bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lifetime Asthma Prevalence and Correlates Among US Youths by Sexual Identity and Race/Ethnicity, 2009–2017
Authors: Curry Caleb W. , Felt Dylan , Beach Lauren B. , Ruprecht Megan M. , Wang Xinzi , Phillips Gregory L. 
Published: May 2020

Objectives. To comprehensively assess asthma disparities and identify correlates in youths at the intersections of sex, sexual identity, and race/ethnicity in the United States. Methods. We obtained a diverse sample of youths (n = 307 073) from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey. We pooled data across 107 jurisdiction-years (2009–2017). We calculated lifetime asthma prevalence by sexual identity, race/ethnicity, and their intersections—stratified by sex. We developed multivariable weighted logistic regression models to examine the impact of selected correlates on lifetime asthma prevalence. Results. Lesbian, gay, and bisexual youths have significant disparities in asthma prevalence compared with heterosexual peers. Moreover, across sex, higher prevalence of lifetime asthma was seen for most sexual identity and race/ethnicity subpopulations (27 of 30) when compared with White heterosexual sex-matched participants. Selected traditional risk factors (overweight, obese, and smoking) and bullying tended to attenuate odds among groups, especially those with a minority sexual identity. Conclusions. Asthma inequities at the intersection of sexual identity and race/ethnicity are substantive. Future studies should investigate the mechanisms contributing to these disparities to promote health equity among vulnerable youth populations.
The utility of red cell distribution width to predict mortality of septic patients in a tertiary hospital of Nepal
Authors: Ghimire Rajan , Shakya Yogendra Man , Shrestha Tirtha Man , Neupane Ram Prasad 
Published: May 2020

Abstract
Background: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. Predicting prognosis is always a difficult task in busy emergency rooms using present scores, which has several variables to calculate. Red cell distribution width (RDW) is an easy, cheap, and efficacious score to predict the severity and mortality of patients with sepsis.Methods: This prospective analytical study was conducted in the emergency room of Tribhuvan University Teaching Hospital among the patients age ≥16 years and with a clinical diagnosis of sepsis using qSOFA score. 148 patients were analyzed in the study by using a non-probability purposive sampling method. Results: RDW has fair efficacy to predict the mortality in sepsis (Area under the Curve of 0.734; 95% C. I= 0.649-0.818; p-value=0.000) as APACHE II (AUC of 0.728; 95% C. I= 0.637 to 0.819; p-value=0.000) or SOFA (AUC of 0.680, 95% C.I =0.591-0.770; p-value=0.001). Youden Index was maximum (37%) at RDW value 14.75, which has a sensitivity of 83% (positive likelihood ratio=1.81) and specificity of 54% (negative likelihood ratio=0.32). Out of 44 patients with septic shock 16 died (36.4 %) and among 104 patients without septic shock, 24 died (22.9%) which had the odds ratio of 0.713 (p=0.555, 95% C. I= 0.231-2.194). Overall mortality was 27.02% (n=40). RDW group analysis showed no mortality in RDW <13.1 group, 3.6% mortality in 13.1 to 14 RDW group, 22.0% mortality in 14 to >15.6 RDW group and 45.9% mortality in >15.6 RDW group. Significant mortality difference was seen in 14 to >15.6 and >15.6 RDW subgroups with a p-value of 0.003 and 0.008 respectively.Conclusion: Area under the curve value for RDW is fair enough to predict the mortality of patients with sepsis in the emergency room. It can be integrated with other severity scores (APACHE II or SOFA score) for better prediction of prognosis of septic patients.
An assessment of the level of awareness of e-health among Saudi medical students
Authors: Aldebasi Bader , Alhassan Abdulaziz I. , Al-Nasser Sami , Abolfotouh Mostafa 
Published: May 2020

AbstractBackground. Many studies are available in the literature about e-health in Saudi Arabia, however, data is limited to a few organizations and does not necessarily reflect the the current and potential use of e-health for health care organizations in the country. The aims of this study were 1)To determine the levels of knowledge, attitude and practice of medical students on e-health, and 2) To identify the predictors of e-health practice. Methods. A cross-sectional survey of 440 medical students at the college of medicine, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was conducted, during October/November 2019, using a previously validated questionnaire, to assess: (1) knowledge in three domains; e-health definition (13 statements), fields of application of e-health (8 statements), methods of using e-health (7 statements), (2) attitude toward using e-health (8 statements) and (3) reported practice of e-health in medical training (5 statements). A scoring system was used to calculate the total and percentage score of knowledge, attitude and practice for each student. Multiple regression analysis was applied to identify predictors of e-health practice. Significance was considered at p<0.05. Results. Of 440 medical students surveyed, the majority were females (55.7%), of stream type1 (79.8%) and from families whose monthly income was more than 10,000SR (82.8%). Overall knowledge about e-health was unsatisfactory (PMS=71.6%), with only 43.6% of students reporting satisfactory level. However, this level was satisfactory for fields of application (Percentage mean score-PMS=76.6%) and unsatisfactory for definition of e-health (PMS=70.7%) and methods of its use (PMS=65.7%) domains. Overall attitude towads e-health use was positive (PMS=82.3%), with nearly three-quarters of students (73.4%) reporting positive attitude. Generally, good level of practice of e-health was reported by students (PMS=84.3%), with more than three-quarters of students (78.4%) reporting good practice. Adjusting for age, gender, stream, educational grade and family monthly income, good practice was significantly predicted with higher knowledge (t=2.22, p=0.03) and attitude (t=2.11, p=0.04) scores.Conclusion. This study provides basic information regarding medical students’ knowledge, attitude, and practice on e-health. More resources should be directed to elevate medical students’ knowledge and to motivate them to practice e-health using the available tools.
Reducing Barriers to Post-9/11 Veterans’ Use of Programs and Services as They Transition to Civilian Life
Authors: Morgan Nicole R. , Aronson Keith R. , Perkins Daniel F. , Bleser Julia A. , Davenport Katie , Vogt Dawne , Copeland Laurel A. , Finley Erin P. , Gilman Cynthia L. 
Published: May 2020

Abstract
Background - Numerous programs exist to support veterans in their transitions to civilian life. Programs are offered by a host of governmental and non-governmental stakeholders. Veterans report encountering many barriers to program participation. This was the first study to identify barrier reduction strategies offered by programs that post-9/11 veterans report using, determine which strategies veterans use and value, and to examine veteran characteristics that impact their odds of using programs that offer barrier reduction strategies. Method - This study reflects findings from the first wave of data collection of The Veterans Metrics Initiative, a longitudinal study examining the military-to-civilian reintegration of post-9/11 veterans. Veterans were asked to indicate which programs they had used. The websites of these programs were coded for the barrier reduction components. Veterans also indicated which barrier reduction components they found most helpful in meeting their reintegration goals. Results - Of 9,566 veterans who participated in Wave 1 data collection, 84% reported using a program that offered at least one barrier reduction component. Barrier reduction components included tangible supports (e.g., scholarships, cash), increased access to programs, decreased stigma, and encouraged motivation to change. Although only 4% of programs that were used by veterans focused on helping them obtain Veterans Administration benefits, nearly 60% of veterans reported that this component was helpful in reaching their goals. Access assistance to other resources and supports was also reported as a helpful barrier reduction component. For instance, approximately 20% of veterans nominated programs that offered transportation. The study also found evidence of a misalignment between the kinds of barrier reduction components veterans valued and those which programs offered. Veterans from the most junior enlisted ranks, who are at most risk, were less likely than those from other ranks to use barrier reduction components. Conclusions – Despite the evidence that barrier reduction components enhance access to programs and contribute to program sustainability, many programs used by post-9/11 veterans do not offer them. There is also a misalignment between the barrier reduction strategies veterans value and the strategies offered by programs. Veteran serving organizations should increasingly implement barrier reduction strategies that veterans value.
Another piece of the Zika puzzle: Assessing the associated factors to microcephaly in a systematic review and meta-analysis.
Authors: Gallo Luciana Guerra , Martinez-Cajas Jorge L , Peixoto Henry Maia , Pereira Ana Carolina Esteves da Silva , Carter Jillian E , McKeown Sandra , Shaub Bruno , Ventura Camila V. , de França Giovanny Vinicius Araújo , Pomar Leo , Ventura Liana O. , Nerurkar Vivek R. , de Araújo Wildo Navegantes , Velez Maria P. 
Published: May 2020

Abstract
Background: Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection. Methods: We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors. Results: We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant’s sex – males compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred – infection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77. Conclusion: Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses.
Vaccine uptake and associated factors in an irregular urban settlement in northeastern Brazil: a cross-sectional study
Authors: Veras Ana Amélia Corrêa de Araújo , Lima Eduardo Jorge da Fonseca , Caminha Maria de Fátima Costa , Silva Suzana Lins da , de Castro Amanda Alves Moreira , Bernardo Andressa Lílian Bezerra , Ventura Maria Lídia Amaral Barbosa , de Lira Pedro Israel Cabral , Filho Malaquias Batista 
Published: May 2020

Abstract
Background: Globally, childhood immunization saves the lives of 2-3 million children annually by protecting them against vaccine-preventable diseases. In 2017, 116.2 million children were vaccinated worldwide according to the World Health Organization. Nevertheless, figures suggest that 19.5 million children around the world fail to receive the benefits of complete immunization. Methods: This cross-sectional study analyzed vaccine uptake and the factors associated with incomplete vaccination schedule in children of up to 36 months of age assisted by the family health strategy in an irregular settlement located in a state capital city in northeastern Brazil. This study was nested within a larger study entitled “Health, nutrition and healthcare services in an urban slum population in Recife, Pernambuco”, conducted in 2015. A census included 309 children, with vaccination data obtained, exclusively, from their vaccination cards records. An ad hoc database was constructed with variables of interest. Absolute and relative values were calculated for the socioeconomic, demographic, obstetric and biological data. To identify possible factors associated with incomplete vaccination schedule, crude and multivariable Poisson regression analyses were performed, and conducted in accordance with the forward selection method with robust variance and the adjusted prevalence ratio was calculated with the 95% CI. Variables with p-values <0.20 in the unadjusted stage were included in the multivariable analysis. The statistical significance of each variable was evaluated using the Wald test, with p-values <0.05. Results: Just half of the children (52,1%) was classified as complete vaccination schedule. In the final model, the factors associated with incomplete vaccination schedule were age 12-36 months and the mother who did not complete high school. Conclusion: The percentage of vaccine uptake found was far below the recommendation of the National Childhood Immunization Schedule and was associated with child’s age and mother’s education level. Based on these findings, the family healthcare teams may elaborate vaccination strategies aimed at reaching the coverage rates established by the national immunization program. Optimizing coverage will ultimately prevent the resurgence, at epidemic level, of infectious diseases that are already under control in this country.
Professional oral care in end-of-life patients with advanced cancers in a hospice ward: Improvement of oral conditions
Authors: Wu Ting-Ying , Liu Hsiu-Yueh , Wu Chien-Yi , Chen Hung-Cheng , Huang Shun-Te , Chen Ping-Ho 
Published: May 2020

Abstract
Background: In end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified. Methods: This prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected for Candida examination; furthermore, oral function was recorded. Results: The presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95–114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06–123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45–223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly.Conclusions: Proper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.
De novo assembly and transcriptome characterization of an endemic species of Vietnam, Panax vietnamensis Ha et Grushv., including the development of EST-SSR markers for population genetics
Authors: Vu Duy Dinh , Shah Syed Noor Muhammad , Pham Mai Phuong , Bui Van Thang , Nguyen Minh Tam , Nguyen Thi Phuong Trang 
Published: May 2020

Abstract
Background: Understanding the genetic diversity in threatened species that occur in forest remnants is necessary to establish efficient strategies for the species conservation, restoration and management. Panax vietnamensis Ha et Grushv. is medicinally important, endemic and endangered species of Vietnam. However, genetic diversity and structure of population is unknown due to lack of efficient molecular markers.Results: In this study, we employed Illumina HiSeq TM 4000 sequencing to analyze the transcriptomes of P. vietnamensis (roots, leaves and stems). A total of 23,741,783 raw reads were obtained and assembled, from which, 89,271 unigenes with an average length of 598.3191 nt were generated. During functional annotation, 31,686 unigenes were annotated in Gene Ontology categories, Kyoto Encyclopedia of Genes and Genomes pathways, Swiss-Prot database, and Nucleotide Collection (NR/NT) database. In addition, 11,343 expressed sequence tag-simple sequence repeat (EST-SSRs) were detected. From 7,774 primer pairs, 101 were selected for polymorphism validation, in which, 20 primer pairs were successfully amplified to DNA fragments and significant amounts of polymorphism was observed within population. The nine polymorphic microsatellite loci were used to analyze genetic diversity and structure of the natural populations. The obtained results revealed that the shows high levels of genetic diversity in populations, the average observed and expected heterozygosity were H O = 0.422 and H E = 0.479. During the Bottleneck analysis using TPM and SMM models (p < 0.01) shows that targeted population is significantly heterozygote deficient. This suggests sign of bottleneck in all populations. Genetic differentiation among populations was moderate (F ST = 0.133) and indicating limited gene flow (Nm = 1.63). Analysis of molecular variance (AMOVA) showed 63.17% of variation within individuals and 12.45% among populations. These results showed a moderate genetic structure of P. vietnamensis. STRUCTURE analysis and the unweighted pair-group method with arithmetic means (UPGMA) tree revealed strong genetic structure and two genetic clusters related to geographical distances, as well. Conclusion: Our study will assist conservators in future conservation management, breeding, production and habitats restoration of the species.
An efficient method to reduce grain angle influence on NIR spectra for predicting extractives content from heartwood stem cores of Toona. sinensis
Authors: Li Yanjie , Dong Xin , Sun Yang , Liu Jun , Jiang Jingmin 
Published: May 2020

Abstract
Background: A fast, reliable and non-destructive method is needed to qualify the extractives content (EC) in heartwood of T. sinensis cores in the breeding program for studying the genetic effect on EC. However, the influence of grain angle on near infrared (NIR) spectra prediction model for EC is unclear. In this study, NIR spectra were collected from both cross section and radial section of wood core samples in order to predict the EC in heartwood. Results: The effect of grain angle on calibration EC model was studied. Several different spectra pre-processing methods were implemented for calibration. It was found that standard normal variation (SNV) followed by 1st derivative yielded the best calibration result for T. sinensis EC. Grain angle had a significant influence on the predicted model for EC when using the whole NIR spectra. However, after testing a certain point of the prior variables for EC that were selected by the significant multivariate correlation (sMC), the influence of grain angle was significantly eliminated. Conclusions: It is suggested that NIR spectroscopy is a promising method to predict EC in the solid wood without effecting grain angle.
Indoor air pollution concentrations and cardiometabolic health across four diverse settings in Peru: a cross-sectional study
Authors: Kephart Josiah L , Fandiño-Del-Rio Magdalena , Koehler Kirsten , Bernabe-Ortiz Antonio , Miranda J Jaime , Gilman Robert H , Checkley William 
Published: May 2020

Abstract
Background: Indoor air pollution is an important risk factor for health in low- and middle-income countries. Methods: We measured indoor fine particulate matter (PM 2.5 ) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We assessed the associations between indoor pollutant concentrations and blood pressure (BP), exhaled carbon monoxide (eCO), C-reactive protein (CRP), and haemoglobin A1c (HbA1c) using multivariable linear regression among all participants and stratifying by use of biomass cookstoves. Results: We found high concentrations of indoor PM 2.5 across all four settings (geometric mean ± geometric standard deviation of PM 2.5 daily average in µg/m 3 ): Lima 41.1 ± 1.3, Tumbes 35.8 ± 1.4, urban Puno 14.1 ± 1.7, and rural Puno 58.8 ± 3.1. High indoor CO concentrations were common in rural households (geometric mean ± geometric standard deviation of CO daily average in ppm): rural Puno 4.9 ± 4.3. Higher indoor PM 2.5 was associated with having a higher systolic BP (1.51 mmHg per interquartile range (IQR) increase, 95% CI 0.16 to 2.86), a higher diastolic BP (1.39 mmHg higher DBP per IQR increase, 95% CI 0.52 to 2.25), and a higher eCO (2.05 ppm higher per IQR increase, 95% CI 0.52 to 3.57). When stratifying by biomass cookstove use, our results were consistent with effect measure modification in the association between PM 2.5 and eCO: among biomass users eCO was 0.20 ppm higher per IQR increase in PM 2.5 (95% CI -2.05 to 2.46), and among non-biomass users eCO was 5.00 ppm higher per IQR increase in PM 2.5 (95% CI 1.58 to 8.41). We did not find associations between indoor air concentrations and CRP or HbA1c outcomes. Conclusions: Excessive indoor concentrations of PM 2.5 are widespread in homes across varying levels of urbanisation, altitude, and biomass cookstove use in Peru and are associated with worse BP and higher eCO.