bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care in Supplementary Health: impact on care costs of elderly patients with heart disease
Authors: Marques Geórgia Silva , Almeida Alessandra Maciel , Gomes Isabel Cristina , Silva Michele Renata Barbosa da , Rezende Bruno Almeida 
Published: June 2020

Abstract
Introduction: Population aging has been changing the epidemiological profile in the World. Cardiovascular diseases are the leading cause of death in many countries and have an impact on health spending. Objectives: To identify factors that influence health care costs in elderly patients with heart disease treated at a Supplementary Primary Health Care (PHC) unit in Brazil. Methods: Retrospective cohort of 223 patients with heart disease aged ≥ 60 years from one year before and one year after PHC implantation. Data were obtained from electronic medical records and the costs in the total cost of care database (hospital, outpatient and home). Patients were classified according to the Clinical-Functional Vulnerability Index (CFVI-20). Results: There was no reduction in total costs, but it occurred in hospitalization expenses after the implementation of PHC for the whole sample (mean ± SD, US$ 698.43 ± US$ 3,500.76, p=0.011), with a significant reduction among (p=0.023), pre-diagnosis of acute myocardial infarction (AMI) (p=0.023), eutrophic BMI (p=0.027), non-smokers (p=0.020), and robust according to the CFVI-20 (p=0.013). There was a decrease in the frequency of hospitalization for the whole sample (p=0.006), among males (p=0.014), age between 71 and 80 years (p=0.001), robust (p=0.025) and AMI (p= 0.027). There was a reduction in the frequency of consultations in the Emergency Department among fragile elderly (p=0.011). Conclusions: There was a reduction in the frequency and cost of hospitalization in elderly patients with heart disease in follow-up at PHC, in addition to reducing the frequency of consultation in PHC in the fragile elderly.
Revisiting Methods For Modeling Longitudinal and Survival Data: The Framingham Heart Study
Authors: Ngwa Julius S , Cabral Howard J , Cheng Debbie M , Gagnon David R , LaValley Michael P , Cupples L. Adrienne 
Published: June 2020

Abstract
Background
Statistical methods for modeling longitudinal and time-to-event data has received much attention in medical research and is becoming increasingly useful. In clinical studies, such as cancer and AIDS, longitudinal biomarkers are used to monitor disease progression and to predict survival. These longitudinal measures are often missing at failure times and may be prone to measurement errors. More importantly, time-dependent survival models that include the raw longitudinal measurements may lead to biased results. In previous studies these two types of data are frequently analyzed separately where a mixed effects model is used for the longitudinal data and a survival model is applied to the event outcome.
Methods
In this paper we compare joint maximum likelihood methods, a two-step approach and a time dependent covariate method that link longitudinal data to survival data with emphasis on using longitudinal measures to predict survival. We apply a Bayesian semi-parametric joint method and maximum likelihood joint method that maximizes the joint likelihood of the time-to-event and longitudinal measures. We also implement the Two-Step approach, which estimates random effects separately, and a classic Time Dependent Covariate Model. We use simulation studies to assess bias, accuracy and coverage probabilities for the estimates of the link parameter that connects the longitudinal measures to survival times.
Results
Simulation results demonstrate that Two-Step approach performed best at estimating the link parameter when variability in the longitudinal measure is low but is somewhat biased downwards when the variability is high. Bayesian semi-parametric and maximum likelihood joint methods yield higher link parameter estimates with low and high variability in the longitudinal measure. Time Dependent Covariate method resulted in consistent underestimation of the link parameter. We illustrate these methods using data from the Framingham Heart Study in which lipid measurements and Myocardial Infarction data were collected over a period of 26 years.
Conclusions
Traditional methods for modeling longitudinal and survival data, such as time dependent covariate method, that use the observed longitudinal data, tend to provide downward bias estimates. Two-step approach and joint models provide better estimates, although a comparison of these methods may depend on the underlying residual variance.
Managing Patient Flows in Radiation Oncology - Reworking Existing Treatment Designs to Prevent Infections During the COVID-19 Pandemic at a German University Hospital
Authors: Akuamoa-Boateng MBA Dennis , Wegen Simone , Ferdinandus Justin , Marksteder Regina , Baues Christian , Marnitz Simone 
Published: June 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
Impact of Health Education Intervention On Knowledge And Prevalence Of Hypertension Among Market Traders In Southeast Nigeria
Authors: Eze Irene Ifeyinwa , Onwe Emeka Ogah , Mbachu Chinyere Ojiugo , Ossai Edmund Ndudi , Umeokonkwo Chukwuma David , Okedo-Alex Ijeoma Nkem , Ogbonnaya Lawrence Ulu 
Published: June 2020

Abstract
Background: Hypertension is a leading cause of morbidity and mortality in adult populations due to complications arising from late detection and poor blood pressure control. Health education has been proven to be an effective strategy in prevention and control of hypertension. However, it’s effectiveness among informal sector workers is under-explored. This study assessed the effect of health education on knowledge of hypertension and its prevalence among market traders in Southeast Nigeria. Methods: The study was conducted in Abakaliki, Ebonyi State Southeast Nigeria using a non-randomized experimental study design comprising an intervention arm and a control arm. Systematic random sampling was used to select 376 adult market traders into the study. Baseline data were collected on participants’ knowledge of hypertension using pretested structured interviewer-administered questionnaire and on their blood pressure status. The intervention group received health education on risk factors, complications, treatment, prevention and early detection of hypertension, while the control group did not. A post-study assessment was carried out after six months using the same study instruments. Bi-variate and multivariate analyses were carried out and statistical significance was set at p < 0.05 Results: The proportion of traders in the intervention group with good knowledge of hypertension increased from 20.7% to 80.7% post intervention (p<0.001); the difference in the control group was not statistically significant. Prevalence of hypertension decreased by 9.8% (p<0.001) from the baseline value of 38.8% in the intervention group but increased in the control group. Predictors of hypertension included having good knowledge of hypertension (AOR: 0.4; CI: 0.2-0.9), being ≥40years (AOR: 2.9; CI: 1.3-6.4), and being single or unmarried (AOR: 2.4; CI: 1.1–5.9) Conclusions: Blood pressure education intervention was effective in improving knowledge of hypertension and reducing prevalence of hypertension. This demonstrates the need to regularly educate market traders on the risk factors, complications, treatment, prevention and early detection of high blood pressure.
CYR61 synthesis is Induced by Interleukin-6 and Promotes Migration and Invasion of Fibroblast-like Synoviocytes in Rheumatoid Arthritis
Authors: Choi Changmin , Jeong Wooseong , Ghang Byeongzu , Park Yonggeun , Cho Moonjae , Kim Jinseok 
Published: June 2020

Abstract
Background:Interleukin-6 (IL-6) is involved in fibroblast-like synoviocyte (FLS) activation and promotes pannus formation and bone and cartilage destruction in rheumatoid arthritis (RA). Cysteine-rich 61 (Cyr61) protein regulates cell proliferation, migration, and differentiation. The aim of this study was to investigate the role of Cyr61 in RA-FLS migration and invasion after IL-6 stimulation. Methods:Western blotting and reverse transcription-polymerase chain reaction were used to examine protein and mRNA levels of Cyr61, matrix metalloproteinases (MMPs), and other signalling proteins. Knockdown of gene expression was performed with siRNA, and RNA sequencing was performed for differential gene analysis. Migration and invasion were assessed by wound healing and Boyden chamber assays. Results:Cyr61 levels were elevated in FLSs from RA patients compared to those in osteoarthritis patients. Control and IL-6-treated FLSs showed differential gene expression. IL-6 stimulated protein synthesis of Cyr61, which was attenuated by the extracellular signal-related kinase 1/2 (ERK 1/2) inhibitor, PD98059, and knockdown of early growth response 3 (EGR3), but not of JUN. IL-6-induced Cyr61 protein synthesis increased expression of MMP2. Cyr61 promoted FLS migration and invasion in an autocrine manner. Knockdown of CYR61 and a neutralizing antibody attenuated Cyr61 synthesis and IL-6 induced FLS migration. Conclusions:By modulating the ERK/EGR3 pathway, IL-6 stimulated Cyr61 production and in turn increasedinvasiveness of FLS. Our data suggest that Cyr61 might be a potential target to prevent the progression of joint damage in RA.
In Utero and Peripubertal Metals Exposure in Relation to Reproductive Hormones and Sexual Maturation and Progression among Boys in Mexico City
Authors: Ashrap Pahriya , Meeker John D. , Sánchez Brisa N. , Basu Niladri , Tamayo-Ortiz Marcela , Solano-González Maritsa ,   Adriana Mercado-García4, Téllez-Rojo Martha M. , Peterson Karen E. , Watkins Deborah 
Published: June 2020

Abstract

Background

Endocrine disrupting chemicals (EDCs) such as metals have been reported to alter circulating reproductive hormone concentrations and pubertal development in animals. However, the relationship has rarely been investigated among humans, with the exception of heavy metals, such as Pb and Cd. Our aim was to investigate measures of in utero and peripubertal metal exposure in relation to reproductive hormone levels and sexual maturation and progression among boys from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohorts.

Methods

Our analysis included 118 pregnant women and their male children from the ELEMENT study. Essential and non-essential metals were measured in urine collected from the mothers during the third trimester of pregnancy and their male children at 8-14 years. Reproductive hormone levels [serum testosterone, estradiol, dehydroepiandrosterone sulfate (DHEA-S), inhibin B, and sex hormone-binding globulin (SHBG)] were measured in blood samples from the children at 8-14 years. We also assessed Tanner stages for sexual maturation (genital, pubic hair development, and testicular volume), at two time points (8–14, 10-18 years). We used linear regression to independently examine urinary metal levels in relation to each peripubertal reproductive hormones adjusting for child age and BMI. Generalized estimation equations (GEEs) were used to evaluate the association of in utero and peripubertal metal exposures with sexual maturation and progression during follow-up based on Tanner staging and testicular volume.

Results

In utero and prepubertal concentrations of some urinary metals were associated with increased levels of peripubertal reproductive hormones, especially non-essential metal(loid)s As and Cd ( in utero ), and Ba (peripubertal) as well as essential metal Mo ( in utero ) in association with testosterone. More advanced pubic hair developmental stage and higher testicular volume at the early teen visit was observed for boys with higher non-essential metal concentrations, including in utero Al and peripubertal Ba, and essential metal Zn concentration (peripubertal). These metals were also associated with slower pubertal progression between the two visits.

Conclusion

These findings suggest that male reproductive development may be associated with both essential and non-essential metal exposure during in utero and peripubertal windows.
Clinical features and etiology of patients with community-acquired pneumonia in southern China
Authors: Gan Caiyan , Liu Sudong , Guo Xuemin , Weng Ruiqiang , Gu Xiaodong , Zhong Zhixiong 
Published: June 2020

Abstract
Background: The aim of this study was to investigate the clinical features and etiology in patients with community-acquired pneumonia (CAP) in southern China. Methods: A total of 342 patients who presented community-acquired pneumonia (CAP) from January 2019 to December 2019 were enrolled in this study. The respiratory pathogens in nine test and loop-mediated isothermal amplification (LAMP) detection were used to identify pathogens. Results: The mean age of this study population was 60.89 ± 18.87 years. The total incidences of CAP were more prevalent in males (60.5%, 207/342) than females (39.5%, 135/342), and the percentage was 65.8% (225/342) CAP patients in summer and autumn. The main causative pathogens were identified in 96/342 (28.1 %) patients. Of these, 14 (14.6 %) were MP infection, the most frequently isolated microorganism. Bacterial infection in the single infection was present in 47 (47/96, 49.0%). Mixed infections were demonstrated in 26 (26/96, 27.1%). MRSA infection was close to patients with systemic diseases (P = 0.001). Factors that were associated with systemic disease was the age >65 (OR 5.555, 95%CI 3.402-9.071, P<0.001). Conclusions: MP is common organisms isolated in community-acquired pneumonia. The year of above 65, the count of WBC and mixed pathogens infections may be associated with an increased risk of CAP patients with systemic disease.
MIR-361-5P Mediates TGF-β Signalling to Promote Granulosa Cell Apoptosis Through Vegfa During Porcine Follicle Atresia
Authors: Ma Mengnan , Gao Xiaomeng , Yao Wang , Pan Zengxiang , zhang jinbi 
Published: June 2020

Abstract
Background: Follicular atresia is an inevitable degenerative process of ovarian follicles in mammals. The molecular events involved in atresia, particularly in granulosa cell apoptosis, have always attracted researchers’ attention. It is known that VEGFA isdownregulated during follicular atresia in pig ovaries and serves as an apoptosis inhibitor of granulosa cells. Besides, the TGF-β signalling has been considered as a central trigger in granulosa cell apoptosis. However, the link between TGF-β signalling and VEGFA is missing.Results:We proved that miR-361-5p significantly up-regulated during the atresia process andenhances GC apoptosis by direct targeting to VEGFA 3’UTR. In addition,we revealed that miR-361-5p coding geneMIR361was significant downregulation bySMAD4, the central intracellular mediator of TGF-β signalling,through promoter binding.Conclusions: Our findingsenriched the knowledge of VEGFA post-transcriptional regulation and completed the TGF-β/miR-361-5p/VEGFAregulatory networkin ovarian granulosa cell apoptosis. It offereduseful references for follicular atresia and ovarian physiological function studies.
Prognostic value of Cardiac Biomarkers in COVID-19 Infection: A Meta-analysis
Authors: Dawson Desiree , Dominic Paari , Sheth Aakash , Modi Malak 
Published: June 2020

Abstract
BackgroundMultiple Biomarkers have recently been shown to be elevated in COVID-19, a respiratory infection with multi-organ dysfunction; however, information regarding the prognostic value of cardiac biomarkers as it relates to disease severity and cardiac injury are inconsistent.Research QuestionThe goal of this meta-analysis was to summarize the evidence regarding the prognostic relevance of cardiac biomarkers from data available in published reports.Study Design and MethodsPubMed was searched from inception through April 2020 for studies comparing median values of cardiac biomarkers in critically ill versus non-critically ill COVID-19 patients, or patients who died versus those who survived. The weighted mean differences (WMD) and 95% confidence interval (CI) between the groups were calculated for each study and combined using a random effects meta-analysis model. The odds ratio (OR) for mortality based on cardiac injury was combined from studies reporting it.ResultsTroponin levels were significantly higher in COVID-19 patients who died or were critically ill versus those who were alive or not critically ill (WMD 0.58, 95% CI 0.42-0.71, p<0.001). Cardiac injury was independently associated with significantly increased odds of mortality (OR 6.641, 95% CI 1.26 - 35.1, p=0.03). No difference in BNP was seen between the two groups. A significant difference in levels of D-dimer was seen in those who died or were critically ill. CK levels were only significantly higher in those who died versus those who were alive (WMD 0.47 95% CI 0.09-0.84, p=0.014).InterpretationCardiac biomarkers add prognostic value to the determination of the severity of COVID-19 and can predict mortality.
Use of a self-rotating nozzle for more efficient flash purification of dirty water
Authors: Sonawan Hery , Aprillianto Kiki 
Published: June 2020

Abstract
An efficient flash-purification system has been developed using a self-rotating nozzle powered by the feed-water flow. Where an electrically-powered, rotating nozzle distributes water droplets evenly in a flashing chamber to increase the evaporation rate, a self-rotating nozzle creates a continuous flow of droplets at the chamber wall by impact momentum effects. The aim of this study was to design and test a new self-rotating nozzle to improve the condensation rate in the flash-purifier. The device investigated employed a self-rotating nozzle of innovative design. The new system was constructed successfully and tested under conditions in which the vacuum and feed-water pressures, and the temperature were varied to maximize the condensation rate. Factorial design methodology showed that vacuum pressure was the most influential variable for condensation rate. The highest condensation rate achieved was 0.0748 ml/s, obtained from a combination of 2.0 bar-g feed-water pressure, vacuum pressure 0.3 bar-a and feed-water temperature 60 °C. Previous studies involved an electric rotating nozzle that generated 0.061 ml/s, but this study proved the efficiency of the self-rotating nozzle by producing a higher condensation rate.
Change dynamics of land-use and land-cover for tropical wetland management
Authors: López N. , Márquez Romance A. , Guevara Pérez E. 
Published: June 2020

Abstract
In hydrographic basins with wetlands, changes in land use (LU) and land cover (LC) impact the conservation of natural resources, leading to dynamics analysis for integral management. A method is proposed offering greater accuracy in determining the LU and LC bi-temporal and spatial change dynamics in tropical wetlands. LU and LC monitoring is based on Landsat images from 1986 to 2017. ‘Pre-classification’ and ‘post-classification’ methods are applied. In the former, reflectance image differencing and principal component N° 1 image differencing are analyzed to estimate the rate of change/no change area. In the latter, supervised classification is carried out of image pairs from different dates. The principal components method shows that principal component N° 1 collects between 88 and 93% of the reflectance variance in n spectral bands of each satellite image, which improves accuracy in determining LU and LC change dynamics.
Phosphate sequestration and recovery from eutrophication water by in situ magnesium phosphate formation
Authors: Xie Fazhi , Song Kang , Geng Shixiong , Li Lu 
Published: June 2020

Abstract
Phosphate removal from eutrophic lakes has caused wide concern in the world, while an effective process is still lacking. A novel synthetic magnesium carbonate with spherical flower-like structure (MCSF) was prepared. Its performance for phosphorus adsorption from a eutrophic lake by in situ magnesium phosphate formation was tested and characterized. The effect of initial phosphorus concentration, adsorption time, adsorption dose, temperature, ionic strength and pH on phosphorus adsorption by MCSF was investigated. Results showed that higher initial phosphorus concentration and longer adsorbing time could improve the adsorption capacity. The maximum sorption capacity was 143.27 mg/g under initial pH value 7.0. The phosphate adsorption process was fitted with the Langmuir isotherm model and pseudo-second-order model. Thermodynamic parameter values revealed that the sorption process at 298–318 K was spontaneous and endothermic. The X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) characterization of MCSF revealed that electrostatic attraction and chemical conversion were the major contributors for phosphate adsorption. MCSF releases magnesium ions from its surface and rapidly combines with phosphate to form insoluble magnesium phosphate precipitate. The prepared MCSF has the potential to be used for the restoration of eutrophic lakes by removing phosphate with higher adsorption capacity.
Evaluation of solar light inactivation on multidrug-resistant Escherichia coli CGMCC 1.1595
Authors: Yin Xiu-Feng , Shi Na , Meng Ting , Sun Ying-Xue 
Published: June 2020

Abstract
This study investigated the simulated solar light disinfection of Escherichia coli CGMCC 1.1595, a multidrug-resistant (MDR) strain resistant to tetracycline and ampicillin. With the increase of light intensity, the maximum inactivation efficiency reached 0.74 log in 60 min following visible light irradiation with an intensity of 115.8 mW/cm2 and following UVA–visible light irradiation, using a 98% UVA-ray contribution at 6.5 mW/cm2 and 95% contribution at 20.0 mW/cm2, the inactivation efficiency was up to 6.09 log. The inactivated MDR E. coli did not regrow after light irradiation or in the dark after 24 or 48 h after visible light disinfection, demonstrating that visible light disinfection can prevent MDR E. coli self-repair. The MDR E. coli plasmid electrophoresis band gradually went dark with increase of the light irradiation time and could be completely eliminated by high UVA light intensity treatment, however, simulated sunlight irradiation had minimal influence on both tetracycline and ampicillin resistance of the MDR E. coli strain.
Inactivation of antibiotic-resistant bacteria and antibiotic resistance genes by electrochemical oxidation/electro-Fenton process
Authors: Chen Lei , Zhou Zhi , Shen Chaofeng , Xu Yilu 
Published: June 2020

Abstract
Antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the environment are of great concern due to their potential risk to human health. The effluents from wastewater treatment plants and livestock production are major sources of ARB and ARGs. Chlorination, UV irradiation, and ozone disinfection cannot remove ARGs completely. In this study, the potential of electrochemical oxidation and electro-Fenton processes as alternative treatment technologies for inactivation of ARB and ARGs in both intracellular and extracellular forms was evaluated. Results showed that the electrochemical oxidation process was effective for the inactivation of selected ARB but not for the removal of intracellular ARGs or extracellular ARGs. The electro-Fenton process was more effective for the removal of both intracellular and extracellular ARGs. The removal efficiency after 120 min of electro-Fenton treatment under 21.42 mA/cm2 was 3.8 logs for intracellular tetA, 4.1 logs for intracellular ampC, 5.2 logs for extracellular tetA, and 4.8 logs for extracellular ampC, respectively in the presence of 1.0 mmol/L Fe2+. It is suggested that electrochemical oxidation is an effective disinfection method for ARB and the electro-Fenton process is a promising technology for the removal of both intracellular and extracellular ARGs in wastewater.