bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived Knowledge Gap of Public Health Officer in Ethiopia
Authors: Ashengo Biniyam Altamo , Soklaridis Sophie 
Published: May 2021

Abstract
Background: Ethiopia has been training health officers as non-physician clinicians to meet the urgent public health service needs including preventive and health promotion as well as curative services. However, to date there is a lack of evidence of whether the curriculum content of the program meets the needs of the community. The purpose of this study was to explore the perception among health officers on whether the curriculum prepared them with what they need to know for practice when deployed to district hospitals and rural health centersMethod: A qualitative research design was used to explore health officer’s perceptions on the curriculum for clinical practice. The study was conducted in Dale district, Sidama region, southern Ethiopia. Data collection was done using semi-structured interview guide with open ended questions. The interview guide were developed using the first author’s experience as a health officer who recently graduated the program. All public health officers training graduates in the Dale districts, included in the study. Data analysis was done following a thematic analysis approach. The data was analyzed using ATLAS.ti qualitative data analysis software. Result: The study revealed a major curriculum-related gap which contributed to the perceived knowledge gap of public health officers. The main gap identified was the disproportional time allocation for very crucial courses of basic sciences and clinical practice during training. In addition the curriculum lacked a strict monitoring system of its implementation. Conclusion: Based on the result most participants believed the course content of the curriculum was very strong and crucial for public health officers. Some weakness of the curriculum were also identified which created the perceived knowledge gap of public health officers. The main weakness in the curriculum was that some of the courses were not proportionally allocated with adequate time for course contents like that of basic science and clinical courses.
Identification of inflammation related miRNA, lncRNA and mRNA in synovial tissue of knee osteoarthritis patients
Authors: qiao linghui , wang guancheng , han jie , liu yang , gu yanglin 
Published: May 2021

Abstract
Osteoarthritis is one of the most common chronic diseases in the elderly, which has caused a heavy burden to the family and society. At present, the clinical treatment can only be total joint replacement, but is hard to prevent the degeneration of cartilage tissue. The molecular mechanism of OA, especially the role of inflammation in disease progression, has been reported, but it is still unclear.Here, we first collected synovial tissues of 8 OA patients and 2 RA patients as controls, and detected the expression profiles of lncRNA, miRNA and mRNA in tissues by RNA-seq technology, and tried to find out the differentially expressed genes and key pathways in OA patients.Compared with the control group, 343 mRNAs, 270 lncRNAs and 247 miRNAs were significantly up-regulated, 232 mRNAs, 109 lncRNAs and 157 miRNAs were significantly down regulated. Then we predicted the targeted mRNAs of dysregulated lncRNAs. Through pathway enrichment and functional annotation of these target genes, we identified 12 differentially expressed transcripts related to inflammation, including CHST11, ALDH1A2, TREM1, IL-1β, IL-8, CCL5, LIF and miR-146a-5p, miR-335-5p, as well as lncRNA GAS5, LINC02288 and LOC101928134.In this study, we identified the differential expression of inflammation related genes and ncRNA in synovial tissue. These differentially expressed transcripts may indicate the network of ceRNA net in synovial tissue and its effect on OA progression. Our research will help to explore the pathogenesis and key therapeutic targets of OA.
Systematic Analysis of the Relationship Between Ovarian Cancer Prognosis and Alternative Splicing
Authors: Zhang Di , Zou Dan , Deng Yue , Yang Lihua 
Published: May 2021

Abstract
Background: Ovarian cancer(OC) is the gynecological tumor with the highest mortality rate, effective biomarkers are of great significance in improving its prognosis. In recent years, there have been many studies on alternative splicing (AS) events, and the role of AS events in tumor has become a focus of attention.Methods: Data were downloaded from the TCGA database and Univariate Cox regression analysis was performed to determine AS events associated with OC prognosis. Eight prognostic models of OC were constructed in R package, and the accuracy of the models were evaluated by the time-dependent receiver operating characteristic (ROC) curves. Eight types of survival curves were drawn to evaluate the differences between the high and low risk groups. Independent prognostic factors of OC were analyzed by single factor independent analysis and multi-factor independent prognostic analysis. Again, Univariate Cox regression analysis was used to analyze the relationship between splicing factors(SF) and AS events, and Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis were performed on OS-related SFs to understand the pathways.Results: Univariate Cox regression analysis showed that among the 15,278 genes, there were 31,286 overall survival (OS) related AS events, among which 1524 AS events were significantly correlated with OS. The area under the time-dependent receiver operating characteristic curve (AUC) of AT and ME were the largest and the RI was the smallest ,which were 0.757 and 0.68 respectively. The constructed models have good value for the prognosis assessment of OC patients. Among the eight survival curves, AP was the most significant difference between the high and low risk groups, with a P value of 1.61e−1.The results of single factor independent analysis and multi-factor independent prognostic analysis showed that risk score calculated by the model and age could be used as independent risk factors. According to univariate COX regression analysis ,109 SFs were correlated with AS events and adjusted in two ways: positive and negative.Conclusions: SFs and AS events can directly or indirectly affect the prognosis of OC patients. It is very important to find effective prognostic markers to improve the survival rate of OC.
Sequential Multiple Assignment Randomized Trial (SMART) To Identify Optimal Sequences Of Telemedicine Interventions For Improving Initiation of Insulin Therapy: A Simulation Study
Authors: Yan Xiaoxi , Matchar David B. , Goel Aastha , Sivapragasam Nirmali , Ansah John P. , Chakraborty Bibhas 
Published: May 2021

Abstract
Background: To examine the value of a Sequential Multiple Assignment Randomized Trial (SMART) design compared to a conventional randomized control trial (RCT) for telemedicine strategies to support titration of insulin therapy for Type 2 Diabetes Mellitus (T2DM) patients new to insulin. Methods: Microsimulation models were created in R using a synthetic sample based on primary data from 63 subjects enrolled in a pilot study of a smartphone application (App), Diabetes Pal compared to a nurse-based telemedicine strategy (Nurse). For comparability, the SMART and an RCT design were constructed to allow comparison of four (embedded) adaptive interventions (AIs). Results: In the base case scenario, the SMART has similar overall mean expected HbA1c and cost per subject compared with RCT, for sample size of n = 100 over 10000 simulations. SMART has lower (better) standard deviations of the mean expected HbA1c per AI, and higher efficiency of choosing the correct AI across various sample sizes. The differences between SMART and RCT become apparent as sample size decreases. For both trial designs, the threshold value at which a subject was deemed to have been responsive at an intermediate point in the trial had an optimal choice (i.e., the sensitivity curve had a U-shape). SMART design dominates the RCT, in the overall mean HbA1c (lower value) when the threshold value is close to optimal. Conclusions: SMART is suited to evaluating the efficacy of different sequences of treatment options, in addition to the advantage of providing information on optimal treatment sequences.
WITHDRAWN: Sodium-glucose Cotransporter 2 Inhibitors and Anemia Among Diabetic Patients in Real Clinical Practice: a Retrospective Observational Study.
Authors: Murashima Miho , Tanaka Tomohiro , Ide Atsuki , Ono Minamo Tomohiro , Mizuno Masashi , Suzuki Taisei , Hamano Takayuki 
Published: May 2021

Abstract
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were reported to increase hemoglobin levels in short-term clinical trials. Whether it is also true in real clinical practice is unknown. Methods: This is a retrospective cohort study. Inclusion criterion was diabetics who visited our outpatient clinic from January 2019 to August 2020. Exposure of interest was the use of SGLT2i. Outcomes were hemoglobin levels. For the cross-sectional analyses, non-linear regression models were fitted with restricted cubic splines to investigate the association between hemoglobin levels and estimated glomerular filtration rate (eGFR) for users and non-users of SGLT2i. For the case-control study, cases (anemia defined as hemoglobin <120 g/L for men, <110 g/L for women or the use of erythropoiesis stimulating agents) and controls were matched by age, sex, and eGFR. Results: Among 2063 diabetics, 723 were on SGLT2i. In the cross-sectional analyses, hemoglobin levels were higher among SGLT2i users compared with non-users at eGFR >15 mL/min/1.73m2. For the case-control study, 197 cases and controls were matched. Conditional logistic regression showed that the use of SGLT2i was associated with significantly lower prevalence of anemia (OR: 0.35 [0.21-0.58]). Adjusted mean differences (95% CIs) in hemoglobin levels between users and propensity score-matched non-users of SGLT2i were 7.0 (3.0-10.0) g/L at 6 months. Among SGLT2i users, odds of increase in 6-month hemoglobin were similar across eGFR categories except for eGFR <15 mL/min/1.73m2.Conclusions: The use of SGLT2i was associated with higher hemoglobin levels and lower prevalence of anemia in real clinical practice.
Modelling Conditional Volatility of NIFTY 50
Authors: NERLEKAR VARSHA SHRIRAM , Nerlekar Shriram 
Published: May 2021

Abstract
The present study demonstrates modelling of conditional volatility of NIFTY 50 using GARCH (1,1) model. The daily returns data of the Indian stock market index NIFTY 50 is used for the period ranging from April 2010- March 2020. The data is analysed using R software. The study estimates and interprets the results arrived in the summary output of the R environment and demonstrates how to forecast the volatility of the returns based on the estimated parameters. Extracting the time series of conditional volatilities is also demonstrated in the study.
Evaluation of Mental Health First Aid training program in Bangladesh: A modified Delphi study
Authors: Huque Akib Ul , Kawser Umme , Rahman Monira , Gnani Shamini , Rao Mala , Baskin Cleo , Mallick Pauroma Preety , Armstrong Stephanie 
Published: May 2021

Abstract
BackgroundBangladesh, like other low-resource countries, faces a shortage of a trained mental health workforce to meet its population's mental health needs adequately. The ongoing COVID-19 pandemic has further aggravated this. Mental health first aid (MHFA) is an internationally recognized training program that has been operating in Bangladesh since 2015. It offers a potential way to reduce the mental health treatment gap and skills shortage by training laypeople to help support individuals with mental health issues. The present study evaluated the effectiveness of MHFA training in Bangladesh. MethodsAn online modified Delphi study was conducted consisting of two rounds of a self-administered survey and a consensus workshop. A five-step logic framework was used to develop questionnaire statements (n=111) that consisted of 'general,' 'I,' and 'social impact' statements around the seven MHFA aims. The statements were constructed in English and adapted in Bangla. The expert panel consisted of 20 participants trained in the MHFA program. Participants anonymously stated their opinion on 111 round-1 statements and then on 27 low agreement statements in round-2. The consensus workshop facilitated a group discussion where participants explained their views on the low consensus items. ResultsThe consensus ranged from 61.5% (Aim 3: Promote recovery of good mental health) to 100% (Aim 7: To improve own health and well-being) with an overall consensus of 83.8%. 'Social impact' items produced the most (50%) disagreements. Participants' comments reflected 12 themes of MHFA's effectiveness in fostering and promoting mental health individually and socially. There were nine themes of disagreement reflecting individual, sociocultural, and political barriers to the implementation of MHFA in Bangladesh. Participants made recommendations for the MHFA and mental health initiatives in Bangladesh to increase mental health awareness, acceptance, and support in society.Conclusion﻿MHFA training offers Bangladesh and other low-and-middle-income countries a potential solution to tackle mental health burden at individual and societal levels and the additional challenges that the COVID-19 pandemic poses to mental health.
Serum Periostin and Cognitive Impairment in Ischemic Stroke Patients: a Prospective Cohort Study
Authors: Li Guangzong , Li Jie , Zhu Chen , Ye Jing , Wang Bin , Luo Xiaojing , Liu Mei 
Published: May 2021

Abstract
Background. Recent evidence suggest elevated periostin is associated with cardiovascular diseases. The aim of this study was to investigate the relationship between serum periostin and post-stroke cognitive impairment (PSCI) at 3 months. Methods. In this prospective cohort study, we enrolled patients with ischemic stroke and hospitalized within 7 days of symptoms onset from January 2019 to January 2020. Serum periostin levels were measured using enzyme-linked immunosorbent assay after admission. Cognitive function assessment was performed at 3-month follow-up visit using the Montreal Cognitive Assessment (MoCA). We defined the PSCI as total MoCA score < 25. Results. A total of 315 ischemic stroke patients were enrolled for the study. PSCI was observed in 173 patients, which accounted for 54.9% (95% confidence interval [CI] 52.1%–57.7%) of the cohort. Serum periostin levels were higher in patients with PSCI than in those without PSCI (median 19.6 vs 14.8 ng/mL; P = 0.001). In logistic regression analysis, the highest quartile of periostin levels were significantly correlated to PSCI (odds ratio [OR], 9.69; 95% CI, 5.06–25.61; P = 0.001), as compared with the lowest quartile. This association remained significant after adjustment for age, gender, educational years, stroke severity, and vascular risk factors. Subgroup analyses further confirmed these results. Furthermore, restricted cubic spline regression demonstrated a linear association between periostin levels and PSCI (P = 0.001 for linearity).Conclusions. This study found that higher serum periostin levels are associated with an increased risk of PSCI at 3 months after ischemic stroke onset.
Presenting Climate Projection Ensembles as Mean and Reasonable Worst Case, with Application to EURO-CORDEX Precipitation
Authors: Jewson Stephen , Messori Gabriele , Barbato Giuliana , Mercogliano Paola , Mysiak Jaroslav , Sassi Maximiliano 
Published: May 2021

Abstract
Users of ensemble climate projections have choices with respect to how they interpret and apply the ensemble. A simplistic approach is to consider just the ensemble mean and ignore the individual ensemble members. A more thorough approach is to consider every ensemble member, although for complex impact models this may be unfeasible. Building on previous work in ensemble weather forecasting we explore an approach in-between these two extremes, in which the ensemble is represented by the mean and a reasonable worst case. The reasonable worst case is calculated using Directional Component Analysis (DCA), which is a simple statistical method that gives a robust estimate of worst-case for a given linear metric of impact, and which has various advantages relative to alternative definitions of worst-case. We present new mathematical results that clarify the interpretation of DCA and we illustrate DCA with an extensive set of synthetic examples. We then apply the mean and worst-case method based on DCA to EURO-CORDEX projections of future precipitation in Europe, with two different impact metrics. We conclude that the mean and worst-case method based on DCA is suitable for climate projection users who wish to explore the implications of the uncertainty around the ensemble mean without having to calculate the impacts of every ensemble member.
Pesticides and Pesticide-Related Products in Ambient Air in Germany
Authors: Kruse-Plaß Maren , Hofmann Frieder , Wosniok Werner , Schlechtriemen Ulrich , Kohlschütter Niels 
Published: May 2021

Abstract
BackgroundTree bark measurements conducted between 2014 and 2017 in a biosphere reserve have indicated the presence of pesticides from conventional agriculture in ambient air in Germany. In the present study, we quantified pesticides and related substances in ambient air at 69 sites using passive air samplers and ventilation filter mats. It is, to our knowledge, so far the most comprehensive dataset on pesticides and their related products in ambient air in Germany. ResultsSamples were collected in 2019 and analysed for over 500 substances, of which 109 were detected, including 28 that are not approved for use in Germany. In each sampling site, we detected one to 36 substances, including at locations such as national parks and forests, where the presence of pesticides is not expected, e.g., on the highest mountain top in the national park “Harz” (13 substances) and in the "Bavarian Forest" (six substances). Glyphosate was detected in every sample. More than half of passive air samplers contained chlorothalonil, metolachlor, pendimethalin, terbuthylazine, prothioconazole-desthio, dimethenamid, prosulfocarb, flufenacet, tebuconazole, aclonifen, chlorflurenol, hexachlorobenzene (HCB), and γ-hexachlorocyclohexane (ɣ-HCH). Filter mats also contained boscalid. The statistical analysis showed that landscape classification and agricultural intensity were the primary factors influencing the number of substances detected in ambient air. Location, such as protected areas or regions of organic farming, had only a small effect on the number of substances recorded. Long-range transport likely accounts for the findings and active sampling of ambient air will probably detect more pesticides and higher concentrations than passive air sampler data presently suggest. ConclusionsAirborne pesticide mixtures are ubiquitous in Germany, which is particularly concerning for glyphosate, pendimethalin, and prosulfocarb. Deposition of these pesticides on organic products may disqualify them from the market, resulting in economic damage to farmers. Air concentrations of pesticides are a relevant issue and must be reduced.
Cimifugin Suppresses NF-κB Signaling to Prevent Osteoclastogenesis and Periprosthetic Osteolysis
Authors: Duan Juan , Hu Xuantao , Li Tao , Dou Pengcheng 
Published: May 2021

Abstract
Background: Aseptic loosening of prosthesis (ALP) is one of the most common long-term complication of knee and hip arthroplasty. Wear paticle-induced osteoclastogenesis and subsequent periprosthetic osteolysis accounts for the morbidity of ALP. Here, we investigate cimifugin (CIM), a natural extract from Cimicifuga Racemosa and Saposhnikovia Divaricata, as a bone protective drug in treatment of ALP.Method: First, we deployed cell viability and osteoclast formation assays to detect the effect of noncytotoxic CIM on osteoclast differentiation in vitro. Bone slice resorption evaluation and F-actin ring immunofluorescence assays were adopted to measure bone-resorbing function affected by CIM. Then, we introduce quantitative real-time polymerase chain reaction (qRT-PCR) analysis to further identify the repressed osteoclastogenesis by CIM in gene expression level. To reveal underlying mechanism of findings above, we used Western blotting and luciferase reporter gene assay to determine the regulation manner of CIM in NF-κB and MAPKs signaling pathways. Moreover, Ti particle-induced murine calvarial osteolysis model and following histomorphometric analysis via micro-CT and immunohistochemical staining were used to demonstrate the effect of CIM on periprosthetic osteolysis in vivo. Result: CIM administration dose-dependently inhibited both bone marrow-derived macrophages (BMMs) and RAW264.7 cells derived osteoclastogenesis and bone resorption pit formation in vitro, which further supported by reduced expression of F-actin and osteoclast specific genes. According to the Western blotting analysis, inhibition of IkBa phosphorylation in NF-κB signaling pathway, not the phosphorylation of MAPKs, was detected as the suppressive effect of CIM on osteoclastogenesis. In vivo animal experiment demonstrated that CIM alleviated Ti particle-induced bone erosion and osteoclast accumulation in murine calvaria. Conclusion: The current study for the first time proved that CIM could dose-dependently inhibit RANKL-induced osetoclastogenesis via suppressing NF-κB signaling pathway in vitro and prevent periprosthetic osteolysis in vivo. These findings suggest the potential therapeutic use of CIM in ALP.
The evolution of pelvic canal shape and rotational birth in humans
Authors: Stansfield Ekaterina , Fischer Barbara , Mitteroecker Philipp 
Published: May 2021

Abstract
The human foetus needs to rotate when passing through the tight birth canal because of the complex shape of the pelvis. In most women the upper part, or inlet, of the birth canal has a round or mediolaterally oval shape, which is considered ideal for parturition, but it is unknown why the lower part, or outlet, of the birth canal has a pronounced anteroposteriorly oval shape. Here we show that the shape of the lower birth canal affects the ability of the pelvic floor to resist pressure exerted by the abdominal organs and the foetus. Based on a series of finite element analyses, we found that the highest deformation, stress and strain occur in pelvic floors with a circular or mediolaterally oval shape, whereas an anteroposterior elongation increases pelvic floor stability. This suggests that the anteroposterior oval outlet shape is an evolutionary adaptation for pelvic floor support. For the pelvic inlet, by contrast, it has long been assumed that the mediolateral dimension is constrained by the efficiency of upright locomotion. But we argue that upright stance limits the anteroposterior dimension of the inlet. A deeper inlet requires greater pelvic tilt and lumbar lordosis, which compromises spine health and the stability of upright posture. These different requirements on the pelvic inlet and outlet have led to the complex shape of the human pelvic canal and to the evolution of rotational birth.