bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sagittal Abdominal Diameter and its Socioeconomic Correlates: Perspective of Sex Differences
Authors: Li Chang , Harris Marcelline , Tsilimingras Dennis , Liu Sophia , Sheng Ying , Liu Xuefeng 
Published: November 2020

Abstract
Background Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates.Methods A complex stratified multistage clustered sampling design was used to select 6,975 men and 7,079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011-2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression. Results SAD was lower in women than in men in the entire sample, as well as in all the subgroups characterized by age, race, birth place, household income, and body mass index except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men. Black women were associated with higher SAD then white women (p<.0001), and Hispanic and Asian men were associated with lower SAD than white men (both p<.01). Women born in other countries were more likely to have lower SAD than women born in the US (p<.0001), and so were men (p=.0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000. The associations of age, race, and household income with SAD differed in women and men.Conclusion SAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. While socio-economic correlates of SAD are similar in women and men, the associations of age, race, and household income with SAD vary across sex.
RarERN Path: a methodology towards the optimisation of patients’ care pathways in rare and complex diseases developed within the European Reference Networks
Authors: Talarico Rosaria , Cannizzo Sara , Lorenzoni Valentina , Marinello Diana , Palla Ilaria , Pirri Salvatore , Ticciati Simone , Trieste Leopoldo , Triulzi Isotta , Terol Enrique , Bucher Anna , Turchetti Giuseppe 
Published: November 2020

Abstract
BackgroundIn 2017, the European Commission has launched the European Reference Networks (ERNs), virtual networks involving healthcare providers across Europe. The aim of the ERNs is to tackle complex and rare diseases and conditions that require highly specialized treatment and a concentration of knowledge and resources. The ERN on rare and complex connective tissue and musculoskeletal diseases (ERN ReCONNET) is one of the 24 ERNs approved that aims to improve the management of Rare and Complex Connective Tissue and Musculoskeletal Diseases.ObjectiveThe RarERN Path methodology aims to create a single reference organisational model for patients’ care pathways which, if applied in different contexts, helps to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases.MethodsStarting from existing standard methods for the creation and elaboration of patients’ care pathways, a specific methodology was created in order to take advantage of the distinctive and peculiar characteristics of the ERNs. Specifically, the development of the RarERN Path methodology involved different stakeholders: health economists, clinicians and researchers expert in rare and complex diseases, communication experts, experts in patients’ involvement and narrative medicine and policy-makers.ResultsThe RarERN Path methodology foresees six consecutive phases, each with different and specific aims. Specifically, the six phases are represented by: Phase 1 - Mapping of existing patients’ care pathways and patients’ stories; Phase 2 – Design of an optimised common patients’ care pathway; Phase 3 – Consensus on an optimised common patients’ care pathway; Phase 4 – Key Performance Indicators (KPI) definition; Phase 5 – Refinement; Phase 6 – Pilot phase (optional).ConclusionThe application of RarERN Path to the different disease-specific and geographical contexts would help to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases across Europe as well as a possible tangible action towards the integration of ERNs into the different European healthcare systems.
COVID-19 precautionary behavior: The Israeli case in the initial stage of the outbreak
Authors: Shinan-Altman Shiri , Levkovich Inbar 
Published: November 2020

Abstract
Background: The lay public's behavioral responses during a virus spread, such as the COVID-19, play an important role in bringing the outbreak under control, and provide insights into development of risk communication messages to the public. Therefore, this study aimed to explore the association between knowledge about COVID-19, perceived susceptibility, emotional reactions and precautionary behavior among the Israeli lay public at the beginning of the COVID-19 outbreak.Method: A cross-sectional study was conducted among 1,407 participants, aged 18+.Participants completed measures of knowledge about COVID-19, perceived susceptibility, emotional reactions, precautionary behavior, and socio-demographic questionnaires. A hierarchical regression model was calculated with precautionary behavior as the dependent variable.Results: Findings indicated that precautionary behavior was higher for females, older participants, participants with higher levels of knowledge about COVID-19, and participants with greater negative emotional reactions. A negative curvilinear relationship was found between perceived susceptibility and precautionary behavior, so that the latter was highest for participants with moderate perceived susceptibility. All interaction terms were non-significant.Conclusions: Findings suggest that in order to enhance precautionary behavior in the initial stage of a virus outbreak, it is recommended to pay attention to the public’s knowledge about the virus, perceived susceptibility and emotional reactions. Although negative feelings about the virus may motivate preventive behavior, it is important to address these feelings.
“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: November 2020

Abstract
Background: Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to 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, a place in northwest Iran. Conventional content analysis was used to analyze the data.Results: Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes.Conclusions: The study highlights the need for health professionals to help and support self-immolation survivors to continue their normal lives. A comprehensive supportive program based on survivors’ needs to support their pathways to recovery in all its complexities is recommended. Health professionals should also not forget that the family of the survivors also will need help to overcome this trauma. A family counseling program may also be provided.
SlGT11 Controls Floral Organ Patterning and Floral Determinacy in Tomato
Authors: Yang Liling , Qi Shilian , touqeer Arfa , Li Haiyang , Zhang Xiaolan , Liu XiaoFeng , wu shuang 
Published: November 2020

Abstract
Background: Flower development directly affects fruit production in tomato. Despite the framework mediated by ABC genes have been established in Arabidopsis, the spatiotemporal precision of floral development in tomato has not been well examined.Results: Here, we analyzed a novel tomato stamenless like flower (slf) mutant in which the development of stamens and carpels is disturbed, with carpelloid structure formed in the third whorl and ectopic formation of floral and shoot apical meristem in the fourth whorl. Using bulked segregant analysis (BSA), we assigned the causal mutation to the gene Solanum lycopersicum GT11 (SlGT11) that encodes a transcription factor belonging to Trihelix gene family. SlGT11 is expressed in the early stages of the flower and the expression becomes more specific to the primordium position corresponding to stamens and carpels in later stages of the floral development. Further RNAi silencing of SlGT11 verifies the defective phenotypes of the slf mutant. The carpelloid stamen in slf mutant indicates that SlGT11 is required for B-function activity in the third whorl. The failed termination of floral meristem and the occurrence of floral reversion in slf indicate that part of the C-function requires SlGT11 activity in the fourth whorl. Furthermore, we find that at higher temperature, the defects of slf mutant are substantially enhanced, with petals transformed into sepals, all stamens disappeared, and the frequency of ectopic shoot/floral meristem in fourth whorl increased, indicating that SlGT11 functions in the development of the three inner floral whorls. Consistent with the observed phenotypes, it was found that B, C and an E-type MADS-box genes were in part down regulated in slf mutants.Conclusions: Together with the spatiotemporal expression pattern, we suggest that SlGT11 functions in floral organ patterning and maintenance of floral determinacy in tomato.
Corticosteroids versus clobazam in epileptic encephalopathy with ESES: a European multicenter randomized controlled clinical trial (RESCUE ESES*)
Authors: Munckhof Bart van den , Arzimanoglou Alexis , Perucca Emilio , Teeseling Heleen C. van , Leijten Frans S.S. , Braun Kees P.J. , Jansen Floor E. 
Published: November 2020

Abstract
Background: Epileptic encephalopathy with electrical status epilepticus in sleep (ESES) is an epilepsy syndrome occurring almost exclusively in children, usually at an age between 4 and 12 years. It is characterized by abundant sleep-induced epileptic activity in the electroencephalogram (EEG) and by acquired cognitive and behavioural deficits. The goal of treatment is to prevent further decline or even improve cognitive functioning. Based on mostly small and retrospective studies, corticosteroids and clobazam are regarded by many clinicians as the most effective pharmacological treatments. This European multicentre randomized controlled trial is designed to compare the effects of corticosteroids and clobazam on cognitive functioning after 6 months. Secondary outcomes include cognitive functioning after 18 months, EEG abnormalities in sleep, safety and tolerability, and seizure frequency. We also aimed at investigating whether treatment response in epileptic encephalopathy with ESES can be predicted by measurement of inflammatory mediators and auto-antibodies in serum.Methods: The pragmatic study will be performed in centres with expertise in the treatment of rare paediatric epilepsy syndromes across Europe. 130 patients, 2 to 12 years of age, with epileptic encephalopathy with ESES will be enrolled and randomized in a 1:1 ratio to receive either corticosteroids (monthly intravenous methylprednisolone pulses or daily oral prednisolone) or oral clobazam for 6 months according to an open-label parallel-group design. Follow-up visits with clinical assessment, EEGs and neuropsychological testing are scheduled for up to 18 months. Blood samples for cytokine and auto-antibody testing are obtained before treatment and after 8 months of treatment.Discussion: The treatment of epileptic encephalopathy with ESES aims at improving cognitive outcome. This randomized controlled study will compare the most frequently used treatments, i.e. corticosteroids and clobazam. If the study proves superiority of one treatment over the other or identifies biomarkers of treatment response, results will guide clinicians in the early treatment of this severe epilepsy syndrome.Trial registration: ISRCTN, ISRCTN42686094, registered 24 May 2013, http://www.isrctn.com/ISRCTN42686094
Effects of Keluoxin Capsule Combined with Losartan Potassium on Diabetic Kidney Disease: Study Protocol for a Randomized Double-Blind Placebo-Controlled Multicenter Clinical Trial
Authors: Wu Rui , Wei Junping , Wei Fan , Qu Lianlian , Bai Litao , Li Jun , Li Fei , Yan Weitian , Wang Qiuhong 
Published: November 2020

Abstract
Background: Diabetic kidney disease (DKD) is one of the most important microvascular complications of diabetes, and its prevalence has increased dramatically in the past few decades. DKD is responsible for considerable morbidity and mortality of patients with diabetes. Keluoxin capsule (KLX) is a Chinese patent medicine that has been used in the clinic to control DKD for years. Previous studies have shown that KLX appears to reduce proteinuria, but the study protocols as well as the primary outcome need to be improved. Thus, we aim to evaluate whether losartan potassium combined with KLX is more effective than losartan potassium in DKD treatment and to provide validated evidence for the application of KLX in the treatment of DKD.Methods: We will conduct a randomized double-blind placebo-controlled multicenter clinical trial. A total of 252 participants diagnosed with DKD recruited from 18 institutions will be randomly allocated to either a losartan potassium plus KLX (n=126) a losartan potassium plus placebo group (n=126). The participants will be administered KLX or placebo in addition to losartan potassium for 24 weeks. The primary outcome measure will be the decline in estimated glomerular filtration rate (eGFR) (ml/min/1.73 m2/year) from baseline within 24 weeks, and the secondary outcomes will be the incidence of serum creatinine doubling, the incidence of end-stage renal disease (ESRD), the proportion of subjects with a progressive decline in eGFR >30%, the percent change in 24 h urinary total protein (UTP), the change in the urinary albumin/creatinine ratio (UACR), and the total effective rate of the traditional Chinese medicine (TCM) syndrome scale scores. Comparison of the differences in the variables between groups will be performed according to the data revealed by independent t tests, chi-squared tests, Fisher exact tests or Wilcoxon tests. All statistical tests will be two-sided, and significance will be considered for p-values <0.05.Discussion: This study will be the first randomized clinical trial to evaluate the efficacy and safety of KLX versus the placebo for the treatment of patients with DKD. The outcome of this trial will provide a basis for prescribing KLX to patients with DKD.Trial registration: The trial was registered at Chinese Clinical Trial Registry (www.chictr.org.cn) under approval number ChiCTR1900021113 (approval date: 2019/01/29).
eRegCom – Quality Improvement Dashboard for healthcare providers and Targeted Client Communication to pregnant women using data from an electronic health registry to improve attendance and quality of antenatal care: study protocol for a multi-arm cluster randomized trial
Authors: Mørkrid Kjersti , Bogale Binyam , Abbas Eatimad , Khader Khadija Abu , Ward Itimad Abu , Attalh Amjad , Awwad Tamara , Baniode Mohammad , Frost Kimberly , Frost Michael J. , Ghanem Buthaina , Hijaz Taghreed , Isbeih Mervett , Issawi Sally , Nazzal Zaher A. S. , O’Donnell Brian , Qaddomi Sharif , Rabah Yousef , Venkateswaran Mahima , Froen J. Frederik 
Published: November 2020

Abstract
Background: This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automated communication strategies from the eRegistry on improving attendance and quality of care for pregnant women.Methods: This four-arm cluster randomized controlled trial will be conducted in the West Bank and the Gaza Strip, Palestine, and includes 138 clusters (primary healthcare clinics) enrolling from 45 to 3000 pregnancies per year. The intervention tools are the QID and the TCC via SMS, automated from the eRegistry built on the District Health Information Software 2 (DHIS2) Tracker. The primary outcomes are appropriate screening and management of anemia, hypertension, and diabetes during pregnancy; and timely attendance to antenatal care. Primary analysis, at the individual-level taking the design effect of the clustering into account, will be done as intention-to-treat.Discussion: This trial, embedded in the implementation of the eRegistry in Palestine, will inform the use of digital health interventions as a health systems strengthening approach.Trial registration: ISRCTN, trial registration number: 10520687, registered 18 October 2018, http://www.isrctn.com/ISRCTN10520687
Mothers’ knowledge and attitudes regarding child feeding recommendations, complementary feeding practices and determinants of adequate diet
Authors: Appiah Kingsley B , Cheyuo Ernest K , Alhassan Abdul-Mumin , Ayanore Martin A , Kubuga Clement K , MOGRE VICTOR 
Published: November 2020

Abstract
Background: Complementary feeding is critical for optimal nutrition in infant and young children as it ensures their growth, health and development to attain their full potential. However, evidence shows children from developing countries do not meet the core indicators for appropriate complementary feeding. We evaluated mothers’ knowledge and attitudes regarding child feeding recommendations and the determinants of adequate diet among children aged 6-23 months. Methods: This cross-sectional study included 200 children aged 6-23 months and their mothers/care givers recruited during the child welfare clinics of two health facilities in Ghana. Data was collected using a structured questionnaire. Multivariate logistic regression was used to assess determinants of adequate diet. Results: Sixty-eight percent of the mothers knew the recommended duration of continued breastfeeding, 56.5% how to ensure dietary diversity and enrich their children’s diets and 94% (n=188) had positive attitude towards recommended infant and young child feeding practices. Majority of the mothers (92%, n=183) practiced continued breastfeeding, 10.5% of the children met minimum diet diversity score, 39.5% minimum meal frequency and 8.5% received minimum adequate diet. Determinants of receipt of minimum adequate diet were: having high knowledge in child feeding recommendations (100% vs. 0.0; p<0.001) and child’s father reportedly earning adequate income to cater for the family (AOR = 12.1 (1.32 – 109.72; p = 0.027). Conclusion: Motherss knowledge levels regarding infant and young child feeding recommendations had notable deficiencies although they generally had a positive attitude towards child feeding recommendations. Knowledge regarding infant and young child feeding recommendations as well as the child’s father having adequate income were important determinants of adequate diet. Nutrition education should emphasize on improving mothers’ nutrition knowledge regarding infant and young child feeding recommendations and supporting mothers to overcome barriers to feed their children with adequate diets.
The study of neuroprotective effects and underlying mechanism of Naoshuantong capsule on ischemia stroke mice
Authors: Luo Lvkeng , Wu Shuling , Chen Ruiqi , Rao Hongyu , Peng Wei , Su Weiwei 
Published: November 2020

Abstract
Background: Naoshuantong capsule (NSTC) is an oral Chinese medicine formula composed of Typhae Pollen, Radix Paeoniae Rubra, Curcumae Radix, Gastrodiae Rhizoma and Radix Rhapontici. It has been widely used at the acute and recovery stage of ischemic stroke since 2001. Comparing with its wide clinical application, there are only few studies emphasize on investigating its pharmacological effects.Methods:To more generally elucidate the underlying mechanisms in this study, we identified active ingredients in NSTC by a network pharmacology approach based on transcriptomics analysis and pharmacological experiments. Modified neurological severity scores and morphometric analysis using Nissl staining were employed to evaluate the neuroprotective effects of NSTC on ischemia stroke in mice.Results: The results showed that NSTC had preventive and protective effects on ischemia stroke, featuring repair of brain tissue during the sub-acute stage of stroke. This may attribute to the underlying mechanisms including anti-inflammatory, antioxidant, and anti-apoptotic activities, as well as an attenuation of excitatory amino acids (EAAs) toxicity of the active ingredients, especially the most active apigenin, from NSTC. Specifically, naringenin, calycosin, gastrodin, caffeic acid, paeoniflorin, and β -elemene seem to be also pharmacological active substances responsible for the anti-inflammatory effects. Meanwhile, 13-hydroxygemone, gastrodin, and p-hydroxybenzyl alcohol contributed to the attenuation of EAAs toxicity Furthermore, apigenin, naringenin, calycosin, gastrodin, and β-elemene accelerated the repair of brain ischemic tissue by up-regulating the expression of TGF-β1 levels.Conclusions: The present study identifies the active ingredients of NSTC and illustrates the underlying mechanism using a combination of network pharmacology, transcriptomics analysis, and pharmacological experiments.
Comparative effect of electroacupuncture with different frequency on headache attacks in migraine outpatients: study protocol for a randomized controlled trial
Authors: Nie Na , Chen Le , Li Tong , Zhou Chuanlong , Li Bangwei , Zhou Jie , Chen Qin , Ji Conghua , Li Qiushuang , Liang Yi , Fang Jianqiao 
Published: November 2020

Abstract
Background: Headache attacks severely impaired life quality and increase economic burden of migraineurs. Electroacupuncture (EA) has been used world-widely to treat several pain-related diseases including migraine. However, whether EA with low- or high-frequency exerts distinct analgesic effect remains unknown and need to further study.Methods/Design: This study is a randomized, prospective randomized trial with three parallel arms. A total of 129 migraine outpatients will be randomly allocated to 2Hz EA group, 100Hz EA group and control group. Twelve treatment sessions will be performed over a four-week period. The primary outcome will be measured by frequency of migraine attacks at baseline, four-week of treatment and consecutive four-week follow-up. Secondary outcome measures will be number of days with migraine, frequency of taking ibuprofen, Visual Analogue Scale (VAS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Migraine Specific Quality of Life questionnaire (MSQ), safety and compliance evaluation.Discussion: This trial is expected to comparative effect of electroacupuncture with different frequency on headache attacks in migraineur.Trial registration: Chinese Clinical Trial Registry, ChiCTR-1800017259.Registered on 20 July 2018.Registered on 20 July 2018.