bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deciphering the pharmacological mechanisms of Fraxini Cortex for ulcerative colitis treatment based on network pharmacology and in vivo studies
Authors: Wang Tianming , Su Xuyang , Peng Jing , Tan Xiaofen , Yang Guangshan , Zhang Tengyue , Chen Feng , Wang Changzhong , Ma Kelong 
Published: May 2023

Abstract
Background
Ulcerative colitis (UC) is a common type of inflammatory bowel disease. Due to the elusive pathogenesis, safe and effective treatment strategies are still lacking. Fraxini Cortex (FC) has been widely used as a medicinal herb to treat some diseases. However, the pharmacological mechanisms of FC for UC treatment are still unclear.

Methods
An integrated platform combining network pharmacology and experimental studies was introduced to decipher the mechanism of FC against UC. The active compounds, therapeutic targets, and the molecular mechanism of action were acquired by network pharmacology, and the interaction between the compounds and target proteins were verified by molecular docking. Dextran sulfate sodium (DSS)-induced colitis model was employed to assess the therapeutic effect of FC on UC, and validate the molecular mechanisms of action predicted by network pharmacology.

Results
A total of 20 bioactive compounds were retrieved, and 115 targets were predicted by using the online databases. Ursolic acid, fraxetin, beta-sitosterol, and esculetin were identified as the main active compounds of FC against UC. PPI network analysis identified 28 FC-UC hub genes that were mainly enriched in the IL-17 signaling pathway, the TNF signaling pathway, and pathways in cancer. Molecular docking confirmed that the active compounds had high binding affinities to the predicted target proteins. GEO dataset analysis showed that these target genes were highly expressed in the UC clinical samples compared with that in the healthy controls. Experimental studies showed that FC alleviated DSS-induced colitis symptoms, reduced inflammatory cytokines release, and suppressed the expression levels of IL1β, COX2, MMP3, IL-17 and RORγt in colon tissues.

Conclusion
FC exhibits anti-UC properties through regulating multi-targets and multi-pathways with multi-components. In vivo results demonstrated that FC alleviated DSS-induced colitis.
Measuring antenatal counseling skill with a milestone-based assessment tool: a validation study
Authors: Bartlett Michelle J. , Umoren Rachel , Amory Josephine H. , Huynh Trang , Kim Amanda J. H. , Stiffler Amanda K. , Mastroianni Rossella , Ficco Ellie , French Heather , Gray Megan 
Published: May 2023

Abstract
Background

Antenatal counseling for parents in the setting of expected preterm delivery is an important component of pediatric training. However, healthcare professionals receive a variable amount and quality of formal training. This study evaluated and discussed validity of a practical tool to assess antenatal counseling skills and provide evaluative feedback: the Antenatal Counseling Milestones Scale (ACoMS).

Methods
Experts in antenatal counseling developed an anchored milestone-based tool to evaluate observable skills. Study participants with a range of antenatal counseling skills were recruited to participate in simulation of counseling sessions in person or via video with standardized patient actors presenting with preterm labor at 23 weeks’ gestation. Two faculty observers scored each session independently using the ACoMS. Participants completed an ACoMS self-assessment, demographic, and feedback survey. Validity was measured with weighted kappas for inter-rater agreement, Kruskal–Wallis and Dunn’s tests for milestone levels between degrees of expertise in counseling, and cronbach’s alpha for item consistency.

Results
Forty-two participants completed observed counseling sessions. Of the 17 items included in the tool, 15 items were statistically significant with scores scaling with level of training. A majority of elements had fair-moderate agreement between raters, and there was high internal consistency amongst all items.

Conclusion
This study demonstrates that the internal structure of the ACoMS rubric has greater than fair inter-rater reliability and high internal consistency amongst items. Content validity is supported by the scale’s ability to discern level of training. Application of the ACoMS to clinical encounters is needed to determine utility in clinical practice.
Development and psychometric validation of an educational support assessment scale for novice home healthcare nurses
Authors: Mori Yoko , Sasaki Miki , Ogata Yasuko , Togari Taisuke 
Published: May 2023

Abstract
Background
Educational support quality is an essential factor in determining the education of novice home healthcare nurses. This study developed a scale to assess the educational support provided by home healthcare agencies among novice home healthcare nurses.

Methods
Hypothetical components were derived from a literature review, including experiential learning theory. Expert panels evaluated the initial scale items, and the scale was tested with 3000 agencies from April to June 2022. A total of 627 valid responses were analyzed.

Results
Exploratory factor analysis produced a four-subscale structure consisting of 34 items that supported the hypothesized components. Cronbach’s alphas ranged 0.889 to 0.961, and the intraclass correlation coefficients ranged 0.703 to 0.905 in the test-retest survey.

Conclusions
The educational support assessment scale developed for novice home healthcare nurses is valid and reliable. Managers in home healthcare agencies should apply the results of assessments using the scale to improve their human resource development.
A drug recommender system for the treatment of hypertension
Authors: Mai Arthur , Voigt Karen , Schübel Jeannine , Gräßer Felix 
Published: May 2023

Abstract
Background
One third (20% to 30%) of patients suffering from hypertension show increased blood pressure resistant to treatment. This resistance often has multifactorial causes, like therapeutic inertia and inappropriate medication but also poor patient adherence. Evidence-based guidelines aim to support appropriate health care decisions. However, (i) research and appraisal of clinical guidelines is often not practicable in daily routine care and (ii) guidelines alone are often insufficient to make suitable and personalized treatment decisions. Shared decision-making (SDM) can significantly improve patient adherence, but is also difficult to implement in routine care due to time constraints.

Methods
Clinical Decision Support Systems (CDSSs), designed to support clinical decision-making by providing explainable and personalized treatment recommendations, are expected to remedy the aforementioned issues. In this work we describe a digital recommendation system for the pharmaceutical treatment of hypertension and compare its recommendations with clinical experts. The proposed therapy recommender algorithm combines external evidence (knowledge-based) – derived from clinical guidelines and drugs’ professional information – with information stored in routine care data (data-based) – derived from 298 medical records and 900 doctor-patient contacts from 7 general practitioners practices. The developed Graphical User Interface (GUI) visualizes recommendations along with personalized treatment information and intents to support SDM. The CDSS was evaluated on 23 artificial test patients (case vignettes), by comparing its output with recommendations from five specialized physicians.

Results
The results show that the proposed algorithm provides personalized treatment recommendations with large agreement with clinical experts. This is true for agreement with all experts (agree_all), with any expert (agree_any), and with the majority vote of all experts (agree_majority). The performance of a solely data-based approach can be additionally improved by applying evidence-based rules (external evidence). When comparing the achieved results (agree_all) with the inter-rater agreement among experts, the CDSS’s recommendations partly agree more often with the experts than the experts among each other.

Conclusion
Overall, the feasibility and performance of medication recommendation systems for the treatment of hypertension could be shown. The major challenges when developing such a CDSS arise from (i) the availability of sufficient and appropriate training and evaluation data and (ii) the absence of standardized medical knowledge such as computerized guidelines. If these challenges are solved, such treatment recommender systems can support physicians with exploiting knowledge stored in routine care data, help to comply with the best available clinical evidence and increase the adherence of the patient by reducing site-effects and individualizing therapies.
Automated approach for quality assessment of RDF resources
Authors: Zhang Shuxin , Benis Nirupama , Cornet Ronald 
Published: May 2023

Abstract
Introduction
The Semantic Web community provides a common Resource Description Framework (RDF) that allows representation of resources such that they can be linked. To maximize the potential of linked data - machine-actionable interlinked resources on the Web - a certain level of quality of RDF resources should be established, particularly in the biomedical domain in which concepts are complex and high-quality biomedical ontologies are in high demand. However, it is unclear which quality metrics for RDF resources exist that can be automated, which is required given the multitude of RDF resources. Therefore, we aim to determine these metrics and demonstrate an automated approach to assess such metrics of RDF resources.

Methods
An initial set of metrics are identified through literature, standards, and existing tooling. Of these, metrics are selected that fulfil these criteria: (1) objective; (2) automatable; and (3) foundational. Selected metrics are represented in RDF and semantically aligned to existing standards. These metrics are then implemented in an open-source tool. To demonstrate the tool, eight commonly used RDF resources were assessed, including data models in the healthcare domain (HL7 RIM, HL7 FHIR, CDISC CDASH), ontologies (DCT, SIO, FOAF, ORDO), and a metadata profile (GRDDL).

Results
Six objective metrics are identified in 3 categories: Resolvability (1), Parsability (1), and Consistency (4), and represented in RDF. The tool demonstrates that these metrics can be automated, and application in the healthcare domain shows non-resolvable URIs (ranging from 0.3% to 97%) among all eight resources and undefined URIs in HL7 RIM, and FHIR. In the tested resources no errors were found for parsability and the other three consistency metrics for correct usage of classes and properties.

Conclusion
We extracted six objective and automatable metrics from literature, as the foundational quality requirements of RDF resources to maximize the potential of linked data. Automated tooling to assess resources has shown to be effective to identify quality issues that must be avoided. This approach can be expanded to incorporate more automatable metrics so as to reflect additional quality dimensions with the assessment tool implementing more metrics.
2.5D MFFAU-Net: a convolutional neural network for kidney segmentation
Authors: Sun Peng , Mo Zengnan , Hu Fangrong , Song Xin , Mo Taiping , Yu Bonan , Zhang Yewei , Chen Zhencheng 
Published: May 2023

AbstractBackgroundKidney tumors have become increasingly prevalent among adults and are now considered one of the most common types of tumors. Accurate segmentation of kidney tumors can help physicians assess tumor complexity and aggressiveness before surgery. However, segmenting kidney tumors manually can be difficult because of their heterogeneity.MethodsThis paper proposes a 2.5D MFFAU-Net (multi-level Feature Fusion Attention U-Net) to segment kidneys, tumors and cysts. First, we propose a 2.5D model for learning to combine and represent a given slice in 2D slices, thereby introducing 3D information to balance memory consumption and model complexity. Then, we propose a ResConv architecture in MFFAU-Net and use the high-level and low-level feature in the model. Finally, we use multi-level information to analyze the spatial features between slices to segment kidneys and tumors.ResultsThe 2.5D MFFAU-Net was evaluated on KiTS19 and KiTS21 kidney datasets and demonstrated an average dice score of 0.924 and 0.875, respectively, and an average Surface dice (SD) score of 0.794 in KiTS21.ConclusionThe 2.5D MFFAU-Net model can effectively segment kidney tumors, and the results are comparable to those obtained with high-performance 3D CNN models, and have the potential to serve as a point of reference in clinical practice.
Quality of obstetric and newborn care in health centers of Addis Ababa City: using the WHO quality framework
Authors: Abebe Amaha Haile , Mmusi-Phetoe Rose 
Published: May 2023

Abstract
Objective
The study aims to assess the quality of obstetric and newborn care using the WHO quality framework.

Design
The study used explanatory sequential mixed methods design.

Setting
This study was conducted in 50 health centers in Addis Ababa city administration from January 25 to December 31, 2021.

Methods
A total of 50 health centers were surveyed using a structured questionnaire and 500 women in the postpartum period were interviewed using a structured questionnaire. Delivery records of the 500 women were reviewed using a structured checklist. A total of 338 midwives were interviewed using a structured questionnaire. The quantitative data was analyzed using Statistical Package for Social Sciences (SPSS).

Results
The study revealed that only a third of the 50 health centers were providing good quality care (a quality score ≥ 75%). All the health centers had the physical resources (100%) to deliver obstetric and newborn care. The majority of the health centers had a system for actionable information (92%), functional referral (80%), and providing dignified care (80%). On the other hand, only a few of the health centers met the quality threshold for effective communication (24%), evidence-based practice of routine obstetric and newborn care (36%), and availability of mechanisms to support and motivate skilled birth attendants (24%). None of the health centers met the quality threshold for emotional support during labour and delivery. Obstetric caregivers’ high workload and job dissatisfaction were barriers to quality care.

Conclusion
Ensuring quality obstetric and newborn care needs effective quality improvement interventions that aim to ensure women had effective communication, emotional support, and dignity during labour and delivery. Reducing the workload and increasing motivation of birth attendants play a critical role in improving the quality of care.
Community Health Teams: a qualitative study about the factors influencing the decision-making process
Authors: Natkin Lisa W. , van den Broek-Altenburg Eline , Benson Jamie S. , Atherly Adam 
Published: May 2023

Abstract
Background
The purpose of this study was to explore the factors influencing how individual Community Health Teams (CHTs) make decisions about what services to offer and how to allocate their resources.

Methods
We conducted thirteen semi-structured interviews with all 13 CHTs program managers between January and March, 2021. We analyzed interviewees descriptions of their service offerings, resources allocation, and decision-making process to identify themes.

Results
Four major themes emerged from the interview data as factors influencing community health team program managers’ decision-making process: commitment to offering high-quality care coordination, Blueprint’s stable and flexible structure, use of data in priority setting, and leveraging community partnerships and local resources.

Conclusions
Community-based CHTs with flexible funding allowed programs to tailor service offerings in response to community needs. It is important for teams to have access to community-level data. Teams are cultivating and leveraging community partners to increase their care coordination capacity, which is focus of their work. CHTs are a model for leveraging community partnerships to increase service capacity and pubic engagement in health services for other states to replicate.
Effects of rye inclusion in dog food on fecal microbiota and short-chain fatty acids
Authors: Palmqvist Hanna , Ringmark Sara , Höglund Katja , Pelve Erik , Lundh Torbjörn , Dicksved Johan 
Published: May 2023

Abstract
Background
Rye intake has been associated with beneficial effects on health in human interventions, possibly due to dietary fiber in rye. In dogs, few studies have explored the effects on health of dietary fiber in general, and rye fiber in particular. The aim of this study was to investigate how inclusion of rye, compared with wheat, influenced fecal microbiota composition, short chain fatty acids (SCFA) and apparent total tract digestibility (ATTD) in dogs. Six male Beagle dogs (mean age 4.6 years, SEM 0.95 years; mean body weight 14.6 kg, SEM 0.32 kg) were fed three experimental diets, each for 21 days, including an adaptation period of six days and with 2–2.5 months between diet periods. The diets were similar regarding energy and protein, but had different carbohydrate sources (refined wheat (W), whole grain rye (R), or an equal mixture of both (RW)) comprising 50% of total weight on a dry matter (DM) basis. The diets were baked and titanium dioxide was added for ATTD determination. Fecal samples were collected before and in the end of each experimental period. Fecal microbiota was analyzed by sequencing 16S rRNA gene amplicons and fecal SCFA by high-performance liquid chromatography. Crude protein, crude fat, neutral detergent fiber, and gross energy (GE) in food and feces were analyzed and ATTD of each was determined. Univariate and multivariate statistical methods were applied in data evaluation.

Results
Faecal microbiota composition, differed depending on diet (P = 0.002), with samples collected after consumption of the R diet differing from baseline. This was primarily because of a shift in proportion of Prevotella, which increased significantly after consumption of the R diet (P < 0.001). No significant differences were found for SCFA, but there was a tendency (P < 0.06) for higher molar proportions of acetic acid following consumption of the R diet. The ATTD of crude protein, crude fat, neutral detergent fiber, and GE was lower after consumption of the R diet compared with the other diets (P < 0.05).

Conclusions
Consumption of the R diet, but not RW or W diets, was associated with specific shifts in microbial community composition and function, but also with lower ATTD.
Impact of individual microvascular disease on the risks of macrovascular complications in type 2 diabetes: a nationwide population-based cohort study
Authors: Yen Fu-Shun , Wei James Cheng-Chung , Shih Ying-Hsiu , Hsu Chih-Cheng , Hwu Chii-Min 
Published: May 2023

Abstract
Background
This study compared the risks of cardiovascular morbidity and mortality between patients with type 2 diabetes (T2D) with and without microvascular diseases, and between matched patients with microvascular diseases.

Methods
We identified newly diagnosed type 2 diabetes patients from National Health Insurance Research Database in Taiwan from January 1, 2008, to December 31, 2019. Propensity score matching was applied to construct matched pairs of patients with diabetic kidney disease, retinopathy, or neuropathy. Multivariable Cox proportional-hazard models were adopted to compare the risks of cardiovascular morbidity and mortality.

Results
Patients with microvascular disease had a significantly higher risk of cardiovascular morbidities and mortality than those without microvascular disease. Among the matched cohorts, patients with diabetic retinopathy had a significantly higher risk of stroke development than those with diabetic kidney disease (aHR 1.11, 95%CI 1.03–1.2). Diabetic neuropathy showed a significantly higher risk of stroke development than diabetic kidney disease (aHR 1.17, 95%CI 1.1–1.25) and diabetic retinopathy (aHR 1.12, 95%CI 1.03–1.21). Diabetic retinopathy had a significantly higher risk of incident heart failure than diabetic kidney disease (aHR 1.43, 95%CI 1.3–1.57), and diabetic neuropathy had a significantly lower risk of incident heart failure than diabetic retinopathy (aHR 0.79, 95%CI 0.71–0.87).

Conclusions
T2D patients with microvascular disease have a significantly higher risk of cardiovascular morbidities and mortality than those without microvascular disease. In the matched cohorts, diabetic neuropathy was significantly associated with stroke development, and diabetic retinopathy had a significant association with heart failure compared to other microvascular diseases.
1-3-7 surveillance and response approach in malaria elimination: China’s practice and global adaptions
Authors: Yi Boyu , Zhang Li , Yin Jianhai , Zhou Shuisen , Xia Zhigui 
Published: May 2023

AbstractThere has been a significant reduction in malaria morbidity and mortality worldwide from 2000 to 2019. However, the incidence and mortality increased again in 2020 due to the disruption to services during the COVID-19 pandemic. Surveillance to reduce the burden of malaria, eliminate the disease and prevent its retransmission is, therefore, crucial. The 1-3-7 approach proposed by China has played an important role in eliminating malaria, which has been internationally popularized and adopted in some countries to help eliminate malaria. This review summarizes the experience and lessons of 1-3-7 approach in China and its application in other malaria-endemic countries, so as to provide references for its role in eliminating malaria and preventing retransmission. This approach needs to be tailored and adapted according to the region condition, considering the completion, timeliness and limitation of case-based reactive surveillance and response. It is very important to popularize malaria knowledge, train staff, improve the capacity of health centres and monitor high-risk groups to improve the performance in eliminating settings. After all, remaining vigilance in detecting malaria cases and optimizing surveillance and response systems are critical to achieving and sustaining malaria elimination.