42]. Conclusion: The findings of this study indicate that different recovery trajectories can be detected. Especially the difference in TUG and KOOS-ADL between the “gain” and “moderate gain” group was considered clinically relevant, while for VAS scores differences between “no/very little pain,” and “sustained pain” were statistically significant but small.
Nanoscale bubble domains with polar topologies in bulk ferroelectrics
Authors: Pennycook Stephen , Yin Jie , Zong Hongxiang , Tao Hong , Tao Xuefei , Wu Haijun , Zhang Yang , Zhao Li-Dong , Ding Xiangdong , Sun Jun , Zhu Jianguo , Wu Jiagang 
Published: December 2020

Abstract
Multitudinous topological configurations spawn new oases of novel phenomena and physical properties in condensed-matter physics1. Nano-sized ferroelectric bubble domains with various polar topologies (e.g., vortices, skyrmions) achieved in ferroelectric films present great potential for valuable physical properties2–5. However, experimentally manipulating bubble domains has remained elusive especially in the bulk form. Here, for the first time in any bulk material, we achieve self-confined bubble domains with multiple polar topologies in bulk Bi0.5Na0.5TiO3 ferroelectrics, especially skyrmions, as validated by direct Z-contrast imaging. This phenomenon is driven by the interplay of bulk, elastic and electrostatic energies of coexisting modulated phases with strong and weak spontaneous polarizations. We demonstrate reversable and tip-voltage magnitude/time-dependent donut-like domain morphology evolution towards continuously and reversibly modulated high-density nonvolatile ferroelectric memories.
The Mason: Health Starts Here Prospective Cohort Study
Authors: Cuellar Alison , Adams Leah , Jonge Elisabeth de , Espina Virginia , Espinoza Laurette , Fischer Sarah , Frankenfeld Cara , Hines Denise , Kornienko Olga , Lawrence Heidi , Ramizani Niloofar , Rana Ziaul , Rossheim Matthew , Short Jerome , Waithaka Eric , Wilson Alyssa , Cheskin Lawrence 
Published: December 2020

Abstract
Background: Young adulthood is a period of increasing independence for the 40% of young adults enrolled in U.S. colleges. Previous research indicates differences in how students’ health behaviors develop and vary by gender, race, ethnicity, and socioeconomic status. George Mason University is a state institution that enrolls a highly diverse student population, making it an ideal setting to launch a longitudinal cohort study using multiple research methods to evaluate the effects of health behaviors on physical and psychological functioning, especially during the COVID-19 pandemic.Methods: Mason: Health Starts Here was developed as a longitudinal cohort study of successive waves of first-time freshmen that aims to improve understanding of the natural history and determinants of young adults’ physical health, mental health, and their role in college completion. The study recruits first-time freshmen who are 18 to 24 years old and able to read and understand English. All incoming freshman are recruited through various methods to participate in a longitudinal cohort for four years. Data collection occurs in fall and spring semesters, with online surveys conducted in both semesters and in-person clinic visits conducted in the fall. Students receive physical examinations during clinic visits and provide biospecimens (blood and saliva). Discussion: The study will produce new knowledge to help understand the development of health-related behaviors during young adulthood. A long-term goal of the cohort study is to support the design of effective, low-cost interventions to encourage young adults’ consistent performance of healthful behaviors, improve their mental health, and improve academic performance.
Correlation Between Improvement in Visual Acuity and QOL After Ranibizumab Treatment for Age-related Macular Degeneration Patients: QUATRO&nbsp;Study
Authors: Oshima Yuji , Ishibashi Yumi , Umeda Naoyasu , Nagata Tatsuo , Yoshida Shigeo , Uchio Eiichi , Kondo Hiroyuki , Sonoda Koh-hei , Ishibashi Tatsuro 
Published: December 2020

Abstract
Background: To evaluate the correlation between visual acuity improvement and vision-related QOL after ranibizumab treatment in Japanese patients with AMD.Methods: In this one-year prospective, interventional, open-label, multicenter study involving four sites, patients with neovascular AMD were enrolled and observed for 12 months. Treatment-naïve patients received 0.5 mg ranibizumab as needed (PRN) after three initial monthly doses. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at every visit. Fluorescein and indocyanine green angiography, and evaluations with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and patient satisfaction questionnaire were performed at baseline and 3 and 12 months after initial treatment. The primary endpoint was the change in BCVA and QOL 3 months after ranibizumab treatment. Secondary endpoints included change in BCVA, QOL, CMT, and patient satisfaction over 12 months.Results: The study enrolled 100 patients. The mean logMAR BCVA after the 3-month treatment improved significantly from 0.43 to 0.30 (p<0.0001). The mean NEI-VFQ-25 composite scores were higher after 3 months of ranibizumab treatment, improving from 79.48 to 84.13 (p<0.0001). The changes in the NEI-VFQ-25 score and BCVA showed significant correlation in the poor baseline visual acuity group (decimal BCVA below 0.5, p=0.02) but not in the better baseline visual acuity group (decimal BCVA above 0.6, p=0.1) after the three loading doses. There were no significant differences in the satisfaction questionnaire score from baseline to after the three loading doses (p=0.5466). The average CMT improved significantly from 340 to 264 mm after the loading doses (p<0.0001).Conclusions: Intravitreal ranibizumab treatment resulted in improvement in visual acuity, anatomical change, and visual function change in Japanese AMD patients. Significant improvement was seen in patient visual function, but this was not correlated with changes in VA in patients with higher or lower baseline VA. The patients' satisfaction with the treatment remained unchanged during the study period.
The Patient Enablement Instrument for Back Pain: Reliability, Content Validity, Construct Validity and Responsiveness
Authors: Nielsen Anne Molgaard , Hartvigsen Jan , Kongsted Alice , Öberg Birigtta , Enthoven Paul , Abbott Allan , Lauridsen Henrik Hein 
Published: December 2020

Abstract
Background Currently, there are no outcome measures assessing the ability of people with non-specific low back pain to self-manage their illness. Inspired by the ‘Patient Enablement Instrument’, we developed the Patient Enablement Instrument for Back Pain (PEI-BP). The aim of this study was to describe the development of the Patient Enablement Instrument for Back Pain (PEI-BP) and investigate content validity, construct validity, internal consistency, test-retest reliability, measurement error, responsiveness and floor and ceiling effects.Methods The PEI-BP consists of 6 items that are rated on a 0-10 Numeric Rating Scale. Measurement properties were evaluated using the COSMIN taxonomy and were based on three cohorts from primary care with low back pain: The content validity cohort (N=14) which participated in semi-structured interviews, the GLA:D Back cohort (N=272) and the test-retest cohort (N=37) which both completed self-reported questionnaires. For construct validity and responsiveness, enablement was compared to disability (Oswestry Disability Index), back pain beliefs (Brief Illness Perception Questionnaire), fear avoidance (Fear-Avoidance Beliefs Questionnaire – physical activity), mental health (SF-36), educational level and number of previous episodes of low back pain.Results The PEI-BP was found to have acceptable content validity, construct validity, reliability (internal consistency, test-retest reliability and measurement error) and responsiveness. The Smallest Detectable Change was 10.1 points illustrating that a patient would have to change more than 1/6 of the scale range for it to be a true change. A skewed distribution towards the high scores were found at baseline indicating a potentially problematic ceiling effect in the current population.Conclusions The PEI-BP can be considered a valid and reliable tool to measure enablement on people seeking care for non-specific LBP. Further testing of the PEI-BP in populations with more severe LBP is recommended.Trial registration: not applicable
The Mediation Effect of Coping Strategies Between Personality and Blood Pressure in Pregnancy Complicated by Hypertension
Authors: Chapuis-de-Andrade Sabrina , Moret-Tatay Carmen , Irigaray Tatiana Quarti , Antonello Ivan Carlos Ferreira , Costa Bartira Ercília Pinheiro da 
Published: December 2020

Abstract
Background: Hypertension is a disorder that affects many people and its complications can cause serious damage to health. In pregnancy, it is even more serious with risks both to pregnant women and their fetuses. This study investigated the role played by personality and coping strategies in blood pressure levels during pregnancy. Its specific goal was to study whether coping strategies can mediate the effect of personality in pregnancy complicated by hypertension. Methods: Assessment of a sample of 351 pregnant women, encompassing 192 pregnancies complicated by hypertension. This is a cross-sectional study where personality traits were measured by the Five-Factor Model and coping was evaluated by the Jalowiec´s Coping Inventory. Results: Personality can partially predict systolic and diastolic blood pressure. Openness to experience trait and emotion focused coping correlated with systolic and diastolic blood pressure. Diastolic blood pressure was predicted by openness to experience (β=-.15; p<.05). Systolic blood pressure was also predicted by openness to experience (β =-.14; p<.05). Conclusions: It is suggested to reinforce the development of coping strategies that are more focused on the problem than on emotion, in order to avoid negative effects of emotional coping in blood pressure in pregnancy.
The Antitumor Mechanism of the Polyphenol-enriched Ethyl Acetate Fraction Extract of Glechoma hederacea (Lamiaceae) against HepG2 Cells Involves Apoptosis Pathways
Authors: Chao Wen-Wan , Liou Yu-Jhen , Ma Hao-Ting , Chen Yi-Hua , Chou Su-Tze 
Published: December 2020

Abstract
Background: Glechoma hederacea (Lamiaceae) is a traditional Chinese herb belonging to the Labiatae family and has many biological activities. This study aimed to investigate the in vitro effects of different polar parts of the water extracts of G. hederacea (Lamiaceae) on HepG2 cells and the possible underlying mechanism.Methods: The cytotoxic effects were determined using the MTT assay. Apoptosis was quantified using annexin V-FITC/PI staining. Caspase-3 and caspase-9 activities were measured using PhiphiLux-G1D2 kit. Apoptosis-related protein expression was determined using western blot analysis. Reactive oxygen species (ROS) generation, mitochondrial transmembrane potential (MMP), and calcium ion levels were measured using specific fluorescence probes and flow cytometry. The HepG2 cell antioxidant state was determined using DAPI and comet assay, and antioxidant enzyme activities. The polyphenol contents of different polar parts of fractional extracts were determined using HPLC. Results: Our results showed that rosmarinic acid, caffeic acid, and ferulic acid were the major polyphenolic components in the ethyl acetate fraction extract (EAFE) of G. hederacea L.. EAFE could significantly inhibit HepG2 cell proliferation, induce apoptosis, and cause S phase arrest. The apoptogenic activity of EAFE involved ROS induction, Ca2+ accumulation, glutathione depletion, MMP disruption, caspases 3, 9 activation, and Bax/Bcl-2 ratio increment.Conclusion: Our findings suggest that the polyphenols in the EAFE can inhibit HepG2 cell growth and induce apoptosis through the mitochondria-mediated pathway and ROS-mediated endoplasmic reticulum stress. EAFE could be developed as a functional food or nutraceutical ingredient for chemotherapy.
A subunit gene of sucrose non-fermenting 1 related kinase, PpSnRK1γ, confers flat fruit abortion in peach by regulating sugar and starch metabolism
Authors: Guo Jian , Cao Ke , Yao Jia-long , Deng Cecilia , Li Yong , Zhu Gengrui , Fang Weichao , Chen Changwen , Wang Xinwei , Wu Jinlong , Guo Wenwu , Wang Lirong 
Published: December 2020

Abstract
Background: Fruit abortion is a major limiting factor for fruit production. In flat peach, fruit abortion is present in the whole tree of some accessions during early fruit development. However, the physiological factors and genetic mechanism underlying flat fruit abortion remain largely elusive. Results: In this study, we have revealed that the fertilization process was accomplished and the reduction of sucrose and starch contents might result in flat fruit abortion. By combining association and gene expression analysis, a key candidate gene, PpSnRK1γ, was identified. A 1.67-Mb inversion co-segregated with flat fruit shape altered the promoter activity of PpSnRK1γ, resulting in much lower expression in aborting flat peach. Ectopic transformation in tomato and transient overexpression in peach fruit have shown that PpSnRK1γ could increase sugar and starch contents. Comparative transcriptome analysis further confirmed that PpSnRK1γ participated in carbohydrate metabolism. Subcellular localization found that PpSnRK1γ was located in nucleus. Conclusions: This study clarified the reason for flat fruit abortion and identified a critical candidate gene, PpSnRK1γ, responsible for fruit abortion in peach. The results would provide great help in peach breeding and facilitate gene identification for fruit abortion in other plant species.
Profiling Immuno-Metabolic Mediators of Vitamin B12 Deficiency Among Metformin-Treated Type II Diabetes Patients in Ghana
Authors: Sakyi Samuel , Laing Edwin F. , Mantey Richard , Kwarteng Alexander , Owiredu Eddie-Williams , Dadzie Richard Ephraim , Amoani Benjamin , Opoku Stephen , Afranie Bright Oppong , Boakye Daniel 
Published: December 2020

Abstract
Background: The association between prolong metformin usage and B12 deficiency has been documented. However, the prevalence estimates of metformin-induced vitamin B12 deficiency showed substantial disparity among studies due to varied study definitions of vitamin B12 deficiency. Metformin blocks the calcium dependent absorption of the vitamin B12-Intrinsic Factor complex at the terminal ileum. Lack of intrinsic factor due to the presence of auto-antibodies to parietal cells (IFA) could lead to vitamin B12 deficiency and subsequently cause peripheral neuropathy. We investigated the prevalence of vitamin B12 deficiency using more sensitive, combined markers of vitamin B12 status (4cB12) and the immuno-biochemical mediators of vitamin B12 deficiency.Methods: In this observational study, 200 consecutive metformin-treated T2DM patients, aged 35 and above, attending the diabetic clinic at KATH were recruited. Vitamin B12 deficiency was classified based on the Fedosov age-normalized wellness quotient. Anthropometric measurement was taken as well as blood samples for immunological and biochemical mediators. Peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI). Statistical analysis was performed using the R Language for Statistical Computing version 3.6.0. Results: Using the combined indicator (4cB12), the prevalence of metformin induced vitamin B12 deficiency was 40.5% whilst the prevalence of MNSI-Q and MNSI-PE diabetic neuropathy was 67.5% and 93.5% respectively. Participants with vitamin B12 deficiency had significantly higher levels of IFA, GPA, TNF-α, TC, LDL and albumin compared to those with normal vitamin B12 levels (p < 0.05). Correlation analysis revealed a statistically significant negative association between 4cB12 and the immunological markers [AIF (rs= -0.301, p<0.0001), GPA (rs= -0.244, p=0.001), TNF-α (rs= -0.242, p=0.001) and IL-6 (rs= -0.145, p=0.041)]. Likewise, 4cB12 was negatively associated with TC (rs= -0.203, p=0.004) and LDL (rs= -0.222, p=0.002) but positively correlated with HDL (rs= 0.196, p=0.005).Conclusion: Vitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF-α and cardiometabolic risk factors (higher LDL and TC and lower HDL). It is imperative Ghana include routine measurement of Vitamin B12 deficiency using the more sensitive combined indicators (4cB12), in the management of T2DM patients on metformin.
Intensity of end-of-life health care and mortality after systemic anti-cancer treatment in patients with advanced lung cancer
Authors: Oselin Kersti , Pisarev Heti , Ilau Keit , Kiivet Raul-Allan 
Published: December 2020

Abstract
Background: We aimed to study the mortality and intensity of health care in patients with advanced lung cancer who received systemic anti-cancer treatment (SACT) compared with patients who were not eligible for SACT (no-SACT). Methods: A retrospective cohort of patients with lung cancer, who were treated at the North Estonia Medical Centre from 2015–2017, was linked to population-based health care data from the Estonian Health Insurance Fund. We calculated 14- and 30-day mortality after SACT and used a composite measure of intensity of care, comprised from the following: emergency department visit, admission to hospital, admission to intensive care unit, receipt of radiotherapy or systemic treatment. Results: The median overall survival (OS) of patients who received at least one cycle of SACT (n = 489) was 9.1 months and in patients with no-SACT (n = 289) 1.3 months (hazard ratio [HR]=4.23, 95% CI=3.60-5.00). In the SACT group 6.7% and 14.7% of patients died within 14 days and 30 days after the last cycle, respectively. During the final 30 days of life, intensive EOL care was received by 69.9% of the SACT patients and 43.7% of the no-SACT patients (p < 0.001). Among SACT patients, sepsis, bacterial infection and/or neutropenia had a significant adverse effect on survival (HR=1.7, 95% CI=1.3-2.21, p < 0.001), whereas the use of the granulocyte colony stimulating growth factor reduced the risk of death (HR= 0.71, 95% CI=0.54-0.92, p = 0.011). Conclusions: Significant proportions of patients with advanced lung cancer continue to receive intensive care near death. Our results highlight that neutropenia and infectious complications are still the primary cause of early SACT-related death.