bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Care Training and Information Support of Patients With Mechanical Heart Valve on International Normalized Ratio and the Bleeding Complications
Authors: Zandi Shirdel , Imani Behzad , Safarpor GHolamreza 
Published: December 2020

Abstract
BackgroundPatients with mechanical heart valve due to the possibility of coagulation complications require lifelong use of anticoagulants and International Normalized Ratio (INR) control. But if not taken care of properly, anticoagulant therapy itself can put people at risk for bleeding and be life-threatening. ObjectivesThe aim of this study was to determine the effect of Self-care training and information support of patients with mechanical heart valve on INR and the bleeding complications.DesignA randomized double-blind controlled trial.Settings and MethodsParticipants were recruited via convenience sampling from Farshchian hospital in Hamadan, Iran; and were randomly divided into two groups control (n=80) and intervention (n=80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of information support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using independent t-test and chi-square in spss16 software at a significance level of 0.05.ResultsDuring 6 months of follow-up, except for the third month, the frequency of INR levels in therapeutic target range (2.5-3.5) in the intervention group was significantly higher than the control group (p<0.05). Also in the intervention group, the incidence of bleeding complications was relatively less than the control group, but this difference was not statistically significant (p>0.05).Conclusion﻿Proper self-care training and information support in patients with mechanical heart valve replacement have positive results. By doing self-care, the level of a therapeutic target range of INR maintained and the incidence of bleeding complications can be reduced.
Prevalence of Chronic Diseases and Alterations of Gut Microbiome in Ningxia China During Urbanization: An Epidemiological Survey
Authors: Du Yong , Ding Lu , Na Li , Sun Ting , Sun Xian , Wang Liqun , He Shulan , Wang Zhizhong , Lu Zhenhui , Li Feng , Guo Xiaofei , Zhang Yanhong , Tian Jin , Wang Bo , Zhai Sifan , Yang Chao , Liu Xiao 
Published: December 2020

Abstract
Background: In the 21st century, the continuous development of urbanization has dramatically changed people's living environment and lifestyle. The urban environment and the lifestyles it formed are accompanied by the risks that would threaten the health of individuals, as shown by the increased prevalence of chronic diseases. However, there is little research on the effect of urbanization on gut microbiome in residents.Results: Here we investigated the relation between living environment and gut microbiota in a homogenous population along an urban-rural gradient in Ningxia China. According to the degree of urbanization, the population is divided into four groups: mountainous rural (MR) represents non-urbanized areas, mountainous urban (MU) and plain rural (PR) represent preliminary urbanization, and plain urban (PU) is a representative of complete urbanization. Studies have found that with the deepening of urbanization, the prevalence of chronic diseases, such as diabetes, dyslipidemia, fatty liver, gallstones, and renal cysts, have gradually increased. The intestinal richness and diversity of the microbial community were significantly reduced in the PR and the PU groups compared with the MR and the MU groups. At the phylum level, the abundance of Proteobacteria gradually increased, while the abundance of Actinobacteria gradually decreased in the MU and the PR groups compared with the MR group. Based on linear discriminant analysis selection, the significantly enriched genera Faecalibacterium, Prevotella, and Pseudobutyrivibrio in the MR group gradually decreased in the MU, the PR, and the PU groups. Effect size results revealed that both residence and diet had an effect on intestinal microbiota.Conclusions: Urbanization attenuates gut microbial diversity and richness and might play a role in the pathogenesis of chronic diseases. Environmental exposure during urbanization, such as westernization of diet and pollution have been shown to affect gut microbiota. In this study, the disparate patterns of gut microbiota composition were revealed at different levels of urbanization, providing an opportunity to understand the pathogenesis of chronic diseases and the contribution of the “rural microbiome” in potential protection against the occurrence of chronic diseases.
Behavioural Strategies in Cyclic Models: The Effects of Directional Movement Tactics
Authors: Moura Beatriz , Silva Josinaldo Menezes da 
Published: December 2020

Abstract
We investigate behavioural strategies in stochastic simulations of systems with cyclic nonhierarchical dominance, as ageneralisation of the rock-paper-scissors game. We introduce directional movement tactics to one out of the species, whose individuals move according to an innate or a conditioned response to a stimulus; individuals of the other species move randomly. The directional movement tactics allow the individuals to conquer or maintain territory, either attacking or anticipating or Safeguarding themselves. We study the effects of the behavioural strategies for individuals with different levels of perception of the neighbourhood. Besides, we investigate the case where not all individuals are conditioned to perform the behavioural strategy or where individuals that do not use the tactic for every move. We found that self-preservation behaviour is more profitable in terms of population growth, where the best result is achieved for individuals with large perception radius that always move according to the movement tactic. Our findings show that the attack tactics is more gainful for short perception radius and if the individuals alternate the tactic with random movement. For anticipation, the best result is achieved for individuals with long-range perception using the tactics rarely. Finally, we calculated the coexistence probability and found that, in addition to providing a greater spatial density for the species, the Safeguarding tactic is the least jeopardising to biodiversity. Our results may be useful for experimental and theoretical biologists to understand systems of species whose individuals behave strategically, and how coexistence is maintained in an uneven scenario.
Diagnostic Yield of Colon Capsule Endoscopy for Crohn’s Disease Lesions in the Whole Gastrointestinal Tract
Authors: Yamada Keisaku , Nakamura Masanao , Yamamura Takeshi , Maeda Keiko , Sawada Tsunaki , Mizutani Yasuyuki , Ishikawa Eri , Ishikawa Takuya , Kakushima Naomi , Furukawa Kazuhiro , Ohno Eizaburo , Kawashima Hiroki , Honda Takashi , Ishigami Masatoshi , Fujishiro Mitsuhiro 
Published: December 2020

Abstract
BACKGROUNDCrohn’s disease (CD) can involve the upper gastrointestinal (GI) tract as well as the small and large bowel. PillCam colon capsule endoscopy (PCCE-2) enables to observe the whole GI tract, but its diagnostic yield for CD lesions in the whole GI tract remains unknown. AIMTo elucidate the diagnostic yield of PCCE-2 in patients with CD.METHODSPatients with CD who underwent PCCE-2 and double-balloon endoscopy (DBE) using oral and anal approaches were evaluated for CD lesions in the whole GI tract. We divided the small bowel into three segments (jejunum, ileum, and terminal ileum), and the large bowel into four segments (right colon, transverse colon, left colon, rectum). Detection of ulcer scars, erosion, ulcers, bamboo joint-like appearance, and notch-like appearance was assessed in each segment. The diagnostic yield of PCCE-2 was analyzed based on the DBE results as the gold standard.RESULTSOf the total 124 segments, the sensitivities of PCCE-2 for ulcer scars, erosion, and ulcers were 83.3%, 93.8%, and 88.5%, respectively, and the specificities were 76.0%, 78.3%, and 81.6%, respectively. For the 60 small bowel segments, the sensitivities were 84.2%, 95.5%, and 90.0%, respectively, and the specificities were 63.4%, 86.8%, and 87.5%, respectively. For the 64 large bowel segments, the sensitivities were 80.0%, 90.0%, and 83.3%, respectively, and the specificities were 84.7%, 72.2%, and 77.6%, respectively.CONCLUSIONPCCE-2 provides a high diagnostic yield for lesions in the whole GI tract of patients with CD. Thus, we recommend its use as a pan-enteric tool in clinical settings.
Microendoscopy-assisted Extraforaminal Lumbar Interbody Fusion for Treating Single-level Spondylodesis
Authors: Shibayama Motohide , Li GuangHua , Zhu LiGuo , Ito Zenya , Ito Fujio 
Published: December 2020

Abstract
Background: Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results.Methods: Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results: Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery.Conclusions: mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.
Identification of Cell Wall-Associated Kinases as Important Regulators Involved in Gossypium Hirsutum Resistance to Verticillium Dahliae
Authors: Yang Jun , Xie Meixia , Wang Xingfen , Wang Guoning , Zhang Yan , Li Zhikun , Ma Zhiying 
Published: December 2020

Abstract
BackgroundVerticillium wilt, caused by the soil borne fungus Verticillium dahliae, is a major threat to cotton production and quality. An increasing number of findings indicate that WAK genes participate in plant−pathogen interactions, but their roles in cotton resistance to V. dahliae remains largely unclear.ResultsHere, we carried out a genome-wide analysis of WAK gene family in Gossypium hirsutum that resulted in the identification of 81 putative GhWAKs, which were all predicated to be localized on plasma membrane. In which, GhWAK77, as a representative, its location was further confirmed using transient expression of fluorescent fusion proteins in tobacco epidermal cells. All GhWAKs could be classified into seven groups according to their various protein domains, indicating that they might sense different outside signals to trigger special intracellular signaling pathways that response to various environmental stresses. A lot of cis-regulatory elements were predicted in the upstream region of GhWAKs and classified into four main groups including hormones, biotic, abiotic and light. 31 GhWAKs, playing a potential role in the interaction between cotton and V. dahliae, were screened out by RNA-seq and qPCR. To further study the function of GhWAKs in cotton resistance to V. dahliae, VIGS was used to silence GhWAKs. At 20 dpi, VIGSed plants exhibited more chlorosis and wilting than the control plants. The disease indices of VIGSed plants were also significantly higher than those of the control. Furthermore, silencing of GhWAKs significantly affected the expression of JA- and SA-related marker genes, increased the spread of V. dahliae in the cotton stems, dramatically compromised V. dahliae-induced accumulation of lignin, H2O2 and NO, but enhanced POD activity.ConclusionOur study presents a comprehensive analysis on cotton WAK gene family for the first time. Expression analysis and VIGS provided direct evidences that GhWAKs participate in the resistance of cotton to V. dahliae.
Post Mastectomy Radiotherapy among Patients with T1-T2 1-3 node Positive Disease: Does it Make a Difference?
Authors: Vohra Lubna Mushtaque , Soomro Rufina , Jabeen Dua , Ali Nasir , Khan Nargis 
Published: December 2020

Abstract
Background: Pakistan has the highest incidence of breast cancer among Asian Countries but there is insufficient representation of local data addressing breast cancer treatment and outcome. We sought to determine the role of post-mastectomy radiotherapy (PMRT) in T1- T2 breast cancer with 1-3 positive axillary lymph nodes. Methods: Data was reviewed retrospectively of total 755 patients out of which 291 received PMRT and 464 did not from two large breast cancer centres.Results: With a median follow up of 78 months, 4 (4.5%) patients developed loco regional recurrence (LRR) in the PMRT group while a substantial number 74 (24.4%) recurred in the non PMRT group (p=0.000). Loco regional free survival rate (LRFS) and overall survival rate (OS) was significantly better for PMRT patients than non-PMRT patients (P = <0.000). Multivariate analysis identified young age, lymphovascular invasion, extra capsular extension, triple negative and ER/PR negative were independent prognostic factors affecting loco regional free survival (LRFS).Conclusion: Disease recurrence is a substantial issue in 1-3 node group despite early stage, PMRT has an instrumental effect in improving LRFS and OS.
WITHDRAWN: Psychological Distress in Urbanizing China: How Does Local Government Effectiveness Matter?
Authors: Chen Juan , Gong Lin , Xie Shenghua 
Published: December 2020

Abstract
PurposeThis study investigates how the effectiveness of local government affects residents’ levels of psychological distress in areas of China undergoing urbanization. We measure the effectiveness of local governments according to their success in promoting access to the social security system through distribution of social security cards among citizens. We hypothesize that higher local government effectiveness will reduce residents’ psychological distress by alleviating worries about medical expenses and elder care.MethodsDrawing on data from the 2018 Urbanization and Quality of Life Survey (N=3,229) conducted in 40 localities undergoing rural-urban transition, we estimate three-level mixed-effects regression models to test the research hypotheses, allowing random effects at the township/county and neighbourhood levels while controlling for a series of individual attributes.ResultsLocal government effectiveness is negatively associated with residents’ psychological distress: effective local governments alleviate worries about medical expenses and elder care, and thereby reduce psychological distress.ConclusionTo reduce residents’ worries and psychological distress during the process of rural–urban transition, it is essential to improve local government effectiveness, particularly in promoting residents’ access to the social security system.
Mathematical Models for Intraoperative Prediction of Metastasis to Lymph Nodes in the Hilar-intrapulmonary or the Mediastinal Region in Patients With Clinical Stage I Non-small Cell Lung Cancer: a Retrospective Cohort Study
Authors: Zhou Yue , Du Junjie , Ma Changhui , Zhao Fei , Li Hai , Ping Guoqiang , Wang Wei , Luo Jinhua , Chen Liang , Zhang Kai , Zhang Shijiang 
Published: December 2020

Abstract
Background: It remains challenging to determine the regions of metastasis to lymph nodes during operation for clinical stage I non-small cell lung cancer (NSCLC). This study aimed to establish intraoperative mathematical models with nomograms for predicting the hilar-intrapulmonary node metastasis (HNM) and the mediastinal node metastasis (MNM) in patients with clinical stage I NSCLC.Methods: The clinicopathological variables of 585 patients in a derivation cohort who underwent thoracoscopic lobectomy with complete lymph node dissection were retrospectively analysed for their association with the HNM or the MNM. After analysing the variables, we developed multivariable logistic models with nomograms to estimate the risk of lymph node metastasis in different regions. The predictive efficacy was then validated in a validation cohort of 418 patients.Results: It was confirmed that CEA (> 5.75 ng/ml), CYFRA211 (> 2.85 ng/ml), the maximum diameter of tumour (> 2.75 cm), tumour differentiation (grade III), bronchial mucosa and cartilage invasion, and vascular invasion were predictors of HNM, and CEA (>8.25 ng/ml), CYFRA211 (> 2.95 ng/ml), the maximum diameter of tumour (> 2.75 cm), tumour differentiation (grade III), bronchial mucosa and cartilage invasion, vascular invasion, and visceral pleural invasion were predictors of MNM. The validation of the prediction models based on the above results demonstrated good discriminatory power.Conclusions: Our predictive models are helpful in the decision‑making process of specific therapeutic strategies for the regional lymph node metastasis in patients with clinical stage I NSCLC.
Analytic Hierarchy Process Model for the Diagnosis of Typhoid Fever
Authors: Uzoka Faith-Michael , Nwokoro Chukwudi , Obot Okure , Ekpenyong Moses , Udo Aniema I.A. 
Published: December 2020

Abstract
Typhoid fever is a global health problem, which seems neglected, but is responsible for significant levels of morbidity in many regions of the world, with about 12 million cases annually, and about 600,000 fatalities. Diagnosis of typhoid poses a great deal of challenge because its clinical presentation is confused with those of many other febrile infections such as malaria, yellow fever, etc. In addition, most developing countries do not have adequate bacteriology laboratories for further investigations. Decision support systems have been known to increase the efficiency and effectiveness of the diagnosis process, in addition to improving access; however, most existing decision support models for diagnosis of diseases have largely focused on ‘non-tropical’ conditions. An effective decision support model for diagnosis of tropical diseases can only be developed though the engineering of experiential knowledge of physicians who are experts in the management of such conditions. In this study, we mined experiential knowledge of twenty-five tropical disease specialist physicians to develop a decision support system based on the Analytic Hierarchy Process (AHP). The resulting model was tested based on 2044 patient data. Our model successfully determined the occurrence (or otherwise) of typhoid fever in 78.91% of the cases, demonstrating the utility of AHP in the diagnosis of typhoid fever.
Incidence and Survival of Head &amp; Neck Cancers in Estonia, 1996–2016
Authors: Kase Sandra , Baburin Aleksei , Kuddu Maire , Innos Kaire 
Published: December 2020

Abstract
Background and MaterialChanging patterns of alcohol and tobacco consumption and human papillomavirus (HPV) infection have affected the epidemiology of head & neck cancers. The aim of the study was to examine 20-year trends in the incidence and survival of head & neck cancers in Estonia by site, sex, morphology and stage.MethodsData on all adult cases of invasive head & neck cancers diagnosed in Estonia in 1996–2016 were obtained from the population-based cancer registry. TNM stage was available for 2010–2016. Incidence trends were modelled with joinpoint regression and five-year relative survival ratios (RSR) were calculated.ResultsA total of 6769 cases were included, 64% among men. We observed significant decline in the incidence of lip and laryngeal cancer and significant increase in the incidence of hypopharyngeal and oropharyngeal cancers. Over 60% of mouth & pharyngeal cancers were diagnosed at stage IV.Age-standardized five-year RSR for mouth & pharyngeal cancer increased significantly over the study period, from 21% in 1996–2002 to 33% in 2010–2016. The largest survival increases were seen for cancers of oral cavity (44% in 2010–2016), tongue (41%) and larynx (63%), while modest changes were seen for oropharynx (24%) and hypopharynx (17%). The latest five-year RSR was 90% for thyroid cancers (99% for papillary carcinoma). Large female survival advantage was seen for most sites.ConclusionsThe observed trends suggest an emerging role of HPV infection in combination with traditional risk factors in the development of head & neck cancers in Estonia. Efforts targeting health behavior, HPV vaccination and earlier diagnosis are crucial for reducing mortality from these cancers.
Comparison of the Mass Tissue Strength of Strawberry Fruit between Vertical and Horizontal axes
Authors: Ansar Ansar , Murad Murad , Sukmawaty Sukmawaty , Ilmaknun Lulu 
Published: December 2020

Abstract
BackgroundStrawberry fruit has a thin skin layer, so it is very susceptible to tissue mass damage during post-harvest handling. This article compares the strength of the strawberry mass tissue between the vertical and horizontal axes using a compression test at different speeds and compressibility levels. ResultsThe results showed that the mass tissue damage of strawberries was greater when compressed from the horizontal axis than from the vertical axis. The loading from the vertical axis obtained a combined mechanical response between the fruit structure and mass tissue cells, while from the horizontal axis the mechanical response was obtained only from the fruit structure. During compression, the fruit undergoes 3 phases of deformation, namely elastic, plastic, and permanent mass tissue damage. In the elastic deformation phase, the fruit mass tissue has not been damaged. Along with the duration of the compression, mass tissue damage has started to occur. ConclusionThe outer mass tissue of a strawberry is more susceptible to damage than the deep mass tissue. Therefore, the post-harvest handling process from agricultural land to the hands of consumers requires gentle handling to maintain fruit quality. The percentage of mass tissue damage of strawberries can be minimized if arranged vertically in the package. The percentage of fruit mass tissue damage obtained from this study can be used to predict changes in fruit volume non-destructively.