bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of candidate genes and mechanisms underlying obesity associated type 2 diabetes mellitus using bioinformatics analysis and screening of small drug molecules
Authors: Prashanth G. , Vastrad Basavaraj , Tengli Anandkumar , Vastrad Chanabasayya , Kotturshetti Iranna 
Published: April 2021

Abstract
Background
Obesity associated type 2 diabetes mellitus is a metabolic disorder ; however, the etiology of obesity associated type 2 diabetes mellitus remains largely unknown. There is an urgent need to further broaden the understanding of the molecular mechanism associated in obesity associated type 2 diabetes mellitus.

Methods
To screen the differentially expressed genes (DEGs) that might play essential roles in obesity associated type 2 diabetes mellitus, the publicly available expression profiling by high throughput sequencing data (GSE143319) was downloaded and screened for DEGs. Then, Gene Ontology (GO) and REACTOME pathway enrichment analysis were performed. The protein - protein interaction network, miRNA - target genes regulatory network and TF-target gene regulatory network were constructed and analyzed for identification of hub and target genes. The hub genes were validated by receiver operating characteristic (ROC) curve analysis and RT- PCR analysis. Finally, a molecular docking study was performed on over expressed proteins to predict the target small drug molecules.

Results
A total of 820 DEGs were identified between healthy obese and metabolically unhealthy obese, among 409 up regulated and 411 down regulated genes. The GO enrichment analysis results showed that these DEGs were significantly enriched in ion transmembrane transport, intrinsic component of plasma membrane, transferase activity, transferring phosphorus-containing groups, cell adhesion, integral component of plasma membrane and signaling receptor binding, whereas, the REACTOME pathway enrichment analysis results showed that these DEGs were significantly enriched in integration of energy metabolism and extracellular matrix organization. The hub genes CEBPD, TP73, ESR2, TAB1, MAP 3K5, FN1, UBD, RUNX1, PIK3R2 and TNF, which might play an essential role in obesity associated type 2 diabetes mellitus was further screened.

Conclusions
The present study could deepen the understanding of the molecular mechanism of obesity associated type 2 diabetes mellitus, which could be useful in developing therapeutic targets for obesity associated type 2 diabetes mellitus.
The early loading of different surface-modified implants: a randomized clinical trial
Authors: Körmöczi Kinga , Komlós György , Papócsi Petra , Horváth Ferenc , Joób-Fancsaly Árpád 
Published: April 2021

Abstract
Background
Various surface treatment options have been adopted with the aim to improve osseointegration, reducing the overall treatment time. Implant stability of early loaded implants with different modified surfaces was compared in the present study.

Methods
Patients were selected from the Department of Oro-Maxillofacial Surgery and Stomatology at Semmelweis University. Patients randomly received SA (alumina sandblasted and acid-etched), NH (bioabsorbable apatite nanocoating) or SLA (large-grit sandblasted and acid-etched) surface implants. Outcome measures were: implant success, implant stability, and periodontal parameters. The implant stability was measured at the time of implant placement (primary stability) and six weeks after (prothesis delivery, secondary stability). Osstell and Periotest were applied to take all the measurements. The primary and secondary stability were compared in the three study groups Finally the periimplant probing depth appearing after three months of loading was checked on 6 points around to the implant-supported prostheses. Shapiro–Wilk and Mann–Whitney tests were used for the comparison between the study groups.

Results
A total of 75 implants with different length and diameter were inserted into various positions. One implant failed spontaneously at the fourth week after implant placement. The survival rate was 98,7%. Comparing the primary and secondary stability values, the data were significantly improved in every groups. The difference was the highest in the NH group, however, this difference was not significant compared to the two other groups. Good periodontal parameters were experienced in all the tested implants, independently by the groups.

Conclusions
With the limitation of the present study, all the implants showed improved stability six weeks after implant placement. A trend of higher result was found for the NH group. Further studies with longer follow-up are needed to confirm this preliminary results.
Trial registration: Current Controlled Trials ISRCTN13181677; the date of registration: 04/03/2021. Retrospectively registered.
Propylene mesh versus acrylic resin stent for palatal wound protection following free gingival graft harvesting: a short-term pilot randomized clinical trial
Authors: Yussif Nermin , Wagih Rasha , Selim Khaled 
Published: April 2021

AbstractBackgroundProtection of the palatal wound is an essential step following harvesting a palatal soft tissue graft. The aim of the current pilot randomized clinical study was to assess the efficacy of using propylene mesh as protective sheet when compared to conventional custom made acrylic stent after harvesting a palatal graft. The primary outcome of this study was bleeding postoperatively and secondary outcomes were pain, healing profile of the donor site as well as patient satisfaction.MethodsBetween 2018 and 2019 we conducted a prospective randomized controlled trial of 24 patients with palatal defects. Two groups of 12 patients with 24 sites were included in this study and were treated with soft tissue grafting technique using free grafts harvested from the hard palate. The palatal wounds were protected with propylene mesh (test group) or custom-made acrylic palatal stent (control group). Participants were assessed for the amount and duration of bleeding, pain duration, and the risk of infection 2, 4, 6, 8, 14 days post-operatively. The trial had been registered in clinical trials.gov (NCT04348279).ResultsFour sites were excluded from the study as dropouts. The polypropylene mesh was more effective at reducing bleeding by (2.4 ± 1.075) and pain by (1.600 ± 0.516), while the custom-made acrylic stent reduced the bleeding (5.8 ± 1.22) and pain (7.100 ± 0.316). The decline in amount of bleeding amount (Pvalue = 0.021) and its duration (Pvalue = 0.001) achieved by the propylene mesh was statistically significant. There was no statistical significant difference in patient satisfaction and the duration of healing process between the 2 groups. However, the healing profile of the test group was statistically significant when compared with the control group (Pvalue = 0.002).ConclusionsPropylene mesh is a promising material for protection of the palatal wound due to its light weight, limited bacterial wicking, tissue compatibility. Further studies are required to adequally assess the benefits of this material in periodontal plastic surgeries.
Comparative cost analysis of cervical cancer screening programme based on molecular detection of HPV in Spain
Authors: Ibáñez R. , Mareque M. , Granados R. , Andía D. , García-Rojo M. , Quílez J. C. , Oyagüez I. 
Published: April 2021

Abstract
Background
HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay—AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35–65 years for the National Health System.

Methods
A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€, 2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35–65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected.

Results
The use of AHPV showed reduction of 290,541 (− 35%) and 355,913 (− 40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (− 47%) colposcopies versus HC2 and 151,165 (− 47%) versus Cobas. The total cost of CCS was € 282,747,877 with AHPV, € 322,587,588 with HC2 and € 324,614,490 with Cobas. Therefore, AHPV savings € − 39,839,711 versus HC2 and € − 41,866,613 versus Cobas.

Conclusions
Assuming that 70% of women from 35 to 65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to € 41.9 million versus DNA tests in Spain.
Neuroprotective effects of pomegranate (Punica granatum L.) juice and seed extract in paraquat-induced mouse model of Parkinson’s disease
Authors: Fathy Samah M. , El-Dash Heba A. , Said Noha I. 
Published: April 2021

Abstract
Background
Paraquat, (PQ), an herbicide that can induce Parkinsonian-like symptoms in rodents and humans. The consumption of phytochemical-rich plants can reduce the risk of chronic illnesses such as inflammation and neurodegenerative diseases. The present study aimed to investigate the protective effects of pomegranate seed extract (PSE) and juice (PJ) against PQ-induced neurotoxicity in mice.

Methods
Mice were assigned into 4 groups; three groups received PQ (10 mg/kg, i.p.) twice a week for 3 weeks. Two of the PQ-induced groups pretreated with either PSE or PJ. Detection of phytochemicals, total phenolics, and total flavonoids in PSE and PJ was performed. Tyrosine hydroxylase (TH) level was measured in the substantia nigra (SN) by Western blotting technique. Striatal dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) were detected using high-performance liquid chromatography (HPLC). The levels of adenosine triphosphate (ATP), malondialdehyde (MDA), and the activity of the antioxidant enzymes were estimated in the striatum by colorimetric analysis. Striatal pro-inflammatory and anti-inflammatory markers using enzyme-linked immunosorbent assay (ELISA) as well as DNA fragmentation degree by qualitative DNA fragmentation assay, were evaluated. Real-time polymerase chain reaction (qPCR) assay was performed for the detection of nuclear factor kappa B (NF-кB) gene expression. Moreover, Western blotting analysis was used for the estimation of the cluster of differentiation 11b (CD11b), transforming growth factor β (TGF-β), and glial cell-derived neurotrophic factor (GDNF) levels in the striatum.

Results
Pretreatment with PSE or PJ increased the levels of TH in the SN as well as DA and its metabolite in the striatum that were reduced by PQ injection. PSE and PJ preadministration improved the PQ-induced oxidative stress via a significant reduction of the MDA level and the augmentation of antioxidant enzyme activities. PSE and PJ also significantly downregulated the striatal NF-кB gene expression, reduced the PQ-enhanced apoptosis, decreased the levels of; pro-inflammatory cytokines, CD11b, and TGF-β coupled with a significant increase of; interleukin-10 (IL-10), GDNF, and ATP levels as compared with PQ-treated mice.

Conclusions
The current study indicated that PSE and PJ consumption may exhibit protective effects against PQ-induced neurotoxicity in mice.
Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL)
Authors: Burgess Annette , Matar Elie , Roberts Chris , Haq Inam , Wynter Lucy , Singer Julian , Kalman Eszter , Bleasel Jane 
Published: April 2021

Abstract
Background
Two established small-group learning paradigms in medical education include Case-based learning (CBL) and Team-based learning (TBL). Characteristics common to both pedagogies include the use of an authentic clinical case, active small-group learning, activation of existing knowledge and application of newly acquired knowledge. However, there are also variances between the two teaching methods, and a paucity of studies that consider how these approaches fit with curriculum design principles. In this paper we explore student and facilitator perceptions of the two teaching methods within a medical curriculum, using Experience based learning (ExBL) as a conceptual lens.

Methods
A total of 34/255 (13%) Year 2 medical students completed four CBLs during the 2019 Renal and Urology teaching block, concurrent to their usual curriculum activities, which included weekly TBLs. Questionnaires were distributed to all students (n = 34) and CBL facilitators (n = 13). In addition, all students were invited to attend focus groups. Data were analysed using descriptive statistics and thematic analysis.

Results
In total, 23/34 (71%) of students and 11/13 (85%) of facilitators completed the questionnaires. Twelve students (35%) participated in focus groups. Findings indicate their experience in CBL to be positive, with many favourable aspects that built on and complemented their TBL experience that provided an emphasis on the basic sciences. The learning environment was enriched by the CBL framework that allowed application of knowledge to solve clinical problems within the small groups with consistent facilitator guidance and feedback, their capacity to focus discussion, and associated efficiencies in learning.

Conclusion
While the TBL model was integral in developing students’ knowledge and understanding of basic science concepts, the CBL model was integral in developing students’ clinical reasoning skills. The strengths of CBL relative to TBL included the development of authentic clinical reasoning skills and guided facilitation of small group discussion. Our findings suggest that delivery of a medical curriculum may be enhanced through increased vertical integration, applying TBL in earlier phases of the medical program where the focus is on basic science principles, with CBL becoming more relevant as students move towards clinical immersion.
The effect of refined nursing intervention on patients undergoing maintenance hemodialysis in the hemodialysis center during the COVID-19 epidemic
Authors: Zhang Qing-Lai , Wang Shuo , Zhang Yue , Meng Fei 
Published: April 2021

Abstract
Background
The outbreak of novel coronavirus pneumonia has exerted considerable psychological pressure on patients undergoing hemodialysis, resulting in unhealthy psychological emotions. Therefore, it is of great significance to carry out strict management and refined nursing intervention for patients undergoing maintenance hemodialysis during the prevention and control of novel coronavirus. This study aims to analyze and discuss the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the coronavirus disease 2019 (COVID-19) epidemic.

Methods
This was a prospective cohort study. In this study, we used the Symptom Checklist-90 (SCL-90) or the Chinese adult SCL-90 norm to conduct nursing interventions for patients undergoing maintenance hemodialysis to investigate the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the COVID-19 epidemic.

Results
The scores for all the factors of SCL-90 of patients undergoing maintenance hemodialysis were higher than those of the Chinese SCL-90, and patients with a single factor score ≥ 2 had a higher level of depression and anxiety, with extremely significant difference (p < 0.01). The depression and anxiety of the patients were reduced after the intervention, and there was a statistical difference. Among the 172 patients, the results of both nucleic acid tests were negative.

Conclusion
During the COVID-19 epidemic, providing patients undergoing maintenance hemodialysis with refined nursing intervention can regulate negative emotions, reduce related complications, improve their quality of life, and improve the nurse–patient relationship.
MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework
Authors: Ansbro Éimhín , Homan Tobias , Qasem Jamil , Bil Karla , Rasoul Tarawneh Mohammed , Roberts Bayard , Perel Pablo , Jobanputra Kiran 
Published: April 2021

Abstract
Background
In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated a multidisciplinary, primary level model of NCD care for Syrian refugees and vulnerable Jordanians delivered by MSF in Irbid, Jordan. We examined the programme’s Reach, Effectiveness, Adoption and acceptance, Implementation and Maintenance over time.

Methods
This mixed methods retrospective evaluation, undertaken in 2017, comprised secondary analysis of pre-existing cross-sectional household survey data; analysis of routine cohort data from 2014 to 2017; descriptive costing analysis of total annual, per-patient and per-consultation costs for 2015–2017 from the provider-perspective; a clinical audit; a medication adherence survey; and qualitative research involving thematic analysis of individual interviews and focus group discussions.

Results
The programme enrolled 23% of Syrian adult refugees with NCDs in Irbid governorate. The cohort mean age was 54.7 years; 71% had multi-morbidity and 9.9% self-reported a disability. The programme was acceptable to patients, staff and stakeholders. Blood pressure and glycaemic control improved as the programme matured and by 6.6 mmHg and 1.12 mmol/l respectively within 6 months of patient enrolment. Per patient per year cost increased 23% from INT$ 1424 (2015) to 1751 (2016), and by 9% to 1904 (2017). Cost per consultation increased from INT$ 209 to 253 (2015–2017). Staff reported that clinical guidelines were usable and patients’ self-reported medication adherence was high. Individual, programmatic and organisational challenges to programme implementation and maintenance included the impact of war and the refugee experience on Syrian refugees’ ability to engage; inadequate low-cost referral options; and challenges for MSF to rapidly adapt to operating in a highly regulated and complex health system. Essential programme adaptations included refinement of health education, development of mental health and psychosocial services and addition of essential referral pathways, home visit, physiotherapy and social worker services.

Conclusion
RE-AIM proved a valuable tool in evaluating a complex intervention in a protracted humanitarian crisis setting. This multidisciplinary programme was largely acceptable, achieving good clinical outcomes, but for a limited number of patients and at relatively high cost. We propose that model simplification, adapted procurement practices and use of technology could improve cost effectiveness without reducing acceptability, and may facilitate replication.
Health system determinants of tuberculosis mortality in South Africa: a causal loop model
Authors: Osman Muhammad , Karat Aaron S , Khan Munira , Meehan Sue-Ann , von Delft Arne , Brey Zameer , Charalambous Salome , Hesseling Anneke C , Naidoo Pren , Loveday Marian 
Published: April 2021

Abstract
Background
Tuberculosis (TB) is a major public health concern in South Africa and TB-related mortality remains unacceptably high. Numerous clinical studies have examined the direct causes of TB-related mortality, but its wider, systemic drivers are less well understood. Applying systems thinking, we aimed to identify factors underlying TB mortality in South Africa and describe their relationships. At a meeting organised by the ‘Optimising TB Treatment Outcomes’ task team of the National TB Think Tank, we drew on the wide expertise of attendees to identify factors underlying TB mortality in South Africa. We generated a causal loop diagram to illustrate how these factors relate to each other.

Results
Meeting attendees identified nine key variables: three ‘drivers’ (adequacy & availability of tools, implementation of guidelines, and the burden of bureaucracy); three ‘links’ (integration of health services, integration of data systems, and utilisation of prevention strategies); and three ‘outcomes’ (accessibility of services, patient empowerment, and socio-economic status). Through the development and refinement of the causal loop diagram, additional explanatory and linking variables were added and three important reinforcing loops identified. Loop 1, ‘Leadership and management for outcomes’ illustrated that poor leadership led to increased bureaucracy and reduced the accessibility of TB services, which increased TB-related mortality and reinforced poor leadership through patient empowerment. Loop 2, ‘Prevention and structural determinants’ describes the complex reinforcing loop between socio-economic status, patient empowerment, the poor uptake of TB and HIV prevention strategies and increasing TB mortality. Loop 3, ‘System capacity’ describes how fragmented leadership and limited resources compromise the workforce and the performance and accessibility of TB services, and how this negatively affects the demand for higher levels of stewardship.

Conclusions
Strengthening leadership, reducing bureaucracy, improving integration across all levels of the system, increasing health care worker support, and using windows of opportunity to target points of leverage within the South African health system are needed to both strengthen the system and reduce TB mortality. Further refinement of this model may allow for the identification of additional areas of intervention.