bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol.
Authors: Hollis Jenna , Doherty Emma , Dray Julia , Tremain Danika , Hunter Mandy , Takats Karen , Williams Christopher M , Murray Henry , Pennell Craig , Tully Belinda , Wiggers John , Daly Justine , Kingsland Melanie 
Published: August 2020

Abstract
Background: Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence, and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.Methods: Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ two behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped wedge RCTs, and non-randomised control trials will be eligible. Studies that include a no intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.Discussion: The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care, and will help researchers, policy makers, and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short and long term health outcomes for women and their children.Systematic review registration: PROSPERO 2018 CRD42018095315
Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices
Authors: Senanayake Sameera , Graves Nicholas , Healy Helen , Baboolal Keshwar , Barnett Adrian , Sypek Matthew P. , Kularatna Sanjeewa 
Published: August 2020

Abstract
Background

Matching survival of a donor kidney with that of the recipient (longevity matching), is use in some kidney allocation systems to maximize graft-life years. It is not part of the allocation algorithm for Australia. Given the growing evidence of survival benefit due to longevity matching based allocation algorithms, development of a similar kidney allocation system for Australia is currently underway. The aim of this research is to estimate the impact that changes to costs and health outcomes arising from ‘longevity matching’ on the Australian healthcare system.

Methods

A decision analytic model to estimate cost-effectiveness was developed using a Markov process. Four plausible competing allocation options were compared to the current kidney allocation practice. Models were simulated in one-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient. Willingness to pay was considered as AUD 28000.

Results

Base case analysis indicated that allocating the worst 20% of Kidney Donor Risk Index (KDRI) donor kidneys to the worst 20% of estimated post-transplant survival (EPTS) recipients (option 2) and allocating the oldest 25% of donor kidneys to the oldest 25% of recipients are both cost saving and more effective compared to the current Australian allocation practice.

Option 2, returned the lowest costs, greatest health benefits and largest gain to net monetary benefits (NMB). Allocating the best 20% of KDRI donor kidneys to the best 20% of EPTS recipients had the lowest expected incremental NMB.

Conclusion

Of the four longevity-based kidney allocation practices considered, transplanting the lowest quality kidneys to the worst kidney recipients (option 2), was estimated to return the best value for money for the Australian health system.
Transcriptomic and proteomic analysis of putative digestive proteases in the salivary gland and gut of&nbsp;Empoasca (Matsumurasca)&nbsp;onukii&nbsp;Matsuda
Authors: Shao Ensi , Song Yujuan , Wang Yaomin , Liao Yichen , Luo Yufei , Liu Sijun , Guan Xiong , Huang Zhipeng 
Published: August 2020

Abstract
Background: Infestation by tea green leafhoppers, Empoasca (Matsumurasca) onukii , could cause a series of biochemical changes in tea leaves. As a typical cell-rupture feeder, E. onukii secretes proteases while probing with its stylet into the tender shoots of tea plants ( Camellia sinensis ). This study identified and analyzed proteases specifically expressed in the salivary gland (SG) and gut of E. onukii through enzymatic activity assays, complemented with an integrated analysis of transcriptome and proteome data.Results: In total, 129 contigs representing seven types of putative proteases were identified. Transcript abundance of digestive proteases and enzymatic activity assays showed that cathepsin B-like protease, cathepsin L-like protease, and serine proteases (trypsin- and chymotrypsin-like protease) were highly abundant in the gut while moderately abundant in the SG. The abundance pattern of digestive proteases in the SG and gut of E. onukii differed from that of other hemipterans including Nilaparvata lugens , Laodelphax striatellus , Acyrthosiphum pisum , Halyomorpha halys and Nephotettix cincticeps . Phylogenetic analysis showed that aminopeptidase N-like proteins and serine proteases abundant in the SG or gut of hemipterans were distributed to two distinct clusters.Conclusions: Altogether, this study provide insightful information on the digestive system of E. onukii and observed different patterns of proteases abundant in the SG and gut of E. onukii , in comparison with other five hemipteran species. These results will be beneficial in understanding the interaction between tea plants and E. onukii .
hUMSCs regulate the differentiation of ovarian stromal cells via TGF-β1 /Smad3 signaling pathway to inhibit ovarian fibrosis to repair ovarian function in POI rats
Authors: Cui Linlu , Bao Hongchu , Liu Zhongfeng , Man Xuejing , Liu Hongyuan , Hou Yun , Luo Qianqian , Wang Siyuan , Fu Qiang , Zhang Hongqin 
Published: August 2020

Abstract
Objective: The basic pathological changes of primary ovarian insufficiency (POI) include ovarian tissue fibrosis and follicular development disorders. The human umbilical cord mesenchymal stem cells (hUMSCs) transplantation has been shown an effective method to improve the ovarian function in POI rat model; however, the exact mechanisms are still unclear. The purpose of this study is to investigate whether the recovery of ovarian function in POI rats is related to the inhibition of tissue fibrosis following hUMSCs transplantation. Furthermore, the transforming growth factor-β1 (TGF-β1 ) signaling pathway is explored to determine the mechanisms of ovarian function recovery through its inhibition of tissue fibrosis. Methods: The primary ovarian insufficiency (POI) rat model was established by intraperitoneal injection of chemotherapy drug cisplatin (CDDP) for 7 days, The levels of serum sex hormones were measured using enzyme-linked immunosorbent assay (ELISA). The tissue fibrosis in ovary was examined using masson staining and Sirus red staining. The collagen fibers in the ovarian tissues were detected by Western blot analysis. To investigate the mechanisms of ovarian function recovery following hUMSCs transplantation, ovarian stromal cells were isolated from the ovarian cortex of immature rats. The expression of Cytochrome P450 17A1 (Cyp17a1) and fibrosis marker of alpha smooth muscle Actin (α-SMA) in ovarian stromal cells were examined using immunofluorescence analysis. Also, the protein levels of Cyp17a1 and α-SMA in ovarian stromal cells were examined by western blot analysis. The expression of TGF-β1 and Smade3 signals were measured by Western blot and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analysis. Results: The results show that the function of ovary in POI rats were significantly improved after hUMSCs transplantation. The expression of fibrosis markers (α-SMA) and production of Collagen Type I (Collagen Ⅰ) and Collagen Type Ⅲ (Collagen Ⅲ) in POI rats were significantly inhibited in POI rats following hUMSCs transplantation. In the cultured ovarian stromal cells, the decrease of TGF-β1 and p-Smade3 protein expression was observed in hUMSCs treated POI rats. The treatment with TGF-β1 inhibitor of SB431542 further confirmed this signal pathway was involved in the process. Conclusion : Our study demonstrated that the TGF-β1 /Smad3 signaling pathway was involved in the inhibition of ovarian tissue fibrosis, which contributed to the restoration of ovarian function in POI rats following hUMSCs transplantation.
Treatment of Defects on the Volar Surface of the Finger using the Dorsal Digital–metacarpal Flap Versus the Free Medial Plantar Artery Flap: A Comparative Study
Authors: Liu Quanzhe , Guo Wenlai , Qu Wenrui , Ou Xiaolan , Li Rui , Tian Heng 
Published: August 2020

Abstract
Background
Few cases are reported on the treatment of defects on the volar surface of the finger, and its utility for digital resurfacing remains unclear. This study compared the outcomes of the free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.
Methods
This cohort study was conducted on 24 patients who had soft-tissue defects on the volar side of the finger from March 2014 to March 2017. The patients were divided into the following 2 groups: the MPAF group and the DDMF group. The operative time as well as complications, including flap necrosis, graft loss, infection, paresthesia, donor-site morbidity, and two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire (MHQ) was applied to conduct follow-up assessment.
Results
After more than 12 months of follow-up, the results were significant. In terms of overall function, MPAF was superior to DDMF (p < 0.005).
Conclusion
The MPAF and the DDMF are available and reliable for reconstruction of the volar surface of the finger; however, the MPAF offers better functional outcomes with a lower frequency of postoperative complications.
Knowledge about the COVID-19 pandemic among undergraduate medical and dental students in Lalitpur, Nepal
Authors: Jha Nisha , Singh Neeti , Bajracharya Omi , Manandhar Tejendra , Devkota Pragya , Kafle Sajala , Shankar Pathiyil Ravi 
Published: August 2020

Abstract
Background The number of cases of coronavirus disease-19 (COVID-19) is still increasing especially in South Asia. There is an urgent need to measure the knowledge of the disease among health science students who may be required to play an active role in pandemic control. The research was conducted to answer how does Nepalese medical students' knowledge about coronavirus compare to medical students in other countries and what are the educational needs of medical students who may be called in to support the treatment of COVID-19 in Nepal. Methods A cross sectional study was performed during the third week of June among first to final year medical and dental students. As the country was in lockdown, a structured online questionnaire was used to obtain data. The responses obtained were cleaned, coded, entered in IBM SPSS Statistics for Windows and the normality of the data checked using one-sample Kolmogorov Smirnov test (p<0.05). The demographic parameters were tabulated and total score compared among different subgroups of participants. The frequency of different measures mentioned by respondents to control the pandemic were also noted. Results Out of the 565 participants, 336 (59.6%) were females followed by 229 (40.4%) males. Nearly half of the participants, 282 (49.8%) were belonging to age group 21-23 years. Majority 415 (73.5%) were undergraduate medical and 150 (26.5%) were undergraduate dental students. The largest number of respondents, 140 (24.9%) were from second year of study and 344 (60.9%) were from urban areas. The median total score was 21 and the interquartile range 4. The maximum possible score was 30. The scores among students belonging to different years of study were significantly different (p=0.033). Total scores were not significantly different among other subgroups of respondents. Conclusions The knowledge of the participants was good. Deficiencies in knowledge were noted in certain areas and these should be addressed through an educational intervention. In countries where epidemic is on the rise, strategies to keep health science students updated with proper information related to COVID-19 is important. Similar studies can be undertaken in other medical colleges in the country and in nursing and pharmacy colleges also.
Addition of Routine Blood Biomarkers to TIMI Risk Score Improves Predictive Performance of 1-year Mortality in Patients with ST-segment Elevation Myocardial Infarction
Authors: Oh Pyung Chun , Eom Young Sil , Moon Jeonggeun , Jang Ho-Jun , Kim Tae-Hoon , Suh Jon , Kong Min Gyu , Park Sang-Don , Kwon Sung Woo , Suh Soon Yong , Lee Kyounghoon , Han Seung Hwan , Ahn Taehoon , Kang Woong Chol 
Published: August 2020

Abstract
Background: Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods: A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase >twice the normal upper limit and glucose <90 or >250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR, 2.019; 95% CI, 1.104-3.695), dysglycemia (HR, 2.535; 95% CI, 1.324-3.923), anemia (HR, 2.071; 95% CI, 1.093-3.923), and high NLR (HR, 3.651; 95% CI, 1.927-6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p<0.001), and the NRI and IDI were estimated at 0.203 (95% CI, 0.130-0.275; p<0.001) and 0.089 (95% CI, 0.060-0.119; p<0.001), respectively. Conclusions: The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.
The burden of the current curative expenditure of injury in Dalian, China-A study based on “System of Health Accounts 2011”
Authors: Sun Shu , Yang Liuna , Hu Xinzhu , Zhu Yalan , Liu Boxi , Yang Yunbin , Wang Xin 
Published: August 2020

Abstract
Background
Injury is one of the major public health problems, which causes more than 5 million deaths in the world every year. Cases of specific types of injury put a tremendous threat to human health and also add a heavy medical burden on individuals and societies. This study was to calculate and analyze the current curative expenditure (CCE) of injury in Dalian and consequently to provide control strategies for decision-makers.
Main text:
A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 4,375,351 valid samples. Subsequently, the distribution of injury CCE in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011(SHA 2011) using the established database. There were increases from 32.36/100,000 in 2006 to 37.34/100,000 in 2017 and from 46.12/100,000 in 2006 to 54.48/100,000 in 2017 in urban and rural residents respectively. The study found that the CCE of injury in Dalian had reached 1572.73 million RMB, accounting for 7.45% of the total curative care expenditure. In the 15–25 age group, the cost of injury accounts for a larger proportion of CCE than other age groups. Among the injuries in different regions of the body, injuries to the spine, lower limb, head and foreign body entering cost the most.
Conclusions
Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost and increase the benefit of attending to patients with injuries. Specific control strategies should be tilted toward the age group 15–25. Injuries to the spine, lower limb, head and foreign body entering also should be priorities of interventions.
The impact of malocclusions and orthodontic treatments on a patient's quality of life.
Authors: BOURZGUI Farid , Diouny Samir , KAMAL Dounia , Serhier Zineb , Othmani Mohamed Bennani 
Published: August 2020

Abstract
Aim: This study aimed to compare the variations in patients’ perception of oral health related quality of life (OHRQoL), using the Moroccan version of PIDAQ, before and after orthodontic treatment among patients with the same initial PAR Index score, age and gender. Methods: In this study, 67 participants were divided into 2 groups. Group A (normal, control group) consisted of 30 patients who received orthodontic treatment; group B comprised of 37 patients who were either at the initiation stage of treatment or potential candidates. The matching of group A and group B was achieved by reaching a compromise between PAR index score, age and gender. The assessment of the psychosocial impact of malocclusion was carried out using the Moroccan version of PIDAQ. The Chi-square test was used to establish associations between qualitative variables. Levene and Mann Whitney's tests were employed to determine the associations between quantitative variables. Results: The age of the patients ranges from 7 to 58 years, with an mean age of 23 years +/_10. 22. While 41 subjects (61.2%) consulted for aesthetic reasons, 26 subjects (38.8%) consulted for a functional reason. The distribution of scores of the two groups before and after orthodontic intervention showed no significant difference between the mean scores of the four PIDAQ domains. Conclusion: The results of our study showed a significant improvement in the psychosocial impact of malocclusion when comparing the two case-control groups, with a reduction in the perceived needs of patients who completed orthodontic treatment.
Implementing Social Distancing Policy Measures in the Battle Against the Coronavirus: Protocol of a Comparative Study of Denmark and Sweden
Authors: Nilsen Per , Seing Ida , Ericsson Carin , Andersen Ove , Stefánsdóttir Nina Thórný , Tjørnhøj-Thomsen Tine , Kallemose Thomas , Kirk Jeanette Wassar 
Published: August 2020

Abstract
Background: Social distancing policies to ensure physical distance between people have become a crucial strategy in the battle against the spread of the Coronavirus. The aim of this project is to analyze and compare social distancing policies implemented in Denmark and Sweden in 2020. Despite many similarities between the two countries, their response to the Coronavirus pandemic differed markedly. Whereas authorities in Denmark initiated mandatory regulations and many severe restrictions, Swedish authorities predominantly promoted voluntary recommendations.Methods: The project is an interdisciplinary collaboration between researchers in Denmark and Sweden with different disciplinary backgrounds. The project is based on a comparative analysis, an approach that attempts to reach conclusions beyond single cases and to explain differences and similarities between objects of analysis and relations between objects against the backdrop of their contextual conditions. Data will be gathered by means of document analysis, qualitative interviews, and a questionnaire survey to address three research questions: (1) What social distancing policies regarding the Coronavirus have been formulated and implemented, who are the policymakers behind the policy measures, which implementers are expected to implement the measures, and who are the targets that the measures ultimately seek to influence? (2) How have the social distancing policies and policy measures been justified, and what types of knowledge form the basis for the measures? and (3) What are the differences and similarities in citizens’ perceptions of acceptability and compliance with social distancing policy measures in relation to the Coronavirus?Discussion: To create a structure for addressing the three research questions, the project applies a theoretical framework informed by the policy and implementation science literatures. The framework consists of five interdependent domains that have an impact on policy implementation: (1) policymakers; (2) policy characteristics; (3) implementers; (4) targets; and (5) policy environment. Details of the framework are provided in the article.
Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic
Authors: Berkenstock Meghan K , Liberman Paulina , McDonnell Peter J , Chaon Benjamin C 
Published: August 2020

Abstract
BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face to face encounters to only patients with urgent and emergent ophthalmic conditions, in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the six weeks before and after the changes in clinical practice associated with COVID-19.RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest decrease of in-person visits. Conversely, telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.