bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Application of Tools to Cost Delivery of Environmental Health Services in Healthcare Facilities: A Financial Analysis in Urban Malawi
Authors: Anderson Darcy , Cronk Ryan , Pak Emily , Fuente David , Tracy J. Wren , Mofolo Innocent , Hoffman Irving , Bartram Jamie 
Published: September 2020

Abstract
Background Environmental health services (EHS) in healthcare facilities (HCFs) are critical for providing a safe, functional healthcare environment, but little is known about their costs. Poor understanding of costs impedes progress towards universal access of EHS in HCFs. We developed frameworks of essential expenses that provide EHS and conducted an ex-post financial analysis of EHS in a network of medical research and training facilities in Lilongwe, Malawi serving an estimated 42,000 patients annually. Methods We estimated the cost of providing the following EHS: water, sanitation, hygiene, personal protective equipment use at the point of care, waste management, cleaning, laundry, and vector control. We developed frameworks of essential outputs and inputs for each EHS through review of international guidelines and standards, which we used to identify required expenses for EHS delivery and evaluate the completeness of costs data in our case study. For costing, we use a mixed-methods approach, applying qualitative interviews to understand facility context and review of electronic records to determine costs. We calculated initial costs to establish services and annual operations and maintenance.Results Available records contained little information on the upfront, capital costs associated with establishing EHS. Annual operations and maintenance totaled USD 220,427 for all EHS, although costs of essential inputs were missing from records. Annual operations and maintenance costs were highest for cleaning (USD 69,372) and waste management (USD 46,752).Discussion Missing expenses suggests that documented costs are substantial underestimates. Costs to establish services were missing predominantly because purchases pre-dated electronic records systems. Annual operations and maintenance costs are incomplete primarily because administrative records did not record sufficient detail to disaggregate and attribute expenses. Conclusions Electronic health information systems have potential to support efficient data collection. However, we found that existing records systems were decentralized and poorly suited to identify EHS costs. Our research suggests a need to better code and disaggregate EHS expenses to properly leverage records for costing. Frameworks developed in this study are a potential tool to develop more accurate estimates of the cost of providing EHS in HCFs.
Design and Psychometric Evaluation of Mothers' Perception of Postpartum Care in Comprehensive Health Centers
Authors: Vizeshfar Fatemeh , Ahmadinezhad Maryam , pakniat azadeh 
Published: September 2020

Abstract
Background: In order to properly evaluate postpartum services in comprehensive health centers, encouraging women to use these services and presence of a reliable and valid tool, is necessary to design and assess mothers' perceptions of postpartum care.Aim: Designed to evaluate the psychometric dimensions of Iranian version of Mothers' Perception of Postpartum Health care Questionnaire at Comprehensive Health Centers. Methods: This is a cross-sectional study. The verbatim translation was used to translate the questionnaire from English to Persian. Face, content, and structural validity as well as reliability of the questionnaire were evaluated. Findings: The results showed that the face, content, and structure validity as well as reliability of this questionnaire to be appropriate. The calculated Cronbach's alpha coefficient for the whole questionnaire was 0.668. Interclass correlation coefficient was 0.688, which confirmed divergent validity.Conclusion: Mothers' Perception of Postpartum Health care Questionnaire at Comprehensive Health Centers is a valid and reliable questionnaire to measure mothers’ perceptions of these vital services.
Serum N-Terminal Telopeptide of Type I Collagen as a Biomarker for Predicting Bone Density Loss in Patients with Crohn Disease
Authors: Ishida Natsuki , Higuchi Tomohiro , Miyazu Takahiro , Tamura Satoshi , Suzuki Satoshi , Tani Shinya , Yamade Mihoko , Iwaizumi Moriya , Hamaya Yasushi , Osawa Satoshi , Furuta Takahisa , Sugimoto Ken 
Published: September 2020

Abstract
Background: The serum N-terminal telopeptide of type I collagen (NTx) is significantly higher in patients with Crohn disease (CD) than in healthy individuals and patients with ulcerative colitis. This study aimed to investigate whether an elevated serum NTx level is a risk predictor of osteoporosis in patients with CD.Methods: Based on whether the femoral Z-score decreased over a 2-year period, 41 CD patients were divided into the ΔZ-score <0 group (Z-score decreased) and the ΔZ-score ≥0 group (Z-score did not decrease). The risk predictors of a femoral Z-score decrease were examined. Furthermore, we investigated the correlations between the ΔZ-score (which represents the change in the Z-score over a 2-year period) and the mean levels of biomarkers including the Crohn’s Disease Activity Index (CDAI), serum albumin, C-reactive protein, and bone metabolism markers (including NTx) measured initially (i.e., in our previous study) and 2 years later (present study). The relation between anti-tumor necrosis factor α (anti-TNF-α) therapy and serum NTx levels were also examined.Results: Although there was no correlation between the mean CDAI and the ΔZ-score, the mean serum NTx and albumin levels were significantly correlated with the ΔZ-score (P<0.01 and P=0.02, respectively). Furthermore, the femoral Z-score tended to be lower in the anti-TNF-α administration group than in the non-administration group.Conclusions: These observations indicated that an elevated serum NTx could be a useful marker for predicting a decrease in the femoral bone mineral density in CD patients. Anti-TNF-α therapy maintained an elevated serum NTx level, suggesting that treatment with anti-TNF-α may help control increased bone resorption in CD patients.
Exploring the Socio-Economic Experiences of Women Post-Mastectomy in the Tamale Metropolis
Authors: Osei-Amoah Evelyn , Paarima Yennuten , Aziato Lydia 
Published: September 2020

Abstract
Background: Breast cancer (BC) is the most commonly diagnosed cancer among females. Mastectomy is the treatment of choice in most African countries due to late reporting. The majority of women diagnosed with BC experience socio-economic challenges. This study explored the factors that affect the socio-economic well-being of women post-mastectomy in Ghana. Methods: The study was conducted at the teaching hospital in the northern region of Ghana using descriptive exploratory qualitative design. A purposive sampling method was employed to recruit participants. Data was saturated with 15 participants aged between 28 and 78 years. The in-depth interviews were recorded and transcribed verbatim. Data were analyzed using thematic content analysis procedures. Results: Participants isolated themselves as society frown on them after mastectomy. Some of the women loss their jobs/businesses and some did not get the needed support. The high cost of treatment placed a huge financial burden on them. Some of the participants felt rejected and loss their femininity, as their partners were not having sex with them after the operation. Conclusion: Women post mastectomy faces several challenges and family support is vital to improve their wellbeing. There is a need to educate the public against the stigmatization of women post mastectomy.
Stress and the City: Living in Rural Environment has a Protective Effect on Hospital Readmission Rates in Chronic Psychiatric Disorders
Authors: Langguth Berthold , Frick Hannah , Frick Ulrich 
Published: September 2020

Abstract
Background:Living in urban environment represents a well-known risk factor for the development of mental disorders. Here we aimed to investigate whether urbanicity has also an effect on the trajectories of psychiatric disorders. For this purpose, we analyzed the relationship between urbanization and hospital readmission risk. Method:We analysed the impact of geospatial, demographic, clinical and socioeconomic data on hospital readmission risk in a sample of 17’145 patients observed during a 12 years period starting from 1996 and leading to 37’697 psychiatric hospitalizations by using a frailty model Results:Living in more urbanized regions was related to an increasing risk for earlier rehospitalization. The impact of urbanicity was less pronounced in patients with affective disorders and more pronounced in patients with co-morbid substance abuse disorder. Shorter distance to the hospital and change of residence increased the readmission risk. Population density, proportion of non-german citizens, local population growth tendency, and local unemployment rate were not associated with readmission risk. Conclusion:A clear impact of urban living environment on the course of mental disorders was demonstrated. In metropolitan regions of our sample it took one year till 50% of discharged patients had been readmitted to the psychiatric clinic, whereas this took 6 years in rural regions.
Desire to Limit Childbearing and Its Associated Factors Among Married Women: Findings From A Cross-Sectional Survey In Karachi, Pakistan&nbsp;
Authors: Razzaq Shama , Jessani Saleem , Ali Sumera Aziz , Abbsai Zahid , Saleem Sarah 
Published: September 2020

Abstract
Background: Increasing population growth and uneven distribution of scarce resources is a hurdle for country’s economic growth. Hence, we aim to determine desire to limit child bearing and factors associated with limiting child bearing among currently married women aged 15 to 49 years residing in squatter settlements of Karachi, Pakistan. Methods:A multistage cluster, cross sectional survey was conducted in randomly selected households of urban squatter settlements of Karachi. A total of 4,485 married, non-pregnant, were interviewed using a structured questionnaire and adapted Operational framework of “Pullum 1980” to determine potential factors associated with limiting family size. Outcome of interest was defined as a desire to limit childbearing among married women of reproductive age group. Multivariable regression was performed using SPSS version 13.0. Results:The median age of participants was 30 years (IQR 25-35 years) and the median number of living children was 3 (IQR 2-4). Of 4485 women, 2109 (47%) expressed desire to limit childbearing in future. Multivariable logistic regression showed that women of 18 to 27 years and 28 to 37 years (AOR 0.25, 95% CI: 0.19-0.39 and AOR 0.39, 95% CI: 0.22-0.47 respectively), illiterate (AOR 0.34, 95% CI: 0.21-0.53), and low wealth quintile (AOR 0.41, 95% CI: 0.25-0.57), not using any contraceptive method (AOR 0.53, 95% CI: 0.44 to 0.63), sons less than daughters (AOR 0.74, 95% CI: 0.62-0.87), were less likely to limit childbearing. Women who practiced autonomy (AOR 1.25, 95% CI: 1.08-1.41) and perceived ideal family size as ≤ 2 children (AOR 2.62, 95% CI: 2.07-3.32) were more likely to limit childbearing.Conclusion:Age, education, low wealth quintile, having sons, autonomy and usage of contraceptives were determining factors of women’s desire for limiting childbearing. Behavior modification strategies should be devised to modify fertility intentions among women to increase contraceptive use and fertility decline.
Biological Profile of Chronic Hepatitis B Infection and Its Predictive Factors According to Liver Histological Activity at the Renaissance Hospital, N’djamena, Chad
Authors: Mahamat-Saleh Tahir , Moussa Ali Mahamat , Bolti Mahamat Ali , Adjeka Doffou Stanislas , Habkreo Mayanna , Ahamat Ali Adam , Assi Constant 
Published: September 2020

Abstract
Background: the profile of chronic viral hepatitis B has been little studied in Chad. The factors predictive of the presence of hepatic fibrosis are not well known. The aim of the study was to determine the biological profile of chronic HBsAg carriers according to the new European classification of chronic hepatitis B.Method: This is a prospective cross-sectional study carried out in the gastroenterology outpatient department at the Renaissance Hospital in N’Djamena from January, 2018 to July, 2019. All patients with chronic HBsAg were included and documented for at least one year. Patients with hepatitis C, hepatitis D or HIV are known alcoholic patients and were excluded from the study. The biological profile was determined according to four forms; HBeAg positive chronic infection, HBeAg positive chronic hepatitis, HBeAg negative chronic infection, HBeAg negative chronic hepatitis and HBsAg negative phase. Factors associated with presence of significant liver fibrosis were founded by logistical regression.Results: The average age of the patients were 42.4 years old. The sex ratio was 1.43 in favor of men and a total number of 106 patients were included. The median of the transaminase concentrations were 24 IU/ml (AST) and 21 IU/ml (ALT). 61 patients had HBeAg negative chronic infection (59.8%) and 37 patients had HBeAg negative chronic hepatitis (36.2%). HBeAg positive chronic infection and HBeA positive chronic hepatitis were both seen in 2% of the cases. Significant liver fibrosis was independently associated with the ALT levels (Odds ratio=1.038 [1.009-1.068]; p=0.009).Conclusion: Chronic HBeAg-negative B infection is the main form found in chronic HBeAg-positive carriers. Transaminases are a predictive factor for the presence of hepatic fibrosis.
LncRNA CRNDE&nbsp;Acts as a ceRNA&nbsp;and Regulates AML&nbsp;Cell Proliferation and Apoptosis via miR136-5p/MCM5&nbsp;Axis
Authors: Liu Chen , Zhong Liang , Shen Chenlan , Chu Xuan , Luo Xu , Yu Lihua , Ye Jiao , Xiong Ling , Dan Wenran , Li Jian , Liu Beizhong 
Published: September 2020

Abstract
Background: Increasing evidence demonstrated that long noncoding RNAs (lncRNAs) act as important factors in the regulation of cell processes and tumorigenesis. The long-noncoding RNA colorectal neoplasia differentially expressed (CRNDE) gene has been found to be related to several types of cancer. Although CRNDE is highly expressed in AML, its mechanism of action in acute myeloid leukemia (AML) is unknown.Methods: The expression levels of CRNDE and miR-136-5p mRNAs were measured by quantitative real-time PCR. The effects of CRNDE knockdown on cell proliferation was assessed by the CCK8 assay, while apoptosis and cell cycle distribution were analyzed by flow cytometry. The expression of proteins related to cell cycle, cell apoptosis and MCM5 were analyzed by Western blotting. The luciferase reporter assay was used to confirm the interaction between CRNDE and miR-136-5p and between MCM5 and miR-136-5p in AML. The RNA immunoprecipitation assay was used to verify whether CRNDE exists in the miRNA mediated RISC complex.Results: In this study, we used GEPIA database to confirm that CRNDE expression was significantly upregulated in AML samples. The silencing of CRNDE inhibited AML cells’ proliferation ability, increased AML cells’ apoptotic rate and arrested AML cells at the G1 phase of the cell cycle. Mechanistically, CRNDE served as a competing endogenous RNA (ceRNA) for miR-136-5p and upregulated MCM5 expression by sponging miR-136-5p. In addition, rescue assays revealed that the effects of CRNDE knockdown could be reversed by miR-136-5p inhibitors in AML cells. Conclusion: Our results demonstrate that the CRNDE-miR-136-5p-MCM5 axis modulates AML progression and provide a new regulatory network of CRNDE in AML.
Radiodermatitis as a Consequence of Radiation Recall Induced by Acyclovir: Case Report.
Authors: Zorzan Marcos Tumitan , Pereira Renata de Mello , Lima Lucas Farina , Mattos Tatiana Veri de Arruda , Sá Rafael 
Published: September 2020

Abstract
Background: Radiation Recall Dermatitis is defined as an inflammatory reaction in a site of skin previously submitted to radiotherapy, and succeeding the administration of a drug or promoter agent. Manifestations range from mild to severe, resulting in tissue necrosis, treated with removal of the probable causative agent, daily dressings and surgical debridement of the necrotic area.Case presentation: The patient whose case is reported presented previous diagnosis of intraductal carcinoma in situ, performed lumpectomy and adjuvant radiotherapy and endocrinotherapy. After 1 year of treatment, develops sores suggestive of Herpes Zoster and starts treatment with Acyclovir, concomitantly with the onset of pain, fever, and in the previously irradiated area, breast hardening, skin infiltration and serosanguinolent discharge. Performed incisional biopsy to rule out radioinduced sarcoma, being treated with surgical debridement.Conclusions: Unlike the cases report of acyclovir drug’s eruption, the patient presented radiodermatitis restricted to the skin’s tissue in the previously irradiated area, suggestive of the radiation recall. This case report describes the acyclovir as a possible indutor of RRD, a rare condition that requires a better understanding of the disease installation mechanism and the adverse drugs effects after radiotherapy.
Microwave Photonic Ising Machine
Authors: Cen Qizhuang , Hao Tengfei , Ding Hao , Guan Shanhong , Qin Zhiqiang , Xu Kun , Dai Yitang , Li Ming 
Published: September 2020

Abstract
Ising machines based on analog systems have the potential of acceleration in solving ubiquitous combinatorial optimization problems. Although some artificial spins to support large-scale Ising machine is reported, e.g. superconducting qubits in quantum annealers and short optical pulses in coherent Ising machines, the spin coherence is fragile due to the ultra-low equivalent temperature or optical phase sensitivity. In this paper, we propose to use short microwave pulses generated from an optoelectronic parametric oscillator as the spins to implement the Ising machine with large scale and also high coherence under room temperature. The proposed machine supports 10,000 spins, and the high coherence leads to accurate computation. Moreover, the Ising machine is highly compatible with high-speed electronic devices for programmability, paving a low-cost, accurate, and easy-to-implement way toward to solve real-world optimization problems.
Screening and Identification of Novel Biomarkers Associated with Cutaneous Squamous Cell Carcinoma
Authors: Su Wenxing , Huang Biao , Han Wei , An Lu , Guan Yi , JI Jiang , Yu Daojiang 
Published: September 2020

Abstract
Background: Cutaneous squamous cell carcinoma (cSCC) is the leading cause of death in patients with non-melanoma skin cancers (NMSC). However, unclear pathogenesis of cSCC limits the application of molecular targeted therapy. Results: To identify the hub genes in the pathogenesis and progression of cSCC, we downloaded the microarray data sets GSE2503, GSE45164 and GSE66359 from the Gene Expression Omnibus (GEO) database, and identified differentially expressed genes (DEGs) between tumor and non-tumor tissues. Functional enrichment analysis was performed using DAVID. The STRING online website was used to construct a protein-protein interaction network (PPI), and then Cytoscape performed module analysis and degree calculation. 146 DEGs were identified with significant differences, including 113 up-regulated genes and 33 down-regulated genes. The enriched functions and pathways of the DEGs include microtubule-based movement, ATP binding, cell cycle, p53 signaling pathway, oocyte meiosis and PLK1 signaling events. Nine hub genes were identified, namely CDK1, AURKA, RRM2, CENPE, CCNB1, KIAA0101, ZWINT, TOP2A, ASPM. The differential expression of these genes has been verified in other data sets. In addition, the ROC curve also confirmed their ability to predict disease. Conclusion: By integrated bioinformatic analysis, the DEGs and hub genes identified in this study elucidated the molecular mechanism of the pathogenesis and progression of cSCC, and are expected to become future biomarkers or therapeutic targets.
Application of Network Pharmacology to Elucidate The Potential Mechanism of Finger Citron Against Obesity
Authors: Wu Zhen , Yang Yujiao , Wei Yao , Hu Xu-guang 
Published: September 2020

Abstract
Background: Finger citron (FS) is one of many traditional Chinese herbs that have been used to treat obesity. However, the active components and potential targets of FS in improving obesity remain unclear. Methods：The aim of this study was to elucidate the pharmacological effects and mechanisms of FS on obesity using network pharmacology analysis. We used network pharmacology to determine the active components, potential targets and mechanisms in the treatment of obesity.Results：We identified 25 active ingredients of FS such as diosmetin, hesperidin and sitosterol-alpha1 with important biological effect. A total of 258 key targets were screened, containing TNF，NOS2, MAPK8 which were found to be enriched in 27 signaling pathways, such as apoptosis, TNF, PPAR and AKT1, and Insulin resistance signaling pathways. Moreover, molecular docking analysis showed that the main ingredients were tightly bound to the core targets, further confirming the effects of weight loss. Conclusion: Based on network pharmacology and molecular docking analysis, our study provides insights into the potential mechanism of FS in ameliorating obesity after screening for associated key target genes and signaling pathways. These findings further provide a theoretical basis for further pharmacological research into the potential mechanism of FS in treating obesity.
Psychological Impact and Associated Factors During the Containment Stage of Covid-19 Epidemic Among College Students in China
Authors: Si Mingyu , Su Xiao-You , Jiang Yu , Wang Wen-Jun , Gu Xiao-Fen , Ma Li , Li Jing , Zhang Shao-Kai , Ren Ze-Fang , Liu Yuan-Li , Qiao You-Lin 
Published: September 2020

Abstract
Background College students are a uniquely vulnerable group and may experience high stress levels due to COVID-19. This study aims to identify the the psychological state and related factors on Chinese college students during the initial phases of the COVID-19 pandemic. Methods From February 23 to March 5, 2020, a cross-sectional online survey was conducted among 3606 college students from seven provinces in China using standard questionnaires measuring adverse psychological outcomes and related factors including Impact of Event Scale-6 (IES-6), Depression, Anxiety and Stress Scale (DASS), Perceived Social Support Scale (PSSS) and Simplified Coping Style Questionnaire (SCSQ). Exploratory factor analysis (EFA) were used to determine underlying constructs of the perceived threat items. Multivariate regression was used to explore the determinants of adverse psychological impact. Results Posttraumatic stress (PTS) were prevalent in this sample of college students, and 34.22% met the cut-off for posttraumatic stress disorder (PTSD). The proportion of having mild to extremely severe symptoms of depression, anxiety and stress were 15.70%, 13.31% and 7.10%, respectively. The impact of closed-off management on life, perceived threat and passive coping strategies were positively correlated to PTS and DASS scores, while knowledge score, perceived social support and active coping strategies were negatively correlated to DASS scores. Conclusions In summary, adverse psychological symptoms were prevalent among college students in China during the COVID-19 epidemic. Identifying vulnerable populations and formulating correspondingly psychological interventions would be beneficial to improve the mental health during the COVID-19 epidemic.