bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potentially Inappropriate Prescribing in a Falls Clinic Using the STOPP &amp; START Criteria
Authors: Chiam Rosalind , Saedon Nor'izzati , Khor Hui Min , Subramaniam Sukanya A/P , Nasir Siti Sakinah binti Mohmad , Hashim Noor Fatin Izzati binti Abu , Tan Maw Pin 
Published: May 2021

Abstract
Background
Potentially inappropriate prescribing which may lead to adverse drug events and linked to polypharmacy is becoming increasingly common in older patients.
Objective
This study applied the STOPP/START criteria to a clinical registry to determine the burden and profile of potentially inappropriate prescribing among patients attending a falls clinic.
Setting
University of Malaya Medical Centre Falls Clinic
Method
Data of individuals aged ≥ 65 years referred to the falls and syncope clinic were extracted from the falls registry. Potentially inappropriate prescribing was determined with the STOPP/START version 2 criteria. The relationship between potentially inappropriate prescribing with polypharmacy (≥ 5 medications), comorbidities and clinical variables were determined using Pearson’s chi-square and potential confounders adjusted for with multivariate regression.
Main outcome measure
Potentially inappropriate medicines and/or omitted medicines using STOPP/START criteria
Results
Data from 421 individuals, aged 77.8 ± 6.7 years and 53.4% women, were included. Potentially inappropriate prescribing was present in 311 (74%). Potentially inappropriate medicines use accounted for 84.6% of the 325 prescriptions. 361/659 instances (54.8%) were falls-risk-increasing drugs, with vasodilators (49.3%) being the main potentially inappropriate medicine identified. Of the 177/421 with polypharmacy, 169/177 (95.5%) were exposed to ≥ one potentially inappropriate medicine. 129 instances of potentially omitted medicines were observed in 109 prescriptions (25.9%).
Conclusion
STOPP/START criteria are useful to identify potentially inappropriate prescribing at the falls and syncope clinic. This finding has important implications for medication review strategies at falls clinic. Future research should determine whether identifying potentially inappropriate prescribing may reduce adverse falls outcomes among patients in this setting.
Impact of The COVID-19 Pandemic on Emergency Admission For Stroke Patients: A Cohort Study in Japan
Authors: Tani Takuaki , Imai Shinobu , Fushimi Kiyohide 
Published: May 2021

Abstract
Background: Hospitalization rates have reportedly reduced on account of measures such as the declaration of a COVID-19-related state of emergency. Appropriate treatment of stroke immediately after its onset contributes to improved survival, and delay in hospitalisation after onset affect stroke severity and mortality. This study aimed to determine the impact of the COVID-19 pandemic on emergency hospitalisation of stroke patients in Japan and the associated changes in stroke severity and mortality. Methods: This was an observational study that used nationwide administrative data. The participants were selected from the data of hospitalised patients diagnosed with stroke. We cross-sectionally observed the background factors of patients during April and May 2020, when COVID-19-related state of emergency was declared, and the same period in 2019. We also modelled monthly trends in the numbers of emergency stroke admissions, of stroke admissions at each level of Japan Coma Scale (JCS), and of deaths within 24 h using interrupted time series regression (ITS). Results: There was no difference between the pre- and the COVID-19 pandemic periods in the pre-hospital baseline characteristics of patients. No significant change was seen through ITS in the number of emergency stroke admissions between the COVID-19 and the pre-COVID-19 pandemic periods (risk ratio [RR]=0.96, 95% confidence interval [95%CI]: 0.90–1.02, P=0.159). There was a significant difference in the JCS3 of impaired consciousness in emergency stroke patients, which was more severe during the COVID-19 pandemic than pre-COVID-19 pandemic (RR=1.16, 95%CI: 1.04–1.28, P=0.005). There was no change in the mortality rate of patients with COVID-19 compared to those without COVID-19, but there were significantly more deaths within 24 h of admission. (No deaths within 24 h: RR=0.97, 95%CI: 0.88–1.06, P=0.446; deaths within 24 h: RR=2.80, 95%CI: 2.40–3.27, P<0.001). Conclusions: COVID-19 infection prevalence increased the number of deaths and severity of illness within 24 h of hospitalisation in Japan. However, there was no association between the number of hospital admissions or deaths with baseline characteristics. These results suggest no problems in accepting hospitalised patients during the COVID-19 pandemic, but the delay in visiting the hospital after disease onset may have increased stroke severity.
The Effect of Decision-aid Based Counseling on Cervical Cancer Screening Behavior Among Women: a Quasi-experimental Study
Authors: Malekzadeh Elnaz , Nourizadeh Roghaiyeh , Farshbaf-Khalili Azizeh , Mehrabi Esmat , Hakimi Sevil 
Published: May 2021

Abstract
Background: The present study was designed to determine the effect of decision-aid-based counseling on changing cervical cancer screening behavior among women. Methods: This quasi-experimental study was conducted on 154 women aged 21-59 with no pap smear history during the past three years. The participants were assigned to the intervention and control groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the socio-demographic and midwifery questionnaire, stages of change checklist, and shared decision making (SDM) and DC questionnaire before and six months after the intervention by interview and then analyzed by SPSS24 software. The chi-square, independent t-test, ANCOVA tests were used. Results: A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior six months after the intervention. After the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P<0.001). The mean score of SDM in the intervention group was significantly higher than the control group [35.48 (1.18) vs. 27.56 (1.18) (Adjusted mean difference: 7.92; 95% CI: 5.59 to 10.25; P<0.001)]. The mean score of total DC in the intervention group was significantly lower than the control group [29.16 (1.09) vs. 34.14 (1.09) (Adjusted mean difference: -4.97; 95% CI: 1.09 to 8.04; P<0.001)].Conclusions: It is suggested to apply decision-aid based counseling along with rutin trainins for promotimg the stages of cervical cancer screening behavior, increasing the , and reducing the DC regarding performing screening.
The jump and stagnation of mass with speed
Authors: Jun Dong , Dong Na 
Published: May 2021

Abstract
In the general theory of relativity the four-dimensional space-time described the accelerated motion or moves in a gravitational field of a mass body, from the perspective of integral geometry, although it is a curved Riemannian geometric space, but for any instantaneous position of the moving mass body, there is a local Flat Space of Riemannian geometric space. The local Flat Space is a Mincowski space in which the inertial coordinate system can be used in the local small area. Between the proper coordinate systems of two interacting moving masses, or between a series of follow-up proper coordinate systems experienced by a mass body moving in any way, there must be a coordinate transformation relationship similar to the traditional special theory of relativity. However, they have an important difference: In these instantaneous local inertial systems, the speed of light is no longer the constant c of vacuum, the effect of gravitational field or acceleration on the speed of light is the same as that of a medium with a dielectric constant of ε and a permeability of μ. Using the special theory of relativity with variable speed of light that the author has established can discuss relevant relativity physics issues in these instantaneous local inertial systems. This article uses the special theory of relativity with variable speed of light to infer the functional relationship between a moving mass and the change of speed. In addition to obtaining the traditional continuous increasing function relationship, a step function relationship with stepped discontinuous changes is also obtained. At the same speed, the mass can have two values, such as a ladder upgrade one level; the same mass can be matched with two different speeds, such as one step extension forward on the same step stair. From the perspective of the increase in speed, the mass is stagnant on the step platform (the speed increases, the mass does not change), and it jumps in the step up ladder (the speed does not change, the mass has a jump change). This obviously incorporates the main image of quantum theory into the theory of relativity, which is the result that all physics researchers care about and expect.
Unsteady squeezing flow of Cu-Al2O3 /water hybrid nanofluid in a horizontal channel with magnetic field
Authors: Khashi’ie Najiyah Safwa , Waini Iskandar , Ari Norihan Md , Pop Ioan 
Published: May 2021

Abstract
The proficiency of hybrid nanofluid from Cu-Al2O3/water formation as the heat transfer coolant is numerically analyzed using the powerful and user-friendly interface bvp4c in the Matlab software. For that purpose, the Cu-Al2O3/water nanofluid flow between two parallel plates is examined where the lower plate can be deformed while the upper plate moves towards/away from the lower plate. Another considerable factor are the wall mass suction/injection and the magnetic field which applied on the lower plate. The reduced ordinary (similarity) differential equations are solved using the bvp4c application. The validation of this novel model is conducted by comparing a few of numerical values for the reduced case of viscous fluid. The results imply the potency of this heat transfer fluid which can enhance the heat transfer performance for both upper and lower plates approximately by 7.10% and 4.11%, respectively. An increase of squeezing parameter deteriorates the heat transfer coefficient by 4.28% (upper) and 5.35% (lower), accordingly. The rise of suction strength inflates the heat transfer at the lower plate while the presence of magnetic field shows reverse result.
Humic Acid and Jasmonic Acid Improves the Growth and Antioxidant Defense System in Salt Stressed - Forage Sorghum Plants
Authors: Ali Adam Yousif Adam , Ibrahim Muhi Eldeen Hussien , Zhou Guisheng , Elsiddig Aboagla Mohammed Ibrahim , Jiao Xiurong , Zhu Guanglong , meng Tian Yao , Ahmed Irshad , Gabralla Ebtehal 
Published: May 2021

Abstract
Salinity is one of the primary abiotic stresses that cause several negative physiological and biochemical changes due to the oxidative stress caused by the generation of ROS. The effect of foliar application of jasmonic acid (JA) and humic acid (HA) as a fertilizer on growth and biochemical attributes exposed to salinity stress was investigated. Soil treated with NaCl at levels of 0 (S0), 2 (S1), and 4 g NaCl kg-1 dry soil (S2) and fertilized with 0 (HA0), 3 (HA1), and 6 g HA kg-1 dry soil (HA2). The plant spray with three JA levels (0, 5, and 10mM JA). Under salinity, JA and HA significantly improved all parameters tested. Salinity stress increased carotenoid, soluble protein content, SOD and MDA. In contrast, salinity stress reduced plant height, leaf area index, relative growth rate, proline content, POD, CAT, and APX. Under S2, HA2 rate increased plant high (9.69%), relative growth rate (70.79%) and CAT (45.47). While, HA1 increased leaf area index (12.45%), chlorophyll content (22.32%), carotenoid contents (38.05%), SOD (20.93), MDA (17.95%), POD (24.64%) and APX (21.67%). At S2, the highest plant height, chlorophyll content, soluble protein content and APX value recorded at 5mMJA, while, the highest value of leaf are index, carotenoid contents, proline, MDA, POD and CAT was achieved at 10mMJA. This study revealed that the level of 10 mM JA and HA1 had a positive effect on forage sorghum plants physiological responses. Furthermore, the results showed that jasmonic acid and humic acid successfully mitigated salinity stress's adverse effects.
Evaluating the Association of State Regulation of Community Health Workers on Adoption of Standard Roles, Skills, and Qualities by Employers in Select States: A Mixed Methods Study
Authors: Jones Tammie M. , Schulte Alex , Ramanathan Suhashini , Assefa Meron , Rebala Srilatha , Maddox Peggy J. 
Published: May 2021

Abstract
BackgroundThe occupation of Community Health Worker (CHW) has evolved to support community member navigation of complex health and social systems. The U.S. Bureau of Labor Statistics formally recognized the occupation of Community Health Worker (CHW) in 2009. Since then, various national and state level efforts to professionalize the occupation have been undertaken. The Community Health Workers Core Consensus (C3) project released a set of CHW roles and competency recommendations meant to provide evidence-based standards for CHW roles across work settings. Some states have adopted the recommendations, however, there are a variety of approaches regarding the regulation of the occupation. As of 2020, 19 U.S. states have implemented voluntary statewide CHW certification programs. The purpose of this study was to explore the relationship between state regulation of CHWs and adoption of standard roles, skills, and qualities by employers in select states.MethodsThis mixed methods study used purposive sampling of job ads for CHWs posted by employers from 2017-2020 in select states. Natural language processing was used to extract content from job ads and preprocess the data for statistical analysis. ANOVA, chi-square analysis, and MANOVA was used to test hypotheses related to the relationship between state regulation of CHWs and differences in skills, roles, and qualities employers seek based seniority of state regulatory processes and employer types.ResultsWe observe that the mean job ads with nationally identified roles (F(6, 80549) = 109.43, p = 0.000), skills (F(6, 80549) = 136.13, p = 0.000), and qualities (F(6, 80549) = 257.29, p = 0.000) included varies significantly between individual states, by state type, and by employer type. ConclusionsEmployment of CHWs is increasing as a means to provide culturally competent care, address the social determinants of health, and improve access to health and social services for members of traditionally underserved communities. Employers in states with CHW certification programs were associated with greater adoption of occupational standards set by state and professional organizations. Wide adoption of such standards may improve recognition of the CHW workforce as a valuable resource in addressing the needs of marginalized and difficult to serve groups.
The effect of taping on maximum plantar pressure and ground reaction force in people with flat foot after applying a fatigue protocol
Authors: Aghakeshizadeh Fatemeh , Letafatkar Amir , Ataabadi Peyman Aghaei , Hosseinzadeh Mahdi 
Published: May 2021

Abstract
Background: People suffering from flat foot show more movements in hindfoot and midfoot joints as compared to the others. The anti-pronation tapings are supposed to provide temporary external support for the medial longitudinal arch. The aim of this study was to examine the effects of two types of anti-pronation taping on the lower limb kinetics in flat foot people before and after performing a physical fatigue protocol. Methods: 20 male and female with flat foot aged 22.39 ± 2.02 years old were studied under three conditions (untaping, reverse-6 taping and low-dye taping) either before or after fatigue states. The maximum plantar pressure and ground reaction force were measured by an RSscan foot scan system during walking. Results: A statistically significant difference was observed after applying two types of taping (reverse-6 vs. low-dye taping) in the maximum plantar pressure perceived in metatarsus 1 (P = 0.016) and lateral heel (P = 0.044). In the post-fatigue conditions, there were significant differences between the two taping types in metatarsus 4 (P = 0.024). The maximum ground reaction force in toe 1 (P = 0.001), toe 2-5 (P = 0.001), metatarsus 5 (P = 0.001), and medial heel (P = 0.001) was significantly different between reverse-6 and Low-dye tapings. Conclusions: The results indicated that the low-dye and reverse-6 taping types can reduce the pressure on the medial side of the foot, and push it towards the lateral side. It is therefore suggested using taping as an effective treatment for redistribution of the pressure and force in sole of the foot in people with flat foot.
Understanding Issues Around Use of Oral Pre-Exposure Prophylaxis Among Female Sex Workers in India.
Authors: Sahay Seema , Verma Archana , Shewale Suhas , Bangar Sampada Dipak , Bijeshkumar Athokpam , Angolkar Mubashir , Subramanian Thilakavathi , Chandhiok Nomita 
Published: May 2021

Abstract
BackgroundEmpowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. FSWs are important target for oral PrEP (Pre Exposure Prophylaxis). A multi-centric qualitative study was conducted to explore the FSWs’ willingness to use oral PrEP in India.MethodsSeventy three qualitative interviews and 02 focus group discussions were conducted at 3 high HIV prevalent states in India during 2013-14. Study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using grounded theory approach was used to analyze the data in N-VIVO version 8.0. ResultsThematic analysis showed events of forced condom-less sex. FSW believed that oral PrEP could provide independence, financial gains, and privacy and therefore hoped to use it as an alternative to male condom. However, any impact on physical/ aesthetic attributes and reproductive system were not acceptable and could become a barrier. Provider initiated oral PrEP was not preferred. Providers voiced safety monitoring concerns. Adherence emerged as a challenge because of: 1) alcohol use; 2) taking PrEP tablet each day being too mundane; 3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose brings forth the need for long acting oral PrEP. ConclusionOral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection and PrEP as compliment to condoms. PrEP roll out requires educating communities about HIV treatment versus prevention. Long-acting oral PrEP could address both ‘mundane’ and alcoholism and sustain adherence.
Evaluation of fNIRS Signal Components Elicited by Cognitive and Hypercapnic Stimuli
Authors: Reddy Pratusha , Izzetoglu Meltem , Shewokis Patricia , Sangobowale Michael , Diaz-Arrastia Ramon , Izzetoglu Kurtulus 
Published: May 2021

Abstract
Functional near infrared spectroscopy (fNIRS) measurements are confounded by signal components originating from multiple physiological causes, whose activities may vary temporally and spatially (across tissue layers, and regions of the cortex). Furthermore, the stimuli can induce evoked effects, which may lead to over or underestimation of the actual effect of interest. Here, we conducted a temporal, spectral, and spatial analysis of fNIRS signals collected during cognitive and hypercapnic stimuli to characterize effects of functional versus systemic responses. We utilized wavelet analysis to discriminate physiological causes and employed long and short source-detector separation (SDS) channels to differentiate tissue layers. Multi-channel measures were analyzed further to distinguish hemispheric differences. The results highlight cardiac, respiratory, myogenic, and very low frequency (VLF) activities within fNIRS signals. Regardless of stimuli, activity within VLF band had the largest contribution to the overall signal. The systemic activities dominated the measurements from the short SDS channels during cognitive stimulus, but not hypercapnic stimulus. Importantly, results indicate that characteristics of fNIRS signals vary with type of the stimuli administered as cognitive stimulus elicited variable responses between hemispheres in VLF band and task-evoked temporal effect in VLF, myogenic and respiratory bands, while hypercapnic stimulus induced a global response across both hemispheres.
ELK4-mediated lncRNA SNHG22 promotes gastric cancer progression through interacting with EZH2 and regulating miR-200c-3p/Notch1 axis
Authors: Mao Xiaqiong , Ji Tao , Liu Aiguo , Weng Yunqi 
Published: May 2021

Abstract
Background

Long non-coding RNAs (lncRNAs) play important regulatory roles in the initiation and progression of various cancers. However, the biological roles and the potential mechanisms of lncRNAs in gastric cancers remain unclear.
Methods

The expression of SNHG22 in gastric cancer was analyzed in public databases (TCGA) and validated via qRT-PCR. SNHG22 knockdown cell lines were construced, and cell proliferation and invasion were analyzed. CHIP and luciferase reporter assays were performed to clarify the transcriptional role of ELK4. RNA pull-down followed MS and RIP assays were employed to identify the interaction between SNHG22 and EZH2. Luciferase reporter assays and RIP assays were used to confirm the regulation of SNHG22 on Notch1 by sponging miR-2003-3p.
Results

Knockdown of SNHG22 inhibited the proliferation and invasion ability of GC cells. Moreover, we identified that the transcriptional factor, ELK4, could promote SNHG22 expression in GC cells. In addition, using RNA pull-down followed MS assay, we found that SNHG22 directly bound to EZH2 to suppress the expression of tumor suppressor genes. At the same time, SNHG22 sponged miR-200c-3p to increase Notch1 expression.
Conclusions

Taken together, our findings demonstrated the role of SNHG22 on promoting proliferation and invasion of GC cells. And we revealed a new regulatory mechanism of SNHG22 in GC cells. SNHG22 is a promising lncRNA biomarker for diagnosis and prognosis and a potential target for GC treatment.