bluuebunny/crossref_metadata_2025_split huggingface dataset:
More Guidelines than states: variations in U.S. lead screening and management guidance and impacts on shareable CDS development
Authors: Michel Jeremy J. , Erinoff Eileen , Tsou Amy Y. 
Published: January 2020

Abstract
Background
Pediatric lead exposure in the United States (U.S.) remains a preventable public health crisis. Shareable electronic clinical decision support (CDS) could improve lead screening and management. However, discrepancies between federal, state and local recommendations could present significant challenges for implementation.

Methods
We identified publically available guidance on lead screening and management. We extracted definitions for elevated lead and recommendations for screening, follow-up, reporting, and management. We compared thresholds and level of obligation for management actions. Finally, we assessed the feasibility of development of shareable CDS.

Results
We identified 54 guidance sources. States offered different definitions of elevated lead, and recommendations for screening, reporting, follow-up and management. Only 37 of 48 states providing guidance used the Center for Disease Control (CDC) definition for elevated lead. There were 17 distinct management actions. Guidance sources indicated an average of 5.5 management actions, but offered different criteria and levels of obligation for these actions. Despite differences, the recommendations were well-structured, actionable, and encodable, indicating shareable CDS is feasible.

Conclusion
Current variability across guidance poses challenges for clinicians. Developing shareable CDS is feasible and could improve pediatric lead screening and management. Shareable CDS would need to account for local variability in guidance.
Social franchising of community-based HIV counselling and testing services to increase HIV testing and linkage to care in Tshwane, South Africa: study protocol for a non-randomised implementation trial
Authors: Shamu Simukai , Chasela Charles , Slabbert Jean , Farirai Thato , Guloba Geoffrey , Nkhwashu Nkhensani 
Published: January 2020

Abstract
Background
Meeting the ambitious UN 90–90-90 HIV testing, treatment and viral load suppression targets requires innovative strategies and approaches in Sub-Saharan Africa. To date no known interventions have been tested with community health workers (counsellors) as social franchisees or owner-managed businesses in Community-based HIV counselling and testing (CBCT) work. The aim of this methods paper is to describe a Social franchise (SF) CBCT implementation trial to increase HIV testing and linkage to care for individuals at community levels in comparison with an existing CBCT programme methods.

Methods/design
This is a two arm non-randomised community implementation trial with a once off round of post-test follow-up per HIV positive participant to assess linkage to care in low income communities. The intervention arm is a social franchise CBCT in which unemployed, self-employed or employed community members are recruited, contracted and incentivised to test at least 100 people per month, identifying at least 5 HIV positive tests and linking to care at least 4 of them. Social franchisees receive approximately $3.20 per HIV test and $8 per client linked to care. In the control arm, full-time employed HIV counsellors conduct CBCT on a fixed monthly salary. Primary study outcomes are HIV testing uptake rate, HIV positivity, Linkage to care and treatment rate and average counsellors’ remuneration cost. Data collection will be conducted using both paper-based and electronic data applications by CBCT or SF counsellors. Data analysis will compare proportions of HIV testing, positivity, linkage to HIV care and treatment rates and counsellors’ cost in the two study arms.

Discussion
The study will provide important insight into whether the SF-delivered CBCT programme increases testing coverage and linkage to care as well as reducing CBCT cost per HIV test and per HIV positive person linked to care.

Trial registration
Pan African Clinical Trial Registry PACTR201809873079121. The trial was retrospectively registered on 11 September 2018.
Reducing screen-time and unhealthy snacking in 9–11 year old children: the Kids FIRST pilot randomised controlled trial
Authors: Pearson Natalie , Biddle Stuart J. H. , Griffiths Paula , Sherar Lauren B. , McGeorge Sonia , Haycraft Emma 
Published: January 2020

AbstractBackgroundMany young people form unhealthy behavioural habits, such as low intake of fruit and vegetables, high intake of energy-dense snack foods, and excessive sedentary screen-based behaviours. However, there is a shortage of parent-and home-focused interventions to change multiple health behaviours in children.MethodsKids FIRST was a 12-week, home- and school-based pilot randomised controlled trial to reduce screen-time and unhealthy snacking with assessments at pre- (baseline) and post-intervention. Four UK schools were randomised to control or one of three interventions targeting reductions in (1) screen-time and unhealthy snacking (ST + Sn), (2) screen-time (ST only), (3) unhealthy snacking (Sn only), and parents with children aged 9–11 years were recruited via schools. Intervention group parents received four online ‘sessions’ and four packages of resources tailored to each group. Children received four 30-min lessons during school time. Children and parents reported their own screen-time behaviours, children reported their own snacking behaviours. Descriptive analyses were undertaken using principles of intention to treat.ResultsInitial feasibility was shown in that this study successfully recruited schools and families into all four study arms and retained them over a period of 13 weeks (retention rate ≥ 74%). Seventy-five children and 64 parents provided full baseline questionnaire data. Reductions in children’s school day and weekend day TV/DVD viewing and computer game use were found in the ST + Sn and ST groups, while self-reported smartphone use increased in these groups. Similar results were found for parents’ TV/DVD, computer and smartphone use in these groups. Little to no changes were found in reports of the dietary variables assessed in any intervention group for children or parents.ConclusionsThese preliminary findings show some promise for the Kids FIRST intervention. Based on these findings, a future full trial should recruit a more diverse sample of families and optimise the intervention and intervention resources to more fully engage parents with the dietary-based components of the intervention programme, where fewer changes were seen. Although most parents reporting receiving the intervention resources, further development work is required to achieve higher levels of engagement. This might include greater parent and child engagement work early in the development of the project.Trial registrationRetrospectively registered in June 21st 2019 with ClinicalTrials.gov (numberNCT03993652).
Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands
Authors: Spronk Inge , Edgar Dale W. , van Baar Margriet E. , Wood Fiona M. , Van Loey Nancy E. E. , Middelkoop Esther , Renneberg Babette , Öster Caisa , Orwelius Lotti , Moi Asgjerd L. , Nieuwenhuis Marianne , van der Vlies Cornelis H. , Polinder Suzanne , Haagsma Juanita A. 
Published: January 2020

Abstract
Background
Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands.

Methods
Existing European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived with disability (YLD).

Results
The combined dataset included 7159 HRQL (EQ-5D-3 L) outcomes from 3401 patients. Disability weights ranged from 0.046 (subgroup < 5% TBSA burned > 24 months post-burn) to 0.497 (subgroup > 20% TBSA burned 0–1 months post-burn). In 2017 the non-fatal burden of disease of burns for the three countries (YLDs/100,000 inhabitants) was 281 for Australia, 279 for New Zealand and 133 for the Netherlands.

Conclusions
This project established a method for more precise estimates of the YLDs of burns, as it is the only method adapted to the nature of burn injuries and their recovery. Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes. Information derived from the adapted method can be used as input for health decision making at both the national and international level. Future studies should investigate whether the application is valid in low- and middle- income countries.
Trends of mortality due to breast cancer in Poland, 2000–2016
Authors: Burzyńska Monika , Maniecka-Bryła Irena , Pikala Małgorzata 
Published: January 2020

Abstract
Background
The aim of the study was to assess trends in mortality and the number of lost years of life due to breast cancer in the female population in the years 2000–2016, with consideration given to differences regarding the level of education and place of residence.

Methods
The analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 92,154 death certificates of all Polish female inhabitants who died in the period 2000–2016 due to breast cancer. The SEYLLp (Standard Expected Years of Life Lost per living person), the SEYLLd (per deaths), the APC (Annual Percentage Change), the AAPC (Average Annual Percentage Change) were calculated to determine years of life lost.

Results
The mean age of women who died from breast cancer increased in the study period from 64.7 years to 69.7. The SEYLLp index (per 100,000) increased to 776.8 years in 2016 (AAPC = 0.5%). The most unfavorable changes were observed in the group of women with secondary education. In 2004, the SEYLLp values started to grow at a rate of 2.3% and since 2011, they have been higher than amongst women with elementary education. In the years 2000–2016, the authors observed that SEYLLp was steadily declining (APC = -1.0%) in the group of inhabitants of rural areas, whereas with regards to city dwellers, the SEYLLp index has been increasing since 2004 (APC = 0.5%), which has resulted in increased disproportions regarding the place of residence.

Conclusions
The results of this study showed that breast cancer is becoming a serious epidemiological problem in Poland. There is the need to intensify activities among women at highest risk group and it should be the starting point for making key decision in combating breast cancer.
Case report: recurrent pituitary adenoma has increased load of somatic variants
Authors: Peculis Raitis , Balcere Inga , Radovica-Spalvina Ilze , Konrade Ilze , Caune Olivija , Megnis Kaspars , Rovite Vita , Stukens Janis , Nazarovs Jurijs , Breiksa Austra , Kiecis Aigars , Silamikelis Ivars , Pirags Valdis , Klovins Janis 
Published: January 2020

Abstract
Background
Pituitary adenomas (PA) have an increased potential for relapse in one to 5 years after resection. In this study, we investigated the genetic differences in genomic DNA of primary and rapidly recurrent tumours in the same patient to explain the causality mechanisms of PA recurrence.

Case presentation
The patient was a 69-year-old female with non-functional pituitary macroadenoma with extension into the left cavernous sinus (Knosp grade 2) who underwent craniotomy and partial resection in August 2010. Two years later, the patient had prolonged tumour growth with an essential suprasellar extension (Knosp grade 2), and a second craniotomy with partial tumour resection was performed in September 2012. In both tumours, the KI-67 level was below 1.5%. Exome sequencing via semiconductor sequencing of patient germline DNA and somatic DNA from both tumours was performed. Tmap alignment and Platypus variant calling were performed followed by variant filtering and manual review with IGV software. We observed an increased load of missense variants in the recurrent PA tumour when compared to the original tumour. The number of detected variants increased from ten to 26 and potential clonal expansion of four variants was observed. Additionally, targeted SNP analysis revealed five rare missense SNPs with a potential impact on the function of the encoded proteins.

Conclusions
In this case study, an SNP located in HRAS is the most likely candidate inducing rapid PA progression. The relapsed PA tumour had a higher variation load and fast tumour recurrence in this patient could be caused by clonal expansion of the leftover tumour tissue.
A multi-institutional and cross-sectional study on empathy in Chinese medical students: differences by student cadre or not, future career preference, and father’s education status
Authors: Yi Kangqi , Kang Mingyi , Li Dongju , Wang Zhipeng , Bai Jinsong , Xu Huiming , Ma Shulan 
Published: January 2020

AbstractBackgroundThe aims of this study were to examine the factor structure of the Chinese version of the Jefferson Scale of Empathy for medical students (JSE-S) and investigate differences in empathy scores among Chinese medical students according to gender, student cadre or not, future career preference, and parents’ education.MethodsMedical students from three universities completed an online questionnaire containing the JSE-S. Exploratory factor analysis was conducted to determine the factor structure, and group comparisons of empathy scores were examined viat-tests and analysis of variance.ResultsFour factors emerged from the factor analysis: “perspective taking,” “compassionate care,” “standing in the patient’s shoes,” and an uninterpretable factor. The results indicated that students who were female, held positions as student cadres, preferred to become a doctor, and whose fathers had a high school education or below tended to have more empathy.ConclusionsOverall, the findings provide information on the dimensions of empathy applicable to Chinese medical students and confirm the factors found in the original measure. The dimensions have implications for developing empathy among medical students throughout the world. Educators can use the information to design interventions to foster empathy among students in the context of medical education reform in many countries, including China.
Towards developing a model for the evaluation of hospital disaster resilience: a systematic review
Authors: Fallah-Aliabadi Saeed , Ostadtaghizadeh Abbas , Ardalan Ali , Fatemi Farin , Khazai Bijan , Mirjalili Mohammad Reza 
Published: January 2020

AbstractBackgroundHospitals play a vital role in disaster stricken regions. The resilient hospitals will be able to provide essential services to affected people and it can mitigate the risk of injuries during and after disasters. This study aimed to obtain the indicators required for the evaluation of hospital resilience.MethodsThis systematic review was conducted in 2018. Through this systematic review, international electronic databases were investigated for the research studies published in English. The exclusion and inclusion criteria were determined to extract the hospital resilience indicators. These indicators will be used in order to develop a model to keep the system performance at an acceptable level during disasters.ResultsOut of 1794 research studies published until September 2018, 89 articles and guidelines with full text were surveyed. Thirty-two articles and guidelines were then selected and analyzed to collect the indicators related to hospital disaster resilience (HDR). The domains and the indicators were extracted from these selected research studies. The authors collected and categorized them into three domains and twenty seven subdomains. The three domains included constructive, infrastructural, and administrative resilience. The relevant indicators were designed for each subdomain to assess HDR.ConclusionSince diverse indicators affect hospital resilience, other studies should be conducted to propose some models or tools to quantify the hospital resilience in different countries and scopes with an all hazards approach.
Identification of a potentially functional circRNA–miRNA–mRNA regulatory network for investigating pathogenesis and providing possible biomarkers of bladder cancer
Authors: Lu Hong-cheng , Yao Jia-qi , Yang Xiao , Han Jie , Wang Jing-zi , Xu Kun , Zhou Rui , Yu Hao , Lv Qiang , Gu Min 
Published: January 2020

Abstract
Background
Circular RNAs (circRNAs) have received considerable attention in human cancer research. However, many circRNAs remain to be detected. In our study, we determined novel circRNAs and investigated their effects on bladder cancer (BCa).

Methods
Microarray dataset GSE92675 was downloaded from Gene Expression Omnibus (GEO). Then, we combined computational biology with quantitative real-time polymerase chain reaction (qRT-PCR) to select related circRNAs in BCa. The selected circRNA–microRNA (miRNA)–messenger RNA (mRNA) regulatory subnetwork was determined by Gene Oncology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses.

Results
The regulatory network constructed from the microarray dataset (GSE92675) contained 49 differentially expressed circRNAs (DECs). GO and KEGG analyses showed that the MAPK and PI3K–AKT signaling pathways were statistically significant. On the basis of qRT-PCR and the degree value calculated by the cytoHubba plugin of Cytoscape, hsa_circ_0011385 was finally confirmed. The subnetwork around hsa_circ_0011385 was constructed. In addition, we created a protein–protein interaction (PPI) network composed of 67 nodes and 274 edges after removing independent nodes. GO and KEGG analyses showed that hubgenes were involved in cell cycle activities. Moreover, they could be regulated by miRNAs and play an eventful role in BCa pathogenesis.

Conclusions
We proposed a novel circRNA–miRNA–mRNA network related to BCa pathogenesis. This network might be a new molecular biomarker and could be used to develop potential treatment strategies for BCa.
Salt consumption and the risk of chronic diseases among Chinese adults in Ningbo city
Authors: Lin Yi , Mei Qiuhong , Qian Xujun , He Tianfeng 
Published: January 2020

Abstract
Background
Chronic diseases have become one of essential public health concerns, leading causes of mortality in China. It is related to the changes in dietary pattern and dietary behavior. The objectives are to assess daily salt intake in Chinese people living in Ningbo and to examine its relationship with health outcomes.

Methods
Our study used data from health and nutrition survey in 2017. This study included 2811 adults aged 18–79 years (48% males) from urban and rural areas in Ningbo. A food frequency questionnaire together with demographic, physical and medical questionnaires was used to collect dietary intake, demographic, lifestyle and medical information. Ordinal logistic regression was used in the statistical analysis.

Results
The mean daily salt intake (13.0 g/day) of the participants was higher than the Chinese dietary reference intake (DRI, 6 g/d), which was related to higher risk of pre-hypertension and hypertension. Stratified by gender, education and lifestyle factors, daily salt intake was only significant in the blood pressure category (male: P = 0.048; less education: P = 0.003; urban: P = 0.006; no regular physical activity: P = 0.005, no regular smoking: P = 0.006). Ordinal logistic regression model shows that daily salt intake was significantly associated with higher odds of developing hypertension.

Conclusion
The daily salt intake of the majority of citizens living in Ningbo exceeded Chinese DRI and may increase the risk of hypertension. Moreover, public health intervention of salt restriction is necessarily needed for the prevention and control the ongoing epidemic of chronic diseases.
Trends in tap and bottled water consumption among children and adults in the United States: analyses of NHANES 2011–16 data
Authors: Vieux Florent , Maillot Matthieu , Rehm Colin D. , Barrios Pamela , Drewnowski Adam 
Published: January 2020

AbstractBackgroundDietary Guidelines for Americans 2015–20 recommend choosing water in place of sugar-sweetened beverages (SSB). This study examined water consumption patterns and trends among children and adults in the US.MethodsDietary intake data for 7453 children (4-18y) and 15,263 adults (>19y) came from two 24 h dietary recalls in three cycles of the National Health and Nutrition Examination Survey (NHANES 2011–2016). Water was categorized as tap or bottled (plain). Other beverages were assigned to 15 categories. Water and other beverage intakes (in mL/d) were analyzed by sociodemographic variables and sourcing location. Consumption time trends from 2011 to 2016 were also examined. Total water intakes from water, other beverages and moisture from foods (mL/d) were compared to Dietary Reference Intakes (DRI) for water.ResultsTotal dietary water (2718 mL/d) came from water (1066 mL/d), other beverages (1036 mL/d) and from food moisture (618 mL/d). Whereas total water intakes remained stable, a significant decline in SSB from 2011 to 2016 was fully offset by an increase in the consumption of plain water. The main sources of water were tap at home (288 mL/d), tap away from home (301 mL/d), and bottled water from stores (339 mL/d). Water and other beverage consumption patterns varied with age, incomes and race/ethnicity. Higher tap water consumption was associated with higher incomes, but bottled water was not. Non-Hispanic whites consumed most tap water (781 mL/d) whereas Mexican Americans consumed most bottled water (605 mL/d). Only about 40% of the NHANES sample on average followed US recommendations for adequate water intakes.ConclusionThe present results suggest that while total water intakes among children and adults have stayed constant, drinking water, tap and bottled, has been replacing SSB in the US diet.