bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of the type of health care sought for symptoms of Acute respiratory infection in children: analysis of Ghana demographic and health surveys
Authors: Danquah Leslie , Amegbor Prince Michael , Ayele Dawit Getnet 
Published: November 2021

Abstract
Background
Globally, acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Currently, it is estimated that 50 million cases of childhood ARI are untreated. In this study, we identified determinants of the type of treatment sought for symptoms of childhood acute respiratory infection (ARI), including non-treatment, amongst a nationally representative sample of children under five years in Ghana.

Methods
In total, 1 544 children were studied by a secondary analysis of pooled survey data from the 1993, 1998, 2003, 2008, and 2014 Ghana Demographic and Health Surveys (GDHS). Cross-tabulations, chi-square, multinomial logistic regression, and Bayesian hierarchical spatial logistic regression analyses were used to identify relationships between the type of treatment sought and maternal socio-economic and household characteristics.

Results
Seeking medical care was significantly associated with child age (RRR= 1.928, 95 % CI 1.276 – 2.915), maternal employment status (RRR = 1.815, 95 % CI 1.202 – 2.740), maternal health insurance status, (RRR = 2.618, 95 % CI 1.801 – 3.989), children belonging to middle (RRR = 2.186, 95 % CI 1.473 – 3.243), richer (RRR = 1.908, 95 % CI 1.145 – 3.180) and richest households (RRR = 2.456, 95 % CI 1.363 – 4.424) and the 1998 survey period (RRR = 0.426, 95 % CI 0.240 – 7.58). Seeking self-care or visiting a traditional healer was significantly associated with maternal educational status (RRR = 0.000, 95 % CI 0.000 – 0.000), and the 1998 (RRR= 0.330, 95 % CI 0.142 – 0.765), 2003 (RRR= 0.195, 95 % CI 0.071 – 0.535), 2008 (RRR= 0.216, 95 % CI 0.068 – 0.685) and 2014 (RRR= 0.230, 95 % CI 0.081 – 0.657) GDHS periods. The probability that the odds ratio of using medical care exceeded 1 was higher for mothers/caregivers in the Western, Ashanti, Upper West, and Volta regions.

Conclusions
Government policies that are aimed at encouraging medical care-seeking for children with ARI may yield positive results by focusing on improving maternal incomes, maternal NHIS enrolment, and maternal household characteristics. Improving maternal education could be a positive step towards addressing challenges with self-care or traditional healing amongst children with ARI.
Incomplete homicide-suicide in Hunan China from 2010 to 2019: characteristics of surviving perpetrators
Authors: Sun Qiaoling , Zhou Jiansong , Guo Huijuan , Gou Ningzhi , Lin Ruoheng , Huang Ying , Guo Weilong , Wang Xiaoping 
Published: November 2021

Abstract
Background
The mental and psychological conditions of the individuals involved in homicide followed by suicide (H-S) are still unclear, especially in China. Information on these aspects cannot be accurately obtained due to the death of perpetrators. This study aims to demonstrate the characteristics of incomplete H-S with surviving perpetrators, which provide the possibility to obtain detailed mental and psychological information.

Methods
This study explores incomplete H-S events occurred in Hunan, China from 2010 to 2019, in which the surviving perpetrators received a forensic psychiatric assessment. Three aspects of information, i.e., the subject’s demographic, clinical and criminal information, were recorded and analysed.

Results
125 incomplete H-S incidents involved 166 victims were found in the current study. A total of 112 (89.6%) perpetrators were diagnosed with mental disorders, but only 56 of them had a history of consultation due to mental problems, and only one of them adhered to treatment. In most cases, the motivation is related to the psychopathological states, with the most common diagnosis being major depression, followed by schizophrenia. Gender difference was significant among the subjects: females were more likely to have a suicidal history, to be diagnosed as major depression and to be motivated by delirious altruism and family problems.

Conclusions
This study indicated that psychopathology might be a predisposing factor, which highlighted the importance of mental state assessment for the population involved in incomplete H-S. A clearer understanding of the role of mental disorders might be helpful for the intervention of H-S.
Factors associated with the consumption of chlorine dioxide to prevent and treat COVID-19 in the Peruvian population: a cross-sectional study
Authors: Soriano-Moreno David R. , Fernandez-Guzman Daniel , Ccami-Bernal Fabricio , Rojas-Miliano Cristhian , Nieto-Gutierrez Wendy 
Published: November 2021

Abstract
Background
Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population.

Methods
Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method.

Results
Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09–1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35–0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02–1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40–0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01–1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45–0.74), using medications (aPR: 1.59; 95% CI: 1.25–2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21–2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18–0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16–0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33–0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12–0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07–0.32).

Conclusions
The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.
RNAseq of TGF-β receptor type I kinase-dependent genes in oral fibroblast exposed to milk
Authors: Panahipour Layla , Moghaddam Dariush Mehdipour , Nasirzade Jila , Kargarpour Zahra , Gruber Reinhard 
Published: November 2021

Abstract
Background
Milk is a rich source of natural growth factors that may support oral tissue homeostasis and wound healing. We had shown earlier that blocking TGF-β receptor type I kinase with the inhibitor SB431542 abolished the expression of IL11 and other genes in human gingival fibroblasts exposed to the aqueous fraction of milk. Our aim was to identify the entire signature of TGF-β receptor type I kinase-dependent genes regulated by the aqueous fraction of human milk.

Result
RNAseq revealed 99 genes being strongly regulated by milk requiring activation of the SB431542-dependent TGF-β receptor type I kinase. Among the SB431542-dependent genes is IL11 but also cadherins, claudins, collagens, potassium channels, keratins, solute carrier family proteins, transcription factors, transmembrane proteins, tumor necrosis factor ligand superfamily members, and tetraspanin family members. When focusing on our candidate gene, we could identify D609 to suppress IL11 expression, independent of phospholipase C, sphinosine-1 phosphate synthesis, and Smad-3 phosphorylation and its nuclear translocation. In contrast, genistein and blocking phosphoinositide 3-kinases by wortmannin and LY294002 increased the milk-induced IL11 expression in gingival fibroblasts.

Conclusion
Taken together, our data revealed TGF-β receptor type I kinase signaling to cause major changes of the genetic signature of gingival fibroblasts exposed to aqueous fraction of human milk.
Ethanolic extract of Mucuna pruriens leaves ameliorates carbon tetrachloride and rifampicin-induced hepatotoxicity and nephrotoxicity in wistar albino rat
Authors: Ogunmoyole Temidayo , Ola-Awe Ayomide Micheal , Fatile Omotola Grace 
Published: November 2021

AbstractBackgroundMucuna pruriens(L.) has been used for the treatment of several ailments in folkloric medicine. The present study therefore investigates the hepatoprotective and nephroprotective potentials of its leaves extract with a view to providing a potent alternative in the management of liver and kidney diseases.MethodologyForty male albino rats were randomly placed into eight groups comprising five animals each. Animals in group I were administered with the distilled water, while groups II and VI were exposed to CCl4and rifampicin respectively. Animals in groups III and IV were initially exposed CCl4and treated with 50 and 100 mg/kg bwM. pruriensrespectively. Similarly, groups VII and VIII animals were exposed to rifampicin and treated with 50 and 100 mg/kg bwM. pruriensrespectively. Animals in group V were treated with 100 mg/kg bw silymarin by oral gavage after an initial exposure to CCl4. Selected biomarkers of liver and kidney damage were determined in the serum and organs homogenate. Liver and kidney slices of experimental animals were also stained for histopathological examination.ResultsExposure to CCl4and rifampicin respectively resulted in marked distortion in lipid profile, inhibition of antioxidant enzymes and a surge in ALT, AST, ALP, urea, uric acid, bilirubin and creatine kinase. Treatment withM. pruriensextract reversed all deranged biochemical and histopathological parameters in a dose-dependent manner.ConclusionExtract ofM. pruriensleaves restored deranged biochemical and histopathological parameters in the liver and kidney with similar potency to silymarin. Hence, leaf extract ofM. pruriensis a potential hepatoprotective and nephroprotective agent that can be exploited in the management of liver and kidney diseases.
Impact of COVID-19 on post graduate medical education and training
Authors: Enujioke Sharon C. , McBrayer Kimberly , Soe Katherine C. , Imburgia Teresa M. , Robbins Cynthia 
Published: November 2021

Abstract
Purpose
The novel Coronavirus Disease 19 (COVID-19) has had a significant impact worldwide that led to changes in healthcare. The purpose of this study was to evaluate the effect of the COVID-19 pandemic on trainee’s mental health and educational preparedness.

Methods
Trainees at the Indiana University School of Medicine were surveyed regarding the impact of the COVID-19 pandemic on their training. Using a Likert scale, participants were asked questions pertaining to educational preparedness, mental health, and clinical work during the pandemic. Data was analyzed using SPSS version 27. The study was approved as exempt by the Institutional review Board (IRB).

Results
324 of the 1204 trainees responded to the survey. The respondents were 76% white with an equal distribution of males and females. A majority of the respondents were first year residents with an equal distribution of second, third, and fourth year residents. Twenty-three percent of respondents were in a procedural residency or fellowship program. Better perceived educational preparedness was associated with an improved home-work balance during COVID-19 (β = 0.506, p < 0.0001) and having a department that advocated/supported focus on mental health during COVID-19 (β = 0.177, p < 0.0001). Worse perceived educational preparedness was associated with being in procedural vs. non-procedural dominant training program (β = − 0.122, p = 0.01).

Conclusion
COVID-19 has had a significant impact on the training experience of residents and fellows. Departmental support increased mental well-being and perceived education preparedness in trainees. Trainees that felt they had a better home-work life balance had better educational preparedness compared to their peers. Also, trainees in procedural programs had less educational preparedness compared to their peers in non-procedural programs. This study highlights the importance for programs to find avenues to increase educational preparedness in their trainees while being attuned to the mental health of their trainees.
Combining data augmentation and domain information with TENER model for Clinical Event Detection
Authors: Zhang Zhichang , Liu Dan , Zhang Minyu , Qin Xiaohui 
Published: November 2021

AbstractBackgroundIn recent years, with the development of artificial intelligence, the use of deep learning technology for clinical information extraction has become a new trend. Clinical Event Detection (CED) as its subtask has attracted the attention from academia and industry. However, directly applying the advancements in deep learning to CED task often yields unsatisfactory results. The main reasons are due to the following two points: (1) A great number of obscure professional terms in the electronic medical record leads to poor recognition performance of model. (2) The scarcity of datasets required for the task leads to poor model robustness. Therefore, it is urgent to solve these two problems to improve model performance.MethodsThis paper proposes a combining data augmentation and domain information with TENER Model for Clinical Event Detection.ResultsWe use two evaluation metrics to compare the overall performance of the proposed model with the existing model on the 2012 i2b2 challenge dataset. Experimental results demonstrate that our proposed model achieves the best F1-score of 80.26%, type accuracy of 93% and Span F1-score of 90.33%, and outperforms the state-of-the-art approaches.ConclusionsThis paper proposes a multi-granularity information fusion encoder-decoder framework, which applies the TENER model to the CED task for the first time. It uses the pre-trained language model (BioBERT) to generate word-level features, solving the problem of a great number of obscure professional terms in the electronic medical record lead to poor recognition performance of model. In addition, this paper proposes a new data augmentation method for sequence labeling tasks, solving the problem of the scarcity of datasets required for the task leads to poor model robustness.
Health promoting lifestyle behaviors and associated predictors among clinical nurses in China: a cross-sectional study
Authors: Zeng Wen , Shang Shaomei , Fang Qian , He Shan , Li Juan , Yao Yuanrong 
Published: November 2021

Abstract
Background
Nurses play a core role and encompass the main workforce in health care systems. Their role model of health promoting lifestyle behaviors (HPLB) would directly or indirectly affect their clients’ beliefs or attitudes of health promotion. There is limited evidence on HPLB in clinical registered nurses. The current study aimed to explore the HPLB and associated influencing factors among clinical registered nurses in China.

Methods
A multi-center cross-sectional anonymous online survey was conducted in 2020. Participants were asked to complete social demographic information as well as the revised Chinese edition of Health Promoting Lifestyle Profile (HPLP). Independent-Sample T-Test, One-Way ANOVA, and categorical regression (optimal scaling regression) were the main methods to analyze the relationship between demographic data and the score of HPLB.

Results
19,422 nurses were included in the study. The mean score of self-actualization, health responsibility/physical activity, nutrition, job safety, interpersonal support, and overall Health Promoting Lifestyle Profile were, 27.61(5.42) out of a score of 36, 22.71(7.77) out of a score of 44, 10.43(2.97) out of a score of 16, 22.05(3.97) out of a score of 28, 20.19(4.67) out of a score of 28, and 102.99 (19.93) out of a score of 144, respectively. There was a significant relationship among Hospital levels, working years, nightshift status, and monthly income per person, and mean score of all subscales and the overall HPLP (P < 0.05).

Conclusions
Nurses who participated in the study presented a moderate level of health promoting lifestyle behaviors. Hospital levels, working years, nightshift status, and monthly income per person were predictors for all subscales and overall HPLP.
Artificial exosomes mediated spatiotemporal-resolved and targeted delivery of epigenetic inhibitors
Authors: Li Huan , Li Songpei , Lin Yinshan , Chen Sheng , Yang Langyu , Huang Xin , Wang Hao , Yu Xiyong , Zhang Lingmin 
Published: November 2021

Abstract
Background
Malignant tumor is usually associated with epigenetic dysregulation, such as overexpression of histone deacetylase (HDAC), thus HDAC has emerged as a therapeutic target for cancer. Histone deacetylase inhibitor has been approved for clinical use to treat hematological cancers. However, the low solubility, short circulation lifetime, and high cytotoxicity partially limited their applications in solid tumor.

Methods
The upconversion nanoparticles (UC) modified with mesoporous silica (SUC) was used to load an HDACI, suberoylanilide hydroxamic acid (SAHA), and further camouflaged with M1 macrophage-derived exosome membranes (EMS). EMS was characterized in size and compositions. We also analyzed the epigenetic regulation induced by EMS. Furthermore, we evaluate the biodistribution and in vivo tumor inhibition after the systemic administration of EMS.

Results
This novel style spatiotemporal-resolved drug delivery system, EMS showed a high loading efficiency of SAHA. EMS could be taken up by lung cancer cells and lead to efficient epigenetic inhibition. We found that the integrin α4β1 on M1-EM, was crucial for the homing of EMS to tumor tissues for the first time. In tumor-bearing mice, EMS showed spatiotemporal-resolved properties and facilitated the drug accumulation in the tumors, which induced superior anti-tumor effects.

Conclusion
This novel style of spatiotemporal-resolved nanoparticles can be used as a theranostic platform for lung cancer therapy.

Graphical Abstract
Dye-loaded mesoporous polydopamine nanoparticles for multimodal tumor theranostics with enhanced immunogenic cell death
Authors: Tian Ying , Younis Muhammad Rizwan , Tang Yuxia , Liao Xiang , He Gang , Wang Shouju , Teng Zhaogang , Huang Peng , Zhang Longjiang , Lu Guangming 
Published: November 2021

Abstract
Background
Tumor phototherapy especially photodynamic therapy (PDT) or photothermal therapy (PTT), has been considered as an attractive strategy to elicit significant immunogenic cell death (ICD) at an optimal tumor retention of PDT/PTT agents. Heptamethine cyanine dye (IR-780), a promising PDT/PTT agent, which can be used for near-infrared (NIR) fluorescence/photoacoustic (PA) imaging guided tumor phototherapy, however, the strong hydrophobicity, short circulation time, and potential toxicity in vivo hinder its biomedical applications. To address this challenge, we developed mesoporous polydopamine nanoparticles (MPDA) with excellent biocompatibility, PTT efficacy, and PA imaging ability, facilitating an efficient loading and protection of hydrophobic IR-780.

Results
The IR-780 loaded MPDA (IR-780@MPDA) exhibited high loading capacity of IR-780 (49.7 wt%), good physiological solubility and stability, and reduced toxicity. In vivo NIR fluorescence and PA imaging revealed high tumor accumulation of IR-780@MPDA. Furthermore, the combined PDT/PTT of IR-780@MPDA could induce ICD, triggered immunotherapeutic response to breast tumor by the activation of cytotoxic T cells, resulting in significant suppression of tumor growth in vivo.

Conclusion
This study demonstrated that the as-developed compact and biocompatible platform could induce combined PDT/PTT and accelerate immune activation via excellent tumor accumulation ability, offering multimodal tumor theranostics with negligible systemic toxicity.

Graphical Abstract
A randomized, double-blind clinical trial of a herbal formulation (GlycaCare-II) for the management of type 2 diabetes in comparison with metformin
Authors: Majeed Muhammed , Majeed Anju , Nagabhusahnam Kalyanam , Mundkur Lakshmi , Paulose Shaji 
Published: November 2021

Abstract
Background
Type 2 diabetes mellitus (T2DM) is a major public health concern with growing prevalence with multiple debilitating complications. GlycaCare-II is a proprietary herbal formulation supplement for T2DM containing extracts of Cinnamomum cassia, Momordica charantia, Pterocarpus marsupium, Gymnema sylvestre, Salacia reticulata, Eugenia jambolana, and a bioavailability enhancer piperine from Piper nigrum.

Objective
The antihyperglycemic potential of GlycaCare-II was compared against metformin in a double-blind study.

Design
It was a randomized, two-arm design on prediabetic (N = 29; 12 in metformin and 17 in GlycaCare-II arm, respectively) and newly diagnosed diabetic (N = 40; 16 in metformin and 24 in GlycaCare-II) patients for 120 days.

Outcome measures
Changes in diabetic panel glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and postprandial blood sugar (PBS) were the primary endpoints. Lipid profile, liver profile, thyroid-stimulating hormone, bilirubin and creatinine were the secondary endpoints.

Result
Twice a day treatment for 120 days with GlycaCare-II led to a statistically significant change in HbA1c (p < 0.001), FBS (p < 0.001), PBS (p < 0.001) on both prediabetic and newly diagnosed diabetic patients. GlycaCare-II showed a similar potential as metformin in the treatment of T2DM. In the prediabetic group, both GlycaCare-II and metformin were comparable for all the hyperglycemic index parameters. In the case of newly diagnosed diabetic patients, GlycaCare-II showed a significantly better reduction for PBS (p = 0.026) as compared to metformin, while all other parameters in the diabetic panel were comparable. No adverse events were reported throughout the trial period.

Conclusion
These results suggest that GlycaCare-II is effective in managing T2DM in both newly diagnosed diabetic and prediabetic patients.