bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial Intelligence in Global Health —A Framework and Strategy for Adoption and Sustainability
Authors: Hadley Trevor D. , Pettit Rowland W. , Malik Tahir , Khoei Amelia A. , Salihu Hamisu M. 
Published: February 2020

Artificial Intelligence (AI) applications in medicine have grown considerably in recent years. AI in the forms of Machine Learning, Natural Language Processing, Expert Systems, Planning and Logistics methods, and Image Processing networks provide great analytical aptitude. While AI methods were first conceptualized for radiology, investigations today are established across all medical specialties. The necessity for proper infrastructure, skilled labor, and access to large, well-organized data sets has kept the majority of medical AI applications in higher-income countries. However, critical technological improvements, such as cloud computing and the near-ubiquity of smartphones, have paved the way for use of medical AI applications in resource-poor areas. Global health initiatives (GHI) have already begun to explore ways to leverage medical AI technologies to detect and mitigate public health inequities. For example, AI tools can help optimize vaccine delivery and community healthcare worker routes, thus enabling limited resources to have a maximal impact. Other promising AI tools have demonstrated an ability to: predict burn healing time from smartphone photos; track regions of socioeconomic disparity combined with environmental trends to predict communicable disease outbreaks; and accurately predict pregnancy complications such as birth asphyxia in low resource settings with limited patient clinical data. In this commentary, we discuss the current state of AI-driven GHI and explore relevant lessons from past technology-centered GHI. Additionally, we propose a conceptual framework to guide the development of sustainable strategies for AI-driven GHI, and we outline areas for future research.
Keywords: • Artificial Intelligence • AI Framework • Global Health • Implementation • Sustainability • AI Strategy

Copyright © 2020 Hadley et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.
Authors: Chinowaita Frank , Chaka Wendy , Nyazika Tinashe K , Maboreke Tendai C , Tizauone Emmanuel , Mapondera Prichard , Chitsike Inam , Cakana Andrew Z , Mavenyengwa Rooyen Tinago 
Published: February 2020

Abstract
Background: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices.
Methods: This was a descriptive cross-sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively.
Results: A total of 142 participants were enrolled; 50 (35.2%) had a positive blood culture, with 56.0% Gram positive, 42.0% Gram-negative bacteria and 2.0% yeast isolated. Common species isolated included coagulase negative Staphylococcus spp. (CoNS) (22.0%), E. coli (16.0%), K. pneumoniae (14.0%), E. faecalis (14.0%) and S. aureus (8.0%). Gram-negative isolates exhibited high resistance to gentamicin (61.9%) and ceftriaxone (71.4%) which are the empiric antimicrobial agents used in our setting. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all Gram-negative isolates, whilst vancomycin and linezolid were effective against 96.2% and 100.0% of all Gram-positive isolates respectively. We isolated 10 (66.7%) extended spectrum β-lactamase (ESBL) amongst the E. coli and K. pneumoniae isolates. Ten (66.7%) of the Staphylococcus spp. were methicillin resistant.
Conclusions: CoNS, E. coli , K. pneumoniae , E. faecalis and S. aureus were the major microbial drivers of sepsis amongst cancer patients in Zimbabwe. Most isolates were found to be resistant to commonly used empirical antibiotics, with isolates exhibiting high levels of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.
The effect of Seizure on School Attendance among Children with Epilepsy: A follow-up study at the Pediatrics Neurology Clinic, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Hassen Oumer , Beyene Ayalew moges 
Published: February 2020

Abstract
Backgound: Epilepsy is the most common chronic neurological disease seen in Pediatrics Neurology Units in developing countries negatively affecting school attendance and academic performance. Comorbid learning and behavioral problems may also contribute to the academic difficulties among children with epilepsy. The main aim of this study is to assess the extent and factors contributing school absenteeism among school-aged children and adolescents with epilepsy.Methods: A hospital based follow-up study was conducted among school-aged children and adolescents with epilepsy between the ages of 7-18 years attending an outpatient Pediatric Neurology Clinic. A sample of 183 children and adolescents were included in the study. The participants (children and their parents/caregivers) gave information concerning the socio-demographic characteristics of the child and the primary caregiver, information regarding the child’s presentation and whether or not they disclosed to teachers and peer. Medical charts were thoroughly reviewed on the diagnosis and prognosis. Study participants characteristics were described and logistic regression was used to determine factors associating with school absenteeism.Results: School absenteeism (≥1 days/month) over six month period among children aged 7-18 years with epilepsy was 69.4%. Factors which correlated with school absenteeism included female sex (AOR 2.19, 95% CI 1.03-4.84), children with known causes for seizures AOR 2.51, 95% CI 1.09-5.86), having seizure at school and longer epilepsy duration.Conclusion recommendation: School absenteeism was found in over two thirds of children aged 7-18 years with epilepsy attending an outpatient epilepsy clinic in Ethiopia.
Effectiveness of Steroids vs Placebo in Preventing Upper Airway Obstruction After Extubation in Critically-Ill Children: Rationale and Design of a Multicentric, Double-Blind, Randomized Study
Authors: Manrique Gema , Laiseca Laura Butragueño , González Rafael , Rey Corsino , Martínez Zuriñe , Gil Javier , Rodriguez Antonio , Martínez Cecilia , Manrique Silvia , López-Herce Jesús 
Published: February 2020

Abstract
Background: Post-extubation upper airway obstruction (UAO) is a frequent complication causing stridor and respiratory distress, which occasionally may require reintubation, thereby increasing morbidity and mortality rates. Contradictory results have been obtained in studies assessing the effectiveness of steroids in preventing post-extubation UAO, and the available evidence is limited. We designed a multicentric randomized, placebo-controlled study to explore the effectiveness of dexamethasone in preventing post-extubation UAO in children. Methods: A multicentric, prospective, double-blind, randomized, placebo-controlled, phase IV clinical trial has been designed. The sample will include pediatric patients between 1 month and 16 years of age who have been intubated for more than 48 hours. Patients with airway disorders or who have received steroids within the last seven days will be excluded. Patients will be randomized to receive either placebo or a therapy with dexamethasone 0.25 mg/kg every 6 hours to be started 6-to-12 hours prior to extubation, to a total of four doses. Randomization will be performed at a 1:1 ratio. Follow-up of patients will be carried out for 48 h after extubation. The main objective of this study is to access the reduction in the incidence of moderate-severe UAO symptoms following extubation. Secondary objectives include assessing the decrease in the incidence of reintubation, evaluating the use of additional therapies for upper airway obstruction, and monitoring dexamethasone potential side effects. Discussion: The results of this study will contribute to the existing evidence on prophylaxis for post-extubation airway obstruction. Trial registration: EudraCT identifier, 2009-016596-30. Registered on 11 May 2010.
Canine colostrum exosomes: characterization and influence on canine mesenchymal stem cell secretory profile and fibroblast anti-oxidative capacity
Authors: Villatoro Antonio J , Martín-Astorga María del Carmen , Alcoholado Cristina , Becerra José 
Published: February 2020

Abstract

Background: Canine colostrum milk (CCM) is a specific secretion of the mammary gland fundamental for the survival of the newborn. It has many described components (immunoglobulins, proteins or fat), but small vesicles named exosomes are largely unknown. Results: A characterization of the CCM exosomes has been performed. Exosome concentrations were abundant in CCM and appeared with characteristic cup-shaped morphology and well-defined round vesicles. Their size distribution was between 37−140 nm and western blot analysis showed positive expression of specific exosomal markers. Proteomic analysis revealed a total of 826 proteins in exosomes cargo. We also found that exosomes modified proliferation and secretory profiles in canine mesenchymal stem cells derived from bone marrow (cBM-MSCs) and adipose tissue (cAd-MSCs). Besides, CCM exosomes demonstrated a potent antioxidant effect on canine fibroblasts in culture. Conclusions: Our findings highlight, for the first time, the abundant presence of exosomes in CCM and their ability to interact with mesenchymal stem cells (MSCs). The addition of exosomes to the two types of MSCs in culture resulted in specific secretory profiles with functions related to angiogenesis, migration and chemotaxis of immune cells. In particular, the cAd-MSCs secretory profile showed a higher potential in adipose tissue development and neurogenesis, while cBM-MSCs production was associated with immunity, cell mobilization and hematopoiesis. Finally, exosomes also presented antioxidant capacity on fibroblasts against reactive oxygen species activity within the cell, demonstrating a fundamental role in the development and maturation of the puppy in the early stages of its life.
Genome-wide Survey of the bHLH Super Gene Family in Brassica napus
Authors: Ke Yunzhuo , Wu Yunwen , Zhou Hongjun , Chen Ping , Wang Mangmang , Liu Mingming , Li Pengfeng , Yang Jing , Li Jiana , Du Hai 
Published: February 2020

Abstract
Background: The basic helix-loop-helix (bHLH) gene family is one of the largest transcription factor families in plants and is functionally characterized in diverse species. However, less is known about its functions in the economically important allopolyploid oil crop, Brassica napus .
Results : We identified 602 potential bHLHs in the B. napus genome ( BnabHLHs ) and categorized them into 35 subfamilies, including seven newly separated subfamilies, based on phylogeny, protein structure, and exon-intron organization analysis. The intron insertion patterns of this gene family were analyzed and a total of eight types were identified in the bHLH regions of BnabHLHs . Chromosome distribution and synteny analyses revealed that hybridization between Brassica rapa and Brassica oleracea was the main expansion mechanism for BnabHLHs . Expression analyses showed that BnabHLHs were widely in different plant tissues and formed seven main patterns, suggesting they may participate in various aspects of B. napus development. Furthermore, when roots were treated with five different hormones (IAA, auxin; GA 3 , gibberellin; 6-BA, cytokinin; ABA, abscisic acid and ACC, ethylene), the expression profiles of BnabHLHs changed significantly, with many showing increased expression. The induction of five candidate BnabHLHs was confirmed following the five hormone treatments via qRT-PCR. Up to 246 BnabHLHs from nine subfamilies were predicted to have potential roles relating to root development through the joint analysis of their expression profiles and homolog function.
Conclusion: The 602 BnabHLHs identified from B. napus were classified into 35 subfamilies, and those members from the same subfamily generally had similar sequence motifs. Overall, we found that BnabHLHs may be widely involved in root development in B. napus . Moreover, this study provides important insights into the potential functions of the BnabHLHs super gene family and thus will be useful in future gene function research.
Keywords: Brassica napus ; bHLH transcription factor; root; gene expression
Protocol for a Randomized Control Trial of the Caregiver Support Intervention with Syrian Refugees in Lebanon
Authors: Miller Kenneth E , Arnous Maguy , Tossyeh Fadila , Chen Alexandra , Bakolis Ioannis , Koppenol-Gonzalez Gabriela V. , Nahas Nayla , Jo Mark J.D. 
Published: February 2020

Abstract
Background There is evidence that chronic stress negatively impacts parenting among refugees and other war-affected communities. Persistent parental stress and distress may lead to unresponsive, anxious, or overly harsh parenting and a corresponding increase in emotional and behaviour problems among children. Most parenting interventions emphasize the acquisition of knowledge and skills; however, this overlooks the deleterious effects of chronic stress on parenting. The Caregiver Support Intervention (CSI) aims to strengthen quality of parenting skills by lowering stress and improving psychosocial wellbeing among refugee caregivers of children aged 3-12, while also increasing knowledge and skills related to positive parenting. The CSI is a 9-session psychosocial group intervention delivered by non-specialist providers. It is intended for all adult primary caregivers of children in high-adversity communities, rather than specifically targeting caregivers already showing signs of elevated distress. Methods The primary objective of this study is to assess the effectiveness of the CSI through a parallel group randomized controlled study with Syrian refugee families in North Lebanon. Participants will be primary caregivers of children ages 3-12, with one index child per family. Families will be randomized to the CSI or a waitlist control group. A total of 240 families (480 caregivers) will be recruited into the study. Randomization will be at the family level, and CSI groups will be held separately for women and men. The study will be implemented in two waves. Outcomes for both arms will be assessed at baseline, post-intervention, and at a three-month follow-up. The primary outcome is quality of parenting skills. Secondary outcomes include parental warmth and sensitivity, harsh parenting, parenting knowledge, and child psychosocial wellbeing. Putative mediators of the CSI on parenting are caregiver stress, distress, psychosocial wellbeing, and stress management. Discussion This trial may establish the Caregiver Support Intervention as an effective intervention for strengthening parenting in families living in settings of high adversity, particularly refugee communities. Trial registration: The trial has been registered with the International Society for the Registration of Clinical Trials. Trial Registration: ISRCTN22321773.
The independent indicators of contrast-enhanced ultrasound for predicting renal cell carcinoma
Authors: Cao Hongli , Fang Liang , Chen Lin 
Published: February 2020

Abstract
Background: The value of contrast-enhanced ultrasound (CEUS) in differentiating between renal cell carcinoma (RCC) and angiomyolipoma (AML) was analyzed. The purpose of this study was to identify the independent indicators of CEUS for predicting RCC.
Methods: A total of 172 renal tumors (150 RCCs, 22 AMLs) in 165 patients underwent conventional ultrasound (CUS) and CEUS examinations before radical or partial nephrectomy, and the features on CUS and CEUS were analyzed.
Results: There were significant differences in echogenicity, blood flow signals in color Doppler flow imaging (CDFI), peak intensity, homogeneity of enhancement, wash in, wash out, and perilesional rim-like enhancement between RCC and AML ( P <0.05 for all). Multivariate analysis indicated that perilesional rim-like enhancement ( P =0.035, odds ratio [OR]=9.907, 95% confidence interval [CI]: 1.169-83.971) and fast wash out ( P =0.001, OR =9.755, 95%[CI]: 2.497-38.115) were independent indicators for predicting RCC. The area under the receiver operating characteristic (ROC) curve (AUC) for perilesional rim-like enhancement was 0.838 (95% CI:0.774-0.890) with 76.7% sensitivity and 90.9% specificity, while the AUC of fast wash out was 0.833 (95% CI:0.768-0.885) with 74.7% sensitivity and 81.8% specificity.
Conclounsions: This study indicated that CEUS has value in differentiating RCC and AML. Present perilesional rim-like enhancement and fast wash out may be important indicators for predicting RCC.
Key words: Renal cell carcinoma; angiomyolipoma; contrast-enhanced ultrasound; ultrasonography
Effects of a single interprofessional simulation session on medical and nursing students’ attitudes toward interprofessional learning and professional identity: A questionnaire study
Authors: Burford Bryan , Greig Paul , Kelleher Michael , Merriman Clair , Platt Alan , Richards Elize , Davidson Neil , Vance Gill 
Published: February 2020

Abstract
Background

Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK.
Method

Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured.
Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures.
Results

A total of 194 medical and 266 nursing students completed questionnaires.
A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site.
Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students.
Conclusions

Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace.

Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect
Factors influencing cognitive reactivity among young adults at high risk for depression in China: a cross-sectional study
Authors: huang fei fei , Wen Zhi Peng , li qi , chen bin , Weng Wen Jie 
Published: February 2020

Abstract
Background: Understanding the factors influencing cognitive reactivity (CR) may help identify individuals at risk for first episode depression and relapse and facilitate routine access to preventative treatments. However, few studies have examined the relationship between CR and depression in Asian countries. This study was performed to assess the current status of CR among Chinese young adults and explore influencing factors.
Methods: A national cross-sectional online study using convenience sampling was conducted among 1597 healthy young adults in China (93.94%) with a mean age of 24.34 (SD=5.76) years.
Results: The mean CR score was 51.36±18.97 (range 0-130). Binary logistic regression showed that a low level of CR was associated with the following factors: high self-compassion, high social support, high resilience, high monthly household income, and living in a rural area, with odds ratios (ORs) ranging from 0.14 to 0.70. Young adults in full-time employment, experiencing poor sleep, with high neuroticism, who reported frequent sad mood, and who had a high intensity of negative life events had increased CR to depression, with ORs ranging from 1.18 to 6.66. The prediction probability of these factors was 75.40%. Causal relationships among the influencing factors and CR could not be established.
Conclusions: The self-reported CR levels among Chinese young adults were moderate. Enhancing self-compassion, resilience, and social support for young adults and reducing negative life events, neuroticism, and poor sleep may help decrease CR. These findings may help healthcare providers or researchers determine how to cultivate and improve the CR of young adults by establishing documented policies and/or improving intervention efficacies.