bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Euphorbia helioscopia in context to a possible connection between antioxidant and antidiabetic activities: a comparative study of different extracts
Authors: Mustafa Imtiaz , Faisal Muhammad Naeem , Hussain Ghulam , Muzaffar Humaira , Imran Muhammad , Ijaz Muhammad Umar , Sohail Muhammad Umar , Iftikhar Arslan , Shaukat Arslan , Anwar Haseeb 
Published: February 2021

AbstractBackgroundEuphorbia helioscopia, conventionally known as sun spurge, has been used as a traditional medicine to treat different diseases owing to its reported antitumor, antiviral and antioxidant activities.MethodsThe current research was formulated to assess the in-vitro antioxidant and antidiabetic ability ofEuphorbia helioscopiasubsequent to the phytochemical analysis of its various extracts. For this purpose, methanol, ethanol and aqueous extracts were prepared using the whole dried plant. Phytochemical analysis of the extracts was done to evaluate the total flavonoid components (TFC) and total phenolic components (TPC) in the extracts. A total of seven phenolic and three flavonoid contents were documented and quantified using HPLC. Antioxidant values were found by DPPH●assay, FRAP and ABTS assays. The antidiabetic potential of the extracts was evaluated by measuring the inhibition ability of the activity of enzymes α amylase and α glucosidase.ResultsAfter analyzing statistically, the results showed that methanolic extract possesses the highest TFC and TPC values while aqueous extract encompassed the lowest level of these contents.Invitroresults showed that methanolic extract of theEuphorbia helioscopiahas the maximum antioxidant capability since it showed the highest scavenging ability towards the DPPH●(IC50value = 0.06 ± 0.02 mg/ml), FRAP (758.9 ± 25.1 μMFe+ 2/g), and ABTS (689 ± 25.94 μMTEq/g) due to the presence of high TPC (24.77 ± 0.35 mgGAEq/g) and TFC (17.95 ± 0.32 mgQEq/g) values. Antidiabetic activity in terms of inhibition potential of α amylase and α glucosidase activity was also observed maximum in methanolic extract having lowest IC50value (0.4 ± 0.01 mg/ml and 0.45 ± 0.01 mg/ml respectively) and minimum in the aqueous extract (IC50value = 0.57 ± 0.02 mg/ml and 0.76 ± 0.1 mg/ml respectively).ConclusionThe experiment outcomes have shown thatEuphorbia helioscopiaextracts used in the current study contain antioxidant and antidiabetic activities; however, it is highest in its methanolic extract. The presence of the same trend towards the highest antidiabetic activity of the methanolic extract in terms of maximum inhibiting activity of α amylase and α glucosidase enzymes suggests a close association of TFC and TPC in minimizing diabetes.
A retrospective quantitative implementation evaluation of Safer Opioid Prescribing, a Canadian continuing education program
Authors: Sud Abhimanyu , Doukas Kathleen , Hodgson Katherine , Hsu Justin , Miatello Amber , Moineddin Rahim , Paton Morag 
Published: February 2021

Abstract
Background
Continuing health professions education (CHPE) is an important policy intervention for the opioid epidemic. Besides effectiveness or impact, health policy implementation should be studied to understand how an intervention was delivered within complex environments. Implementation outcomes can be used to help interpret CHPE effects and impacts, help answer questions of “how” and “why” programs work, and inform transferability. We evaluated Safer Opioid Prescribing (SOP), a national CHPE program, using implementation outcomes of reach, dose, fidelity, and participant responsiveness.

Methods
We conducted a retrospective quantitative implementation evaluation of the 2014–2017 cohorts of SOP. To measure reach and dose, we examined participation and completion data. We used Ontario physician demographic data, including regulatory status with respect to controlled substances, to examine relevant trends. To measure fidelity and participant responsiveness, we analyzed participant-provided evaluations of bias, active learning, and relevance to practice. We used descriptive statistics and measures of association for both continuous and categorical variables. We used logistic regression to determine predictors of workshop participation and analysis of covariance to examine variation in satisfaction across different-sized sessions.

Results
Reach: In total, there were 472 unique participants, 84.0% of whom were family physicians. Among Ontario physician participants, 90.0% were family physicians with characteristics representative of province-wide demographics. Dose: Webinar completion rate was 86.2% with no differences in completion based on rurality, gender, or controlled substance prescribing status with medical regulatory authorities. Fidelity and participant responsiveness: Nearly all participants rated the three webinars and workshop as balanced, and each element of SOP was also rated as highly relevant to clinical practice.

Conclusions
This evaluation demonstrates that Safer Opioid Prescribing was implemented as intended. Over a short period and without any external funding, the program reached more than 1% of the Ontario physician workforce. This suggests that the program may be a good model for using virtual CHPE to reach a critical mass of prescribers. This study represents a methodological advance of adapting evaluation methods from health policy and complex interventions for continuing health professions education. Future studies will assess effectiveness and impact on opioid prescribing and utilization within evaluation models of complex interventions.
Genetics education program to help public health nurses improve their knowledge and enhance communities’ genetic literacy: a pilot study
Authors: Kawasaki Hiromi , Kawasaki Masahiro , Iki Tomoko , Matsuyama Ryota 
Published: February 2021

Abstract
Background
As human genetics knowledge develops, public genetic literacy needs to be increased, though the educational capacity for this purpose has not yet been fully developed. Under this circumstance, the daily work of public health nurses can be viewed as an opportunity to enhance public genetic literacy. However, in Japan, there is not only a lack of public knowledge of human genomics but also a lack of public health nurses’ recognition about genomic literacy. A short-term education program was implemented as a pilot study. This study aimed to examine the effectiveness of the program to support public health nurses’ activity aimed at promoting health services-related genetic literacy.

Methods
The genetics education program was implemented in December 2019, in Kagoshima, Japan. Twenty-three public health nurses cooperated with the research. The program was composed of a case study on consultation, a lecture on hereditary diseases, and a discussion on the role of public health nurses. Familial hypercholesterolemia was used as the topic of the case study. We evaluated scores for cognition, affect, and psychomotor characteristics related to their learning goals before and after the program using Wilcoxon signed-rank tests. Answers in the consultation were qualitatively analyzed.

Results
The mean cognitive score, capturing provision of explanations of hereditary disease, was 6.3 before the program but increased significantly to 9.3 after the program (p < 0.001). For the affective score, the goal of which was deepening interest in human genetics, the mean score increased significantly from 8.5 before to 11.0 after (p < 0.001). For the psychomotor score, addressing the need for genetic consultation, the mean score increased significantly from 4.4 before to 8.1 after (p < 0.001). Prominent themes extracted from descriptions on the worksheet post training included, “providing advice and accurate information on genetic disorders” and “referral to a specialized organization.”

Conclusions
Our findings indicated that this education program helps public health nurses be positively involved in human genetic disorders. Thus, they may connect to their local community to provide accurate genetics knowledge and advice for health management and promoting genetic literacy.
Development and validation of a questionnaire to determine medical orders non-adherence: a sequential exploratory mixed-method study
Authors: Yazdi-Feyzabadi Vahid , Nakhaee Nouzar , Mehrolhassani Mohammad Hossein , Naghavi Soheila , Homaie Rad Enayatollah 
Published: February 2021

Abstract
Background
Patients’ non-adherence with medical orders of physicians in outpatient clinics can lead to reduced clinical effectiveness, inadequate treatment, and increased medical care expenses. This study was conducted to develop and validate a questionnaire to determine the reasons for patients’ non-adherence with physicians’ medical orders.

Methods
A sequential exploratory mixed-method study was conducted in two stages. The first stage comprised a qualitative stage to generate the primary items of the questionnaire. This stage provided findings of two sub-stages comprising a literature review and the findings of a qualitative conventional content analysis of 19 semi-structured interviews held with patients, physicians, and managers of the outpatient clinics in Kerman, an area located in southeastern Iran. The second stage comprised a quantitative study aiming evaluation of the instrument psychometric properties, including the face, content, construct, and reliability assessment of the questionnaire. Construct validity assessment was evaluated using exploratory factor analysis (EFA). The reliability assessment was done using assessing internal consistency (Cronbach’s alpha). To assess the construct validity of the questionnaire, four hundred and forty patients referred to outpatient clinics in Kerman were selected using stratified convenience sampling to fill out the questionnaire. The sample size was calculated using the Cochran formula. Qualitative and quantitative data were analyzed by MAXQDA 10 and Stata version 14, respectively.

Results
The primary items contained 57 items, of which 42 met the minimum acceptable value of 0.78 for item-level content validity index (I-CVI = 1 for 24 items and I-CVI = 0.8 for 18 items). Item-level content validity ratio (I-CVR) was confirmed for 18 items with a minimum acceptable value of 0.99 for five experts. Finally, 18 items obtained the acceptable value for both I-CVI and I-CVR indicators and were confirmed. Using EFA, four factors (intrapersonal-psychological, intrapersonal-cognitive, provider-related, and socio-economic reasons) with 18 items and Cronbach’s alpha coefficient of 0.70, 0.66, 0.73, and 0.71, respectively, were identified and explained 51% of the variance. The reliability of the questionnaire (r = 0.70) was confirmed.

Conclusion
The questionnaire with four dimensions is a valid and reliable instrument that can help determine the perceived reasons for non-adherence with medical orders in the outpatient services system.
Determinants of caregiver satisfaction with child neurodevelopmental assessment in neuropaediatric clinics
Authors: Kjærandsen Katarina Smejda , Brøndbo Per Håkan , Halvorsen Marianne Berg 
Published: February 2021

AbstractBackgroundIn addition to patient evaluations, caregiver evaluations and experiences are important indicators of the quality of health services. The aim of this study was to examine determinants of caregiver satisfaction with and perceived benefit of child neurodevelopmental assessment in neuropaediatric clinics.MethodsThe study was conducted among caregivers of children and adolescents aged 4–18 years (N = 330) referred for neurodevelopmental assessment in two neuropaediatric clinics in the specialised health service in Northern Norway. The Generic Short Patient Experiences Questionnaire (GS-PEQ) for child psychiatric outpatient patients was distributed to caregivers immediately following the assessment, and two of its items were used as measurements of caregiver satisfaction with and perceived benefit of the assessment.ResultsCaregiver satisfaction with the assessment was correlated with a better general level of function in the child, higher socioeconomic status, Norwegian mother tongue, referral from a specialist, and the respondent being a woman. Higher perceived benefit of the assessment was correlated with higher socioeconomic status, Norwegian mother tongue, and younger age of the child. Regression analysis revealed that caregivers’ perception that the assessment was suited to their child’s situation and that there was good cooperation with other public services (e.g., primary care and social/educational services) seemed more fundamental to caregiver satisfaction with neuropaediatric clinics’ services than any background variable. Younger age of the child, in addition to caregivers’ perception that the assessment was suited to their child and receiving sufficient information about the child’s diagnosis/afflictions, were essential to the perceived benefit of the assessment.ConclusionsCaregiver satisfaction with child neurodevelopmental assessment in neuropaediatric clinics partly depends on variables not related to the assessment experience per se. An assessment that was suited to the child, good cooperation with other public services such as primary health care and social/educational services, and giving sufficient information about the child’s diagnosis are essential to an overall positive caregiver evaluation of neurodevelopmental assessments.
Patient satisfaction and its socio-demographic correlates in a tertiary public hospital in Nepal: a cross-sectional study
Authors: Adhikari Mukesh , Paudel Narendra Raj , Mishra Shiva Raj , Shrestha Archana , Upadhyaya Dipak Prasad 
Published: February 2021

Abstract
Background
Patient satisfaction is one proxy indicator of the health care quality; however, enhancing patient satisfaction in low-income settings is very challenging due to the inadequacy of resources as well as low health literacy among patients. In this study, we assess patient satisfaction and its correlates in a tertiary public hospital in Nepal.

Methods
We conducted a cross sectional study at outpatient department of Bhaktapur Hospital of Nepal. To recruit participants for the study, we applied a systematic random sampling method. Our study used a validated Patient Satisfaction Questionnaire III (PSQ-III) developed by RAND Corporation including various contextual socio-demographic characteristics. We calculated mean score and percentages of satisfaction across seven dimensions of patient satisfaction. To determine the association between various dimensions of patient satisfaction and socio-demographic characteristics of the patient, we used a multi-ordinal logistic regression.

Results
Among 204 patients, we observed a wide variation in patient satisfaction across seven dimensions. About 39% of patients were satisfied in the dimension of general satisfaction, 92% in interpersonal manner, and 45% in accessibility and convenience. Sociodemographic factors such as age (AOR: 6.42; CI: 1.30–35.05), gender (AOR: 2.81; CI: 1.41–5.74), and ethnicity (AOR: 0.26; CI: 0.08–0.77) were associated with general satisfaction of the patients. Other sociodemographic variables such as education, occupation, and religion were associated with a majority of the dimensions of patient satisfaction (p < 0.05). Age was found to be the strongest predictor of patient satisfaction in five out of seven dimensions.

Conclusions
We concluded that patient satisfaction varies across different dimensions. Therefore, targeted interventions that direct to improve the dimensions of patient satisfaction where the proportion of satisfaction is low are needed. Similar studies should be conducted regularly at different levels of health facilities across the country to capture a wider picture of patient satisfaction at various levels.
Enriching the nutritive value of marigold (Tagetes erecta L) crop residues as a ruminant feed by lactic acid bacteria during ensilage
Authors: Hou Zhijiang , Liu Jianyong , Cai Ming , Liu Yanpei , Mu Lan , Gao Yuee , Wanapat Metha , Huang Bizhi 
Published: February 2021

Abstract
Background
Marigold (Tagetes erecta L) accounts for over half of the world’s loose flower production, and marigold crop residue (MCR) are abundantly available and should be used as a forage. In this study, MCR from the last commercial flower pickings was ensilaged with lactic acid bacteria (LAB) and the shift in their volatile organic compounds (VOCs) profiles was monitored. Samples were collected at 6 different times during ensilage (3, 6, 9, 12, 15, 30 days) to determine and quantify the VOCs changes using a solid-phase microextraction (SPME) technique and gas chromatography – mass spectrometry (GC-MS).

Results
After 30 days, the caryophyllene and piperitone, which account for 14.7 and 12.1% of total VOCs, decreased by 32.9 and 9.6% respectively, alcohols increased from 2.8 to 8.1%, and the acetic acid content increased by 560%.

Conclusion
We have confirmed LAB can degrade the content of terpenes and enhance the content of alcohols and acids in MCR, which was for the first time on terpene degradation in fodder by ensilage. These results have shed light on our understanding of how to improve fodder odor and to enhance terpene degradation by lactic acid bacteria fermentation.
Three-dimensional motion of the patella in French bulldogs with and without medial patellar luxation
Authors: Lehmann Silvia V. , Andrada Emanuel , Taszus Roxana , Koch Daniel , Fischer Martin S. 
Published: February 2021

Abstract
Background
French bulldogs exhibit significantly larger femoral external rotation and abduction than other breeds. We were curious as to whether this peculiar leg kinematic affects patellar motion and/or might induce medial patellar subluxation (MPSL) or medial patellar permanent luxation (MPPL). We hypothesized that the more abducted leg posture during stance causes an unusual medial pull direction of the rectus femoris muscle during stance, and that this may facilitate the occurrence of MPSL or even MPPL during locomotion. To test our hypothesis, we analyzed existing stifle-joint X-ray-sequences collected during the treadmill walk and trot of seven adult female French bulldogs. We estimated 3D-patellar kinematics using Scientific Rotoscoping.

Results
The three-dimensional motion of the patella comprises rotations and translations. From the seven dogs analyzed, three exhibited MPSL and one MPPL during the gait cycle. Medial patellar luxation (MPL) occurred mostly around toe-off in both gaits studied.
Patellar position was generally not gait-related at the analyzed timepoints. In dogs with MPL, the patella was placed significantly more distally (p = 0.037) at touch-down (TD) and at midswing (p = 0.024), and significantly more medial at midswing (p = 0.045) compared to dogs without MPL.

Conclusions
Medial patellar luxation seems to be the consequence of the far from parasagittal position of the stifle joint during stance due to a broad trunk, and a wide pelvis. This peculiar leg orientation leads to a medial sideway pull caused by the rectus femoris muscle and the quadriceps femoris and may initiate plastic deformation of the growing femur and tibia. Thus, a way to avoid MPL could be to control breeding by selecting dogs with lean bodies and narrow pelvis. Actual breeding control programs based on the orthopedic examination are susceptible to errors. Systematic errors arise from the fact that the grading system is highly dependent on the dog’s condition and the veterinarians’ ability to perform the palpation on the stifle. Based on our results, the position of the patella at TD, or even perhaps during stand might offer a possibility of an objective radioscopic diagnostic of the MPL.
Does pulmonary subspecialty referral from primary care affect the adherence to vaccination recommendations in COPD patients?
Authors: Ehteshami-Afshar Solmaz , Crothers Kristina , Rodwin Benjamin , Bade Brett , Brandt Cynthia , Akgün Kathleen M. 
Published: February 2021

AbstractThe importance of vaccinations for COPD patients has been previously described. However, there is still a gap between guideline recommendations and the implementation of preventive care delivery for these patients. Specially, the rise of SARS-CoV-2 pandemic has made the significance of vaccination adherence more critical to address. Our study showed that referral to pulmonary clinic is associated with increased odds of receiving influenza (OR = 1.97, [95% CI 1.07, 3.65]) and pneumococcal vaccinations (PCV13 OR = 3.55, [1.47, 8.54]; PPSV23 OR = 4.92, [1.51, 16.02]). These data suggest that partnerships between primary care physicians and pulmonologists can potentially improve the vaccination rates for patients with COPD.
Qi-Long-Tian formula extract alleviates symptoms of acute high-altitude diseases via suppressing the inflammation responses in rat
Authors: Fu Xing , Yang Chunyan , Chen Bing , Zeng Kexing , Chen Siyuan , Fu Yi 
Published: February 2021

Abstract
Background
Chinese Yunnan Province, located in the Yunnan–Guizhou Plateau, is a famous tourist paradise where acute high-altitude illness common occurs among lowland people visitors due to non-acclimatization to the acute hypobaric hypoxia (AHH) conditions. Traditional Chinese medicine, such as Qi-Long-Tian (QLT) formula, has shown effectiveness and safety in the treatment of acute high-altitude diseases. The aim of this study was to clarify the therapeutic mechanisms of this traditional formula using a rat model in a simulated plateau environment.

Methods
Following testing, lung tissue samples were evaluated by hematoxylin–eosin staining and for biochemical characteristics. mRNA-Seq was used to compare differentially expressed genes in control rats, and in rats exposed to AHH and AHH with QLT treatment.

Results
Inflammation-related effectors induced following QLT treatment for AHH included MMP9 and TIMP1, and involved several phosphorylation signaling pathways implicated in AHH pathogenesis such as PI3K/AKT and MAPK signaling.

Conclusion
This study provides insights into the major signaling pathways induced by AHH and in the protective mechanisms involved in QLT formula activity.
Prognostic and predictive value of FCER1G in glioma outcomes and response to immunotherapy
Authors: Xu Houshi , Zhu Qingwei , Tang Lan , Jiang Junkun , Yuan Huiwen , Zhang Anke , Lou Meiqing 
Published: February 2021

Abstract
Purpose
Glioma is the most prevalent malignant form of brain tumors, with a dismal prognosis. Currently, cancer immunotherapy has emerged as a revolutionary treatment for patients with advanced highly aggressive therapy-resistant tumors. However, there is no effective biomarker to reflect the response to immunotherapy in glioma patient so far. So we aim to assess the clinical predictive value of FCER1G in patients with glioma.

Methods
The expression level and correlation between clinical prognosis and FER1G levels were analyzed with the data from CGGA, TCGA, and GEO database. Univariate and multivariate cox regression model was built to predict the prognosis of glioma patients with multiple factors. Then the correlation between FCER1G with immune cell infiltration and activation was analyzed. At last, we predict the immunotherapeutic response in both high and low FCER1G expression subgroups.

Results
FCER1G was significantly higher in glioma with greater malignancy and predicted poor prognosis. In multivariate analysis, the hazard ratio of FCER1G expression (Low versus High) was 0.66 and 95 % CI is 0.54 to 0.79 (P < 0.001), whereas age (HR = 1.26, 95 % CI  1.04–1.52), grade (HR = 2.75, 95 % CI 2.06–3.68), tumor recurrence (HR = 2.17, 95 % CI  1.81–2.62), IDH mutant (HR = 2.46, 95 % CI 1.97–3.01) and chemotherapeutic status (HR = 1.4, 95 % CI  1.20–1.80) are also included. Furthermore, we illustrated that gene FCER1G stratified glioma cases into high and low FCER1G expression subgroups that demonstrated with distinct clinical outcomes and T cell activation. At last, we demonstrated that high FCER1G levels presented great immunotherapeutic response in glioma patients.

Conclusions
This study demonstrated FCER1G as a novel predictor for clinical diagnosis, prognosis, and response to immunotherapy in glioma patient. Assess expression of FCER1G is a promising method to discover patients that may benefit from immunotherapy.