bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equity analysis of Chinese physician allocation based on Gini coefficient and Theil index
Authors: Yu Huimin , Yu Shuangyan , He Da , Lu Yuanan 
Published: May 2021

Abstract
Background
Unequal allocation of medical physician resource represents one of major problems in the current medical service management in China and many other countries. This study is designed to analyze the current distribution of physicians in 31 provincial administrative regions in China, to estimate the fairness of the distribution of physicians and provide a theoretical basis for the improvement of the allocation of physicians.

Methods
This study took physicians from 31 provincial administrative regions in China as the study objects, and the data were obtained from the China Health Statistics Yearbook 2019 and the official website of the National Bureau of Statistics of China. Calculation of the Gini coefficient (G) and the Theil index (T) were carried out by drawing the Lorenz curve. The fairness of present physician location in 31 provincial administrative regions in China was analyzed from the perspective of distribution by both population and service area.

Results
The Gini coefficients of medical physicians in China are 0.003 and 0.88 by population and by service area, respectively. This shows that the distribution of medical physicians is fair basing on population, and there is little difference in the number of physicians per 1000 population in different regions. However, the physician distribution basing on service area is highly unfair and shows a large gap in the number of physicians per square kilometer between different regions. In general, Beijing, Zhejiang, Shanghai, Jiangsu, Shandong, and Tianjin are higher than the overall level of 31 provincial administrative regions. In addition, the number of medical physicians in Zhejiang, Shandong, Beijing and Jiangsu is over-provisioned.

Conclusion
Bridging the number of medical physicians in different regions is a key step to improve the equity of physicians’ resource allocation. Thus, findings from this study emphasize the need to take more measures to reduce physician quality differences between regions, balance and coordinate medical resources. This will increase the access of all citizens to quality medical services.
The effects of webcams on German neonatal intensive care units – study protocol of a randomised crossover trial (Neo-CamCare)
Authors: Scholten Nadine , Bretthauer Sebastian , Eilermann Kerstin , Hagemeier Anna , Hellmich Martin , Hoffmann Jan , Horenkamp-Sonntag Dirk , Jannes Christiane , Kuntz Ludwig , Mantell Pauline , Mause Laura , Müller Andreas , Reimer Alinda , Samel Christina , Spiecker genannt Döhmann Indra , Wobbe-Ribinski Stefanie , Woopen Christiane , Dresbach Till 
Published: May 2021

Abstract
Background
The separation of parents and their prematurely born children during care in a neonatal intensive care unit (NICU) can have far-reaching consequences for the well-being of the parents and also of the children. The aim of this study is to evaluate the use of webcams on NICUs and to conduct a systematic assessment of their possible effects on parents and clinical staff. In addition, it aims at determining the need for webcams in German NICUs and to identify possible barriers and moderators. The development and evaluation of practical guidance for the use of webcams will enable the comprehensive education of clinical staff and parents and, as a result, is intended to mitigate any potential undesirable consequences.

Methods
The study will be based on a mixed methods approach including all groups concerned in the care. Qualitative data will be collected in interviews and focus groups and evaluated using content analysis. The collection of quantitative data will be based on written questionnaires and will aim to assess the status quo as regards the use of webcams on German NICUs and the effects on parents, physicians, and nursing staff. These effects will be assessed in a randomised cross-over design. Four NICUs will be involved in the study and, in total, the parents of 730 premature babies will be invited to take part in the study. The effects on the nursing staff, such as additional workload and interruptions in workflows, will be evaluated on the basis of observation data.

Discussion
This study will be the largest multicentre study known to us that systematically evaluates the use of webcams in neonatal intensive care units. The effects of the implementation of webcams on both parents and care providers will be considered. The results provide evidence to decide whether to promote the use of webcams on NICUs or not and what to consider when implementing them.

Trial registration
The trial has been registered at the German Clinical Trial Register (DRKS). Number of registration: DRKS00017755, date of registration: 25.09.2019,
Design and preliminary evaluation of a newly designed patient-friendly discharge letter – a randomized, controlled participant-blind trial
Authors: Smolle Christian , Schwarz Christine Maria , Hoffmann Magdalena , Kamolz Lars-Peter , Sendlhofer Gerald , Brunner Gernot 
Published: May 2021

AbstractBackgroundLow health literacy has been associated with poor health outcome and impaired use of healthcare services. The hospital discharge letter represents a key source of medical information for patients and can be used to address the problem of low health literacy. The aim of this project was to develop and evaluate a new, patient-directed, version of the discharge letter.MethodsBased upon two conventional discharge letters (CDL; one surgical and one medical letter), two new, patient-friendly discharge letters (PFDL) were designed following 5 key principles: short sentences, few abbreviations, large font size, avoidance of technical terms and no more than 4 pages length. Medical undergraduates were randomized into two blinded groups (CDL, PFDL) and asked to assess the assigned letter for the 3 domains structure, content and patient-friendliness. Subsections were rated on a 6-point Likert scale (1 = completely agree, 6 = completely disagree), the results of the survey were compared using the Mann-Whitney-U-Test with a p < 0.05 being the level of significance.ResultsIn total, 74 undergraduates participated in this study. PFDL (35 participants) were rated significantly better than CDL (39 participants) regarding structure (median 1 vs. 2, p = 0.005), content (1 vs. 3, p < 0.001) and patient-friendliness (2 vs. 6, p < 0.001). Of all 17 subsections, PFDL were rated significantly better in 12 cases, and never worse than CDL.ConclusionsPFDL were rated significantly better than their CDL counterparts. Medical undergraduates were considered the ideal cohort, not being medical lays and yet unbiased regarding everyday clinical practice procedures. Further tests evaluating the impact of the PFDL on patient comprehension and health literacy are necessary.
Relationship between long non-coding RNA PCAT-1 expression and gefitinib resistance in non-small-cell lung cancer cells
Authors: Wang Shaojia , Liu Chao , Lei Qing , Wu Zhengwei , Miao Xiangshuai , Zhu Debing , Yang Xu , Li Na , Tang Mingwei , Chen Yan , Wang Weiwei 
Published: May 2021

Abstract
Background
Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, has been used as first-line treatment for advanced non-small-cell lung cancer (NSCLC). However, during treatment, cancer cells often develop resistance to gefitinib, the mechanisms of which are not fully understood. This study was designed to elucidate the expression and role of long non-coding RNA (lncRNA)-PCAT-1, a potential biomarker for drug resistance and a therapeutic target for NSCLC, in gefitinib resistance in NSCLC cells.

Methods
In this study, we verified differential PCAT-1 expression in NSCLC gefitinib-resistant tissues or cells. PCAT-1 knockdown, clone formation, Transwell, flow cytometry, and immunofluorescence assays were used to verify the correlation between PCAT-1 and gefitinib sensitivity. A nude mouse tumor-bearing model verified that PCAT-1 can reverse gefitinib resistance in vivo. Then, a PI3K/Akt agonist was used to verify the possible mechanism of PCAT-1 action.

Results
PCAT-1 is highly expressed in gefitinib-resistant NSCLC tissues and cells. PCAT-1 knockdown enhanced gefitinib sensitivity and gefitinib-induced apoptosis in H1299/GR cells. PCAT-1 knockdown reduced tumor volume and weight, and reversed acquired gefitinib resistance in vivo. PCAT-1 knockdown inhibited AKT and GSK3 phosphorylation in H1299/GR cells. A PI3K/AKT agonist reversed PCAT-1 knockdown-mediated enhancement of gefitinib sensitivity in H1299/GR cells

Conclusion
PCAT-1 knockdown improves sensitivity to gefitinib by inhibition of AKT and GSK3 phosphorylation in NSCLC. PCAT-1 is as potential target for improving the clinical efficacy of gefitinib.
Conventional suture with prolonged timing of drainage is as good as quilting suture in preventing seroma formation at pectoral area after mastectomy
Authors: Huang Juan , Wang Shouman , Wu Yuhui , Hai Jian , Mao Jie , Dong Xue , Xiao Zhi 
Published: May 2021

Abstract
Background
The aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph node biopsy (SLN) or axillary lymph node dissection (ALND) for breast cancer.

Methods
Three hundred and eighty-eight consecutive breast cancer patients were retrospectively analyzed and categorized into three groups. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13–15 days drainage in situ, and group 3 with conventional suture and 20–22 days drainage. The primary outcome was the incidence of grades 2 and 3 seroma at anterior pectoral area within 1 month postoperatively. Cox regression was used for analysis.

Results
The incidence of grades 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late grades 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index, and hypertension were independent risk factors for grades 2 and 3 seroma.

Conclusions
Prolonged timing of drainage to 13–15 days in conventional suture was long enough to decrease the incidence of grades 2 and 3 seroma as lower as that in quilting suture group at pectoral area within 1 month after mastectomy.
Deconvolution of sarcoma methylomes reveals varying degrees of immune cell infiltrates with association to genomic aberrations
Authors: Simon Malte , Mughal Sadaf S. , Horak Peter , Uhrig Sebastian , Buchloh Jonas , Aybey Bogac , Stenzinger Albrecht , Glimm Hanno , Fröhling Stefan , Brors Benedikt , Imbusch Charles D. 
Published: May 2021

Abstract
Background
Soft-tissue sarcomas (STS) are a heterogeneous group of mesenchymal tumors for which response to immunotherapies is not well established. Therefore, it is important to risk-stratify and identify STS patients who will most likely benefit from these treatments.

Results
To reveal shared and distinct methylation signatures present in STS, we performed unsupervised deconvolution of DNA methylation data from the TCGA sarcoma and an independent validation cohort. We showed that leiomyosarcoma can be subclassified into three distinct methylation groups. More importantly, we identified a component associated with tumor-infiltrating leukocytes, which suggests varying degrees of immune cell infiltration in STS subtypes and an association with prognosis. We further investigated the genomic alterations that may influence tumor infiltration by leukocytes including RB1 loss in undifferentiated pleomorphic sarcomas and ELK3 amplification in dedifferentiated liposarcomas.

Conclusions
In summary, we have leveraged unsupervised methylation-based deconvolution to characterize the immune compartment and molecularly stratify subtypes in STS, which may benefit precision medicine in the future.
Chemical compositions, antimicrobial effects, and cytotoxicity of Asia minor wormwood (Artemisia splendens Willd.) growing in Iran
Authors: Heshmati Afshar Fariba , Zadehkamand Masumeh , Rezaei Zahra , Delazar Abbas , Tarhriz Vahideh , Asgharian Parina 
Published: May 2021

Abstract
Background
Artemisia splendens from the Asteraceae family is a new source of biologically active compounds. The current study investigated to evaluate antimicrobial and cytotoxicity activity of methanolic extracts and their fractions obtained from aerial parts by agar disk diffusion and MTT methods, respectively. The active fractions were subjected to preparative HPLC for isolating the pure compounds, which were structurally elucidated, by 1H and 13C NMR.

Results
The results showed that the methanolic extract and its 60% SPE fraction have the anti-proliferative activity on A549 cell line in comparison with the control group. Meanwhile, the methanolic extract and its 40% SPE fraction can inhibit the growth of Gram-positive strains as anti-microbial activity. The 60% SPE fraction also illustrated anti-proliferative activity on the HT-29 cell line compared to the control group. Chromatographic separations via preparative HPLC yielded 5 flavonoids and three flavonoid glycosides.

Conclusion
Based on the results it can be concluded that A. splendens as a potential source of cytotoxic and antimicrobial compounds can be used in pharmaceutics.
How the pandemic has affected Turkish housing affordability: why the housing running cost is so important
Authors: Emekci Seyda 
Published: May 2021

AbstractThe housing affordability problem in Turkey is not new. With the pandemic increasing pressure on the economy, the issue of housing affordability problem has reached an alarming level. The problem has been deepened not only as a result of the pandemic but also due to the incomplete and wrong policies from the past. This paper on the one hand aims to examine how the pandemic has exacerbated the problem; on the other hand, it purposes to reveal that the problem has been handled incorrectly and how weaknesses in the policy strategies contribute to this problem through a case study of the low-income group. The article also focuses on how architects can contribute to solving this problem.
Science teachers’ experiences of inquiry-based learning through a serious game: a phenomenographic perspective
Authors: Lameras Petros , Arnab Sylvester , de Freitas Sara , Petridis Panagiotis , Dunwell Ian 
Published: May 2021

AbstractThis study employed a phenomenographic approach to investigate science teachers’ conceptions of inquiry-based learning through a serious game. Simaula is a prototype game designed and used as a virtual practicum for eliciting understandings on how in-game inquiry was appeared to, or experienced by, the participating teachers. Group interviews with 20 secondary education science teachers revealed four qualitatively different ways of experiencing inquiry-based learning through Simaula: (a) as uncovering insights about student’s learning needs, interests and emotions; (b) as generating ideas and concepts for meaningful inquiry; (c) as a set of operations for designing and carrying out scientific research; and (d) as authentic inquiry for enabling knowledge building processes. Seven dimensions of variation have been identified viewed as contextual influences on conceptions of in-game inquiry constituting discernment of: epistemic inquiry-based learning modes; role of teacher; role of student; game-play focus; core mechanics focus; feedback and progress mechanics and game uncertainty. The results illuminated a partial in-game inquiry approach with distinct epistemic modes from developing empathy and meaning making to knowledge construction and knowledge building. The findings also indicated that game design elements played central role in shaping conceptions of in-game inquiry from focusing on rules and logic as means to completing the game’s level to understanding the complexity of core mechanics for developing and transferring in-game inquiry to the real classroom. This insinuates that distinct game design properties may be considered in terms of extending intrinsic in-game inquiry experiences to actual in-class inquiry practice.
Acute death caused by invasive aspergillosis after living-donor liver transplantation despite good graft function: a case report
Authors: Tomiyama Takahiro , Motomura Takashi , Iseda Norifumi , Morinaga Akinari , Shimagaki Tomonari , Kurihara Takeshi , Wang Huanlin , Toshima Takeo , Nagao Yoshihiro , Itoh Shinji , Harada Noboru , Yoshizumi Tomoharu , Mori Masaki 
Published: May 2021

Abstract
Background
Invasive aspergillosis (IA) is one of the most serious causes of death after liver transplantation (LT). IA is the second most common fungal infection, and its mortality rate exceeds 80%.

Case presentation
A 67-year-old man presented to our hospital because of fulminant hepatitis caused by hepatitis B virus. Candidiasis was detected in his sputum, and micafungin had already been administered. Living-donor LT was performed using a right lobe graft donated from his daughter with no intraoperative complications. Although he appeared to have good graft function, his oxygenation was inadequate, and a chest radiograph showed many invasive shadows on postoperative day 1. A computed tomography scan also showed many invasive shadows with the halo sign. A blood examination revealed positivity for Aspergillus antigen, and Aspergillus species were detected in his sputum. IA was diagnosed. The antifungal therapy was soon modified to amphotericin B combined with caspofungin. Despite good graft blood flow through the portal vein and hepatic artery and good graft function, the patient died of IA on postoperative day 3. The median time from LT to IA among reports published to date ranges from 18 to 25 days.

Conclusions
The present report describes the first case of very early onset of IA after LT.
Effect of directly acting anti-viral agents on immunological imprints in chronic HCV-4a patients: interleukin-10 and vascular endothelial growth factor genes expression level
Authors: Naga Iman S. , Kamel Amel Abdel Fattah , Ooda Said Ahmed , Elbab Hadeer Muhammad Fath , El-Sharkawy Rania Mohamed 
Published: May 2021

Abstract
Background
Hepatitis C virus infection is a global health challenge with Egypt being one of the highly affected countries. IL-10 has been suggested as a suitable marker to assess necroinflammation and to monitor the progression of liver damage. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor playing a central role in many physiological as well as pathological processes. Several factors can be predictive of the response to treatment and achievement of SVR; some of which are host-related, and others are virus-related. The gene expression of IL-10 and VEGF have multiple effects for treatment response. The aim of the present work was to study the effect of treatment with directly acting agents (DAA) on the expression of VEGF and IL-10 genes in chronic hepatitis C virus-infected Egyptian genotype-4a patients. Twenty-five HCV subjects where evaluated for IL-10 and VEGF gene expression before and after treatment with DAA.

Results
IL-10 expression was downregulated in 92% of the cases. VEGF expression was heterogeneous showing spreading of values along a wide range with 64% of the cases being downregulated.

Conclusion
DAAs do not completely reverse the immunological imprints established upon chronic HCV infection.
Laverne Gas Area, Beaver and Harper Counties, Oklahoma
Authors: Pate J. Durwood 
Published: May 2021

Abstract
The Laverne gas area, along the northern shelf of the Anadarko basin, covers 262 sq mi in Harper and Beaver Counties of northwest Oklahoma and the Oklahoma Panhandle. The field is unique in Oklahoma in that it contains four stratigraphic traps producing oil and gas from accumulations independent of structural closure.
The first gas well in the Laverne district was completed in 1930; however, it was not until December 1955 that the shallower Laverty “Hoover” gas pay (Virgilian) was discovered. The “Hoover” pay, which has a maximum thickness of 210 ft near the Laverne townsite, is the most productive reservoir in the field, containing more than one-half of the total gas reserves. The rest of the reserves are trapped in sandstones of Missouri and Morrow ages and in limestone of Chester age which underlies the angular unconformity between the two systems.
Combined total gas reserve for the “Hoover,” Tonkawa, Morrow, and Chester reservoirs in the field is 2,827 billion cu ft.
J. Gas in Cenozoic Rocks in Ventura-Santa Maria Basins, California
Authors: Dryden J. E. , Erickson R. C. , Off T. , Yost S. W. 
Published: May 2021

Abstract
The occurrence of natural gas in the Santa Maria and Ventura basins comprises only a small part of the hydrocarbons found to date. The preponderance of gas occurs in direct association with the oil, either as solution gas or, rarely, as gas caps. There are 16 known natural gas accumulations with the largest concentration located along the Santa Barbara coast line. There the age of the producing formations is largely restricted to Oligocene and lower Miocene sandstone.
Geology of Natural Gases Rich in Helium, Nitrogen, Carbon Dioxide, and Hydrogen Sulfide
Authors: Dobbin Carroll E. 
Published: May 2021

Abstract
Although natural gases may contain up to 10.0 per cent helium in rocks ranging in age from Cambrian to Cretaceous in scattered parts of the United States and Canada, the greatest concentration of rich gas is in Permian carbonate rocks in the Panhandles of Texas and Oklahoma and in southwestern Kansas. At Pinta dome, just northeast of Holbrook in northeastern Arizona, a Permian sandstone yields commercial quantities of gas containing about 8.0 per cent helium. In Canada, the richest known helium gas—1.0-2.0 per cent—is in Cambrian and Ordovician sandy beds just north-northwest of Swift Current, in southwestern Saskatchewan.
The presence of most of the rich helium gas in Paleozoic strata close to the ancient basement rocks suggests that much of it was derived originally from the decay and subsequent vertical diffusion of radioactive elements, such as uranium and thorium, in those rocks. Helium-rich gas from deep wells generally is rich in nitrogen, but not in every case. Seemingly, the origin of rich nitrogen and helium gas is largely a problem for bacteriologists, chemists, and biochemists to solve.
Deep wells yielding natural gas rich in carbon dioxide are chiefly in the western part of the United States and in the Pánuco district, Mexico. Most of the rich gas is in beds ranging in age from Missis- sippian to Cretaceous.
Natural gas rich in hydrogen sulfide is produced chiefly from carbonate rocks in many areas, especially in western Texas.
M. Playa Del Rey Oil Field, Los Angeles County, California Natural Gas Storage
Authors: Barnds Ray M. 
Published: May 2021

Abstract
The Playa del Rey oil field is on Santa Monica Bay, about 15 mi southwest of Los Angeles. The discovery well was drilled by Ohio Oil Company in 1929 to a depth of 6,200 ft and produced approximately 2,000 bbls a day of 24.3° API-gravity oil. Rapid development of the Townlot field took place, and an upper producing zone was found at an average depth of 3,900 ft. By the end of 1930, 141 wells had been drilled in the area.
In 1931, Union Oil Company of California completed a deep-zone well south of the Townlot field. Subsequent development proved this to be a separate accumulation, and it was called the Del Rey Hills area. Fifty wells were drilled in 1934 and 1935 in the Del Rey Hills area, and it was chosen as the reservoir for natural gas storage necessary because of the industrial growth of the Los Angeles area. The Defense Plant Corporation acquired the southern 240 acres of the Del Rey Hills area and designated Union Oil Company of California as operator of the storage facility. Full-scale injection operations were begun in June 1943. In 1945, title to the properties was transferred to the Reconstruction Finance Corporation, which declared them surplus. The Southern California Gas Company purchased the properties and accepted operation on December 1, 1945.