bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study
Authors: Shi Xin ge , Xu Ming , Yu Xu , Lu Yibin 
Published: February 2020

Abstract
Background Peripheral perfusion index (PPI) is associated with hypoperfusion in critical patients. Many researches focus on using PPI as a predictor in septic shock, but few studies report on its significance in surgical patients. We performed this study to find out association between PPI and surgical patients’ prognoses. Methods It’s a retrospective study from January to June 2019, on surgical patients transferred to ICU, Xinyang Central hospital, Henan province, China. The inclusive/exclusive criteria are followings, inclusive:1) age ≥18 years old; 2) surgical length ≥120min; Exclusive: 1) died in ICU; 2) discharging against medical advice; 3) existing diseases affecting blood flow of upper limbs, for example, vascular thrombus in arms; 4) severe liver dysfunction Patients were grouped according to their length of ICU stay (LOS ICU, >48h regarded as prolonged ICU stay, otherwise non-prolonged). Baseline characteristics (age, gender, comorbidity), surgical sites and length, SOFA and APACHE II on 1st day in ICU, LOS ICU, mean artery pressure (MAP), lactate clearance rate (LCR), peripheral perfusion index (PPI), temperature (axillary) were collected and compared between the 2 groups. Correlation and ROC (receiver operating characteristic) analysis was also performed. Results Eventually, 72 patients were included, 30 in prolonged and 42 in non-prolonged group. Compared to non-prolong, patients in prolonged ICU stay group had higher lactate(6h: 3.70±0.52 vs 2.50±0.59 mmol/L, p<0.001; 12h: 2.78±0.50 vs 1.90±0.30 mmol/L, p<0.001), lower LCR(0-6h: -20%[-37%, 0%] vs 19%[9%, 31%], p<0.001) and PPI (0h: 0.80± 0.27 vs 1.47±0.43, p<0.001; 6h: 0.88±0.25 vs 1.57±0.40, p<0.001). No difference was found in gender, age, surgical length, SOFA, APACHE II, temperature and comorbidity. Averaged 1h and 6h PPI were strongly associated with LCR (0-6h, correlation coefficient 0.5521h and 0.4366h) and LOS ICU(correlation coefficient: -0.6391h and -0.5606h). The area under the receiver operating characteristic (AUC) of PPIT0 and PPIT1 for predicting prolonged ICU stay were 0.905 and 0.916 respectively. The cutoff values of PPIT0 and PPIT1 were 1.15(with 73.8% sensitivity and 90.0% specificity) and 1.35(with 83.3% sensitivity and 96.7% specificity). Conclusions PPI is associated with LOS ICU in surgical patients transferred to ICU. Lower PPI reflects slower lactate clearance rate and longer ICU stay.
Bleomycin mouse model with active-phase pulmonary fibrosis and no acute mortality
Authors: KADAM ANIL H , Faix Peggy H. , Schnitzer Jan E. 
Published: February 2020

Abstract
Background The bleomycin mouse model is the most prevalent animal model used to study idiopathic pulmonary fibrosis (IPF), ranging from basic pathophysiological mechanisms to therapeutic modalities. High mortality rates, inconsistencies in disease induction, and great severity of the disease phenotype have limited its utility and clinical relevance. In this study, we identify conditions in the mouse bleomycin model that maintain the desired IPF phenotype found in patients while avoiding the usual, associated rapid mouse mortality. Methods In two independent studies, we analyzed the effects of incremental intratracheal (IT) high (1-3 U/kg) and low (0.05-0.5 U/kg) bleomycin doses on pulmonary fibrosis in mice. We observed dose effects on weight loss, morbidity and mortality, inflammation, lung collagen content, presence of various biomarkers in bronchoalveolar lavage fluid (BALf), and histology 14 days post-treatment, when the animals were in the active phase of fibrosis. Results We characterize the fibrotic effects of various bleomycin doses in mice on pulmonary inflammation, myofibroblast activation, vascular leakiness, angiogenesis, and extracellular tissue remodeling. Higher bleomycin doses induced acute disease with severe and saturated responses, extreme and progressive weight loss, and high morbidity and mortality rates. In contrast, lower doses of bleomycin induced a milder and chronic response, featuring robust, active-phase fibrosis with mild weight loss and no mortality. Conclusion Here we demonstrate that the bleomycin mouse model can be used to reproduce symptoms of IPF patients in an animal by using low doses of bleomycin. Low concentrations of bleomycin induce chronic and progressive fibrosis with no mortality.
Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance
Authors: Yang Yong , Man Xiaowei , Nicholas Stephen , Li Shuo , Bai Qian , Huang Lieyu , Ma Yong , Shi Xuefeng 
Published: February 2020

Abstract
Background: As the second most common cause of death globally, strokes impose a significant financial burden on patients and a country’s health system. This study demonstrates the disparities in the utilization of inpatient health services for stroke patients covered by different urban basic health insurance schemes in China.Methods: We conducted statistical analysis based on the data containing urban employee-based basic medical insurance scheme (UEBMI) and urban resident-based basic medical insurance scheme (URBMI) groups, supplied by the China Health Insurance Research Association (CHIRA). Descriptive analysis was the main method to finish this study.Results: Of the inpatients (N=56485) who had been diagnosed with ischemic stroke, extracted from the CHIRA claimed database, 64.6% (36487) were covered by UEBMI and 35.4% (19998) were covered by URBMI. The annual frequency of hospitalization of UEBMI subgroup was 1.21 times and 1.15 times for URBMI subgroup. The average length of stay of UEBMI subgroup(13.93days) was longer than URBMI subgroup (10.82 days). The UEBMI group had higher hospitalization costs but fewer out-of-pocket costs: for the UEBMI subgroup, the average hospitalization cost was RMB11187.64($1724.02), the average total out-of-pocket costs was RMB2646.42($407.81). While for the URBMI subgroup, the average hospitalization cost was RMB6402.27($986.59) and the average total out-of-pocket costs was RMB2746.10($423.17). All the above differences were significant(P<0.001). Meanwhile, patients with UEBMI had higher reimbursement rate (82.65% and 63.82%) and lower self-paid ratio (23.65% and 42.89%).Conclusions: We found that there were nonnegligible disparities in the utilization of inpatient health services between UEBMI and URBMI. Thus, our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gap in health insurance schemes in China.
Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone
Authors: Proos R. , Mathéron H. , Nunes J. Vas , Falama A. , Serry-Kamal P. , Grobusch M. P. , Akker T. H. van den 
Published: February 2020

Abstract
BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes the perspectives of health workers in rural facilities in Sierra Leone concerning the referral of women with obstetric complications.MethodsWe conducted semi-structured group interviews with health care workers in nine peripheral health units in rural Sierra Leone regarding the referral of women with obstetric complications. Themes discussed were based on an interview guide. The data was analysed by systematic text condensation.ResultsPerspectives were grouped according to the following themes identified: 1) communication between health care workers; 2) underlying influences on decision-making; 3) women’s compliance to referral; 4) logistic constraints.ConclusionSeveral factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among health care workers for having maternal deaths or severe obstetric complications at their own facilities. Furthermore, the decision-making of health care workers concerning referral is negatively influenced by an atmosphere of hierarchy between health care workers. Such factors must be considered in efforts to reduce maternal mortality.
Controllable valley filter in graphene topological line defect with magnetic field
Authors: Tian Hongyu , Ren Chongdan , Zhou Benhu , Lu Weitao , Li Yunfang , Li Daoyong , Wang Sake , Zhang Lin 
Published: February 2020

Abstract
The extended line defect of graphene is an extraordinary candidate in valleytronics while the high valley polarization can only occur for electrons with high incidence angles which brings about tremendous challenges to experimental realization. In this paper, we propose a simple scheme to filter one conical valley state by applying a local magnetic field. It is found that due to the movement of the Dirac points, the transmission profiles of the two valleys are shifted along the injection-angle axis at the same pace, resulting in the peak transmission of one valley state being reduced drastically while remaining unaffected for the other valley state, which induces nearly perfect valley polarization. This scheme can be easily implemented in experiments and plays a key role in graphene valleytronics.
Teaching Digital Health Ethics – Considerations and Lessons in Hands on Learning.
Authors: Kumaravel Arthi , Henson Philip , Torous John 
Published: February 2020

Abstract
Background

Educators need new tools to teach resident learners how to evaluate the privacy risks of and utilize the benefits of smartphone applications with their patients. To address this need for education addressing the changing landscape of mental health care delivery, we sought to create a simple tool that can be used in the clinic. Through this 10-point assessment framework for screening health apps based from ethical principles of the General Data Protection Regulation (GDPR), we propose a method that educators can utilize to teach residents about the privacy concerns of utilizing smartphone applications as part of clinical care with their patients.

Methods

We utilized an ethical-educational framework we developed from ethical principles of the GDPR with a group of 27 psychiatry residents from two academic centers for a simulation exercise to assess harms of using smartphone apps with a patient.

Results

All 27 raters completed the evaluations, but only 24 reported a time record for completion of the evaluation. The mean time to evaluate the privacy policy of the sample app’s privacy policy was 434.2 seconds (just over five minutes). Percentage agreement of each question on the survey ranged from a high of 81.5% to a low of 48.1%.

Conclusions

In this study, we developed an assessment framework based on the ethical principles contained within the GDPR to utilize for education of resident learners around digital health privacy. This is the first framework developed for resident learners to help them understand the potential risks to patient privacy with the use of smartphone applications for mental health. The discussion prompted by an examination of a privacy policy through this framework highlights the need for further educational tools built into the residency education curriculum regarding these risks as use of these applications become more wide spread.
An unusual Staphylococcus saccharolyticus spondylodiscitis post vertebroplasty, a case report
Authors: Trojani Marie Charlotte , Lamy brigitte , Ruimy Raymond , Amoretti nicolas , Risso Karine , roux christian 
Published: February 2020

Abstract
Background: Staphylococcus saccharolyticus is a rarely encountered coagulase-negative slowly grower and strictly anaerobic staphylococcus from the skin. It is usually considered as a contaminant, but some rare reports describe deep-seated infections. Virulence factors remain poorly known although genomic analysis highlight pathogenic potential.Case presentation: we report a case of Staphylococcus saccharolyticus spondylodiscitis that followed kyphoplasty, a procedure associated with a low rate of sometimes severe infectious complication (0.46%) and we reviewed the literature. This case specifically stresses the risk of S. saccharolyticus health-care associated infection in patients of poor condition.Conclusion: infection to S. saccharolyticus is difficult to diagnose due to microbiological characteristics of this bacterium, requires timely treatment and improved infection control procedure should be encouraged for patients with poor condition.
Associations Of Abnormalities Detected On Mri And Radiography With Hand Pain And Function In A Population-Based Older Adult Cohort.
Authors: Mattap Siti Maisarah , Wills Karen , Aitken Dawn , Halliday Andrew , Luong Shi-Nan , Squibb Kathryn , Cicuttini Flavia , Jones Graeme , Laslett Laura 
Published: February 2020

Abstract
Objective To describe associations between hand abnormalities on MRI or radiographs (X-ray) and pain and function in a cross-sectional study of community-based older adults. Methods Distal and proximal interphalangeal index finger joints (n=221) were examined using MRI, X-ray, and hand examination. Hand pain, function, and stiffness were assessed using Australian/Canadian hand osteoarthritis index (AUSCAN) questionnaire. Grip strength was assessed using dynamometer. Models were adjusted for age, sex, and other MRI or X-ray abnormalities. Results Absence of collateral ligament (CLs) on MRI (relative risk; RR=3.15 (95% confidence interval 1.33, 7.50), and joint space narrowing (JSN) on X-ray (RR=2.96 (1.33, 6.58)) was associated with having a painful joint after adjustment for confounders. JSN was also associated with tender joints (RR=2.19 (1.01, 4.76)). Effusion-synovitis was associated with better AUSCAN pain scores (OR=0.51 (0.28, 0.94)) and JSN with worse AUSCAN pain scores (odds ratio; OR=1.67 (1.13, 2.48)). Absent CLs were also associated with stiffer joints (OR=3.12 (1.26, 7.70)) and weaker grip strength (β=-1.69 (-2.95, -0.43)) independent of pain and other features; JSN was also associated with weaker grip strength (β=-0.87 (-1.62, -0.14)). No other MRI or X-ray abnormalities were associated with pain or function independent of age, sex or pain. Conclusion Most MRI abnormalities were not associated with pain and function cross-sectionally. Absent CLs and JSN were associated with painful joints and weak grip strength independent of pain and other imaging features. JSN was also associated with tender joints and absent CLs with stiff joints. Unexpectedly, effusions were associated with reduced odds of pain.
MAAWf: An Integrated and Visual Tool for Microbiome Data Analyses
Authors: Zhu Sibo , Sun Tao , Zhu Chengkai , Qing Tao , Jiang Yanfeng , Ding Ruifeng , Su Haoxuan , Sun Yunwen , Xu Xiulin , Xu Kelin , Suo Chen , Yuan Ziyu , Zhang Tiejun , Zhao Genming , Ye Weimin , Jin Li , Chen Xingdong 
Published: February 2020

Abstract
BackgroundMicrobiomic research has grown in popularity in recent decades. The widespread use of next-generation sequencing technologies, including 16S rRNA gene-based and metagenomic shotgun-based methods, has produced a wealth of microbiome data. At present, most software and analysis workflows for analysis and processing of microbiomic data are command line-based, which requires considerable computing time and makes interaction difficult.ResultsTo provide a command-line free, integrated, user interface friendly and online/local deployable microbiome analysis tool, we developed Microbiome Automated Analysis Workflows (MAAWf). The MAAWf assesses taxonomy, protein-coding genes, metabolic pathways, carbohydrate-active enzymes (CAZy) and antibiotic resistance genes (ARGs) for WMS, and clusters operational taxonomic units, alpha-/beta-diversity and functional annotations for 16S. MAAWf generates similar results to currently popular tools, but the running time was much shorter. MAAWf is freely accessible and source code available at http://www.maawf.com.ConclusionsMAAWf is a visual, integrated, rapid analysis tool that enables remote and local computing of microbiome data.
How to improve the satisfaction levels of new rural cooperative medical system in underdeveloped areas of China?
Authors: Yao Pin , Wu Yifan , Chen Xiaodong , Ouyang Jing , Liu Chunping , Sun Shu 
Published: February 2020

Abstract
Background: Over the years, China has designed a new rural cooperative medical system for large rural population, which enables them to obtain adequate medical services and prevents poverty caused by medical treatments. However, the rapid economic growth makes the allocation of health resources and the efficient utilization of health services face severe challenges. The study aims to reveal the medical inequality of eight underdeveloped provinces from the perspectives of medical institutions, insurance policies, the government and farmers, in order to puts forward relevant recommendations.Methods: The relevant statistics about assessing the characteristics and equity of demographics, socio-economic and geographical dimensions were from the China Statistical Yearbook and the China Health Statistics Yearbook. A face-to-face sampling survey of farmers in 24 counties of eight less developed provinces (Guizhou, Yunnan, Sichuan, Shanxi, Gansu, Qinghai, Ningxia and Xinjiang) was carried out by multi-stage stratified random sampling. The protection effect of New Rural Cooperative Medical System（NRCMS）, satisfaction of medical service and willingness to participate in NRCMS were analyzed.Results: Since the implementation of the new rural cooperative medical system, there has been an inequality in medical service and insurance policy among poor residents in western China. The uneven distribution of medical resources, the inadequacy of local government investment, the complexity of the reimbursement process, and the low amount of compensation resulted in only 26.6% of the population believing that the economic burden of the disease had been reduced, and 57.3% that the relief effect was not obvious. The remaining 16.1% thought the system was ineffective and farmers' satisfaction was not enough. Conclusion: Compared with the eastern and central regions, there was a certain degree of unfairness in government investment in the resources of medical institutions of the western region with new rural cooperative medical care. This study suggested that policy makers can attract high-quality medical staff to the western region by providing economic security and improving policies. In addition, the increase of the government regional health expenditure and supervision propaganda was one of the important ways to improve the farmers' satisfaction with the policy.
Health Related Quality of Life in Patients with Crohn's Disease: A case control Study
Authors: AlQahtani Manar , AlHarbi Reema , AlAsmari Reem , AlNowaiser Lamya , AlThunayan Ebtehal , Alzaben Abeer Salman 
Published: February 2020

Abstract
Background The study objective was to compare health-related quality of life (HRQoL) between participants with Crohn's Disease (CD) and healthy controls (CONs). Methods A case-control study was conducted in adults with CD and CONs in Saudi Arabia (aged between 18-60 years). Sociodemographic data (age, sex, age at diagnosis) were collected. The following additional information was collected for the CD group: the onset of disease, treatment, and symptomology associated with CD. The validated Arabic version of the SF-36 was used to assess HRQoL. Results The study included 109 CD patients and 370 CON participants. Participants with CD had significantly lower HRQoL scores in the physical functioning [CD=75 (50-90) vs CON=85 (60-95)], role physical [CD=50 (0-100) vs CON=100 (50-100)], role emotional [CD=67 (0-100) vs CON= 67 (33-100)], vitality [CD= 50 (30-58) vs CON=50 (40-60)], social functioning [CD=63 (50-75) vs CON=75 (50-88)], bodily pain [CD=70 (45-90) vs CON=80 (68-100)], general health [CD=55 (40-65) vs CON=65 (55-75)], physical [CD=63 (52-75), vs CON=75 (63-85)], and mental domains [CD=51 (32-69) vs CON=63 (55-72)] than the CON group (p<0.02). In the CD group, participants with loss of appetite had lower HRQoL scores in the physical functioning [loss appetite=60 (40-80) vs no loss appetite=83 (65-90)], role physical [loss appetite=25 (0-75) vs no loss appetite=50 (25-100)], social functioning [loss appetite=63 (50-75) vs no loss appetite=75 (50-88)], physical [loss appetite=57 (45-68) vs no loss appetite=69 (56-78)], and mental domains [loss appetite=47 (30-67) vs no loss appetite=59 (44-72)] than participants without loss of appetite (p<0.04). Conclusion Individuals with CD had lower HRQoL than CON participants. Loss of appetite is associated with a lower HRQoL score.
Time-course and factors affecting movement control in acute low back pain: A prospective cohort study in a primary care setting
Authors: Hofstetter Angela , Pfeiffer Fabian , Meichtry André , Luomajoki Hannu , Hotz-Boendermaker Sabina 
Published: February 2020

Abstract
Background: A subgroup of low back pain (LBP) patients present with movement control impairment (MCI). Although there has been extensive research in this area, there is a lack of knowledge of how movement control develops over time and the factors that impact MCI after an acute LBP-episode. Objective : The investigation followed the time-course of MCI in the first three months after an onset of acute LBP-episode, including a baseline-effect evaluation of various demographic, physical and psychosocial characteristics on MCI. Methods : Within this prospective cohort study, 68 subjects with an acute onset of LBP of less than four weeks duration were recruited. In conclusion, 56 subjects were assessed three times at four, eight and twelve weeks. Questionnaire data was collected using an online survey, including demographic data, pain intensity, recurrence of LBP, disability, depression, pain-related activity patterns, activity level and the use of physiotherapy treatment. In addition, a physical examination was performed at the same time points (TP) to assess MCI. For the data analysis, we performed a regression analysis, using proportional odds models. Results : The majority of the participants presented with MCI during the measurement period, although with highly individual courses. The evaluation of baseline and time effects for disability, pain-related activity patterns and physical treatment confirmed interactions with MCI. In contrast, pain intensity and recurrent episodes of LBP revealed effects on MCI only in the adjusted model in combination with other variables. Conclusions : MCI plays a significant role in a subgroup of subjects in the course of LBP after an acute onset of symptoms. Physiotherapy treatment showed short time effects on MCI and might be essential in stratified care in a primary care setting. Further longitudinal studies are needed to assess the association of those different physical and psychosocial characteristics of MCI to calculate their time-interaction on MCI. This is due to the multidimensional nature of LBP and the underlying mechanisms of MCI still being unidentified.