bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of multiple births in relation to current regulations in Turkey regarding embryo transfer
Authors: Kahraman Semra , Duzguner Ipek Nur Balin , Duzguner Soner , Sahin Yucel , Sen Cihat 
Published: February 2021

Abstract
Background
Before 2010, there were no regulations in Turkey regarding the number of embryos to be transferred in one cycle. In March 2010, regulations restricting this number were implemented by the Turkish Ministry of Health. These specify the transfer of a maximum of one embryo in the first and second cycles and a maximum of two embryos in subsequent cycles in women aged < 35, and a maximum of two embryos in women aged ≥35 in any one cycle. Our study evaluates the effect of these regulations.

Methods
This large retrospective single center study first evaluates the incidence of multiple pregnancies before and after the implementation of the 2010 regulations. Secondly, it compares the clinical outcomes of double blastocyst transfer (DBT) and single blastocyst transfer (SBT) performed in compliance with these regulations from 2014 onwards.

Results
After the introduction of the 2010 regulations, the multiple pregnancy rate decreased significantly from 37.9 to 15.7%. The singleton live birth rate increased significantly, whereas multıiple live birth rates significantly decreased (p = < 0.001).
When the clinical outcomes of SBT and DBT performed in compliance with regulations from 2014 onwards were evaluated, in patients < 35 years, the multiple pregnancy rate decreased from 47.2% in the DBT group to 1.7% in the SBT group (p = < 0.001). In patients ≥35 years, in the DBT group, the twin birth rate was again high at 28.4%, whereas in the SBT group, it was only 1.8% (p = < 0.001). Importantly, there was no statistically significant difference in clinical pregnancy rates between these two groups.

Conclusion
Turkish regulations have led to an encouragement of double embryo transfer (DET) as a routine practice, with many patients understanding it as an absolute right to have two embryos transferred. The results of our study suggest that, especially in the light of the success of blastocyst transfer, the Turkish regulations should be amended to limit the use of DET and encourage the use of single embryo transfer except in exceptional cases and particularly in women under 35 years old.
Minimal invasive versus open esophagectomy for patients with esophageal squamous cell carcinoma after neoadjuvant treatments
Authors: Chen Dongni , Wang Weidong , Mo Junxian , Ren Qiannan , Miao Huikai , Chen Youfang , Wen Zhesheng 
Published: February 2021

Abstract
Background
Although previous studies have discussed whether the minimally invasive esophagectomy (MIE) is superior to open surgery, the data concerning esophageal squamous cell carcinoma (ESCC) patients underwent neoadjuvant treatment followed by radical resection is limited. The purpose of our study was to compare the short- and long-term clinical outcomes of the two surgical approaches in treating ESCC patients.

Methods
Between January 2010 and December 2016, ESCC patients who had received neoadjuvant therapy and underwent Mckeown esophagectomy at our institute were eligible. The baseline characteristics, pathological data, short-and long-term outcomes of these patients were collected and compared based on the surgical approach.

Results
A total of 195 patients was included in the current study. Compared to patients underwent open surgery, patients underwent MIE had shorter operative time and less intraoperative bleeding (390 min vs 330 min, P = 0.001; 204 ml vs 167 ml, P = 0.021). In addition, the risk of anastomotic leakage was decreased in MIE group (20.0% vs 3.3%, P < 0.001), while the occurrence of other complications did not have statistical significance between two groups. Overall survival (OS) and disease-free survival (DFS) was no difference in patients received neoadjuvant chemotherapy between the two approaches. For the patients underwent neoadjuvant chemoradiotherapy, OS was significantly better in the MIE group (log rank = 6.197; P = 0.013).

Conclusion
Minimally invasive Mckeown esophagectomy is safe and feasible for ESCC patients who underwent neoadjuvant therapy. MIE approach presented better perioperative results than open esophagectomy. The effect of surgical approaches on survival was depending on the scheme of neoadjuvant treatment.
A simulation experiment study to examine the effects of noise on miners’ safety behavior in underground coal mines
Authors: Li Jing , Qin Yaru , Yang Lei , Wang Zhen , Han Ke , Guan Cheng 
Published: February 2021

Abstract
Background
Noise pollution in coal mines is of great concern. Personal injuries directly or indirectly related to noise occur from time to time. Its effects impact the health and safety of coal mine workers. This study aimed to identify if and how the level of noise impacts miners’ safety behavior in underground coal mines.

Methods
In order to study the influence of noise on miners in the mining industry, we built a coal mine noise simulation experiment system, and set the noise test level at 50 dB ~ 120 dB according to the actual working environment at well. We divided the noise gradient into 8 categories and conducted 93 experiments, in which we aim to test miners’ attention distribution, fatigue, and reaction under each level, and the experimental results were analyzed by SPSS22.0 software.

Results
The results show that the increase of environmental noise level will have an impact on the attention, reaction, and fatigue. The noise is positively related to the fatigue, the noise is negatively related to the attention and reaction. In the noise environment, the sensitivity of the personnel to optic stimuli is higher than that to acoustic stimuli. The test indicators of attention, fatigue, and reaction will change significantly, when the noise level is greater than 70 ~ 80 dB.

Conclusions
From the perspective of accident prevention, the noise level can be controlled within the range of less than 70 ~ 80 dB, which can control the occurrence of accidents to a certain extent.
Diet quality in the population of Norway and Poland: differences in the availability and consumption of food considering national nutrition guidelines and food market
Authors: Janowska-Miasik Ewelina , Waśkiewicz Anna , Witkowska Anna Maria , Drygas Wojciech , Markhus Maria Wik , Zujko Małgorzata Elżbieta , Kjellevold Marian 
Published: February 2021

AbstractBackgroundAdequate nutrition is a public health challenge due to the increase in the incidence of diet-related diseases. The aim of this study was to examine food and nutrient intakes in the light of the current dietary guidelines of Poland and Norway. This is a suitable model for studying the diet quality in countries with different degrees of government intervention in the food market, which may affect food diversity available for citizens.MethodsThe food diversity on the market was assessed using national food balance sheets. To show the actual food and nutrient intake within countries, data from 24-h recalls from the national surveys, NORKOST 3 from Norwegians and WOBASZ II from Poles, were used. In order to evaluate whether dietary patterns comply with nutritional and dietary recommendations, the Norwegian and Polish recommendations for nutrition and the national food based dietary guidelines (FBDGs) were analyzed.ResultsSignificant differences between the national supplies for most food products were found. Only subtle differences in the national FBDGs and nutritional recommendations were found. Low compliance with the national FBDGs for milk, fish and sugar consumption in Poland was observed. The intakes of most nutrients were in line with the countries’ nutrition recommendations. The intakes of folate and vitamin D by both genders and the intake of iron among women, were inadequate in both countries. Calcium and magnesium intakes were below the recommended intake among the adult population of Poland, additionally, insufficient intake of potassium and thiamine was found among Polish women.ConclusionsDespite the limited availability of certain food products on the market, the diet of Norwegians was better balanced in terms of food consumed and micronutrient intakes. The good supply of various groups of food has not, however, reduced the problem of widespread deficiency of vitamin D and folic acid in the diet, and action should be taken at national level to eliminate their inadequacy. In view of increasing risk of non-communicable diseases, low compliance with the dietary guidelines requires educational campaigns aimed at increasing dietary literacy in vulnerable groups.
Follow-up results of microendoscopic discectomy compared to day surgery using percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation
Authors: Song Zhaojun , Ran Maobo , Luo Juan , Zhang Kai , Ye Yongjie , Zheng Jiazhuang , Zhang Zhi 
Published: February 2021

AbstractBackgroundPercutaneous endoscopic lumbar discectomy (PELD) is satisfactory for hospitalized patients with lumbar disc herniation (LDH). Currently, only a few studies have reported about the day surgery patients undergoing PELD.MethodsA total of 267 patients with LDH underwent PELD during day surgery and were followed up for at least 3 years. Clinical outcomes were assessed using the visual analog scale (VAS) for leg and lower back pain (VAS-B and VAS-L, respectively) and the Oswestry disability index (ODI). The radiological outcomes, such as lumbar lordosis (LL), sacral slope (SS), the disc-height ratio, and disc instability, were recorded and compared. The clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized 116 patients with LDH were compared.ResultsPatients treated by PELD had lower blood loss and shorter hospital stay (P <  0.001) compared to those treated by MED. VAS-L, VAS-B, and ODI decreased significantly after PELD than before the operation and 3 years postoperatively. The postoperative VAS-B in the PELD group was significantly decreased than in the MED group (P = 0.001). The complications rate was 9.4% in the PELD group and 12.1% in the MED group (P = 0.471). The 1-year postoperative recurrence rate in the PELD group was much higher than that in MED group (P = 0.042). The postoperative LL and SS in the PELD group improved significantly compared to the values in the MED group (P <  0.001). According to the disc-height ratio at 3-year follow-up, a significant height loss was observed in the MED group than in the PELD group (P = 0.014).ConclusionsAlthough the 1-year postoperative recurrence rate was relatively high, the day surgery for LDH undergoing PELD had advantages in terms of less blood loss intraoperatively, short hospital stay, efficacy for back pain, and efficiency to maintain lumbar physiological curvature.
A survey on critical health competences among diabetes educators using the Critical Health Competence Test (CHC Test)
Authors: Hecht Lars , Meyer Gabriele , Steckelberg Anke 
Published: February 2021

Abstract
Background
Diabetes associations claim to have a patient-centered approach in diabetes care including shared decision-making (SDM). Diabetes educators are important healthcare professionals for implementing the concept of informed SDM in diabetes care. They need critical health competences (CHC) in order to provide evidence-based information and to support patients in understanding the risks of the disease and also the possible benefits or harm of the healthcare options. Therefore, we surveyed the CHC of diabetes educators.

Methods
We performed a cross-sectional survey using the validated Critical Health Competences (CHC) Test to measure CHC of certified diabetes educators and trainees in Germany. Diabetes educators were approached via newsletter, mailing lists or in person during the conference of the German Diabetes Association. Trainees were approached during their training sessions. We applied scenario 1 of the CHC test, which comprises 17 items with open-ended and multiple-choice questions. Mean person parameters with a range from 0 to 1000 were calculated to assess the levels of critical health competences and a multiple linear regression analysis was conducted to determine correlations between sociodemographic variables and levels of CHC.

Results
A total of 325 participants, mean age 38.6 (±11.1) years, completed the CHC test; n = 174 (55.5%) were certified diabetes educators and n = 151 (46.5%) were trainees. The participants achieved a mean score of 409.84 person parameters (±88.10) (scale from 0 to 1000). A statistically significant association was found only between the level of education and the level of CHC (b = 0.221; p-value 0.002). Participants with grammar school education achieved higher mean scores compared to participants with secondary school education (432.88 ± 77.72 vs. 396.45 ± 85.95; mean difference 36.42 ± 9.29; 95%CI 18.15 to 54.71; p < 0.0001).

Conclusion
Diabetes educators achieved low competence scores and it can be assumed that they do not have sufficient CHC to conduct consultations based on the SDM principles. Poor CHC among healthcare providers are a major barrier for the implementation of SDM. Core concepts of evidence-based medicine should be implemented into the curricula for diabetes educators in order to increase their levels of CHC.
A brain cyst load-associated antigen is a Toxoplasma gondii biomarker for serodetection of persistent parasites and chronic infection
Authors: Dard Céline , Swale Christopher , Brenier-Pinchart Marie-Pierre , Farhat Dayana C. , Bellini Valeria , Robert Marie Gladys , Cannella Dominique , Pelloux Hervé , Tardieux Isabelle , Hakimi Mohamed-Ali 
Published: February 2021

AbstractBackgroundBiomarker discovery remains a major challenge for predictive medicine, in particular, in the context of chronic diseases. This is true for the widespread protozoanToxoplasma gondiiwhich establishes long-lasting parasitism in metazoans, humans included. This microbe successively unfolds distinct genetic programs that direct the transition from high to low replicative potential inside host cells. As a slow-replicating cell, theT. gondiibradyzoite developmental stage persists enclosed in a cyst compartment within tissues including the nervous system, being held by a sustained immune equilibrium which accounts for the prolonged clinically silent phase of parasitism. Serological surveys indicate that nearly one third of the human population has been exposed toT. gondiiand possibly host bradyzoites. Because any disruption of the immune balance drives the reverse transition from bradyzoite to fast replicating tachyzoite and uncontrolled growth of the latter, these people are at risk for life-threatening disease. While serological tests for discriminating recent from past infection are available, there is yet no immunogenic biomarker used in the serological test to allow ascertaining the presence of persistent bradyzoites.ResultsCapitalizing on genetically engineered parasites induced to produce mature bradyzoites in vitro, we have identified the BCLA/MAG2 protein being restricted to the bradyzoite and the cyst envelope. Using laboratory mice as relevantT. gondiihost models, we demonstrated that BCLA/MAG2 drives the generation of antibodies that recognize bradyzoite and the enveloping cyst structure. We have designed an ELISA assay based on a bacterially produced BCLA recombinant polypeptide, which was validated using a large collection of sera from mice of different genetic backgrounds and infected with bcla+ or bcla-null cystogenic and non-cystogenicT. gondiistrains. To refine the design of the ELISA assay, we applied high-resolution BCLA epitope mapping and identified a specific combination of peptides and accordingly set up a selective and sensitive ELISA assay which allowed the detection of anti-BCLA/MAG2 antibodies in the sera of human patients with various forms of toxoplasmosis.ConclusionsWe brought proof of principle that anti-BCLA/MAG2 antibodies serve as specific and sensitive serological markers in the perspective of a combinatorial strategy for detection of persistentT. gondiiparasitism.
Identification of monocyte-associated genes as predictive biomarkers of heart failure after acute myocardial infarction
Authors: Chen Qixin , Yin Qijin , Song Junxian , Liu Chuanfen , Chen Hong , Li Sufang 
Published: February 2021

AbstractBackgroundAcute myocardial infarction (AMI) is a major contributor of heart failure (HF). Peripheral blood mononuclear cells (PBMCs), mainly monocytes, are the essential initiators of AMI-induced HF. The powerful biomarkers for early identification of AMI patients at risk of HF remain elusive. We aimed to identify monocyte-related critical genes as predictive biomarkers for post-AMI HF.MethodsWe performed weighted gene co-expression network analysis (WGCNA) on transcriptomics of PBMCs from AMI patients who developed HF or did not. Functional enrichment analysis of genes in significant modules was performed via Metascape. Then we obtained the single-cell RNA-sequencing data of recruited monocytes/macrophages from AMI and control mice using the Scanpy and screened 381 differentially expressed genes (DEGs) between the two groups. We validated the expression changes of the 25 genes in cardiac macrophages from AMI mice based on bulk RNA-sequencing data and PBMCs data mentioned above.ResultsIn our study, the results of WGCNA showed that two modules containing 827 hub genes were most significantly associated with post-AMI HF, which mainly participated in cell migration, inflammation, immunity, and apoptosis. There were 25 common genes between DEGs and hub genes, showing close relationship with inflammation and collagen metabolism. CUX1, CTSD and ADD3 exhibited consistent changes in three independent studies. Receiver operating characteristic curve analysis showed that each of the three genes had excellent performance in recognizing post-AMI HF patients.ConclusionOur findings provided a set of three monocyte-related biomarkers for the early prediction of HF development after AMI as well as potential therapeutic targets of post-AMI HF.
FKBP10 promotes proliferation of glioma cells via activating AKT-CREB-PCNA axis
Authors: Cai Hong-Qing , Zhang Min-Jie , Cheng Zhi-Jian , Yu Jing , Yuan Qing , Zhang Jin , Cai Yan , Yang Li-Yan , Zhang Yu , Hao Jia-Jie , Wang Ming-Rong , Wan Jing-Hai 
Published: February 2021

Abstract
Background
Although the availability of therapeutic options including temozolomide, radiotherapy and some target agents following neurosurgery, the prognosis of glioma patients remains poor. Thus, there is an urgent need to explore possible targets for clinical treatment of this disease.

Methods
Tissue microarrays and immunohistochemistry were used to detect FKBP10, Hsp47, p-AKT (Ser473), p-CREB (Ser133) and PCNA expression in glioma tissues and xenografts. CCK-8 tests, colony formation assays and xenograft model were performed to test proliferation ability of FKBP10 in glioma cells in vitro and in vivo. Quantitative reverse transcriptase-PCR, western-blotting, GST-pull down, co-immunoprecipitation and confocal-immunofluorescence staining assay were used to explore the molecular mechanism underlying the functions of overexpressed FKBP10 in glioma cells.

Results
FKBP10 was highly expressed in glioma tissues and its expression was positively correlates with grade, poor prognosis. FKBP10-knockdown suppressed glioma cell proliferation in vitro and subcutaneous/orthotopic xenograft tumor growth in vivo. Silencing of FKBP10 reduced p-AKT (Ser473), p-CREB (Ser133), PCNA mRNA and PCNA protein expression in glioma cells. FKBP10 interacting with Hsp47 enhanced the proliferation ability of glioma cells via AKT-CREB-PCNA cascade. In addition, correlation between these molecules were also found in xenograft tumor and glioma tissues.

Conclusions
We showed for the first time that FKBP10 is overexpressed in glioma and involved in proliferation of glioma cells by interacting with Hsp47 and activating AKT-CREB-PCNA signaling pathways. Our findings suggest that inhibition of FKBP10 related signaling might offer a potential therapeutic option for glioma patients.
The Malay version of SF-36 health survey instrument: testing data quality, scaling assumptions, reliability and validity in post-coronary artery bypass grafting (CABG) surgery patients at the National Heart Institute (Institut Jantung Negara—IJN), Kuala Lumpur
Authors: Musa Ahmad Farouk , Yasin Mohamed Shajahan Mohamed , Smith Julian , Yakub Mohd Azhari , Nordin Rusli Bin 
Published: February 2021

Abstract
Background
The Short Form 36 (SF-36) is a scoring system comprising of 36 items categorized into eight constructs corresponding to patients’ health-related quality of life.
It has been used extensively in various countries on different sub-populations and used to indicate the health status and help to ascertain the effect of clinical interventions on the particular population.

Objective
To examine the psychometric properties of the Malay version of SF-36 (Malay SF-36) summated rating scales and validate the scale among post-coronary artery bypass grafting surgery (CABG) patients at the National Heart Institute (IJN), Kuala Lumpur.

Methods
Five hundred and nine post-CABG patients at the IJN, Malaysia completed the questionnaires between 1 July and 31 December 2017. Psychometric tests endorsed by the “International Quality of Life Assessment Project” were utilised.

Results
The data quality was excellent with a high questionnaire completion rate (100%). As hypothesized, the ordering of item means within scales was clustered. In unison, scaling assumptions were satisfied. Good discriminant validity was shown between subsets of patients with various levels of health status. Notwithstanding, there were probably translation issues of the Physical Functioning scale which showed small ceiling effects. We clearly observed high ceiling and floor effects in both Role Physical and Role Emotional scale most probably attributed to the dichotomous style of their choice of responses. Cronbach alpha values of the eight scales ranged from 0.73 to 0.90, showing good internal consistency reliability. Confirmatory Factor Analysis (CFA) confirmed the 8-factor solution and Composite Reliability revealed internal consistency reliability except for Vitality and Social Functioning. Based on the Average Variance Extracted (AVE), convergent validity was adequate except for two domains. Discriminant Validity is good for the eight constructs as the √AVE are generally higher than the correlation coefficients between the latent constructs.

Conclusion
The scoring for the Malay SF-36 based on the summated ratings method was proven to be valid to be applied in our local clinical population. The CFA, fitness estimates, reliability and validity assessments suggest that the Malay version of SF36 is a valid and reliable instrument. However, further work is warranted to further refine the convergent validity and reliability of some scales.