bluuebunny/crossref_metadata_2025_split huggingface dataset:
Putting cultural difference in its place: Barriers to access to health services for parents of children with intellectual disability in an urban African setting
Authors: Mkabile Siyabulela , Swartz Leslie 
Published: August 2021

Background: Access to appropriate specialist level services for children with intellectual disability is challenging in Africa, with very few services available. Much literature on the utilisation of services by carers of children with intellectual disability in Africa emphasises the supposed incompatibility between indigenous and western beliefs, failing to identify more obvious, embodied barriers to access to care. Method: As part of a study on children with intellectual disability in Cape Town, South Africa, we interviewed caregivers regarding the difficulties in accessing care, specifically the complex, expensive and time-consuming travelling routes from home to care. Results: Caregivers discussed the embodied difficulties accessing care. Everyday struggles with transport, and crowded, dangerous and hostile environments were identified as barriers to care. Conclusion: These challenges are often overlooked in the literature, in favour of an emphasis on cultural difference. This dualistic view of the world may obscure more obvious reasons why people find it difficult to use services, even when they are available.
Do transparency mechanisms reduce government corruption? A meta-analysis
Authors: Chen Can , Ganapati Sukumar 
Published: August 2021

This article presents a meta-analysis of empirical studies to examine the role of transparency mechanisms for curbing corruption. The analysis reveals that transparency has an overall significant, though small, effect size in reducing corruption. Transparency is more effective for reducing subjective than objective corruption measures. While legal transparency mechanisms with freedom of information laws are important, fiscal transparency and e-transparency play a stronger role in fighting government corruption. Accountability and publicity add to transparency mechanisms for reducing corruption. Points for practitioners This meta-analysis study confirms a significantly negative association between transparency and corruption. Transparency advocates can champion transparency mechanisms as significant tools for reducing corruption. Different transparency mechanisms and good governance mechanisms are needed to reinforce transparency for reducing corruption.
Magnitude of Substance Use and Its Associated Factors Among the Medical Students in India and Implications for Medical Education: A Narrative Review
Authors: Gupta Himank , Gupta Snehil , Rozatkar Abhijit R. 
Published: August 2021

Background: Medical students are at an increased risk of developing substance use and related problems (SURP) because of the inherent stress associated with the professional medical course apart from the developmental risk factors. However, this is under-researched. Moreover, a comprehensive review on the prevalence of SURP among the medical undergraduates (UGs) and associated factors is lacking from India. To fill this gap, the current research work is aimed to review the existing literature on the magnitude of the SURP among UGs of India and its determinants. Methods: PubMed, Medline, and Google Scholar databases were searched for the original articles studying the prevalence of SURP among medical UGs of India, published from inception till date. Non-original articles, studies on behavioral addictions, and those not directly assessing the prevalence of SURP among the medical UGs were excluded. Results: A total of 39 studies were found eligible for the review. Alcohol (current use: 3.2%–43.8%), followed by tobacco (3.7%–28.8%) and cannabis (1.6%–15%), were the common substances used by the medical students. Among the females, an increasing trend of substance use, particularly of nonprescription sedatives (even higher than males), alcohol, and smoking, was seen. Family history, peer pressure, transition from school to college life, and progression in the medical course were important associated factors. Conclusion: Sensitizing medical students and college authorities, increasing the duration of training on SURP in medical curricula, and providing psychological support for the students with SURP could address this issue.
Serum levels of inhibitory costimulatory molecules and correlations with levels of innate immune cytokines in patients with pulmonary tuberculosis
Authors: Zhao Yunjuan , Zhang Jia , Xue Bing , Zhang Fengbo , Xu Qian , Ma Haimei , Sha Tong , Peng Lei , Li Fengsen , Ding Jianbing 
Published: August 2021

Objective To analyze serum levels of inhibitory costimulatory molecules and their correlations with innate immune cytokine levels in patients with pulmonary tuberculosis (PTB). Methods Data for 280 PTB patients and 280 healthy individuals were collected. Serum levels of immune molecules were measured using ELISA. Univariate, multivariate, subgroup, matrix correlation, and receiver operating characteristic curve analyses were performed. Results Host, environment, lifestyle, clinical features, and medical history all influenced PTB. Serum levels of soluble programmed death ligand 1 (sPD-L1), soluble T-cell immunoglobulin- and mucin-domain–containing molecule 3 (sTim-3), soluble galectin-9 (sGal-9), interleukin (IL)-4, and IL-33 were significantly higher in patients with PTB, while levels of IL-12, IL-23, IL-18, and interferon (IFN)-γ were significantly lower. Serum levels of sTim-3 were higher in alcohol users. Levels of sTim-3 were negatively correlated with those of IL-12. Levels of IL-12, IL-23, and IL-18 were positively correlated with those of IFN-γ, while levels of IL-12 were negatively correlated with those of IL-4. The areas under the curve of sPD-L1, sTim-3, sGal-9, IL-12, IL-23, IL-18, IFN-γ, IL-4, and IL-33 for identifying PTB were all >0.77. Conclusions Inhibitory costimulatory molecules may be targets for controlling PTB. Immune molecules may be helpful for diagnosis of PTB.
Development of a multi-arm polyrotaxanes modified mesoporous silica-coated gold nanoplatform for protecting endothelial progenitor cells against high glucose environment
Authors: Cao Duanwen , Zuo Huihua , Jiang Mingjin , Huang Yiteng , Li Liang , Lin Fengxia , Liu Yue 
Published: August 2021

Recent study reported that endothelial progenitor cells (EPCs) have potential to treat diabetic macroangiopathy. High glucose environment of diabetes can affect the adhesion of EPCs by decreasing the expression of CXC chemokine receptor 4 (CXCR4) and affect the proliferation of EPCs by decreasing the expression of miR-126. The results showed that the cytotoxicity of GNR@MSNs@PEI to EPCs was significantly lower than PEI; the temperature of GNR@MSNs@PEI solution can be controlled between 38–40°C under 808 nm laser irradiation. 25.67 µg of pcDNA3.1-GFP-CXCR4 and 5.36 µg of FITC-miR-126 could be loaded in 1 mg of GNR@MSNs@PEI; GNR@MSNs@PEI has gene transfection almost the same as Lipofectamine 3000. Subsequent in vitro studies showed that pcDNA3.1-GFP-CXCR4 and miR-126 loaded GNR@MSNs@PEI can significantly increase the adhesion and proliferation and decrease the apoptosis of EPCs treated with high glucose under 808 nm laser irradiation. In conclusion, nano-carriers (GNR@MSNs@PEI) with high pcDNA3.1-CXCR4 and miR-126 loading capacity, high biocompatibility, well cell internalization, and controllable release ability were constructed to transfer CXCR4 expression plasmid (pcDNA3.1-CXCR4) and miR-126 into EPCs efficiently. Further in vitro studies indicated that pcDNA3.1-CXCR4 and miR-126-loaded GNR@MSNs@PEI could protect EPCs against high glucose-induced injury.
Preparation and characterization of phase-change energy storage nonwoven fabric
Authors: Zhao Zhou , Tong Ningning , Song Hong , Guo Yan , Wang Jinmei 
Published: August 2021

In this work, a phase-change energy storage nonwoven fabric was made of polyurethane phase-change material (PUPCM) by a non-woven melt-blown machine. Polyethylene glycol 2000 was used as the phase transition unit and diphenyl-methane-diisocyanate as the hard segment to prepare PUPCM. Thermal stability of the PUPCM was evaluated through thermal stability analysis. The performance of pristine PUPCM was determined by Fourier transform infrared spectroscopy and differential scanning calorimetry to analyze the spinning technology of spinning temperature and the stretching process. Phase-change energy storage nonwoven fabric (413.22 g/m2) was prepared, and the morphology, solid–solid exothermic phase transition, mechanical properties, and the structures were characterized. The enthalpy of solid–solid exothermic phase transition reached 60.17 mJ/mg (peaked at 23.14°C). The enthalpy of solid–solid endothermic phase transition reached 67.09 mJ/mg (peaked at 34.34°C). The strength and elongation of phase-change energy storage nonwoven fabric were found suitable for garments and tent fabrics.
Post-Market Surveillance Assessment of the Clinical Accuracy of a Blood Glucose Monitoring System with an Improved Algorithm for Enhanced Product Performance
Authors: Setford Steven , Liu Zuifang , McColl David , Phillips Stuart , Cameron Hilary , Grady Mike 
Published: August 2021

Background: On-going manufacturer-led post-market surveillance (PMS), assessing the clinical accuracy of blood glucose monitoring (BGM) systems, is critical to substantiate the performance of such products for people with diabetes. Materials and Methods: Batches of Verio test-strip product were randomly and routinely selected over the period from launch of an improved-algorithm product to reporting date and sent to 3 clinic sites for clinician-led accuracy assessment. Accuracy is reported as per recently adopted FDA guidance for BGM systems, EN ISO 15197:2015 and MARD/MAD (Mean absolute relative difference/Mean absolute difference). Results: Thirty-three individual test-strip batches were evaluated corresponding to 506 unique donors. Accuracy performance - FDA: 98.9% of values within ±15% of comparator; ISO: 99.0% within ±15 mg/dL or ±15% at <100 mg/dL (<5.55 mmol/L) or ≥100 mg/dL (≥5.55 mmol/L) glucose, respectively. Overall MARD was 4.19% with a MARD range of 3.54%-5.73% across all test strip batches. Conclusions: This post-market surveillance program demonstrates the new BGM system consistently meets measures of clinical accuracy specified by regulators. This program supports a growing demand by regulators for real-world evidence demonstrating consistent in-market product efficacy as opposed to the current largely passive approach that relies on assessment of reports filed by device users.
Insights into bioinformatic approaches for repurposing compounds as anti-viral drugs
Authors: Zheng Wenxiao , D’Aiuto Leonardo , Demers Matthew J , Muralidaran Vaishali , Wood Joel A , Wesesky Maribeth , Chattopadhyay Ansuman , Nimgaonkar Vishwajit L 
Published: August 2021

Background Drug repurposing is a cost-effective strategy to identify drugs with novel effects. We searched for drugs exhibiting inhibitory activity to Herpes Simplex virus 1 (HSV-1). Our strategy utilized gene expression data generated from HSV-1-infected cell cultures which was paired with drug effects on gene expression. Gene expression data from HSV-1 infected and uninfected neurons were analyzed using BaseSpace Correlation Engine (Illumina®). Based on the general Signature Reversing Principle (SRP), we hypothesized that the effects of candidate antiviral drugs on gene expression would be diametrically opposite (negatively correlated) to those effects induced by HSV-1 infection. Results We initially identified compounds capable of inducing changes in gene expression opposite to those which were consequent to HSV-1 infection. The most promising negatively correlated drugs (Valproic acid, Vorinostat) did not significantly inhibit HSV-1 infection further in African green monkey kidney epithelial cells (Vero cells). Next, we tested Sulforaphane and Menadione which showed effects similar to those caused by viral infections (positively correlated). Intriguingly, Sulforaphane caused a modest but significant inhibition of HSV-1 infection in Vero cells (IC50 = 180.4 µM, p = 0.008), but exhibited toxicity when further explored in human neuronal progenitor cells (NPCs) derived from induced pluripotent stem cells. Conclusions These results reveal the limits of the commonly used SRP strategy when applied to the identification of novel antiviral drugs and highlight the necessity to refine the SRP strategy to increase its utility.
Do universities matter for the location of foreign R&D?
Authors: Añón Higón Dolores , Díez-Minguela Alfonso 
Published: August 2021

This article explores the extent to which the regional higher education system (HES) influences the location of foreign research and development (R&D). To do so, we use a dataset with information on the location choices of new foreign R&D establishments within Spain from 2005 to 2013. Similarly, we use a multiple measure of the three university missions, distinguishing between research capacity training, scientific research, and technology transfer. We find that the probability of a foreign R&D establishment being located in a region is positively affected by the strength of the region’s HES missions, and more specifically by the quality of its scientific research, while its research training capacity and knowledge transfer activities do not seem to play a significant role. Moreover, the strength of the research mission has a positive influence on the location choice of foreign units conducting research activities but is weak to explain the location of those performing development activities. JEL CLASSIFICATION F21; F23; O32
Exploring the diagnostic effectiveness for myocardial ischaemia based on CCTA myocardial texture features
Authors: Zhao Hengyu , Yuan Lijie , Chen Zhishang , Liao Yuting , Lin Jiangzhou 
Published: August 2021

Abstract
Background
To explore the characteristics of myocardial textures on coronary computed tomography angiography (CCTA) images in patients with coronary atherosclerotic heart disease, a classification model was established, and the diagnostic effectiveness of CCTA for myocardial ischaemia patients was explored.

Methods
This was a retrospective analysis of the CCTA images of 155 patients with clinically diagnosed coronary heart disease from September 2019 to January 2020, 79 of whom were considered positive (myocardial ischaemia) and 76 negative (normal myocardial blood supply) according to their clinical diagnoses. By using the deep learning model-based CQK software, the myocardium was automatically segmented from the CCTA images and used to extract texture features. All patients were randomly divided into a training cohort and a test cohort at a 7:3 ratio. The Spearman correlation and least absolute shrinkage and selection operator (LASSO) method were used for feature selection. Based on the selected features of the training cohort, a multivariable logistic regression model was established. Finally, the test cohort was used to verify the regression model.

Results
A total of 387 features were extracted from the CCTA images of the 155 coronary heart disease patients. After performing dimensionality reduction with the Spearman correlation and LASSO, three texture features were selected. The accuracy, area under the curve, specificity, sensitivity, positive predictive value and negative predictive value of the constructed multivariable logistic regression model with the test cohort were 0.783, 0.875, 0.733, 0.875, 0.650 and 0.769, respectively.

Conclusion
CCTA imaging texture features of the myocardium have potential as biomarkers for diagnosing myocardial ischaemia.
Primary care clinical provider knowledge and experiences in the diagnosis and treatment of tick-borne illness: a qualitative assessment from a Lyme disease endemic community
Authors: Mattoon Stephanie , Baumhart Caitlin , Barsallo Cochez Ana C. , MacQueen Douglas , Snedeker Jeffrey , Yancey Caroline B. , Gatch Melissa , Mader Emily M. 
Published: August 2021

Abstract
Background
Primary care and frontline healthcare providers are often the first point of contact for patients experiencing tick-borne disease (TBD) but face challenges when recognizing and diagnosing these diseases. The specific aim of this study was to gain a qualitative understanding of frontline and primary care providers’ knowledge and practices for identifying TBDs in patients.

Methods
From fall 2018 to spring 2019, three focus groups were conducted with primary care providers practicing in a small-town community endemic to Lyme disease (LD) and with emerging incidence of additional TBDs. A follow up online survey was distributed to urgent and emergency care providers in the small-town community and an academic medical center within the referral network of the local clinical community in spring and summer 2019. Qualitative analysis of focus group data was performed following a grounded theory approach and survey responses were analyzed through the calculation of descriptive statistics.

Results
Fourteen clinicians from three primary care practices participated in focus groups, and 24 urgent and emergency care clinicians completed the survey questionnaire. Four overarching themes emerged from focus group data which were corroborated by survey data. Themes highlighted a moderate level of awareness on diagnosis and treatment of LD among participants and limited knowledge of diagnosis and treatment for two other regionally relevant TBDs, anaplasmosis and babesiosis. Providers described challenges and frustrations in counseling patients with strong preconceptions of LD diagnosis and treatment in the context of chronic infection. Providers desired additional point-of-care resources to facilitate patient education and correct misinformation on the diagnosis and treatment of TBDs.

Conclusions
Through this small study, it appears that clinicians in the small-town and academic medical center settings are experiencing uncertainties related to TBD recognition, diagnosis, and patient communication. These findings can inform the development of point-of-care resources to aid in patient-provider communication regarding TBDs and inform the development of continuing medical education programs for frontline and primary care providers.
Improving preparedness prior to reconstructive breast surgery via inclusion of 3D images during pre-operative counselling: a qualitative analysis
Authors: McCrorie Alan D. , Begley Aislinn M. , Chen Jingwen J. , McCorry Noleen K. , Paget Glenda , McIntosh Stuart A. 
Published: August 2021

Abstract
Background
A proportion of women undergoing mastectomy for breast cancer choose to undergo breast reconstruction. Evidence suggests that women’s preparedness for this surgery is low and that this may contribute to feelings of unmatched expectations and anxiety. There is substantial interest in decision-aids to remedy this. This study explores the incorporation of digitally rendered three-dimensional images into pre-operative counselling sessions as a means of enhancing patient preparedness.

Methods
A database of three-dimensional images was produced showing both optimal and sub-optimal aesthetic outcome, matched to participant on the basis of type of surgical reconstruction, body habitus, and skin tone. Women undergoing mastectomy for breast cancer followed by immediate reconstruction were targeted for inclusion. Participants interacted with image software during pre-operative counselling sessions by viewing, rotating, and zooming in/out to gain a more in-depth appreciation of post-operative aesthetic outcome. Semi-structured face-to-face interviews followed thereafter. Interviews were audio-recorded, transcribed, coded, and themes identified.

Results
Eight semi-structured interviews took place. The major emergent theme was ‘increased preparedness’ with subthemes including ‘expectation management’, ‘software interaction’, and ‘enhanced realism’. There were no prohibitively negative emotions after interacting with images. Women reported gaining ‘more of a perspective’ and feeling ‘more informed’ after viewing images. They also valued the enhanced interactivity and better appreciation of reconstructed breast symmetry that viewing three-dimensional images offered when compared to viewing two-dimensional photographs. Finally, women also commented that three-dimensional images were more realistic.

Conclusions
Results suggest that incorporation of three-dimensional images into pre-operative counselling sessions prior to breast reconstruction, is a fairly simple yet effective method of enhancing patient preparedness prior to surgery. Women particularly valued the ability to use the software to generate a more realistic idea of what to expect after their operation. Future work should focus on better understanding any quantifiable benefit from incorporating three-dimensional images routinely into pre-operative decision-making.
Secondary infections in critically ill patients with COVID-19
Authors: Grasselli Giacomo , Cattaneo Emanuele , Florio Gaetano 
Published: August 2021

AbstractThis article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
Advanced management of intermediate-high risk pulmonary embolism
Authors: Weinstein Tatiana , Deshwal Himanshu , Brosnahan Shari B. 
Published: August 2021

AbstractThis article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
A potent weighted risk model for evaluating the occurrence and severity of diabetic foot ulcers
Authors: Shi Lu , Wei Huiyi , Zhang Tianxiao , Li Zhiying , Chi Xiaoxian , Liu Dandan , Chang Dandan , Zhang Yueying , Wang Xiaodan , Zhao Qingbin 
Published: August 2021

Abstract
Background
Diabetic foot ulcer (DFU) is a serious chronic complication of diabetes. This study aimed to establish weighted risk models for determining DFU occurrence and severity in diabetic patients.

Methods
This was a multi-center hospital-based cross-sectional study. A total of 1488 diabetic patients with or without an ulcer from three tertiary hospitals were included in the study. Random forest method was used to develop weighted risk models for assessing DFU risk and severity. Receiver operating characteristic curves were used to validate the models and calculate the optimal cut-off values of the important risk factors.

Results
We developed potent weighted risk models for evaluating DFU occurrence and severity. The top eight important risk factors for DFU onset were plasma fibrinogen, neutrophil percentage and hemoglobin levels in whole blood, stroke, estimated glomerular filtration rate, age, duration of diabetes, and serum albumin levels. The top 10 important risk factors for DFU severity were serum albumin, neutrophil percentage and hemoglobin levels in whole blood, plasma fibrinogen, hemoglobin A1c, estimated glomerular filtration rate, hypertension, serum uric acid, diabetic retinopathy, and sex. Furthermore, the area under curve values in the models using plasma fibrinogen as a single risk factor for determining DFU risk and severity were 0.86 (sensitivity 0.74, specificity 0.87) and 0.73 (sensitivity 0.76, specificity 0.58), respectively. The optimal cut-off values of plasma fibrinogen for determining DFU risk and severity were 3.88 g/L and 4.74 g/L, respectively.

Conclusions
We have established potent weighted risk models for DFU onset and severity, based on which precise prevention strategies can be formulated. Modification of important risk factors may help reduce the incidence and progression of DFUs in diabetic patients.