bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sodium hyaluronate combined with rhEGF contributes to alleviate clinical symptoms and Inflammation in patients with Xerophthalmia after cataract surgery
Authors: Gong Xuewu , Yao Hongbo , Wu Jing 
Published: February 2022

Abstract
Background
To determine the effect of sodium hyaluronate combined with recombinant human epidermal growth factor (rhEGF) on clinical symptoms and inflammation in patients with newly diagnosed xerophthalmia after cataract surgery.

Methods
A total of 106 patients who underwent cataract surgery and were newly diagnosed with xerophthalmia in our hospital between June 2018 and August 2019 were enrolled. Of these, 50 patients who were treated with sodium hyaluronate (0.1%) were assigned to the monotherapy group (MG) and the remaining 56 patients who were treated with sodium hyaluronate (0.1%) combined with rhEGF (20 μg/ml) were assigned to the combination group (CG). The 2 groups were compared based on ocular surface disease index (OSDI) score, break-up time (BUT), fluorescein corneal staining level, Schirmer I test (SI) level, clinical efficacy (disappearance of typical symptoms, including eyes drying, burning sensation, foreign body sensation, etc), and interleukin (IL)-1, IL-6, and tumor necrosis factor-α (TNF-α) levels. Spearman correlation analysis was conducted to analyze the relationship between IL-1, IL-6, TNF-α and clinical efficacy. In addition, receiver operating characteristic curves were drawn to analyze the predictive value of IL-1, IL-6, and TNF-α in efficacy on xerophthalmia. Results: After treatment, the CG showed reduced OSDI score compared with the MG. The CG showed increased BUT (s) and SI (mm) levels compared with MG. After treatment, the CG exhibited decreased levels of IL-1(ng/mL), IL-6 (ng/mL), and TNF-α (ng/mL) compared with the MG. Spearman correlation analysis revealed that IL-1, IL-6, and TNF-α were negatively correlated with clinical efficacy. The areas under the curves of IL-1, IL-6, and TNF-α were 0.801, 0.800, and 0.736 respectively.

Conclusions
Sodium hyaluronate combined with rhEGF is helpful to alleviate clinical symptoms and inflammation in patients with xerophthalmia undergoing cataract surgery.
The feasibility and ongoing use of electronic decision support to strengthen the implementation of IMCI in KwaZulu-Natal, South Africa
Authors: Jensen Cecilie , McKerrow Neil H. 
Published: February 2022

Abstract
Background
Continued efforts are required to reduce preventable child deaths. User-friendly Integrated Management of Childhood Illness (IMCI) implementation tools and supervision systems are needed to strengthen the quality of child health services in South Africa. A 2018 pilot implementation of electronic IMCI case management algorithms in KwaZulu-Natal demonstrated good uptake and acceptance at primary care clinics. We aimed to investigate whether ongoing electronic IMCI implementation is feasible within the existing Department of Health infrastructure and resources.

Methods
In a mixed methods descriptive study, the electronic IMCI (eIMCI) implementation was extended to 22 health facilities in uMgungundlovu district from November 2019 to February 2021. Training, mentoring, supervision and IT support were provided by a dedicated project team. Programme use was tracked, quarterly assessments of the service delivery platform were undertaken and in-depth interviews were conducted with facility managers.

Results
From December 2019 – January 2021, 9 684 eIMCI records were completed across 20 facilities, with a median uptake of 29 records per clinic per month and a mean (range) proportion of child consultations using eIMCI of 15% (1–46%). The local COVID-19-related movement restrictions and epidemic peaks coincided with declines in the monthly eIMCI uptake. Substantial inter- and intra-facility variations in use were observed, with the use being positively associated with the allocation of an eIMCI trained nurse (p < 0.001) and the clinician workload (p = 0.032).

Conclusion
The ongoing eIMCI uptake was sporadic and the implementation undermined by barriers such as low post-training deployment of nurses; poor capacity in the DoH for IT support; and COVID-19-related disruptions in service delivery. Scaling eIMCI in South Africa would rely on resolving these challenges.
Change in pre- and in-service early childhood educators’ knowledge, self-efficacy, and intentions following an e-learning course in physical activity and sedentary behaviour: a pilot study
Authors: Bruijns Brianne A. , Vanderloo Leigh M. , Johnson Andrew M. , Adamo Kristi B. , Burke Shauna M. , Carson Valerie , Heydon Rachel , Irwin Jennifer D. , Naylor Patti-Jean , Timmons Brian W. , Tucker Patricia 
Published: February 2022

AbstractBackgroundEarly childhood educators (ECEs) are the primary daytime role models for many young children, and are responsible for facilitating physical activity (PA) opportunities and minimizing sedentary behaviour (SB) in childcare. However, they have reportedly received little related education in their pre-service training. The purpose of the Training pre-service EArly CHildhood educators in physical activity (TEACH) pilot study was to explore changes in pre- and in-service ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control following the TEACH e-Learning course in PA and SB.MethodsPre-service ECEs were purposefully recruited from three Canadian colleges, while in-service ECEs were recruited via social media. A pre-post study design was used. ECEs completed two online surveys; one prior to, and one immediately following the completion of the TEACH e-Learning course (~ 5 h). Descriptive statistics were reported, and McNemar Chi-Square tests and paired samplest-tests were used to examine changes in ECEs’ question-specific, and total knowledge scores, respectively. Wilcoxon Signed Ranks tests were employed to examine changes in self-efficacy, behavioural intention, and perceived behavioural control.ResultsBoth pre- (n = 32) and in-service (n = 121) ECEs significantly increased their total knowledge scores from pre- to post-course completion (p < .05*). Significant positive changes in self-efficacy (p < .025*), behavioural intention (p < .007*), and perceived behavioural control (p < .007*) were demonstrated by in-service ECEs following course completion, while only select composite scores within these tools were significant among pre-service ECEs.ConclusionsThese findings provide preliminary evidence of the potential efficacy of the e-Learning course at improving ECEs’ knowledge, self-efficacy, behavioural intention, and perceived behavioural control to support PA and minimize SB in childcare. Following the success of the pilot study, testing the effectiveness of the TEACH e-Learning course on a larger scale, with a comparison group, is warranted prior to recommending broader dissemination of the training in pre-service ECE programs and for in-service ECE professional learning.
COVID-19 measures in Belgium: how perception and adherence of the general population differ between time periods
Authors: van Loenhout Joris Adriaan Frank , Vanderplanken Kirsten , Van den Broucke Stephan , Aujoulat Isabelle 
Published: February 2022

Abstract
Background
Since the onset of the COVID-19 pandemic, Belgium has been hit by a series of surges in the number of COVID-19 cases. Each of these resulted in more stringent measures being taken to curb the pandemic. This study compared perception of and adherence to COVID-19 measures of the Belgian population at two time periods: September 2020 (survey 1) and April/May 2021 (survey 2).

Methods
Two samples of approximately 2000 participants, representative for the Belgian population in terms of gender, age, province and socio-economic status, participated in an online survey. The survey questionnaire measured the perceived infection risk and severity, and the perception of and adherence to protective measures. Answers were compared between the time periods and risk factors for lower adherence were identified using multivariate linear regression.

Results
In survey 2, at which time the measures were more stringent, respondents assessed the risk of infection for themselves as lower, and for parents and grandparents as higher than in survey 1. Scores for understanding and usefulness of the measures were higher in survey 2 compared to survey 1, while reported past and future adherence were lower. Risk factors for a lower adherence were being male, being young, speaking French vs. Dutch, and having undergone a symptomatic infection.

Conclusions
It is important to consider the potential effect of fatigue among the population with regards to measures that are sustained for a long time, especially regarding measures related to social contacts. The identified risk factors for lower adherence offer insights to policy makers for future crisis communication regarding COVID-19.
Individual and community-level factors of perinatal mortality in the high mortality regions of Ethiopia: a multilevel mixed-effect analysis
Authors: Girma Desalegn , Abita Zinie , Fetene Gossa , Birie Bamlaku 
Published: February 2022

AbstractBackgroundEven though perinatal mortality has declined globally; it is still the major public health concern in sub-Saharan Africa countries. Ethiopia is one of the sub-Saharan countries which contribute the highest-burden of perinatal mortality with a devastating rate in some of the regions. Therefore, this study aimed to identify the determinants of perinatal mortality in the high mortality regions of Ethiopia.MethodA secondary data analysis was done using the 2016 Ethiopian Demographic and Health Survey data. The outcomes of 4120 pregnancies reaching ≥ 7 months of gestational age were considered for the analysis. A multilevel mixed logistic regression model was fitted to identify the predictors of perinatal mortality. Finally, a statistically significant association was declared at ap-value of ≤ 0.05.ResultThe study found that birth interval < 2 years (AOR = 3.71, 95%CI:2.27, 6.07),having no antenatal care (AOR = 2.43,95%CI:1.15,5.38), initiating breastfeeding after 1 h(AOR = 4.01,95%CI:2.49,6.51), being distant from health institutions (AOR = 1.99, 95%CI: 1.24, 3.22), having previous terminated pregnancy (AOR = 4.68, 95%CI:2.76,7.86), being mothers not autonomous(AOR = 1.96, 95%CI:1.19,3.20),being no media exposure (AOR = 2.78, 95%CI:1.48,5.59),being households ≤ 4 family sizes (AOR = 4.12, 95%CI:2.19,7.79), having ≥ 6 parity (AOR = 2.48, 95%CI:1.21, 5.22) were associated with a high odds of perinatal mortality.ConclusionThe study concludes that birth interval, antenatal care, time for breastfeeding initiation, distance from health institutions, previous history of terminated pregnancy, maternal autonomy, media exposure, family size, and parity were predictors of prenatal mortality. Therefore, programmatic emphases to maternal waiting service utilization for mothers distant from health institutions and media advertising regarding the complications related to pregnancy, childbirth and on its respective direction that the mothers should follow could reduce perinatal mortality in high mortality regions of Ethiopia.
Surgical treatment of slipped capital femoral epiphysis (SCFE) by Dunn procedure modified by Ganz: a systematic review
Authors: Gorgolini Giulio , Caterini Alessandro , Efremov Kristian , Petrungaro Lidio , De Maio Fernando , Ippolito Ernesto , Farsetti Pasquale 
Published: February 2022

Abstract
Background
Treatment of SCFE is still controversial, especially in moderate and severe forms. Dunn osteotomy performed with the Ganz approach became very popular in the last decade, although it is a complicated and challenging surgical procedure with a risk of AVN. The aim of our study was to analyze the current literature verifying the effectiveness of this surgical procedure, with specific attention to the incidence of AVN and other complications.

Main body
A systematic review on the subject was performed according to the PRISMA guidelines. A literature search was performed by searching all published articles about the topic in the databases. The articles were screened for the presence of the following inclusion criteria: patients affected by slipped capital femoral epiphysis (SCFE) surgically treated by Dunn osteotomy using the Ganz surgical approach. All the patients affected by pathologies other than SCFE, treated without surgery or with procedures not including a surgical hip dislocation were excluded.
Based on inclusion and exclusion criteria, 23 studies were included in our systematic review. Selected articles were published from 2009 to 2021 and they included 636 overall hips. According to the selected articles, Dunn osteotomy modified by Ganz, performed by an experienced surgeon, allows for anatomical reduction of moderate or severe SCFE with a low incidence of AVN.

Conclusions
The few papers with long term follow-up, reported no progression of hip osteoarthritis, however, since the patients are adolescent at surgery, longer follow-up studies are needed to validate this statement. It is still debated if better results are obtained in stable or unstable SCFE. The indication of this procedure in mild SCFE remains controversial.

Level of evidence
3
Epstein–Barr virus infection is associated with the nuclear factor-kappa B p65 signaling pathway in renal cell carcinoma
Authors: Farhadi Ali , Namdari Sepide , Chong Pei Pei , Geramizadeh Bita , Behzad-Behbahani Abbas , Sekawi Zamberi , Sharifzadeh Sedigheh 
Published: February 2022

AbstractBackgroundThere have been few studies regarding viral involvement in the pathogenesis of renal cell carcinoma (RCC). The aim of this study was to examine the possible association of Epstein–Barr virus (EBV) infection with clinicopathological features and cellular biomarkers including p53, p16INK4a, Ki-67 and nuclear factor-kappa B (NF-κB) in RCC tumors.MethodsIn this prospective study, 122 histologically confirmed Formalin-fixed Paraffin-embedded RCC tissue specimens along with 96 specimens of their corresponding peritumoral tissues and 23 samples of blunt renal injuries were subjected to nested polymerase chain reaction (nPCR) in order to amplify EBV DNA sequences. The expression of p53, p16INK4a, Ki-67 and NF-κB was investigated by immunohistochemistry (IHC) assay. Statistical analysis was employed to demonstrate the possible associations.ResultsInfection with EBV was found to be significantly associated with RCC. Our results indicate that p65 NF-κB signaling pathway is probably involved in EBV-mediated RCC pathogenesis. Moreover, we found p53, Ki-67 and cytoplasmic NF-κB expression to be associated with tumor nuclear grade in RCC patients. The expression of p53 and Ki-67 was associated with primary tumor category as well. In addition, p53 overexpression was significantly more frequent among nonconventional RCC tumors than the conventional histologic type.ConclusionsInfection with EBV is likely to play an important role in the development of RCC through the constitutive and permanent activation of NF-κB p65 signaling pathway. However, more experiments and supporting data are required to reach a decisive conclusion.
Health care burden and mortality of acute on chronic liver failure in Thailand: a nationwide population-based cohort study
Authors: Chirapongsathorn Sakkarin , Poovorawan Kittiyod , Soonthornworasiri Ngamphol , Pan-ngum Wirichada , Chaiprasert Amnart , Phaosawasdi Kamthorn , Treeprasertsuk Sombat 
Published: February 2022

Abstract
Background
Accurate population-based data are required concerning the rate, economic impact, and long-term outcome from acute on chronic liver failures (ACLF) in hospitalized patients with cirrhosis.
We aimed to discover time trends for the epidemiology, economic burden, and mortality of ACLF in Thailand.

Methods
We conducted a nationwide, population-based, cohort study which involved all hospitalized patients with cirrhosis in Thailand during the period between 2009 and 2013, with data from the National Health Security Office. ACLF was defined by two or more extrahepatic organ failures in patients with cirrhosis. Primary outcomes were trends in hospitalizations, hospital costs, together with inpatient mortality.

Results
The number of ACLF hospitalizations in Thailand doubled between 3185 in 2009 and 7666 in 2013. The average cost of each ACLF hospitalization was 3.5-fold higher than for cirrhosis ($ 1893 versus $ 519). The hospital is paid using a diagnosis-related group (DRG) payment system that is only 15% of the average treatment costs ($ 286 from $ 1893). The in-hospital fatality rate was 51% for ACLF while the additional fatality rate was 85% up to 1 year. The ACLF organ failure trends indicated sepsis with septic shock and renal failure as the majority proportion. Age, the number and types of organ failure and male sex were predictors of ACLF death.

Conclusions and relevance
Cirrhosis and ACLF both represent substantial and increasing health and economic burdens for Thailand. These data can assist national health care policy stakeholders to target high-risk patients with cirrhosis for care.
Mating behavior and reproductive morphology predict macroevolution of sex allocation in hermaphroditic flatworms
Authors: Brand Jeremias N. , Harmon Luke J. , Schärer Lukas 
Published: February 2022

AbstractBackgroundSex allocation is the distribution of resources to male or female reproduction. In hermaphrodites, this concerns an individual’s resource allocation to, for example, the production of male or female gametes. Macroevolutionary studies across hermaphroditic plants have revealed that the self-pollination rate and the pollination mode are strong predictors of sex allocation. Consequently, we expect similar factors such as the selfing rate and aspects of the reproductive biology, like the mating behaviour and the intensity of postcopulatory sexual selection, to predict sex allocation in hermaphroditic animals. However, comparative work on hermaphroditic animals is limited. Here, we study sex allocation in 120 species of the hermaphroditic free-living flatworm genusMacrostomum. We ask how hypodermic insemination, a convergently evolved mating behaviour where sperm are traumatically injected through the partner’s epidermis, affects the evolution of sex allocation. We also test the commonly-made assumption that investment into male and female reproduction should trade-off. Finally, we ask if morphological indicators of the intensity of postcopulatory sexual selection (female genital complexity, male copulatory organ length, and sperm length) can predict sex allocation.ResultsWe find that the repeated evolution of hypodermic insemination predicts a more female-biased sex allocation (i.e., a relative shift towards female allocation). Moreover, transcriptome-based estimates of heterozygosity reveal reduced heterozygosity in hypodermically mating species, indicating that this mating behavior is linked to increased selfing or biparental inbreeding. Therefore, hypodermic insemination could represent a selfing syndrome. Furthermore, across the genus, allocation to male and female gametes is negatively related, and larger species have a more female-biased sex allocation. Finally, increased female genital complexity, longer sperm, and a longer male copulatory organ predict a more male-biased sex allocation.ConclusionsSelfing syndromes have repeatedly originated in plants. Remarkably, this macroevolutionary pattern is replicated inMacrostomumflatworms and linked to repeated shifts in reproductive behavior. We also find a trade-off between male and female reproduction, a fundamental assumption of most theories of sex allocation. Beyond that, no theory predicts a more female-biased allocation in larger species, suggesting avenues for future work. Finally, morphological indicators of more intense postcopulatory sexual selection appear to predict more intense sperm competition.
Ionotropic receptors in the turnip moth Agrotis segetum respond to repellent medium-chain fatty acids
Authors: Hou Xiao-Qing , Zhang Dan-Dan , Powell Daniel , Wang Hong-Lei , Andersson Martin N. , Löfstedt Christer 
Published: February 2022

Abstract
Background
In insects, airborne chemical signals are mainly detected by two receptor families, odorant receptors (ORs) and ionotropic receptors (IRs). Functions of ORs have been intensively investigated in Diptera and Lepidoptera, while the functions and evolution of the more ancient IR family remain largely unexplored beyond Diptera.

Results
Here, we identified a repertoire of 26 IRs from transcriptomes of female and male antennae, and ovipositors in the moth Agrotis segetum. We observed that a large clade formed by IR75p and IR75q expansions is closely related to the acid-sensing IRs identified in Diptera. We functionally assayed each of the five AsegIRs from this clade using Xenopus oocytes and found that two receptors responded to the tested ligands. AsegIR75p.1 responded to several compounds but hexanoic acid was revealed to be the primary ligand, and AsegIR75q.1 responded primarily to octanoic acid, and less so to nonanoic acid. It has been reported that the C6-C10 medium-chain fatty acids repel various insects including many drosophilids and mosquitos. We show that the C6-C10 medium-chain fatty acids elicited antennal responses of both sexes of A. segetum, while only octanoic acid had repellent effect to the moths in a behavioral assay. In addition, using fluorescence in situ hybridization, we demonstrated that the five IRs and their co-receptor AsegIR8a are not located in coeloconic sensilla as found in Drosophila, but in basiconic or trichoid sensilla.

Conclusions
Our results significantly expand the current knowledge of the insect IR family. Based on the functional data in combination with phylogenetic analysis, we propose that subfunctionalization after gene duplication plays an important role in the evolution of ligand specificities of the acid-sensing IRs in Lepidoptera.