bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Descending Health Resources Reform Impact Patient Low-level Hospital Selection Behavior? Evidence from Zhejiang, China
Authors: SUN Zesheng , Wang Shuhong , Zhao Hongjun , Zhou Xu , Zhang Ludan , Shi Jiongping 
Published: April 2021

Abstract
Background: Since 2013, China launched descending resources reform, which is a new attempt to correct unbalanced allocation of health resources through human capital spillovers and brand implantation from high-level hospitals. The purpose of this paper is to explore the patients’ hospital selection response to this reform with the focus of low-level hospitals to better understand the effect of this reform on correcting regional inequality of health resources allocation. Methods: The European Consumer Satisfaction Index model (ECSI) was used to design a questionnaire, and cross-sectional data from 17 hospitals were collected through 1,287 questionnaires from Zhejiang Province. Patient hospital selection (loyalty) is measured using ordinary variables by considering patient willingness to choose a low-level hospital when suffering an illness or severe illness. Analysis of variance (ANOVA) and the structure equation model are applied to examine the effect of reforms on patient behavior. Results: The descending resources reform promotes improvements in the capabilities and medical environment of low-level hospitals, and descending doctors also have high accessibility. Perceived quality, patient expectations, and hospital image have significant positive effects on patient satisfaction, and the explanatory power of brand implantation from cooperative high-level hospitals and descending doctors is stronger than the image of the low-level hospital itself. And descending resources reform and patient satisfaction have significant positive impacts on patient’s choice for low-level hospitals with the existence of mediating effect of satisfaction. Conclusions: This paper provides supporting empirical evidence of the descending resources reform’s impact on patients’ low-level hospital selection. This reform has been effective in improving the capabilities of low-level hospitals, and brand implantation of high-level hospitals shows strong explanatory power. China’s reform offers a distinct and valuable approach to correcting the uneven allocation of health resources. Besides, the findings also suggest that policymakers could pay more attention to the importance of information channels in impacting patient awareness, responses, and hospital selection.
A Retrospective Study of 51 Pediatric Cases of Traumatic Asphyxia
Authors: huirong luo , jin xin 
Published: April 2021

Abstract
Backgroundtraumatic asphyxia (TA) is a rarely reported disease characterized as thoraco-cervico-facial petechiae, facial edema and cyanosis, subconjunctival hemorrhage and neurological symptoms. This study aimed to report 51 children of TA at the pediatric medical center of west China.Methodsscanned medical reports were reviewed and specific variables as age, sex, cause of injury, clinical manifestations and associated injuries were analyzed using SPSS 25.0.Resultsaged as 5.3±2.9 (1.3-13.2), 30 (58.8%) were boys and 21 (41.2%) were girls. Most TAs occurred during vehicle accident, object compression and stampede. All patients showed facial petechiae (100.0%, CI 93.0%-100.0%), 25 (49.0%, CI 34.8%-63.2%) out of 51 presented with facial edema, 29 (56.9%, CI 42.8%-70.9%) presented with subconjunctival hemorrhage, including bilateral 27 and unilateral 2. 6 patients had facial cyanosis (11.8%, CI 2.6%-20.9%). Other symptoms were also presented as epileptic seizure, vomiting, incontinence, paraplegia, etc. The most frequent companion injury was pulmonary contusion (76.5%, CI 64.4%-88.5%). Other companion injuries included mediastinal emphysema, fracture, cerebral contusion and hemorrhage, hypoxic-ischemic brain injury, abdominal organ contusion, mastoid hemorrhage, hematocele of paranasal sinuses, spinal injury, hepatic insufficiency, myocardial injury and retinal hemorrhage and edema. Treatment was mainly supportive. No death occurred in our study. The prognosis is rather good if without damage of central nervous system.ConclusionTA could bring out multiple symptoms, among which retinal hemorrhage and edema, spinal injury and viscera impairment have been less observed. Comprehensive physical and auxiliary examination should be performed considering TA. Its prognosis is rather good with focus on life-threatening complications.
The aging whole blood transcriptome reveals a potential role of FASLG in COVID-19
Authors: Chuffa Luiz Gustavo , Freire Paula Paccielli , Souza Jeferson dos Santos , Mello Mariana Costa de , Neto Mario de Oliveira , Carvalho Robson Francisco 
Published: April 2021

Abstract
The risk for severe COVID-19 increases with age as older patients are at the highest risk. Identifying how Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) interacts with blood components during aging is urgent. We investigated the aging whole blood transcriptome from the Genotype-Tissue Expression (GTEx) database to explore differentially expressed genes (DEGs) translated into proteins interacting with viral proteins. From 22 DEGs in aged blood, FASLG, CTSW, CTSE, VCAM1, and BAG3 changed their expression with involvement in immune response, inflammation, cell component and adhesion, and platelet activation/aggregation. Males and females older than 50 overexpress FASLG possibly inducing a hyper-inflammatory cascade. The expression of cathepsins (CTSW and CTSE) and the anti-apoptotic co-chaperone molecule BAG3 was increased throughout aging in both gender. By exploring publicly available Single-Cell RNA-Sequencing data on peripheral blood of SARS-CoV-2-infected patients, we found FASLG and CTSW expressed in natural killer cells and CD8 + T lymphocytes, whereas BAG3 was expressed in CD4 + T cells, naive T cells, and CD14 + monocytes. The expression of FASLG in aged blood may explain why older patients are more prone to viral infection complications. The results indicate FASLG as a prognostic candidate and potential therapeutic target for the more aggressive clinical manifestation of COVID-19. The reduction of FASLG could be helpul against disease progression.
Increasing Perioperative Risk Scoring in Emergency Laparotomy: A Surgical Trainee-Led Nationwide Quality Improvement Programme
Authors: Nally Deirdre M , Lonergan Peter E , Connell Emer P O , McNamara Deborah 
Published: April 2021

Abstract
Background: Emergency laparotomy is associated with high morbidity and mortality. The early identification of high-risk patients allows for the provision of timely perioperative care and appropriate resource allocation. The aim of this study was to develop a nationwide surgical trainee-led quality improvement (QI) programme to increase the use of perioperative risk scoring in emergency laparotomy.Methods: The programme was structured using the active implementation framework in 15 state-funded Irish hospitals to guide the staged implementation of perioperative risk scoring. The primary outcome was a documented preoperative risk score for patients undergoing an emergency laparotomy at each site.Results: The percentage of patients undergoing emergency laparotomy who received perioperative risk scoring increased from 0-11% during the exploratory phase to 35-100% during the full implementation phase. This change was consistently maintained throughout the full implementation phase of the programme.Conclusions: A trainee-led QI programme increased the use of perioperative risk assessment in patients undergoing emergency laparotomy, suggesting that such an approach may be feasible for improving patient outcomes and care delivery performance.
Warming enhanced the climate temporal effects on vegetation across Siberia
Authors: Shi Shangyu , Wang Ping , Zhang Yichi , Yu Jingjie 
Published: April 2021

Abstract
Widespread climate warming and growing season greening have been observed across most of the Northern Hemisphere in recent decades. However, the response of greening to amplified warming remains unclear with regard to the temporal effects (cumulative and time-lag effects) in cold regions of the Northern Hemisphere. We therefore provide a comprehensive analysis of the relationship between the enhanced vegetation index (EVI) and climate factors (e.g., land surface temperature (LST), precipitation, and solar radiation) across Siberia, which is experiencing rapid warming and greening, during 2000–2016 by using a random forest regression model. We found that solar radiation was the dominant driving factor of vegetation greening in 55.95% of the study area (concentrated in southwest Siberia), followed by temperature (41.28%, concentrated in northeast Siberia) and precipitation (2.78%). Furthermore, the cumulative and time-lag effects increased the explanation of vegetation variation by climate factors, from 0.71 to 0.78, and were observed in more than 80% of the area of Siberia. The average cumulative duration was 3.61 ± 1.97 months, and the time-lag period was 1.51 ± 1.20 months, with the longest term found in deciduous broadleaf forests and the shortest term found in shrublands. Our results indicated that the vegetation activities were influenced by cumulative effects combined with time-lag effects. The temporal effects varied with land cover categories, and the complex ecosystem generally corresponded to long-term temporal effects, and vice versa. Hence, the tundra shrub converted to boreal forest caused by warming in Siberia enhanced the climate temporal effects.
Eliminating Mosquitoes with Precision Guided Sterile Males
Authors: Li Ming , Yang Ting , Bui Michelle , Gamez Stephanie , Wise Tyler , Kandul Nikolay , Liu Junru , Alcantara Lenissa , Lee Haena , Edula Jyotheeswara , Raban Robyn , Zhan Yinpeng , Wang Yijin , DeBeaubien Nick , Chan Jieyan , Sanchez Hector , Bennett Jared , Antoshechkin Igor , Montell Craig , Marshall John , Akbari Omar 
Published: April 2021

Abstract
The mosquito Aedes aegypti is the principal vector for arboviruses including dengue/yellow fever, chikungunya, and zika, infecting hundreds of millions of people annually. Unfortunately, traditional control methodologies are insufficient, so innovative control methods are needed. To complement existing measures, here we develop a molecular genetic control system termed precision guided sterile insect technique (pgSIT) in Aedes aegypti. PgSIT uses a simple CRISPR-based approach to generate sterile males that are deployable at any life stage. Supported by mathematical models, we empirically demonstrate that released pgSIT males can compete, suppress, and eliminate mosquitoes in multigenerational population cages. This platform technology could be used in the field, and adapted to many vectors, for controlling wild populations to curtail disease in a safe, confinable, and reversible manner.
The Fusion Circular RNA F-circEA1 Promotes Non-small Cell Lung Carcinoma Progression through ALK Downstream Signaling
Authors: Huo yinping , Lv Tangfeng , Ye Mingxiang , Zhu Suhua , Liu Jiaxin , Liu Hongbing , Song Yong 
Published: April 2021

Abstract
Background Circular RNA has a stable closed structure, which plays an important role in the occurrence and development of tumors. However, there are no reports on the relationship between fusion circular RNA and EML4-ALK variant 1, or their underlying molecular mechanisms in non-small cell lung carcinoma (NSCLC). Methods To test F-circEA1 in NCI-H3122 cells (carrying the EML4-ALK variant 1 gene) by RT-PCR, FISH and Sanger sequencing; To determine cell proliferation with a CCK-8 assay. Transwell experiments were used to detect cell migration and invasion. Cell cycle stage and apoptosis were detected by flow cytometry. The sensitivity of cells to crizotinib was tested using a CCK-8 assay. RT-PCR and western blots were used to measure the expression of EML4-ALK1 and downstream signaling factors associated with ALK. Subcutaneously transplanted tumors were used in nude mice to determine the effect of F-circEA1 on tumor formation and the expression of EML4-ALK1 by immunohistochemistry. Statistical analyses were carried by GraphPad Prism 8.0 and differences between groups were compared using Student's t test. Difference with p value <0.05 is statistically significant.Results F-circEA1 was present both in the cytoplasm and nucleus of NCI-H3122 cells. F-circEA1 was contributed to cell proliferation, metastasis, invasion. F-circEA1 induced cell arrest, promoted cell apoptosis and improved drug sensitivity to crizotinib. After knockdown with F-circEA1, subcutaneously transplanted tumors in nude mice grew slowly, the expression of EML4-ALK1 in tumor tissues decreased significantly. The mRNA and protein levels of EML4-ALK1 decreased after knockdown of F-circEA1 but increased after its overexpression. The protein expression of downstream ALK signaling factors increased after overexpression of F-circEA1, but not at the mRNA level.Conclusions We have confirmed a potential carcinogenenic and therapeutic role for F-circEA1 in NSCLC. Our experimental results may provide a new biomarker, treatment method, and prognostic monitoring index for use in the clinic.
FCTC Ratification, Smoking Prevalence and GDP per Capita : Lesson Learn for Indonesia
Authors: Ahsan Abdillah , Afin Rifai , Amalia Nadira , Hindriyani Martha , Jacinda Ardhini Risfa 
Published: April 2021

Abstract
Background The stagnated tobacco control progress in Indonesia needs to be accelerated through a more comprehensive implementation of Framework Convention of Tobacco Control (FCTC) measurement. Nevertheless, the tobacco industry argument concerning the negative economic impacts of tobacco control still hinders the government to ratify or even sign the FCTC, which has been ratified by more than 180 countries. This study aims to bring the empirical evidence on the tobacco industry argument concerning FCTC. This study applied two stage least square estimation strategy to unbalanced panel data at country level. On the first stage we estimate the impact FCTC ratification on smoking activity, and on the second step, estimating the influence of smoking activities on macroeconomic performance.Results The result of this study shows that FCTC ratification is negatively related to a country’s smoking prevalence, in which the ratifying party of FCTC has lower smoking prevalence. Moreover, country who ratifies FCTC longer is also associated with lower smoking prevalence. Whereas FCTC ratification is beneficial in reducing smoking prevalence, the declining smoking prevalence is not related to the decline in GDP per capita.Conclusions The result of this study shows the decrease in smoking prevalence has nothing to do with the macroeconomic indicator. Hence, FCTC ratification, which is an important driver for tobacco control actions acceleration, should not be seen as a backfire to the economy. Instead, FCTC ratification could be mutually beneficial for the health and economic aspects as it provides comprehensive guidance and protocols by taking into account the well-being states of both aspects.
Pilot Study to Explore the Use of Mobile Spaced Learning as a Digital Learning Platform When Teaching Symptom Management to Undergraduate Nursing Students: Splendids Study
Authors: Veigh Clare Mc , Carlisle Susan , Birch Matt , Ace Lindsay , Oliver Christine , Kerr Helen 
Published: April 2021

Abstract
Background: The management of patients’ holistic symptom needs are often complex and challenging. The education needs of undergraduate nursing students must be optimally addressed to have a significant positive impact on patient care. Mobile spaced learning has been recognised as a form of online education which can provide a novel approach to delivering effective evidence based healthcare education to undergraduate students. The objective of this pilot study was to explore the experiences of undergraduate nursing students in a university setting, of using mobile spaced learning as a digital platform for symptom management education.Methods: This pilot study used a mixed methods approach. Online spaced learning material, which utilised both case based scenarios and multiple choice questions, was delivered to first year undergraduate nursing students over a period of 2 weeks. Participants were then invited to participate in an online survey related to the usability of mobile spaced learning. A focus group was conducted to further explore the participants’ views.Results: Findings conveyed that students viewed mobile spaced learning as an acceptable platform that enhanced both their learning and their ability to transfer knowledge into clinical practice. Conclusions: Implementation of a digital spaced learning intervention would be acceptable to undergraduate nursing students learning about holistic symptom management. Further research is needed to explore the feasibility of implementing this intervention within the undergraduate nursing curriculum, and also to explore the impact on long-term knowledge retention.
Differences in Clinical Nature and Outcome Among Youth and Older Patients Suffering from an Acute Coronary Syndrome
Authors: Al-Shahrani Mohammad Saeed , Katbi Faisal Ahmad , Al-Sharydah Abdulaziz Mohammad , AlShahrani Saad Dhafer , Al-Ghamdi Talal Mosfer , Al-Sharidah Mohammad Adnan 
Published: April 2021

Abstract
Objective: Acute coronary disease (ACS) is an acute regional reduction in coronary blood flow. Pathophysiology, clinical appearance, risk factors and clinical outcomes may vary between younger and older patients. The purpose of this study was to assess these factors in patients less than 45 years of age compared to older adults admitted with a ACS diagnosis.Patients and methods: Retrospective chart review study of ACS patients admitted between 2015 and 2020. Results: Overall, 652 patients were enrolled. Of these, 109 patients (16.7%) were under 45, with a mean age of 38 ± 7. Younger patients showed a higher rate of palpitation (23.9% versus. 13.6%; P = 0.019). A positive smoking history and a family history of CAD were seen more often in younger patients (42.2% vs. 27.3%, P < 0.001; 22.9% vs. 9.4%, P < 0.001, respectively). Older patients had greater renal impairment with higher creatinine (median = 1.10 mg /dl (range, 0.3-13.0) vs. 1.0 (0.3-19.0; p = 0. 001), BUN (median = 16.0 (mange, 0.9-141.0) vs 12.0 (0.9-49.0); P < 0.001)).Younger patients had higher levels of LDL and total cholesterol (median 138c. 115; p < 0.001) and cholesterol (median 209 vs. 178.5; p < 0.001). Hospital mortality was 0.9% in younger patients versus 7.4% in older patients (P=0.004). Conclusion: Palpitations, smoking, family history, higher LDL levels, and total cholesterol levels were more prevalent in adults younger than 45 years old with ACS. Impaired renal function, hypertension, and diabetes were more in older patients with ACS.
Factors Related to Interprofessional Collaboration and Teamwork Climate in the Family Health Strategy
Authors: Vasconcelos Jader , Higashijima MARCIA Naomi Santos , Costa Marcelo Viana , Probst Livia Fernandes , Santos Mara Lisiane Moraes dos , Souza Albert Schiaveto , Carli Alessandro Diogo De 
Published: April 2021

Abstract
Background: Working with an interprofessional focus is increasingly necessary, in view of the growing complexity of the population's health needs. This study aims to assess interprofessional collaboration and the teamwork climate in primary health care and determine whether there is a relationship between these two variables. In addition, the relationship of these two measures with the participants' sociodemographic variables was also analyzed. Methods: The AITCS-II instrument was used to measure interprofessional collaboration, while to diagnose teamwork climate, the ECTE instrument was used, a version adapted to the SUS context of the Teamwork Climate Inventory instrument. These two instruments were applied online together with a questionnaire for the sociodemographic characterization of the 544 participants, who belonged to 97 Family Health Strategy teams in a Brazilian municipality. Results: The study showed a strong correlation between interprofessional collaboration and teamwork climate. The studied sample had an unsatisfactory overall score regarding interprofessional collaboration. In addition, there was no relationship between teamwork climate or interprofessional collaboration and the participants' sociodemographic data; including the time of training and the presence or absence of postgraduate studies in public health or family health in the curriculum. Conclusions: The study corroborates the literature, by indicating a correlation between teamwork and interprofessional collaboration, pointing to ECTE as another way to evaluate interprofessional work and the health work process. As for the sociodemographic variables, the results raise an alert towards the strengthening of interprofessional education actions, both during the training of new professionals and in the work process of professionals who are already working.
Frequency of Psychosomatic-Prone Myofascial Pain Syndrome in Patients with Incurable Cancer and its Association with the Armchair Sign: A Secondary Analysis of A Prospective, Multicenter, Observational Clinical Study
Authors: Hasuo Hideaki , Ishiki Hiroto , Matsuda Yoshinobu , Matsuoka Hiromichi , Hiramoto Shuji , Kinkawa Junya , Nojima Masanori 
Published: April 2021

Abstract
Background

Few studies have reported psychosomatic-prone functional damage in cancer patients. Because psychosomatic diseases are pathological conditions, it is difficult to identify their degrees. The armchair sign is a test used to assess voluntary muscle relaxation. This study aimed to evaluate the frequency of psychosomatic-prone functional damage in cancer patients and its association with the armchair sign.
Methods

This was a secondary analysis of a prospective, multicenter, observational clinical study. We evaluated the frequency of psychosomatic-prone myofascial pain syndrome (MPS) in patients with incurable cancer who were at the start of palliative care and how it is associated with the armchair sign. Moreover, we assessed the usefulness of the armchair sign for the diagnosis of psychosomatic-prone MPS.
Results

A total of 101 patients were enrolled from March 2018 to December 2018, of whom 44 met MPS diagnostic criteria. Of these, 27 patients (61.3%) had psychosomatic-prone MPS. There was a significant association between the armchair sign and psychosomatic-prone MPS (p = 0.002). Sensitivity and specificity were 40.7% (95% confidence interval: 18.0–63.4) and 100.0%, respectively. The area under the curve score was 0.704 (95% confidence interval: 0.553–0.855).
Conclusions

MPS in patients with incurable cancer has a high frequency of psychosomatic pathology. The armchair sign may be useful as an ancillary test for the diagnosis of psychosomatic-prone MPS.
Trial registration:
UMIN000031338. Registered 16 February 2018.