bluuebunny/crossref_metadata_2025_split huggingface dataset:
Additional records and new species of Hydraena Kugelann, 1794 (Insecta: Coleoptera: Hydraenidae) from Balabac and Palawan, Philippines
Authors: Freitag Hendrik , Hornyák Marta 
Published: August 2021

Abstract
Three new species of the genus Hydraena Kugelann, 1794 of the Philippine Island of Palawan are described in detail, namely H. angelitofelipepunoi sp. n., H. buschietanni sp. n., and H. perpusilla sp. n., along with faunistic records of further species of the genus from previously unexplored areas of Balabac and Palawan. The genital characters of the new species are illustrated by digital line drawings. Photographs of their habitus and type localities are provided. The habitat conditions of their collection sites are assessed and implications of the usefulness of Hydraena species as monitoring organisms for the conservation of vulnerable habitats are briefly discussed. An updated checklist of the Hydraena of Greater Palawan is provided which now comprises 15 described species, of which 13 are endemic to this intra-Philippine island complex.
Evaluation of Auto-Planning for Left-Side Breast Cancer After Breast-Conserving Surgery Based on Geometrical Relationship
Authors: Li Yijiang , Bai Han , Huang Danju , Chen Feihu , Xia Yaoxiong 
Published: August 2021

Purpose: This study aimed to evaluate (1) the performance of the Auto-Planning module embedded in the Pinnacle treatment planning system (TPS) with 30 left-side breast cancer plans and (2) the dose-distance correlations between dose-based patients and overlap volume histogram-based (OVH) patients. Method: A total of 30 patients with left-side breast cancer after breast-conserving surgery were enrolled in this study. The clinical manual-planning (MP) and the Auto-Planning (AP) plans were generated by Monaco and by the Auto-Planning module in Pinnacle respectively. The geometric information between organ at risk (OAR) and planning target volume (PTV) of each patient was described by the OVH. The AP and MP plans were ranked to compare with the geometry-based patients from OVH. The Pearson product-moment correlation coefficient (R) was used to describe the correlations between dose-based patients (APs and MPs) and geometry-based patients (OVH). Dosimetric differences between MP and AP plans were evaluated with statistical analysis. Result: The correlation coefficient (mean R = 0.71) indicated that the AP plans have a high correlation with geometry-based patients from OVH, whereas the correlation coefficient (mean R = 0.48) shows a weak correlation between MP plans and geometry-based patients. The dosimetric comparison revealed a statistically significant improvement in the ipsilateral lung V5Gy and V10Gy, and in the heart V5Gy of AP plans compared to MP plans, while statistical reduction was seen in PTV V107% for MP plans compared to AP plans. Conclusion: The overall results of AP plans were superior to MP plans. The dose distribution in AP plans was more consistent with the distance-dose relationship described by OVH. After eliminating the interference of human factors, the AP was able to provide more stable and objective plans for radiotherapy patients.
Reaching A Female Majority: A Silent Transition for Dentistry in the United Kingdom
Authors: Gallagher Jennifer E. , Scambler Sasha 
Published: August 2021

This paper highlights the process of transition to a female majority for dentistry, examines various influences on this trajectory, and considers the implications for the profession, health systems and patients, as well as individual dentists. This celebratory transition has been facilitated by educational systems that provide both males and females with equal opportunities and is supported by legislation, as well as societal change that has spanned decades. In crossing this gender representation threshold, we have outperformed doctors nationally. In order to embrace our highly educated workforce and support them to better serve their patients and the population, urgent debate and action aimed at reshaping current systems of dental care provision are required. In this regard, flexible working arrangements, together with reshaping professional leadership to better represent the workforce, as well as changes in terminology can all play their part; however, we will need careful discussions about how this might happen effectively. A collaborative effort between the dental profession and wider health systems is required to ensure that there are opportunities for everyone to flourish and contribute back to the profession and society. Our medical counterparts have been considering how healthcare should be shaped creatively, particularly in relation to working patterns, economic models and quality patient care: we need to catch up.
Intention to Receive COVID-19 Vaccine by U.S. Health Sciences University Employees
Authors: Dowdle Travis S. , Dennis Jeff , Nugent Kenneth M. , Byrd Theresa 
Published: August 2021

Objectives: Understanding vaccine intentions and attitudes of health professionals is critical as the Pfizer-BioNTech and the Moderna COVID19 vaccines are being administered throughout the United States. This study estimates the level of vaccine hesitancy at a health sciences center in West Texas prior to the distribution of the vaccines. Methods: An analytical cross-sectional study was performed via anonymous Qualtrics survey administered to approximately 4500 faculty, staff, postdoctoral research associates/medical residents, and employees at a multi-campus health sciences university in the United States. Respondents were asked demographic questions and intention to receive the vaccine. Factors associated with the intention to receive a vaccine were determined using logistic regression analysis. Results: A total sample of 2258 subjects were evaluated (50.0% response rate). Among all respondents, 64.6% reported that they would probably or definitely receive the COVID-19 vaccine. Men had higher levels of intention to receive the vaccine (OR = 2.11, 95% CI 1.64-2.71); respondents who indicated yearly influenza vaccines are necessary were also more likely to receive the vaccine (OR = 6.04, 95% CI 4.70-7.75). Eighty-three percent of faculty and 56% of the staff reported intention to receive the vaccine. Respondents who had previously tested positive for COVID-19 reported more interest in receiving the vaccine (58.5% yes vs 41.5% no). Conclusion: In this study, the intention to receive the COVID-19 vaccination at a United States health sciences center falls below the necessary herd immunity estimates. Public health initiatives must be developed to decrease vaccine hesitancy, especially among health professionals.
Spatial distribution and contamination assessment of heavy metal pollution of sediments in coastal reclamation areas: a case study in Shenzhen Bay, China
Authors: Zhang Qiuying , Ren Futian , Xiong Xiangyun , Gao Hongjie , Wang Yudong , Sun Wenjun , Leng Peifang , Li Zhao , Bai Yangwei 
Published: August 2021

Abstract
Background
With the continuous advancement of global urbanisation, humans have begun to overutilise or improperly utilise the natural resources of bay areas, which has led to a series of ecological and environmental problems. To evaluate the spatial distributions and potential ecological risks of heavy metals in sediments of Shenzhen Bay, China, an analysis of As, Cd, Cr, Cu, Pb, and Zn regarding their content, correlation (Pearson coefficient), pollution degree, and potential ecological risks was conducted.

Results
The heavy metal contents in the sediments decreased in the order of Zn > Cu > Cr > Pb > As > Cd, with contents of 175.79 mg kg−1, 50.75 mg kg−1, 40.62 mg kg−1, 37.10 mg kg−1, 18.27 mg kg−1, and 0.20 mg kg−1, respectively. The results showed that the overall sediment quality in Shenzhen Bay generally met the China Marine Sediment Quality criteria, and the heavy metal contents were significantly lower than those reported in the same type of bay area worldwide. Furthermore, the order of grade of potential ecological risk of the heavy metals was as follows: As and Cd were found to pose moderate ecological risks, with their potential hazard indices reaching a high level, whereas the potential ecological hazard indices of Cu, Pb, Zn, and Cr were all at relatively low levels.

Conclusions
The potential hazard indices of the heavy metals decreased from the inner bay toward the outside. The accumulation and content of the analysed heavy metals in the Shenzhen Bay sediments are mainly controlled by historical land-source pollution and land reclamation projects. This study presents the current state of sediment quality in Shenzhen Bay. The results may assist in the definition of future bay area management measures specifically targeted at monitoring heavy metal contamination.
Premature neonatal gut microbial community patterns supporting an epithelial TLR-mediated pathway for necrotizing enterocolitis
Authors: Shaw Alexander G. , Sim Kathleen , Rose Graham , Wooldridge David J. , Li Ming-Shi , Misra Raju V. , Gharbia Saheer , Kroll J. Simon 
Published: August 2021

Abstract
Background
Necrotising enterocolitis (NEC) is a devastating bowel disease, primarily affecting premature infants, with a poorly understood aetiology. Prior studies have found associations in different cases with an overabundance of particular elements of the faecal microbiota (in particular Enterobacteriaceae or Clostridium perfringens), but there has been no explanation for the different results found in different cohorts. Immunological studies have indicated that stimulation of the TLR4 receptor is involved in development of NEC, with TLR4 signalling being antagonised by the activated TLR9 receptor. We speculated that differential stimulation of these two components of the signalling pathway by different microbiota might explain the dichotomous findings of microbiota-centered NEC studies. Here we used shotgun metagenomic sequencing and qPCR to characterise the faecal microbiota community of infants prior to NEC onset and in a set of matched controls. Bayesian regression was used to segregate cases from control samples using both microbial and clinical data.

Results
We found that the infants suffering from NEC fell into two groups based on their microbiota; one with low levels of CpG DNA in bacterial genomes and the other with high abundances of organisms expressing LPS. The identification of these characteristic communities was reproduced using an external metagenomic validation dataset. We propose that these two patterns represent the stimulation of a common pathway at extremes; the LPS-enriched microbiome suggesting overstimulation of TLR4, whilst a microbial community with low levels of CpG DNA suggests reduction of the counterbalance to TLR4 overstimulation.

Conclusions
The identified microbial community patterns support the concept of NEC resulting from TLR-mediated pathways. Identification of these signals suggests characteristics of the gastrointestinal microbial community to be avoided to prevent NEC. Potential pre- or pro-biotic treatments may be designed to optimise TLR signalling.
Effect of d-limonene and its derivatives on breast cancer in human trials: a scoping review and narrative synthesis
Authors: Chebet Joy J. , Ehiri John E. , McClelland Deborah Jean , Taren Douglas , Hakim Iman A. 
Published: August 2021

Abstract
Background
D-limonene and its derivatives have demonstrated potential chemopreventive and anticancer activity in preclinical and clinical studies. The aim of this scoping review was to assess and critically appraise current literature on the effect of these bioactive citrus peel compounds on breast cancer in human trials and to identify knowledge gaps for exploration in future studies.

Methods
This study followed a scoping review framework. Peer-reviewed journal articles were included if they reported the effect of d-limonene or its derivatives on breast cancer in human subjects. Articles were retrieved from academic databases – PubMed, EMBASE, CINAHL, Web of Science, and Cochrane reviews – and iteratively through review of bibliographies of relevant manuscripts. Titles and abstracts were appraised against the aforementioned inclusion criteria in a first round of screening. Through consensus meetings and full article review by authors, a final set of studies were selected. Results were reported according to the PRISMA extension for scoping reviews.

Results
Our search strategy yielded 367 records. Following screening and adjudication, five articles reporting on phase 1(n = 2), phase 2 (n = 2) and both trial phases (n = 1) were included as the final dataset for this review. Trials evaluating the effect of d-limonene (n = 2) showed it was well tolerated in subjects. One study (n = 43 participants) showed d-limonene concentrated in breast tissue (mean 41.3 μg/g tissue) and reduction in tumor cyclin D1 expression, which is associated with tumor proliferation arrest. This study did not show meaningful change in serum biomarkers associated with breast cancer, except for a statistically significant increase in insulin-like growth factor-1 (IGF-I) levels. While elevation of IGF-I is associated with increased cancer risk, the clinical implication of this study remains uncertain given its short duration. Trials with perillyl alcohol (n = 3) showed low tolerance and no effect on breast cancer.

Conclusion
This review demonstrated a dearth of clinical studies exploring the effect of d-limonene and its derivatives on breast cancer. Limited literature suggests d-limonene is safe and tolerable in human subjects compared to its derivative, perillyl alcohol. Our review demonstrates the need for additional well-powered placebo-controlled trials that assess d-limonene’s efficacy on breast cancer compared to other therapies.
Morphological changes after lower eyelid epiblepharon surgery in Asian children
Authors: Lee Sang Jae , Lee Shin-Hyo , Lee Min Sub , Jo Youn Hye , Shin Hyun Jin , Lee Andrew G. 
Published: August 2021

Abstract
Background
This study aimed to determine the morphological changes in Asian lower eyelid epiblepharon patients after surgery.

Methods
The medical records of 59 patients who underwent lower eyelid epiblepharon repair were reviewed retrospectively. Eighty-nine patients who underwent strabismus surgery were set as the control group. The photographs for each group were analyzed based on the following factors: inferior half area (IHA) of the eye, eyelash angular direction (EAD), angle between the eyelashes and the cornea, marginal reflex distance 1 (MRD1) and marginal reflex distance 2 (MRD2).

Results
After surgery, the medial EAD changed from 92.45° ± 20.21° (mean ± SD) to 79.43° ± 23.31°, while the central and lateral EADs were unchanged. IHA increased from 36.33 ± 9.78 mm3 to 43.06 ± 10.57 mm3, and MRD1 increased from 1.92 ± 0.99 mm to 2.50 ± 0.93 mm, whereas MRD2 did not change. The mean angle between the eyelashes and the cornea increased from 39.64° to 72.19° immediately postoperatively, but had reduced to 58.75° 3 months later, followed by no further significant change at the 6-month and 9-month postoperative follow-ups.

Conclusions
There is morphological changes of the eyelid after lower eyelid epiblepharon surgery, with increases in the IHA and MRD1. In addition, contact between the eyelashes and the cornea occurred mainly in the medial portion of the eyelid the position, which everted and stabilized over 3 months. Thus, follow-up observations are required for at least 3 months to properly evaluate the surgical outcome.
Health literacy, health status and health behaviors of German students– study protocol for the “Healthy Habits” cohort study
Authors: Lange Martin , Löwe Alexandra , Stassen Gerrit , Schaller Andrea 
Published: August 2021

Abstract
Background
The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention.
To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students’ health literacy, health status, and health behaviors, and on the impact of the study format on students’ health. The aim of this prospective cohort study is to reduce this research gap.

Methods
Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations.

Discussion
This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students’ health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions.

Trial registration
German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).
Operationalising the “One Health” approach in India: facilitators of and barriers to effective cross-sector convergence for zoonoses prevention and control
Authors: Asaaga F. A. , Young J. C. , Oommen M. A. , Chandarana R. , August J. , Joshi J. , Chanda M. M. , Vanak A. T. , Srinivas P. N. , Hoti S. L. , Seshadri T. , Purse B. V. 
Published: August 2021

Abstract
Background
There is a strong policy impetus for the One Health cross-sectoral approach to address the complex challenge of zoonotic diseases, particularly in low/lower middle income countries (LMICs). Yet the implementation of this approach in LMIC contexts such as India has proven challenging, due partly to the relatively limited practical guidance and understanding on how to foster and sustain cross-sector collaborations. This study addresses this gap by exploring the facilitators of and barriers to successful convergence between the human, animal and environmental health sectors in India.

Methods
A mixed methods study was conducted using a detailed content review of national policy documents and in-depth semi-structured interview data on zoonotic disease management in India. In total, 29 policy documents were reviewed and 15 key informant interviews were undertaken with national and state level policymakers, disease managers and experts operating within the human-animal-environment interface of zoonotic disease control.

Results
Our findings suggest that there is limited policy visibility of zoonotic diseases, although global zoonoses, especially those identified to be of pandemic potential by international organisations (e.g. CDC, WHO and OIE) rather than local, high burden endemic diseases, have high recognition in the existing policy agenda setting. Despite the widespread acknowledgement of the importance of cross-sectoral collaboration, a myriad of factors operated to either constrain or facilitate the success of cross-sectoral convergence at different stages (i.e. information-sharing, undertaking common activities and merging resources and infrastructure) of cross-sectoral action. Importantly, participants identified the lack of supportive policies, conflicting departmental priorities and limited institutional capacities as major barriers that hamper effective cross-sectoral collaboration on zoonotic disease control. Building on existing informal inter-personal relationships and collaboration platforms were suggested by participants as the way forward.

Conclusion
Our findings point to the importance of strengthening existing national policy frameworks as a first step for leveraging cross-sectoral capacity for improved disease surveillance and interventions. This requires the contextual adaptation of the One Health approach in a manner that is sensitive to the underlying socio-political, institutional and cultural context that determines and shapes outcomes of cross-sector collaborative arrangements.
Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study
Authors: Areru Hiwot Abera , Dangisso Mesay Hailu , Lindtjørn Bernt 
Published: August 2021

Abstract
Background
Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities’ suggestions to improve the services. No study has assessed this in Ethiopia previously.

Methods
An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases’ diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis.

Result
A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18–0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08–0.09). Children in the age group of 5–14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21–0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09–4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals’ skill and attitudes, and improving affordability and physical accessibility of the services.

Conclusion
The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.