bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a multi-level community-clinical linkage intervention to improve glycemic control among south Asian patients with uncontrolled diabetes: study protocol of the DREAM initiative
Authors: Lim Sahnah , Wyatt Laura C. , Mammen Shinu , Zanowiak Jennifer M. , Mohaimin Sadia , Troxel Andrea B. , Lindau Stacy Tessler , Gold Heather T. , Shelley Donna , Trinh-Shevrin Chau , Islam Nadia S. 
Published: November 2021

AbstractBackgroundA number of studies have identified patient-, provider-, and community-level barriers to effective diabetes management among South Asian Americans, who have a high prevalence of type 2 diabetes. However, no multi-level, integrated community health worker (CHW) models leveraging health information technology (HIT) have been developed to mitigate disease among this population. This paper describes the protocol for a multi-level, community-clinical linkage intervention to improve glycemic control among South Asians with uncontrolled diabetes.MethodsThe study includes three components: 1) building the capacity of primary care practices (PCPs) to utilize electronic health record (EHR) registries to identify patients with uncontrolled diabetes; 2) delivery of a culturally- and linguistically-adapted CHW intervention to improve diabetes self-management; and 3) HIT-enabled linkage to culturally-relevant community resources. The CHW intervention component includes a randomized controlled trial consisting of group education sessions on diabetes management, physical activity, and diet/nutrition. South Asian individuals with type 2 diabetes are recruited from 20 PCPs throughout NYC and randomized at the individual level within each PCP site. A total of 886 individuals will be randomized into treatment or control groups; EHR data collection occurs at screening, 6-, 12-, and 18-month. We hypothesize that individuals receiving the multi-level diabetes management intervention will be 15% more likely than the control group to achieve ≥0.5% point reduction in hemoglobin A1c (HbA1c) at 6-months. Secondary outcomes include change in weight, body mass index, and LDL cholesterol; the increased use of community and social services; and increased health self-efficacy. Additionally, a cost-effectiveness analysis will focus on implementation and healthcare utilization costs to determine the incremental cost per person achieving an HbA1c change of ≥0.5%.DiscussionFinal outcomes will provide evidence regarding the effectiveness of a multi-level, integrated EHR-CHW intervention, implemented in small PCP settings to promote diabetes control among an underserved South Asian population. The study leverages multisectoral partnerships, including the local health department, a healthcare payer, and EHR vendors. Study findings will have important implications for the translation of integrated evidence-based strategies to other minority communities and in under-resourced primary care settings.Trial registrationThis study was registered with clinicaltrials.gov:NCT03333044on November 6, 2017.
High quality nursing based on childlike interest in children with cleft lip and palate: application assessment after operation
Authors: Peng Yi , Hao Xiaoyan , Guo Yuan , Zhang Xueqin , Li Yang , Ma Yanmei , Wang Juan 
Published: November 2021

Abstract
Purpose
The aim of this study was to assess the effect of high-quality nursing based on the concept of childlike interest in children with cleft lip and palate following operation on healing time, degree of pain, psychological state, quality of life, and the occurrence of complications.

Methods

A series of 62 children with cleft lip and palate was treated in our hospital from January 2019 to March 2021. The patients were randomly divided into observation group (31 cases, given high-quality nursing based on childlike interest) and control group (31 cases, given routine nursing intervention). The healing time and hospital stay of the two groups were recorded. The degree of pain, psychological state and quality of life of the two groups before and after intervention were compared, and the occurrence of complications was closely monitored.

Results
Compared with the control group, the healing time and hospital stay of the study group were significantly shorter after the intervention (P < 0.05). Before the intervention, no significant difference was identified in pain score between the two groups (P < 0.05), after the intervention, however, the pain score of the study group was significantly lower compared with the control group (P < 0.05). Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) scores of the two groups were comparable before intervention (P > 0.05), while after intervention the SDS and SAS scores of the two groups were lower than those before treatment. Compared with the control group, the SDS and SAS scores of the study group were remarkably lower (P < 0.05). Before the intervention, the quality of life scores of the two groups were comparable (P > 0.05), while after the intervention, the scores of quality of life in the two groups were associated with lower outcomes. Compared with the control group, the scores of quality of life in the study group were significant lower (P < 0.05). After the intervention, there were evident fewer incidence of complications in the study group compared to the control group (P < 0.05).

Conclusions
High quality nursing based on childlike interest exerted beneficial outcomes in terms of shortening the healing time and hospital stay, reducing the degree of pain and complications, as well as improving the psychological state and quality of life of children harboring cleft lip and palate. Additionally, its high safety feature contributes to the wide application for clinical practice.
Complementary medicine in Germany: a multi-centre cross-sectional survey on the usage by and the needs of patients hospitalized in university medical centers
Authors: Lederer Ann-Kathrin , Baginski Alexandra , Raab Lena , Joos Stefanie , Valentini Jan , Klocke Carina , Samstag Yvonne , Hübner Katrin , Andreeva Ivana , Simmet Thomas , Syrovets Tatiana , Hafner Susanne , Freisinger Anna , Storz Maximilian Andreas , Huber Roman 
Published: November 2021

Abstract
Background
The results of recent surveys indicate that more than 50% of the German population has experience with complementary and alternative medicine (CAM) or uses CAM regularly. This study investigated the CAM usage and CAM-related needs of hospitalized patients at university medical centres in the state of Baden-Württemberg, Germany.

Methods
A multi-centre, paper-based, pseudonymous survey was carried out by the members of the Academic Centre for Complementary and Integrative Medicine. Patients of all ages, regardless of sex, diagnosis and treatment, who were hospitalized in the Department of Cardiology, Gastroenterology, Oncology, Gynaecology or Surgery at the university medical centres in Freiburg, Heidelberg, Tübingen and Ulm were eligible for inclusion.

Results
Of the 1275 eligible patients, 67% (n = 854) consented to participate in the survey. Forty-eight percent of the study participants stated that they were currently using CAM. The most frequently used therapies were exercise (63%), herbal medicine (54%) and dietary supplements (53%). Only 16% of the patients discussed CAM usage with their attending physician. Half of the patients (48%) were interested in CAM consultations. More than 80% of the patients desired reliable CAM information and stated that physicians should be better informed about CAM.

Conclusions
The frequency of CAM usage and the need for CAM counselling among hospitalized patients at university medical centres in Baden-Württemberg are high. To better meet patients’ needs, CAM research and physician education should be intensified.

Trial registration
German Clinical Trial register (DRKS00015445).
A tree based approach for multi-class classification of surgical procedures using structured and unstructured data
Authors: Khaleghi Tannaz , Murat Alper , Arslanturk Suzan 
Published: November 2021

Abstract
Background
In surgical department, CPT code assignment has been a complicated manual human effort, that entails significant related knowledge and experience. While there are several studies using CPTs to make predictions in surgical services, literature on predicting CPTs in surgical and other services using text features is very sparse. This study improves the prediction of CPTs by the means of informative features and a novel re-prioritization algorithm.

Methods
The input data used in this study is composed of both structured and unstructured data. The ground truth labels (CPTs) are obtained from medical coding databases using relative value units which indicates the major operational procedures in each surgery case. In the modeling process, we first utilize Random Forest multi-class classification model to predict the CPT codes. Second, we extract the key information such as label probabilities, feature importance measures, and medical term frequency. Then, the indicated factors are used in a novel algorithm to rearrange the alternative CPT codes in the list of potential candidates based on the calculated weights.

Results
To evaluate the performance of both phases, prediction and complementary improvement, we report the accuracy scores of multi-class CPT prediction tasks for datasets of 5 key surgery case specialities. The Random Forest model performs the classification task with 74–76% when predicting the primary CPT (accuracy@1) versus the CPT set (accuracy@2) with respect to two filtering conditions on CPT codes. The complementary algorithm improves the results from initial step by 8% on average. Furthermore, the incorporated text features enhanced the quality of the output by 20–35%. The model outperforms the state-of-the-art neural network model with respect to accuracy, precision and recall.

Conclusions
We have established a robust framework based on a decision tree predictive model. We predict the surgical codes more accurately and robust compared to the state-of-the-art deep neural structures which can help immensely in both surgery billing and scheduling purposes in such units.
Comparison of wavelet transformations to enhance convolutional neural network performance in brain tumor segmentation
Authors: Hajiabadi Mohamadreza , Alizadeh Savareh Behrouz , Emami Hassan , Bashiri Azadeh 
Published: November 2021

AbstractIntroduction and goal to backgroundDue to the importance of segmentation of MRI images in identifying brain tumors, various methods including deep learning have been introduced for automatic brain tumor segmentation. On the other hand, using a combination of methods can improve their performance. Among them is the use of wavelet transform as an auxiliary element in deep networks. The analysis of the requirements of such combinations has been addressed in this study.MethodIn this developmental study, different wavelet functions were used to compress brain MRI images and finally as an auxiliary element in improving the performance of the convolutional neural network in brain tumor segmentation.ResultsBased on the results of the tests performed, the Daubechies1 function was most effective in enhancing network performance in segmenting MRI images and was able to balance the performance and computational overload.ConclusionChoosing the wavelet function to optimize the performance of a convolutional neural network should be based on the requirements of the problem, also taking into account some considerations such as computational load, processing time, and performance of the wavelet function in optimizing CNN output in the intended task.
Additive Bayesian network analysis of the relationship between bovine respiratory disease and management practices in dairy heifer calves at pre-weaning stage
Authors: Yamaguchi Emi , Hayama Yoko , Shimizu Yumiko , Murato Yoshinori , Sawai Kotaro , Yamamoto Takehisa 
Published: November 2021

Abstract
Background
Nursery farms that accept nursing and growing pre-weaned heifer calves from private dairy farms must work to prevent bovine respiratory disease (BRD). Knowledge of the BRD-associated risk factors related to calf management and calves’ condition will help to develop appropriate neonatal management practices at original farms and to identify calves at higher risk for BRD at nursery farms. In this study, the relationship between BRD and calf management practices (colostrum feeding, dam parity, serum total protein concentration at introduction (TP), body weight at introduction, introduction season, and daily average growth) was investigated using observational data from pre-weaned dairy calves introduced into a nursery farm in Hokkaido, Japan between 2014 and 2018 (n = 3185). Using additive Bayesian network (ABN) analysis, which is a multivariate statistical modelling approach, the direct and indirect associations between these factors were assessed.

Results
Colostrum feeding contributed to an increase in TP (correlation 1.02 [95 % CI, 0.94;1.10]), which was negatively associated with BRD directly (log odds ratio − 0.38 [− 0.46;−0.31]) and indirectly through increasing daily growth (correlation 0.12 [0.09;0.16]). Calves of multiparous dams had higher body weight at introduction (correlation 0.82 [0.74;0.89]), which indirectly reduced BRD risk through the increasing daily growth (correlation 0.17 [0.14;0.21]). Calves introduced during winter had the highest risk for BRD (log odds ratio 0.29 [0.15;0.44]), while those introduced in summer had the lowest risk (log odds ratio − 0.91 [− 1.06;−0.75]). The introduction season was also associated with BRD indirectly through dam parity, body weight at introduction, and daily growth.

Conclusions
The following calf management practices are recommended for preventing BRD in pre-weaned calves at nursery farms: (1) encouraging colostrum feeding to neonatal calves at their original farms; and (2) identifying calves with higher BRD risk, i.e., those without feeding colostrum, born to primiparous cattle, with low body weight at introduction, and/or introduced in winter, and paying intensive attention to the calves for rapid detection of BRD. ABN analysis applied enabled us to understand the complex inter-relationships between BRD incidence and the risk factors, which will help to reduce BRD incidence and to rear healthy calves at nursery farms.
Transcriptome sequencing identified the ceRNA network associated with recurrent spontaneous abortion
Authors: Huang Yong , Hao Jiayuan , Liao Yuan , Zhou Lihua , Wang Kaiju , Zou Hui , Hu Ying , Li Juan 
Published: November 2021

Abstract
Background
Recurrent spontaneous abortion (RSA) is one of the common complication of pregnancy, bringing heavy burden to the patients and their families. The study aimed to explore the lncRNA-miRNA-mRNA network associated with recurrent spontaneous abortion.

Methods
By transcriptome sequencing, we detected differences in lncRNA, miRNA and mRNA expression in villus tissue samples collected from 3 patients with RSA and 3 normal abortion patients. Differentially expressed lncRNAs, miRNAs and genes (DELs, DEMs and DEGs, respectively) were identified, and Geno Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to determine the functions of DELs and DEGs, which were analysed by Fisher’s test. We also observed the regulatory relationships between miRNA-mRNA and lncRNA-miRNA by Cytoscape 3.6.1.

Results
The results showed that 1008 DELs (523 upregulated and 485 downregulated), 475 DEGs (201 upregulated and 274 downregulated) and 37 DEMs (15 upregulated and 22 downregulated) were identified. And we also constructed a novel lncRNA-related ceRNA network containing 31 lncRNAs, 1 miRNA (hsa-miR-210-5p) and 3 genes (NTNG2, GRIA1 and AQP1).

Conclusions
lncRNA-related ceRNA network containing 31 lncRNAs, 1 miRNA (hsa-miR-210-5p) and 3 mRNAs (NTNG2, GRIA1 and AQP1) was constructed. The results may provide a basic theory for elucidating the mechanism underlying RSA.
Three decades of Cdk5
Authors: Pao Ping-Chieh , Tsai Li-Huei 
Published: November 2021

AbstractCdk5 is a proline-directed serine/threonine protein kinase that governs a variety of cellular processes in neurons, the dysregulation of which compromises normal brain function. The mechanisms underlying the modulation of Cdk5, its modes of action, and its effects on the nervous system have been a great focus in the field for nearly three decades. In this review, we provide an overview of the discovery and regulation of Cdk5, highlighting recent findings revealing its role in neuronal/synaptic functions, circadian clocks, DNA damage, cell cycle reentry, mitochondrial dysfunction, as well as its non-neuronal functions under physiological and pathological conditions. Moreover, we discuss evidence underscoring aberrant Cdk5 activity as a common theme observed in many neurodegenerative diseases.
Antibody cocktail effective against variants of SARS-CoV-2
Authors: Liang Kang-Hao , Chiang Pao-Yin , Ko Shih-Han , Chou Yu-Chi , Lu Ruei-Min , Lin Hsiu-Ting , Chen Wan-Yu , Lin Yi-Ling , Tao Mi-Hua , Jan Jia-Tsrong , Wu Han-Chung 
Published: November 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an RNA virus with a high mutation rate. Importantly, several currently circulating SARS-CoV-2 variants are associated with loss of efficacy for both vaccines and neutralizing antibodies.

Methods
We analyzed the binding activity of six highly potent antibodies to the spike proteins of SARS-CoV-2 variants, assessed their neutralizing abilities with pseudovirus and authentic SARS-CoV-2 variants and evaluate efficacy of antibody cocktail in Delta SARS-CoV-2-infected hamster models as prophylactic and post-infection treatments.

Results
The tested RBD-chAbs, except RBD-chAb-25, maintained binding ability to spike proteins from SARS-CoV-2 variants. However, only RBD-chAb-45 and -51 retained neutralizing activities; RBD-chAb-1, -15, -25 and -28 exhibited diminished neutralization for all SARS-CoV-2 variants. Notably, several cocktails of our antibodies showed low IC50 values (3.35–27.06 ng/ml) against the SARS-CoV-2 variant pseudoviruses including United Kingdom variant B.1.1.7 (Alpha), South Africa variant B.1.351 (Beta), Brazil variant P1 (Gamma), California variant B.1.429 (Epsilon), New York variant B.1.526 (Iota), and India variants, B.1.617.1 (Kappa) and B.1.617.2 (Delta). RBD-chAb-45, and -51 showed PRNT50 values 4.93–37.54 ng/ml when used as single treatments or in combination with RBD-chAb-15 or -28, according to plaque assays with authentic Alpha, Gamma and Delta SARS-CoV-2 variants. Furthermore, the antibody cocktail of RBD-chAb-15 and -45 exhibited potent prophylactic and therapeutic effects in Delta SARS-CoV-2 variant-infected hamsters.

Conclusions
The cocktail of RBD-chAbs exhibited potent neutralizing activities against SARS-CoV-2 variants. These antibody cocktails are highly promising candidate tools for controlling new SARS-CoV-2 variants, including Delta.
Changes in young adults' mental well-being before and during the early stage of the COVID-19 pandemic: disparities between ethnic groups in Germany
Authors: Plenty Stephanie , Bracegirdle Chloe , Dollmann Jörg , Spiegler Olivia 
Published: November 2021

Abstract
Background
The COVID-19 pandemic resulted in substantial disruptions to the daily lives of young people. Yet knowledge is lacking about changes in mental well-being among young adults, whether those from ethnic minorities were more adversely impacted by the pandemic than the ethnic majority, and the extent to which pandemic-related stressors contributed to any declines in mental well-being.

Methods
We draw on nationally representative German CILS4COVID data, collected early in the pandemic (N = 3517, Mage = 25). Respondents provided information on mental well-being (psychosomatic complaints, anxiety, depression, life satisfaction) and exposure to pandemic-related stressors (financial worries, health worries, discrimination, contact with COVID-19). Responses on mental well-being were matched to responses from two pre-pandemic waves. Individual fixed effects regressions examined ethnic group differences in changes in mental well-being prior to, and at the early stage of, the pandemic. Path analysis tested the role of pandemic-related stressors in declines in mental well-being.

Results
Overall, young adults’ mental well-being had improved at the pandemic assessment compared to pre-pandemic assessments, and few ethnic group differences in changes were found. However, greater pandemic-related stressors were associated with worsened mental well-being at the pandemic assessment. Among Asian minorities, indirect effects were found on anxiety via health worries, and on depression via health worries and discrimination. For Turkish, Middle Eastern and African minorities, indirect effects on anxiety and depression were found via health worries.

Conclusions
We did not find widespread declines in mental well-being among young adults at the early stage of the pandemic, and changes in mental well-being prior to and at the early stage of the pandemic were mostly similar across ethnic German and minority groups. Nevertheless, pandemic-related stressors posed risks for young adults’ mental well-being, particularly increased discrimination and health worries among Asian minorities, and health worries among Turkish, Middle Eastern and African minorities.
Harsh parenting and non-suicidal self-injury in adolescence: the mediating effect of depressive symptoms and the moderating effect of the COMT Val158Met polymorphism
Authors: Liu Jinmeng , Liu Xia , Wang Hui , Gao Yemiao 
Published: November 2021

AbstractBackgroundPrevious studies have suggested that negative parenting environments, especially harsh parenting, are a specific risk factor for non-suicidal self-injury (NSSI). However, the potential mechanism between harsh parenting and NSSI has not been explored. Based on the experiential avoidance model and empirical research, we aimed to examine whether depressive symptoms are a mediator between harsh parenting and NSSI. Moreover, the catechol-O-methyltransferase (COMT) Val158Met polymorphism related to depressive symptoms may also exert a moderating effect on NSSI; thus, the interaction between harsh parenting and COMT was also considered in our study.MethodsA total of 373 junior high school students were recruited for the study by using a longitudinal design. The adolescents answered self-report questionnaires and provided saliva samples for DNA genotyping.ResultsThe results revealed that harsh parenting was positively associated with NSSI after 24 months, and this association was mediated by depressive symptoms. Moreover, the moderating role of COMT in the direct and indirect effects of harsh parenting on NSSI was observed only among adolescents with two Val alleles and the relationship was not significant for Met carriers.ConclusionsGenetic variations of COMT Val158Met may be a critical candidate in understanding the development of depression and NSSI. We conclude that Val homozygotes of the COMT Val158Met polymorphism play a role in susceptibility to both depressive symptoms and NSSI.