bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic targeting of STAT3 pathways in pancreatic adenocarcinoma: A systematic review of clinical and preclinical literature
Authors: Peisl Sarah , Mellenthin Claudia , Vignot Lucie , Gonelle-Gispert Carmen , Bühler Leo , Egger Bernhard 
Published: June 2021

Background/Objectives
Pancreatic ductal adenocarcinoma is a highly lethal disease with increasing incidence. Due to high resistance, chemo/radiotherapy has limited success in pancreatic cancer and only marginally prolongs patient survival. Therefore, novel biomarkers and therapeutic targets are needed. In the present review, we performed a comprehensive summary of therapeutic approaches targeting the GP130/JAK/STAT3 pathway.

Methods
We systematically reviewed the PubMed and Embase databases for preclinical and clinical studies, from inception to October 4, 2020, on drugs targeting the GP130/JAK/STAT3 pathway. Bias assessments and qualitative analyses were performed.

Results
Twenty-five preclinical and nine clinical trials were included in the review. All preclinical studies reported a favorable outcome in terms of pancreatic ductal adenocarcinoma progression. Futhermore, drugs targeting the GP130/JAK/STAT3 pathway were shown to be efficient chemosensitizers. However, high publication bias was assumed. In the clinical setting, bazedoxifene and itacitinib improved patient outcomes.

Conclusion
Preclinical studies strongly suggest significant efficacy of drugs targeting GP130/JAK/STAT3 in the treatment of pancreatic ductal adenocarcinoma and that these molecules are effective chemosensitizers. Though only a few trials have shown the efficacy in a clinical setting, the STAT3 pathway remains a promising drug target for future treatment of pancreatic ductal adenocarcinoma and may help overcome chemotherapy resistance.
Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis
Authors: Balakrishnan Athira , Puthean Sandra , Satheesh Gautam , M. K. Unnikrishnan , Rashid Muhammed , Nair Sreedharan , Thunga Girish 
Published: June 2021

Background & objectiveThough blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education.MethodsPubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling.Key findingsA total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41).ConclusionBL is associated with better academic performance and achievement than didactic teaching in pharmacy education.
Factors influencing the iodine status of children aged 12 to 59 months from Jaffna District, Sri Lanka in the post-iodization era; a descriptive, cross-sectional study
Authors: Karthigesu Kandeepan , Sandrasegarampillai Balakumar , Arasaratnam Vasanthy 
Published: June 2021

BackgroundIodine status, including Iodine Deficiency (ID) of the children aged 12–59 months of Jaffna District, Sri Lanka, have never been studied. This study thus aimed to assess ID among children aged 12–59 months by monitoring the Urinary Iodine Concentrations (UIC), the prevalence of goitre, and the factors causing ID.MethodA cross-sectional study was conducted among 846 children aged 12–59 months in Jaffna District, Sri Lanka. Sociodemographic characteristics and other factors were collected using an interviewer-administered questionnaire. Dietary pattern of children was obtained using semi-quantitative food frequency questionnaire. We performed urinary iodine estimation and physical examinations to detect the goitre, according to the World Health Organization criteria. A multivariate logistic linear regression model was used to identify the factors that causing ID.ResultThe median UIC was 146.4 μg/L (interquartile range = 112.6–185.3 μg/L). Based on the UIC (<100 μg/L), 17.8% had ID, of which 15.7% and 2.1% had mild and moderate ID. The mean consumption of iodine from food was 128.7 (±20.2) μg/day. Gender variation had no influence on ID (p>0.05). Median UIC was significantly associated with living area, wealth status, type of drinking water, and method of iodized salt usage. A higher percentage of ID was significantly associated with younger age [AOR 2.32 (95% CI: 1.31–4.10)], urban area [AOR 1.94 (95% CI 1.27–2.96)], inland regions [AOR 3.20 (95% CI 1.85–5.55)], improper method of iodized salt usage [AOR 3.63 (95% CI: 1.38–9.56)], and low consumption of iodine-containing foods. The neck palpation revealed that only three children had goitre (0.4%).ConclusionThis study revealed that high ID among the children in Jaffna children was due to improper usage of iodized salt, even though the iodized salt is freely available in the region, living area, and age, while the prevalence of goitre was not significantly identified as a public health problem.
The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis
Authors: Berg Rigmor C. , Page Samantha , Øgård-Repål Anita 
Published: June 2021

Background
The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-management of their chronic health condition. The objective of this systematic review was to assess the effects of peer-support for people living with HIV.

Methods
We conducted a systematic review in accordance with international guidelines. Following systematic searches of eight databases until May 2020, two reviewers performed independent screening of studies according to preset inclusion criteria. We conducted risk of bias assessments and meta-analyses of the available evidence in randomised controlled trials (RCTs). The certainty of the evidence for each primary outcome was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system.

Results
After screening 219 full texts we included 20 RCTs comprising 7605 participants at baseline from nine different countries. The studies generally had low risk of bias. Main outcomes with high certainty of evidence showed modest, but superior retention in care (Risk Ratio [RR] 1.07; Confidence Interval [CI] 95% 1.02–1.12 at 12 months follow-up), antiretroviral therapy (ART) adherence (RR 1.06; CI 95% 1.01–1.10 at 3 months follow-up), and viral suppression (Odds Ratio up to 6.24; CI 95% 1.28–30.5 at 6 months follow-up) for peer-support participants. The results showed that the current state of evidence for most other main outcomes (ART initiation, CD4 cell count, quality of life, mental health) was promising, but too uncertain for firm conclusions.

Conclusions
Overall, peer-support with routine medical care is superior to routine clinic follow-up in improving outcomes for people living with HIV. It is a feasible and effective approach for linking and retaining people living with HIV to HIV care, which can help shoulder existing services.

Trial registration
CRD42020173433.
Experiences of Dutch maternity care professionals during the first wave of COVID-19 in a community based maternity care system
Authors: van Manen Eline L. M. , Hollander Martine , Feijen-de Jong Esther , de Jonge Ank , Verhoeven Corine , Gitsels Janneke 
Published: June 2021

Background and objectiveDuring the COVID-19 pandemic the organization of maternity care changed drastically; this study into the experiences of maternity care professionals with these changes provides suggestions for the organization of care during and after pandemics.DesignAn online survey among Dutch midwives, obstetricians and obstetric residents. Multinomial logistic regression analyses were used to investigate associations between the respondents’ characteristics and answers.ResultsReported advantages of the changes were fewer prenatal and postpartum consultations (50.1%). The necessity and safety of medical interventions and ultrasounds were considered more critically (75.9%); 14.8% of community midwives stated they referred fewer women to the hospital for decreased fetal movements, whereas 64.2% of the respondents working in hospital-based care experienced fewer consultations for this indication. Respondents felt that women had more confidence in giving birth at home (57.5%). Homebirths seemed to have increased according to 38.5% of the community midwives and 65.3% of the respondents working in hospital-based care. Respondents appreciated the shift to more digital consultations rather than face-to-face consultations. Mentioned disadvantages were that women had appointments alone, (71.1%) and that the community midwife was not allowed to join a woman to obstetric-led care during labour and subsequently stay with her (56.8%). Fewer postpartum visits by family and friends led to more tranquility (59.8%). Overall, however, 48.0% of the respondents felt that the safety of maternity care was compromised due to policy changes.ConclusionsMaternity care professionals were positive about the decrease in routine care and the increased confidence of women in home birth, but also felt that safety in maternity care was sometimes compromised. According to the respondents in a future crisis situation it should be possible for community midwives to continue to deliver a personal handover after the referral of women to the hospital, and to stay with them.
12-month clinical outcomes of combined phacoemulsification and ab interno trabeculectomy for open-angle glaucoma in the United Kingdom
Authors: Ansari Ejaz , Loganathan Deva 
Published: June 2021

Background/Objectives
To describe intraocular pressure (IOP) and ocular hypotensive medication outcomes of combined phacoemulsification and ab interno trabeculectomy with the Kahook Dual Blade (KDB; New World Medical, Inc, Rancho Cucamonga, CA) in adults with cataract and open-angle glaucoma (OAG).

Subjects/Methods
Retrospective chart review of existing medical records. Data collected included intraocular pressure (IOP) and IOP-lowering medication use preoperatively and through up to 24 months postoperatively. Paired t-tests were utilized to compare preoperative to postoperative mean IOP and mean medications used.

Results
Data from 32 eyes of 26 subjects were analyzed. Subjects were predominantly Caucasian (25/26) had mean (standard error) age of 79.3 (1.2) years, and eyes had moderate-advanced OAG (mean visual field mean deviation -8.3 [1.3] dB). Mean IOP was 19.8 (0.8) mmHg at baseline and 15.5 (0.6) mmHg (p<0.0001) after mean follow-up of 11.5 (1.0) months; IOP reductions of ≥20% were achieved in 20/32 eyes (62.5%). Mean medication use declined from 2.4 (0.2) medications per eye at baseline to 0.5 (0.2) at last follow-up (p<0.0001); 23/32 eyes (71.9%) were medication-free at last follow-up. No vision-threatening complications were observed.

Conclusions
Combined phacoemulsification and ab interno trabeculectomy with the KDB safely provided mean IOP reductions of 21.7% and mean IOP medication reductions of 83% after mean follow-up of 12 months in eyes with moderate to advanced OAG. This procedure provides medication-independence in most eyes with statistically and clinically significant IOP reductions.
Predictors of incident viral symptoms ascertained in the era of COVID-19
Authors: Marcus Gregory M. , Olgin Jeffrey E. , Peyser Noah D. , Vittinghoff Eric , Yang Vivian , Joyce Sean , Avram Robert , Tison Geoffrey H. , Wen David , Butcher Xochitl , Eitel Helena , Pletcher Mark J. 
Published: June 2021

Background
In the absence of universal testing, effective therapies, or vaccines, identifying risk factors for viral infection, particularly readily modifiable exposures and behaviors, is required to identify effective strategies against viral infection and transmission.

Methods
We conducted a world-wide mobile application-based prospective cohort study available to English speaking adults with a smartphone. We collected self-reported characteristics, exposures, and behaviors, as well as smartphone-based geolocation data. Our main outcome was incident symptoms of viral infection, defined as fevers and chills plus one other symptom previously shown to occur with SARS-CoV-2 infection, determined by daily surveys.

Findings
Among 14, 335 participants residing in all 50 US states and 93 different countries followed for a median 21 days (IQR 10–26 days), 424 (3%) developed incident viral symptoms. In pooled multivariable logistic regression models, female biological sex (odds ratio [OR] 1.75, 95% CI 1.39–2.20, p<0.001), anemia (OR 1.45, 95% CI 1.16–1.81, p = 0.001), hypertension (OR 1.35, 95% CI 1.08–1.68, p = 0.007), cigarette smoking in the last 30 days (OR 1.86, 95% CI 1.35–2.55, p<0.001), any viral symptoms among household members 6–12 days prior (OR 2.06, 95% CI 1.67–2.55, p<0.001), and the maximum number of individuals the participant interacted with within 6 feet in the past 6–12 days (OR 1.15, 95% CI 1.06–1.25, p<0.001) were each associated with a higher risk of developing viral symptoms. Conversely, a higher subjective social status (OR 0.87, 95% CI 0.83–0.93, p<0.001), at least weekly exercise (OR 0.57, 95% CI 0.47–0.70, p<0.001), and sanitizing one’s phone (OR 0.79, 95% CI 0.63–0.99, p = 0.037) were each associated with a lower risk of developing viral symptoms.

Interpretation
While several immutable characteristics were associated with the risk of developing viral symptoms, multiple immediately modifiable exposures and habits that influence risk were also observed, potentially identifying readily accessible strategies to mitigate risk in the COVID-19 era.
Iron-rich food consumption and associated factors among children aged 6–23 months in sub-Saharan Africa: A multilevel analysis of Demographic and Health Surveys
Authors: Akalu Yonas , Yeshaw Yigizie , Tesema Getayeneh Antehunegn , Demissie Getu Debalkie , Molla Meseret Derbew , Muche Abebe , Diress Mengistie , Tiruneh Sofonyas Abebaw 
Published: June 2021

IntroductionAnemia remains a major public health problem for children in sub-Saharan Africa (SSA). Iron-rich foods consumption has a determinant role on the anemia status. Hence, this study aimed to determine the prevalence of good consumption of iron-rich foods and its associated factors among children aged 6–23 months in SSA.Materials and methodsThe recent Demographic and Health Survey data sets of thirty-five SSA countries were used. Data were analyzed using STATA/MP version 16.0 and all statistical analyses were done after weighting the data. A generalized linear mixed model using Poisson regression with robust error variance was used to determine factors associated with good consumption of iron-rich food. Association of variables was declared at a p-value of ≤0.05 and adjusted prevalence ratio (aPR) ratio with its 95% confidence interval (CI) was calculated for each variable.ResultsThe total weighted samples of 77,001 children aged 6–23 months were included. The prevalence of consumption of iron rich foods was 42.1% (95% CI: 41.78–42.48). Children with age of 12–17 (adjusted prevalence ratio (aPR) = 1.96, 95% CI: 1.89–2.04) and 18–23 months (aPR = 2.05, 95% CI: 1.97–2.14), who took drugs for intestinal parasites (aPR = 1.30, 95% CI: 1.26–1.34), with postnatal check within 2 months (aPR = 1.09, 95% CI: 1.06–1.13), and children from women with ANC visit of 1–3 (aPR = 1.31, 95% CI: 1.24–1.37) and ≥4 (aPR = 1.41, 95% CI: 1.34–1.48) had higher prevalence of good consumption of iron rich foods. Moreover, the prevalence of consumptions of iron rich foods was higher among children from; family with rich (aPR = 1.36, 95%CI: 1.30–1.42) and middle (aPR = 1.14 95% CI: 1.09–1.19) wealth index, and mother with media exposure (aPR = 1.26, 95%CI: 1.22–1.31).ConclusionThe prevalence of good consumption of iron-rich foods among children aged 6–23 months in SSA countries is low. Child factors, family factors, and community-level factors were significantly associated with consumption of iron rich foods. Strategies to increase the consumption of iron-rich foods during this critical stage of growth and development should be designed in SSA.
El arribo institucional a las regiones a partir del proceso de paz en 2016. Estudio de caso en el corregimiento de Madrigal-Nariño (Colombia)
Authors: Guerra García Jhon Mauricio 
Published: June 2021

El presente artículo pretende analizar la representación del Estado, a través de sus instituciones y de órganos no gubernamentales en los territorios afectados por el conflicto armado interno, especialmente en aquellos escogidos para instalar las Zonas Veredales de Transición y Normalización (ZVTN), para ello se entrara a examinar en qué términos se produjo su intervención en estos escenarios para finalmente hacer una reflexión sobre su incidencia positiva y negativa alrededor de los objetivos del proceso de paz, todo se analizara desde la experiencia obtenida a partir de la investigación adelantada en el corregimiento de Madrigal, departamento de Nariño, región escogida por el gobierno como lugar de ubicación de una de las ZTN.
Experimental research on the performance of the thermal-reflective coatings with liquid silicone rubber for pavement applications
Authors: Wang Kaifeng , Cheng Jing , Zhu Yunsheng , Wang Xianrong , Li Xiaowei 
Published: June 2021

Abstract
The thermal-reflective coating technology can effectively realize the active cooling of asphalt pavement, thus delaying the occurrence of pavement rutting. Although solid fillers are usually used to absorb light and weaken light dazzle in traditional thermal-reflective coatings, this method makes the filler component complicated and the coatings more viscous and increases the difficulty of painting the coating material on the pavement surface. On account of all the aforementioned factors, this experimental study aims to effectively improve the performance of the thermal-reflective coating with liquid silicone rubber addition in which epoxy resin is the base material and rutile titanium dioxide is the pigment filler for the coating film. Through lab experiments, the effects of the proper liquid silicone rubber dosage on the glossiness, cooling performance, and hardness of the thermal-reflective coating are studied and analyzed. The experimental results show that the liquid silicone is very effective for coating toughness improvement. The thermal-reflective coating, when the liquid silicone rubber dosage changes from 10 to 14 wt%, exhibits a matt state, and its glossiness can be controlled below 30 GU, which meets the safety and antiglare requirements of traffic vehicles. It demonstrates that liquid silicone rubber can influence the viscosity of the thermal-reflective coatings, and when the liquid silicone dosage reaches 16 wt%, the viscosity of the coating increases by 7.26 wt% less than that of the solid matting filler. Liquid silicone rubber can also influence the cooling effect of the thermal-reflective coatings, with the liquid silicone rubber dosage of 16 wt%, the asphalt pavement temperature can reduce 0.5°C. Besides, liquid silicone rubber reduces the hardness of the coatings, the coating hardness is 6H when the liquid silicone rubber dosage is 0–10 wt%, and the hardness of the coating reduces to 5H when liquid silicone dosage is from 12 to 16 wt%, which meets the actual requirements. Therefore, this article recommends a 12 wt% dosage of the liquid silicone rubber to be used as a matting filler for the thermal-reflective coatings.
COVID-19 pandemic and remote teaching: transition and transformation in nursing education
Authors: Madhavanprabhakaran Girija , Francis Frincy , John Sheeba Elizabeth , Al Rawajfah Omar 
Published: June 2021

Abstract
Remote teaching (RT) was the only option left to educators to continue education with public policy of lockdowns and social distancing during COVID-19 pandemic. RT is the online mode of instructional delivery. Globally it has become mandatory for all nurse educators to switch to RT mode. Many factors have been identified for effective implementation of RT, of which the major elements are choice of online teaching mode, pedagogy to choose the platform or technology, faculty preparedness, and the learner motivation and expectations. The dire need to meet the educational objectives demanded sudden transition to online mode. The paradigm shifts to RT brought many challenges and pragmatic guidance for teachers and institutions Remote teaching is flexible, student centered and feasible with opportunities to develop technically empowered faculty and coherent digital education strategies. However, tackling threats like academic integrity, inequity in accessibility and limited faculty preparedness necessitates attention. RT being flexible tool is weakened by low self-motivated students and low connectivity with digital inequity and security issues. The challenges opened opportunity to enhance faculty technical competency and learning management system.
Optimal injection interval for testosterone undecanoate treatment of hypogonadal and transgender men
Authors: Shankara Narayana Nandini , Ly Lam P , Jayadev Veena , Fennell Carolyn , Savkovic Sasha , Conway Ann J , Handelsman David J 
Published: June 2021

Objective
To define the optimized inter-injection interval of injectable testosterone undecanoate (TU) treatment for hypogonadal and transmen based on individual dose titration in routine clinical practice.

Design and methods
A prolective observational study of consecutive TU injections in men undergoing testosterone replacement therapy for pathological hypogonadism or masculinization of female-to-male transgender (transmen) subject to individual dosing titration to achieve a stable replacement regimen.

Results
From 2006 to 2019, 6899 injections were given to 325 consecutive patients. After excluding the 6-week loading dose, 6300 injections were given to 297 patients who had at least three and a median of 14 injections. The optimal injection interval (mean of last three injection intervals) had a median of 12.0 weeks (interquartile range 10.4–12.7 weeks). The interval was significantly influenced by age and body size (body surface area, BSA) but not by diagnosis or trough serum LH, FSH, and SHBG. Longer (≥14 weeks; 68/297, 23%), but not shorter (≤10 weeks; 22/297, 7.4%), intervals were weakly correlated with age but not diagnosis or other covariables. Low blood hemoglobin increased with trough serum testosterone to reach plateau once testosterone was about 10 nmol/L or higher.

Conclusion
Optimal intervals between TU injection after individual titration resulted in the approved 12-week interval in 70% of patients with only minor influence for clinical application of BSA and not of trough serum LH, FSH, and SHBG. Individually optimized inter-injection interval did not differ between men with primary or secondary hypogonadism or transmen.