bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China
Authors: Dai Lili , Yu Xiaochun , Shao Ying , Wang Yali , Li Zaicun , Ye Jiangzhu , Bai Shaoli , Guo Xiaoling , Wang Jianyun , Su Bin , Jiang Taiyi , Zhang Tong , Wu Hao , Scott Sarah Robbins , Liu An , Sun Lijun 
Published: July 2020

Abstract
Background
This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients’ adherence, and ameliorate antiretroviral treatment (ART)-related outcomes.

Methods
All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model.

Results
4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18–133) days, much shorter than the control group (56 (26–253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years’ follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17–0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group.

Conclusions
People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country.
Isolation and characterization of WUPyV in polarized human airway epithelial cells
Authors: Wang Chao , Wei Tianli , Huang Yiman , Guo Qiong , Xie Zhiping , Song Jingdong , Chen Aijun , Zheng Lishu 
Published: July 2020

Abstract
Background
Washington University polyomavirus (WUPyV) is a novel human polyomavirus detected in childwith acute respiratory infection in 2007. However, the relationship between WUPyV and respiratory diseases has yet to be established for lacking of a suitable in vitro culture system.

Methods
To isolate WUPyV with human airway epithelial (HAE) cells, the positive samples were incubated in HAE, and then the nucleic acid, VP1 protein and virions were detected using real-time PCR, immunofluorescence and electron microscopy respectively.

Results
The result showed that WUPyV could replicate effectively in HAE cells and virions with typical polyomavirus characteristics could be observed. Additionally, the entire genome sequence of the isolated strain (BJ0771) was obtained and phylogenetic analysis indicated that BJ0771 belongs to gene cluster I.

Conclusions
Our findings demonstrated clinical WUPyV strain was successfully isolated for the first time in the world and this will help unravel the etiology and pathogenic mechanisms of WUPyV in respiratory infection diseases.
Prevalence of and factors associated with unplanned pregnancy among women in Koshu, Japan: cross-sectional evidence from Project Koshu, 2011–2016
Authors: Huynh Son Trung , Yokomichi Hiroshi , Akiyama Yuka , Kojima Reiji , Horiuchi Sayaka , Ooka Tadao , Shinohara Ryoji , Yamagata Zentaro 
Published: July 2020

Abstract
Background
Unplanned pregnancy is a public health issue with adverse consequences for maternal and neonatal health. In Japan, the prevalence of unplanned pregnancy was 46.2% in 2002. However, few studies have investigated this topic, and there is little recent data from Japan. We described and examined the prevalence and determinants of unplanned pregnancy among rural women in Japan from 2011 to 2016.

Methods
We used cross-sectional data from a community-based cohort study (Project Koshu). Data were collected from 2011 to 2016 via a self-report questionnaire included in the Maternal and Child Health Handbook of Japan. Pregnancy intention was measured as a binary variable (planned or unplanned). Univariate and multivariate logistic regression analyses were performed to examine factors associated with unplanned pregnancy, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). We conducted sensitivity analyses with different definitions of pregnancy intention to assess the robustness of the results. The significance level was set at 5%.

Results
Of the 932 participants (mean ± standard deviation age at baseline: 31.3 ± 5.2 years), 382 (41%) pregnancies were reported as unplanned. The multivariate analyses showed that maternal age (+ 1 year: OR = 0.94, 95% CI: 0.92–0.97, p <  0.001), ‘other’ family structure (OR = 2.76, 95% CI: 1.12–6.76, p = 0.03), three or more pregnancies (OR = 2.26, 95% CI: 1.66–3.08, p <  0.001), current smoking (OR = 2.60, 95% CI: 1.26–5.35, p = 0.01), balanced diet (OR = 0.62, 95% CI: 0.47–0.83, p <  0.001) and current depression (OR = 1.63, 95% CI: 1.24–2.16, p <  0.001) were strongly associated with unplanned pregnancy. These associations were consistent across definitions of pregnancy intention, supporting the robustness of our results.

Conclusions
The prevalence of unplanned pregnancy in the study population was high (41%). Risk factors for unplanned pregnancy were age, number of pregnancies, smoking, having a balanced diet and current depression. These results suggest greater efforts are needed to enhance sex education for young people, improve access to family planning services and provide comprehensive health care for high-risk women to help reduce unplanned pregnancies.
Symptoms of ocular surface disease in construction workers: comparative study with office workers
Authors: Hernandez-Llamas Sergio , Paz-Ramos Ana Karen , Marcos-Gonzalez Patricio , Amparo Francisco , Garza-Leon Manuel 
Published: July 2020

Abstract
Background
To investigate and contrast the prevalence of dry eye symptoms in construction workers and office workers using the OSDI questionnaire.

Methods
A cross-sectional, observational study was conducted using the OSDI questionnaire to evaluate dry eye symptoms and associated risk factors. Sampled size calculation with a power of 80% and a 95% degree of confidence suggested the inclusion of 298 participants.

Results
We studied 304 subjects (149 construction workers and 155 office workers). More than half (55%) of the participants presented dry eye symptoms (OSDI > 12). The average OSDI score was 21.30 ± 22.20 points, being lower in the group of construction workers (12.45 ± 17.50) than in-office workers (28.51 ± 22.99) (p <  0.001). Considering participants who had moderate and severe symptoms (23 to 100 points in OSDI), office workers presented dry eye symptoms 4.15 times more frequently than construction workers (OR 4.15, 95% CI 2.52, 6.85). Women presented statistical evidence of higher OSDI scores than men (32.47 ± 23.72 vs. 14.87 ± 18.48, respectively).

Conclusions
construction workers have four times less risk of presenting dry eye symptoms than people working in the average office space. This highlights the pernicious effects on the ocular surface of the office environment, which poses a significant risk for the development or worsening of dry eye symptoms.
Psychometric properties and contextual appropriateness of the German version of the Early Development Instrument
Authors: Georg Sabine , Bosle Catherin , Fischer Joachim E. , De Bock Freia 
Published: July 2020

Abstract
Background
Assessing the early development of children at a population level in educational settings, may be useful for public health and policy decision making. In this study, we evaluated the psychometric properties and the contextual appropriateness of a German language version of the Early Development Instrument (EDI), a survey-based instrument originally developed in Canada, which assesses developmental vulnerability for children in preschool settings.

Methods
Sixty preschool teachers from six preschool organizations (22% of organizations contacted) in three cities in southwest Germany participated. They administered a German version of the EDI (GEDI) to 225 children (51% of eligible children). We assessed internal consistency, test-retest and interrater reliability. Preschool teachers assisted in determining face-validity by reviewing item coverage and comprehensibility. Exploratory factor analysis (EFA) was used to evaluate convergent validity. Concurrent validity was measured using correlations and agreements (Bland-Altman plots) between GEDI and other validated instrument scores. Additionally, we compared associations between GEDI domain scores and sociodemographic characteristics with similar associations in EDI studies worldwide.

Results
GEDI domains showed good to excellent internal consistency (0.73 < α > 0.99) and moderate to good test-retest and interrater reliability (0.50 to 0.81 and 0.48 to 0.71, respectively [p-value < 0.05]). Face validity was considered acceptable. EFA showed a factor structure similar to the original EDI. Correlations (range: 0.32 to 0.67) and agreements between GEDI scores and other German language instruments suggested good external reliability. Scoring within the lowest 10th percentile was strongly associated with age.

Conclusions
Our psychometric assessment suggests good reliability and consistency of the GEDI. Differences in the age distribution of children, pedagogical objectives and educational system features of German preschools require future work to determine score thresholds indicative of vulnerability. Aside from dropping selected items from the original EDI that were inconsistent with features of the German educational system, the distribution of values in the language and cognitive development domain also suggested that context-specific cut-offs must be established for the German version. Such efforts are needed to account for relevant contextual differences between the educational systems.
Knowledge, attitude, and practices toward chronic kidney disease among care providers in Jimma town:cross-sectional study
Authors: Wolide Amare Desalegn , Kumela Kabaye , Kerga Fantu , Debalke Serkadis , Seboka Meskerem , Edilu Birtukan , Gashe Fanta , Bobassa Eshetu Mulisa 
Published: July 2020

AbstractBackgroundChronic kidney disease (CKD) is a common and growing health problem that requires adequate Knowledge by health care providers to reduce the progress of the disease. Thus, this study aimed to assess the care provider’s Knowledge, attitude, and practices toward CKD.MethodA cross-sectional study conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered into Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal used to analyze the data.ResultThe mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted Knowledge, attitude, and practice score of the study participant were 9.0971(8.77, 9.42), 2.53(2.4, 2.65), 10.14(9.94, 10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to Nephrologists. Also, many care providers knew the five-stage of CKD and the risk factors of CKD, such as diabetes, long-term alcohol consumption, anemia, and cardiovascular disorders, respectively. Care providers had an understanding of late detection, and referral of CKD would increase kidney disease complications. Besides, 275(84.4%) of them are worried about treatment costs related to CKD. Over half of the care providers, 238(73.0%), believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested in studying more on CKD management. Majority 256(78.5%), very likely or likely refer the patient to senior physician and Nephrologist.ConclusionCare providers showed enough Knowledge, a favorable attitude, and practice toward CKD.
Occurrence and quantification of Anelloviruses and Herpesviruses in gingival tissue in Chinese Shanghai sub-population
Authors: Yu Tian , Pan Shaokun , Zhang Yu , Pei Jun , Liu Jing , Xie Youhua , Feng Xiping 
Published: July 2020

AbstractBackgroundHerpesvirusesand bacteria and their interplay have long been believed to play important roles in the pathogenesis of periodontitis, but other microbial entities in the oral environment might also be involved.Anellovirusesare commonly detected in human, including in oral samples. The aim of the present study was to explore the occurrence and co-occurrence ofhuman cytomegalovirus(HCMV),Epstein–Barr virus(EBV), andhuman anelloviruses(HTTVs) in gingival tissue samples collected from participants recruited in Shanghai, China.MethodsGingival tissues were collected from 159 participants (57 with aggressive periodontitis (AP), 59 with chronic periodontitis (CP) and 43 with healthy periodontal status). The presence of HCMV, EBV,torque teno virus(TTV),torque teno mini virus(TTMV) andtorque teno midi virus(TTMDV) DNA was detected by nested-PCR. The virus loads were quantified by real-time PCR.ResultsThe detection rates of EBV, TTV, TTMV and TTMDV were significantly higher in the AP and CP groups compared to the healthy group (allP < 0.01). A statistically significant association was found between EBV, TTV and TTMV virus load and periodontitis (allP < 0.05). Participants infected with EBV showed significantly higher infection rates and higher virus loads of TTV and TTMV than the EBV-negative group (allP < 0.05). The coexistence rates of EBV andanellovirusesand the coexistence of three HTTVs were significantly higher in AP and CP groups (allP < 0.01).ConclusionsCollectively, results obtained in this study suggest that HTTVs and the coexistence of EBV and HTTVs in particular, may be associated with periodontitis. Possible mechanisms of the interaction betweenherpesvirusesandanellovirusesin the context of periodontitis require further investigation.
Enhanced character-level deep convolutional neural networks for cardiovascular disease prediction
Authors: Zhang Zhichang , Qiu Yanlong , Yang Xiaoli , Zhang Minyu 
Published: July 2020

Abstract
Background
Electronic medical records contain a variety of valuable medical information for patients. So, when we are able to recognize and extract risk factors for disease from EMRs of patients with cardiovascular disease (CVD), and are able to use them to predict CVD, we have the ability to automatically process clinical texts, resulting in an improved accuracy of supporting doctors for the clinical diagnosis of CVD. In the case where CVD is becoming more worldwide, predictive CVD based on EMRs has been studied by many researchers to address this important aspect of improving diagnostic efficiency.

Methods
This paper proposes an Enhanced Character-level Deep Convolutional Neural Networks (EnDCNN) model for cardiovascular disease prediction.

Results
On the manually annotated Chinese EMRs corpus, our risk factor identification extraction model achieved 0.9073 of F-score, our prediction model achieved 0.9516 of F-score, and the prediction result is better than the most previous methods.

Conclusions
The character-level model based on text region embedding can well map risk factors and their labels as a unit into a vector, and downsampling plays a crucial role in improving the training efficiency of deep CNN. What’s more, the shortcut connections with pre-activation used in our model architecture implements dimension-matching free in training.
Japanese nurse practitioners’ legal liability ambiguity regarding their medical practice: a qualitative study
Authors: Sugiyama Shoko , Asakura Kyoko , Takada Nozomu 
Published: July 2020

Abstract
Background
Nurse practitioners’ role is always expanding. The Japanese Nurse Practitioner (JNP) system was initiated in 2015 to shift some aspects of doctors’ work to various other healthcare professionals, including nurses. JNPs’ fulfillment of their roles was shown to have a certain degree of efficacy and provide positive outcomes for patients (e.g., shortening hospitalization period). Nurse practitioners are considered legally liable for their medical practices because they are performed on doctors’ behalf; however, in real life, there is ambiguity regarding such practice. It is necessary to clarify nurse practitioners’ legal liability in order to ensure the safety of their medical practice and protect them in medical procedures performed on physicians’ behalf. This study aimed to clarify how JNPs understand their own legal liability in medical practice.

Methods
A qualitative, inductive research design was adopted to record participants’ opinions. The survey was conducted from October 2017 to February 2018. Participants were nurses working as JNPs at general hospitals in eastern Japan. We recruited participants via snowball sampling.

Results
With regard to JNPs’ legal liability in their medical practice, three themes understanding were observed: “determining whether the JNP has the ability to perform the assigned medical procedure,” “exercising caution when performing medical procedures on a doctor’s behalf” and “an urge to follow up with appropriate medical practice until the end of care.”

Conclusions
We demonstrated that JNPs recognized their own legal liability in medical practice. They had to protect themselves because their legal position was ambiguous. Furthermore, JNPs accepted that diagnosis and drug prescription could be performed on behalf of doctors if trusting relationships had been previously established.
Evaluating the integration of chronic care elements in primary health care for people with mental illness: a longitudinal study in Nepal conducted among primary health care workers
Authors: Upadhaya Nawaraj , Jordans Mark J. D. , Adhikari Ramesh P. , Gurung Dristy , Petrus Ruwayda , Petersen Inge , Komproe Ivan H. 
Published: July 2020

Abstract
Background
Despite many important developments in the global mental health arena in the past decade, many people with mental health problems still do not have access to good quality mental health care. The aim of this study was to evaluate the perceived impact of a mental health care package (MHCP) in integrating chronic care elements in primary health care for people with mental illness.

Methods
A controlled pre-post study design was used in 20 primary health care facilities in Chitwan, Nepal. We compared 10 health facilities that had implemented a MHCP (intervention group), with 10 health facilities that had not implemented the MHCP (comparative control group) but provided regular physical health services. We administered the Assessment of Chronic Illness Care (ACIC) tool on a group basis within all 20 health facilities among 37 health workers. Data was collected at three time points; at baseline, midline (at 13 months from baseline) and end line (at 25 months from baseline).

Results
From baseline to end line, we see a notable shift in the level of support reported by the intervention health facilities compared to those in the comparative control group. While at baseline 10% of the intervention health facilities had basic support for the implementation of chronic illness care, at the end line, 90% of the intervention group reported having reasonable support with the remaining 10% of the intervention facilities reporting that they had full support. In contrast, 20% of the health facilities in the comparative control group at end line still reported having limited support for the implementation of chronic illness care, with the remaining 80% only managing to shift to the next level which is basic support.

Conclusions
These findings suggest that training and supervision of primary health care workers in the implementation of MHCP interventions can lead to strengthening of the system to better address the needs of patients with chronic mental health problems. However, substantial financial and coordination inputs are needed to implement the MHCP. The comparative control group also demonstrated improvements, possibly due to the administration of the ACIC tool and components of counselling services for family planning and HIV/AIDS services.
The state of emergency medical services and acute health facility care in Uganda: findings from a National Cross-Sectional Survey
Authors: Ningwa Albert , Muni Kennedy , Oporia Frederick , Kalanzi Joseph , Zziwa Esther Bayiga , Biribawa Claire , Kobusingye Olive 
Published: July 2020

Abstract
Background
There is limited information on the state of emergency medical services (EMS) in Uganda. The available evidence is from studies that focused on either assessing EMS capacity and gaps at the national level especially in Kampala or identifying risk factors for specific emergency medical conditions (e.g., injuries). In this study, we sought to provide a snapshot of the state of EMS in Uganda by assessing the pre-hospital and hospital emergency care capacity at both national and sub-national (district) levels.

Methods
We conducted a cross-sectional national survey administering structured questionnaires to EMS providers and policy makers from 38 randomly selected districts across seven of the 14 health regions of Uganda. This resulted in a study sample of 111 health facilities and 52 pre-hospital service providers. We collected data on six pillars of EMS whose frequencies and percentages were calculated and qualitatively compared for different levels of the health care system.

Results
At the time of this study, Uganda did not have any EMS policy or guidelines. In addition, there was no functional toll-free number for emergency response in the country. However, Ministry of Health reported that a taskforce had been set up to lead development of EMS policy, guidelines, and standards including establishment of a toll-free emergency number.
At the sub-national level, ambulances lacked the products and supplies needed to provide pre-hospital care, and mainly functioned as emergency transport vehicles, with no capacity for medical care.
Only 16 (30.8%) of the 52 pre-hospital providers assessed had standard ambulances with required equipment, medicines, and personnel. The rest of the service providers had improvised ambulances that were not equipped to provide pre-hospital care.
Traffic police and bystanders were the first responders to the majority (> 90%) of the emergency cases.

Conclusion
Our findings reveal weaknesses at every level of what should be a critical component in the health care system – one that deals with the ability to treat life-threatening conditions in a time sensitive manner. The Ministry of Health needs to speed up efforts to provide policies and guidelines, and to increase investments for the creation of a functional EMS in Uganda.