bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China
Authors: Si Yafei , Zhou Zhongliang , Su Min , Hu Han , Yang Zesen , Chen Xi 
Published: September 2020

Abstract
Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using the cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient rate and expenditure as well as inpatient rate and expenditure.Results The matched outpatient rate of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient rate was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).Conclusion Our results lend support on supplier-induced demand hypothesis and highlight the need for policies to address the large outpatient care expenses of patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decrease sharply due to the decline in supplier-induced demand. As significant misbehaviors performed by providers, it’s important to create right incentives to offer less avoidable healthcare service during outpatient visits may work to reduce healthcare costs.
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: September 2020

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%).Interpretation 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”. Study registration CRD42018088962
Canine helminthiases and associated risk factors in Kigali city, Rwanda
Authors: Ntampaka Pie , Niragire François , Nyaga Philip Njeru , Habarugira Gervais 
Published: September 2020

Abstract
Background: Canine helminthiases pose a public health risk to humans and livestock; however, the prevalence of canine helminthiases in Rwanda is unknown. This study aimed to determine the prevalence of canine helminthiases and to identify the risk factors of such infections in Kigali, the capital city of Rwanda. A cross-sectional study involved 93 dogs selected across Kigali city. Faecal samples were collected from apparently healthy dogs and helminth eggs were identified and quantified under microscope using McMaster technique. Risk factors for canine helminthiases were analysed by multivariable binary logistic regression analysis.Results: The overall prevalence of intestinal helminthiases in dogs was 39.8% ±5.08 (α=0.05). The most prevalent species was Ancylostoma spp with 32.3% ± 4.85 (30/93). About 38.7% and 3.4% (n= 31) of dogs suffering from ancylostomosis and/or toxocarosis had high egg counts per gram (EPG) of faeces (≥ 550) each. Approximately 97.3% (36/37) of dogs infected with helminths had mono-infection. Logistic regression analysis showed that dog's age (1 to 2. 5 years old and at least 5 years old) and location (Gasabo and Kicukiro) were significantly associated with the prevalence of canine helminthiases. The adjusted odds ratio (AOR) of dogs suffering from helminthiases was more than 61% lower in dogs dewormed once to twice a year compared to those who were never dewormed. In addition, the AOR was more than 5 times higher for dogs fed on raw animal origin supplements, leftovers from family food and restaurants compared to those who ate food prepared for them. The AOR was also more than 8 times higher for dogs that ate leftovers from household food and scavenged compared to those who ate food prepared for them. Conclusions: All the identified helminths including Ancylostoma spp, Toxocara canis, and tapeworms are zoonotic and they pose a public health risk to humans. There is an urgent need of increasing the awareness among pet owners on the role of dogs in the transmission of zoonotic helminthiases to other animals and also to humans. Moreover, it is highly relevant to inform and to take effective control measures in dog populations.
Intermediate outcomes of ab externo circumferential trabeculotomy and canaloplasty in POAG patients with prior incisional glaucoma surgery
Authors: Wang Huaizhou , Xin Chen , Han Ying , Shi Yan , Ziaei Sarah , Wang Ningli 
Published: September 2020

Abstract
Background: To compare the efficacy and safety of ab externo circumferential trabeculotomy (ECT) and canaloplasty on primary open angle glaucoma (POAG) patients with failed filtering surgery and intact schlemm’s canal (SC). Methods : We conducted a retrospective chart review of POAG patients with failed filtering surgery and intact SC, who further received ECT and canaloplasty. The primary outcome measures were intraocular pressure (IOP) and the number of topical medications at each follow-up point.The secondary outcome compared the quantified success rate at1-year follow-up between the groups. Results: Twenty-nine eyes were recruited in the ECT group and 19 eyes in canaloplasty group. The postoperative IOP and the number of topical medications decreased significantly in both groups(p<0.001). The IOP at 3-month and 6-monthwas significantly lower in the ECT group (p=0.039, p=0.001) than in the canaloplasty group. Although the IOP at 12-mon was similar between the two groups, the number of topical medications was less in the ECP group (p=0.040). Hyphema (72.4%) and ciliary body detachment (27.6%), which mainly resolve spontaneously, were two leading complications in the ECT group. The prevalence of hyphema was higher in ECT than in canaloplasty group (p<0.001). Conclusion: For POAG with failed filtering surgery and intact SC, canaloplasty may be safer, whereas ECT presented better IOP control.
SP1 induced Long non-coding RNA AGAP2-AS1 promotes cholangiocarcinoma proliferation via silencing of CDKN1A&nbsp;
Authors: Ji Hao , Wang Juan , Lu Binbin , Li Juan , Zhou Jing , Wang Li , Xu Shufen , Peng Peng , Hu Xuezhen , Keming Wang 
Published: September 2020

Abstract
Background: LncRNA can regulate gene at various levels such as apparent genetics, alternative splicing, and regulation of mRNA degradation. However, the molecular mechanism of LncRNA in cholangiocarcinoma is still unclear. This deserves further exploration. Methods:We investigated the expression of AGAP2-AS1 in 32 CCA tissues and two CCA cell lines. We found a LncRNA AGAP2-AS1 which induced by SP1 has not been reported in CCA, and Knockdown and overexpression were used to investigate the biological role of AGAP2-AS1 in vitro. CHIP and RIP were performed to verify the putative targets of AGAP2-AS1. Results:AGAP2-AS1 was significantly upregulated in CCA tumor tissues.SP1 induced AGAP2-AS1 plays an important role in tumorigenesis. AGAP2-AS1 knockdown significantly inhibited proliferation and caused apoptosis in CCA cells. In addition, we demonstrated that AGAP2-AS1 promotes the proliferation of CCA. Conclusions: We conclude that the long non-coding RNA AGAP2-AS1 plays a role in promoting the proliferation of cholangiocarcinoma.
Study of a robotic system to detect water leakage and fuel debris -System proposal and feasibility study of visual odometry providing intuitive bird's eye view-
Authors: Wang Zhenyu , Endo Gen , Takahashi Masashi , Nabae Hiroyuki , Suzumori Koichi , Nobuyoshi Tsuzuki , Takahashi Hideharu , Kimoto Kazushi , Ihara Tomonori , Kikura Hiroshige 
Published: September 2020

Abstract
To obtain the necessary information on fuel debris and water leakages during the decommissioning task of the Fukushima Daiichi Nuclear Power Plant, an ultrasonic-based method was proposed for future internal investigation of the primary containment vessel (PCV). In this article, we describe the rotatable winch mechanism and visual localization method, which were used to aid the investigation. We used the rotatable winch mechanism to adjust the height and orientation of the ultrasonic sensor and localized the robot with cameras to localize the sensor, to provide assisting information for data combination. We studied the feasibility of the conventional visual odometry method for application to the situation and performed localizing accuracy evaluation experiments with a mobile robotic platform prototype. The results showed that the visual odometry method could generate intuitive bird’s-eye-view maps, and provided an average error rate of 35 mm/1500 mm, which met the required maximum error rate of 100 mm/1500 mm for the grating movement. Experiments were also conducted with adjustable parameter ranges that could provide the required accuracy.
Platelet to Lymphocyte Ratio is Correlated with a Delay in Feeding Resumption Following a Transhiatal Esophagectomy With Cervical Anastomosis
Authors: Asmar Antoine El , Ghabi Elie , Saber Toufic , Abou-Malhab Christina , Akl Bernard , Rassi Ziad El 
Published: September 2020

Abstract
Introduction: The lymphocytic population, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are prognostic tools predictive of adverse outcomes for several solid tumors and oncologic surgeries, one of which is esophageal adenocarcinoma. Furthermore, delayed resumption of oral feeding postoperatively is associated with significant morbidity. Given the controversies regarding post-op nutritional support in these patients, this study investigates the prognostic role of the lymphocytic percentage, the NLR and the PLR in predicting prolonged length of hospital stay (LOHS) and ICU stay (LOICUS) as well as delayed oral feeding following transhiatal esophagectomy (THE) for adenocarcinoma of the esophagogastric junction (AEG). Methods: 40 consecutive patients who underwent transhiatal esophagectomy performed by a single surgeon for Siewert type II and type III adenocarcinoma of the esophagogastric junction at a tertiary referral center was selected. Retrospective data collection was performed from the patients’ medical records and statistical analysis was performed using Pearson correlation and Student’s T-test and Chi-square testing.Results: An increased LOHS was correlated with a lower preoperative lymphocyte percentage (p=0.043), higher NLR (p=0.010) and PLR (p=0.015), and an increased number of packed red blood cell (PRBCs) transfusions perioperatively (p=0.030). An increased LOICUS was correlated with a lower preoperative lymphocyte percentage (p=0.033), higher NLR (p=0.018) and PLR (p=0.044), an increased number of PRBCs transfusions (p=0.001) and patients’ comorbidities (p<0.05). A delay in feeding resumption was correlated with a lower preoperative lymphocyte percentage (p=0.022), higher NLR (p=0.004) and PLR (p=0.001), an increased PRBCs transfusions (p=0.001) and diabetes mellitus (p=0.033). Multivariate analysis with automatic linear modeling showed that only the preoperative PLR was a powerful predictor for the delay of feeding resumption (p<0.01).Conclusion: The lymphocyte percentage, PLR and NLR are found to be associated with prolonged hospitalization and ICU stay, delayed oral feeding following THE for Siewert type II and III AEG. We hope by this series, to have set, at least one preliminary cornerstone, in the creation of a prognostic model, capable of assessing the need for an intraoperative jejunostomy placement, in patients undergoing esophagectomy for distal esophageal carcinoma.
Pharmacological intervention to restore connectivity deficits of neuronal networks derived from ASD patient iPSCs with a TSC2 mutation
Authors: Alsaqati Mouhamed , Heine Vivi M , Harwood Adrian J. 
Published: September 2020

Abstract
Background Tuberous sclerosis complex (TSC) is a rare genetic multisystemic disorder resulting from autosomal dominant mutations in the TSC1 or TSC2 genes. It is characterised by hyperactivation of the mechanistic target of rapamycin complex 1 (mTORC1) pathway and has severe neurodevelopmental and neurological components including autism, intellectual disability and epilepsy. In human and rodent models, loss of the TSC proteins causes neuronal hyperexcitability and synaptic dysfunction, although the consequences of these changes for the developing central nervous system is currently unclear.MethodsHere we apply Multi-electrode array (MEA)-based assays to study the effects of TSC2 loss on neuronal network activity using Autism Spectrum Disorder (ASD) patient-derived iPSCs. We examine both temporal synchronisation of neuronal bursting, and spatial connectivity between electrodes across the network. Results We find that ASD patient-derived neurons with a functional loss of TSC2, in addition to possessing neuronal hyperactivity, develop a dysfunctional neuronal network with reduced synchronisation of neuronal bursting and lower spatial connectivity. These deficits of network function are associated with elevated expression of genes for inhibitory GABA signalling and glutamate signalling, indicating a potential abnormality of synaptic inhibitory-excitatory signalling. mTORC1 activity functions within a homeostatic triad of protein kinases, mTOR, AMP-dependent protein Kinase 1 (AMPK), and Unc-51 like Autophagy Activating Kinase 1 (ULK1) that orchestrate the interplay of anabolic cell growth and catabolic autophagy while balancing energy and nutrient homeostasis. The mTOR inhibitor rapamycin suppresses neuronal hyperactivity, but does not increase synchronised network activity, whereas activation of AMPK restores some aspects of network activity. In contrast, the ULK1 activator, LYN-1604 increases the network behaviour, shortens the network burst lengths, and reduces the number of uncorrelated spikes.LimitationsAlthough a robust and consistent phenotype is observed across multiple independent iPSC cultures, the results are based on one patient. There may be more subtle differences between patients with different TSC2 mutations or differences of polygenic background within their genomes. This may affect the severity of the network deficit or the pharmacological response between TSC2 patients.ConclusionsOur observations suggest that there is a reduction in the network connectivity of the in vitro neuronal network associated with ASD patients with TSC2 mutation, which may arise via an excitatory/inhibitory imbalance due to increased GABA-signalling at inhibitory synapses. This abnormality can be effectively suppressed via activation of ULK1.
Feasibility of remote digital monitoring using wireless Bluetooth monitors, the Smart AngelTM&nbsp;app and an original web platform for patients following outpatient surgery: A prospective observational pilot study.
Authors: Chevallier Thierry , Buzancais Gautier , Occean Bob-valery , Rataboul Pierre , Boisson Christophe , simon natacha , Lannelongue Ariane , Chaniaud Noemie , Gricourt Yann , Lefrant Jean-Yves , cuvillon philippe 
Published: September 2020

Abstract
Background: Remote monitoring of mean arterial blood pressure (MAP), heart rate (HR) or oxygen saturation (SpO2) remains a challenge in outpatient surgery. This study evaluates a new digital technology (Smart AngelTM) for remotely monitoring hemodynamic data in real time: data transmitted from the patient's home to a central server, using a dedicated web-based software package.Methods: Adults scheduled for elective outpatient surgery were prospectively enrolled. In the first 5 postoperative days, patients completed a self-report questionnaire (pain, comfort, nausea, vomiting) and recorded SpO2, HR and MAP via two wireless Bluetooth monitors connected to a 4G tablet to transmit the data to a website, in real time, using Smart AngelTM software. Before transmission to the website, these data were also self-reported by the patient on a paper form. The primary outcome was the proportion of variables (self-monitored physiological data + questionnaire scores) correctly transmitted to the hospital via the system compared with the paper version.On Day 5, a system usability scale survey (SUS score 1-100) was also attributed.Results: From May 2018 to September 2018, data were available for 29 out of 30 patients enrolled (1 patient was not discharged from hospital after surgery). The remote monitoring technology recorded 2038 data items (62%) compared with 2656 (82%) items recorded on the paper form (p=0.001). The most common errors with the remote technology were software malfunctioning when starting the MAP monitor and malfunctioning between the tablet and the Bluetooth monitor. No serious adverse events were noted. The SUS score for the system was 85 (68-93) for 26 patients. Conclusion: This work evaluates the ability of a pilot system for monitoring remote physiological data using digital technology after ambulatory surgery and highlights the digital limitations of this technology. Technological improvements are required to reduce malfunctioning (4G access, transmission between apps).Trial registration: ClinicalTrials.gov (NCT03464721) (March 8, 2018)
Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach
Authors: Ortiz-Prado Esteban , Simbana-Rivera Katherine , Gomez-Barreno Lenin , Tamariz Leonardo , Lister Alex , Baca Juan Carlos , Norris Alegria , Adana-Diaz Lila 
Published: September 2020

Abstract
Background: Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples. Methods: We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities asking about their experiences and perceptions of participating in biomedical investigations. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work. Results: A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples among Waorani people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project. Conclusion: Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological and genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.