bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early upregulation of AR and steroidogenesis enzyme expressions after 3 months of androgen-deprivation therapy.
Authors: Hamid Agus Rizal A.H. , Putra Harun Kusuma , Sari Ningrum Paramita , Diana Putri , Sesari Saras Serani , Novita Eka , Gultom Fajar Lamhot , Saraswati Meilania , Tanurahardja Budiana , Asmarinah Asmarinah , Umbas Rainy , Mochtar Chaidir Arief 
Published: February 2020

Abstract
Background: Androgen-Deprivation Therapy (ADT) is a standard treatment for advanced prostate cancer (PCa). However, there is a high recurrence or progression rate during ADT. Until now, there is no evidence on when the progression starts. This study would like to evaluate the early response of intraprostatic androgen receptor (AR) and steroidogenic enzyme gene expressions in ADT.Methods: Prostate tissue samples were taken from PCa patients with urinary retention, who had ADT (ADT- PCa; n=10), and further grouped into ≤12 months (n=4) and ADT >12 months (n=6). ADT-PCa group were then compared with BPH (n=12) and primary (no treatment) PCa tissues (n=16). AR and steroidogenic enzyme genes were extracted from Formalin Fixed Paraffin embedded (FFPE) tissues and analysed using rtPCR. Protein expressions were evaluated by immunohistochemistry of specific antibodies. Results: AR gene expression was found higher in ADT-PCa group compared to BPH and primary PCa. Both ADT ≤12 and > 12 months subgroups had significantly higher relative gene expression of AR (p 0.01 and 0.03) compared to primary PCa. AR protein expression in ADT-PCa group showed an increase trend in ADT ≤12 months subgroup and a significantly elevated expression AR protein in ADT >12 months subgroup compared with PCa (100%; p <0.01). Half (50%) of ADT ≤12 months patients were found to have upregulation of AR, and one undergone upregulation from only 3 months of ADT. A trend of elevating relative gene expression of SRD5A3 were also found within the groups given ADT. Conclusion: There are upregulation of AR and steroidogenic enzymes in ADT-PCa patients, as early as 3 months without showing PSA elevation. Steroidogenic enzyme, especially SRD5A3 expression was also showing upregulation before PSA rises.
Morphologic and biochemical changes in the retina and sclera induced by form deprivation high myopia in guinea pigs
Authors: zi yingxin , Deng Yu , Zhao Jingru , Ji Meiqi , Qin Yali , Deng Tingting , Jin Ming 
Published: February 2020

Abstract
Background: To study the morphologic and biochemical changes in the retina and sclera induced by form deprivation high myopia (FDHM) in guinea pigs and explore the possible mechanisms of FDHM formation.Methods: Forty 3-week-old guinea pigs were randomized into the blank control (Group I, 20 cases) and model groups (20 cases). In the model group, the right eyes of the guinea pigs were sutured for 8 weeks to induce FDHM (Group II) and the left eyes were considered a self-control group (Group III). The refractive errors were measured with retinoscopy. The anterior chamber depth (AC), lens thickness (L), vitreous chamber depth (V) and axial length (AL) were measured using ultrasonometry A. Retinal and scleral morphology and ultrastructural features were observed with light and electron microscopy. The malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in the retina and sclera were detected with a chemical colorimetric assay.Results: After eight weeks of stitching, the refractive errors of Group II changed from (+3.59±0.33) D to (-7.96±0.55) D, and these values were significantly higher than those of Group I (+0.89±0.32) D and Group III (-0.55±0.49) D (P < 0.05). The vitreous chamber depth (4.12±0.13) mm and axial length (8.93±0.22) mm of Group II were significantly longer than those of Group I [(3.71±0.23) mm and (7.95±0.37) mm, respectively] and Group III [(3.93±0.04) mm and (8.01±0.15) mm, respectively] (P < 0.05). With the prolongation of form deprivation (FD), the retina and scleral tissues showed thinning, the ganglion cell and inner and outer nuclear layers of the retina became decreased, and the arrangement was disordered. In Group II, the SOD activity was significantly lower than that in Group I and Group III; the MDA content was significantly higher than that in Group I and Group III. The differences were statistically significant (P < 0.05).Conclusions: These findings suggested that in the FDHM guinea pigs model, the refractive errors, the vitreous chamber depth, and axial length increased significantly with prolongation of monocular FD time, and morphological structural changes in the retina and sclera were observed. Oxygen free radicals might participate in the formation of FDHM.
Impact of chronic kidney disease and anemia on health-related quality of life and work productivity: Analysis of multinational real-world data
Authors: Haalen Heleen van , Jackson James , Spinowitz Bruce , Milligan Gary , Moon Rebecca 
Published: February 2020

Abstract
Background Reductions in health-related quality of life (HRQoL) in patients with chronic kidney disease (CKD) are thought to be exacerbated by the low hemoglobin (Hb) levels that define anemia, a common complication of CKD. The current analysis evaluated the impact of anemia on HRQoL and work productivity in patients with non-dialysis dependent and dialysis-dependent CKD using real-world data. Methods Data were collected in France, Germany, Italy, Spain, the UK, the USA and China in 2012–2018 in the Adelphi Real World Disease Specific Programme™ for CKD, a large, cross-sectional, survey of physicians and their patients. Patients completed three patient-reported outcomes (PRO) instruments: the EuroQol 5-Dimension 3-level (EQ-5D-3L), the Kidney Disease Quality of Life (KDQOL-36) instrument and the Work Productivity and Activity Impairment questionnaire. PROs were assessed by CKD stage and Hb levels, and regression analyses were performed with CKD stage and Hb level as independent variables and PROs as outcome variables, while adjusting for age, sex, CKD stage, comorbidities and cardiovascular risk. Results Overall, 5276 patients participated in the survey, including 28% stage 4 and 36% dialysis patients. Patients with lower Hb levels more often reported problems/issues on all EQ-5D-3L domains (p<0.0001). Regression analyses showed significant associations between lower Hb levels and the probability of low (<0.8) EQ-5D-3L utility scores (p<0.0001) and low visual analog scale scores (p<0.05), indicating poorer health status. Associations were seen even when adjusting for CKD stage and other potential confounding factors. Significant associations were observed between Hb level and the 12-Item Short-Form Health Survey (SF-12) Physical Component Summary, SF-12 Mental Component Summary and the three KDQOL-36 subscales (all p<0.0001), and were confirmed using linear regression analyses adjusting for CKD stage and other potential confounders. Numerically greater work productivity losses and greater activity impairment were observed with lower Hb levels. Conclusions Lower Hb levels worsen the impact of CKD on HRQoL, and are associated with lower work productivity in patients with CKD. Assessment and treatment of anemia should be recognized as a key component of integral CKD management throughout all stages of the disease.
How can we support best practice? A situational assessment of injury prevention practice in public health.
Authors: Richmond Sarah A. , Carsley Sarah , Prowse Rachel , Manson Heather , Moloughney Brent 
Published: February 2020

Abstract
Background:To effectively impact the significant population burden of injury, we completed a situational assessment of injury prevention practice within a provincial public health system to identify system-wide priorities for capacity-building to advance injury prevention in public health.

Methods: A descriptive qualitative study was used to collect data on the current practice, challenges and needs of support for injury prevention. Data was collected through semi-structured interviews (n=20) and focus groups (n=19). Participants included a cross-section of injury prevention practitioners and leadership from public health units reflecting different population sizes and geographic characteristics, in addition to public health researchers and experts from academia, public health and not-for-profit organizations. Thematic analysis was used to code all of the data by one reviewer, followed by a second independent reviewer who coded a random selection of interview notes. Major codes and sub codes were identified and final themes were decided through iterations of coding comparisons and categorization. Once data were analysed, we confirmed the findings with the field, in addition to participating in a prioritization exercise to surface the top three needs for support.

Results: Major themes that were identified from the data included: current public health practice challenges; capacity and resource constraints, and; injury as a low priority area. Overall, injury prevention is a broad, complex topic that competes with other areas of public health. Best practices are challenged by system-wide factors related to resources, direction, coordination, collaboration, and emerging injury public health issues. Injury is a reportedly under prioritized and under resourced public health area of practice. Practitioners believe that increasing access to data and evidence, and improving collaboration and networking is required to promote best practice.

Conclusions: The results of this study suggest that there are several system level needs to support best practice in public health injury prevention in Ontario including reducing research to practice gaps and supporting opportunities for collaboration. Our research contributes to the literature of the complexity of public health practice, and presents several mechanisms of support to increase capacity at a system level to improve injury prevention practice, and eventually lessen the population burden of injury.
Defining the short-term disease recurrence after Loop Electrosurgical Excision Procedure (LEEP)
Authors: Papalia Nicholas , Rohla Amanda , Tang Selphee , Nation Jill G. , Nelson Gregg 
Published: February 2020

Abstract
Background
The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing Human Papilloma virus (HPV) testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP.
Methods
In a retrospective cohort study, consecutive patient charts were accessed through the electronic medical record system, ARIA, at the Tom Baker Cancer Centre, in Calgary, Alberta, from January 2010 to December 2015. Data was extracted and a REDCap database was used to compile pertinent information from charts meeting inclusion criteria. Descriptive and analytic statistics were performed.
Results
Of the 303 patients identified, 221 patients met inclusion criteria. 86% of these patients met discharge criteria from colposcopy after the second follow up visit. 31 (14%) were seen in a subsequent visit for abnormal findings. Of these, 7 (3.2%) underwent further treatment for high-grade disease (Cervical Intraepithelial Neoplasia, CIN 2/3). Of the 31, 23 (10.6%) had a third – negative – visit, resulting in discharge from colposcopy. One patient had a repeat LEEP for persistent Low-Grade Squamous Intraepithelial Lesion (LSIL).
Conclusion
In summary, our data demonstrates a prevalence of 3.2% of high-grade disease at the time of a second colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3.
Three-hour post-ERCP amylase level: a useful indicator for early prediction of post-ERCP pancreatitis
Authors: Lv Ze-Hui , Kou Da-Qing , Guo Shi-Bin 
Published: February 2020

Abstract
Background: To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP).
Method:
A study of 206 patients performed ERCP was analysed. The patients with PEP were recorded. ROC curves were used to statistically analyze the data.

Results: PEP occurred in 21 patients (10.19%). The 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot ROC curve. The area under the curve (AUC) was 0.816 , and was statistically significant (P<0.001). The standard error (SE) was 0.0507, the 95% confidence interval (CI) was 0.756-0.866, and the optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). The ROC curves were plotted for both serum amylase and lipase respectively. The areas under the ROC curves were statistically significant(P<0.001). The area under the ROC curve for the 3-hour post-ERCP lipase was 0.778, the 95% confidence interval was 0.673-0.862, and optimal cut-off value was 1834 U/L. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%.

Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to predict PEP. For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .
Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal
Authors: Bhatt Laxman Datt , Dhami Shankar Singh , Yadav Dipendra Kumar 
Published: February 2020

Abstract
Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method. Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group. Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.
Concurrence of ocular infection with Demodex folliculorum
Authors: Kosik-Bogacka Danuta Izabela , Pyzia Joanna , Galant Katarzyna , Czepita Maciej , Kot Karolina , Lanocha-Arendarczyk Natalia , Czepita Damian 
Published: February 2020

Abstract
Background: The ectoparasite Demodex spp. is the most common human parasite detected in skin lesions such as rosacea, lichen, and keratosis. It is also an etiological factor in blepharitis. As Demodex spp. is involved in the transmission of pathogens that can play a key role in the pathogenesis of demodecosis, the aim was to assess the concurrence of Demodex folliculorum and bacterial infections.Methods: The study involved 232 patients, including 128 patients infected with Demodex folliculorum and 104 non-infected patients. The ophthalmological examination consisted of examining the vision of the patient with and without ocular correction, tonus in both eyes) and a careful examination of the anterior segment of both eyes with special emphasis on the appearance of the eyelid edges and the structure and appearance of eyelashes from both eyelids of both eyes. The samples for microbiological examination were obtained from the conjunctival sac. The bacterial culture was obtained by inoculating the samples on chocolate agar and agar with 5% sheep blood. After 24-48 h of incubation at 37 °C, the growth of various colonies of bacteria was identified based on morphological evaluation of the colonies on the media and preparations stained by the Gram method. Species identification was performed biochemical examination ex. coagulase test or VITEK Compact (bioMerieux, Poland).Results: Physiological flora was found in all patients infected with D. folliculorum and 9 (8.7%) participants from the control group.Only in patients infected with D. folliculorum we isolated Staphylococcus aureus (9 patients, 7%), Acinetobacter baumannii (one patient, 0.8%), Streptococcus pneumoniae (one patient, 0.8%), Klebsiella oxytoca (one patient, 0.8%), and Bacillus spp. (one patient, 0.8%) in the conjunctival sac.Conclusions: The occurrence of symptoms: dryness and burning sensation in the eye, tearing, conjuctival redness, foreign body sensation, eyelash loss, blockage of the Meibomian glands, cylindrical dandruff, and chalazia may suggest infection with Demodex spp. Patients infected with Demodex spp. should also undergo microbiological examination of conjunctival swabs. The treatment of each patient should be individualized, adapted to the clinical condition, and in cases of bacterial co-infection. Furthermore, daily hygiene of the eyelid margins should be recommended.
Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study
Authors: Foo Kah Mun , Sundram Meena , Legido-Quigley Helena 
Published: February 2020

Abstract
Background: Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore.Methods: This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare.Results: Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time.Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients.Although providers could equip patients with self-management and lifestyle-related guidelines, patients’ actions are influenced by multiple factors, including work requirements, beliefs and environment.Conclusions: There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.