bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Homocysteine Level with Adverse Outcomes in Patients with Acute Ischemic Stroke: A Meta-Analysis
Authors: Zhang Heng , Huang Jiabin , Zhou Yongjing , Fan Yu 
Published: April 2021

Background:
Studies on the prognostic value of homocysteine level have
yielded controversial results in patients with acute ischemic stroke (AIS). The aim of this
meta-analysis was to evaluate the prognostic utility of homocysteine among patients with
AIS in terms of recurrent stroke, poor functional outcome or all-cause mortality.

Methods:
Two independent authors searched the articles published in PubMed and Embase
databases prior to March 31, 2020. Original studies that investigated the value of homocysteine
level in predicting recurrent stroke, poor functional outcome (modified
Rankin Scale ≥ 3) or all-cause mortality in AIS patients were eligible.

Results:
Eleven articles (10 studies) that enrolled 19,435 patients with AIS were included.
Meta-analysis indicated that the patients with the highest homocysteine level had an
increased risk of all-cause mortality (risk ratio [RR] 1.40; 95% confidence interval [CI]
1.26-1.55). However, elevated homocysteine level was not significantly associated with
recurrent stroke (RR 1.28; 95% CI 0.99-1.65) or poor functional outcome (RR 1.71; 95%
CI 0.77-3.83).

Conclusion:
Elevated homocysteine level is independently associated with a higher risk
of all-cause mortality but not recurrent stroke or poor functional outcome in patients with
AIS. However, additional well-designed studies are required to confirm the findings of
this meta-analysis.
Advances in Polyaniline for Biomedical Applications
Authors: Pina Cristina Della , Falletta Ermelinda 
Published: April 2021

:
Conducting polymers are an outstanding class of materials characterized by
electroconductive properties that make them good candidates for applications in several
sectors. Among them, polyaniline (PANI) is unique for its extraordinary ability to
conduct electricity, biocompatibility, and low toxicity. In spite of its surprising features,
to date, PANI has not found application in practical uses due to its low solubility and processability.
In order to overcome these limitations, different approaches have been developed,
such as polymer grafting processes, PANI-based composites, and blends preparation.
The present review describes the most recent advances on PANI applications in
biomedical fields, such as antioxidant, antimicrobial and antivirus activity, drug delivery,
cancer therapy, etc. In this article, synthetic procedures are also reported which are crucial
for the realization of more innovative materials in the future.
Prospects of Non-Coding Elements in Genomic DNA Based Gene Therapy
Authors: Simna S.P. , Han Zongchao 
Published: April 2021

:
Gene therapy has made significant development since the commencement of the first
clinical trials a few decades ago and has remained a dynamic area of research regardless of obstacles
such as immune response and insertional mutagenesis. Progression in various technologies
like next-generation sequencing (NGS) and nanotechnology has established the importance of non--
coding segments of a genome, thereby taking gene therapy to the next level. In this review, we
have summarized the importance of non-coding elements, highlighting the advantages of using full-
length genomic DNA loci (gDNA) compared to complementary DNA (cDNA) or minigene, currently
used in gene therapy. The focus of this review is to provide an overview of the advances and
the future of potential use of gDNA loci in gene therapy, expanding the therapeutic repertoire in
molecular medicine.
Factors Influencing Patient Satisfaction with Healthcare Services Offered in Selected Public Hospitals in Bulawayo, Zimbabwe
Authors: Nyakutombwa Content P. , Nunu Wilfred N. , Mudonhi Nicholas , Sibanda Nomathemba 
Published: April 2021

Introduction:
Patient satisfaction with health care services is vital in establishing gaps to be improved, notably in public health facilities utilised by the majority in Low and Middle-Income Countries. This study assessed factors that influenced patient satisfaction with United Bulawayo Hospitals and Mpilo Hospital services in Bulawayo in Zimbabwe.

Methods:
A cross-sectional survey was conducted on 99 randomly selected respondents in two tertiary hospitals in Bulawayo. Chi-squared tests were employed to determine associations between different demographic characteristics and patient satisfaction with various services they received. Multiple Stepwise Linear regression was conducted to assess the strength of the association between different variables.

Results:
Most of the participants who took part in the study were males in both selected hospitals. It was generally observed that patients were satisfied with these facilities' services, symbolised by over 50% satisfaction. However, patients at Mpilo were overall more satisfied than those at United Bulawayo Hospitals. Variables “received speciality services,” “average waiting times,” and “drugs being issued on time” were significant contributors to different levels of satisfaction observed between Mpilo and United Bulawayo Hospitals.

Conclusion:
Generally, patients are satisfied with the services and interactions with the health service providers at United Bulawayo Hospitals and Mpilo Hospitals. However, patients at Mpilo were more satisfied than those at United Bulawayo Hospitals. There is generally a need to improve pharmaceutical services, outpatient services, and interaction with health service provider services to attain the highest levels of patient satisfaction.
New Green Animal Waste Hydrolysis Initiated by Malic Acid
Authors: Hanika Jiri , Rouskova Milena , Sabata Stanislav , Kastanek Frantisek , Solcova Olga 
Published: April 2021

Background:
A giant amount of poultry waste represents one of the threats to the environment,
or conversely, a significant source of peptides and other substances in demand. Rational
use of huge quantities of poultry waste, especially after industrial chicken processing, is one of the
pillars of biorefinery of animal wastes.

Introduction:
Six different animal wastes: chicken feathers, cartilages and the residue after meat
separation, sheep wool, rabbit hair, and the rest of the goose feathers from blankets after cleaning
were chosen for a hydrolysis test with malic acid as the initiator.

Result:
The newly designed hydrolysis of animal wastes at 140 oC with malic acid for initiation was
successfully verified for all animal wastes. The resulting hydrolysates contained a mixture of amino
acids, peptides, proteins, glycoproteins, and no salts.

Conclusion:
Hydrolysate applications for agriculture was successfully tested as a biostimulant in
the form of a 10% water solution.
Effects of Propolis Extract Supplementation during Pregnancy on Stress Oxidative and Pregnancy Outcome: Levels of Malondialdehyde, 8-Oxo-2â€²-Deoxogunosine, Maternal Body Weight, and Number of Fetuses
Authors: Wibowo Joko Wahyu , Fasitasari Minidian , Zulaikhah Siti Thomas 
Published: April 2021

Oxidative stress is related to pregnancy complications that could increase maternal and infant mortality. This study aimed to determine the effect of propolis extract supplementation during pregnancy on oxidative stress level and pregnancy outcomes utilizing Malonedealdehyde (MDA) and 8-Oxo-2â€²-Deoxogunosine (8-OHdG) levels, maternal body weight, and the average number of fetuses as the parameters. The study was conducted by using a posttest only control group design on 24 pregnant Wistar rats, which were divided into four groups. Group I was control, Group II-IV were the treatment groups given propolis extract of 1.8mg, 3.6mg, and 7.2mg/200gBW/day, respectively. The standard feed given was AIN93G dose of 20g/day and distilled water ad libitum. Propolis extract was given using a gastric feeding tube every morning for 20 days. At the end of the treatment, body weight was meisured and blood collected for assessed MDA and 8-OHdG levelsÂ by ELISA methodÂ and then we performed abdominal surgery to count number of fetuses. The result are there were decreasing level of MDA and 8-OHDG by administration of propolis significantly (p<0.05) group: I: 2,04Â±0,091, II: 1,55Â±0,067, III: 1,05Â±0,176, IV: 0,73Â±0,075 (mmol/mL) (p=0.001); 8 OHdG level (ng/mL) group I: 10,02Â±0,403, II: 8,60Â±0,078, III: 7,89Â±0,051, IV: 7,53Â±0,063 (p=0,001). Average of maternal body weight (g) were increased: group I: 228,33Â±3,93, II: 237,17Â±4,36, III: 244,83Â±4,02, IV: 248,00Â±5,76 (p=0,001) and Average number of fetuses tend to increased as well, group I : 8,5Â±0,05, II: 7,8Â±0,41, III: 9,5Â±1,05, IV: 9,6Â±0,52 (p=0,02). The conclusion of this research are supplementation of propolis extract in pregnant rats can reduce oxidative stress and improve pregnancy outcomes.
Evaluation of the Effectiveness of Digital Technology Interventions to Reduce Loneliness in Older Adults: Systematic Review and Meta-analysis
Authors: Shah Syed Ghulam Sarwar , Nogueras David , van Woerden Hugo Cornelis , Kiparoglou Vasiliki 
Published: April 2021

Background
Loneliness is a serious public health issue, and its burden is increasing in many countries. Loneliness affects social, physical, and mental health, and it is associated with multimorbidity and premature mortality. In addition to social interventions, a range of digital technology interventions (DTIs) are being used to tackle loneliness. However, there is limited evidence on the effectiveness of DTIs in reducing loneliness, especially in adults. The effectiveness of DTIs in reducing loneliness needs to be systematically assessed.

Objective
The objective of this study is to assess the effectiveness of DTIs in reducing loneliness in older adults.

Methods
We conducted electronic searches in PubMed, MEDLINE, CINAHL, Embase, and Web of Science for empirical studies published in English from January 1, 2010, to July 31, 2019. The study selection criteria included interventional studies that used any type of DTIs to reduce loneliness in adults (aged ≥18 years) with a minimum intervention duration of 3 months and follow-up measurements at least 3 months after the intervention. Two researchers independently screened articles and extracted data using the PICO (participant, intervention, comparator, and outcome) framework. The primary outcome measure was loneliness. Loneliness scores in both the intervention and control groups at baseline and at follow-up at 3, 4, 6, and 12 months after the intervention were extracted. Data were analyzed via narrative synthesis and meta-analysis using RevMan (The Cochrane Collaboration) software.

Results
A total of 6 studies were selected from 4939 screened articles. These studies included 1 before and after study and 5 clinical trials (4 randomized clinical trials and 1 quasi-experimental study). All of these studies enrolled a total of 646 participants (men: n=154, 23.8%; women: n=427, 66.1%; no gender information: n=65, 10.1%) with an average age of 73-78 years (SD 6-11). Five clinical trials were included in the meta-analysis, and by using the random effects model, standardized mean differences (SMDs) were calculated for each trial and pooled across studies at the 3-, 4-, and 6-month follow-ups. The overall effect estimates showed no statistically significant difference in the effectiveness of DTIs compared with that of usual care or non-DTIs at follow-up at 3 months (SMD 0.02; 95% CI −0.36 to 0.40; P=.92), 4 months (SMD −1.11; 95% CI −2.60 to 0.38; P=.14), and 6 months (SMD −0.11; 95% CI −0.54 to 0.32; P=.61). The quality of evidence was very low to moderate in these trials.

Conclusions
Our meta-analysis shows no evidence supporting the effectiveness of DTIs in reducing loneliness in older adults. Future research may consider randomized controlled trials with larger sample sizes and longer durations for both the interventions and follow-ups.

International Registered Report Identifier (IRRID)
RR2-10.1136/bmjopen-2019-032455
Health Care Cybersecurity Challenges and Solutions Under the Climate of COVID-19: Scoping Review (Preprint)
Authors: He Ying , Aliyu Aliyu , Evans Mark , Luo Cunjin 
Published: April 2021

BACKGROUND

COVID-19 has challenged the resilience of the health care information system, which has affected our ability to achieve the global goal of health and well-being. The pandemic has resulted in a number of recent cyberattacks on hospitals, pharmaceutical companies, the US Department of Health and Human Services, the World Health Organization and its partners, and others.

OBJECTIVE

The aim of this review was to identify key cybersecurity challenges, solutions adapted by the health sector, and areas of improvement needed to counteract the recent increases in cyberattacks (eg, phishing campaigns and ransomware attacks), which have been used by attackers to exploit vulnerabilities in technology and people introduced through changes to working practices in response to the COVID-19 pandemic.

METHODS

A scoping review was conducted by searching two major scientific databases (PubMed and Scopus) using the search formula “(covid OR healthcare) AND cybersecurity.” Reports, news articles, and industry white papers were also included if they were related directly to previously published works, or if they were the only available sources at the time of writing. Only articles in English published in the last decade were included (ie, 2011-2020) in order to focus on current issues, challenges, and solutions.

RESULTS

We identified 9 main challenges in cybersecurity, 11 key solutions that health care organizations adapted to address these challenges, and 4 key areas that need to be strengthened in terms of cybersecurity capacity in the health sector. We also found that the most prominent and significant methods of cyberattacks that occurred during the pandemic were related to phishing, ransomware, distributed denial-of-service attacks, and malware.

CONCLUSIONS

This scoping review identified the most impactful methods of cyberattacks that targeted the health sector during the COVID-19 pandemic, as well as the challenges in cybersecurity, solutions, and areas in need of improvement. We provided useful insights to the health sector on cybersecurity issues during the COVID-19 pandemic as well as other epidemics or pandemics that may materialize in the future.

CLINICALTRIAL
Analisis Distribusi Apotek Berdasar Standar Pelayanan Kefarmasian Melalui Sistem Informasi Geografis
Authors: Dahbul Nura Ali , Yasin Nanang Munif , Lazuardi Lutfan 
Published: April 2021

Apotek sebagai fasilitas kesehatan primer yang menjangkau seluruh lapisan masyarakat. Faktor lokasi apotek berperan dalam kualitas pelayanan dan keberlangsungan bisnis apotek. Tujuan penelitian adalah memberikan gambaran mengenai profil distribusi apotek melalui sistem informasi geografis dari segi aksesibilitas masyarakat dalam pelayanan apotek berdasar standar WHO dan Kemenkes serta evaluasi standar pelayanan kefarmasian apotek sesuai permenkes no 73 tahun 2016.Penelitian ini berupa cross-sectional menggunakan analisis deskriptif non eksperimental secara kuantitatif. Pengumpulan data nama dan lokasi apotek melalui PC IAI Kota dan Kabupaten Pekalongan dan Dinas Kesehatan Kota dan Kabupaten Pekalongan. Data geografi dan jumlah penduduk serta tingkat kepadatan penduduk diperoleh dari Badan Pusat Statistik Kota dan Kabupaten Pekalongan. Analisis distribusi apotek melalui sistem informasi geografis diperoleh melalui visualisasi terhadap peta persebaran apotek di Kota dan Kabupaten Pekalongan, hasil yang diperoleh belum merata di seluruh wilayah Pekalongan. Ada kecamatan yang belum ada apotek dan banyak apotek yang terkonsentrasi pada titik tertentu di pusat kota, dekat rumah sakit dan dekat pasar. Analisa aksesibilitas pelayanan apotek dengan perhitungan rasio antara jumlah apotek dengan jumlah penduduk di setiap kecamatan di Kota dan Kabupaten Pekalongan dibandingkan dengan standar WHO dan Kemenkes yaitu 1:2000 apoteker, diperoleh hasil hanya lima kecamatan yang memenuhi syarat Kemenkes.Evaluasi penerapan Permenkes no 73 tahun 2016 tentang prosedur pelayanan kefarmasian terdiri dari pengelolaan sediaan farmasi dan pelayanan farmasi klinis. Analisis data kuantitatif dilakukan menggunakan skala Guttman. Kemudian dibagi tiga kategori yaitu baik (81-100%), cukup (61-80%), dan kurang (20-60%). Hasil penelitian diperoleh rerata tingkat pengelolaan obat 75,04 % pada apotek kota dan 70,06% apotek kabupaten Pekalongan, pelayanan farmasi klinis 55,32% apotek kota Pekalongan dan 57,45% di wilayah kabupaten Pekalongan, pengelolaan SDM 82,36% wilayah kota Pekalongan dan 78,57% wilayah kabupaten Pekalongan. Sarana dan prasarana kota Pekalongan 67,66% dan 66,51% di kabupaten Pekalongan. Dapat disimpulkan bahwa tingkat penerapan standar pelayanan kefarmasian di apotek termasuk dalam kategori cukup, namun pelayanan farmasi klinis tergolong kategori kurang.
Pengaruh Komponen Neraca Air Terhadap Produktivitas Kelapa Sawit pada Berbagai Jenis Tanah:: Studi Kasus Kalimantan Tengah dan Barat
Authors: Ardiyanto Adhy , Murtilaksono Kukuh , Dwi Wahjunie Enni , Sutandi Atang 
Published: April 2021

Perbedaan jenis tanah dan letak geografis kebun kelapa sawit menyebabkan variasi sifat fisik tanah (terutama tekstur dan porositasnya). Perbedaan letak geografis juga menyebabkan variasi jumlah curah hujan yang mempengaruhi neraca air lahan. Respons fluktuasi produksi kelapa sawit yang berbeda akibat variasi jenis tanah dan neraca air lahan dapat dikaji dengan analisis hubungan neraca air lahan dan produktivitas kelapa sawit antar jenis tanah dan antar wilayah. Pada penelitian ini, analisis neraca air lahan dilakukan pada tiga lokasi area perkebunan kelapa sawit PT Bumitama Gunajaya Agro yang berada di provinsi Kalimantan Tengah dan Kalimantan Barat, menggunakan metode Thornthwaite-Mather. Analisis hubungan komponen neraca air dengan produksi TBS kelapa sawit dihitung berdasarkan data bulanan selama 8 tahun (2012 – 2019) menggunakan time series analysis dan untuk mencari model regresi terbaik digunakan stepwise regression. Komponen neraca air yang paling mempengaruhi produksi tandan buah segar (TBS) kelapa sawit (ton/ha/bulan) adalah curah hujan 7 bulan sebelum panen, hari hujan 11 dan 28 bulan sebelum panen, dan defisit air 10 bulan sebelum panen. Penurunan produksi TBS (ton/ha/bulan) terjadi setiap ada kenaikan defisit air senilai 10 mm/bulan pada tanah Dystrudept, Paleudults dan Haplohumods di Area 3 berturut-turut adalah 11, 2, dan 3%. Pada Area 5 penurunannya adalah 12, 4, dan 5%. Pada Area 6 penurunannya adalah 5, 18 dan 3%.
A Method for Assessing the Severity of Obstructive Jaundice of Non-Neoplastic Origin
Authors: Vlasov A. P. , Sheyranov N. S. , Markin O. V. , Vlasova T. I. , Muratova T. A. , Ryazantsev V. E. , Timoshkin D. E. , Sinyavina K. M. , Kolesov A. V. 
Published: April 2021

AIM OF STUDY To develop a method for assessing the severity of obstructive jaundice (OJ) of non-neoplastic orogin on the basis of functional parameters of the liver and the activity of pathogenetic agents of hepatodepression.MATERIAL AND METHODS Clinical and laboratory studies of 142 patients with breast cancer of non-tumor origin. The indicators of the functional state of the liver, the index of plasma toxicity for albumin, and the content of malondialdehyde (MDA) were evaluated.RESUlTS Based on the assessment of a number of blood parameters - the content of total bilirubin (TB), the plasma toxicity index for albumin, the MDA level — the severity index of obstructive jaundice of non-neoplastic origin (SIOJ) was developed:SIOJ = IT1/ITn + TB1/TB + 5(MDA1/MDAn)where IT 1 is the plasma albumin toxicity index at the current moment, ITn is the normal albumin plasma toxicity index, TB1 is the current bilirubin content, TBn is the normal bilirubin content, MDA1 is the current malondialdehyde content, MDAn is the normal value. The index less than 13 indicates a mild severity, 14–21 is moderate severity, 22 and higher indicates a severe degree of OJ. The method increases the objectivity of determining the severity of non-neoplastic origin by establishing the severity of liver damage and the processes underlying it.CONClUSiON The suggested clinical and laboratory index allows the severity of obstructive jaundice to be objectively and quickly determined upon admission of a patient to the hospital and also adequate therapy to be initiated in case of severe degree for anticipation of possible post-operative complications, so the treatment should be focused on managing triggers of hepatodepression. The method is simple and available in medical institutions of various levels. The method is especially valuable when used in the dynamics of the early postoperative period.
Atypical Manifestation of Crohn’s Disease in a Teenage Girl
Authors: Donskaya E. V. , Gavrilyuk V. P. , Kostin S. V. , Severinov D. A. , Zakutayeva L. Y. 
Published: April 2021

Crohn’s disease (CD) is nonspecific granulomatous inflammatory disease of all layers of the intestinal wall, characterized by a variety of clinical forms, heterogeneity of age groups of children and extraintestinal manifestations. The diagnosis of the disease is difficult due to the presence of many symptoms specific to a number of other surgical diseases of the abdominal cavity organs. This diagnosis is often made intraoperatively. In this study we report a case of treatment of a teenage girl who was admitted with complaints of a mass in the right iliac region extruding above the skin surface, instability of body weight, an increase in body temperature to 37.2° C for one month. As a result of laboratory and instrumental examination, the etiology was not established. Laparoscopy revealed abdominal infiltrate, consisting of the cecum, the distal ileum and a part of the greater omentum, tightly fixed to the anterior abdominal wall, which led to the destruction ofthe peritoneum, muscle tissue and aponeurosis with further infiltration into the sub-cutaneous fat. Appendectomy and separation of the infiltrate were performed. After that, the girl was discharged due to the categorical refusal of the parents of the further treatment.Twelve days later the patient had abdominal pain again, the dynamics of the pain syndrome intensified, the body temperature was febrile. After examination and detection of signs of peritonitis, emergency laparotomy, subtotal resection of the greater omentum, separation of the abdominal infiltrate (repeated), sanitation and drainage of the abdominal cavity were performed. During the surgery, the access to the abdominal cavity was performed with technical difficulties due to the fact that a conglomerate of intestinal loops and omentum was fixed to the anterior abdominal wall from the interior. The conglomerate was separated from the anterior abdominal wall by blunt dissection. The size of the conglomerate was up to 12–15 cm, formed by the transverse colon, the ileum and the greater omentum. The walls of the transverse colon and ileum in the area of the conglomerate had the cartilaginous density. For the purpose of further examination and determination of tactics for further treatment, the child was transferred to the Gastroenterology Department with a diagnosis of “Terminal ileitis. Purulent omentitis. Serous peritonitis. Mild normochromic anemia of mixed origin. Crohn’s disease?” After the additional examination in a specialized hospital, the diagnosis of CD was confirmed.