bluuebunny/crossref_metadata_2025_split huggingface dataset:
Completeness of Social and Behavioral Determinants of Health in Electronic Health Records: A case study on the Patient-Provided Information from a minority cohort with sexually transmitted diseases
Authors: Kshatriya Bhavani Singh Agnikula , Balls-Berry Joyce E , Freeman William D , Zhang Rui , Wang Yanshan 
Published: December 2020

Abstract
IntroductionRacially and ethnically diverse minorities often experience the disease burden of sexually transmitted infections or diseases (STD) more often than their White counterparts. Yet, little is known about the connection of STD systematic discrimination, racism, and social and behavioral determinants. Plus, little to no details exists related to how this information is recorded in their Electronic Health Records (EHRs). The objective of this study is to assess the completeness of social and behavioral determinants of health (SDOH) data in the EHRs of a minority cohort with STD.Materials and Methods2,993 minority patients diagnosed with a STD at the Mayo Clinic were identified for this study. A natural language processing (NLP) algorithm was applied on the Patient-Provided Information (PPI) in their EHRs to extract SDOH information in six domains that are associated with STD, namely alcohol use, substance use, sexual activity, sexual orientation, housing status, and employment status. The completeness of SDOH was assessed in terms of documentation, breadth, and density.ResultsOur study indicates that nearly half of 2,993 patients did not have SDOH-related PPI records in their EHRs whereas the patients who had SDOH-related PPI records had well-documented records for five out of six SDOH domains, including alcohol use, substance use, sexual activity, housing status, and employment status, except for sexual orientation. A total of 1,504 patients had PPI in their EHRs for at least one of six SDOH domains, which is about 50.3% of the study cohort. Most SDOH domains have a short time span of 1 year, with up to 18 years of record data. Our analysis also indicated that education and age have a significant impact on the recording of SDOH-related PPI records. Patients that are female, older, and higher educated tend to have more SDOH information available in their records.Discussion and ConclusionWe assessed the completeness of SDOH information recorded in the PPI from patients’ EHRs. Due to large amounts of missing SDOH information in the PPI, future research is needed to integrate accurate and robust SDOH related data for downstream research and the impact of systematic discrimination on how this information is collected and interpreted in the EHRs.
Study Rationale and Design of a Study of Empagliflozin’s Effects in Patients With Type 2 Diabetes Mellitus and Coronary ARtery&nbsp;Disease: The EMPA-CARD&nbsp;Randomized Controlled Trial
Authors: Gohari Sepehr , Reshadmanesh Tara , Khodabandehloo Hadi , Fathi Mojtaba , Ahangar Hassan , Arsang-Jang Shahram , Ismail-Beigi Faramarz , Ghanbari Samin , Dadashi Mohsen , Muhammadi Muhammad Javad , Gohari Sheida , Ghaffari Saeid 
Published: December 2020

Abstract
Background: Recent trials have revealed that sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are effective against hyperglycemia and also reduce micro- and macro-vascular complications in patients with type 2 diabetes mellitus (T2DM). Most of the beneficial cardiovascular effects have been investigated in patients with heart failure and coronary artery disease (CAD). Yet, no human study has been conducted to investigate the mechanisms underlying these clinically beneficial effects in patients with CAD. Accordingly, the EMPA-CARD trial was designed to focus on the molecular effects of empagliflozin in patients with T2DM and CAD.Methods: In this multicenter, triple-blind randomized controlled trial, patients with documented known T2DM and CAD will be recruited. They will be randomized on a 1:1 ratio and assigned into two groups of empagliflozin 10 mg/daily and placebo. The primary endpoint is the effect of empagliflozin on changes of plasma interleukin 6 (IL-6) after 26 weeks of treatment. The secondary endpoints will consist of changes in other inflammatory biomarkers (Interleukin 1-beta and high-sensitive C-reactive protein), markers of oxidative stress, platelet function, and glycemic status. Discussion: The EMPA-CARD trial mainly tests the hypothesis that SGLT2 inhibition by empagliflozin may improve inflammatory status measured as reduction in inflammatory biomarkers in patients with T2DM and CAD. The results will provide information about the underlying mechanisms of SGLT2 inhibition that mediate the beneficial effects of this medication on clinical outcomes.Trial registration: Iranian Registry of Clinical Trials. www.IRCT.ir, Identifier: IRCT20190412043247N2. Registration Date: 6/13/2020. Registration timing: prospective
“Health Technology Assessment in High, Middle and Low-income Countries: New Systematic and Interdisciplinary Approach for Sound Informed-policymaking”
Authors: AlKhaldi Mohammed , Ahmed Sara , Basuoni Aisha Al , Tanner Marcel 
Published: December 2020

Abstract
Technological innovation has a significant role in improving health systems (HSs) and achieving universal health coverage. The World Health Organization (WHO) has declared resolutions on Health Technology Assessment (HTA) and other global organizations emphasized on HTA systems to achieve the Sustainable Development Goals (SDGs). HTA is a modern multidisciplinary decision-making framework linking knowledge and policymaking in order to provide evidence to leaders and ensuring the value of resources by evaluating properties, effects, and/or impacts. The scope of HTA focuses on conducting assessments and analyses to investigate the medical, social, economic, organizational and ethical issues within health and social systems for generating management and technical solutions. HTA is important as it is rapidly growing and is seen as an essential development approach to tackle existing challenges, particularly in developing countries as they share most of the health burdens worldwide. The research aims to comprehensively evaluate HTA within the health and social systems and understand HTA within the national health system with regards to the level of knowledge about HTA, current HTA practices, application, capacity, gaps, and solutions by investigating the perceptions of health systems’ stakeholders in five countries, Canada, Switzerland, Lebanon, Palestine, and Tanzania selected according to the World Bank income classification. The project will last 12 months starts in January 2021 and ends in January 2022. A mixed-methods, quantitative and qualitative, along with a scoping review will be applied. In each country, fifty semi-structured questionnaires, twenty in-depth interviews, and one national focus group discussion will be conducted with health experts, managers, and policymakers selected purposively from the 1st and 2nd levels of the HS structure. Excel, IBM Statistical Package for the Social Sciences (SPSS), and MAXQDA 12 (VERBI GmbH, Berlin) software programs will be used for data management and analysis. The research will form cutting-edge evidence and reference not only for the six countries, but also for the global, regional, and national endeavors with regards to opening a room for HTA best application and optimization based on the produced knowledge from this research. It will reveal lessons learned, determine gaps, and set an applicable strengthening framework for HTA. This framework will eventually aid the decision and policymakers in these countries, and other similar countries and international organizations to build a well-enabled and institutionalized HTA for better universal health coverage, health systems, and multi-sectoral development.
Mechanism of Protective Effect of Xuan-Bai-Cheng-Gi Decoction on LPS-Induced Acute Lung Injury Based on an Integrated Network Pharmacology and RNA-Sequencing Approach
Authors: Zhu Huahe , Wang Shun , Shan Cong , Li Xiaoqian , Tan Bo , Chen Qilong , Yang Yunxiang , Yu Hongji , Yang Aidong 
Published: December 2020

Abstract
Xuan-bai-cheng-qi decoction (XCD), a traditional Chinese medicine (TCM) prescription, has been widely used to treat a variety of respiratory diseases in China, especially to seriously infectious diseases such as acute lung injury (ALI). Due to the complexity of the chemical constituent, however, the underlying pharmacological mechanism of action of XCD is still unclear. To explore its protective mechanism on ALI, firstly, a network pharmacology experiment was conducted to construct a component-target network of XCD, which identified 46 active components and 280 predicted target genes. Then, RNA sequencing (RNA-seq) was used to screen differentially expressed genes (DEGs) between ALI model rats treated with and without XCD and 753 DEGs were found. By overlapping the target genes identified using network pharmacology and DEGs using RNA-seq, and subsequent protein-protein interaction (PPI) network analysis, 6 kernel targets such as vascular epidermal growth factor (VEGF), mammalian target of rapamycin (mTOR), AKT1, hypoxia-inducible factor-1α (HIF-1α), and phosphoinositide 3-kinase (PI3K) and gene of phosphate and tension homology deleted on chromsome ten (PTEN) were screened out to be closely relevant to ALI treatment. Validation experiments in the LPS-induced ALI model rats showed that XCD could alleviate lung tissue pathological injury through attenuating proinflammatory cytokines release such as tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β. Meanwhile, both the mRNA and protein expression levels of PI3K, mTOR, HIF-1α, and VEGF in the lung tissues were downregulated with XCD treatment. Therefore, the regulations of XCD on PI3K/mTOR/HIF-1α/VEGF signaling pathway was probably a crucial mechanism involved in the protective mechanism of XCD on ALI treatment.
Clinical Implications of Size of Cavities in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Single-Center Cohort Study
Authors: Kang Hye-Rin , Hwang Eui Jin , Kim Sung A , Choi Sun Mi , Lee Jinwoo , Lee Chang-Hoon , Yim Jae-Joon , Kwak Nakwon 
Published: December 2020

Abstract
BackgroundThe presence of cavities is a poor prognostic factor in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). However, little is known about the characteristics of such cavities and their impact on clinical outcomes. The aim of this study is to investigate the size of cavities and their implications on treatment outcomes and mortality in patients with NTM-PD.MethodsWe included patients diagnosed with NTM-PD at Seoul National University Hospital between 1 January 2007 and 31 December 2018. We measured the size of cavities on chest computed tomography scans performed at the time of diagnosis, and used multivariable logistic regression and Cox-proportional hazards regression analysis to investigate the impact of these measurements on treatment outcomes and mortality. ResultsThe study cohort comprised 421 patients (non-cavitary, n=329; cavitary, n=92) with NTM-PD. During a median follow-up period of 49 months, 118 (35.9%) of the 329 patients with non-cavitary and 64 (69.6%) of the 92 patients with cavitary NTM-PD received antibiotic treatment. Cavities >2 cm were associated with worse treatment outcomes (adjusted odds ratio, 0.38; 95% confidence interval [CI], 0.16–0.86) and higher mortality (adjusted hazard ratio, 2.50; 95% CI, 1.04–6.02), while there was no difference in treatment outcomes and mortality between patients with cavities <2 cm and patients with non-cavitary NTM-PD. ConclusionsClinical outcomes are different according to the size of cavities in patients with cavitary NTM-PD; thus the measurement of the size of cavities could help in making clinical decisions.
Clinical Significance of Protrusion Edge Enhancement Using Contrast-Enhanced Magnetic Resonance Imaging in The Conservative Treatment of Giant Lumbar Disc Herniation: A Prospective Observational&nbsp;Study
Authors: Ma Zhijia , Yu Pengfei , Dai Yuxiang , Feng Qiuxiang , Jiang Hong , Li Xiaochun , Yu Zhenhan , Liu Jin Tao 
Published: December 2020

Abstract
Background: Contrast-enhanced lumbar spine magnetic resonance imaging (MRI) was used to predict the efficacy of conservative treatment of giant lumbar disc herniation.Methods: From June 2017 to June 2019, 30 patients with giant lumbar disc herniation with positive and negative bull’s eye signs on contrast-enhanced lumbar spine MRI were assessed to measure differences in the rate of intervertebral disc herniation, rate of protrusion absorption, treatment effect, protrusion rate, and curative effect according to the lumbar Japanese Orthopedic Association (JOA) score before and after treatment.Results: Thirty patients with positive and negative bull’s eye signs (36 men and 24 women) aged 19 to 58 years (mean, 36.37 ± 9.56 years) were included. All patients were followed up for more than 1 year, and at least one MRI review was conducted within 1 year of treatment. The results of the first and final MRI examinations were compared. The protrusion rate was 82.16% ± 14.58% before treatment and 32.20% ± 30.80% after treatment, and the absorptivity of the protrusion was 59.48% ± 38.62%. There was no statistically significant difference in the general data before treatment between the positive and negative groups (P > 0.05). After treatment, the protrusion rate in the positive and negative bull’s eye sign groups was 14.41% ± 14.37% and 49.99% ± 32.70%, respectively (P < 0.05). The absorptivity in the positive and negative bull’s eye sign groups was 83.09% ± 15.54% and 35.87% ± 40.49%, respectively (P < 0.05). There was no statistically significant difference in the JOA score between the two groups before treatment (P > 0.05); however, there was a statistically significant difference in the JOA score between the two groups at 3 months (P < 0.05) and 1 year (P < 0.05) after treatment.Conclusions: Conservative treatment of giant lumbar disc herniation has a satisfactory clinical effect. Contrast-enhanced MRI can be used to predict the resorption of giant lumbar disc herniation. Protrusion resorption is more likely to occur in patients with than without a bull’s eye sign.Trial registration: Chinese Clinical Trial Registry (No. ChiCTR1900022377). Retrospectively registered 08 April 2019.
20-Year Trends in Lipid Intake From Korean Adults: Using Korea National Dietary Survey Data
Authors: Kwon Yong-Seok , Hwang Yu-Jin , Chu Hanna , Ju Seyoung 
Published: December 2020

Abstract
Background: This study was undertaken to analyze 20-year trend regarding the lipid intake of Korean adults according to general characteristics, dietary behavior, food groups, and the Dietary Reference Intakes for Koreans (KDRIs), using KNHANES (Korea National Health and Nutrition Examination Survey) data. Methods: This study selected adults who participated in the 24-hour recall method to investigate the trend of lipid intake for the 20-year period from 1998 to 2018 of the KNHANES. A total of 86,222 individuals with adults aged 19 and over were included in the study. Results: The lipid intake increased significantly in all individuals (+7.34g), men (+9.71g), and women (+4.93g) (p for trend<0.001) from the first to the seventh term. The lipid ratio contributed to energy increased significantly in all individuals (+3.52% percentage points), men (+3.12% percentage points), and women (+3.90% percentage points) over the 20-year period (p for trend<0.001). Lipid intake increased significantly overall as well as by sex, age, residential area, education level (except below 12 years of education), and presence of obesity and abdominal obesity increased over the 20-year period. Total plant and animal lipid intake has increased over the 20-year period from 1998 to 2018. Specifically, the ratio of lipid intake from potatoes, sugars, seeds and nuts, seaweed, beverages, meats, eggs, dairy products, and other animal foods has increased, while that from grains, beans, vegetables, mushrooms, fruits, vegetable oils, fish and shellfish, and animal fats has decreased. Conclusions: The results of this study will aid in the preparation of basic data for nutrition policy and proper nutrition and dietary education with the aim of improving the diets of Koreans nationwide.
Transdiagnostic Comparison of Visual Working Memory Capacity in Bipolar Disorder and Schizophrenia
Authors: Barnes-Scheufler Catherine , Passow Caroline , Rösler Lara , Mayer Jutta , Oertel Viola , Kittel-Schneider Sarah , Matura Silke , Reif Andreas , Bittner Robert A 
Published: December 2020

Abstract
BackgroundImpaired working memory is a core cognitive deficit in both bipolar disorder and schizophrenia. Its study might yield crucial insights into the underpinnings of both disorders on the cognitive and neurophysiological level. Visual working memory capacity is a particularly promising construct for such translational studies. However, it has not yet been investigated across the full spectrum of both disorders. The aim of our study was to compare the degree of reductions of visual working memory capacity in patients with bipolar disorder (PBD) and patients with schizophrenia (PSZ) using a paradigm well established in cognitive neuroscience. Methods62 PBD, 64 PSZ, and 70 healthy controls (HC) completed a canonical visual change detection task. Participants had to encode the color of four circles and indicate after a short delay whether the color of one of the circles had changed or not. We estimated working memory capacity using Pashler’s K. ResultsWorking memory capacity was significantly reduced in both PBD and PSZ compared to HC. We observed a small effect size (r = .202) for the difference between HC and PBD and a medium effect size (r = .370) for the difference between HC and PSZ. Working memory capacity in PSZ was also significantly reduced compared to PBD with a small effect size (r = .201). Thus, PBD showed an intermediate level of impairment. ConclusionsThese findings provide evidence for a gradient of reduced working memory capacity in bipolar disorder and schizophrenia, with PSZ showing the strongest degree of impairment. This underscores the importance of disturbed information processing for both bipolar disorder and schizophrenia. Our results are compatible with the cognitive manifestation of a neurodevelopmental gradient affecting bipolar disorder to a lesser degree than schizophrenia. They also highlight the relevance of visual working memory capacity for the development of both behavior- and brain-based transdiagnostic biomarkers.
How to promote exclusive breastfeeding in Ireland: a qualitative study on views of Chinese immigrant mothers
Authors: Chen Haoyue , Li Cheng , Zhou Qianling , Cassidy Tanya M. , Younger Katherine M. , Shen Siao , Kearney John M. 
Published: December 2020

Abstract
Background: The exclusive breastfeeding rate in Ireland is very low with extremely slow annual growth. The population of immigrants in Ireland is increasing. Improving exclusive breastfeeding practice among immigrants may contribute to the overall improvement of exclusive breastfeeding rates in Ireland. This study was conducted to elicit suggestions on improving exclusive breastfeeding rate for six months among Chinese immigrants in Ireland. Methods: Fourteen semi-structured in-depth interviews were conducted with Chinese immigrant mothers residing in Ireland, who breastfed exclusively for four to six months. Interviews were recorded and transcribed in Chinese. Data were analyzed using qualitative thematic analysis. Themes were developed through categorization of codes and via in-depth discussion between two researchers.Results: Themes generated from thematic content analyses were 1) suggestions for new mothers: being strong mentally and getting support from family and friends; 2) suggestions for employers: creating a supportive workplace by setting up private room and breastmilk storage facilities; 3) suggestions for health care professionals: advocating breastfeeding in the hospital and addressing cultural differences by recruiting multilingual staff; 4) suggestions for the government: promoting breastfeeding by initiating societal and policy changes. Conclusions: The key findings emerging from this study may be considered in the development of breastfeeding promotion strategies in Ireland. Our findings could also have implications for other English-speaking countries with low rates of exclusive breastfeeding.
A cross-sectional comparison of breastfeeding knowledge, attitudes, and perceived partners’ support among expectant couples in Mekelle Ethiopia
Authors: Gebremariam Kidane , Zelenko Oksana , Mulugeta Afework , Gallegos Danielle 
Published: December 2020

Abstract
Background: Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influential determinant. The aim of this study was to compare antenatal breastfeeding knowledge, attitudes, and perceived breastfeeding support of expectant couples in Mekelle, Ethiopia. Methods: As part of a randomised controlled trial of an mHealth intervention, 128 couples in their third trimester from three selected health centres in Mekelle city were recruited to participate between September and October 2018. Couples who each had a personal mobile phone, read and spoke Tigrigna, and lived together were included. Baseline data on breastfeeding knowledge, attitudes, and perceived support (breastfeeding savvy, help, appreciation, presence and responsiveness) were collected using previously validated tools through interview by health workers. Result: Compared to mothers, male partners were more likely to indicate their intention to provide breastfeeding appreciation (p=0.02), breastfeeding presence (p=0.002), and breastfeeding responsiveness (p=0.04). The mothers’ prenatal perception of their partners’ intended breastfeeding support was lower than fathers’ perceptions to support their partners. Multiparous mothers had more positive perceptions regarding their partners’ breastfeeding savvy (p=0.03), and breastfeeding help (p=0.02) compared to primiparous mothers.Conclusion: Fathers in Ethiopia are potentially strong supporters of breastfeeding practice. Future breastfeeding interventions should promote the involvement of fathers in breastfeeding and encourage mothers to increase their partners’ involvement in breastfeeding.
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: December 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.