bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economics of the Management of Craniospinal Chordoma and Chondrosarcoma and the Feasibility of the Bundled Payment Model
Authors: Aljuboori Zaid , Ugiliweneza Beatrice , Wang Dengzhi , Andaluz Norberto , Boakye Maxwell , Williams Brian 
Published: January 2020

Abstract
Background Healthcare expenditures are continuously rising in the United States. The Centers for Medicare and Medicaid Services (CMS) created a new reimbursement model called the “Bundled Payment for Care Improvement (BPCI)”. This model reimburses providers a predetermined payment in advance to cover all possible services delivered to patients within a certain time window. Chordoma and Chondrosarcoma are locally aggressive malignant primary bony tumors. Treatment includes surgical resection and radiotherapy with substantial risk for recurrence which necessitates monitoring and further treatment. We assess the BPCI model in complex neurosurgical diseases. Methods We obtained data from the United States MarketScan database. Patients were identified patients using the International Classification of Diseases 10 codes. Results A total of 2041 patients were included. 1412 patients had cranial, 343 patients had a mobile spine, and 286 patients had sacrococcygeal chordoma and chondrosarcoma. For Index hospitalization, the median length of stay (days) was 4, 6, and 7, mean total payments were ($58,130), ($84,854), and ($82,440), and complication rates were 30%, 35%, and 43% for groups 1, 2, and 3, respectively. The payments during the first 6 months after discharge were comparable to the amounts reimbursed during the index hospitalization for all groups. Conclusion The management of craniospinal chordoma and chondrosarcoma is costly and sustained over time. The success of BPCI requires a joint effort between insurers and hospitals. It should consider patients’ comorbidities, the complexity of the disease. Finally, adoption of quality improvement programs by hospitals can help with cost reduction.
Mapping Chronic Disease Prevalence based on Medication Use and Socio-demographic variables: an Application of LASSO in healthcare in the Netherlands
Authors: Füssenich Koen , Boshuizen Hendriek C. , Nielen Markus M.J. , Buskens Erik , Feenstra Talitha L. 
Published: January 2020

Abstract
Objectives Policymakers generally lack sufficiently detailed health information to develop localized health policy plans. Chronic disease prevalence mapping is difficult as accurate direct sources are often lacking. Improvement is possible by adding extra information such as medication use and demographic information to identify disease. The aim of the current study was to use a LASSO (Least Absolute Shrinkage and Selection) model on a wide set of variables including medication use to obtain small geographic area prevalence estimates for four common chronic diseases and investigate regional patterns of disease. Methods Administrative hospital records and general practitioner registry data were linked to medication use and socio-economic characteristics. The training set (n=707021) contained GP diagnosis and/or hospital admission diagnosis as the standard for disease prevalence. For the entire Dutch population (n = 16,777,888), all information except GP and hospital admission was available. A LASSO operator regression model for binary outcomes was used to select variables strongly associated with disease. Dutch municipality (non-)standardized prevalence estimates for stroke, CHD, COPD and diabetes were then based on the average of individual predicted probabilities. Results Adding medication use data as a predictor substantially improves model performance. Estimates at the municipality level are best for diabetes with a weighted percentage error (WPE) of 6.8%, and worst WPE for COPD, with 14.5%. Disease prevalence has clear regional patterns, also after standardization for age. Conclusion Adding medication use as an indicator of disease prevalence next to socio-economic variables substantially improved estimates at the municipality level. The resulting individual disease probabilities can be aggregated into any desired regional level and provide a useful tool to identify regional patterns and subsequently inform local policy.
Gut microbiota regulates autism-like behavior by mediating vitamin B6 metabolism in EphB6-deficient mice
Authors: Li Jian-Ming , Li Ying , Luo Zheng-Yi , Hu Yu-Ying , Bi Yue-Wei , Yang Jian-Ming , Zou Wen-Jun , Song Yun-Long , Li Shi , Shen Tong , Li Shu-Ji , Huang Lang , Zhou Ai-Jun , Gao Tian-Ming 
Published: January 2020

Abstract
Background Autism spectrum disorder (ASD) is a developmental disorder with limited effective pharmacological treatments for the core autistic symptoms so far. Increasing evidences, especially the clinical studies in ASD patients, suggest a functional link between gut microbiota and development of ASD. However, the mechanisms linking gut microbiota and brain dysfunctions (gut-brain axis) in ASD are still not well-established. With genetic mutations and down-regulated expression in patients with ASD, EPHB6, which is also important in homeostasis of gut, has been generally considered to be a candidate gene for ASD. Nonetheless, the role and mechanism of EPHB6 involved in regulating gut microbiota and development of ASD have been unclear. Results Here, we found deletion of EphB6 induced autism-like behavior and disturbed gut microbiota in mice. More importantly, transplanting fecal microbiota from EphB6-deficient mice resulted in autism-like behavior in antibiotics-treated C57BL/6J mice. Meanwhile, transplanting fecal microbiota from wild-type mice ameliorated autism-like behavior in EphB6-deficient mice. At the metabolic levels, disturbed gut microbiota led to vitamin B6 and dopamine defects in EphB6-deficient mice. At the cellular levels, excitation/inhibition (E/I) imbalance in medial prefrontal cortex was induced by gut microbiota-mediated defects of vitamin B6 metabolism in EphB6-deficient mice. Conclusions Our study uncovers a key role for gut microbiota in regulation of autism-like social behavior by mediating vitamin B6 metabolism, dopamine synthesis and E/I balance in EphB6-deficient mice, suggesting new strategies for understanding and treatment of ASD.
Use of BioFire FilmArray gastrointestinal PCR panel associated with reductions in antibiotic use, time to optimal antibiotics, and length of stay.
Authors: Torres-Miranda Daisy , Akselrod Hana , Karsner Ryan , Secco Alessandra , Silva-Cantillo Diana , Siegel Marc O. , Roberts Afsoon D. , Simon Gary L. 
Published: January 2020

Abstract
Rapid and accurate diagnostic tools are needed for appropriate management of infectious diarrhea. We evaluated the impact of the introduction of rapid multiplex PCR testing using the FilmArray gastrointestinal (GI) panel (BioFire Diagnostics, LLC, Salt Lake City, UT) at our institution, and compared the results to those of standard stool cultures. The most common pathogens detected by the FilmArray GI panel were Clostridium difficile (55.0%), Campylobacter species (20.9%), Salmonella species (12.4%), and Shigella/EIEC species (12.4%). Rates of reproducibility in stool culture for these pathogens ranged from 56.3% to 77.8%. Co-detection of two or more organisms was common (24.2%), most commonly involving EPEC, EAEC, ETEC, and STEC. The time from arrival in the Emergency Department to discharge or admission to the hospital was unchanged after the introduction of FilmArray GI panel, but length of hospital stay was shorter (3 vs. 7.5 days, p=0.0002) for the FilmArray group. The time to empiric antibiotics did not differ significantly, but optimal antibiotics were started earlier after introduction of the FilmArray GI panel (hospital day 1 vs. 2, p<0.0001). More patients were discharged without antibiotics after introduction of the FilmArray GI panel (14.0% vs. 4.5%; p<0.001). Our results demonstrate that the FilmArray GI panel is an important tool for improving both patient care and antibiotic stewardship, despite the tendency for positive results with multiple pathogens.
Number of remaining teeth and its association with educational level in Chilean adults: data from the National Health Survey 2016-2017
Authors: Margozzini Paula , Berrios Rodrigo , García-Huidobro Rosario , Véliz Claudia , Valle Carolina del , Vargas Juan Pablo , Padilla Oslando , Ortuno Duniel 
Published: January 2020

Abstract
Background: Several population studies have addressed oral health inequity-related issues. Edentulism, functional dentition and number of remaining teeth have been linked to different socioeconomic level measurements. The aim of this study was to evaluate the association between educational level (EL) and tooth loss in the Chilean population aged 15 years old and above, based on the recent data collected from the 2016-2017 National Health Survey (ENS 2016-2017). Methods: The sample for this cross-sectional study comprised 5473 subjects. The main independent variable in the study was educational level (LEL: low, MEL: medium, HEL: high). In order to measure tooth loss number of remaining teeth, edentulism and functional dentition were considered. Based on a multivariate logistic regression, it was possible to obtain odds ratios (OR) and, therefore, to assessing the condition of dentition according to the subject’s EL. As to the number of teeth variable, multiple linear regressions were conducted. The analyses were carried out in the SPSS 24.0 program considering the complex sampling design of ENS 2016-2017. Results: When comparing LEL subjects with HEL subjects, the adjusted difference in the number of remaining teeth was 3.11 for maxilla and 1.72 for mandible. An individual with a LEL had a 7.51 [3.50-16.10] and 6.06 [2.68-13.68] times higher risk of upper edentulism and lower edentulism than a HEL individual respectively. Regarding functional dentition, the adjusted OR in HEL subjects was 13.33 [8.02-22.15] and in MEL subjects was 2.81 [2.03-3.87], compared to LEL results. Conclusions: LEL was associated with a significant tooth loss in the Chilean population. Regardless of age, subjects with a LEL obtained a lower mean of number of remaining teeth, higher prevalence of edentulism and lower prevalence of functional dentition.
What might it cost to increase soil organic carbon using no-till on U.S. cropland
Authors: Sperow Mark 
Published: January 2020

Abstract
Background Existing research provides estimates of the biophysical potential for increasing soil organic carbon (SOC) stock, however additional research is needed to enhance our understanding of the economic potential for agricultural soils to offset or help reduce CO 2 emissions. This study derives the marginal cost to increase SOC sequestration by combining SOC sequestration potential estimates developed using the Intergovernmental Panel on Climate Change (IPCC) factors with an existing payment scheme that was designed to increase no-till (NT) adoption on U.S. cropland. The marginal costs of increasing SOC is a function of the amount of SOC that could be increased through NT and the expected cost to landowners of changing management to use NT. Results The variability in SOC sequestration rates due to different land-use, management histories, climate, and soils, combined with the 48 unique payment rates to adopt NT, yield over 5,000 unique marginal cost values for increasing SOC sequestration. Nearly 95 percent of the biophysical potential SOC sequestration increase on U.S. cropland (140.1 Tg CO 2 yr -1 ) could be captured for a cost less than $100 Mg -1 CO 2. An estimated 64 to 93 percent of the biophysical potential could be captured for less than the low and high estimated costs to capture CO 2 for geologic storage of $36.36 to $86.06 Mg -1 CO 2 , respectively. Conclusions Decreasing tillage intensity through adoption of no-till agricultural offers a cost-effective way to offset a portion of increasing global CO 2 emissions. This research demonstrates that increasing SOC stocks through NT adoption can offset CO 2 emissions at a lower cost than some other options for preventing CO 2 from entering the atmosphere.
Detection of Mycobacteria in Paraffin-Embedded Ziehl–Neelsen-Stained Tissues using Digital Pathology
Authors: Sua Luz Fernanda , Bolaños Jhon Edwar , Maya Juliana , Sanchez Aura , Medina Giovanna , Zúñiga-Restrepo Valeria , Fernández-Trujillo Liliana 
Published: January 2020

Abstract
BackgroundTuberculosis is the first infection-related cause of death worldwide. Early diagnosis of paucibacillary tuberculosis represents a challenge, even with direct tissue examination. Digital pathology allows the digital analysis of tissues to identify microorganisms. We aim to develop a program to detect and quantify typical and atypical mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues.MethodsProgram development: The building of the program, named Pat-Scan, included pathology, systems engineering, and scientific applications. The iScan Coreo Au scanner® was used, and 9 variables were adjusted: Temp Directory Path, Output Directory Path, Server Path, Focus Approach, Focus Mode, AOI Detection Approach, Scan at, No. of Z Layers, and Z Delta. Software parameter settings: Brightness, contrast, sharpness, and red/green/blue. Control module scan and analysis: Ten Ziehl–Neelsen-stained samples were fragmented into 2,000 images and analyzed by a multidisciplinary team to validate the reproducibility of the bacilli images in the tissue, as detected by the software.ResultsPat-Scan included software and a scanner that were used to detect and quantify bacilli in paraffin-embedded Ziehl–Neelsen-stained tissues. HD quality image segmentation was performed, and nine planes of the Z-axis were scanned with a 1-micron distance between planes. Image magnification: 40x–80x. Scan time: 10–12 minutes. All samples containing mycobacteria were successfully analyzed by the scanner, and the bacilli could be detected; these results were validated by expert pathologists by microscopy examination, and the presence of bacilli was confirmed in all cases.ConclusionsPat-Scan allowed the identification and quantification of mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues, offering a reproducible diagnostic method that reduces the time for diagnosis and does not affect precision. Further validation is needed for application in the clinical setting.
The role of mass media exposure on Tuberculosis knowledge and attitude among migrant and seasonal farmworkers in Northwest Ethiopia
Authors: Gelaye Kassahun Alemu , Debalkie Getu , Ayele Tadesse Awoke , Wami Sintayehu Daba , sisay Malede mequanent , Fetene Destaw , Wolde Haileab Fekadu , Akalu Temesgen Yihunie 
Published: January 2020

Abstract
Background Globally, tuberculosis (TB) is the 9 th leading cause of death. Despite no country achieved its target, the world health organization (WHO) proposed a 90-90-90 approach to fastening the end TB strategy. Improvement and progression of TB control need good knowledge and a favorable attitude towards the disease. However, interventions designed don’t take migrants and seasonal farmworkers into account. Therefore, this study aimed at estimating the level of knowledge and attitude on Tuberculosis among migrant and seasonal farmworkers in northwest Ethiopia. Methods Community-based cross-sectional study was conducted in the West Gondar zone from October to November 2018. A two-stage cluster sampling was used to select 949 migrant and seasonal farmworkers. Both bivariate and multivariable logistic regression analyses were performed. A p-value of <0.05 was used to declare statistical significance. The goodness of fit was checked using Hosmer and Lemeshow test. Results In this study, (41.8%), (95% CI: 38.73, 45.01) and (50.5%), (95% CI: 47.29, 53.65) of migrants and seasonal farmworkers had good knowledge and a favorable attitude, respectively. The odds of good knowledge among mass media exposed migrants were AOR=1.42, 95% CI: (1.02, 2.01). Moreover, urban residence and having good knowledge increase the odds of favorable attitude by 1.66, (AOR=1.7; 95% CI: 1.05, 2.62) and 4.3 (AOR=4.3, 95%CI: 3.26, 5.75), respectively. Conclusion In this study, the overall knowledge and attitude of migrant and seasonal farmworkers on TB were low. Family size and mass media exposure significantly affect knowledge of the migrants on TB. On the other hand, the attitude was affected by urban residence, health information, and having good knowledge. Health promotion interventions, focused on TB cause, mode of transmission, prevention, and treatment are important to migrant and seasonal farmworkers to improve the knowledge and attitude of migrants and seasonal farmworkers.
Microaneurysms Detection in Color Fundus Images based on Naive Bayesian Classification
Authors: Long Shengchun , Chen Jiali , Hu Ante , Liu Haipeng , Chen Zhiqing , Zheng Dingchang 
Published: January 2020

Abstract
Background: As a major complication of diabetes, diabetic retinopathy (DR) is a leading cause of visual impairment and blindness due to delayed diagnosis and intervention. Microaneurysm appears as the earliest symptom of DR. Accurate and reliable detection of microaneurysms in color fundus images has great importance for DR screening. Methods: A microaneurysms detection method based on Naive Bayesian classifier is proposed for the early diagnosis of DR. First, blood vessels were enhanced and segmented using the analysis of eigenvalues of Hessian matrix. Next, with blood vessels excluded, microaneurysm candidate regions were obtained according to shape characteristics. After image segmented to patches, the features of each microaneurysm candidate patch were extracted, and each candidate patch was classified using Naive Bayes into microaneurysm or non- microaneurysm. The proposed algorithm was trained and tested on e-ophtha MA database, and further tested on another independent DIARETDB1 database. Results of microaneurysms detection on the two databases were evaluated on lesion level and compared with existing algorithms. Results: The proposed method has achieved better performance compared with existing algorithms. On e-ophtha MA and DIARETDB1 databases, the area under curve (AUC) of receiver operating characteristic (ROC) curve was 0.845 and 0.831, respectively. The free-response ROC (FROC) score on the two databases was 0.362 and 0.207, respectively. Conclusions: The proposed method based on Naive Bayesian classification of image patches can effectively detect microaneurysms in color fundus images and provide an effective scientific basis for early clinical DR diagnosis.
Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome
Authors: Jiang Tao , Zhou Xiaozhou , Chen Zhipeng , Xiong Tailing , Fu Jian , Liu Zhengchao , Yan Dishi , Zhou Zhansong , Shen Wenhao 
Published: January 2020

Abstract
Background: To evaluate the efficacy of submucosal injection of triamcinolone acetonide for the treatment of type II/III interstitial cystitis/bladder pain syndrome.
Methods: A retrospective analysis of the clinical data of type II/III interstitial cystitis/bladder pain syndrome patients treated in our department from April 2016 to August 2018 was conducted, and changes in International Prostate Symptom Scores and the Pelvic Pain and Urgency/Frequency symptom scale after surgery were evaluated to explore factors that may affect patient outcomes.
Results: A total of 27 female patients and 8 male patients were enrolled, with type II patients accounting for 62.9% of the sample, and the median follow-up duration was 31 months (range: 12-40 months). Twenty-two patients (74.3%) had significantly improved questionnaire scores at 4 weeks postoperatively. Treatment efficacy was sustained for at least 1 year in 15 patients, and persistent effectiveness was noted in 10 (28.6%) patients. Patients with an advanced age (p=0.015), high pain scores (p=0.040), and higher International Prostate Symptom Scores (p=0.037) and Pelvic Pain and Urgency/Frequency symptom scale scores (p=0.020) were more likely to benefit from submucosal injection of triamcinolone acetonide. Gender, disease duration, and the presence of Hunner’s lesions had no predictive value for treatment outcomes.
Conclusion: Submucosal injection of triamcinolone acetonide can improve the clinical symptoms and quality of life in both men and women with type II/III interstitial cystitis/bladder pain syndrome. Patients with an advanced age and more severe interstitial cystitis/bladder pain syndrome related symptoms may benefit more from triamcinolone acetonide injection.
Assessment of two POC technologies for CD4 count in Morocco
Authors: Elharti Elmir , Abbadi Halima , Bensghir Rajae , Filali Kamal Marhoum El , Elmrabet Hajar , Oumzil Hicham 
Published: January 2020

Abstract
Background : In the era of “test and treat strategy”, CD4 testing remains an important tool for monitoring HIV-infected individuals. Since conventional methods of CD4 count measurement are costly and cumbersome, POC CD4 counting technique are more affordable and practical for countries with limited resources. Before introducing such methods in Morocco, we decided to assess their reliability. Methods : in this study 92 blood samples from HIV-infected patients, were tested by PIMA to generate absolute CD4 count and by FACSPresto to derive percentage and absolute CD4 count. Flow cytometry using FacsCalibur, was used as reference method for CD4 count comparison. Linear regression, Bland and Altman analysis were performed to assess correlation and agreement between POC methods and the reference method. In addition, sensibility and specificity, positive predictive value (PPV), negative predictive value (NPV) at 350 CD4 count threshold were also determined. Finally, because FACSPresto can also measure hemoglobin (Hb) concentration, 52 samples were used to compare FACSPresto against an automated hematology analyzer. Results : With PIMA technology, the coefficient of determination R 2 was 0.93. Regarding FACSPresto, R 2 was 0.93 and 0.96for absolute CD4 count and percentage CD4 count, respectively. Bland and Altman analysis displayed a mean bias of -32.3 cells/µl with a limit of agreement (LOA): -181.3 to116.8, for Pima. The mean bias for FACSPresto was -8.1 cells/µl with LOA:-158.2 to 142.0for absolute CD4 count and 0.2 with LOA:-3.8 to 4.3, for CD4 percentage. Moreover, with a threshold of 350 CD4 count, sensibility, specificity, PPV, NPV, were 98%, 87%, 89%, 86%, and 88%, 96%,93% and 92% for PIMA and FACSPresto, respectively. Finally, the hemoglobin measurement evaluation displayed an R 2 of 0.80 and a mean bias of-0.12 with a LOA between -1.75 and 1.51. Conclusion : When compared to the reference method, PIMA and FACSPresto have shown good performance, for CD4 counting. The introduction of such POC technology will speed up the uptake of patients in the continuum of HIV care, in our country.