bluuebunny/crossref_metadata_2025_split huggingface dataset:
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: August 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 was used 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 (3224) for the respondents and US$ 1355 (3993) for the family members. The mean utility values using EQ-5D-3L and VAS methods were 0.779 and 0.800, respectively. The WTP for the additional QALY gained by the individual participants using the EQ-5D-3L and VAS methods were respectively US$ 1202 and US$ 1101, while the estimated value of the family members was US$ 1355 (SD= 3993). 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. Besides, education level and monthly income 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 rage of 0.20 to 0.24 of Iran’s gross domestic product (GDP) per capita, which 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.
Acute Flaccid Paralysis: A Registry-based Study of Demographic, Clinical, and Diagnostic Characteristics of Children in a Referral Center in Iran
Authors: Tavasoli Ali Reza , Pazouki Roxana , Hosseinpour Sareh , Ashrafi Mahmoud Reza , Akbari Masood Ghahvechi , Rezaei Sanaz , Parvaneh Nima , Vafaee-Shahi Mohammad , Mohammadi Bahram , Abdi Alireza , Bagheri Sayna 
Published: August 2020

Abstract
Background: Acute Flaccid Paralysis(AFP) is a clinical syndrome characterized by acute progressive weakness in limbs and respiratory and swallowing muscles. Etiologies of AFP mostly include infections in anterior horn cells of the spinal cord, Guillain-Barre syndrome(GBS), transverse myelitis, viral myositis, myasthenia gravis and botulism. An accurate and early diagnosis of AFP is crucial. The aims of this study were to determine the main etiologies and characteristics of AFP in children and also design a diagnostic approach for AFP based on a hospital-based registry system.Method: This retrospective, cross-sectional study is a five-years survey, from 2011 to 2016 in Children’s Medical Center as the main children referral hospital in Iran. Totally 118 patients who had met AFP ICD-10- CM and inclusion criteria were included. All clinical and Paracinical data were collected based on a prepared questionnaire for the study.Result: The mean age of the patients was 6.09 ± 3.60 years old. The most frequent underlying etiologies were GBS, viral myositis and Vaccine-Associated Paralytic Poliomyelitis(VAPP) accounting for 67.8%, 15.3% and 5% of the patients, respectively. In terms of preceding clinical symptoms coryza, fever and gastrointestinal symptoms were more common. The most common neurologic presenting symptom was motor dysfunction. Cerebrospinal fluid analysis mainly indicated increase level of protein in favor of GBS. Elevated Creatine kinase level with the mean of 2184 IU/L has been reported in patients with viral myositis. Brain imaging principally revealed normal results and spinal MRI findings were compatible with the diagnoses of GBS and transvers myelitis. All stool sample results for polio virus detection were negative.Conclusion: In this study, we determined the etiologies of AFP in Iranian children referred to Children’s Medical Center. Guillain-Barre syndrome, viral myositis, transverse myelitis and VAPP were the most common etiologies. We also recommended a diagnostic approach for AFP in pediatric population regards to main etiologies in emergency room of a children referral hospital.
Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events
Authors: Chen Xuemei , Wang Lin , Jiang Junying , Gao Yuanyuan , Zhang Rui , Zhao Xiaoyuan , Shen Tingwen , Dai Qi , Li Junrong 
Published: August 2020

Abstract
Objective: As one of the Magnetic resonance imaging (MRI) makers of cerebral small vessel disease (SVD), increasing evidences have showed that white matter hyperintensity (WMH) can predict the short-term outcome of acute ischemic stroke (AIS). It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, We investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods: Consecutive first-ever stroke patients(n=546)from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence. Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction,which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.
Quality of Life and Associated Factors Among Women With Obstetric Fistula in Ethiopia
Authors: Matiwos Biruktawit , Tesfaw Getachew , Belete Asmare , Abebaw Dessie , shumet shegaye 
Published: August 2020

Abstract
Background: The physical, emotional and social suffering associated with continuous leakage of urine has a profound impact on women quality of life. The aim of this study was to assess quality of life and associated factors among obstetric fistula patients in Ethiopia, has a significant role for further intervention. Objective: To assess quality of life and associated factors among obstetric fistula patients in Ethiopia, 2017. Methods: In this cross-sectional study, 289 women with obstetric fistula were recruited for interviews, using the systematic random sampling technique. The World Health Organization Quality of Life – Brief (WHOQOL-BREF) Version was used to assess quality of life. The Jacob perceived stigma scale and the Oslo-3 social support instruments were used to assess the factors. We computed simple and multiple linear regression analysis to assess factors associated with quality of life. P-value <0.05 was declared statistically significant.Result: Of 289 women studied, only 12.1% felt satisfied with their general state of health and quality of life. In the physical health domain, the mean quality of life score was 40.78±.78. In the psychological domain, the mean quality of life score was 39.96±.82. In the social and environmental domain, the mean quality of life score was 32.9±.95, 36.45±.8 respectively. Duration of incontinence (unstandard β=-3.8,95% CI(-6.95,-.62), patients coming for surgical procedure (β=-4.4, 95% CI(-7.64,-1.2), poor social support(β= -6.14, 95%CI (-8.8,-3.4), Co-morbid anxiety(β= -4, 95% CI (-7,-1.1) and depression(β=-9.2, 95% CI (-12,-6.4) were negatively associated with physical domain of quality of life. Co-morbid anxiety (β= -11,95% CI (-14.8,-7.3), employment(β= 9.1,95%CI(.5, 17.6), number of children(β= 2.1,95%CI(.8, 3.4), and depression(β= -6.3,95%CI(-9.7,-2.9) were associated with a psychological domain. Duration of incontinence (β=-8.1,95%CI(-12.82,-3.4), poor social support(β= -7.8(-12,-3.6), patients coming for surgical procedure (β= -12,95%CI(-17.4,-6.4) and co-morbid anxiety(β= -9.2,95%CI(-13.8, 4.5) were negatively associated with social domain of quality of life. Number of children present (β=2.4,95%CI(.82, 3.6), and poor social support(β= -5.5,95%CI(-9.5,-1.5) were significantly associated with an environmental domain of quality of life. Conclusion and recommendation: Co-morbid depression and anxiety, poor social support, duration of urine incontinence, employment, number of children, and duration of hospital stay were factors significantly associated with domains of QOL. Treating co-morbid depression and anxiety, strong social support and controlling urine incontinence is necessary to increase women’s domain of quality of life.
In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy - a prospective pilot study-
Authors: Ono Shoko , Nozaki Ayako , Matsuda Kana , Takakuwa Emi , Sakamoto Naoya , Watari Hidemichi 
Published: August 2020

Abstract
BackgrouundFor patients with any kind of atypical squamous intraepithelial lesion of the uterine cervix or vagina, colposcopy and punch biopsy are common procedures for histological determination following cytology. However, colposcopy-guided biopsy does not provide a high level of diagnostic accuracy. The aim of this study was to determine the usefulness of optical biopsy in vivo using endocytoscopy compared with conventional procedures using colposcopy.MethodsBetween May 2018 and March 2019, patients who were scheduled for cervical conization or mapping biopsies of the vagina were prospectively enrolled. Endocytoscopy was performed by senior endoscopists prior to scheduled procedures, and endocytoscopic images and biopsy samples were taken from the most prominent site and surrounding area of the cervical or vaginal lesions. The collection process of images was randomized and anonymous, and three doctors separately evaluated the images according to the ECA classification. ECA 4 and 5 are indicative of endoscopic malignancy. The primary endpoint was diagnostic accuracy (benign or malignant: cervical intraepithelial neoplasia (CIN) 3 or vaginal intraepithelial neoplasia (VAIN) 3 or worse) of cell images at the most prominent site in each patient.ResultsA total of 28 consecutive patients were enrolled. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endocytoscopic images were 95.0% (84.8-98.6%), 87.5% (61.9-96.5%), 95.0% (84.8-98.6%), 87.5% (61.9-96.5%) and 92.9% (78.2-98.0%), respectively. Inter-observer agreement among three reviewers was 0.78 (0.08-9.88, P < 0.01). On the other hand, the accuracy of colposcopy-guided biopsy was 74.1% (64.0-84.0%).ConclusionsOptical cell diagnosis of cervical or vaginal intraepithelial neoplasia using endocytoscopy provides a high level of diagnostic accuracy.Trial registrationThe study was registered with the UMIN database (ID: 000031712).UMIN000031712. Registered 16 March 2017, https://rctportal.niph.go.jp/detail/um?trial_id=UMIN000031712
Cause and incidence of Cancellation of elective surgeries at Gondar University hospital, Ethiopia
Authors: Nigatu Yonas Addisu , Aytolign Habitu Adane 
Published: August 2020

Abstract
Background: High rates of cancellation of surgical procedures are common in hospital settings which may subsequently lead to economic loss to hospital besides burden given to patients, their families and medical teams .It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload and wastes operating room time.Cancellation of elective surgical procedures also causes significantly emotional trauma to the patients as well as their families and the community in general, and its impact on hospital resources is great due to prolonged hospitalization and high cost of health care.The aim of this study was to find the causes and incidence of surgical patient cancellation at Gondar university hospital, North-west Ethiopia.Methods: prospective observational study was conducted from January 10 to April 10, 2019. Information regarding the cancellation of surgeries were collected from various sources including; the operating room daily surgical schedule, preoperative anaesthesia record sheet, primary physicians, the anaesthetist responsible for the preoperative assessment and conducting the case and by communicating patients if required. Data were checked on daily basis for completeness and were entered to Epi info and analyzed using statistical package for social sciences (SPSS) version 20 software.Result: There were 64 causes of case cancellation. The commonest reasons for cancellation were overbooking of elective surgeries (33.13%).Conclusion: Preventable causes of case cancellation were the most prominent.
Research practices and research misconduct
Authors: Kalichman Michael 
Published: August 2020

Abstract
Background: Research on research integrity has tended to focus on frequency of research misconduct and factors that might induce someone to commit research misconduct. A definitive answer to the first question has been elusive, but it remains clear that research misconduct occurs too often. Answers to the second question are so diverse, it might be productive to ask a different question: What about how research is done allows research misconduct to occur? Methods: With that question in mind, research integrity officers (RIOs) of the 62 members of the American Association of Universities were invited to complete a brief survey about their most recent instance of a finding of research misconduct. Respondents were asked whether one or more good practices of research (e.g., openness and transparency, keeping good research records) were present in their case of research misconduct. Results: Twenty-four (24) of the respondents (39% response rate) indicated they had dealt with at least one finding of research misconduct and answered the survey questions. Over half of these RIOs reported that their case of research misconduct had occurred in an environment in which at least nine of the ten listed good practices of research were deficient. Conclusions: These results are not evidence for a causal effect of poor practices, but it is noteworthy that good research practices such as those listed would make it more difficult if not impossible for someone in such an environment to commit research misconduct.
Gut Microbes and Microbial Metabolites in Colorectal Cancer Complicat Ed With Different Serum Albumin Levels
Authors: Han Shuwen , Wu Wei , Da Miao , Zhou Qing , Xu Jiamin , Zhuang Jing , Liu Jin , Yang Xi 
Published: August 2020

Abstract
Background: Patients with colorectal cancer (CRC) are at risk of malnutrition. Gut microbes and microbial metabolites are involved in the initiation and development of CRC.Aims: To investigate serum protein levels in CRC patients and explore the role of gut microbes and microbial metabolites in CRCs complicated with different serum albumin levels.Methods: Overall, 398 CRC patients and same number of healthy volunteers in Huzhou Central Hospital from January 2016 to December 2018 were recruited to compare serum protein levels. A total of 30 and 56 stool samples from CRC patients were used to detect intestinal microbes and microbial metabolites, respectively. Bacterial 16S V3-V4 and fungal ITS ribosomal DNA genes were sequenced and gas chromatography/mass spectrometry (GC/MS) was performed to detect microbial metabolites. Results: Some serum protein-related indicators in the CRC group were lower than those in the control group (p＜0.05). The total protein and albumin levels in colon cancer patients were lower than those in rectal cancer patients (p＜0.05). The higher abundance of Sutterella is correlated with lower serum albumin level in CRCs. There were statistically significant differences in the abundance of fungi including Agaricomycetes， Simplicillium, Sclerotiniaceae, and Exophiala among patients with different serum albumin levels. Multiple gut bacteria and fungi are closely related to serum albumin levels.We found some characteristic microbial metabolites in CRCs complicated with different serum protein levels.Conclusions: The different serum albumin levels were associated with the gut microbes and microbial metabolites in CRCs.Trial registration: Correlation analysis of intestinal flora and its metabolites with tumor nutritional status in patients with colorectal cancer,ChiCTR1900022460,Registered 12 April 2019,http://www.chictr.org.cn/edit.aspx?pid=37950&htm=4
Correlation Between Psychological Rumination and Symptoms of Traumatic Stress in Patients with Mild Paralysis in Acute Phase of Stroke: A Cross-sectional Study
Authors: Okihara Tetsuya , Koizumi Kohei , Takahashi Hidetoshi , Suzuki Mayumi , Takeda Tomonori , Ishioka Toshiyuki , Hamaguchi Toyohiro , Makita Shigeru 
Published: August 2020

Abstract
Background: Research shows that post-traumatic stress symptoms (PTSS) are common in survivors of acute life-threatening illnesses, and rumination is considered to be associated with PTSS. Additionally, post-stroke symptoms of post-traumatic stress disorder (sPTSD) usually manifest as a type of anxiety disorder after a stroke. This study investigated the prevalence of sPTSD and the relationship between PTSS and rumination.Methods: The participants comprised 29 patients admitted to the Saitama Medical University International Medical Center within one week after experiencing a stroke. The Impact of Event Scale-Revised Japanese version (IES-R-J) and Leuven Adaptation of the Rumination on Sadness Scale Japanese version (LARSS-J) were employed for the evaluation of PTSS, sPTSD, and rumination.Results: The 29 patients (15 males, mean age: 63 ± 11 years) were classified as follows: 17 patients with cerebral infarction, 10 patients with cerebral hemorrhage, and 2 patients with subarachnoid hemorrhage. The ratio of persons with sPTSD (IES-R-J total score > 25) was 34% (10 patients). A significant positive correlation was found between PTSS and rumination (r = 0.460, p < 0.05).Conclusion: The findings indicated that approximately 30% of acute stroke patients experienced sPTSD, and that the severity of PTSS is related to rumination.
A Novel Frameshift Mutation in F9 in a Mixed Breed Dog With Clinical Hemophilia B
Authors: Ryke Erica , Nath Shefali , Chu Erin 
Published: August 2020

Abstract
A male mixed breed dog with clinical Hemophilia B was tested with a direct-to-consumer dog genomics service. After being genotyped as “normal” at three previously published Hemophilia B variants, all coding regions of the dog’s F9 gene were sequenced. A single basepair deletion in exon 5 of F9 led to a frameshift mutation leading to a premature truncation of FIX, including loss of the catalytic domain. The dam for this individual is a Great Pyrenees suggesting this X chromosome variant could segregate within the Great Pyrenees and possibly related breeds. The discovery of this novel variant could be applicable to the Great Pyrenees community should hemophiliac Great Pyrenees be observed at appreciable frequency and emphasizes the utility of genetic testing in mixed breed dogs.
Determinants of Post-Operative Cognitive Decline in Elderly People
Authors: Cartailler Jerome , Loyer Camille , Vanderlynden E. , Nizard Remy , Rabuel Christophe , Baumann Laurence Coblentz , Hourregue Claire , Dumurgier Julien , Paquet Claire 
Published: August 2020

Abstract
Background: Surgery and anesthesia can result in temporary or permanent deterioration of the cognitive functions, for which causes remain unclear. In this pilot study, we analyzed the determinants of cognitive decline following a non-emergency elective prosthesis implantation surgery for hip or knee.Methods: Prospective single-center study investigating psychomotor response time and changes in MoCA scores between the day before (D-1) and 2 days after (D+2) following surgery in Lariboisière Hospital (Paris, France). 60 patients (71.9±7.1-year-old, 72% women) were included. Collected data consisted in sociodemographic data, treatment, comorbidities and type of anesthesia (local, general or both). Furthermore, we evaluated pain and well-being before as well as after the surgery using point scales. Findings: Post-operative (D+2) MoCA scores were significantly lower than pre-operative ones (D-1) with a difference of 2.25+3.0pts (p=0.004), we found no significant difference between locoregional and general anesthesia. Pre-operative benzodiazepine or anticholinergic treatment were also associated to a drop in MoCA scores (p=0.023). Finally, the use of ketamine during anesthesia (p=0.034) and the well-being (p=0.023) evaluated before intervention, were both linked to a reduced cognitive impact.Discussion: In this pilot study, we observed a post-operative short-term cognitive decline following a lower limb surgery. We also identified pre and perioperative independent factors linked to cognitive decline following surgery. In a next stage, a larger cohort should be used to confirm the impact of these factors on cognitive decline.