bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing inequalities and regional disparities in child nutrition outcomes in India using MANUSH – a more sensitive yardstick
Authors: Jain Ayushi , Agnihotri Satish Balram 
Published: June 2020

Abstract
Background India is strongly committed to reducing the burden of child malnutrition, which has remained a persistent concern issue. Findings from recent surveys indicate co-existence of child undernutrition, micronutrient deficiency and overweight/obesity, i.e. the triple burden of malnutrition in children below five years. While considerable efforts are being made to address this challenging issue, and several composite indices are being explored to inform policy actions, the methodology used for creating such indices, i.e., linear averaging, has its limitations. Briefly put, it could mask the uneven improvement across different indicators by discounting the ‘lagging’ indicators, and hence not incentivising a balanced improvement. signifying negative implications on policy discourse for improved nutrition. To address this gap, we attempt to develop a composite index for estimating the triple burden of malnutrition in India, using a more sensitive measure, MANUSH. Methodology Data from publicly available nation-wide surveys - National Family Health Survey (NFHS) and Comprehensive National Nutrition Survey (CNNS), was used for this study. First, we addressed the robustness of MANUSH method of composite indexing over conventional aggregation methods. Second, using MANUSH scores, we assessed the triple burden of malnutrition at the subnational level over different periods NHFS- 3(2005-06), NFHS-4 (2015-16) and CNNS (2106-18). Using mapping and spatial analysis tools, we assessed neighbourhood dependency and formation of clusters, within and across states. Result MANUSH method scores over other aggregation measures that use linear aggregation or geometric mean. It does so by fulfilling additional conditions of Shortfall and Hiatus Sensitivity, implicitly penalising cases where the improvement in worst-off dimension is lesser than the improvement in best-off dimension, or where, even with an overall improvement in the composite index, the gap between different dimensions does not reduce. MANUSH scores helped in revealing the gaps in the improvement of nutrition outcomes among different indicators and, the rising inequalities within and across states and districts in India. Significant clusters (p<0.05) of high burden and low burden districts were found, revealing geographical heterogeneities and sharp regional disparities. A MANUSH based index is useful in context-specific planning and prioritising different interventions, an approach advocated by the newly launched National Nutrition Mission in India. Conclusion MANUSH based index emphasises balanced development in nutritional outcomes and is hence relevant for diverse and unevenly developing economy like India.
Functionally enhanced placenta-derived mesenchymal stem cells inhibit adipogenesis in orbital fibroblasts with Graves’ ophthalmopathy
Authors: Kim Jae Yeon , Park Sohae , Lee Hyun-Jung , Lew Helen , Kim Gi Jin 
Published: June 2020

Abstract
Background: Placenta-derived mesenchymal stem cells (PD-MSCs) have unique immunomodulatory properties, and phosphatase of regenerating liver-1 (PRL-1) regulates the self-renewal ability of stem cells and promotes proliferation. Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disease of the orbit and is characterized by increased orbital levels of adipose tissue. Because the mechanism of inhibiting adipogenesis in orbital fibroblast (OF) with GO patients remains uncertain, the major objective of the present study is to investigate the mechanisms by which PRL-1-overexpressing PD-MSCs (PD-MSCsPRL-1, PRL-1+) alleviate adipogenesis in OFs derived from GO patients.Methods: Primary OFs were isolated from orbital adipose tissue specimens from GO patients. After maturation as adipogenic differentiation, normal and GO-derived OFs were cocultured with naïve PD-MSCs and PD-MSCsPRL-1. Western blotting was conducted to evaluate the molecular mechanisms associated with adipogenesis inhibition in GO.Results: The characteristics of PD-MSCsPRL-1 were similar to those of naïve cells. OFs from GO patients underwent stimulated adipocyte differentiation and had significantly decreased lipid accumulation after coculture with PD-MSCsPRL-1 compared with naïve cell coculture. The mRNA and protein expression of adipogenic markers was decreased in PD-MSCsPRL-1. The protein expression of phosphorylated PI3K/AKT/mTOR in OFs from GO patients was downregulated by coculture with PD-MSCsPRL-1, which secreted IGFBPs. Interestingly, IGFBP2, -4, and -7 expression in PD-MSCsPRL-1, which was mediated by integrin alpha 4 (ITGA4) and integrin beta 7 (ITGB7), was higher than that in naïve cells and upregulated phosphorylated focal adhesion kinase (pFAK) downstream factors.Conclusion: In summary, PD-MSCPRL-1-secreted IGFBPs inhibit adipogenesis in OFs from GO patients by upregulating FAK and blocking IGF, providing a novel therapeutic strategy using functionally enhanced MSCs to treat degenerative diseases.
Users' perspectives on non-clinical quality of care in public and private primary healthcare in Albania
Authors: Gabrani Jonila , Schindler Christian , Wyss Kaspar 
Published: June 2020

Abstract
Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyse perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along eight non-clinical domains of quality of care. The data of 954 patients were analysed through descriptive statistics and linear mixed regression models.Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain ‘communication’ (3.75) followed by ‘dignity’ (3.65), while the lowest mean scores were given for ‘choice’ (2.89) and ‘prompt attention’ (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in ‘coordination of care’ (2.90 vs 2.12, p < 0.001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in ‘confidentiality’ (3.77 vs 3.38, p = 0.04) and ‘quality of basic amenities’ (3.70 vs 3.02, p < 0.001). For the other domains, no statistically significant differences were observed. ‘Autonomy’ was reported as least important attribute of quality. Enrolment in health insurance was a predictor of higher quality ratings (coefficient = 0.06, p = 0.02).Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to shift from a ‘paternalistic’ model to a ‘co-managing the illness’, raising awareness on autonomy.
Socio-economic inequalities in the association between alcohol-use disorder and depressive disorder among Thai adults: a population-based study
Authors: Assanangkornchai Sawitri , Nontarak Jiraluck , Aekplakorn Wichai , Chariyalertsak Suwat , Kessomboon Pattapong , Taneepanichskul Surasak 
Published: June 2020

Abstract
Background: Previous evidence indicates significant associations between alcohol use disorder (AUD) and depressive disorders and their strong links with social conditions. This study aims to investigate the association between AUD and major depressive episode (MDE) across various socio-economic groups.Methods: We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged >20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels.Results: The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5%, 10.3%, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR=6.89, 95% CI: 4.13, 11.48) and lowest (AOR=6.14, 95% CI: 3.33, 11.34) levels of wealth index but marginally significant among those in the middle level (AOR=2.58, 95% CI: 1.00, 6.67). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR=15.19, 95% CI: 9.5, 24.29 among those completing secondary school or higher and AOR=1.23, 95% CI: 0.55, 2.76 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR=7.37, 95% CI: 4.53, 12.00) compared to those living in rural areas (AOR=4.23, 95% CI: 3.10, 5.77).Conclusion: Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.
Atrial septal defect closure in a young patient presenting with recurrent cryptogenic stroke: A case report
Authors: Nazer Rakan 
Published: June 2020

Abstract
Background: Having an inter-atrial shunt in the form of a patent foramen ovale or atrial septal defect increases the risk of developing cryptogenic stroke. Prompt action is required in order to prevent stroke recurrence. The source of embolization may not be clear on stroke workup.Case presentation: A young female acutely presented with recurrent embolizations to the eye and brain. She was found to have an atrial septal defect. No clear intra-cardiac source of embolization was detected on workup including trans-esophageal echocardiography. Given the options between surgical versus device closure, the attending team opted for the surgical closure which yielded on direct left heart inspection small organized clots adherent to the tips of the mitral valve leaflets. Conclusions: The case report illustrates the potential advantages of the direct surgical closure in detecting and extracting the embolization source in patients who present with recurrent cryptogenic stroke.
Sport policy and practice: Why a focus on retention of children and young people as sport participants is required for both health and performance
Authors: Eime Rochelle , Charity Melanie , Westerbeek Hans 
Published: June 2020

Abstract
Background: Australia like many developed countries is largely an inactive nation. Participation in sport, a form of leisure-time physical activity, can contribute to a range of individual and community health benefits. National sport policy often has a dual focus on population-based participation, and elite performance. Whist there are various sport models depicting the pathway to elite, there has been no strategic population-level sport participation pathway model developed as a guide towards increasing sport participation across the lifespan. The aim of this study is to explore sport participation across the lifespan and develop a neutral (conceptual) model that does not favour community or elite sport and that highlights the critical participation transition points including drop-out. Methods: We conducted a longitudinal analysis of sport participation records for 8 major sports from 2015-2017 for children and young people aged 4-29 years. Individual participation within sports was tracked from 2015 and subsequent years 2016 and 2017. Results: The total number of participants was 579,696. Only half 50.8% played continuously for the three years, 44.7% dropped out, and 4.5 played discontinuously. Drop-out was highest for those aged 4 (57.0%), and lowest for those aged 10-14 years (39.3%). From the retention and drop-out participation patterns across the lifespan, in conjunction with the published literature on sport policy and participation, we developed the Sport Participation Pathway Model (SPPM). The SPPM conceptually depicts current sport participation and in doing so emphasises the significant drop-out of sport across the lifespan. Conclusion: Sport policy should focus on retention strategies. Further, a population level, competitive club-based sport alone is not going to solve the physical inactivity epidemic. Our SPPM, and the new (retention related) data presented in this paper, demonstrates the population trends in participation in sport and the high drop-out of competitive club-based sport. We suggest that for people to eventually become active sport participants, the recruitment narrative could be changed towards, first, engaging people in leisure time physical activities. We feel that this can only be done by developing an integrated policy system across the physical activity-sport spectrum rather than looking at sport participation in a closed (club-based) system.
CPEB3 inhibits epithelial-mesenchymal transition by disrupting the crosstalk between colorectal cancer cells and tumor-associated macrophages via IL-6R/STAT3 signaling
Authors: Zhong Qian , Fang Yuxin , Lai Qiuhua , Wang Shanci , He Chengcheng , Li Aimin , Liu Side , Yan Qun 
Published: June 2020

Abstract
Background: Crosstalk between cancer cells and tumor-associated macrophages (TAMs) mediates tumor progression in colorectal cancer (CRC). Cytoplasmic polyadenylation element binding protein 3 (CPEB3) has been shown to exhibit tumor-suppressive role in CRC. Methods: The expression of CPEB3, CD68, CD86 and CD163 was determined in CRC tissues. SW480 or HCT116 cells overexpressing CPEB3 and LoVo or RKO cells with CPEB3 knockdown were constructed. Stably transfected CRC cells were co-cultured with THP-1 macrophages to determine the malignant phenotype of CRC cells, macrophage polarization, and secretory signals. The inhibition of CPEB3 on tumor progression and M2-like TAM polarization was confirmed in nude mice. Results: Decreased CPEB3 expression in CRC was associated with fewer CD86+ TAMs and more CD163+ TAMs. CPEB3 knockdown in CRC cells increased the number of CD163+ TAMs and the expression of IL1RA, IL-6, IL-4 and IL-10 in TAM supernatants. TAMs enhanced CRC cell proliferation and invasion via IL-6, and then activated the IL-6R/STAT3 pathway in CRC cells. However, CPEB3 reduced the IL-6R protein levels by directly binding to IL-6R mRNA, leading to decreased phosphorylated-STAT3 expression in CRC cells. CCL2 was significantly increased in CPEB3 knockdown cells, while CCL2 antibody treatment rescued the effect of CPEB3 knockdown in promoting CD163+ TAM polarization. Eventually, we confirmed that CPEB3 inhibits tumor progression and M2-like TAM polarization in vivo. Conclusions: CPEB3 is involved in the crosstalk between CRC cells and TAMs by targeting IL-6R/STAT3 signaling.
Disclosure of Medical Errors: Physicians’ Knowledge, Attitudes and Practices (KAP) in an Oncology Center
Authors: Mansour Razan , Ammar Khawlah , Al-Tabba’ Amal , Arawi Thalia , Mansour Asem , Al-Hussaini Maysa 
Published: June 2020

Abstract
Background Between the need for transparency in healthcare widely promoted by patient’s safety campaigns and the fear of negative consequences and malpractice threats, physicians find themselves faced with challenging decisions on whether to disclose medical errors to patients and families or not. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center towards medical error disclosure.Methods This is a cross-sectional self-administered questionnaire study. We piloted the questionnaire and no major modifications were made. A daylong training workshop consisting of didactic lectures, short and long case scenarios with role-playing and feedback from the instructors were conducted. Physicians who attended the training workshops were invited to complete the questionnaire at the end of the training and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. Results Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). 65.5% of physicians were males and mean years of experience was 16.5 years. 86.9% (n=73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value= 0.024).Conclusion Formal training workshops on disclosing medical errors can positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.
Transcriptome Analysis of Aedes aegypti Aag2 Cells in Response to Dengue Virus-2 Infection
Authors: Li Man-jin , Lan Ce-jie , Gao He-ting , Xing Dan , Gu Zhen-yu , Su Duo , Zhao Tong-yan , Yang Hui-ying , Li Chun-xiao 
Published: June 2020

Abstract
Background Dengue virus (DENV) is a flavivirus transmitted by mosquitoes that is prevalent in tropical and subtropical countries and has four serotypes (DENV1-4). Aedes aegypti, as the main transmission vector of DENV, exhibits strong infectivity and transmission. With the aim of obtaining a better understanding of the Ae. aegypti-DENV interaction, the transcriptome changes in DENV-2-infected Aag2 cells were studied to describe the immune responses of mosquitoes using the Ae. aegypti Aag2 cell line as a model.Methods RNAseq technology was used to sequence the transcripts of the Ae. aegypti Aag2 cell line before and after infection with DENV-2. A bioinformatics analysis was then performed to assess the biological functions of the differentially expressed genes, and the sequencing data were verified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR).Results The transcriptome analysis generated 8,866 unigenes that were found in both groups, 225 unigenes that were only found in the infection group, and 683 unigenes that only existed in the control group. A total of 1199 differentially expressed genes, including 1014 upregulated and 185 downregulated genes, were identified. The bioinformatics analysis showed that the differentially expressed genes were mainly involved in the longevity regulating pathway, circadian rhythm, DNA replication, and peroxisome, purine, pyrimidine, and drug metabolism. The qRT-PCR verification results showed the same trend, which confirmed that the expression of the differentially expressed genes had changed and that the transcriptome sequencing data were reliable.Conclusions This study investigated the changes in the transcriptome levels in the DENV-2-infected Ae. aegypti Aag2 cell line, which provides a faster and effective method for discovering genes related to Ae. aegypti pathogen susceptibility. The findings provide basic data and directions for further research on the complex mechanism underlying host-pathogen interactions.
A comparative study of fractional order models on state of charge estimation for lithium ion batteries
Authors: Tian Jinpeng , XIONG Rui , Shen Weixiang , Wang Ju 
Published: June 2020

Abstract
State of charge (SOC) estimation for lithium ion batteries plays a critical role in battery management systems for electric vehicles. Battery fractional order models (FOMs) which come from frequency-domain modelling have provided a distinct insight into SOC estimation. In this article, we compare five state-of-the-art FOMs in terms of SOC estimation. To this end, firstly, characterisation tests on lithium ion batteries are conducted, and the experimental results are used to identify FOM parameters. Parameter identification results show that increasing the complexity of FOMs cannot always improve accuracy. The model R(RQ)W shows superior identification accuracy than the other four FOMs. Secondly, the SOC estimation based on a fractional order unscented Kalman filter is conducted to compare model accuracy and computational burden under different profiles, memory lengths, ambient temperatures, cells and voltage/current drifts. The evaluation results reveal that the SOC estimation accuracy does not necessarily positively correlate to the complexity of FOMs. Although more complex models can have better robustness against temperature variation, R(RQ), the simplest FOM, can overall provide satisfactory accuracy. Validation results on different cells demonstrate the generalisation ability of FOMs, and R(RQ) outperforms other models. Moreover, R(RQ) shows better robustness against truncation error and can maintain high accuracy even under the occurrence of current or voltage sensor drift.
Proposal for a new therapeutic high dosage of Pidotimod in children with Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome: a randomized controlled study.
Authors: Manti Sara , Filosco Federica , Parisi Giuseppe Fabio , Finocchiaro Giuseppe Germano , Papale Maria , Giugno Andrea , Barone Patrizia , Leonardi Salvatore 
Published: June 2020

Abstract
Background. Despite to PFAPA syndrome is considered a benign and self-limited condition in childhood its impact on patients and families can be remarkable in many cases. Currently, the therapeutic options for managing are non-specific and no consensus exists about the best treatment to use. Pidotimod has been suggested as a new potential treatment in PFAPA syndrome for its immunodulatory effects. We conducted a preliminary, prospective, controlled, open, cross-over trial to assess the efficacy and the safety of Pidotimod in the treatment of children with PFAPA syndrome. Methods. 22 children with PFAPA syndrome were randomly allocated to treatment with pidotimod (with 2 vials of 400mg daily) in combination with betamethasone 0.5-1 mg on need, based on parents/caregivers' decision (group A) or betamethasone 0.5-1mg on need, based on parents/caregivers' decision (group B). Each treatment period was for 3 months (Phase 1), after that patients were switched to the other arm for other 3 months (Phase 2). Efficacy was expressed in terms of number of episodes of fever, pharyngitis, or aphthous stomatitis, as well as the additional use of betamethasone on need. Safety and tolerability of the Pidotimod were evaluated on the basis of the number and type of adverse events (AEs) recorded during the treatment.Results. Patients receiving Pidotimod and use betametasone showed a significant decrease in frequency of fevers (p=0.002); number of episodes of pharyngitis (p=0.049); aphthous stomatitis (p=0.036) as well as the betamethasone use on need (p=0.007). Overall, 19/22 (86.4%) showed benefits from Pidotimod administration. The safety profile of Pidotimod was excellent as no serious adverse events have been reported in the treated groups.Conclusions. We firstly showed that high dosage of Pidotimod could be an effective and safe to reduce the PFAPA attacks in children.