bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound-Assisted Extraction for Simultaneous Quantitation of Potential Sweetening Compounds from Derris reticulata Aqueous Extracts: A Response Surface Methodology Approach
Authors: Thamapan Keerati , Laohakunjit Natta , Kerdchuchen Orapin , Vongsawasdi Punchira , Mingvanish Withawat 
Published: August 2020

Abstract
Background: Derris reticulata or Oi Sam Saun is a highly sweet Thai plant, rich in bioactive compounds, and widely used for its medicinal properties. In this study, sweet aqueous extracts from the stems of Oi Sam Saun were extracted using ultrasound-assisted extraction (UAE). Phenolic, flavonoid, and sugar compound extraction was optimized using the Box-Behnken design (BBD) and response surface methodology (RSM). Methods: Three independent variables—extraction temperature (40–80°C), sonication time (20–60 min), and extraction ratio (1:10–1:30 g/mL)—were investigated, and the optimal condition was used to determined phenolics, flavonoid and 18β-glycyrrhetinic acid by High performance liquid chromatography-diode array detector (HPLC-DAD). Sensory evaluation was also performed.Results: The values of 84°C, 64 min, and ratio 1:8 g/mL were found to be optimal. Under these conditions, experimental values were well correlated with predicted values, and phenolic, flavonoid, and sugar contents were determined as 0.4725 mgGAE/gDW, 0.1489 ± 0.033 mgCE/gDW, and 4.802 ± 0.651 mg/gDW, respectively. Gallic acid, p-coumaric acid, quercetin, and kaempferol was also found in optimal condition. Moreover, the extract contained 18β-glycyrrhetinic acid (0.529 ± 0.002 mg/100 mg) and was 166 times sweeter than sucrose.Conclusion: High level of phenolics, flavonoids and sugars was detected in optimal condition of the extract. Therefore, this Thai medicinal plant, which has several pharmacological benefits, is newly potentially and applicable as a sweetening agent or sugar substitute in foods.
Factors Related to the Practice of Vacuum-Assisted Birth: Findings from Provider Interviews in Kigoma, Tanzania
Authors: Dominico Sunday Alfred , Kasanga Mkambu Godfrey , Mwakatundu Nguke , Chaote Paul , Lobis Samantha , Bailey Patricia E. 
Published: August 2020

Abstract
Background: Vacuum-assisted birth is not widely practiced in Tanzania but efforts to re-introduce the procedure suggest some success. Few studies have targeted childbirth attendants to learn how their perceptions of and experiences with the procedure affect practice.This study explores a largely rural cohort of health providers to determine associations between recent practice of the procedure and training, individual and contextual factors.Methods: A knowledge, attitudes and practice cross-sectional survey of 297 providers was conducted in 2019 at 3 hospitals and 12 health centers that provide comprehensive emergency obstetric care. We used descriptive statistics and binary logistic regression to model the probability of having performed a vacuum extraction in the last 3 months. Results: Providers were roughly split between working in maternity units in hospitals and health centers. They included: medical doctors, assistant medical officers (14%); clinical officers (10%); nurse officers, assistant nurse officers, registered nurses (32%); and enrolled nurses (44%). Eighty percent reported either pre-service, in-service vacuum extraction training or both, and 31% reported conducting a vacuum-assisted birth in the last 3 months. Based on 11 training and enabling factors, a positive linear association with recent practice was observed; the single most predictive factor was hands-on solo practice during in-service training (66%). The logistic model showed that for each additional training factor the likelihood of recent performance increased by 52% (OR 1.52, CI 1.327-1.740). A knowledge score based on indications and contra-indications for vacuum extraction showed an 11% increased probability for each item mentioned (OR 1.11, CI 1.033-1.196). Providers who worked in a health center compared to those in a hospital were 2.5 times more likely to have conducted a recent vacuum extraction (OR 2.46, CI 1.325-4.579), and male providers were twice as likely as females (OR 2.0, CI 1.088-3.733).Conclusions: Knowledge and training were positively associated with recent practice of vacuum extraction. Multiple training modalities appear to predict recent practice but hands-on experience during training may be the most critical component. We recommend a low-dose high frequency strategy to skills building with simulation and e-learning. A gender integrated approach to training may help ensure female trainees are exposed to critical training components.
How Breast Cancer Treatments Affect the Quality of Life of Women with Non-metastatic Breast Cancer One Year After Surgical Treatment: A Cross-sectional Study in Greece.
Authors: Yfantis Aris , Sarafis Pavlos , Moisoglou Ioannis , Tolia Maria , Intas George , Tiniakou Ioanna , Zografos Konstantinos , Zografos George , Constantinou Marianna , Nikolentzos Athanasios , Kontos Michalis 
Published: August 2020

Abstract
Background: The continuously increasing survivorship of female breast cancer makes the monitoring and improvement of patients’ quality of life ever so important. While globally there is a growing body of research on health-related quality of life one year after surgical treatment for non-metastatic breast cancer, up-to-date information regarding Greek patients is scarce.Objective: To measure the level of QoL of non-metastatic BC survivors in Greece 1 year after surgery.Methods: A sample of 200 female breast cancer survivors aged 18 to 75, who followed up as outpatients in five public hospitals were included in this cross-sectional study. All recruited patients agreed to participate in the study (100% response rate). Quality of life data were collected through the EORTC QLQ-C30 as well as BR23 questionnaires.Results: Cronbach’s alpha for all scales of the two questionnaires was from 0.551 to 0.936 indicating very good reliability. According to the Multiple Linear Regression, older patients showed a lower future perspective (p= .031), with those living in rural areas, which was associated with more financial difficulties (p= .001). Women with tertiary education and those who had been hospitalized in a university hospital recorded better on global health status (p= .003 and .000 respectively). Patients who underwent chemotherapy reported better scores in the emotional function sub-scale (p= .025). Women with reconstruction and at least one complication appeared to have significantly better scores in future perspective and social function (p= .005, .002 respectively).Conclusions: Breast cancer survivors were found to have an overall good quality of life, functioning/symptoms scores and were satisfied with the provided care.
Artificial Neural Network-based Predicting the Risk of Complicating Ventricular Tachyarrhythmia After Acute Myocardial Infarction During Hospitalization
Authors: Zheng Xifeng , Nong Weidong , Feng Dehui , Wang Junxian , He Yan 
Published: August 2020

Abstract
An artificial neural network (ANN) model was developed to predict the risks of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI). We enrolled information of 503 patients with 13 risk factors from the affiliated hospital of Guangdong medical university from January 2017 to December 2019. Risk factors were dimensionally reduced and simplified as new variables by principal component analysis (PCA). The cohort were randomly divided into a training set and a testing set at the ratio of 70%:30%. Training set was used to develop a model for the prediction of VTA while testing set was used to evaluate the performance of the model. Three new comprehensive variables by PCA are able to reflect all information of the original data. We determined the prediction model with optimizing parameters by cyclic searching which includes an input layer of three comprehensive variables, a single hidden layer composed of two neurons and a output layer. The area under curve (AUC) is 0.812 in training set and confusion matrix with accuracy 94.60%, sensitivity 63.04%, specificity 99.35%, positive predicative value 93.55%, negative predictive value 94.70%. The model displayed a decreased but medium discrimination with an AUC of 0.688 in the independent testing cohort, confusion matrix with accuracy 87.42%, Sensitivity 39.26%, specificity 98.37%, positive predicative value 84.62%, negative predictive value 87.68%. The research suggests that ANN model could be used to predict the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction while should be further improved.
Visualization of clinical teaching citations using social network analysis
Authors: Hazrati Hakimeh , Bigdeli Shoaleh , Arabshahi Seyed Kamran Soltani , Gavgani Vahideh Zarea , Vahed Nafiseh 
Published: August 2020

Abstract
Background
This study aimed to visualize the co-authorship networks and scientific map of research outputs of clinical teaching and medical education by Social Network Analysis (SNA).
Methods
We Identified 858 publications on clinical teaching through a systematic search strategy in the Scopus (Elsevier), Web of Science (Clarivate Analytics) and Medline (NCBI/NLM) through PubMed. Date of publication was limited to 1980 to 2018.The Ravar PreMap, Netdraw, UCINet and VOSviewer software were used for data visualization and analysis.
Results
Based on the findings of study the network of clinical teaching was weak in term of cohesion and the density in the co-authorship networks of authors (clustering coefficient (CC): 0.749, density: 0.0238) and collaboration of countries (CC: 0.655, density: 0.176). In regard to centrality measures; the most influential authors in the co-authorship network was Rosenbaum ME, from the USA (0.048). More, the USA, the UK, Canada, Australia and the Netherlands have central role in collaboration countries network and has the vertex co-authorship with other that participated in publishing articles in clinical teaching. Nineteen subject clusters were identified in the clinical teaching research network, seven of which were related to the expected competencies of clinical teaching and three related to clinical teaching skills.
Conclusions
Co-authorship between clinicians and medical educator specialists need to be strengthened through research development policies, appropriate academic networks and use of encouraging grants. In addition humanitarian and clinical reasoning need to consider in education of clinical teaching to empower the scientific map from thematic aspects.
Valproate prescription to women of childbearing age in English primary care: repeated cross-sectional analyses and retrospective cohort study
Authors: Gaudio Mariangela , Konstantara Emmanouela , Joy Mark , Vlymer Jeremy Van , de Lusignan Simon 
Published: August 2020

Abstract
Background: Valproate is teratogenic drug that should be avoided during the preconception period and pregnancy. The aim was to explore GPs’ prescription patterns over time, describe trends, and explore inter-practice variation within primary care. Methods: We identified women of childbearing age (12-46 years old) in the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network. We performed repeated cross-sectional analyses from 2004 to 2018 to determine rates of prescription and a retrospective cohort estimated the prevalence of use of valproate during pregnancy. Results: In 2004, 0.31% (95% Confidence Interval (95%CI):0.18 to 0.44%) women were prescribed valproate, decreasing to 0.16% (95%CI:0.07 to 0.24%) by 2018. Among women with epilepsy, the rate fell from 15.2% (95%CI:14.4 to 16.0%) to 8.8 % (95% CI:8.2 to 9.7%) over the same period. In 2018, almost two thirds (62.2%) of women who were prescribed valproate had epilepsy only, whereas bipolar disorder and migraine accounted for 15.8% and 7.4% respectively. Contraceptive prescriptions did not increase over time, and only in 2018 was there greater odds of being prescribed contraception (OR 1.41, 95%CI:1.08 to 1.45). Just under a fifth (19.7%) of women were prescribed valproate during their pregnancy; two out of three of these pregnancies were preceded by folic acid prescription (5 mg). While some practices reduced their rate of valproate prescription, others did not.Conclusions: Regulatory guidelines have changed GPs' prescription patterns in women of childbearing potential for valproate but not for contraception. Further research is needed to identify the barriers of GPs and women of childbearing potential to undertaking contraception.
Association between maternal serum lipids during late pregnancy and adverse birth outcomes
Authors: Dai Meng-Yi , Wang Lu-Lin , Wu Yun-Tao , Li Huan , Xia Jian-Hong , Wu Li , Tian Yaohua 
Published: August 2020

Abstract
Background: Adverse birth outcomes have short- and long-term impacts on maternal and child health. Maternal dyslipidemia during late pregnancy has been found to be associated with increased risk of adverse birth outcomes. However, similar evidence on association between maternal blood lipid levels and adverse birth outcomes is limited in China.Methods: The data were extracted from Guangdong Women and Children Hospital Information System from September 2014 to March 2018. A total of 3951 mother-newborn pairs were included in our study. Logistic regression model and linear trend analysis were conducted to analyze the correlation between maternal blood lipid levels and adverse birth outcomes after controlling potential confounders including gestational age, pre-pregnancy body mass index, fetal sex, and parity. Results: Among the 3951 subjects, the rates of macrosomia, large-for-gestational age (LGA), low birth weight infants (LBW), and preterm birth were 3.9% (154/3951), 8.5% (334/3951), 9.5% (377/3951), and 9.8% (388/3951), respectively. LDL was a risk factor for preterm birth (OR: 1.20; 95% CI: 1.08-1.34) while HDL was a protective factor (OR: 0.73; 95% CI: 0.55-0.96) after adjusting for covariates. As every unit increase in TG, the risk of macrosomia and LGA increased by 25% (adjusted OR: 1.25; 95% CI: 1.12-1.38) and 16% (adjusted OR: 1.16; 95% CI: 1.07-1.26), respectively. However, every unit increase in HDL concentration was associated with decreased risk for LGA (adjusted OR: 0.60; 95% CI: 0.44-0.81) and macrosomia (adjusted OR: 0.64; 95% CI: 0.41-0.99). High LDL concentrations were associated with a decreased risk of macrosomia (adjusted OR: 0.82; 95% CI: 0.68-0.99) and LGA (adjusted OR: 0.86; 95% CI: 0.76-0.98) but an increased risk of LBW (adjusted OR: 1.16; 95% CI: 1.04-1.30). The results of linear trend analysis were similar to those of logistic regression model.Conclusions: Maternal dyslipidemia during the third trimester is closely related to adverse birth outcomes. Monitoring and managing maternal blood lipid levels in an appropriate range may help to reduce the burden of adverse birth outcomes.
Longitudinal Episodes of Under nutrition and its Predictors among HIV Positive Adults in Public Hospitals, Guraghe Zone: Linear Mixed model
Authors: Abdu Abdu Oumer , Mekonnen Berhanu Abebaw 
Published: August 2020

Abstract
Background: More than one-fourth of adult HIV patients had malnutrition which has high risk of relapse after treatment. Hence, assessing the longitudinal episodes and its predictors has great importance. Therefore, this study was aimed to assess the longitudinal trends of under nutrition and its predictors among HIV positive adults attending Public Hospitals in southwest Ethiopia, 2019. Methods: Longitudinal study with repeated measure was conducted among 519 randomly selected records of adult HIV clients who were on treatment. Malnutrition was assessed using the records of weight and height at different points of follow up (0, 6, 12, 18 and 24 months of ART follow up). Analysis of variance, analysis of covariance and spaghetti plot were done to compare the mean change in BMI across different repeated measures. To assess predictors of malnutrition episodes, linear mixed model was used considering fixed and random variables. Thus, parameter estimate, and p-value with 95% confidence interval was estimated via maximum likelihood method. From the model information criteria, Akaikes information criteria (AIC) were used to assess model fitness with smaller value as indicative of better model fit.Results: a total of 480 records were reviewed with mean age of 36 years (± 9 years). A total of 354(73.8%) of clients mentioned that they got dietary counseling. While, 34.6% of them got nutritional support. Statistical significant increasing trend of mean BMI score across the five follow up intervals (F statistics = 13.9, p value = 0.0001) were observed. Being male (β = -0.72; P = 0.044), with problem of eating difficulty (β = -1.61; p = 0.0001), having anemia (β = -1.51; p = 0.003), shorter follow up interval (β = 0.04.; p = 0.129), not getting nutritional counselling (β = 0.63; p =0.32) and diarrheal disease (β = -0.04; p = 0.129) were negatively associated with improvement in BMI indices. Conclusions: Improvement was seen in nutritional status after initiation of ART. Presence of eating disorder, anemia, not getting nutritional counseling, short follow interval were predictors of under nutrition. In addition to giving better nutritional counseling, the health professionals working in ART clinic should emphasize for early detection, and treatment of eating disorders, diarrheal disease and others.
Evaluation of Earth Systems Models and Atmospheric Inversions using Total Column CO2 Observations from GOSAT and OCO-2
Authors: Patra Prabir K , Hajima Tomohiro , Saito Ryu , Chandra Naveen , Yoshida Yukio , Ichii Kazuhito , Kawamiya Michio , Kondo Masayuki , Ito Akihiko , Crisp David 
Published: August 2020

Abstract
The measurements of one of the major greenhouse gases, carbon dioxide (CO 2 ), are being made using dedicated satellite remote sensing since the launch of the greenhouse gases observing satellite (GOSAT) by JAXA in 2009 and NASA’s Orbiting Carbon Observatory-2 (OCO-2). In the past 10 years, estimation of CO 2 fluxes from land and ocean using the earth system models (ESMs) and inverse modelling of in situ atmospheric CO 2 data have also made significant progress. In this article, we attempt, for the first time, to evaluate the CO 2 fluxes simulated by an earth system model (MIROC-ES2L) using GOSAT observations and the fluxes estimated by an inverse model (MIROC4-Inv) for the period 2009-2014. Further, we use the OCO-2 measurements for testing the consistency of inversion results for the period 2014-2018, along with the GOSAT data. Both MIROC-ES2L and MIROC4-Inv fluxes are used in the MIROC4-atmospheric chemistry transport model (referred to as ACTM_ES2LF and ACTM_InvF, respectively) for calculating CO 2 concentrations that are sampled at the time and location of the satellite measurements. Our results suggest the inverse model using in situ data are more consistent with the OCO-2 retrievals, compared to those of the GOSAT XCO 2 data, suggesting possible improvements in the present GOSAT retrieval system by better accounting for the degradation correction of the TANSO-FTS. The ACTM_ES2LF simulation shows a slightly weaker seasonal cycle for the meridional profiles of CO 2 fluxes, compared to that from the ACTM_InvF. This difference is revealed by greater ACTM_ES2LF vs GOSAT differences, compared to those of ACTM_InvF vs GOSAT. We also find that the simulated seasonal cycle amplitude of XCO 2 by ACTM_ES2LF are slightly weaker compared to those observed by GOSAT or ACTM_InvF. Using remote sensing based global products of leaf area index (LAI) and gross primary productivity (GPP) over land, we show a weaker sensitivity of MIROC-ES2L biospheric activities to the weather and climate in the tropical regions. Our results clearly suggest the usefulness of XCO 2 measurements by satellite remote sensing for evaluation of large-scale ESMs, which so far remained untested by the sparse in situ data.
How oral health educators conceptualise health promotion: a qualitative study.
Authors: Bracksley-O'Grady Stacey , Anderson Karen , Masood Mohd 
Published: August 2020

Abstract
Background: Dental diseases, dental caries and periodontal disease, place a significant burden on individual and population health level. These diseases are largely preventable; health promotion initiatives have been shown to decrease the disease rates. However, there is limited implementation of health promotion in dentistry, this could be due to a number of factors, the ethos and philosophy of dentistry is focused on a curative, individualised approach to oral diseases, there is confusion around health promotion as a concept. However, dental professionals are well placed to implement health promotion, but there is a lack of understanding about the training and what dental professionals understand about health promotion.The aim was to explore conceptualization of health promotion among oral health educators and identifying the barriers and opportunities for health promotion in practiceMethods: Nominal group technique (NGT), a highly structured face-to-face meeting, was conducted with 24 oral health educators to explore how they conceptualize health promotion and the barriers and opportunities for health promotion in practice. An additional 4 questions were emailed to oral health educators after the NGT to gather additional data, 6 oral health educators were involved. The data was analyzed using thematic analysis.Results: The oral health educators in this study discussed health promotion in a holistic way, however, health education and behaviour change were mentioned more than other aspects of health promotion. Collaboration with other health professionals and getting involved in already existing health promotion programs were the identified opportunities for health promotion practice. However, the barriers of health promotion practice were identified as the curative approach that underpins dentistry and the lack of funding, time and value placed on health promotion.Conclusions: This study moves beyond a problem describing to problem solving in this space. Collaboration with other health professionals is an opportunity to be capitalised on. However, to see the biggest improvement in health promotion the curative, individualised approach to dentistry needs to be challenged.
Prevention of lumbar disc degeneration through co-manipulation of insulin-like growth factor 1 and vascular endothelial growth factor
Authors: Zhao Shan , Ye Zuo-Zhou , Liu Zuo-qing 
Published: August 2020

Abstract
Background:

Associated with abnormal angiogenesis and disc dysfunction, Lumbar disc degeneration (LDD) appears to be an important disease suffered by aged people. Previous studies have highlighted the importance of insufficient insulin-like growth factor 1 (IGF1) and excessive vascular endothelial growth factor (VEGF) in the development and progression of LDD, whereas a practical therapeutic strategy is lacking.
Results:

Here, we did a gene therapy approach using adeno-associated virus (AAV) carrying both IGF1 and shVEGF (AAV-IGF1/shVEGF), which simultaneously corrected IGF1 and VEGF issues in a rat model for LDD.We found that AAV-IGF1/shVEGF significantly reduced disc cell death in the vertebral pulp and annulus fibrosus and significantly improved the lumbar proteoglycan and collagen II levels. Therefore, this approach effectively prevented the development of LDD.
Conclusions:

Our study presents a novel therapeutic approach on LDD, which is clinically translatable.