bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out of pocket health expenditures in Turkey following introduction of co‐payments along with improved primary care services
Authors: Erus Burcay 
Published: November 2019

SummaryIn 2002, Turkey started to implement reforms in health care aiming to improve access and increase efficiency. Reforms increased health insurance coverage and resulted in higher number of outpatient and inpatient treatments at both public and private hospitals. Later, to change preference towards the use of secondary and tertiary care over primary care and rein in increasing health expenditures, a series of co‐payments were instituted along with an extension of primary care services through a family‐medicine system that provided free access to all. This work aims to measure the impact of these two simultaneous policy measures on out‐of‐pocket expenditures. We find that while contributory payments resulted in higher OOP health expenditures, especially for lower income households, the impact was small. We also observe that inability to consult a physician and to visit a hospital, especially for monetary reasons, was reduced after the policy change.
The use of evidence in decision making by hospital managers in Lebanon: A cross‐sectional study
Authors: Hilal Nadeen , Harb Sara , Jamal Diana , El‐Jardali Fadi 
Published: November 2019

SummaryBackgroundKnowledge synthesis products have emerged as support agents for decision making in clinical practice and policy. However, their use for evidence‐informed decision making remains limited in health care management especially in low‐ and middle‐income countries. This study assesses the use of evidence by middle and senior managers in Lebanese hospitals.MethodsThis multihospital cross‐sectional study used a self‐administered web survey of middle and senior managers. Hospitals were purposively selected, and data were analyzed using descriptive statistics and thematic analysis.ResultsHospital participation rate was 25%, while adjusted managers' response rate was 44.8%. Prevalence of using evidence was 70%, while prevalence of evidence‐seeking behavior was 90%. Evidence was mainly used in design of policies, protocols, and procedures; nursing issues; or procurement decisions. Facilitators for evidence‐informed decision making included upper management support and organizational culture, whereas limited resources such as funding, time, and training hindered use of evidence.ConclusionsFindings indicate that utilization of evidence was comparable with that of high‐income countries. Training and continuous education were crucial for advancing evidence‐informed decision making among hospital managers. However, neither the quality nor the sources of evidence used for decision making were assessed in this study. Future studies should assess the quality and sources of evidence utilized in decision making.
Mobile money use and social health insurance enrolment among rural dwellers outside the formal employment sector: Evidence from Kenya
Authors: Obadha Melvin , Colbourn Tim , Seal Andrew 
Published: November 2019

SUMMARYBackgroundThe study set out to explore whether mobile money use (mobile phone‐based financial services) increased the probability of rural dwellers outside the formal employment sector of being enrolled in Kenya's social health insurance, the National Hospital Insurance Fund (NHIF).MethodsWe used data from the 2015 FinAccess Household Survey and analysed responses of 4282 rural individuals outside the formal employment sector. Probit and bivariate probit models were used and adjusted for mobile phone ownership, sex, age, age‐squared, education, wealth quintile, bank account use, informal group membership, occupation, and health shocks.ResultsWe found that 16.26% (95% CI, 14.58% to 18.10%) of mobile money users had NHIF cover as compared with 2.44% (95% CI, 1.83% to 3.23%) of nonusers. Importantly, mobile money use increased the probability of being enrolled in NHIF by 4.6% (95% CI, 2.1% to 7.1%) after controlling for confounders. Access to mobile money was associated with reduced travel time and lower transport costs, which are likely to be key mechanisms for increasing NHIF enrolment.ConclusionBy lowering transport costs and saving travel time, mobile money provides an easy means to pay social health insurance premiums thus incentivising its uptake among rural people outside of formal employment.
Motivations for capital controls and their effectiveness
Authors: Pandey Radhika , Pasricha Gurnain K. , Patnaik Ila , Shah Ajay 
Published: November 2019

AbstractWe assess the motivations for changing capital controls and their effectiveness in India, a country with the legal and administrative machinery to implement controls. We focus on the controls on foreign borrowing that can, in principle, be motivated by macroprudential concerns. We construct a fine‐grained dataset of capital control actions on foreign borrowing in India. Using event study methodology, we assess the factors that motivate these capital control actions. We find that capital controls are tightened after appreciation and eased after depreciation of the exchange rate. We also assess the impact of controls. The results suggest no impact of capital controls on most variables, including the currency.
Phosphate functionalization and enzymatic calcium mineralization synergistically enhance oligo[poly(ethylene glycol) fumarate] hydrogel osteoconductivity for bone tissue engineering
Authors: George Matthew N. , Liu Xifeng , Miller Alan Lee , Xu Haocheng , Lu Lichun 
Published: November 2019

AbstractA current approach in bone tissue engineering is the implantation of polymeric scaffolds that promote osteoblast attachment and growth as well as biomineralization. One promising polymer is oligo[poly(ethylene glycol) fumarate] (OPF), a polyethylene glycol‐based material that is biocompatible, injectable, and biodegradable, but in its native form does not support robust bone cell attachment or growth. To address this issue, this study evaluated the osteoconductivity of bis[02‐(methacryloyloxy)ethyl] phosphate (BP) functionalized OPF hydrogels (OPF‐BP) using MC3T3‐E1 pre‐osteoblast cells, both before and after enzymatic mineralization with a calcium solution. The inclusion of negatively charged functional groups allowed for the tailored uptake and release of calcium, while also altering the mechanical properties and surface topography of the hydrogel surface. In cell culture, OPF‐BP hydrogels with 20 and 30% (w/w) BP optimized osteoblast attachment, proliferation, and differentiation after a 21‐day in vitro period. In addition, the OPF‐BP30 treatment, when mineralized with calcium, exhibited a 128% increase in osteocalcin expression when compared with the non‐mineralized treatment. These findings suggest that phosphate functionalization and enzymatic calcium mineralization can act synergistically to enhance the osteoconductivity of OPF hydrogels, making this processed material an attractive candidate for bone tissue engineering applications.
Enhancement of methane production from high solid anaerobic digestion of pretreated palm oil decanter cake using a modified solid inclined reactor
Authors: Eko Heryadi , Chaiprasert Pawinee 
Published: November 2019

AbstractBACKGROUNDThe potential of methane production from high solid anaerobic digestion (AD) of oil palm decanter cake (OPDC) in a laboratory‐scale modified solid inclined (MSI) reactor was investigated. The OPDC was pretreated with liquid hot water (LHW) before being fed to the MSI reactor which operated under high solid content (21% total solids, TS) with leachate recirculation once a day at ambient temperature. The result was compared to the non‐pretreated OPDC. The performance of the MSI reactor was evaluated in term of the percentages of solid reduction, methane production rate and yield including removal of organic solids (lignocelluloses and oil and grease). The process stability was also monitored.RESULTSPretreatment of OPDC with LHW (OPDC‐P) influenced lignocellulosic materials by increasing decrystalline cellulose from 50.6 to 28.9% and partial solubilization by reduction of hemicellulose and lignin from 7.6 to 4.9 and 10.6 to 9.5%, respectively. It was found that the chemical oxygen demand (COD) in OPDC‐P was increased from 28.5.9 to 62.95 g.L−1. The methane yield and rate of OPDC‐P from the anaerobic MSI reactor were as high as 411 L kg−1VSadded and 23.8 L d−1(respectively) within a short time of only 15 days compared to corresponding values for nonpretreated OPDC of 245 L kg−1VSadded and 4.9 L d−1 within 50 days. The MSI reactor had high stability within a pH range of 7–8 and a TVA:alkalinity ratio of 0.1–0.2.CONCLUSIONThe anaerobic MSI reactor was able to handle high solid content at 21% of OPDC with high performance and stability within a short incubation time. This reactor could be implemented and promoted to utilize solid waste in the palm oil industry. © 2019 Society of Chemical Industry
Stunting and growth velocity of adolescents with perinatally acquired HIV: differential evolution for males and females. A multiregional analysis from the IeDEA global paediatric collaboration
Authors: Jesson Julie , Schomaker Michael , Malasteste Karen , Wati Dewi K , Kariminia Azar , Sylla Mariam , Kouadio Kouakou , Sawry Shobna , Mubiana‐Mbewe Mwangelwa , Ayaya Samuel , Vreeman Rachel , McGowan Catherine C , Yotebieng Marcel , Leroy Valériane , Davies Mary‐Ann ,   the IeDEA global cohort consortium
Published: November 2019

AbstractIntroductionStunting is a key issue for adolescents with perinatally acquired HIV (APH) that needs to be better understood. As part of the IeDEA multiregional consortium, we described growth evolution during adolescence for APH on antiretroviral therapy (ART).MethodsWe included data from sub‐Saharan Africa, the Asia‐Pacific, and the Caribbean, Central and South America regions collected between 2003 and 2016. Adolescents on ART, reporting perinatally acquired infection or entering HIV care before 10 years of age, with at least one height measurement between 10 and 16 years of age, and followed in care until at least 14 years of age were included. Characteristics at ART initiation and at 10 years of age were compared by sex. Correlates of growth defined by height‐for‐age z‐scores (HAZ) between ages 10 and 19 years were studied separately for males and females, using linear mixed models.ResultsOverall, 8737 APH were included, with 46% from Southern Africa. Median age at ART initiation was 8.1 years (interquartile range (IQR) 6.1 to 9.6), 50% were females, and 41% were stunted (HAZ<−2 SD) at ART initiation. Males and females did not differ by age and stunting at ART initiation, CD4 count over time or retention in care. At 10 years of age, 34% of males were stunted versus 39% of females (p < 0.001). Females had better subsequent growth, resulting in a higher prevalence of stunting for males compared to females by age 15 (48% vs. 25%) and 18 years (31% vs. 15%). In linear mixed models, older age at ART initiation and low CD4 count were associated with poor growth over time (p < 0.001). Those stunted at 10 years of age or at ART initiation had the greatest growth improvement during adolescence.ConclusionsPrevalence of stunting is high among APH worldwide. Substantial sex‐based differences in growth evolution during adolescence were observed in this global cohort, which were not explained by differences in age of access to HIV care, degree of immunosuppression or region. Other factors influencing growth differences in APH, such as differences in pubertal development, should be better documented, to guide further research and inform interventions to optimize growth and health outcomes among APH.
Inborn errors of metabolite repair
Authors: Veiga‐da‐Cunha Maria , Van Schaftingen Emile , Bommer Guido T. 
Published: November 2019

AbstractIt is traditionally assumed that enzymes of intermediary metabolism are extremely specific and that this is sufficient to prevent the production of useless and/or toxic side‐products. Recent work indicates that this statement is not entirely correct. In reality, enzymes are not strictly specific, they often display weak side activities on intracellular metabolites (substrate promiscuity) that resemble their physiological substrate or slowly catalyse abnormal reactions on their physiological substrate (catalytic promiscuity). They thereby produce non‐classical metabolites that are not efficiently metabolised by conventional enzymes. In an increasing number of cases, metabolite repair enzymes are being discovered that serve to eliminate these non‐classical metabolites and prevent their accumulation. Metabolite repair enzymes also eliminate non‐classical metabolites that are formed through spontaneous (ie, not enzyme‐catalysed) reactions. Importantly, genetic deficiencies in several metabolite repair enzymes lead to ‘inborn errors of metabolite repair’, such as L‐2‐hydroxyglutaric aciduria, D‐2‐hydroxyglutaric aciduria, ‘ubiquitous glucose‐6‐phosphatase’ (G6PC3) deficiency, the neutropenia present in Glycogen Storage Disease type Ib or defects in the enzymes that repair the hydrated forms of NADH or NADPH. Metabolite repair defects may be difficult to identify as such, because the mutated enzymes are non‐classical enzymes that act on non‐classical metabolites, which in some cases accumulate only inside the cells, and at rather low, yet toxic, concentrations. It is therefore likely that many additional metabolite repair enzymes remain to be discovered and that many diseases of metabolite repair still await elucidation.
Binding mechanism of maltol with catalase investigated by spectroscopy, molecular docking, and enzyme activity assay
Authors: Huo Mengling , Zhao Lining , Wang Ting , Zong Wansong , Liu Rutao 
Published: November 2019

AbstractMaltol is a flavor additive that is widely used in the daily diet of humans, and its biosafety attention is concomitantly increasing. Catalase (CAT) is an antioxidant enzyme to maintain homeostasis in the tissue's environment of human body and protect cells from oxidative damages. The adverse effects of maltol to CAT activity within mouse hepatocytes as well as the structural and functional changes of CAT on molecular level were investigated by multiple spectroscopy techniques, enzyme activity experiments, and molecular docking. Results suggested that when the maltol concentrations reached to 8 × 10−5 mol L−1, the viability of hepatocytes decreased to 93%, and CAT activity was stimulated by maltol to 111% than the control group after exposure for 24 hours. Changes in CAT activity on molecular level were consistent with those on cellular level. The fluorescence quenching of CAT by maltol was static with the forming of maltol‐CAT complex. Moreover, ultraviolet‐visible (UV‐visible) absorption, synchronous fluorescence, and circular dichroism (CD) spectra reflected that the presence of maltol caused conformational change of CAT and made the CAT molecule skeleton loose and increased α‐helix of CAT. Maltol mainly bound with CAT through hydrogen bond, and binding site that is near the heme ring in the enzyme activity center did not interact with its main amino acid residues. This study explores the combination between maltol and CAT, providing references for evaluating health damages caused by maltol.
Task‐Specific Perturbation Training Improves the Recovery Stepping Responses by Women With Knee Osteoarthritis Following Laboratory‐Induced Trips
Authors: Foucher Kharma C. , Pater Mackenzie L. , Grabiner Mark D. 
Published: November 2019

ABSTRACTTrip‐specific training improves the kinematics of trip‐specific compensatory stepping response (CSR) in the laboratory and reduces prospectively measured trip‐related fall‐rate of middle age and older women. We examined whether one session of trip‐specific perturbation training could improve recovery step kinematics in women with knee osteoarthritis (OA), a condition known to increase fall risk. Seventeen women with self‐reported symptomatic knee OA (age 61.1 ± 7.7 years, body mass index [BMI] 29.7 ± 5.9 kg/m2) and 22 control women (age 59.5 ± 6.8 years, BMI 28.4 ± 6.2 kg/m2) completed a brief training protocol consisting of 20 trials of treadmill‐delivered trip‐specific perturbations. We assessed pre‐ and post‐training recovery step length and trunk kinematics at the instant of recovery step completion. Repeated‐measures analysis of variance was used to determine the significance of between‐group differences following the training protocol, and to evaluate the significance of within‐group pre‐to‐post changes in the variables of interest. The group by training interaction effects for step length (p = 0.466), trunk flexion angle (p = 0.751), and trunk angular velocity (p = 0.413) were not significant and the pre‐to‐post changes in step length were not significant (p = 0.286). However, pre‐to‐post trunk flexion angle improved by 26% and 34% in the OA and control groups, respectively (p < 0.001) and trunk flexion angular velocity decreased by 193% in the OA group and by 32% in the control group, respectively (p < 0.001), often reflecting a transition to the direction of extension. The results suggest that trip‐specific training can improve CSR kinematics in women with knee OA. It is important to determine, the effectiveness of trip‐specific training in decreasing trip‐specific fall‐rate by women with knee OA. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:663–669, 2020
Gram‐Negative Bacteria Are Internalized Into Osteocyte‐Like Cells
Authors: Saunders Ray K. , Infanti Joseph , Ali Hibah , Shuey Timothy , Potteiger Courtney , McNeilly Shelby , Adams Christopher S. 
Published: November 2019

ABSTRACTWhile Gram‐positive organisms are the most common causative agent of initial bone infections, the percentage of Gram‐negative species increases in reoccurring bone infections. As bacterial internalization has been suggested as one cause of reoccurring bone infection, we tested the hypothesis that Gram‐negative species of bacteria can be internalized into bone cells. Using the MLO‐A5 and the MLO‐Y4 cell lines as our cell models, we demonstrated that the Gram‐negative species, Proteus mirabilis and Serratia marcescens, can be internalized in these cells using an internalization assay. This rate at which these two species were internalized was both time‐ and initial concentration‐dependent. Confocal analysis demonstrated the presence of internalized bacteria within both cell types. Inhibition of the cellular uptake with methyl‐β‐cyclodextrin and chloroquine both reduced internalized bacteria, indicating that this process is, at least in part, cell mediated. Finally, we demonstrated that the presence of internalized P. mirabilis did not impact cell viability, measured either by lactate dehydrogenase (LDH) release or 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) activity, while the presence of S. marcescens, on the other hand, both increased LDH release and reduced MTT activity, indicating a loss of cell viability in response to the organism. These results indicated that both species of Gram‐negative bacteria can be internalized by bone cells and that these internalized bacteria could potentially result in reoccurring bone infections. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:861‐870, 2020
Does Raman spectroscopy recognize different G‐quadruplex arrangements?
Authors: Palacký Jan , Mojzeš Peter , Kejnovská Iva , Vorlíčková Michaela 
Published: November 2019

AbstractIn this work, we demonstrate the underused potential of Raman spectroscopy in detecting formation of DNA G‐quadruplex (G4) and differentiating between various G4‐folding topologies. As model structures, we used a 22‐mer human telomere fragment AG3(TTAG3)3 (denoted here as wt) and its two variants with adenine abasic lesions at the position 19 (ap19) or at the positions 7, 13, and 19 (ap7‐13‐19), the structures of which were previously characterized. These oligonucleotides adopt three basic G4‐folds: a basket‐type form for wt in Na+, a (3+1) hybrid form for ap19 in K+, and a parallel G4 for ap7‐13‐19 in K+, the last one furthermore stabilized at increased temperatures. We show that although wt and ap7‐13‐19 in Na+ adopt predominately antiparallel G4‐folds, these oligonucleotides in K+ display several Raman features of parallel G4 folds. Interestingly, ap19 has a Raman spectrum with some features of parallel G4 folds in both Na+ and K+ solutions. Raman signals indicative of parallel G4 are most obvious with ap7‐13‐19 in K+. The population of ap7‐13‐19 guanosines (unlike of wt and ap19 in K+) in the C2'‐endo/anti geometry gradually increases with increasing temperature, reaching its maximum at ~50°C, where an all‐parallel topology is observed. In summary, Raman spectroscopy has been proven to distinguish between different conformational properties of G4‐DNA structures, with reliability comparable with circular dichroism spectra, and with the potential to provide additional structural information.
Highly Stretchable and Tough Physical Silk Fibroin–Based Double Network Hydrogels
Authors: Zhao Yu , Guan Juan , Wu Su Jun 
Published: November 2019

AbstractRegenerated silk fibroin (RSF) is a promising biomedical material, but the poor mechanical properties of RSF hydrogels may hinder the use as structural components. Herein, an equilibrium RSF hydrogel is prepared and optimized based on the double network (DN) concept. After sufficient soaking in water and removal of small molecules, the equilibrium RSF DN hydrogels prove stable in water, strong, highly extensible, and tough with 0.26–0.44 MPa tensile strength, 500–900% elongation, and 2 MJ m−3 work of extension. The combination of high strength and extensibility is attributed to the homogeneous morphology and the hydrophobic interactions and hydrogen bonding between the two networks. The strategy in this work overcomes the previous issue of swelling and eventual fracture of as‐prepared RSF/SDS DN hydrogels in water. In addition, such mechanically superior RSF DN hydrogels also display low cytotoxicity. It concludes that the elastic and tough RSF DN hydrogels could be engineered by introducing widely used polymer networks, and the hydrogels from inexpensive, environmentally friendly, and biocompatible silk fibroin may hold great potential in biomedical applications.
Multiple System Atrophy: Recent Developments and Future Perspectives
Authors: Meissner Wassilios G. , Fernagut Pierre‐Olivier , Dehay Benjamin , Péran Patrice , Traon Anne Pavy‐Le , Foubert‐Samier Alexandra , Lopez Cuina Miguel , Bezard Erwan , Tison François , Rascol Olivier 
Published: November 2019

AbstractMultiple system atrophy (MSA) is a rare and fatal neurodegenerative disorder characterized by a variable combination of parkinsonism, cerebellar impairment, and autonomic dysfunction. The pathologic hallmark is the accumulation of aggregated α‐synuclein in oligodendrocytes, forming glial cytoplasmic inclusions, which qualifies MSA as a synucleinopathy together with Parkinson's disease and dementia with Lewy bodies. The underlying pathogenesis is still not well understood. Some symptomatic treatments are available, whereas neuroprotection remains an urgent unmet treatment need. In this review, we critically appraise significant developments of the past decade with emphasis on pathogenesis, diagnosis, prognosis, and treatment development. We further discuss unsolved questions and highlight some perspectives. © 2019 International Parkinson and Movement Disorder Society