bluuebunny/crossref_metadata_2025_split huggingface dataset:
The work competence of Shanghai’s GPs: a cross-sectional study based on self-assessment
Authors: Wang Tianhao , Ru Xueying , Zhang Yuan , Zhang Xiangjie , Gong Jian , Lao Limin , Gao Junling , Pan Zhigang 
Published: March 2021

Abstract
Background: General practitioners(GPs) have taken new challenges as requested in a new model introduced in China recently. Unlike some countries where general medicine are well developed, there is a lack of a standard in China that can be generalized to assess GPs’ work competence. The aim of the study was to investigate work competence of GPs in Shanghai’s community health services(CHS) in China by self-assessment, providing evidences for effectiveness of GPs’ post-education and training. Methods: A stratified and proportional cluster sampling method was adopted in this cross-sectional study from 116 CHS in Shanghai.(n=2954). We collected data on GPs demographic variables and work competence which was separated as patient care ability, teaching ability, communication skill and coordination ability, using a self-designed questionnaire. Results: The mean score of patient care ability, teaching ability, communication skill and coordination ability were 76.93±12.55, 63.47±28.97, and 76.31±20.25 on a scale of 100, respectively. GPs who were 30-39 years old, worked in urban CHSs, and participated in GP trainer’s training or had teaching experience got higher scores in patient care ability. Those GPs who worked for 5-20 years in CHS, especially in training CHSs which is involved in post-graduate GPs training program, and participated in GP trainer’s training program had higher scores in teaching ability. As for communication skill and coordination ability, GPs who were older than 30-39 years old and with a senior professional title, worked in training CHSs, participated in GP trainer’s training and had teaching experiences in CHS can got higher scores.Conclusions: There is a large space to improve the patient care ability, teaching ability, communication skill and coordination ability for GPs in Shanghai’s CHS ,especially in teaching ability.
Using finite volume method for investigating the turbulent flow field and heat transfer of a non-Newtonian nanofluid in a channel with triangular vortex generators
Authors: Ibrahim Muhammad , Saeed Tareq 
Published: March 2021

Abstract
This study examines the turbulent flow field and heat transfer rate (HTR) of the non-Newtonian H2O-Al2O3-carboxymethyl (CMC) in a channel with vortex generators. The finite volume method and SIMPLE algorithm were employed for solving the partial differential equations. The mean Nusselt numbers (Num) and pressure drops were studied at angles of 30-60°, vortex generator depths of 1-3 mm, Reynolds numbers (Re) of 3000-30000, and nanoparticles volume fractions (φ) of 0.5% and 1.5%. According to the numerical results, the use of triangular vortex generators significantly incremented the Nusselt number (Nu) of the non-Newtonian nanofluid (NF), while it had a lower effect on the enhancement of pressure drop (DP). It was also indicated that a change in the vortex generator depth in the range of a few millimeters had no significant effects on the Nu and pressure drop. Moreover, a rise in the Re (i.e., more turbulent flow) significantly incremented HTR. An increase in the Re raised pressure drop; however, the Num incremented more than the pressure drop. Also, the variations of the local Nu indicated that the local Nu significantly incremented around vortex generators due to the formation of vortex flows. An enhancement in the volume fraction of the base fluid’s nanoparticles (NPs) from 0.5% to 1.5% significantly incremented HTR and the Nu.
Catastrophic Carpal Fractures in Racehorses during Traditional Competitions: Assessing Mechanobiology using Multibody Modelling and Comparative Analysis
Authors: Pagliara Eleonora , Pasinato Alvise , Valazza Alberto , Cantatore Federica , Terzini Mara , Putame Giovanni , Parrilli Annapaola , Sartori Maria , Fini Milena , Zanetti Elisabetta , Bertuglia Andrea 
Published: March 2021

Abstract
Background: City circuit competitions (Palio) in Italy are traditional horse race held in the heart of some cities centre once a year. The prevalence of accidents during these competitions is only anecdotally reported; however there is a diffuse perception that these events adversely affect racehorse industry and impact on equine welfare. The aim of the study is to understand the basic physiopathology of catastrophic fracture of the carpus in a 7-y old thoroughbred euthanized following catastrophic fracture of the left carpus during a traditional horse race, comparing the localization and the magnitude of the contact forces at the level of the affected joint, obtained in simulated conditions with the macro- and microscopic structural damages.Methods: A retrospective analysis of a thoroughbred racehorse galloping at high speeds on an urban racetrack conditions was set up. Computational modelling of the carpal joint was generated using a multibody code for dynamics simulation, considering the circuit design, the speed of the animal, and the surface characteristic. The results were compared to the findings observed during computed tomography, micro-computed tomography and histological evaluation following hematoxylin and eosin and safranin-O fast green staining.Results: The articular surfaces of the radial, intermediate and ulnar facet of the radius together with the proximal articular surface of small carpal bones exhibited diffuse wear lines, erosions of the articular cartilage and subchondral bone exposure. The fracture line along the radial carpal bone initiating the injury does not travel in a region with bone sclerosis. In the computational model, the peak force for the contact between the radius and the radial carpal bone has a value of 6880 N. Conclusions: This study highlight how during traditional racing circuits it develops elevate impact forces at the level of contact surfaces of the carpal joint, due to effect of speed and curve, causing catastrophic bone fracture and hyaline cartilage breakdown in the absence of pre-existing pathology.
The Role of FOLFIRINOX in Advanced Pancreatic Cancer: A Meta-analysis
Authors: Du Nannan , Zhou Fengyan , Hong Jiaze , Ng Derry Minyao , Yang Tong , Zhou Xinyu , Jin Jieyin , Zhou Feifei , Chen Ping , Chen Jingjie 
Published: March 2021

Abstract
BackgroundThe prognosis of pancreatic cancer (PC) is extremely poor and most patients with metastatic PC still receive palliative care. Here, we report the efficacy and safety of FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, 5-fluorouracil) in the treatment of metastatic PC.MethodsWe searched PubMed, Web of Science, EBSCO, and Cochrane library databases for articles that described efficacy and safety of FOLFIRINOX in patients with metastatic PC, from their inception to July 2020. The primary outcomes targeted included overall survival (OS) and progression-free survival (PFS).ResultsWe found that FOLFIRINOX could directly improve OS rate of patients with metastatic PC (HR: 0.76, 95% Cl: 0.67-0.86, p<0.001), but had no benefit on PFS. Results from subgroup analyses showed that FOLFIRINOX had superior benefits than mono-chemotherapy (HR: 0.59, 95% Cl: 0.52-0.67, p<0.001), followed by FOLFIRINOX versus combination chemotherapy (HR: 0.76, 95% Cl: 0.61-0.95, p<0.001). The result of FOLFIRINOX versus nab-paclitaxel + gemcitabine had no benefit (HR: 0.91, 95% Cl: 0.82-1.02, p>0.05). The main adverse events (AEs) targeted hematological toxicity and the gastrointestinal system, and included febrile neutropenia, a reduction in white blood cells and appetite, as well as diarrhea.ConclusionThese findings indicated that FOLFIRINOX has potential benefits for the prognosis of patients with metastatic PC. Furthermore, there is no difference between the regimen of FOLFIRINOX and nab-paclitaxel + gemcitabine in this study. The application of FOLFIRINOX should be according to the actual situation of the patients and the experience of the doctors.
Adherence to recommendations for secondary prevention medications after myocardial infarction in Estonia – comparison of real-world data from 2004-2005 and 2017-2018
Authors: Lõiveke Piret , Marandi Toomas , Ainla Tiia , Fischer Krista , Eha Jaan 
Published: March 2021

Abstract
Background: Relatively high rates of adherence to myocardial infarction (MI) secondary prevention medications have been reported, but register-based, objective real-world data is scarce.We aimed to analyse adherence to guideline-recommended medications for secondary prevention of MI in 2017-2018 (period II) and compare the results with data from 2004-2005 (period I) in Estonia.Methods: Study populations were formed based on data from the Estonian Health Insurance Fund's database and on Estonian Myocardial Infarction Register. By linking to the Estonian Medical Prescription Centre database adherence to guideline-recommended medications for MI secondary prevention was assessed for one year follow-up period from the first hospitalization due to MI. Data was analysed using the defined daily dosages methodology. Results: Total of 6694 and 6060 cases of MI were reported in periods I and II, respectively. At least one prescription during the follow up period was found for beta-blockers (BB) in 81.0 % and 83.5 % (p = 0.001), for angiotensin converting enzyme inhibitor/angiotensin II receptor blocker (ACEi/ARB) in 76.9 % and 66.0 % (p < 0.001), and for statins in 44.0 % and 67.0 % (p < 0.001) of patients in period I and II, respectively. P2Y12 inhibitors were used by 76.4 % of patients in period II. The logistic regression analysis adjusted to gender and age revealed that some drugs and drug combinations were not allocated similarly in different age and gender groups. Conclusions: In Estonia, adherence to MI secondary prevention guideline-recommended medications has improved. But as adherence is still not ideal more attention should be drawn to MI secondary prevention through systematic guideline implementation.
De-novo Multilayering in Fibrovascular Pigment Epithelial Detachment
Authors: Soman Manoj , Sheth Jay U , Indurkar Asmita , Meleth Padmanabhan , Nair Unnikrishnan 
Published: March 2021

Abstract
This study describes the occurrence of multilayered pigment-epithelial detachment (MLPED) as a De-novo phenomenon (DN-MLPED) and compare the features with multi-layering secondary to chronic anti-vascular endothelial growth factor(anti-VEGF) therapy(s-MLPED). We did a retrospective evaluation of spectral-domain optical coherence tomography(SD-OCT) features, treatment-profile, and visual-acuity (VA) outcomes in eyes with MLPED. Out of 17 eyes with MLPED, 7 eyes had DN-MLPED and 10 eyes had s-MLPED. There was no significant difference in baseline and final VA between the groups. At the final visit, the DN-MLPED eyes showed improvement in VA (LogMAR-BCVA: Baseline=0.79±0.91; Final=0.76±0.73; p=0.87) while the s-MLPED eyes showed decline (LogMAR BCVA: Baseline=0.43±0.68; Final=0.94±0.71; p=0.87), although not significantly. Moreover, after presentation, the median number of injections in DN-MLPED eyes were significantly lower compared to s-MLPED eyes (DN-MLPED:4; s-MLPED:12; p=0.03) (Median follow-up: DN-MLPED=26months; s-MLPED=54months; p=0.15). Subretinal hyperreflective-material (SHRM) deposition heralded the onset of multilayering and was seen to progress in all DN-PED eyes and 1/4 eyes of s-MLPED. To conclude, MLPED is a unique form of cicatrizing fibrovascular-PED which can evolve denovo too. Long-standing disease with intermittent or low-grade activity can potentially explain this unique phenomenon. With fewer anti-VEGF therapy, the de-novo MLPED eyes show more visual stability as compared to s-MLPED eyes.
Matta’s criteria may be useful for evaluating and predicting the reduction quality of simultaneous acetabular and ipsilateral pelvic ring fractures
Authors: Yu Yi-Hsun , Liu Chang-Heng , Hsu Yung-Heng , Chou Ying-Chao , Chen I-Jung , Wu Chi-Chuan 
Published: March 2021

Abstract
Background Although the incidences, fracture types, and radiological outcomes for simultaneous ipsilateral pelvic ring and acetabular fractures were reported, there have been no reports on factors that may affect reduction quality of an acetabular fracture. Here, we evaluate the radiological outcomes of patients treated for simultaneous ipsilateral pelvic and acetabular fractures and analyze the factors that affect the reduction quality of acetabular fractures.Methods We conducted a retrospective review of patients treated for simultaneous ipsilateral pelvic ring and acetabular fractures between 2016 to 2020. Potential factors were analyzed to predict inadequate reduction of the acetabular fractures.Results Data from 27 hips of 26 patients were collected. AO B2.2 and anterior columnar fractures were the most common fracture types of the pelvic ring and acetabular fractures, respectively. Univariate analysis revealed that Matta’s criteria for pelvic ring fracture may be useful for predicting fair to poor reduction quality of acetabular fractures on X-rays. Furthermore, associated fractures identified by Letournel’s classification system on CT scan may be factors for predicting greater step-offs.Conclusions The associated fractures identified via Letournel’s classification may be factors that contribute to inadequate reduction for such fractures. Matta’s criteria for pelvic ring fractures may also be useful for predicting the similar risk of inadequate reduction of the acetabulum on X-ray scans. These findings may be applied intraoperatively by fluoroscopy before the beginning of osteosynthesis for acetabular fractures.
Evaluation of a Sample Pooling Strategy for Sars-cov-2 Using Real Time PCR
Authors: Nankya Annet M , Nyakarahuka Luke , Balinandi Stephen , Kayiwa John , Lutwama Julius , Tamale Andrew , Kungu Joseph M 
Published: March 2021

Abstract
Back ground: Corona Virus Disease 2019 (COVID 19) in Uganda was first reported in a male traveler from Dubai on 21st March, 2020 shortly after WHO had announced the condition as a global pandemic. Timely laboratory diagnosis of COVID -19 for all samples from both symptomatic and asymptomatic patients was observed as key in containing the pandemic and breaking the chain of transmission. However, there was a challenge of limited resources required for testing SARS-COV-2 in low and middle income countries. To mitigate this, a study was conducted to evaluate a sample pooling strategy for COVI-19 using real time PCR. The cost implication and the turn around time of pooled sample testing versus individual sample testing were also compared.Methods: In this study, 1260 randomly selected samples submitted to Uganda Virus Research Institute for analysis were batched in pools of 5, 10, and 15. The pools were then extracted using a Qiagen kit. Both individual and pooled RNA were screened for the SARS-COV-2 E gene using a Berlin kit. Results: Out of 1260 samples tested, 21 pools were positive in pools of 5 samples, 16 were positive in pools of 10 and 14 were positive in pools of 15 samples. The study also revealed that the pooling strategy helps to save a lot on resources, time and expands diagnostic capabilities without affecting the sensitivity of the test in areas with low SARS-COV-2 prevalence.Conclusion: This study demonstrated that the pooling strategy for COVID-19 reduced on the turnaround time and there was a substantial increase in the overall testing capacity with limited resources as compared to individual testing.
Involvement of Cyclin Dependent Kinase 5 in M4 Muscarinic Acetylcholine Receptor-Mediated Cholinergic&nbsp;Transmission within the Mouse Dorsal Striatum
Authors: Zhou Hu , Shi Huaxiang , Li Xing , Zhang Jingxin , Sui Xin , Zhao Zhe , Nie Zhiyong , Wang Yongan , Li Jin , Wang Liyun 
Published: March 2021

Abstract
Background: An imbalance between dopamine (DA) and acetylcholine (ACh) within the striatum has reemerged as key to the pathophysiology of the neurodegenerative disorder, Parkinson's disease (PD). M4 is a prominent muscarinic ACh receptor subtype in the striatum and we have previously reported that M4 controls cyclin-dependent kinase 5 (Cdk5) / dopamine- and cAMP-regulated phosphoprotein of Mr 32 kDa (DARPP-32) activity in cultured medium spiny neurons (MSNs). However, the mechanism of this control remains unclear. Methods: Genetic, electrophysiological, and immunohistochemical approaches were used in conjunction with pharmacological methods to study isolated M4-deleted MSNs (M4-KD MSNs) and a dorsomedial striatum (DMS) M4 knockout mouse model. We examined the role of Cdk5 in M4-mediated neural cholinergic transmission and related behavior.Results: Oxotremorine M, a nonselective mAchR agonist, promoted Cdk5/P35 signaling activity in DSM MSNs both in vivo and in vitro. Either pharmacological inhibition or genetic knockdown of M4 decreased the amount of Cdk5 and DARPP-32 phosphorylation at Thr75 in dopamine 1 receptor-expressing MSNs. Furthermore, whole-cell patch-clamp recording confirmed Cdk5 is necessary for M4-mediated cholinergic inhibition of excitatory synaptic transmission in MSNs in vivo and in vitro. Concomitantly, deletion of M4 activity in the DMS caused Oxotremorine M-induced Cdk5 signaling and glutamatergic synaptic input to be altered in parallel with behavioral responses. Conclusions: We characterized a novel regulatory mechanism of Cdk5/DARPP-32 involved in M4-mediated cholinergic regulation on striatonigral neurons and on motor behavior. The findings indicate that inhibition of M4 mAChR could be a novel approach to correct the pathological conditions of PD.
The Stages of Debris Flow Activity During the Quaternary in the Xiaojiang River Basin, China
Authors: Liang Xuezhan , Chen Hongkai , Zhang Jinhao , Liu Bin 
Published: March 2021

Abstract
This study aimed to predict the laws and trends of modern debris flow by examining the activity cycle of debris flow during the Quaternary and its relationship with environmental change. The timing of the debris flow activity period was determined using sediment dating data based on typical debris flow deposition profiles selected from various terraces in the Xiaojiang River Basin, China. The relationships between debris flow and environmental change were compared and analyzed using neotectonic history, the deep-sea oxygen isotope δ18O curve, and the loess paleosol series. The results showed that the debris flow activities in the Xiaojiang River Basin could divided into eight activity cycles, namely 11.42 Ma, 0.985 Ma, 0.562–0.52 Ma, 0.218 Ma, 0.137 Ma, 14 Ka, 0.73 Ka, and since 3 Ka. The activity cycle of debris flow deposition coincided with the neotectonically active period. Neotectonic movement has controlled the cycle of large debris flow deposition in the Xiaojiang River Basin since the Quaternary. The sedimentary activity of debris flow was not completely consistent with a warm and humid climate, and the sedimentation activity of debris flow was the result of the combined effects of tectonic movement and climate change.
Evaluation of Autonomic Nervous System in Children With Cerebral Palsy: Clinical and Electophysiological Study
Authors: Azouz Hanan Galal , Mohsen Ali M Abdel , Mohamed Rana M , abdelghany hayam mostafa 
Published: March 2021

Abstract
Cerebral palsy (CP) is the most prevalent severe motor disability among children. The aim of this work was to assess autonomic dysfunction in children with cerebral palsy clinically and electrophysiologically .The study was carried out on forty children with cerebral palsy their age ranged from 4-12 years and twenty healthy children with matched age and sex as control group. CP children were subjected to questionnaire for autonomic dysfunction symptoms. Both CP children and Control group were assessed for Sympathetic Skin Response and Heart rate variability. Most of children had quadriplegic spastic cerebral palsy (82.5%). Based on Gross motor function classification system (GMFCS) classification the majority of children were in levels 4 and 5. The prevalence of autonomic dysfunction symptoms was 80% for thermoregulatory abnormalities (cold extremities), chronic constipation 65%, sleep disturbance 52.5%, loss of appetite 47.5%, sweating abnormalities 40% , recurrent nausea and/or vomiting 25%, increased sensitivity to light or dark 22.5% and bloating 15%. The percentage of unelicited Sympathetic skin response in CP children was 47.5% and 60% in upper limbs and lower limbs respectively, all of them were in level 4 and 5 of GMFCS. 20% of CP children had postural hypotension. Mean Heart rate of CP children was significantly increased more than healthy children upon head tilt test. Sympathetic Skin Response and Heart rate variability were proven to be simple and non invasive procedures in investigating autonomic dysfunction in CP children.
Carvacrol Promotes Cisplatin-induced Apoptosis of Triple-negative Breast Cancer Through TRPM7 Channels
Authors: Li Jing , Ye Haiyan , Wang Jun , Qin Junli , Chen Lixia 
Published: March 2021

Abstract
Triple-negative breast cancer (TNBC) is the most dangerous type of breast cancer. Cisplatin is a chemotherapy agent for solid tumors treatments, but it is subjected to drug resistance. A natural compound, carvacrol, showed anti-cancer potential for TNBC and can be a cisplatin sensitizer. Carvacrol inhibits the transient receptor potential melastatin-like 7 channel (TRPM7), which plays a critical role in cancer apoptosis. In this study, we proposed that carvacrol can promote cisplatin-induced apoptosis of TNBC through TRPM7 channels. We tested this hypothesis using five TNBC cell lines. Cell viability and apoptosis were determined using the MTT and Bax (Bcl-2-associated X protein) ELISA respectively. 4T1 /BALB/c mice model was used to test the effect of carvacrol on cisplatin treatment. TRPM7 and Bax expression in the tumors were determined using western blotting. We also tested the effect of TRPM7 knockdown and TRPM7 inhibitor, 2-APB, on carvacrol actions in MDA-MB-231. The TRPM7 channel inhibition by carvacrol was confirmed using patch-clamp and Fura-2-based fluorescence quench assay. Results showed that carvacrol enhanced the suppression of cisplatin and cisplatin-induced apoptosis in all five TNBC cancer cell lines. Carvacrol improved cisplatin treatment in mice model by promoting cisplatin-induced apoptosis in tumors, but did not affect TRPM7 in tumors. Both knockdown and 2-APB inhibition of TRPM7 channels eliminated the effects of carvacrol and 2-APB showed a similar effect as carvacrol. Our study demonstrated that carvacrol is a cisplatin sensitizer in TNBC chemotherapy and TRPM7 channels might play a role in the synergistic effect of carvacrol on cisplatin.