bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung function variability in children and adolescents (LUV study): protocol for a prospective interventional trial in healthy individuals and patients with asthma
Authors: Frima Eirini Sofia , Theodorakopoulos Ilias , Gidaris Dimos , Karantaglis Nikolaos , Chatziparasidis Grigorios , Plotas Panagiotis , Anthracopoulos Michael B , Fouzas Sotirios 
Published: March 2020

Abstract
Background Variability analysis of peak expiratory flow (PEF) and forced expiratory volume at 1 s (FEV1) has been used in research to predict exacerbations in adult individuals with asthma. However, there is a paucity of data regarding PEF and FEV 1 variability in healthy or asthmatic children and adolescents. The objective of the present study is the assessment of PEF and FEV 1 variability in: a) healthy children and adolescents, to define the normal daily fluctuation of PEF and FEV 1 and the parameters that may influence it, and b) children and adolescents with asthma, to explore the differences from healthy subjects and reveal any specific variability changes prior to exacerbation.Methods The study will include 100 healthy children and adolescents aged 6 to 18 years (assessment of normal PEF and FEV 1 variability) and 100 children and adolescents of the same age with diagnosed asthma (assessment of PEF and FEV 1 variability in asthmatics). PEF and FEV1 measurements will be performed using an ultra-portable spirometer (MIR Spirobank Smart) capable to smartphone connection. Measurements will be performed twice a day between 07:00-09:00 and 19:00-21:00 hours and will be dispatched via email to a central database for a period of 3 months. PEF and FEV1 variability will be assessed by detrended fluctuation and sample entropy analysis, aiming to define the normal pattern (healthy controls) and to detect and quantify any deviations (asthmatics). The anticipated duration of the study is 24 months.Discussion Healthy children and adolescents may present normal short- and long-term fluctuations in lung function; the pattern of this variability may be influenced by age, sex and environmental conditions. Significant lung function variability may also be present in children and adolescents with asthma, but the patterns may differ from those observed in healthy children and adolescents. Such data would improve our understanding regarding the chronobiology of asthma and permit the development of integrated tools for assessing the level of control and risk of future exacerbations.Trial registration ClinicalTrials.gov, NCT04163146. Registered on 14 November 2019
Trend Analysis of Climate variables, Stream flow and their Linkage at Modjo River Watershed, Central Ethiopia
Authors: Zena Kokeb , Adugna Tamene , Fufa Fekadu 
Published: March 2020

Abstract
Background: Trend and variability analysis of precipitation and stream flow series provides valuable information to understand hydrological changes associated with climate variability. In this study, annual and seasonal trends of precipitation and stream flow series and their relationship was investigated over the Modjo river watershed. The Mann-Kendall test and Sen’s slope estimator were used for trend analysis and evaluation of its magnitude respectively, with an approach that corrects the serial correlation. The Pearson correlation analysis was also applied to evaluate the relationships between river flow and precipitation series.Results: the mean and maximum stream flow series showed downward trends at the annual and kiremt time series, whereas no significant trend was observed for the minimum flow over the Modjo watershed. The study indicated that the mean annual and kiremt (monsoon) stream flow decreased significantly at a rate of 8.262 and 6.528 m3s-1per year respectively. In contrary to the river flow, there is no positive or negative trend in the annual and seasonal precipitation series although the tendency was towards increasing trends. It was evidenced that the annual, and kiremt season river flow series was affected abruptly since 2000, however for the same analysis period there was no evidence of changes in precipitation events, which is also not related significantly with the variability of river flow during the analysis period.Conclusions: the river flow decreased dramatically in the Modjo watershed during the analysis period (1981-2015), however it was not primarily associated significantly with climate variability (precipitation & temperature). The result suggests the need of considering the unplanned water extraction and the poor land use management practices to sustain and restore river flow trend observed in the watershed.
Identify key genes and pathways in pancreatic ductal adenocarcinoma via bioinformatics analysis
Authors: Luo Huatian , Chen Da-qiu , Pan Jing-jing , Wu Zhang-wei , Yang Can , Xu Hao-jie , Wang Yao-dong , Chen Shi 
Published: March 2020

Abstract
Background: Pancreatic cancer has many pathologic types, among which pancreatic ductal adenocarcinoma (PDAC) is the most common one. Bioinformatics has become a very common tool for the selection of potentially pathogenic genes. Methods: Three data sets containing the gene expression profiles of PDAC were downloaded from the gene expression omnibus (GEO) database. The limma package of R language was utilized to explore the differentially expressed genes (DEGs). To analyze functions and signaling pathways, the Database Visualization and Integrated Discovery (DAVID) was used. To visualize the protein-protein interaction (PPI) of the DEGs ,Cytoscape was performed under the utilization of Search Tool for the Retrieval of Interacting Genes (STRING). With the usage of the plug-in cytoHubba in cytoscape software, the hub genes were found out. To verify the expression levels of hub genes, Gene Expression Profiling Interactive Analysis (GEPIA) was performed. Last but not least, UALCAN analysis online tool was implemented to analyze the overall survival. Results: The 376 DEGs were highly enriched in biological processes including signal transduction, apoptotic process and several pathways, mainly associated with Protein digestion and absorption and Pancreatic secretion pathway. The expression levels of nucleolar and spindle associated protein 1 (NUSAP1) and SHC binding and spindle associated 1 (SHCBP1) were discovered highly expressed in pancreatic ductal adenocarcinoma tissues. NUSAP1 and SHCBP1 had a high correlation with prognosis. Conclusions: The findings of this bioinformatics analysis indicate that NUSAP1 and SHCBP1 may be key factors in the prognosis and treatment of pancreatic cancer.
Perinatal oral exposure to low doses of bisphenol A, S or F impairs immune functions at intestinal and systemic levels in female offspring mice
Authors: Malaisé Yann , Lencina Corinne , Cartier Christel , Olier Maïwenn , Ménard Sandrine , GUZYLACK-PIRIOU Laurence 
Published: March 2020

Abstract
Background Bisphenol A (BPA), one of the highest-volume chemicals produced worldwide, has been identified as an endocrine disruptor. Many peer-reviewing studies have reported adverse effects of low dose BPA exposure, particularly during perinatal period (gestation and/or lactation). We previously demonstrated that perinatal oral exposure to BPA (via gavage of mothers during gestation and lactation) has long-term consequences on immune response and intestinal barrier functions. Due to its adverse effects on several developmental and physiological processes, BPA was removed from consumer products and replaced by chemical substitutes such as BPS or BPF, that are structurally similar and not well studied compare to BPA. Here, we aimed to compare perinatal oral exposure to these bisphenols (BPs) at two doses (5 and 50 μg/kg of body weight (BW)/day (d)) on immune response at intestinal and systemic levels in female offspring mice at adulthood (Post Natal Day PND70). Methods Pregnant female mice were orally exposed to BPA, BPS or BPF at 5 or 50 μg/kg BW/d from 15th day of gravidity to weaning of pups at PostNatal Day (PND) 21. Humoral and cellular immune responses of adult offspring (PND70) were analysed at intestinal and systemic levels. Results In female offspring, perinatal oral BP exposure led to adverse effects on intestinal and systemic immune response that were dependant of the BP nature (A, S or F) and dose of exposure. Stronger impacts were observed with BPS at the dose of 5µg/kg BW/d on inflammatory markers in feces associated with an increase of anti- E . coli IgG in plasma. BPA and BPF exposure induced prominent changes at low dose in offspring mice, in term of intestinal and systemic immune responses, provoking an intestinal and systemic Th1/Th17 inflammation. Conclusion These findings provide, for the first time, results of long-time consequences of BPA, S and F perinatal exposure by oral route on immune response in offspring mice. This work warns that it is mandatory to consider immune markers and dose exposure in risk assessment associated to new BPA’s alternatives.
Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: A mixed method approach
Authors: Henriksen André , Sand Anne-Sofie , Deraas Trygve , Grimsgaard Sameline , Hartvigsen Gunnar , Hopstock Laila 
Published: March 2020

Abstract
Background: Physical inactivity is a leading risk factor for death and several non-communicable diseases. Despite this, more than one fourth of adults worldwide do not follow the World Health Organization physical activity (PA) guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker as part of the intervention, and as a tool for measuring PA outcomes. The purpose of the present study was to identify elements that increases wear adherence when using a consumer-based activity tracker as part of a PA intervention. Methods: Sixteen people with obesity, aged 55-74 years, with sedentary lifestyle and elevated cardiovascular risk, were recruited to a 12-month feasibility study for a planned randomized controlled trial. Participants wore a Polar M430 activity tracker during a six-month intervention period and for six months of follow-up, to collect continuous PA data. We performed qualitative interviews mid-way in the intervention and six months after intervention end, to investigate how individual wear-time was linked to participant responses. Results: From one year of tracking, mean number of valid wear days were 293 (SD=86). Several technical issues arose due to the long recording period, especially related to loss of connection between participants’ activity tracker and smartphone. Some participants found it motivating to track progress and identify effective PA types, but most wore the Polar activity tracker because they were asked to. Participants’ major sources of annoyance were tracker inaccuracy and limited usage training. Furthermore, tracker complexity and appearance were frequently addressed. Conclusions: Adherence to wearing a consumer-based activity tracker was high. Results indicate that it is feasible to use a consumer-based activity tracker to measure PA over a longer period. Potential success factors for increased wear time includes adequate participant training on the activity tracker, allowing participant to choose between different activity tracker designs, and using trackers with accurate measurements. To identify accurate trackers, validation studies using available activity trackers in the target cohort may be needed. Trial registration: U.S. National Library of Medicine, Clinical Trial registry: NCT03807323; Registered 16 September 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03807323
Adherence to antiretroviral therapy among children under five years in Jinja, Uganda, assessed using a combined measure
Authors: Ssanyu Jacquellyn Nambi , Nakafeero Mary , Nuwaha Fred 
Published: March 2020

Abstract
Background: Adherence to Anti-Retroviral Therapy (ART) is required to achieve HIV viral load suppression but children under five years in Jinja, Uganda, had been shown to have low HIV suppression rates. This study aimed to determine the level of ART non-adherence among these children and the associated factors. Methods: Data for the cross-sectional study was obtained from caregivers of 206 HIV positive children under five years attending health facilities in Jinja who had been on ART for at least three months. Non-adherence was measured using a Visual Analog Scale that assessed both dosing and timing non-adherence, and by determining the Proportion of Days Covered by the medication. A questionnaire administered to the caregivers was used to collect the data, together with medical record review. A child was only considered adherent if they had adherence greater than 95% on both measures. The data was analysed using Modified Poisson Regression, taking a p-value less than 0.05 as statistically significant. Results: Of the 206 children, 73.8% were older than 2 years, and 52.9% were female. Likewise, the majority of the caregivers were female (93.7%). According to the combined adherence measure, 51.5% of the children were categorized as non-adherent. School attendance, Prevalence Ratio (PR) = 1.32 (p = 0.024), receiving financial support from family, PR = 0.68 (p = 0.026) and satisfaction with the quality of service at the health facility, PR = 0.96 (p <0.001) were associated with non-adherence. Household food insecurity was also associated with non-adherence: PR = 1.63 (p = 0.007) for mild food insecurity, PR= 1.67 (p = 0.006) for moderate insecurity and PR = 1.59 (p = 0.006) for severe food insecurity. Conclusions: Children under five years in Jinja had a high level of ART non-adherence. It is important to engage schools to support adherence among children living with HIV. Addressing household food insecurity would also reduce the barriers to optimal adherence.
What Kinds of Advantages and Disadvantages May Merging Health Insurance Funds Bring About? A Qualitative Policy Analysis from Iran
Authors: Bazyar Mohammad , Yazdi-Feyzabadi Vahid , Rahimi Nouroddin , Rashidian Arash 
Published: March 2020

Abstract
Background In countries with health insurance system, the number, the size of insurance funds and the amount of risk distribution among them is a major concern. One possible solution to overcome problems resulting from fragmentation is combining risk pools together to create fewer and larger ones, ideally a single pool. This study aims to realize what kind of advantages and disadvantages merging health insurance funds together may bring about to the health insurance system in particular and health system in general. Methods In this qualitative study, nesting purposive sampling with maximum variation was used to obtain representativeness and rich data. Sixty face-to-face interviews were conducted. Documentary review was used as supplementary source of data collection. Content analysis using the ‘framework method’ was used to analyze the qualitative data. For assuring the quality of results, four trustworthiness criteria including credibility, transferability, dependability and confirmability were used. Results The results of this study indicated that there are diverse positive and negative consequences for merging of health insurance funds in Iran which are categorized into seven categories including governance/stewardship, financing, population, benefit package, structure, operational procedures and interaction with providers. These themes are subdivided further into thirty-seven sub-categories which represent a wide range of different policy aspects which need close attention to deal with the merging of health insurance funds. Conclusions Implementation of merging health insurance schemes in Iran would be influenced by a wide range of potential merits and drawbacks, so to facilitate the process and lessen the opposition of opponents, policy makers should act as brokers taking into account the contextual factors and adopting tailored policies to maximize the benefits and minimize the potential drawbacks of consolidation in Iran.
National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?
Authors: Sorpreso Isabel Cristina Esposito , Figueiredo Francisco Winter dos Santos , Ramos José Lucas Souza , Zuchelo Lea Tami SuzuKi , Adami Fernando , Baracat Edmund Chada , Júnior José Maria Soares 
Published: March 2020

Abstract
Background: The National Policy of Comprehensive Women’s Health Care was implemented more than two decades ago, and the monitoring of potential benefits should be explored. Menopause is a period of life for which there are prevention and health promotion actions carried out by the government’s all-encompassing sole Unify Health System (UHS) and factored into Brazilian policies. It is thus our purpose to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: This is an ecological study with secondary data analysis conducted by the Setor de Atenção Primária, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the IT Department of SUS between 1996 and 2016, divided in two periods 1996 to 2004 and 2005 to 2006 according to implementation of the National Police. The data included the death records of Brazilian women aged 35 to 64 years who had a precise diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was set at 5%. Stata 11® (StataCorp, LCC) was used. Results: Menopausal women’s main causes of death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), but not to any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death among menopausal women are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality. The trend of mortality rates among menopausal women, following PNAISM implementation, was a decline in circulatory system diseases and in nutritional, metabolic, and endocrine diseases, with no changes for neoplasms and respiratory system diseases.
Determinants and risk factors of gastroenteritis in the general population, a web-based cohort between 2014 and 2017 in France
Authors: Ecollan Marie , Guerrisi Caroline , Souty Cécile , Rossignol Louise , Turbelin Clément , Hanslik Thomas , Colizza Vittoria , Blanchon Thierry 
Published: March 2020

Abstract
Background: Although it is rarely fatal in developed countries, acute gastroenteritis (AGE) still induces significant morbidity and economic costs. The objective of this study was to identify factors associated with winter AGE in the general population. Methods: A prospective study was performed during winter seasons from 2014-2015 to 2016-2017. Participants filled an inclusion survey and reported weekly data on acute symptoms. Factors associated with having at least one AGE episode per winter season were analyzed using a conditional logistic regression model. Results: On average, 8.1% of participants declared at least one AGE episode during a winter season. People over 60 declared fewer AGE episodes (OR=0.76, 95% CI [0.64; 0.89]) compared to individuals between 15 and 60 years old, as well as children between 10 and 15 (OR=0.60 [0.37; 0.98]). Overweight (OR= 1.25 [1.07; 1.45]) and obese (OR= 1.47 [1.19; 1.81]) individuals, those having frequent cold (OR=1.63 [1.37; 1.94]) and those with at least one chronic condition (OR=1.35 [1.16; 1.58]) had more AGE episodes. Living alone was associated with a higher AGE episode rate (OR=1.31 [1.09; 1.59]), as well as having pets at home (OR=1.23 [1.08; 1.41]). Conclusions: Having a better knowledge of AGE determinants will be useful to adapt public health prevention messages.
Austerity policy and child health in European countries: a systematic literature review
Authors: Rajmil Luis , Hjern Anders , Spencer Nick , Taylor-Robinson David , Gunnlaugsson Geir , Raat Hein 
Published: March 2020

Abstract
Objectives : To analyse the impact of austerity measures taken by European governments as a response to the 2008 economic and financial crisis on social determinants and child health (SDCH), and child health outcomes (CHO). Methods : A systematic literature review was carried out in Medline (Ovid), Embase, Web of Science, PsycInfo, and Sociological abstracts in the last 5 years from European countries. Studies aimed at analysing the Great Recession, governments’ responses to the crisis, and its impact on SDCH were included. A narrative synthesis of the results was carried out. The risk of bias was assessed using the STROBE and EPICURE tools. Results : Fourteen studies were included, most of them with a low to intermediate risk of bias (average score 72.1%). Government responses to the crisis varied, although there was general agreement that Greece, Spain, Ireland and the United Kingdom applied higher levels of austerity. High austerity periods, compared to pre-austerity periods were associated with increased material deprivation, child poverty rates, and low birth weight. Increasing child poverty subsequent to austerity measures was associated with deterioration of child health. High austerity was also related to poorer access and quality of services provided to disabled children. An annual reduction of 1% on public health expenditure was associated to 0.5% reduction on Measles-Mumps-Rubella vaccination coverage in Italy.Conclusions : Countries that applied high level of austerity showed worse trends on SDCH and CHO. European governments must act urgently and reverse these austerity policy measures that are detrimental to family benefits and child protection.