bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Impact of Patients’ Disease Types on Caregiving Time and Caregiver Burden: An Analysis of the Health Information National Trends Survey
Authors: Su Zhaohui , Zhou Zi , Gelfond Jonathan 
Published: August 2020

Abstract
Background: Patients with different medical conditions often have distinctive caregiving needs that could result in varying levels of caregiver burden. However, despite empirical advances in this area, little is known about how patients’ disease types interact with caregiving time and caregiver burden. To bridge this gap, we examined the impact of patients’ disease types on caregiving time and burden. Methods: Data were analyzed from the 2018 Health Information National Trends Survey 5 Cycle 2. Only participants self-identified as caregivers were included in the final analysis. Data on patients’ disease types, caregiving time (i.e., caregiving duration and caregiving hours spent per week), and caregiver burden (i.e., caregivers’ self-rated health, body mass index, and psychological distress) were examined using logistic regression analysis.Results: Patients’ disease types impacted caregiving time and burden. Caregivers of patients with neurological disease spent the greatest amount of time. For caregiver burden, caregivers of patients with cancer or aging related disease experienced worst self-rated health, caregivers of patients with orthopedic disease have the greatest likelihood to be overweight or obese, while cancer caregivers experienced greatest levels of psychological distress. Conclusions: Patients’ disease types had highly varied effects on caregiving time and burden. This study underscores the need for healthcare researchers to adopt a nuanced approach in acknowledging and addressing the burden of care experienced by caregivers, such as tailoring interventions based on both patients and caregivers’ characteristics and preferences.
Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance
Authors: Kang Leni , Liang Juan , He Chunhua , Miao Lei , Li Xiaohong , Dai Li , Li Qi , Liu Zheng , Zhu Jun , Wang Yanping , Liu Hanmin 
Published: August 2020

Abstract
Background
Breastfeeding is vital to children’s lifelong health and reduces costs for families and societies. Basic data on breastfeeding practices in China are crucial for understanding how to advance health-related goals.
Methods
This was an observational study. We used data from the Under-5 Child Nutrition and Health Surveillance System in China for the period 2013–2018. The prevalence of EIBF and EBF were calculated for each year for urban and rural areas and for East, Central and West China. The Cochran-Armitage test was used to explore the time trends. The annual percent of change (APC) were calculated by log-linear regression followed by exp transformation.
Results
The prevalence of EIBF and EBF increased significantly from 44.57% (95% CI: 44.07, 45.07) and 16.14% (95% CI: 15.10, 17.18) in 2013 to 55.84% (95% CI: 55.29, 56.38) and 34.90% (95% CI: 33.54, 36.26) in 2018 (Ptrend<0.001). The respective APCs were 4.67% (95% CI: 3.51, 5.85) and 14.90% (95% CI: 9.97, 20.04). Increases were observed in both urban and rural areas, with urban areas showing greater APCs for EIBF (6.05%; 95% CI: 4.22, 7.92 v.s. 2.26%; 95% CI: 1.40, 3.12) and EBF (18.21%; 95% CI: 11.53, 25.29 v.s. 9.43%; 95% CI: 5.52, 13.49). Disparities existed among different geographic regions in China.
Conclusion
Breastfeeding practices in China are improving in recent years, though with disparities between urban and rural areas and among East, Central and West China. More efforts should be made to protect and promote breastfeeding to achieve near- and long-term goals in child health.
Do childhood measles and DTaP vaccination decrease the mortality rate caused by SARS CoV-2 in OECD countries?: An Epidemiologic Study
Authors: Guven Ramazan , Sasmaz Muhammed Ikbal , Eyupoglu Gokhan , Semerci Seda Yilmaz 
Published: August 2020

Abstract
Background The mortality rates caused by SARS CoV-2 differ between countries and this difference might be explained by several reasons. Childhood vaccination rate is thought to be one of them. Therefore, present study aimed to examine the possible relationship between DTaP (diphtheria, tetanus, acellular pertussis vaccine) and measles vaccination rates of Organization for Economic Co-operation and Development (OECD) countries and case fatality rate (CFR) caused by SARS CoV-2.Methods A total of 32 OECD countries, of northern hemisphere, have been included in this study. Statistical analysis performed according to the CFR data of these countries based on SARS CoV-2. The CFR data calculated according to the total mortality count of a specific country for the 3-month period down from the date when first SARS CoV-2 case was observed. Results Based on the correlation levels of vaccination rates of OECD countries with a period of 3-month CFR, a strong negative correlation of significance between CFR and measles (r=-0.479, p=0.006) were pointed, while a negative but not significant correlation were seen between CFR and DTaP vaccination rates (r=-264.0, p=0.145). Conclusion Depending on the results of the study, lower CFR based on COVID-19, is suggested to be related to the successful vaccination rates of those OECD countries. Therefore, further effort is required to improve rates of childhood vaccination not only for specified diseases, but either possible protection against COVID-19 worldwide. Trial Registration: This study is registered to clinicaltrials.gov with trial number: NCT04468802.
A randomised controlled trial to reduce highest priority critically important antimicrobial prescription in companion animals
Authors: Singleton David , Rayner Angela , Brant Bethaney , Smyth Steven , Noble Peter-John , Radford Alan , Pinchbeck Gina 
Published: August 2020

Abstract
Robust evidence supporting antimicrobial stewardship schemes in companion animals is limited, despite frequent highest priority critically important antimicrobial (HPCIA) prescription. In this randomised controlled trial, electronic prescription data were utilised (August 2018–January 2019) to evenly assign 60 above average HPCIA-prescribing practices into a control group (CG) and two intervention groups. In March 2019, the light intervention group (LIG) and heavy intervention group (HIG) were notified of their above average status, and were provided with educational material (LIG, HIG), in-depth benchmarking (HIG), and follow-up meetings (HIG). Post-intervention, in the HIG a 30% and 42% significant reduction in canine (0.5% of consultations, 95% confidence interval, 0.4–0.6) and feline (4.4%, 3.4–5.5) HPCIA-prescribing consultations was observed, and maintained for three and six months, respectively, compared to the CG (dogs: 0.7% (0.5–0.8); cats: 7.6% (6.1-9.0)). The LIG was not associated with significant variation. This evidence is now informing development of a national stewardship scheme.
Development, validation and evaluation of a scale for identifying falsified hand sanitizer in the UAE: Public and regulatory authorities collaborative perspective for COVID-19
Authors: Jairoun Ammar Abdulrahman , Al-Hemyari Sabaa Saleh , Shahwan Moyad , El-Dahiyat Faris , Jamshed SHAZIA 
Published: August 2020

Abstract
BackgroundFrom the time the WHO announced that a global pandemic of COVID-19 had begun, falsified hand sanitizer began to appear more regularly in the markets. These pose a possible danger to public health, especially as they may include undeclared methanol. The current study developed and validated a novel tool to document falsified hand sanitizer in the UAE community.MethodA descriptive cross-sectional community-based study was conducted among Ajman University (AU) students and staff in the UAE. Simple random-sampling selection was used to choose the study sample. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.ResultsA total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p < 0.001). Our factor analysis revealed a 3-component model. The 3-factor solution was confirmed by PCFA analysis and had associations with good fit values. The PCFA for NFI was 0.970, CFI 0.978, and TLI 0.967. All values were in excess of 0.95, with RMSEA values below 0.06 at 0.03; all of these values indicated a good model fit. The Cronbach's alpha was good overall (0.867). All factors had a Cronbach's alpha value in excess of 0.70. The instrument demonstrated that every item met the IIC correlation standard ≥ 0.40. The scale displayed good overall ICC statistics of 0.867 (95% CI 0.856–0.877) with statistical significance (p < 0.001). The scale's test-retest reliability was assessed through correlation of the falsified hand sanitizer identification score of respondents at the two time points. The test-retest correlation coefficient was 0.770 (p value < 0.01). Participants with post-graduate education were more likely to identify the falsified hand sanitizer compared to those with high school education. (p < 0.001).ConclusionsThis study developed and validated a new scale for the measurement of falsified hand sanitizer. This research could promote greater collaboration between the health regulators and the public, improve customer satisfaction and encourage the public to participate more with regard to this issue.
Factors Associated with Duration of Breastfeeding in Bangladesh: Evidence from Bangladesh Demographic and Health Survey 2014
Authors: Ayesha Ummay , Mamun ASMA , Sayem Md. Abu , Hossain Golam 
Published: August 2020

Abstract
Background: Breastfeeding is one of the most effective ways for reducing infant mortality and confirming optimal growth and development of children. The aim of this study was to find the effect of socio-demo­graphic determinants on duration of breast­feeding among Bangladeshi mothers.Methods: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 3541 married non–pregnant Bangladeshi mothers in reproductive age who had at least one child aged 6-36 months were included. Independent sample t-test and ANOVA were used to find the significance deference in duration of breastfeeding between two and more than two groups respectively. Multiple linear regression model was utilized to determine the effect of some quantitative variables on duration of breastfeeding among Bangladeshi mothers. Results: This study raveled that the mean duration of breastfeeding among Bangladeshi mothers was 18.91±7.98 (95% CI: 18.65-19.17) and median was 19.00 month. Independent sample t-test provided that short duration of breastfeeding was observed among; (i) mothers received antenatal care facilities during their pregnancy period, (ii) Muslim and (iii) delivered their last child by caesarean section. ANOVA showed that duration of breastfeeding significantly influenced by (i) parents’ education, (ii) geographical location and (iii) household wealth quintile. Multiple regression analysis demonstrated that mothers’ age, mothers’ body mass index, total number of children and mothers’ mothers’ age at first birth were important predictors of duration of breastfeeding.Conclusion: Health care providers and decision makers can consider these findings to make plan for counseling of mothers and family members to promote optimal duration of breastfeeding practice in first three years of baby’s life.
Safety of IL-23/17 Antagonists in Patients with Psoriasis or Other Immune-mediated Inflammatory Diseases: A Systematic Meta-Analysis.
Authors: Li Siying , Zhang Suhan , Tang Guishao , Wu Ruifang , Su Yuwen 
Published: August 2020

Abstract
Background: The IL-23/17 axis plays central role in the pathogenesis of several immune-mediated inflammatory diseases (IMIDs). IL-23/17 antagonists showed significant improvement in the treatment for psoriasis and other IMIDs, including psoriasis(PSO), psoriatic arthritis(PsA), rheumatoid arthritis(RA) and ankylosing spondylitis(AS).Objective: To assess the safety of IL-23/17 antagonists therapy on patients with psoriasis and other IMIDs.Methods: Pooled analysis from thirty-nine placebo-controlled randomized clinical trials (RCTs) of IL-23/17 axis antagonists for IMIDs. Incidences of adverse events (AEs), serious adverse events (SAEs) and AEs of interest were applied to evaluate the safety profile.Result: A Total of 15967 patients were exposed to IL-23/17 axis antagonists. The proportions of patients suffered at least one AE in antagonists group and placebo-control group are 67.5% and 51.1% respectively. Incidence of SAE was increased in patients treated with IL-23/17 axis antagonists compared to patients given placebo (relative risk 2.03; 95% CI, 1.62, 2.56). Incidence of AEs of interest were all increased in patients treated with IL-23/17 axis antagonists compared to patients given placebo.Conclusion: In this analysis, we found increased risk of AEs, SAEs, nervous system disorder, cardiovascular disorder and hypertension among patients with IMIDs treated with IL-23/17 axis antagonists.
A predictive formula for difficult endotracheal intubation in the emergency department
Authors: Liao En-Chih , Chang Wen-Han , Yu Ching-Hsiang , Shen Cheng-Ying , Sun Fang-Ju , Lai Wen-Jyun , Chien Ding-Kuo 
Published: August 2020

Abstract
Background

Current predictors for evaluating difficult endotracheal intubation had poor accessibility or sensitivity at the emergency department, so we evaluated the incidence and predictive factors, then built an easy-to-use predictive formula.
Methods

This was a 17-month prospective observational study. For the 110 patients, difficult airway was defined as Cormack & Lehane classification grade III and IV at first attempt of intubation. The univariate associations between patient characteristics and difficult endotracheal intubation were then analyzed, and the significantly associated factors were included in a multivariate binary logistic regression model then a predictive formula was generated. Generalized association plot (GAP) was used to show the relationship between each variable.
Results

The incidence of difficult intubation in our study was 35.5%. In the difficult airway group, significantly higher rates (p < 0.05) of high body mass index (BMI); double chin; thick, short neck; Mallampati difficulty; smaller inter-incisors distance; smaller thyromental distance; and upper airway obstruction were noted. Finally, a predictive formula for difficult intubation was successfully established by the combination of four predictors: BMI (odds ratio [OR] = 1.270), thyromental distance (OR = 0.614), upper airway obstruction (OR = 4.038), and Mallampati difficulty (OR = 5.163). A cut-off score of 4 provided the best sensitivity (79.5%) and specificity (81.7%)(95% CI: 0.794 to 0.938).
Conclusions

Our predictive formula could be used by emergency physicians to quickly identify and carefully manage patients with potentially difficult intubation. Early expert consultation could be sought when necessary.
Pragmatic Trial to Enhance Medication Adherence: Protocol for the NUDGE Trial
Authors: Glasgow Russell E. , Knoepke Christopher E. , Magid David , Grunwald Gary K. , Glorioso Thomas J. , Waughtal Joy , Marrs Joel C. , Bull Sheana , Ho P. Michael 
Published: August 2020

Abstract
Background: Nearly half of patients do not take their cardiovascular medications as prescribed, resulting in increased morbidity, mortality, and healthcare costs. Mobile and digital technologies for health promotion and disease self-management offer an opportunity to adapt behavioral “nudges” using ubiquitous mobile phone technology to facilitate medication adherence. The Nudge pragmatic clinical trial uses population-level pharmacy data to deliver nudges via mobile phone text messaging and an artificial intelligent interactive chat bot with the goal of improving medication adherence and patient outcomes in three integrated healthcare delivery systems. Methods: The Theory of mHealth, the Expanded RE-AIM/PRISM, and the PRECIS-2 frameworks were used for program planning, implementation and evaluation, along with a focus on dissemination and cost considerations. During the planning phase, the Nudge study team developed and piloted a technology-based nudge message and chat bot of optimized interactive content libraries for a range of diverse patients. Inclusion criteria are very broad and include patients in one of three diverse health systems who take medications to treat hypertension, atrial fibrillation, coronary artery disease, diabetes, or hyperlipidemia. A target of approximately 10,000 participants will be randomized to one of 4 study arms: usual care (no intervention), generic nudge (text reminder), optimized nudge, and optimized nudge plus interactive AI chat bot. The PRECIS-2 tool indicated that the study protocol is very pragmatic, although there is variability across PRECIS-2 dimensions. Discussion: The primary effectiveness outcome is medication adherence defined by the proportion of days covered (PDC) using pharmacy refill data. Implementation outcomes are assessed using the RE-AIM framework, with particular focus on reach, consistency of implementation, adaptations, cost, and maintenance/sustainability. The project has limitations including limited power to detect some subgroup effects, medication complications (bleeding) and longer-term outcomes (myocardial infarction). Strengths of the study include the diverse health care systems, a feasible and generalizable intervention, transparent reporting using established pragmatic research and implementation science frameworks, strong stakeholder engagement and planning for dissemination and sustainment. Trial registration: The study was funded by the NIH grant number is 4UH3HL144163-02 issued 4/5/19. The Clinicaltrial.gov identifier number is NCT03973931 which was registered on 6/4/2019. URL: https://clinicaltrials.gov/ct2/show/NCT03973931
Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship
Authors: Shen Xingrong , Shen Jilu , Pan Yaping , Cheng Jing , Chai Jing , Bowker Karen , MacGowan Alasdair , Oliver Isabel , Lambert Helen , Wang Debin 
Published: August 2020

Abstract
Background: This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural China and implications for future antibiotic stewardship.Methods: The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.Results: A total of 1068 completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR=1.91), season (OR=0.41 to 0.60), days since infection onset (OR=1.54 to 1.81), and runny or blocked nose (OR=1.39 to 1.61), cough with green or white sputum (OR=1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR=0.53) and sore throat (OR=1.64).Conclusions: The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.
Infectious Mononucleosis Complicated With Idiopathic Thrombocytopenic Purpura: A Case Report and Literature Review
Authors: Ren Yong , Wang Qiong , Liu Qiang , Zhang Jinsheng 
Published: August 2020

Abstract
Background: Epstein-Barr virus (EBV) is the cause of infectious mononucleosis (IM), a self-limited lymphoproliferative disorder among patients. EBV usually infects B-lymphocytes rather than T-lymphocytes. The clinicopathologic features of the idiopathic thrombocytopenic purpura (ITP) patients complicated with EBV-positive IM have been rarely described.Case presentation: We describe a case of a 19-year-old man complained with epistaxis and thrombocytopenia for one year, who was admitted to hospital for high grade fever after catching a cold. A lot of petechiae were found on the skin of both lower limbs and both hands during physical examination. Multiple enlarged lymph nodes could be touched in both sides of the neck. Ultrasound examination showed abnormal lymph nodes enlargement on both sides of the neck and supraclavicular area, and a strong echo mass was found in the liver. Serological tests for EBV revealed high level of IgM and IgG antibodies against viral capsid antigen (VCA), virus DNA quantitative<1000UI/mL. CD8-positive cytotoxic T cells accounted for up to 92.94% by flow cytometry. T cells were positive for CD38, CD57 and HLA-DR marker. Bone marrow cytology showed that the proportion of lymphocytes had increased considerably, and the rate of abnormal lymphocyte was as high as 29.5%. EBV virus encoded RNA was demonstrated in lymph node biopsy by in-situ hybridization (ISH) analysis. Immunohistochemically, there were more CD8-positive cells than CD4-positive cells in lymph node biopsy. The expression of CD7 was missing. CD99 was diffuse positive. The MIB-1/ki-67 labeling index was about 70%. EBER in situ hybridization revealed positive signals located in the nucleus. The patient was diagnosed as Infectious mononucleosis complicated with idiopathic thrombocytopenic purpura. The patient was hospitalized and discharged after recovery.Conclusions: ITP patients complicated with EBV-positive IM have been rarely reported in the literature. Comprehensive understanding of its clinicopathological features will help diagnose of this disease.