bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translating Evidence into Policy: Opinions and Insights of Health Researchers and Policymakers in Nepal
Authors: Tiwari Biplav Babu , Ban Anusha , Gurung Sony , Karki Khem Bahadur 
Published: October 2020

Abstract
Background: The Evidence-Based Policymaking (EBP) process in Nepal is rife with poor practices where often policymakers are portrayed as perpetrators for such practices. However, we need to think of the EBP as a two-sided coin where both research pull and research push play equally significant roles. Methods: Therefore, through 12 in-depth interviews, this study aimed to assess the perception of Nepalese health policymakers and researchers on EBP and identify appropriate mechanisms to integrate evidence into policies. Following the constructivist philosophical paradigm, qualitative research design was used in the study with the grounded theory approach. Purposive sampling was performed and the total number of interviews was finalized following saturation theory. All interviews were audio-recorded, transcribed, translated to English, coded line by line, and then developed into themes. Thematic analysis technique was used to manually analyze the data. Results: Study participants highlighted that evidence is being utilized during policy formulation but not in the amount it should be, with a preference for anecdotal evidence further reducing the chance. Apart from these barriers, poor credibility of information obtained, poorly targeted dissemination, inadequate policy-based researches, and policymakers and researchers operating within the spheres of their own with a feeble link to channel the flow of information between them were identified by participants. On the other hand, the publication of one-pager research brief, conduction of nationally representative surveys especially quantitative studies, the practice of cost-effectiveness study, and policymaker’s involvement during the research were some facilitators identified. Conclusions: Moreover, the study accentuates that better communication strategies such as the establishment of formal forums with policymakers and researchers, better-targeted dissemination, and identification of priority areas have wide potential to promote a unified front of health policymakers and researchers for EBP.
Hepatectomy Provides Good Long-Term Outcomes for Hepatocellular Carcinoma Patients With Portal Hypertension: A Propensity Score Matching Analysis
Authors: Wu Xiwen , Chen Wei , Chen Bin , Xie Wenxuan , Wang Shutong , Peng Baogang , Shen Shunli 
Published: October 2020

Abstract
Background: The role of hepatectomy in hepatocellular carcinoma (HCC) with portal hypertension (PH) remains controversial. This study aimed to evaluate the effect of hepatectomy on overall survival (OS) of HCC patients with PH.Methods: A total of 1651 HCC initially treated with hepatectomy were retrospectively reviewed and divided into PH group (n=157) or non-PH group (n=1494). Propensity score matching (PSM) was conducted to match the baseline characteristics of the PH group and non-PH group. Results: The PH group presented a similar OS (p=0.29) and recurrence free survival (RFS) (p=0.83) compared with non-PH group after initial hepatectomy before PSM. After PSM processing, the baseline characteristics were highly comparable for both groups (133 patients in each group). The PH group also presented a similar OS (p=0.81) and RFS (p=0.65) compared with non-PH group after initial hepatectomy. After PSM, multivariate analysis identified tumor size (>5 cm) (p=0.02), macro-venous invasion (p < 0.001), AST (>37 U/L) (p =0.008) as independent risk factors for OS.Conclusions: Hepatectomy provides good long-term outcomes for HCC patients with PH. PH should not be regarded as a contraindication for hepatectomy in HCC patients.
Hospital Case-Volume and Mortality After Ovarian Cancer Surgery: A Population-Based Retrospective Cohort Study
Authors: Kim Bo Rim , Kim Heewon , Joo Se-gyeong , Jang Eun Jin , Jo Junwoo , Lee Hannah , Ryu Ho Geol 
Published: October 2020

Abstract
Background: The goal of ovarian cancer surgery has recently shifted from optimal cytoreduction to more complete resection. This study attempted to reassess and update the association between surgical case-volume and both in-hospital and long-term mortality after ovarian cancer surgery using recent data.Methods: Data from all adult patients who underwent ovarian cancer surgery in Korea between 2004 and 2017 were obtained from the database of Korean National Health Insurance Service. Hospitals were categorized by average annual number of surgeries considering overall distribution of case-volume. Postoperative in-hospital and 1, 3, 5-year mortality were analyzed using logistic regression. Results: During the study period, 23,487 ovarian cancer surgeries were performed in 354 hospitals. High-, medium-, and low-volume centers were defined as >100 cases/year, 30-100 cases/year, and <30 cases/year, respectively. In-hospital mortality was significantly higher in medium-volume (1.63%; adjusted odds ratio, 2.28; confidence interval, 1.64-3.17; P <0.001) and low-volume (1.62%; adjusted odds ratio; 2.12; confidence interval, 1.55-2.90; P <0.001) centers compared to high-volume centers (1.13%). In addition, 1-year mortality after ovarian cancer surgery was 6.26%, 7.07%, and 8.06% for high-volume, medium-volume, and low-volume centers, respectively, and the differences among the groups were significant. However, case-volume effect was not apparent in 3- and 5-year mortality after ovarian cancer surgery.Conclusion: Case-volume effect was observed for in-hospital and 1-year mortality after ovarian cancer surgery while no clear association was found between the case-volume and 3- or 5-year mortality.
Morphological, Physiological, and Molecular Responses of Sweetly Fragrant Luculia Gratissima During the Floral Transition Stage Induced by Short-day Photoperiod
Authors: Liu Xiongfang , Wan Youming , An Jing , Zhang Xiujiao , Cao Yurong , Li Zhenghong , Liu Xiuxian , Ma Hong 
Published: October 2020

Abstract
Background: Photoperiod-regulated floral transition is vital to the flowering plant. Luculia gratissima ‘Xiangfei’ is a flowering ornamental plant with high development potential and is a short-day woody perennial. However, the genetic regulation of short-day-induced floral transition in L. gratissima is unclear. To systematically research the responses of L. gratissima during this process, dynamic changes in morphology, physiology, and transcript levels were observed and identified in different developmental stages of long-day and short-day-treated shoot apexes. Results: The results showed that floral transition in L. gratissima occurred 10 d after short-day induction, but flower bud differentiation did not occur under long-day conditions. A total of 1,226 differentially expressed genes were identified, of which 146 genes were associated with flowering pathways of sugar, phytohormones, photoperiod, ambient temperature, and aging signals, as well as floral integrator and meristem identity genes. The trehalose-6-phosphate signal positively modulated floral transition by interacting with SPL4 in the aging pathway. Endogenous gibberellin, abscisic acid, cytokinin, and jasmonic acid promoted floral transition, whereas strigolactone inhibited it. In the photoperiod pathway, FD, COL12, and NF-Ys positively controlled floral transition, whereas PRR7, FKF1, and LUX negatively regulated it. SPL4 and pEARLI1 positively affected floral transition. SOC1 and AGL24 integrated multiple flowering signals to modulate the expression of FUL/AGL8, AP1, LFY, SEPs, SVP, and TFL1, thereby regulating floral transition. Finally, we propose a regulatory network model for short-day-induced floral transition in L. gratissima. Conclusions: Short-day photoperiod activated systemic responses of morphology, physiology, and transcript levels in L. gratissima and induced the generation of floral transition signals in the photoperiod pathway. Furthermore, multiple flowering signal pathways including phytohormone-, sugar-, temperature-, age-related genes synergistically control this process. This study improves our understanding of flowering time regulation in L. gratissima and provides knowledge for its production and commercialization.
Ionic Homeostasis, Acid-base Balance and the Risk of Citrate Accumulation in Patients After Cardiovascular Surgery Treated With Continuous Veno-venous Haemofiltration With Post-dilution Regional Citrate Anticoagulation
Authors: Kośka Agnieszka , Kowalik Maciej Michał , Lango-Maziarz Anna , Karolak Wojtek , Jagielak Dariusz , Lango Romuald 
Published: October 2020

Abstract
Background: Patients with known or new-onset acute renal failure after cardiovascular surgery, requiring renal replacement therapy, can benefit from adequate non-heparin circuit anticoagulation. The idea behind not using heparin relates to the post-operative risk of bleeding. Simplified regional citrate anticoagulation (RCA) protocol proposes the use of citric acid dextrose formula A (ACD-A) during post-dilutional continuous veno-venous hemofiltration (CVVH) with standard bicarbonate buffered calcium containing replacement solution. Citrate accumulation diagnosed upon total to ionized calcium ratio (tCa/iCa) and low ionized calcium (iCa) are considered as the biggest risks related to regional citrate accumulation.Methods: This prospective observational study evaluated electrolyte and acid-base homeostasis in cardiovascular surgery patients with known chronic or new-onset acute renal failure treated with post-dilution continuous veno-venous haemofiltration (CVVH) with a simplified RCA protocol with ACD-A. In total, 50 consecutive cardiovascular surgery patients treated with CVVH with RCA were evaluated. Base excess; pH; bicarbonate, lactate, Na+, Cl-, Mg++, and inorganic phosphate concentrations; the total to ionized calcium ratio (tCa/iCa); and high anion gap metabolic acidosis were assessed during haemofiltration treatment in survivors and non-survivors.Results: Thirty-three (66%) patients died. In total, 235 haemofiltration sessions with a median circuit survival time of 57 hours (1-117) were evaluated. The therapies were very well balanced with regard to sodium and chloride homeostasis. The lactate concentration and anion gap decreased during CVVH sessions longer than 72 hours, but no inter-group difference was observed. The tCa/iCa ratio exceeded 2.5 in 11 of 246 (4.5%) readings and was significantly higher in non-survivors (p=0.037). No correlation was observed between the lactate concentration before haemofiltration and the tCa/iCa ratio during haemofiltration. Magnesium and phosphate concentrations decreased during CVVH, and additional supplementation with magnesium was necessary. The magnesium concentration was lower in the non-survivors.Conclusions: The CVVH RCA protocol provides stable sodium and chloride concentrations and a tendency towards higher pH values and bicarbonate concentrations. Supplementation with magnesium and phosphate ions is needed. The incidence of citrate accumulation exceeded 4% and was significantly higher in non-survivors.Trial registration: retrospectively registered: Clinicaltrials.gov, NCT03836742.
Naringenin, a Flavonoid, Modulates Gut Microbiome and Ameliorates Hormone Levels to Improve Polycystic Ovary Syndrome in Letrozole-induced Rats&nbsp;
Authors: Wu Yan-Xiang , Yang Xiu-Yan , Hu Yuan-yuan , An Tian , Lv Bo-Han , Lian Juan , Wang Ting-Ye , Bao Xue-Li , Zhu Jia-Jian , Gao Lin , Jiang Guangjian 
Published: October 2020

Abstract
Background: Polycystic ovary syndrome (PCOS) is a common female endocrinopathy, which severely affect the menstruation and fertility of patients. Naringenin, a natural flavanone, has emerged as a potential therapeutic agent for the management a variety of diseases. However, the underlying mechanism of naringenin in anti‑PCOS is unclear. This study was focused on investigating the effects of naringenin on body weight, ovarian tissue, serum hormone level, glucose metabolism level and gut microbiome in letrozole-induced PCOS model rats.Methods: First, we administered letrozole gavage to 10-week-old SD female rats for 4 weeks to induce PCOS rats model, the estrus cycle was observed through the vaginal smear of rats to determine the establishment successful of a PCOS rat model. Then, the successfully modeled PCOS rats were treated with naringenin for 2 months. Finally, observed the changes of rat body weight, ovarian tissue, serum hormone level, glucose metabolism level and gut microbiome after naringenin treatment. Results: The naringenin treatment ameliorate the hormone levels, such testosterone (T), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), improve insulin resistance and the ovarian tissue pathological changes, reduced body weight in the PCOS model rat. Meanwhile, through the detection of rDNA in the faeces of the PCOS model rat, we found some beneficial microbes such [Ruminococcus], Faecalibacterium, Butyricimonas, Lachnospira, Parabacteroides, Butyricicoccus and Roseburia were enrichment in naringenin group when compared with the PCOS rats. Conclusions: In summary, our results indicated that naringenin could play an anti-PCOS role, and its mechanism may be closely related to regulating the beneficial microbes of gut microbiome. Our research could provide a new perspective for the treatment of PCOS and its related disease.
Examining the Prognostic Utility of Frailty for Post-arrest Outcomes Following the Provision of Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis Protocol
Authors: Mowbray Fabrice I , Foroutan Farid , Fernando Shannon , McIsaac Daniel , Douma Matthew , Wit Kerstin de , Muscedere John , Nolan Jerry , Griffith Lauren E , Worster Andrew , Couban Rachel , Costa Andrew , Strum Ryan , Correia Rebecca , Manlongat Donna 
Published: October 2020

Abstract
BackgroundAdvanced knowledge of patient prognosis following a cardiac arrest is necessary to determine if resuscitation efforts are futile and ensure value-congruent care. Prior reviews have identified the prognostic factors associated with survival and recovery following cardiac arrest. However, few studies to date have examined the prognostic value of frailty in predicting post-arrest outcomes. The objective of this systematic review is to synthesize the available evidence reporting the association between frailty and patient outcomes following the provision of CPR in-hospital or out-of-hospital MethodsWe searched the following electronic databases from inception until August 2020: Medline Epub Ahead of Print, In-Process and Other Non-Index citations, Pubmed exclusive of Medline citations, EMBASE, CINAHL and Web of Science. We plan to include observational studies that examine the association between frailty and any of the following outcomes: survival to hospital discharge, survival at one, three and twelve months post-arrest, return of spontaneous circulation, functional status at hospital discharge and one-month post-discharge, health-related quality of life at 90 days and one-year post-arrest, and discharge to continuing or long-term care. We plan to conduct a random-effects meta-analysis that pools the effect estimates from all eligible studies to obtain a summary estimate and confidence interval. DiscussionThe findings of this review can be used to determine if the evidence supports the consideration of frailty when discussing advanced directives and care planning with patients, families and caregivers. The findings of this review can also be used to inform future prognostic and clinical prediction models aiming to predict post-resuscitation outcomes. Systematic Review RegistrationThis review has been submitted to the PROSPERO registry (submission ID: 212922)
DTI for Parkinson's Disease: A Protocol for Systematic Review and Meta-Analysis
Authors: Yin Xiaoqin , Liu Meijun , Liao Yang , Jin Shuoguo , Li Qizheng , Zhu Chan , Hou Xiaolin , Yang Dongdong , Chu Xing 
Published: October 2020

Abstract
Background: There is no robust biological marker for the diagnosis of Parkinson's disease, and most of them are diagnosed until motor symptoms develop, which may affect the early intervention and prognosis Objective: To evaluate the diagnostic value of different parameter values of DTI in PD.Methods and analysis: We will systematically search the cochrane, pubmed, and embase databases, but we only consider observational studies and English studies. The main outcomes are DTI parameters, including FA, MDC, and ADC. We will evaluate the quality of the included studies through the NOS scale, and the data synthesis will be analyzed by revman5.3.Discussion: This systematic review will integrate all relevant DTI observation results on PD imaging, and evaluate whether DTI can be used as a biological marker for the diagnosis of PD. The review results will provide a useful reference for the diagnosis of PDSystematic review registration: The protocol has been registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols(INPLASY202070098).
Liver Transplantation, IBD Clinical Course, Is There a Link? A Systematic Review and Meta-Analysis Protocol
Authors: Sivandzadeh GholamReza , Mehrabi Manoosh , Safarpour Ali Reza , Ashrafizadeh Hadis , Keshtkar Abbas Ali 
Published: October 2020

Abstract
BackgroundPrimary sclerosing cholangitis (PSC) is an uncommon chronic and progressive cholestatic liver disease. There is a robust association between PSC and Inflammatory Bowel Disease (IBD), usually Ulcerative Colitis (UC). According to the review of literature, the incidence of de novo IBD after solid organ transplantation (SOT) is found to be higher than general population. Considering lacking of any systematic review and pursuing debate on the clinical course and risk factors of IBD activity after Liver Transplantation (LT), the present study will be performed with a focus investigation on the correlation of IBD clinical course with liver transplantation. MethodsIn this systematic review, the electronic databases including PubMed/MEDLINE, Scopus, WoS (Clarivate Analytics), Embase (Embase.com), and ProQuest will be searched. Our search strategy (i.e. The eligibility criteria) covers prospective and retrospective observational studies that evaluated the clinical course of ulcerative colitis or/and Crohn’s disease after liver transplantation with no language limitation published between 1970.01.01 and 2020.03.30. The selection phase, data extraction and quality assessment will be independently implemented by two authors. In case of any disagreement between the authors, the issue will be resolved by consensus; if not resolved, the opinion of a third expert will be asked. We will use one of the following two models: Random Effect Model or Fixed Effect Model according to the severity of methodological heterogeneity and forest plot will present the combination of data obtained from all finally included studies, to show the separated and combined frequency and their corresponding 95% CIs. Statistical heterogeneity will be evaluated by the Q-statistic test and I2 statistics. Funnel plot for assessing the potential reporting bias, Begg's and Egger's tests for meaningful results of the publication bias, and the Fill & Trim method for corrected publication bias will be used. DiscussionThis systematic review and meta-analysis study will clarify the correlation of IBD clinical course with liver transplantation. Because of the importance of inflammatory bowel disease, if the future study reveals consistent results, it will be clinically beneficial for physicians and other health care professionals to better manage inflammatory bowel disease after liver transplantation.Systematic review registrationPROSPERO, CRD42020179412.
Three-dimensional Printing in Spine Surgery: Protocol of a Systematic Review and Meta-analysis
Authors: Xie Guanli , Wang Tao , Jiang Bo , Yang Chunyan , Li Deguang , Su Yan , Xie Xiuping , Sun Haoming , Li Jian , Li Lvyu , Liao Jianglong 
Published: October 2020

Abstract
BackgroundThe complexity and diversity of spine pathology lead to the complexity and diversity of spinal surgery. The emergence and application of three-dimensional printing (3DP) technology has brought good news to surgeons and patients. However, the use of 3DP in spinal surgery remains controversial. Therefore, this study was designed to investigate whether 3D printing technology is beneficial for spinal surgery.MethodsThree English online databases including EMBASE (via embase.com), Medline (via PubMed), and Cochrane Central Register of Controlled Trials (CENTRAL) will be searched from inception until August 31, 2020. Document records retrieved according to the pre-defined search strategy will be managed by EndNote X7. The MINORST (methodological index for non-randomized studies) item recommended for non-randomized controlled interventional studies in surgery will be used to assess the quality of non-randomized controlled studies. The “Risk of bias” (ROB) table will be used to assess the quality of randomized controlled studies. The data extraction will be completed by two authors independently, one of whom extracts and the other checks. If there is any missing data, original author will be contacted to obtain the data required. Any inconsistencies were agreed upon by discussion with a third investigator. If the collected data can be synthesized, Review Manager (RevMan5.3) will be used to estimate the overall effect of 3DP for Spinal surgery. Otherwise, only the qualitative analysis will be carried out. According to the results of clinical heterogeneity test, random effects model or fixed effects model will be used for data synthesis. The sources of clinical heterogeneity will be explored by meta-regression and subgroup analysis. If more than 10 studies are included, funnel plots will be used to assess the publication bias. This review will be carried out in strict accordance with Cochrane Handbook for Systematic Reviews of Interventions.ConclusionThis study will can provide surgeons and patients with evidence-based evidence for the use of 3D printing technology in spinal surgery.Systematic review registrationPROSPERO/ID = CRD42020204053.
Summer STEM Course Gone Viral: A Virtual Curriculum Development
Authors: MacKinnon Grant , Langford Kyle , Harper Holly , Brown Kelsei , Divakar Sushmitha , Limb Mollie , Alexander Louise , Brown Charlotte 
Published: October 2020

Abstract
Due to the COVID-19 pandemic, a high school academic summer course concentrated in medicine was converted from a three-week on-campus experience to a two-week virtual course. While attending a residential summer course may be a barrier for some students, a virtual program may provide an equally rigorous and rewarding experience.