bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined therapy with early initiation of infliximab following drainage of perianal fistulising Crohn’s disease: a retrospective cohort study
Authors: Zhu Ping , Sun Jin-fang , Gu Yun-fei , Chen Hong-jin , Xu Min-min , Li You-ran , Yang Bo-lin 
Published: January 2022

Abstract
Background
Recent studies have confirmed that combined surgery and anti-TNF therapy could improve outcomes in patients with perianal fistulising Crohn’s disease (PFCD). However, the optimal timing for infliximab infusion after surgical intervention is uncertain. We aimed to determine the long-term efficacy of early initiation of infliximab following surgery among PFCD patients.

Methods
We performed a retrospective cohort study of PFCD patients who received combined infliximab and surgical treatment between 2010 and 2018 at a tertiary referral hospital. Patients were grouped according to the time interval between surgery and infliximab infusion, with < 6 weeks into early infliximab induction group and > 6 weeks into delayed infliximab induction group. The primary outcome was to compare surgical re-intervention between early and delayed infliximab induction groups. The secondary outcomes were fistula healing and predictors associated with these outcomes of early infliximab induction approach.

Results
One hundred and seventeen patients were included (73 in early infliximab induction, 44 in delayed infliximab induction). The median interval between surgery and infliximab initiation was 9.0 (IQR 5.5–17.0) days in early infliximab induction group and 188.0 (IQR 102.25–455.75) days in delayed infliximab induction group. After followed-up for a median of 36 months, 61.6% of patients in early infliximab induction group and 65.9% in delayed infliximab induction group attained fistula healing (p = 0.643). The cumulative re-intervention rate was 23%, 32%, 34% in early infliximab induction group and 16%, 25%, 25% in delayed infliximab induction group, at 1, 2, and 3 years respectively (p = 0.235). Presence of abscess at baseline (HR = 5.283; 95% CI, 1.61–17.335; p = 0.006) and infliximab maintenance therapy > 3 infusions (HR = 3.691; 95% CI, 1.233–11.051; p = 0.02) were associated with re-intervention in early infliximab induction group. Presence of abscess at baseline also negatively influenced fistula healing (HR = 3.429, 95% CI, 1.216–9.668; p = 0.02).

Conclusion
Although no clear benefit was shown compared with delayed infliximab induction group, early initiation of infliximab after surgery could achieve promising results for PFCD patients. Before infliximab infusion, durable drainage is required for patients with concomitant abscess or prolonged infliximab maintenance therapy.
Control in the Hospital by Extensive Clinical rules for Unplanned hospitalizations in older Patients (CHECkUP); study design of a multicentre randomized study
Authors: Linkens Aimée E. M. J. H. , Milosevic Vanja , van Nie Noémi , Zwietering Anne , de Leeuw Peter W. , van den Akker Marjan , Schols Jos M. G. A. , Evers Silvia M. A. A. , Gonzalvo Carlota Mestres , Winkens Bjorn , van de Loo Bob P. A. , de Wolf Louis , Peeters Lucretia , de Ree Monique , Spaetgens Bart , Hurkens Kim P. G. M. , van der Kuy Hugo M. 
Published: January 2022

Abstract
Background
Due to ageing of the population the incidence of multimorbidity and polypharmacy is rising. Polypharmacy is a risk factor for medication-related (re)admission and therefore places a significant burden on the healthcare system. The reported incidence of medication-related (re)admissions varies widely due to the lack of a clear definition. Some medications are known to increase the risk for medication-related admission and are therefore published in the triggerlist of the Dutch guideline for Polypharmacy in older patients. Different interventions to support medication optimization have been studied to reduce medication-related (re)admissions. However, the optimal template of medication optimization is still unknown, which contributes to the large heterogeneity of their effect on hospital readmissions. Therefore, we implemented a clinical decision support system (CDSS) to optimize medication lists and investigate whether continuous use of a CDSS reduces the number of hospital readmissions in older patients, who previously have had an unplanned probably medication-related hospitalization.

Methods
The CHECkUP study is a multicentre randomized study in older (≥60 years) patients with an unplanned hospitalization, polypharmacy (≥5 medications) and using at least two medications from the triggerlist, from Zuyderland Medical Centre and Maastricht University Medical Centre+ in the Netherlands. Patients will be randomized. The intervention consists of continuous (weekly) use of a CDSS, which generates a Medication Optimization Profile, which will be sent to the patient’s general practitioner and pharmacist. The control group will receive standard care. The primary outcome is hospital readmission within 1 year after study inclusion. Secondary outcomes are one-year mortality, number of emergency department visits, nursing home admissions, time to hospital readmissions and we will evaluate the quality of life and socio-economic status.

Discussion
This study is expected to add evidence on the knowledge of medication optimization and whether use of a continuous CDSS ameliorates the risk of adverse outcomes in older patients, already at an increased risk of medication-related (re)admission. To our knowledge, this is the first large study, providing one-year follow-up data and reporting not only on quality of care indicators, but also on quality-of-life.

Trial registration
The trial was registered in the Netherlands Trial Register on October 14, 2018, identifier: NL7449 (NTR7691). https://www.trialregister.nl/trial/7449.
Distinct trajectories of perinatal depression in Chinese women: application of latent growth mixture modelling
Authors: Hong Lan , Le Tao , Lu Yinping , Shi Xiang , Xiang Ludan , Liu Meng , Zhang Wenmiao , Zhou Meixi , Wang Jiangling , Xu Dongwu , Yu Xin , Zhao Ke 
Published: January 2022

AbstractBackgroundCurrent research on perinatal depression rarely pays attention to the continuity and volatility of depression symptoms over time, which is very important for the early prediction and prognostic evaluation of perinatal depression. This study investigated the trajectories of perinatal depression symptoms and aimed to explore the factors related to these trajectories.MethodsThe study recruited 550 women during late pregnancy (32 ± 4 weeks of gestation) and followed them up 1 and 6 weeks postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent growth mixture modelling (LGMM) was used to identify trajectories of depressive symptoms during pregnancy.ResultsTwo trajectories of perinatal depressive symptoms were identified: “decreasing” (n = 524, 95.3%) and “increasing” (n = 26, 4.7%). History of smoking, alcohol use and gestational hypertension increased the chance of belonging to the increasing trajectories, and a high level of social support was a protective factor for maintaining a decreasing trajectory.ConclusionsThis study identified two trajectories of perinatal depression and the factors associated with each trajectory. Paying attention to these factors and providing necessary psychological support services during pregnancy would effectively reduce the incidence of perinatal depression and improve patient prognosis.
The impact of prenatal screening tests on prenatal diagnosis in Taiwan from 2006 to 2019: a regional cohort study
Authors: Hsiao Ching Hua , Chen Ching Hsuan , Cheng Po Jen , Shaw Steven W. , Chu Woei Chyn , Chen Ran Chou 
Published: January 2022

Abstract
Background
The purpose of this study is to evaluate the impact of prenatal screening tests on prenatal diagnosis in Taiwan’s 14 years from 2006 to 2019.

Methods
The prenatal screening methods evolved from the second-trimester serum screening to combined first-trimester screening (cFTS) and then followed by the non-invasive cell-free DNA prenatal test (NIPT). The data used by the Department of Statistics, the Ministry of Health and Welfare and Department of Household Registration, Ministry of the Interior public website.

Results
This regional registry-based cohort retrospective study examined a total of 2,775,792 births from January 2006 to December 2019. The proportion of advanced maternal age (AMA) pregnancies increased from 11.63% in 2006 to 30.94% in 2019. Overall, invasive diagnostic testing was used in 87.22% of AMA pregnancies. The prenatal detection rate of trisomy 21 and 18 increased from 74.1% and 83.3% in 2006 to 96.9% and 98.8% in 2019, respectively.

Conclusion
During the second-trimester and cFTS periods, the percentage of AMA pregnancies increased every year and the number of invasive procedures also accompany with increased percentage of AMA. However, during the period that NIPT were implemented, the percentage of invasive procedures decreased.
Parental care status and sexual risk behavior in five nationally-representative surveys of sub-Saharan African nations
Authors: Neville Sarah Elizabeth , Saran Indrani , Crea Thomas M. 
Published: January 2022

Abstract
Background
About 10% of children worldwide do not live with either of their biological parents, and although some of these children are orphans, many have living parents. While research shows that orphaned children in Sub-Saharan Africa tend to engage in more sexual risk behaviors than their peers, possibly due to decreased parental oversight and support, it is unclear if these effects also apply to children separated from their living parents. Exploring the question of whether living without parents, regardless of whether they are deceased, is linked to greater sexual risk-taking, this study is the first, to our knowledge, to examine correlates of parental care status in a multi-country, nationally-representative analysis.

Methods
This study was a secondary analysis of the Centers for Disease Control and Prevention’s Violence Against Children Surveys from Kenya, Malawi, Tanzania, Nigeria, and Zambia. We conducted logistic regressions on N = 6770 surveys of youth aged 13 to 17 years to determine if living with their biological parents predicted the odds of engaging in risky sexual behavior, controlling for demographic factors including orphanhood. Post-hoc regressions examined specific risk behaviors.

Results
Compared to those living with both parents, youth not living with either parent had heightened odds of engaging in any sexual risk behavior, even when controlling for orphanhood (OR = 2.56, 95% CI: [1.96, 3.33]). Non-parental care predicted heightened odds of non-condom use (OR = 3.35, 95% CI: [2.38, 4.72]), early sexual debut (OR = 1.80, 95% CI: [1.31, 2.46]), and more sexual partners (β = .60, p < .001).

Conclusions
This study extends prior research linking orphanhood and sexual risk behavior, lending credence to the idea that it is not parental death, but rather parental absence, that leads to sexual risk in youth. Public health programming in Sub-Saharan Africa should consider targeting not only “orphaned youth,” but all children separated from their parents.
Obesity indicators as mediators of association between daytime napping and type 2 diabetes mellitus: the Guangzhou Biobank Cohort Study
Authors: Xiao Jing Yi , Zhang Wei Sen , Jiang Chao Qiang , Jin Ya Li , Zhu Feng , Cheng Kar Keung , Lam Tai Hing , Xu Lin 
Published: January 2022

Abstract
Objective
To examine the mediating effect of obesity indicators on the association between daytime napping and type 2 diabetes mellitus (T2DM) qualitatively and quantitatively using baseline data from the Guangzhou Biobank Cohort Study.

Methods
Twenty-nine thousand three hundred fifty-five participants aged 50+ years were included in this cross-sectional study. Mediation analysis was used to assess the mediating effect of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) on the association between daytime napping and T2DM after adjustment for sex, age, education, occupation, smoking status, alcohol use and physical activity.

Results
The mean (standard deviation) age of participants was 61.5 ( 7.1) years. The prevalence of T2DM and daytime napping was 12.5% and 65.2%, respectively. After adjustment for potential confounders, WC, WHR and WHtR showed partial mediating effects on the association between daytime napping and T2DM, with the proportion (95% confidence interval) of mediation effect being 10.17% (8.14–14.43%), 14.91% (11.95–21.24%) and 9.36% (7.49–13.29%), respectively. No mediating effect of BMI or HC on the association between daytime napping and T2DM was found.

Conclusions
Our results showed significant mediating effects of WC, WHR and WHtR on the association between daytime napping and T2DM, suggesting that waist circumference management could be important in daytime nappers.
Association between work-related musculoskeletal symptoms and quality of life among dental students: a cross-sectional study
Authors: Sezer Berkant , Kartal Sinan , Sıddıkoğlu Duygu , Kargül Betül 
Published: January 2022

Abstract
Background
Dental students are frequently affected by work-related musculoskeletal symptoms (WMSs) due to reasons such as working conditions, difficult education process and long work periods. The aim of the study was to investigate the frequency and anatomical distribution of WMSs, and its effect on the quality of life (QoL) in dental students.

Methods
Sociodemographic and health-related characteristics of one-hundred and five dental students were recorded. WMSs were scored by the participants with the Nordic Musculoskeletal Questionnaire. Then, participants were asked to evaluate their QoL by scoring the World Health Organization Quality of Life-Brief Form. Differences between independent groups for continuous variables were evaluated by Student’s t-test and ANOVA as appropriate. Linear regression analysis was performed to determine the effect of demographic and health-related parameters in predicting the QoL subscales.

Results
The most common painful region in the last 12 months was the neck (66.7%). The body region with the most WMSs in the last 7 days was the upper back (43.8%). Physical health-related QoL of those with diagnosed musculoskeletal symptoms, and general health-related QoL of those using medicine due to any musculoskeletal symptoms were found to be statistically significantly lower (p = 0.018, p = 0.041, respectively). It was observed that the general and physical health, psychological well-being, and social relationship of the participants who reported the presence of neck pain in the last 7 days were statistically significantly lower (p = 0.003, p < 0.001, p = 0.004, p = 0.012; respectively). According to multiple regression analyses, pain occurrence in the body in the last 12 months and/or in the last 7 days had a negative impact on the participants’ general and physical health, psychological well-being, social relationship, and environmental status and related QoL (p = 0.026, p = 0.047, p = 0.021, p = 0.001, p = 0.027, respectively).

Conclusions
The results of this study show that dental students’ body regions, especially the neck and the back, are affected by WMSs. These negative changes observed in the body had a negative effect on the QoL of the dental students.
Benefits of semiology taught using near-peer tutoring are sustainable
Authors: Gripay Benjamin , André Thomas , De Laval Marie , Peneau Brice , Secourgeon Alexandre , Lerolle Nicolas , Annweiler Cédric , Justeau Grégoire , Connan Laurent , Martin Ludovic , Bière Loïc 
Published: January 2022

Abstract
Background
Near-peer tutoring appears to be an efficient approach for teaching clinical skills. However, the clinical experience gained in the form of student medical internships may offset any interest in such tutoring programme. We then investigated the long-term benefits of this programme.

Methods
This study was conducted in a medical school that experimented in near-peer tutoring for semiology intended for undergraduate medical students. Objective Structured Clinical Examinations and a written semiology test were used to assess students’ clinical skills immediately on its conclusion and repeated one and 2 years after the tutoring was completed.

Results
116 students were evaluated initially (80 tutored and 36 untutored), 38 at 1 year (16 tutored and 22 untutored), 42 at 2 years (21 tutored and 21 untutored). In the global score for Objective Structured Clinical Examinations: at 1 year, the tutored group scored 14.0 ± 1.05 and the untutored group scored 11.3 ± 2.3 (p < 0.001), at 2 years, the tutored group scored 15.1 ± 1.5 and the untutored group scored 12.4 ± 2.2 (p < 0.001). We found a similar but smaller difference for the written semiology test. The difference for Objective Structured Clinical Examinations between tutored and untutored students vanished over time for cross-cutting skills.

Conclusions
Near-peer tutoring in semiology for undergraduate medical students led to better results that remained with the passing of time. Though internships do allow an improvement in the clinical skills of untutored students, they did not reach the level of tutored students.
Health care providers’ awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia
Authors: Mukhamedshina Y. O. , Fayzullina R. A. , Nigmatullina I. A. , Rutland C. S. , Vasina V. V. 
Published: January 2022

AbstractBackgroundAutism spectrum disorder (ASD) is a complex developmental range of conditions that involves difficulties with social interaction and restricted/repetitive behaviors. Unfortunately, health care providers often experience difficulties in diagnosis and management of individuals with ASD, and may have no knowledge about possible ways to overcome barriers in ASD patient interactions in healthcare settings. At the same time, the provision of appropriate medical services can have positive effects on habilitative progress, functional outcome, life expectancy and quality of life for individuals with ASD.MethodsThis online survey research study evaluated the awareness and experience of students/residents (n = 247) and physicians (n = 100) in the medical management of children with ASD. It also gathered the views and experiences of caregivers to children with ASD (n = 158), all based in Russia.ResultsWe have established that the Russian medical community has limited ASD knowledge among providers, and have suggested possible reasons for this. Based on results from online surveys completed by students/residents, non-psychiatric physicians, and caregivers of children diagnosed with ASD, the main problems pertaining to medical management of individuals with ASD were identified. Possible problem solving solutions within medical practice were proposed.ConclusionsThe results from this study should be considered when implementing measures to improve healthcare practices, and when developing models for effective medical management, due to start not only in Russia but also in a number of other countries.
Brazilian private health system: history, scenarios, and trends
Authors: Cruz June Alisson Westarb , da Cunha Maria Alexandra Viegas Cortez , de Moraes Thyago Proença , Marques Sandro , Tuon Felipe Francisco , Gomide Arivelton Loeschke , de Paula Linhares Gisele 
Published: January 2022

Abstract
Background
Health care is a complex economic and social system, which combines market elements and public and social interest. This combination in Brazil, like systems in China and United States of America, is operationalized through the public and private system. The sector represents approximately 9% of the country’s GDP, of which 56% is privately sourced and 44% is of public origin. In the private sector includes a structure with 711 private health institutions, 47 million beneficiaries and revenues of US$30 billion a year.

Methods
Therefore, this research describes and analyzes the complementarity of Private Health before the Brazilian Unified Health System, highlighting its main characteristics, scenarios, and trends in the face of the health system and the Brazilian market. This descriptive and exploratory research uses secondary data from various sources, submitted to quantitative data analysis methods. The object of the research is the history of private health in Brazil and its main actors.

Results
The data are organized into three groups, each with its approach of collection and analysis. Thus, it is perceived as the notorious growth of large operators, to the detriment of operators with a lower concentration of beneficiaries; the increasing concentration of the market through mergers and acquisitions promoted by large publicly traded corporations, especially in regions with a lower rate of private health coverage; and the growth of the sector through business plans, whose central characteristic is the dependence on the country’s employability rate.

Conclusions
It is possible to perceive an intense trend of concentration of Brazilian private health in large institutions that have capitalized and have a great appetite for growth through mergers and acquisitions, whether from smaller operators or health institutions that integrate their health networks, following complementary health models already consolidated in countries such as China, and the United States of America, among others. This concentration projects a market with fewer options and competitiveness, reduction in transaction costs and increase the operational effectiveness of health care.
RETRACTED ARTICLE: Bone mesenchymal stem
cell-derived exosomal microRNA-7-5p inhibits progression of acute myeloid leukemia by
targeting OSBPL11
Authors: Jiang Duanfeng , Wu Xin , Sun Xiaoying , Tan Wei , Dai Xin , Xie Youbang , Du Ashuai , Zhao Qiangqiang 
Published: January 2022

Abstract

Background
Acute myeloid leukemia (AML) is a malignant clonal disease of
hematopoietic stem- and progenitor-cell origin. AML features massive proliferation of
abnormal blasts and leukemia cells in the bone marrow and the inhibition of normal
hematopoiesis at onset. Exosomes containing proteins or nucleic acids are secreted by
cells; they participate in intercellular communication and serve as key modulators of
hematopoiesis. The purpose of this study was to investigate the effects of exosomes
derived from bone marrow mesenchymal stem cells (BMSCs) on the regulation of AML and
the underlying mechanisms mediated by microRNA (miRNA).

Methods
Dysregulated miR-7-5p in AML patients was identified using qRT-PCR and
its clinical significance was explored. Bioinformatic analysis revealed the target
gene OSBPL11 that could be regulated by miR-7-5p.
The findings were validated using a dual-luciferase reporter assay and western
blotting. The functional genes of the PI3K/AKT/mTOR signaling pathway were
identified, and the functional significance of miR-7-5p in AML cells was determined
using a functional recovery assay. AML cells were co-cultured with exosomes
originating from BMSCs overexpressing miR-7-5p to determine cell–cell regulation by
Exo-miR-7-5p, as well as in vitro and in vivo functional validation via gain- and
loss-of-function methods.

Results
Expression of miR-7-5p was decreased in AML patients and cells.
Overexpression of miR-7-5p curbed cellular proliferation and promoted apoptosis.
Overexpression of OSBPL11 reversed the tumorigenic
properties of miR-7-5p in AML cells in vitro. Exo-miR-7-5p derived from BMSCs induced
formation of AML cells prone to apoptosis and a low survival rate, with OSBPL11 expression inhibited through the PI3K/AKT/mTOR
signaling pathway. Exo-miR-7-5p derived from BMSCs exhibited tumor homing effects in
vitro and in vivo, and inhibited AML development.

Conclusions
Exo-miR-7-5p derived from BMSCs negatively regulates OSBPL11 by suppressing the phosphorylation of the
PI3K/AKT/mTOR signaling pathway, thereby inhibiting AML proliferation and promoting
apoptosis. The data will inform the development of AML therapies based on
BMSC-derived exosomes.

Graphical Abstract