bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative performance study of three Ebola rapid diagnostic tests in Guinea
Authors: Moran Zelda , Rodriguez William , Ahmadou Doré , Soropogui Barré , Magassouba N’ Faly , Kelly-Cirino Cassandra , Ben Amor Yanis 
Published: September 2020

Abstract
Background
The 2014/15 Ebola outbreak in West Africa resulted in 11,000 deaths and massive strain on local health systems, and the ongoing outbreak in Democratic Republic of Congo has afflicted more than 3000 people. Accurate, rapid Ebola diagnostics suitable for field deployment would enable prompt identification and effective response to future outbreaks, yet remain largely unavailable. The purpose of this study was to assess the accuracy of three novel rapid diagnostic tests (RDTs): an Ebola, an Ebola-Malaria, and a Fever Panel test that includes Ebola, all from a single manufacturer.

Methods
We evaluated the three RDTs in 109 Ebola-positive and 96 Ebola-negative stored serum samples collected during the outbreak in Guinea in 2014/15, and tested by real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, and overall percent agreement were calculated for each RDT using RT-PCR as a reference standard, stratified by Ct value ranges.

Results
All tests performed with high accuracy on samples with low Ct value (high viral load). The Fever Panel test performed with the highest accuracy, with a sensitivity of 89.9% and specificity of 90.6%. The Ebola and Ebola-Malaria tests performed comparably to each other: sensitivity was 77.1 and 78% respectively, and specificity was 91.7% for the Ebola test and 95.8% for the Ebola-Malaria test.

Conclusions
This study evaluated the accuracy of three novel rapid diagnostic tests for Ebola. The tests may have significant public health relevance, particularly the Fever Panel test, which detects seven pathogens including Ebola. Given limitations to the study resulting from uncertain sample quality, further evaluation is warranted. All tests performed with highest accuracy on samples with low Ct value (high viral load), and the data presented here suggests that these RDTs may be useful for point-of-care diagnosis of cases in the context of an outbreak. Restrictions to their use in non-severe Ebola cases or for longitudinal monitoring, when viral loads are lower, may be appropriate. Highlighting the challenge in developing and evaluating Ebola RDTs, there were concerns regarding sample integrity and reference testing, and there is a need for additional research to validate these assays.
Distribution pattern of amino acid mutations in chloroquine and antifolate drug resistance associated genes in complicated and uncomplicated Plasmodium vivax isolates from Chandigarh, North India
Authors: Kaur Hargobinder , Sehgal Rakesh , Kumar Archit , Bharti Praveen K. , Bansal Devendra , Mohapatra Pradyumna K. , Mahanta Jagadish , Sultan Ali A. 
Published: September 2020

Abstract
Background
The increasing antimalarial drug resistance is a significant hindrance to malaria control and elimination programs. For the last six decades, chloroquine (CQ) plus pyrimethamine remains the first-line treatment for P. vivax malaria. Regions where both P. falciparum and P. vivax co-exist, P. vivax is exposed to antifolate drugs due to either misdiagnosis or improper treatment that causes selective drug pressure to evolve. Therefore, the present study aims to estimate antimalarial drug resistance among the complicated and uncomplicated P. vivax patients.

Methods
A total of 143 P. vivax malaria positive patients were enrolled in this study, and DNA was isolated from their blood samples. Pvcrt-o, Pvmdr-1, Pvdhps, and Pvdhfr genes were PCRs amplified, and drug resistance-associated gene mutations were analyzed. Statistical analysis of the drug resistance genes and population diversity was performed using MEGA vs. 7.0.21 and DnaSP v software.

Results
Among the CQ resistance marker gene Pvcrt-o, the prevalence of K10 insertion was 17.5% (7/40) and 9.5% (7/73) of complicated and uncomplicated P vivax group isolates respectively. In Pvmdr-1, double mutant haplotype (M958/L1076) was found in 99% of the clinical isolates. Among the pyrimethamine resistance-associated gene Pvdhfr, the double mutant haplotype I13P33F57R58T61N117I173 was detected in 23% (11/48) in complicated and 20% (17/85) in uncomplicated group isolates. In the sulphadoxine resistance-associated Pvdhps gene, limited polymorphism was observed with the presence of a single mutant (D459A) among 16 and 5% of the clinical isolates in the complicated and uncomplicated group respectively.

Conclusion
The study presents the situations of polymorphism in the antimalarial drug resistance-associated genes and emphasizes the need for regular surveillance. It is imperative for the development of suitable antimalarial drug policy in India.
Rasch analysis of the living with chronic illness scale in Parkinson’s disease
Authors: Ambrosio Leire , Rodriguez-Blazquez Carmen , Ayala Alba , Forjaz Maria João 
Published: September 2020

Abstract
Background
Neurologists play an essential role in facilitating the patient’s process of living with Parkinson’s disease (PD). The Living with Chronic Illness Scale-PD (LW-CI-PD) is a unique available clinical tool that evaluates how the patient is living with PD. The objective of the study was to analyse the LW-CI-PD properties according to the Rasch model.

Methods
An open, international, cross-sectional study was carried out in 324 patients with Parkinson’s disease from four Latin American countries and Spain. Psychometric properties of the LW-CI-PD were tested using Rasch analysis: fit to the Rasch model, item local independency, unidimensionality, reliability, and differential item functioning by age and gender.

Results
Original LW-CI-PD do not fit Rasch model. Modifications emerged included simplifying the response scale and deleting misfit items, the dimensions Acceptance, Coping and Integration showed a satisfactory fit to the Rasch model, with reliability indices greater than 0.70. The dimensions Self-management and Adjustment to the disease did not reach fit to the Rasch model.

Conclusion
Suggestions for improving the LW-CI-PD include a multidimensional and shorter scale with 12 items grouped in three subscales with a simpler response scheme. The final LW-CI-PD Scale version is a reliable scale, with good internal construct validity, that provides Rasch transformed results on linear metric scale.
Plasma-based longitudinal mutation monitoring as a potential predictor of disease progression in subjects with adenocarcinoma in advanced non-small cell lung cancer
Authors: Jiang John , Adams Hans-Peter , Lange Maria , Siemann Sandra , Feldkamp Mirjam , McNamara Sylvie , Froehler Sebastian , Yaung Stephanie J. , Yao Lijing , Balasubramanyam Aarthi , Tikoo Nalin , Ju Christine , Achenbach H. Jost , Krügel Rainer , Palma John F. 
Published: September 2020

Abstract
Background
Identifying and tracking somatic mutations in cell-free DNA (cfDNA) by next-generation sequencing (NGS) has the potential to transform the clinical management of subjects with advanced non-small cell lung cancer (NSCLC).

Methods
Baseline tumor tissue (n = 47) and longitudinal plasma (n = 445) were collected from 71 NSCLC subjects treated with chemotherapy. cfDNA was enriched using a targeted-capture NGS kit containing 197 genes. Clinical responses to treatment were determined using RECIST v1.1 and correlations between changes in plasma somatic variant allele frequencies and disease progression were assessed.

Results
Somatic variants were detected in 89.4% (42/47) of tissue and 91.5% (407/445) of plasma samples. The most commonly mutated genes in tissue were TP53 (42.6%), KRAS (25.5%), and KEAP1 (19.1%). In some subjects, the allele frequencies of mutations detected in plasma increased 3–5 months prior to disease progression. In other cases, the allele frequencies of detected mutations declined or decreased to undetectable levels, indicating clinical response. Subjects with circulating tumor DNA (ctDNA) levels above background had significantly shorter progression-free survival (median: 5.6 vs 8.9 months, respectively; log-rank p = 0.0183).

Conclusion
Longitudinal monitoring of mutational changes in plasma has the potential to predict disease progression early. The presence of ctDNA mutations during first-line treatment is a risk factor for earlier disease progression in advanced NSCLC.
Functional outcomes after combined iris and intraocular lens implantation in various iris and lens defects
Authors: Mayer Christian S. , Hoffmann Andrea M. , Prahs Phillipp , Reznicek Lukas , Khoramnia Ramin 
Published: September 2020

Abstract
Background
To assess the functional outcomes after combined iris and intraocular lens (IOL) repair in aniridia patients.

Methods
Retrospective observational study in 59 aniridic and aphakic eyes for ArtificialIris (AI) and IOL reconstruction. The iris prostheses were placed together with the IOL in the capsular bag using an injection system or were fixed by transscleral suturing of the IOL and AI. The primary outcomes measured were visual acuity, contrast and glare sensitivity (Pelli-Robson chart for photopic and dark adaptometer for mesopic conditions), intraocular pressure, endothelial cell density (ECD) and patient impairment.

Results
Blunt trauma (37 eyes) and penetrating injuries (16 eyes) were observed more frequently than congenital aniridia (1 eye), iatrogenic causes (1 eye), aniridic state after severe iritis (2 eyes) or iris tumor (2 eyes). Monocular CDVA improved significantly (p < 0.0001) from median 0.7 logMAR (0.0–1.98) to 0.3 logMAR (− 0.08–2.0). Median pupillary area could significantly (p < 0.0001) be reduced by 79.3% from 51.27 mm2 (17.91 to 98.23) to 8.81 mm2 (4.16 to 8.84). Median ECD decreased from 2646.0 mm2 to 2497.5 mm2 (p = 0.007). Contrast and glare sensitivity improved significantly (p = 0.008) in photopic light conditions from 0.9 (0.0–1.95) to 1.35 (0.0–1.8). Patients reported to be highly satisfied with the functional improvement.

Conclusion
The flexible ArtificialIris seems to be a safe and effective iris prosthesis in combination with an IOL having functionally and cosmetically exceptional reconstruction options.
Chest x-ray findings and temporal lung changes in patients with COVID-19 pneumonia
Authors: Rousan Liqa A. , Elobeid Eyhab , Karrar Musaab , Khader Yousef 
Published: September 2020

Abstract
Background
Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.

Methods
From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.

Results
A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19. Their age ranged from 3 to 80 years (35.2 ± 18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6–11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12–17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6–11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P = 0.005).

Conclusion
Almost half of patients with COVID-19 have abnormal chest x-ray findings with peripheral GGO affecting the lower lobes being the most common finding. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.
Gradient boosting for Parkinson’s disease diagnosis from voice recordings
Authors: Karabayir Ibrahim , Goldman Samuel M. , Pappu Suguna , Akbilgic Oguz 
Published: September 2020

Abstract
Background
Parkinson’s Disease (PD) is a clinically diagnosed neurodegenerative disorder that affects both motor and non-motor neural circuits. Speech deterioration (hypokinetic dysarthria) is a common symptom, which often presents early in the disease course. Machine learning can help movement disorders specialists improve their diagnostic accuracy using non-invasive and inexpensive voice recordings.

Method
We used “Parkinson Dataset with Replicated Acoustic Features Data Set” from the UCI-Machine Learning repository. The dataset included 44 speech-test based acoustic features from patients with PD and controls. We analyzed the data using various machine learning algorithms including Light and Extreme Gradient Boosting, Random Forest, Support Vector Machines, K-nearest neighborhood, Least Absolute Shrinkage and Selection Operator Regression, as well as logistic regression. We also implemented a variable importance analysis to identify important variables classifying patients with PD.

Results
The cohort included a total of 80 subjects: 40 patients with PD (55% men) and 40 controls (67.5% men). Disease duration was 5 years or less for all subjects, with a mean Unified Parkinson’s Disease Rating Scale (UPDRS) score of 19.6 (SD 8.1), and none were taking PD medication. The mean age for PD subjects and controls was 69.6 (SD 7.8) and 66.4 (SD 8.4), respectively. Our best-performing model used Light Gradient Boosting to provide an AUC of 0.951 with 95% confidence interval 0.946–0.955 in 4-fold cross validation using only seven acoustic features.

Conclusions
Machine learning can accurately detect Parkinson’s disease using an inexpensive and non-invasive voice recording. Light Gradient Boosting outperformed other machine learning algorithms. Such approaches could be used to inexpensively screen large patient populations for Parkinson’s disease.
Marketing communications in health and medicine: perspectives from Willis-Knighton Health System
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

Abstract
Background
Communications prowess is a key ingredient of productive healthcare delivery pursuits, with associated successes clearly positioning health and medical establishments for growth and prosperity. Many conveyance mechanisms are at the disposal of healthcare providers, permitting numerous opportunities for engaging current and prospective patients. For the best communicative outcomes, all must be considered when formulating marketing communications initiatives, with consideration first, of course, requiring that healthcare providers acquire an understanding of communications options and associated fundamentals.

Discussion
In pursuing knowledge of communications options and related guidance, healthcare providers can benefit greatly by gaining operational perspectives from peer institutions. Over many decades, through scores of deployments, Willis-Knighton Health System has acquired significant communications prowess, prompting development of this special supplement in BMC Health Services Research, entitled “Marketing communications in health and medicine: perspectives from Willis-Knighton Health System,” with this particular article supplying a brief profile of the contents included in the associated supplement. Across the pages of the collection of articles contained in the supplement, attention specifically is directed toward the components of the marketing communications mix, foundational elements of communication, the patronage process, and the necessity for integrating marketing communications.

Conclusions
Establishing an effective dialogue with current and prospective patients is an absolute necessity for healthcare organizations, warranting intensive efforts to master marketing communications. Given the imperative for excellence in marketing communications, it is hoped that the light shed by this supplement and its collection of articles will help healthcare providers better understand marketing communications and deploy associated initiatives successfully, affording greater patient engagement opportunities.
Advertising in health and medicine: using mass media to communicate with patients
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

AbstractBackgroundAdvertising—a marketing communications method involving the paid use of mass media to deliver messages to desired audiences—represents one of the most common and effective avenues for engaging current and prospective patients. Although late to proliferate in the health services industry due to tradition, the medium of communication is now firmly established and routinely deployed by health and medical organizations far and wide. Despite widespread use, healthcare providers must take opportunities, when and where possible, to stay abreast of the latest details concerning advertising and its associated applications, increasing the likelihood of successful audience engagements.DiscussionMaintaining an awareness of current developments in health services advertising can be facilitated by acquiring operational perspectives and practices from peer institutions. Most any healthcare provider can benefit from experiential views as they can shape and hone advertising approaches. Gaining such insights can be difficult, given competitive sensitivities, but occasionally healthcare institutions are compelled to share knowledge in published accounts, with this particular article following suit. Specifically, insights and experiences from Willis-Knighton Health System’s extensive and historic use of advertising are shared, bolstering the experiential accounts available in the literature and supplying operational guidance for health and medical providers.ConclusionsAdvertising, if well devised and deployed, offers healthcare providers opportunities to dramatically improve their fortunes by successfully engaging current and prospective patients, hastening exchange and building vital market share. In pursuit of advertising excellence, health and medical establishments can bolster associated endeavors by tapping into the experiences of other healthcare providers, permitting insights which might potentially be incorporated into communicative pathways. This account sheds light on the advertising operations of a major health system, supplying food for thought for the advancement of advertising acumen.
Public relations in health and medicine: using publicity and other unpaid promotional methods to engage audiences
Authors: Elrod James K. , Fortenberry John L. 
Published: September 2020

Abstract
Background
Public relations—a marketing communications method involving the use of publicity and other unpaid promotional methods to deliver messages—historically has served as the communicative workhorse of the health services industry, representing the predominant pathway over many decades by which health and medical facilities conveyed stories to the public. While other components of the marketing communications mix, perhaps most notably that of advertising, have now captured a significant portion of interest, attention, and use by healthcare establishments, public relations remains a valuable communicative avenue when deployed properly.

Discussion
As an unpaid method of promotion, public relations is uniquely positioned among its counterparts in the marketing communications mix which require direct expenditures to reach audiences. Typically effected by preparing and submitting press releases to news media firms in hopes that they, in turn, will present given stories to their audiences, limitations are somewhat obvious as transmission control rests with external entities. But overcoming limitations is possible with prudent strategies. This article presents Willis-Knighton Health System’s associated strategies, along with a range of public relations insights from decades of deployment experience.

Conclusions
Prudently deployed and led by guiding strategies, public relations offers health and medical organizations opportunities to engage audiences in an efficient and highly credible manner. Courtesy of its unique properties, public relations capably can complement other marketing communications, operating synergistically to help healthcare institutions achieve their conveyance goals, fostering exchange and bolstering market share. Careful operationalization of this marketing communications avenue can help healthcare establishments realize their full communicative potential.
Economic impact of clinical decision support interventions based on electronic health records
Authors: Lewkowicz Daniel , Wohlbrandt Attila , Boettinger Erwin 
Published: September 2020

Abstract
Background
Unnecessary healthcare utilization, non-adherence to current clinical guidelines, or insufficient personalized care are perpetual challenges and remain potential major cost-drivers for healthcare systems around the world. Implementing decision support systems into clinical care is promised to improve quality of care and thereby yield substantial effects on reducing healthcare expenditure. In this article, we evaluate the economic impact of clinical decision support (CDS) interventions based on electronic health records (EHR).

Methods
We searched for studies published after 2014 using MEDLINE, CENTRAL, WEB OF SCIENCE, EBSCO, and TUFTS CEA registry databases that encompass an economic evaluation or consider cost outcome measures of EHR based CDS interventions. Thereupon, we identified best practice application areas and categorized the investigated interventions according to an existing taxonomy of front-end CDS tools.

Results and discussion
Twenty-seven studies are investigated in this review. Of those, twenty-two studies indicate a reduction of healthcare expenditure after implementing an EHR based CDS system, especially towards prevalent application areas, such as unnecessary laboratory testing, duplicate order entry, efficient transfusion practice, or reduction of antibiotic prescriptions. On the contrary, order facilitators and undiscovered malfunctions revealed to be threats and could lead to new cost drivers in healthcare. While high upfront and maintenance costs of CDS systems are a worldwide implementation barrier, most studies do not consider implementation cost. Finally, four included economic evaluation studies report mixed monetary outcome results and thus highlight the importance of further high-quality economic evaluations for these CDS systems.

Conclusion
Current research studies lack consideration of comparative cost-outcome metrics as well as detailed cost components in their analyses. Nonetheless, the positive economic impact of EHR based CDS interventions is highly promising, especially with regard to reducing waste in healthcare.