bluuebunny/crossref_metadata_2025_split huggingface dataset:
The interaction effect of health insurance reimbursement and health workforce on health care‐seeking behaviour in China
Authors: Jin Yinzi , Yuan Beibei , Zhu Weiming , Zhang Yaoguang , Xu Ling , Meng Qingyue 
Published: July 2019

SummaryObjectiveIn China, patients generally seek health care at high‐level hospitals, which is leading to escalating medical costs and overloaded hospitals. Some studies have suggested that the health system is an important factor influencing individuals' health care‐seeking behaviour; however, this association has not been studied in much depth. We therefore examined the impact of the health system (in terms of the interaction between health insurance reimbursement and health workforce) on health care‐seeking behaviour.MethodsDrawing on national survey data from 2008 and 2013, we linked individual‐level data on choice of health care providers (our index of health care‐seeking behaviour) with county‐level data on the health workforce and health insurance. We then constructed a multilevel multinomial logistic model to examine the impacts of health insurance reimbursement (indexed as average reimbursement rate [ARR]) and the health workforce (number of registered physicians per 1000 population) at county hospitals and primary health care institutions (PHCs) on choice of inpatient care providers.ResultsIncreases in ARR at county hospitals were associated with a greater probability of visiting such hospitals (relative risk ratio [RRR] = 1.23), and this positive impact was even greater in county hospitals with higher physician densities (RRR = 2.76). Greater ARR in PHCs was associated with a 73% lower probability of visiting municipal‐ and higher‐level hospitals; increasing ARR was associated with an even lower probability when physician density in PHCs was considered (RRR = 0.09).ConclusionIncreases in the health insurance reimbursement and health workforce are necessary to improve health care access and thereby health care‐seeking behaviour. Thus, comprehensive health system reform is necessary.
Determining the cause of stillbirth in Kumasi, Ghana
Authors: Angell Jennifer N. , Abdul‐Mumin Abdul‐Razak S. , Gold Katherine J. 
Published: July 2019

AbstractObjectiveTo classify cause‐of‐death (COD) for stillbirths occurring in a major referral hospital in Kumasi, Ghana.MethodsIn a retrospective review conducted between June 8, 2011, and June 12, 2012, detailed information was collected on all stillbirths delivered at Komfo Anokye Teaching Hospital in Kumasi, Ghana. Patient records were independently reviewed by investigators using the Perinatal Society of Australia and New Zealand's Perinatal Death Classification system to determine COD for each case.ResultsCOD was analyzed in 465 stillbirth cases. The leading causes of death were hypoxic interpartum death (105, 22.6%), antepartum hemorrhage (67, 14.4%), hypertension (52, 11.2%), and perinatal infection (32, 6.9%). One hundred and fifty seven (33.8%) stillbirths were classified as unexplained antepartum deaths.ConclusionsThis evaluation of stillbirth in a busy, tertiary care hospital in Kumasi, Ghana provides crucial insight into the high volume of stillbirth in Ghana as well as its medical causes. The study demonstrated the high rate of stillbirth attributed to hypoxic intrapartum events, placental abruption, pre‐eclampsia, and unspecified bacterial infections. Yet, our rate of unexplained stillbirths underscores the need for a stillbirth classification system that thoughtfully integrates the needs and limitations of low‐resource settings as unexplained stillbirth rates are a common indicator of the effectiveness of a classification system.
Comparison of the AV Magnivisualizer device with colposcopy to detect cervical intraepithelial neoplasia using the Swede scoring system
Authors: Dayal Utkarsh , Gupta Bindiya , Hariprasad Roopa , Shriya Rashmi , Rajaram Shalini , Prasad Bhavya , Mehrotra Ravi 
Published: July 2019

AbstractObjectiveTo compare the AV Magnivisualizer with colposcopy to detect cervical intraepithelial neoplasia (CIN) using the Swede scoring system.MethodsCross‐sectional study conducted in a tertiary care hospital from May 2017 to March 2018. One hundred women with positive results at visual inspection with acetic acid underwent cervical inspection using the Magnivisualizer followed by a colposcope. Biopsies were taken if the Swede score was greater than 4. Pregnant women, women with an obvious cervical growth, acute cervicitis, or prior cervical surgery were excluded. Diagnostic accuracy of the Magnivisualizer and colposcope was calculated for high‐grade lesions (CIN 2/CIN 2+) and agreement was compared between the two modalities.ResultsThe sensitivity, specificity, and positive and negative predictive values of the Magnivisualizer were 88.2%, 70.0%, 50.0%, and 94.6%, respectively, to detect high‐grade lesions at a Swede score cutoff of 5 or more. The area under the curve for the Magnivisualizer was 0.80 (95% CI, 0.67–0.92), which was comparable with colposcopy (AUC 0.86; 95% CI, 0.76–0.96). There was very good agreement between the Magnivisualizer and colposcopy (κ=0.865, P<0.001) for high‐grade lesions.ConclusionThe Magnivisualizer had high diagnostic accuracy to detect high‐grade CIN in screen‐positive women, which was comparable with colposcopy.
Anal prevalence of HPV in women with pre‐malignant lesion or cancer in the cervix and anal canal simultaneously: cross‐sectional study
Authors: Heráclio Sandra A. , de Souza Alex S.R. , Silveira Raquel K. , Torres Leuridan C. , Nunes Maria J.G. , Amorim Melania M.R. 
Published: July 2019

AbstractObjectiveTo determine the prevalence of anal HPV genotypes and associated factors in women with pre‐malignant lesion or cancer in the cervix and anal canal.MethodsA prospective, cross‐sectional study analyzed DNA samples taken from women with cervical pre‐malignant lesions or cancer to identify anal HPV by polymerase chain reaction (PCR). The prevalence of high‐risk HPV (HR‐HPV) in women with intraepithelial neoplasia and anal cancer was calculated; sociodemographic and clinical risk factors were identified using multivariate analysis.ResultsA total of 152 patients were included (mean age 37.8 ± 10.01 years), of whom 101 (66.4%) had anal HR‐HPV. Fourteen different anal HPV types were identified. HPV 16 and 18 were found in 30 (52.6%) anal high‐grade squamous intraepithelial lesions (HSIL), and HPV 31 and 33 in 21 (36.8%) lesions. In the logistic regression analysis, the factors that remained associated with HR‐HPV types were: an anal histopathology report of HSIL or invasive carcinoma (odds ratio [OR] 8.96, 95% confidence interval [CI] 3.40–23.57; P<0.0001) and alcohol consumption (OR 2.20, 95% CI 1.01–4.80; P=0.04).ConclusionPrevalence of HR‐HPV is high in the anal canal of women with cervical and anal pre‐malignant lesions simultaneously or cancer of the cervix and/or anal canal. HPV 16, 31, 33, and 18 were the four major genotypes identified.
STATISTICAL DATA COLLECTION METHODOLOGIES OF IRRIGATED AREAS AND THEIR LIMITATIONS: A REVIEW
Authors: Ajaz Ali , Karimi Poolad , Cai Xueliang , De Fraiture Charlotte , Akhter Muhammad Saleem 
Published: July 2019

AbstractInconsistencies in the statistical data sets of irrigated areas at the national level could have considerable implications for policies developed for food and water security. Remote sensing can address this issue; however, doubts about its reliability inhibit its protagonist role. Methods that integrate both remote sensing based and statistical data sets seem expedient, and they are more likely to be acknowledged by policymakers. Therefore, it is important for scientists to know the basis and limitations of statistical data sets which originate at the country level. Data collection methodologies of irrigated areas have been reviewed for seven Asian countries, namely China, India, Pakistan, Bangladesh, Nepal, Indonesia and Thailand. Factors causing the uncertainties in data, and the limitations of data collection methodologies, were highlighted. Also, an irrigation density distribution analysis was conducted to understand the relation of spatial spread pattern of irrigated areas and uncertainty in their statistical records. It was found that irrigated area statistics are mostly based on information originating from water user associations and farmers, which is either self‐reported or collected through interviews during surveys and censuses. The main causes of discrepancy were lack of resources to frequently enumerate the irrigated land, inconsistency in data collection methodologies, unaccounted secondary crops, illegal and unregulated water use, and bureaucratic and political constraints. Irrigation density distribution analysis showed that largely scattered irrigated areas might be prone to a lack of comprehensive and frequent enumeration. Furthermore, dense irrigation regions might have potentially unrecorded irrigated areas where temporary or supplementary irrigation arrangements are made by marginal farmers. © 2019 John Wiley & Sons, Ltd.
Nanoscale zerovalent iron particles induce differential cytotoxicity, genotoxicity, oxidative stress and hemolytic responses in human lymphocytes and erythrocytes in vitro
Authors: Ghosh Ilika , Mukherjee Amitava , Mukherjee Anita 
Published: July 2019

AbstractThe growing usage of nanoscale zerovalent iron particles (nZVI) in the remediation of soil, ground/surface water has elicited large‐scale environmental release triggering human exposure. The size of nanomaterials is a key regulator of toxicity. However, the effect of a variable size of nZVI on genotoxicity is unexplored in human cells. To the best of our knowledge, in this study, the cytotoxic, genotoxic and hemolytic potential of nZVI‐1 (15 nm) and nZVI‐2 (50 nm) at concentrations of 5, 10 and 20 μg/mL was evaluated for the first time in human lymphocytes and erythrocytes treated for 3 hours. In erythrocytes, spherocytosis and echinocytosis occurred upon exposure to nZVI‐1 and nZVI‐2, respectively, leading to hemolysis. Lymphocytes treated with 20 μg/mL nZVI‐2 and 10 μg/mL nZVI‐1, incurred maximum DNA damage, although nZVI‐2 induced higher cyto‐genotoxicity than nZVI‐1. This can be attributed to higher Fe ion dissolution and time/concentration‐dependent colloidal destabilization (lower zeta potential) of nZVI‐2. Although nZVI‐1 showed higher uptake, its lower genotoxicity can be due to lesser Fe content, Fe ion dissolution and superior colloidal stability (higher zeta potential) compared with nZVI‐2. Substantial accumulation of Ca2+, superoxide anions, hydroxyl radicals and H2O2 leading to mitochondrial impairment and altered antioxidant enzyme activity was noted at the same concentrations. Pre‐treatment with N‐acetyl‐cysteine modulated these parameters indicating the indirect action of reactive oxygen species in nZVI‐induced DNA damage. The morphology of diffused nuclei implied the possible onset of apoptotic cell death. These results validate the synergistic role of size, ion dissolution, colloidal stability and reactive oxygen species on cyto‐genotoxicity of nZVI and unlock further prospects in its environmental nano‐safety evaluation.
Respiratory exposure to nano‐TiO2 induces pulmonary toxicity in mice involving reactive free radical‐activated TGF‐β/Smad/p38MAPK/Wnt pathways
Authors: Zhou Yingjun , Ji Jianhui , Ji Li , Wang Ling , Hong Fashui 
Published: July 2019

AbstractNumerous studies have shown that lung injury can be caused by respiratory exposure to nanoparticulate titanium dioxide (nano‐TiO2), but whether pulmonary inflammation and fibrosis are related to the activation of the TGF‐β/Smad/p38MAPK/Wnt pathways remains unclear. In this study, mice were administrated nano‐TiO2 by nasal instillation for nine consecutive months, and the molecular mechanisms of nano‐TiO2 on the pulmonary toxicity of mice were examined. The findings suggested that nano‐TiO2 caused pneumonia and pulmonary fibrosis. Furthermore, the results also showed that an overproduction of reactive free radicals occurred in mouse lungs, and that the expression of TGF‐β/p38MAPK/Wnt pathway‐related factors, including hypoxia‐inducible factor 1α (HIF‐1α), transforming growth factor‐β1 (TGF‐β1), phosphorylated p38 mitogen activated protein kinases (p‐p38MAPK), small mothers against decapentaplegic homolog 2 (Smad2), extracellular matrix (ECM), Wingless/Integrated 3 (Wnt3), Wingless/Integrated 4 (Wnt4), integrin‐linked kinase (ILK), β‐catenin, nuclear factor‐κB (NF‐κB), α‐smooth muscle actin (α‐SMA), c‐Myc, Type I collage (collagen I), and Type collage III (collagen III) were remarkably elevated, while phosphorylated glycogen synthase kinase‐3β (p‐GSK‐3β) expression was decreased. Those data implied that the pulmonary inflammation and fibrosis caused by nano‐TiO2 exposure may be involved in reactive free radical‐mediated activation of the TGF‐β/Smad/p38MAPK/Wnt pathways.
Bisphosphonate Use and Fractures in Adults with Hypophosphatasia
Authors: Rassie Kate , Dray Michael , Michigami Toshimi , Cundy Tim 
Published: July 2019

ABSTRACTAdults with hypophosphatasia (HPP) may suffer femoral fractures resembling the atypical femoral fractures that can occur with long‐term bisphosphonate treatment, and there is an emerging consensus that bisphosphonates should not be used in adults with HPP and low bone mass. However, the spectrum of HPP in adults is wide: ranging from the severely affected—who commonly have osteomalacia—through to the minimally affected. The former typically have biallelic and the latter, heterozygous ALPL mutations. We have reviewed reports of fractures in adults with genetically proven HPP which suggest that the risk of fracture is at least 200‐fold greater in those with biallelic mutations. We also discuss two cases of postmenopausal women with heterozygous ALPL mutations. One had fractures and severe osteoporosis, but histology revealed no evidence of osteomalacia. The second had taken alendronate for 8 years, but despite profound suppression of bone turnover, histology again revealed no evidence of osteomalacia. The management of adults with HPP who have coexisting osteoporosis is challenging. More data are clearly needed, but we suggest that the risks of bisphosphonate therapy may be relatively low in patients who have heterozygous mutations and no histological evidence of osteomalacia. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
siRNA‐mediated NCAM1 gene silencing suppresses oxidative stress in pre‐eclampsia by inhibiting the p38MAPK signaling pathway
Authors: Zhang Xiao‐Lin , Xu Feng‐Xian , Han Xiao‐Yun 
Published: July 2019

AbstractPre‐eclampsia (PE), whose pathophysiology and etiology remain undefined, represents a leading consequence of fetal and maternal mortality and morbidity. Oxidative stress (OS) is recognized to involve in this disorder. In this study, we hypothesized that neural cell adhesion molecule 1 (NCAM1) gene silencing would suppress the OS in the pregnancy complicated by PE. Initially, clinical samples were collected for determination of NCAM1 expression in placental tissues and levels of OS products in blood. To assess the regulatory mechanism of NCAM1 knockdown on OS, we used small interfering RNA (siRNA) to silence NCAM1 expression in human umbilical vein endothelial cells (HUVECs). Next, cells were treated with or without hypoxia/reoxygenation to observe the level changes of OS products and p38 mitogen‐activated protein kinase (p38MAPK) pathway‐related genes. Finally, an evaluation of HUVEC migration and invasion abilities was conducted by wound‐healing and transwell assays. Placenta of pregnancy with PE presented significantly increased NCAM1 expression in comparison to placenta of normal pregnancy. Meanwhile, enhanced OS in blood of pregnant women with PE was observed relative to women with normal pregnancy. siRNA‐mediated knockdown of NCAM1 gene could inhibit the p38MAPK signaling pathway, repress OS, and promote cell migration and invasion in HUVECs, indicating that NCAM1 inhibition could reduce the influence of PE. Importantly, blocking the p38MAPK signaling pathway reversed the inhibitory role of NCAM1 gene silencing on PE. Collectively, this study defines potential role of NCAM1 gene silencing as a therapeutic target in PE through inhibiting OS and enhancing HUVEC migration and invasion by disrupting the p38MAPK signaling pathway.
Effect of Lercanidipine on the Pharmacokinetics‐Pharmacodynamics of Carvedilol Enantiomers in Patients With Chronic Kidney Disease
Authors: Hanauer Schaab Estela , Lanchote Vera Lucia , Balthazar Nardotto Glauco Henrique , Marques Pereira Maria Paula , Dantas Márcio , Paiva Carlos Eduardo , Barbosa Coelho Eduardo 
Published: July 2019

AbstractThis study evaluates the carvedilol‐lercanidipine drug interaction, and the influence of chronic kidney disease (CKD) on both drugs. Patients with high blood pressure (8 with normal renal function [control] and 8 with CKD with estimated glomerular filtration rate categories of G3b to G5 [12‐38 mL/min/1.73 m2]) were included and prescribed 3 different treatment regimens, a single oral dose of racemic carvedilol 25 mg (CAR), a single oral dose of racemic lercanidipine 20 mg (LER), and single oral doses of CAR plus LER. Blood samples were collected and variations in heart rate were assessed (using isometric exercise with handgrip) for up to 32 hours. Lercanidipine pharmacokinetics were not enantioselective, and were not affected by carvedilol and CKD. Carvedilol pharmacokinetics (data presented as median) were enantioselective with higher plasma exposure of (R)‐(+)‐carvedilol in both control (103.5 vs 46.0 ng ∙ h/mL) and CKD (190.6 vs 98.9 ng ∙ h/mL) groups. Lercanidipine increased the area under the plasma concentration–time curve of only (R)‐(+)‐carvedilol in the CKD group (190.6 vs 242.2 ng ∙ h/mL) but not in the control group (103.5 vs 98.7 ng ∙ h/mL). CKD increased plasma exposure (46.0 vs 98.9 ng ∙ h/mL) and effect‐compartment exposure (5.5 vs 20.9 ng ∙ h/mL) to (S)‐(–)‐carvedilol, resulting in higher β‐adrenergic inhibition (10.0 vs 6.1 bpm). Therefore, carvedilol dose titration in CKD patients with estimated glomerular filtration rate categories of G3b to G5 should be initiated, with no more than half the dose used for patients with normal renal function.
Assessing risk for HIV infection among adolescent girls in South Africa: an evaluation of the VOICE risk score (HPTN 068)
Authors: Giovenco Danielle , Pettifor Audrey , MacPhail Catherine , Kahn Kathleen , Wagner Ryan , Piwowar‐Manning Estelle , Wang Jing , Hughes James P 
Published: July 2019

AbstractIntroductionTo maximize impact and minimize costs, antiretroviral pre‐exposure prophylaxis (PrEP) interventions should be offered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being utilized to determine eligibility in adolescent PrEP trials in sub‐Saharan Africa. This study is aimed at evaluating the utility of the risk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa.MethodsWe utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial conducted in rural Mpumalanga province, South Africa. School‐attending young women aged 13 to 20 years were enrolled into the trial from 2011 to 2012 and followed for up to three years. A risk score based on individual‐level risk factors measured at enrolment was calculated for HPTN 068 participants who completed a one‐year follow‐up visit and were HIV seronegative at enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score at enrolment was predictive of incident HIV infection at follow‐up and an area under the curve analysis was used to examine the predictive ability of the score.Results and DiscussionThe risk score had limited variability in the HPTN 068 sample. Scores ≥5 identified 85% of incident infections from 94% of the sample, compared to the VOICE sample in which scores ≥5 identified 91% of incident infections from only 64% of participants. The risk score did not predict HIV incidence after one year of follow‐up (hazard ratio = 1.029; 95% confidence interval (CI): 0.704, 1.503, p = .884) and showed poor predictive ability (area under the curve = 0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or not relevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of determining PrEP eligibility.ConclusionsThe VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings highlight the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use of the VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.
Profiling the interaction of 1‐phenylbenzimidazoles to cyclooxygenases
Authors: Gómez‐Castro Carlos Z. , López‐Martínez Margarita , Hernández‐Pineda Jessica , Trujillo‐Ferrara José G. , Padilla‐Martínez Itzia I. 
Published: July 2019

AbstractIn the design of 1‐phenylbenzimidazoles as model cyclooxygenase (COX) inhibitors, docking to a series of crystallographic COX structures was performed to evaluate their potential for high‐affinity binding and to reproduce the interaction profile of well‐known COX inhibitors. The effect of ligand‐specific induced fit on the calculations was also studied. To quantitatively compare the pattern of interactions of model compounds to the profile of several cocrystallized COX inhibitors, a geometric parameter, denominated ligand‐receptor contact distance (LRCD), was developed. The interaction profile of several model complexes showed similarity to the profile of COX complexes with inhibitors such as iodosuprofen, iodoindomethacin, diclofenac, and flurbiprofen. Shaping of high‐affinity binding sites upon ligand‐specific induced fit mostly determined both the affinity and the binding mode of the ligands in the docking calculations. The results suggest potential of 1‐phenylbenzimidazole derivatives as COX inhibitors on the basis of their predicted affinity and interaction profile to COX enzymes. The analyses also provided insights into the role of induced fit in COX enzymes. While inhibitors produce different local structural changes at the COX ligand binding site, induced fit allows inhibitors in diverse chemical classes to share characteristic interaction patterns that ensure key contacts to be achieved. Different interaction patterns may also be associated with different inhibitory mechanisms.