bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macronutrient, immunoglobulin A and total antioxidant capacity profiles of human milk from 1 to 24 months postpartum
Authors: ongprasert krongporn , Ruangsuriya Jetsada , Malasao Rungnapa , Sapbamrer Ratana , Suppansan Pikul , Ayood Pisittawoot , Kittisakmontri Kulnipa , Siviroj Penprapa 
Published: June 2020

Abstract
Background: A longer duration of breastfeeding of up to two years is encouraged by many health authorities, but there is limited information regarding the composition of milk after one year postpartum. The goal of this study was to determine the changes in human milk macronutrient, immunoglobulin A (IgA), and total antioxidant capacity (TAC) profiles during extended lactation.Methods: One hundred eighty-four breastfeeding mothers with full-term healthy children who had been lactating from 1 to 24 months were recruited from January 2019 to April 2019. Human milk was biochemically analyzed for protein and carbohydrate content by colorimetric assays. The fat content was determined by capillary centrifugation, and the energy content was calculated from the results of centrifugation assays. IgA levels and TAC were determined by ELISA and a Trolox equivalent antioxidant capacity (TEAC) assay, respectively. Pearson’s correlation coefficient and Spearman’s rank correlation coefficient were used to determine the association of milk composition with month of lactation.Results: The fat, energy and IgA contents were positively correlated with the duration of lactation (r = 0.229, p = 0.002 ; r = 0.229, p =0.002 and r = 0.304, p < 0.001, respectively). No significant correlations between protein, carbohydrate concentrations and TAC with the duration of lactation were observed (r = 0.106, p = 0.15; r = -0.032, p = 0.67; r = -0.056, p = 0.45, respectively).Conclusions: We demonstrated that fat, energy and IgA contents increased during extended lactation lasting up to two years postpartum, while protein and carbohydrate concentrations and TAC were not related to lactation duration. Based on these results, lactating mothers should be encouraged to continue breastfeeding for at least two years postpartum.
Realist Evaluation of Public Engagement and Involvement in Data-intensive Health Research
Authors: Hobbs Georgina , Tully Mary Patricia 
Published: June 2020

Abstract
Background: High quality public engagement and involvement (PEI) in data-intensive health research is seen as one way of ensuring that social legitimacy, i.e. a social license, is conferred through public acceptance of the need for research use of their data. This is a complex research area, and portfolios of involvement have been suggested, but not yet evaluated, to support the role of public contributors. The study aim was to evaluate if and how membership of a data-intensive research public forum can act as a mechanism for enhancing members’ personal development. Our objective was to understand the circumstances and mechanisms that help to explain how, why and for whom involvement with a public forum enhanced those members’ personal development.Method: Qualitative data were collected from 15 current and previous members, via semi-structured interviews, notes from meetings, and consultations with and feedback from members. Data were critically compared, contrasted and reviewed until no new themes could be discerned and then condensed into context-mechanism-outcome (CMO) configurations. Realist evaluation was used to generate a theoretical and empirical appreciation of the contextual circumstances and mechanisms which help to explain the extent to which involvement with a public forum would enhance members’ personal development and, if so, how, why, and for whom.Results: Three CMO configurations were identified. All of them showed that using the portfolio facilitated growth in forum members’ personal development, but only where the members valued using the portfolio. This was particularly so for female members. Members valued the portfolio in one or more of three ways: as a tool to record and evidence activities, to facilitate reflective practice or as a guiding framework. Conclusions: Data analysis and consideration of the three CMO configurations suggests a refined middle range theory that ‘The use of a portfolio as a framework for learning in a public forum will facilitate members’ personal development if they value its use as a framework for learning’. Further work is needed to confirm these findings both elsewhere in data-intensive health research and in other complex research areas using public forums for PEI.
Diversity and distribution of marine heterotrophic bacteria from a large culture collection
Authors: Sanz-Sáez Isabel , Salazar Guillem , Sánchez Pablo , Lara Elena , Royo-Llonch Marta , Sà Elisabet L. , Lucena Teresa , Pujalte Maria J. , Vaqué Dolors , Duarte Carlos M. , Gasol Josep M. , Pedrós-Alió Carlos , Sánchez Olga , Acinas Silvia G. 
Published: June 2020

Abstract
Background: Isolation of marine microorganisms is fundamental to gather information about their physiology, ecology and genomic content. To date, most of the bacterial isolation efforts have focused on the photic ocean leaving the deep ocean less explored. We have created a marine culture collection of heterotrophic bacteria (MARINHET) using a standard marine medium comprising a total of 1561 bacterial strains, and covering a variety of oceanographic regions from different seasons and years, from 2009 to 2015. Specifically, our marine collection contains isolates from both photic (817) and aphotic layers (744), including the mesopelagic (362) and the bathypelagic (382), from the North Western Mediterranean Sea, the North and South Atlantic Ocean, the Indian, the Pacific, and the Arctic Oceans. We described the taxonomy, the phylogenetic diversity and the biogeography of a fraction of the marine culturable microorganisms to enhance our knowledge about which heterotrophic marine isolates are recurrently retrieved across oceans and along different depths. Results: The partial sequencing of the 16S rRNA gene of all isolates revealed that they mainly affiliate with the classes Alphaproteobacteria (35.9%), Gammaproteobacteria (38.6%), and phylum Bacteroidetes (16.5%). In addition, Alteromonas and Erythrobacter genera were found the most common heterotrophic bacteria in the ocean growing in solid agar medium. When comparing all photic, mesopelagic, and bathypelagic isolates sequences retrieved from different stations, 37% of them were 100% identical. This percentage increased up to 59% when mesopelagic and bathypelagic strains were grouped as the aphotic dataset and compared to the photic dataset of isolates, indicating the ubiquity of some bacterial isolates along different ocean depths. Finally, we isolated three strains that represent a new species, and the genome comparison and phenotypic characterization of two of these strains (ISS653 and ISS1889) concluded that they belong to a new species within the genus Mesonia. Conclusions: Overall, this study highlights the relevance of culture-dependent studies, with focus on marine isolated bacteria from different oceanographic regions and depths, to provide a more comprehensive view of the culturable marine bacteria as part of the total marine microbial diversity.
Influence of Transcatheter Aortic Valve Replacement on Patients With Severe Aortic Stenosis Undergoing Non-cardiac Surgery
Authors: Omoto Tadashi , Aoki Atsushi , Maruta Kazuto , Masuda Tomoaki , Horikawa Yui 
Published: June 2020

Abstract
Objectives: The purpose of this study was to clarify the influence of introduction of transcatheter aortic valve replacement (TAVR)on patients with aortic stenosis(AS) undergoing non-cardiac surgery.Methods: Thirty-four patients with severe AS diagnosed by preoperative evaluation for non-cardiac surgery were reviewed and compared in following two categories. First,patient’s profile and surgical risk were compared between pre-TAVR group (n=10) and post-TAVR group (n=24)according to before or after the introduction of TAVR. Second, completion rate of non-cardiac surgery and interval between two operation were compared between surgical aortic valve replacement(AVR)patients before introduction of TAVR (pre-AVR group (n=10)), AVR patientsafter introduction of TAVR (post-AVR (n=12)), and TAVR patients (TAVR group (n=12)).Results: Ageand Japan score were higherin post-TAVR group than in pre-TAVR group. Malignancy was the most common non-cardiac disease (80%) in pre-TAVR group, however, orthopedic disease became the most common (50%) in post-TAVR group. Completion rate of non-cardiac operation in pre-AVR, post-AVR and TAVR group were 70%, 33%, and 75% (post-AVR vs. TAVR: p=0.010), and interval between two operations were 129±98 days, 87±40 days and 27±15 days, respectively (pre AVR vs. TAVR: p=0.034 and post AVR vs. TAVR: p=0.025).In Post-TAVR group, AVR was selected because of unfit condition for TAVR in 5 out of 12 patients. Conclusions:After introduction of TAVR, more senile and high-risk patients became the candidate for two staged operation and orthopedics became the most common non-cardiac disease. Innovation of transcatheter valvular interventionsand expansion of indication for currently evaluated as “unfit for TAVR” might be crucial issue for non-cardiac surgery with severe AS.
Plasma Ephrin-A1 level in a cohort of diabetic retinopathy patients
Authors: Mao Danna , Hu Ying , Bao Qi , Wu Kewei , Zheng Yaoding , Yang Yukun , Jiang Ying , Lei Bo 
Published: June 2020

Abstract
Background: To determine plasma Ephrin-A1 and VEGF 165 levels in a cohort of diabetic retinopathy patients. Methods: Plasma ephrin-A1 and VEGF 165 levels in fifty-five subjects including 19 individuals without diabetes (non-DM), 16 patients with diabetes (DM) but without diabetic retinopathy, and 20 patients with diabetic retinopathy (DR), were determined by ELISA. Serum creatinine, total cholesterol, fasting blood glucose and HbA1c were also measured. Mann-Whitney U analysis, independent sample T analysis and Spearman correlation coefficient analysis were used for data analysis. Results: Ephrin-A1 expression could be detected in human plasma with an average of 1.52 ± 0.43 (mean ± SEM) ng/ml. In DR subjects, the plasma ephrin-A1concentration was 3.63 ± 4.63 ng/ml, which was significantly higher than that of the other two groups (non-DM: 0.27 ± 0.13 ng/ml, DM: 0.35 ± 0.34 ng/ml). The expression of VEGF 165 in human plasma was 34.00 ± 42.55 pg/ml, with no statistical difference among the three groups. There was no correlation between Ephrin-A1 and VEGF 165 in human plasma. Conclusions: Plasma ephrin-A1 was highly expressed in patients with diabetic retinopathy, and there was no difference of plasma VEGF 165 expression in patients with diabetic retinopathy compared to the other two groups, suggesting that changes of plasma ephrin-A1 may be a more sensitive biomarker than plasma VEGF 165 in detecting diabetic retinopathy.
Placental Growth Factor for the Prognosis of Women with Preeclampsia (fullPIERS model extension): Context matters
Authors: Ukah U. Vivian , Payne Beth A , Hutcheon Jennifer , Chappell Lucy , Seed Paul , Conti-Ramsden Frances Inez , Ansermino J Mark , Magee Laura A , von Dadelszen Peter 
Published: June 2020

Abstract
Background
The fullPIERS risk prediction model was developed to identify which women admitted with confirmed diagnosis of preeclampsia are at highest risk of developing serious maternal complications. The model discriminates well between women who develop (vs. those who do not) adverse maternal outcomes. It has been externally validated in several populations. We assessed whether placental growth factor (PlGF), a biomarker associated with preeclampsia risk, adds incremental value to the fullPIERS model.
Methods
Using a cohort of women admitted into tertiary hospitals in well-resourced settings (the USA and Canada), between May 2010 to February 2012, we evaluated the incremental value of PlGF added to fullPIERS for prediction of adverse maternal outcomes within 48 hours after admission with confirmed preeclampsia. The discriminatory performance of PlGF and the fullPIERS model were assessed in this cohort using the area under the receiver`s operating characteristic curve (AUROC) while the extended model (fullPIERS + PlGF) was assessed based on net reclassification index (NRI) and integrated discrimination improvement (IDI) performances.
Results
In a cohort of 541 women delivered shortly (< 1 week) after presentation, 8.1% experienced an adverse maternal outcome within 48hrs of admission. Prediction of adverse maternal outcomes was not improved by addition of PlGF to fullPIERS (NRI: -8.7, IDI − 0.06). Discriminatory performance (AUROC) was 0.67 [95%CI: 0.59–0.75] for fullPIERS only and 0.67 [95%CI: 0.58–0.76]) for fullPIERS extended with PlGF, a performance worse than previously documented in fullPIERS external validation studies (AUROC > 0.75).
Conclusions
While fullPIERS model performance may have been affected by differences in healthcare context between this study cohort and the model development and validation cohorts, future studies are required to confirm whether PlGF adds incremental benefit to the fullPIERS model for prediction of adverse maternal outcomes in preeclampsia in settings where expectant management is practiced.
The Quality of Primary Care in Community Health Centers: Comparison among Urban, Suburban and Rural Users in Shanghai, China
Authors: Shi Jianwei , Jin Hua , Shi Leiyu , Chen Chen , Ge Xuhua , Lu Yuan , Zhang Hanzhi , Wang Zhaoxin , Yu Dehua 
Published: June 2020

Abstract
Background
Following World Health Organization’s initiatives to advance primary care, China put forth forceful policies including the Personal Family Doctor Contract to ensure that every family sign up with a qualified doctor in a community health center (CHC) ever since its 2009 New Health Reform. This study used the Johns Hopkins-designed Primary Care Assessment Tool (PCAT) to assess primary care quality experienced by the contracted residents and compare this across different socioeconomic regions.
Methods
Using a multistage sampling method, four CHCs each were randomly selected from urban, suburban and rural districts of Shanghai, a metropolitan with 24 million residents. ANOVA and Multivariate analyses were used to assess the association between location of CHC and the quality of primary care experience.
Results
A total of 2,404 CHC users completed our survey. Except for the domain of coordination (information systems), users from suburban CHCs reported best primary care experiences in all other domains, followed by users of rural CHCs. After controlling for covariates, suburban CHC users were more likely to report higher total PCAT scores (ß=1.57, P < 0.001). The older users, more frequent users, and those in better health condition reported higher PCAT scores.
Conclusions
CHC users generally reported high quality primary care experience especially in the domain of first-contact (utilization), family centeredness, and comprehensiveness (services provided). That suburban and rural CHC residents reported better primary care experience than urban CHCs demonstrates the unique value of CHCs in relatively medical underserved areas.
Closing the Knowledge Gap in Pelvic Neuroanatomy: Assessment of a Cadaveric Training Program
Authors: Marcu Ioana , Balica Adrian , Gavard Jeffrey , Campian Eugen , Fernandes Gustavo , Solnik M Jonathon , Morozov Vadim , Lemos Nucelio 
Published: June 2020

Abstract
Background
The objective of this study is to characterize participants in a laparoscopic cadaveric neuroanatomy course and assess knowledge of pelvic neuroanatomy before and after this course.
Methods
This is a survey-based cohort study with a setting in a university educational facility. The participants are surgeons in a multiday laparoscopic cadaveric pelvic neuroanatomy course. Participants completed a precourse survey, including demographics and comfort with laparoscopic surgery. They then completed identical precourse and postcourse anatomic knowledge test.Main outcomes are scores on anatomic knowledge test precourse and postcourse.
Results
44 respondents were included: 25 completed fellowship, 15 completed residency, 2 were residents, and 2 were fellows. Participants were on average 11.09 years post training, with an average of 8.67 years from training if they completed fellowship and 18.62 years if they completed residency only. 22 of 42 respondents strongly agree or agree they are comfortable performing complex laparoscopic hysterectomies. The average precourse score was 32.18/50 points and the mean difference score (MDS, defined as mean of posttest scores minus pretest scores) was 9.80, showing significant improvement (p < 0.001). Precourse and MDS scores were not significantly different when comparing country of practice, level of training, or time since training.
Conclusion
Baseline knowledge of pelvic neuroanatomy was equal among groups when comparing fellowship status, place of training, or time since training. There was significant improvement in knowledge after training in this dissection method. This course garnered interest from surgeons with broad training backgrounds.
Inequalities in Infant Mortality in Brazil at Subnational Levels in Brazil, 1990 to 2015
Authors: Szwarcwald Celia Landmann , de Almeida Wanessa da Silva , Teixeira Renato Azeredo , França Elisabeth Barboza , de Miranda Marina Jorge , Malta Deborah Carvalho 
Published: June 2020

Abstract
Background: In this study, infant mortality rate (IMR) inequalities are analyzed from 1990 to 2015 in different geographic scales. Methods: The Ministry of Health (MoH) IMR estimates by Federative Units (FU) were compared to those obtained by the Global Burden of Disease (GBD) group. In order to measure the inequalities of the IMR by FU, the ratios from highest to lowest from 1990 to 2015 were calculated. Maps were elaborated in 2000, 2010 and 2015 at the municipality level. To analyze the effect of income, IMR inequalities by GDP per capita were analyzed, comparing Brazil and the FU to other same-income level countries in 2015, and the IMR municipal estimates were analyzed by income deciles, in 2000 and 2010. Results: IMR decreased from 47.1 to 13.4 per 1,000 Live Births (LB) from 1990 to 2015, with an annual decrease rate of 4.9%. The decline was less pronounced for the early neonatal annual rate (3.5%). The Northeast region showed the most significant annual decline (6.2%). The IMR estimates carried out by the GBD were about 20% higher than those obtained by the MoH, but in terms of their inequalities, the ratio from the highest to the lowest IMR among the 27 FU decreased from 4 to 2, for both methods. The percentage of municipalities with IMR higher than 40 per 1000 LB decreased from 23% to 2%, between 2000 and 2015. Comparing the IMR distribution by income deciles, all inequality measures of the IMR decreased markedly from 2000 to 2010. Conclusion: The results showed a marked decrease in the IMR inequalities in Brazil, regardless of the geographic breakdown and the calculation method. Despite clear signs of progress in curbing infant mortality, there are still challenges in reducing its level, such as the concentration of deaths in the early neonatal period, and the specific increases of post neonatal mortality in 2016, after the recent cuts in social investments.
Effects of circadian clock and light on melatonin concentration in Hypericum perforatum L. (St. John’s Wort)
Authors: Ming-Hsiu Chung , Deng Tzu-Shing 
Published: June 2020

Abstract
Background
Melatonin acts as a signaling hormone and entraining agent in many organisms. Here, we studied the spatiotemporal regulation and influence of light (photoperiods, intensities and spectral qualities) on melatonin concentration in the medicinal herb Hypericum perforatum L. Furthermore, melatonin concentration in leaves of 8 species of Hypericum genus collected has been compared and analyzed by HPLC.
Results
Melatonin concentration was found to be the highest in its flowers and leaves. The leaves exhibited a rhythmic variation in melatonin concentration of approximately 24 h under both light–dark entrained (Zeitgeber time) and constant light [circadian time (CT)] conditions, with melatonin concentration peaking at approximately CT6 in the middle of the subjective day. Melatonin concentration was influenced significantly by not only photoperiods but also applied light’s wavelength and intensity. It was approximately six times higher under long-day conditions (18-h light:6-h dark) than under short-day photoperiods (10-h light:14-h dark) and was the highest (131 µg/g fresh weight [FW]) under treatment with blue light at an intensity of 45 µmol·m2/s of photons. The melatonin concentration of the two examined Hypericum spp., namely H. kouytchense Lev. and H. coris L., were approximately twice that of H. perforatum L.
Conclusion
Our findings provide first insights on melatonin-related functions and mechanisms in the circadian system of H. perforatum and useful resources for further melatonin-oriented research and possible applications in agriculture and pharmaceutical industries.
Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey
Authors: Alser Osaid , Alghoul Heba , Alkhateeb Zahra , Hamdan Ayah , Albarqouni Loai , Saini Kiran 
Published: June 2020

Abstract
Background
The coronavirus disease 19 (COVID-19) pandemic threatens to overwhelm the capacity of the vulnerable healthcare system in the occupied Palestinian territory (oPt). Sufficient training of healthcare workers (HCWs) in how to manage COVID-19 and the provision of personal protective equipment (PPE) to enable them to do so will be key tools in allowing oPt to mount a credible response to the crisis.
Methods
A cross-sectional study was conducted using a validated online questionnaire. Data collection occurred between March 30, 2020 and April 12, 2020. The primary outcomes were availability of PPE and HCWs preparedness in oPt for COVID-19 pandemic. The secondary outcome was the regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness.
Results
Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks when needed and 15 (10.9%) for isolation gowns. The vast majority of HCWs did not find eye protection (n = 128, 92.8%), N95 respirators (n = 132, 95.7%), and face shields (n = 127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers (p = 0.026) and gloves (p < 0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE measures than non-governmental institutions (p = 0.001). As for preparedness, only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case. With 57 (41.3%) having received any COVID-19 related training and 57 (41.3%) not having a local hospital protocol.
Conclusion
HCWs in oPt are underprepared and severely lacking adequate PPE provision. The lack of local protocols, and training has left HCWs confidence exceedingly low. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk.