bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of stakeholders’ perspectives on the Front-of-Pack Labeling regulation in Mexico
Authors: Durán Regina , Asmitia Edalith , Rivera Juan , Barquera Simón , Tolentino-Mayo Lizbeth 
Published: May 2022

Abstract
Background
In Mexico, the inclusion of a Front-of-Pack Label in the Official Mexican Standard-051 (NOM-051 for its Spanish acronym) has been widely discussed for years by different stakeholder groups. In 2019, the NOM-051 modification project was proposed, which included front-of-pack warning labels. To be modified, it went through a public consultation period where stakeholders sent their comments to be reviewed and considered. The purpose of this study was to analyze the perspectives of key stakeholders during the public consultation of the NOM-051 modification project in order to understand their positions and their effect on the final public policy.
Methods
To analyze perspectives, the 795 comments received on the website of the National Commission for Regulatory Improvement were analyzed. Identity, expectations, and demands were identified from each comment using content analysis in NVivo. In addition, frequencies and percentages were obtained. To identify the public consultation’s effect on the modification project, we compared the most significant changes made to the NOM-051 modification project with the outstanding demands of the stakeholders.
Results
56% of the comments were against the NOM-051 modification project. Industry and Business Interest Non-Governmental Organizations were against it, they considered that their revenues and profits would be affected. Public Interest Non-Governmental Organizations, academy and health professionals were in favor, they expected that eating habits would improve and demanded the front-of-pack warning label suggested in the modification proposal be maintained. The published regulation (NOM-051) demonstrates that the stakeholders’ main demands were considered in the policy development and their involvement was fundamental for the process.
Conclusions
The comments against the NOM-051 modification project were consistent with the literature, indicating that food industry stakeholders use all possible strategies to interfere in public health policies. The main issues used by the food industry to discredit the NOM-051 modification project coincide with those used in other countries to stop public health policies and with those used by the tobacco industry to avoid market regulations. On the other hand, those in favor looked after the interests of the Mexican population.
Perceptions of permitting physician dual practice with restrictions: empirical evidence of public hospital managers from East, Middle and West of China
Authors: Yu Yuanyuan , Chen Xiaolin , Cho William CS , Jia Leipo , Fan Xiaojing , Liu Qiaoman , Zhang Xiumin , Lv Yijun , Xu Huiqing 
Published: May 2022

Abstract
Background: This study aims to explore public hospital managers’ perceptions of permitting Physician dual practice (PDP) with restrictions in China.Methods: A cross-sectional study among 1,513 public hospital managers in 31 provinces of mainland China was carried out from January to October, 2019. Presidents in charge of medical affairs, and directors of medical affairs departments in Chinese public hospitals were recruited for this study. Exploratory factor analysis (EFA) was conducted to determine the factorial validity of perceptions of permitting physician dual practice with restrictions (institution-oriented restriction, IR; physician-oriented restriction, PR). Generalized linear models (GLM) were used to explore and analyze perceptions of permitting PDP with restrictions of public hospital managers with demographic and working-related characteristics.Results: Public hospital managers’ decision of prohibiting PDP, allowing PDP, and implementing PDP with restrictions was 5.7%, 8.9%, 85.4%, respectively. Mean scores of IR and PR were 16.49 ± 3.03 and 10.84 ± 2.55 respectively. General hospital managers (coefficient of -0.52; P <.01) showed less preference to IR; managers from public hospitals in the West (coefficient of 0.77; P <.01) and Middle of China (coefficient of 0.50; P <.05) favoured IR; managers with academic background of clinical medicine (coefficient of -0.37; P <.05) held lower PR intention. On the contrary, female managers (coefficient of 0.54; P <.01) and managers from public hospitals in non-provincial capital cities (coefficient of 0.35; P <.05) preferred PR.Conclusions: From the perspectives of the public hospital managers in China, permitting PDP with restrictions would be feasible compared to completely prohibiting or allowing PDP, which could be further enforced in terms of IR and PR. Moreover, public hospital managers hold a slightly more positive view about IR than PR.
Evaluation of the Effect of Propolis versus Calcium Hydroxide, Intracanal Medicaments, on Post-Operative Pain in Patients with Necrotic Pulp (A Randomized Clinical Trial)
Authors: Sirry Serene Mohamed Hisham , Marzouk Abeer , Gawdat Shaimaa , Omer ElSayed Abulfotowh 
Published: May 2022

Abstract
AimPropolis is an immunomodulatory, antioxidant, flavonoid-rich resinous product of honeybees. Propolis was reported as less cytotoxic and more effective against resistant microorganisms than calcium hydroxide (Ca(OH)2) as well as biocompatible to the periradicular tissues than existing intracanal medicaments. The aim of this single-blinded randomized clinical trial was to evaluate the effect of propolis versus Ca(OH)2, intracanal medicaments, on post-operative pain in patients with necrotic single canal teeth.MethodsForty-six participants, aged 20–40 years, with necrotic pulp in their single-rooted, single canal teeth were randomized into this parallel study, with 23 participants in Ca(OH)2 (control) group and 23 participants in propolis (intervention) group. Root canal treatment was done in two visits and the medicament was applied for one week in between. The participants were blinded to the medicament used. The participants rated their pain score by a numerical rating scale after 24, 48, 72 hours and at 7 days before medicament removal and canals obturated. The data was statistically analyzed by multivariate analysis and t-test. The significance level was set at P ≤ 0.05 for all tests.ResultsThe incidence of post-operative pain between both groups showed no statistically significant difference at different time intervals (p > 0.05). There was a non-significant, gradual decrease in post-operative pain of all 46 participants in both propolis (P = 0.17) and Ca(OH)2 group (P = 0.274), at different time intervals.ConclusionsThe intracanal use of both Ca(OH)2 and propolis were equally effective in controlling post-operative pain. Propolis can be used, as an alternative intracanal medicament, to Ca(OH)2 paste.This trial is registered at ClinicalTrials.gov, number NCT04983524
Primary neuroendocrine tumor of the portal hepatic duct in adolescence: a case report
Authors: Wang Fanghong , Zhu Kexiang , Zhang Hui , Zhang Lei , Zhang Bo , Wang Fang , Zhou Wence , Li Xun 
Published: May 2022

Abstract
Background: It is not uncommon for neuroendocrine tumors (NETs) to occur in the gastrointestinal tract, pancreas, and lungs, but NETs originating from the biliary system are relatively rare, accounting for 0.67% of gastroenteropancreatic system tumors. At present, less than 10 cases of extrahepatic biliary neuroendocrine tumors have been reported in adolescent. Case presentation: This report presents a case of a 17-year-old boy with a NET of the portal hepatic duct. Obstructive jaundice was judged from the laboratory examination and imaging findings. After the evaluation and multidisciplinary discussion, he underwent resection of the common bile duct, common hepatic duct, and gallbladder and Roux-en-Y hepaticojejunostomy. Pathological examination revealed a NET with the tumor invading the wall of the bile duct and surrounding adipose tissue. The patient had no NETs in any other organs or tissues. This case was a primary NET, not a metastatic tumor. Conclusion: The preoperative diagnosis of primary neuroendocrine tumor of the portal hepatic duct is difficult, and this tumor is often confused with hilar cholangiocarcinoma. Surgical treatment is the only effective way to cure it. Once the diagnosis has been made, surgical resection should be performed as soon as possible.
A decade-long innovative collaboration network between hospitals and the biomedical industry in China: A social network analysis
Authors: Yu Wenya , Chen Hong , Tian Jiahe , Cao Zilong , Li Meina , Lv Yipeng , Chu Qiao , Wang Zhaoxin , Liu Xiang 
Published: May 2022

Abstract
Background: Innovative collaboration between hospitals and biomedical enterprises is crucial for ensuring breakthroughs in their development. The aim of this study is to explore the characteristics and examine the main roles of the associated key actors of an innovative collaboration between hospitals and biomedical enterprises in China. Methods: Using the patent data owned jointly by these two key actors within the country’s healthcare industry, a decade-long innovative collaboration network between hospitals and biomedical enterprises in China was established and analyzed through social network analysis. Patent data from the IncoPat global patent database, which is based on the International Patent Classification system, were extracted. Results: Findings show that innovative collaboration resulted in enhanced development within economically developed regions. Hospitals occupied a dominant position in the innovative collaboration network, whereas a biomedical enterprise located in Shenzhen had the highest degree, betweenness, and closeness centralities. Conclusions: Innovative collaboration between hospitals and biomedical enterprises in China is still low. Policy support and economic investments should be encouraged, especially in less-developed regions to enhance innovative collaboration between hospitals and the biomedical industry in China and other similar countries or regions.
Computer-assisted Gross Pathological Classification for Resected Hepatocellular Carcinoma
Authors: Nakayama Hisashi , Okamura Yukiyasu , Mochizuki Susumu , Hojo Akihisa , Moriguchi Masamichi , Higaki Tokio , Takayama Tadatoshi , Tsukamoto Arata , Itoh Akiyoshi 
Published: May 2022

Abstract
Aims: We aimed to develop a computer-assisted system for the gross classification of resected hepatocellular carcinoma (HCC) and to evaluate whether this objective classification can be used to predict patient outcomes.Methods: This study included 236 patients diagnosed with solitary HCC who underwent initial resection. We analyzed photographed images of the cut surface of HCCs using a new software to establish a novel gross classification system. Survival curves in each of the classified groups were compared. Results: The median (range) values for the equivalent diameter, circularity, and complexity of tumors were 2.63 cm (0.72–14.49), 0.49 (0.00–0.84), and 0.51 (0.16–1.00), respectively. HCCs were classified into three groups using hierarchical cluster analysis: Type I (circular type, n=130), Type II (rough type, n=92), and Type III (disordered type, n=14). Microscopic portal invasion was observed in 14.6%, 23.9%, 71.4% patients in the Type I, II, and III groups, respectively. The 5-year recurrence-free survival rates of patients with Type I, II, and III HCC were 31.5%, 24.7%, and 14.3%, respectively. The 5-year overall survival rates of patients with Types I, II, and III HCC were 65.4%, 54.7%, and 28.6%, respectively. Type II or III HCC were independently associated with death and an increased risk of recurrence. The conventional classification was not adopted due to its weaker power than the above-mentioned contributors.Conclusion: Our computer-assisted gross classification system for HCC indicated that this classification is closely associated with microscopic portal invasion, suggesting aid in predicting patient outcomes than that of conventional subjective classification.
A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards.
Authors: Fien Samantha , Lawes Jasmin C. , Ledger Jessica , Drummond Murray , Simon Pamela , Joseph Nancy , Daw Shane , Best Talitha , Stanton Robert , de Terte Ian 
Published: May 2022

Abstract
Background
Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The present study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and stigma in Surf Life Saving (SLS) members.
Methods
An anonymous, online survey was developed (adolescent and adult versions) was created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson’s correlations investigated relationships between PTEs, PTSS, social support, self-efficacy, stigma, age, years as a SLS member, and years patrolling. Spearman’s Rank was used for violations of normality.
Results
A total of 57 surf lifesavers/lifeguards aged 13–59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative stigma towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed.
Conclusion
This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and wellbeing associated with this first responder role. More research to protect the vulnerability of this population is warranted.
Distraction osteogenesis in two cases of unilambdoid synostosis
Authors: Oka Chihiro , Hirokawa Daisuke , Homma Hirokuni , Yasumura Kazunori , Kobayashi Shinji , Sato Hironobu 
Published: May 2022

Abstract
Unilateral lambdoid synostosis (ULS) is a rare suture anomaly and its diagnosis and treatment remain controversial. We investigated how to improve their function and morphology through the review of two cases of ULS with improved function and morphology by the same unreported operative procedure. Moreover, we discussed the diagnosis and treatment of ULS. Case 1 involved a 15-month-old female, brought for consultation because of suspected right ULS. She was diagnosed with right lambdoid and squamous synostoses and approximately 15 mm descent of the cerebellar tonsil. Thus, we performed foramen magnum decompression, first cervical vertebra laminectomy, and skull lengthening. Case 2 involved an 18-month-old female. She also consulted for suspected right ULS. Computed tomography revealed right ULS and squamous synostosis and magnetic resonance imaging showed approximately 9 mm descent of the cerebellar tonsil. We performed foramen magnum decompression and skull lengthening. Both procedures included decompression of the foramen magnum. We enforced osteotomy of the affected side of the lambdoid suture by crossing the superior sagittal sinus and added horizontal osteotomy from the superior right squamous suture to the coronal suture. Three extension devices were placed, two and one in the lambdoid and squamous sutures, respectively. After skull extension and descent of the cerebellar tonsil, exertion of the left frontal bone was improved. In cases of ULS, the squamous suture fusion and the drooping of the cerebellar tonsils can be complicated. Extending the lambdoid suture upward and downward and decompressing the posterior cranial fossa may improve the morphological and functional prognoses.
A Rare Case of Human Urogenital Myiasis Caused by Chironomus crassicaudatus (Diptera: Chironomidae) from Kolkata, India
Authors: Banerjee Kokila , Dutta Arindam , Roy Subhendu 
Published: May 2022

Abstract

Infestation by the Dipteran insect larvae is one of the public health problems in tropical countries, including India. Calliphorid flies are reported to cause various types of myiases, including urogenital myiasis. Besides, non-myiasis-producing flies also occasionally invade human or animal tissues and cause myiasis. For the first time, we report here, an uncommon type of myiasis of the urogenital system due to an infestation by Chironomus larvae. A 19-year-old female patient from a poor socio-economic background from Kolkata, India attended the outpatient department with a complaint of passing worms in her urine with one-to-five larvae, several times a day, for four weeks. Another member of the family had a similar complaint. The larvae isolated from the patient were identified to be Chironomus crassicaudatus (Diptera: Chironomidae). It was probable that Chironomid flies breeding in and around the dwellings had infested the urethra. The patient was successfully treated with albendazole. Implementing overall environmental and personal hygienic living conditions, eliminating fly breeding habitats, and avoiding sharing of a common toilet facility are important measures to avoid such kind of fly infestation.
Exploratory study: use of OSCEs in teleconsultation to evaluate diagnostic hypotheses provided by a symptom checker
Authors: Vuillaume Laure Abensur , Turpinier Julien , Cipolat Lauriane , Dépil-Duval Arnaud , Dumontier Thomas , Peschanski Nicolas , Kieffer Yann , Barbat Boris , Riquier Thomas , Dinot Vincent , Galland Joris 
Published: May 2022

Abstract
Backround: The overloading of health care systems is an international problem. In this context, new tools such as symptom checker (SC) are emerging to improve patient orientation and triage. Similarly, the COVID-19 pandemic saw the emergence of teleconsultations. The OSCEs could be adapted in this sense for evaluation and training purposes.Objective: The main objective of this study was to explore the performance of a symptom checker against emergency physicians using OSCEs as an assessment method.Methods: We explored a method to evaluate a SC and physician with simulation. A panel of medical experts wrote 220 simulated patients. Each situation was played twice by an actor trained to the role, once in front of the SC, once in front of a physician. Like a telephone consultation, only the patient's voice was accessible. We performed a prospective diagnostic non-inferiority study. If primary analysis failed to detect non-inferiority, we have planned a superiority analysisResults: We cannot conclude if the SC is non-inferior. However, the emergency physician was superior compared to the SC in terms of principal diagnosis (81% versus 30%) and association of principal and secondary diagnosis (92% versus 52%). In terms of patient triage (vital emergency or not), there is still a medical superiority (96% versus 71%). There is also a non-inferiority of the SC compared to the physician in terms of interviewing time.Conclusions and relevance: This type of evaluation should be extended to other types of software in order to provide scientific evidence of the application of tools used in pedagogy to a more clinical research, but also to deepen the evaluation for educational purposes in the face of the advent of physician 2.0.
RAGE inhibition alleviates LPS-induced lung injury via directly suppressing autophagic apoptosis of alveolar epithelial cells
Authors: Xiong Xi , Dou Jiaying , Shi Jingyi , Ren Yuqian , Wang Chunxia , Zhang Yucai , Cui Yun 
Published: May 2022

Abstract
Background: Advanced glycation end product receptor (RAGE) acts as the receptor of pro-inflammatory ligands and highly expressed in alveolar epithelial cells (AECs). Autophagy in AECs has received much attention nowadays. However, the role between autophagy and RAGE in the pathogenesis of acute lung injury remains unclear. Therefore, the aim of this study is to explore whether RAGE activation signals take part in disfunction of alveolar epithelial barrier through autophagic death.Methods: We established the acute lung injury animal model using C57BL/6 and ager genes knockout (ager -/- mice) mice. A549 cells were treated with siRNA to reduce ager gene expression. Autophagy was inhibited by 3-methyladenine. Lung injury was assessed by histopathological examination. Cell viability was estimated by cell counting kit-8. The serum and bronchoalveolar lavage fluid (BALF) of IL-6, IL-8 and soluble RAGE (sRAGE) evaluated by ELISA, further studied the involvement of RAGE signals, autophagy and apoptosis by western blots, immunohistochemistry, immunofluorescence, transmission electron microscopy and TUNEL test.Results: The expression of RAGE was promoted by LPS, which was associated with activation of autophagy both in mice lungs and A549 cells. sRAGE in the BALF presented a positive correlation with inflammatory factors, inflammation and apoptosis in lungs were alleviated in ager-/- mice than wild-type controls. Persistently activated autophagy contributed to cells apoptosis, while blocking autophagy by 3-MA protects from lung damage, ager knockdown inhibited LPS-induced autophagy and attenuated lung injury. RAGE knockdown by siRNA in A549 cells significantly suppressed LPS-induced autophagy activation and apoptosis. The expression of RAGE activates the downstream STAT3 signaling pathway. Conclusion: RAGE plays an essential role in the pathogenesis of AECs injury, RAGE inhibition alleviates LPS-induced lung injury via directly suppressing autophagic apoptosis of alveolar epithelial cells.