bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methylprednisolone Protects SAP and Pancreatitis-Associated ALI in Mice by Inhibiting NLRP3 Inflammasome Through NF-κB
Authors: Liu Chuan-jiang , Fu Qiang , Zhou Wenjing , Zhang Xu , Chen Rui , Zhai Zhen-sheng , Wang Yu-zhu , Qin Tao , Zhang Hongwei 
Published: October 2020

Abstract
Background: Methylprednisolone (MP) is a synthetic corticosteroid with potent anti-inflammatory and antioxidant properties used as therapy for a variety of diseases. The underlying mechanism of MP to reduce acute pancreatitis still needs to be elucidated.Methods: Twenty-four male C57BL/6 mice (6-8 weeks) were used to establish SAP mouse model by administering an intraperitoneal injection of Cae and LPS. Amylase expression levels of serum and PLF were measured with an amylase assay kit. The concentrations of IL-1β and TNF-α in the serum and PLF were detected by ELISA. The level of pancreatic and lung tissue damage and inflammation was assessed by H&E staining and immunofluorescence staining. Western blot and qPCR were used to detect the expression levels of NLRP3, IL-1β and TNF-αin vivo and in vitro.Results: In this study, we found MP, used in the early phase of SAP, decreased the levels of IL-1β and TNF-α in serum and peritoneal lavage fluids (PLF), reduced the level of serum amylase and the expression of MPO in lung tissue, attenuated the pathological injury of the pancreas and lungs in a dose-dependent manner. The expression of NLRP3 and IL-1β in pancreas and lungs was down-regulated significantly depending on the MP concentration. In vitro, MP reduced the levels of IL-1β and TNF-α by down-regulating the expression of NLRP3, IL-1β and p-NF-κB in isolated peritoneal macrophages. Conclusion: MP can attenuate the injury of pancreas and lungs, and the inflammatory response in SAP mice by down-regulating the activation of NF-κB and the NLRP3 inflammasome.
Accounting for Context: Using Qualitative Methods to Model the Effects of Adaptations to Family Planning Services During COVID-19
Authors: Hamon Jessie K. , Hoyt Jenna , Krishnaratne Shari , Kambanje Misozi , Demissie Shiferaw Dechasa , Ariko Angela Barbra , Mbembe Miriam , Moseti Easterlina , Gnintoungbe Marius , Curry Dora , Webster Jayne 
Published: October 2020

Abstract
Background – During the first six months of the global response to Coronavirus Disease-2019 (COVID-19), multiple service delivery adaptations were suggested to maintain access to modern contraceptive methods (MCMs) and family planning (FP) services. Though these adaptations may help maintain services during COVID-19, they may also trigger mechanisms capable of fundamentally shifting MCM use and community perceptions of FP long after routine services are restored if they fail to take into account the contexts in which they are implemented. This study aimed to model the context-specific effects of suggested adaptations to FP service delivery. Methods – A multi-step approach to modelling using qualitative methods was employed. Methods involved a targeted review of relevant literature on adaptations to FP service delivery, the development of context categories using empirical findings from five countries, and the construction of a model based on realist concepts to predict the mechanisms and outcomes likely to be triggered by adaptations to FP service delivery in specific contexts. Results – Eleven key adaptations to FP service delivery were identified, and 19 mechanisms and their associated outcomes were predicted. The model revealed 8 negative and 11 positive effects of suggested adaptations when implemented in contexts where women’s decisions around MCM use are influenced by: 1) stigma surrounding FP; 2) male control of reproductive decisions; 3) covert use of MCMs; 4) fear of MCM side effects; and 5) concerns about long-acting reversible contraceptives. These effects were predicted to drive changes in MCM use, community perceptions of FP, and women’s trust in health services. The model also demonstrated that suggested adaptations are likely to have important long-term effects and result in changes to the prevailing contexts.Conclusions – Though adaptations to FP service delivery are needed in response to COVID-19, the contexts in which these are implemented should be carefully considered by national and sub-national decision-makers to minimise unwanted outcomes. The model constructed in this study can be leveraged as a theorising tool to facilitate this process in different settings.
Experimental and theoretical insights into the effects of pH on catalysis of bond-cleavage by the lignin peroxidase isozyme H8 from Phanerochaete chrysosporium
Authors: Pham Le Thanh Mai , Deng Kai , Northen Trent R , Singer Steven W , Adams Paul D , Simmons Blake A , Sale Kenneth L 
Published: October 2020

Abstract
Background: Lignin peroxidases catalyze a variety of reactions, including cleavage of both β-aryl ether bonds and C–C bonds in lignin, both of which are essential for depolymerizing lignin into fragments amendable to biological or chemical upgrading to valuable products. Studies of the specificity of lignin peroxidases to catalyze these various reactions and the role reaction conditions such as pH play have been limited by the lack of assays that allow quantification of specific bond-breaking events. The subsequent theoretical understanding of the underlying mechanisms by which pH modulates the activity of lignin peroxidases remains nascent. Here, we report on combined experimental and theoretical studies of the effect of pH on the enzyme-catalyzed cleavage of β-aryl ether bonds and of C–C bonds by a lignin peroxidase isozyme H8 from Phanerochaete chrysosporium and an acid stabilized variant of the same enzyme. Results: Using a nanostructure initiator mass spectrometry assay that provides quantification of bond cleavages in a phenolic model lignin dimer we found that degradation of the lignin dimer was greatly enhanced at lower pH, and the acid-stable lignin peroxidase isozyme H8 increased the degradation of the lignin dimer to products from 38.4 % at pH 5 to 92.5% at pH 2.6. At pH 2.6, the observed product distribution resulted from 65.5% b -aryl ether bond cleavage, 27.0% C a -aryl carbon bond cleavage and 3.6% C a -oxidation as by-product . Using ab initio molecular dynamic simulations and climbing-image Nudge Elastic Band based transition state searches, we suggest the effect of lower pH is via hydration of hydronium cation on aliphatic and phenolic hydroxyl groups under, which extremely acidic conditions resulted in lower energetic barriers for bond-cleavages, especially β-ether bonds. Conclusion: These coupled experimental results and theoretical explanations suggest pH is a key driving force for selective and efficient lignin peroxidase isozyme H8 catalyzed depolymerization of lignin and further suggest that lignin peroxidase isozyme H8 engineering efforts include targeting stability at low pH.
Clinical and Economic Consequences of Switching From Omalizumab to Mepolizumab in Uncontrolled Severe Eosinophilic Asthma: an Observational Retrospective Study
Authors: Carpagnano Giovanna Elisiana , Resta Emanuela , Povero Massimiliano , Pelaia Corrado , D'Amato Mariella , Crimi Nunzio , Scichilone Nicola , Scioscia Giulia , Resta Onofrio , Calabrese Cecilia , Pelaia Girolamo , Barbero Maria Pia Foschino 
Published: October 2020

Abstract
Background: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids, which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab to mepolizumab in patients eligible for both biologics, but not optimally controlled by omalizumab.Methods: We retrospectively enrolled uncontrolled severe asthmatic patients, referred to seven asthma clinics in Italy, who switched from omalizumab to mepolizumab during the last two years. Clinical, functional, and laboratory information included blood eosinophil count, asthma control test, spirometry, serum IgE, fractional exhaled nitric oxide, oral corticosteroids intake, use of controller and rescue drugs, exacerbations/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-mepolizumab 12-month standardized total cost per patient was calculated.Results: 33 patients were enrolled: 5 males and 28 females, mean age 57 years, mean disease onset 24 years. At omalizumab discontinuation, 88% were oral corticosteroids-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4 days per patient. Switch to mepolizumab improved all clinical outcomes, reducing total exacerbation rate (RR = 0.06, 95% CI 0.03 to 0.14), oral corticosteroids -dependent patients (OR = 0.02, 95% CI 0.005 to 0.08), and the number of lost working days because of uncontrolled disease (Δ = -7.9, 95% CI -11.2 to -4.6). Pulmonary function improved, as well as serum IgE, fractional exhaled nitric oxide and eosinophils decreased. Mean annual costs were € 12,239 for omalizumab and € 12,639 for mepolizumab (Δ = € 400, 95% CI -1,588 to 2,389); the increment due to drug therapy (+ € 1,581) was almost offset by savings regarding all other cost items (- € 1,181). Conclusions: Patients with severe eosinophilic asthma, not controlled by omalizumab, experienced comprehensive benefits in asthma control by switching to mepolizumab. These relevant improvements were burdened by only very slight increases in economic costs.
Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa
Authors: Mothupi Mamothena Carol , Man Jeroen De , Tabana Hanani , Knight Lucia 
Published: October 2020

Abstract
Introduction: The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in South Africa. Materials and Methods: The composite index was computed as a geometric mean of four dimensions of adequacy of the continuum of care. Data was sourced from the district health information system, household surveys and the census. The index formula was tested for robustness when alternative inputs for indicators and standardization methods were used. The index was used to assess performance in service delivery in the North West province of South Africa, as well as its four districts over a five-year period (2013-2017). The index was validated by assessing associations with maternal health and other outcomes. And factor analysis was used to assess the statistical dimensions of the index. Results: The provincial level index score increased from 62.3 in 2013 to 74 in 2017, showing general improvement in service delivery over time. The district level scores also improved over time, and our analysis identified areas for performance improvement. These include social determinants of health in some districts, and access and linkages to care in others. The provincial index was correlated with institutional maternal mortality rates (rs=-0.90, 90% CI = (-1.00, -0.25)) and the Human Development Index (r=0.97, 95% CI = (0.63, 0.99). It was robust to alternative approaches including z-score standardization of indicators. Factor analysis showed three groupings of indicators for the health system and social determinants of health. Conclusions: This study demonstrated the development and testing of a composite index to monitor and assess service delivery on the continuum of care for maternal health. The index was shown to be robust and valid, and identified potential areas for service improvement. A contextualised version can be tested in other settings within and outside of South Africa.
Prevalence, Incidence, Risk and Protective Factors of Amnestic Mild Cognitive Impairment in the Elderly in Shanghai
Authors: Wang Tao , Xiao Shifu , Chen Kewei , Yang Cece , Dong Shuhui , Cheng Yan , Li Xia , Wang Jinghua , Zhu Minjie , Yang Fuzhong , Li Guanjun , Su Ning , Liu Yuanyuan , Dai Jing , Zhang Mingyuan 
Published: October 2020

Background:
Amnestic MCI (aMCI) has notably increased in Shanghai, China.

Objective:
The study was designed to estimate the prevalence and incidence rates of aMCI and to determine
the risk and protective factors for aMCI among persons ≥ 60 years-old and ≥ 70 years-old in Shanghai communities,
respectively.

Method:
We carried out this 1-year longitudinal study to survey a random sample of 1,302 individuals ≥ 60
years-old, to collect baseline and follow-up data about lifestyle through self-reports, and vascular and comorbid
conditions from medical records and a physical examination. We also analyzed a subgroup of individuals ≥
70 years-old.

Results:
The prevalence rate of aMCI in persons ≥ 60 years-old was 22.3%, and the incidence rate (per 1,000
person-years) was 96.9. Being female was a risk factor for aMCI; protective factors included smoking, drinking
tea, engaging in intellectual work before retirement, social activities and hobbies, regular reading habits,
and surfing the internet. The prevalence rate of aMCI in persons ≥ 70 years was 30.3%, and the incidence rate
was 145.6. Smoking, drinking tea, and surfing the internet were not protective factors for this age group (≥ 70
years).

Conclusion:
The present study indicates that aMCI is a considerable health problem in Shanghai. Preventive
strategies for aMCI are needed to enhance lifestyle factors that promote brain activity.
Gender Disparity in the Medical Speciality of Obstetrics and Gynecology
Authors: Kaliberdenko Vitalii B. , Kulanthaivel Shanmugaraj , Popova-Petrosyan Elena V. , Kosolapova Natalya V. , Balasundaram Keerthanaa 
Published: October 2020

Background::
The actual question on the health care system all over the world is gender inequity in some
specialties. In spite of different influencing factors for choosing their specialty by medical students and residents, the
recent research studies show that gender is significantly influencing on their specialty. Especially gender disparity or
inequity is mostly seen in the field of Obstetrics and gynecology.

Aim :
The purpose of our study is to understand the actual problems for male specialists in the field of
obstetrics and gynecology in health care system and to understand how it affects the nation’s health care system and to
analyze the possible solutions.

Materials and Methods::
The research consists of 815 respondents, which includes medical students, obstetricians and
gynecologists and ObsGyn patients. Average age of the respondents were 20 - 50 years. They were divided into three
groups. Questionnaire consists of 15 different questions for each group of people in different languages.

Results::
The significant difference about the future plan towards choosing of specialty of ObsGyn were less among male
respondents with 4%, whereas female respondents accounts for 69% (P<0.001). The main reason for women to choose
ObsGyn specialty were comfortability on field with 43%. On the other hand, male respondents didn’t choose ObsGyn
specialty because of its less scope for male specialists in this field with 37% and they weren’t sure about the availability of
patients with 51%. There is a direct proportion between patients age and wish to visit the male consultants. And indirect
proportion between patients age and wish to visit the female consultants.

Conclusion::
Less number of male specialists in the obstetrics and gynecology field, doesn’t mean that the male students
and residents have no interests on obstetrics and gynecology, but they are thinking and doubting on employment, patient’s
availability and scope in the field. By including male and female specialists equally in this field we can improve the
quality in preservation of reproductive health, women’s health and significant changes in crude and specific demographic
indices. Making proper awareness and explaining about the current reality could be the best possible solution for this
issue. The interpersonal style and communication skills should be the most important traits in physicians rather than
gender.
Review of Prelabor Rupture of the Membranes: Pathophysiologic Concepts and Novel Therapeutic Strategies
Authors: Ghafoor Saadia 
Published: October 2020

Background::
Prelabor rupture of membrane (PROM) refers to the breakage of fetal
membranes before the onset of labor, resulting in the leakage of amniotic fluid. PROM affects approximately
3% and 8% of preterm and term pregnancies, respectively. Because of associated high
maternal and perinatal mortality, correct and timely diagnosis together with effective management
is highly recommended to prevent adverse fetal and maternal outcomes.

Objective::
To provide an overview of the novel concepts in the understanding of PROM including etiology, pathophysiology, risk factors, complications, assessment, diagnostic modalities, and contemporary management strategies for PROM at preterm and term.

Methodology::
This narrative literature review was conducted through a literature search using the Cochrane library and electronic databases including PubMed, Web of Science, Medline, Scopus, Crossref, Google Scholar, Wiley online library, ScienceDirect with specific search terms in scientific publications published from March 1980 to March 2020.

Main Body::
Preterm PROM has the potential to cause prenatal morbidity and mortality. It is imperative
to monitor the signs and symptoms of an impending infection due to the risk of infectious morbidity
with PROM at preterm and preterm. PROM at preterm and term requires prompt diagnosis followed
by an appropriate management strategy.

Conclusion::
The correct and timely diagnosis of PROM is essential for efficacious management. Furthermore, it can reduce avoidable emergent health care visits and related costs in a clinical setting subjected to pregnancy with suspected PROM. Further studies are needed to fill the gaps in identifying better diagnostic predictive tools in high- risk pregnancies.
Clinical Characteristics, Comorbidities, and Prognosis in Patients with Heart Failure with Unknown Ejection Fraction
Authors: Lavine Steven J. , Murtaza Ghulam , Rahman Zia Ur , Kelvas Danielle , Paul Timir K 
Published: October 2020

Background:
Heart Failure (HF) is a frequent cause of mortality and recurrent hospitalization. Although HF databases are assembled based on left ventricular (LV) ejection fraction, patients without LV ejection fraction determination are not further analyzed.

Objective:
The purpose of this study is to characterize patient attributes and outcomes in this group-HF with unknown Ejection Fraction (HFunEF).

Methods:
We queried the electronic medical record from a community-based university practice for patients with a HF diagnosis. We included patients with >60 days follow-up and had interpretable Doppler-echocardiograms. We recorded demographic, Doppler-echocardiographic, and outcome variables (up to 2083 days).

Results:
There were 820 patients: 269 with HF with preserved Ejection Fraction (HFpEF), 364 with HF with reduced Ejection Fraction (HFrEF), of which 231 had a LV ejection fraction=40-49% and 133 had a LV ejection fraction<40%, and 187 with HFunEF. As compared to patients with HFunEF, HFpEF patients were younger, had a higher coronary disease and hyperlipidemia prevalence. Patients with HFrEF had more prevalent coronary disease, myocardial infarction, and hyperlipidemia. Patients with HFunEF were more likely to be seen by non-cardiology providers. All-cause mortality (ACM) was greater in HFunEF patients than patients with HFpEF (Hazard Ratio (HR)=1.60 (1.16-2.29), p=0.004). Furthermore, HF readmission rates were lower in HFunEF as compared to HFpEF (HR=0.33 (0.27-0.54), p<0.0001) and HFrEF (HR=0.30 (0.028-0.50), p<0.0001).

Conclusion:
Patients with HFunEF have greater ACM and lower HF re-admission than other HF phenotypes. Adherence to core measures, including LV ejection fraction assessment, may improve outcomes in this cohort of patients.
Resilience, Psychological Characteristics, and Resting-state Brain Cortical Activity in Athletes and Non-athletes
Authors: Cevada Thais , Moreira Alexandre , Vilete Liliane Maria Pereira , Oertel-Knöchel Viola , Deslandes Andrea Camaz 
Published: October 2020

Background:
Athletes might build long-term resilience due to their need to adapt constantly to stressful situations. Further, physical activity is a powerful tool for stress-release, and controlling anxiety and depressive symptoms which might induce resilience by enhancing coping skills.

Objective:
This study aimed to compare the resilience, psychological characteristics, and the resting-state brain cortical activity of athletes and non-athletes. The secondary goal was to identify which variables could predict the resilience score.

Methods:

Ninety participants were divided into three groups, athlete (n=30), physically active (n=30) and sedentary (n=30), and asked to fill out the international physical activity questionnaire – short version (IPAQ), the resilience scale, the Beck depression inventory (BDI) and the trait and state anxiety inventory (STAI). Moreover, resting-state brain cortical activity was recorded by using an EEG to compute the standardized low-resolution brain electromagnetic tomography (sLORETA) analyses.

Results:
Significant differences between groups were observed in terms of resilience (X2=8.52; p=0.014) and physical activity level (X 2=76.07; p<0.001), with the athletes presenting higher values. Lower anxiety and depression, and higher physical activity levels were associated with higher resilience scores (R2=0.45; p=0.02). The results of sLORETA showed higher activity for sedentary individuals compared to athletes in frontal areas (Broadmann Area-BA 6, BA 8, BA 9), as well as when compared to physically active individuals in the superior frontal gyrus (BA 9). Additionally, physically active individuals presented less activity than athletes in the inferior occipital gyrus (BA 18).

Conclusion:
The results suggest that the physically active and athlete groups may have built a more resilient profile (compared to sedentary), have similar anxiety and depressive symptoms, and present a divergent resting-state brain cortical activity from the sedentary group, mainly in prefrontal areas. These findings suggest that regular physical activity and sports should be encouraged to aid in enhancing resilience and resting-state brain cortical function, and consequently, improving mental health.