bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overexpression of lipoic acid synthase gene alleviates diabetic nephropathyof Leprdb/dbmice
Authors: Zhao Yingzheng , Yan Tingting , Xiong Cheng , Chang Meiyu , Gao Qiyu , Yao Sanqiao , Wu Weidong , Yi Xianwen , Xu Guangcui 
Published: June 2021

IntroductionDiabetic nephropathy (DN) develops in about 40% of patients with type 2 diabetes and remains the leading cause of end-stage renal disease. The mechanisms of DN remain to be elucidated. Oxidative stress is thought to be involved in the development of DN but antioxidant therapy has produced conflicting results. Therefore, we sought to define the role of antioxidant in retarding the development of DN in this study.Research design and methodsWe generated a new antioxidant/diabetes mouse model,LiasH/HLeprdb/dbmice, by crossingdb/dbmice withLiasH/Hmice, which have overexpressedLiasgene (~160%) compared with wild type, and also correspondingly increased endogenous antioxidant capacity. The new model was used to investigate whether predisposed increased endogenous antioxidant capacity was able to retard the development of DN. We systemically and dynamically examined main pathological alterations of DN and antioxidant biomarkers in blood and kidney mitochondria.ResultsLiasH/HLeprdb/dbmice alleviated major pathological alterations in the early stage of DN, accompanied with significantly enhanced antioxidant defense. The model targets the main pathogenic factors by exerting multiple effects such as hypoglycemic, anti-inflammation, and antioxidant, especially protection of mitochondria.ConclusionThe antioxidant animal model is not only very useful for elucidating the underlying mechanisms of DN but also brings insight into a new therapeutic strategy for clinical applications.
Case study of the beneficiary group distribution of curative care expenditure based on SHA 2011 in Xinjiang autonomous region, China
Authors: Feng Honghong , Pan Kai , Li Xiaoju , Zhang Liwen , Mao Lu , Rui Dongsheng 
Published: June 2021

BackgroundThe System of Health Accounts 2011 (SHA 2011) assists in health policy analysis and health expenditure comparison at the international level. Based on SHA 2011, this study analysed the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang, to present suggestions for developing health policies.MethodsA total of 160 health institutions were selected using the multistage stratified random sampling method. An analysis of the agewise CCE distribution, institutional flow, and disease distribution was then performed based on the SHA 2011 accounting framework.ResultsIn 2016, the CCE in Xinjiang was ¥50.05 billion, accounting for 70.18% of current health expenditure and 6.66% of the gross domestic product. The per capita CCE was ¥2366.56. The CCE was distributed differently across age groups, with the highest spending on people over the age of 65 years. The CCE was highest for diseases of the circulatory, respiratory and digestive systems. Most of the expenditure was incurred in hospitals and, to a lesser extent, in primary healthcare institutions. Family health expenditure, especially on children aged 14 years and below, accounted for a relatively high proportion of the CCE.ConclusionSHA 2011 was used to capture data, which was then analysed according to the newly added beneficiary dimension. The findings revealed that the use of medical resources is low, the scale of primary medical institutions needs to be significantly expanded and there is a need to optimise the CCE financing scheme. Therefore, the health policymaking department should optimise the relevant policies and improve the efficiency of health services.
Translation and adaptation of the STOPP-START screening tool to Portuguese for detecting inappropriate prescriptions in older people: a protocol
Authors: Monteiro Luís , Monteiro-Soares Matilde , Mendonça Liliane Vélia , Ribeiro-Vaz Inês , Martins Carlos , Teixeira Andreia 
Published: June 2021

IntroductionRational prescribing for older adults is a challenge because they usually exhibit multimorbidity and multimedication. One available and reliable tool to tackle this issue consists of the Screening Tool of Older People’s Prescriptions (STOPP) and the Screening Tool to Alert to Right Treatment (START), which has been associated with improvements in clinical outcomes. Our goal here is to translate and validate the STOPP-START screening tool for use with Portuguese general practitioners/family physicians.Methods and analysisThe study will be conducted in four phases: phase I—translation of the STOPP-START screening tool to Portuguese; phase II—data collection of patient data; phase III—intrarater reliability and agreement study; and phase IV—inter-rater reliability and agreement study.Ethics and disseminationThis study was approved by the Ethics Committee of the Central Health Region of Portugal (where the study will take place). Every participant will sign a written consent form. We intend to publish the full article in a related peer-reviewed journal, conference presentations, reports and in a PhD thesis.
Thromboembolic risk stratification by TRiP(cast) score to rationalise thromboprophylaxis in patients with lower leg trauma requiring immobilisation: a study protocol of the casting stepped-wedge cluster randomised trial
Authors: Douillet Delphine , Riou Jeremie , Thoma Maximilien , Moumneh Thomas , Darsonval Astrid , Trinh-Duc Albert , Hugli Olivier , Chauvin Anthony , Penaloza Andrea , Roy Pierre-Marie 
Published: June 2021

IntroductionPatients with lower limb trauma requiring orthopaedic immobilisation may be at risk of venous thromboembolism but opinions differ about who may benefit from thromboprophylactic anticoagulant treatment.The aim of this CASTING study is to demonstrate the safety of thromboprophylaxis based on the Thrombosis Risk Prediction for patients with cast immobilisation (TRiP(cast) score with regards to the 3-month incidence of symptomatic venous thromboembolism events in low-risk patients not receiving thromboprophylaxis, as well as the usefulness of this strategy on the rate of patients receiving anticoagulant treatment in comparison to current practice.Methods and analysisCASTING will be a stepped-wedge cluster randomised controlled clinical trial, performed in 15 emergency departments in France and Belgium. With their informed consent, outpatients admitted to one of the participating emergency departments for a lower limb trauma requiring orthopaedic immobilisation without surgery will be included. All centres will begin the trial with the ‘observational period’ and, every 2 weeks, 1 centre will be randomly assigned to switch to the ‘interventional period’ and to apply the TRiP(cast) score, in which only patients with a score ≥7 will receive thromboprophylactic anticoagulant treatment. The primary endpoint is the rate of clinical thromboembolic events within 90 days following the inclusion of low-risk patients not receiving thromboprophylaxis.Ethics and disseminationThe protocol has been approved by the Comité de Protection des Personnes Sud I (Ethics Review ID-RCB: 2019-A01829-48) for France and the Comité d’éthique hôpital-facultaire Saint Luc (N° B403201941338) for Belgium. It is carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04064489.
Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic
Authors: Lamb Danielle , Gnanapragasam Sam , Greenberg Neil , Bhundia Rupa , Carr Ewan , Hotopf Matthew , Razavi Reza , Raine Rosalind , Cross Sean , Dewar Amy , Docherty Mary , Dorrington Sarah , Hatch Stephani , Wilson-Jones Charlotte , Leightley Daniel , Madan Ira , Marlow Sally , McMullen Isabel , Rafferty Anne-Marie , Parsons Martin , Polling Catherine , Serfioti Danai , Gaunt Helen , Aitken Peter , Morris-Bone Joanna , Simela Chloe , French Veronica , Harris Rachel , Stevelink Sharon A M , Wessely Simon 
Published: June 2021

ObjectivesThis study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April–June) of the COVID-19 pandemic in the UK.MethodsPreliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale.ResultsAnalyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse.ConclusionsOur findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.
Effect of Alternating Stray Current Density on Corrosion Behavior of X80 Steel under Disbonded Coating
Authors: Ding Qing-Miao , Qin Yong-Xiang , Shen Tao , Gao Yu-ning 
Published: June 2021

In this paper, the effect of alternating stray current (AC) density on the corrosion behavior of X80 steel under disbonded coating was studied by electrochemical methods, wire beam electrode (WBE) technology, and surface observation technology. The results showed that under the interference of different AC densities, the corrosion potential of X80 steel under disbonded coating underwent negative deviation, and the degree of negative deviation increased with the increase of AC density. The corrosion current density of X80 steel under disbonded coating with the action of 0~100 A/m2 AC density had few differences. While the corrosion current density of X80 steel with the action of 200~300 A/m2 AC density increased and the corrosion current density was higher than that under low AC density. The cathode area of the wire beam electrode under disbonded coating is mainly distributed outside and the edge of the gap between disbonded coating and X80 steel, while the anode area is mainly distributed inside the gap.
O bibliotecário em pauta na prática de contar histórias: uma atividade educativa incentivada nas bibliotecas escolares da Grande Vitória, Espírito Santo, Brasil
Authors: Miguel Marcelo Calderari , Carvalho Sandra Maria Souza de 
Published: June 2021

O ato de contar histórias acompanha a humanidade desde os primórdios e, essa trajetória impõe e vem estruturando novos âmbitos de atuação. Assim, o objetivo do estudo é analisar e compreender o ato de contar histórias na trajetória profissional de alguns bibliotecários escolares que atuam no Ensino Fundamental na região metropolitana de Vitória, Espírito Santo, Brasil (RMGV-ES). A articulação metodológica baseia-se no método da História de Vida e, retoma as narrativas profissionais e as examina numa abordagem sócio-interacionista. O resultado situa que a contação de histórias é uma manifestação que entrelaça a imaginação e a criação; e tal arte se apoiando muitas vezes em uma subjetividade transformadora que faz com que se mantenha viva e disseminada a memória comunicativa e cultural. Em síntese, na via da ação cultural, o ato de contar histórias reconstruí e ressignifica a conjuntura das práticas leitoras e, em geral, os entrevistados assinalam que o curso de graduação não os prepara para a realização dessas atividades. Nesse painel, sugerem os profissionais que o ato de contar histórias deve ser incluído no currículo dos cursos de biblioteconomia. Assim, a biblioteca escolar tem a incumbência de ser um orbe de conhecimento, flexibilidade cultural, exercício da cidadania e locus creationis – para múltiplas trocas e intervenções literárias. A conclusão situa que a ação de contar histórias traz significado e valor para o processo ensino-aprendizagem na educação, principalmente para alunos do ensino fundamental. Frisa-se que a biblioteca escolar e o bibliotecário, com a contação de histórias, auxiliam o desenvolvimento educacional e social do discente, estimulando o mundo da imaginação e o despertar de novos leitores.
Different Predictive Factors for Early Neurological Deterioration Based on the Location of Single Subcortical Infarction
Authors: Nam Ki-Woong , Kwon Hyung-Min , Lee Yong-Seok 
Published: June 2021

Background and Purpose:
Patients with single subcortical infarctions (SSIs) have relatively a favorable prognosis, but they often experience early neurological deterioration (END). In this study, we compared the predictors for END in patients with SSI according to the location of the lesion.

Methods:
We included consecutive patients with SSIs within 72 hours of symptom onset presenting between 2010 and 2016. END was defined as an increase of ≥2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 in the motor NIHSS score within the first 72 hours of admission. Along with the analysis of all patients with SSI, we also analyzed the predictors for END in proximal/distal SSI patients and anterior/posterior circulation SSI patients.

Results:
A total of 438 patients with SSI were evaluated. In multivariable analysis, initial NIHSS score (adjusted odds ratio, 1.36 [95% CI, 1.15–1.60]), pulsatility index (adjusted odds ratio, 1.25 [95% CI, 1.03–1.52]), parent artery disease (adjusted odds ratio, 2.14 [95% CI, 1.06–4.33]), and neutrophil-to-lymphocyte ratio (adjusted odds ratio, 1.24 [95% CI, 1.04–1.49]) were positively associated with END. In patients with proximal SSI, initial NIHSS score, pulsatility index, parent artery disease, and neutrophil-to-lymphocyte ratio showed positive associations with END. Meanwhile, no variable related to END was found in the distal SSI group. When we compared the predictors for END based on the involved vascular territory, higher initial NIHSS score and neutrophil-to-lymphocyte ratio were significantly associated with END in patients with anterior circulation SSIs. On the contrary, higher pulsatility index values and the presence of parent artery disease were independent predictors for END in patients with SSIs in the posterior circulation.

Conclusions:
Initial NIHSS score, pulsatility index, parent artery disease, and neutrophil-to-lymphocyte ratio are associated with END in patients with SSIs. The frequency and predictors for END differ depending on the location of the SSI.
Assessment of Extreme Precipitation Indices over Indochina and South China in CMIP6 Models
Authors: Tang Bin , Hu Wenting , Duan Anmin 
Published: June 2021

AbstractPrecipitation extremes over the Indochina and South China (INCSC) region simulated by 40 global climate models from phase 6 of the Coupled Model Intercomparison Project (CMIP6) were quantitatively assessed based on the skill score metrics of four extreme precipitation indices when compared with observational results from a high-resolution daily precipitation dataset for 1958–2014. The results show that it is difficult for most of the CMIP6 models to reproduce the observed spatial pattern of extreme precipitation indices in the INCSC region. The interannual variability of the extreme precipitation indices is relatively better simulated for South China than for Indochina. In general, most of the CMIP6 models perform better in South China compared with Indochina when taking both the simulations of spatial pattern and interannual variability into consideration. Only three models (EC-EARTH3, EC-EARTH3-Veg, and NorESM2-MM) can successfully reproduce both the spatial pattern and the interannual variability for the INCSC region. Through model ranking, the multimodel ensemble generated by a selection of the most skillful models leads to a more realistic simulation of the extreme precipitation indices both in South China and Indochina. Better simulation of the meridional wind component over South China and the water vapor convergence over Indochina can partly reduce the wet biases, resulting in a more realistic simulation of extreme precipitation indices over the INCSC region.
Revisiting the Ocean’s Nonisostatic Response to 5-Day Atmospheric Loading: New Results Based on Global Bottom Pressure Records and Numerical Modeling
Authors: Thomson Richard E. , Fine Isaac V. 
Published: June 2021

AbstractWe use bottom pressure records from 59 sites of the global tsunami warning system to examine the nonisostatic response of the World Ocean to surface air pressure forcing within the 4–6-day band. It is within this narrow “5-day” band that sea level fluctuations strongly depart from the isostatic inverted barometer response. Numerical simulations of the observed bottom pressures were conducted using a two-dimensional Princeton Ocean Model forced at the upper boundary by two versions of the air pressure loading: (i) an analytical version having the form of the westward propagating, 5-day Rossby–Haurwitz air pressure mode; and (ii) an observational version based on a 16-yr record of global-scale atmospheric reanalysis data with a spatial resolution of 2.5°. Simulations from the two models—consisting of barotropic standing waves of millibar amplitudes and near uniform phases in the Pacific, Atlantic, and Indian Oceans—are in close agreement and closely reproduce the observed bottom pressures. The marked similarity of the outputs from the two models and the ability of both models to accurately reproduce the seafloor pressure records indicate a pronounced dynamic response of the World Ocean to nonstationary air pressure fields resembling the theoretical Rossby–Haurwitz air pressure mode.
Modifiable and Nonmodifiable Factors Contributing to Hypothermia Among High Risk Neonates at Admission to NICU—A Prospective Observational Study
Authors: Sharma Deepak , Rao Praveen , Dinesh Pawale , Kulkarni Dattatray , Deshbotla Sai Kiran , Murki Srinivas 
Published: June 2021

Background: Hypothermia is a well-known contributor to neonatal morbidity and mortality, especially for preterm and low-birth weight neonates. Identifying the predictors for admission hypothermia which are specific to the settings is important to initiate quality improvement projects and improve clinical outcomes. Methods: Study was conducted over a period of 6 months from 1 April to 31 September 2018. All inborn infants needing neonatal intensive care unit (NICU) admission were eligible for the study. The study involved measuring temperatures at exit from delivery room (DR) and at admission to NICU. Hypothermia was defined as core admission temperature <36.5°C. The data collected included all modifiable and nonmodifiable risk factors for hypothermia in newborns. Data was analyzed using logistic regression to determine associations, if any, between admission hypothermia and maternal, neonatal, and environmental characteristics. Results: One hundred and ninety-three infants were enrolled in the study. The incidence of admission hypothermia (<36.5°C) was 83.9%. Forty-four (22.8%) infants had mild hypothermia, 61.1% infants had moderate hypothermia, and none of the neonates had severe hypothermia. Nonmodifiable factors affecting admission temperature were birth weight/gestational age and mother’s temperature before shifting to DR. DR temperature strongly predicted the admission temperature and every 1°C increase in DR temperature improved the rate of admission hypothermia by 34%. Conclusion: Significant proportion of neonates is hypothermic at the time of admission to NICU. DR temperature significantly predicts hypothermia at admission in neonates needing NICU admission.
Intravascular Ultrasound Assessment and Correlation With Angiographic Findings of Arterial Dissections Following Auryon Laser Atherectomy and Adjunctive Balloon Angioplasty: Results of the iDissection Auryon Laser Study
Authors: Shammas Nicolas W. , Torey James T. , Shammas W. John , Jones-Miller Susan , Shammas Gail A. 
Published: June 2021

Background Femoropopliteal arterial angiographic dissections with the use of the Auryon laser atherectomy system (previously the B-laser) have been infrequent and non–flow limiting. However, the pattern of these dissections (depth and arc) using intravascular ultrasound remains unknown. Materials and Methods We prospectively enrolled 29 patients in the iDissection Auryon study. The primary objective was to define the occurrence of new adventitial injury with intravascular ultrasound (IVUS). Secondary objectives included distal embolization and bailout stenting as judged by the operator because of 30% or more residual narrowing and/or NHLBI (National Heart, Lung, and Blood Institute) angiographic dissection C and higher. Core laboratory analysis was carried on all cases except for 1 patient (that crossed over to Jetstream atherectomy). Dissections were classified according to the iDissection classification as involving the intima (A), media (B), and adventitia (C) and ≤ 180-° arc (1) or >180-° arc (2). Overall, 22 of 29 patients had an embolic filter (per protocol). Results Median lesion and treated lengths were 100.0 and 150.0 mm, respectively. Vessel diameter by IVUS was 6.5 ± 1.5 mm. Chronic total occlusion (CTO) was present in 24.1% of cases. The arc of calcium was: no calcium in 27.6%, <90° in 13.8%, 90° to 180° in 20.7%, and >180° in 34.4%. Lesion severity was reduced to a median of 14% post laser and adjunctive percutaneous transluminal angioplasty (PTA) from a baseline of 76%. Bailout stenting occurred in 6 of 28 (21.4%) patients (3 for dissections, 2 for residual >30%, and 1 for both) and primary stenting in 1 of 28 (3.6%). By IVUS, there were 9 new dissections post laser (1 adventitial; 3≥180°) and 21 new dissections post laser and PTA (3 adventitial; 1≥180°). No distal embolization requiring treatment was seen and no macrodebris ≥2 mm was recovered in the filters. Conclusion The Auryon laser atherectomy system had minimal rate of adventitial injury despite complex disease with relatively low bailout stent rate and no clinically significant macrodebris.