bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Knowledge of Danger Signs of Obstetric Complications among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program
Authors: Ahmad Danish , Mohanty Itismita , Hazra Avishek , Niyonsenga Theo 
Published: January 2021

Abstract
Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods: Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.
Frequency of Providing a Palliative Approach to Care in Family Practice: A Chart Review and Perceptions of Healthcare Practitioners in Canada
Authors: Gallagher Erin , Carter-Ramirez Daniel , Boese Kaitlyn , Winemaker Samantha , MacLennan Amanda , Hansen Nicolle , Hafid Abe , Howard Michelle 
Published: January 2021

Abstract
Background: Most patients nearing the end of life can benefit from a palliative approach in primary care. We currently do not know how to measure a palliative approach in family practice. The objective of this study was to describe the provision of a palliative approach and evaluate their clinicians’ perceptions of the results.Methods: We conducted a descriptive study of deceased patients in an interprofessional team family practice. We integrated conceptual models of a palliative approach to create a chart review tool to capture a palliative approach in the last year of life and assessed a global rating of whether a palliative approach was provided. Clinicians completed a questionnaire before learning the results and after, on perceptions of how often they believed a palliative approach was provided by the team.Results: Among 79 patients (mean age at death 73 years, 54% female) cancer and cardiac diseases were the top conditions responsible for death. One-quarter of patients were assessed as having received a palliative approach. 53% of decedents had a documented discussion about goals of care, 41% had nurse involvement, and 15.2% had a discussion about caregiver well-being. These indicators had the greatest discrimination between a palliative approach or not. Agreement that elements of a palliative approach were provided decreased significantly on the clinician questionnaire from before to after viewing the results. Conclusions: This study identified measurable indicators of a palliative approach in family practice, that can be used as the basis for quality improvement.
Cryopreserved human adipose-derived stromal vascular fraction maintains fracture healing potential via angiogenesis and osteogenesis in an immunodeficient rat model
Authors: Kamenaga Tomoyuki , Kuroda Yuichi , Nagai Kanto , Tsubosaka Masanori , Takashima Yoshinori , Kikuchi Kenichi , Fujita Masahiro , Ikuta Kemmei , Anjiki Kensuke , Maeda Toshihisa , Nakano Naoki , Takayama Koji , Hashimoto Shingo , Hayashi Shinya , Matsushita Takehiko , Niikura Takahiro , Kuroda Ryosuke , Matsumoto Tomoyuki 
Published: January 2021

Abstract
Background: Novel therapeutic strategies for the healing of nonunion, which has serious effects on the quality of life of patients, are needed. We evaluated the therapeutic effect of local transplantation of human stromal vascular fraction (SVF) cells on fracture healing in a rat non-healing fracture model and compared the effects between freshly isolated (F) and cryopreserved (C)-SVFs. Methods: Nonhealing fracture model was induced in the femur of female immunodeficient rats (F344/N Jcl rnu/rnu) with cauterizing periosteum. Immediately after the creation of non-healing fracture, rats received local transplantation of F and C-SVFs suspended in phosphate-buffered saline (PBS) or the same volume of PBS without cells using the same scaffold as a control group. During 8 weeks post-surgery, radiologic, histological, immunohistochemical, and biomechanical analyses were performed to evaluate fracture healing. The comparison of radiological results was performed with a chi-square test, and the multiple comparisons of immunohistochemical, histological and biomechanical results among groups were made using a one-way analysis of variance. A probability value of 0.05 was considered to denote statistical significance.Results: At week 8, in 60% of animals receiving F-SVF cells and in 50% of animals receiving C-SVF cells, the fracture radiologically healed with bone union whereas nonunion was observed in the control group. The healing potential was also confirmed by histological and biomechanical assessments. One of the mechanisms underlying healing involving intrinsic angiogenesis/osteogenesis was enhanced in F- and C-SVF groups compared with that in the control group. Human cells-derived vasculogenesis/osteogenesis, which was also confirmed in an in vitro differentiation assay, was also enhanced in the F- and C-SVF groups compared with that in the control groups and could be another mechanism for healing. Conclusions: SVF cells can enhance bone healing and cryopreserved cells have almost equal potential as fresh cells. SVF cells can be used for improving nonunion bone fracture healing as an alternative to other mesenchymal stem cells and the effect of SVF cells can be maintained under cryopreservation.
An Improved BM25 Algorithm for Clinical Decision Support in Precision Medicine based on Co-word Analysis and Cuckoo Search
Authors: zhang zicheng 
Published: January 2021

Abstract
Background: Retrieving gene and disease information from a vast collection of biomedical abstracts to provide doctors with clinical decision support is one of the important research directions of Precision Medicine. Method: We propose a novel article retrieval method based on expanded word and co-word analyses, also conducting Cuckoo Search to optimize parameters of the retrieval function. The main goal is to retrieve the abstracts of biomedical articles that refer to treatments. The methods mentioned in this manuscript adopt the BM25 algorithm to calculate the score of abstracts. We, however, propose an improved version of BM25 that computes the scores of expanded words and co-word leading to a composite retrieval function, which is then optimized using the Cuckoo Search. The proposed method aims to find both disease and gene information in the abstract of the same biomedical article. This is to achieve higher relevance and hence score of articles. Besides, we investigate the influence of different parameters on the retrieval algorithm and summarize how they meet various retrieval needs. Results: The data used in this manuscript is sourced from medical articles presented in Text Retrieval Conference (TREC):Clinical Decision Support (CDS) Tracks of 2017, 2018, and 2019 in Precision Medicine. A total of 120 topics are tested. Three indicators are employed for the comparison of utilized methods, which are selected among the ones based only on the BM25 algorithm and its improved version to conduct comparable experiments. The results showed that the proposed algorithm achieves better results.Conclusion: The proposed method, an improved version of the BM25 algorithm, utilizes both co-word implementation and Cuckoo Search, which has been verified achieving better results on a large number of experimental sets. Besides, a relatively simple query expansion method is implemented in this manuscript. Future research will focus on ontology and semantic networks to expand the query vocabulary.
Disaster Safety Assessment of Primary Healthcare Facilities: A Cross-Sectional Study in Kurdistan province of Iran
Authors: Yari Arezoo , Zarezadeh Yadolah , Fatemi Farin , Ardalan Ali , Vahedi Siamak , Khoshsabeghe Homa Yousefi- , Boubakran Mohsen Soufi , Bidarpoor Farzam , Motlagh Mohamad Esmaeil 
Published: January 2021

Abstract
Background: Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential.Methods: In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01-66.0) and high (>66.0). Results: The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. Conclusions: The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.
Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve functionality of patients with mechanical neck pain: a randomized control study
Authors: Mylonas Konstantinos , Angelopoulos Pavlos , Billis Evdokia , Tsepis Elias , Fousekis Konstantinos 
Published: January 2021

Abstract
Background: The purpose of this study was to evaluate the short- and intermediate-term effects of the combined application of instrument-assisted soft tissue mobilization (IASTM) techniques andneuromuscular exercises of the cervical and thoracic area on the improvement of the functionality of patients with mechanical neck pain and accompanying forward head posture (FHP).Methods: Twenty patients with neck pain and FHP were randomized and received eight treatment sessions of either targeted IASTM in combination with neuromuscular exercises (Group A) or a classical massage and the same set of exercises (Group B). The cervical vertebral angle, cervical range of motion (ROM) and strength, and pain and disability were measured throughout the treatment period and in the two- and four-week post-treatment periods.Results: The combined application of IASTM and neuromuscular exercise (Group A) contributed to a significantly greater improvement in FHP and disability than massage and the application of the same exercises (Group B). Both interventions improved cervical ROM and strength in the short term. Pain was also improved in both groups in both the short and intermediate term.Conclusions: Combining IASTM and exercises for the cervical and thoracic area can induce positive postural adaptations and improve the functional status of neck pain patients.Trial registration: ISRCTN, ISRCTN54231174. Registered 19 March 2020 - Retrospectively registered, https://doi.org/10.1186/ISRCTN54231174
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: A prospective observational study
Authors: Zhang Rui , Bai Linfu , Han Xiaoli , Huang Shicong , Zhou Lintong , Duan Jun 
Published: January 2021

Abstract
Background: Factors that may increase the risk for delirium and the firm knowledge around mechanism for delirium in noninvasive ventilation (NIV) patients is lacking. We investigated the incidence, characteristics, and outcomes of delirium in NIV patients. Methods: A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients in whom NIV was used as a first-line intervention were enrolled. During NIV intervention, delirium was screened using the Confusion Assessment Method for the ICU each day. The association between delirium and poor outcomes (e.g., NIV failure, ICU and hospital mortality) was investigated using forward stepwise multivariate logistic regression analyses.Results: We enrolled 1083 patients. Of these, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p < 0.01), higher ICU mortality (33.2% vs. 14.3%, p < 0.01), and higher hospital mortality (37.2% vs. 17.0%, p < 0.01) than subjects without delirium. They also had a longer duration of NIV (median 6.3 vs. 3.7 days, p < 0.01), and stayed longer in the ICU (median 9.0 vs. 6.0 days, p < 0.01) and the hospital (median 14.5 vs. 11.0 days, p < 0.01). These results were confirmed in COPD and non-COPD cohorts. According to subtype, compared to hyperactive delirium patients, hypoactive and mixed delirium patients spent more days and many more days on NIV (median 3.4 vs. 6.5 vs. 10.1 days, p < 0.01). Similar outcomes were found for length of stay in the ICU and hospital. However, NIV failure, ICU mortality, and hospital mortality did not differ among the three subtypes.Conclusions: Delirium is associated with increases in poor outcomes (NIV failure, ICU mortality, and hospital mortality) and the use of medical resources (duration of NIV, and lengths of stay in the ICU and hospital). Regarding subtype, hypoactive and mixed delirium are associated with higher, and much higher, consumption of medical resources, respectively, compared to hyperactive delirium.
“It makes me feel not so alone”: Features of the Choose to Move physical activity intervention that reduce loneliness in older adults
Authors: Franke Thea , Sims-Gould Joanie , Nettlefold Lindsay , Ottoni Callista , McKay Heather A. 
Published: January 2021

Abstract
Background: Despite the well-known health benefits of physical activity (PA), older adults are the least active citizens. Older adults are also at risk for loneliness. Given that lonely individuals are at risk for accelerated loss of physical functioning and health with age, PA interventions that aim to enhance social connectedness may decrease loneliness and increase long-term PA participation. The objectives of this mixed-method study are to: (1) evaluate whether an evidence-based PA intervention (Choose to Move; CTM) influenced PA and loneliness differently among self-identified ‘lonely’ versus ‘not lonely’ older adults and (2) to describe factors within CTM components most likely to promote social connectedness/reduce loneliness.Methods: ﻿ CTM is a flexible, scalable, community-based health promoting physical activity intervention for older adults. Two community delivery partner organizations delivered 56 CTM programs in 26 urban locations across British Columbia. We collected survey data from participants (n=458 at baseline) at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We conducted in depth interviews with a subset of older adults to understand how CTM facilitated or impeded their PA and social connectedness.Results: PA increased significantly from baseline to 3 months in lonely and not lonely participants. PA decreased significantly from 3-6 months in lonely participants; however, PA at 6 months remained significantly above baseline levels in both groups. Loneliness decreased significantly from baseline to 3 and 6 months in participants identifying as lonely at baseline. Factors within CTM components that promote social connectedness/reduce loneliness include: Activity coach characteristics/personality traits and approaches; opportunity to share information and experiences and learn from others; engagement with others who share similar/familiar experiences; increased opportunity for meaningful interaction; and accountability.Conclusion: Health promoting interventions that focus on PA and social connectedness through group-based activities can effectively reduce social isolation and loneliness of older adults. Given the ‘epidemic of loneliness’ that plagues many countries currently, these kinds of interventions are timely and important. Research that further delineates mechanisms (e.g., sharing experiences vs. lectures), that modify the effect of an intervention on social connectedness outcomes for older adults engaged in community-based PA programs would be a welcome addition to the literature.
Calcium-dependent cytosolic phospholipase A2 activation is implicated in neuroinflammation and oxidative stress associated with ApoE4
Authors: Wang Shaowei , Li Boyang , Solomon Victoria , Fonteh Alfred , Rapoport Stanley I. , Bennett David A. , Arvanitakis Zoe , Chui Helena C. , Miller Carol A. , Sullivan Patrick M. , Wang Hoau-Yan , Yassine Hussein 
Published: January 2021

Abstract
Background: Apolipoprotein E4 (APOE4) is associated with a greater response to neuroinflammation and the risk of developing late-onset Alzheimer's disease (AD), but the mechanisms for this association are not clear. The activation of calcium-dependent cytosolic phospholipase A2 (cPLA2) is involved in inflammatory signaling and is elevated within the plaques of AD brains. The relation between APOE4 genotype and cPLA2 activity is not known.Methods: Mouse primary astrocytes, mouse and human brain samples differing by APOE genotypes were collected for measuring cPLA2 expression, phosphorylation, and activity in relation to measures of inflammation and oxidative stress. Results: Greater cPLA2 phosphorylation and activity was identified in ApoE4 compared to ApoE3 in primary astrocytes and brains of ApoE-targeted replacement (ApoE-TR) mice. These differences were also demonstrated in brain homogenates from the inferior frontal cortex from AD patients carrying APOE3/4 compared to APOE3/3. Higher cPLA2 activation with APOE4 was associated with greater activation of the MAPK p38 pathway in human postmortem frontal cortical synaptosomes and astrocytes, as well as with higher levels of leukotriene B4 (LTB4), reactive oxygen species (ROS), and inducible nitric oxide synthase (iNOS) in astrocytes. Inhibition of cPLA2 reduced LTB4, ROS, and iNOS levels in ApoE4 primary astrocytes to those in ApoE3 astrocytes. Conclusions: Our findings implicate greater activation of cPLA2 signaling system with APOE4, which could represent a potential drug target for mitigating the increased neuroinflammation with APOE4 and AD.
A data-driven approach to assessing the impact of water harvesting structures on regional water storage in East Africa
Authors: Eisma J. A. , Merwade V. 
Published: January 2021

Abstract
A small-scale water harvesting structure known as a sand dam has gained popularity across East Africa due to the efforts of non-governmental organizations. A sand dam is a subsurface water reservoir that stores water between sand grains. Stored thus, the water is filtered and protected from evaporation. This study uses remotely sensed data to investigate the impact of these structures on water storage and vegetative growth. The relationship between sand dams and water storage was modeled using a binary sand dam factor, climate data from the Famine Early Warning Systems Network Land Data Assimilation System (FLDAS), and water storage data measured by the Gravity Recovery and Climate Experiment (GRACE) twin satellites. The analysis revealed that GRACE largely fails to detect a statistically significant impact of sand dams on regional water storage. However, analysis of the Normalized Difference Vegetation Index (NDVI) indicated that sand dams have a significant impact on regional vegetation. Vegetative growth is correlated with groundwater levels, indicating that sand dams have a positive impact on water storage albeit on a smaller scale than GRACE can regularly detect. Significantly, this study shows that NDVI data can be used effectively to study small-scale, regional changes in vegetation and water storage.
The adsorption efficiency of nitrogen and phosphorus by in-situ remediation of modified sediment composite material
Authors: Zhu Zhaoliang , Zou Jiale , Li Qi , Zhou Hao , Liu Mengmeng 
Published: January 2021

Abstract
Dredged sediment can occupy a large amount of land area, resulting in waste of land resources, and high disposal costs. In response to the problem, this work calcinates and modified the sediment and compounds it with the modified water purification plant sludge, zeolite powder, and bentonite. This is used as a covering material to inhibit the release of nitrogen (N) and phosphorus (P) in the sediment. The results showed that sediment modified composite material covering effectively reduces the release of nitrogen (N) and phosphorus (P) in the sediment, especially the release of P. When the thickness of the covering layer is 3 cm, the reduction rate of total N, NH4+-N, and total P in the overlying water by the modified composite material of sediment is 61.58, 79.59, and 70.34%, respectively. It can be seen that the covering material has a significant effect on the control of the release of N and P in the sediment. Additionally, the reduction of nutrients in the overlying water can overcome the negative effects of temperature rise in controlling the release of N and P in the sediment.