bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reality of the Noncommunicable disease policy landscape in Low Income Countries: the example of Mozambique
Authors: Munguambe Khatia Rebeca , Madede Tavares , Muchanga Vasco , Somerville Claire , Beran David Henri , Damasceno Albertino 
Published: February 2021

Abstract
Background Noncommunicable diseases (NCD) are the leading cause of morbidity and mortality worldwide with a disproportionate burden affecting low- and middle-income countries (LMIC). Mozambique, is a low income country situated in Southern Africa with an emerging burden of NCDs, but still facing a large challenge with regards to communicable diseases. Using the policy prioritisation framework developed by Shiffman and Smith this study aims to present the different elements that have shaped the current policy landscape for NCDs in Mozambique.Results The policy review identified 18 documents, and seven KIs were interviewed. The policy community could be seen as cohesive in that a few leading experts in Mozambique agreed on both the challenges of NCDs and the possible response, but overall leadership was lacking. Although the Ministry of Health and its NCD Department were seen as the guiding institutions the Department was not resourced to be able to fulfil its mandate. Some external resources were available to assist, but these were insufficient. In addition civil society mobilisation was missing. With regards to ideas three disconnects were present: language used in overarching government documents and their translation into practice; the views of experts; and the perceptions of NCDs in a context like Mozambique in contrast to other health issues. The NCD Department and different strategies and government documents laid out the governing structure, but again a lack of resources hampered progress. This was compounded by a lack of understanding of the problem and solutions, as well as barriers to integrate the NCD response with HIV/AIDS for example. Conclusions This study shows that despite gaining prominence on the global health agenda, NCDs have yet to truly gain a strong foothold on the policy agenda of LMICs such as Mozambique. In order to do this both governments and donors need to be sensitised to this issue as well as clear guidance developed to enable countries to have practical solutions to address both prevention and treatment of NCDs in underfunded and weak health systems, but also be able to build on existing initiatives to improve the health and well-being of populations.
Antegrade Intramedullary Fixation for Adolescent Fifth Metacarpal Neck Fracture and its Impact on Epiphyseal Growth
Authors: Fan Xiao-Lei , Wang Jian , Zhang De-hua , Mao Feng , Liao Yi , Xiao Rui 
Published: February 2021

Abstract
Background: Antegrade intramedullary nailing (AIMN) with Kirschner wire (K-wire) is a minimally invasive osteosynthesis technique. This procedure has been widely performed to treat the fifth metacarpal neck fracture (FMNF) in adults. This study was performed to determine whether using AIMN with K-wire to treat FMNF in adolescents would have good clinical and radiographic outcomes. Methods: In this retrospective study, 21 children (aged 11–16 years) with FMNF were treated using AIMN with K-wire from May 2017 to January 2020 in our hospital. Indications for intervention were total displacement, malrotation deformity, and apex dorsal angulation of greater than 40°. Collected data included apex dorsal angulation, range of motion (ROM) in the fifth metacarpophalangeal (MCP) joint, Visual Analog Scale (VAS) for pain, grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score.Results: All patients were followed up for 12–24 months (average, 17 months), and all patients obtained anatomical reduction postoperatively. The healing time was 2.8±1.1 months (range, 2–4 months). Average apex dorsal angulation was reduced significantly from 44.5°±2.6° to 15.7°±2.5° (P<0.001). The average ROM in the MCP joint and apex dorsal angulation of the injured side were not significantly different from those of the uninjured side. The average DASH score was 1.7 (range, 0–4), the mean VAS was 0.18±0.6 (range, 0–2), and the mean grip strength was 91.5%±4.5% (range, 85%–101%). No secondary displacement, dysfunction, nonunion, infection, or osteonecrosis was observed during the follow-up. Although premature epiphyseal closure was found in one patient, no long-term clinical finding of angulation or shortening was identified. Conclusions: Antegrade intramedullary fixation with K-wire was an effective and reliable technique that successfully resulted in good functional and cosmetic outcomes for treating adolescents with FMNF. The impact on the growth plate was low in this population given that most patients were at or approaching skeletal maturity. Level of Evidence: Level IV.
Clinical Impact and Imaging Results after A Modified Procedure of ACDF: A Prospective Case-Controlled Study Based on Ninety Cases With Two-Year Follow-Up
Authors: wang shunmin , zhu jian , sun kaiqiang , chen rongzi , cao jie , you ruijin , liu aigang , Zhao Feng , shi jiangang 
Published: February 2021

Abstract
Study design This is a prospective case-controlled studyBackground: To analyze the postoperative axial pain and cage subsidence of patients presenting with cervical spondylotic myelopathy (CSM) after a modified procedure of ACDF (mACDF). Methods: 90 patients with CSM were prospectively collected from 2014 to 2018. The patients were divided into spread group and non-spread group (48:42 ratio) according to the cage placement with or without releasing the Caspar cervical retractor after decompression. Spread group received conventional ACDF and non-spread group received mACDF. Patients were followed-up for at least 24 months after surgery. Radiologic data, including height of intervertebral space and Cobb Angle, were collected. Nervous system function was obtained using JOA scores, and level of pain was assessed using VAS scores.Results: A total of 90 patients were enrolled and the patients were divided into spread group (n=48) and none-spread group(n=42). Cage subsidence of (spread group vs none-spread group) was (0.82±0.68 vs 0.58±0.81) mm, (0.64±0.77 vs 0.34±0.46) mm, (0.48±0.43 vs 0.25±0.28) mm, and (0.45±0.47 vs 0.17±0.32) mm at 3months, 6months, 12months and 24 months, respectively. The period exhibiting the most decrease of the height of intervertebral space was 3 months postoperatively. However, there was no statistical difference in the height of intervertebral space, JOA or VAS scores at the final follow-up between the two groups. Conclusion: The mACDF can avoid excessive distraction by releasing the Caspar Cervical retractor, restore the "natural height" of cervical vertebra, reduce the occurrence of axial pain in patients with CSM involving single-level, and prevent rapid Cage subsidence and the loss of cervical curvature.
Effective Factors on Sharp Score in Patients with Rheumatoid Arthritis: A Retrospective Study
Authors: Wen Jianting , Liu Jian , Wang Xin , Wang Jie 
Published: February 2021

Abstract
Background: This study aims to describe the association between Sharp Score and clincial indexes, bone metabolism indexes, Disease Activity Score (DAS28) and sociodemographic factors in rheumatoid arthritis (RA).Methods: Data were were collected from the HIS (hospital information system), a national inpatient database in China, with information on the patients hospitalized during the period from 2012 to 2019. The association between Sharp Score and effective factors were identified using multinomial logistic regression and association rule mining (ARM).Results: Three thousand eight hundred and forty patients were included: 82.66% males, 17.34% females, mean (SD) age 56.95 (12.68) years and symptom duration 3.45 (1.09) years. Spearman correlation analysis and Association rules analysis showed that there were significant positive correlations between Sharp Score and effective factors. Logistic regression analysis presented that erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (CRP), rheumatoid factor (RF) were risk factors of Sharp Score. In the analysis of individual outcomes, sex, age, symptom duration, DSA28 score, RF, ever drinker, radiographic grading of hands were influencents of Sharp Score.Conclusion: Sharp Score should be taken into consideration in formulating treatment strategies in RA.
In-situ multiomics analysis reveals only minor genetic and epigenetic changes in human liver cancer stem cells
Authors: Liu Dan , Li Hong , Dong Hui , Qu Min-Cheng , Yang Liguang , Chen Li-Na , Li Yixue , Wang Hongyang , He Yufei 
Published: February 2021

Abstract
Cancer stem cells (CSCs) play pivotal roles in human cancer but their genetic and epigenetic changes are still largely unknown. Here we show that human CSCs are more similar to paratumor cells in liver cancer. Using single-cell-based in-situ multiomics analysis, we found that although liver CSCs (LCSCs) from patients had some potential key genetic and epigenetic changes in their genome, they had substantially fewer somatic single nucleotide variants (SNVs), copy number alterations (CNAs) and differentially methylated regions, and less change in the global levels of DNA cytosine modifications, than other tumor parenchymal cells. The cluster analysis of SNVs, CNAs and DNA methylation patterns and spatial transcriptomes all clearly showed that the LCSCs were clustered with the paratumor liver cells. Thus, only minor genetic and epigenetic changes occurred in human LCSCs. Targeting key changes in CSCs, not just changes in bulk tumor cells, should be more effective for human cancer therapy.
Factors Influencing Physicians' Departure from General Practitioners Field in Developing Countries: A Case Study in Iran
Authors: Shokri Azad , Akbari-Sari Ali , Harirchi Iraj , Farzianpour Fereshteh , Foroushani Abbas Rahimi , Shokri Somaieh , Moghadam Sima Mirzaei , Bayat Mahboubeh 
Published: February 2021

Abstract
Background: Migration, intersectoral flows, early retirement, illness and premature death of General Practitioners (GPs), maintaining adequate and effective workforce has become a major challenge in many countries. The present study aimed to investigate the factors affecting the departure of physicians from the GPs field in developing countries.Methods: We used qualitative research and performed as a conventional content analysis through in-depth interview. Sampling method was purposeful sampling which was performed with variation in individuals include policy makers and different situation in GPs (including immigration, unemployment, specialty student, employment in other non-medical jobs, etc.). Lincoln and Guba evaluation method were used to determine the validity and reliability of the study. The conceptual model was used to illustrate the situation and deeper understanding of the problemResults: The results of the interviews showed, eight themes, 22 sub-themes were identified as factors influencing tendency GPs to other states. Major themes included income, referral system, specialization, human resource policy-making, education related issues, working environment conditions, quality of life and community attitude. The causal relationships were shown inside and outside each theme in the conceptual model.Conclusion: According to the results, there are various factors that lead people out of the field of GP and their tendency to different states, while lack of awareness of policy makers and officials can make decisions for years to come. A wide range of interventions is recommended to reduce these stimuli include pre-selection reforms such as "information about physicians' working conditions", during academic training such as "changing hospital education to clinic education and rural community experience" and after entering areas of the medical profession such as "defining the career path for physicians 'distribution and physicians' career development" and long-term reforms include fundamental reforms to promote family medicine referral and change community attitudes.
Risk Genes in Schizophrenia and Their Importance in Choosing the Appropriate Antipsychotic Treatment
Authors: Werner Felix-Martin , Coveñas Rafael 
Published: February 2021

Background:
Schizophrenia is a chronic mental illness that in 80% of cases has a genetic etiology.
In the last years, 260 risk genes with a predisposition to schizophrenia have been discovered and correlations
between risk genes and the therapeutic efficacy of an antipsychotic treatment/pharmacotherapy resistance have
been reported.

Objective:
The objective of this review is to update the main risk genes involved in schizophrenia and to establish
an association between the single nucleotide polymorphisms (SNPs) of these genes and pharmacotherapy
resistance/efficacy of a determined antipsychotic treatment. Besides, neural networks in the brain centers involved
in schizophrenia will be updated to point out the altered functions of classical neurotransmitters and
neuropeptides due to risk genes.

Methods:
In schizophrenia, important risk genes, such as catechol-O-methyl transferase (COMT), monoamine
oxidase (MAO A/B), glutamic acid decarboxylase 67 (GAD 67), dysbindin-1 and neuregulin-1 will be mentioned.
To describe the function of these risk genes, neural networks in the ventral tegmental area, hippocampus
and prefrontal cortex will also be developed.

Results :
An association between the SNPs of some risk genes and the efficacy of an antipsychotic treatment is
reported: SNPs such as rs165599 (COMT gene), rs1801028 (D2 receptor gene) and rsSer9Gly (D3 receptor
gene) are associated with a better antipsychotic treatment efficacy (e.g., treatment of negative schizophrenic
symptoms with risperidone). The rs4680 SNP (COMT and D2 receptor genes) is associated with antipsychoticinduced
dopamine hypersensitivity and pharmacotherapy resistance. The function of risk genes is described:
COMT and MAO A/B genes, with reduced activity in the corresponding enzymes, are associated with a decrease
in dopamine degradation and hence dopamine hyperactivity occurred via D2 receptors. The GAD 67 risk gene is
linked with GABAergic dysfunction and consequently GABAergic neurons weakly presynaptically inhibit D2
dopaminergic neurons. The D-amino acid oxidase activator (DAOA) risk gene is connected with glutamatergic
dysfunction via NMDA receptors. Glutamatergic neurons might exert a weak presynaptic inhibition upon 5-
HT2A serotonergic neurons located in the ventral tegmental area and hippocampus. Neural networks in the latter
two regions and in the prefrontal cortex are updated.

Conclusion:
It is important to examine the SNPs of the risk genes involved in schizophrenia to establish a correlation
between these SNPs and the efficacy of a determined antipsychotic drug. In the future, after examining
these SNPs, it might be possible to choose the most appropriate antipsychotic drug. Thus, schizophrenic patients
with a good response to a determined antipsychotic treatment and patients with resistance to this treatment
could be well differentiated.
Predictive Model for the Quality of Life of Infertile Men
Authors: Park Jummi , Shin Nayeon 
Published: February 2021

Purpose:
This study explores factors influencing the quality of life of infertile men, and attempts to construct a structural model to predict their quality of life.

Methods:
Data was collected via questionnaires from 242 infertile male outpatients from 3 infertile clinics at general hospital urologist departments, with the subjects’ confidentiality was ensured. The self-reported questionnaires were collected for 7 months from February to August 2016 in the outpatient centers. The collected data was analyzed using SPSS/WIN 21.0 Program and Mplus 6.0 Program.

Results:
Hypothesis test of the quality of life as the endogenous variable identified infertility-related stress (β=-0.79, t=-9.41), depression (β=-0.20, t=-2.58), and spirituality (β=0.21, t=2.90) as statistically significant variables. Marital adjustment (β=-0.06, t=-0.69) and social support (β=-0.12, t=-1.79) were not statistically significant. The variables accounted for 84.1% of the variation.

Conclusion:
The results of the study show that infertility-related stress and depression have negative correlation, and spirituality has a positive correlation with infertile men’s quality of life. As such, there needs to be a development of practical and multi-faceted nursing intervention programs to control infertility-related stress and depression levels so as to sustain infertile men’s quality of life.
An Examination of Geographic Differences in Social Determinants of Health Among Women with Diagnosed HIV in the United States and Puerto Rico, 2017
Authors: Nwangwu-Ike Ndidi , Jin Chan , Gant Zanetta , Johnson Shacara , Balaji Alexandra B. 
Published: February 2021

Objective:
To examine differences, at the census tract level, in the distribution of human immunodeficiency virus (HIV) diagnoses and social determinants of health (SDH) among women with diagnosed HIV in 2017 in the United States and Puerto Rico.

Background:
In the United States, HIV continues to disproportionately affect women, especially minority women and women in the South.

Methods:
Data reported in the National HIV Surveillance System (NHSS) of the Centers for Disease Control and Prevention were used to determine census tract-level HIV diagnosis rates and percentages among adult women (aged ≥18 years) in 2017. Data from the American Community Survey were combined with NHSS data to examine regional differences in federal poverty status, education level, income level, employment status, and health insurance coverage among adult women with diagnosed HIV infection in the United States and Puerto Rico.

Results:
In the United States and Puerto Rico, among 6,054 women who received an HIV diagnosis in 2017, the highest rates of HIV diagnoses generally were among those who lived in census tracts where the median household income was less than $40,000; at least 19% lived below the federal poverty level, at least 18% had less than a high school diploma, and at least 16% were without health insurance.

Conclusion:
This study is the first of its kind and gives insight into how subpopulations of women are affected differently by the likelihood of an HIV diagnosis. The findings show that rates of HIV diagnosis were highest among women who lived in census tracts having the lowest income and least health coverage.
Biodiesel Production by Transesterification of Soybean Oil with Ethanol using SBA-15 and Al-SBA-15 Catalysts
Authors: Marinho Janaina C. , Lima Erivaldo G. , Barbosa Tellys Lins A. , Rodrigues Meiry G. F. 
Published: February 2021

Background:
Increasing environmental pollution generated by fossil fuel consumption
has intensified the consumption and development of renewable fuels.

Objective:
Thus, the aim of this work was to investigate the use of heterogeneous catalysts (SBA-
15 and Al-SBA-15) for the transesterification of soybean oil to produce biodiesel.

Methods:
The pore size and surface acidity of SBA-15 were modified by the addition of heterogeneous
Al atoms. Samples were characterized by X-ray diffraction, Nitrogen adsorption, Scanning
electron microscopy, Infrared Spectroscopy, and Thermogravimetry.

Results:
Results of the characterization study evidenced that a large amount of mesopore and surface
acidity can significantly improve the transesterification reaction with the incorporation of
aluminum into the SBA-15 framework. The best results were obtained with a 24 h reaction time
and Al-SBA-15. The transesterification reaction of soybean oil with ethanol during 24 h showed in
this work presented an efficient conversion of 85.5% with SBA-15 catalyst and 96.5% with the Al-
SBA-15 catalyst.
Magnesium Based Hybrid Nanocomposites: An Insight into Nanoparticle Effects on the Microstructure and Mechanical Properties
Authors: Seetharaman Sankaranarayanan , Subramanian Jayalakshmi , Singh Ramachandra A. , Gupta Manoj 
Published: February 2021

Aims:
The primary aim of this research is to understand the effects of type of nanoparticles on the microstructure and mechanical properties of Mg-based hybrid nanocomposites. For this reason, new Mg-based hybrid nanocomposites containing 2.2 vol.% Ti and 1.1 vol.% nano-Al2O3 or nano B4C particles were synthesized and their properties were studied in comparison with Mg-Ti and pure Mg.

Background:
Magnesium with excellent weight-saving potential is ideal for automotive and aerospace
applications. But its use in pure Mg is restricted due to inherent limitations such as poor absolute
strength, elastic modulus, deformability, and corrosion susceptibility. While most of these limitations
can be circumvented by the judicious addition of micron-sized ceramic reinforcements, ductility
is often compromised. One of the promising ways for ductility enhancement involves the use
of nano-length scale reinforcements. Similar ductility improvements were also reported when hybrid
reinforcements were introduced into the Mg matrix. While the role of hybrid reinforcement
preparation, the particle size distribution, and volume fraction of hybrid reinforcements were
studied extensively in the past, no detailed investigation on the effects of type of nanoparticles has
been conducted so far.

Objective:
The objectives of this research include the successful synthesis and property characterization of Mg-based hybrid nanocomposites containing hybrid (Ti+Al2O3 or Ti+B4C) reinforcements.

Result:
While both hybrid nanocomposites displayed fine grains when compared to pure Mg and
Mg-Ti, there was no noticeable difference between the grain size distribution profiles of Mg-
(Ti+Al2O3) and Mg-(Ti+B4C) hybrid composites. The results of property measurements indicated
an improvement in dimensional stability, indentation, tension, and compression properties of Mg
due to the addition of either individual Ti or hybrid (Ti+Al2O3) or Mg-(Ti+B4C) particles. Among
the hybrid composites, Mg-(Ti+B4C) containing hybrid (Ti+B4C) reinforcement exhibited a better
combination of strengths and ductility. While the inherent strengthening contribution from B4C
and Al2O3 reinforcements resulted in slightly different strength properties, the ductilization benefits
of boron compounds enhanced the tensile fracture strain of Mg-(Ti+B4C).

Conclusion:
Since the particle size distribution and volume fraction of (Ti+Al2O3) and (Ti+B4C) are similar, the difference in strength values between Mg-(Ti+Al2O3) and Mg-(Ti+B4C) can be attributed to the matrix strengthening contribution from reinforcement type.
Effect of Nano Silica on Strength and Water Absorption of Cement Mortar Exposed Low Pressure Environment
Authors: Zhang Ai , Ge Yong 
Published: February 2021

Background:
Buildings in high altitude region often face low pressure and low humidity service environment, which has a great impact on the mechanical properties and durability of cement-based materials.

Objective:
In this paper, the effects of nano-silica (NS) on the strength and water absorption of cement mortar exposed to the low pressure and low humidity environment were studied.

Methods:
Mechanical properties (compressive strength and flexural strength) and durability (water absorption) were measured. And the hydration degree of cement was tested to assist analysis.

Results:
The flexural strength of mortar decreased and the compressive strength increased slowly after 28 days of exposure under low pressure and low humidity environment. Especially, the introduction of 1% NS could reduce the compressive strength loss and flexural strength loss of mortar under low pressure and low humidity environment. It was also found that the water absorption of the mortar in low pressure and low humidity environment was related to the tortuous degree of the pores inside the specimen.

Conclusion:
The introduction of 1% NS contributed the most to the mechanical properties (compressive strength and flexural strength) and durability (water absorption) of cement mortar.