bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fairness evaluation for the elder population in China
Authors: Wang Guan , Shen Qing 
Published: March 2020

Abstract
Introduction: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Kakwani indexes and curves were obtained from concentration index/ curves and Gini coefficient/ATP for progressivity analysis in healthcare financing. Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions. Key words : Non-communicable diseases, the elderly, socioeconomic status, health financing, kakwani index
Perceived Benefits, Challenges, and Recommendations for National HIV/AIDS Research Dissemination Efforts in Tanzania
Authors: Conserve Donaldson , Saini Subina , Issango Jumanne , Kamwela Jerome , Maboko Leonard , Kilale Andrew , Nhigula Patrick , Shirima Sylvia , Vargo Julianna , Rawson Ryleigh , Ondrus Abigail , Whembolua Guy-Lucien 
Published: March 2020

Abstract
Background Although a number of international and national HIV/AIDS conferences exist, there is not a national conference in Tanzania focusing on disseminating HIV/AIDS research conducted in the country. This creates a missed opportunity for researchers to share their research findings with local policy makers and HIV program implementers who can influence the adoption and implementation of locally promising research to public health and clinical practice settings. This paper reports on the findings from a brainstorming session conducted at the first HIV/AIDS Research Forum designed to enhance local dissemination efforts of HIV/AIDS research conducted in Tanzania. Method During the second day of the Forum, which was held in Morogoro, Tanzania, a 1-hour structured brainstorming session was conducted with the Forum participants. Participants included researchers, medical professionals, policymakers, representatives from different ministries. Transcription of the brainstorming session was analyzed to identify benefits of the Forum, perceived challenges for organizing similar HIV/AIDS research dissemination events, and recommendations for addressing the challenges. Results Overall, 50 participants attended the Forum and they perceived the forum to be beneficial because it brought together researchers, policymakers, and other stakeholders working in HIV/AIDS programs and implementers. Having policymakers and researchers in the same place enhance the likelihood of policymakers using research findings to inform policies and influence adoption and implementation of effective interventions. Forum participants identified several potential challenges of similar local HIV/AIDS research dissemination efforts including the costs and lack of funding for organizing and hosting such forums or having repetitive presentations. To address these concerns, they recommended a biennial national conference in order to allow more time to raise funds to cover the costs associated with organizing such a conference. Conclusion The benefits identified for the Forum highlight the importance of developing a national level HIV/AIDS conference in Tanzania. However, the potential challenges discussed need to be addressed in order to develop a sustainable national HIV/AIDS conference by incorporating the recommendations that forum attendees proposed.
Preserving left colic artery in anterior resection reduce the incidence of anastomotic leakage in rectal cancer patients: A prospective cohort study
Authors: Zheng Huichao , Ye Jingwang , Tian Yue , Zhang Yong , Shen Haode , Li Fan , Liu Baohua , Tong Wei-Dong 
Published: March 2020

Abstract
Background Whether or not to preserving left colic artery(LCA) in anterior resection for rectal cancer and its effect on anastomotic leakage are remains controversial. The aim of this study was to investigate the clinical outcomes of preserving the LCA during anterior resection for rectal cancer. We further explored branching types of the inferior mesenteric artery(IMA) based on the three-dimensional computed tomography reconstruction images. Methods Between January 2017 and October 2019, patients who underwent anterior resection for rectal cancer were allocated to preservation LCA or non-preservation LCA. Evaluation parameters including intraoperative conditions, pathological outcomes, postoperative complications, and short-term results. Furthermore, preoperative three-dimensional computer tomography reconstruction were performed to assess types of IMA. Results 160 patients with rectal cancer were enrolled in this study, 56 were arranged to preservation LCA and 104 to non-preservation LCA. The incidence of anastomotic leakage and overall early complications were significantly(P<0.05) decreased in the preservation LCA group. The reoperation rate of the preservation LCA group (1.8%) was lower than that of the non-preservation LCA group (10.6%), but the difference was not statistically significant (P>0.05). The two groups did not significantly(P>0.05) differ in blood loss, intraoperative complications, total number of harvested lymph nodes, and number of positive lymph nodes. The three-dimensional computer tomography reconstruction images of 108 patients with rectal cancer were evaluated, the IMA was divided into four types, of which 53(49.1%) were type I, 24 (22.2%) were type II, 18 (16.7%) were type III, and 13 (12%) were type IV. Conclusions The preservation of LCA in anterior resection for rectal cancer could help reducing the incidence of anastomotic leakage, overall early complications and without increasing other known risks. The three-dimensional computer tomography reconstruction technique was useful for evaluating the IMA types to facilitate make intraoperative surgical decisions and preservation of LCA during rectal cancer surgery.
Assessment of DLG Correction Factor in Mobius3D Commissioning Affected by Couch Top
Authors: Han Min Cheol , Kim Jihun , Hong Chae-Seon , Chang Kyung Hwan , Han Su Chul , Park Kwangwoo , Kim Dong Wook , Park Myoung Kyu , Noh Yu Yun , Kim Jin Sung 
Published: March 2020

Abstract
Purpose: This study assesses the dosimetric leaf gap (DLG) correction factor in Mobius3D commissioning affected by a couch top platform and calculates the optimal DLG value according to the point dose difference function. Methods: DLG optimizations were performed for 3 LINAC machines and a total of 30 patient VMAT plans (i.e., 10 plans per each LINAC). Point dose calculations were performed using an automatic dose calculation system in Mobius3D as well as Mobis3D calculation using an MVP-based QA plan with a carbon fiber couch top. Subsequently, the results were compared with measurement data. Results: The averaged point dose measured for the MVP with a couch top decreased by approximately 2% relative to that without the couch top. The average of the optimal DLG factors increased by 1.153 due to the couch top effect for a dose decrease of 2% at the measured point. Conclusions: Users should adjust the DLG correction factor using a specific phantom (including MVP) with a couch top. If the factor adjusted by using MVP automatic dose calculation system, the factor should be increased by approximately 1.153 per 2% dose difference considering user’s couch top effect.
Clinical Characteristics of 6 patients with SARS-Cov-2 infected severe pneumonia in Zunyi, China
Authors: Fu Bao , Qian Kun , Chen Tao , Fu Xiaoyun , Chen Miao 
Published: March 2020

Abstract
Purpose To study the clinical characteristics, laboratory examination, radiological changes and treatments of 6 patients with severe SARS-Cov-2 infected pneumonia in Zunyi City, China.MethodsThe clinical data, laboratory examination, radiological changes and clinical treatment process of 6 patients with severe SARS-Cov-2 infected pneumonia admitted to the Department of Critical Medicine of the Affiliated Hospital of Zunyi Medical University were retrospectively analyzed.Results Four of the six patients were older than 65 years. Two patients had a history of exposure to Wuhan, and four patients had family clustering infection. The most common symptoms at onset of illness were dry cough (4, 66%) and fever (4, 66%). Laboratory tests showed that white blood cell count, neutrophil count, C-reactive protein, IL-6, IL-10, and urea nitrogen elevated. The Total lymphocyte count and T lymphocyte count decreased. All patients received antiviral therapy, blood purification, immunomodulatory therapy, and Chinese herb treatments. One patient was discharged from the hospital, and 5 patients' condition improved significantly. ConclusionT lymphocyte decreased significantly, IL-6 and IL-10 elevated in severe SARS-Cov-2 infected pneumonia patients. Elderly patients with comorbidities appear to be more severe and to recover more slowly. Blood purification can be tried for severe and critically ill patients. Early identification and timely treatment of critical cases is of crucial importance.
A single-center analysis of clinical features of 145 tuberous sclerosis complex—associated renal angiomyolipoma cases in China
Authors: Wang Xu , Zhao Yang , Wang Wenda , Wang Zhan , Zhang Yushi 
Published: March 2020

Abstract
Background: Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disease with multiple organ system involvement. Renal angiomyolipoma (RAML) is a leading cause of death in TSC-adult patients. The aim of the study was to investigate the clinical features of tuberous sclerosis-associated renal angiomyolipoma among Chinese population so that clinicians can make better clinical diagnosis.Methods: Retrospective review of clinical data of 145 patients with tuberous sclerosis-associated renal angiomyolipoma treated in the Department of Urology, Peking Union Medical College Hospital from January 2014 to January 2019. Analysis of age and gender distribution, tumor stage, and combined clinical manifestations. All analyses used a significance level of 0.05 and were presented in SPSS23.0 software.Results: A total of 145 patients were enrolled. There were 51 males and 94 females. The male to female ratio was 1:1.84, with mean age of 30.50±9.79 years (range 7-58 years). 92 cases were mainly distributed in 21-40 age group, accounting for 63.45%. Among all 6 age groups, 21-30 age group contained the largest number of patients(48 case，33.10%). 86 (59.31%) renal angiomyolipoma cases were classified stage 6; 19 cases had a history of tumor rupture and hemorrhage, including 7 selective arterial embolization, 8 partial nephrectomy and 4 nephrectomy. Subependymal nodules (104/122cases, 85.24%), angiofibromas /fibrous cephalic plaque (121 cases, 83.44%), hypomelanotic macules (89 cases, 61.39%), shagreen patch (65 cases, 44.83%) and ungual fibromas (62 cases, 42.07%) were the main combined clinical manifestation. 91.30% (42/46) lymphangioleiomyomatosis cases were female.Conclusion: Patients with TSC-RAML were mainly young and middle-aged females with giant Angiomyolipoma. Most tumor were ranged in stage 5 and 6. Nervous system characteristics (subependymal nodules), dermatological lesions (angiofibromas or fibrous cephalic plaque, hypomelanotic macules, shagreen patch and ungual fibromas) were common combined clinical manifestations. Lymphangioleiomyomatosis showed an obvious difference in gender distribution
A grape seed extract maternal dietary supplementation improves egg quality and reduces ovarian steroidogenesis without affecting fertility parameters in reproductive hens: a link with plasma and ovarian cell adipokines expression?
Authors: Barbe Alix , Mellouk Namya , Ramé Christelle , Grandhaye Jérémy , Anger Karine , Chahnamian Marine , Ganier Patrice , Brionne Aurélien , Riva Antonella , Froment Pascal , dupont joelle 
Published: March 2020

Abstract
Background: In mammals, oxidative stress (OS) induces negative effects on reproductive functions. In broiler hens, the genetic selection has increased susceptibility to OS. Grape seed extracts (GSE) are known as potent antioxidants. Here, we investigated the effects of time and level of GSE dietary supplementation on egg production and quality, fertility parameters, Reactive Oxygen Species (ROS) and steroid content in yolk egg associated to plasma adipokines in broiler hens. Methods: We designed an in vivo study using four groups of hens: A (control), B and C (supplemented with GSE at 0.5% and 1% of the total diet composition, respectively, starting at week 4) and D (supplemented with GSE at 1% of the total diet composition since hatching). We assessed the egg production from 23 th to 40 th weeks and quality at 33 th week. After artificial inseminations, the fertility parameters were calculated. In egg yolk, Reactive Oxygen Species (ROS) level and steroid production were evaluated by Ros-Glo H202 and ELISA assay, respectively. Expression of steroidogenic enzymes and adipokines and their receptors was determined by RT-qPCR in ovarian cells and plasma adipokines (RARRES2, ADIPOQ and NAMPT) were evaluated by specific ELISA assays. Results: The fertility parameters and egg production were unaffected by GSE supplementation. However, the rate of double-yolk eggs decreased for all GSE supplemented. Eggs from the C group were bigger and larger. The shell elasticity was higher for B and C groups. In the yolk egg, GSE supplementation reduced ROS content and steroidogenesis consistent with a decrease in P450 aromatase and StAR mRNA expression and basal in vitro progesterone secretion in granulosa cells. Interestingly, RARRES2 plasma levels were positively correlated while ADIPOQ and NAMPT plasma levels were negatively correlated, with steroids and ROS in yolk. Conclusions: Maternal dietary GSE supplementation did not affect egg production and fertility parameters whereas it reduced ROS content and steroidogenesis in yolk egg. Furthermore, it ameliorated egg quality by decreasing the number of double-yolk eggs and by improving the size of normal eggs and the elasticity of the shell. Taken together, our data suggest the possibility of using dietary maternal GSE to improve egg quality.
The serum levels of circulating matrix metalloproteinase MMP-9, MMP-2/TIMP-2 complex and TIMP-1 do not change significantly during normal pregnancy.
Authors: Nissi Ritva , Santala Markku , Talvensaari-Mattila Anne 
Published: March 2020

Abstract
Background Matrix metalloproteinases (MMPs) are important regulators of vascular and uterine remodeling. Normal pregnancy is associated with increased MMP activity. Measurements of the plasma levels on MMPs have not been consistent between studies in complicated pregnancies. Methods We have examined MMP-9, MMP-2 and their respective tissue inhibitors TIMP-1 and TIMP-2 in different time points in the sera of 13 women with normal pregnancy Results The serum levels of MMP-9 and TIMP-1 were stable throughout pregnancy. The level of MMP-2/TIMP-2 complex was slightly increased after week 15 without statistical significance.Conclusions The serum levels of MMP-9, MMP-2/TIMP-2 and TIMP-1 on different time points during normal pregnancy are poorly studied. Further measurements of the plasma levels of MMPs and the correlation with MMP levels in the placenta and other maternal tissues are needed.
Changes in physical activity across pregnancy among Chinese women: a longitudinal cohort study
Authors: Lü Yan , Feng Yahui , Ma Shuai , Jiang Yu , Ma Liangkun 
Published: March 2020

Abstract
Background Sufficient physical activity (PA) during pregnancy is beneficial for a woman’s health; however, the PA levels of Chinese women at different pregnancy stages are not clear. The aim of our study was to investigate PA changes during pregnancy and determinants of PA changes among Chinese women.Methods Data were obtained from 2485 participants who were enrolled in the multicentre prospective Chinese Pregnant Women Cohort Study. PA level was assessed in early pregnancy and again in mid-to-late pregnancy using the International Physical Activity Questionnaire short form (IPAQ-SF). Sufficient PA (≥600 MET min/week) in early pregnancy and insufficient PA in mid-to-late pregnancy indicated decreasing PA. Insufficient PA in early pregnancy and sufficient PA in mid-to-late pregnancy indicated increasing PA. The associations between demographic, pregnancy-related and health-related characteristics and PA changes were examined by logistic regression analysis.Results Energy expenditure on PA increased significantly from early to mid-to-late pregnancy ( P <0.001), and 55.25% of the participants eventually had sufficient PA. Walking was the dominant form of PA. Women with sufficient PA levels in early pregnancy were more likely to have sufficient PA in mid-to-late pregnancy (OR=1.897, 95% CI: 1.583-2.274; P <0.001). Women in West China and those in Central China were most and least likely, respectively, to have increasing PA (OR=1.387, 95% CI: 1.078-1.783; P =0.011 vs. OR=0.721, 95% CI: 0.562-0.925; P =0.010). Smoking was inversely associated with increasing PA (OR=0.480, 95% CI: 0.242-0.955; P =0.036). Women with higher educational levels were less likely to have decreasing PA (OR=0.662, 95% CI: 0.442-0.991; P =0.045).Conclusions PA increased as pregnancy progressed, and walking was the dominant form of PA among Chinese women. Avoiding smoking and maintaining sufficient PA in early pregnancy may help women achieve sufficient PA throughout the whole pregnancy. Interventions for PA should consider differences in regional distributions and educational levels.
AMH as an ovarian function predictor in premenopausal female breast cancer patients receiving chemotherapy is effective only for those over 35 years old
Authors: Li Xiaolin , Liu Sixuan , Ma Lisi , Chen Xuan , Weng Huaiyu , Huang Run , Yu Yang , ZONG XIANGYUN 
Published: March 2020

Abstract
Background The predicting value of AMH for ovarian dysfunction after chemotherapy is controversial. This study is designed to evaluate the value of serum AMH clinically and theoretically. Methods We detected the serum estradiol, FSH and AMH in 144 pre-menopausal women with breast cancer receiving cyclophosphamide-based chemotherapy. The differences of hormones before and after chemotherapy were compared; the correlations among the hormones and amenorrhea, menstrual recovery were analyzed. In addition, serum AMH was detected randomly in 177 normal healthy women and 36 normal female C57BL/6J mice of different ages, meanwhile the status of ovary follicles was observed. Furthermore, 72 Balb/c nude mice with breast cancer were randomly assigned to three groups with different dosage of CTX (control, 100mg/kg, 200mg/kg), the alterations of serum AMH and ovary follicles were recorded and analyzed. Results Chemotherapy induced amenorrhea was associated with pre-chemo AMH level, E2 level and FSH level (P <0.0001). Recovery of menstruation was associated with pre-chemo AMH level (P <0.0001) but not E2 and FSH level (P >0.05). In breast cancer patients received chemotherapy, the serum AMH did not differ significantly between pre- and post- chemotherapy in patients younger than 35 years old (P>0.05), while dramatic decline was detected in patients over 35 years old (P<0.0001). In healthy women, the AMH level sharply declined after 35 years old ( P <0.0001) and remained relatively stable in early age. Similar results were obtained in normal mice experiments. The cancer-bearing mice exposed to 200mg/kg CTX endured significant decline of AMH levels and remarkable decrease of primordial and growing follicles (P <0.0001). Conclusion Our results indicate that AMH is effective for predicting post-chemo ovarian function only in premenopausal female breast cancer patients over 35 years old.
Goal-directed hemodynamic therapy in patients with colorectal cancer undergoing laparoscopic surgery
Authors: Panaﬁdina V. A. , Shlyk I. V. 
Published: March 2020

Introduction.The conductance of goal-directed hemodynamic therapy is controversial due to the difficulty in its implementation in routine practice despite the signiﬁcant number of studies and meta-analyses.Objective.To estimate the efficacy of a modiﬁed algorithm of goal-directed hemodynamic management in patients with colorectal cancer who undergo laparoscopic surgery based on non-invasive monitoring of cardiac output.Subjects and methods.A single-centered, randomized trial was conducted. The control group included 75 patients, while the goal-directed therapy (GDT) group included 72 patients. In the control group, hemodynamic management was based on mean arterial pressure and intraabdominal perfusion pressure. In addition, results of ﬂuid responsiveness tests were considered in the GDT group. The suggested protocol efficacy was evaluated on the basis of frequency of critical incidents, shifts in acid-base balance and lactate concentration, infusion volume, vasopressor doses, the incidence of acute kidney injury, and other complications.Results.After anesthesia induction and according to the results of a modiﬁed, passive leg raising test, 67.1% of patients were considered responders and received 1250 (1000; 1500) ml of balanced crystalloids before carboxyperitoneum. The infusion differentiation test of hypotension cause was performed in 47 patients of the GDT group, 37% were considered responders, and others received vasopressors and/or inotropes. The use of the GDT protocol led to a decrease in total infusion volume and vasopressor doses. A lower frequency of critical incidents was recorded when the GDT protocol was used. In the GDT group, there were no signs of ischemia and increased frequency of complications (including acute kidney injury).Conclusions.Testing of ﬂuid responsiveness and non-invasive cardiac output monitoring allows for the correction of hemodynamics during surgery. Goal-directed therapy in the intraoperative period allows different approaches to maintaining systemic and intraabdominal perfusion pressure, thus decreasing the total volume of infusion without increasing hypoperfusion risk.