bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overuse of medical care in paediatrics: A survey from five countries in the European Academy of Pediatrics
Authors: Jankauskaite Lina , Grechukha Yevgenii , Kjær Kristin Avranden , Mamenko Marina , Nakstad Britt , Romankevych Ivanna , Schnyder Sara , Selvakumar Joel , Trapani Sandra , Daniliaviciene Sandra , Valiulis Arunas , Wyder Corinne , Størdal Ketil 
Published: September 2022

Studies and initiatives such as the “Choosing wisely” (CW) campaign emphasise evidence-based investigations and treatment to avoid overdiagnosis and overtreatment. The perception of the extent of medical overactivity among professionals and drivers behind are not well studied in the paediatric field.AimWe aimed to investigate the physicians‘ opinion and clarify the main drivers regarding medical overactivity in member countries of the European Academy of Paediatrics (EAP).MethodsIn this study, paediatricians, paediatric residents, primary care paediatricians, and family doctors treating children were surveyed in Norway, Lithuania, Ukraine, Italy, and Switzerland. Over-investigation was defined as “diagnostic work-up or referral that is unlikely to provide information which is relevant for a patient” and overtreatment was defined as “treatment that does not benefit or can harm more than benefit the patient.” The original questionnaire was developed in 2018 by a working group from the Norwegian Paediatric Association.ResultsOverall, 1,416 medical doctors participated in the survey, ranging from 144 in Lithuania to 337 in Switzerland. 83% stated that they experienced over-investigation/overtreatment, and 81% perceived this as a problem. The majority (83%) perceived expectations from family and patients as the most important driver for overtreatment in their country. Other drivers for overuse were use of national guidelines/recommendations, worry for reactions, and reduction of uncertainty.ConclusionThis is the first study investigating knowledge and attitude toward medical overactivity in European countries. Despite different cultural and economic environments, the patterns and drivers of increased investigations and medicalisation are similar.
Central administration of human opiorphin alleviates dextran sodium sulfate-induced colitis in mice through activation of the endogenous opioid system
Authors: Luo Pan , Li Xuelin , Gao Yuan , Chen Zhengjun , Zhang Quanwei , Wang Zhimin , Tian Xiaozhu 
Published: September 2022

The opioid system plays a crucial role in maintaining gastrointestinal homeostasis. Endogenous opioid peptide enkephalins have anti-inflammatory effect and participate in the treatment of inflammatory bowel diseases (IBDs). Here, we investigated the effect of natural enkephalinase inhibitor human opiorphin (HO) on dextran sodium sulfate (DSS)-induced colitis in mice. Our results showed that central administration of HO attenuated DSS-induced colitis, as indicated by the reduction of disease activity index (DAI) scores, macroscopic scores, histological scores, and the myeloperoxidase (MPO) activity. Moreover, HO alleviated DSS-induced inflammation by decreasing inflammatory cytokines TNF-α, IL-6, and IL-1β, and increasing anti-inflammatory cytokine IL-10 in both serum and colon tissues in DSS-treated mice. The potential anti-inflammatory effect of HO at a dose of 40 μg/kg was observed as evidenced by a decrease in nuclear factor κB (NF-κB) p65, toll-like receptor-4 (TLR-4), iNOS, and COX-2. HO also improved intestinal barrier function by enhancing the expression of tight junction proteins. Furthermore, HO treatment significantly inhibited activities of neutral endopeptidase (NEP) and aminopeptidase N (APN), elevated serum enkephalins concentrations, and increased expressions of mu and delta opioid receptors. In addition, pretreatment with opioid receptor antagonist naloxone hydrochloride (NH) compromised the protective effect of HO and aggravated colitis symptoms, as indicated by inhibited anti-inflammatory effects, disrupted intestinal barrier function, and decreased opioid receptor activity. In conclusion, these data indicate that HO protects against DSS-induced colitis by inhibiting TLR4/NF-κB pathway activation and improving intestinal barrier function through activation of the endogenous opioid system. Therefore, targeting the opioid system with peptidase inhibitors intervention would be a novel strategy in the therapy of IBD.
Moving through adulthood: The lived experience of Irish adults with PKU
Authors: O'Shea Mary-Ellen , Sheehan Gilroy Bernadette , Greaney Anna-Marie , MacDonald Anita 
Published: September 2022

BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria (PKU) living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework (1978) in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice.
Depressive symptoms in older adult couples: Associations with dyadic physical health, social engagement, and close friends
Authors: Miller Lyndsey M. , Steele Joel S. , Wu Chao-Yi , Kaye Jeffrey , Dodge Hiroko H. , Gonzales Mitzi M. , Lyons Karen S. 
Published: September 2022

ObjectiveThe objective of this study was to examine associations between level of depressive symptoms in older adult spouse/partner couples and their physical health and social factors (social activity and number of close friends).MethodsUsing data from 116 community-dwelling couples (age 76.2 ± 8.5), we simultaneously analyzed associations between depressive symptoms (Geriatric Depression Scale, range 0–11) and dyadic physical health, engagement in social activities, and connectedness with close friends.ResultsGreater engagement in social activities was associated with fewer depressive symptoms in men, whereas more close friendships were associated with fewer depressive symptoms in women, controlling for partner effects, age, education, and cognitive function, with good model fit. Additionally, more disparate physical health within the couple (latent incongruence score) was associated with greater depressive symptoms in men.DiscussionLess social activity and fewer close friends were associated with depressive symptoms in older adult couples, but may be distinctly influential depending on gender and in the context of the older adult couple's physical health.
Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study
Authors: Goiana-da-Silva Francisco , Cruz-e-Silva David , Rito Ana , Lopes Carla , Muc Magdalena , Darzi Ara , Araújo Fernando , Miraldo Marisa , Morais Nunes Alexandre , Allen Luke N. 
Published: September 2022

BackgroundExcessive salt consumption—associated with a range of adverse health outcomes—is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds.AimsTo estimate the health impact of subjecting imported and traditional breads to the current 1.4 g threshold, and to model the potential health impact of implementing the proposed 1.0 g threshold.MethodsWe gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modeling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; (1) Extending the 1.4 g threshold to all types of bread, and (2) Applying the 1.0 g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals.ResultsApplying the current 1.4 g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95% CI: 43–172). Lowering the current threshold from 1.4 to 1.0 g and applying it to all bread products would reduce daily salt consumption by 3.6 tons per day, saving an estimated 286 lives a year (95% CI: 123–454).ConclusionsSalt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.
Equity in maternal and child health care utilization in Guangdong province of China 2009–2019: A retrospective analysis
Authors: Wang Xin , Zhu Yingxian , Liu Jia , Ma Yuanzhu , Birch Stephen 
Published: September 2022

BackgroundEquity is the principal challenge of maternal and child health care (MCH) across the world, especially in China. Existing researches focused on equity in MCH resources and outcomes. There is an evidence gap regarding equity of MCH services utilization, revealing the black box between equity in MCH resources and MCH outcomes. In the study, we evaluate the changes of equity in integrated MCH service utilization in Guangdong province of China during 2009–2019.MethodsData used in this study are from the Guangdong Maternal and Child Health Routine Reporting System and the Guangdong Health Statistical Yearbook (2009–2019). The Gini coefficient (G) and Theil index (T) were employed to assess equity and source of inequity in four geographic regions of Guangdong province.ResultsGenerally, among the integrated MCH care, coverage of pre-pregnancy care (&lt;50%) is lower than in other stages. In the past decade, inequity of MCH care in the Equalization of Essential Public Health Service (EEPHS) program has gradually reduced to G &lt; 0.1. Screening of genetic metabolic disease and of hearing showed largest reductions of inequity (G reducing from 0.3–0.4 to 0.03–0.04). Inequity in reproductive health tests for brides-to-be, psychological assessment and consultation, education classes for mother-to-be and health management of children under 3 were mainly contributed by intra-region disparities in 2019.ConclusionEquity has gradually improved in the last decade in Guangdong. The national EEPHS program and the Integrated Prevention of Mother-to-Child Transmission of HIV, Syphilis and HBV of Guangdong have played important roles in reducing inequity in MCH service utilization. Further strategies, targeting pre-pregnancy reproductive healthcare, psychological assessments and consultations for the pregnant and education classes for mothers-to-be, should be taken to promote coverage and equity.
Fermentative Production of Volatile Metabolites Using Brettanomyces bruxellensis from Fruit and Vegetable By-Products
Authors: Lindsay Melodie A. , Granucci Ninna , Greenwood David R. , Villas-Boas Silas G. 
Published: September 2022

Natural sources of flavour and aroma compounds are highly sought by the modern consumer; however, traditional sources are often low-yielding, and global supply is often outstripped by consumer demand. Fermentation is a favourable route by which natural flavours and fragrances can be produced. A non-Saccharomyces yeast, Brettanomyces bruxellensis, was investigated for its fermentative potential for the production of flavour and aroma metabolites from juice industry by-products: apple pomace, carrot pomace, and orange pomace. Submerged solid-substrate fermentations were carried out using sterile by-products without nutrient supplementation. Gas chromatography–mass spectrometry was used for volatile metabolite profiling of fermented substrates. One compound of interest, phenylethyl alcohol (rose fragrance), was extracted and quantified using GC-MS at a yield of 2.68 g/kg wet carrot pomace weight. This represents a novel, natural production strategy for phenylethyl alcohol compared to the traditional steam distillation of Rosa domascus sp. petals.
Bharathi and Parakalar Announcing Separation Unendurable
Authors: S Kiruthiga , S Gandhidurai 
Published: September 2022

Some devotional literatures appeared by portraying the Lord as the superior male and the soul as a woman to make people to realize the philosophy of surrender. Bharati, who realized the aspiration of woman, and Thirumangaiyalwar (Parakalar), who realized the superiority of the Lord, created verses by assuming themselves as the heroine to express their devotion to Thirumal. The expression of love is manifested only in Separation unendurable. The purpose of this study is to compare the part of Kannan Pattu, ‘Kannan – En Kaadhalan’ composed by Bharathiar with the Thirumadals ‘Siriya Thirumadal’ and ‘Periya Thirumadal’ composed by Thirumangaiyalwar to reveal the inseparable sorrows caused to both of them by the separation of Kannan. The Descriptive Approach has been adopted for this research to express the sorrows of the departed heroines, the psychological approach to explore how the heroines’ love is felt, and the comparative approach to compare the two's feelings of separation.
Analysis of Character Education Value on English Textbook Students Grade Seventh Of SMPN 10 Parepare
Authors: Hirdayu Nurul , Anwar  , Hidayat Wahyu 
Published: September 2022

Character values should be taken into consideration in teaching and learning material. Textbook is one of media that can be used in teaching character education. The purpose of this research were to find out what character education values in English textbook students for grade seventh entitled “When English Rings A Bells”. This research was focused on revealing the Character Educational Value based on The Ministry of Education and Culture within the textbooks. This research used content analysis study to know the implemented EFL textbook. The procedure in data collection were table checklist and documentation. Technique of data analysis is data collection, data reduction, data display and conclussion. Based on the results of the analysis and discussion that has been described shows that Character Educational value in English Textbook entitled When English Rings A Bell, The value of Friendship/Communicative was the most Common Value With 21%. Then it was followed by Independent with 17%. The other valaue such as Religious 12%. Hard work value contains 7%. Discipline and Social Care value with 5%. Curiosity value with 4.6%. Creativity, Nationalism, and Appreciation Achievement with 4.1%. Enviromental Awareness and Honesty values with 3.5%. Reading Interest value with 2.5%. Tolerance value with 2.0%.Patriotism and Responsibility value contains 1.02%. The smallest were Love and Peace value with 0.5%. These findings lead to the conclusion that the textbook contain character educational values and upcoming for the future textbooks must pay a lot more attention to the character values.
Keywords: Character Education, Value, Textbook Analysis, English textbook, 2013 Curriculum,
Problematika Pembelajaran Kimia Peserta Didik Pada Pemahaman Konsep Dan Penyelesaian Soal Soal Hitungan
Authors: Susanty Heni 
Published: September 2022

<p>Menyadari belum optmalnya kemampuan peserta didik pada penyelesaian soal soal hitungan kimia stoikiometri dan konsep mol yang ditandai dengan masih rendahnya ketuntasan kelas rata-rata 60% - 65% peserta didik belum mencapai KKM yang telah ditetapkan , menuntut guru melakukan perbaikan pembelajaran, agar kemampuan peserta didik terhadap materi stoikiometri perhitungan kimia konsep mol dapat meningkat. Selama ini, guru hanya menyajikan pembelajaran tentang soal soal perhitungan kimia stoikiometri perhitungan kimia konsep mol hanya dengan menggunakan metode ceramah dan metode penugasan tanpa refleksi sehingga peserta didik tidak aktif dan tida mendapat pengalaman belajar yang bermakna sesuai dengan konteks dan pengalamamnnya sehari-hari. Oleh karena itu kemampuan dan aktifitas peserta didik perlu ditingkatkan. Fakta-fakta yang mengindikasikan adanya kesulitan belajar kimia<br /> Untuk memberikan gambaran tentang kesulitan belajar kimia, beberapa informasi telah dikumpulkan dari mailing list para penggemar kimia, penelitian-penelitian (mahasiswa S1, S2 dan S3) dan informasi lain yang yang mengindikasikan adanya kesulitan belajar. Informasi yang ditemukan ada yang berupa data-data kuantitatif, seperti prosentase siswa yang berhasil mengerjakan tes, nilai rata-rata ujian, atau dapat berupa data kualitatif dari hasil angket dan wawancara dengan siswa yang berupa bentuk-bentuk kesulitan belajar. Kesulitan yang dialami siswa adalah: 1) Dirasa sulit memnghubungkan antar konsep; 2) Diperlukan kemampuan dalam memanfaatkan kemampuan logika matematika dan bahasa (tidak semua siswa punya 3 kemampuan sekaligus); 3) Perlu daya juang yang tinggi dalam memahami dan menyelesaikan setiap soal. 4) Pemahaman antara teori dan praktik sering tidak nyambung. kemampuan matematikanya rendah cenderung tidak tertarik untuk mempelajari kimia. Masalah lain juga ditemui di pelosok-pelosok daerah kebanyakan peseta didik kurang memenuhi prasyarat belajar kimia seperti matematika, logika dan bahasa. Memang kimia tidak melulu matematika, tetapi juga berisi konsep lain yang tidak selalu berbau matematik.</p>
Akhlak Sebagai Esensi Pendidikan Islam
Authors: Maulidah Maulidah 
Published: September 2022

<p><em>Manusia sebagai makhluk berketuhanan, jiwa manusia terdapat fitrah diniyah, yaitu potensi yang dimiliki manusia untuk mempercayai Allah sebagai Tuhan yang wajib disembah. Islam mengajarkan pentingnya akhlak yang mulia dalam perilakunya. Sehubungan dengan aqidah, Islam memiliki tiga unsur pokok yang menjadi landasan agama yang sering disebut dengan Arkaanuddiin yaitu yang terdiri dari iman, Islam, dan ikhsan. Iman, berada dalam urutan pertama yang dimaksudkan agar iman menjadi sumber atau pedoman semua sikap, tindakan, dan perilaku umat Islam dalam melaksanakan tugas-tugas kehidupannya secara baik sehingga hasilnya bermanfaat bagi manusia di dunia maupun di akhirat. Dalam rangka membina dan mengembangkan seluruh potensi baik jasmani maupun rohani, dapat dilakukan melalui Pendidikan. Dengan proses Pendidikan, manusia mampu membentuk kepribadiannya.Untuk itu perlu diciptakan suasana kondusif agar terbentuk interaksi proses belajar mengajar yang mampu menyentuh dan menghubungkan seluruh aspek peserta didik. Ketersentuhan seluruh aspek anak didik akan mempermudah terangsangnya reaksi dan perhatian serta keinginan peserta didik untuk melaksanakan proses belajar mengajar. Formulasi secara integral dan harmonis dalam setiap interaksi Pendidikan islam menawarkan tiga konsep pendekatan, yaitu al-basyar, al-insan, dan al-nas. Dengan konsep ini akan dapat menumbuhkan minat peserta didik untuk mengembangkan seluruh potensi yang dimilikinya. Guna mewujudkan hal yang demikian itu diperlukan adanya norma akhlak dan aturan nilai moral yang disepakati bersama dan dijadikan sebagai acuan yang dapat membantu merumuskan tujuan Pendidikan, yaitu membentuk manusia agar memiliki akhlak mulia yang ditandai oleh adanya integritas kepribadian yang utuh, satu hati, ucapan dan perbuatan, memiliki tanggung jawab terhadap dirinya, masyarakat dan bangsanya.</em></p>
ЕФЕКТИВНІСТЬ КОМБІНОВАНОЇ ІМУНОТЕРАПІЇ ПРОПЕСОМ ТА ІНФЛАМАФЕРТИНОМ ПРИ ВИБІРКОВОМУ ДЕФІЦИТІ NK- І NKT-КЛІТИН У ДОРОСЛИХ ПАЦІЄНТІВ З ГЕНЕТИЧНИМ ДЕФІЦИТОМ ФОЛАТНОГО ЦИКЛУ
Authors: Стефанишин Володимир Михайлович , Мальцев Дмитро Валерійович 
Published: September 2022

Обґрунтування. Результати попередніх клінічних досліджень вказують на потенційну користь від комбінованої імунотерапії Пропесом та Інфла-мафертином для компенсації дефіциту NK- і/або NKT-клітин, зумовленого генетичним дефіцитом фолатного циклу (ГДФЦ), у дітей з розладами спектру аутизму.
Мета дослідження: вивчити ефективність комбінованої імунотерапії Пропесом та Інфлама-фертином при дефіциті NK- і/або NKT-клітин у дорослих з ГДФЦ.
Матеріали і методи. В даному одноцентровому ретроспективному контрольованому нерандомізованому клінічному дослідженні проаналізовано дані медичних карток 212 дорослих пацієнтів віком від 19 до 50 років з ГДФЦ (досліджувана група, ДГ). Пацієнти ДГ отримували Пропес в дозі 2 мл в/м через день на ніч протягом 3 місяців підряд (45 ін’єкцій) та Інфламафертин в дозі 2 мл в/м через день на ніч протягом 3 місяців підряд, чергуючи з Пропесом (45 ін’єкцій). Контрольну групу (КГ) склади 34 пацієнти аналогічного вікового і гендерного розподілу з ГДФЦ, однак не отримували імунотерапії.
Результати та їх обговорення. Кількість NK-клітин досягла нижньої межі норми у 95 із 131 пацієнта (72% випадків) з вихідним дефіцитом цих лімфоцитів, а середня кількість NK-клітин в крові в ДГ збільшилася майже вдвічі протягом 3-місячного курсу імунотерапії (р<0,05; Z<Z0,05), однак повернулася майже до вихідного рівня протягом 2-х на-ступних місяців після відміни імунотерапевтичних агентів (р>0,05; Z>Z0,05). Кількість NKT-клітин нормалізувалася у 136 із 174 пацієнтів (78% випадків) з вихідним дефіцитом цих клітин, а середня кількість NKT-клітин в крові в ДГ зросла під час курсу імунотерапії наполовину (р<0,05; Z<Z0,05) і продовжувала зростати протягом 2-х наступних місяців після відміни імунотропних препаратів (р<0,05; Z<Z0,05). Відзначалася спряженість між проведенням імунотерапії та нормалізацією кількості NK- (χ2=22,786; OR=11,215; 95%CI=3,534-35,590) і NKT-клітин (χ2=34,238; OR=9,54; 95%CI=4,094-22,247) в крові з середнім зв’язком між цими процесами (критерій φ=0,387 i 0,407 відповідно; С=0,361 і 0,377 відповідно).
Висновки. Комбінована імунотерапія за допомогою Пропесу та Інфламафертину – ефективна стратегія лікування імунодефіциту, зумовленого ГДФЦ, у дорослих пацієнтів.