bluuebunny/crossref_metadata_2025_split huggingface dataset:
H. Pylori is related to osteoporosis but only in premenopausal female: a cross-sectional study
Authors: Wang Jing-Wei , Dong Feng-Xiao , Su Hui , Zhu Licun , Shao Sujun , Liu Hong 
Published: August 2020

Abstract
Background
Recently, an increasing number of studies have focused on the extra-gastrointestinal effects of Helicobacter pylori (H. pylori), including metabolic syndrome, fatty liver, and rheumatic and skin diseases. Osteoporosis is an asymptomatic disease that can eventually lead to fractures and has a significant impact on the quality of life of elderly individuals. Sex is an influential factor that plays a crucial role in the development of osteoporosis. The aim of this study was to investigate the relationship between H. pylori infection and osteoporosis and to identify potential influencing factors.

Methods
We conducted a cross-sectional study of individuals older than 50 years old, who had undergone regular physical examinations at the Beijing Shijitan Hospital Health Examination Center from July to October 2018. We evaluated the associations of osteopenia and osteoporosis with H. pylori infection and related serum markers by using multiple linear regression and logistic regression. Then, we analysed the correlation between sex and potential serum biomarkers.

Results
There were significant relationships between H. pylori infection status and bone density in premenopausal females but not in males (P = 0.381) according to Fisher’s exact test. In females, H. pylori positivity (OR = 0.132, P = 0.023), Body Mass Index (BMI) (OR = 28.163, P = 0.021), and homocysteine (HCY) (OR = 17.218, P = 0.045) were associated with osteoporosis. Calcium had a trend but no statistically significant (OR = 0.060, P = 0.076) relationship with osteoporosis. Furthermore, the waist-to-hip ratio (OR = 5.783, P = 0.029), BMI (OR = 0.152, P = 0.014) and triglyceride levels (OR = 0.201, P = 0.036) were significantly different by sex, after adjusting for age as a confounder.

Conclusion
H. pylori positivity, BMI and HCY are associated with osteoporosis in premenopausal females. Chronic inflammation may be involved in the relationship between H. pylori and osteoporosis.
The development of a framework of entrustable professional activities for the intern year in Ireland
Authors: O’Dowd Emily , Lydon Sinéad , O’Connor Paul , Boland Josephine , Offiah Gozie , Byrne Dara 
Published: August 2020

AbstractBackgroundEntrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. This study aimed to develop and ensure face validity of a set of EPAs for junior doctors in the first year of clinical practice in the Republic of Ireland.MethodsAn iterative eight stage consensus building process was used to develop the set of EPAs. This process was based on international best practice recommendations for EPA development. A series of surveys and workshops with stakeholders was used to develop a framework of EPAs and associated competencies. An external stakeholder consultation survey was then conducted by the Irish Medical Council. The framework of EPAs was then benchmarked against the 13 core EPAs developed by the Association of American Medical Colleges (AAMC).ResultsA framework of seven EPAs, and associated competencies resulted from this study. These EPAs address all core activities that junior doctors should be readily entrusted with at the end of the intern year, which is the first year of clinical practice in the Republic of Ireland. Each EPA contains a series of defined competencies. The final EPAs were found to be comparable to the AAMC core EPAs for entering residency.ConclusionsA framework of EPAs for interns in Ireland that are appropriate for the intern year has been developed by key stakeholders. The implementation of the EPAs in practice is the next step, and is likely to result in an improved intern training process and increased patient safety.
Exploring links between resilience and the macro-level development of healthcare regulation- a Norwegian case study
Authors: Øyri Sina Furnes , Braut Geir Sverre , Macrae Carl , Wiig Siri 
Published: August 2020

AbstractBackgroundThe relationship between quality and safety regulation and resilience in healthcare has received little systematic scrutiny. Accordingly, this study examines the introduction of a new regulatory framework (the Quality Improvement Regulation) in Norway that aimed to focus on developing the capacity of hospitals to continually improve quality and safety. The overall aim of the study was to explore the governmental rationale and expectations in relation to the Quality Improvement Regulation, and how it could potentially influence the management of resilience in hospitals. The study applies resilience in healthcare and risk regulation astheoretical perspectives.MethodsThedesignis a single embedded case study, investigating the Norwegian regulatory healthcare regime. Data was collected by approaching three regulatory bodies through formal letters, asking them to provide internal and public documents, and by searching through open Internet-sources. Based on this, we conducted a document analysis, supplemented by interviews with seven strategic informants in the regulatory bodies.ResultsTherationalefor introducing the Quality Improvement Regulation focused on challenges associated with implementation, lack of management competencies; need to promote quality improvement as a managerial responsibility. Some informants worried that the generic regulatory design made it less helpful for managers and clinicians, others claimed a non-detailed regulation was key to make it fit all hospital-contexts. The Government expected hospital managers to obtain an overview of risks and toadaptrisk management and quality improvement measures to their specific context and activities.ConclusionsBased on the rationale of making the Quality Improvement Regulation flexible to hospital context, encouraging the ability to anticipate local risks, along with expectations about the generic design as challenging for managers and clinicians, we found that the regulators did consider work as done as important when designing the Quality Improvement Regulation. These perspectives are in line with ideas of resilience. However, the Quality Improvement Regulation might be open for adaptation by the regulatees, but this may not necessarily mean that it promotes or encourages adaptive behavior in actual practice. Limited involvement of clinicians in the regulatory development process and a lack of reflexive spaces might hamper quality improvement efforts.
Assessing the capacity for conflict and health research in Lebanon: a qualitative study
Authors: El Achi Nassim , Honein-Abouhaidar Gladys , Rizk Anthony , Kobeissi Elsa , Papamichail Andreas , Meagher Kristen , Ekzayez Abdulkarim , Abu-Sittah Ghassan S. , Patel Preeti 
Published: August 2020

Abstract
Background
Conflicts pose new challenges for health systems, requiring rapid and practical approaches to meet emerging needs on the ground. Lebanon has been highly influenced by surrounding conflicts in the Middle East and North Africa (MENA) region, especially the Syrian crisis. Strengthening research capacity to collect evidence on conflict in the MENA region and beyond is crucial to inform healthcare policy and practice. For targeted capacity strengthening interventions, the main objective of this paper is to present key findings of a needs assessment of conflict and health research in Lebanon. This will support recent efforts to scale up context-specific policies, interventions to strengthen the country’s health system, and research capacity.

Methods
The study is based on 30 semi-structured interviews with key informants such as specialist academics, humanitarian workers and public sector officials.

Results
Despite being ranked third in the number of publications on biomedical and health research per capita in MENA and in hosting reputable universities which are considered central academic hubs in the region, lack of nationwide research culture, insufficient funding and limited access to data were reported to be major challenges for health researchers in Lebanon. Even with the ongoing efforts, poor impact of research on policy continues to be a persistent gap. Large disparities in research capacities and taught skills were reported between different universities in Lebanon, with a disproportionate emphasis on quantitative over qualitative skills. Most medical students are not trained to conduct research or to practice in conflict settings. Concerns were also expressed regarding the ethics of research conducted, specifically by local non-governmental organizations.

Recommendations
To conduct contextualized trainings on research skills with a stronger focus on qualitative approaches, medical practice, and ethical research in conflict. To better involve policymakers in designing research agendas by organizing multiple stakeholder meetings.

Conclusion
The study indicates that health research in Lebanon is characterized by considerable strengths in terms of human capital and research capacities of certain universities. However, the Lebanese research infrastructure needs further development in terms of ensuring sustainable funding, providing access to data, teaching qualitative research skills, conducting ethical and multidisciplinary research, and promoting cross-sectoral knowledge transfer.
Population structure and geographical segregation of Cryptosporidium parvum IId subtypes in cattle in China
Authors: Zhang Zhenjie , Hu Suhui , Zhao Wentao , Guo Yaqiong , Li Na , Zheng Zezhong , Zhang Longxian , Kváč Martin , Xiao Lihua , Feng Yaoyu 
Published: August 2020

Abstract
Background
Cryptosporidium parvum is a zoonotic pathogen worldwide. Extensive genetic diversity and complex population structures exist in C. parvum in different geographical regions and hosts. Unlike the IIa subtype family, which is responsible for most zoonotic C. parvum infections in industrialized countries, IId is identified as the dominant subtype family in farm animals, rodents and humans in China. Thus far, the population genetic characteristics of IId subtypes in calves in China are not clear.

Methods
In the present study, 46 C. parvum isolates from dairy and beef cattle in six provinces and regions in China were characterized using sequence analysis of eight genetic loci, including msc6-7, rpgr, msc6-5, dz-hrgp, chom3t, hsp70, mucin1 and gp60. They belonged to three IId subtypes in the gp60 gene, including IIdA20G1 (n = 17), IIdA19G1 (n = 24) and IIdA15G1 (n = 5). The data generated were analyzed for population genetic structures of C. parvum using DnaSP and LIAN and subpopulation structures using STRUCTURE, RAxML, Arlequin, GENALEX and Network.

Results
Seventeen multilocus genotypes were identified. The results of linkage disequilibrium analysis indicated the presence of an epidemic genetic structure in the C. parvum IId population. When isolates of various geographical areas were treated as individual subpopulations, maximum likelihood inference of phylogeny, pairwise genetic distance analysis, substructure analysis, principal components analysis and network analysis all provided evidence for geographical segregation of subpopulations in Heilongjiang, Hebei and Xinjiang. In contrast, isolates from Guangdong, Shanghai and Jiangsu were genetically similar to each other.

Conclusions
Data from the multilocus analysis have revealed a much higher genetic diversity of C. parvum than gp60 sequence analysis. Despite an epidemic population structure, there is an apparent geographical segregation in C. parvum subpopulations within China.
New type of degenerate Daehee polynomials of the second kind
Authors: Kumar Sharma Sunil , Khan Waseem A. , Araci Serkan , Ahmed Sameh S. 
Published: August 2020

AbstractRecently, Kim and Kim (Russ. J. Math. Phys. 27(2):227–235, 2020) have studied new type degenerate Bernoulli numbers and polynomials by making use of degenerate logarithm. Motivated by (Kim and Kim in Russ. J. Math. Phys. 27(2):227–235, 2020), we consider a special class of polynomials, which we call a new type of degenerate Daehee numbers and polynomials of the second kind. By using their generating function, we derive some new relations including the degenerate Stirling numbers of the first and second kinds. Moreover, we introduce a new type of higher-order degenerate Daehee polynomials of the second kind. We also derive some new identities and properties of this type of polynomials.
Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections
Authors: Zhang Yuzheng , Du Mingmei , Johnston Janice Mary , Andres Ellie Bostwick , Suo Jijiang , Yao Hongwu , Huo Rui , Liu Yunxi , Fu Qiang 
Published: August 2020

Abstract
Background
Hospital-acquired bloodstream infection (BSI) is associated with high morbidity and mortality and increases patients’ length of stay (LOS) and hospital charges. Our goals were to calculate LOS and charges attributable to BSI and compare results among different models.

Methods
A retrospective observational cohort study was conducted in 2017 in a large general hospital, in Beijing. Using patient-level data, we compared the attributable LOS and charges of BSI with three models: 1) conventional non-matching, 2) propensity score matching controlling for the impact of potential confounding variables, and 3) risk set matching controlling for time-varying covariates and matching based on propensity score and infection time.

Results
The study included 118,600 patient admissions, 557 (0.47%) with BSI. Six hundred fourteen microorganisms were cultured from patients with BSI. Escherichia coli was the most common bacteria (106, 17.26%). Among multi-drug resistant bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) was the most common (42, 38.53%). In the conventional non-matching model, the excess LOS and charges associated with BSI were 25.06 days (P < 0.05) and US$22041.73 (P < 0.05), respectively. After matching, the mean LOS and charges attributable to BSI both decreased. When infection time was incorporated into the risk set matching model, the excess LOS and charges were 16.86 days (P < 0.05) and US$15909.21 (P < 0.05), respectively.

Conclusion
This is the first study to consider time-dependent bias in estimating excess LOS and charges attributable to BSI in a Chinese hospital setting. We found matching on infection time can reduce bias.
Seasonal dynamics and starvation impact on the gut microbiome of urochordate ascidian Halocynthia roretzi
Authors: Wei Jiankai , Gao Hongwei , Yang Yang , Liu Haiming , Yu Haiyan , Chen Zigui , Dong Bo 
Published: August 2020

Abstract
Background
Gut microbiota plays important roles in host animal metabolism, homeostasis and environmental adaptation. However, the interplay between the gut microbiome and urochordate ascidian, the most closet relative of vertebrate, remains less explored. In this study, we characterized the gut microbial communities of urochordate ascidian (Halocynthia roretzi) across the changes of season and starvation stress using a comprehensive set of omic approaches including 16S rRNA gene amplicon sequencing, shotgun metagenomics, metabolomic profiling, and transcriptome sequencing.

Results
The 16S rRNA gene amplicon profiling revealed that ascidians harbor indigenous gut microbiota distinctly different to the marine microbial community and significant variations in composition and abundance of gut bacteria, with predominant bacterial orders representing each season. Depressed alpha-diversities of gut microbiota were observed across starvation stress when compared to the communities in aquafarm condition. Synechococcales involving photosynthesis and its related biosynthesis was reduced in abundance while the enrichments of Xanthomonadales and Legionellales may facilitate bile acid biosynthesis during starvation. Metabolomics analysis found that long chain fatty acids, linolenic acid, cyanoamino acid, and pigments derived from gut bacteria were upregulated, suggesting a beneficial contribution of the gut microbiome to the ascidian under starvation stress.

Conclusions
Our findings revealed seasonal variation of ascidian gut microbiota. Defense and energy-associated metabolites derived from gut microbiome may provide an adaptive interplay between gut microbiome and ascidian host that maintains a beneficial metabolic system across season and starvation stress. The diversity-generating metabolisms from both microbiota and host might lead to the co-evolution and environmental adaptation.

Graphical Abstract
Some nano topological structures via ideals and graphs
Authors: El-Atik Abd El-Fattah A. , Hassan Hanan Z. 
Published: August 2020

AbstractIn this paper, new forms of nano continuous functions in terms of the notion of nano Iα-open sets called nano Iα-continuous functions, strongly nano Iα-continuous functions and nano Iα-irresolute functions will be introduced and studied. We establish new types of nano Iα-open functions, nano Iα-closed functions and nano Iα-homeomorphisms. A comparison between these types of functions and other forms of continuity will be discussed. We prove the isomorphism between simple graphs via the nano continuity between them. Finally, we apply these topological results on some models for medicine and physics which will be used to give a solution for some real-life problems.
Radiological findings spectrum of asymptomatic coronavirus (COVID-19) patients
Authors: Ali Rasha Mostafa Mohamed , Ghonimy Mai Bahgat Ibrahim 
Published: August 2020

Abstract
Background
Radiological examinations of COVID-19 positive patients play a vital role in early diagnosis and assessment of disease course, as most COVID-19 infected patients were diagnosed with pneumonia and characteristic CT imaging patterns. Asymptomatic infected individuals, called “asymptomatic carrier or transmitter”, who are the infectious sources of SARS-CoV-2, and some of them progress rapidly, even resulting in acute respiratory distress syndrome (ARDS) with a high case-fatality rate. Our study is a prospective study and aims to be familiar with the CT imaging features of asymptomatic cases with COVID-19 pneumonia.

Results
A total of 44 asymptomatic cases with COVID-19 pneumonia between March 20, 2020 and May 23, 2020 were enrolled. All patients had a history of exposure to SARS-CoV-2 or recent travel history. All patients had no symptoms. The predominant feature of CT findings in this cross-sectional study was ground-glass opacity (GGO) (41, 93%) with peripheral (34, 77.3%) distribution, bilateral location (20, 45.5%) with lower lobe predominance (left lower lobe 72% and right lower lobe 50%).

Conclusion
CT imaging of asymptomatic cases with COVID-19 pneumonia has highly characteristics findings. Since asymptomatic patients are the asymptomatic transmitter, and some patients can progress rapidly in the short term, it is essential to early diagnose asymptomatic patients with COVID-19. CT scan has great sensitivity in screening and detecting patients with COVID-19 pneumonia.
Computational virtual screening and structure-based design of some epidermal growth factor receptor inhibitors
Authors: Ibrahim Muhammad Tukur , Uzairu Adamu , Uba Sani , Shallangwa Gideon Adamu 
Published: August 2020

Abstract
Background
The foremost cause of cancer mortality worldwide was lung cancer. Lung cancer is divided into small cell lung cancer and non-small cell lung cancer (NSCLC). The latter is the main type of lung cancer that account for about 90% of the cancer issues and estimate about 25% of the cancer mortality each year in the world. Among the types of lung cancer with about 1.5 million patients and less than 20% survival rate is NSCLC. Overexpression of EGFR tyrosine kinase was recognized to be the cause of NSCLC. Therefore, there is a need to develop more EGFR inhibitors due to drug-resistance development by the mutation.

Result
Computational virtual screening on some epidermal growth factor receptor inhibitors (EGFRL858R/T790M inhibitors or NSCLC therapeutic agents) against their target protein (EGFR tyrosine kinase receptor pdb entry 3IKA) was performed via molecular docking simulation and pharmacokinetics to identify hit compounds with a promising affinity toward their target. The hit compounds discovered were compound 22 with −9.8 kcal/mol, 24 with −9.7 kcal/mol, 17 with −9.7 kcal/mol, and 19 with −9.5 kcal/mol respectively. These lead compounds were further subjected to drug-likeness and ADME prediction and found to be orally bioavailable. Six (6) new EGFRL858R/T790M inhibitors using compound 22 with the highest binding affinity as a template were designed.

Conclusion
The six newly EGFRL858R/T790M inhibitors were found to have a better binding affinity than the template used in the designing process and AZD9291 (the positive control). None of the designed compounds was found to violate more than the permissible limit set by RO5 thereby predicting their easy transportation, absorption, and diffusion. More so, the designed compounds were found to have good synthetic accessibility which indicates that these designed compounds can be easily synthesized in the laboratory.
Influence of sodium glucose co-transporter 2 inhibitors on fatty liver index parameters in type 2 diabetes mellitus
Authors: Gameil Mohammed Ali , Abdelgawad Mohammed Shereif , Bahgat Monir Hussein , Elsebaie Ahmed Hassan , Marzouk Rehab Elsayed 
Published: August 2020

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) represents a major public health challenge worldwide. It affects more than half of the patients with type 2 diabetes mellitus (T2D). It may progress to non-alcoholic steatohepatitis, cirrhosis, and carcinoma. The sodium glucose co-transporter 2 inhibitors (SGLT2 inhibitors) may improve hepatic steatosis. We aimed to estimate the effect of empagliflozin or dapagliflozin versus conventional treatment on fatty liver status in patients with concomitant T2D and NAFLD over 24 weeks.

Results
We found a significant improvement of the fatty liver index (FLI) with a significant reduction of the bodyweight, body mass index, waist circumference, ALT, AST, GGT, AST to ALT ratio, lipid profile, and lipid profile ratios in both SGLT2 inhibitors groups versus the conventional treatment group. Post hoc analysis revealed no statistically significant difference between the SGLT2 inhibitors groups (dapagliflozin versus empagliflozin).

Conclusion
SGLT2 inhibitors, empagliflozin and dapagliflozin, exert a beneficial effect on the fatty liver index of diabetic patients with NAFLD.