bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intersektorale Vernetzung im Gesundheitswesen: Prozessverbesserung durch den Einsatz von Plattformen am Fallbeispiel der Palliativversorgung
Authors: Behne Alina , Teuteberg Frank 
Published: June 2021

ZusammenfassungEine effiziente Überführung der Patienten in die häusliche Versorgung steht bei der Palliativentlassung insbesondere aufgrund der häufig kurzen Versorgungsdauer im Fokus. Dabei besteht die Herausforderung, dass viele unterschiedliche Akteure an dem Prozess beteiligt sind. Plattformen bieten Potenziale, eine einfache Dokumentation und Kommunikation der an der Versorgung beteiligten Gesundheitsakteure zu ermöglichen. Der vorliegende Beitrag zeigt, wie das Zusammenspiel unterschiedlicher Akteure auf Prozess- und Personenebene untersucht werden kann, um anschließend Prozessschwachstellen zu erkennen und diese mittels Informations- und Kommunikationstechnologien zu verbessern. In Zusammenarbeit mit verschiedenen Praxisakteuren vor allem aus dem Gesundheitswesen aber auch aus der Softwareentwicklung konnten aktuelle Herausforderungen im Palliativbereich erhoben werden. Daran anknüpfend konnte eine Anforderungsanalyse abgeleitet, ein bestehendes System erweitert und anschließend der Entlass- und Versorgungsprozess restrukturiert werden. Dabei werden Bedarfe, Potenziale und Herausforderungen von der Erhebung des aktuellen Prozesses bis zur Implementierung der Restrukturierung hervorgehoben. Es wird deutlich, dass das intersektorale Medikationsmanagement ein Schlüsselelement in der Gesundheitsversorgung ist und die Apotheke die Rolle eines Gesundheitslotsen einnehmen könnte. Bislang ist noch keine standardisierte oder einheitliche intersektorale Kommunikation oder Dokumentation via Plattform im Gesundheitswesen etabliert, jedoch bestehen einsatzbereite Plattformlösungen, die den Austausch erleichtern und den Weg bis zur Entstehung einer einheitlichen Lösung für alle beteiligten Akteure ebnen. Dieser Beitrag zeigt, wie die Erweiterung einer bestehenden Plattform aus dem Palliativsektor es ermöglichen kann, die hier untersuchten Prozesse in Hinblick auf eine sektorenübergreifende, effiziente Zusammenarbeit zu verbessern.
The role of let-7b in the inhibition of hepatic stellate cell activation by rSjP40
Authors: Sun Xiaolei , Zhang Li , Jiang Yuting , Li Aihong , Zhu Dandan , Wu Jiangrong , Duan Yinong 
Published: June 2021

Background
Hepatic stellate cells (HSCs) are one of the main cell types involved in liver fibrosis induced by many factors, including schistosomes. Previous studies in our lab have shown that recombinant P40 protein from Schistosoma japonicum (rSjP40) can inhibit HSC activation in vitro. Let-7b is a member of the let-7 microRNA family and plays an inhibitory role in a variety of diseases and inflammatory conditions. In this study, we investigated the role of let-7b in the inhibition of HSC activation by rSjP40.

Methods
Expression of let-7b was detected by quantitative real-time PCR. A dual luciferase assay was used to confirm direct interaction between let-7b and collagen I. We also used western blot to assess protein levels of TGFβRI and collagen type I α1 (COL1A1).

Results
We found that rSjP40 up-regulates expression of let-7b in HSCs. Let-7b inhibits collagen I expression by directly targeting the 3’UTR region of the collagen I gene. Furthermore, we discovered that let-7b inhibitor partially restores the loss of collagen I expression caused by rSjP40.

Conclusion
Our research clarifies the role of let-7b in the inhibition of HSC activation by rSjP40 and will provide new insights and ideas for the inhibition of HSC activation and treatment of liver fibrosis.
Association between environmental and climatic risk factors and the spatial distribution of cystic and alveolar echinococcosis in Kyrgyzstan
Authors: Paternoster Giulia , Boo Gianluca , Flury Roman , Raimkulov Kursanbek M. , Minbaeva Gulnara , Usubalieva Jumagul , Bondarenko Maksym , Müllhaupt Beat , Deplazes Peter , Furrer Reinhard , Torgerson Paul R. 
Published: June 2021

BackgroundCystic and alveolar echinococcosis (CE and AE) are neglected tropical diseases caused byEchinococcus granulosus sensu latoandE.multilocularis, and are emerging zoonoses in Kyrgyzstan. In this country, the spatial distribution of CE and AE surgical incidence in 2014-2016 showed marked heterogeneity across communities, suggesting the presence of ecological determinants underlying CE and AE distributions.Methodology/Principal findingsFor this reason, in this study we assessed potential associations between community-level confirmed primary CE (no.=2359) or AE (no.=546) cases in 2014-2016 in Kyrgyzstan and environmental and climatic variables derived from satellite-remote sensing datasets using conditional autoregressive models. We also mapped CE and AE relative risk. The number of AE cases was negatively associated with 10-year lag mean annual temperature. Although this time lag should not be considered as an exact measurement but with associated uncertainty, it is consistent with the estimated 10–15-year latency following AE infection. No associations were detected for CE. We also identified several communities at risk for CE or AE where no disease cases were reported in the study period.Conclusions/SignificanceOur findings support the hypothesis that CE is linked to an anthropogenic cycle and is less affected by environmental risk factors compared to AE, which is believed to result from spillover from a wild life cycle. As CE was not affected by factors we investigated, hence control should not have a geographical focus. In contrast, AE risk areas identified in this study without reported AE cases should be targeted for active disease surveillance in humans. This active surveillance would confirm or exclude AE transmission which might not be reported with the present passive surveillance system. These areas should also be targeted for ecological investigations in the animal hosts.
The gut microbiome and type 2 diabetes status in the Multiethnic Cohort
Authors: Maskarinec Gertraud , Raquinio Phyllis , Kristal Bruce S. , Setiawan Veronica W. , Wilkens Lynne R. , Franke Adrian A. , Lim Unhee , Le Marchand Loïc , Randolph Timothy W. , Lampe Johanna W. , Hullar Meredith A. J. 
Published: June 2021

Background
The gut microbiome may play a role in inflammation associated with type 2 diabetes (T2D) development. This cross-sectional study examined its relation with glycemic status within a subset of the Multiethnic Cohort (MEC) and estimated the association of circulating bacterial endotoxin (measured as plasma lipopolysaccharide-binding protein (LBP)) with T2D, which may be mediated by C-reactive protein (CRP).

Methods
In 2013–16, cohort members from five ethnic groups completed clinic visits, questionnaires, and stool and blood collections. Participants with self-reported T2D and/or taking medication were considered T2D cases. Those with fasting glucose >125 and 100–125 mg/dL were classified as undiagnosed (UT2D) and pre-diabetes (PT2D) cases, respectively. We characterized the gut microbiome through 16S rRNA gene sequencing and measured plasma LBP and CRP by standard assays. Linear regression was applied to estimate associations of the gut microbiome community structure and LBP with T2D status adjusting for relevant confounders.

Results
Among 1,702 participants (59.9–77.4 years), 735 (43%) were normoglycemic (NG), 506 (30%) PT2D, 154 (9%) UT2D, and 307 (18%) T2D. The Shannon diversity index decreased (ptrend = 0.05), while endotoxin, measured as LBP, increased (ptrend = 0.0003) from NG to T2D. Of 10 phyla, Actinobacteria (ptrend = 0.007), Firmicutes (ptrend = 0.003), and Synergistetes (ptrend = 0.02) were inversely associated and Lentisphaerae (ptrend = 0.01) was positively associated with T2D status. Clostridium sensu stricto 1, Lachnospira, and Peptostreptococcaceae were less, while Escherichia-Shigella and Lachnospiraceae were more abundant among T2D patients, but the associations with Actinobacteria, Clostridium sensu stricto 1, and Escherichia-Shigella may be due metformin use. PT2D/UT2D values were closer to NG than T2D. No indication was detected that CRP mediated the association of LBP with T2D.

Conclusions
T2D but not PT2D/UT2D status was associated with lower abundance of SCFA-producing genera and a higher abundance of gram-negative endotoxin-producing bacteria suggesting that the gut microbiome may contribute to chronic systemic inflammation and T2D through bacterial translocation.
Lived experiences of older adults during the first COVID-19 lockdown: A qualitative study
Authors: Falvo Ilaria , Zufferey Maria Caiata , Albanese Emiliano , Fadda Marta 
Published: June 2021

Background and aim
Public health measures used to mitigate the COVID-19 epidemic may have unintended, detrimental consequences particularly on older adults, whose voices and perspectives are often silent or silenced. The aim of this study was to explore the lived experiences of individuals aged 64 or older during the first COVID-19 lockdown.

Methods
We conducted a qualitative study in a convenience sample of 19 older adults (aged 64+) living at home in the Italian-speaking region of Switzerland during the first COVID-19 lockdown, between April and May 2020. Participants varied in terms of gender, education, age, nationality, and socio-economic status. We conducted semi-structured phone interviews to elicit emotions, expectations and hopes in relation to the present situation, and the post-pandemic world. We inquired about opinions on the enforced public health measures, including those specifically targeting older adults, and on the societal portrayal of older adults.

Findings
We found that the epidemic and the public health response to it had both generated a variety of resentments and a high degree of ambivalence at the individual, micro-, meso- and macro-social levels. We also found that labelling older adults as an at-risk sub-population inevitably contributed to public and self-stigmatization.

Discussion
We conducted an in-depth qualitative investigation of lived experiences of older adults during the first wave of the COVID-19 pandemic in one of the most gravely hit region in Europe. Our findings on the complexity of unintended, detrimental consequences of outbreak responses on older adults have relevant implications for local adaptions of public health measures, and suggest that public health authorities should engage vulnerable sub-populations and promote bi-directional communication to inform and support communities.
Transcutaneous electrical nerve stimulation and solifenacin succinate versus solifenacin succinate alone for treatment of overactive bladder syndrome: A double-blind randomized controlled study
Authors: Zhang Yumeng , Wang Shaoyong , Zu Shulu , Zhang Chanjuan 
Published: June 2021

Objective
We evaluated a combination of transcutaneous electrical nerve stimulation (TENS) and solifenacin succinate versus solifenacin alone in the treatment of overactive bladder (OAB).

Methods
Ninety-seven female outpatients with OAB were screened for this double-blind randomized controlled study. Eighty-six patients who met our inclusion criteria were divided randomly into two groups. In group A (43 patients), patients received oral solifenacin and “fake” TENS on the foot; in group B (43 patients), patients received oral solifenacin and effective TENS on the foot. Improvements in OAB symptoms were assessed by Overactive Bladder Symptom Score (OABSS), Overactive Bladder Questionnaire (OAB-q), voiding diaries and urodynamic tests. 70 of 86 patients (36 in group A, 34 in group B) completed the 2 months of treatment and 3 months of follow-up.

Results
Statistically, the maximum bladder volume and OAB symptoms of both groups improved significantly after treatment. The improvement in group B was significantly better than that in group A, as indicated by the maximum bladder volume, OAB-q score and voiding diary. Some mild adverse effects were observed, including dry mouth, stomach upset, constipation, muscle pain and local paresthesia.

Conclusion
The combination of TENS and solifenacin was more effective in improving OAB symptoms than solifenacin alone.
Physical activity motives, barriers, and preferences in people with obesity: A systematic review
Authors: Baillot Aurélie , Chenail Stéphanie , Barros Polita Naiara , Simoneau Mylène , Libourel Mathilde , Nazon Evy , Riesco Eléonor , Bond Dale S. , Romain Ahmed J. 
Published: June 2021

Background
Although the benefits of physical activity (PA) are well known, physical inactivity is highly prevalent among people with obesity. The objective of this systematic review was to i) appraise knowledge on PA motives, barriers, and preferences in individuals with obesity, and ii) quantify the most frequently reported PA motives, barriers and preferences in this population.

Methods
Six databases (Pubmed, CINAHL, Psyarticle, SportDiscus, Web of science and Proquest) were searched by independent reviewers to identify relevant quantitative or qualitative articles reporting PA motives, barriers or preferences in adults with body mass index ≥ 30 kg/m2 (last searched in June 2020). Risk of bias for each study was assessed by two independent reviewers with the Mixed Methods Appraisal Tool (MMAT).

Results
From 5,899 papers identified, a total of 27 studies, 14 quantitative, 10 qualitative and 3 mixed studies were included. About 30% of studies have a MMAT score below 50% (k = 8). The three most reported PA motives in people with obesity were weight management, energy/physical fitness, and social support. The three most common PA barriers were lack of self-discipline/motivation, pain or physical discomfort, and lack of time. Based on the only 4 studies available, walking seems to be the preferred mode of PA in people with obesity.

Conclusions
Weight management, lack of motivation and pain are key PA motives and barriers in people with obesity, and should be addressed in future interventions to facilitate PA initiation and maintenance. Further research is needed to investigate the PA preferences of people with obesity.
COVID-19 pneumonia in Galicia (Spain): Impact of prognostic factors and therapies on mortality and need for mechanical ventilation
Authors: Pérez-de-Llano Luis , Romay-Lema Eva María , Baloira-Villar Adolfo , Anchorena Christian , Torres-Durán María Luisa , Sousa Adrián , Corbacho-Abelaira Dolores , Paz-Ferrin José , Diego-Roza Carmen , Vilariño-Maneiro Laura , Marcos Pedro J. , Montero-Martínez Carmen , de la Iglesia-Martínez Fernando , Riveiro-Blanco Vanessa , Rodríguez-Núñez Nuria , Abal-Arca José , Bustillo-Casado María , Golpe Rafael 
Published: June 2021

Introduction
This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia.

Methods
Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable.

Results
A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01–1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39–3.63)] and [OR = 3.04 (95% CI: 1.88–4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06–1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91–0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12–0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45–2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15–5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02–1.11)].

Conclusion
These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.
Prevalence and associated factors of respiratory allergies in the Kingdom of Saudi Arabia: A cross-sectional investigation, September–December 2020
Authors: Almatroudi Ahmad , Mousa Ayman M. , Vinnakota Divya , Abalkhail Adil , Alwashmi Ameen S. S. , Almatroodi Saleh A. , Alhumaydhi Fahad A. , Kabir Russell , Mahmud Ilias 
Published: June 2021

Background
Prevalence of different respiratory allergies is increasing in the Kingdom of Saudi Arabia (KSA). Environmental risk factors of respiratory allergy vary regionally, hence the prevalence. This necessitates the needs for regional studies. This article reports prevalence and symptoms of respiratory allergies in the Qassim region, and the factors associated with the prevalence.

Methods
Eight hundred and fifty individuals aged ≥18 years and were living in the Qassim region filled up our structured online questionnaire between September and December 2020. We estimated the prevalence of different respiratory allergies with 95% confidence intervals. Multi-variable logistic regression analyses were performed to investigate the risk factors of respiratory allergies.

Findings
The prevalence of any respiratory allergy in the Qassim region was 28.8%. Most families (58.1%) had at least one member with respiratory allergy. The prevalence of allergic rhinitis and bronchial asthma were 13.5% and 11.2% 4.1% respectively. The reported symptoms included runny nose (13.6%), red, watery, and itchy eyes (10.4%), difficulty sleeping at night (10.2%), difficulty breathing in cold weather (9.2%), noisy breathing (8.5%), sneezing (8%), repeated coughing (7.5%) and shortness of breath (6.4%). Individuals with a family history were more likely to report any respiratory allergy (OR: 7.8), bronchial asthma (OR: 4.2) and allergic rhinitis (OR: 8.1) compared to the individuals without such family history. Odds of respiratory allergies was higher among males (OR: 1.5). Saudi nationals were less likely to report allergic rhinitis than the non-Saudis (OR: 0.4). Among those who reported a respiratory allergy, most (73.5%) received treatment and majority (61.7%) demonstrated compliance to the treatment, 8.8% needed hospitalization, and 23.1% needed emergency nebulization.

Conclusions
Prevalence reported in our study is different than that reported in other regions. Variability in the environmental exposures might explain this. We recommend a meta-analysis to estimate the national prevalence of respiratory allergies.
Obeticholic Acid and Fibrates in Primary Biliary Cholangitis: Comparative Effects in a Multicentric Observational Study
Authors: Reig Anna , Álvarez-Navascués Carmen , Vergara Mercedes , Gómez-Domínguez Elena , Gallego-Moya Adolfo , Pérez-Medrano Indhira M. , Fábrega Emilio , Hernández-Guerra Manuel , Berenguer Marina , Estevez Pamela , Arencibia Ana , Morillas Rosa M. , Horta Diana , Albillos Agustín , Casado Marta , De la Cruz Gema , Fernandez-Bonilla Eva , Molina Esther , Hijona Lander , Diago Moises , Fernández-Rodriguez Conrado M. , González-Santiago Jesús M. , Sala Margarita , Gómez-Camarero Judith , Romero-Gomez Manuel , Suárez Francisco , Vargas Victor , Ferre-Aracil Carlos , Andrade Raúl J. , Chahri Nadia , Parés Albert 
Published: June 2021

INTRODUCTION:
Obeticholic acid (OCA) and fibrates therapy results in biochemical improvement in placebo-controlled trials in patients with primary biliary cholangitis and insufficient response to ursodeoxycholic acid. There is scarce information outside of clinical trials. Therefore, we have assessed the effectiveness and adverse events of these treatments.

METHODS:
Data from patients included in the ColHai registry treated with OCA, fibrates, or both were recorded during a year, as well as adverse events and treatment discontinuation.

RESULTS:
Eighty-six patients were treated with OCA, 250 with fibrates (81% bezafibrate; 19% fenofibrate), and 15 with OCA plus fibrates. OCA group had baseline significantly higher alkaline phosphatase (ALP) (P = 0.01) and lower platelets (P = 0.03) than fibrates. Both treatments significantly decreased ALP, gamma-glutamyl transferase (GGT), and transaminases and improved Globe score. Albumin and immunoglobulin type M improved in the fibrates group. ALP decrease was higher under fibrates, whereas alanine aminotransferase decline was higher under OCA. Although baseline transaminases and GGT were higher in patients with OCA plus fibrates, significant ALP, GGT, alanine aminotransferase, and Globe score improvement were observed during triple therapy. Adverse events were reported in 14.7% of patients (21.3% OCA; 17.6% fenofibrate; 10.7% bezafibrate), mainly pruritus (10.1% with OCA). Discontinuation was more frequent in fenofibrate treatment mainly because of intolerance or adverse events.

DISCUSSION:
Second-line therapy with OCA or fibrates improves hepatic biochemistry and the GLOBE score in primary biliary cholangitis patients with suboptimal response to ursodeoxycholic acid. Simultaneous treatment with OCA and fibrates improved ALP as well.
Benchmarking Adenoma Detection Rates for Colonoscopy: Results From a US-Based Registry
Authors: Shaukat Aasma , Holub Jennifer , Pike Irving M. , Pochapin Mark , Greenwald David , Schmitt Colleen , Eisen Glenn 
Published: June 2021

INTRODUCTION:
Adenoma detection rate (ADR) is highly variable across practices, and national or population-based estimates are not available. Our aim was to study the ADR, variability of rates over time, and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy.

METHODS:
We used colonoscopies submitted to the GI Quality Improvement Consortium, Ltd. registry from 2014 to 2018 on adults aged 50–89 years. We used hierarchical logistic models to study factors associated with ADR.

RESULTS:
A total of 2,646,833 colonoscopies were performed by 1,169 endoscopists during the study period. The average ADR for screening colonoscopies per endoscopist was 36.80% (SD 10.21), 44.08 (SD 10.98) in men and 31.20 (SD 9.65) in women. Adjusted to the US population, the ADR was 39.08%. There was a significant increase in ADR from screening colonoscopies over the study period from 33.93% in 2014 to 38.12% in 2018.

DISCUSSION:
The average ADR from a large national US sample standardized to the US population is 39.05% and has increased over time.
Seamless control of grid-tied PV-Hybrid Energy Storage System
Authors: Chankaya Mukul , Hussain Ikhlaq , Ahmad Aijaz 
Published: June 2021

Abstract
This paper describes the normalized maximum correntropy criteria (NMCC) based seamless control of three-phase four-wire voltage source converter (VSC) for a grid-tied PV-Hybrid energy storage system (HESS). The micro-grid can operate in both islanded and grid-tied mode with seamless control. The seamless control facilitates the VSC control transition from grid current control (GCC) during grid-tied mode to voltage control during grid-isolated mode and back to GCC control with grid-resynchronized mode. The seamless control ensures the system stability and security of the personnel with reduces transients on the grid and load side of the system during the VSC control transition. The VSC is designed to fulfill the multi-objective including power quality enhancement, reactive power compensation, load balancing during unity power factor (UPF) operation. The VSC maintains the system stability during diverse dynamic conditions, inducing disturbances on grid side, load side and PV side of the system, i.e., Irradiation variation, unbalanced load, abnormal grid voltage, intentional islanding, specified power mode and grid-resynchronization. The hybrid energy storage system (HESS) consisting of lead-acid battery and ultra-capacitor (UC) further enhances the stability and disturbances handling capability of the grid-tied PV system. The functioning of the proposed system is found adequate as per IEEE 519 standards during steady and induced dynamic conditions.