bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problems and prospects of creating health tourism villages as a potential for developing medical tourism in the Islamic Republic of Iran (Case study: Yazd province)
Authors: Hosseini S. S. , Tagvayi M. , Ataev Z. V. , Bratkov V. V. 
Published: October 2020

Aim. The article discusses the current state of medical tourism, problems and prospects in order to assess the obstacles and limitations in creating tourist health villages in the Iranian province of Yazd.Materials and Methods. The data were obtained using the analytical and documentary method with a focus on content analysis and by interviewing and questionnaires of key experts of the region: this allowed the identifation and development indices for the development of medical tourism in the development of health villages.Results. During the first stage, data analysis was performed using the MAXQDA-11 program. In the second stage, the data obtained were studied in order to assess the state of these indices using the SOWAT model. Priorities were then set and the specific weight of obstacles and restrictions was calculated using complex criteria.Conclusions. Poor transportation provision for medical tourists due to the limited number of domestic and international flights, unavailability of treatment and followup after discharge, ineffective insurance legislation and lack of appropriate new legislation were identified as the main obstacles to the development of medical tourism. Accordingly, long-term and short-term strategies should be developed and implemented in accordance with these issues. On the other hand, taking into account the restrictions and obstacles noted, we have proposed locations suitable for building health villages at a minimum distance from Yazd. These are indicated on a map created using the Arc GIS program. During project implementation, strategic objectives were developed.
PERFIL CLÍNICO DE MULHERES SUBMETIDAS À CIRURGIA DE REVASCULARIZAÇÃO DO MIOCÁRDIO E TROCA VALVAR
Authors: Gutierres Evilin Diniz , Rocha Laurelize Pereira , Brum Aline Neutzling , Yasin Janaína Cassana Mello , Carvalho Deciane Pintanela  de , Brum Raissa Garcia 
Published: October 2020

<p>Objetivo: descrever o perfil clínico de mulheres submetidas à cirurgia de revascularização do miocárdio e troca valvar. Método: estudo documental, retrospectivo, analítico, quantitativo, realizado em 131 prontuários de pacientes submetidas à cirurgia cardíaca em um hospital no sul do Rio Grande do Sul. A coleta de dados foi realizada no ano de 2018. Os dados foram analisados pelos testes de Qui-quadrado e o teste de Correlação de Spearman. Foi considerado o nível de significância de 5% para todos os testes estatísticos (p&lt;0,05). Resultados: verificou-se que houve associações significativas nas características clínicas para tabagismo, obesidade e infarto agudo do miocárdio recente (p=0,009, 0,017 e 0,029, respectivamente). Conclusão: os achados mostraram características importantes de um grupo significativo de pacientes, sinalizando a atenção que deve ser atribuída às atividades de prevenção da saúde e controle dos fatores de risco nas mulheres, principalmente pela associação do climatério e o desenvolvimento de doenças cardiovasculares.</p><p><br />Descritores: Saúde da Mulher. Doenças Cardiovasculares. Revascularização Miocárdica. Válvulas Cardíacas. Enfermagem.</p>
O DOM DE CURAR
Authors: Chaves Ana Maria Chaves de , Saraiva Luis Junior Costa 
Published: October 2020

A produção fílmica que se apresenta é resultado de uma pesquisa realizada em Soure-Marajó-Pará sobre as experiências sobre o dom de curar a partir da observação etnográfica da Senhora Maria Florinda e do seu cotidiano com suas plantas e seus saberes ligados ao dom de curar. Assista aqui.
Handling Big Models and Big Data Sets in History-Matching Problems through an Adaptive Local Analysis Scheme
Authors: Soares Ricardo Vasconcellos , Luo Xiaodong , Evensen Geir , Bhakta Tuhin 
Published: October 2020

SummaryIn applications of ensemble-based history matching, it is common to conduct Kalman gain or covariance localization to mitigate spurious correlations and excessive variability reduction resulting from the use of relatively small ensembles. Another alternative strategy not very well explored in reservoir applications is to apply a local analysis scheme, which consists of defining a smaller group of local model variables and observed data (observations), and perform history matching within each group individually. This work aims to demonstrate the practical advantages of a new local analysis scheme over the Kalman gain localization in a 4D seismic history-matching problem that involves big seismic data sets. In the proposed local analysis scheme, we use a correlation-based adaptive data-selection strategy to choose observations for the update of each group of local model variables. Compared to the Kalman gain localization scheme, the proposed local analysis scheme has an improved capacity in handling big models and big data sets, especially in terms of computer memory required to store relevant matrices involved in ensemble-based history-matching algorithms. In addition, we show that despite the need for a higher computational cost to perform model update per iteration step, the proposed local analysis scheme makes the ensemble-based history-matching algorithm converge faster, rendering the same level of data mismatch values at a faster pace. Meanwhile, with the same numbers of iteration steps, the ensemble-based history-matching algorithm equipped with the proposed local analysis scheme tends to yield better qualities for the estimated reservoir models than that with a Kalman gain localization scheme. As such, the proposed adaptive local analysis scheme has the potential of facilitating wider applications of ensemble-based algorithms to practical large-scale history-matching problems.
Comparative Efficacy of Glucocorticoid Receptor Agonists on Th2 Cell Function and Attenuation by Progesterone
Authors: Luchak Alexander , Solomon Lauren A , Kanagalingam Tharsan , Vijeyakumaran Meerah , Rowe Brian H , Cameron Lisa 
Published: October 2020

Abstract
Background: Corticosteroids (CS)s suppress cytokine production and induce apoptosis of inflammatory cells. Prednisone and dexamethasone are oral CSs prescribed for treating asthma exacerbations. While prednisone is more commonly prescribed, dexamethasone is long acting and a more potent glucocorticoid receptor (GR) agonist. It can be administered as a one or two dose regime, unlike the five to seven days required for prednisone, a feature that increases compliance. We compared the relative ability of these two oral CSs to suppress type 2 inflammation. Since progesterone has affinity for the GR and women are more likely to relapse following an asthma exacerbation, we assessed its influence on CS action.Results: Dexamethasone suppressed the level of IL-5 and IL-13 mRNA within Th2 cells with ~10-fold higher potency than prednisolone (the active form of prednisone). Dexamethasone induced a higher proportion of apoptotic and dying cells than prednisolone, at all concentrations examined. Addition of progesterone reduced the capacity of both CS to drive cell death, though dexamethasone maintained significantly more killing activity. Progesterone blunted dexamethasone-induction of FKBP5 mRNA, indicating that the mechanism of action was by interference of the CS:GR complex.Conclusions: Dexamethasone is both more potent and effective than prednisolone in suppressing type 2 cytokine levels and mediating apoptosis. Progesterone attenuated these anti-inflammatory effects, indicating its potential influence on CS responses in vivo. Collectively, our data suggest that when oral CS is required, dexamethasone may be better able to control type 2 inflammation, eliminate Th2 cells and ultimately lead to improved long-term outcomes. Further research in asthmatics is needed.
Public awareness and knowledge of factors associated with dementia in China
Authors: Zheng Yong-bo , Shi Le , Gong Yi-Miao , Wang Xiao-Xiao , Lu Qing-Dong , Que Jian-Yu , Khan Muhammad Zahid , Bao Yan-Ping , Lu Lin 
Published: October 2020

Abstract
Background: Dementia is a global public health priority. Many modifiable factors have been shown to influence the development of dementia, but these factors are not adequately known by the general public. This study aimed to assess public awareness of the factors that are associated with dementia in China.Methods: A cross-sectional study was conducted from May to October 2019 using an Internet-based questionnaire. Data on basic sociodemographic characteristics were collected, and the knowledge of risk and protective factors for dementia was investigated. Logistic regression analysis was performed to compare levels of the knowledge of factors associated with dementia across populations with different demographic characteristics.Results: Data from 3,338 respondents were analyzed. The percentages of participants who accurately identified the risk factors of dementia were follows: 84.24% for negative affect, 65.07% for alcohol use, 56.68% for smoking, 48.74% for hypertension, and 42.66% for diabetes. The percentages of participants who accurately identified the protective factors for dementia were follows: 90.00% for exercise, 84.69% for social activity, 80.92% for intelligence games, 74.45% for reading, and 6.14% for antihypertensive or hypolipidemic drugs. The majority of Chinese people correctly recognized the role of lifestyle factors in the development of dementia but not medical factors. The levels of knowledge of the factors associated with dementia were significantly distinct across populations with different characteristics. The following sociodemographic characteristics were associated with more comprehensive knowledge of dementia risk and protective factors: women, young age, high education levels, nonmanual jobs, and contact with patients with dementia.Conclusions: Public awareness and knowledge of risk and protective factors for dementia in China are still insufficient. More efforts are needed to publicize information to reduce the risk of dementia.
Socio-economic drivers of Drug-Resistant Tuberculosis in Africa: A Scoping Review
Authors: Cannon Lesley-Ann Lynnath , Oladimeji Kelechi Elizabeth , Goon Daniel Ter 
Published: October 2020

Abstract
Background Drug-resistant TB (DR-TB) remains a public health concern due to the high morbidity and mortality rates from the disease. The DR-TB is a multifaceted illness with expensive treatment regimens, toxic medications and most often the long duration of treatment constitutes a substantial financial burden on both infected patients and the health system. Despite significant research advances in the diagnosis and treatment, there is a paucity of synthesized evidence on how socio-economic factors are associated with DR-TB. This review aims to address this gap by synthesizing available evidence and data on the common socio-economic drivers of DR-TB infection in Africa.MethodsA systematic search was conducted on PUBMED and Google Scholar databases from January 2011 to January 2020 using Joanna Briggs Institute’s scoping review approach. An updated search was conducted on 21 September 2020. The eligibility criteria only included systematic reviews and studies with quantitative research methods (cross-sectional, case-control, cohort and randomized-control trials). Studies conducted in Africa and focusing on socio-economic factors influencing DR-TB burden in African countries were also considered. Data was extracted from all the studies that met the eligibility criteria based on the study’s objectives. ResultsOut of the 154 articles that were retrieved for review, 20 abstracts of these articles met all the eligibility criteria. Of the 20 articles, 17 quantitative and 3 reviews. 2 additional articles were found eligible, following the updated search. The following themes were identified as major findings: Social and economic drivers associated with DR-TB. Substance abuse of which, stigma and discrimination were the prominent social drivers. Economic drivers included poverty, financial constraints because of job loss, loss of productive time during hospital admission and treatment costs. ConclusionThis review has highlighted which socio-economic factors contribute to DR- TB This is relevant to assist DR-TB management program and TB stakeholders in different settings to address identified socio-economic gaps and to reduce its negative impact on the programmatic management of DR TB. Therefore, redirecting strategies with more focus on socio-economic empowerment of DR-TB patients could be one of the innovative solutions to reduce the spread and eliminate DR-TB in Africa.
Early childhood infections, antistreptococcal and basal ganglia antibodies in adult ADHD: A preliminary study
Authors: Oliva Francesco , Girolamo Giulia di , Malandrone Francesca , Iaia Noemi , Biasi Fiorella , Maina Giuseppe 
Published: October 2020

Abstract
Background: To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood.Method: Childhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer's specifications. Absolute titers were also collected as continuous variables.Results: Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.Conclusions: Patients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood, moreover they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.
Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure
Authors: Li Min , Liu Jia , Deng Xuhui , Gan Qingzhou , Wang Yijie , Xu Xiaofeng , Jiang Ying , Peng Fuhua 
Published: October 2020

Abstract
Background: Raised intracranial pressure (ICP) and insufficient antifungal regimens are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole, 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, fluconazole plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP. Methods: We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal ﬂuid proﬁles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS. Results: Triple therapy plus VPS group had more satisfactory outcomes, more CSF sterilization at 10 weeks follow-up, lower CSF opening pressure, lower BMRC staging scores one week after VPS, less CSF C. neoformans counts and CSF culture positive. Besides, these patients had shorter hospital stay than triple therapy group. Conclusions: Triple antifungal agents combined with VPS could effectively reduce ICP, had faster rate of clearance of C. neoformans counts, more improved neurological function, shorten hospitalization time and better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS may be an optimal treatment for non-HIV CM patients with increased ICP.
Measurement of salivary testosterone in adolescents and young men with Duchenne muscular dystrophy
Authors: Sahun Yolanda Alins , Cheetham Tim D , Boot Christopher , Straub Volker , Wood Claire L 
Published: October 2020

Abstract
BackgroundMany young adults with Duchenne Muscular Dystrophy (DMD) receive long-term glucocorticoids (GC). GC can cause hypogonadotrophic hypogonadism and adolescents may therefore be candidates for pubertal induction. It is unclear whether men with DMD on or off GC have age-appropriate endogenous testosterone production.MethodsWe undertook a quality improvement project to assess the feasibility of measuring salivary testosterone (SalT) levels in men with DMD at home. A Sal-T sampling kit was sent by post to all patients with DMD, aged 17 and older, registered at the John Walton Muscular Centre in Newcastle (n=75). Submitted Sal-T samples were collected and submitted for analysis. Results28 out of 75 patients returned samples (age range: 17-34 years). 6/28 samples were unsuitable for analysis. Overall Sal-T levels (n=22) were significantly lower than in the healthy population (178 ±107 v 287 ±109 pmol/l, p=0.0001). Sal-T was lower in those on GC compared to those off GC (144± 81 versus 218 ±125 pmol/l, p=0.05). 3 patients were unable to collect a sample due to ventilator dependence.ConclusionSal T can provide information about androgen status in DMD patients at home, overcoming barriers such as mobility difficulties and challenging venepuncture. However we only obtained samples in a minority of patients suggesting that Sal-T measurement may not be appropriate or acceptable to everyone. There needs to be a more detailed exploration of the barriers to sample submission.
Primarily Treated Patients versus Referred Patients in the Treatment of Native Septic Arthritis of Digits: A Retrospective Comparative Study
Authors: Kwak Sang Ho , Bae Jung Yun , Oh Youngkwang , Jang Hyo Seok , Ahn Tae Young , Lee Sang Hyun 
Published: October 2020

Abstract
BackgroundSeptic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare.MethodsIn this retrospective review of consecutive case series, 45 patients (primary, n=11; referred, n=34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. ResultsIn the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients.ConclusionsThis study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.
Effect of a telemedicine intervention for diabetes-related foot ulcers on health, well-being and quality of life: Secondary outcomes from a cluster randomized controlled trial (DiaFOTo)
Authors: Iversen Marjolein Memelink , Igland Jannicke , Smith-Strøm Hilde , Østbye Truls , Tell Grethe Seppola , Skeie Svein , Cooper John G. , Peyrot Mark , Graue Marit 
Published: October 2020

Abstract
BACKGROUND Follow-up care provided via telemedicine (TM) is intended to be a more integrated care pathway to manage diabetes-related foot ulcers (DFU) than traditionally-delivered healthcare. However, knowledge of the effect of TM follow-up on PROMs including self-reported health, well-being and QOL in patients with DFUs is lacking and often neglected in RCT reports in general. Therefore, in this study of secondary outcomes from the DiaFOTo trial, the aim was to compare changes in self-reported health, well-being and QOL between patients with DFUs receiving telemedicine follow-up care in primary healthcare in collaboration with specialist healthcare, and patients receiving standard outpatient care. METHODS The current study reports secondary endpoints from a cluster randomized controlled trial whose primary endpoint was ulcer healing time. The trial included 182 adults with diabetes-related foot ulcers (94/88 in the telemedicine/standard care groups) in 42 municipalities/districts, recruited from three clinical sites in Western Norway. Mean (SD) diabetes duration for the study population was 20.8 (15.0). The intervention group received care in the community in collaboration with specialist healthcare using an asynchronous telemedicine intervention. The intervention included an interactive web-based ulcer record and a mobile phone enabling counseling and communication between the community nurses and specialist healthcare; the control group received standard outpatient care. In total 156 participants (78/78) reported on secondary endpoints: self-reported health, well-being and quality of life evaluated by generic and disease-specific patient-reported outcome measures (e.g. Euro-QOL, the Hospital Anxiety and Depression Scale (HADS), Problem Areas in Diabetes (PAID), Neuropathy and Foot Ulcer–Specific Quality of Life Instrument (NeuroQOL)). Linear mixed-effects regression was used to investigate possible differences in changes in the scores between the intervention and control group at the end of follow-up. RESULTS In intention to treat analyses, differences between treatment groups were small and non-significant for the health and well-being scale scores, as well as for diabetes-related distress and foot ulcer-specific quality of life. CONCLUSIONS There were no significant differences in changes in scores for the patient reported outcomes between the intervention and control group, indicating that the intervention did not affect the participants’ health, well-being and quality of life. Trial registration: clinicaltrials.gov, NCT01710774. Registered October 19th, 2012https://clinicaltrials.gov/ct2/show/NCT01710774?term=iversen+marjolein&draw=2&rank=1