bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental and Numerical Investigation of Backwash Flow in Nutshell Filter
Authors: Sadeghi F. , Bashiri Hamed , Vissers A. J. W. H. 
Published: January 2020

Summary
The granular nutshell filter is commonly used as deep-bed media filter to remove insoluble hydrocarbons and suspended solids from water. The important advantage of using such a filter is the ability to backwash and regenerate the media. The process of backwash includes fluidization of the media by applying two fluid flows: backwash flow that is upward vs. a jet flow that is downward. A computational fluid dynamics (CFD) simulation of such fluidization was performed for a pilot-scale nutshell filter. The effect of the backwash flow, jet flow, and medium depth in the filter on the fluidization quality during the backwash mode of the filter were investigated. The media fluidization uniformity was studied as the media depth and flow patterns varied. A fair consistency was observed between the experimental values and the results obtained by CFD analysis. It was observed that the longer the media depth, the more uniform the media fluidization will occur. Increasing the media depth resulted in longer fluidization times. Shorter media-depth filters are more sensitive to jet flows. For shorter filters, when the jet flow was reduced, a more uniform fluidization was obtained. The fluidization time (the time for the media to reach the top of the vessel) is strongly related to the jet flow for both shorter- and longer-depth media filters. For long-depth media filters, the effect of increasing the backwash flow and reducing the jet flow on the uniformity of media fluidization vs. the fluidization time was studied. The velocity pattern for the fluid showed vortices close to the floor screen in lower mid-depths of the filter. The CFD analysis for the commercial-scale nutshell filter with a diameter of 12 ft (3.65 m) and height of 8 ft (2.4 m) showed a similar vortex pattern with uniform media fluidization.
Seroprevalence of Hepatitis B Virus among antenatal clinic attendees in Gamawa Local Government Area, Bauchi State, Nigeria
Authors: MUSTAPHA GARBA UMAR , Ibrahim Abdulrasul , Balogun Muhammad Shakir , Umeokonkwo Chukwuma David , Mamman Aisha Indo 
Published: January 2020

Abstract
Background: Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State.
Methods: We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49 years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel.
Results: The mean age of respondents was 24.5 ± 6.0 years; 112 (53%) of whom were younger than 25 years. All were married, 183 (87%) had no formal education and up to 190 (90%) were employed. Overall, 14 (6.7%) tested positive for HBsAg; women aged ≥35 years had the highest prevalence (10%). None with tertiary education tested positive and women married before 18 years had 13 (6.2%) prevalence.
Conclusions: The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC.
Keywords: Hepatitis B virus, Hepatitis B Surface antigen, Prevalence, Pregnancy, Health facilities, Hepatitis B
Child Characteristics and Early Intervention Referral and Receipt of Services: A Retrospective Cohort Study
Authors: McManus Beth , Richardson Zachary , Schenkman Margaret , Murphy Natalie , Everhart Rachel , Hambidge Simon , Morrato Elaine 
Published: January 2020

Abstract
Background Early Intervention (EI) is a federally mandated, state-administered system of care for children with developmental delays and disabilities under the age of three. Gaps exist in the process of accessing EI through pediatric primary care, and low rates of EI access are well documented and disproportionately affect poor and minority children. The aims of this paper are to examine child characteristics associated with gaps in EI (1) referral, (2) access and (3) service use. To our knowledge, this is the first study to leverage linked safety net health system pediatric primary care and EI records data to follow EI-referred children longitudinally to understand EI service use gaps from EI referral to EI service utilization. Methods In a retrospective cohort design (14,710 children with developmental disability or delay), we linked pediatric primary care records between a large, integrated safety net health system in metro Denver and its corresponding EI program (2014-2016). Using adjusted marginal effects [ME, (95% CI)], we estimated gaps in EI referral, access, and service type (i.e., physical [PT], occupational [OT], speech therapy [ST] and developmental intervention [DI]). Analyses accounted for child characteristics including socio-demographics, diagnosis, condition severity, and baseline function. Results Only 18.7% of EI-eligible children (N=2,726) received a referral; 26% of those (N=722) received services for a net enrollment rate of 5% among EI-eligible children. Having the most severe developmental condition was positively associated with EI referral [ME=0.334 [0.249, 0.420]) and Individualized Family Services Plan (IFSP) receipt [ME=0.156 [0.088, 0.223]). Children less likely to be EI-referred were Black, non-Hispanic (BNH) [ME=-0.029 (-0.054, -0.004)] and had a diagnosed condition ([ME=-0.046 (-0.087, -0.005)]. Children with a diagnosis and those with higher income were more likely to receive PT or OT. Higher baseline cognitive and adaptive skills were associated with lower likelihood of PT [ME=-0.029 (-0.054, -0.004)], OT [ME=-0.029 (-0.054, -0.004)], and ST [ME=-0.029 (-0.054, -0.004)]. Conclusions We identified and characterized gaps in EI referral, access, and service use in an urban safety-net population of children with high rates of developmental delay. Interventions are needed to improve integrated systems of care affecting primary care and EI processes and coordination.
Association among cytokine profiles of innate and adaptive immune responses and clinical-virological features in untreated patients with chronic hepatitis B
Authors: Gu Yurong , Lian Yifan , Zheng Qiaolan , Huang Zexuan , Gu Lin , Bi Yanhua , Li Jing , Huang Yanlin , Wu Yuankai , Chen Lubiao , Huang Yuehua 
Published: January 2020

Abstract
Background: Complete clearance of intracellular viruses depends on effector cells of innate and adaptive immune systems. This study aimed to identify the relationships among antiviral cytokines produced by natural killer (NK) and T cells and clinical-virological characteristics in untreated chronic hepatitis B (CHB) patients.
Methods: We measured antiviral cytokines interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), and interleukin-2 (IL-2) produced by T, NK and natural killer T (NKT) cells, respectively, in a cohort with chronic hepatitis B virus (HBV) infection (CHB). We also correlated these cytokines with clinical-virological characteristics using a linear regression model.
Results: levels of IFN-γ + and TNF-α + CD4 + and CD8 + T cells were significantly higher in immune active (IA) phase than in other phases. Immune tolerant (IT) patients showed the lowest expression of IFN-γ by NK and NKT cells, and TNF-α by NK cells. IFN-γ + , TNF-α + and IL-2 + CD4 + and CD8 + T cells frequencies were similar between IA and gray zone (GZ) phases. Principal component analysis based on cytokines confirmed that most IT patients significantly differed from inactive carriers (IC) and IA patients, while GZ patients were widely scattered. Multivariate analysis showed both T and NK cells producing IFN-γ and TNF-α, but not IL-2, had significant association with serum alanine aminotransferase (ALT). Moreover, IFN-γ + NKT cells were associated with HBV DNA, while IFN-γ + CD4 + and CD8 + T cells were correlated with age.
Conclusion : HBV clinical phases are characterized by distinct cytokine signatures, which showed relationship to viral features in these untreated CHB patients.
Closing the (incarceration) gap: Assessing the socio-economic and clinical indicators of Indigenous males by lifetime incarceration status
Authors: Shepherd Stephane M , Spivak Benjamin , Ashford Linda Joyce , Williams Isabel , Trounson Justin , Paradies Yin 
Published: January 2020

Abstract
Background

“Closing the Gap” is an Australian government strategy that was established to address the inequality in health and education outcomes between Indigenous and non-Indigenous Australians. Although some gains have been realised, progress has been ostensibly slow. One potential obstacle is the large number of Indigenous Australians in prison. 1 in 5 to 1 in 6 Indigenous Australian males are currently imprisoned or have previously been imprisoned. Recent work has also pointed to a widening socio-economic gap within the Indigenous population. Given the myriad social, wellbeing and environmental risk factors associated with justice-involvement, it is conceivable that incarceration may contribute to the increasing disparities found within the Indigenous population. This study aimed to explore the presence and extent of an ‘incarceration gap’ within the Indigenous population and to uncover which social factors characterise the disparity.

Methods

The study utilised data from the 2014-5 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). A number of socio-economic, environmental and clinical factors were compared by life-time incarceration status. Chi-square tests were used to examine the association between incarceration status and each of the comparison variables.

Results

Disparities were observed within the Indigenous Australian population across a number of important health and socio-economic markers by incarceration status - the most pronounced being for educational obtainment – year 10 completion (Never incarcerated 73%, Ever incarcerated 50%), labour force participation (Never incarcerated 56%, Ever incarcerated 26%) and drug/alcohol problems (Never incarcerated 7%, Ever incarcerated 29%). Never-incarcerated Indigenous males yielded aggregate proportions across numerous variables that approximated or matched general Australian population estimates.

Conclusions

There appears to be evidence for an ‘incarceration gap’ within the Indigenous Australian population. It is evident that the national ‘closing the gap’ strategy necessitates contending with Indigenous over-incarceration.
Factors Associated with Salmonella Infection in Patients with Gastrointestinal Complaints Seeking Health Care at Regional Hospital in Southern Highland of Tanzania
Authors: Ngogo Fadhili Ashery , Joachim Agricola , Abade Ahmed M , Rumisha Susan F , Mizinduko Mucho M , Majigo Mtebe Venance 
Published: January 2020

Abstract
Background
Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries that experience poor hygiene and lack of access to clean and safe water. There was an increase in reported cases of Salmonellosis in Njombe region, Southern Highland of Tanzania between 2015 and 2016, based on clinical diagnosis. Nevertheless, little is known about the factors contributing to the transmission of this disease in the region. This study was conducted to determine the prevalence, antimicrobial susceptibility, and factors associated with Salmonella infection among patients who report gastrointestinal complaints.
Methods
A cross-sectional study was conducted from December 2017 to February 2018 among patients with gastrointestinal complaints at Kibena Regional Hospital. Stool samples were submitted for isolation of Salmonella spp. Identification was based on conventional biochemical tests and serotyping to differentiate typhoid and non-typhoid Salmonella (NTS). Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion method. Multivariable logistic regression analysis was performed to examine the factors independently associated with Salmonella infection.
Results
The prevalence of Salmonella infection among participants with gastrointestinal complaints was 16.5% (95% CI: 12.7-21.1) of them, 83.7%, 95% CI: 70.9-91.5 were NTS while 16.3%, 95% CI: 8.5-29.0 were Typhoid Salmonella species.
All isolates were sensitive to ceftriaxone and ciprofloxacin, whereas 27.8% and 100% were resistant to co-trimoxazole and ampicillin respectively. The odd of Salmonella infection was fourfold higher among participants with formal employment (AOR 3.8, 95% CI, 1.53-9.40). Use of water from wells/rivers (AOR 2.2, 95% CI, 1.07-4.45), drinking untreated water (AOR 2.6, 95% CI, 1.21-5.48) and often eating at a restaurant (AOR 3.4, 95% CI, 1.28-8.93) had increased odds of Salmonella infection. Likewise, having abdominal pain (AOR 8.5, 95% CI, 1.81-39.78) and diarrhea (AOR 2.3, 95% CI, 1.12-4.68) were independent symptoms that predict Salmonella infection.
Conclusion
There is a high prevalence of Salmonella infection among people who report gastrointestinal complaints and it is clinically predicated by diarhoea and abdominal pain. Employed participants and those eating at restaurant and drinking unsafe water had higher risk of infection. Salmonella spp causing gastroenteritis has developed resistance to commonly used antibiotics.
Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort
Authors: Zhang Tong , Ding Haibo , An Minghui , Wang Xiaonan , Tian Wen , Zhao Bin , Han Xiaoxu 
Published: January 2020

Abstract
Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, whether LLV increases the risk of virologic failure (VF) is controversial because of the non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002–2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.7% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HLB) showed higher risk of VF (hazards ratios, HRHLLV=5.93, and HRHLB=2.84, p<0.05 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR=3.49, p=0.002), nadir baseline CD4+T cell counts below 200 cells/mm3 (aOR=1.78, p=0.011), Manchu (aOR=2.03, p=0.003), ART over 60 months (aOR=1.81, p=0.004), AZT+3TC+NVP (aOR=2.26, p<0.001) or DDI-based regimen (aOR=9.96, p=0.002), and subtype B’ infection (aOR=8.22, p=0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B’ infection might also predict the occurrence of high-risk LLV.
An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: Proposal for a selective whole-spine MRI examination scheme
Authors: Xu Wei , Zhang Xiangyang , Zhu Ying , Zhu Xiaodong , li zhikun , Li Dachuan , Jia Jianjun , Chen Liwei , Wang Silian , Bai Yushu , Li Ming 
Published: January 2020

Abstract
Objective This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities(IA).
Method The clinical data of adolescent patients between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. 12 data were compared between the two groups. Student’s t test and the chi-square test were used to evaluate the differences in the continuous variables and categorical variables. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities.
Result A total of 714 adolescent patients with scoliosis with a mean age of 13.5 (10-18 years) were included in the study, and IA were found in 68 (9.5%) patients. There were statistically significant differences in the incidence rates of intramedullary abnormalities between males and females, left and right thoracic curvatures, angular scoliosis and smooth scoliosis, and abnormal abdominal wall reflex and ankle clonus (P<0.01). Logistic regression showed that the ratios for sex, scoliosis direction, scoliosis type, abdominal wall reflex and ankle clonus were 2.987, 3.493, 4.823, 3.94 and 8.083, respectively. The ROC curve showed a sensitivity of 66.18% and a specificity of 89.01%(0.5519).
Conclusion The incidence of scoliosis caused by IA was approximately 9.5%.The risk factors associated with AS caused by abnormal IA included the male sex, thoracic scoliosis on the left side, a sharp curvature of the spine, an abnormal abdominal wall reflex and ankle clonus.
Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention
Authors: Lin Kai-Yang , Chen Han-Chuan , Jiang Hui , Wang Sun-Ying , Chen Hong-mei , Wu Zhi-Yong , Jiang Feng , Guo Yan-Song , ZHU PENG-LI 
Published: January 2020

Abstract
Introduction: DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods: We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results: Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUCDD=0.729 vs AUCMehran=0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95％CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion: Admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.
Conserved associations between G-quadruplex-forming DNA motifs and virulence gene families in malaria parasites
Authors: Gage Hunter L. , Merrick Catherine J. 
Published: January 2020

Abstract
Background: The Plasmodium genus of malaria parasites encodes several families of antigen-encoding genes. These genes tend to be hyper-variable, highly recombinogenic and variantly expressed. The best-characterized family is the var genes, exclusively found in the Laveranian subgenus of malaria parasites infecting humans and great apes. Var genes encode major virulence factors involved in immune evasion and the maintenance of chronic infections. In the human parasite P. falciparum, var gene recombination and diversification appear to be promoted by G-quadruplex (G4) DNA motifs, which are strongly associated with var genes in P. falciparum. Here, we investigated how this association might have evolved across Plasmodium species – both Laverania and also more distantly related species which lack vars but encode other, more ancient variant gene families. Results: The association between var genes and G4-forming motifs was conserved across Laverania, spanning ~1 million years of evolutionary time, with suggestive evidence for evolution of the association occurring within this subgenus. In rodent malaria species, G4-forming motifs were somewhat associated with pir genes, but this was not conserved in the Laverania, nor did we find a strong association of these motifs with any gene family in a second outgroup of avian malaria parasites. Secondly, we compared two different G4 prediction algorithms in their performance on extremely A/T-rich Plasmodium genomes, and also compared these predictions with experimental data from G4-seq, a DNA sequencing method for identifying G4-forming motifs. We found a surprising lack of concordance between the two algorithms and also between the algorithms and G4-seq data. Conclusions: G4-forming motifs are uniquely strongly associated with Plasmodium var genes, suggesting a particular role for G4s in recombination and diversification of these genes. Secondly, in the A/T-rich genomes of Plasmodium species, the choice of prediction algorithm may be particularly influential when studying G4s in these important protozoan pathogens.