bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Retreats on Resident Physician Well-being as Measured by Maslach Burnout Index Analysis: a Cross-sectional Study
Authors: McLeod Kristyn N , Woods Emily J , Hopp Shelby L , Bellolio Fernanda , Lohse Christine M , Battaglioli Nicole J , Colletti James E 
Published: June 2020

Abstract
Background: Awareness of burnout has led residency programs to seek interventions to promote well-being, resiliency, camaraderie and social network development. Limited evidence exists on the efficacy of specific interventions. This study evaluated the efficacy of an emergency medicine residency program’s semi-annual retreat using serial administration of the Maslach burnout index and resident well-being survey.Methods: Surveys were administered to all emergency medicine residents (n=25) in July 2018 and before and after fall 2018 and winter 2019 retreats. Retreats included a meal, team building, and social networking opportunities (bowling, softball, snow tubing, and sledding). Comparisons of responses between baseline, pre-retreat, and post-retreat were evaluated using two-sample t, Wilcoxon rank sum, and Fisher exact tests. Results: Sixteen emergency medicine residents (64%) responded at baseline. Response rates on subsequent surveys ranged from 14 (56%) to 21 (84%). Nineteen percent of residents exhibited burnout at baseline. This peaked at 36% pre-winter retreat. Burnout decreased after each retreat (fall: 29% to 6%, winter: 36% to 13%). Mean Maslach burnout index subscores for emotional exhaustion (13 to 9) and depersonalization (7 to 5) decreased from baseline to post-fall retreat, but neither changed significantly over the entire study period (emotional exhaustion: 13 to 12, depersonalization: 7 to 6). Resident well-being survey pre- and post-retreat responses were similar on all items.Conclusion: Meaningful, but not statistically significant differences were detected on the Maslach burnout index and resident well-being survey in association with a retreat. Mean emotional exhaustion, depersonalization and burnout decreased after retreats. Larger studies would provide further insight into the significance of these trends.
Dengue Vector Density Incident and Its Implication to Urban Livability
Authors: Majid Nuriah Abd , Razman Muhammad Rizal , Zakaria Sharifah Zarina Syed , Nazi Nurafiqah Muhamad 
Published: June 2020

Abstract
Background: Malaysia's population is set to reach 33.10 million by the end of 2020. About 75% of the population of Malaysia lived in urban areas and cities. The metropolitan area of Greater Kuala Lumpur had a population of more than seven million that year, making it the largest urban area in Malaysia. Kuala Lumpur as the city centre for Greater Kuala Lumpur has been ranked as Southeast Asia's second most liveable city after Singapore. The livable city imperative is relevant because Malaysia's urbanization process is moving towards harmonization with the principles of sustainable development. Livable city involves many interdependent factors contributing to the urban quality of life. With their complete physical and social infrastructures, the urban types are an essential basis for improving the quality of life of the urbanites. However, increasing population and rapid land-use changes led to the emergence of vector-borne diseases such as dengue in an urban area. Prolong dengue outbreaks will reduce livability in urban areas. Therefore, this study aims to look at the density of dengue distribution in Bandar Baru Bangi town in 2014, 2015, 2016 and 2017.Methods: The study uses data provided from the Ministry of Health Malaysia and shows the focus of dengue cases in residential and industrial areas of Bandar Baru Bangi town. Spatial analysis using Geographical Information System (GIS) was applied to identify the locality of dengue incidence within the study area. Spatial statistical analysis of dengue cases used Kernel Density Estimation to distinguish dengue hotspots from the distribution of the exact location of dengue cases reported in Bandar Baru Bangi town.Results: Kernel density estimation showed the dengue hotspots concentrated on the east of Bandar Baru Bangi town. The results found that the highest density was in 2015 was 605 to 706 points per square kilometres. This study also discovers that most of the hotspots constructed were located in the residential area of Bandar Baru Bangi.Conclusions: This study is essential to help local authorities eradicate dengue in urban areas for future management strategies; therefore, this study is vital to help local authorities eradicate dengue in urban areas for future management strategies.
Infectious endocarditis: Improving diagnostic performance in native and prosthetic valve infection with 18F-FDG PET/CT
Authors: Marinho Ana Vera , Almeida José Paulo , Soeiro Paula , Silva Rodolfo , Gonçalves Francisco , Costa Gracinda , Gonçalves Lino , Ferreira Maria João 
Published: June 2020

Abstract
Background ﻿The diagnosis of infective endocarditis (IE) remains a clinical challenge. Diagnostic accuracy of the modified Duke criteria is suboptimal for native valve endocarditis (NVE) and even worse in the presence of prosthetic material-related infection (PVE). We aim to evaluate the diagnostic performance of 18F-FDG PET in patients with suspected IE referred to perform PET/CT.Methods: Consecutive patients with suspected IE, referred to perform PET/CT between May 2016 and June 2019 were included. Diagnostic performance of modified Duke criteria (mDC) and PET/ CT for IE for NVE and PVE was determined.Results: In total, 82 patients (mean age of 61 ± 19 years, 62% of male gender) were enrolled. There were 67 18F-FDG PET/CT concordant results with final diagnosis, corresponding to a 96% of agreement, k=0.91(p=0.04). A SUV max cutoff value of ≥3.1 identified positive cases with 88.9% sensitivity and 70.0% specificity. In patients with NVE, the addition of PET/CT to the mDC resulted in a reduction of the number of possible IE cases (from 58% to 4.3%). In patients with PVE/intracardiac devices, PET/CT allowed reclassification of 67.4% of possible cases to 4.2%. An alternative diagnosis was provided in 55.6% of the negative IE cases.Conclusions:18F-FDG PET/CT proved to be a useful diagnostic tool in patients with both suspected NVE and PVE with good sensitivity and specificity, resulting in a significant decrease of the number of possible endocarditis. Furthermore, it allowed the identification of the cause of clinical scenario in more than 50% of patients in which the diagnosis was excluded.
The Concurrent Anti-C1q and Anti-dsDNA but not Anti-C3b Antibodies as Potent Biomarkers for Lupus Nephritis prediction
Authors: Kianmehr Nahid , Khoshmirsafa Majid , Shekarabi Mehdi , Falak Reza , Seif Farhad , Haghighi Anousheh , Omidi Forouzan , Shirani Fatemeh , Dadfar Nima 
Published: June 2020

Abstract
Background: Lupus Nephritis (LN) in patients with Systemic Lupus Erythematosus (SLE) is one of the most serious and prevalent manifestations. The procedure of renal biopsy is harmful and accompanied by potential hazards. Therefore, introducing reliable biomarkers to predict LN is exceedingly worthwhile. In the current study, we compared the diagnostic values of circulating autoantibodies against dsDNA, C1q, C3b, SSA, SSB, and Sm alone or in combination to predict LN.Methods: This study evaluated abovementioned autoantibodies in 40 healthy controls (HCs) and 95 SLE patients with different kidney involvements, including absent (n = 40), inactive (n = 20), and active (n= 35) LN using EIA method.Result: The frequency and odds ratio of anti-dsDNA (71.4%, OR=4.2), anti-C1q (62.9%, OR= 5.1), and the simultaneous existence of anti-C1q and anti-dsDNA (51.4%, OR=6) antibodies were significantly higher in the active LN group compared with both inactive and absent LN groups. Moreover, the levels of anti-C1q and anti-dsDNA antibodies positively correlated with disease activity in patients with SLE. The prevalence of these autoantibodies was associated with the severity of LN biopsies. Conclusion: These data suggest that anti-C1q and anti-dsDNA antibodies and also the simultaneous presence of them may be valuable diagnostic biomarkers for LN prediction in patients with SLE.
Predicting and Relation between Bio-psychosocial Factors and Type of Childbirth using Decision Tree Method
Authors: Hajimirzaie Saiedeh sadat , Tehranian Najmeh , Mousavi Seyed Abbas , Golabpour Amin , Mirzaii Mehdi , Keramat Afsaneh , Khosravi Ahmad 
Published: June 2020

Abstract
Background

Growing the worldwide and Iranian cesarean section rate and rising morbidity and mortality thereafter for the mother and infant has been an important health issue. Predictive models can identify individuals with a higher probability of cesarean section and make better decisions. In this study, we investigated the bio-psychosocial factors associated with type of delivery. We designed a predictive model using the decision tree C4.5 algorithm.
Methods

In this longitudinal study 170 pregnant women were sampled in the third trimester of pregnancy. At the baseline phase blood samples were taken from mothers to measure estrogen hormone. Birth information was recorded at the follow-up time at 30–42 days postpartum. Modeling was performed using MATLAB software and C4.5 decision tree algorithm using input variables and the target variable.
Results

Previous type of childbirth, maternal body mass index at childbirth, maternal age, and serum estrogen were the most significant factors in predicting the childbirth type, respectively and decision tree model with 89.6%accuracy in the training stage and 83.3% in the test stage predicted the result.
Conclusion

The decision tree model designed with high accuracy and sensitivity can predict the type of childbirth. By recognizing the contributing factors and model rules, health practitioners and policymakers can take preventive action.
Value of Biopsy in a Cohort of Children with High-Titer Celiac Serologies: Observation of Dynamic Policy Differences between Europe and North America
Authors: Badizadegan Kamran , Vanlandingham David M. , Hampton Wesley , Thompson Kimberly M. 
Published: June 2020

Abstract
Background: Healthcare systems implement change at different rates because of differences in incentives, organizational processes, key influencers, and management styles. A comparable set of forces may play out at the national and international levels as demonstrated in significant differences in the diagnostic management of pediatric Celiac Disease (CD) between European and North American practioners. Methods: We use retrospective clinical cohorts of 27,868 serum tissue transglutaminase (tTG) immunoglobulin A levels and 7,907 upper gastrointestinal endoscopy pathology reports to create a dataset of 793 pathology reports with matching tTG results between July 1 of 2014 and July 1 of 2018. We use this dataset to characterize histopathological findings in the duodenum, stomach and esophagus of patients as a function of serum tTG levels. In addition, we use the dataset to estimate the local and national cost of endoscopies performed in patients with serum tTG levels greater than 10 times the upper limit of normal. Results: Using evidence from a US tertiary care center, we show that in the cohort of pediatric patients with high pre-test probability of CD as determined by serum tTG levels, biopsy provides no additional diagnostic value for CD, and that it counter-intuitively introduces diagnostic uncertainty in a number of patients. We estimate that using the European diagnostic algorithms could avoid between 4,891 and 7,738 pediatric endoscopies per year in the US for evaluation of CD. Conclusions: This study considers the North American and European management guidelines for the diagnosis of pediatric CD and highlights the slow adoption in North America of evidence-based algorithms developed and applied in Europe for triage of endoscopy and biopsy. We suggest that the forces that maintain the status quo in North America go beyond medical evidence and include a variety of social and economic factors. This work contributes to the growing body of evidence that suggests that the dynamics that largely favor maintaining status quo management policies extend to clinical medicine and influence a variety of clinical decisions at the level of individual patients and the population.
Case Control Study: Incidence And Risk Factors Of Postpartum Haemorrhage In Primigravida
Authors: Yusof Juliana 
Published: June 2020

Abstract
Introduction: According to WHO, postpartum haemorrhage is defined as blood loss of more than 500 mL following vaginal delivery. Postpartum haemorrhage is still one of the leading causes of maternal deaths in Malaysia. The risk factors of postpartum hemorrhage in this study was divided into three which were pre-pregnancy, antenatal and intrapartum. Methods: A case control study was performed to identify the risk factors for postpartum hemorrhage among primigravida in Sungai Buloh Hospital from 2016 to 2018. From the calculation done by using simple random sampling method, the required respondents were 150 for both case and control. The data collection method was in an audit form. The data obtained was entered using SPSS 21 (a statistical software). Results: From 2016 to 2018, 75 cases and 75 random controls of postpartum hemorrhage among primigravida were identified . The risk factors associated with postpartum hemorrhage in primigravida that is significant were age (P=0.001), occupation mainly self-employed ( P= 0.001), anemia during antenatal (P= 0.001), uterine fibroid (P=0.007), prolonged labour more than 8 hours (P=0.005), instrumental delivery (p=0.001) ,extensive vaginal wall tear (P= 0.009), cervical tear (P =0.013), 3rd and 4th degree tear (P=0.006), uterine atony (P=0.001) and vascular lower segment during caesarean section (P=0.029). Conclusion: The results showed that the risk factors for post-partum hemorrhage in primigravida were age, occupation (self-employed), antenatal anemia, uterine fibroid, prolonged labour more than 8 hours, instrumental delivery, extensive vaginal wall tear, cervical tear, 3rd and 4th degree tear, uterine atony and vascular lower segment during Caesarean section.
Optimizing Mechanical Stretching Protocols for Hypertrophic and Anti-apoptotic Responses in H9c2 Cardiomyocytes
Authors: Zevolis Evangelos , Philippou Anastassios , Moustogiannis Athanasios , Chatzigeorgiou Antonis , Koutsilieris Michael 
Published: June 2020

Abstract
Background: Cardiomyocytes are sensitive to mechanical loading, possessing the ability to respond to mechanical stimuli by reprogramming their gene expression. In this study, signaling as well as expression responses of myogenic, anabolic, inflammatory, atrophy and pro-apoptotic genes to different mechanical stretching protocols were examined in differentiated cardiomyocytes.Methods: H9C2 cardiomyoblasts were cultured on elastic membranes up to their 5th day of differentiation (myotubes) and then subjected to three different stretching protocols by altering their strain, frequency and duration characteristics, using an in vitro cell tension system. cells were harvested and lysed 24 hours after the completion of each stretching protocol and Real Time-PCR was used to monitor changes in mRNA expression of myogenic regulatory factors (MyoD, Myogenin, MRF4), the IGF-1 isoforms (IGF-1Ea, IGF-1Eb), as well as atrophy (Atrogin-1), pro-apoptotic (FoxO, Fuca), and inflammatory (IL-6) factors in response to the different mechanical loading conditions. The activation of Akt and Erk 1/2 signaling proteins following the various stretching protocols was also evaluated by Western blot analysis.Results: We documented that the low strain (2.7% elongation), low frequency (0.25 Hz) and intermediate duration (12 hrs) stretching protocol was overall the most effective in inducing beneficial responses in differentiated cardiomyoblasts as it increased the expression of IGF-1 isoforms and phosphorylation of Akt and Erk1/2 (p<0.05), while it provoked the downregulation of all the other factors examined (p<0.05-0.001). Conclusion: These findings demonstrated that a low strain, low frequency of intermediate duration stretching protocol is the most effective in inducing a hypertrophic and anti-apoptotic response in H9C2 cardiomyotubes, in vitro.
Low‐intensity Pulsed Ultrasound Ameliorates Angiotension Ii-induced Cardiac Fibrosisbyalleviating Inflammation via a Caveolin-1-dependent Pathway
Authors: Zhao Kun , Zhang Jing , Xu Tianhua , Yang Chuanxi , Weng Liqing , Wu Tingting , Wu Xiaoguang , Mao Jiaming , Guo Xiasheng , Tu Juan , Zhang Dong , Zhou Bin , Sun Wei , Kong Xiangqing 
Published: June 2020

Abstract
Background: Cardiac hypertrophy and fibrosis are major pathological manifestations observed in left ventricular remodeling induced by Angiotensin II (AngII). Concerning the fact that low‐intensity pulsed ultrasound (LIPUS) has been reported to improve cardiac dysfunction and myocardial fibrosis in myocardial infarction (MI) through mechanotransductionanditsdownstream pathways, we aimed to investigate whether LIPUS could also exert a protective effect on ameliorating AngII-induced cardiac hypertrophy and fibrosis andand if so, to further elucidate the underlying molecular mechanisms.Methods: In our study, we used AngII to mimic the animal and cell culture models of cardiac hypertrophy and fibrosis, where LIPUS irradiation (0.5MHz, 77.20mW/cm2) was applied for 20 minutes every 2 days from 1 week before surgery to 4 weeks after surgery in vivo, and every 6 hours for a total of 2 times in vitro. Following that, the levels of cardiac hypertrophy and fibrosis were evaluated by echocardiographic, histopathological, and molecular biological methods. Results: Our results showed that LIPUS irradiation could ameliorate left ventricular remodeling in vivo and cardiac fibrosis in vitro by reducing AngII-inducedrelease of inflammatory cytokines, while the protective effects were limited on cardiac hypertrophy in vitro. Given that LIPUS irradiation increased the expression of caveolin-1 related to mechanical stimulation, we inhibited caveolin-1 activity with pyrazolopyrimidine 2 (pp2) in vitro, by which LIPUS-induced downregulation of inflammation was reversed and the anti-fibrosis effects of LIPUS irradiation were absent. Conclusions: Taken together, these results indicate that LIPUS irradiation could ameliorate AngII-induced cardiac fibrosis by alleviating inflammation via a caveolin-1-dependent pathway, providing new insights for the development of novel therapeuticapparatus in clinical practice.
Long noncoding RNA LINC00152 promotes glioma cell proliferation via Src-YAP signaling pathway
Authors: Jin Liang , Jin Ai , Lan Weitu , Jin Yan , Zhang Wei , Zhao Lizhi 
Published: June 2020

Abstract
Objective The study is designed to observe the influence of LncRNA LINC00152 on the proliferation of glioma cells and explore the role of Src-YAP signal pathway in the process.Methods U251 and U87 cell were used for in vitro experiments and xenograft studies; transfection method was adopted to build a LINC00152 overexpressing cell strain, and cell viability was determined by MTT assay; cell colony formation ability was measured through colony formation assay, and protein expression was determined by Western blot; YAP protein expression distribution is detected through Immunofluorescence.Key findings LINC00152 overexpressing can enhance the U251 and U87 cell proliferation, the colony formation and the growing ability of subcutaneously transplanted tumor, and it induces YAP nuclear import and down-regulates p-LATS1 and p-YAP protein expression, and up-regulates p-Src protein expression. Src inhibitor 1 can inhibit the changes in protein expression and the cell colony formation of p-LATS1, p-YAP and p-Src, which are induced by overexpression of LINC00152 in U251 and U87 cells.Conclusions LINC00152 promotes cell proliferation of glioma U251 and U87, and the action might be associated with process of activation of Src, inhibition of phosphorylation cascade reaction of LATS1-YAP pathway and final inducing of YAP nuclear import.
Evidence of Early Vasogenic Edema Following Minor Head Injury That Can Be Reduced With a Vasopressin V1a Receptor Antagonist
Authors: Kulkarni Praveen , Bhosle Mansi R , Lu Shi-fang , Iriah Sade , Simon Neal G. , Ferris Craig 
Published: June 2020

Abstract
Background: Does minor head injury without signs of structural brain damage cause short-term changes in vasogenic edema as measured by an increased apparent diffusion coefficient (ADC) using diffusion weighted imaging? If so, could the increase in vasogenic edema be treated with a vasopressin V1a receptor antagonist? We hypothesized that SRX251, a highly selective V1a antagonist, would reduce vasogenic edema in response to a single minor head injury.Methods: Lightly anesthetized male rats were subjected to a sham procedure or a single hit to the forehead using a closed skull, momentum exchange model. Animals recovered in five min and were injected with saline vehicle (n=8) or SRX251 (n=8) at 15 min post head injury and again 7-8 hrs later. At 2 hrs, 6 hrs, and 24 hrs post injury, rats were anesthetized and scanned for increases in ADC, a neurological measure of vasogenic edema. Sham rats (n=6) were exposed to anesthesia and scannedat all time points but were not hit or treated. Images were registered to and analyzed using a 3D MRI rat atlas providing site-specific data on 150 different brain areas. These brain areas were divided into 11 major brain regions.Results: Untreated rats with head injury showed a significant increase in global brain vasogenic edema as compared to sham and SRX251 treated rats. Edema peaked at 6 hrs in injured, untreated rats in three brain regions where changes in ADC were observed, but returned to sham levels by 24 hrs. There were regional variations in the time course of vasogenic edema and drug efficacy. Edema was significantly reduced in cerebellum and thalamus with SRX251 treatment while the basal ganglia did not show a significant response to treatment. Conclusion: A single minor impact to the forehead causes regional increases in vasogenic edema that peak at 6 hrs but return to baseline within a day in a subset of brain regions. Treatment with a selective V1a receptor antagonist can reduce much of the edema.
Factors in implementation of clinical commissioning policy in improving health and wellbeing and/or reducing health inequalities in the English&nbsp;NHS: a systematic review of the evidence
Authors: Regmi Krishna , Mudyarabikwa Oliver 
Published: June 2020

Abstract
Objective: This study aimed to identify and synthesise the factors in implementing clinical commissioning policy in improving health and/or reducing health inequalities in the English NHS. Methods: Systematic review was conducted. We searched Medline, EMBASE, CINAHL, Allied & Complementary Medicine, DH-DATA, Global Health and CINAHL for primary studies that assessed the enablers and barriers, and reported in accordance with PRISMA statement. Methodological quality was appraised using JBI Critical Appraisal tools and Mixed Methods Appraisal Tool [MMAT] to assess the methodological qualities, and synthesised performing thematic analysis. Two reviewers independently screened the papers and extracted data. Results: We included six primary studies (including a total of 1155 participants) in the final review. The studies reported two broad categories, under four separate themes: agenda of health inequalities not fully addressed; poor evidence for reducing health inequalities; reform through restructuring of organisations, and strategic approaches. Conclusion: This study provides useful factors – enablers and barriers – to implement and deliver clinical commissioning policy in improving health and wellbeing. These factors could be assessed in future to develop objective measures and interventions to establish the link between commissioning and health inequalities improving equitable access, health outcomes and effective partnerships.