bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge of PEP and PrEP Among People Living with HIV/aids in Brazil
Authors: Sousa Laelson Rochelle Milanês , Elias Henrique Ciabotti , Fernandes Nilo Martinez , Gir Elucir , Reis Renata Karina 
Published: August 2020

Abstract
Background:The objective was to analyze the factors associated with knowledge of PrEP and PEP among people living with HIV/aids in Brazil. Cross-sectional analytical study carried out among people living with HIV/aids treated at five specialized services in the city of Ribeirão Preto, São Paulo, Brazil.Methods:Logistic regression analysis was used to assess the influence of independent variables on dependent variables: having knowledge about PrEP and PEP. Of the 397 participants, 140 (35.26%) were heterosexual women, aged 40 to 49 years (36.27%).Results: Participants with less than 11 years of study (adjusted odds: 0.2903; 95% CI: 0.1340-0.6007); who did not have a low viral load or did not know how to report viral load (adjusted odds: 0.2931; 95% CI: 0.0961-0.8398) and those with casual partners (adjusted odds: 0.2931; 95% CI: 0.0961- 0.8398) were less likely to have knowledge about the PrEP. MSM (adjusted odds: 2.8788; 95% CI: 1.5912-5.3092) and those who used alcohol during sexual intercourse (adjusted odds: 1.7305; 95% CI: 1.0656-2.8248) were more likely to have knowledge about the PEP.Conclusions: Awareness about PrEP and PEP should be widely disseminated by health promoting institutions in order to expand knowledge of these two methods.
New Family of Ionic Supersalts with Covalent-like Directionality and Unconventional Multiferroicity
Authors: Gao Yaxin , Wu Menghao , Jena Puru 
Published: August 2020

Abstract
Ionic crystals composed of elemental ions such as NaCl are centro-symmetric and, thus, non-polar due to directionless ionic bonding interactions. To develop polar materials, the directionality feature of covalent bonding is necessary. Here, we propose a novel way where ionically bonded crystals can develop polarity by changing their building blocks from elemental ions to cluster-ions. Superalkalis and superhalogens are clusters which mimic the chemistry of alkali and halogen atoms. Equally important, unlike the elemental ions, the geometries of these superions are not spherical. Endowed with these unique features, ionic supersalts form anisotropic polar structures with ionic bonding, yet covalent-like directionality, akin to sp3 hybridized systems. Using density functional theory and extensive structure searches, we predict a series of stable supersalts, PnH4MX4 (Pn = N, P; M = B, Al, Fe; X = Cl, Br) composed of superalkali PnH4 and superhalogen MX4 ions with unprecedented properties: (1) ferroelectricity with ultra-long ion displacements (~ 3 Å); (2) ferroelasticity with ultra-large reversible strain (> 40%); and (3) both with ultra-low switching barriers (about 6 to 13 meV/atom). These values are inconceivable in traditional ferroelectric/ferroelastic materials owing to their brittle covalent nature. Coupling of ferroelectricity with ferroelasticity can further enable strain-controlled polarization as well as electrically-controlled strain. In particular, PnH4FeX4 exhibits triferroic coupling of ferroelectricity, ferroelasticity, and antiferromagnetism where the spin directions can be altered via either ferroelastic or 90-degree ferroelectric switching. These ionic supersalts can be synthesized using facile solution-processed fabrication by exothermic reactions, MPn + 4HX→PnH4MX4 or PnH4X + MX3→PnH4MX4, which may open a new chapter in multiferroics.
Understanding Demand for, and Feasibility of, Centre-based Child-care for Poor Urban Households: A Mixed Methods Study in Dhaka, Bangladesh.
Authors: Elsey Helen , Fieroze Fariza , Shawon Riffat , Nasreen Shammi , Hicks Joseph Paul , Das Mahua , Huque Rumana , Hirano Izumi , Wallace Hilary , Mashreky Saidur 
Published: August 2020

Abstract
Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.Conclusion: sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values.
Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: An application of K-means clustering algorithm
Authors: Gesicho Milka , Babic Ankica , Were Martin 
Published: August 2020

Abstract
Introduction: The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. In this study, we report on a comprehensive assessment of the reporting status for HIV indicators, from the time of DHIS2 implementation, using Kenya as a case example.Methods: A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 to 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters.Results: Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups.Conclusion: The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.
A Systematic Review and Meta-Analysis of Nab-Paclitaxel Mono-Chemotherapy for Metastatic Breast Cancer.
Authors: Lu Haili , Zha Siluo , Zhang Wei , Wang Qiang , Jiang Daozhen , Xu Xinyun , Zheng Xiangmin , Qiu Ming , Shan Chengxiang 
Published: August 2020

Abstract
Background: Various clinical trials and real-life studies have tried to explore the value of nab-paclitaxel mono-chemotherapy for metastatic breast cancer (MBC). The safety and efficacy of nab-paclitaxel needs to be systematically evaluated. Methods : Electronic searches for prospective clinical trials containing nab-paclitaxel monotherapy for MBC were performed. Requisite data were extracted, integrated and analyzed from the included studies according to different purposes using systematic review and meta-analysis.Results: 22 studies with 3287 MBC patients were included. 1685 MBC patients received nab-paclitaxel as first-line therapy, 640 patients as further-line therapy, and 962 patients as mixed-line therapy. 1966 MBC patients (60.40%) received nab-paclitaxel weekly, while 1190 patients (36.56%) received nab-paclitaxel triweekly and 99 patients (3.04%) biweekly. The overall incidence of all grades neutropenia, leukopenia, peripheral sensory neuropathy, and fatigue was 52% (95% CI, 38%-66%), 58% (95% CI, 43%-73%), 58% (95% CI, 48%-68%), and 49% (95% CI, 41%-56%) respectively. The overall response rate (ORR) was 40% (95% CI, 35%-45%) and the clinical benefit rate (CBR) was 66% (95% CI, 59%-73%) following nab-paclitaxel monotherapy. The median progression free survival (PFS) was 7.64 months (95% CI, 6.89-8.40 months) and the median overall survival (OS) was 24.51 months (95% CI, 21.25-27.78 months). According to the meta-regression analysis, grade 3/4 neutropenia occurred less frequently in Her-2 negative patients compared with all population (P=0.046). Patients who received first-line nab-paclitaxel monotherapy showed higher ORR (P=0.006) and longer PFS (P=0.045). Patients who received further-line therapy was demonstrated to have shorter median OS versus first- and mixed-line therapy. Efficacy outcomes were not affected by the administration schedule. However, patients appeared to have more superior ORR (P=0.044) and longer PFS (P=0.03) along with the increasing dosage of nab-paclitaxel under the same schedule. Conclusions: Both weekly and triweekly nab-paclitaxel mono-chemotherapy were proved to be effective for MBC with generally reasonable toxicity profiles. Higher ORR, longer PFS and OS would be achieved in patients treated with nab-paclitaxel as first line. Increasing nab-paclitaxel dosage would result in better tumor control (higher ORR and PFS). Changing nab-paclitaxel schedule had no benefit on ameliorating the overall survival.
Melatonin Confers Heavy Metal Tolerance of a Dark Septate Endophyte (DSE) Exophiala Pisciphila Via Lowering Oxidative Stress and Heavy Metal Accumulation
Authors: Yu Yang , Teng Zhaowei , Mou Zongmin , Lv Yan , Li Tao , Chen Suiyun , Zhao Dake , Zhao Zhiwei 
Published: August 2020

Abstract
Background: The high antioxidant capacity of melatonin contributing to heavy metal tolerance for plants and animals is widely studied, while researches on microorganisms especially in filamentous fungi are rare. One typical dark septate endophyte (DSE), Exophiala pisciphila, showed significant resistance to heavy metals.Results: In this study, exogenous melatonin was verified to reduce heavy metal damage via relieving oxidative stress, activating antioxidant systems, and decreasing heavy metal accumulation in E. pisciphila. Melatonin biosynthesis enzyme genes were upregulated under heavy metal stress. Furthermore, the overexpression of E. pisciphila TDC1 (EpTDC1) and E. pisciphila ASMT1 (EpASMT1) responsible for melatonin biosynthesis in Escherichia coli and Arabidopsis thaliana, enhanced heavy metal stress tolerance for the two organisms by lowering the oxidative stress and reducing the Cd accumulation in the whole plants, especially in the roots.Conclusions: Our results indicate that melatonin confers heavy metal resistance in E. pisciphila by lowering oxidative stress and heavy metal accumulation.
Tutor uncertainty in dealing with unprofessional behaviours of medical students and trainees: a mixed methods study
Authors: Kelly Dervla , O'Doherty Diane , Harney Sarah , Slattery Natasha , Crowley Louise , McKeague Helena 
Published: August 2020

Abstract
Background: Despite acknowledgement of medical students’ expected professional behaviours and attitudes, there remains widespread reluctance to report students that behave inappropriately. Existing literature focuses on why faculty fail to fail, overlooking the clinical teachers who deal with students day to day. We investigated how clinical teachers address inappropriate behaviours and attitudes in students and trainees.Methods: A mixed methods study was carried out consisting of a survey and two focus groups with clinical teachers. Seventeen clinical teachers from the at University of Limerick School of Medicine, Ireland, took part in the survey (n=22%) and eight clinical teachers participated in two focus groups during the 2018-2019 academic year.Results: Findings suggested that 59% of tutors would take a different approach in regards to professional identity formation (PIF) between addressing unprofessional behaviours witnessed in medical students and trainees. 88% of tutors said they intervened on a professionalism issue with 52% saying ‘once in a while’ In contrast to the survey, tutors in the focus groups expressed a lack of confidence in addressing some behaviors due to a lack of time, not seeing the outcome of process/remediation etc. Tutors indicated a strong preference for case-based training on assessing PIF.Conclusions: We found tutors typically work closely with students on a day-to-day basis and manage unprofessionalism issues. Clinical tutors valued regular communication about policies and procedures about appropriate conduct as well as support, advice and/or oversight from independent member of the university staff. This research also highlights the need for training designed for busy clinical tutors as a distinct type of medical teacher.
Risk Factors and Incidence of Suction Loss during Small Incision Lenticule Extraction (SMILE) in 8487 eyes
Authors: Huang Tian-Ze , Shen Ling , Yu Xiao-Ning , Jin Hong-Ying 
Published: August 2020

Abstract
Background: To report the incidence and risk factors of suction loss during small incision lenticule extraction (SMILE).Methods: This retrospective comparative case control study included 8487 eyes of 4261 patients. Patients underwent SMILE surgery between January 2014 and September 2019 were included. Videos of suction loss were reviewed, and the direct causes of suction loss were noted. An independent samples t-test was used for comparisons between the suction loss group and the control group. A binary logistic regression model was used to determine the possible significant risk factors that might increase the likelihood of suction loss during SMILE surgery.Results: Suction loss occurred in 31 (0.37%) eyes of 30 patients; 23 (74%) cases occurred in the right eye (the first operative eye) and 8 (26%) cases occurred in the left eye. Among the 30 patients, 23 (76.7%) were male and 7 (23.3%) were female. The incidence in the six consecutive years were 0%, 2.13%, 0.34%, 0.24%, 0.22%, and 0.23%. Head and eye movements during surgery caused suction loss in 15 (48.4%) and 16 (51.6%) eyes, respectively. Comparison between the suction loss group and the control group showed that the first operative eye and male gender are at a significantly high risk for suction loss (p < 0.05).Conclusions: Surgical experience may influence the incidence of suction loss during SMILE surgery. The two events that easily led to suction loss were head and eye movements. The risk factors were first operative eye and male gender.Trial registration: Retrospectively registered. ChiCTR-ORC-17011040. Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 1 January 2014.
Longitudinal Speech Biomarkers for Automated Alzheimer's Detection
Authors: Laguarta Jordi , Hueto Ferran , Rajasekaran Prithvhi , Sarma Sanjay , Subirana Brian 
Published: August 2020

Abstract
Background: We introduce a novel speech processing framework, the MIT CBMM Open Voice Brain Model (OVBM), combining implementations of the 4 modules of intelligence: The brain OS chunks and overlaps audio samples and transfers CNN features from the sensory stream and cognitive core creating a multi-modal graph neural network of symbolic compositional models for the target task.Methods: Our approach consists of pre-training models to extract acoustic features from selected biomarkers and then leverage transfer learning to combine the biomarker feature extractors into a graph neural network to provide an explainable diagnsotic for Alzheimer's Dementia (AD) using speech recordings.Results: We apply OVBM to the automated diagnostic of Alzheimer's Dementia patients, achieving above state-of-the-art accuracy of 93.8% using only raw audio, while extracting a personalized subject saliency map to track relative disease progression of 16 explainable biomarkers.Conclusion: By using independent biomarker models, OVBM lets health experts explore biomarker features and whether there are common biomarkers features between AD and other diseases like COVID-19. We present a novel lungs and respiratory tract biomarker created using 200.000+ cough samples to pre-train a model discriminating English from Catalan coughs. Transfer Learning is subsequently used to transfer features from this model with various other biomarker OVBM models. This strategy yielded consistent improvements in ADdetection, no matter the combination used. This cough dataset sets a new benchmark as largest audio health dataset with 30.000+ subjects participating in April 2020, demonstrating for the rst time cough cultural bias.
Prognostic significance of a combined gene expression analysis in EpCAM(+) CTCs in metastatic breast cancer based on a long follow-up
Authors: Strati Areti , Nikolaou Michael , Georgoulias Vasilis , Lianidou Evi S. 
Published: August 2020

Abstract
Background In metastatic breast cancer (MBC) the molecular characterization of Circulating Tumor Cells (CTCs) provides a unique tool to understand metastasis-biology and therapy-resistance. We evaluated the prognostic significance of gene expression in EpCAM(+) CTCs in 46 MBC patients based on a long follow-up. Methods We selected a panel consisting of stem cell markers (CD24, CD44, ALDH1), the mesenchymal marker TWIST1, receptors (ESR1, PGR, HER2, EGFR) and the epithelial marker CK-19. Singleplex RT-qPCR was used for TWIST1 and CK-19 and multiplex RT-qPCR for a) CD24, CD44, ALDH1, HPRT and b) ESR1, PR, HER2, EGFR. A group of 19 healthy donors (HD) was used as control. Results Univariate (p=0.001) and multivariate analysis (p=0.002) revealed the prognostic value of combined gene expression of CK-19(+), CD44high/CD24-/low, ALDH1high/CD24-/low and HER2 over-expression for overall survival (OS). The Kaplan–Meier estimates of OS were significantly different in patients positive for CK-19 (p = 0.028), CD44high/CD24-/low (p = 0.002), ALDH1high/CD24-/low (p = 0.007) and HER2-positive (p = 0.022). Conclusions Our results indicate that combined gene expression analysis in EpCAM(+) CTCs provides prognostic information in MBC but need to be further confirmed in a prospective study, including a larger and well-defined patient cohort.
Changes in hemodialysis catheter management after introduction of the end-stage renal disease prospective payment system
Authors: Roetker Nicholas S. , Guo Haifeng , Decker-Palmer Marquita , Peng Yi , Wetmore Jamaes 
Published: August 2020

Abstract
Background
We investigated whether implementation of the end-stage renal disease prospective payment system (ESRD PPS) was associated with changes in thrombolytic therapy use and other aspects of catheter management in hemodialysis (HD) patients.
Methods
Using quarterly, period prevalent cohorts of patients undergoing maintenance HD with a catheter in the US Renal Data System (2008–2015), we studied rates of claims for within- and outside-HD-unit thrombolytic use, and thrombus/fibrin sheath removal, and rates of delayed HD treatment after ESRD PPS implementation, January 1, 2011. Associations between PPS implementation and change in trend of rates of each outcome were assessed using covariate-adjusted Poisson regression, using a piecewise linear function for quarter-time (with breakpoint at PPS implementation).
Results
Among an average of 69,428 quarterly catheter users, rates of claims for within-HD-unit thrombolytic use declined from 236.6 (Q1-2008) to 81.4 (Q4-2012) per 100 person-years (P < 0.0001, PPS association with change in trend); rates of claims for thrombus/fibrin sheath removal procedures increased from 3.9 (Q1-2008) to 8.8 (Q3-2015) per 100 person-years (P = 0.0001, PPS association with change in trend). Rates of delayed HD treatment increased from 1.6 (Q2-2008) to 2.3 (Q3-2015) per patient-quarter, although PPS implementation was associated with a decrease in this rising trend (1.6% increase per quarter pre-PPS, 1.2% post-PPS; P < 0.0001, change in trend).
Conclusions
After PPS implementation, thrombolytic use decreased and thrombus/fibrin sheath removal increased. The increasing trend in delayed HD treatment appeared to slow after PPS implementation, but delayed sessions continued to increase year over year for unclear reasons.
Social work responses and household-level determinants of coronavirus preparedness in rural Ethiopia
Authors: Addis Yonnas , Abate Dubale , Batista João 
Published: August 2020

Abstract
Background: The novel coronavirus (2019-nCOV) arisen in Ethiopia in early March at its capital city (Addis Ababa) and is now spreading to different administrative regions of the country. This study aimed to assess the attentiveness of the rural community to COVID 19, social work response, and major factors that affect rural community preparedness and response to COVID 19 in Ethiopia. A probit model was used to identify these major factors that affect rural households’ preparedness for the pandemic. Results: Rural households recognize little about COVID 19 and in response, a few community groups, which consist of youth and university students, religious leaders, and elders were engaged to reduce the consequence of COVID 19. Results from the probit model employed indicate that literacy status (household head and family member), gender, age, and economical status of the households; extension information on COVID 19, cash income from non/off-farm activities, participation in community groups, and ownership of mobile phone with a household all influence households preparedness. The main barriers include a lack of information on COVID 19 and financial constraints.Conclusions: Commitment to preparedness and response to COVID 19 by the rural community increases with enhancing proper information dissemination system and applicable support. Thus, much more attention needs to be given by a government and other stakeholders to reduce the venerability of the rural community in Ethiopia.