bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resilience and self-harm among left-behind children in Yunnan, China: a community-based survey
Authors: Tian Xin , Chang Wei , Meng Qiong , Chen Ying , Yu Zhen , He Limei , Xiao Yuanyuan 
Published: December 2019

AbstractBackgroundSelf-harm (SH) behaviors are established risk factors of suicide, however, in Chinese left-behind children (LBC), SH remains severely under-discussed. In this study, we aimed to investigate SH and explore its association between resilience in a large group of LBC.MethodsA community-based cross-sectional study of 2898 LBC was conducted in Yunnan province, China. Information was collected by self-reporting questionnaires. Descriptive analysis was used to depict and compare characteristics of the subjects. Univariate and multivariate logistic regression models were applied to estimate the associations between resilience and SH prevalence, SH severity, SH repetition.ResultsThe prevalence of SH in LBC was 48.8% (95%CI: 47.0–49.7%). Compared to LBC with lower level of resilience, a higher level of resilience was related to 0.40 folds of SH odds (95%CI: 0.34–0.48). Besides, among all dimensions of resilience, every 1 average score increase of emotion regulation and family support were associated with 0.13 (95%CI: 0.04–0.37) and 0.14 (95%CI: 0.04–0.47) folds of odds in severer SH, respectively; one unit increase in the average score of emotion regulation was related to an OR of 0.23 (95%CI: 0.07–0.71) for repeated SH.ConclusionsPsychological resilience presented protective effect on SH in LBC, especially the dimensions of emotion regulation and family support. Intervention measures focusing on enhancing emotion regulation ability and building parent-child connection could be considered in order to reduce SH and suicidal risk in LBC.
Prevalence of intestinal parasitic infections and associated factors among street children in Jimma town; south West Ethiopia in 2019: a cross sectional study
Authors: Zenu Sabit , Alemayehu Eshetu , Woldemichael Kifle 
Published: December 2019

AbstractBackgroundStreet child is any child whose age is less than 18 years for whom the street has become his or her habitual abode and/or source of livelihood, is inadequately protected, supervised or directed by responsible adults. In Ethiopia the health problems of street children are given poor attention in research. This problem is pronounced when it comes to intestinal parasitic infections, making it difficult to design appropriate interventions targeting this segment of population. The aim of this study was to assess the prevalence of intestinal parasitic infections and associated factors among street children in Jimma town in the year 2019.MethodsCommunity based cross sectional study was employed. Complete enumeration was used to include 312 street children. Pretested questionnaire was used to collect the data. Data was entered to Epidata version 3.1 and exported to SPSS version 20. Stool samples were examined by wet mount and formalin ether concentration techniques. Bivariable and multivariable logistic regression was used to identify factors associated with intestinal parasitic infection. Significance of association was decided by using the 95% confidence interval of AOR andP-value of ≤0.05 in the multivariable model.ResultA total of 312 children of the street were involved in the study making the response rate 96.2%. The prevalence of intestinal parasitic infection was 66.7%. Untrimmed finger nails AOR = 2.03;95%CI (1.02–4.06), eating street food AOR = 2.24;95% CI (1.04–5.02), practice of swimming in unprotected water bodies AOR = 2.5; 95% CI (1.24–5.04), not wearing shoes at the time of data collection AOR = 3.8;95% CI (1.8–8.2) and lacking knowledge of way of transmission of intestinal parasites AOR = 2.5; 95% CI (1.25–5.0) were significantly associated with parasitic infections.ConclusionsThe prevalence of intestinal parasitic infections among street children in the study area was high and require integrated interventions to avert the problem. Several factors were also found to be associated with intestinal parasitic infections. Measures has to be taken to curb the problem by including them in mass drug administration and targeted health education towards identified factors.
Use of SOPARC to assess physical activity in parks: do race/ethnicity, contextual conditions, and settings of the target area, affect reliability?
Authors: Marquet Oriol , Hipp J. Aaron , Alberico Claudia , Huang Jing-Huei , Fry Dustin , Mazak Elizabeth , Lovasi Gina S. , Floyd Myron F. 
Published: December 2019

Abstract
Background
Since its introduction in 2006, SOPARC (Systematic Observation of Play and Recreation in Communities) has become a fundamental tool to quantify park visitor behaviors and characteristics. We tested SOPARC reliability when assessing race/ethnicity, physical activity, contextual conditions at the time of observation, and settings of target areas to understand its utility when trying to account for individual characteristics of users.

Methods
We used 4725 SOPARC observations completed simultaneously by two independent observers to evaluate intraclass correlation and agreement rate between the two observers when trying to assess sex, age group, race/ethnicity, and level of physical activity of urban park users in different park settings. Observations were in 20 New York City parks during Spring and Summer 2017 within the PARC3 project.

Results
Observers counted 25,765 park users with high interobserver reliability (ICC = .94; %Agreement.75). Reliability scores were negatively affected by the population being observed, the intensity of physical activity, and the contextual conditions and settings of the target area at the time of observation. Specific challenges emerged when assessing the combination of physical activity and race/ethnicity.

Conclusions
SOPARC training should aim to improve reliability when assessing concurrent measures such as physical activity, race/ethnicity, age, and sex. Similarly, observing crowded park areas with many active users areas may require more observation practice hours.
Early-life exposure to humidifier disinfectant determines the prognosis of lung function in children
Authors: Cho Hyun-Ju , Lee So Yeon , Park Donguk , Ryu Seung-Hun , Yoon Jisun , Jung Sungsu , Lee Eun , Yang Song-I , Hong Soo-Jong 
Published: December 2019

AbstractBackgroundUse of humidifier disinfectants (HD) at home leads to chemical airborne exposure, causing HD associated lung injury (HDLI) with high mortality. However, the lung function in children diagnosed with HDLI is not well studied. We investigated the effect of HD exposure on lung function, prognosis, and exposure characteristics associated with the lung function phenotype in children.MethodsEighty-one children diagnosed with HDLI in a nationwide cohort were tested for spirometry and diffusing capacity of the lung for carbon monoxide (DLco) from July 2013 and followed up with at five time points over 2 years. The results were compared with 122 children without HD exposure as controls. Home investigation and questionnaire analysis were conducted to assess HD inhalation exposure.ResultsHDLI survivor’s mean percent of predicted forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and corrected DLco were significantly lower compared with the control group. On longitudinal assessment, FVC was within the normal range, but flattened, and spirometry showed a predominantly restrictive pattern. Corrected DLco did not normalize above 80% despite increasing age. The persistently low phenotype of lung function was associated with initial exposure age, especially less than 12 months of age. Higher density HD exposure during sleep and close distance between the bed and the humidifier were significantly associated with persistently low corrected DLco.ConclusionsHD exposure affects prolonged decrement in lung function, especially DLco, particularly among children who are exposed within the first year of life. These results suggested that early-life HD exposure determines long-term prognosis of lung function in children.
Robot-assisted laparoscopic antegrade versus open inguinal lymphadenectomy: a retrospective controlled study
Authors: Yu Hualiang , Lu Yongliang , Xiao Yi , Guo Jiaxiang , Yin Xiaotao , Yang Yu , Wang Hongwei , Gao Jiangping 
Published: December 2019

AbstractBackgroundTo investigate the surgical methods and clinical results of robot-assisted laparoscopic antegrade inguinal lymphadenectomy.MethodsA retrospective study was performed on clinical data from 19 patients with penile cancer admitted from March 2013 to October 2017. Among them, nine patients underwent robot-assisted laparoscopic antegrade inguinal lymphadenectomy (robot-assisted group) and 10 patients underwent open inguinal lymphadenectomy (open group). In the robot-assisted group, preoperative preparation, patient position, robot placement, design of operating channel and establishment of operating space are described. Key surgical procedures and techniques are also summarized. In addition, the number of lymph nodes removed, postoperative complications and follow-up in both groups were statistically analyzed.ResultsFor the 9 patients in the robot-assisted group, surgery was successfully accomplished at 17 sides without intraoperative conversion to open surgery. The surgery time for each side was 45~90 min using laparoscope with an average of 68.5 ± 13.69 min/side. The intraoperative blood loss was estimated to be < 10 ml/side, and the number of removed lymph nodes was not significantly different from that of the open group (12 ± 4.2/side vs.11 ± 5.8/side,P = 0.84). There were no postoperative complications such as skin necrosis, delayed wound healing and cellulitis in the robot-assisted group. Skin-related complications occurred in 9 (45%) of the 20 sides in the open group. During a median follow-up of 25 months in robot-assisted group and 52.5 mouths in open group, was not significantly different there were no statistical differences in recurrence-free survival between the groups (75% vs 60%,p = 0.536).ConclusionRobot-assisted laparoscopic antegrade inguinal lymphadenectomy achieved the desired surgical outcomes with fewer intraoperative and postoperative complications. The robotic arms of the surgical system were placed between the lower limbs of each patient. There was no need to re-position the robotic arms during bilateral inguinal lymphadenectomy. This simplified the procedure and reduced the use of trocars. If necessary, pelvic lymphadenectomy could be performed simultaneously using the original trocar position.
Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports
Authors: Zezza Marco , Kosinski Christophe , Mekoguem Carine , Marino Laura , Chtioui Haithem , Pitteloud Nelly , Lamine Faiza 
Published: December 2019

AbstractBackgroundThe use of immune checkpoint inhibitor (ICI) therapy is becoming a standard of care for several cancers. Monoclonal antibodies targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand (PD-L1) cause a broad spectrum of autoimmune adverse events. ICI-induced type 1 diabetes mellitus (T1DM) is extremely rare (< 1%) but potentially life-threatening. It appears to be more common with PD-1 blockade (or combination immunotherapy) than with anti-CTLA-4 therapy, often during the first three to six months of therapy.Cases presentationWe report an acute onset T1DM with severe inaugural diabetic ketoacidosis (DKA) and remarkably elevated Glutamic Acid Decarboxylase antibody (GADA) titres following a single administration of combined ICI therapy with nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4) in two adult patients with advanced metastatic melanoma. In these cases, the time to diabetes onset was remarkably short (two and five weeks), and one presented with fulminous T1DM in a previous long-standing type 2 diabetes mellitus.ConclusionsOncological patients treated with combination therapy of anti-PD-1 and anti-CTLA-4 can develop a particular pattern of T1DM, with very rapid onset within a few weeks after starting ICI therapy, even in the presence of an existing type 2 diabetes. ICI-induced T1DM is a medical emergency in presence of severe inaugural DKA and requires a collaboration between specialists and primary care physicians, as well as patient education, for early diagnosis and supportive care.
Vitamin D receptor and binding protein polymorphisms in women with polycystic ovary syndrome: a case control study
Authors: Song Do Kyeong , Lee Hyejin , Hong Young Sun , Sung Yeon-Ah 
Published: December 2019

Abstract
Background
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, characterized by hyperandrogenism, oligomenorrhea, polycystic ovary morphology, and insulin resistance. Vitamin D deficiency and vitamin D receptor (VDR)/vitamin D binding protein (VDBP) gene variants could play an important role in susceptibility to PCOS and contribute to metabolic disturbances and menstrual dysfunction. We aimed to investigate the associations of VDR gene and VDBP gene polymorphisms with PCOS susceptibility and to elucidate the impacts of these polymorphisms on the hormonal and metabolic parameters of PCOS.

Methods
We recruited 432 women with PCOS and 927 controls. Polymorphisms in the VDR gene (VDR Fok-I, Cdx2, Apa-I, and Bsm-I) and VDBP gene (VDBP rs4588, rs7041, and rs22822679) were genotyped. A 75-g oral glucose tolerance test was performed.

Results
The distributions of genotypes and allele frequencies in VDR and VDBP genes did not differ between PCOS and control. In women with PCOS, compared to the VDR Fok-I GG genotype, the VDR Fok-I AG genotype was significantly associated with increased levels of total testosterone (β = 5.537, P = 0.005). Compared to the VDR Cdx2 AC genotype, the VDR Cdx2 CC genotype was associated with increased levels of fasting insulin and HOMA-IR in women with PCOS, however, the associations were not statistically significant.

Conclusions
This finding indicates that genetic variations in VDR and VDBP were not associated with increased risk for PCOS. In contrast, the VDR Fok-I polymorphism was associated with testosterone level and the Cdx2 polymorphism with insulin sensitivity in PCOS. However, the Cdx2 polymorphism was not significantly associated with increased insulin and insulin sensitivity in women with PCOS after multiple linear regression.
RETRACTED ARTICLE: Epidemiological characteristic of Orofacial clefts and its associated congenital anomalies: retrospective study
Authors: Impellizzeri A. , Giannantoni I. , Polimeni A. , Barbato E. , Galluccio G. 
Published: December 2019

AbstractBackgroundTo evaluate the relationship between gender, ethnicity/citizenship, clinical phenotype, total prevalence, and the various congenital malformations associated with oral clefts (OC) in Italy across the period 2001–2014.MethodsA retrospective analysis (2001–2014) was conducted based on the National Congenital Malformation Registries network of Italy (Emilia-Romagna Registry of Birth Defects [IMER] and Registro Toscano Difetti Congeniti [RTDC]), which were analyzed to investigate time trends, geographical/ethnic clusters, topography, sex ratio, and associated congenital anomalies of OC phenotypes.ResultsAmong 739 registered cases, 29.8% were syndromic or had multi-malformed associated anomalies, compared with 70.2% having isolated orofacial cleft. Cleft lip (CL) was observed in 22%, cleft palate (CP) in 40%, and cleft lip and palate (CLP) in 38% of live births, stillbirths, and terminations of pregnancy for fetal anomaly cases. Other associated conditions were major anomalies of cardiovascular defects (39%), followed by defects of the limbs (28%), neuroectodermal defects (23%), and urogenital malformations (10%).Male-to-female sex ratio was 1:1.14 in CP, 1.22:1 in CL, and 1.9:1 in CLP. Foreigners were represented by 29% from Southeast Asia, 25% from Balkans, 25% from North-Central Africa, 9% from the East, 7% from Western Europe, and 5% from South America. Total prevalence of OC cases ranged from 0.9 (RTDC) to 1.1 (IMER) of 1000 births.ConclusionsThis retrospective study provides a population-based, clinical-epidemiological description of the orofacial cleft phenomenon. As a relatively frequent congenital malformation, its social and economic impact is worthy of further study. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment.
Recent advances in Swedish and Spanish medical entity recognition in clinical texts using deep neural approaches
Authors: Weegar Rebecka , Pérez Alicia , Casillas Arantza , Oronoz Maite 
Published: December 2019

AbstractBackgroundText mining and natural language processing of clinical text, such as notes from electronic health records, requires specific consideration of the specialized characteristics of these texts. Deep learning methods could potentially mitigate domain specific challenges such as limited access to in-domain tools and data sets.MethodsA bi-directional Long Short-Term Memory network is applied to clinical notes in Spanish and Swedish for the task of medical named entity recognition. Several types of embeddings, both generated from in-domain and out-of-domain text corpora, and a number of generation and combination strategies for embeddings have been evaluated in order to investigate different input representations and the influence of domain on the final results.ResultsFor Spanish, a micro averaged F1-score of 75.25 was obtained and for Swedish, the corresponding score was 76.04. The best results for both languages were achieved using embeddings generated from in-domain corpora extracted from electronic health records, but embeddings generated from related domains were also found to be beneficial.ConclusionsA recurrent neural network with in-domain embeddings improved the medical named entity recognition compared to shallow learning methods, showing this combination to be suitable for entity recognition in clinical text for both languages.
Investigating the causal effect of socioeconomic status on quality of care under a universal health insurance system - a marginal structural model approach
Authors: Cho Hoyune E. , Wang Lu , Chen Jung-Sheng , Liu Mochuan , Kuo Chang-Fu , Chung Kevin C. 
Published: December 2019

Abstract
Background
Social disparities in healthcare persist in the US despite the expansion of Medicaid under the Affordable Care Act. We investigated the causal impact of socioeconomic status on the quality of care in a setting with minimal confounding bias from race, insurance type, and access to care.

Methods
We designed a retrospective population-based study with a random 25% sample of adult Taiwan population enrolled in Taiwan’s National Health Insurance system from 2000 to 2016. Patient’s income levels were categorized into low-income group (<25th percentile) and high-income group (≥25th percentile). We used marginal structural modeling analysis to calculate the odds of hospital admissions for 11 ambulatory care sensitive conditions identified by the Agency for Healthcare Research and Quality and the odds of having an Elixhauser comorbidity index greater than zero for low-income patients.

Results
Among 2,844,334 patients, those in lower-income group had 1.28 greater odds (95% CI 1.24–1.33) of experiencing preventable hospitalizations, and 1.04 greater odds (95% CI 1.03–1.05) of having a comorbid condition in comparison to high-income group.

Conclusions
Income was shown to be a causal factor in a patient’s health and a determinant of the quality of care received even with equitable access to care under a universal health insurance system. Policies focusing on addressing income as an important upstream causal determinant of health to provide support to patients in lower socioeconomic status will be effective in improving health outcomes for this vulnerable social stratum.
Implementing a national diabetes prevention programme in England: lessons learned
Authors: Stokes Jonathan , Gellatly Judith , Bower Peter , Meacock Rachel , Cotterill Sarah , Sutton Matt , Wilson Paul 
Published: December 2019

Abstract
Background
Type 2 diabetes mellitus is preventable through lifestyle intervention. Diabetes prevention programmes (DPPs) aim to deliver prevention-based behaviour change interventions to reduce incidence. Such programmes vary from usual primary care in terms of where, how, and by whom they are delivered. Implementation is therefore likely to face new commissioning, incentive and delivery challenges. We report on the implementation of a national DPP in NHS England, and identify lessons learned in addressing the implementation challenges.

Methods
In 2017/18, we conducted 20 semi-structured telephone interviews covering 16 sampled case sites with the designated lead(s) responsible for local implementation of the programme. Interviews explored the process of implementation, including organisation of the programme, expectations and attitudes to the programme, funding, target populations and referral and clinical pathways. We drew on constant comparative methods to analyse the data and generate over-arching themes. We complemented our qualitative data with a survey focused on variation in the financial incentives used across sites to ensure usual primary care services recruited patients to new providers.

Results
We identified five over-arching areas of learning for implementing this large-scale programme: 1) managing new providers; 2) promoting awareness of services; 3) recruiting patients; 4) incentive payments; and 5) mechanisms for sharing learning. In general, tensions appeared to be caused by a lack of clear roles/responsibilities between hierarchical actors, and lack of communication. Both local sites and the national NHS coordination team gained experience through learning by doing. Initial tensions with roles and expectations have been worked out during implementation.

Conclusions
Implementing a national disease prevention programme is a major task, and one that will be increasingly faced by health systems globally as they aim to adjust to demand pressures. We provide practical learning opportunities for the wider uptake and sustainability of prevention programmes. Future implementers might wish to define clear responsibilities for each actor prior to implementation, ensure early engagement with new providers, offer mechanisms/forums for sharing learning, generate evidence and provide advice on incentive payments, and prioritise public and professional awareness of the programme.