bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with non-vaccination against measles among 12-23 months old children in Yirgachefe district of SNNPR, Ethiopia, 2016
Authors: Degife Luna Habtamu , Worku Yoseph , Tadesse Muse 
Published: January 2020

Abstract
Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district. This study was done to assess the risk factors associated with non-vaccination against measles. A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were children in the age group of 12- 23 months of age who did not take measles vaccination and controls were children in the same age group who took at least one dose of measles vaccine. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05.A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Knowledge regarding measles vaccination was also asked and among cases 72% heard about measles, 26% knew that all children should be vaccinated, 31% had awareness about the right age of vaccination, 60% agrees that measles is vaccine preventable and 65% knew that it is contagious. In multivariable logistic regression, Lack of Ante Natal Care follow up(ANC) (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors.Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.
The prevalence of selected non-communicable disease risk factors among HIV patients on anti-retroviral therapy in Bushbuckridge Sub-district, Mpumalanga province
Authors: Mathebula Rudy Londile , Maimela Eric , Ntuli Thembelihle Samuel 
Published: January 2020

Abstract

Background: The rates of non-communicable diseases (NCD’s) appear to be increasing in human immunodeficiency virus (HIV) infected people as compared to non-HIV infected people and this will have major implications for clinical care. The aim of the current study was to profile selected cardiovascular disease risk factors among HIV patients on anti-retroviral therapy (ART) in Bushbuckridge sub-district. Methodology: The current study followed a quantitative cross-sectional study design using a questionnaire which was adapted from World Health Organization STEPwise approach to Surveillance (WHO STEPS). Participants were HIV infected people on ART and data was entered into a computer software Microsoft excel, then imported to Stata 12 for analysis. Results: The overall prevalence of overweight at the initiation of ART amongst the participants was 18.1% and obesity was 11.5% as compared to the time of the study which was 21.4% overweight and 19.6% obese. The average time of ART initiation to study period was 3.6 years. The study findings revealed a significant difference (p-value 0.006) between the baseline and current body mass index at time of study for females. Hypertension was found to be having a significant difference (p-value 0.026 and 0.038) between the baseline and current body mass index at time of study for males and females respectively. The overall prevalence of hypertension was found to be 34.6%, overweight was 21.4% obesity was 19.6%. The overall prevalence of abnormal waist circumference was 31.9% and females had a higher prevalence of 42.5% as compared to 4.4% of males. The overall prevalence of smoking 10.8% and alcohol consumption was 21.7%. Males were 22.5 times more likely to be smokers than females (p<0.001) and older people were found to be 0.3 times less likely to consume alcohol as compared to young people. Conclusion: High levels of selected risk factors for NCDs among adults on ART in the current study area suggest an urgent need for health interventions to control risk factors in an era of HIV with an aim of reducing multiple morbidity of chronic diseases. occurrence of NCDs and their risk factors with an aim to achieve positive effects of the long-term ART.
Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: A prospective randomized trial
Authors: Wang Huai-Zhen , Wang Ling-Yu , Liang Hui-Hong , Fan Yan-Ting , Song Xing-Rong , She Ying-Jun 
Published: January 2020

Abstract
Background: Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the minimum local anesthetic concentration (MLAC) of ropivacaine for intra-operative analgesia is unclear. Methods: One hundred and sixty-nine children were randomized to five groups: Group C (caudal ropivacaine only), Group K 0.25 (caudal ropivacaine plus 0.25 mg/kg ketamine), Group K 0.5 (caudal ropivacaine plus 0.5 mg/kg ketamine), Group K 0.75 (caudal ropivacaine plus 0.75 mg/kg ketamine), and Group K 1.0 (caudal ropivacaine plus 1.0 mg/kg ketamine). The primary outcome was the MLAC values of ropivacaine with/without ketamine for caudal block. Results: The MLAC values of ropivacaine were 0.128% (0.028%) in the control group, 0.112% (0.021%) in Group K 0.25 , 0.112% (0.018%) in Group K 0.5 , 0.110% (0.019%) in Group K 0.75 , and 0.110% (0.020%) in Group K 1.0 . There were no significant differences among the five groups for the MLAC values (p=0.11). During the post-operative period the mean durations of analgesia were 270, 381, 430, 494, and 591 min in the control, K 0.25 , K 0. 5 , K 0.75 , and K 1.0 groups respectively, which shown significant differences among the five groups (p<0.05). Conclusions: Adding caudal ketamine to ropivacaine prolong the duration of post-operative analgesia; however, it does not decrease the MLAC of caudal ropivacaine for intra-operative analgesia in children.
Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma
Authors: Lv Tian , Liu Zhuoran , Kuang Jie , Yan Jiqi 
Published: January 2020

Abstract
Background: There were are few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in the patients with papillary thyroid carcinoma (PTC). Therefore,Thus, we investigated the clinical significance of aimed to increase acknowledgement of LN-epRLN and implications it may have.explore clinical implication.
Methods: A prospective observational analysis including of 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was conductedperformed. We explored the surrounding tissue of laryngeal entry pointentrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination. Thereafter, , and the complications and follow-ups were recorded.
Results: LN-epRLNs was were found in 73 of the 878 patients, with and the metastasis metastatic rate of was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Univariate and multivariate analysis showed central lymph node metastases can serve as independent predictors for LN-epRLN metastasis.
Conclusions: LN-epRLN can be the site of metastasis of PTC, and the positive LN-epRLN was highly predictive of other central nodal metastasis. LN-epRLN metastases in PTC were also associated with tumor location in the isthmus or upper third of the thyroid and tumor multifocality. In our study, we focus on acknowledgement of LN-epRLN. We emphasized the value of exactitude anatomy and the thoroughness of CLND for cN0-1a PTC.In summary, we confirmed the significance of LN-epRLN in metastasis and recurrence, which required precise anatomy and thorough CLND. In PTC patients, especially in suspicious presence of central cervical lymph node metastasis, attention should be given to excising the nodal tissue at the laryngeal entry point.
Electronic Medical Records for Discovery Research in Nonalcoholic Fatty Liver Disease
Authors: Kartoun Uri , Aggarwal Rahul , Perer Adam , Park Yoonyoung , Zhang Ping , Luo Heng , Dey Sanjoy , Corey Kathleen , Ng Kenney 
Published: January 2020

Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent yet under-diagnosed and under-discussed disease. Given that NAFLD has not been explored sufficiently compared with other diseases, opportunities abound for scientists to discover new biomarkers (such as laboratory observations, current comorbidities, behavioral descriptors) that can be linked to the development of conditions and complications that may develop at a later stage of the patient’s life. Methods: We analyzed IBM Explorys, a repository that contains electronic medical records (EMRs) of more than 60 million individuals. We used a classification algorithm that members of our group have previously validated to identify patients at a high probability for NAFLD. The algorithm identified more than 80,000 patients with a high probability for NAFLD who had at least 5 years of follow-up. We applied standard statistical methods (such as logistic regression and bootstrapping) and used Clinical Classifications Software (CCS) definitions to identify associations between a variety of covariates and disease outcomes. Results: Our methodology identified several thousand strongly statistically significant associations between covariates and outcomes in NAFLD. Most of the associations are known, but others may be new and require further investigation in subsequent studies. Conclusions: A discovery mechanism composed of standard statistical methods applied on a large collection of EMRs, confirmed known associations and identified potentially new associations that can act as biomarkers that might merit further research.
The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening
Authors: Otieno Frederick C. F. , Ogola Elijah N , Kimando Mercy W , Mutai Ken K 
Published: January 2020

Abstract
Background : Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances their cardiovascular risk and diseases, and a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that optimizes outcomes, including forestalling progression to end-stage kidney disease.
This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area.
Methods : A cross-sectional study was conducted at the out-patient of Nyeri County hospital where 385 patients were enrolled over five months. Informed consent was obtained and clinical evaluation was done. A spot sample of urine was obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative.
Main outcomes measure: Estimated Glomerular filtration rate and albuminuria as markers of chronic kidney disease.
Results : A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0 % (95%CI 34.3-44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8-37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age >50years, long duration with diabetes >5years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status.
Conclusion : Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over thirty percent of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.
Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease: The GOASIA study
Authors: Author) Panyavee Pitisuttithum(Former Corresponding , Chan Wah Kheong , Piyachaturawat Panida , Imajo Kento , Nakajima Atsushi , Seki Yosuke , Kasama Kazunori , Kakizaki Satoru , Fan Jian Gao , Song Myeong Jun , Yoon Seung Kew , Dan Yock Young , Lesmana Laurentius , Ho Khek Yu , Goh Khean Lee , Wong Vincent Wai Sun , Author) Sombat Treeprasertsuk(New Corresponding 
Published: January 2020

Abstract
Background: The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD); 2) identify predictors of advanced fibrosis in elderly patients with NAFLD; and 3) assess the performance of non-invasive fibrosis scores in the prediction of advance fibrosis in the elderly population.
Methods: We abstracted the data of 1008 patients with NAFLD from nine centers across eight countries. Characteristics of elderly and non-elderly patients with NAFLD were compared using 1:3 sex-matched analysis.
Results: Of the 1008 patients, 175 were elderly [age 64 (62-67) years], who were matched with 525 non-elderly patients [46 (36-54) years]. Elderly patients were more likely to have advanced fibrosis (35.4% vs. 13.3%; p<0.001). By multivariable analysis, factors associated with advanced fibrosis in elderly patients included female sex [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.37-7.54] and hypertension (OR 3.68; 95%CI 1.11-12.23). The area under receiver-operating characteristics curve (95% CI) of aspartate aminotransferase-to-platelet ratio index, NAFLD fibrosis score and Fibrosis-4 index for predicting advanced fibrosis in elderly patients were 0.62 (0.52-0.72), 0.65 (0.55-0.75) and 0.64 (0.54-0.74) respectively.
Conclusions: Elderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-elderly patients. Female and hypertension were predicting factors for advanced fibrosis in the elderly. Non-invasive fibrosis scores had a lower specificity in elderly.
Assessing health system challenges and opportunities for better noncommunicable disease outcomes: the case of Mauritius
Authors: Musango Laurent , TIMOL Maryam , BURHOO Premduth , SHAIKH Faisal , DONNEN Philippe , KIRIGIA Joses Muthuri 
Published: January 2020

Abstract
Background: The objectives of the study reported in this paper were: (a) to score the coverage of core NCD population-based interventions and individual services in Mauritius; (b) to analyse and score the presence of 15 common health system challenges that impede delivery of core NCD interventions and services in Mauritius; and (c) to provide policy recommendations for Mauritius to address health system barriers to delivery of NCD interventions and services.Methods: The Mauritius country assessment applied the guidelines developed by the World Health Organization Regional Office for Europe for systematically scoring coverage of NCD interventions and assessing health system challenges for improving NCD outcomes. The assessment used qualitative research design approach. Results: Of the 24 core population-based interventions for addressing key NCD risk factors, 16.7% were rated extensive, 37.5% moderate and 45.8% limited. Three (20%), 8 (53%) and 4 (27%) of the 15 individual/personal CVD, diabetes and cancer services were rated extensive, moderate and limited respectively. The top five health system challenges hampering scale-up of coverage of population-based NCD interventions in Mauritius were inadequate interagency cooperation; limited application of explicit priority setting approaches; inadequate change management; sub-optimal distribution and mix human resources; insufficient population empowerment; and insufficient political commitment. The top five challenges had average scores of between 3.1 (interagency cooperation) and 2.4 (distribution and mix of human resources).The top five health system challenges constraining expansion in coverage of individual NCD services were limited integration of evidence into practice; limited use of explicit priority-setting approaches; inadequate application of information and technology solutions; insufficient population empowerment; and sub-optimal distribution and mix of human resources. The top five challenges for individual interventions had mean scores varying between 2.6 (integration of evidence into practice) and 1.7 (distribution and mix of human resources).Conclusions: Mauritius needs to increase its domestic general government investments into the national health system and requisite multi-sectoral action to address the priority health system challenges with a view of bridging the existing gaps in coverage of NCD population-based interventions and individual services.
A survey of the working status of family medicine physicians in clinics and hospitals in Korea
Authors: Shin Hyun-Young 
Published: January 2020

Abstract
Background In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea.Methods We conducted an online survey with 4,057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics.Results Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals ( p < 0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals ( p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6% and 68.0% in clinics and 93.6% and 78.5% in hospitals, retrospectively.Conclusions Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.
Finite Elements Analysis of the Temporomandibular Joint Disc in Patients with Intra-articular Disorders
Authors: Lai Linfeng , Xiong Guofeng , Huang Chenyao , Zhou Fan , Xia Fujian 
Published: January 2020

Abstract
Background：Anterior and/or medial displacement of the temporomandibular joint disorder(TMJ) disc or intra-articular disorders( ID) is the most common form of TMJ dysfunction(TMD).TMD cause change of friction coefficient during TMJ movement. In the present study, We provided a 3D finite elements models(FEM) including the maxilla, disc and mandible and evaluated the stress distribution with different friction coefficient.Methods: 14 volunteers without TMD and 20 TMD patients,who were diagnosed by MRI, were selected.CT and MRI data were collected to build 3D FEA model of mandibular and TMJ disc.Stress distribution with different friction coefficient was measured.Result: In the normal model, stress distribution on TMJ disc was 2.07±0.17,1.49±0.14,1.41±0.14MPa with 0.001 0.3 and 0.4 friction coefficient.In TMD model,stress distribution is 3.87±0.15,7.23±0.22,7.77±0.19MPa respectively. Conclusion:When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were higher than those of the normal lateral joint.
Hard-threshold-Neural-Network based Prediction of Organic Synthetic Outcomes
Authors: Hu Haoyang , Yuan Zhihong 
Published: January 2020

Abstract
Retrosynthetic analysis is the canonical technique to plan the synthesis route of organic molecules in drug discovery and development. In this technique, the screening of synthetic tree branches requires accurate forward reaction prediction, but existing software is still far from completing this step independently. Previous studies have attempted to apply neural network in the forward reaction prediction, but the accuracy is not satisfying. Through using the Edit Vector based description and Extended-Connectivity Fingerprints to transform reaction into vector, the presented work focuses on the update of neural network to improve the template-based forward reaction prediction. Hard-threshold activation and target propagation algorithm are implemented by introducing the mixed-convex combinatorial optimization. Comparative tests are conducted to explore the optimal hyperparameter set. Using 15, 000 experimental reaction extracted from granted United States patents, the proposed hard-threshold neural network is systematically trained and tested. The results demonstrate that a higher prediction accuracy is obtained when compared to the traditional neural network with backpropagation algorithm. Some successfully predicted reaction examples are also briefly illustrated.