bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building Resilient Health Systems: Experimental Evidence from Sierra Leone and The 2014 Ebola Outbreak*
Authors: Christensen Darin , Dube Oeindrila , Haushofer Johannes , Siddiqi Bilal , Voors Maarten 
Published: November 2020

Abstract
Skepticism about the quality of health systems and their consequent underuse are thought to contribute to high rates of mortality in the developing world. The perceived quality of health services may be especially critical during epidemics, when people choose whether to cooperate with response efforts and frontline health workers. Can improving the perceived quality of health care promote community health and ultimately help to contain epidemics? We leverage a field experiment in Sierra Leone to answer this question in the context of the 2014 West African Ebola crisis. Two years before the outbreak, we randomly assigned two interventions to government-run health clinics—one focused on community monitoring, and the other conferred nonfinancial awards to clinic staff. Prior to the Ebola crisis, both interventions increased clinic utilization and patient satisfaction. Community monitoring additionally improved child health, leading to 38% fewer deaths of children under age five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62%, and community monitoring significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that both interventions improved the perceived quality of health care, encouraging patients to report Ebola symptoms and receive medical care. Improvements in health outcomes under community monitoring suggest that these changes partly reflect a rise in the underlying quality of administered care. Overall, our results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to emergent crises.
ESTIMATION OF ACTUAL DOSE BASED ON BAYESIAN PROBABILISTIC APPROACH USING PERSONNEL MONITORING DOSE RECORDS
Authors: Pathan Munir S , Pradhan S M , Selvam T Palani 
Published: November 2020

Abstract
In this study, the Bayesian probabilistic approach is applied for the estimation of the actual dose using personnel monitoring dose records of occupational workers. To implement the Bayesian approach, the probability distribution of the uncertainty in the reported dose as a function of the actual dose is derived. Using the uncertainty distribution function of reported dose and prior knowledge of dose levels generally observed in a monitoring period, the posterior probability distribution of the actual dose is estimated. The posterior distributions of each monitoring period in a year are convoluted to arrive at actual annual dose distribution. The estimated actual doses distributions show a significant deviation from reported annual doses particularly for low annual doses.
Auditory-Based Cognitive Training Drives Short- and Long-Term Plasticity in Cortical Networks in Schizophrenia
Authors: Koshiyama Daisuke , Miyakoshi Makoto , Thomas Michael L , Joshi Yash B , Molina Juan L , Tanaka-Koshiyama Kumiko , Nungaray John A , Sprock Joyce , Braff David L , Swerdlow Neal R , Light Gregory A 
Published: November 2020

Abstract
Schizophrenia patients have widespread deficits in neurocognitive functioning linked to underlying abnormalities in gamma oscillations that are readily measured by the 40 Hz auditory steady-state response (ASSR). Emerging interventions such as auditory-based targeted cognitive training (TCT) improve neurocognitive function in patients. While acute ASSR changes after 1 hour of TCT predict clinical and cognitive gains after a 30-hour course of TCT, the neural substrates of underlying short- and long-term TCT interventions are unknown. To determine the neural substrates underlying TCT-associated ASSR changes, a novel data analysis method was applied to assess the effective connectivity of gamma-band ASSR among estimated cortical sources. In this study, schizophrenia patients (N = 52) were randomized to receive either a treatment as usual (TAU; N = 22) or TAU augmented with TCT (N = 30). EEG recordings were obtained immediately before (T0) and after 1 hour of either computer games (TAU) or cognitive training (TCT; T1), and at 65 ± 15 days (mean ± SD) post-randomization (T2). Results showed increased connectivity from the left ventral middle cingulate gyrus to the left posterior cingulate gyrus, accompanied by decreased connectivity from the left Rolandic operculum (a region that includes auditory cortex) to the right ventral middle cingulate gyrus after 1 hour of TCT. After 30 hours, decreased connectivity from the frontal cortex to a region near the calcarine sulcus were detected. Auditory-based cognitive training drives short- and long-term plasticity in cortical network functioning in schizophrenia patients. These findings may help us understand the mechanisms underlying cognitive training effects in schizophrenia patients and enhance the development of pro-cognitive therapeutics.
Nocturnal hypoxemia severity influences the effect of CPAP therapy on renal renin–angiotensin–aldosterone system activity in humans with obstructive sleep apnea
Authors: Nicholl David D M , Hanly Patrick J , Zalucky Ann A , Handley George B , Sola Darlene Y , Ahmed Sofia B 
Published: November 2020

Abstract

Study Objectives
Nocturnal hypoxemia (NH) in obstructive sleep apnea (OSA) is associated with renal renin–angiotensin–aldosterone system (RAAS) up-regulation and loss of kidney function. Continuous positive airway pressure (CPAP) therapy is associated with RAAS down-regulation, though the impact of NH severity remains unknown. We sought to determine whether NH severity alters the effect of CPAP on renal hemodynamics and RAAS activity in humans.

Methods
Thirty sodium-replete, otherwise healthy, OSA participants (oxygen desaturation index ≥ 15 h−1) with NH (SpO2 &lt; 90% ≥ 12%/night) were studied pre- and post-CPAP (&gt;4 h/night∙4 weeks). NH severity was characterized as moderate (mean SpO2[MSpO2] ≥ 90%; N = 15) or severe (MSpO2 &lt; 90%; N = 15). Glomerular filtration rate (GFR), renal plasma flow (RPF), and filtration fraction (FF) were measured at baseline and in response to angiotensin-II (3 ng/kg/min∙30 min, 6 ng/kg/min∙30 min), a marker of RAAS activity.

Results
Pre-CPAP, baseline renal hemodynamics did not differ by NH severity. Pre-CPAP, severe NH participants demonstrated blunted GFR (Δ30 min, −9 ± 4 vs 1 ± 3 mL/min, p = 0.021; Δ60 min, −5 ± 5 vs 8 ± 5 mL/min, p = 0.017) and RPF (Δ30 min, −165 ± 13 vs −93 ± 19 mL/min, p = 0.003; Δ60 min, −208 ± 18 vs −112 ± 22 mL/min, p = 0.001; moderate vs severe) responses to angiotensin-II. Post-CPAP, severe NH participants demonstrated maintained GFR (112 ± 5 vs 108 ± 3 mL/min, p = 0.9), increased RPF (664 ± 35 vs 745 ± 34 mL/min, p = 0.009), reduced FF (17.6 ± 1.4 vs 14.9 ± 0.6%, p = 0.009), and augmented RPF responses to Angiotensin-II (Δ30 min, −93 ± 19 vs −138 ± 16 mL/min, p = 0.009; Δ60 min, −112 ± 22 vs −175 ± 20 mL/min, p = 0.001; pre- vs post-CPAP), while moderate participants were unchanged.

Conclusions
Correction of severe, but not moderate, NH with CPAP therapy was associated with improved renal hemodynamics and decreased renal RAAS activity in humans with OSA.
A special issue addressing healthful food access and food insecurity: risk factors, behavioral variables, interventions, and measurement
Authors: Calloway Eric E , Parks Courtney A , Byker Shanks Carmen , Bowen Deborah J , Yaroch Amy L 
Published: November 2020

AbstractThis article introduces a special issue in Translational Behavioral Medicine that focuses on translational aspects of food insecurity research. The purpose of this special issue was to add to the evidence base to inform short- and intermediate-term intervention development and implementation and to spark additional future discourse around these important topics. The special issue included 12 articles and 2 commentaries roughly evenly split across four topic areas, including subpopulation food insecurity risk factors; food behaviors and psychosocial variables; implementation and/or evaluation of food insecurity interventions; and food insecurity-related measurement issues. The articles in this special issue offer a number of contributions to the translational literature specific to food insecurity. They add to our understanding that depression, stress, and social isolation (sometimes related to language barriers) may play a large role in individuals’ food insecurity experience. The articles explored the differences between food insecure and food secure households in relation to food and grocery shopping behaviors, and nutritional self-efficacy. In addition, authors described the implementation and/or efficacy of interventions meant to promote healthful diets and food access among food insecure populations. And finally, several studies explored current measurement issues such as intra-household subjectivity, disconnect between perceived and objective measures of food access, and a need for more holistic and nutrition-focused measurement approaches. While there are deeper systemic factors driving food insecurity, the findings provided in this special issue can help guide those addressing the current challenges faced by food insecure households that struggle to achieve healthful diets.
Drug-resistant Mycobacterium tuberculosis and its genotypes isolated from an outbreak in western Thailand
Authors: Rudeeaneksin Janisara , Phetsuksiri Benjawan , Nakajima Chie , Bunchoo Supranee , Suthum Krairerk , Tipkrua Nattakan , Fukushima Yukari , Suzuki Yasuhiko 
Published: November 2020

Abstract

Background
Multidrug-resistant TB (MDR-TB) outbreaks have occurred in the Thamaka district, Kanchanaburi province in Thailand.

Methods
Seventy-two isolates, which included 7% mono-, 30.6% MDR and extensively drug-resistant TB (XDR-TB), were genotyped by spoligotyping, mycobacterial interspersed repetitive unit-variable-number tandem repeat (MIRU-VNTR) and single nucleotide polymorphism genotyping, and their drug resistance was analysed.

Results
The spoligotyping results showed that Beijing spoligo-international type (SIT)1 was predominant (n=38; 52.8%) while the remaining were non-Beijing sublineages (n=34). The MIRU-VNTR analysis showed that Beijing isolates, most of which belonged to the modern type (n=37), formed 5 clusters and 13 individual patterns. In katG, only mutation Ser315Thr was identified. In rpoB, Ser531Leu was predominant, except for His526Arg and Leu533Pro, which were found in two isolates. A cluster of 14 Beijing strains contained these common mutations and shared the MIRU-VNTR genotype with isolates in the Thamaka district that had spread previously. Two U SIT523 isolates contained the mutations A1400G in rrs and Asp94Gly in gyrA genes, indicating a spread of XDR-TB.

Conclusions
Most mutations were associated with drug resistance and the specific MDR Beijing and XDR-TB in U SIT523 isolates remain. This genotyping is a key tool for tracking TB transmission in the Thamaka district of Thailand.
Coronavirus disease 2019 and asthma, allergic rhinitis: molecular mechanisms and host–environmental interactions
Authors: Wakabayashi Mako , Pawankar Ruby , Narazaki Hidehiko , Ueda Takahiro , Itabashi Toshikazu 
Published: November 2020

Purpose of review
Coronavirus disease 2019 (COVID-19), a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), is a pandemic in over 120 countries worldwide. Risk factors for severe COVID-19 include older age, ethnicity, sex, comorbidities, and living conditions. Although asthmatics and those with allergies are susceptible to more severe outcomes to viral infections, interestingly, asthma has not been reported to be a major comorbidity of COVID-19. However, there are some conflicting reports on the impact of asthma on COVID-19. The underlying immunological and molecular mechanisms may explain at least in part these observations. Furthermore, environmental factors like air pollution that have detrimental effects on asthma and respiratory illnesses also have an impact on COVID-19.

Recent findings
Angiotensin-converting enzyme 2 (ACE2) is the receptor for the attachment and entry of SARS-CoV-2 into the host cells that is upregulated by Th1-mediated responses. In asthmatics, ACE2 gene expression is generally reduced and recent studies have shown a negative correlation between the levels of Th2 cytokines including IL-4, IL-5, and IL-13 in airway epithelial cells and other type 2 biomarkers with ACE2 expression. This may explain in part the potential protective role of asthma on COVID-19. Here, we review the relation of respiratory viral illnesses and asthma, the immune-molecular mechanisms of SARS-CoV-2 infection, the impact of asthma on COVID-19 and that of SARS-CoV-2 on asthma and allergic rhinitis, and the impact of environmental factors like air pollution on COVID-19.

Summary
Expression of ACE2 in airway epithelial cells in SARS-COV-2 is influenced by inflammatory profile. Respiratory allergic diseases like asthma appear to have a protective effect against SARS-COV-2 infection. However, the clinical association between asthma and SARS-COV-2 is not fully established and the underlying immune-molecular mechanisms may explain these observations.
Cryoglobulinemic vasculitis: pathophysiological mechanisms and diagnosis
Authors: Kolopp-Sarda Marie N. , Miossec Pierre 
Published: November 2020

Purpose of review
Cryoglobulins (CG) are immunoglobulins that precipitate in the cold, and dissolve at 37°C. In vivo, in cold exposed tissues and organs, they can induce vasculitis and occlusive vasculopathy after deposition on vascular endothelium under low temperature and high concentration conditions. Clinical manifestations are cutaneous (purpura, ulcers, vasomotor symptoms, and livedo reticularis), rheumatological (arthralgia and arthritis), and peripheral neuropathy (paresthesia and pain in the lower limbs). In profound organs such as the kidneys, CG deposition is less temperature-dependent, favored by local protein and anion concentrations, and can lead to glomerulonephritis. This review will focus on cryoglobulinemic vasculitis and vascular lesion, and their diagnosis.

Recent findings
The mechanisms of vascular lesions of pathogenic CG in function of CG type and their characteristics are better defined. Optimal conditions for CG detection are critical. The importance of looking for underlying diseases, especially hepatitis C virus status in mixed CG, is reminded.

Summary
A decision diagram for CG vasculitis diagnosis based on clinical and biological parameters is proposed.
A Technique for the In Vivo Study of Three-dimensional Cervical Segmental Motion Characteristics After Anterior Screw Fixation for Odontoid Process Fractures
Authors: Zhong Yanlong , Yao Haoqun , Tang Benyu , Song Quanwei , Shaobai Wang , Li Guoan , Wan Zongmiao 
Published: November 2020

Study Design.
Kinematics of the cervical spine was investigated using cone beam computed tomography (CBCT) images combined with three dimensions to three dimensions (3D-3D) registration technology in patients after anterior odontoid screw fixation (AOSF) surgery.

Objective.
The aim of this study was to investigate in vivo 3D cervical motion characteristics of patients who had undergone AOSF surgeries.

Summary of Background Data.
AOSF surgery is a classic surgical method for the treatment of odontoid fracture, but there are few studies that investigated its effect on in vivo biomechanics of the cervical spine. Postoperative biomechanical characters of the atlantoaxial joint (C1-C2) and the caudal adjacent segment (C2–C3) have yet to be clarified.

Methods.
The study involved 14 patients subjected to a procedure of AOSF with lag screw. Subjects were matched with 14 healthy controls. All subjects underwent CBCT scanning of the cervical spine under seven functional positions. A 3D-3D registration was performed for each vertebra at each functional position to calculate the segmental motion characteristics. The ranges of motion (ROMs) of the C1-C2, C2–C3, and the overall cervical spine (C1-C7) for each of the functional positions were determined.

Results.
The ROMs of the AOSF group were significantly (P < 0.05) smaller than the control group in flexion-extension positions for the C1-C2 (7.0°vs.11.0°), C2-C3 (3.7°vs.6.7°) and C1-C7 (43.3°vs.54.4°). The twisting ROM of the C1-C2 was 39.3° in the AOSF group and 65.7° in the control (P < 0.05), the bending ROM of the C2-C3 was 2.8° in the AOSF group and 8.9° in the control (P < 0.05). The twisting ROM of C1-C7 segment was 63.2° for the AOSF and 98.1° for the healthy control groups (P < 0.05).

Conclusion.
Although AOSF surgery reduced the flexion-extension ROMs of all investigated spinal segments, additionally, it reduced twisting ROMs of C1-C2 and C1-C7, but only lateral bending ROM of C2-C3, when compared with the control group. The data implied that the AOSF surgery would result in different biomechanics changes in the atlantoaxial segment and caudal adjacent segment. Longer-term follow-up studies of larger patient cohorts are necessary to evaluate the clinical outcomes of patients after the AOSF surgery.

Level of Evidence: 3
Adjuvant therapy of operable nonsmall cell lung cancer: an update
Authors: Mitsudomi Tetsuya , Soh Junichi 
Published: November 2020

Purpose of review
The current status of postoperative adjuvant therapy for nonsmall cell lung cancer (NSCLC) is reviewed.

Recent findings
Cisplatin-based postoperative chemotherapy is a current standard of care for patients with stage II–III NSCLC who underwent complete resection. However, its benefit is limited. In these 20 years, the introduction of targeted therapies and immune checkpoint inhibitors has dramatically changed the treatment of metastatic lung cancer. The accumulated knowledge is now being applied in the adjuvant setting and many clinical trials are underway. Recently, postoperative osimertinib was shown to greatly prolong disease-free survival of patients with resected, stage II/IIIA NSCLC with EGFR mutation with an unprecedented hazard ratio of 0.17 in ADAURA study. Furthermore, initial results of adjuvant studies of immune checkpoint inhibitors are expected to be reported shortly.

Summary
As lung cancer is inherently prone to metastasize even though it looks in its earlier stage, it is essential to develop a newer generation of adjuvant therapies to improve patient outcomes. To this end, international and multidisciplinary collaboration is key to establish a new standard of care. It is anticipated that the treatment algorithm of early-stage lung cancer will be completely revised in 5 years using a more individualized approach.
The effect of immediate postoperative Boussignac CPAP on adverse pulmonary events after thoracic surgery
Authors: Puente-Maestú Luis , López Eloísa , Sayas Javier , Alday Enrique , Planas Antonio , Parise Diego J. , Martínez-Borja Marcos , Garutti Ignacio 
Published: November 2020

BACKGROUND
The effectiveness of prophylactic continuous positive pressure ventilation (CPAP) after thoracic surgery is not clearly established.

OBJECTIVE
The aim of this study was to assess the effectiveness of CPAP immediately after lung resection either by thoracotomy or thoracoscopy in preventing atelectasis and pneumonia.

DESIGN
A multicentre, randomised, controlled, open-label trial.

SETTINGS
Four large University hospitals at Madrid (Spain) from March 2014 to December 2016.

PATIENTS
Immunocompetent patients scheduled for lung resection, without previous diagnosis of sleep-apnoea syndrome or severe bullous emphysema. Four hundred and sixty-four patients were assessed, 426 were randomised and 422 were finally analysed.

INTERVENTION
Six hours of continuous CPAP through a Boussignac system versus standard care.

MAIN OUTCOME MEASURES
Primary outcome: incidence of the composite endpoint ‘atelectasis + pneumonia’. Secondary outcome: incidence of the composite endpoint ‘persistent air leak + pneumothorax’.

RESULTS
The primary outcome occurred in 35 patients (17%) of the CPAP group and in 58 (27%) of the control group [adjusted relative risk (ARR) 0.53, 95% CI 0.30 to 0.93]. The secondary outcome occurred in 33 patients (16%) of the CPAP group and in 29 (14%) of the control group [ARR 0.92, 95% CI 0.51 to 1.65].

CONCLUSION
Prophylactic CPAP decreased the incidence of the composite endpoint ‘postoperative atelectasis + pneumonia’ without increasing the incidence of the endpoint ‘postoperative persistent air leaks + pneumothorax’.
Rural and Racial/Ethnic Differences in Children Receiving Early Intervention Services
Authors: Barnard-Brak Lucy , Morales-Alemán Mercedes M. , Tomeny Kimberly , McWilliam R. A. 
Published: November 2020

A review of the literature shows that racial and ethnic minority children (eg, African American, Asian, and Hispanic) received diagnoses for developmental concerns later in life compared with their age-matched white counterparts. Research has also documented disparities in access to and receipt of health care services among children with developmental concerns as compared with children with other disabilities.

Objectives:
We examined health care providers' (HCPs') responses to parents' developmental concerns about their children. We looked at the association with race, ethnicity, gender, rurality, and time to diagnosis.

Methods:
All data were secondary and derived from the Centers for Disease Control and Prevention's Survey of Pathways to Diagnosis and Services. Participants consisted of 1321 parents of children who had received early intervention services as reported by respondents' data collected in 2011.

Results:
From a nationally representative sample of families receiving early intervention services, 76% were white, 10% were African American, 3% were Asian, 5% were Native American, and 9% were Hispanic. Families who were Hispanic were more likely to have received only a delaying response from HCPs. The average time to a developmental delay diagnosis was 5 months longer for families who received a delaying HCP response.

Conclusions:
Families who were Hispanic or who were from rural areas were most likely to receive a delayed HCP response; for parents who received a delayed HCP response, a developmental delay diagnosis took 5 months longer than for families from the other groups listed.
Influence of social determinants on fertility: a critical review
Authors: Tabernero Rico Pedro M. , Garcia Velasco Juan A. 
Published: November 2020

Purpose of review
Intrinsic factors, such as age, weight and lifestyle habits, together with extrinsic factors, such as socioeconomic level, must be considered when it comes to reproductive healthcare. Over the last few years, studies that attempt to respond to the participation and interaction of these factors in subfertility have been published; however, some questions remain unanswered.

Recent findings
Although there are little modifiable factors for women, it is possible to influence other factors, such as behavioural or cultural factors in order to minimize fertility problems; however, they are often highly influenced by each other.

Summary
Advanced age, obesity, sedentary lifestyle, alcohol, tobacco and other compounds, have a clearly negative effect and may extend time-to-pregnancy, although the responsible mechanisms and the magnitude of the detriment that they produce in the reproductive health are yet to be studied. Economic context and new environmental factors are a current challenge for reproductive health too.