bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Blood Biomarkers and Autoimmunity with Immune Related Adverse Events in Patients with Cancer treated with Immune Checkpoint Inhibitors
Authors: Michailidou Despina , Khaki Ali , Morelli Maria , Diamantopoulos Leonidas , Singh Namrata , Grivas Petros 
Published: January 2021

Abstract
Background: Patients with cancer treated with immune checkpoint inhibitors (ICIs) develop immune related adverse events (irAEs), however biomarkers are lacking. We hypothesized that clinicopathologic and laboratory factors would be associated with irAE risk and overall survival (OS) in this population.Methods: In a retrospective study of patients treated with ICIs we collected clinicopathologic, laboratory, irAEs and outcomes data. The association between baseline blood biomarkers, clinicopathologic features and irAEs was assessed by logistic regression adjusting for age, sex, smoking, cancer type, performance status, concomitant other systemic therapy, history of autoimmune disease (AD) and chronic infection. Optimal cutoff values of biomarkers were identified by recursive partitioning analysis.Results: 470 patients were identified; 156 (33%) developed irAEs, which were associated with baseline absolute lymphocyte count >2.6k/ul (adjusted [a]OR:4.12), neutrophil to lymphocyte ratio (NLR) ≤5.3 (aOR:2.08) and monocyte to lymphocyte ratio (MLR)≤0.73 (aOR:3.11). Patients with pre-existing AD (aOR:2.81), family history of AD (aOR:5.86), and ICI combination (aOR:2.26) had higher odds of irAEs. Baseline NLR≤5.3 (aHR:0.68) and MLR≤0.73 (aHR:0.43) were associated with longer OS.Conclusion: irAE were associated with autoimmune history, ICI combination and baseline laboratory measurements. Lower NLR and MLR may have favorable prognostic value. Our hypothesis-generating findings require validation in larger prospective studies.
The Impact of Organic Extracts of Seasonal PM2.5 on Primary Human Lung Epithelial Cells and Their Chemical Characterization
Authors: Park Jieun , Lee Kyoung-Hee , Kim Hyewon , Woo Jisu , Heo Jongbae , Lee Chang-Hoon , Yi Seung-Muk , Yoo Chul-Gyu 
Published: January 2021

Abstract
Background: Lung epithelial cells serve as first line of defense against various inhaled pollutant particles. This study focused on assessing the impact of organic extracts of PM2.5 collected in Seoul, South Korea on primary human lung epithelial cells and identifying the relevant components and sources which induced lung epithelial cell injury.Results: We used primary lung epithelial cells isolated directly from healthy donors and evaluated the effects of organic compounds of twelve selected, seasonal PM2.5 on inflammation, cellular aging, and macroautophagy in primary lung epithelial cells. Organic extracts of PM2.5 specifically induced neutrophilic chemokine, interleukin-8, via extracellular signal regulated kinase activation. Moreover, PM2.5 significantly increased the expression of aging markers (p16, p21, and p27) and activated macroautophagy. Average mass concentrations, OC and EC, had no significant correlations with PM2.5 effects. However, regression analysis showed that polycyclic aromatic hydrocarbons and n-alkanes were the most relevant components of PM2.5 correlated with neutrophilic inflammation. Vegetative detritus and residential bituminous coal combustion sources were strongly correlated with neutrophilic inflammation, aging and macroautophagy activation.Conclusions: These data suggest that the chemical composition of PM2.5 is crucially important to determine the adverse health effects of PM2.5. Our study provides encouraging evidence to regulate the harmful components of PM2.5 in Seoul.
Epidemiological analysis of 3,219 COVID-19 outbreaks in the state of Baden-Wuerttemberg, Germany.
Authors: Dressler Aparna , Finci Iris , Wagner-Wiening Christiane , Eichner Martin , Brockmann Stefan 
Published: January 2021

Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has emerged as an unprecedented global crisis challenging health systems. The dynamic nature of the pandemic warrants ongoing characterisation and assessment of outbreak settings to identify groups at greatest risk, to establish early measures to curb transmission. The current analysis aims to assess and characterise SARS-CoV-2 outbreaks in the state of Baden-Wuerttemberg. Methods: We analysed all mandatory notified (i.e. laboratory-confirmed) coronavirus disease (COVID-19) outbreaks from the state of Baden-Wuerttemberg in calendar weeks 18 to 49 (from April 27 to December 06, 2020). We used the following classification for settings: asylum and refugee accommodation, care homes, care facilities, day care child centers, hobby related, hospitality, hospitals, households, other, residence halls, schools, supported housing, training schools, transportation, treatment facilities, and workplace (occupational). We used R program version 3.6.3 for analysis. Results: In the current analysis, 3,219 outbreaks with 22,238 individuals were included. Around 48% of all outbreaks in this period were in household settings and hobby related activities. We observed an exponential increase in the number of notified outbreaks starting around the 41th week with N = 291 outbreaks reported in week 49. We observed an increase in hospitalisations, and mortality associated with COVID-19 outbreaks in care homes after the 40th week. Overall, 70% (500/715) of all deceased persons in outbreaks in the study period were in care homes compared to 4.2% in household settings (30/715). Conclusions: The increase in the number of outbreaks and in the number of cases per outbreak in high-risk settings, specifically in care homes after the 40th week highlights the imperative of controlling transmission in vulnerable populations.
To Explore the Mechanism of Tibetan Medicine Gaoyuan' an Capsule Improving Plateau Hypoxia Tolerance
Authors: He Chunjuan , Xing Shishi , Peng Linna , Li Dandan , Wang Li , Yuan Dongya , Jin Tianbo 
Published: January 2021

Abstract
Background: Tibetan medicine Gaoyuan 'an capsule (GYAC) is widely used to prevent pulmonary edema at high altitude, but the specific mechanism of its action has not been explored. Therefore, based on bioinformatics and network pharmacology, this study analyzed the mechanism of improving hypoxia tolerance of GYAC, and provided new ideas for the prevention of altitude disease.Methods: The effective components and corresponding targets of GYAC were screened by using the Chinese herbal medicine network database, and the key targets of diseases were retrieved by using Genecards, OMIM and PubMed database with the key word "hypoxia". The drug targets and disease targets were mapped into common targets to obtain the final target. Cytoscape 3.7.2 was used to analyze the topological network and construct the Herbs-Components-Targets network and Core Targets-Signal Pathways network. GO function and KEGG enrichment analysis were performed to predict the mechanism of action, and molecular docking techniques were used to verify the binding force of target compounds and targets.Results: The results showed that GYAC enhanced hypoxia tolerance by simultaneously regulating the functions of various signaling proteins, including IL6、TNF、NOS3、VEGFA etc. The main regulatory pathways were HIF-1 signaling pathway, Chagas disease, and pathway in cancer. The main biological processes involved are the positive regulation of RNA polymerase II promoter transcription, the extracellular space as the cell component, and the cytokine activity as the molecular function. Molecular docking shows that hydrogen bonding is the main form of binding between drug molecules and proteins.Conclusions: GYAC is mainly directed at the interaction of HIF-1 signaling pathway with targets such as IL6 and TNF to improve the body's hypoxia tolerance, that is, they are multi-pathway, multi-pathway and multi-target interaction.
Healthcare Utilization of Below Poverty Line Population under Government-Funded Health Protection Scheme in one sub-district in Bangladesh: A Cross-Sectional Study
Authors: Hasan Md. Zahid , Ahmed Mohammad Wahid , Mehdi Gazi Golam , Khan Jahangir AM , Islam Ziaul , Chowdhury Mahbub Elahi , Ahmed Sayem 
Published: January 2021

Abstract
BackgroundThe below poverty line (BPL) population in rural Bangladesh have low access to hospital inpatient-care (IPC) services. The Government of Bangladesh (GoB) launched pilot Shasthyo Suroksha Karmasuchi (SSK) at Kalihati Upazila of Tangail district in 2016 aiming to improve IPC access of the BPL population and financial protection for healthcare. The GoB funded scheme provides IPC for 78 diseases and outpatient consultation through an existing health facility. In this study, we aimed to assess the level of healthcare utilization among the scheme beneficiaries and identify the associated factors with utilization.MethodsThis was an exploratory study with a cross-sectional household survey conducted from July to September 2018 among 806 sampled households using a structured questionnaire. Data on illness and healthcare utilization was collected from the selected households for the last 90 days of the interview date. A logistic regression model was applied to determine the factors associated with healthcare utilization from SSK facility.ResultsOverall, 8% of the ill patients in the last 90 days prior to survey sought healthcare from SSK facilities (n=639; total patients who sought care), 28% from medically trained providers (MTPs), and 64% from non-MTPs. Of the 23 (3.6%) patients who sought inpatient care (IPC), less than half (10 patients) of them utilized IPC under SSK. Individuals with accident/injury, unemployed, having knowledge about SSK, non-BPL status, were more likely to utilize healthcare from SSK facility. Individuals reside more than 15 km away from facility, had 4-5 family members, and above secondary level education were less likely to utilize care from SSK facility.Conclusions It is evident that healthcare utilization of beneficiaries from the SSK scheme was very low. Effective strategies for enhancing knowledge on SSK benefits and precise BPL households targeting can be instrumental in increasing utilization of the scheme. The scheme also has a potential to bring the individuals under its coverage who utilize healthcare from other MTP and non-MTP.
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Authors: Hedsköld Mats , Sachs Magna Andreen , Rosander Thorleif , von Knorring Mia , Harenstam Karin Pukk 
Published: January 2021

Abstract
Abstract

Background:
Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units.
Methods:
Interview study with first line managers in intensive care units in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used, this was then followed by a deductive analysis of the strategies informed by constructs from High reliability organizations.
Results:
We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote patient safety in everyday work.
Conclusions:
Our study shows the central role of front-line managers in organizing for safe care and creating a culture for patient safety. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
Age at First Marriage and Fertility Decline in Dabat Health and Demographic Surveillance System Site, northwest Ethiopia: Decomposition analysis
Authors: Alazbih Nega Mihret , Kaya Assefa Hailemariam , Mengistu Mezgebu Yitayal , Gelaye Kassahun Alemu 
Published: January 2021

Abstract
Background: Fertility declines in Ethiopia have been documented since 1990s. Amhara National Regional State has recorded the most noticeable fertility decline. However, specific factors that explain the incipient course of fertility decline in the study area and their relative contributions were not well investigated. Hence, the purpose of this study was to determine the factors that contributed for fertility decline, and to assess the variations in fertility that can be attributed to both changes in characteristics and reproductive behaviors of women aged 15–49 years between 2008 and 2014 in Dabat Demographic and Health Surveillance System Site, Northwest Ethiopia.Methods: Cross sectional censuses were carried out in Dabat Health and Demographic Surveillance System site in 2008 and 2014. Data for 4,775 and 10,807 women with reproductive age in 2008 and 2014 were used for the analysis. Poisson regression model was employed to assess the trends of determinants of fertility, and Multivariate Decomposition technique was applied to evaluate observed changes in fertility using data from two consecutive cross-sectional censuses of Dabat HDSS conducted in 2008 and 2014.Results: The findings indicated that there was a reduction of an average 640.69 births per 1,000 women of the reproductive age during the year 2014 compared to the year 2008 in the surveillance site (P-value <0.001; 95% CI: -669.5 to -582.4). This overall change in fertility during the study period was attributed to both changing characteristics of women (the distribution effect) (76%) (P-value < 0.001; 95%CI: -524.74, -453.13, and their reproductive behavior (the effect shown by regression coefficients of the variables on the outcome) (24%) (P-value <0.001; 95% CI: -224.36 to -79.14). The drivers of the recent fertility decline during the study period were the shift observed in the age at first marriage, the change in the proportion of currently married women, the shift in women’s birth to later age and the change in women's educational status.Conclusion: This study indicated that the overall reduction in fertility was attributed to both changing characteristics of women and their reproductive behavior. The major contributors to the changes in fertility were the postponing of women’s first marriage to later age and the change in the proportion of currently married women over the study period. Encouraging women to complete at least secondary education are important to increase the age at first marriage and birth which intern accelerate the current fertility transition.
Association Between Supportive Interventions and Healthcare Utilization and Outcomes in Patients on Long-Term Prescribed Opioid Therapy Presenting to Acute Healthcare Settings: a systematic review and meta-analysis
Authors: Deschamps Jean , Gilbertson James , Straube Sebastian , Dong Kathryn , MacMaster Frank P. , Korownyk Christina , Montgomery Lori , Mahaffey Ryan , Downar James , Clarke Hance , Muscedere John , Rittenbach Katherine , Featherstone Robin , Sebastianski Meghan , Vandermeer Ben , Lynam Deborah , Magnussen Ryan , Bagshaw Sean M , Rewa Oleksa G 
Published: January 2021

Abstract
Background Long-term prescription of opioids by healthcare professionals has been linked to poor individual patient outcomes and high resource utilization. Supportive strategies in this population regarding acute healthcare settings may have substantial impact. Methods We performed a systematic review and meta-analysis of primary studies. The studies were included according to the following criteria: 1) age 18 and older; 2) long-term prescribed opioid therapy; 3) acute healthcare setting presentation from a complication of opioid therapy; 4) evaluating a supportive strategy; 5) comparing the effectiveness of different interventions; 6) addressing patient or healthcare related outcomes. We performed a qualitative analysis of supportive strategies identified. We pooled patient and system related outcome data for each supportive strategy.Results A total of 5664 studies were screened and 19 studies were included. A total of 9 broad categories of supportive strategies were identified. Meta-analysis was performed for the “supports for patients in pain” supportive strategy on two system-related outcomes using a ratio of means. The number of emergency department (ED) visits were significantly reduced for cohort studies (n = 6, 0.36, 95% CI [0.20-0.62], I2 = 87%) and randomized controlled trials (RCTs) (n = 3, 0.71, 95% CI [0.61-0.82], I2 = 0%). The number of opioid prescriptions at ED discharge was significantly reduced for RCTs (n = 3, 0.34, 95% CI [0.14-0.82], I2 = 78%).Conclusion For patients presenting to acute healthcare settings with complications related to long-term opioid therapy, the intervention with the most robust data is “supports for patients in pain”.
Comparative Evaluation of Six Molecular Assays based on RT-PCR and Cross Primer Isothermal Amplification for SARS-CoV-2 RNA Detection
Authors: Wu Shuang , Shi Xiaolu , Chen Qiongcheng , Jiang Yixiang , Zuo Le , Wang Lei , Jiang Min , Lin Yiman , Fang Shisong , Peng Bo , Wu Weihua , Liu Hui , Zhang Renli , Kwan Patrick S.L. , Hu Qinghua 
Published: January 2021

Abstract
Background: SARS-CoV-2 is a newly emerged coronavirus, causing the coronavirus disease 2019 (COVID-19) outbreak in December, 2019. As drugs and vaccines of COVID-19 remain in development, accurate virus detection plays a crucial role in the current public health crisis. Quantitative real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) kits have been reliably used for detection of SARS-CoV-2 RNA since the beginning of the COVID-19 outbreak, whereas isothermal nucleic acid amplification-based point-of-care automated kits have also been considered as a simpler and rapid alternative. However, as these kits have only been developed and applied clinically within a short timeframe, their clinical performance has not been adequately evaluated to date. We describe a comparative study between a newly developed cross-priming isothermal amplification (CPA) kit (Kit A) and five RT-qPCR kits (Kits B–F) to evaluate their sensitivity, specificity, predictive values and accuracy.

Methods: Fifty-two clinical samples were used including throat swabs (n=30), nasal swabs (n=7), nasopharyngeal swabs (n=7) and sputum specimens (n=8), comprising confirmed (n=26) and negative cases (n=26). SARS-CoV-2 detection was simultaneously performed on each sample using six nucleic acid amplification kits. The sensitivity, specificity, positive/negative predictive values (PPV/NPV) and the accuracy for each kit were assessed using clinical manifestation and molecular diagnoses as the reference standard. Reproducibility for RT-qPCR kits was evaluated in triplicate by three different operators using a SARS-CoV-2 RNA-positive sample. On the basis of the six kits’ evaluation results, CPA kit (Kit A) and two RT-qPCR Kits (Kit B and F) were applied to the SARS-CoV-2 detection in close-contacts of COVID-19 patients.

Results: For Kit A, the sensitivity, specificity, PPV/NPV and accuracy were 100%. Among the five RT-qPCR kits, Kits B, C and F had good agreement with the clinical diagnostic reports (Kappa≥0.75); Kits D and E were less congruent (0.4≤Kappa<0.75). Differences between all kits were statistically significant (P<0.001). The reproducibility of RT-qPCR kits was determined using a coefficients of variation (CV) between 0.95% and 2.57%, indicating good reproducibility.

Conclusions: This is the first comparative study to evaluate CPA and RT-qPCR kits’ specificity and sensitivity for SARS-CoV-2 detection, and could serve as a reference for clinical laboratories, thus informing testing protocols amid the rapidly progressing COVID-19 pandemic.

Keywords: SARS-CoV-2; COVID-19; nucleic acid detection; real-time reverse transcriptase PCR (RT-qPCR); cross-priming isothermal amplification (CPA)
Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study
Authors: Wang Caiying , Zhang Huimin , Zhang Yanlan , Xu Lin , Miao Min , Yang Hongling , Liu Yuhuan , He Shuxin , Pang Lin 
Published: January 2021

Abstract
Background: The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants. Methods: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed. Results: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05). Conclusions: 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.