bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular characterization of the viral structural gene of the first dengue virus type 2 outbreak in Hunan Province, inland China
Authors: Guan Jiaoqiong , He Zhanlong , Qin Meng , Deng Xialin , Chen Jun , Duan Suqin , Gao Xiaojun , Pan Yue , Chen Junying , Yang Yaping , Feng Shijun , Sun Qiangming 
Published: January 2020

Abstract
Background: An unexpected dengue outbreak occurred in the Hunan Province in 2018. This is the first dengue outbreak in this area of inland China resulting 172 infected. Methods: To verify the causative agent of this outbreak and investigate gene characterization, the structural protein C/prM/E genes of viruses isolated from local residents were sequenced followed by mutation, phylogenetic analysis. The recombination, selection pressure, potential secondary structure and three-dimensional structure analysis were also performed. Results: Phylogenetic analysis revealed that all epidemic strains were classified as the cosmopolitan DENV-2 genotype, closest to the Zhejiang strain (MH010629, 2017) and then Malaysia strain (KJ806803, 2013). Compared with the DENV-2SS, 151 base substitutions were found in 89 sequences of isolates, resulting in 20 nonsynonymous mutations, of which 17 mutations existed among all samples (two in capsid protein, six in prM/M, and nine in envelope proteins). Moreover, amino acid substitutions at 602 th (E322:Q→H) and 670 th (E390: N→S) may result in heightened virulence of the epidemic strains. One new DNA-binding site and five new protein binding sites were observed. Two polynucleotide-binding sites and seven protein binding sites were lost compared with DENV-2SS. Meanwhile, five changes were found in helix regions. The helical transmembrane and disordered regions have minor changes. Protein tertiary structure prediction revealed the 429 th amino acid of E proteins was switch from histamine (positively charged) to asparagines (neutral) in 89 isolate strains. No recombination events or positive selection pressure sites were detected. To our knowledge, this study is the first gene analysis of epidemic strain in the first dengue outbreak in Hunan Province, inland China. Conclusions: The causative agent is likely to come from Zhejiang Province, a neighbouring Province where dengue fever broke out in 2017. This study may help understand the intrinsic geographical relatedness of DENV-2 and contributes further to research on pathogenicity and vaccine development.
Current Census of Oncology Critical Care Medicine in China
Authors: Wang Yao , Wang Changsong , Gao Yan , Hu Zhenjie , Wang Hongzhi , Ma Gang , Zhu Biao , Wang Donghao , Yu Kaijiang 
Published: January 2020

Abstract
Objective The purposes of this survey were to show the current situation of oncology critical care medicine in China, to understand the resource distribution of oncology critical care medicine, and to analyze and evaluate the existing resources and reserve capacity of oncology critical care medicine.Methods A general survey was conducted at the 36 member units of the Oncology Critical Care Medicine Committee of the Chinese Anti-cancer Association through e-mailed questionnaires. The census takers filled out the questionnaires with feedback. The survey covered 8 items: basic information on the hospital, basic profile of the ICU, personnel allocation, management status, technical skills, patient sources, equipment configuration and tumor- related treatment technology.Results The survey results involved information from 28 member units, all of which are tertiary hospitals, distributed in 20 provinces and 4 direct-controlled municipalities. The results are as follows. (1) The total ratio of ICU beds to hospital beds was 1.06%, and the average number of ICU beds was 16.36. (2) The ratio of ICU physicians to beds was approximately 0.62:1, and the ratio of nurses to beds was approximately 1.98:1. (3) According to the census of the population and GDP of different regions conducted by the State Statistics Bureau in 2017, the ratio of ICU beds for tumor patients to population was 4.55 beds per 10 million people, and the ratio of ICU beds to GDP was 8.00 beds per RMB 100 billion, on average. (4) The equipment configuration is relatively perfect, while the technical skills need to be improved.Conclusion The development of oncology critical care is becoming better, but there is still a certain gap compared with the ICU standards in China and the average level of the national ICU. It is urgent to develop oncology critical care medicine.
Modelling the impact of MAUP on environmental drivers for Schistosoma japonicum prevalence
Authors: Navas Andrea Araujo , Osei Frank , Magalhães Ricardo J. Soares , Leonardo Lydia R. , Stein Alfred 
Published: January 2020

Abstract
Background: The modifiable areal unit problem (MAUP) arises when the support size of a spatial variable affects the relationship between prevalence and environmental risk factors. Its effect on Schistosomiasis modelling studies could lead to unreliable parameter estimates. The present research aims to quantify MAUP effects on environmental drivers of Schistosoma japonicum infection by (i) bringing all covariates to the same spatial support, (ii) estimating individual-level regression parameters at 30 m, 90 m, 250 m, 500 m, and 1 km spatial supports, and (iii) quantifying the differences between parameter estimates using five models.Methods: We modelled the prevalence of Schistosoma japonicum using sub-provinces health outcome data and pixel-level environmental data. We estimated and compared regression coefficients from convolution models using Bayesian statistics. Results: Increasing the spatial support to 500 m gradually increased the parameter estimates and their associated uncertainties. Abrupt changes in the parameter estimates occur at 1 km spatial support, resulting in loss of significance of almost all the covariates. No significant differences were found between the predicted values and their uncertainties from the five models. We provide suggestions to define an appropriate spatial data structure for modelling that gives more reliable parameter estimates and a clear relationship between risk factors and the disease. Conclusions: Inclusion of quantified MAUP effects was important in this study on schistosomiasis. This will support helminth control programs by providing reliable parameter estimates at the same spatial support, and suggesting the use of an adequate spatial data structure, to generate reliable maps that could guide efficient mass drug administration campaigns.
Preventive health service coverage among infants and children at six maternal-child health clinics in western Kenya: A cross-sectional assessment
Authors: Deathe Andrew , Oyungu Eren , Ayaya Samuel O. , Ombitsa Ananda R. , McAteer Carole I. , Vreeman Rachel C. , McHenry Megan S. 
Published: January 2020

Abstract
BackgroundDespite the substantial reduction of child mortality in recent decades, Kenya still strives to provide universal healthcare access and to meet other international benchmarks for child health. This study aimed to describe child health service coverage among children visiting six Maternal and Child Health (MCH) clinics in western Kenya. MethodsIn a cross-sectional study of Kenyan young children (≤5 years) presenting to MCH clinics, child health records were reviewed to determine coverage of immunizations, growth monitoring, vitamin A supplementation, and deworming. Among 78 children and their caregivers, nearly 70% of children were fully vaccinated for their age. ResultsWe found a significant disparity in full vaccination coverage by gender (p = .017), as males had 3.5x higher odds of being fully vaccinated compared to females. Further, full vaccination coverage also varied across MCH clinic sites ranging from 43.8% to 92.9%. ConclusionsHealth service coverage for Kenyan children in this study is consistent with national and sub-national findings; however, our study found a significant gender equity gap in coverage at these six clinics that warrants further investigation to ensure that all children receive critical preventative services.
Tailoring the Determinants of Implementation Behaviour Questionnaire (DIBQ) to best-practice low back pain primary care program implementation: a mixed-methods validity-testing in Sweden and Denmark
Authors: Ris Inge , Schröder Karin , Kongsted Alice , Abbott Allan , Nilsen Per , Hartvigsen Jan , Öberg Birgitta 
Published: January 2020

Abstract
Background: Best-practice low back pain (LBP) primary care programs have been developed based on evidence-based clinical guidelines and are implemented in Sweden and Denmark. The Theoretical Domains Framework and its linkage to The Behavioural Change Wheel has been utilised in the design of the implementation object and its implementation strategy. Based on the Theoretical Domains Framework domains, the Determinants of Implementation Behaviour Questionnaire (DIBQ) has been developed to evaluate implementation determinants but its feasibility and validity needs to be tested and adapted to study specific contexts while maintaining its linkage to the Behavioural Change Wheel. The aim of this study was to tailor the DIBQ for evaluation of the implementation processes for best-practice LBP primary care programs in Sweden and Denmark. More specifically, the objectives were to i) Translate the DIBQ into Swedish and Danish, ii) Adapt the DIBQ into DIBQ-tailored (DIBQ-t) to study content validity, iii) Test the DIBQ-t for feasibility and iv) Perform initial validity testing of DIBQ-t. Methods: A mixed methods design with a four-step process was used. First, forward translation of the DIBQ, then adaptation into DIBQ-t using qualitative face validity assessed by the project group followed by quantitative content validity assessment by an expert group. Finally, primary care clinicians completed the DIBQ-t directly after participation in a 2-day educational course prior to the implementation of the program to determine feasibility and construct validity using confirmatory factor analyses. Results: In total 598 clinicians out of 609 responded, with only 2% of the items missing. The final DIBQ-t included 28 items describing 10 of the original 18 TDF domains and was considered feasible. The confirmatory factor analyses showed good fit after removing items 4 and 13 with the lowest domain loading. The DIBQ-t maintained linkage to all domains of the Capability–Opportunity-Motivation-Behaviour model within the Behavioural Change Wheel. The clinicians´ expectations according to the DIBQ-t indicate facilitating determinants outweighing barriers at the initiation of implementation processes. Conclusions: The study resulted in a tailored version of the DIBQ, DIBQ-t, which is feasible and valid for evaluating clinicians’ expectations regarding implementation determinants of best-practice LBP primary care programs.
Fenobody and RANbody-based sandwich enzyme-linked immunosorbent assay to detect Newcastle disease virus
Authors: Ji Pinpin , Zhu Jiahong , Li Xiaoxuan , Fan Wenqi , Liu Qianqian , Wang Kun , Zhao Jiakai , Sun Yani , Liu Baoyuan , Zhou En-Min , Zhao Qin 
Published: January 2020

Abstract
Background: Traditional sandwich enzyme-linked immunosorbent assay (ELISA) using polyclonal and monoclonal antibodies as reagents presents several drawbacks, including limited amounts, difficulty in permanent storage, and required use of a secondary antibody. Nanobodies can be easily expressed with different systems and fused with several tags in their tertiary structure by recombinant technology, thus offering an effective detection method for diagnostic purposes. Recently, the fenobody (ferritin-fused nanobody) and RANbody (nanobody-fused reporter) have been designed and derived from the nanobody for developing the diagnostic immunoassays. However, there was no report about developing the sandwich ELISA using the fenobody and RANbody as pairing reagents.Results: A platform for developing a sandwich ELISA utilizing fenobody as the capture antibody and RANbody as the detection antibody was firstly designed in the study. Newcastle disease virus (NDV) was selected as the antigen, from which 13 NDV-specific nanobodies were screened from an immunized Bactrian camel. Then, 5 nanobodies were selected to produce fenobodies and RANbodies. The best pairing of fenobodies (NDV-fenobody-4, 800 ng/well) and RANbodies (NDV-RANbody-49, 1:10) was determined to develop the sandwich ELISA for detecting NDV. The detection limits of the assay were determined to be 22 of hemagglutination (HA) titers and 10 ng of purified NDV particles. Compared with two commercial assays, the developed assay shows higher sensitivity and specificity. Meanwhile, it exhibits 98.7% agreement with the HA test and can detect the reference NDV strains belonging to Class II but not Class I. Conclusions: In the presented study, the 13 anti-NDV nanobodies binding the NDV particles were first produced. Then, for the first time, the sandwich ELISA to detect the NDV in the different samples has been developed using the fenobody and RANbody as reagents derived from the nanobodies. Considering the rapidly increasing generation of nanobodies, the platform can reduce the cost of production for the sandwich ELISA and be universally used to develop assays for detecting other antigens.
Severe infections following rituximab treatment in antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Li Zhi-Ying , Chen Min , Zhao Ming-Hui 
Published: January 2020

Abstract
Background: Severe infections were not rare in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients treated with rituximab. The current study aimed to evaluate severe infections in AAV patients received rituximab administration in a single Chinese center.Methods: Twenty-seven patients were retrospectively included in this study. Their demographic and clinical data were analyzed. Severe infections were classified as grade ≥3 as proposed by the Common Terminology Criteria for Adverse Events V.4.0.Results: Patients were followed up for 23.6±14.0 months from the time of rituximab initiation (mean rituximab dose 1270.4 mg). Ten severe infection events were recorded in 10 (37.0%) patients, corresponding to an event rate of 20.9 per 100 person-years. Pulmonary infections were the leading infectious complications (90%). Eight of the 10 infections occurred during the first 12 months of follow-up. In multivariable analysis, severe infection in the first year was independently associated with age (HR 1.121, 95% CI 1.011 to 1.243, P=0.031) and serum creatinine level (increased by per 88.4 μmol/L, HR 1.493, 95% CI 1.017 to 2.191, P=0.041).Conclusions: In AAV patients receiving rituximab, severe infections were common even with the low-dose regimen. Pulmonary infections were the leading cause, and most infections occurred during the first 12 months of follow-up. Older age and renal dysfunction were the risk factors for infection.
Classifying maternal deaths in Suriname using WHO ICD-MM: different interpretation by physicians, national and international maternal death review committees
Authors: Kodan Lachmi , Verschueren Kim J.C. , McCaw-Binns Affette M. , Fat Ray Tjon Kon , Browne Joyce L. , Rijken Marcus J. , Bloemenkamp Kitty W.M. 
Published: January 2020

Abstract
Background: Insight into the underlying causes of pregnancy-related deaths is essential to develop policies to avert preventable deaths. The WHO International Classification of Diseases-Maternal Mortality (ICD-MM) guidelines provide a framework for uniform classifications which enables comparison within and between countries and over time. However, despite using the guidelines, differences in classifying pregnancy-related deaths within and among countries remain. We evaluated consensus on maternal death classification using ICD-MM.Methods: Classification of the 2010-2014 pregnancy-related deaths in Suriname were compared (1) between the attending physician (death certificate/medical record) and the national maternal death review (MDR) committee; and (2) between MDR committees from Suriname, Jamaica and the Netherlands. All reviewers applied ICD-MM. The inter-rater reliability (Fleiss kappa [κ]) was used to measure agreement.Results: Nearly half (n=42) of the 89 cases reviewed by the Surinamese MDR committee were classified differently by the attending physicians. There was consensus among the three committees that 16 (18%) possible pregnancy-related deaths were not maternal, with opinions differing on 11 (15%, n=73) maternal deaths. Classification agreement into direct, indirect or unspecified (κ=0.53) and underlying cause attribution (κ=0.52) was moderate. The Dutch committee classified more maternal deaths as unspecified (19%), than the Jamaican (7%) and Surinamese MDR committees (4%). The Surinamese and Jamaican committees achieved better mutual agreement (κ=0.69) than Surinamese and the Dutch committees (κ=0.48). Agreement on the underlying cause category was best for abortive outcomes (κ=0.85) and obstetric hemorrhage (κ=0.74) and worst for unspecified (κ=0.29) and other direct causes (κ=0.32). Conclusions: Maternal death classification differs within Suriname and among MDR committees from different countries. Specific challenges applying ICD-MM included attribution of underlying cause when co-morbidities occur, inclusion of suicides, and maternal deaths occurring outside the country of residence.
Slc6a3-dependent expression of a CAPS-associated Nlrp3 allele results in progressive behavioral abnormalities and neuroinflammation in aging mice
Authors: von Herrmann Katharine M , Anderson Faith L , Martinez Eileen M , Young Alison L , Havrda Matthew C 
Published: January 2020

Abstract
Background An association between neuroinflammation and age-related neurologic disorders has been established but the molecular mechanisms and cell types involved have not been thoroughly characterized. Activity of the proinflammatory NLRP3 inflammasome is implicated in Alzheimer’s and Parkinson’s disease and our recent studies in patients suggest that dopaminergic neurons within the degenerating mesencephalon express NLRP3 throughout the progression of PD. Here, we directly test the impact of enhanced inflammasome activity in mesencephalic neurons by characterizing motor function, tissue integrity, and neuroinflammation in aging mice harboring hyper-activating mutations within the endogenous murine Nlrp3 locus, enabled only in cells expressing the dopamine neuron specific Slc6a3 promoter. Methods We compared mice harboring inducible alleles encoding the cryopyrin-associated periodic syndrome activating mutations Nlrp3A350V and Nlrp3L351P inserted into the endogenous mouse Nlrp3 locus. Tissue specific expression was driven by breeding these animals with mice expressing Cre recombinase under the control of the dopamine neuron specific Slc6a3 promoter. The experimental mice, designed to express hyperactive NLRP3 only when the endogenous mouse Nlrp3 promotor is active in dopaminergic neurons, were analyzed throughout 18 months of aging using longitudinal motor function assessments. Biochemical and histologic analyses of mesencephalic tissues were conducted in 1- and 18-month old animals. Results We observed progressive and significant deficits in motor function in animals expressing Nlrp3L351P, compared with animals expressing Nlrp3WT and Nlrp3A350V. Age-dependent neuroinflammatory changes in the mesencephalon were noted in all animals. Analysis of GFAP-immunoreactive astrocytes in the substantia nigra revealed a significant increase in astrocyte number in animals expressing Nlrp3L351P compared with Nlrp3WT and Nlrp3A350V. Further analysis of Nlrp3L351P striatal tissues indicated genotype specific gliosis, elevated Il1b expression, and both morphologic and gene expression indicators of proinflammatory A1 astrocytes. Conclusions Dopaminergic neurons have the potential to accumulate NLRP3 inflammasome activators with age, including reactive oxygen species, dopamine metabolites, and misfolded proteins. Results indicate the Nlrp3 locus is active in dopaminergic neurons in aging mice, and that the hyperactive Nlrp3L351P allele can drive neuroinflammatory changes in association with progressive behavioral deficits. Findings suggest neuronal NLRP3 inflammasome activity may contribute to neuroinflammation observed during normal aging and the progression of neurologic disorders.
Healthcare Service Use, Costs, and Treatment Patterns within a Cohort of Experienced and New Users of Preventive Migraine Medications
Authors: Bonafede Machaon , Sapra Sandhya , Tepper Stewart , Cappell Katherine , Desai Pooja 
Published: January 2020

Abstract
Background: Migraine is a debilitating disease associated with increased use of healthcare services. Pharmacological interventions include acute medications to reduce symptoms and restore patient functioning, and preventive migraine medications (PMM), to reduce frequency, duration, and intensity of migraine symptoms . This study examined treatment and associated healthcare service use and costs between PMM naïve and experienced patients.Methods: Migraine patients initiating treatment with a PMM from January 1, 2010-June 30,2014 were identified in the IBM MarketScan Commercial and Medicare Supplemental Databases. Migraine medication use, service utilization, and costs were examined over the 12 months following PMM initiation; outcomes were compared between patients experienced with and naïve to PMM treatment.Results: Adherence and persistence with PMMs was low, with only 24% of patients adherent to their index PMM. Rates of discontinuation were high, with 71.4% of the sample discontinuing their PMM over the 12-month follow up. Utilization of acute medications was common, as was PMM switching in experienced patients. Annual healthcare costs were $12,044 and $19,093 for the PMM naïve and experienced populations respectively. Migraine-specific service use accounted for approximately 20% of all-cause healthcare costs. The PMM experienced cohort consistently evidenced higher service use and costs than the PMM naïve cohort.Conclusion: Utilization of PMM remains suboptimal and is accompanied by both lack of PMM adherence and high use of acute medications. Rates of PMM switching and use of acute medications suggest that patients have unmet needs regarding migraine management. Improved treatment regimens that effectively manage migraine symptoms are needed to improve patient level of functioning while reducing healthcare costs associated with migraine management.