bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prefilled pen versus prefilled syringe: evaluation of methotrexate subcutaneous intake method in patients with juvenile idiopathic arthritis – results of the pilot study
Authors: Roszkiewicz Justyna , Swacha Zbigniew , Smolewska Elzbieta 
Published: January 2020

Abstract
BACKGROUND Methotrexate is the most commonly used disease-modifying antirheumatic drug recommended in the treatment of juvenile idiopathic arthritis. It can be administered orally or subcutaneously, the latter method is associated with fewer side effects and higher drug bioavailability. Nevertheless, the pain associated with injection is a considerable drawback of this treatment option in the pediatric population. Currently, there are two single-use subcutaneous injection devices available: the prefilled syringe and the prefilled pen. This prospective, two-sequence crossover study aimed to compare ease of use, frequency of therapy side effects, injection-site pain and patient preference of those methotrexate parenteral delivery systems.METHODS 23 patients with juvenile idiopathic arthritis, already treated with subcutaneous methotrexate in the form of prefilled syringe in the period October 2018 – April 2019 completed a questionnaire evaluating their experience with this device. Subsequently, children received a one-month supply of pen autoinjector and completed the same questionnaire, regarding their experience with the new methotrexate delivery system. The results obtained in both questionnaires were compared using the Wilcoxon matched-pairs signed-rank test.RESULTS 82,6% patients and their caregivers voted for the prefilled pen as their preferred method of subcutaneous methotrexate administration. Moreover, the injection with the prefilled pen was reported as less painful in comparison to the prefilled syringe (p<0.01). Side effects of methotrexate were less pronounced after the prefilled pen treatment, this difference was most prominent regarding gastrointestinal adverse events associated with the injection (p<0.01).CONCLUSIONS Administration of methotrexate using the pen device is a promising way of subcutaneous methotrexate delivery in children with juvenile idiopathic arthritis, as the injection is less painful and associated with fewer side effects.
Evidence-based educational pathway and teaching materials for first aid training of children in Sub-Saharan Africa
Authors: De Buck Emmy , Laermans Jorien , Vanhove Anne-Catherine , Dockx Kim , Vandekerckhove Philippe , Geduld Heike 
Published: January 2020

Abstract
Background First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop evidence-based contextualized materials to train Sub-Saharan African children in first aid. Methods Systematic literature searches were conducted to identify studies on first aid education to children up to 18 years old (research question one), and studies investigating different teaching approaches (broader than first aid) in LMIC (research question two). A multidisciplinary expert panel translated the evidence to the context of Sub-Saharan Africa, and evidence and expert input were used to develop teaching materials. Results For question one, we identified 58 studies, measuring the effect of training children in resuscitation, first aid for skin wounds, poisoning etc. For question two, two systematic reviews were included from which we selected 36 studies, revealing the effectiveness of several pedagogical methods, such as problem-solving instruction and small-group instruction. Expert input was useful for placing the evidence against the African context. Conclusions The above approach resulted in an educational pathway (i.e. a scheme with educational goals concerning first aid for different age groups), a list of recommended educational approaches, and evidence-based first aid teaching materials for children, adapted to the African context.
Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study
Authors: Jin Yinzi , Xu Jin , Zhu Weiming , Zhang Yaoguang , Xu Ling , Meng Qingyue 
Published: January 2020

Abstract
Objective People bypass primary healthcare (PHC) institutions to seek expensive healthcare at high-level hospitals, leading to escalating medical costs and inefficient use of resources. In 2009, China launched nationwide synergic policies on primary care strengthening, to tackle access to healthcare and financial protection. This study aimed to assess the impact of the two policy areas, health insurance and health workforce, on healthcare seeking behavior.Methods Drawing on national survey data before (2008) and after (2013) the policies, we linked individual-level data on healthcare-seeking behavior with county-level data on health workforce and health insurance. We constructed a multilevel zero-inflated negative binomial regression to examine the impacts of average reimbursement rate (ARR) of health insurance and the density of registered physicians on outpatient/inpatient visits, and multilevel multinomial logistic regression for the impacts on choice of outpatient/inpatient care providers.Results Although the increase in health insurance ARR and physician density have positive impacts on individuals’ healthcare use, their impacts might be weakened during 2008 and 2013, and the negative impacts of investment of those in PHC institutions on likelihood of visiting hospitals was larger. The negative impacts of ARR at PHC institutions on likelihood of visiting county-, municipal- and higher-level hospitals in 2013 was 28 percentage points, 66 percentage points and 33 percentage points larger than these in 2008.Conclusion Primary care strengthening requires synergic policies. Effective mechanisms for coordination across multisectoral actions are necessities for deepening those policies to ensure efficient delivery of healthcare without experiencing financial risks.
Changes in Provision of Social Support among the Older Population in Nine European Countries during 2004—2015: A panel data analysis
Authors: Lestari Septi Kurnia , de Luna Xavier , Eriksson Malin , Malmberg Gunnar , Ng Nawi 
Published: January 2020

Abstract
Background : Providing support to others may be beneficial for older adults. As people age, their health and social relationships change. These changes may relate to change in social support provision as well. We examined the trajectory of social support provision by older people in three European regions throughout eleven years of follow-up. We then examined the extent to which age, gender, and region (represents welfare state regime) influenced the variations in the trajectory. Methods :Data collected from 8,354 respondents who had completed at least waves 1 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was analysed. Social support provision was determined from asking a single question regarding whether the respondent provided help personally for people outside their household. Region, sex, and age were the main predictors tested. We used growth model to address the aims of this study. Results :The northern European region (Sweden and Denmark) had the highest odds ratio of providing social support. The likelihood of social support provision decreases by 10% yearly (OR: 0.901, 95%CI: 0.878,0.925) over 11 years of follow-up. Older respondents were less likely to provide support and their trajectories declined faster the younger respondents. Gender difference in social support provision was more apparent among younger older people in the southern European region. Conclusions : European older adults are important source of support, especially for their family. The probability of social support provision by European older adults declines over time. Age, gender and welfare state regime predict this trajectory.
Reliability and validity of Mandarin (Simplified) version of Head and Neck Cancer-specific Supportive Care Needs (SCNS-HNC) scale
Authors: LYU Jianxia , Yin Li , Cheng Ping , Li Bin , Peng Shanshan , Yang Chunlian , Yang Jing , Liang Haixin , Jiang Qinghua 
Published: January 2020

Abstract
Background To translate the English version of supportive care needs scale of head and neck cancer patients (SCNS-HNC) questionnaire into Mandarin (Simplified), and to test reliability and validity. Methods The With authorization of the English version scale were obtained from Professor Irma M. Verdonck-de Leeuw who worked at VU University Medical Center of Cancer Center Amsterdam (CCA), in the Netherlands. The Mandarin (Simplified) version of the SCNS-HNC scale was developed by translation, back-translation and cultural adaptation. The Mandarin (Simplified) version of Supportive Care Needs Survey Short-Form (SCNS-SF34) and SCNS-HNC scales were used to measure 206 patients with head and neck cancer in a upper first-class hospital in Chengdu. Among them, 51 patients were re-tested 2 or 3 days after the first survey. The internal consistency of the scale was evaluated by Cronbach's alpha coefficient, the retest reliability of the scale was evaluated by retest correlation coefficient r, the structural validity of the scale was evaluated by exploratory factor analysis, and the ceiling and floor effects of the scale were evaluated. Item-domain correlation analysis was used to evaluate the collective validity and differential validity of the scale. Results The Mandarin (Simplified) version of SCNS-HNC had Cronbach's alpha coefficients of more than 0.700 (0.737 ≤ 0.962)for the all of the domians. Except for the psychological demand dimension of SCNS-SF34 scale, the retest reliability in other fields was more than 0.8. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 64.39%. The correlation coefficient of all items in Mandarin (Simplified) version of SCNS-SF34and SCNS-HNC with their own domians were higher than those with otherdomians. Conclusion The Mandarin (Simplified) of SCNS-HNC demonstrates satisfactory reliability and validity, which is available for measurement of the supportive care needs of Chinese patients with head and neck cancer.Clinical registration number: ChiCTR1900026635
Honokiol-Mesoporous Silica Nanoparticles Inhibit Vascular Restenosis via the Suppression of TGF-β Signaling PathwayHonokiol-Mesoporous Silica Nanoparticles Inhibit Vascular Restenosis via the Suppression of TGF-β Signaling Pathway
Authors: Wei Xiao , Wang Yu , Fang Zhiwei , Lu Ping , Yuan Wei-En 
Published: January 2020

Abstract
Background and aims: MSNPs improves the solubility of drugs through physical, chemical and other interactions, and can be used to overcome the defects of poor water-solubility of drugs. We used MSNPs standard substance to encapsulate honokiol and then assemble into honokiol-mesoporous silica nanoparticles, and we investigated the effect of these nanoparticles on the process of restenosis after common carotid artery injury in rats.Results: Here, we report a promising delivery system that load honokiol into mesoporous silica nanoparticles (MSNPs), and finally assemble into a nano composite particle. This HNK-MSNPs not merely inhibit proliferation and migration of VSMCs by reducing phosphorylation of Smad3 but also showed a higher suppression of vascular restenosis than the free-honokiol form in a rat model of balloon injury. Conclusions: This drug delivery system supplies a potent nano-platform for the intracellular delivery of honokiol to VSMCs and shows a promising use for the future clinical trial.
The Effect of Preoperative Anxiety Level on Mean Platelet Volume and Propofol Consumption
Authors: uysal ali ihsan , Altıparmak Başak , Toker Melike Korkmaz , Dede Gülseda , Sezgin Çiğdem , Demirbilek Semra Gümüş 
Published: January 2020

Abstract
Background: The mean platelet volume (MPV) is an important indicator of platelet function with large platelets showing higher enzymatic and metabolic activity than other platelets. There can be a relationship between increased platelet activity and anxiety and depression. Our primary hypothesis was that patients with high anxiety scores would have higher MPV, and the secondary hypothesis was that propofol induction time and total propofol consumption within the first 30 min of surgery would be higher in patients with higher anxiety scores.
Methods: The Beck Anxiety Inventory (BAI) was administered to the participating patients one day before surgery to evaluate the level of anxiety. Based on the scores from the BAI, 40 patients with an anxiety score of <8 were assigned to the non-anxious group (Group NA) and 40 patients with an anxiety score of ³8 were assigned to the anxious group (Group A). At the anesthesia induction the mean time to achieve an entropy value below 60 (T1) was recorded. The total intraoperative propofol consumption within the first 30 min was recorded.
Results: There was a statistically significant difference between the groups in terms of preoperative MPV and demographic data, including age and sex. The mean total propofol consumption at 30 min after induction in the groups was statistically significant. The cut-off value for MPV was calculated as 9.65.
Conclusions: The preoperative MPV values and propofol consumption at 30 minutes among patients with high preoperative anxiety scores were high. We suggest that MPV is helpful in the clinical practice in predicting the amount of anesthetic agents required for the induction of anesthesia.
The draft genome of horseshoe crab Tachypleus tridentatus reveals its evolutionary scenario and well-developed innate immunity
Authors: Zhou Yan , Liang Yuan , Yan Qing , Zhang Liang , Chen Dianbao , Ruan Lingwei , Kong Yuan , Shi Hong , Chen Mingliang , Chen Jianming 
Published: January 2020

Abstract
Background: Horseshoe crabs are ancient marine arthropods with a long evolutionary history extending back approximately 450 million years, which may benefit from their innate immune systems. However, the genetic mechanisms underlying their abilities of distinguishing and defending against invading microbes are still unclear.
Results: Here, we describe the 2.06 Gbp genome assembly of Tachypleus tridentatus with 24,222 predicted protein-coding genes. Comparative genomics shows that T. tridentatus and the Atlantic horseshoe crab Limulus polyphemus have the most orthologues shared among two species, including genes involved in the immune-related JAK-STAT signalling pathway. Divergence time dating results show that the last common ancestor of Asian horseshoe crabs (including T. tridentatus and C. rotundicauda ) and L. polyphemus appeared approximately 130 Mya (121-141), and the split of the two Asian horseshoe crabs was dated to approximately 63 Mya (57-69). Hox gene analysis suggests two clusters in both horseshoe crab assemblies. Surprisingly, selective analysis of immune-related gene families revealed the high expansion of conserved pattern recognition receptors. Genes involved in the IMD and JAK-STAT signal transduction pathways also exhibited a certain degree of expansion in both genomes. Intact coagulation cascade-related genes were present in the T. tridentatus genome with a higher number of coagulation factor genes. Moreover, most reported antibacterial peptides have been identified in T. tridentatus with their potentially effective antimicrobial sites.
Conclusions: The draft genome of T. tridentatus would would provide important evidence for further clarifying the taxonomy and evolutionary relationship of Chelicerata. The expansion of conserved immune signalling pathway genes, coagulation factors and intact antimicrobial peptides in T. tridentatus constitutes its robust and effective innate immunity for self-defence in marine environments with an enormous number of invading pathogens and may affect the quality of the adaptive properties with regard to complicated marine environments.
Insights into RNA-dependent RNA Polymerase Inhibitors as Antiinfluenza Virus Agents
Authors: Giacchello Ilaria , Musumeci Francesca , D’Agostino Ilaria , Greco Chiara , Grossi Giancarlo , Schenone Silvia 
Published: January 2020

Background:
Influenza is a seasonal disease that affects millions of people every year and
has a significant economic impact. Vaccines are the best strategy to fight this viral pathology, but they
are not always available or administrable, prompting the search for antiviral drugs. RNA-dependent
RNA polymerase (RdRp) recently emerged as a promising target because of its key role in viral replication
and its high conservation among viral strains.

Discussion:
This review presents an overview of the most interesting RdRp inhibitors that have been
discussed in the literature since 2000. Compounds already approved or in clinical trials and a selection
of inhibitors endowed with different scaffolds are described, along with the main features responsible
for their activity.

Results:
RdRp inhibitors are emerging as a new strategy to fight viral infections and the importance
of this class of drugs has been confirmed by the FDA approval of baloxavir marboxil in 2018. Despite
the complexity of the RdRp machine makes the identification of new compounds a challenging research
topic, it is likely that in the coming years, this field will attract the interest of a number of academic
and industrial scientists because of the potential strength of this therapeutic approach.
Attachment in Patients with Bipolar and Unipolar Depression: A Comparison with Clinical and Non-clinical Controls
Authors: Picardi Angelo , Pallagrosi Mauro , Fonzi Laura , Martinotti Giovanni , Caroppo Emanuele , Meldolesi Giulio Nicolò , Di Gennaro Giancarlo , De Risi Marco , Biondi Massimo 
Published: January 2020

Background:
A link between depression and insecure attachment has long been postulated. Although many studies examined the relationship between depressive symptoms and attachment, relatively few studies were performed on patients diagnosed with depression. Also, research on patients with bipolar disorder is scarce.

Objective:
We aimed at testing the association between attachment insecurity and unipolar and bipolar depression.

Methods:
We studied 21 patients with bipolar disorder, current episode depressed, and three age- and sex-matched groups, each consisting of 21 individuals: patients with major depressive disorder, recurrent episode; patients with epilepsy; non-clinical participants. The Experience in Close Relationships questionnaire was used to assess adult attachment style.

Results:
Patients with both bipolar and unipolar depression displayed significantly higher scores on attachment-related avoidance as compared with patients with epilepsy and non-clinical participants. Also, patients with bipolar depression scored significantly higher on attachment-related anxiety than all other groups. In both psychiatric groups, attachment dimensions were not significantly correlated with global clinical severity or severity of depression.

Conclusion:
Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression. Attachment theory may provide a valuable theoretical framework for future research and for guiding treatment.
Transportation of Donated Hearts by Drone in Comparison to Road-Bound Vehicles in Mexico City
Authors: Al-Ayyad Muhammad , Al-Ghraibah Amani , Alkhatib Husam 
Published: January 2020

Background:
Organ transportation between hospitals has many challenges since the harvested organ needs to be transplanted to the recipient within an optimal time frame. It is important to transfer the organ from the donor to the recipient site quickly and professionally.

Aim:
The aim of this research is to investigate whether the transportation of donated hearts by drones is more efficient than transportation using road-bound vehicles.

Methods:
A simulation using MatLab software was performed to calculate the heart transportation time between three different hospitals in Mexico City by road-bound vehicles and by drones. This simulation was performed to demonstrate how congestion and traffic in Mexico City prevent healthy hearts from being transplanted to patients on time. The 24-hour period was divided into four 5-hour periods and these were chosen to be: Period 1 (22:00-03:00), Period 2 (04:00-09:00), Period 3 (10:00-15:00) and Period 4 (16:00-21:00).

Results:
The time it took to travel between the hospitals by car within each of the 5-hour periods was calculated. It was observed that, in period 2, a high volume of traffic was present causing road-bound vehicles to take a longer time to deliver hearts to hospitals. All hospitals were within reach of each other if the hearts were to be transported by drone and the delivery time by drone in all cases was less than 1.88 hours, which is the optimum time for the harvested heart to be transported without risk from the donor to the recipient.

Conclusion:
Using drones will increase the safety of transplants, reduce the heart transplantation waiting list and eventually, heart transplantation may be possible in different areas of the city at rush hour times.
The Effect of slit-friction hybrid damper on the Performance of Dual System
Authors: Khoshkroodi Azadeh , Sani Hossein Parvini 
Published: January 2020

Aims:
The aim of the present paper is to evaluate the behavior of slit friction hybrid dampers (SFHD) on steel structures. Therefore, the behavior moment resisting steel frames of structures in original stats and structures equipped with hybrid damper with two different types of behavior was analyzed and evaluated.

Background:
The recent study evaluated the combined effect of shear-friction dampers and slit dampers with measurements of non-uniform strips in seismic protection for different levels of energy. The recent study was carried out a about hybrid dampers, consisting of friction and split dampers in response to small and large earthquakes. Previous results have shown the ability of inactive hybrid systems in improving the reaction of structures to traditional lateral-systems. Kim and Shin showed that structures consisted of hybrid dampers needed less repair cost and time.

Methods:
Pushover and time history were carried out on original structures and structures equipped with dampers, in 5 and 10 stories structures.

Results:
Analysis about the probability of collapse showed about 30% and 84%.

Conclusion:
According to the result, by adding the SFHD, increased stiffness by 17% in retrofitted structures such as drift and displacement of roof decreases by 27% and 20% in push over analysis, respectively. Also, displacement in time history analysis up to 55% reduces in average. Also, the results of the IDA show that adding the SFHD to structures significantly increases by 55% the spectral acceleration capacity in structures.