bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequity under Equality: Research on the Benefits Equity of Chinese Basic Medical Insurance
Authors: Diao Li , Liu Yiwei 
Published: July 2020

Abstract
Background: The pursuit of equity is one of the basic principles behind the strengthening of health care reform. China's new rural cooperative medical insurance (NRCMI) and urban residents' basic medical insurance (URBMI) are both “equalized” in terms of fundraising and reimbursement. This paper studies the benefits equity under this "equalized" system.Methods: The data analysed in this paper are from the China Family Panel Studies (CFPS) from 2014 to 2016, implemented by the Institute of Social Science Survey at Peking University. A two-part model and a binary choice model are used in the empirical test.Results: The empirical test revealed that high-income people benefit more from basic medical insurance than low-income people. Mechanism analysis demonstrated that high-income people have higher medical insurance applicability and can utilize better health care. Since low-income people are unhealthier, inequity in benefits exacerbates health inequity. We also found that the benefits equity of URBMI is better than that of NRCMI.Conclusions: The government needs to pay more attention to the issue of medical insurance inequity. We should consider allowing different income groups to pay different premiums according to their medical expenses or applying different reimbursement policies for different income groups.
Barriers and motivators to participation and retention in HIV/HCV cohort studies among people who inject drugs: A community consultation in Iran
Authors: mirzazadeh ali , Hooshyar Samira Hosseini , Shahesmaeili Armita , Bahramnejad Ali , Barsham Adibeh , Moosavian Ghazal , Najafi Ismail , Sharifi Hamid , Haghdoost Ali-Akbar , Briceno Alya , McFarland Willi , Page Kimberly 
Published: July 2020

Abstract
Background: The lack of robust estimates of HIV/HCV incidence among people who inject drugs (PWID) in Iran calls for well-designed prospective cohort studies. Successful recruitment and follow-up of PWID in cohort studies may require formative assessment of barriers PWID are faced with in participation and retention in cohort studies and factors they think may facilitate their engagement in such studies. Using a focus group discussion (FGD) format, we conducted a consultation with PWID in southeast Iran to recognize those barriers and motivators.Methods: Using targeted sampling and through snowball referrals, we recruited PWID (aged≥18, injected in last 6 months) from community-based drop-in centers (DICs), homeless shelters, and through outreach efforts to participate in four FGDs (one women-only). Socio-demographic characteristics, injection behaviors and self-reported HCV/HIV testing and diagnosis history were obtained. Then, a semi-structured FGD guide was applied to explore barriers and motivators to participation and retention in cohort studies among study participants. All FGD sessions were recorded and transcribed verbatim, removing any identifying information. The content of FGDs were analyzed by thematic analysis using an inductive approach.Results: In total, 30 individuals (10 women) participated in the study. The median age of participants was 35 (IQR 31-40), with majority (73.3%) reporting injecting drug use within the last month. Only 40.0% reported ever being tested for HCV whereas a larger proportion (63.4%) reported ever being tested for HIV. While the majority were willing to participate in cohort studies, breach of confidentiality, fear of positive test results, perceived required commitment, and marginalization were reported as barriers to participation and retention in such studies. Monetary incentive, the thought of a better life, protection from police interventions and trust between health workers and PWID were addressed as motivators of engagement in cohort studies among PWID.Conclusions: Strategies to enhance data security and reduce stigma associated with injecting drug use along with involving peer workers in research, providing pre and post-test counselling and education and addressing the needs of more marginalized groups potentially through integrated healthcare programs and housing support are among few approaches that may help address barriers and strengthen the motivators for successful cohort studies among this population.
Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.
Authors: Apostol Courtney , Cranwell Kathryn , Hitch Danielle 
Published: July 2020

Abstract
Background: The term ‘’life limiting conditions’ refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for two years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: 103 occupational therapists responded (n=55 pre, n=48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.
Characterization of total adenosine deaminase activity (ADA) and its isoenzymes in saliva and serum in health and inflammatory conditions to four different species: an analytical and clinical validation pilot study
Authors: Contreras-Aguilar María Dolores , Tvarijonaviciute Asta , Monkeviciene Ingrida , Martín-Cuervo María , Gonzales Luis Guillermo , Franco Lorena , Cerón José Joaquín , Tecles Fernando , Escribano Damian 
Published: July 2020

Abstract
Background: Measurement of adenosine deaminase (ADA) can provide information about cell-mediated immunity. This report’s objetive was to study the enzymatic activity of total ADA (tADA) and its isoenzymes ADA1 and ADA2 in canine, equine, porcine, and bovine serum and saliva and their changes in different inflammatory situations in each species. Besides, an automated method for ADA2 measurement was developed and validated.Results: tADA was present in serum and saliva of healthy animals of the four species. Erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) concentration of 0.47mM was needed for ADA1 inhibition in canine and porcine samples (serum and saliva) and bovine saliva, whereas for equine saliva 0.94mM was needed. ADA2 activity was not detected in bovine serum and was very low or absent in equine serum and bovine saliva. An automated procedure to measure ADA2 consisting of adding EHNA to a commercial reagent for tADA measurement provided repetitive (coefficients of variation <8.8% in serum and <10% in saliva) and accurate (linearity under dilution approaches gave R 2 >0.90) results, being equivalent to a manual incubation of the sample with EHNA at a similar concentration. Salivary tADA, as well as ADA1 and ADA2, were higher in dogs with leishmaniosis, horses with acute abdominal disease and pigs with lameness than in healthy animals. ADA showed significant correlation with serum ferritin in dogs ( r = 0.602, P <0.01; r = 0.555, P <0.05; and r = 0.632, P <0.01; respectively for tADA, ADA1 and ADA2) and serum C-reactive protein in pigs ( r = 0.700, P <0.01, for both tADA and ADA1; r = 0.770, P <0.001, for ADA2), whereas salivary ADA2 significantly correlated with serum amyloid A in the horse ( r = 0.649, P <0.01). In the cow, salivary tADA and ADA1 significantly increased after calving, correlatingd with total white blood cell count ( r = 0.487, P <0.05, both).Conclusions: ADA activity, as well as its isoenzymes, can be measured in serum and saliva of different animal species. The salivary levels of these analytes could potentially be inflammatory biomarkers in these species.
Integrated sRNAome and RNA-Seq Analysis Reveals miRNA Effects on Betalain Biosynthesis in Pitaya
Authors: Chen Canbin , Xie Fangfang , Hua Qingzhu , Zur Noemi Tel , Zhang Lulu , Zhang Zhike , Zhang Rong , Zhao Jietang , Hu Guibing , Qin Yonghua 
Published: July 2020

Abstract
Background: MicroRNAs (miRNAs) and their regulatory functions in anthocyanin, carotenoid, and chlorophyll accumulation have been extensively characterized in many plant species. However, the miRNA regulatory mechanism in betalain biosynthesis remains mostly unknown. Results: In this study, 126 conserved miRNAs and 41 novel miRNAs were first isolated from Hylocereus monacanthus, among which 95 conserved miRNAs belonged to 53 miRNA families. 34 candidate miRNAs related to betalain biosynthesis were differentially expressed. The expression patterns of those differential expressed miRNAs were analyzed in various pitaya tissues by RT-qPCR. A significantly negative correlation was detected between the expression levels of half those miRNAs and corresponding target genes. Target genes of miRNAs i.e. Hmo-miR157b-HmSPL6-like, Hmo-miR160a-Hpcyt P450-like3, Hmo-miR6020-HmCYP71A8-like, Hmo-novel-2-HmCYP83B1-like, Hmo-novel-15-HmTPST-like, Hmo-miR828a-HmTT2-like, Hmo-miR858-HmMYB12-like, Hmo-miR858-HmMYBC1-like and Hmo-miR858-HmMYB2-like were verified by 5′RACE and transient expression system in tobacco.Conclusions: Hmo-miR157b, Hmo-miR160a, Hmo-miR6020 Hmo-novel-2, Hmo-novel-15, Hmo-miR828a and Hmo-miR858 play important roles in pitaya fruit coloration and betalain accumulation. Our findings provide new insights into the roles of miRNAs and their target genes of regulatory functions involved in betalain biosynthesis of pitaya.
Interrelation Between Defensive Mechanisms and Coping Strategies in Psychiatry Trainees in Romania: A Multicenter Study
Authors: Panfil Anca-Livia , Frandes Mirela , Nirestean Aurel , Hurmuz Marinela , Lungeanu Diana , Cristanovici Madalina , Lemeti Laura , Isac Andra , Papava Ion , Bredicean Cristina 
Published: July 2020

Abstract
Background: The challenges faced by professionals when working in the field of psychiatry require the development of adequate defensive and coping mechanisms. This study aimed to explore both coping strategies and defense mechanisms and their relationship in psychiatry trainees in Romania.Methods: A cross-sectional study was conducted to determine and evaluate both defensive and coping mechanisms of Romanian psychiatry trainees. Defensive Style Questionnaire-60 and COPE scale were applied to psychiatry trainees from five training centers in Romania. By applying structural equation modeling, models that presumed the existence of relationships between coping strategies and defensive mechanisms were analyzed. Results: Superior defense mechanisms and task-oriented coping strategies were the commonly used approaches by psychiatry trainees. Furthermore, significantly consistent correlations (ranging from 0.2 to 0.5) between adaptive defense mechanisms and coping strategies focused on the problem or emotion were shown. Similarly, avoidant coping strategies correlated with non-adaptive defense mechanisms (correlations between 0.3 and 0.5). Our model presented good fit indices (X2(34) = 64.324, p < 0.001; GFI = 0.93; root mean square error = 0.08). Moreover, the results indicated a weak association between the two types of adaptive processes (r = 0.07, p < 0.001).Conclusion: Psychiatry trainees present a profile based on two independent groups of adaptation processes, namely, adaptive defenses and problem-oriented coping scales and non-adaptive defenses and avoidant coping scales.
Prediction of different airway gradings in T1-2 laryngeal cancer with anterior vocal commissure involvement
Authors: Luo Chunlin , Zheng Ying , Lei Wenbin 
Published: July 2020

Abstract
Background: A retrospective analysis was conducted to investigate the clinical efficacy of the modified Mallampati test (MMT) combined with indirect laryngoscopy in measuring glottic exposure levels of early glottic laryngeal carcinoma (T1-2) with anterior vocal commissure involvement.Methods: One hundred eighty-two patients with early glottic laryngeal cancer were divided into two groups: one group comprised patients treated with transoral carbon dioxide laser microsurgery (TLM, 65 patients), and the other group comprised patients treated with open partial laryngectomy (OPL, 117 patients). The MMT and indirect laryngoscopy were used to re-evaluate the level of glottic exposure and to classify the patients based on these levels. The local control and disease-free survival rates of those patients were measured based on their MMT and indirect laryngoscopy classifications.Results: The 5-year local control rate was significantly different between the two groups according to the MMT (log-rank test: χ2=4.020, P=0.045, 90.9% in the OPL group vs. 71.4% in the TLM group). For patients diagnosed with grade IV tumors using indirect laryngoscopy, the 5-year local control rate was significantly different between the two groups (log-rank test: χ2=4.076, P=0.044, 91.7% in the OPL group vs. 54.7% in the TLM group). Among patients diagnosed with grade III or IV tumors using indirect laryngoscopy and with class III or IV tumors using MMT, the 5-year local control rate was significantly different between the two groups (log-rank test: χ 2 = 8.037, P = 0.005, 97.14% in the OPL group vs. 75.47% in the TLM groups).Conclusions: The combination of the MMT and indirect laryngoscopy to evaluate difficult airways is relatively simple and is very useful for surgeons to better prepare for surgery.Trial registration: ChiCTR-ORC-17010515
Protocol registration issues of systematic review and meta-analysis studies: a survey of global researchers
Authors: Tawfik Gehad Mohamed , Giang Hoang Thi Nam , Ghozy Sherief , Altibi Ahmed M. , Kandil Hend , Le Huu-Hoai , Eid Peter Samuel , Radwan Ibrahim , Makram Omar Mohamed , Hien Tong Thi Thu , Sherif Mahmoud , Hossain As-Saba , Thang Tai Luu Lam , Puljak Livia , Salem Hosni , Numair Tarek , Moji Kazuhiko , Huy Nguyen Tien 
Published: July 2020

Abstract
Background: Although protocol registration of systematic reviews/meta-analysis (SR/MA) is still not mandatory, it is highly recommended that authors publish their SR/MA protocols prior to submitting their manuscripts for publication as recommended by the Cochrane guidelines for conducting SR/MAs. our aim was to assess the awareness, obstacles, and opinions of SR/MA authors about the protocol registration process. Methods: A cross-sectional survey study included the authors who published SR/MAs during the period from 2010 to 2016, and they were contacted for participation in our survey study. They were identified through the literature search of SR/MAs in Scopus database. An online questionnaire was sent to each participant via e-mail after receiving their approval to join the study. We have sent 6650 emails and received 275 responses.Results: A total of 270 authors responses were complete and included in the final analysis. Our results has shown that PROSPERO was the most common database used for protocol registration (71.3%). The registration-to-acceptance time interval in PROSPERO was less than one month (99.1%). Almost half of the authors (44.2%) did not register their protocols prior to publishing their SR/MAs and according to their opinion that the other authors lack knowledge of protocol importance and mandance to be registered, was the most commonly reported reason (44.9%). A significant percenatge of respondents (37.4%) believed that people would steal their ideas from protocol databases, while only 5.3% reported that their SR/MA had been stolen. However, the majority (72.9%) of participants have agreed that protocol registries play a role in preventing unnecessary duplication of reviews. Finally, 37.4% of participants agree that SR/MA protocol registration should be mandatory. Conclusion: About half of the participants believes that the main reason for not registering protocols, is that the other authors lack knowledge concerning obligation and importance to register the SR/MA protocols in advance. Therefore, tools should be available to mandate protocol registration of any SRs beforehand and increasing awareness about the benefits of protocol registration among researchers.
“It was like nobody cared about what I said?” Iranian women committed self- immolation: A qualitative study
Authors: Aghakhani Nader , Lopez Violeta , Parizad Naser , Baghaei Rahim 
Published: July 2020

Abstract
Background: Suicide-attempts have increased across the world and have become more higher among females. In Iran, there has been a high prevalence of self-immolation mostly young married women admitted in the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social and economic impacts of suicide and suicide attempts. Methods: A qualitative descriptive approach using open-ended in-depth face to face interviews was conducted in a purposive sample of 16 married Iranian women aged 16 to 40 years in the burn centers in Urmia city located in northwest Iran. Conventional content analysis was used to analyze the data.Results: Four themes emerged from the data including: (1) antecedents of self-immolation, (2) suicidal ideation method, (3) defeat and humiliation, and (4) pathway to recovery. Each of these themes are supported by sub-themes.Conclusions: The study highlights the need for health professionals to focus in helping and supporting self-immolation survivors to continue a normal life. A comprehensive supportive program based on survivors’ needs to support their pathways to recovery in all its complexities is recommended. Health professional should also not forget that the family of the survivors also will need help to overcome this trauma. Family counselling program may also be provided.
Functional hyperemia drives fluid exchange in the paravascular space
Authors: Kedarasetti Ravi , Turner Kevin L. , Echagarruga Christina , Gluckman Bruce J. , Drew Patrick J. , Costanzo Francesco 
Published: July 2020

Abstract
The brain lacks a conventional lymphatic system to remove metabolic waste. It has been proposed that directional fluid movement through the arteriolar paravascular space (PVS) promotes metabolite clearance. We performed simulations to examine if arteriolar pulsations and dilations can drive directional CSF flow in the PVS and found that arteriolar wall movements do not drive directional CSF flow. We propose an alternative method of metabolite clearance from the PVS, namely fluid exchange between the PVS and the subarachnoid space (SAS). In simulations with compliant brain tissue, arteriolar pulsations did not drive appreciable fluid exchange between the PVS and the SAS. However, when the arteriole dilated, as seen during functional hyperemia, there was a marked exchange of fluid. Simulations suggest that functional hyperemia may serve to increase metabolite clearance from the PVS. We measured blood vessels and brain tissue displacement simultaneously in awake, head-fixed mice using two-photon microscopy. These measurements showed that brain deforms in response to pressure changes in PVS, consistent with our simulations. Our results show that the deformability of the brain tissue needs to be accounted for when studying fluid flow and metabolite transport.Acknowledgements: This work was supported by NSF Grant CBET 1705854.
Staging Procedures Fail to Benefit Women with Borderline Ovarian Tumours Who Want to Preserve Fertility: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Tingwenyi , Li Zhengyu 
Published: July 2020

Abstract
Background

This study aimed to evaluate the effect of clinicopathologic and surgical factors on the prognosis and fertility outcomes of patients with borderline ovarian tumour (BOT).

Methods

We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from January 2008 to January 2015. The disease-free survival (DFS) outcomes and potential prognostic factors were evaluated using the Kaplan-Meier method and Cox regression analysis, respectively. Furthermore, fertility outcomes were analysed using Pearson Χ 2 and Fisher’s correlation tests.

Results

A total of 448 patients were included, with a median age of 37.1 years and a median follow-up time of 113 months; 52 (11.6%) recurrences were observed, with a mean recurrence interval of 80.2 months and four (0.9%) deaths; 118 (26.3%) patients underwent staging surgery and the remaining 330 (73.7%) underwent unstaged surgery. In total, 233 patients undergoing fertility-sparing surgery (FSS) attempted to conceive, and 92 (39.48%) of them achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups ( P = 0.691). In univariate analysis, staging surgery was associated with DFS (hazard ratio [HR] = 2.191; P = 0.005), but it was not an independent prognostic factor ( P = 0.600) for DFS on multivariate analysis. Multivariate Cox analysis revealed that advanced FIGO stage (≥stage II), positive ascites\pelvic washings, and laparotomy approach were independent prognostic factors for DFS in patients with BOT, whereas advanced stage (≥stage II), laparotomy approach, cystectomy-related procedures, invasive implants, and bilateral tumours were independent prognostic factors for DFS in patients undergoing FSS. In addition, laparoscopy resulted in better prognosis than laparotomy in patients with early-stage (stage I) tumours and a desire for fertility preservation.

Conclusion

Patients with BOT fail to benefit from surgical staging in terms of prognosis and fertility outcomes. Laparoscopy is recommended for patients with stage I disease who desire to preserve their fertility. Physicians should pay more attention to the risk of recurrence in patients who want to preserve fertility with advanced stage (≥stage II) disease, invasive implants, and bilateral tumours, and choose FSS carefully.