bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Lupus Erythematosus Activity and Hydroxychloroquine Use Before and After End-Stage Renal Disease
Authors: Guerrero Maria Salgado , Jimenez Alejandra Londono , Dobrowolski Chrisanna , Mowrey Wenzhu B. , Goilav Beatrice , Wang Shudan , Broder Anna 
Published: September 2020

Abstract
Background: SLE manifestations after ESRD may be underdiagnosed and undertreated, contributing to increased morbidity and mortality. Whether specific symptoms persist after ESRD or a shift towards new manifestations occurs has not been extensively studied, especially in the non-Caucasian patients in the United States. In addition, hydroxychloroquine (HCQ) prescribing patterns post-ESRD have not been described. The objective of this study was to assess lupus activity and HCQ prescribing before and after ESRD development. Knowledge gained from this study may aid in the identification of SLE manifestations and improve medication management post-ESRD. Methods: We performed a retrospective cohort study of SLE patients with incident ESRD between 2010 and 2017. SLE-related symptoms, serologic markers of disease activity, and medication use were collected from medical records before and after ESRD development.Results: Fifty-nine patients were included in the study. Twenty-five (43%) patients had at least one clinical (non-renal) SLE manifestation documented within 12 months before ESRD. Of them, 11/25 (44%) continued to experience lupus symptoms post-ESRD; 9 patients without clinical or serological activity pre-ESRD developed new symptoms of active SLE. At the last documented visit post-ESRD, 42/59 (71%) patients had one or more clinical or serological markers of lupus activity; only 17/59 (29%) patients achieved clinical and serological remission.Thirty-three of 59 (56%) patients had an active HCQ prescription at the time of ESRD. Twenty-six of the 42 (62%) patients with active SLE manifestations post-ESRD were on HCQ. Patients who continued HCQ post-ESRD were more likely to be followed by a rheumatologist (26 [87%] vs 17 [61%], p=0.024), had a higher frequency of documented arthritis (10 [32%] vs 1 [4%], p=0.005), CNS manifestations (6 [20%] vs 1 [4%], p=0.055), and concurrent immunosuppressive medication use (22 [71%] vs 12 [43%], p=0.029).Conclusions: Lupus activity may persist after the development of ESRD. New onset arthritis, lupus-related rash, CNS manifestations, low complement and elevated anti-dsDNA may develop. HCQ may be underutilized in patients with evidence of active disease pre- and post ESRD. Careful clinical and serological monitoring for signs of active disease and frequent rheumatology follow up is advised in SLE patients both, pre and post-ESRD.
Knowledge and attitudes among preschools staff in Shanghai, China, regarding epilepsy
Authors: Qiu Liyan , Shen Lixiao , Wang Junli , Ren Fang , Xu Mingyu , Jiang Fan , Sheng Xiaoyang , Li Fei , Li Feng 
Published: September 2020

Abstract
Background Epilepsy is one of the most common neurological problems among children. The aim of this survey was to assess the knowledge and attitude among preschool staff in Shanghai regarding epilepsy.Methods A cross-sectional survey was carried out among the staff at selected preschools. A stratified random sampling method was first used to identify suitable subjects. Data were obtained using a self-completed questionnaire. A standardized collection of demographic information was performed, and participants were given a questionnaire about their knowledge and attitudes regarding epilepsy.Results A total of 1069 subjects completed the questionnaire. In this survey, 387 (36.2%) staff members had previously participated in related training. 17.6% of teachers knew how to provide appropriate first aid for seizures. Correct responses regarding first aid for seizures, such as laying the person on his or her side (24.9%), moving harmful objects out of the way (20.7%), protecting the head (36.1%), waiting until the seizure ends (7.9%), and dialing the emergency number (40.1%), were low. The staff members had different attitudes towards children with epilepsy: some subjects had a positive attitude, some had a negative attitude.Conclusions The level of first-aid knowledge among preschool staff in Shanghai relevant to epilepsy was low. There is an urgent need to educate staff about epilepsy and appropriate first-aid practices for seizures.
Three-dimensional Multi-site Random Access Photostimulation (3D-MAP)
Authors: Xue Yi , Waller Laura , Adesnik Hillel , Pégard Nicolas 
Published: September 2020

Abstract
Optical control of neural ensemble activity has been crucial for understanding brain function and disease, yet no technology can achieve optogenetic control of very large numbers of neurons at extremely fast rates over a large volume. State-of-the-art multiphoton holographic optogenetics requires high power illumination that only address relatively small populations of neurons in parallel. Conversely, one-photon holographic techniques can stimulate more neurons but with a trade-off between resolution and addressable volume. We introduce a new one-photon light sculpting technique, termed Three-Dimensional Multi-site random Access Photostimulation (3D-MAP), that simultaneously overcomes all these limitations by dynamically modulating light in both the spatial and angular domain at multi-kHz rates. Electrophysiological measurements confirm that 3D-MAP achieves high spatial precision in vitro and in vivo. Using 3D-MAP, we then interrogate neural circuits with 3D multi-site illumination with high resolution over a large volume of intact brain that existing techniques cannot achieve.
Decomposing socio-economic inequality for routine medical check-ups among older adults in India
Authors: Srivast Shobhit , Patel Ratna , Chauhan Shekhar , Kumar Pradeep , Gupte Samriddhi S , Bansod Dhananjay W. 
Published: September 2020

Abstract
BackgroundRoutine medical check-ups not only reduce the health-care costs over time by detecting potentially life-threatening health conditions at an early stage but also reduces the risk of getting sick and thereby increasing the life span and improving overall health. Therefore, this study examined the prevalence and factors associated with medical check-ups among older adults in India.MethodsThe study utilized data from Building a Knowledge Base on Population Aging in India(BKPAI). The routine medical check-up is the outcome variable of this study. Multivariate analysis has been implemented to fulfil the objectives of the study. Concentration index and decomposition analysis were carried out to examine observed socio-economic inequality in the routine medical check-ups.ResultsNearly one-fourth (23.1%) of the older adults were undergoing the routine medical check-up. Older adults with below five years (OR, 1.31; CI: 1.13-1.51), 6 to 10 years (OR, 1.36; CI: 1.16-1.60), and 11+ years of schooling (OR, 2.02; CI: 1.6-2.54) were significantly more likely to go for routine medical check-ups than illiterate older adults. The concentration Index value of 0.19 depicts the pro-rich inequality in health check-ups among older adults. Furthermore, the results from the decomposition analysis revealed that the wealth quintile of the household contributed nearly 57 percent to the observed socio-economic inequality in the prevalence of routine medical check-up. Education and working status of older adults made a substantial contribution to the inequalities in routine medical check-ups and explained 16.9 percent, and 4.2 percent of the total inequality, respectively.ConclusionsFrom a policy perspective, at first, there is a dire need to spread awareness about the usefulness of routine medical check-ups among older adults. Further, this study reflects the association between education and routine medical check-up, and therefore there is a need to promote literacy at the grass-root level; also, it is recommended to promote health literacy among the older adults. A low level of medical check-up among older adults in rural areas could be reduced by offering free health check-ups regularly. Furthermore, the care of the elderly needs to be prioritized while policy formulation.
An Analysis on Failure Reasons of Quit Smoking Among Smokers in Beijing Communities----based on a cross sectional study
Authors: Jin Qianying , Li Xingming , Liu Han , Ma Hanqiao , Qiao Kun , Akbar Ali 
Published: September 2020

Abstract
Objective To understand the reasons for failure of smoking cessation among community smokers in Beijing, and analyze the influencing factors of the reasons for failure to quit, in order to provide a reference for providing smoking cessation guidance services. Method Based on a cross-sectional study, a one-to-one questionnaire was used. The survey included basic demographic information, tobacco use, and past attempts to quit. And descriptive analysis was used to analyze the distribution of the reasons for the failure of smoking cessation. c2 test or Fisher's exact probability method were used to analyze the causes of smoking cessation failure, demographic indicators, tobacco use and other factors. Correspondence analysis was used to further explore the relationship between each factor and the reasons for smoking cessation failure. Result A total of 442 smokers who had tried to quit smoking were investigated. The top three reasons for failure to quit were difficulty in controlling addiction, insufficient self-willingness (54.3%), the effects of other smokers(35.3%), and lack of smoke-free support environment(26.0%). There were statistically significant differences in the distribution of the reasons for failure of smoking cessation among different ages, occupations, and discomforts during smoking cessation(All P<0.05). Correspondence analysis results show that the reasons for failure of smoking cessation among smokers aged 19-30 are mainly work or study stress. There are differences in the reasons why smokers in different occupations fail to quit smoking; The influence of other smokers and the lack of a smoke-free support environment are closely related to the desire to quit during the process of quitting. Conclusion Work or study pressure, the influence of other smokers and the lack of smoke-free support environment are the main reasons for the failure of smoking cessation attempts. Therefore, it is suggested to strengthen education in different occupational places and implement personalized smoking cessation education. It is recommended to provide tips on coping with smoking cessation and alleviating peer pressure in social situations, as well as help for stress coping and negative emotion relief in smoking cessation guidance. At the same time, it is essential to strengthen the shaping of a smoke-free support environment.
C-Reactive Protein Concentration as A Risk Predictor of Mortality in Intensive Care Unit: A Multicenter, Prospective, Observational Study
Authors: Qu Rong , Hu Linhui , Ling Yun , Fang Heng , Zhang Huidan , Liang Silin , He Zhimei , Fang Miaoxian , Li Jiaxin , Li Xu , Chen Chunbo 
Published: September 2020

Abstract
Background: It is not clear whether there is value inflammatory markers for prognosis judgment in the intensive care unit (ICU). We therefore conducted a multicenter, prospective, observational study to evaluate the prognostic role of inflammatory markers.Methods: The clinical and laboratory data of patients at admission, including C-reactive protein (CRP), were collected in four general ICUs from September 1, 2018, to August 1, 2019. Multivariate logistic regression was used to identify factors independently associated with nonsurvival. The area under the receiver operating characteristic curve (AUC-ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the effect size of different factors in predicting mortality during ICU stay. 3 knots was used to assess whether alternative cut points for these biomarkers were more appropriate. Results: A total of 813 patients were recruited, among whom 121 patients (14.88%) died during the ICU stay. The AUC-ROC values of PCT and CRP for discriminating ICU mortality were 0.696 (95% confidence interval [CI], 0.650-0.743) and 0.684 (95% CI, 0.633-0.735), respectively. In the multivariable analysis, only APACHE II score (odds ratio, 1.166; 95% CI, 1.129-1.203; P=0.000) and CRP concentration > 62.8 mg/L (odds ratio, 2.145; 95% CI, 1.343-3.427; P=0.001), were significantly associated with an increased risk of ICU mortality. Moreover, the combination of APACHE II score and CRP > 62.8 mg/L significantly improved risk reclassification over the APACHE II score alone, with NRI (0.556) and IDI (0.013). Restricted cubic spline analysis confirmed that CRP concentration >62.8 mg/L was the optimal cut-off value for differentiating between surviving and nonsurviving patients.Conclusion: CRP markedly improved risk reclassification for prognosis prediction.
Effect of Integrated Community Case Management on Access and Utilization of Maternal, Newborn and Child Health and Immunization Services in Hard-to-Reach Communities in Migori County, Kenya: A Quasi-Experimental Study
Authors: Shikuku Duncan N. , Masavah Leakey K. , Muganda Maxwell , Otieno Felix , Magolo George , Njoki Lilian , Odhong Tom , Sisimwo Kenneth , Matete Thomas , Orero Solomon , Kisia Paul 
Published: September 2020

Abstract
Background Integrated community case management (iCCM) improves access to management of leading causes of under 5 (U5) mortality. Evidence of iCCM on maternal and newborn health and immunization services is scanty. The objective of this study was to determine the additional effect of iCCM on antenatal, skilled birth attendance (SBA) and immunization coverage in hard-to-reach communities.Methods A quasi-experimental (nonequivalent control group pretest – posttest) design for iCCM in Migori county. The intervention was iCCM training, mentorship/coaching and supportive supervision of 20 community health volunteers (CHVs). Twelve months pre-post intervention Kenya Health Information System (KHIS) data between July 2017-Sept 2019 reviewed. Differences in proportions for MNCH indicators pre – post-training were tested through test of proportions and considered statistically significant at P≤0.05 values.ResultsPost-training, average monthly community cases identification increased from 1.3-5, 0-1.5, 8.9-11.8 for suspected pneumonia, malnutrition and malaria positive cases treated in the intervention sites respectively. Intervention communities reported significant increases in proportions of malaria positive cases treated (32.0% vs 47.8%), pregnant women referred for ANC (25.4% vs 45.8%), defaulters referred for ANC (9.8% vs 14.9%), newborns with danger signs referred (1.4% vs 7.3%), U5s referred for immunization (4% vs 7.5%) and defaulters referred for immunization (2.2% vs 3%) (P≤0.05). Control communities reported significant reductions in proportion of malaria positive cases treated (57.6% vs 41.6%) and U5s referred for immunization (10% vs 5%) (P<0.0001) with no changes in MNH indicators (P≥0.05). Intervention facilities reported significant increases in 4th ANC coverage (39.4% vs 79.3%), SBA (24.5% vs 43%) and immunization coverage for U5s in all key expanded program on immunization antigens (P≤0.05) with no change in the control facilities.Conclusion iCCM improved access and utilization of ANC, SBA and immunization coverage in the hard-to-reach communities. Community level management of childhood illnesses using simple algorithms by CHVs as well as identification and referral of antenatal mothers for ANC, immunization defaulters, and newborns with danger signs for hospital management improved. Governments should strengthen community health systems so that CHVs are motivated and retained to carry out demand creation for maternal, newborn and child health and immunization services in hard-to-reach communities.
Assessments on Sustainability Potential by Upgrade of Existing Heritage Buildings: a case study of Liyuan Courtyard in Qingdao, China
Authors: Huang Yi , Xiao Yufan , Yu Fan 
Published: September 2020

Abstract
Background: The existing heritage buildings are considered as symbols of the original spirit of a city, which also contains vitality and resilience through centuries. In Qingdao, the Liyuan courtyard styles are still existed as a very regional and representative colonial residential architecture form in the urban development history from 1900s in this city. Method: The research here made the hypotheses of the heritage buildings can regain its authentic appearance while achieve energy efficiency in building performance through optimization and renovation strategies. The sustainability potentials assessment is discussed and evaluated with field investigation in a Liyuan building case study by on-site observation and building performance simulation analysis of two renovation options.Result and Discussion: One model with façade supplemented in the insulation layers in the envelope walls and another model with further upgrade with consideration of recycling materials mixed were discussed and estimated with building performance simulation method. Both scenarios improved the energy efficiency, while the advanced model could achieve better result in the building energy behavior dramatically.Conclusion: This research paper verified the hypotheses of sustainability embodied in Liyuan buildings. It also confirmed the vitality and resilience could be regained through history with considerable and reasonable guideline in strategy together with personal alternatives. Technologies innovation helps to improve their energy performance by reducing consumption or self-supplying on the existing buildings renovation actions. Every specific choices of renovation action could achieve low energy goals and impose optional positive effects on the behavior of the living comfort preference. Multicriteria considerations might influence the balanced between different factors when making decisions in the heritage building restoration and it is expected to empower the fresh glory in the development of heritage building protection and restoration.
Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals
Authors: Sun Yu , Liu Gordon G. , Wang Mengxiao , Liu Sijia 
Published: September 2020

Abstract
BackgroundDoctor-patient relationship has become an intense concern in public health in recent years. Medical malpractice lawsuits have presented an increasing trend over past decade. This study aims to describe distributions of medical malpractice lawsuits across different provinces and to investigate its relationship to the growth of private hospitals.MethodsData was drawn from China Judgments Online, the China Health Statistic Yearbooks and China Statistical Yearbooks between January 1, 2010 to December 31, 2016. Private hospitals expansion was measured by the number and proportion of private hospitals, the ratio of outpatient visits from private to public hospitals and the ratio of discharges from private to public hospitals. Fixed-effects negative binomial regressions were utilized to estimate the association between the growth of private hospitals and the number of medical malpractice lawsuits.ResultsIn total, we identified a total of 18220 lawsuits relevant to medical malpractices across China between 2010 and 2016. The regression results revealed that more private hospitals, larger proportion of private hospitals and higher ratio of discharges from private to public hospitals were significantly associated with fewer medical malpractice lawsuits. An increase of 100 private hospitals in health care market was associated with a decrease in the number of medical malpractice lawsuits by 21%. The ratio of outpatient visits from private to public hospitals was not significantly associated with the number of malpractice lawsuits. ConclusionsThere was great disparities of incidences of medical malpractice lawsuits across different provinces. Greater expansion of private hospitals was associated with fewer medical malpractice lawsuits at province level. This negative association indicated that more private hospitals in health care market might provide more incentives for hospitals to contain the incidences of medical malpractice cases.
Newly Mothers' Mental Health and Breastfeeding Rates During 2019 Coronavirus Disease Outbreak
Authors: Morniroli Daniela , Consales Alessandra , Colombo Lorenzo , Bezze Elena Nicoletta , Zanotta Lidia , Plevani Laura , Fumagalli Monica , Mosca Fabio , Giannì Maria Lorella 
Published: September 2020

Abstract
BackgroundNewly mothers are at higher risk of experiencing higher levels of anxiety and stress, especially during a pandemic event. Mothers’ mental health can negatively impact breastfeeding rates and the dyad’s overall health. Aim of the study was to determine the prevalence of anxiety symptoms in newly mothers throughout hospital stay during the COVID-19 pandemic and its association with perceived postpartum support and breastfeeding outcomes at discharge.MethodsA cross-sectional survey study was conducted in a neonatal tertiary referral center, in northern Italy between April and May 2020 during Italy’s lockdown, including a sample of 117 mothers with a negative naso-pharyngeal swab for SARS-CoV-2.Maternal anxiety levels were assessed through State-Trait Anxiety Inventory-Form Y, with TRAIT-A and STATE-A scores indicating personality trait and current emotional state, respectively. Maternal perception of staff’s support was evaluated by the Nurse Parent Support Tool (NPST). Breastfeeding rates at discharge and sociodemographic information were also collected. A STATE-A score >=40 was considered indicative of clinically significant symptoms of anxiety. Binary logistic regression models were used to examine correlations between anxiety levels and variables of interest.ResultsA total of 109 mothers completed the study. Mean STATE-A score was >=40 in 42% of mothers and median NPST score was 4.23. A TRAIT-A score>=40, a NPST score <=4.23, father’s absence during hospital stay and primiparity were independently associated with a STATE-A score >=40 (OR 3.45 (95%CI 1.27; 9.35), 4.72 (1.91; 11.64), 2.73 (1.06; 7.07), 3.74 (1.35; 10.37), respectively). Exclusive breastfeeding rates at discharge were 80% and were not affected by neither mothers’ anxiety level nor changes in hospital policies.Conclusions Our study describes the short-term effects on newly-mothers of hospital policies and preventive measures implemented during the COVID-19 pandemic, highlighting the positive impact of fathers’ presence and high perceived support during hospital stay on maternal mental health, particularly primiparas’. Breastfeeding rates at discharge were not affected by the pandemic.