bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium is associated with high mortality in elderly patients with acute decompensated heart failure
Authors: Pak Misun , Hara Masahiko , Miura Shoko , Furuya Motohide , Tamaki Masatake , Okada Taiji , Watanabe Nobuhide , Endo Akihiro , Tanabe Kazuaki 
Published: October 2020

Abstract
Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.
Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively.
Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia.
Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.
Evidence on Article 5.3 of FCTC (Tobacco Industry Interference in tobacco control activities) in India- a Qualitative scoping study
Authors: Goel Sonu , Kar Sitanshu Sekhar , Verma Madhur , Sivanantham Parthibane , Naik Bijay Nanda 
Published: October 2020

Abstract
Background: Tobacco Industry (TI) strives to portray itself as being “socially responsible” and contest for pertinent decision-making positions, which it uses to deter, delay or dilute tobacco control measures. There is little documented evidence of Tobacco Industry Interference (TII) from India, the scope of their interference and challenges faced by the experts for effective tobacco control.Methods: A cross-sectional qualitative research design, based upon in-depth interviews (N=26), was used to explore the opinion of key stakeholders regarding TII in India. The interview schedule collected information about the participant’s roles and responsibilities in tobacco control, the nature of TII faced by the participant, means of influence by TI, barriers and challenges to tobacco control efforts using a set of questions. Results: Most of the respondents were engaged in tobacco control, training, advocacy, and awareness generation activities from the last 5-10 years or more. The respondents defined the TI and its scope as per their experience with the help of power ranking methodology. Most of them perceived TI as ‘Manufacturers’ while others consider them as ‘advertisers’, ‘public relation companies’, ‘wholesalers’, ‘vendors’, and ‘Government firms having TI stocks’ as TI. We identified six major domains (Influencing the policy and administrative decisions, Interference with implementation of tobacco control laws and activities, False propaganda and hiding the truth, manipulating front action groups (FAG), Rampant tobacco advertising and promotion activities, and others) under which TII activities were classified. Most respondents were of opinion that TI players were interfering in the policy decisions, implementation of the tobacco control laws and activities, and manipulating the FAG. A detailed taxonomic classification of the TII strategies that emerged from our analysis were linked to article 5.3 of FCTC. Conclusions: The activity documented a significant level of TII in different domains with stakeholders acting at various hierarchical levels. The study provide insights about the nefarious tactics of TI, enable stakeholders to anticipate and pre-empt the kinds of alliances the TI may attempt to build, stimulate academicians and researchers to undertake in-depth analysis into various strategies and underscore the need for ensuring transparency in official interactions with the TI and their representatives.
Awareness of COVID-19: What do Pakistanis perceive? A Large Survey of 1200 Residents
Authors: Ladiwala Zoya Fatima Rizwan , Dhillon Rubaid Azhar , Zahid Ibrahim , Irfan Omar , Khan Muhammad Sharjeel , Awan Safia , Khan Javaid Ahmad 
Published: October 2020

Abstract
Background: The Novel Coronavirus Disease (COVID-19) has created havoc globally as countries worldwide struggle to combat this pandemic. Since prevention and social isolation are known to be the only ways to prevent the spread of COVID-19, this has created challenges among the lower-middle income countries (LMIC) including Pakistan, as it battles between an under-resourced healthcare, an economic shutdown, and widespread myths and misconceptions. Therefore, we conducted a study to evaluate the knowledge, attitude and perceptions regarding COVID-19 as public understanding is vital to help facilitate the control of this outbreak. Methods: A pre-validated online questionnaire was distributed among the general population of Pakistan from 1st to 12th June 2020. Descriptive statistics were analyzed using SPSS v25. Adequate knowledge was assigned as a score of >4 (range: 0-8) and good perception as a score of >3 (range: 0-5). Chi‑square test was used to determine the significance of difference in knowledge and perception of COVID-19 among socio-demographics. Logistic regression analysis was run to identify factors associated with adequate knowledge and perception. P < 0.05 was considered as significant.Results: A total of 1200 respondents participated in this study with a wide range of age groups and education. Majority of the respondents had adequate knowledge (93.3%) with a mean score of 6.59 ± 1.35, and good perception (85.6%) with a mean score of 4.29 ± 0.82. Significant differences in knowledge and perception were observed among genders, age groups, education and between students and employees in the healthcare and non-healthcare department. A multivariable analysis revealed an advanced degree and a female gender to be significant predictors of adequate knowledge and perception. Conclusions: Albeit the surge of COVID-19 cases in Pakistan, the participants demonstrated an overall adequate knowledge and good perception towards COVID-19. Perhaps, a potential hint towards noncompliance practices in following preventive protocols requires further educational interventions that target safe health practices and complications of this infection.
An exploratory study to estimate cost-effectiveness threshold value for life saving treatments in western Iran
Authors: Moradi Najmeh , Woldemichael Abraha , Malekian Parisa , Rotavandi Delnia Moradi , Rezaei Satar 
Published: October 2020

Abstract
Background: Cost-effectiveness analysis provides a crucial means for evidence-informed decision-making on resource allocation. This study aims to elicit individuals' willingness to pay (WTP) for one additional quality-adjusted life-year (QALY) gained from life-saving treatment and associated factors in Kermanshah city, western Iran.Methods: We conducted a cross-sectional study on a total of 847 adults aged 18 years and above to elicit their WTP for one additional QALY gained by oneself and a family member using a hypothetical life-saving treatment. We used a multistage sampling technique to select the samples, and the Iranian version of EQ-5D-3L, and visual analogue scale (VAS) measures to obtain the participants’ health utility value. The Tobit regression model was used to identify the factors affecting WTP per QALY values.Results: The mean WTP value and standard deviation (SD) was US$ 862 (3,224) for the respondents. The mean utility values using EQ-5D-3L and VAS methods for respondents were 0.779 and 0.800, respectively. Besides, the WTP for the additional QALY gained by the individual participants using the EQ-5D-3L and VAS methods were respectively US$ 1,202 and US$ 1,101, while the estimated value of the family members was US$ 1,355 (SD= 3,993). The Tobit regression models indicated that monthly income, education level, sex, and birthplace were statistically significantly associated (p < 0.05) with both the WTP for the extra QALY values using the EQ-5D-3L and the VAS methods. Educational level and monthly income also showed statistically significant relationships with the WTP for the additional QALY gained by the family members (p < 0.05). Conclusion: Our findings indicated that the participants' WTP value of the additional QALY gained from the hypothetical life-saving treatment was in the range of 0.20 to 0.24 of the gross domestic product (GDP) per capita of Iran. This value is far lower than the World Health Organization (WHO) recommended CE threshold value of one. This wide gap reflects the challenges the health system is facing and requires further research for defining the most appropriate CE threshold at the local level.
Transcriptional response of Bacillus megaterium FDU301 to PEG200-mediated arid stress
Authors: Zhao Lei , Zhou Yanjun , Li Jianbei , Xia Yucheng , Wang Weiyun , Luo Xiuqi , Yin Juan , Zhong Jiang 
Published: October 2020

Abstract
Background For microorganisms on a paper surface, the lack of water is one of the most important stress factors. A strain of Bacillus megaterium FDU301 was isolated from plaques on a paper surface using culture medium with polyethylene glycol 200 (PEG200) to simulate an arid condition. Global transcriptomic analysis of B. megaterium FDU301 grown under normal and simulated arid conditions was performed via RNA-seq technology to identify genes involved in arid stress adaptation.Results The transcriptome of B. megaterium FDU301 grown in LB medium under arid (15% PEG200 (w/w)) and normal conditions were compared. A total of 2941 genes were differentially expressed, including 1422 genes upregulated and 1519 genes downregulated under arid conditions. Oxidative stress-responsive regulatory genes perR, fur, and tipA were significantly upregulated, along with DNA protecting protein (dps), and catalase (katE). Genes related to Fe2+ uptake (feoB), sporulation stage II (spoIIB, spoIIE, spoIIGA), small acid-soluble spore protein (sspD), and biosynthesis of compatible solute ectoine (ectB, ectA) were also highly expressed to various degrees. Oxidative phosphorylation-related genes (atpB, atpE, atpF, atpH, atpA, atpG, atpD, atpC) and glycolysis-related genes (pgk, tpiA, frmA) were significantly downregulated.Conclusion This is the first report about transcriptomic analysis of a B. megaterium to explore the mechanism of arid resistance. Major changes in transcription were seen in the arid condition simulated by PEG200 (15%), with the most important one being genes related to oxidative stress. The results showed a complex mechanism for the bacteria to adapt to arid stress.
The Influence of Empowered Work Environments on the Psychological Experiences of Nursing Assistants During COVID-19: A Qualitative Study
Authors: Travers Jasmine , Schroeder Krista , Norful Allison A. , Aliyu Sainfer 
Published: October 2020

Abstract
Background: Nursing Assistants (NA) who feel empowered tend to perform their duties better, have higher morale and job satisfaction, and are less likely to leave their jobs. Organizational empowerment practices in hospitals likely shape the psychological experiences of empowerment among these personnel; however, little is known about this relationship.Objective: We used qualitative inquiry to explore the relationship between organizational empowerment structural components and feelings of psychological empowerment among hospital frontline workers during a public health emergency. Methods: Kanter’s Theory of Structural Empowerment and Spreitzer’s Psychological Empowerment in the Workplace Framework were applied to identify the conceptual influences of organizational practices on psychological experiences of empowerment. In-depth interviews were conducted with a convenience sample of NAs, caring for hospitalized COVID-19 patients. Directed content analysis was performed to generate a data matrix consisting of the psychological experiences of meaning, competence, self-determination, and impact embedded under the organizational structural components of information, resources, support, and opportunity. Results: Thirteen NAs (mean age= 42 years, 92% female) completed interviews. Information, or lack thereof, provided to the NAs influenced feelings of fear, preparation, and autonomy. Resources (e.g., protocols, equipment, and person-power) made it easier to cope with overwhelming emotions, affected the NAs’ abilities to do their jobs, and when limited, drove NAs to take on new roles. NAs noted that support was mostly provided by nurses and made the NAs feel appreciated, desiring to contribute more. While NAs felt they could consult leadership when needed, several felt leadership showed little appreciation for their roles and contributions. Similar to support, the opportunity to take care of COVID-19 patients yielded a diverse array of emotions, exposed advances and gaps in NA preparation, and challenged NAs to autonomously develop new care practices and processes. Conclusion: Management and empowerment of healthcare workers are critical to hospital performance and success. We found many ways in which the NAs’ psychological experiences of empowerment were shaped by the healthcare system’s empowerment-related structural conditions during a public health emergency. To further develop an empowered and committed critical workforce, hospitals must acknowledge the organizational practice influence on the psychological experiences of empowerment among NAs.
Body Image, Life Satisfaction and Associated Factors Among Women in Sweden having Undergone Mastectomy after Breast Cancer
Authors: Lundberg Pranee C , Phoosuwan Nitikorn 
Published: October 2020

Abstract
Background: Women having undergone mastectomy due to breast cancer have experience which is very much individual and contextual. In order to facilitate efforts to understand the women and improve their quality of life, the aim of this study was to investigate body image, life satisfaction and associated factors among women having undergone mastectomy.Methods: Four hundred and eighty-one women in Sweden having undergone mastectomy after breast cancer were enrolled in a descriptive cross-sectional study. Each participant completed a questionnaire comprising socio-demographic characteristics, social support, body image and life satisfaction. Multiple linear regression analyses estimated relationships between socio-demographic characteristics, information support, social support, and treatment variables, and continuous outcome variables such as body image and life satisfaction).Results: Body image was associated with all dimensions of life satisfaction. Lower age, underlying disease, chemotherapy and breast reconstruction increased body image dissatisfaction, while treatment options were factors associated with life satisfaction. Total social support was a factor that increased life satisfaction in the dimensions of physical symptoms, sickness impact and quality of close friend relationship.Conclusion: The findings highlight that some socio-demographic characteristics, treatment options and social support were associated with body image dissatisfaction and life dissatisfaction among the women with breast cancer after mastectomy. This can increase healthcare professionals’ understanding of women with breast cancer after treatment. They should provide effective information, focus attention on the women’s needs, and prepare intervention programs that make the women cope with their life situations during follow-up care.
Association between triglyceride-glucose index and risk of incident diabetes: a secondary analysis based on a Chinese cohort study
Authors: Li Xiaoli , Li Guilong , Cheng Tiantian , Liu Jing , Song Guangyao , Ma Huijuan 
Published: October 2020

Abstract
Background: Recent studies have suggested the triglyceride-glucose index (TyG index) may serve as a suitable substitute for insulin resistance. However, evidence for the relationship between TyG index and risk of diabetes remains limited. This study sought to explore the association of baseline TyG index with risk of developing diabetes in Chinese adults.Methods: This retrospective cohort study was conducted using data from the health screening program in China. A total of 201,298 non-diabetic individuals were included. TyG index was calculated as Ln [fasting plasma glucose (mg/dl) × fasting triglyceride level (mg/dl)/2]. Diabetes was defined as fasting plasma glucose ≥126 mg/dl and/or self-reported diabetes. Cox proportion-hazard model was employed to evaluate the independent impact of baseline TyG index on future diabetes risk. Sensitivity and subgroup analyses were implemented to verify the reliability of results. Notably, data were downloaded from the DATADRYAD website, and used only for secondary analyses.Results: During an average follow-up of 3.12 years, among 201,298 individuals aged ≥20 years, 3,389 subjects developed diabetes. After adjusting for potential confounders, elevated TyG index were independently correlated with greater risk of incident diabetes (hazard ratio (HR), 3.34; 95% confidence interval (CI), 3.11–3.60). Compared with the lowest quartile (Q1), increasing TyG index (Q2, Q3, and Q4) was related to increased HR estimates of incident diabetes [HR (95% CI), 1.83 (1.49–2.26); 3.29 ( 2.70–4.01), and 6.26 (5.15–7.60), respectively]. Moreover, a nonlinear relationship was observed between TyG index and risk of diabetes and the slope of the curve increased accompanying the rise of TyG index. Subgroup analysis revealed the positive association was stronger among subjects with age < 40 years, body mass index ≥18.5 kg/m2 and < 24 kg/m2, or systolic blood pressure <140 mmHg, or in females.Conclusions: Elevated TyG index is independently correlated with increased risk of incident diabetes in Chinese adults, indicating it may represent a reliable predictor of diabetes in high-risk populations.
REDIAL-2020: A suite of machine learning models to estimate Anti-SARS-CoV-2 activities
Authors: KC Govinda , Bocci Giovanni , Verma Srijan , Hassan Md , Holmes Jayme , Yang Jeremy , Sirimulla Suman , Oprea Tudor 
Published: October 2020

Abstract
Strategies for drug discovery and repositioning are an urgent need with respect to COVID-19. We developed "REDIAL-2020", a suite of machine learning models for estimating small molecule activity from molecular structure, for a range of SARS-CoV-2 related assays. Each classifier is based on three distinct types of descriptors (fingerprint, physicochemical, and pharmacophore) for parallel model development. These models were trained using high throughput screening data from the NCATS COVID19 portal (https://opendata.ncats.nih.gov/covid19/index.html), with multiple categorical machine learning algorithms. The “best models” are combined in an ensemble consensus predictor that outperforms single models where external validation is available. This suite of machine learning models is available through the DrugCentral web portal (http://drugcentral.org/Redial). Acceptable input formats are: drug name, PubChem CID, or SMILES; the output is an estimate of anti-SARS-CoV-2 activities. The web application reports estimated activity across three areas (viral entry, viral replication, and live virus infectivity) spanning six independent models, followed by a similarity search that displays the most similar molecules to the query among experimentally determined data. The ML models have 60% to 74% external predictivity, based on three separate datasets. Complementing the NCATS COVID19 portal, REDIAL-2020 can serve as a rapid online tool for identifying active molecules for COVID-19 treatment. The source code and specific models are available through Github (https://github.com/sirimullalab/redial-2020), or via Docker Hub (https://hub.docker.com/r/sirimullalab/redial-2020) for users preferring a containerized version.
Investigating Public Values in Health Care Priority – Chileans´ Preferences for National Health Care
Authors: Núñez Alicia , Chi Chunhuei 
Published: October 2020

Abstract
Background: This study aims to assess preferences and values for priority setting in healthcare in Chile through an original and innovative survey method. Based on the answers from a previous survey that look into the barriers the Chilean population face, this study considers the preferences of the communities overcoming those barriers. As a result six programs were identified: (1) new infrastructure, (2) better healthcare coverage, (3) increasing physicians/specialists, (4) new informatics systems, (5) new awareness healthcare programs, and (6) improving availability of drugs. Methods: We applied an innovative survey method developed for this study to sample subjects to prioritize these programs by their opinion and by allocating resources. The survey also asked people´s preferences for a distributive justice principle for healthcare to guide priority setting of services in Chile. The survey was conducted with a sample of 1,142 individuals. Results: More than half of the interviewees (56.4%) indicated a single program as their first priority, while 20.1% selected two of them as their first priority. To increase the number of doctors/specialists and improve patient-doctor communication was the program that obtained the highest priority. The second and third priorities correspond to improving and investing in infrastructure and expanding the coverage of healthcare insurances. Additionally, the results showed that equal access for equal healthcare is the principle selected by the majority to guide distributive justice for the Chilean health system. Conclusions: This study shade lights on how a large population sample can participate in major decision making of national health policies, including making a choice of a distributive justice principle. Despite the complexity of the questions asked, this study demonstrated that with an innovative method and adequate guidance, average population is capable of engaging in expressing their preferences and values. Results of this study provide policy-makers useful community generated information for prioritizing policies to improve healthcare access.
Platelet-to-Lymphocyte Ratio and C-Reactive Protein as Markers for Colorectal Polyp Histological Type
Authors: Chen Rui , Wang Liguang , Zhao Qi , Li Zhen , Chen Man , Lian Guodong , Zhang Junyong 
Published: October 2020

Abstract
Background: The PLR and CRP level are markers that have been reported to predict the histological type of various tumors, and here, we evaluated their utility in predicting colorectal polyp histological types.Methods: We retrospectively reviewed 172 patients with colorectal polyps who underwent endoscopic polypectomy. The associations between histological type and clinicopathologic parameters were assessed by multivariate analysis. Results: The optimal PLR and CRP cut-off values were 113.32 and 0.39, respectively. The PLR (P=0.002) and CRP (P= 0.009) values were associated with the histological type according to the univariate analysis, whereas low PLR (P ≤0.001) and CRP (P =0.017) values were independent risk factors in the multivariate analysis together with maximum tumor diameter (P ≤0.001) and tumor number (P =0.0014).Conclusions: Preoperative PLR and CRP are correlated with the colorectal polyp histological type.