bluuebunny/crossref_metadata_2025_split huggingface dataset:
Specialty-level Factors Historically Influencing Telehealth Use Can Provide Implications for Sustainability in a Post-Pandemic Era: A Systematic Review and Narrative Synthesis
Authors: Rangachari Pavani , Mushiana Swapandeep S. , Herbert Krista 
Published: January 2021

Abstract
Background: Recent studies in the US have found wide variation in telehealth use across medical specialties (e.g., 6.1% in Allergy-Immunology vs. 24.1% in Cardiology). This is a problem-of-interest, because the US lacks a standardized set of telehealth reimbursement policies, which in turn has hindered telehealth use across all specialties. Despite these policy-level constraints experienced by all specialties, some have normalized telehealth use to mainstream practice, while others are just getting started during the pandemic. Despite accelerated telehealth use during COVID-19 through removal of federal coverage restrictions, uncertainties remain regarding future sustainability. This paper conducts a systematic review to identify “specialty-level factors” historically influencing telehealth use, with a view to identifying implications for widespread sustainability in the post-pandemic era.Methods: We conducted a systematic review and narrative synthesis to examine factors historically influencing telehealth use across six medical specialties in the US, including three “lower-using” specialties (Allergy-Immunology, Gastroenterology, Family Medicine) and three “higher-using” specialties (Cardiology, Psychiatry, Radiology). The “macro-meso-micro” framework was used to guide the review. Article searches were conducted on PubMed. The PRISMA checklist was used to guide reporting of literature reviewed. Three reviewers worked to develop a preliminary synthesis, identify eligibility criteria, explore themes in the data, and assess robustness of final synthesis.Results: Fifty-three articles were reviewed across six medical specialties. The review identified 12 factors across 3 layers, including: 1) macro-layer (policy-level, legal, other-structural), 2) meso-layer (specialty-level historical telehealth rationale, hospital-organizational, specialty-society, treatment, technological, research, cultural) and 3) micro-layer (individual-level provider-and-patient-specific) factors. A key finding was that among “higher-using” medical specialties, the specialty societies and hospital organizations in the meso-layer, proactively promoted telehealth use by influencing both macro- and micro-layer factors (e.g., advocating for consistent payment policies and enabling provider practices to be more tech-savvy & patient-centric, respectively).Conclusion: By identifying a comprehensive set of contextual, individual (and interaction) factors influencing telehealth use across six medical specialties, this review addresses a gap and provides a foundation for future research. Importantly, it identifies: 1) strategies for reducing variation in telehealth use across medical specialties, and 2) implications for ensuring widespread sustainability in the post-pandemic era.
Spatio-temporal Evolution of Water-Energy-Food System Risk from the Provincial Perspective: A Case Study of China
Authors: Ding Tonghui , Chen Junfei , Li Ming 
Published: January 2021

Abstract
In this paper, the definition of Water-energy-food system risk (WEF-R) was firstly defined based on stability, coordination and sustainability. Set pair analysis and risk matrix were applied to assess the spatio-temporal dynamics of WEF-R in China from 2008 to 2017. The research results showed that stability subsystem had the greatest influence on the WEF-R, and sustainability subsystem was an important factor affecting the WEF-R. According to the spatial-temporal analysis, the risk levels of coordination and sustainable subsystems showed a gradual downward trend, while that of stability subsystem showed small fluctuations from 2008 to 2017. In terms of the WEF-R level, it presented a decreasing trend of small fluctuations. In addition, the higher-risk areas of stability subsystem and lower-risk areas of sustainability subsystem, which were mainly centralized in southeast coastal and central regions, were consistent with the areas of good economic development level and high level of urbanization. While the lower-risk areas of stability subsystem and higher-risk areas of sustainability subsystem, which were mainly centralized in the northwest regions, brought into correspondence with the areas of good resource endowment but lower levels of economic development. Therefore, the spatial differences of economic development level and resource endowment were the main factors affecting the spatial pattern of the WEF-R level in China. Therefore, policy makers should focus on WEF-R and implement measures to improve the sustainable development of WEF nexus.
Overall Survival in Metastatic Renal Cancer in the Central Region of Morocco: A Real Life Experience Over One Decade
Authors: mellas nawfel , nouiakh lamyae , kinany Khaoula El , benhami meriam , oualla Karima , amaadour lamiae , arifi samia , mellas soufiane , tazi fadl , elfatemi hinde , fakir samira el , farih moulay hassan , benbrahim zineb 
Published: January 2021

Abstract
Background: Available treatments for metastatic RCC (mRCC) are usually non-curative. In the last decade, novel targeted therapies have significantly improved mRCC outcome. The objective in this study was to describe outcomes in patients with mRCC in Morocco.Methods: 100 patients with mRCC were recruited between January 2008 and December 2018 in the Hassan II University Hospital of Fez. Data were retrospectively collected. Kaplan-Meier survival analysis was used to determine overall survival (OS) and progression free survival (PFS).Results: Mean age of the patients was 58.6 years(±12). Sixty seven percent of patients were male. Clear cell carcinoma was the most common histological subtype (78%). According to the IMDC scoring, 72% of patients were in the intermediate and 18% in the poor risk groups. Seventy patients received targeted therapy. Overall response rate (according to RECIST criteria version 1.0) was 38.6%. The median PFS was 7.0 months (95% CI, 4.6 to 9.4). The median OS was 11.6 months (95% CI, 7.9 to 15.3). In the multivariate analysis, cancer specific mortality was impacted by treatment with VEGFR inhibitors (HR: 0.2; 95% CI, 0.1 to 0.4; p =0.001) and IMDC score (intermediate risk group HR: 3.5 (95% CI, 1.4 to 9.1; p =0.009); and poor risk group HR: 5.5 (95% CI, 1.9 to 16.1; p =0.002)).Conclusion: This is the first report from clinical practice in an African country of OS data in mRCC. The study showed high mortality rates. However, outcomes of VEGFR inhibitors are consistent with studies investigating these treatments.
High Level of Complement Factor Ba Within 11 to 17 Weeks of Gestation Increases the Risk of Subsequent Gestational Diabetes: A Propensity Score-Matched Study
Authors: Shen Ying , Li Junxian , Tian Hairong , Ji Ye , Li Ziyun , Lu Junxi , Lu Huijuan , Liu Bo , Liu Fang 
Published: January 2021

Abstract
Background: Several studies have shown that the over activation of complement factor B(CFB) was related to obesity, insulin resistance(IR) and type 2 diabetes mellitus. This study was to assess whether circulating complement factor Ba (CFBa) within 11 to 17 weeks of gestation is associated with subsequent gestational diabetes mellitus (GDM) or not.Methods: Biochemical parameters and blood samples were collected from 399 pregnant women within 11 to 17 weeks of gestation. At 24 to 28 weeks of pregnancy, all participants underwent 75-g oral glucose tolerance test (fasting for more than 8 hours before blood sampling) and were assigned to GDM group(n=80) and normal control group(n=319). Perinatal data were collected after delivery. A propensity score-matched (PSM) analysis was performed to reduce the impact of confounding factors on glucose metabolism during pregnancy between the two groups.Results: Two groups of 74 well-matched patients who maintained balance in terms of baseline characteristics. The levels of CFBa in pregnant women who later developed GDM were significantly higher than those in healthy pregnant women [0.4(0.1-0.8) vs. 0.2(0.2-0.3), P=0.031]. Logistic regression results confirmed that the level of CFBa was an independent influencing factor for the occurrence of GDM (OR=1.52, 95% CI: 1.25-1.85, P=0.000). Further grouping according to the quartile of CFBa level, it was found that the incidence of GDM in category 3 was markedly higher than that in the first and the second categories. Conclusions: High level of the CFBa within 11 to 17 weeks of gestation increased the risk of subsequent GDM, and maybe a biomarker for predicting GDM.
Endocan, VEGF, FGF2 and PDGF Expression in Pituitary Tumors. A Precise Angiogenic Marker Relationship in the Context of Tumor Invasiveness
Authors: Tao Pengyou , Perrone Sofia , Demarchi Gianina , Chimento Agustina , Cervio Andres , Sevlever Gustavo E , Berner Silvia Ines , Becu-Villalobos Damasia , Basso Armando , Ge Chen , Ling Feng , Zhang Qiuhang , Cristina Carolina 
Published: January 2021

Abstract
Background: Pituitary adenomas can become invasive and aggressive, and in turn produce tumor recurrence. Endocan or endothelial cell specific molecule-1 (ESM1) has been associated with angiogenesis and tumor growth in gliomas, and lung, kidney, liver among other cancers, but there is a scarcity of information regarding its role in pituitary adenomas. In the search for biomarkers of tumor behavior our objective was to determine the relationship between endocan (ESM1) mRNA expression and cavernous sinus invasion, and its association with gene expression of VEGF, FGF2 and PDGF angiogenic factors in human pituitary adenomas.Methods: ESM1, VEGF, FGF2 and PDGF expression was determined by qRT-PCR in 28 pituitary tumor samples and tumor invasion was determined by the Knosp grade classification. Results were associated with clinical data. Results: We found that ESM1 was expressed in 75% of the tumors. FGF2 expression was higher in ESM1-positive compared to ESM1-negative tumors, and a significant negative correlation in the expression of FGF2 and PDGF was found. Although ESM1 expression did not show any differences in invasive and non-invasive tumors, a positive correlation between ESM1 and Knosp grade was reached when grade 0-3 tumors were considered, suggesting its participation in the initial periods of tumor invasion. Finally, no difference in ESM1 expression was found between functioning and non-functioning adenomas, or patients age. Conclusions: Our study points to a precise pattern of angiogenic factor expression in pituitary tumors, and its relation to invasive behavior, which should be considered in the tailoring of drug treatments for aggressive and resistant pituitary adenomas.
Association of Circulating Omega 3, 6 and 9 Fatty Acids with Gestational Diabetes Mellitus: A Systematic Review
Authors: hosseinkhani shaghayegh , Dehghanbanadaki Hojat , Aazami Hossein , Pasalar Parvin , Asadi Mojgan , Razi Farideh 
Published: January 2021

Abstract
Background: Gestational diabetes mellitus (GDM) is associated with increased risks of disease for mother and child during pregnancy and after that. Early diagnosis of GDM would promote both maternal and fetal health. Metabolomics can simplify and develop our understanding of the etiology, manifestation, or pathophysiology of the disease. This systematic review investigates the association of circulating omega 3, 6, and 9 fatty acids with GDM.Methods: We conducted a systematic search of PubMed, Scopus, Web of Science and EMBASE databases up to May 8, 2020, using the key term combinations of all types of omega fatty acids with gestational diabetes mellitus. Additional articles were identified through searching the reference lists of included studies.Results: This systematic review included 14 articles. four were cohort studies, four included case-control studies and four were case-control studies. Omega fatty acids, as potential biomarkers, are considered to be associated with GDM risk and thus provide useful information regarding the prevention and early diagnosis of GDM. Moreover, existing metabolomic studies on GDM are shown to provide conflicting results about metabolite profile characteristics. Conclusions: The results of this study demonstrate an increasing trend in the amount of oleic acid and palmitoleic acid in the second trimester and an increase in decosahexanoic acid in the third trimester of GDM mothers. The changes in other fatty acids of interest are either not significant or if significant, their results are inconsistent with the other exisiting articles. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42020196122.
Urbanized rural areas: Identification, spatiotemporal patterns, socioeconomic characteristics, and impacts on sustainable development
Authors: He Zhichao , Spyra Marcin , Guo Qinghai 
Published: January 2021

Abstract
Sustainable development studies tend to give urban areas a priority seat, with rural areas cast in an inferior role. Despite of the growing urbanization, rural areas still are homes of billions of people universally suffering from poverty, hunger, disease, poor education. The urbanized rural areas, where population, economy, and built-up land area are higher than urban areas, present the opportunities and challenges to sustainable development. Using large-scale and high-granular spatial data (e.g., population, economy, land-use) from Fujian Province of China, we identified 69, 123, and 213 urbanized rural areas in 1995, 2005, and 2015 from 14,136 village-level administrative units. Spatial agglomeration, proximity to well-developed urban centers, and transportation accessibility are the important spatial factors influencing the development of the urbanized rural areas. Furthermore, we investigated the socioeconomic characteristics of the urbanized rural areas based on the Point of Interest data and found the urbanized rural areas had urban-like housing model, diverse non-agricultural livelihoods, complex road networks, mature public transportation, and better access to medical service. Our results suggest that the urbanized rural areas contribute to sustainable development in terms of economy and society, such as alleviating rural poverty, reducing urban-rural inequality, improving health. However, the environment impacts of the urbanized rural areas should be emphasized because urban-like socioeconomic activities and land conversions toward built-up land may lead to increased energy consumption, land degradation and biodiversity loss in rural areas.
Pulmonary Cavitation – An Under-recognized Late Complication of Severe COVID-19 Lung Disease
Authors: Zoumot Zaid , Bonilla Maria-Fernanda , Wahla Ali S. , Shafiq Irfan , Uzbeck Mateen , El-Lababidi Rania M. , Hamed Fadi , Abuzakouk Mohamed , ElKaissi Mahmoud 
Published: January 2021

Abstract
Background: Pulmonary radiological findings of the novel coronavirus disease 2019 (COVID-19) have been well documented and range from scattered ground-glass infiltrates in milder cases to confluent ground-glass change, dense consolidation, and crazy paving in the critically ill. However, lung cavitation has not been commonly described in these patients. The objective of this study was to assess the incidence of pulmonary cavitation in patients with COVID-19 and describe its characteristics and evolution.Methods: We conducted a retrospective review of all patients admitted to our institution with COVID-19 and reviewed electronic medical records and imaging to identify patients who developed pulmonary cavitation.Results: Twelve out of 689 (1.7%) patients admitted to our institution with COVID-19 developed pulmonary cavitation, comprising 3.3% (n=12/359) of patients who developed COVID-19 pneumonia, and 11% (n=12/110) of those admitted to the intensive care unit. We describe the imaging characteristics of the cavitation and present the clinical, pharmacological, laboratory, and microbiological parameters for these patients. In this cohort six patients have died, two are recovering in hospital and four have been discharged home. Conclusion: Cavitary lung disease in patients with severe COVID-19 disease is not uncommon, and is associated with a high level of morbidity and mortality.
Pleiotropic therapy for the initial stages of chronic venous insufficiency in post-thrombotic disease
Authors: Kuznetsov M. R. , Bogachev V. Yu. , Sapelkin S. V. , Marchenko I. P. , Neskhodimov L. A. , Khotinskiy A. A. 
Published: January 2021

Introduction. The current surgical techniques for the treatment of post-thrombotic disease are at the design phase, are performed in individual cases, not always result in an unambiguous outcome, and cannot completely solve this complex clinical problem. The use of drugs with a pleiotropic mechanism of action that act on various links in the pathogenesis of chronic venous insufficiency show promise.Objective of the study. Assess the clinical efficacy of a drug based on deproteinized hemoderivative obtained from calf blood used to treat the initial manifestations of chronic venous insufficiency affected by post-thrombotic disease.Materials and methods. Results of examination and treatment of 64 patients (30 men, 34 women) with lower extremity post-thrombotic disease and initial manifestations of chronic venous insufficiency (C1-C3). Treatment with a drug based on deproteinized hemoderivative obtained from calf blood at a dosage of 1200 mg per day (intravenous infusion, 30 ml of the drug diluted with 400 ml of Normal Saline) for 10 days. Then, per os at a dose of 1200 mg per day (2 tablets t.i.d.) for 30 days at the outpatient stage. Monotherapy was carried out without the addition of phlebotonics.Results. The therapy resulted in a significant edema syndrome decrease in the ankle area. This indicator decreased from 27.12 ± 0.41 cm to 24.95 ± 0.38 cm (p <0.05). Patients’ complaints about pins and needles decreased from 5.76 ± 0.81 to 2.31 ± 0.65 points (p < 0.05), the frequency and intensity of seizures decreased from 6.53 ± 1.40 to 3.19 ± 0, 94 points (p < 0.05). The intensity of the edema syndrome significantly decreased from 8.13 ± 1.73 to 4.31 ± 1.19 points (p < 0.05), pain syndrome – from 7.94 ± 1.86 to 3.11 ± 1.44 points (p < 0.05), heaviness in the lower extremities – from 8.54 ± 1.72 to 3.90 ± 1.46 points (p < 0.05), the overall patients’ quality of life improved (the integral indicator decreased from 63.29 ± 1.84 to 44.31 ± 1.18 points, p < 0.05).Conclusions. The use of pleiotropic drugs is justified in the early stages of chronic venous insufficiency in patients with post-thrombotic disease, as the therapy produces a complex effect on the microcirculatory bloodstream, metabolic processes in tissues and the rheological properties of blood.
Clinical guidelines for sclerotherapy: implementation in actual practice
Authors: Markin S. M. , Bogachev V. Yu. , Grishin S. V. , Kravtsov P. F. , Mazayshvili K. V. 
Published: January 2021

Introduction. The simplicity of the sclerotherapy procedure, its high efficiency and low cost along with the possibility of performing the procedure on an outpatient basis stimulate the widespread use of the method.Objective of the study. Examine the current state of actual clinical practice regarding the treatment of patients with varicose veins using the sclerotherapy procedure.Materials and methods. An anonymous survey of 162 doctors, members of the professional community of specialists engaged in the treatment of venous diseases was performed. It comprised 15 questions concerning the features of the sclerotherapy procedure and following up of the patients.Results and discussion. The lack of clear-cut standardization for sclerotherapy in the regulatory documents contributes to the significant heterogeneity in the approaches of specialists to the performance of the procedure. The views on the use of sclerotherapy to remove perineal varicose veins (routinely performed only by 25.3% of physicians) and the upper extremity veins (less than 4%) turned out to be controversial. There were significant differences in the therapeutic approaches to the administration of anticoagulants by the patients (refusal in the procedure – 26.3% of respondents, discontinuation of drugs during sclerotherapy – 7.5%). Approximately a third of the respondents regularly exceed recommended 10 ml-volume of foam per session, there is no consensus on the choice of the needle diameter, drug concentration even in the similar clinical situations. About half of them have experience in using glucose as the sclerosant, every third – in using a transcutaneous laser, 5.6% – in using the mechanochemical obliteration techniques that are not currently certified in the Russian Federation. The use of compression therapy after sclerotherapy is not standardized; the regulatory documents provide contradictory durations of its use, which is due to the weakness of clinical research data on this issue. Up to 99% of physicians observe pigmentation, 83.2% – development of secondary telangiectasias and 60.2% – superficial necrosis in their practice. These circumstances arouse legal suspicion in relation to this type of treatment and the legal vulnerability of physicians. At the same time, physicians need to be more informed about the current requirements for some issues.Conclusion. The current legislation regulating the practical aspects of the sclerotherapy considers it largely through the lens of medicine, ignoring a significant cosmetic component. It is necessary to work out the provisions describing the specifics of cosmetic manipulations performed by the phlebologists, and the need for more detailed familiarization with the regular updates of the guidelines.