bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can a Virtual Microbiology Laboratory Simulation be as Effective as the Traditional Wetlab for Pharmacy Student Education?
Authors: Birkbeck Lyndsee Baumann , Anoopkumar-Dukie Shailendra , Khan Sohil A , Cheesman Matthew J , O’Donoghue Margaret , Grant Gary Dean 
Published: January 2021

Abstract
Background: Pharmacy practice education requires the development of proficiencies and an understanding of clinical microbiology. Learning in this area could be delivered using practical laboratory exercises, or potentially, simulation-based education. The current global climate due to COVID-19 has further highlighted the important role of technology-enhanced learning in delivering outcomes that meet the requisite learning objectives of a course. The aim of the present study was to compare the impact of a commercially available virtual microbiology simulation (VUMIE™) with a traditional wet laboratory (wetlab) on learner engagement and learning outcomes in a second-year integrated pharmacotherapeutics course for Bachelor of Pharmacy students. Methods: A randomised, controlled, crossover study was employed to determine whether the simulation intervention (VUMIE™) improves learning outcomes (knowledge, skills and confidence) of pharmacy students, when compared to a traditional wetlab intervention. Each student completed three 1-2 hour length sessions, for both the wetlab and VUMIE™ interventions (6 sessions total). Data was collected using surveys deployed at baseline (pre-interventions), post-intervention (VUMIE™ or wetlab) and endpoint (post-interventions). Statistical analysis was conducted using SPSS Statistics 25 and Instat™ software. Results: Both interventions produced statistically significant differences for mean scores compared to baseline (pre-VUMIE™ and wetlab) across the domains of knowledge, skills and confidence. VUMIE™ produced higher post-intervention mean scores for knowledge, skills and confidence compared to post-intervention mean scores for the wetlab, however there was no statistical significance between the mean score for the two interventions, thus the VUMIE™ activity produced learning outcomes comparable to the wetlab activity. Conclusion: These findings demonstrated that VUMIE™ was just as effective as traditional wetlab activities for student learning outcomes. The simulation’s implementation was not cost-prohibitive, provided students with a physically and psychologically safe learning environment, and the benefit of being able to repeat activities, supporting deliberate practice.
Prenatal Methamphetamine Exposure could Cause Chronic Abnormalities in Transcriptomic Pattern; an Extended Follow-up Cohort Study
Authors: Haghighatfard Arvin , Seifollahi Soha , Rajabi Pegah , Rahmani Niloofar , zadeh Rojin Ghannad 
Published: January 2021

Abstract
BackgroundThe high rate of methamphetamine abuse among young adults and women of childbearing age makes it imperative to clarify the long-term effects of Methamphetamine exposure on the offspring. Behavioral and cognitive problems had reported in children with parental Methamphetamine exposure (PME). The present study aimed to assess the acute and chronic effects of PME in molecular regulations and gene expression profiles of children during their first years of life.ResultsAll subjects were recruited before birth, and sampling was conducted from the first ten days of birth, twelve months, twenty months and thirty-six months of age. Finally, 2658 children with PME and 3573 normal children had been finished the follow-up. RNA extraction was operated from blood samples and gene expression profiling was conducted by using the Affymetrix GeneChip Human Genome U133 plus 2.0 Array Platform. Gene expression data were confirmed by Real-time PCR. Gene expression profiling during thirty-six months showed several constant mRNA level alterations in children with PME compared with normal. These genes are involved in several gene ontology and pathways involved with the immune system, neuronal functions and bioenergetic metabolism. It seems that Methamphetamine abuse before and during the pregnancy period may affect the expression profile of children, and these changes could be remain years after birth. Affected genes have some similarities to the gene expression patterns of addiction, psychiatric disorders, neurodevelopmental disabilities and immune deficiencies. ConclusionFindings may shed light on the molecular effects of prenatal methamphetamine exposure and may lead to new psychological and somatic caring protocols for these children based on their potential abnormalities.
Testing The Effect of an Integrated-Intervention To Promote Access to Sexual and Reproductive Healthcare and Rights Among Women With Disabilities In Ghana: A Quasi-Experimental Study Protocol
Authors: Ganle John K. , Ofori Charlotte , Dery Samuel 
Published: January 2021

Abstract
Background: There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15-49years in Ghana. Methods: A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for effect modifiers. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion: Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services.
Post-irradiation Hyperamylasemia Is a Prognostic Marker for Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Pediatric Population: a Retrospective Single-centre Cohort Analysis.
Authors: Baldo Francesco , Simeone Roberto , Marcuzzi Annalisa , Vidimari Rossella , Ciriello Francesca , Zanon Davide , Maestro Alessandra , Barbi Egidio , Maximova Natalia 
Published: January 2021

Abstract

Background: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients. Methods: We retrospectively analyzed the medical records of all the patients who underwent allogeneic HSCT between January 2000 and November 2019. Inclusion criteria were the following: recipient’s between 2 and 18, diagnosis of ALL, no previous transplantation, and use of TBI-based conditioning. Serum total amylase and pancreatic amylase were evaluated before, during and after transplantation. Cytokines and chemokines assays were retrospectively performed. Results: 78 patients fulfilled the inclusion criteria. 57 patients were treated with fractionated TBI and 21 with a single dose regimen. Overall survival (OS) was 62.8%. Elevated values of TA were detected in 71 patients (91%). TA were excellent in predicting the OS (AUC = 0.773; 95% CI = 0.66-0.86; P < 0.001). TA values below 374 U/L were correlated with a higher OS. The highest mean TA values (673 U/L) were associated with a high disease-progression mortality rate. TA showed high predictive performance for disease progression-related death (AUC = 0.865; 95% CI = 0.77 – 0.93; P < 0.0001). Elevated TA values were also connected with significantly higher levels of proinflammatory cytokines such as TNF-α, IL-6 and RANTES (P < 0.001).Conclusions: This study shows that TA is a valuable predictor of post-transplant OS and increased risk of leukemia relapse.
The combined healthy lifestyle score is a protective factor for cardiovascular disease: a representative national cohort study in Taiwan
Authors: Tsai Ming-Chieh , Yeh Tzu-Lin , Hsu Hsin-Yin , Hsu Le-Yin , Lee Chun-Chuan , Tseng Po-Jung , Chien Kuo-Liong 
Published: January 2021

Abstract
BackgroundThe protective effect of different healthy lifestyle scores for the risk of cardiovascular disease (CVD) was reported but the comparisons of performance were lack. We compared the performance measures of cardiovascular diseases from different healthy lifestyle scores among adult Taiwan.MethodsWe conducted a nationwide prospective cohort study of 6042 participants (median age 43 years, 50.2% women) in Taiwan’s Hypertensive, Hyperglycemia and Hyperlipidemia Survey, 2002 who were free of CVD at baseline. Simple and weighted Taiwan healthy lifestyle score was defined as combination of normal body mass index, Mediterranean diet, adequately physical activity, not smoking and regular healthy drinking and each dichotomous lifestyle factor. World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) cancer prevention recommended lifestyle and Life's Simple 7 following the guideline definition. The incidence of cardiovascular disease incidence among the 4 healthy lifestyle score each divided into 4 groups based on scores were estimated.ResultsDuring a median 14.3 years follow-up period, totally 520 cases developed CVD events. In multivariate-adjusted Cox proportional hazard models, adherence to highest category compared with lowest one of simple Taiwan lifestyle score for hazard ratio 0.43 (95% confidence interval [CI] 0.2, 0.94) and weighted Taiwan lifestyle score for 0.44 (95%CI 0.28, 0.68) were independently and significantly. In addition, age played a significant effect modifier for the protective effect of healthy lifestyle scores for CVD risk. Specifically, when the simple and weighted Taiwan healthy lifestyle score were added to the classical model, the Harrell’s C-statistic increasing from 0.85 to 0.86 (95% confidence interval [CI], 0.84, 087; Pdiff=0.02) in both lifestyle scores. The performance measures by integrated discriminative improvement showed significant increasing after adding simple Taiwan healthy lifestyle score (integrated discriminative improvement: 0.51, 95% CI 0.16, 0.86, P=0.002) and weighted Taiwan lifestyle score (integrated discriminative improvement: 0.38, 95% CI 0.01,0.74, P=0.021) information.Conclusions We demonstrated that healthy lifestyle scores with an inverse association with CVD, and the reduction of CVD risk was more for young adults than for old adult. Further investigations to study the mechanism of lifestyle role on CVD prevention are warranted.
Energy-Delay-Balanced Load Dispatching in Cloud-Assisted Edge Computing of Smart City
Authors: Zhang Ren , Wu Qianhong , Zhang Han , Qin Bo 
Published: January 2021

Abstract
As smart city develops, Cloud Assisted Mobile Edge computing (CAME) framework is popular because it has the advantage of low delay and cost. But the computing capacity of mobile users is constrained in energy consumption, especially how to overcome the tradeoff between system latency and energy. In this article, an energy-delay-balanced load dispatching algorithm is suggested by exploiting the Karush-Kuhn-Tucker (KKT) conditions. Its exponential complexity is circumvented by taking the advantage of the linear property of constraints, rather than directly figuring out the KKT conditions. Compared to the fair ratio algorithm and the greedy algorithm, our suggested one is proved to provide better performance by simulation, which can decrease the delay by 35% and 49% respectively on the basis of the same energy consumption. The results indicate that the designed algorithm provides desirable tradeoff between system latency and energy.
Does Medicaid Broaden the Choices of Patients with Low Socioeconomic Status? An Analysis of Bypassing Behaviors in Brooklyn
Authors: Lee Jae Bok 
Published: January 2021

Abstract
Background: Many governments worldwide have committed to extending choices in public service delivery. However, the extent to which policies ensure equity is unclear. We investigated whether Medicaid programs in the United States improve hospital accessibility among patients with low socioeconomic status, compared to those with non-low socioeconomic status who are non-Medicaid recipients or uninsured.Methods: We employed a difference-in-difference-in-differences approach using a rich dataset of information on inpatients and their choice of hospitals from Statewide Planning Research and Cooperative System and information on hospitals from the American Hospital Association in Brooklyn, New York, from 2003 to 2009Results: The findings indicated that Medicaid has failed to broaden the range of the hospital choices for patients with low socioeconomic status, assessed in terms of bypassing behaviors. Conclusions: Medicaid is a public program that offers choices driven by purchasing power. The findings of this study imply that this program has some limitations in alleviating existing socioeconomic inequities in available hospital choices.
Determinants of Facilitators, Barriers and Structural Factors on the Behavior to Physical Activity and Interventional Framework among Nulliparous Pregnant Women: A Qualitative Study Using Maxqda
Authors: kianfard leila , SHokravi Farkhonde Amin , Rakhshanderou Sakineh , Niknami Shamsaddin 
Published: January 2021

Abstract
BackgroundThe goal of this study was to recognize facilitators, barriers, and structural influences on behavior of physical activity among pregnant women.MethodsData analyses were done from 30 pregnant women (second and third trimester) and four of provider who were employed for this study (2020). Participants were answered to open-ended questions relating to the obstacles that deprived them of physical activity during pregnancy. ResultsThe barrier factors consist of lack of sufficient information about the advantages of physical activity, lack of suitable place, lack of access to economically and affordable classes. Social norms are pertinent to subjective norms and motivators. Facilitating factors included using the E-learning to educate pregnant women and awareness of the existence of sport classes.ConclusionIt is essential to comprehend why pregnant women meet obstacles for physical activity. Many of issues were raised: the need of sufficient information on the advantages of physical activity, the role of nurtures factors that need to be motivated in physical activity. Need for consultation to investigate structural problems in the community to provide facilities for pregnant women.
Interventions for Improving Outcomes in Patients With Multimorbidity in Primary Care and Community Setting: A Systematic Review
Authors: Smith Susan , Wallace Emma , Clyne Barbara , Boland Fiona , Fortin Martin 
Published: January 2021

Abstract
BackgroundMultimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.MethodsWe searched eight databases and two trials registers up to 9th September 2019. Two review authors independently screened and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.ResultsWe included 16 RCTs with 4,753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI -0.01 to 0.07, I2 = 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall the certainty of the evidence was graded as low due to significant variation in study participants and interventions. Conclusions There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.
Key Factors Contributing to The Anchorage Loss of Maxillary First Molars: A Retrospective Study of 726 Extraction Cases
Authors: Su Hong , Xu Kaiyuan , Han Bing , Chen Gui , Xu Tianmin 
Published: January 2021

Abstract
Background: Anchorage control is one of the key components in the treatment of extraction cases. However, why anchorage loss happens is still an unanswered question. The purpose of this study was to investigate the most important factors contributing to the anchorage loss of maxillary first molars in premolar extraction cases. The study enrolled 726 upper premolar extraction cases, including 214 male patients and 512 female patients, and the average age was 14 (range: 9-45 years old).Factors including physiological characteristics, treatment mechanics and cephalometric variables were collected and their influences on the angulation changes of maxillary first molars were analyzed. Results: The average angulation change of maxillary first molar after treatment was 2.81°, meaning the molar tipped forward during treatment by 2.81°. The change of UM/PP showed statistically significant difference in different sex ( male 3.84°±5.26 ° vs female 2.38°±5.10°), age (adult -0.05°±4.73 ° vs teenager 3.46°±5.07°), and molar relationship(Class II 3.28°±5.15°vs Class I 2.36°±5.19°). There are six variables accounted in the regression analysis (R=0.608, R²=37.0%). Among them, the pre-treatment molar tipping (Standardized Coefficients：-0.65) and the pre-treatment incisor/molar height ratio (Standardized Coefficients：-0.27)were the most important factors influencing anchorage loss during treatment.Conclusion: Compared with treatment-related factors, the patient’s physiological characteristics play a more important role in anchorage loss. The pre-treatment angulation of the maxillary first molar is the most contributing factor of the maxillary molar angulation changes, which are often predisposing anchorage loss.
A Potential Misdiagnosis in the COVID-19 Pandemic Era: A Case Report of Superimposed Thrombosis or Tumor Recurrence
Authors: Zoroufian Arezou , Mohseni-Badalabadi Reza , Mahalleh Mehrdad , Ghorashi Seyyed Mojaba , Momtahen Sharam , Omidi Negar 
Published: January 2021

Abstract
Background: The clinical manifestation of coronavirus disease 2019 (COVID-19) overlap with other disorders especially cardiovascular diseases (CVD). The prevailing conditions in the COVID-19 pandemic can distract us from other differential diagnoses.Case presentation: We report a 58 years old female presented with syncope episodes and dyspnea on exertion (DOE) with the left atrial (LA) mass, candidate for surgical removal and mitral valve replacement. Nearly 3 months later, she developed dyspnea, fever, and a sore throat cause to admit her with suspected COVID-19. During diagnostic evaluation, a larger LA mass detected that seemed to be COVID-19 induced organized thrombus with prosthetic mitral valve malfunction. The mass resected and immunohistochemistry revealed liposarcoma.Conclusions: The unusual early recurrence of liposarcoma and misdiagnosis with COVID-19 induced thrombosis is the hallmark of the present case that we keep other causes in mind besides COVID-19.
Development of a Framework for Managing Severe Burns Through a 17-year Retrospective Analysis of Burn Epidemiology and Outcomes
Authors: Chen Ling , He Xiaochong , Xian Jishu , Liao Jianmei , Chen Xuanji , Luo Yue , Wang Zonghua , Li Ning 
Published: January 2021

Abstract
Background Burns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. Methods The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17939 burn patients were included in this retrospective study. Information regarding demographic, burn characteristics, and the burn severity of ABSI were collected, calculated and compared.Results The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64±16.83% (median 8%) with a range of 0.1~100%. A total of 874 (4.9%) patients had TBSA >50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11±65.72 days (median: 17days). Eventually, the retrospective analysis resulted in the development of a framework of burn management continuum used for developing strategies to prevent and manage severe burns.Conclusions The annual number of burn injuries has kept decreasing, which was partially attributed to the increased awareness and education of burn prevention and the improved burn-preventative circumstances. However, the burn severity and the economic burden were still in a high level. And the gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.