bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling tuberculosis transmission flow in China
Authors: Wang Li , Xu Chengdong , Hu Maogui , Chen Wei , Wang Jinfeng , Qiao Jiajun , Cheng Shiming 
Published: January 2020

Abstract

Background: China has the largest population and third largest number of tuberculosis cases in the world. Tuberculosis still remains a major public health concern in China. The increasing floating population has become an important part of China’s socioeconomic process and brought the potential risk for infectious disease transmission in the huge population. Both the flow of tuberculosis population in the country and the role of massive floating population in tuberculosis transmission are yet unclear.Methods: 14,027 tuberculosis flow data were derived from the new smear-positive pulmonary tuberculosis cases in China in 2012, provided by the nationwide Infectious Disease Reporting System. Spatial interaction model was used to model the tuberculosis flow and the regional socioeconomic factors.Results: The Pearl River Delta in southern China and the Yangtze River Delta along China’s east coast presented as the largest destination and concentration areas of tuberculosis inflows. Socioeconomic factors were determinants of tuberculosis flow. A 10% increase in per capita GDP was associated with 2.1% decrease in tuberculosis outflows from the provinces of origin, and 0.5% increase in tuberculosis inflows to the destinations and 18.9% increase in intraprovincial flow. Per capita net income of rural households and per capita disposable income of urban households were positively associated with tuberculosis flows. A 10% increase in per capita net income corresponded to 3.6% increase in outflows from the origin, 12.8% increase in inflows to the destinations and 47.9% increase in intraprovincial flows. Tuberculosis incidence had positive impacts on tuberculosis flows. A 10% increase in the number of tuberculosis cases corresponded to 1.1% increase in tuberculosis inflows to the destinations, 2.0% increase in outflows from the origins, and 2.2% increase in intraprovincial flows. A 10% increase in the tuberculosis incidence rate was associated with 9.9% increase in tuberculosis intraprovincial flows. In addition, the tuberculosis flow had a significant spatial dependence and positively affected tuberculosis flows in the neighboring regions.Conclusions: Tuberculosis flows had clear spatial stratified heterogeneity and spatial autocorrelation; regional socio-economic characteristics had different and statistically significant effects on tuberculosis flows in the origin and destination, and income factor played an important role among the determinants.
Molecular detection and identification of piroplasms (Babesia spp. and Theileria spp.) and Anaplasma phagocytophilum in questing ticks from northwest Spain
Authors: Remesar Susana , Diaz Pablo , Prieto Alberto , García-Dios David , Panadero Rosario , Fernández Gonzalo , Brianti Emmanuele , Díez-Baños Pablo , Morrondo Patrocinio , López Ceferino Manuel 
Published: January 2020

Abstract
Background: Ticks can transmit a wide range of pathogens; some of them are regarded as emerging or re-emerging pathogens causing a significant impact on human and animal health. Methods: In order to determine prevalence and zoonotic potential of Anaplasma spp., Candidatus Neoehrlichia mikurensis and piroplasms in questing ticks from north-western Spain, 1,056 Ixodes ricinus, nineteen Dermacentor marginatus, seventeen Dermacentor reticulatus, twelve Ixodes frontalis and a single Ixodes acuminatus were molecularly analysed. Also, 23 pools of I. ricinus larvae were investigated for the presence of piroplasms. Anaplasma and piroplasm DNA was firstly detected using two commercial qPCR assays. Samples positive to Anaplasma spp. were confirmed and identified at species level by sequence analysis of the groESL, 16S rRNA and msp2 genes. Those samples negative to Anaplasma spp. groESL were pooled and processed to detect a fragment of the groESL gene of Ca. N. mikurensis. qPCR piroplasm positive samples were molecularly identified at the species level by partial sequencing of the 18S rRNA and ITS1 genes.Results: Four pathogen species were detected in individual I. ricinus, namely Babesia venatorum (1.5%), A. phagocytophilum (0.7%), Babesia microti (0.3%) and Theileria sp. OT3 (0.2%). Babesia venatorum was also identified in a single I. ricinus larvae pool (maximum likelihood estimation 0.6%) whereas no I. ricinus pools were positive to Ca. N. mikurensis. In addition, one I. frontalis (8.3%) tested positive to A. phagocytophilum. Conclusions: Our results revealed that a low percentage of I. ricinus from northwest Spain were infected with A. phagocytophilum and piroplasms. Since a potentially pathogenic variant of A. phagocytophilum and two zoonotic Babesia species were detected, these results may have public health concern. Since the vector of Theileria sp. OT3 remains unknown, its identification in I. ricinus is especially interesting; nevertheless, further investigations are needed to unravel the role of I. ricinus in the transmission of this Theileria species.
Patient Willingness to Accept Hepatitis C-Infected Kidneys for Transplantation.
Authors: Edwards Gretchen C. , Shipe Maren E , Smith Lindsay , Gamble Christianna , Shaffer David , Concepcion Beatrice P. , Forbes Rachel C 
Published: January 2020

Abstract
Background As organs infected with Hepatitis C virus (HCV) provide an opportunity to expand the donor pool, the primary aim of this study is to gauge patient willingness to accept a kidney from HCV-infected donors compared to other high-risk donors.Methods An anonymous, electronic survey was sent to all active kidney transplant waitlist patients at a single large volume transplant center. Patients were asked to respond to three hypothetical organ offers from the following: 1) HCV-infected donor 2) Donor with active intravenous drug use and 3) Donor with longstanding diabetes and hypertension.Results The survey was sent to 435 patients of which 125 responded (29% response rate). While 86 out of 125 patients (69%) were willing to accept an HCV-infected kidney, only a minority of respondents were willing to accept a kidney from other high-risk donors. In contrast to other studies, by multivariable logistic regression, age and race were not associated with willingness to accept an HCV-infected kidney.Conclusions From a patient perspective, utilization of kidneys from HCV-infected donors to expand the donor pool appears to be an acceptable option.
Tolerability And Safety Of Urotainer® Polihexanide 0.02% In Long-Term Catheterized Patients: A Prospective Cohort Study
Authors: Pannek Jürgen , Everaert Karel , Möhr Sandra , Vance Will , Aa Frank Van der , Kesselring Jürg 
Published: January 2020

Abstract
Background: In patients with long-term indwelling bladder catheters, bacterial colonization is inevitable, leading to urinary tract infections or encrustations with subsequent catheter blockage. Currently, bladder irrigations are the most frequently used prophylactic means, but the best solution remains yet to be determined. In vitro studies demonstrate that polihexanide is a promising option for catheter irrigation, but no data about safety and tolerability exist. Methods: In a prospective observational study in patients with long-term (> 2 weeks) indwelling bladder catheter, a 0.02% polihexanide solution was used to rinse the catheter on five consecutive days. Adverse events, tolerability and vital signs were assessed before, during, after and at the end of the treatment period. Results: There was no serious adverse event in the study. A total of 28 adverse events (AEs) in 15 (46.88%) participants were experienced. Absolute changes in pain scores were not clinically relevant. No incidences of either flushing or sweating were found during instillation. Bladder spasms during instillation were reported in two cases during a single instillation. Mean pulse rates did not change by more than 3 beats per minute. Mean changes in body temperature did not exceed 0.12 °C. Clinically relevant changes in blood pressure were recorded for 3 patients. Conclusions: This is the first study to demonstrate that a 0.02% polihexanide solution can safely be used for catheter Irrigation.
Mix Of Destinations And Sedentary Behavior Among Brazilian Adults
Authors: Florindo Alex Antonio , Turrel Gavin , Garcia Leandro Martin Totaro , Barbosa Joao João Paulo dos Anjos Souza , Cruz Michele Santos , Failla Marcelo Antunes , Aguiar Breno Souza , Barrozo Ligia Vizeu , Goldbaum Moises 
Published: January 2020

Abstract
Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, the associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey (n=3,145). Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Linear and categorical (<4, ≥4 hours/day) measures of sitting time were derived and analyzed using linear and logistic multilevel regression. Models accounted for clustering within census-tracts and households, were stratified by gender, and adjusted for environmental, sociodemographic, and health-related factors. Results: Average minutes of sitting, and the likelihood of sitting for more than four hours, were significantly higher among males, younger people, the more educated, single persons, smokers, those who engaged in low levels of physical activity, the obese and those with chronic disease, and those who owned a private motor vehicle. Among females, mix of destinations was inversely related with minutes of sitting time on a weekday (β= -11 minutes; p=0.001) and weekend day (β= -8 minutes; p=0.012). Females who had a higher mix of destinations within their residential catchment had a significantly lower likelihood of sitting for four hours or more on weekdays (OR=0.66 IC95%0.47-0.94). No significant associations were found for males. Conclusion: This is the first-known study to examine the relationship between mix of destinations and sedentary behavior among adults in Sao Paulo City, Brazil. Our results suggest that health promotion and policy should focus on reducing sedentary behavior in the whole population, and especially those groups who engage in higher-levels of sitting time.
Overview of evidence-based clinical practice guidelines for preoperative care: a systematic review.
Authors: Ciapponi Agustín , Elena Tapia-López , Sacha Virgilio , Bardach Ariel 
Published: January 2020

Abstract
Background Our aim was to summarize and compare relevant recommendations from evidence-based CPGs (EB-CPGs). Methods Systematic review of clinical practice guidelines. Data sources: PubMed, EMBase, Cochrane Library, LILACS, Tripdatabase and additional sources. In July 2017, we searched CPGs that were published in the last 10 years, without language restrictions, in electronic databases, and also searched specific CPG sources, reference lists and consulted experts. Pairs of independent reviewers selected EB-CPGs and rated their methodological quality using the AGREE-II instrument. We summarized recommendations, its supporting evidence and strength of recommendations according to the GRADE methodology. Results We included 16 EB-CPGs out of 2262 references identified. Only nine of them had searches within the last five years and seven used GRADE. The median (percentile 25-75) AGREE-II scores for rigor of development was 49% (35-76%) and the domain ‘applicability’ obtained the worst score: 16% (9-31%). We summarized 31 risk stratification recommendations, 21.6% of which were supported by high/moderate quality of evidence (41% of them were strong recommendations), and 16 therapeutic/preventive recommendations, 59% of which were supported by high/moderate quality of evidence (75.7% strong). We found inconsistency in ratings of evidence level. ‘Guidelines’ applicability’ and ‘monitoring’ were the most deficient domains. Only half of the EB-CPGs were updated in the past five years. Conclusions We present many strong recommendations that are ready to be considered for implementation as well as others to be interrupted, and we reveal opportunities to improve guidelines’ quality.
Indicators and gaps for monitoring service provision along the continuum of care for maternal health in South Africa
Authors: Mothupi Mamothena , Knight Lucia , Tabana Hanani 
Published: January 2020

Abstract
Objective This study assesses indicators for service provision along the continuum of care for maternal health at subnational levels in South Africa. It applies the emerging construct of adequacy of the continuum of care to assess multi-dimensionality of available indicators. Using adequacy and the process of assessment in the study, the comprehensiveness of the continuum of care for improving maternal health outcomes can be assessed. Results We found indicators along the adequacy dimensions of care utilization and access, linkages of care, and quality of care in the routine district health information system. The General Household Survey contained indicators for the social determinants of health on the continuum of care framework. Indicator gaps include health promotion during and after pregnancy, maternal nutrition, empowerment and quality of care. At present, the available indicators measure about 74% of the interventions on the continuum of care framework. We make recommendations regarding improvements needed to better measure and monitor the continuum of care for maternal health. These involve actions within the health system and include integration of non-health system indicators.
Prediction of myasthenia gravis generalization under immunosuppressive therapy in Northwest China
Authors: Ding Jiaqi , Zhao Sijia , Ren Kaixi , Dang Dan , Li Hongzeng , Wu Fang , Zhang Min , Li Zhuyi , Guo Jun 
Published: January 2020

Abstract
Objective It is well demonstrated that immunosuppressants can reduce, but not eliminate the risk of generalized development in ocular myasthenia gravis (OMG). Herein, we explored the potential predictors of conversion of OMG patients receiving immunosuppressive treatments. Methods OMG patients under immunosuppressive treatments in Tangdu Hospital from June 2008 to June 2012 were retrospectively reviewed. Baseline clinical characteristics were documented. Patients were followed up regularly by face-to-face interview to evaluate clinic status and treatment efficacy. Main outcome measure was generalized conversion and the relative data were collected and analyzed by logistic regression. Results 223 eligible OMG patients completed the final follow-up visit and 38 (17.0%) progressed to generalized MG (GMG) at a median interval of 0.9 year. Patients with adult onset and positive repetitive nerve stimulation (RNS) of facial or axillary nerve had higher conversion rate than those with juvenile onset and negative RNS ( p = 0.001; p = 0.019; p = 0.015, respectively). Adult-onset patients converted earlier than juvenile-onset OMG patients ( p = 0.014). Upon multivariate logistic regression analysis, age of onset (Odds ratio [OR] 1.023, 95% confidence interval [CI] 1.006–1.041, p = 0.007) and positive facial nerve RNS (OR 2.826, 95%CI 1.045–5.460, p = 0.038) were found to be positively associated with generalized development. Moreover, an obviously negative association was found for disease duration (OR 0.603, 95%CI 0.365–0.850, p = 0.019). Conclusions Age of onset, disease duration and facial nerve RNS test can predict conversion of OMG under immunosuppressive treatment. Adult-onset, shorter disease duration and facial nerve RNS-positive patients have a higher risk of generalized development.
Original research Workplace-Based Health Research Training: A Qualitative Study of Perceived Needs in a Rural Setting
Authors: Schmidt David , Reyment Jill , Webster Emma , Kirby Sue , Lyle David 
Published: January 2020

Abstract
Background: The calls for increased numbers of researchers in rural health are growing. To meet this demand training is needed. If training is to be effective the value placed on research, organizational need for research training and key targets for research skill development within a rural health organisation must be understood. Methods: This qualitative study was underpinned by a critical realist perspective which allowed exploration of the organisational, cultural and structural contexts of research training, and the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation’s board, executive and facility management (n=7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n=11) were held. Data were analysed using NVivo software and thematic analysis. Results: The themes emerging from this study were1. Fragmentation of research activity2. A need for supportive structures3. Collaboration for expertiseConclusions: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.
Developing a Perinatal Palliative Care Service Package for women with fetal Anomaly Diagnosis: Protocol for Mixed Methods Study
Authors: Dehkordi ziba Raisi , Kohan Shahnaz , Rassouli Maryam , Zarean Elahe , malekian Azadeh 
Published: January 2020

Abstract
Background

diagnosis of perinatal anomalies is a stressful experience that can negatively affect mothers, families, health-care systems, and societies. Perinatal palliative care (PPC) is a new development in maternity services which focuses on emotional, spiritual, social, and symptom management and provides care for women and families with fetal anomaly diagnosis. Therefore, this study aimed to develop a service package for women with fetal anomaly diagnosis in socio-cultural context of Iran.

Methods

This research is an exploratory mixed methods study with the qualitative-quantitative sequencing design that consists of four sequential phases. In the first phase, following a qualitative approach, the researcher will explore the needs and experiences of women with fetal anomaly diagnosis, their families, health care providers and policy-makers. At the second phase, based on the review of the literature, Program, guideline, service package and protocol for care of women and their families after perinatal anomaly diagnosis will be identified in other countries. In the third phase, recommendations from qualitative phase and literature review will be combined, the initial protocol of the palliative care service package for perinatal anomaly diagnosis will be identified and prioritized. In the fourth phase, the opinion of experts about this service package will be collected by using RAND/UCLA Appropriateness Method technique and the applicability of the service package’s recommendations in clinical settings will be determined.

Discussion

The results of this Mixed Methods study are expected response the needs and experiences of the women with perinatal anomaly diagnosis being met in the socio-cultural context of Iran and a service package for palliative care of these women developed.
Maternal age and adverse pregnancy outcomes: a population-based register study in Wuhan, China, 2011-2016
Authors: Cao Jiangxia , Zhang Bingzheng , Liu Yan , Yu Ting , Zhang Yiming , Xu Wanglin , Liu Xin , Chen Longwei , Duan Yiting , Zou Yuliang , Zhang Bin 
Published: January 2020

Abstract
Background A trend towards increasing maternal age has been witnessed in China. Evidence from high-income countries has shown that older women have higher risks of various adverse pregnancy outcomes. However, few large, contemporary, population-based studies have adjusted for potential confounders in examining the association between maternal age and adverse pregnancy outcomes in China. Methods Data from the Wuhan Maternal and Child Health Management Information System including all women aged ≥20 years with live singleton pregnancies in 2011-2016 were analyzed. A range of adverse pregnancy outcomes including pregnancy induced hypertension disorder(PIH), gestational diabetes mellitus(GDM), cesarean delivery, postpartum hemorrhage, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and 5-min Apgar score<7 among women aged 20-24, 30-35 and ≥40 years were compared with women aged 25-29 years using binary logistic regression models, with social-demographic characteristics, pre-pregnancy BMI, parity, and fetal gender adjusted. Subgroup analyses by stratifying on parity were also performed. Results 415,632 women were included during the study period. Among them, 91536(22.0%) were aged 20-24 years, 203687(49.0%) were aged 25-29 years, 89883(21.6%) were aged 30-34 years, 26271(6.3%) were aged 35-39 years, and 4255 (1.0%) were aged ≥40 years. After adjusting for the potential confounders, older maternal age (≥30 years) was associated with higher risks of PIH, GDM, cesarean delivery, preterm birth, LGA, and 5-min Apgar score<7, but not with SGA. Relative to older multiparous women, older nulliparous women were more likely to experience cesarean delivery, preterm birth, and 5-min Apgar score<7. Conclusion Older maternal age is independently associated with various adverse pregnancy outcomes. The risks may occur earlier than the commonly used definition of advanced maternal age, and may also differ by parity. Ensuring age and parity specific clinical counseling, antenatal surveillance, and health interventions may be of great significance to improve older mother’s pregnancy outcomes.