bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of circulating irisin with metabolic risk factors in Chinese adults: a cross-sectional community-based study
Authors: Tang Lizhi , Tong Yuzhen , Zhang Fang , Chen Guilin , Zhang Yun Cong , Jobin John , Tong Nanwei 
Published: October 2019

Abstract
Background Irisin is a myokine that leads to increased energy expenditure by stimulating the browning of white adipose tissue. We aimed to investigate the association of serum irisin levels with metabolic parameters in middle aged Chinese population.
Methods The study was based on a cross-sectional analysis of data from 524 nondiabetic subjects aged 40~65. All participants were recruited from a screening survey for Metabolic Syndrome in a community in Southwest China, including 294 subjects categorized as overweight (defined as BMI≧25 kg/m2 ) and 230 subjects as normal control (defined as 18.5≦BMI<25 kg/m2). Serum irisin concentration was quantified by enzyme linked immunosorbent assay (ELISA). The relationship of irisin with metabolic factors was determined by Pearson correlation. Multivariate linear regression was used to analyze the association of irisin with insulin resistance. Logistic regression was performed to assess the association of irisin with odds of overweight.
Results Serum irisin levels were significantly lower in nondiabetic overweight subjects compared with control (11.46 ± 4.11vs14.78 ± 7.03µg/mL, p = 0.02). Circulating irisin was positively correlated with quantitative insulin sensitivity check index (QUICKI, r = 0.178, p = 0.045) and triglycerides (r = 0.149, p = 0.022); while irisin was negatively correlated with waist circumference (WC, r = -0.185, p = 0.037), waist-to-hip ratio (WHR, r = -0.176, p = 0.047), fasting insulin (r = -0.2, p = 0.024), serum creatinine (r = -0.243, p = 0.006), homeostasis model assessment for insulin resistance (HOMA-IR, r = -0.189, p = 0.033). Multiple linear regression showed that irisin was inversely associated with HOMA-IR (β = -0.342 ± 0.154, p = 0.029). Higher irisin was associated with decreased odds of being overweight (OR = 0.281, β = -1.271, p = 0.024).
Conclusions We found that serum irisin levels were lower in overweight subjects. Moreover, serum irisin levels were inversely correlated with adverse metabolic parameters including WC, WHR, creatinine, HOMA-IR and fasting insulin, suggesting that irisin may play a role in obesity related insulin resistance.
Comparing the influence of 1-day versus 3-day low-residue diet on bowel preparation for colonoscopy:a randomized controlled trial
Authors: Jiao Li , Wang Junmin , Zhao Wenjuan , Ma Huan , Fan Xiao , Yang Liang , Zhu Xuejuan 
Published: October 2019

Abstract
Backgroud :A low-residue diet (LRD) can potentially reduce the hunger of patients while improving compliance and tolerance,without compromising the quality of bowel preparation.This study investigated the effects of 1-day low-residue diets compared with 3-day for colonoscopic bowel preparation . Methods: Patients undergoing bowel preparation before colonoscopy were randomly divided into 1-day and 3-day LRD groups.Oral polyethylene glycol (PEG) electrolyte solution and simethicone were applied to all patients submitted to bowel preparation. The primary outcome measure included the quality of the bowel preparation rated by the Boston bowel preparation scale(BBPS), and the secondary measures included (i) cecal intubation time and withdrawal time, (ii) polyp detection rate, (iii) patient tolerance and (iv) the willingness of the patient to repeat the diet protocol thereafter. Results: No significant difference was detected in regards the quality of the bowel preparation when comparing the two groups, since the mean of BBPS score was 6.54 versus 6.55 in the 1- and 3-day LRD groups. The cecal intubation times,withdrawal times, polyp detection rates,and the patient tolerance (i.e.hunger-comfort score[1]) showed no significant difference between the 1- and 3-day LRD groups. However,overall satisfaction was higher with the 1-day LRD group than with the 3-day LRD group. Conclusion: The 1-day and 3-day low-residue diets showed no major effect on bowel preparation previously to colonoscopy, while the tolerance and satisfaction of patients were higher after 1-day low-residue diet. Trial registration: Clinical Trial Registry Identifier:ChiCTR1900025843.Date of registration:September 10,2019 “Retrospectively registered”. Key words: colonoscopy; bowel preparation; low-residue diet; duration; bowel-cleansing quality
Effect of biological larviciding with Bacillus thuringiensis israelensis for malaria control on non-target vector mosquito species in rural Burkina Faso – A cluster randomized trial
Authors: Dambach Peter , Bärnighausen Till , Yadouleton Anges , Dambach Martin , Traore Issouf , Korir Patricia , Ouedraogo Saidou , Sié Ali , Sauerborn Rainer , Becker Norbert , Louis Valérie 
Published: October 2019

Abstract
Background: Biological larviciding is an additional tool that can help address the current dilemma in malaria control, namely vector resistances to pyrethroids and shifting of biting activity to times when people are not protected. Although malaria interventions primarily target Anopheles mosquitoes, there might be an impact on populations of other mosquito genera that share the same breeding sites. In this study we research to what extent Culex and Aedes mosquitoes, the primary vectors of numerous zoonotic diseases, are affected by larviciding interventions against malaria mosquitoes. Methods: We researched the impact of different larviciding choices with Bacillus thuringiensis israelensis on non-target mosquitoes in 127 rural villages and a semi-urban town in a health district in Northwestern Burkina Faso. All villages were distributed into a total of three study arms with different larviciding choices: full, selective and untreated control. Geographically close villages were distributed into clusters to avoid contamination between treated and untreated villages. Adult mosquitoes were captured in light traps inside and outside houses during the rainy seasons of a baseline and an intervention year. A negative binomial regression was used to determine the reductions achieved through larviciding among different mosquito genera.Results: Larviciding interventions against malaria showed only limited or no impact against Culex mosquitoes, while against Aedes, reductions of up to 34% were achieved when all detected breeding sites in the public space were treated. While the semi-urban setting showed high abundance of Culex, in the rural villages we captured more Aedes. Conclusions: Future larviciding programs should be evaluated for including the treatment of Aedes and Culex breeding habitats. Since the major cost components of such programs are labor and transport, other disease vectors could be targeted at little additional cost.
Family Caregivers’ Perspectives of the Economic Burden Imposed through Caring for Family Members with Cancer in KwaZulu-Natal, South Africa
Authors: Mlaba Phindile Chantalle , Ginindza Themba , Hlongwana Khumbulani 
Published: October 2019

Abstract
Background This study explored the perspectives of family caregivers on the economic burden imposed through caring for their family members who are living with cancer in KwaZulu-Natal.Methods This study employed qualitative methods to explore the subjective experiences of the family caregivers caring for family members living with cancer, drawing from the interpretivist paradigm. Data saturation was reached after conducting 20 in-depth interviews among family caregivers. These family caregivers were either actively involved in caring for or previously had the experience of caring for a family member with cancer. Interview questions focused on the caregivers’ perspectives of the economic burden of caring for a family member with cancer.Results Three key themes emerged from the analysis of the research findings. These themes were: loss of income, financial coping prior to the cancer diagnosis, and financial challenges due to the cancer diagnosis.Conclusions Cancer care giving can be financially taxing on families, and especially impose more strain on families with low household incomes. There is a need for health policy makers to consider exploring financial relief mechanisms for families caring for members living with cancer.
'Tobacco and alcohol use are playing critical role in the interaction of social determinants of non-communicable diseases in Nepal': a systems perspective
Authors: Sharma Sudesh Raj , Matheson Anna , Lambrick Danielle , Faulkner James , Lounsbury David W , Vaidya Abhinav , Page Rachel 
Published: October 2019

Abstract
Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal contributing to rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health system. Systems approach has potential to facilitate understanding of such complex causal mechanism. The objective of this paper was to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study was a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n-12) at different levels (policy, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study based thematic analysis using framework approach and development of causal loop diagram. The study also involved three sense making sessions with key stakeholders. Results: Five key interacting themes emerged during the data analysis. Habit and misconception relating to alcohol and tobacco use contributed to the use and addiction of tobacco and alcohol. Low focus on prevention by health system further contributed to the problem. Decline in community capital and gendered social constructs influenced tobacco and alcohol use. Socio-economic status of families/communities was discussed as a potential root cause of use and addiction of tobacco and alcohol. These interacting themes were utilized to develop iterative causal loop diagrams showing the influence of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Conclusion: Tobacco and alcohol use and addiction causally linked broader social determinants (social, economic and political) to NCD in the context of Nepal. These CLDs showed how socio-economic circumstances was influencing addiction and availability of tobacco and alcohol products in Nepal. A multi-sectoral response led by health system is urgently needed.
Perceptions and Attitudes about the Concept and Approach of Palliative Care among Carer’s and Family Members of Patients on End-of-Life Care: A Cross-sectional Survey
Authors: Shah Sameena , Qaisar Faizan , Azam Iqbal , Mansoor Khairunnisa 
Published: October 2019

Abstract
BACKGROUND It is necessary to assess carer's understanding of palliative care. The objectives of this study were to ascertain the attitudes and perceptions about the concept and components of palliative care. METHODS A cross-sectional survey was conducted. Data was collected from the Aga Khan University Hospital in-patient and out-patient departments and home-based palliative care services from mid 2015 to 2016. All adult care-givers who met the inclusion criteria and gave informed consent were approached by trained data collectors till the sample size was reached.Univariate and multivariable analysis and results were reported as crude prevalence’s, crude and adjusted prevalence ratios with 95% confidence intervals using Cox-proportional hazard algorithm. Mean difference of knowledge and attitude scores by care giver variables was assessed using one-way ANOVA. SPSS version 18 was used and a p-value of less than 5 percent was treated as significant. RESULTS Out of 250 care givers more than 60% were 40 years or less and the majority were males. Majority were at least graduates. Approximately 70% of the respondents agreed with the opinion that the person suffering from cancer should be informed about the diagnosis and disease progression. About forty five percent (95% C.I.: 39.03%, 51.37%) of the study respondents had correct knowledge about palliative care. Age and relationship with patient had the most variation in response in terms of significance. CONCLUSION Young individuals aged <40 years, with an education level of matric, children or relations of the patient were found to have significantly more and correct knowledge. The majority believed that the patient should be informed about the diagnosis and that patients should be encouraged to carry out routine activities and be facilitated to fulfill their wishes. Two foundational aspects showed a consistently good understanding and therefore correct knowledge across age groups, gender, education level, and relationship with the patient. Firstly, that palliative care should be offered to everyone suffering from an incurable disease and, secondly, that this approach encompasses not just physical, but also psychological and social needs of the patient, in addition to the needs of the family caring for the patient.
Effect of the duration of intraretinal or subretinal fluid persistence on the response to treatment in undertreated age-related macular degeneration
Authors: Yoshida Izumi , Sakamoto Masashi , Sakai Asao , Maeno Takatoshi 
Published: October 2019

Abstract
Backgrounds: To investigate the association between intraretinal fluid (IRF) or subretinal fluid (SRF) persistence and response to anti-vascular endothelial growth factor injection in age-related macular degeneration (ARMD). Methods: Eighty-nine eyes of ARMD patients with VA ≤ 20/100 or persistent subretinal hyper-reflective material were retrospectively assessed. Each injection’s efficacy was classified, and fluid accumulation prior to each injection was evaluated. Effect changes within the longest persistent IRF period (≥ 10 months) and their association with previous treatment and accumulated IRF and SRF were determined. Results: Injection span was shorter and the polypoidal choroidal vasculopathy and occult choroidal neovasculopathy (CNV) proportions were higher among patients with diminished than among those with maintained effects. Throughout observation, acquired refractoriness appeared rarely associated with increased IRF or SRF. VA differed significantly with IRF duration, but not accumulated fluid. Conclusions: Diminishing effect of injections during long- standing IRF was associated with highly active CNV rather than with undertreatment. The mechanism underlying acquired refractoriness remains unknown; the effect change demonstrated various patterns, including diminished and improved responses. Persistent IRF duration was associated with VA decline. To shorten the duration of persistent IRF, it may be necessary to ensure strict control in refractory patients with high CNV activity.
Imaging modality for measuring the presence and extent of the labral lesions of the shoulder: a systematic review and meta-analysis
Authors: Liu Fanxiao , Cheng Xiangyun , Dong Jinlei , Zhou Dongsheng , Sun Qian , Bai Xiaohui , Wang Dawei 
Published: October 2019

Abstract
Background: Multiple published studies quantitatively analysing the diagnostic value of MRI, MR arthrography (MRA) and CT arthrography (CTA) for labral lesions of the shoulder have had inconsistent results. The aim of this meta-analysis was to systematically compare the diagnostic performance of MRI, MRA, CTA and CT. Methods: Two databases, PubMed and EMBASE, were used to retrieve studies targeting the accuracy of MRI, MRA, CTA and CT in detecting labral lesions of the shoulder. After carefully screening and excluding studies, the studies that met the inclusion criteria were used for a pooled analysis, including calculation of sensitivity and specificity with 95% confidence intervals (CIs) and the area under the hierarchical summary receiver operating characteristic (HSROC) curves. Results: The retrieval process identified 2633 studies, out of which two reviewers screened out all but 14 studies, involving a total of 1216 patients who were deemed eligible for inclusion in the meta-analysis. The results assessing the diagnostic performance of MRI vs. MRA for detecting labral lesions showed a pooled sensitivity of 0.77 (95% CI 0.70-0.84) vs. 0.92 (95% CI 0.84-0.96), a specificity of 0.95 (95% CI 0.85-0.98) vs. 0.98 (95% CI 0.91-0.99), and an area under the HSROC curve of 3.78 (95% CI 2.73-4.83) vs. 6.01 (95% CI 4.30-7.73), respectively. Conclusion: MRA was suggested for use in patients with chronic shoulder symptoms or a pathologic abnormality. MRI is by far the first choice recommendation for the detection of acute labral lesions. CT should be a necessary supplemental imaging technique when there is highly suspected glenoid bone damage.
Accident-related neurogenic fecal incontinence: a retrospective study
Authors: Liu Jie , Wei Ruiling , Wu Dewei , Chen Hulin , Dong Juan , Lv Chaolan , Zhu Xiuli , Yu Yue 
Published: October 2019

Abstract
Abstract Background To evaluate the anorectal motility characteristics, the quality of life and psychological health of accident-related neurogenic fecal incontinence(ArNFI) patients. Methods A retrospective study was conducted on 26 patients with ArNFI visiting the gastrointestinal motility center of affiliated provincial hospital of Anhui medical university were collected as research objects from January 2016 to August 2019. The anorectal motility characteristics of these patients were recorded and analysed by high resolution manometry (HRM), 10 healthy subjects for the same period were recruited as the control group. The psychological characteristics of these patients and healthy subjects were compared by HAMA and HAMD scores,and their quality of life was investigated by SF36. Results Anal sphincter resting pressure in the ArNFI group was more lowwer than that of the control group (21.18± 4.68vs34.83± 14.13, P<0.05). Anorectal compliance in the ArNFI group was more lowwer than that of the control (1.41± 0.32vs4.03± 1.06, P<0.05). Maximal squeeze pressure were in the ArNFI group was also lowwer than that of the control(53.66±14.59 vs 143.95±19.82, P<0.05).HAMA ,HAMD scores of the ArNFI group in the ArNFI group were all higher than that of the control ( 21.29±2.06 vs 7.63±1.41 ;22.00±3.70 vs 8.75±1.91, respectively.all P<0.01). There were significant differences between SF36 scores of ArNFI group and the control group in the 8 dimensions of PF,RP,GH,VT,SF,RE and MH.(P<0.01) . Conclusion In patients with ArNFI,there were significantly reduced anorectal motility characteristics, increased HAMA.HAMD scores,and their life quality was obviously declined.
Pre- and post-sequencing recommendations for functional annotation of human fecal metagenomes
Authors: Treiber Michelle L. , Taft Diana H. , Korf Ian , Mills David A. , Lemay Danielle G. 
Published: October 2019

Abstract
Background
Shotgun metagenomes are often assembled prior to annotation of genes which biases the functional capacity of a community towards its most abundant members. For an unbiased assessment of community function, short reads need to be mapped directly to a gene or protein database. The ability to detect genes in short read sequences is dependent on pre- and post-sequencing decisions. The objective of the current study was to determine how library size selection, read length and format, protein database, e-value threshold, and sequencing depth impact gene-centric analysis of human fecal microbiomes when using DIAMOND, an alignment tool that is up to 20,000 times faster than BLASTX.
Results
Using metagenomes simulated from a database of experimentally verified protein sequences, we find that read length, e-value threshold, and the choice of protein database dramatically impact detection of a known target, with best performance achieved with longer reads, stricter e-value thresholds, and a custom database. Using publicly available metagenomes, we evaluated library size selection, paired end read strategy, and sequencing depth. Longer read lengths were acheivable by merging paired ends when the sequencing library was size-selected to enable overlaps. When paired ends could not be merged, a congruent strategy in which both ends are independently mapped was acceptable. Sequencing depths of 5 million merged reads minimized the error of abundance estimates of specific target genes, including an antimicrobial resistance gene.
Conclusions
Shotgun metagenomes of DNA extracted from human fecal samples sequenced using the Illumina platform should be size-selected to enable merging of paired end reads and should be sequenced in the PE150 format with a minimum sequencing depth of 5 million merge-able reads to enable detection of specific target genes. Expecting the merged reads to be 180-250bp in length, the appropriate e-value threshold for DIAMOND would then need to be more strict than the default. Accurate and interpretable results for specific hypotheses will be best obtained using small databases customized for the research question.
Main Driving Factors and Prediction Model of Total Health Expenditure in China: A Study Based on Grey System Theory
Authors: Jia Huanhuan , Yu Xihe , Yu Jianxing , Zheng Zhou , Li Yingying , Song Fangying , Jiang Hairui , Zhang Jingru 
Published: October 2019

Abstract
Background: The continuous increase in total health expenditure has become a social issue of common concern in most countries. In China, the total health expenditure still maintains a fast growth trend which is much higher than the growth of the country’s economy, although the new health system reform had been going on for 8 years until 2017. The aims of the current study were thus to investigate the main driving factors affecting total health expenditure and to establish a prediction model.
Methods: Gray system theory was employed to explore the correlation degree between total health expenditure and 13 hot spots from the fields of economy, population, health service utilization, and public policy using national data in China from 2009 to 2017. Besides, a prediction model was established using the main driving factors among the 13 hot spots.
Results: The main driving factors related to the changes of total health expenditure were public policy (ranked first), health development, economics, and aging, which correlation degrees were more than 0.7. The average error of the GM(1,7) model was 3.17%, the correlation degree, β , between the predicted simulation sequence and the original sequence was 0.78, the variance ratio, C, was 0.138, and the probability of residuals, P, was 1.0000. Therefore, the prediction model of total health expenditure with 6 main driving factors was excellent.
Conclusion:
The paper finds that since the new health system reform in China, government policies and social invest have contributed greatly to reducing the burden of health expenditure. However, the development of economic and the increase in the elderly population, which are main driving factors, will increase the total health expenditure, so improving the efficiency of investment and providing the precautionary health care and nursing for the elderly are crucial. Besides, the grey system theory had a good application in the field of health economics and policy.