bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to Patients’ Access to New Medicines in Greece: Evaluation of Health Technology Assessment (HTA) Process from July 2018 until January 2021.
Authors: Kourlaba Georgia , Beletsi Alexandra 
Published: July 2021

Abstract
Background: To present the outcome of the Health Technology Assessment (HTA) process in Greece from its onset back in July 2018 till January 2021 and to quantify the median time from marketing authorization (MA) to listing especially for new medicines. Methods: All products included in the reimbursement positive list from July 2018 to January 2021, were identified through the relevant Ministerial Decisions (MDs) posted on the website of the Ministry of Health (MoH) and the Positive Reimbursement Lists issued this period. The following information were collected for these medicines: date that MDs and Positive Reimbursement lists were issued, the legal basis of the initial MA, the MA date, the date of price registration, and the type of the HTA application. The time from MA to listing was calculated. Results: During the study period, 38 MDs were issued from which 35 (92%) were positive and resulted in the inclusion of 318 medicines and 3 (8%) were negatives that excluded 6 medicines. Focusing on new medicines, the median time from MA to listing was found to be 30 months with an interquartile range of 22 to 39 months. This time was statistically significantly shortened for FDC [19.3 (13-35) months], compared to biosimilars [26 (22-35) months, p=0.09] and on patent [38.5 (29-44) months, p=0.008]. For new generics, the corresponding median time was 22 (IQR: 12.5-31) months, statistically significantly lower than that of new medicines (p=0.028). Focusing on the four most common therapeutics areas, the median (IQR) time from MA to listing for new medicines was 28.3 (24.9–32.9) months and 34.9 (21.9-41.1) months, for oncologic and immunosuppressants (p=0.136), respectively, while on the field of cardiovascular and CNS there was no reimbursement of new active substances during the study period. Conclusions: This study showed that it takes a long time for Greek patients to get access to newly registered medicines. Given that the delay in access might result in potential loss of many life years, actions should be taken by policy makers to speed up patients access to new and innovative medicines.
Effectiveness of Double-hit Model (Post-weaning Social Isolation and NMDA Receptor Antagonist) in the Development of Schizophrenic Like Symptoms on Rodents: A Protocol for a Systematic Review.
Authors: Shangase Khanyiso Bright , Magwai Thabo , Oginga Fredrick Otieno , Xulu Khethelo Richman , Mpofana Thabisile 
Published: July 2021

Abstract
BackgroundSchizophrenia is a heterogeneous neuropsychiatric disorder, categorized by positive, negative, and cognitive symptoms. In trying to improve diagnosis and treatment of schizophrenia researchers have turn to “dual hit” models of schizophrenia that are able to reproduce all symptoms of the disorder. The main objective of this protocol is to present a transparent process on how we plan to review the existing international literature on effectiveness of “dual hit” models used to induce schizophrenia on rodents. MethodsLiterature search strategies will be developed using medical search headings (MeSH). The MEDLINE (PubMed), EMBASE, and Google Scholar databases will be used to search for published studies electronically. We will search for studies involving inducing schizophrenic symptoms using “dual hit” rodent model (post-weaning social isolation and NMDA receptor antagonist). Studies will be screened by titles, abstracts, keywords, and synonyms followed by identifying the full-text articles. All studies that will pass the quality assessment will be included. Data will be extracted by two authors independently and in duplicate, from each eligible study in ensuring that there is consistency between reviews. If the design and comparator are sufficiently homogenous for all studies, meta-analysis will be conducted using a random-effect model.DiscussionThe results of this review will contribute in the development of new “dual hit” models that will be able to characterize schizophrenia symptoms better. It will also shed light to researchers on new developments that need to be made in improving animal models of schizophrenia.Systematic reviews registrationPROSPERO CRD42021247585
Effect of Injection Timing In Reducing The Harmful Pollutants Emitted From CI Engine Using N-Butanol Antioxidant Blended Eco-Friendly Mahua Biodiesel
Authors: Chellakumar Isaac JoshuaRamesh Lalvani Joshua Stephen , V Elumalai P , Parthasarathy M 
Published: July 2021

Abstract
Consuming non-renewable energy sources has genuine and long-standing unfavorable consequences on people’s health, neighborhood networks and ecosystems, and also on the worldwide atmosphere. The burgeoning demand and use of diesel engines in various fields cause emission of exhaust gases like NOx and CO that lead to serious environmental pollution and hazards like global warming, respiratory problems, and so on, has necessitated a reduction in the use of diesel and addition of suitable biodiesel. Mahua biodiesel blend has also been considered as a safe renewable fuel for conventional engines. This is due to its desirable properties such as rapid growth rate, higher productivity, and the ability to utilize CO2 into fuel. The introduction of an antioxidant, preferably n-butanol eliminates these harmful emissions from the diesel engine. In this experimental investigation, mahua biodiesel blend mixed with n-butanol has been used as test fuel in a conventional engine. Because of the special character n-butanol has been chosen for use with the mahua biodiesel blend. About 20–30 vol.% of n-butanol has been blended with 80 vol.% of diesel and tested. The manufacturer set injection timing was 23oCA bTDC. The injection timing is preferably between 21oCA bTDC and 25oCA bTDC. Nitrogen oxides and carbon monoxide are reduced by 49 percent and 5.88 percent, respectively, when a blend of B20 + D80 + 30% n-butanol is used at 21oCA bTDC relative to diesel fuel. The smoke and hydrocarbon emission of blend B20 + D80 + 30% n-butanol at 25oCA bTDC is reduced by 40% and 38.07%, respectively, related to diesel. The brake thermal efficiency for entire injection timing has been identified to be increased correlated to all other test blends. The brake thermal efficiency in blend B20 + D80 + 30% n-butanol of 25oCA bTDC is increased by 15.30%, when compared with diesel fuel. These promising results assure that mahua biodiesel blend containing antioxidant would be eco-friendly fuel.
Digital Detection of Sarcopenia in Pancreatic Cancer: Additional Utilization to Plan Patient Management
Authors: Jalal Mustafa , Campbell Jennifer A , Wadsley Jonathan , Hopper Andrew D 
Published: July 2021

Abstract
Purpose: The presence of a sarcopenia adversely affects the prognosis of patients with pancreatic cancer. There is an emerging role for using computed tomography (CT) to calculate skeletal muscle index (SMI) and the presence of sarcopenia. The aim of this study was to assess if detecting ‘digital sarcopenia’ is feasible and can contribute to the management of patients with locally advanced pancreatic cancer (LAPC).Methods: Patients diagnosed with LAPC referred for endoscopic ultrasound guided biopsy (EUS-B) by our regional cancer network were identified. Age, body mass index (BMI), and Eastern Cooperative Oncology Group performance status (ECOG-PS) was noted. CT images were analysed for SMI and the presence of sarcopenia. Decision outcomes on receiving chemotherapy or not were collected from the regional oncology database. Results: In total 51/204 (25%) patients with LAPC who underwent EUS-B were not given chemotherapy and received BSC only. The prevalence of sarcopenia (p=0.0003), age ≥ 75 years old (p=0.03) and ECOG-PS 2-3 (p=0.01) were significantly higher in the patents receiving BSC only. Logistic regression analysis demonstrated that SMI was the only independent associated factor identifying patients with LAPC who were treated with BSC only and not chemotherapy after adjusting for age and ECOG-PS. Conclusion: Our study has shown that digital skeletal muscle analysis at the time of a diagnostic CT for patients with pancreatic cancer is feasible and can detect sarcopenia and malnourished patients who are much less likely to take up chemotherapy. These patients could be triaged to oncology assessment prior to EUS-B to avoid unnecessary investigations.
Can we scale up a comprehensive school-based eye health programme in Zambia?
Authors: Yong Ai Chee , Buglass Anne , Mwelwa Godfrey , Abdallah Ibrahim , Chan Ving Fai 
Published: July 2021

Abstract
Background

Globally, 19 million children have preventable vision impairment simply because refractive and eye health services are inaccessible to most of them. In Zambia, 50,000 school children need spectacle provision. The School-based Eye Health Programme (SEHP) has been identified worldwide as a proven strategy to address childhood blindness. Given the great benefits of it, the Zambian government intends to scale up the programme. This scalability assessment aims to identify and evaluate the essential components of an effective SEHP, determine roles, assess existing capacities within user organisations, identify environmental facilitating and inhibiting factors, and estimate the minimum resources necessary for the scaling up and their proposed scale-up strategies.
Methods

Five elements (innovation, user organisation, resource team, environment, and strategies for horizontal and vertical scaling-up) were assessed guided by the ExpandNet-WHO Nine Steps for Developing a Scaling-Up Strategy. Literature reviews and stakeholders' interviews were conducted to collect data for this assessment. Subsequently, twenty questions in the Worksheets for Developing a Scaling-up Strategy were used to systematically reporting the assessment outcome.
Results

Additional components of SEHP incorporated in Zambia's model enhanced the innovation's credibility and relevance. The resource team was relatively competent in the pilot, and the same team will be employed during the scaling-up. Political instability, the lack of supply chain, and unstable financial supports were identified as inhibiting factors. The objectives of SEHP were aligned with the National Eye Health Strategic Plan 2017–2021 that support the institutionalisation of the SEHP into the existing School Health and Nutrition Programme. For the pace of expansion, replicating SEHP to another district rather than a province will be more realistic.
Conclusion

Scaling up a comprehensive SEHP in Zambia is feasible, provided if sufficient funding is available. Additionally, the pace must be adapted to the local context to ensure that every component within the SEHP is intact.
Determining the safety and effectiveness of Tai Chi: A critical overview of 210 systematic reviews of controlled clinical trials
Authors: Yang Guo-Yan , Hunter Jennifer , Bu Fan-Long , Hao Wen-Li , Zhang Han , Wayne Peter M , Liu Jian-Ping 
Published: July 2021

Abstract
Background: This overview aims to critically appraise the best available systematic review (SR) evidence on the health effects of Tai Chi. Methods: Nine databases (English and Chinese languages) were searched for SRs of controlled clinical trials of Tai Chi interventions published between Jan-2010 and Dec-2020 in any language. Excluded were primary studies and meta-analyses that combined Tai Chi with other interventions. To minimise overlap, effect estimates were extracted from the most recent, comprehensive, highest quality SR for each population, condition, and outcome. SR quality was appraised using AMSTAR 2 and effect estimates with GRADE.Results: Of the 210 included SRs, 193 only included randomised controlled trials, one only included non-randomised studies of interventions, and 16 included both. The most common conditions were neurological (18.6%), falls/balance (14.7%), cardiovascular (14.7%), musculoskeletal (11.0%), cancer (7.1%) and diabetes mellitus (6.7%). Except for stroke, no evidence for disease prevention was found, instead proxy-outcomes/risks factors were evaluated. 114 effect estimates were extracted from 37 SRs (2 high quality, 6 moderate, 18 low, and 11 critically low), representing 59,306 adults. Compared to active and/or inactive controls, a clinically important benefit from Tai Chi was reported for 66 effect estimates; 53 reported an equivalent or marginal benefit, and 6 an equivalent risk of adverse events. Eight effect estimates (7.0%) were graded as high certainty evidence, 43 (37.7%) moderate, 36 (31.6%) low, and 27 (23.7%) very low. This was due to concerns with risk of bias in 92 (80.7%) effect estimates, imprecision in 43 (37.7%), inconsistency in 37 (32.5%) and publication bias in 3 (2.6%). SR quality was limited by the search strategies, language bias, inadequate consideration of clinical, methodological and statistical heterogeneity, poor reporting standards, and/or no registered protocol. Conclusions: The findings suggest Tai Chi has multisystem effects with physical, psychological, and quality of life benefits for a wide range of conditions, including individuals with multiple health problems. Clinically important benefits were most consistently reported for Parkinson’s disease, falls risk, knee osteoarthritis, low back pain, cardiovascular diseases including hypertension, and stroke. Notwithstanding, for most conditions, higher quality primary studies and SRs are required.
The Characteristics of Husbands and Violence Against Women in Wuhan, China: A Cross-sectional Study
Authors: Chang Xuening , Yang Yifan , Ruizhen Li 
Published: July 2021

Abstract
Objective. To understand the prevalence of domestic violence (DV) in Wuhan, China, to explore the correlation between domestic violence and husbands. Methods. A cross-sectional study was conducted in a community health center in Wuhan from June 2015 to December 2015. Participants were 1015 women who came to the center for gynecological examination. They were assessed using WHO violence against women instrument to evaluate the prevalence of domestic violence. Chi-square test, Wilcoxon rank test and unadjusted and adjusted logistic regression analysis were used to analyze the possible risk factors of domestic violence. Results. The prevalence of domestic violence was 29.36% (298/1015). The risk factors included heavy physical labor (OR=3.56, 95%CI:1.63~7.78), long-term drinking (OR=1.61, 95%CI:1.20~2.16), overweight or obesity (OR=1.38, 95%CI:1.02~1.88) and long-term smoking (OR=1.02, 95%CI:1.01~1.04). Protective factors were higher education (OR=0.78, 95%CI: 0.66-0.93). Conclusion. The prevalence of domestic violence in women from Wuhan, China was common. We might decrease the occurrence of the possible risk factors of domestic violence to control it.
Sphingomonas and Phenylobacterium As Major Microbiota in Thymic Epithelial Tumors
Authors: Higuchi Rumi , Goto Taichiro , Hirotsu Yosuke , Otake Sotaro , Oyama Toshio , Amemiya Kenji , Ohyama Hiroshi , Mochizuki Hitoshi , Omata Masao 
Published: July 2021

Abstract

Background
Microbiota has been reported to be closely associated with carcinogenesis and cancer progression. However, its involvement in the pathology of thymoma remains unknown. In this study, we aimed to identify thymoma-specific microbiota using resected thymoma samples.
Methods
Nineteen thymoma tissue samples were analyzed through polymerase-chain-reaction amplification and 16S rRNA gene sequencing. The subjects were grouped according to histology, driver mutation status in the GTF2I gene, PD-L1 status, and smoking habits. To identify the taxa composition of each sample, operational taxonomic units (OTUs) were classified on the effective tags with 97% identity. The Shannon index of the 97% identity OTUs was calculated to evaluate alpha diversity. The linear discriminant analysis effect size (LEfSe) method was used to compare the relative abundances of all bacterial taxa.
Results
We identified 107 OTUs in the tumor tissues, which were classified into 26 genera. Sphingomonas and Phenylobacterium were identified as abundant genera in almost all samples. No significant difference was determined in the alpha diversity within these groups; however, type A thymoma exhibited higher bacterial diversity than type B thymoma. Through LEfSe analysis, we identified the following differentially abundant taxa: Bacilli, Firmicutes, and Lactobacillales in type A thymoma; Proteobacteria in type B thymoma; Gammaproteobacteria in tumors harboring the GTF2I mutation; and Alphaproteobacteria in tumors without the GTF2I mutation.
Conclusions
Sphingomonas and Phenylobacterium were identified as dominant genera in thymic epithelial tumors. These genera appear to comprise thymoma-specific microbiota involved in tumor progression; thus, they could serve as targets for the prevention of thymoma.
Development and Validation of an Equation to Predict the Incidence of Coronary Heart Disease in Patients with Type 2 Diabetes in Japan
Authors: Yamashita Yasunari , Inoue Gaku , Nozaki Yoichi , Kitajima Rina , Matsubara Kiyoshi , Horii Takeshi , Mohri Junichi , Atsuda Koichiro , Matsubara Hajime 
Published: July 2021

Abstract
Objective: In the diabetes treatment policy after the Kumamoto Declaration 2013, it is difficult to accurately predict the incidence of complications in patients using the JJ risk engine. This study was conducted to develop a prediction equation suitable for the current diabetes treatment policy using patient data from Kitasato Institute Hospital (Hospital A) and to externally validate the developed equation using patient data from Kitasato University Hospital (Hospital B). Outlier tests were performed on the patient data from Hospital A to exclude the outliers. Prediction equation was developed using the patient data excluding the outliers and was subjected to external validation.Results: By excluding outlier data, we were able to develop a new prediction equation for the incidence of coronary heart disease (CHD) as a complication of type 2 diabetes, incorporating the use of antidiabetic drugs with a high risk of hypoglycemia. This is the first prediction equation in Japan that incorporates the use of antidiabetic drugs. We believe that it will be useful in preventive medicine for treatment for people at high risk of CHD as a complication of diabetes or other diseases. In the future, we would like to confirm the accuracy of this equation at other facilities.
Salicylic Acid Increases Photosynthesis of Drought Grown Mustard Plants Effectively with Sufficient-N via Regulation of Ethylene, ABA and Nitrogen-Use Efficiency
Authors: Iqbal Noushina , Fatma Mehar , Gautam Harsha , Sehar Zebus , Rasheed Faisal , Khan M.I.R. , Sofo Adriano , Khan Nafees 
Published: July 2021

Abstract
An essential approach to reduce drought in plants is to maximize the use of most limited resources. The increase in water-use efficiency (WUE) is important to maximally utilize the available water to increase photosynthesis and growth of plants under water-deficit stress. Both WUE and photosynthetic nitrogen use efficiency (PNUE), as the indices of resource-use efficiency were studied in mustard (Brassica juncea L.) plants grown under limited water conditions with low-N (100 mg N kg−1 soil) and sufficient-N (200 mg N kg− 1 soil) N and sprayed with 0- and 0.5 mM salicylic acid (SA). Application of SA increased water potential, osmotic potential, WUE and incorporation of soil N into photosynthetic machinery by enhancing PNUE. It also increased photosynthesis of plants maximally by increasing stomatal conductance and intercellular CO2 concentration under water-deficit stress. This increase was greater in the presence of sufficient-N where 0.5 mM SA maximally enhanced the N-metabolism, redox ratio that mitigated the oxidative stress. The application of SA on plants supplemented with N reduced ethylene and abscisic (ABA) synthesis. It could be inferred that SA enhanced N utilization at its optimal level to maintain redox ratio and inhibit ABA-mediated stomatal closure to enhance the resource utilization and photosynthesis. SA also enhanced glucose utilization which prevented photosynthetic repression by enhanced glucose under stress. Thus, SA application may impart a potential management tool for increasing photosynthetic NUE, WUE and photosynthesis under drought.
Distribution of Hepatitis B Genotypes Among Hepatitis B Patients Visiting Decode Genomics Research Center
Authors: Pandey Gaurab , Bogati Bibek , Shrestha Sangam 
Published: July 2021

Abstract
The hepatitis B virus (HBV) is non-cytopathic, hepatotropic and enveloped virus which causes Hepatitis B and infects the liver causing inflammation and hepatocellular necrosis. The genome sequence database shows that HBV has ten genetic diversities (A-J) ten in which the HBV genotypes, I and J are the new one. Three major genotypes of HBV (A, C and D) were found in Nepal. Despite being a low prevalence, Nepal has a diversity of hepatitis B. Hence, the study aims to determine the distribution of hepatitis B genotypes among the hepatitis B patients visiting Decode Genomics Research Center. HBV genotypes were determined by using a simpler, more rapid, and more specific genotyping system for HBV involving PCR using type-specific primers. Our study showed that different HBV genotypes were identified in which genotype D to be predominant one followed by C and also showed presence of genotype A, B and F. Many recombinant genotypes were also present in our study.
Forecasting China’s food grain demand 2021-2050 with attention to balanced dietary and fertility policies
Authors: Liu Xiuli , Dou Yuxing , Guan Dabo , He Geoffrey J.D. , Wang Shouyang 
Published: July 2021

Abstract

The estimation of China's future food grain demand has become vital input for designing grain security measures. Addressing the population's age-gender and urban-rural structures under three fertility policies scenarios together with concerns for balanced diets, we established a multi-factor driven model to forecast China's food grain demand (including staple food grain and feed grain) during 2021-2050. The three scenarios are as follows; the two-child fertility policy for couples when either the husband or the wife is from a single-child family (scenario 1); universal two-child policy (scenario 2), and no limitations on the number of children (scenario 3). The results show that in scenario 3, China's food grain demand would peak in 2030 at about 329.3 million tons, about 3.7 million tons higher than that in scenario 2, and 104.7 million tons lower than that estimated with the traditional per capita method. These findings indicate that the demographic transition for fertility policy adjustment is not the main impacting factor of China's food grain security from 2021 to 2050. We might overestimate food grain demand by about 15 percent if we ignored each age-gender and urban-rural structure of the population. Then it may lead to an oversupply of grain and accumulation of stocks, which would generate about 1 billion RMB annual inventory cost burden. An important complement to the demographic strategy would come from the adoption of the proposed Dietary Guideline for Chinese Residents (2019). It can make people much healthier and save about 7.5 percent of China's food grain consumption, reducing the pressure scarce supplies of water and land in the country.