bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using machine learning of clinical data to diagnose COVID-19: a systematic review and meta-analysis
Authors: Li Wei Tse , Ma Jiayan , Shende Neil , Castaneda Grant , Chakladar Jaideep , Tsai Joseph C. , Apostol Lauren , Honda Christine O. , Xu Jingyue , Wong Lindsay M. , Zhang Tianyi , Lee Abby , Gnanasekar Aditi , Honda Thomas K. , Kuo Selena Z. , Yu Michael Andrew , Chang Eric Y. , Rajasekaran Mahadevan “ Raj” , Ongkeko Weg M. 
Published: September 2020

Abstract
Background
The recent Coronavirus Disease 2019 (COVID-19) pandemic has placed severe stress on healthcare systems worldwide, which is amplified by the critical shortage of COVID-19 tests.

Methods
In this study, we propose to generate a more accurate diagnosis model of COVID-19 based on patient symptoms and routine test results by applying machine learning to reanalyzing COVID-19 data from 151 published studies. We aim to investigate correlations between clinical variables, cluster COVID-19 patients into subtypes, and generate a computational classification model for discriminating between COVID-19 patients and influenza patients based on clinical variables alone.

Results
We discovered several novel associations between clinical variables, including correlations between being male and having higher levels of serum lymphocytes and neutrophils. We found that COVID-19 patients could be clustered into subtypes based on serum levels of immune cells, gender, and reported symptoms. Finally, we trained an XGBoost model to achieve a sensitivity of 92.5% and a specificity of 97.9% in discriminating COVID-19 patients from influenza patients.

Conclusions
We demonstrated that computational methods trained on large clinical datasets could yield ever more accurate COVID-19 diagnostic models to mitigate the impact of lack of testing. We also presented previously unknown COVID-19 clinical variable correlations and clinical subgroups.
Medication reviews in hospitalized patients: a qualitative study on perceptions of primary and secondary care providers on interprofessional collaboration
Authors: Walraven Bregje , Ponjee Godelieve , Heideman Wieke , Çarkit Fatma Karapinar 
Published: September 2020

Abstract
Background
In-hospital medication reviews are regularly performed. However, discontinuity in care could occur because secondary care providers lack insight into the outpatient history. Furthermore, for the implementation or follow-up of some medication review-based interventions, the help of primary care providers is essential. This requires interprofessional collaboration between secondary and primary care. Therefore, the aim of this qualitative study was to gain insight into the perceptions of primary and secondary care providers on interprofessional collaboration on medication reviews in hospitalised patients.

Methods
Ten face-to-face semi-structured interviews and three focus group discussions were conducted with 20 healthcare providers from three hospitals and community health services. The interviews were aimed at exploring general practitioners’, community pharmacists’, geriatricians’, and hospital pharmacists’ experiences, attitudes, and views of interprofessional collaboration. Focus groups consisted of representatives of all professional groups. Through group discussion, interprofessional collaboration was explored by addressing three main questions: 1) What are the benefits of in-hospital medication reviews? 2) What are the barriers to in-hospital medication reviews from an interprofessional collaboration perspective? 3) Given the barriers mentioned, how should this interprofessional collaboration between primary and secondary care be designed? Data were analysed using a thematic-content approach.

Results
The need for in-hospital medication reviews was underlined due to their many benefits, such as reducing potentially preventable re-admissions. Barriers regarding interprofessional collaboration between primary and secondary care can be subdivided into three main themes: 1) defining in-hospital medication reviews (e.g., lack of clear goals), 2) execution of medication reviews (e.g., hospital setting is dynamic), and 3) follow-up after discharge (e.g., unclear instructions). Care providers suggested solutions for each of the barriers mentioned, for example, by using supportive staff in order to overcome the gap between primary and secondary care providers and making clear agreements on proper means of communication.

Conclusion
Primary and secondary care providers recognise the importance of in-hospital medication reviews and the need for interprofessional collaboration. To create satisfying interprofessional collaboration, conditions should be met on defining in-hospital medication reviews across settings and involving both primary and secondary care providers in implementing medication reviews and organising their follow-up.
The perceived behavior and barriers of community care professionals in encouraging functional activities of older adults: the development and validation of the MAINtAIN-C questionnaire
Authors: Vogel Ruth G. M. , Bours Gerrie J. J. W. , Metzelthin Silke F. , Erkens Petra M. G. , van Breukelen Gerard J. P. , Zwakhalen Sandra M. G. , van Rossum Erik 
Published: September 2020

Abstract
Background
Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version.

Methods
Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach’s alpha coefficients.

Results
The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach’s alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients’ context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83).

Conclusions
The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.
Molecular prevalence of emerging Anaplasma and Ehrlichia pathogens in apparently healthy dairy cattle in peri-urban Nairobi, Kenya
Authors: Peter Shepelo Getrude , Aboge Gabriel Oluga , Kariuki Hellen Wambui , Kanduma Esther Gathoni , Gakuya Daniel Waweru , Maingi Ndichu , Mulei Charles Matiku , Mainga Alfred Omwando 
Published: September 2020

Abstract
Background
Anaplasma and Ehrlichia species are tick-borne pathogens of both veterinary and public health importance. The current status of these pathogens, including emerging species such as Ehrlichia minasensis and Anaplasma platys, infecting cattle in Kenya, remain unclear, mainly because of limitation in the diagnostic techniques. Therefore, we investigated the Anaplasma and Ehrlichia species infecting dairy cattle in Nairobi, Kenya using molecular methods.

Results
A total of 306 whole blood samples were collected from apparently healthy dairy cattle. Whole blood DNA was extracted and tested for presence of Anaplasma and Ehrlichia DNA through amplification and sequencing of the 16S rDNA gene. Sequence identity was confirmed using BLASTn analysis while phylogenetic reconstruction was performed to determine the genetic relationship between the Kenyan isolates and other annotated genotypes available in GenBank. Anaplasma and Ehrlichia species were detected in 19.9 and 3.3% of all the samples analyzed, respectively. BLASTn analysis of the sequences against non-redundant GenBank nucleotide database revealed infections with A. platys (44.8%), A. marginale (31%) and A. bovis (13.8%). All four sequenced Ehrlichia spp. were similar to Ehrlichia minasensis. Nucleotide polymorphism was observed for A. platys, A. bovis and E. minasensis. The Anaplasma species clustered in four distinct phylogenetic clades including A. marginale, A. platys, A. bovis and some unidentified Anaplasma spp. The Kenyan Ehrlichia minasensis clustered in the same clade with isolates from America and Australia but distant from E. ruminantium.

Conclusion
This study provides the first report of infection of dairy cattle in Kenya with A. platys and E. minasensis, which are emerging pathogens. We conclude that cattle in peri-urban Nairobi are infected with various species of Anaplasma and E. minasensis. To understand the extent of these infections in other parts of the country, large-scale screening studies as well as vector identification is necessary to inform strategic control.
Expression of SARS-CoV-2 entry receptors in the respiratory tract of healthy individuals, smokers and asthmatics
Authors: Matusiak Magdalena , Schürch Christian M. 
Published: September 2020

AbstractSARS-CoV-2 is causing a pandemic with currently > 29 million confirmed cases and > 900,000 deaths worldwide. The locations and mechanisms of virus entry into the human respiratory tract are incompletely characterized. We analyzed publicly available RNA microarray datasets for SARS-CoV-2 entry receptors and cofactorsACE2,TMPRSS2,BSG (CD147)andFURIN. We found thatACE2andTMPRSS2are upregulated in the airways of smokers. In asthmatics,ACE2tended to be downregulated in nasal epithelium, andTMPRSS2was upregulated in the bronchi. Furthermore, respiratory epithelia were negative for ACE-2 and TMPRSS2 protein expression while positive for BSG and furin, suggesting a possible alternative entry route for SARS-CoV-2.
Artificial intelligence accuracy in detecting pathological breath sounds in children using digital stethoscopes
Authors: Kevat Ajay , Kalirajah Anaath , Roseby Robert 
Published: September 2020

Abstract
Background
Manual auscultation to detect abnormal breath sounds has poor inter-observer reliability. Digital stethoscopes with artificial intelligence (AI) could improve reliable detection of these sounds. We aimed to independently test the abilities of AI developed for this purpose.

Methods
One hundred and ninety two auscultation recordings collected from children using two different digital stethoscopes (Clinicloud™ and Littman™) were each tagged as containing wheezes, crackles or neither by a pediatric respiratory physician, based on audio playback and careful spectrogram and waveform analysis, with a subset validated by a blinded second clinician. These recordings were submitted for analysis by a blinded AI algorithm (StethoMe AI) specifically trained to detect pathologic pediatric breath sounds.

Results
With optimized AI detection thresholds, crackle detection positive percent agreement (PPA) was 0.95 and negative percent agreement (NPA) was 0.99 for Clinicloud recordings; for Littman-collected sounds PPA was 0.82 and NPA was 0.96. Wheeze detection PPA and NPA were 0.90 and 0.97 respectively (Clinicloud auscultation), with PPA 0.80 and NPA 0.95 for Littman recordings.

Conclusions
AI can detect crackles and wheeze with a reasonably high degree of accuracy from breath sounds obtained from different digital stethoscope devices, although some device-dependent differences do exist.
A comparison of global surgery tariffs and the actual cost of bills at Hazrate Rasoole Akram educational and medical center
Authors: Aboutorabi Ali , Radinmanesh Maryam , rezapour Aziz , afshari Mahnaz , taheri Ghasem 
Published: September 2020

Abstract
Background
the health service tariff is an appropriate policymaking tool and the financial leverage of the health system control which affects quality, availability, cost, efficiency, equity and accountability of health services. Global surgeries include 91 common cases of general and specialized surgeries in hospitals; fixed tariffs are annually defined for these surgeries, and insurance companies must pay medical centers based on these tariffs. The aim of this study was to examine and compare hospital bills with global surgery tariffs at Hazrate Rasoole Akram Educational and Medical Center in 2017.

Methods
This descriptive-analytic study was conducted retrospectively and compared the global and actual costs of global surgeries performed in the third quarter of the year 2017 at Hazrate Rasoole Akram Educational and Medical Center. Required data on the actual costs of surgeries was collected through the Hospital Information System (HIS) and patients’ records. Information on the global costs was obtained from the Annual Circulars of Insurance Council for the studied period about the cost of global surgeries. Linear regression (STATA13 software) was used to investigate the effect of items on tariff and invoice differences; concerning other calculations, EXCEL software was used.

Results
The highest frequency of global surgeries was related to ophthalmic surgery which accounted for approximately half of total surgeries performed at Hazrate Rasoole Akram Hospital. The most significant difference between global tariff and invoice was also related to ophthalmic surgery (188709.3 Dollar a year).Overall, the actual hospital bills were much higher than the tariffs approved for global surgeries, and the total difference was 461805.5 Dollar. The results revealed that there was a significant relationship between some of the items such as the cost of operating rooms, anesthesia and other services.

Conclusions
Referral hospitals which are at the level three of referral networks usually treat more complex patients; this should be taken into account when defining surgery tariffs of these centers. On the other hand, hospitals need to control the costs and reduce the end cost of these surgeries by improving clinical management and cost management. In addition, prospective and case-based payment methods can control health costs.
Associations between breastfeeding and cognitive function in children from early childhood to school age: a prospective birth cohort study
Authors: Kim Kyoung Min , Choi Jae-Won 
Published: September 2020

AbstractBackgroundDespite evidences of breastfeeding for preventing acute physical illnesses in infants, the evidence for the association between breastfeeding and long-term cognitive development is not yet convincing.MethodsThe data of nationwide representative sample of 1752 children born between 2008 and 2009 in Korea were prospectively assessed from the fetal period to examine the benefits of breastfeeding and cognitive development. Breastfeeding duration was prospectively assessed by parents. The Korean Ages and Stages Questionnaire and the Korean version of Denver II were used to assess early development annually from 5.5 to 26.2 months of age. Language development at 3 years of age was assessed with Receptive and Expressive Vocabulary Tests. Cognitive function at 8 years of age was assessed using multifactorial intelligence test.ResultsIn the analysis of categorical variables, children who were breastfed for > 1 and ≤ 3 months displayed significantly higher odds ratios for delayed development assessed with Korean Ages and Stages Questionnaire at 14.1 months than those breastfed for > 3 and ≤ 6 months (OR = 2.21; 95% CI: 1.08, 4.50), but no significant differences in other rounds of assessments. In the analysis with continuous variables, there were significant differences among six groups of breastfeeding duration in communication (F = 3.72;p < 0.002) and problem solving (F = 3.09;p < 0.009) at 14.1 months, expressive language (F = 3.74;p = 0.002) at 3 years, and calculation (F = 2.43;p < 0.033) at 8 years. When analyzed by two groups, children breastfed for > 3 months scored significantly higher on the communication (F = 17.71;p < 0.001) and problem-solving (F = 11.26;p < 0.001) subscales at 14.1 months, and expressive language (F = 12.85;p < 0.001) at 3 years, and vocabulary (F = 6.78;p = 0.009) and language inference (F = 5.62;p = 0.018) at 8 years, compared to children breastfed for 3 months or less.ConclusionWe found that cognitive development was improved in children that were breastfed for > 3 months. Although these results are supported by previous studies, it is important to note that other factors were reported as larger determinants of cognitive development than breastfeeding. Future studies that examine the underlying mechanism for the association between breastfeeding and cognitive development are warranted.
Iatrogenic acute aortic dissection caused by intervention for spontaneous coronary artery dissection: a surgical case report
Authors: Hayashi Yuki , Taoka Makoto , Osaka Shunji , Unosawa Satoshi , Tanaka Masashi 
Published: September 2020

Abstract
Background
Iatrogenic acute aortic dissection (AAD) caused by cardiovascular intervention is rare. Also rare is spontaneous coronary artery dissection (SCAD), a form of acute coronary syndrome, which develops in relatively young women without coronary risk factors. We encountered type A iatrogenic AAD caused by an intervention for SCAD.

Case presentation
A 53-year-old woman was brought to our hospital after cardiopulmonary resuscitation. She was diagnosed with acute coronary syndrome caused by SCAD, and percutaneous coronary intervention was carried out on her distal left anterior descending artery. The dissection proceeded to the proximal left anterior descending artery and left main coronary artery trunk, so additional percutaneous coronary intervention was performed on the left circumflex artery. After the intervention, type A AAD occurred with a primary entry tear from the left main coronary artery trunk, and computed tomography showed a type A AAD of the aortic arch. We performed emergency ascending aorta replacement and coronary artery bypass grafting to the left anterior descending artery and left circumflex artery. The patient had an uneventful recovery after the operation and was discharged on postoperative day 25.

Conclusion
To our knowledge, this is the first report of an iatrogenic AAD caused by percutaneous coronary intervention for SCAD.
Specific DNA mini-barcoding for identification of Gekko gecko and its products
Authors: Su Yanyan , Ding Dandan , Yao Mengjie , Wu Lan , Dong Gangqiang , Zhang Dong , Chen Shilin , Xiang Li 
Published: September 2020

Abstract
Background
The dry body of the Tokay Gecko (Gekko gecko) is the source of a valuable traditional Chinese medicine, it is therefore listed as a Class II protected animal species in China. Due to increasing market demand and a declining supply of the species, a considerable number of adulterants have emerged in the market. Thus, it is necessary to establish an accurate and rapid method of identification for distinguishing G. gecko from its adulterants and for separating it from highly processed products.

Methods
A total of 274 COI sequences were analyzed by using MEGA 5.0 software. Several specific primers were designed to amplify mini-barcode regions and identify G. gecko from its counterfeits and products.

Results
274 COI sequences of G. gecko and 15 adulterants species were analyzed. G. gecko could be distinguished from its adulterants through BLAST analysis, intra- and inter-specific distance analyses, and an NJ tree based on COI sequences. Two pairs of specific primers designed for this study, COISF2/COISR2 and COISF3/COISR3, amplified 200- and 133-bp fragments of the COI region, respectively, both of which were suitable for the identification of G. gecko and its adulterants. Furthermore, COISF3/COISR3 detected G. gecko in 15 batches of products.

Conclusion
Therefore, the specific DNA mini-barcoding method developed here may be a powerful tool for the identification of G. gecko and counterfeits, and may also be used to distinguish G. gecko from its highly processed by-products.
Predicting complete cytoreduction for advanced ovarian cancer patients using nearest-neighbor models
Authors: Laios Alexandros , Gryparis Alexandros , DeJong Diederick , Hutson Richard , Theophilou Georgios , Leach Chris 
Published: September 2020

Abstract
Background
The foundation of modern ovarian cancer care is cytoreductive surgery to remove all macroscopic disease (R0). Identification of R0 resection patients may help individualise treatment. Machine learning and AI have been shown to be effective systems for classification and prediction. For a disease as heterogenous as ovarian cancer, they could potentially outperform conventional predictive algorithms for routine clinical use. We investigated the performance of an AI system, the k-nearest neighbor (k-NN) classifier, to predict R0, comparing it with logistic regression. Patients diagnosed with advanced stage, high grade serous ovarian, tubal and primary peritoneal cancer, undergoing surgical cytoreduction from 2015 to 2019, was selected from the ovarian database. Performance variables included age, BMI, Charlson Comorbidity Index, timing of surgery, surgical complexity and disease score. The k-NN algorithm classified R0 vs non-R0 patients using 3–20 nearest neighbors. Prediction accuracy was estimated as percentage of observations in the training set correctly classified.

Results
154 patients were identified, with mean age of 64.4 + 10.5 yrs., BMI of 27.2 + 5.8 and mean SCS of 3 + 1 (1–8). Complete and optimal cytoreduction was achieved in 62 and 88% patients. The mean predictive accuracy was 66%. R0 resection prediction of true negatives was as high as 90% using k = 20 neighbors.

Conclusions
The k-NN algorithm is a promising and versatile tool for R0 resection prediction. It slightly outperforms logistic regression and is expected to improve accuracy with data expansion.