bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeting the N-terminus of α-synuclein Monomer Reduces Fibril-induced Aggregation in the Brain
Authors: Szegõ Éva M. , Szegő Éva M. , Boß Fabian , Komnig Daniel , Gärtner Charlott , Höfs Lennart , Shaykhalishahi Hamed , Wördehoff Michael , Saridaki Theodora , Schulz Jörg B. , Hoyer Wolfgang , Falkenburger Björn H. 
Published: July 2020

Abstract
Background

Removing α-synuclein aggregates or preventing their formation constitutes a plausible strategy against Parkinson’s disease (PD). As we recently demonstrated, the β-wrapin protein AS69 binds an N-terminal region in monomeric α-synuclein (aSyn), interferes with fibril nucleation and reduces aSyn aggregates in vitro and in a fruit fly model of A53T aSyn toxicity. Here we tested whether AS69 could also reduce aSyn pathology in mammalian neurons and in mouse brain.
Methods

Primary mouse neurons were exposed to pre-formed fibrils (PFF) of human WT aSyn or PFF was injected into the striatum of A30P-aSyn transgenic mice to induce aSyn pathology. Densities of phospho-aSyn positive somatic inclusions and dystrophic neurites, degeneration of dopaminergic axon terminals in the striatum and the glial response were determined.
Results

PFF were readily taken up by primary mouse neurons, and AS69 did not alter PFF uptake. aSyn pathology, as determined by phospho-aSyn staining, was much more pronounced 72 h after PFF addition than after 24 h, and was reduced by AS69. In the striatum, PFF increased aSyn pathology, induced degeneration of dopaminergic axon terminals and glial activation at 90 days after PFF injection. The extent of terminal loss correlated with the density of dystrophic neurites, but not with the number of somatic inclusions. Co-injection of AS69 with PFF abrogated the induction of somatic inclusions and dystrophic neurites, reduced the loss of dopaminergic axon terminals and the reaction of astroglia, but not the effect on microglia.
Conclusion

AS69, an aSyn monomer-binding protein, reduces aSyn pathology and loss of dopaminergic terminals in primary neurons and in a mouse model. Therefore, our data suggests, that small aSyn-monomer binding proteins, such as AS69, could be promising new therapeutic approaches against Parkinson's disease.
A qualitative study exploring barriers to adequate uptake of antenatal care in pre-conflict Syria: Implications for post conflict interventions addressing the demand-side barriers
Authors: Mourtada Rima , Bashour Hyam , Houben Fiona 
Published: July 2020

Abstract
Background

Until the onset of the conflict in 2011, Syria has made noticeable progress in reducing maternal mortality and morbidity. Despite the improvement in antenatal care (ANC) coverage and patterns of use, analyses of national surveys demonstrated wide regional variations in uptake, timing and number of visits even after controlling for women’s socio-demographic characteristics. The main aim of this study is to highlight the barriers to women’s adequate uptake of ANC that existed in Syria pre-conflict, comparing two governorates: Latakia, where uptake of antenatal care was high and Aleppo, where uptake of ANC was low.
Methods

This qualitative study carried out 30 in-depth interviews with (18–45 year old) pregnant women from Aleppo and Latakia and conducted 15 participant observation sessions in different types of health facilities that provide ANC. Participants were purposively recruited from randomly selected rural and urban, public and private health facilities, and independent midwives’ clinics, with onward sampling of women who did not attend ANC. Transcripts and fieldnotes were analyzed using the framework approach.
Results

Inadequate uptake of ANC in Aleppo included not attending ANC, discontinuing care or seeking care with unqualified providers. Three themes emerged that explained the disparities in uptake of ANC in Aleppo compared to Latakia: women’s assessment of their own health status in pregnancy, women’s evaluation of the risks of seeking ANC, and women’s appraisal of the value of different types of service providers. These evaluations were connected with the availability, accessibility (geographical and financial) and acceptability of ANC services however women’s views were shaped by the knowledge and prevailing opinions in their families and community.
Conclusions

Findings are utilized to discuss low-cost interventions addressing the disparities in uptake of ANC. Interventions should be aimed at increasing vulnerable women’s capacity and capabilities to make informed decisions. Women’s groups that foster education and empowerment and which have been effective in other low resource settings are worth exploring in Syria. Increased use of mobile phones and social media platforms that were not present pre-conflict, suggests mobile health technologies (mHealth) may present efficient platforms to deliver these interventions.
Assessment of Blood Consumption score for pediatrics (ped-ABC score) predicts transfusion requirements for children with trauma.
Authors: Komori Akira , Deshpande Gautam A. , Aoki Makoto , Saitoh Daizoh , Naito Toshio , Abe Toshikazu 
Published: July 2020

Abstract
Background

Although transfusion is one of primary life-saving elements, the assessment of requirement for transfusion in children with trauma at an early phase has been challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma.
Methods

This is a retrospective cohort study, which employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included the patients aged < 16 years with blunt trauma between 2004 and 2015. An Assessment of Blood Consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤ 90 mmHg; heart rate ≥ 120/min; Glasgow Coma Scale (GCS) < 15; and positive result on focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cut-off points for different ages.
Results

In total, 540 patients had transfusion within 24 hours after trauma among the eligible 5,943 pediatric patients with trauma. The in-hospital mortality rate was 2.6% (145/5,615). Transfusion increased from 7.6% (430/5,631) to 35.3% (110/312) in patients with systolic blood pressure ≤ 90 mmHg (1 point); from 6.1% (276/4,504) to 18.3% (264/1,439) for heart rate ≥ 120/min (1 point); from 4.1% (130/3,198) to 14.9% (410/2,745) for disturbance of consciousness with GCS < 15 (1 point); and from 7.4% (400/5,380) to 24.9% (140/563) for FAST positivity (1 point). The ped-ABC score of 0, 1, 2, 3, and 4 points were associated with the transfusion rates of 2.2% (48/2,210), 7.5% (198/2,628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% CI, 0.74–0.78).
Conclusions

The ped-ABC score using the vital signs and FAST may be helpful in predicting the transfusion requirements within 24 hours for children with trauma.
Diagnostic value of combined pleural IL-33, ADA and peripheral T-SPOT.TB for tuberculous pleurisy
Authors: Fenhua Jin , Daohui Wang , Hui Lin , Xiaodong Xia , huang wen 
Published: July 2020

Abstract
【Objective】To investigate the correlation between pleural fluid interleukin-33(IL-33) and adenosine deaminase ༈ADA༉ and peripheral blood tuberculosis T cell spot detection ༈T-SPOT.TB༉,and the combined value of the three tests for the diagnosis of tuberculous pleurisy.【Method】79 patients with pleural effusion admitted from June 2017 to December 2018 were enrolled. They were divided into tuberculous pleural effusion ༈TPE༉ group (57 cases, 72.2%) and malignant pleural effusion group(17 cases,21.5%), pneumonia-like pleural effusion group (5 cases, 6.3%). Correlation between pleural fluid IL-33,pleural effusion ADA and peripheral blood T-SPOT.TB was analyzed, comparison of the three separate and combined diagnostic efficacy was also performed.【Result】The levels of IL-33, ADA and peripheral blood T-SPOT.TB in patients with TPE were significantly higher than those in non-TPE (P < 0.001). The level of pleural fluid IL-33 was positively correlated with pleural effusion ADA and peripheral blood T-SPOT.TB. The Area under the ROC curve༈AUC༉of TPE diagnosed by pleural IL-33, ADA and peripheral blood T-SPOT.TB were 0.753, 0.912 and 0.865, respectively. AUC for combined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB is the largest, with a value of 0.962. Specificity is 100% and sensitivity is 88.5%.【Conclusion】Combined detection of pleural effusion IL-33, ADA and peripheral blood T-SPOT.TB can improve the diagnostic efficacy of tuberculous pleurisy.
Bolstering Maternity Insurance to Support Family Health of Ethnic-Minority Women under Universal Two-Child Policy: Empirical Evidence from China’s Ningxia-Hui Autonomous Region
Authors: Antwi Henry Asante , Zhou Lulin , Antwi Maxwell Opuni , Boafo-Arthur Ama , Mustafa Tehzeeb 
Published: July 2020

Abstract
Background Despite the overwhelming feeling of great happiness, joyful excitement and rituals that heralds the arrival of a child, for too many women (especially in developing countries), child bearing is associated with suffering, ill health and even death. The need to consolidate and support women to procreate in tranquillity has inspired international and domestic agencies to harness the resources at their disposal to protect the health of women especially during pregnancy, child birth and the post-partum period. Methods The study applied a systems dynamic model to selected data to establish the influence of the universal two-child policy in China on maternity insurance fund income. The study also established sensitivity analysis of the appropriate rate of contribution to keep the fund active. Results The study revealed that increases in utilisation rate as results of increase in number of births under the universal two-child policy increased the accumulated deficit of the maternity insurance fund income in the Ningxia-Hui Autonomous Region. At the current rate, the entire fund will be depleted by the end of 2021 unless the contribution rate is increased from 0.5% to 0.75%. Conclusions Maternal health is a “sentinel event” requiring an unprecedented global resource mobilisation to safeguard the future of humanity. Thus maternity insurance schemes in China require new methods of fund raising to keep a sustainable maternity insurance fund in the region. Study also reveals that population reform is not done in isolation but require changes in the fundamental social structures to ensure its sustainability.
A Strategic Action Plan to Enhance the Accessibility of Healthcare in Rural Areas of Zimbabwe
Authors: Mangundu Manenji , Roets Lizeths , Rensburg Janse Van 
Published: July 2020

Abstract
Background: Accessibility to health care in rural areas of Zimbabwe is challenging. Developing a strategic action plan was in essence, a road map leading to a required potential like achieving a goal. Wider consultation with communities, healthcare leaders and policymakers to inform development of strategic action plan, often overlooked has necessitated this research. The aim was to identify strategies and develop a strategic action plan to enhance accessibility to healthcare in rural areas of Zimbabwe through active involvement of key stakeholders like healthcare users, healthcare workers, leaders and legislators.Methods: A multiple methods approach were used and study was carried out in 4 phases. In Phase 1 (quantitative), data was collected from professional nurses using self-administered questionnaire and health care users using interview questionnaire. Phase 2 (qualitative) collected data through a nominal group with national health directors. A strategic action plan was developed in phase 3 using findings from phase 1 and 2, the Systems Model and a literature control. In phase 4, the strategic action plan was finalised and validated by members of parliamentary portfolio committee on health who were members of parliament of Zimbabwe. Two districts (Masvingo and Chegutu) in two provinces (Masvingo and Mashonaland West) were included in the study, targeting 45 public health facilities in rural areas of Zimbabwe.Participants included in the study were conveniently sampled professional nurses (90), health care users (445) using the sampled public health facilities (phase 1), conveniently sampled 5 national health coordinators (phase 2) and all-inclusive 5 members of the parliamentary portfolio committee on health (phase 4).Results: The study contributed to the development and validation of the strategic action plan with 6 strategies. These included improving the health infrastructure, provision of medical drugs, health workers, medical equipment, reviewing the health worker workload and addressing shortages, and improving the capacity of the health care system.Conclusion: The active participation at all phases by professional nurses, health care users, national health directors and members of parliament contributed to development of a strategic action plan with 6 strategies to enhance accessibility to health care in rural areas of Zimbabwe.
Significance of Serum Expression of Rho Kinase, Endothelin-1, and Nitric Oxide in Pediatric Patients With Left-to-right Shunt Congenital Heart Disease Accompanied by Pulmonary Hypertension
Authors: Sun Xing-Zhen , Hu Jian , Tian Xiang-Yang , Hong Ze 
Published: July 2020

Abstract
Background

The study aimed to investigate the serum expression levels of Rho kinase, endothelin-1 (ET-1), and nitric oxide (NO) in pediatric patients with left-to-right shunt congenital heart disease (CHD) and their correlation with pulmonary artery systolic pressure (PASP).
Methods

90 pediatric patients diagnosed with left-to-right shunt CHD and hospitalized were selected as the study objects.They were divided into three groups according to their PASP: the non-pulmonary artery hypertension (non-PAH) group (PASP < 30 mmhg), the mild PAH group (PASP 30–49 mmhg), and the moderate to severe PAH group (PASP ≥ 50 mmhg). Healthy children were selected as the control group. Enzyme-linked immunosorbent assay, radioimmunoassay, and nitrate reductase assay were used to determine the patients’ serum levels of Rho kinase, ET-1, and NO, respectively. The correlation between PASP and the above indexes was analyzed.
Results

In pediatric patients with left-to-right shut CHD, the serum expression levels of Rho kinase and ET-1 were higher than in the control group members, while the serum expression level of NO was lower. In pediatric patients with CHD accompanied by pulmonary hypertension (PH), the expression levels of Rho kinase and ET-1 were even higher, and the level of NO even lower, than in patients and control group members without PH. The serum levels of Rho kinase and ET-1 were positively correlated with PASP, while the serum level of NO was negatively correlated with PASP.
Conclusion

Rho kinase, ET-1, and NO may be involved in the development of PH in pediatric patients with left-to-right shunt CHD.
Does Estradiol Orally and Vaginally Administered Together Impact Live Birth and Neonatal Outcome in Artificial Frozen-thawed Embryo Transfer Cycles: A Retrospective Cohort Study
Authors: Liu Yuan , Yang Yixia , Zhou Xinting , Hu Yanmei , Wu Yu 
Published: July 2020

Abstract
Background: Previous studies have demonstrated that newborns from fresh embryo transfer are with higher risk of small for gestation (SGA) rate than those from frozen-thawed embryo transfer (FET). It is suggested that supraphysiologic serum estradiol in controlled ovarian stimulation (COS)is one of reasons. Out study aims to investigate whether exogenous estradiol delivered regimens have an impact on live birth rate and singleton birthweight in hormone replacement (HRT)-FET cycles.Methods:This retrospective study involved patients undergoing their first FET with HRT endometrium preparation followed by two cleavage-staged embryos transfer, comparing orally and vaginal estradiol tablets (OVE) group versus oral estradiol tablets (OE) group from January 2015 to December 2018 at our center. A total of 792 patients fulfilled the criteria, including 282 live birth singletons. Live birth was the primary outcome. Secondary outcome included clinical pregnancy rate, singleton birthweight, large for gestational age (LGA) rate, SGA rate, preterm delivery rate. Results:Patients in OVE group achieved higher serum estradiol level with more days of estradiol treatment. No difference in live birth (Adjusted OR 1.327; 95%CI 0.982, 1.794, p=0.066) and clinical pregnancy rate (Adjusted OR 1.278; 95%CI 0.937, 1.743, p=0.121) was found between OVE and OE groups. Estradiol route did not affect birth weight (β=-30.962, SE=68.723, p=0.653), the odds of LGA (Adjusted OR 1.165; 95%CI 0.545, 2.490, p=0.694), the odds of SGA (Adjusted OR 0.569; 95%CI 0.096, 3.369, p=0.535) or the preterm delivery rate (Adjusted OR 0.969; 95%CI 0.292, 3.214, p=0.959).Conclusion:Estrogen orally and vaginally together did not have an impact on clinical outcomes and singleton birthweight compared to estrogen orally taken, but was accompanied with relative higher serum E2 level and potential maternal undesirable risks.
Postpartum rupture of Splenic hydatid cyst: An extremely rare presentation of a rare condition
Authors: Ashraf Aabid , Wani Yaqoob Hassan , Bhat Javid Ahmad , Rather Ajaz Ahmad 
Published: July 2020

Abstract
BackgroundHydatid disease is endemic in some regions of the world. Even in endemic regions, splenic hydatid cysts are rare, especially in pregnancy. The most serious presentation is intra peritoneal rupture, which is a surgical emergency. Exploration with splenectomy is the favoured management.Case presentationWe present a case of splenic hydatid cyst detected late in pregnancy, which presented with intraperitoneal rupture in the postpartum period. A brief review in the context is also presented.ConclusionCystic lesions located anywhere in the body in endemic regions could be hydatid cysts. Prompt treatment should be planned immediately on detection in order to prevent potentially serious complications like rupture.
The Burden of the Current Curative Expenditure of Injury in Dalian, China-A study Based on "System of Health Accounts 2011"
Authors: Sun Shu , Yang Liuna , Hu Xinzhu , Zhu Yalan , Liu Boxi , Yang Yunbin , Wang Xin 
Published: July 2020

Abstract
Background: Injury is one of the major public health problems, which causes more than 5 million deaths in the world every year. Cases of specific types of injury put a tremendous threat to human health and also add a heavy medical burden on individuals and societies. This study was to calculate and analyze the current curative expenditure (CCE) of injury in Dalian and consequently to provide control strategies for decision-makers.Methodology: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 4,375,351 valid samples. Subsequently, the distribution of injury CCE in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011(SHA 2011) using the established database.Results: There were increases from 32.36/100,000 in 2006 to 37.34/100,000 in 2017 and from 46.12/100,000 in 2006 to 54.48/100,000 in 2017 in urban and rural residents respectively. The study found that the CCE of injury in Dalian had reached 1572.73 million RMB, accounting for 7.45% of the total curative care expenditure. In the 15-25 age group, the cost of injury accounts for a larger proportion of CCE than other age groups. Among the injuries in different regions of the body, injuries to the spine, lower limb, head and foreign body entering cost the most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost and increase the benefit of attending to patients with injuries. Specific control strategies should be tilted toward the age group 15-25. Injuries to the spine, lower limb, head and foreign body entering also should be priorities of interventions.
Engaging Research Participants with Results: A Rights Informed Approach
Authors: George Mathew Sunil , Gaitonde Rakhal , Davey Rachel , Mohanty Itismita , Upton Penney 
Published: July 2020

Abstract
IntroductionSharing findings with research participants is gaining attention as an ethical imperative for the research community. However, current discussions on this topic typically take a paternalistic approach to the issue, with the research team having the power to decide whether or not the sharing of results should be carried out and how this is done. In this paper we propose an alternative approach to engaging participants with the findings from the research to which they have contributed.MethodsThe ethnographic fieldwork for our study was carried out in multiple phases from August 2018 to January 2019 and again from August 2019 to December 2019 among two vulnerable communities in the south Indian state of Kerala. Engagement of research participants with findings was integrated into the research protocol and various strategies including forming partnerships with participants and identifying appropriate forms of dissemination among the different categories of participants were carried out during fieldwork. The format and mode of dissemination varied depending on the participant category and was tailored to ensure that each participant was able to engage actively with the findings as opposed to merely passively receiving the results from our study,ResultsPrevious research studies that had been undertaken among our participants had not shared research results with them and were interpreted by the communities that researchers were not interested in making any difference to their situation. Building reciprocal relationships in a way that minimised power disparities and tailoring outputs to forms that promoted active engagement were key factors that helped participants to engage with our results. Such engagement added value to our research by enabling us to jointly evolve the recommendations from our study.Conclusion Participants contribute to the success of research by providing information that is sought by researchers. Compared to the dominant bio-medical research ethics framework, a rights informed approach to sharing research results with participants acknowledges this and recognises their agency to engage with research findings. Such an approach is not only socially responsible and ethical, but also improves the impact and legitimacy of research among the participants and the larger population that they represent.
A water quality assessment model for Suya Lake Reservoir
Authors: Ji Xiaolei , Wang Xin , Yang Guoping 
Published: July 2020

Abstract
Reasonable water quality assessment of reservoirs plays an important part in strengthening water source management. Based on the monitoring data on the water quality in Suya Lake Reservoir provided by water quality environmental monitoring agencies, this paper selected typical water quality indexes such as dissolved oxygen, permanganate (CODMn), ammonia nitrogen (NH3-N), total phosphorus (TP) and total nitrogen (TN) as the water quality assessment factors, and applied the fuzzy comprehensive evaluation method to assess the quality of water in the Suya Lake Reservoir on the basis of single factor assessment. The result shows that the fuzzy comprehensive evaluation method can accurately quantify the fuzzy assessment of water quality. The main pollution factors in Suya Lake Reservoir are TP and TN, and pollution mainly occurs in the waters on the west bank of the reservoir (between the Cold Water River and the Lianjiang River), with the Huangxi River and its inlet being the most seriously polluted. This study provides some reference for the improvement to the water quality assessment model and scientific basis for the prevention and control of water environment pollution in the reservoir area.