bluuebunny/crossref_metadata_2025_split huggingface dataset:
The in-vitro effect of gonadotropins’ type and combination on Granulosa cells gene expressions
Authors: Yung Yuval , Aizer Adva , Tieb Sarah , Maydan Sharon Avhar , Maman Ettie , Haham Lilach Marom , Haas Jigal , Orvieto Raoul 
Published: September 2022

Abstract
Objective
Nowadays, different modes and timing of GnRH-agonist combined with hCG trigger, for final follicular maturation, have been described. While LH + FSH are the naturally occurring final follicular maturation trigger, hCG is commonly use during stimulated cycle, and recently the introduction of the Dual/Double trigger combines LH + FSH + hCG. In the present study we aim to investigate the messenger RNA (mRNA) expression of reproduction-related genes in human granulosa cells (GCs) exposed to the aforementioned different types and combinations of gonadotropins.

Material and methods
Mural GCs were obtained from follicular fluid aspirated during IVF protocol. GCs were seeded in culture for 4 days with daily medium exchange followed by administration of either hCG (1 U/ml); FSH (1 U/ml) and LH (8 U/ml); or hCG (1 U/ml) and FSH (1 U/ml) and LH (8 U/ml) for 16 h. mRNA was purified from harvested GCs and gene expression was quantitative by qPCR.

Main outcome measures
The expression of genes related to steroidogenesis (StAR/ CYP19) and oocyte maturation (COX2/Amphiregulin) in cultured GCs.

Results
The Dual/Double trigger (LH + FSH + hCG) showed higher activation of steroidogenesis (StAR/CYP19) and maturation (COX2/Amphiregulin) as compared to the naturally occurring trigger (LH + FSH) and the hCG triggers. Moreover, while the naturally occurring trigger (LH + FSH) activated maturation significantly and more intensely than the hCG trigger, no in between group differences were observed with regards to steroidogenic related genes.

Conclusions
Our findings are in agreement with clinical experience, demonstrating the superiority of the double/dual (LH + FSH + hCG) trigger over the naturally occurring and the hCG triggers.
A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions
Authors: Poon Yuan-Sheng Ryan , Lin Yongxing Patrick , Griffiths Peter , Yong Keng Kwang , Seah Betsy , Liaw Sok Ying 
Published: September 2022

AbstractBackgroundGlobally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.MethodsA mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute’s Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically.ResultsForty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia–Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support.ConclusionsA wide range of factors influence healthcare workers’ turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.
Which patients bring the most costs for hospital? A study on the cost determinants among COVID-19 patients in Iran
Authors: Ramezani-Doroh Vajihe , Tapak Leili , Hamidi Yadollah , Bashirian Saeid , Soltanian Ali Reza , Motaghed Mahyar , Ghelichkhani Ebrahim , Talebi-Ghane Elaheh 
Published: September 2022

Abstract
Background
Accurate information on the cost determinants in the COVID-19 patients could provide policymakers a valuable planning tool for dealing with the future COVID-19 crises especially in the health systems with limited resources.

Objectives
This study aimed to determine the factors affecting direct medical cost of COVID-19 patients in Hamadan, the west of Iran.

Methods
This study considered 909 confirmed COVID-19 patients with positive real-time reverse-transcriptase polymerase-chain-reaction test which were hospitalized from 1 March to 31 January 2021 in Farshchian (Sina) hospital in Hamadan, Iran. A checklist was utilized to assess the relationship of demographic characteristics, clinical presentation, medical laboratory findings and the length of hospitalization to the direct hospitalization costs in two groups of patients (patients with hospitalization ≤ 9 days and > 9 days). Statistical analysis was performed using chi-square, median test and multivariable quantile regression model at 0.05 significance levels with Stata 14 software program.

Results
The median cost of hospitalization in patients was totally 134.48 dollars (Range: 19.19–2397.54) and respectively 95.87 (Range: 19.19–856.63) and 507.30 dollars (Range: 68.94–2397.54) in patients with hospitalization ≤ 9 days and > 9 days. The adjusted estimates presented that in patients with 9 or less hospitalization days history of cardiovascular disease, wheezing pulmonary lung, SPO2 lower than 90%, positive CRP, LDH higher than 942 U/L, NA lower than 136 mEq/L, lymphosite lower than 20% and patients with ICU experience had significantly positive relationship to the median of cost. Moreover, in patients with more than 9 hospitalization days, history of cardiovascular disease and ICU experience was statistically positive association and age older than 60 years and WBC lower than 4.5 mg/dL had statistically negative relationship to the median of hospitalization cost.

Conclusion
As the length of hospital stay, which can be associated with the severity of the disease, increases, health systems become more vulnerable in terms of resource utilization, which in turn can challenge their responsiveness and readiness to meet the specialized treatment needs of individuals.
Features of effective staff training programmes within school-based interventions targeting student activity behaviour: a systematic review and meta-analysis
Authors: Ryan Mairead , Alliott Olivia , Ikeda Erika , Luan Jian’an , Hofmann Riikka , van Sluijs Esther 
Published: September 2022

Abstract
Background
Evaluations of school-based activity behaviour interventions suggest limited effectiveness on students’ device-measured outcomes. Teacher-led implementation is common but the training provided is poorly understood and may affect implementation and student outcomes. We systematically reviewed staff training delivered within interventions and explored if specific features are associated with intervention fidelity and student activity behaviour outcomes.

Methods
We searched seven databases (January 2015–May 2020) for randomised controlled trials of teacher-led school-based activity behaviour interventions reporting on teacher fidelity and/or students’ device-measured activity behaviour. Pilot, feasibility and small-scale trials were excluded. Study authors were contacted if staff training was not described using all items from the Template for Intervention Description and Replication reporting guideline. Training programmes were coded using the Behaviour Change Technique (BCT) Taxonomy v1. The Effective Public Health Practice Project tool was used for quality assessment. Promise ratios were used to explore associations between BCTs and fidelity outcomes (e.g. % of intended sessions delivered). Differences between fidelity outcomes and other training features were explored using chi-square and Wilcoxon rank-sum tests. Random-effects meta-regressions were performed to explore associations between training features and changes in students’ activity behaviour.

Results
We identified 68 articles reporting on 53 eligible training programmes and found evidence that 37 unique teacher-targeted BCTs have been used (mean per programme = 5.1 BCTs; standard deviation = 3.2). The only frequently identified BCTs were ‘Instruction on how to perform the behaviour’ (identified in 98.1% of programmes) and ‘Social support (unspecified)’ (50.9%). We found moderate/high fidelity studies were significantly more likely to include shorter (≤6 months) and theory-informed programmes than low fidelity studies, and 19 BCTs were independently associated with moderate/high fidelity outcomes. Programmes that used more BCTs (estimated increase per additional BCT, d: 0.18; 95% CI: 0.05, 0.31) and BCTs ‘Action planning’ (1.40; 0.70, 2.10) and ‘Feedback on the behaviour’ (1.19; 0.36, 2.02) were independently associated with positive physical activity outcomes (N = 15). No training features associated with sedentary behaviour were identified (N = 11).

Conclusions
Few evidence-based BCTs have been used to promote sustained behaviour change amongst teachers in school-based activity behaviour interventions. Our findings provide insights into why interventions may be failing to effect student outcomes.

Trial registration
PROSPERO registration number: CRD42020180624
The potential impact of a probiotic: Akkermansia muciniphila in the regulation of blood pressure—the current facts and evidence
Authors: Lakshmanan Arun Prasath , Murugesan Selvasankar , Al Khodor Souhaila , Terranegra Annalisa 
Published: September 2022

AbstractAkkermansia muciniphila (A. muciniphila) is present in the human gut microbiota from infancy and gradually increases in adulthood. The potential impact of the abundance of A. muciniphila has been studied in major cardiovascular diseases including elevated blood pressure or hypertension (HTN). HTN is a major factor in premature death worldwide, and approximately 1.28 billion adults aged 30–79 years have hypertension. A. muciniphila is being considered a next-generation probiotic and though numerous studies had highlighted the positive role of A. muciniphila in lowering/controlling the HTN, however, few studies had highlighted the negative impact of increased abundance of A. muciniphila in the management of HTN. Thus, in the review, we aimed to discuss the current facts, evidence, and controversy about the role of A. muciniphila in the pathophysiology of HTN and its potential effect on HTN management/regulation, which could be beneficial in identifying the drug target for the management of HTN.
Long-term neuromuscular consequences of SARS-Cov-2 and their similarities with myalgic encephalomyelitis/chronic fatigue syndrome: results of the retrospective CoLGEM study
Authors: Retornaz Frédérique , Rebaudet Stanislas , Stavris Chloé , Jammes Yves 
Published: September 2022

Abstract
Background
Patients with long-COVID often complain of continuous fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise. No data are available on EMG recording of evoked myopotentials (M-waves) or exercise-induced alterations in long-COVID patients, providing evidence of muscle membrane fatigue. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) develops in more than half of patients after an infectious disease, particularly viral diseases. A large proportion (around 70%) of these patients have neuromuscular disorders with M-wave alterations during and after exercise. Our hypothesis was that M-wave alterations would be also found in long-COVID patients, in association with neuromuscular symptoms, similar to ME/CFS.

Methods
This retrospective observational ColGEM (Covid LonG Encéphalomyelite Myalgique) study compared 59 patients with long-COVID and 55 ME/CFS patients with a history of severe infection who presented before the COVID pandemic. All of these patients underwent the same protocol consisting of a questionnaire focusing on neural and neuromuscular disorders and M-wave recording in the rectus femoris muscle before, during, and 10 min after a progressive cycling exercise. Maximal handgrip strength (MHGS) and maximal exercise power were also measured. The frequency of symptoms and magnitude of M-wave changes in the two groups were compared using non-parametric and parametric tests.

Results
The frequency of fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise as well as the magnitude of exercise-induced M-wave alterations were the same in the two groups. By contrast, digestive problems were less present in long-COVID. M-wave alterations were greater in ME/CFS patients as in those with long-COVID when the highest muscle strength and highest exercise performance were measured.

Conclusions
These high clinical and biological similarities between long-COVID and ME/CFS support the hypothesis that SARS-Cov-2 infection can cause ME/CFS symptoms.
Trial registration Registered retrospectively.
Effect of lunch with different calorie and nutrient balances on dinner-induced postprandial glucose variability
Authors: Kuwahara Mai , Kim Hyeon-Ki , Furutani Akiko , Mineshita Yui , Nakaoka Takashi , Shibata Shigenobu 
Published: September 2022

AbstractAimThis study aimed to examine the effect of lunches with different caloric contents (Study 1) and nutrient balances (Study 2) on dinner-induced postprandial glucose fluctuation.MethodsEnergy trial (Study 1): Thirteen healthy young participants (n = 10 men, n = 3 women) were investigated to determine the effects of different caloric intakes at lunch on glucose level variability. The study was comprised of four trials (no lunch, low lunch, standard lunch, and high-energy lunch). Energy balance trial (Study 2): Fourteen healthy young adults (n = 8 men, n = 6 women) were investigated to determine the effect of different nutrient balances during lunch on glucose level variability. The study consisted of four trials (standard, protein-rich, fat-rich, and carbohydrate-rich). In studies 1 and 2, each trial was spaced at least 24 full hours apart, and breakfast and dinner were tested as meals. The mealtimes for each trial were then aligned. Continuous glucose monitoring was used to assess the blood glucose fluctuations.ResultsStudy 1: The no-lunch (95% CI 95.5–149.7) and low-energy lunch (95% CI 90.8–143.1) trials had significantly higher values in the incremental area under the curve (iAUC) of postprandial blood glucose at dinner compared to the standard (95% CI 55.4–90.0) and high-energy lunch (95% CI 29.3–54.6) trials (P = 0.006,P = 0.001 vs. none), (P = 0.004,P = 0.001 vs. low-energy trial). Study 2: A significantly higher postprandial blood glucose iAUC for dinner was found in the fat-rich trial (95% CI 58.5–114.0) than that in the protein-rich (95% CI 25.6–63.9) and standard (95% CI 25.6–112.4) trials, (P = 0.006,P = 0.035 vs. fat-rich trial).ConclusionsOur findings indicate that skipping lunch and low-calorie or high-lipid intake increased postprandial blood glucose levels after dinner.
Identification of citrus diseases based on AMSR and MF-RANet
Authors: Yang Ruoli , Liao Tingjing , Zhao Peirui , Zhou Wenhua , He Mingfang , Li Liujun 
Published: September 2022

Abstract
Background
As one of the most widely planted fruit trees in southern China, citrus occupies an important position in the agriculture field and forestry economy in China. There are many kinds of citrus diseases. If citrus infected with diseases cannot be controlled in time, it easily seriously affects citrus production and causes large economic losses. Timely monitoring of disease characteristics in the citrus growth process is important for implementing timely control measures. Citrus images are easily disturbed by environmental factors such as dust, low light, clouds or leaf shadows. This makes it easy for some disease spot features in citrus pictures to be obscured. Occluded lesions cannot be effectively extracted and recognized. Second, similar characteristics of different diseases also make it difficult to distinguish the different types of diseases. However, the existing machine vision technology for identifying citrus diseases still has some difficulties in dealing with the above problems.

Results
This paper proposes a new citrus disease identification framework. First, a citrus image enhancement algorithm based on the MSR-AMSR algorithm is proposed, which can enhance the image and highlight the disease characteristic information. The AMSR algorithm can also greatly alleviate the interference of clouds and low light on image lesions, making the image features clearer. Second, an MF-RANet network is proposed to recognize citrus disease images. MF-RANet is composed of a main feature frame and a detail feature frame. The main feature frame uses the cross stacking structure of ResNet50 and RAM to extract the main features in the citrus image dataset. RAM is used to extract the attention weight in the feature layer, which enables RAM to give higher weight to disease features. The detailed feature frame path uses AugFPN to extract features from multiple scales and fuse the main feature frame path. AugFPN enables the network to retain more detailed features, so it can effectively distinguish similar features in different diseases. In addition, we use the ELU activation function not only to solve the problem of gradient explosion and gradient disappearance but also to effectively use the negative input of the network. Finally, we use the label smoothing regularization method to prevent overfitting the network in the classification process. Finally, the experimental results show that the highest detection accuracy of the network for Huanglong disease, Corynespora blight of citrus, fat spot macular disease, citrus scab, citrus canker and healthy citrus is 96.77%, 96.22%, 95.96%, 95.93%, 94.04% and 97.55%, respectively.

Conclusions
The citrus disease algorithm based on AMSR and MF-RANet can effectively perform the disease detection function. It has a high recognition rate for different kinds of citrus diseases. With the addition of AMSR preprocessing, RAM, AugFPN, ELU activation function and other structures, the MF-RANet network performance improves.
Accelerating effect of Shilajit on osteogenic property of adipose-derived mesenchymal stem cells (ASCs)
Authors: Kangari Parisa , Roshangar Leila , Iraji Aida , Talaei-Khozani Tahereh , Razmkhah Mahboobeh 
Published: September 2022

Abstract
Background
Shilajit has been widely used remedy for treating a numerous of illness such as bone defects in Iran traditional folk medicine since hundreds of years ago. The aim of the present study was to explore the effect of Shilajit on the osteogenic differentiation of human adipose-derived mesenchymal stem cells (ASCs) in two- (2D) and three-dimensional (3D) cultures.

Materials and methods
ASCs were seeded in 3D 1% alginate (Alg) hydrogel with or without Shilajit (500 µg/mL) and compared with 2D cultures. Then, characterization was done using electron microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDX), alkaline phosphatase (ALP) activity, alizarin red staining and Raman confocal microscopy.

Results
Adding Shilajit had no impact on the Alg scaffold degradability. In the 3D hydrogel and in the presence of osteogenic medium (OM), Shilajit acted as enhancer to increase ALP activity and also showed osteoinductive property in the absence of OM compared to the 2D matched groups at all time points (days 7 and 21 both P = 0.0006, for 14 days P = 0.0006 and P = 0.002, respectively). In addition, calcium deposition was significantly increased in the cultures exposed to Shilajit compared to 2D matched groups on days 14 (P < 0.0001) and 21 (P = 0.0003 and P = 0.003, respectively). In both 3D and 2D conditions, Shilajit induced osteogenic differentiation, but Shilajit/Alg combination starts osteogenic differentiation in a short period of time.

Conclusion
As Shilajit accelerates the differentiation of ASCs into the osteoblasts, without changing the physical properties of the Alg hydrogel, this combination may pave the way for more promising remedies considering bone defects.
Application of dual-trajectory screws in revision surgery for lumbar adjacent segment disease: a finite element study
Authors: Wu Jincheng , Yang Dongmei , Han Ye , Xu Hanpeng , Wen Wangqiang , Xu Haoxiang , Li Kepeng , Liu Yong , Miao Jun 
Published: September 2022

Abstract
Background
Advancements in medicine and the popularity of lumbar fusion surgery have made lumbar adjacent segment disease (ASDz) increasingly common, but there is no mature plan for guiding its surgical treatment. Therefore, in this study, four different finite element (FE) ASDz models were designed and their biomechanical characteristics were analysed to provide a theoretical basis for clinical workers to choose the most appropriate revision scheme for ASDz.

Methods
According to whether internal fixation was retained, different FE models were created to simulate ASDz revision surgery, and flexion, extension, axial rotation and lateral bending were simulated by loading. The biomechanical characteristics of the adjacent segments of the intervertebral disc and the internal fixation system and the range of motion (ROM) of the lumbar vertebrae were analysed.

Results
The difference in the ROM of the fixed segment between FE models that did or did not retain the original internal fixation was less than 0.1°, and the difference was not significant. However, the stress of the screw–rod system when the original internal fixation was retained and prolonged fixation was performed with dual-trajectory screws was less than that when the original internal fixation was removed and prolonged fixation was performed with a long bar. Especially in axial rotation, the difference between models A and B is the largest, and the difference in peak stress reached 30 MPa. However, for the ASDz revision surgery segment, the endplate stress between the two models was the lowest, and the intradiscal pressure (IDP) of the adjacent segment was not significantly different between different models.

Conclusion
Although ASDz revision surgery by retaining the original internal fixation and prolonging fixation with dual-trajectory screws led to an increase in stress in the fusion segment endplate, it provides stability similar to ASDz revision surgery by removing the original internal fixation and prolonging fixation with a long bar and does not lead to a significant change in the IDP of the adjacent segment while avoiding a greater risk of rod fracture.