bluuebunny/crossref_metadata_2025_split huggingface dataset:
How informative are web searches for risk communication during COVID-19 in Germany?
Authors: Kristensen Kaja , Lorenz Eva , May Jürgen , Strauss Ricardo 
Published: October 2020

Abstract
Background: Risk communication during pandemics is an element of paramount importance. Understanding the level of public concern implicates expensive and time-consuming surveys. We hypothesize that the relative search volume from Google Trends could be used as an indicator of public concern towards prevention measures as well as of the adequacy of the official messages spread. Methods: The search terms ‘RKI’, ‘corona’ and ‘protective mask’ in German language were shortlisted. Cross-correlations between these terms and the reported cases from February 15th to April 27th were conducted for each German federal state. The findings were contrasted against a timeline of official communications concerning COVID-19.Results: The highest correlations of the term ‘RKI’ (Robert Koch Institute, national public health authority in Germany) with reported COVID-19 cases were found between lags of -2 and -12 days, meaning web searches were already performed two to twelve days before case numbers increased. A similar pattern was seen for the term ‘corona’. Cross-correlations indicated that most searches on ‘protective mask’ were performed six to twelve days after the increase of cases. Conclusions: The results for the term ‘protective mask’ indicate some degree of confusion in the population, which is supported by the contradictory recommendations on the wearing of face masks over time. In addition, the relative search volumes could be a useful tool to provide timely information on location-based risk communication strategies.
Clinical characteristics and outcomes of adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections: a prospective, cohort study
Authors: Chen Liang , Han Xiudi , Bai Lu , Zhang Jian 
Published: October 2020

Abstract
Background Respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza virus infections cause countless adult hospitalizations each year, yet the clinical characteristics and outcomes of RSV and hMPV infections in adults remain poorly understood. This study was thus designed to compare the clinical findings and severity between adult patients hospitalized with RSV/hMPV infections relative to those hospitalized with influenza.Methods This study prospectively enrolled 594 patients that had been hospitalized with influenza-like illness and laboratory confirmed RSV, hMPV, or influenza viral infections over the course of three consecutive influenza seasons at a tertiary hospital in China. In order to identify clinical features associated with these three viral infections and with disease severity, univariate and multivariate logistic regression analyses were conducted. Results Myalgia and lymphocyte counts < 0.8×109/L were positively correlated with the incidence of influenza infection, whereas age ≥ 65 years, nasal congestion, dyspnea, and the presence of solid malignant tumors were positively associated with RSV or hMPV infections. However, none of these variables exhibited good predictive performance as a means of discriminating among patients infected with these three different viruses (AUC < 0.70). After controlling for potential confounding variables, RSV infections in pneumonia patients were associated with a comparable 30-day mortality risk [odds ratio (OR) 1.016, 95% confidence interval (CI) 0.267-3.856, p = 0.982], whereas hMPV infection was associated with a reduced risk of mortality (OR 0.144, 95% CI 0.027-0.780, p = 0.025). In patients without pneumonia, however, 30-day mortality risk in patients infected with influenza virus was comparable to that in patients infected with RSV (OR 1.268, 95% CI 0.172-9.355, p = 0.816) or hMPV (OR 1.128, 95% CI 0.122-10.419, p = 0.916). Conclusions Clinical features of influenza, RSV, and hMPV infections are helpful , but not sufficiently distinct to permit discrimination among these three different infection types, and specific pathogenic testing is thus necessary to understand the etiological basis for disease in patients with influenza-like illness. In addition, disease severity associated with these three types of viral infection was inconsistent when comparing patients with and without pneumonia.
Neuropsychiatric Adverse Events During 12 Months of Treatment with Efavirenz in a Treatment-Naïve HIV-Infected Population in China: A Prospective Cohort Study
Authors: Dai Lili , Wang Sen , Shao Ying , Wang Yali , Ye Jiangzhu , Su Bin , Jiang Taiyi , Zhang Tong , Wu Hao , Liu An , Hua Wei , Mahajan Supriya Dinkar , Li Zaicun , Sun Lijun 
Published: October 2020

Abstract
Background: Efavirenz (EFV) is a widely used antiretroviral therapy (ART), but side effect risks of neuropsychiatric adverse events (NPAEs) have not been investigated in Chinese populations receiving rapid ART. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4%, 22.7%, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV-based first-line antiretroviral therapy was well-tolerated and associated with improvements in HADS-A, HADS-D, and PSQI scores. Certain risk factors associated with neuropsychiatric disorders may be useful in identifying HIV-infected patients at higher NPAE risk.
Determinants of&nbsp;Tuberculosis Among HIV Infected Adults in Horro Guduru Wollega Zone, West Ethiopia: A Facility-Based Case-Control Study
Authors: Adugna Zelalem Belay , Tolessa Belachew Etana , Yilma Mekdes Tigistu 
Published: October 2020

Abstract
Background: Tuberculosis is a contagious air born disease caused by Mycobacterium tuberculosis species and the leading causes of morbidity and mortality among people living with HIV/AIDS worldwide. Globally, it causes ill-health among millions of people living with HIV/AIDS each year. Objective: To identify determinants of Tuberculosis among HIV infected adults in public health facilities, in Horro Guduru Wollega Zone, 2019. Methods: Unmatched case-control study was conducted among 127 cases and 255 controls which were selected using systematic random sampling technique. Data were collected by record review and through face to face interview. Then, analysis was done using SPSS version 25.To identify determinants of tuberculosis multivariable logistic regression was employed. Adjusted odds ratio was calculated with 95 % CI to show strength of association and P-value < 0.05 was used to declare statistical significance.Results: - A total of 127 cases and 255 controls were participated into the study with 97.2% response rate. Aged ≥35 years [ AOR= 2.63, 95% CI(1.29,5.36)], alcohol consumption [AOR=3.34,95%CI(1.68,6.99)], Having CD4 cells <200 [AOR=3.67, 95% CI (1.5, 9.1)], Having Haemoglobin <11g/dl [AOR=3.77, 95%CI(1.84,7.72)], Imprisoned in the past 2 years [AOR=4.22, 95%CI(1.56, 11.37)], Living with TB patients in the same house [AOR=14.97, 95% CI(1.99, 21.63)] were factors associated with TB among HIV infected adults. Importantly, using Cotrimoxazole prophylaxis [AOR=0.193, 95% CI(0.81,0.46)] had a protective effect from acquiring TB. Conclusion and Recommendation: Being in old age, alcohol use, Chewing khat, Having CD4cells <200, Advanced WHO clinical stage, Hgb <11g/dl, Imprisoned in the past 2 years, History of previous TB and living with TB patients in the same house were factors associated with TB/HIV co-infection. Using Cotrimoxazole had a protective effect from acquiring TB/HIV co-infection. For most of these determinants interventions can be made at individual and institutional levels, whereas, some factors need societal level integrations.
Association between resting-state functional connectivity of amygdala subregions and peripheral pro-inflammation cytokines levels in bipolar disorder
Authors: Gong Jiaying , Chen Guanmao , Chen Feng , Zhong Shuming , Chen Pan , Zhong Hui , Lai Shunkai , Tang Guixian , Wang Jurong , Luo Zhenye , Qi Zhangzhang , Jia Yanbin , Huang Li , Wang Ying 
Published: October 2020

Abstract
Background: The pathophysiological mechanisms of mood disorders including bipolar disorder (BD) are not completely known, and systemic inflammation and immune dysregulation are considered as risk factors of it. Previous neuroimaging studies have proved metabolic, structural and functional abnormalities of the amygdala in BD patients, suggesting the vital role of amygdala in BD patients. This study aimed to test the underlying neural mechanism of inflammation-induced functional connectivity (FC) in the amygdala subregions of BD patients.Methods: Resting-state functional MRI (rs-fMRI) was used to delineate the amygdala FC from two pairs of amygdala seed regions (the bilateral lateral and medial amygdala) in 51 unmedicated BD patients and 69 healthy controls (HCs). The levels of pro-inflammatory cytokines including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α were measured in the serum. The correlation between abnormal levels of pro-inflammatory cytokines and FC values were calculated in BD patients.Results: The BD group exhibited decreased FC between the right medial amygdala and bilateral medial frontal cortex (MFC), and decreased FC between the left medial amygdala and the left temporal pole (TP), right orbital inferior frontal gyrus compared with HCs. The BD patients had higher levels of TNF-α than HCs. Correlation analysis showed negative correlation between the TNF-α level and abnormal FC of the right medial amygdala-bilateral MFC; and negative correlation between TNF-α levels and abnormal FC of the left medial amygdala-left TP in BD group.Conclusions: These findings suggest that dysfunctional and immune dysregulation between the amygdala and the frontotemporal circuitry might play a critical role in the pathogenesis of BD.
Chest X-ray interpretation does not complement Xpert MTB/RIF in diagnosis of smear-negative pulmonary tuberculosis among TB-HIV co-infected adults in a resource-limited setting
Authors: Nakiyingi Lydia , Bwanika John Mark , Ssengooba Willy , Mubiru Frank , Nakanjako Damalie , Joloba Moses L , Mayanja-Kizza Harriet , Manabe Yukari C. 
Published: October 2020

Abstract
Background: Chest X-ray (CXR) interpretation remains a central component of current World Health Organization recommendations as an adjuvant test in diagnosis of smear-negative tuberculosis (TB). With its low specificity, high maintenance and operational costs, utility of CXR in diagnosis of smear-negative TB in high HIV/TB burden settings in the Xpert MTB/RIF era remains unpredictable. We evaluated accuracy and additive value of CXR to Xpert MTB/RIF in the diagnosis of TB among HIV-positive smear-negative presumptive TB patients. Methods: HIV co-infected presumptive TB patients were recruited from the Infectious Diseases Institute outpatient clinic and in-patient medical wards of Mulago Hospital, Uganda. CXR films were reviewed by two independent radiologists using a standardized evaluation form. CXR interpretation with regard to TB was either positive (consistent with TB) or negative (normal or unlikely TB). Sensitivity, specificity and predictive values of CXR and CXR combined with Xpert MTB/RIF for diagnosis of smear-negative TB in HIV-positive patients were calculated using sputum and/or blood mycobacterial culture as reference standard.Results: 366 HIV co-infected smear-negative participants (female, 63.4%; hospitalized, 68.3%) had technically interpretable CXR. Median (IQR) age was 32 (28-39) years and CD4 count 106 (24-308) cells/mm3. Overall, 22% (81/366) were positive for Mycobacterium tuberculosis (Mtb) on culture; 187/366 (51.1%) had CXR interpreted as consistent with TB, of which 55 (29.4%) had culture-confirmed TB. Sensitivity and specificity of CXR interpretation in diagnosis of culture-positive TB were 67.9% (95%CI 56.6-77.8) and 53.7% (95%CI 47.7-59.6) respectively, while Xpert MTB/RIF sensitivity and specificity were 65.4% (95%CI 54.0-75.7) and 95.8% (95%CI 92.8-97.8) respectively. Addition of CXR to Xpert MTB/RIF had overall sensitivity and specificity of 87.7% (95%CI 78.5-93.9) and 51.6% (95%CI 45.6-57.5) respectively; 86.2% (95%CI 75.3-93.5) and 48.1% (95%CI 40.7-55.6) among inpatients and 93.8% (95%CI 69.8-99.8) and 58.0% (95%CI 47.7-67.8) among outpatients respectively.Conclusion: In this high prevalence TB/HIV setting, CXR interpretation added sensitivity to Xpert MTB/RIF test at the expense of specificity in the diagnosis of culture-positive TB in HIV-positive individuals presenting with TB symptoms and negative smear. CXR interpretation may not add diagnostic value in settings where Xpert MTB/RIF is available as a TB diagnostic tool.
The determination of data collection tools that can measure and document the cooperation of local health care providers in Hungary
Authors: Nagy Beáta Erika , Oláh Róza , Zombor Erika , Boris Péter , Szele Anna Szabina 
Published: October 2020

Abstract
Background

The overall objective of the study is to improve the mental health of the age group below 18 years through the investigation of the intra-and inter-sectoral cooperation between local suppliers and to make the intensity and quality of collaborations measurable. In this paper, based on Hungarian and international literature, we aim at describing the current and future optimal cooperation between the members of the mental health care system and examine the possibilities for documenting and measuring cooperation.
Methods

Semi-structured interviews were recorded with the leaders or representatives of 12 public educational institutions, six social and six health institutions involvement of the relevant experts (N = 24) to explore data collection tools that can measure and document the cooperation of local health care providers.
Results

The function of the institutions belonging to these systems, as well as the daily work of the professionals working there, have a significant impact on the mental health of children in either positive or negative directions. After exploring the current situation, the cooperation of local suppliers and inter-institutional relations can highly improve the mental health of the youth.
Conclusion

According to the results, the developing progress can be more effective through organising the different forms of care, sectors and professionals together to achieve a common goal.
The perceived feasibility and acceptability of integrating depression management in non-communicable diseases clinics in Malawi
Authors: Udedi Michael , Pence Brian W. , Stewart Robert C. , Muula Adamson S. 
Published: October 2020

Abstract
Background
Integration of mental health into other health care services is one way of reducing the treatment gap and increasing access to mental health care.
Aim
This study was conducted to explore the perceptions of health workers about the perceived feasibility and acceptability of integrating depression management into diabetes clinics.
Methods
This qualitative study used a descriptive exploratory design; it is the second phase of a mixed methods study aimed at evaluating the effect of integrating depression management into non-communicable diseases (NCD) routine care on patient and service outcomes in Malawi. We conducted in-depth interviews with 8 healthcare workers who provide diabetes care within NCD clinics in three districts in the central region of Malawi. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of feasibility and acceptability of integrating depression screening and management. Interviews were transcribed and analysed using deductive and inductive coding in NVivo 12 software.
Results
Depression was acknowledged as a common mental health problem that affects many patients attending NCD clinics. The chronic nature of the diseases seen in the NCD clinics was identified as the cause of depression. All study participants acknowledged the need to screen for and manage depression at the NCD clinics. Additionally, they viewed training and expanding the healthcare workforce involved in NCD care as crucial to effectively integrating depression screening and management in NCD care.
Conclusion
This study demonstrated the acceptability to health workers of integrating depression screening and management in NCD clinics in Malawi. It also highlights the importance of building capacity of NCD healthcare workers in depression screening and management through training and workforce expansion.
More severe hypercoagulation status, cytokine storm, and disease progression in coronavirus disease 2019 with persistent RT-PCR negative results: a multicenter prospective study
Authors: Du Wei , Shi Guochao , Zhou Min , Liu Yahui , Lan Gelei , Du Xueqing , Huang Chunrong , Dai Ranran , Chen Wei 
Published: October 2020

Abstract
Purpose: Persistent negative results (at least 3 times) of reverse transcription–polymerase chain reaction (RT-PCR) from pharyngeal swabs are not rare in coronavirus disease 2019 (COVID-19) patients, but their characteristics have not yet been well studied.Methods: PCR confirmed, serum antibody confirmed with persistent negative PCR results, and clinically diagnosed patients hospitalized in two medical centers during February and March 2020 were included. Differences in clinical, imaging and laboratory characteristics as well as factors affecting their prognosis were analyzed.Results: There were 114 PCR confirmed, 17 serology confirmed and 21 clinically diagnosed patients included. Time from onset of disease to the first PCR and admission were similar among the groups. Compared with PCR-confirmed patients, serology-confirmed patients were older and likely to have hypertension, vomiting, or symptoms of chest pain and dyspnea. Regarding imaging manifestations, serology-confirmed patients were more prone to pleural effusion. In addition, higher levels of C-reactive protein, neutrophil-to-lymphocyte ratio, total bilirubin, D-dimer, fibrinogen, troponin, interleukin-6 and IL-8 were also found. Although with similar mortality, serology confirmed patients were more likely to have disease progression. High levels of D-dimer and IL-6 were possibly the underlying factors leading to their worse prognosis. On the other hand, clinically diagnosed patients were more similar to PCR-confirmed patients.Conclusion: Serology confirmed COVID-19 patients with at least three negative PCR results had different clinical characteristics and were likely to have disease progression, possibly due to more severe hypercoagulation status and cytokine storm.
Smoking between Young Workers in Healthy Field, Trigger Factors and Reasons of Cessation
Authors: Alduihi Fatima Alhamed 
Published: October 2020

Abstract
Background: Smoking is an important factor correlates with morbidity and mortality all over the world and it still a real challenge according to the promotion of tobacco companies and war conditions. It correlates well with emphysema and cancers of lung and bladder in elderly adults. Materials and Methods: A cross-sectional questionnaire-based study was applied to workers on healthy field and medical students in age (15-45) in Aleppo University Hospital. They were divided into 2 groups (smokers and non-smokers). This study aims to define the relationship between smoking and different variants in young ages.Results: The study included 169 healthy workers (93 males, 76 females). Smokers were 88 (52.07%), 62.5% active and 37.5% passive. Most of them classified as lighter smokers, whereas13.6% were heavy smokers. 37 of smokers (42.53%) smoke shisha. 68 smokers want to stop smoking (77.27%), and 61 of them (69.31%) try that. Only 4 smokers try drugs or electronic cigarette.Promotion is the most common trigger factor for smoking 38.27% followed by war 30.86%. Genders, living with a smoker and awareness of the correlation between shisha and tuberculosis, have a statically significant between the two groups of study (p =0.009, <0.0001, 0.041) respectively. Weight and regular sporting have no significance. Conclusions: Promotion is still the first reason for smoking between young ages. Awareness by the risk of tuberculosis by shisha, living with smoker people and gender correlates well with the smoking and plays a role in this field.
Entropy weight method coupled with an improved DRASTIC model to evaluate the special vulnerability of groundwater in Songnen Plain, Northeastern China
Authors: Wang Bin , Teng Yanguo , Wang Huiqun , Zuo Rui , Zhai Yuanzheng , Yue Weifeng , Yang Jie 
Published: October 2020

Abstract
The Songnen Plain in Northeast China is the only remaining black soil agricultural area in the world and is an important food base for China. The groundwater resources in this area are abundant, but human activities have caused them polluted. This paper established a groundwater vulnerability assessment to characterize the influence of human activities which used an entropy weight method. The index was tested using the nitrate pollution distribution in the groundwater to verify the effectiveness of this method. The results showed that areas with high specific vulnerability were distributed in the northern and eastern parts of the Songnen Plain and were consistent with areas that showed serious nitrate pollution of the groundwater. The correlation coefficient between these areas was 0.2536, which greatly improved the vulnerability assessment without superimposing human activities in the model. The results clearly showed that human activities increased groundwater vulnerability on the Songnen Plain. The evaluation method provided a reference for similar evaluations and a basis for the protection and management of groundwater resources in this region.